title: Exfoliative cytology as a tool for monitoring pre-malignant and malignant lesions based on combined stains and morphometry techniques.
abstract: BACKGROUND
  Prevention and early diagnosis have the greatest potential for public health and are the most effective method in the long-term to control oral cancer. The aim was to apply PAP staining together with AgNOR staining and morphometric analysis in oral exfoliative cytology, to determine the sensitivity and specificity of these methods in the detection of malignant changes for the purposes of both initial population monitoring and follow-up.
  
  
  METHODS
  AgNOR, Papanicolau, and morphometric tests were conducted in samples of patients with oral cancer, oral potentially malignant disorders and controls (opposite side of lesions). Specificity and sensitivity values for each stain method and the curve under ROC area were estimated.
  
  
  RESULTS
  The diagnostic variables which allowed greatest accuracy in identifying malignancy relative to the healthy control were cluster (76.92%), satellite (75.64%), and total (90%). The diagnosis was seen to be associated with PAP and total AgNOR, total AgNOR and PAP, total AgNOR and satellites and clusters, and total AgNOR nuclear area/cytoplasmic area ratio.
  
  
  CONCLUSIONS
  The total number of AgNOR is a reliable marker for detecting neoplastic cells; this method increases sensitivity and specificity by decreasing the likelihood of false negatives or positives, as the accuracy obtained was 90%. It is also a low-cost, non-invasive, simple methodology that can be recommended to help the early detection of oral cancer and monitoring of patients with a first diagnosis of cancer.
authors: Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina.
authors: Ignacio
authors: I
authors: Gonzalez Segura
authors: Dante
authors: D
authors: Secchi
authors: Andres
authors: A
authors: Carrica
authors: Rosario
authors: R
authors: Barello
authors: Dario
authors: D
authors: Arbelo
authors: Adriana
authors: A
authors: Burgos
authors: Mabel
authors: M
authors: Brunotto
authors: Ana M
authors: AM
authors: Zarate
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D034961:Antigens, Nuclear / Q000648:ultrastructure; D019540:Area Under Curve; D002467:Cell Nucleus / Q000648:ultrastructure; D004396:Coloring Agents; D003430:Cross-Sectional Studies; D003581:Cytodiagnosis / Q000379:methods* / Q000706:statistics & numerical data; D003593:Cytoplasm / Q000648:ultrastructure; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007972:Leukoplakia, Oral / Q000175:diagnosis / Q000473:pathology; D017676:Lichen Planus, Oral / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009697:Nucleolus Organizer Region / Q000648:ultrastructure; D065006:Papanicolaou Test / Q000706:statistics & numerical data; D011230:Precancerous Conditions / Q000473:pathology*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016622:Silver Staining / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D034961:Antigens, Nuclear; D004396:Coloring Agents; C051963:nucleolar organizer region associated proteins
keywords: AgNOR; cancer; cytology; oral; papanicolau