title: Cytological and Immunocytological Monitoring of Oropharyngeal Dysplasia and Squamous Cell Carcinomas.
abstract: OBJECTIVE
  Due to the high recurrence rates of squamous cell carcinoma of the head and neck (SCCHN) and de-novo local secondary carcinomas, a close monitoring of patients is mandatory. In doubtful cases, a clearance by histological biopsy is necessary. This, however, bears potential complications. We analyzed the application of combined cytology and immunocytology in cytological brush smears for diagnosing pre-malignant and malignant lesions of the oral/oropharyngeal cavity.
  
  
  METHODS
  Brush biopsies of 30 subsequently histologically-confirmed oral/oropharyngo-/laryngeal cavity cancer cases (all then in a recurrence status) and normal mucosa were obtained for routine cytology and immunocytology for cytokeratin-8 (CK-8). Additionally 20 samples with inflammatory lesions were investigated.
  
  
  RESULTS
  Our results showed a high rate for positive prediction of oral/oropharyngo-/laryngeal dysplasia/cancer cases. Accordingly, 82% of all subsequently confirmed cases were detected by cytology alone (sensitivity). The specificity, however, of cytology was distinctly lower since several doubtful cases contained only inflammatory lesions (specificity 85%). The addition of CK-8-immunocytology did not increase the sensitivity, since the rate of detected cases by immunocytology was comparable to routine cytology (79%); however, the addition of immunocytology significantly increased the specificity (up to 90%).
  
  
  CONCLUSIONS
  Routine cytology is a simple, non-invasive and cost-effective method for routine control and screening of dysplastic oral/oropharyngo-/laryngeal lesions. In doubtful cases, the addition of CK-8-immunocytology is very helpful for the distinction of reactive from neoplastic cases.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Helios Medical Center Dachau, Academic Teaching Hospital of the Ludwig-Maximilians-University of Munich, Munich, Germany Department of Otorhinolaryngology, Head and Neck Surgery, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Andratschke
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Helios Medical Center Dachau, Academic Teaching Hospital of the Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Suna
authors.initials: S
authors.lastname: Schmitz
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Helios Medical Center Dachau, Academic Teaching Hospital of the Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Hjalmar
authors.initials: H
authors.lastname: Hagedorn
authors.affiliation: Institute of Pathology, Academic Clinic Bogenhausen, Munich, Germany Andreas.Nerlich@klinikum-muenchen.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nerlich
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000473:pathology; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009062:Mouth Neoplasms / Q000276:immunology* / Q000473:pathology; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: Cytology; SCCHN; immunocytology; oropharynx; pre-malignant lesions