Brush Cytology and AgNOR in the Diagnosis of Oral Squamous Cell Carcinoma.
OBJECTIVE
We aimed to evaluate the role of brush cytology in the screening of oral lesions with malignant suspicion and compare it with histopathology in north-eastern India.


METHODS
Brush cytology samples taken from 48 patients were processed for conventional cytology (CC) and liquid-based cytology (LBC), and biopsy samples were also obtained. LBC samples were also stained to assess the argyrophilic nucleolar organizer region (AgNOR). The cytology was compared with histopathology, both individually and in combination with AgNOR. The smear quality was compared with histopathology for evaluating their diagnostic accuracy.


RESULTS
The sensitivity of diagnosing oral cavity squamous cell carcinoma by LBC and CC alone was 75 and 85%, respectively, which improved on combining with the AgNOR count, with a cutoff of 6.5. The presence of round cells on cytology was significantly associated with high-grade lesions. LBC provided clearer cytomorphology but compromised the background information in high-grade lesions.


CONCLUSIONS
Brush cytology is a minimally invasive tool for screening oral lesions with malignant suspicion. LBC and CC are complementary techniques for cytological screening and combining them with AgNOR can increase the diagnostic yield. With objective criteria for assessment, cytology can be an indispensable tool for screening oral lesions in a resource-limited set-up, especially in high-incidence regions.
Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.
Ekta
E
Jajodia
Vandana
V
Raphael
N Brian
NB
Shunyu
Sarah
S
Ralte
Star
S
Pala
Ankit Kumar
AK
Jitani
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000235:genetics* / Q000276:immunology; D034961:Antigens, Nuclear / Q000235:genetics* / Q000276:immunology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D004847:Epithelial Cells / Q000276:immunology / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D012680:Sensitivity and Specificity
D000951:Antigens, Neoplasm; D034961:Antigens, Nuclear; C051963:nucleolar organizer region associated proteins