Clinical study on primary screening of oral cancer and precancerous lesions by oral cytology
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RESEARCH
Open Access
Clinical study on primary screening of oral cancer and precancerous lesions by oral cytology Shintaro Sukegawa1,2* , Sawako Ono3,4, Keisuke Nakano2, Kiyofumi Takabatake2, Hotaka Kawai2, Hitoshi Nagatsuka2 and Yoshihiko Furuki1
Abstract Background: This study was conducted to compare the histological diagnostic accuracy of conventional oral-based cytology and liquid-based cytology (LBC) methods. Methods: Histological diagnoses of 251 cases were classified as negative (no malignancy lesion, inflammation, or mild/moderate dysplasia) and positive [severe dysplasia/carcinoma in situ (CIS) and squamous cell carcinoma (SCC)]. Cytological diagnoses were classified as negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), or SCC. Cytological diagnostic results were compared with histology results. Results: Of NILM cytology cases, the most frequent case was negative [LBC n = 50 (90.9%), conventional n = 22 (95.7%)]. Among OLSIL cytodiagnoses, the most common was negative (LBC n = 34; 75.6%, conventional n = 14; 70.0%). Among OHSIL cytodiagnoses (LBC n = 51, conventional n = 23), SCC was the most frequent (LBC n = 31; 60.8%, conventional n = 7; 30.4%). Negative cases were common (LBC n = 13; 25.5%, conventional n = 14; 60.9%). Among SCC cytodiagnoses SCC was the most common (LBC n = 16; 88.9%, conventional n = 14; 87.5%). Regarding the diagnostic results of cytology, assuming OHSIL and SCC as cytologically positive, the LBC method/conventional method showed a sensitivity of 79.4%/76.7%, specificity of 85.1%/69.2%, false-positive rate of 14.9%/30.7%, and false-negative rate of 20.6%/23.3%. Conclusions: LBC method was superior to conventional cytodiagnosis methods. It was especially superior for OLSIL and OHSIL. Because of the false-positive and false-negative cytodiagnoses, it is necessary to make a comprehensive diagnosis considering the clinical findings. Keywords: Cytology, Pathology, Liquid-based cytology, Screening, Inflammation
Background Head and neck cancer is one of common malignancies in the world, and the most common histopathological type is squamous cell carcinoma (SCC). Several patients * Correspondence: [email protected] 1 Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa 760-8557, Japan 2 Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan Full list of author information is available at the end of the article
die every year because of advanced oral SCC [1]. Conversely, studies have reported that early detection and treatment of oral SCC can reduce mortality and morbidity and increase the likelihood of complete recovery [2, 3]. Therefore, it is important to use the simplest and the most accurate method that can to detect early-stage abnormalities in oral mucosal cells. An example of such method is exfoliated mu
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