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Year : 2014  |  Volume : 10  |  Issue : 2  |  Page : 232-238

Clinical correlative study on early detection of oral cancer and precancerous lesions by modified oral brush biopsy and cytology followed by histopathology

1 Department of Oral Medicine and Radiology, Subharti Dental College, Subhartipuram, Meerut, India
2 Department of Oral Medicine and Radiology, Government Dental College and Hospital, Ahmedabad, Gujarat, India

Correspondence Address:
Swati Gupta
B-202, Nandan Apartments, 31 A, Saket, Meerut - 250 002
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.136539

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Background: Oral cancer accounts for 5% of all malignant tumors and 60% of these lesions are well advanced at the time of diagnosis. The early diagnosis could prevent a large number of deaths due to this disease. Aims: This study aims to evaluate and compare the clinical usefulness of exfoliative cytology, modified brush biopsy (without computer assisted analysis), and biopsy in early detection of oral premalignant and malignant lesions. Materials and Methods: Modified oral brush biopsy (using baby toothbrush) and exfoliative cytology was performed on 225 clinically diagnosed oral precancerous lesions (suspected) selected from among 1099 lesions in 877 patients. Scalpel or punch biopsy was performed based on clinic-cytological evidence (test result and/or clinical judgment) on only 117 lesions. All the specimens were analyzed manually in a double-blinded fashion. Statistical Analysis Used: Results were analyzed using Statistical package for Social Sciences version 12 (SPSS Inc., Chicago, IL, USA) and subjected to Fischer exact test. Results: Of 117 lesions that underwent all the three tests, modified oral brush biopsy showed a reasonably higher specificity (68.42%) and sensitivity (81.69%) when compared with specificity (86.48%) and sensitivity (48.57%) of cytology. Conclusion: The results demonstrate that modified oral brush biopsy has higher efficacy than routine cytology and can be used as a potentially practical oral cancer screening tool in resource challenged settings. However, clinical judgment is of prime importance. Immediate biopsy is mandatory in highly suspicious lesions proposed under the diagnostic criteria of "clinically diagnosed carcinoma in situ".

Abstract in Chinese

通过改良口腔拭子活检及组织病理学、细胞学检查在临床上早期发现口腔癌和癌前病变 摘要 背景:口腔癌占所有恶性肿瘤的5%,这些病变中60%在诊断时很晚期。早期诊断可以防止大量因这种疾病的死亡。 目的:评估和比较脱落细胞学与改良刷拭细胞活检(无计算机辅助分析)在口腔癌前病变和恶性病变的早期检测的临床价值, 材料与方法:对从877病人的1099个损伤组织中选择的225例临床(疑似)诊断为口腔癌前病变使用改良口腔刷拭活检(使用婴儿牙刷)和脱落细胞学检查。基于临床细胞学证据(测试结果和/或临床判断),其中只有117例病变进行了手术刀或穿刺活检。所有标本在一个双盲方式手动分析。 统计分析:结果用SPSS 12版分析(Inc.,芝加哥,IL,USA)进行Fischer检验。 结果:117个病灶接受所有的三个测试,改良口腔刷活检显示相当高的特异性(68.42%)和敏感性(81.69%),相比细胞学的特异性(86.48%)和灵敏度(48.57%)。 结论:结果表明,改性口腔刷检比常规细胞学疗效高,可作为一种潜在的实用的口腔癌筛检工具设置资源的挑战。然而,临床判断是最重要的。在“临床诊断为原位癌”的诊断标准下提出的高度可疑病变,即时活检是强制性的。 关键词:细胞学检查,早期发现,口腔刷检,口腔癌,口腔癌前病变

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