Advantages and difficulties of brush cytology in the identification of early oral cancer

Abstract

Background: Early oral cancer is asymptomatic and highly curable, but unfortunately most cancers are advanced by the time when they are discovered, so the mortality is relatively high. The aim of this study was to refer the advantages as well as the difficulties of brush cytology in the identification of early oral cancer. Methods: Cytological smears obtained from of the oral mucosa of 36 patients were evaluated. The materials were taken with a cytobrush by scraping the surface of the suspected lesions, fixed with cytospray fixative and stained with the Papanicolaou method, whereas the residual was prepared by the liquid-based technique Thin-Prep 2000. Results: There were 29 inflammatory and mild dysplastic lesions, three cases with mild dysplasia only and two cases with severe dysplasia possible carcinoma. Another two showed squamous cell carcinoma. Histological examination of possible malignant and malignant cases showed well differentiated squamous cell carcinomas, so wide excisions were performed. Conclusion: Oral cytology is well accepted by the patient and attractive option for the early diagnosis of the oral cancer. It is useful when the lesion is large or multiple or the patients refuse biopsy. However there are factors that contribute to a false negative diagnosis such as the selection of the site of biopsy, necrosis, blood crusting, lack of adequate training, and the fact that malignant features of squamous cell carcinoma can be subtle resembling dysplasia

Diagnostic utility of endoscopic brush cytology in upper gastrointestinal lesions and its correlation with biopsy.

“…[6] The introduction of flexible fiberoptic endoscope which allows brushing under direct visual control has greatly expanded the usefulness and precision of gastrointestinal tract cytology. [1,6] Direct vision brush cytology of the upper GIT mucosa as obtained through the channel of the flexible endoscope is now a standard method of diagnosis either as an adjunct to tissue biopsy or as an independent method. The Japanese pioneered fiberoptic gastroscopy and brushing cytology because of the high rates of gastric carcinoma in Japan.…”

“…[13] Early detection of malignancy greatly improves the survival rate of the patients. [6,10,14] Early cancers are asymptomatic, and may be difficult for early diagnosis. Cytological method is well accepted by the patient and is an attractive option for the early diagnosis of upper GIT lesions.…”

“…It has also the advantage of penetrating to the basement membrane and collecting cells from all the epithelial cell layers of mucosa. [1,6] The present study was done to analyze the advantages as well as the difficulties of brush cytology and to utilize it as a reliable screening tool for rapid diagnosis of upper GIT lesions. [6] II.…”

Advanced Diagnostic Aids in Oral Cancer

“…In that context, Oral CDx is useful in the assessment of dysplastic changes in various suspected lesions especially in oral cancer (Patton et al, 2008). As majority of oral cancers are squamous cell carcinomas, Cytological study of oral cells is a relatively inexpensive, simple, noninvasive and also risk-free technique which is well accepted by the patient and medical practitioner today (Smaroula et al, 2009). The oral cells can be obtained by the use of a cytobrush.…”

Novel non-invasive Adjunctive Techniques for Early Oral Cancer Diagnosis and Oral Lesions Examination

“…This technique method, unlike the conventional cytology, allows obtaining a complete transepithelial sample in which all epithelial layers (superficial, intermediate and basal) are represented. The full-thickness epithelium sampling is essential for a correct diagnosis [85].…”