Background: A laboratory requisition form (LRF) is the main communication link between the laboratories and the clinicians. In a cytopathology laboratory, incomplete forms with inadequate information significantly impact the quality of the results and waste precious time of the lab. Aims: The aim of this study was to audit the LRFs for adequacy of demographic and clinical data and to analyze the reasons for the same. Settings and Design: A retrospective study was conducted in the cytopathology laboratory of a tertiary care center. Materials and Methods: All the original LRFs received for Pap smears and FNACs of 1-month duration were retrieved. The forms were scrutinized for the presence of specific parameters which were classified as patient information, clinician information and clinical information. In addition to the completeness of the form, clarity of the data was also noted. Statistical Analysis: The data were entered on excel worksheets and percentage of Pap smear and FNAC forms lacking information of various parameters was calculated. Results: A total of 431 LRFs were received in the month of January 2020. These included 274 Pap smear LRFs and 157 FNAC LRFs. Patient information was mentioned in predominantly all the forms, however, clinician and clinical information, which is indispensible for reporting, was missing in a significant proportion of the Pap smear and fine needle aspiration cytology (FNAC) forms. Conclusions: Receiving inadequately filled LRFs has been an age-old problem in all medical laboratories. Audit of inadequacy of LRFs helped in assessing the prevailing practices in the hospital and gave an insight into the quality of information available to the cytologists for reporting. Many clinicians withhold information out of ignorance about its importance or due to lack of time to fill up the details on the LRF. Also, filling out a LRF is a task usually delegated to the junior doctor in the OPD and the significance of filling the LRF correctly and comprehensively is often not emphasized upon adequately by the senior clinicians. This audit helped us taking preventive action by giving feedback to the clinicians and emphasizing to them the importance of clinical data on the LRF and in improvising the LRF using a more objective and user-friendly format.

Background: To find the association of tumor budding, depth of invasion (DOI), and epithelial-to-mesenchymal transition (EMT) markers (E-cadherin and smooth muscle actin [SMA] expression) with prognostic factors of oral squamous cell carcinoma (OSCC). Materials and Methods: A cross-sectional study conducted on 50 cases of histologically proven OSCC were selected for the assessment of TNM staging, tumor budding, DOI, and EMT markers (E-cadherin and SMA expression). Associations were evaluated between established clinical prognostic factors and histological parameters. Statistical analysis was performed using SPSS version 21.0. (IBM, Chicago, Illinois, USA) and P < 0.05 was considered statistically significant. Results: In the study, the median age of distribution was 48.5 years with 86% of males. Tobacco consumption was seen among 90% of patients. A significant association of pathological TNM staging with tumor budding and DOI (P < 0.05). There was a loss of E-cadherin expression with loss of tumor differentiation, progressive TNM stage, increasing DOI and more tumor budding (P < 0.05). On the contrary, α-SMA (% stained cells) expression showed an increase with increasing pathological T stage, N stage, tumor budding, and DOI (P < 0.0001). However, the tumor differentiation showed no significant association with SMA expression (P = 0.44). Conclusion: It can be concluded that EMT has a strong association with OSCC demonstrated by loss of E-cadherin and increased expression of α-SMA at the invasive front in higher grade carcinomas, in tumors with increased DOI, high-risk tumor budding, and increased pathological T and cases showing lymph node metastasis. Hence, SMA can be used in conjunction with loss of E-cadherin expression for determining the aggressive nature of OSCC and predicting the survival rates of the patients.