An audit of the efficacy of the oral brush biopsy technique in a specialist Oral Medicine unit

Poate, Timothy; Buchanan, John; Hodgson, Tim; Speight, Paul M.; Barrett, A.W.; Moles, David R; Scully, Crispian; Porter, Stephen

doi:10.1016/j.oraloncology.2004.02.005

Cited by 115 publications

(105 citation statements)

References 19 publications

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“…It is noteworthy that, there were equivocal or weakly staining results in several studies of toluidine blue, which were controversial to be defined as positive or negative results. 6,16,21,26,31 In study of Epstein et al, 6 there were 20 equivocal results in 81 lesions, relatively large proportion of equivocal results might confuse the clinicians to accurately evaluate its efficacy.…”

Section: Discussionmentioning

confidence: 99%

Rose bengal staining in detection of oral precancerous and malignant lesions with colorimetric evaluation: A pilot study

Chen

et al. 2007

Intl Journal of Cancer

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Early detection of oral precancerous and malignant lesions is still a diagnostic challenge for most of clinicians, and ideal adjuncts for detection of these lesions are currently unavailable. Our preliminary study has indicated that rose bengal (RB) staining might have the potency as a diagnostic aid; however, its clinical significance and reliability in hospital-based population are still not clear. In the present study, we investigated the efficacy of RB staining in detection of oral precancerous and malignant lesions. RB staining was conducted in 132 patients, and staining results were determined by a 4-graded shade guide, which had been quantitatively measured in the 1976 CIEL*a*b* space by instrumental colorimetry. Histological examination was performed in 128 of 132 patients after RB staining. The sensitivity and specificity to detect epithelial dysplasia (DP) and oral squamous cell carcinoma were 93.9 and 73.7%, respectively. The positive and negative likelihood ratios were 3.570 and 0.082, respectively. Moreover, RB staining seemed promising to detect DP in oral leukoplakia, lichen planus and leukokeratosis. In this study, 5 of 6 DP or oral squamous cell carcinoma were identified by RB staining before histological examination. In conclusion, RB staining may be a valuable diagnostic test in detection of oral precancerous and malignant lesions. ' 2007 Wiley-Liss, Inc.Key words: rose bengal; early detection; oral squamous cell carcinoma; epithelial dysplasia; colorimetry It was estimated that cancer of the head and neck, including all oral, laryngeal and pharyngeal sites, is the fifth most common cancer, accounting for about 615,000 new cases annually. 1 About 40% of head and neck malignancies are known to be squamous cell carcinomas (SCCs) arising in the oral cavity, 1 and it has one of the lowest survival rates, 50%, within a 5-year period. 2 These survival rates have remained relatively unchanged for the past 3 decades, probably because of late recognition of the disease. Consequently, emphasis has been placed on early detection and diagnosis of precancerous lesions and early stages of oral cancer. Nevertheless, oral epithelial lesions have many different presentations, such that clinical variants require diagnostic tests beyond visual examination to obtain definitive diagnoses. [3][4][5] Adjuncts for detection of lesions and selection of biopsy sites include toluidine blue staining, exfoliative cytology and other recently emerging techniques. But because of various reasons, such as less effective when used in oral precancerous lesions, inevitably bewildered when equivocal results occurred, 4,6 these techniques have not been accepted all over the world at present.Rose bengal (RB), the 4,5,6,7-tetrachloro-2 0 ,4 0 ,5 0 ,7 0 -tetraiododerivative of fluorescein, has been widely used to diagnose various ocular surface disorders. 7 It has been believed to stain desquamated ocular epithelial cells, dead or degenerated cells but not healthy epithelial cells, or wherever there is poor protection of the surface e...

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Section: Discussionmentioning

confidence: 99%

Rose bengal staining in detection of oral precancerous and malignant lesions with colorimetric evaluation: A pilot study

Chen

et al. 2007

Intl Journal of Cancer

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“…La edad media fue 48,9 años. Estos datos están de acuerdo con los obtenidos por otros autores (1,3). Todos los sujetos eran fumadores.…”

Section: La Mayoría De Los Sujetos Eran Varones (H: M 47:33)unclassified

“…(1), en el que también se incluyeron lesiones orales de aspecto "sospechoso" (o Clase I de Sciubba). La localización más frecuente fue la mucosa bucal (n=36), resultados que están en coincidencia con lo observado por otros autores (1,3,14,15), seguida del labio, paladar y lengua. La tasa de falsos negativos obtenidos en este estudio (4 de cada 60 casos) fue superior a la obtenida por Sciubba y cols.…”

Section: La Mayoría De Los Sujetos Eran Varones (H: M 47:33)unclassified

“…(1). La sensibilidad fue 43,5%, la especificidad fue 81,25% y el VPP 58,3%, resultados, en general, inferiores a los obtenidos por otros autores (3,14,15) y que, en la opinión de los autores, pueden deberse al tamaño de la muestra.…”

Section: La Mayoría De Los Sujetos Eran Varones (H: M 47:33)unclassified

“…Ensayos clínicos con diferencias en la metodología utilizada mostraron resultados contradictorios a los observados por Sciubba y cols. (2)(3)(4)(5)(6)(7). Esto dio lugar a lo que Greenberg designó la "controversia del cepillo" y a una incertidumbre, que aún hoy prevalece, en cuanto al uso de esta prueba diagnóstica como herramienta adyuvante de detección de LOMP (8).…”

Section: Introductionunclassified

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Biopsia por cepillado con el OralCDx®: Estado de la cuestión

Cruz¹,

Bascones-Martínez²

2013

Av Odontoestomatol

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RESUMENLa controversia en torno al OralCDx ® (OralScan Laboratories Inc., Suffern, Nueva York) se ha mantenido desde la publicación del primer estudio evaluando la validez y seguridad de esta prueba diagnóstica, como artículo de portada de la revista JADA en 1999. Aunque el estudio fue muy elogiado por algunos, otros han cuestionado la interpretación de la estadística y por consiguiente la aplicabilidad clínica de estos resultados. Esto dio lugar a lo que Greenberg designó la "controversia del cepillo" y a una incertidumbre, que aún hoy prevalece, en cuanto al uso de esta prueba diagnóstica. Entendemos que es importante llevar a cabo un análisis actualizado de la literatura que permita resumir la evidencia actual en torno al OralCDx ® . El objetivo de este artículo es realizar una revisión bibliográfica relacionada con la precisión del sistema de Test de cepillado OralCDx ® como técnica adyuvante de diagnóstico de LOMP. Se resumen datos acerca del diseño, muestras y características del grupo de estudio, intervenciones, resultados comunicados y medidas básicas de precisión diagnóstica de este método adyuvante, a partir de los estudios clínicos publicados entre los años de 1999 y 2013.Palabras clave: Cáncer oral, condiciones precancerosas, diagnóstico, biopsia por cepillado, análisis asistido por ordenador. SUMMARYThe controversy surrounding the OralCDx® (OralScan Laboratories Inc., Suffern, New York) has been on since the first study evaluating the validity and safety of this diagnostic test was published as cover story of the JADA in 1999. Although the study was highly praised by some, others have challenged the interpretation of the statistics and therefore the practical implications of these results. This resulted in what Greenberg called the "brush controversy" and in an uncertainty regarding the use of this diagnostic test that still prevails today. We believe it is important to conduct an updated review of the literature to summarize the current evidence regarding OralCDx®. The aim of this article is to review the literature regarding the accuracy of the OralCDx® brush biopsy in the detection or diagnosis of oral premalignant and malignant lesions (OPML). We abstracted data relating to study design, sampling and characteristics of the study group, interventions, reported outcomes and diagnostic accuracy of this adjunctive aid from the clinical studies published between 1999 and 2013.

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Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions

Macey

Walsh

Brocklehurst

et al. 2015

Cochrane Database of Systematic Reviews

127

109

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BackgroundOral squamous cell carcinoma is the most common form of malignancy of the lip and oral cavity, often being proceeded by potentially malignant disorders (PMD). Early detection can reduce the malignant transformation of PMD and can improve the survival rate for oral cancer. The current standard of scalpel biopsy with histology is painful for patients and involves a delay whilst histology is completed; other tests are available that are unobtrusive and provide immediate results. ObjectivesPrimary objective: To estimate the diagnostic accuracy of index tests for the detection of oral cancer and PMD of the lip and oral cavity, in people presenting with clinically evident lesions.Secondary objective: To estimate the relative accuracy of the different index tests. Search methodsThe electronic databases were searched on 30 April 2013. We searched MEDLINE (OVID) (1946 to April 2013) and four other electronic databases (the Cochrane Diagnostic Test Accuracy Studies Register, the Cochrane Oral Health Group's Trials Register, EMBASE (OVID) and MEDION (Ovid)). There were no restrictions on language in the searches of the electronic databases. We conducted citation searches and screened reference lists of included studies for additional references. Selection criteriaWe selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting PMD or oral squamous cell carcinoma of the lip or oral cavity: vital staining, oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). Data collection and analysisTwo review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using QUADAS-2. Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. Main resultsWe included 41 studies, recruiting 4002 participants, in this review. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (14 studies), oral cytology (13 studies), light-based detection or oral spectroscopy (13 studies). Six studies assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis.The summary estimates for vital staining obtained from the meta-analysis were sensitivity of 0.84 (95% CI 0.74 to 0.90) with specificity of 0.70 (0.59 to 0.79), with 14 studies were included in the meta-analysis. For cytology, sensitivity was 0.91 (0.81 to 0.96) and specificity was 0.91 (0.81 to 0.95) with 12 studies included in the meta-analysis. For light-based detection, sensitivity was 0.91 (0.77 to 0.97) and specificity was 0.58 (0.22 to 0.87) with 11 studies included in the meta-analysis. Th...

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An audit of the efficacy of the oral brush biopsy technique in a specialist Oral Medicine unit

Cited by 115 publications

References 19 publications

Rose bengal staining in detection of oral precancerous and malignant lesions with colorimetric evaluation: A pilot study

Rose bengal staining in detection of oral precancerous and malignant lesions with colorimetric evaluation: A pilot study

Biopsia por cepillado con el OralCDx®: Estado de la cuestión

Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions

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