Analysis of false-negatives in exfoliative cytology in oral potentially malignant disorders: A retrospective cohort study

Ishii, Shigeru; Sakaguchi, Wakako; Sugai, Masafune; Nagumo, Tatsuhito; Koeda, Satoko; Ozawa, Manami; Kitamura, Toru; Yamamura, Makiko; Akiyama, Hiroki; Tsukinoki, Keiichi; Nakamura, Atsushi

doi:10.1016/j.jormas.2022.02.001

Cited by 3 publications

(7 citation statements)

References 26 publications

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“…Few statistical studies have been conducted on the clinicopathological factors affecting the screening accuracy of oral cytology. To date, only one statistical study investigating false negative factors in oral cytology has been reported ( 13 ). These researchers reported that leukoplakia, an age of ≤64 years and tongue lesions were contributing factors to false negative findings.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the liquid-based cytology (LBC) technique can detect morphological changes as well as DNA, RNA, and protein expression changes in the same samples (8,9). Moreover, LBC samples have been reported to have lower inadequate rates and higher sensitivity and specificity than conventional cytology (CC) in the cervical and oral regions (10)(11)(12)(13)(14). However, very few studies have compared the application of CC and LBC in the oral cavity, and currently, there is no agreement regarding the screening accuracy and inadequate sample rates.…”

Section: Introductionmentioning

confidence: 99%

“…However, very few studies have compared the application of CC and LBC in the oral cavity, and currently, there is no agreement regarding the screening accuracy and inadequate sample rates. Furthermore, oral cytology has not yet gained the trust of clinicians because several studies have reported a high false negative rate (FNR) ( 13 , 14 ). Since low cellularity increases the FNR of cytology in detecting squamous lesions, cellularity assessment prior to cytological screening is important ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the criteria for cervical cytology are not applicable to oral cytology. To the best of our knowledge, no study has examined the appropriate cellularity for oral cytology and the research on factors influencing false negative findings is limited ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathologic factors influencing the screening accuracy of oral cytology: A retrospective cohort study

et al. 2022

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Cytology is a simple and non-invasive screening method for oral cancer. However, this method is not yet routinely used by clinicians because of its high false negative rate (FNR) and due to lack of sufficient studies examining the factors for high FNRs. The present retrospective study aimed to compare the screening performance of conventional cytology (CC) and liquid-based cytology (LBC) through histological validation, and to elucidate factors inducing false negative screening in oral cytology. Cytological specimens with histological examination and intraoral digital images of the lesion were retrospectively collected between January 2017 and December 2018 for CC and between October 2019 and September 2021 for LBC. Oral cytological screening was conducted based on the oral Bethesda system for oral cytology. Clinical subtypes were re-evaluated using intraoral digital images. The screening accuracy of oral cytology was calculated considering the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting the malignant transformation of oral lesions. No statistically significant difference was noted in the inadequate rate between CC and LBC groups. For CC and LBC, the sensitivities were 60.9 and 59.2%, the specificities were 87.3 and 79.1%, the PPVs were 85.8 and 76.2%, and the NPVs were 63.9 and 63.2%, respectively. Thus, the screening accuracy was similar between methodologies. Among the clinicopathological factors investigated, histological diagnosis and cellularity contributed to false negative results. Homogeneous findings of oral epithelial dysplasia and the superficial growth of carcinoma in situ/squamous cell carcinoma resulted in false negative findings for CC and LBC. Furthermore, LBC samples with a lower cell number (<2,000 squamous cells) exhibited statistically significantly increased FNRs. The present study found that the cytological methods did not affect the inadequate rate and screening accuracy, whereas clinical subtype and cellularity decreased screening accuracy. Therefore, cytological screening and subsequent follow-up should be performed while considering clinical findings and the cellularity of cytology smears.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinicopathologic factors influencing the screening accuracy of oral cytology: A retrospective cohort study

et al. 2022

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“…In a study published in 2022, homogenous ndings of oral epithelial dysplasia and the super cial growth of CIS were obtained, and a lower cell-number collection in LBC signi cantly increased the false negative rate (FNR) [9]. Another investigation indicated that the presence of leukoplakia, age ≤ 64 years, and the tongue as the lesion's location are related to false negative ndings [10]. There are few reports about the clinical and pathological factors in uencing LBC's accuracy for identifying malignant lesions, however.…”

Section: Introductionmentioning

confidence: 99%

Clinical and pathological factors affecting the accuracy of liquid-based oral cytology for oral potentially malignant disorders

Miyazaki

Ishikawa

Sukegawa

et al. 2023

Preprint

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Background Early detection and early treatment are important for oral squamous cell carcinoma (SCC), and liquid-based cytology (LBC) is a convenient and easy method for detecting malignancies. However, achieving an accurate diagnosis of potential malignancies of the oral cavity remains challenging. We investigated clinical factors that are important for oral cytology diagnoses. Materials and Methods We retrospectively analyzed the pathological diagnoses of 133 LBC samples obtained at Kagawa University Hospital. The samples' cytological diagnoses were based on Papanicolaou staging. We investigated samples of oral epithelial dysplasia (OED)(n = 35), carcinoma in situ (CIS) (n = 13), and SCC (n = 85) to determine the associations between the clinicopathological features and the false negative rate (FNR) by the χ2-test. Results Our analyses demonstrated that OED (n = 14), CIS (n = 6), and SCC (n = 5) had been misdiagnosed as negative (class 2). Age (≤ 64 or > 65 years; p = 0.0391), whitening of the lesion (p = 0.0054), and the ulcer of the lesion (p = 0.0034) were significantly associated with the FNR. No significance was observed for sex, smoking, or alcohol consumption. Conclusion Our results indicate that despite the limitations of LBC and regardless of clinical features, LBC is a simple and useful supplementary method to detect oral cancers.

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Nasopharyngeal carcinoma cell screening based on the electroporation-SERS spectroscopy

Hong,

Chen,

Zhang

et al. 2024

Spectrochimica Acta Part A: Molecular and Biomolecular Spectros

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Analysis of false-negatives in exfoliative cytology in oral potentially malignant disorders: A retrospective cohort study

Cited by 3 publications

References 26 publications

Clinicopathologic factors influencing the screening accuracy of oral cytology: A retrospective cohort study

Clinicopathologic factors influencing the screening accuracy of oral cytology: A retrospective cohort study

Clinical and pathological factors affecting the accuracy of liquid-based oral cytology for oral potentially malignant disorders

Nasopharyngeal carcinoma cell screening based on the electroporation-SERS spectroscopy

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