Comparison of three sampling instruments, Cytobrush, Curette and OralCDx, for liquid-based cytology of the oral mucosa

Abstract

Exfoliative cytology of the oral cavity is a simple and noninvasive technique that permits the study of epithelial cells. Liquid-based cytology is an auxiliary diagnostic tool for improving the specificity and sensitivity of conventional cytology. The objective of our study was to compare the quality of normal oral mucosa cytology samples obtained using three different instruments, Cytobrush®, dermatological curette and Oral CDx® for liquid-based cytology. One hundred four cytological samples of oral cavity were analyzed. Samples were obtained from healthy volunteer subjects using all three instruments. The clinical and demographic variables were age, sex and smoking habits. We analyzed cellularity, quality of the preparation and types of cells in the samples. All preparations showed appropriate preparation quality. In all smears analyzed, cells were distributed uniformly and showed no mucus, bleeding, inflammatory exudate or artifacts. We found no correlation between the average number of cells and the type of instrument. The samples generally consisted of two types of cells: superficial and intermediate. No differences were found among the cytological preparations of these three instruments. We did not observe basal cells in any of the samples analyzed.

Evaluation of an innovative oral brush for potential applications using liquid based cytology

“…However, there has been some controversy about the sensitivity and specificity of this system (17,19,21,22). A modified LBC technique using the Oral CDx brush without computer-assisted analysis to detect oral lesions has been tested (23,24). The results were encouraging, with high specificity, sensitivity and accuracy for detection of oral malignancy/ dysplasia in transepithelial cells (23,24).…”

“…A modified LBC technique using the Oral CDx brush without computer-assisted analysis to detect oral lesions has been tested (23,24). The results were encouraging, with high specificity, sensitivity and accuracy for detection of oral malignancy/ dysplasia in transepithelial cells (23,24). However, none of these previous studies specifically investigated patient acceptability of the technique, or the number and types of cells that were obtained.…”

“…Moreover, a comparative study of the cytobrush, curette and Oral CDx brush using LBC failed to demonstrate any differences among the cytological preparations of these three instruments. Furthermore, no basal cells were found in any of the samples analysed (24). A modified oral brush cytology technique using a commercially available nylon baby toothbrush (Johnson & Johnson, Mumbai, India) without LBC preparation has been assessed (25,26), and found to have potential for low-cost screening of oral cancer.…”

“…Several studies have investigated oral pathological samples obtained using oral brushing and liquid-based cytology (5)(6)(7)(23)(24)(25)(27)(28)(29) and reported that oral brushing with liquid-based cytology was useful for obtaining samples from oral lesions, giving better results in terms of both sensitivity and specificity, and providing material for further investigation. However, none of those studies used the Orcellex brush as a sample collection tool.…”

The Role and Application of Exfoliative Cytology in the Diagnosis of Oral Mucosa Pathology – Contemporary Knowledge with Review of the Literature

“…Tools for collecting smears should be easy to use in any location, not irritating and provide an adequate number of epithelial cells. The types used and compared were wooden, plastic and metal spatulas, dermatological curette, fisherbrand sterilized polyester swab and different types of brushes (interproximal brush, cytobrush, oral Cdx brush and Cytobrush Plus GT) [9,10]. Cytobrush sampling is used more frequently; it maximizes the number of cells obtained, and facilitates their uniform distribution on the microscope slide.…”