Evaluation of the diagnostic value of a Modified Liquid-Based Cytology using OralCDx Brush in early detection of oral potentially malignant lesions and oral cancer

Abstract

Objectives: To determine diagnostic value of modified Liquid Based Brush Biopsy technique. Study design: 26 oral premalignant and malignant lesions in 25 patients (12 females; 54.23±19.77 years and 13 males; 53.77±15.43 years) underwent Modified (Liquid Based) Brush Biopsy and scalpel biopsy simultaneously from the same area. Results: There were 16 positive and 10 negative brush biopsy results, with no inadequate readings. Histological findings were compatible with oral leukoplakia(n=5)with dysplasia, Oral lichen planus and lichenoid reaction(n=7) (with or without dysplasia)oral squamous cell carcinoma(n=11),verrucous carcinoma(n=1) and granular cell tumors( n=2). Sensitivity, specificity, positive predictive value, negative predictive value, positive diagnostic likelihood ratio(LR+) and negative diagnostic likelihood ratio(LR-) were 88.8%,100%,100% , 80%, infinity and 0.11 respectively(no false positive results). Conclusion: It is the first attempt to do LBC (liquid based cytology) with a specialized oral brush. Our results show that modified technique is a useful tool for screening of oral premalignant and malignant lesions.

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.…”

“…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.…”

Diagnostic Aids in Oral Cancer Screening

“…"Brush biopsy" employs oral CD-x brush, which is then analyzed by computer. Some studies have used oral CD-x brush, but have analyzed the result by visual histopathology examination and not by computer (Mehrotra et al 2006;Delavarian et al 2010).…”

“…OSCC is proceeded by visible changes in the oral mucosa, such as: white plaque, redness, ulcer or exophytic lesion, with no other signs/symptoms. (Delavarian et al 2010). If OSCC is diagnosed and treated in this stage, it will be curable and inexpensive to treat with excellent treatment outcomes and survival (Rosenberg and Cretin 1989).…”