Liquid‐based oral brush cytology in the diagnosis of oral leukoplakia using a modified Bethesda Cytology system

Alsarraf, Abdulhameed; Kujan, Omar; Farah, Camile S.

doi:10.1111/jop.12759

Cited by 40 publications

(82 citation statements)

References 25 publications

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“…In line with previous studies, the Orcellex ® brush has been shown to be useful in harvesting transepithelial cells from oral lesions as there was significant correlation with the corresponding histopathological diagnosis. The sensitivity, specificity, PPV, NPV, and accuracy of OLBC using the modified Bethesda system were satisfactory and consistent with previously published data …”

Section: Discussionsupporting

confidence: 83%

“…RA/4/1/9313) and conducted in accordance with the ethical and scientific principles of the Declaration of Helsinki, and the STROBE statement. Cases were selected from an ongoing project evaluating OLBC in diagnosis of OPMD and OSCC . Adult patients aged more than 18 years who were diagnosed with OLK or OSCC were included.…”

Section: Methodsmentioning

confidence: 99%

“…All slides were assessed cytologically using the modified 2014 Bethesda Cervical Cytology grading system as previously described by us . Briefly, following the preparation of Pap‐stained liquid‐based cytology slides, cellularity, quality of preparation, types of cells present, data on microbiota, presence of leucocytes/inflammatory cells, artifacts present and, when applicable, dyskaryotic epithelial changes or features suggestive of OSCC using the modified 2014 Bethesda Cervical Cytology grading system were reported.…”

Section: Methodsmentioning

confidence: 99%

“…Further, the current scalpel method of surgical biopsy is a sensitive technique associated with high morbidity and warrants specialised training . Oral brush cytology is emerging as a promising diagnostic adjunct which provides reliable minimally invasive intra‐epithelial sampling for the early detection of oral cancer …”

Section: Introductionmentioning

confidence: 99%

“…6 Oral brush cytology is emerging as a promising diagnostic adjunct which provides reliable minimally invasive intra-epithelial sampling for the early detection of oral cancer. [7][8][9][10] Recent molecular advances have revealed the multistep heterogenous nature of oral carcinogenesis that involves specific genetic and epigenetic events 11 ; however, the precise understanding of the underlying molecular mechanisms of oral carcinogenesis is still incomplete and warrant further investigations. 12 The pursuit of valid and reproducible biomarkers to predict the malignant transformation of OPMDs is still underway.…”

Section: Introductionmentioning

confidence: 99%

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CDK4, CDK6, cyclin D1 and Notch1 immunocytochemical expression of oral brush liquid‐based cytology for the diagnosis of oral leukoplakia and oral cancer

Kujan

Huang

Ravindran

et al. 2019

J Oral Pathology Medicine

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Objectives This study aimed to investigate the feasibility of using oral liquid‐based brush cytology (OLBC) coupled with immunocytochemistry as a minimally invasive approach to stratify the cancer risk in patients with oral leukoplakia. Methods Fifty‐five patients diagnosed with either oral leukoplakia (OLK) or oral squamous cell carcinoma (OSCC) were recruited. All patients underwent oral brush biopsy followed by surgical biopsy. 275 liquid‐based cytology preparations were made. Pap‐stained OLBC slides were assessed using the modified 2014 Bethesda Cytology system. The expression of CDK4, CDK6, cyclin D1, and Notch 1 was immunocytochemically analysed and compared against the histopathological diagnosis. A combined index score of OLBC grading and protein expression was calculated. Results A significant association was found between the definitive histopathological diagnosis and the cytological interpretation (P = 0.0005). The index scores of CDK4, CDK6, and cyclin D1 were significantly associated with the development of disease from non‐dysplastic epithelium to OSCC. No significant association was observed between the Notch 1 index score and disease stage. The diagnostic accuracy of OLBC showed the highest values of sensitivity, specificity, positive predictive value, negative predictive value, and accuracy: 84.6%, 70.4%, 73.3%, 82.6%, and 78.8%, respectively, compared with the cumulative protein index, CDK4/6 index, and the combined OLBC grading and CDK4/6 index. Conclusion This study has also demonstrated the efficacy of the use of OLBC in the detection of OED and OSCC, and showed that the use of CDK4, CDK6, cyclin D1, and Notch 1 immunocytochemistry failed to improve the diagnostic accuracy of OLBC suggesting they are not useful in the early detection of OSCC.

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Section: Discussionsupporting

confidence: 83%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CDK4, CDK6, cyclin D1 and Notch1 immunocytochemical expression of oral brush liquid‐based cytology for the diagnosis of oral leukoplakia and oral cancer

Kujan

Huang

Ravindran

et al. 2019

J Oral Pathology Medicine

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Diagnostic accuracy of brush biopsy–based cytology for the early detection of oral cancer and precursors in Fanconi anemia

Velleuer

Dietrich²,

Pomjanski

et al. 2020

Cancer Cytopathology

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BACKGROUND: Individuals with Fanconi anemia (FA) have a 500-fold to 700-fold elevated risk, much earlier onset, and limited therapeutic options for oral squamous cell carcinoma (SCC) compared with the general population. The early detection of SCC, or preferably its precursors, is mandatory to retain curative therapeutic options. Due to frequent synchronic and metachronic oral lesions, tissue biopsies, as usually recommended by guidelines, often are not feasible. In the current study, an alternative strategy for early detection using oral brush biopsy-based cytology was validated regarding its diagnostic accuracy. METHODS: Over a 12-year period, the oral cavities of a large cohort of 713 individuals with FA were inspected systematically and brush biopsy-based cytology of 1233 visible oral lesions was performed. In cases of inconclusive cytology, analysis of DNA ploidy was performed whenever possible. The results were correlated to a long-term clinicopathological follow-up reference standard. RESULTS: A total of 737 lesions were suitable for statistical analysis, including 86 lesions with at least high-grade oral epithelial dysplasia in 30 patients. For cytology, the sensitivity and specificity were 97.7% and 84.5%, respectively. Additional analysis of DNA ploidy increased the sensitivity and specificity to 100% and 92.2%, respectively. CONCLUSIONS: Careful inspection of the oral cavity of individuals with FA followed by brush biopsy-based cytology appears to identify visible oral, potentially malignant and malignant lesions that warrant treatment. Approximately 63% of SCC and precursor lesions are detected at a noninvasive or early stage. Negative cytology or a lack of DNA aneuploidy can exclude high-grade oral epithelial dysplasia or SCC with high accuracy and thus reduce the need for invasive diagnostic biopsies. Cancer Cytopathol 2020;128:403-413.Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Oral brush biopsy using liquid‐based cytology is a reliable tool for oral cancer screening: A cost‐utility analysis

Idrees

Farah

Sloan

et al. 2022

Cancer Cytopathology

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BACKGROUND:This study aimed to assess the diagnostic utility and associated cost of oral liquid-based brush cytology (OLBC) in the diagnosis of oral cancer and oral potentially malignant disorders (OPMDs). METHODS: A total of 284 patients with oral mucosal lesions were included. OLBC samples were collected from all patients immediately before undergoing surgical biopsies. A liquid-based cytology slide was prepared from each OLBC sample for cytological evaluation using the modified 2014 Bethesda cytology system. The results and the cost were compared with the histopathological outcomes. RESULTS:The level of agreement between the two approaches was very good (weighted kappa = 0.824). The accuracy of OLBC in differentiating between the different diagnostic groups was 91.69%, whereas the associated sensitivity and specificity were 79.23% and 94.81%, respectively. The estimated cost of each OLBC sample was at least 26% less than the cost of a single biopsy and more than 42% less in cases of multiple biopsied lesions. CONCLUSIONS: The proposed modifications of the Bethesda system can be adopted as a standardized system for oral cytological assessment. Our findings support OLBC as a reliable adjunct to surgical biopsy in the diagnosis of OPMDs. This tool has potential for oral cancer-finding and surveillance programs.

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Liquid‐based oral brush cytology in the diagnosis of oral leukoplakia using a modified Bethesda Cytology system

Cited by 40 publications

References 25 publications

CDK4, CDK6, cyclin D1 and Notch1 immunocytochemical expression of oral brush liquid‐based cytology for the diagnosis of oral leukoplakia and oral cancer

CDK4, CDK6, cyclin D1 and Notch1 immunocytochemical expression of oral brush liquid‐based cytology for the diagnosis of oral leukoplakia and oral cancer

Diagnostic accuracy of brush biopsy–based cytology for the early detection of oral cancer and precursors in Fanconi anemia

Oral brush biopsy using liquid‐based cytology is a reliable tool for oral cancer screening: A cost‐utility analysis

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