Comparison of Oral Brush Cytology and Tissue Biopsy in Diagnosing Oral Lesions

Abstract

Objective: To assess the diagnostic efficacy of oral brush cytology in the diagnosis of potentially malignant and malignant lesions of the oral cavity. Study Design: Cross-sectional analytical study. Place and Duration of Study: Outpatient Department of ENT and Maxillofacial Surgery, Pakistan Institute of Medical Sciences and Pathology Department of Pakistan Railway Hospital Rawalpindi from 1 March 2017 to 28 February 2018. Materials and Methods: A total of 50 patients with oral lesions were enrolled through non-probability convenient sampling. All patients presented with oral potentially malignant lesions were included, while patients with age less than 10 years and with bleeding diathesis were excluded from the study. The oral lesions were first sampled by oral brush biopsy technique using a toothbrush and then later on by scalpel biopsy. Samples were then studied under microscope for diagnosis. The data was analyzed using SPSS software version 21.0. Sensitivity, specificity, positive predictive value and negative predictive values were calculated keeping histopathology as a gold standard. Pearson's Chi-Square Test was used for calculating p-value, where p-value of ≤ 0.05 was considered significant. Results: In this study, the mean age of patients presented with non-malignant oral lesions was 59 ± 12 years, while those with oral cancers were 60 ± 12 years. Men were affected than women. Among 50 patients 39 were found to have oral cancers. The sensitivity of oral brush biopsy was 88%, specificity was 83.3%, positive predictive value was 97.6% and negative predictive value was 50%. The p-value was calculated as 0.001, which was significant. Conclusion: Our study found that oral brush cytology is reliable and can be easily performed with less cost and discomfort to the patient. It can be used for screening of suspicious oral lesions. It is useful in those situations where a patient refuses to have a biopsy or where a patient with bleeding diathesis would be exposed to unnecessary surgical risks.

Keywords

• brush cytology, dysplasia, oral squamous cell carcinoma, potentially malignant disorders.