Quantitative and qualitative features of tissue biopsy for successful diagnosis of oral cancer

Abstract

Objective: This study aimed to evaluate quantitative and qualitative tissue features as factors associated with successful cancer diagnosis at the first attempt of oral biopsy. Study design: Histologic slides from the first biopsy of patients with oral cancer were included and classified as successful (cancer was diagnosed at the first attempt, 252 cases) and unsuccessful biopsies (65 cases). Tissue parameters included the number of tissue fragments in each slide, size of the tissue, and tissue area. Qualitative features included the depth of tissue (presence or absence of underlying submucosal stroma), crush artifact, inflammation, and hemorrhage. Logistic regression was used for statistical analysis. Results: Multivariate logistic regression showed that deep tissue with stroma underneath was the strongest factor associated with successful biopsy (odds ratio [OR]: 14.12, 95% confidence interval [CI]: 4.83–41.25). Other significant tissue parameters included the number of tissue fragments of >2 pieces (OR: 2.36, 95% CI: 1.18–4.71), total tissue area of ≥12.7 mm2 (OR: 3.03, 95%CI: 1.3–7.09), and the largest fragment of ≥2.6 ​mm (OR: 4.25, 95% CI: 2.11–8.59). Conclusions: A deep tissue biopsy of optimum size and quantity is essential for successful diagnosis of oral cancer at the first biopsy attempt.

Keywords

• Oral cancer
• Biopsy
• Tissue quality
• Tissue quantity
• Diagnosis