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Efficacy of oral exfoliative cytology in diagnosis of oral cancer

Kusumbati Besra, Sagarika Samantaray, Pramod Chandra Pathy, Prafulla Kumar Das, Sasmita Panda, Niranjan Rout.

Background: Oral cancer is the major health hazard prevailing in the South Asia particularly in Indian subcontinent. Unlike other cancer, due to its accessibility the oral cancer can be detected at the early stage. Oral exfoliative cytology (OEC) is the simple, sensitive and noninvasive method that is well accepted by the patient and is, therefore, suitable for screening at risk population for early diagnosis of oral cancer and valuable adjuvant for gold standard biopsy.

Objective: The purpose of this study is to evaluate the efficacy of OEC in the detection of oral premalignant and malignant lesions in comparison to the histopathology.

Materials and Methods: In this retrospective study, a total of 1510 lesions from 1481 patients underwent oral scrape cytology and were followed up with punch biopsy. Sensitivity, specificity, positive, and negative predictive values, and diagnostic accuracy were calculated.

Results: Out of 1510 lesions, 1121 were histopathologically confirmed cases of squamous cell carcinoma, out of which 1101 (98.2%) lesions tested positive on cytological examination, among which 987 (88.0%) lesion conclusive, 44 (3.9%) strongly suggestive of malignancy, and 59 (5.2%) suggestive but not conclusive of malignancy. Sensitivity for cytology was 95.91%, specificity was 99.17%, and accuracy was 96.68%.

Conclusion: Oral exfoliative cytopathology showed high sensitivity, specificity, positive predictive value, and accuracy with good diagnostic concordance with the histopathological method and that makes it a potentially practical tool in resource challenged settings. However, the histopathological method should always be performed when the cytopathological diagnosis is not conclusive.

Key words: Oral Scrape Cytology; Squamous Cell Carcinoma; Punch Biopsy; Histopathology; Early Detection

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