Abstract
Introduction: Oral cancer is the sixth most common malignancy worldwide and accounts for 30% of all cancers in India, with 5-year survival rate, except when diagnosed in the early stages. Hence, early diagnosis of oral cancer is very much essential for the sake of the patient. However its burden on the economy for providinghealthcare is substantial and with the increasing incidence of oral cancer in developing countries like India and the other South-East-Asian countries, the role of screening methodologies for early detection of pre – cancerous and cancerous lesions of oral cavity are becoming more vital
 Methodology: An observational cross-sectional study conducted in the departments of Otolaryngology & head neck surgery in close association with department of Pathology in a tertiary based teaching institute in North Bengal, India, during April 2021 to March 2022. All the patients aged above 18 years, who visited the outpatient department of Otolaryngology & Head Neck Surgery, and admitted in the ward of the same, having oral lesions which are clinically suspected as pre- malignant and malignant lesions were included in this study.
 Results: The study population comprised of total 69 cases. Among them 47 cases (~68%) were malignantlesions, 13 (~19%) cases were pre-malignant and 9 (~13%) cases were diagnosed as benign lesions consideringHistopathology result. 30 (63.8%) out of 47 malignant cases show class-5 cytological grading in brush cytology smear, stained with Pap stain. 25.5% of the malignant cases were in class-4 and 10.6% cases were in class-3 whereas, in premalignant cases (n=13), 3 cases were in class-2 and 7 cases were in class-3 and 3 were in class-1. Maximum value of AgNOR counts for benign, pre malignant and malignant lesions were 3.54, 4.16, 7.28 respectively.
 Conclusion: The brush cytology with PAP grading and AgNOR analysis in clinically suspected oral lesionscan be used as an early diagnostic tool for diagnosing oral squamous cell carcinoma especially for lower socio-economic status people who present with late stages.
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