Abstract
BackgroundThis study was conducted to compare the histological diagnostic accuracy of conventional oral-based cytology and liquid-based cytology (LBC) methods.MethodsHistological diagnoses of 251 cases were classified as negative (no malignancy lesion, inflammation, or mild/moderate dysplasia) and positive [severe dysplasia/carcinoma in situ (CIS) and squamous cell carcinoma (SCC)]. Cytological diagnoses were classified as negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), or SCC. Cytological diagnostic results were compared with histology results.ResultsOf NILM cytology cases, the most frequent case was negative [LBC n = 50 (90.9%), conventional n = 22 (95.7%)]. Among OLSIL cytodiagnoses, the most common was negative (LBC n = 34; 75.6%, conventional n = 14; 70.0%). Among OHSIL cytodiagnoses (LBC n = 51, conventional n = 23), SCC was the most frequent (LBC n = 31; 60.8%, conventional n = 7; 30.4%). Negative cases were common (LBC n = 13; 25.5%, conventional n = 14; 60.9%). Among SCC cytodiagnoses SCC was the most common (LBC n = 16; 88.9%, conventional n = 14; 87.5%). Regarding the diagnostic results of cytology, assuming OHSIL and SCC as cytologically positive, the LBC method/conventional method showed a sensitivity of 79.4%/76.7%, specificity of 85.1%/69.2%, false-positive rate of 14.9%/30.7%, and false-negative rate of 20.6%/23.3%.ConclusionsLBC method was superior to conventional cytodiagnosis methods. It was especially superior for OLSIL and OHSIL. Because of the false-positive and false-negative cytodiagnoses, it is necessary to make a comprehensive diagnosis considering the clinical findings.
Highlights
This study was conducted to compare the histological diagnostic accuracy of conventional oral-based cytology and liquid-based cytology (LBC) methods
Cytological diagnoses were made based on the Bethesda system according to the Japanese society of clinical cytology (JSCC) diagnostic guideline and were classified into negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), squamous cell carcinoma (SCC), and indefinite for neoplasia [8]
In the LBC method, there were no cases of insufficient sample processing
Summary
Study design and sample We designed and implemented a cross-sectional study using the oral exfoliative cytology results of patients who had been referred to the Kagawa Prefectural Central Hospital (Takamatsu, Japan) for diagnosis, treatment, and examination of oral lesions. During the period from April 2010 to March 2019, a total of 1234 specimens were obtained from the cytology specimens collected by the Department of Oral and Maxillofacial Surgery and diagnosed by the Department of Pathology. Cytological diagnoses were made based on the Bethesda system according to the Japanese society of clinical cytology (JSCC) diagnostic guideline and were classified into negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), SCC, and indefinite for neoplasia [8]. Procedure of histological diagnosis A histological diagnosis was provided by pathologists, and the number of biopsy samples was determined at the investigator’s discretion These histological slides were subjected to hematoxylin and eosin staining, and their histological findings were divided into two categories as negative group and positive group. TP and TN indicate true positive and true negative classifications, respectively; FP and FN indicate falsepositive and false-negative classifications, respectively
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