The use of quantitative cytology in identifying high-risk oral lesions in community practice

Abstract

This study evaluated whether quantitative cytology (QC) can disclose abnormal DNA content (aneuploidy) and abnormal nuclear morphology of high-risk potentially malignant disorders (PMDs) of the oral mucosa found in the community in reference to clinicohistopathologic features. A total of 171 patients at community-based clinic with suspicious oral lesions were evaluated with concurrent but independent histopathologic and QC assessments. QC-positive results were associated with oral lesions with higher clinical risk factors: large size, nonhomogeneous surface texture, and located at high-risk anatomic sites. Only 3% of benign/reactive and 5% of low-risk PMDs were QC positive, while 92% of high-risk PMDs and 88% of squamous cell carcinomas (SCCs) were QC positive. The sensitivity and specificity of QC for detection of high-grade dysplasia/SCC were 89% and 97%. QC could serve as an adjunctive tool for the detection of high-risk PMD/SCC requiring immediate clinical care.