Background:？Liquid-based cytology？(LBC) is a method of manufacturing cyto-diagnostic specimens. Improved accuracy is expected from standardizing specimen production and use of this method is rapidly spreading in oral cytology. On the other hand, LBC reportedly requires training to show peculiar cell findings compared to those of conventional smear cytology (CVC). Few studies have compared detailed cell findings for oral CVC and LBC.？Objectives:？The aim of this study was to compare cytological findings between CVC and LBC using cytomorphological image analysis.？Materials and Methods:？Cytological specimens were collected from 20 patients (negative for squamous neoplasia in 10, dysplasia in 5, squamous cell carcinoma in 5) and 5 controls of the tongue between January 2017 and December 2018. Two different preparation techniques were investigated cytomorphologically for CVC and LBC (BD CytorichTM).？Results:？LBC showed significantly higher cell numbers than CVC for all lesions. LBC-to-CVC ratio ranged from 9.52 (hyperkeratosis) to 1.87 (deep cells in oral squamous cell carcinoma (OSCC)). Nuclear area of normal, hyperkeratosis, and inflammation were significantly higher in LBC than those of CVC. Hyperchromasia was significantly more frequent with CVC than with LBC for hyperkeratosis, inflammation, dysplasia and OSCC. There was no significant difference in circularity between CVC and LBC among all lesions. Conclusion:？Only one cytomorphological disadvantage was seen with LBC, in the form of decreased hyperchromasia. Further clarification of the advantages and disadvantages of LBC is needed, including management of precision and screening practices.
References
[1]
Navone, R., Pentenero, M. and Gandolfo, S. (2011) Liquid-Based Cytology in Oral Cavity Squamous Cell Cancer. Current Opinion in Otolaryngology & Head and Neck Surgery, 19, 77-81. https://doi.org/10.1097/MOO.0b013e328343af10
[2]
Franceschi, S., Barzan, L. and Talamini, R. (1997) Screening for Cancer of the Head and Neck: If Not Now, When? Oral Oncology, 33, 313-316. https://doi.org/10.1016/S1368-8375(97)00034-1
[3]
Howaldt, H.P., Frenz, M. and Pitz, H. (2005) Results from DÖSAK Observational Studies. In: Pape, H.D., Ganzer, U. and Schmitt, G., Eds., Carcinoma of the Oral Cavity and Oropharynx, Springer-Verlag, Berlin, Heidelberg, 173-182. https://doi.org/10.1007/978-3-642-84971-8_19
[4]
Reibel, J., Gale, N., Hille, J., Hunt, J., Lingen, M., Muller, S., Sloan, P., Tilakaratne, W., Westra, W., Williams, M., Vigneswaran, N., Fatani, H., Odell, E. and Zain, R. (2017) Oral Potentially Malignant Disorders and Oral Epithelial Dysplasia. In: El-Naggar, A.K., Chan, J.K.C., Grandis, J.R., Takata, T. and Slootweg, P.J., Eds., WHO Classification of Head and Neck Tumours, 4th Edition, IARC Press, Lyon, 112-115.
[5]
Sawaf, M.H., Ouhayoun, J.P. and Forest, N. (1991) Cytokeratin Profiles in Oral Epithelial: A Review and a New Classification. Journal de Biologie Buccale, 19, 187-198.
[6]
Smith, J.H.F. (2011) Cytology, Liquid-Based Cytology and Automation. Best Practice & Research Clinical Obstetrics & Gynaecology, 25, 585-596. https://doi.org/10.1016/j.bpobgyn.2011.04.006
[7]
Cotran, R.S., Kumar, V. and Collins, T. (2000) Robbins Patología Estructural Y Funcional. Mcgraw-Hill Interamericana, Madrid.
[8]
Ogden, G.R. (1997) The Future Role for Oral Exfoliative Cytology—Bleak or Bright? Oral Oncology, 33, 2-4. https://doi.org/10.1016/S0964-1955(96)00047-4
[9]
Dabelsteen, E., Roed-Petersen, B., Smith, C.J. and Pindborg, J.J. (1971) The Limitations of Exfoliative Cytology for the Detection of Epithelial Atypia in Oral Leukoplakias. British Journal of Cancer, 25, 21-24.
[10]
Folsom, T.C., White, C.P., Bromer, L., Canby, H.F. and Garrington, G.E. (1972) Oral Exfoliative Study: Review of the Literature and Report of a Three-Year Study. Oral Surgery, Oral Medicine, Oral Pathology, 33, 61-74. https://doi.org/10.1016/0030-4220(72)90209-5
[11]
Diniz-Freitas, M., Garcia-Garcia, A., Crespo-Abelleira, A., Martins-Carneiro, J.L. and Gandara-Rey, J.M. (2004) Applications of Exfoliative Cytology in the Diagnosis of Oral Cancer. Medicina Oral: Organo Oficial de la Sociedad Espanola de Medicina Oral Y de la academia Iberoamericana de Patologia Y Medicina Bucal, 9, 355-361.
[12]
Davey, E., Barratt, A., Irwig, L., Chan, S.F., Macaskill. P., Mannes, P. and Saville, A.M. (2006) Effect of Study Design and Quality on Unsatisfactory Rates, Cytology Classifications, and Accuracy in Liquid-Based versus Conventional Cervical Cytology: A Systematic Review. Lancet, 367, 122-132. https://doi.org/10.1016/S0140-6736(06)67961-0
[13]
Payne, N., Chilcott, J. and Mcgoogan, E. (2000) Liquid-Based Cytology for Cervical Screening. Cytopathology, 11, 469-470. https://doi.org/10.1046/j.1365-2303.2000.00291.x
[14]
Singh, V.B., Gupta, N., Nijhawan, R., Srinivasan, R., Suri, V. and Rajwanshi, A. (2015) Liquid-Based Cytology versus Conventional Cytology for Evaluation of Cervical Pap Smears: Experience from the First 1000 Split Samples. Indian Journal of Pathology and Microbiology, 58, 17-21. https://doi.org/10.4103/0377-4929.151157
[15]
Sahin, D., Yilmazbayhan, D., Firat, P., Hacisalihoglu, U.P., Kirimlioglu, S.H., Celenk, E. and Arslan, R. (2017) Comparison of Conventional Cytology and Surepath in Split Thyroid Fine Needle Aspiration Materials. Cytopathology, 28, 291-298. https://doi.org/10.1111/cyt.12430
[16]
Park, G.S., Lee, S.H., Jung, S.L. and Jung, C.K. (2015) Liquid-Based Cytology in the Fine Needle Aspiration of Parathyroid Lesions: A Comparison Study with the Conventional Smear, Thinprep, and Surepath. International Journal of Clinical and Experimental Pathology, 8, 12160-12168.
[17]
Kobayashi, T.K., Ueda, M., Nishino, T., Terasaki, S. and Kameyama, T. (1998) Brush Cytology of Herpes Simplex Virus Infection in Oral Mucosa: Use of the Thinprep Processor. Diagnostic Cytopathology, 18, 71-75. https://doi.org/10.1002/(SICI)1097-0339(199801)18:1<71::aID-DC12>3.0.CO;2-6
[18]
Maksem, J.A. and Weidmann, J. (2001) Specialized Preparative Devices Are Not Needed for Liquid-Based, Thin-Layer Cytology: An Alternate Manual Method Using a Metastable Alcoholic Gel. Diagnostic Cytopathology, 25, 262-264. https://doi.org/10.1002/dc.2051
[19]
Mollaoglu, N., Wilson, M. J. and Cowpe, J.G. (2001) Extraction of DNA from Oral Cytological Samples by Scraping and Smear Method Suitable for Restriction Site Mutation analysis: A Pilot Study. Diagnostic Cytopathology, 25, 83-85. https://doi.org/10.1002/dc.2009
[20]
Jajodia, E., Raphael, V., Shunyu, N.B., Ralte, S., Pala, S. and Jitani, A.K. (2017) Brush Cytology and Agnor in the Diagnosis of Oral Squamous Cell Carcinoma. Acta Cytologica, 61, 62-70. https://doi.org/10.1159/000451050
[21]
Kujan, O., Pemberton, M.N., Schwarz, M. and Sloan, P. (2018) Evaluation of an Innovative Oral Brush for Potential Applications Using Liquid Based Cytology. Journal of Oral Science, 60, 45-50.
[22]
Macey, R., Walsh, T., Brocklehurst, P., Kerr, A.R., Liu, J.L.Y. and Lingen, M.W (2015) Diagnostic Tests for Oral Cancer and Potentially Malignant Disorders in Patients Presenting with Clinically Evident Lesions. The Cochrane Database of Systematic Reviews, No. 5, Article No. CD010276. https://doi.org/10.1002/14651858.CD010276.pub2
[23]
Allegra, S.R., Broderick, P.A. and Corvese, N. (1973) Oral Cytology. Seven Year Oral Cytology Screening Program in the State of Rhode Island. Analysis of 6448 Cases. Acta Cytologica, 17, 42-48.
[24]
Dolens, E.S., Nakai, F.V.D., Santos, P., José, L. and Alborghetti, N.G. (2013) Cytopathology: A Useful Technique for Diagnosing Oral Lesions? A Systematic Literature Review. Diagnostic Cytopathology, 41, 505-514. https://doi.org/10.1002/dc.22875
[25]
Mehrotra, R., Gupta, A., Singh, M. and Ibrahim, R. (2006) Application of Cytology and Molecular Biology in Diagnosing Premalignant or Malignant Oral Lesions. Molecular Cancer, 5, Article No. 11. https://doi.org/10.1186/1476-4598-5-11
[26]
King, O.H.J. and Coleman, S.A. (1965) Analysis of Oral Exfoliative Cytologic Accuracy by Control Biopsy Technique. Acta Cytologica, 9, 351-354.
[27]
Stahl, S.S., Sandler, H.C. and Cahn, L.R. (1964) The Significance of Dyskaryotic Cells in Exfoliative Cytology. Acta Cytologica, 8, 73-79.
[28]
Mehta, F.S., Daftary, D.K. and Sahiar, B.E. (1970) A Correlative Histocytological Study of Epithelial Atypia in Leukoplakic and Submucous Fibrosis Lesions amongst Indian Villagers in a Mass Screening Programme. Indian Journal of Cancer, 7, 18-23.
[29]
Mehta, F.S., Sahiar, B.E., Daftary, D.K., Gupta P.C. and Pindborg, J.J. (1972) A Correlative Histocytological Study of Carcinoma and Epithelial Atypia of the Palate among Indian Reverse Smokers. British Journal of Cancer, 26, 230-233. https://doi.org/10.1038/bjc.1972.31
[30]
Mollaoglu, N., Cowpe, J.G. and Walker, R. (2001) Quantitative Cytomorphologic Analyses of Papanicolaou-Stained Smears from Oral Lichen Planus. Analytical and Quantitative Cytology and Histology, 23, 118-122.
[31]
Bancroft, J.D. and Stevens, A. (1990) Theory and Practice of Histological Techniques. Churchill Livingstone, London.
[32]
Kuyama, K., Matsumoto, T., Morikawa, M., Fukatsu, A., Ichimura, M., Wakami, M., Fukumoto, M., Kato, T. and Yamamoto, H. (2013) Morphometrical Findings among Dysplasias of Oral, Cervical and Bronchial Regions. Open Journal of Stomatology, 3, 215-222. https://doi.org/10.4236/ojst.2013.32037
[33]
Kahn, M. A. (2001) Oral Exfoliative Cytology Procedures: Conventional, Brush Biopsy and Thinprep. The Journal of the Tennessee Dental association, 81, 17-20.
[34]
Karnon, J., Peters, J., Platt, J., Chilcott, J., Mcgoogan, E. and Brewer, N. (2004) Liquid-Based Cytology in Cervical Screening: An Updated Rapid and Systematic Review and Economic Analysis. Health Technology Assessment, 8, 1-78. https://doi.org/10.3310/hta8200
[35]
Hayama, F.H., Motta, A.C.F., Silva, A.P.G. and Migliari, D.A. (2005) Liquid-Based Preparations versus Conventional Cytology: Specimen Adequacy and Diagnostic Agreement in Oral Lesions. Medicina Oral, Patologia Oral y Cirugia Bucal, 10, 115-122.
[36]
Delavarian, Z., Mohtasham, N., Mosannen-Mozafari, P., Pakfetrat, A., Shakeri, MT. and Ghafoorian-Maddah, R. (2010) Evaluation of the Diagnostic Value of a Modified Liquid-Based Cytology Using Oralcdx Brush in Early Detection of Oral Potentially Malignant Lesions and Oral Cancer. Medicina Oral, Patologia Oral y Cirugia Bucal, 15, e671-676. https://doi.org/10.4317/medoral.15.e671
[37]
Osaka, R., Hayashi, K., Onda, T., Shibahara, T. and Matsuzaka, K. (2019) Evaluation of Liquid Based Cytology for Tongue Squamous Cell Carcinoma: Comparison with Conventional Cytology. The Bulletin of Tokyo Dental College, 60, 29-37.
[38]
Singh, P., Rohilla, M. and Dey, P. (2016) Comparison of Liquid-Based Preparation and Conventional Smear of Fine-Needle Aspiration Cytology of Lymph Node. Journal of Cytology, 33, 187-191. https://doi.org/10.4103/0970-9371.190444
[39]
Sharma, S., Ahluwalia, C., Singh, M. and Mandal, A.K. (2018) Diagnostic Utility and Efficacy of Conventional versus Surepath Liquid-Based Cytology in Head and Neck Pathology: A Study in an Indian Tertiary Care Hospital. Iranian Journal of Pathology, 13, 188-195. https://doi.org/10.30699/ijp.13.2.188
