UWA Dental School, University of Western Australia, Nedlands, WA, Australia.
Australian Centre for Oral Oncology Research & Education, UWA Dental School, University of Western Australia, Nedlands, WA, Australia.
J Oral Pathol Med. 2018 Oct;47(9):887-894. doi: 10.1111/jop.12759. Epub 2018 Jul 19.
This study aimed to develop diagnostic criteria to identify oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs) using oral liquid-based brush cytology (OLBC), and to compare its accuracy with the gold standard of surgical biopsy and histopathological diagnosis of oral leukoplakia.
A total number of 134 samples were collected. All patients underwent Orcellex® brush biopsy with liquid-based cytology immediately prior to diagnostic surgical biopsy. A preliminary study was first performed utilizing samples from 4 distinct lesion groups (20 samples) to revise the 2014 Bethesda Cytology system for use with OLBC specimens.
Five diagnostic groups of OLBC for the diagnosis of OSCC and OPMDs with relevant cytopathological features were established. From the 114 samples in the test group, 101 were included. The other 13 were excluded due to inadequate cellularity. The test showed sensitivity, specificity, positive predictive value and negative predictive value of 75%, 76%, 76% and 75%, respectively, and an accuracy of 75%. The use of the oral brush sampling technique was well accepted by multiple clinicians; however, local anaesthetic was suggested to be useful prior to performing the brush biopsy.
Oral liquid-based brush cytology using the Orcellex® brush and ThinPrep® system is a simple and minimally invasive procedure for adequate intraepithelial sampling and can be used as an adjunct for the early detection of oral cancer. The modified Bethesda system established useful means for OLBC assessment that can be utilized in future studies to increase the standardization of oral cytology assessment.
本研究旨在开发一种使用口腔液基刷细胞学（OLBC）诊断口腔鳞状细胞癌（OSCC）和口腔潜在恶性疾病（OPMD）的诊断标准，并将其与口腔白斑病的金标准——手术活检和组织病理学诊断进行比较。
共采集了 134 个样本。所有患者均在接受诊断性手术活检前立即进行 Orcellex®刷活检和液基细胞学检查。首先对来自 4 个不同病变组（20 个样本）的样本进行了初步研究，以修订适用于 OLBC 标本的 2014 年 Bethesda 细胞学系统。
建立了用于诊断 OSCC 和 OPMD 并具有相关细胞学特征的 OLBC 五种诊断组。在 114 个实验组样本中，纳入了 101 个样本。其余 13 个样本由于细胞数量不足而被排除。该试验的敏感性、特异性、阳性预测值和阴性预测值分别为 75%、76%、76%和 75%，准确率为 75%。使用口腔刷采样技术得到了多位临床医生的认可；然而，在进行刷活检前建议使用局部麻醉。
使用 Orcellex®刷和 ThinPrep®系统的口腔液基刷细胞学是一种简单、微创的上皮内取样方法，可作为早期发现口腔癌的辅助手段。建立的改良 Bethesda 系统为 OLBC 评估提供了有用的方法，可用于未来的研究，以提高口腔细胞学评估的标准化。
