Prospective, blinded comparison of cytology and DNA-image cytometry of brush biopsies for early detection of oral malignancy.
OBJECTIVES: Adjunctive techniques like DNA image cytometry (DNA-ICM) have been attributed to enhance the diagnostic performance of oral brush biopsies. The aim of the study was an evaluation of brush biopsies, analysed according to morphological criteria and by DNA-ICM vs. histological findings in a...
| Publicado en: | Oral Oncology Vol. 49; no. 5; pp. 420 - 427 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Pergamon Press - An Imprint of Elsevier Science
May2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104261487&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104261487 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13688375 JRJ jtl: Oral Oncology issn: 13688375 maglogo: N pubinfo: dt: May2013 vid: 49 iid: 5 pid: 2410 pub: Pergamon Press - An Imprint of Elsevier Science artinfo: ui: 104261487 2012065059 10.1016/j.oraloncology.2012.12.006 NLM23318121 104261487 ppf: 420 ppct: 7 formats: tig: atl: Prospective, blinded comparison of cytology and DNA-image cytometry of brush biopsies for early detection of oral malignancy. aug: au: Kämmerer, Peer W Koch, F P Santoro, M Babaryka, G Biesterfeld, S Brieger, J Kunkel, M affil: Harvard Medical School, Boston, USA; Department of Oral, Maxillofacial and Plastic Surgery, University Medical Centre of The Johannes Gutenberg-University Mainz, 55131 Mainz, Germany. Electronic address: peer.kaemmerer@gmx.de. sug: subj: Cytodiagnosis Equipment and Supplies DNA Analysis Early Detection of Cancer Methods Image Cytometry Methods Mouth Neoplasms Pathology Adult Aged Aged, 80 and Over Carcinoma in Situ Pathology Carcinoma, Squamous Cell Pathology False Negative Results Female Genes Human Image Processing, Computer Assisted Methods Leukoplakia, Oral Pathology Lichen Planus, Oral Pathology Male Middle Age Mouth Floor Pathology Mouth Mucosa Pathology Precancerous Conditions Pathology Prospective Studies Sensitivity and Specificity Tongue Neoplasms Pathology Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: OBJECTIVES: Adjunctive techniques like DNA image cytometry (DNA-ICM) have been attributed to enhance the diagnostic performance of oral brush biopsies. The aim of the study was an evaluation of brush biopsies, analysed according to morphological criteria and by DNA-ICM vs. histological findings in a blinded prospective trial. MATERIALS AND METHODS: Eighty eight brush biopsies of 70 patients were sampled. Only clinical suspicious but not evident malignant oral lesions were included. Clinical diagnosis was leukoplakia (n=36), lichen planus (n=18), verruciform erythroplakia (n=12), erythroleukoplakia (n=9), erosion (n=7) and induration (n=6). Evaluation was conducted via histology, cytology and DNA-ICM. RESULTS: Histological diagnosis revealed eight cases of squamous intraepithelial dysplasia (SIN 1 n=6, SIN 2 n=2), four cases of carcinoma-in situ and 25 cases of oral T1-cancer. Remaining cases were leukoplakia (n=28), lichen planus (n=15) and local inflammation (n=8). Brush biopsy detected malignant lesions including SIN>1 with a sensitivity of 55% and a specificity of 100%. DNA-ICM had a sensitivity of 70% and a specificity of 100%. The combination of both methods showed a sensitivity of 76% and a specificity of 100%. The predominant reason for false negative results were sampling errors with insufficient cells (86% in brush biopsy and 100% in DNA-ICM). CONCLUSION: DNA-ICM has the potential to substantially improve the sensitivity of a pure morphological interpretation of oral brush biopsies. Method inherent sampling errors may be accountable for a lower sensitivity compared to conventional histological diagnosis. Therefore, DNA-ICM should not be used to rule out malignancy, when lesions are already clinically suspicious for oral cancer. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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