Accuracy, Sensitivity and Specificity of Oral Brush Cytology in the Diagnosis of Oral Epithelial Lesions

Background: Oral Squamous cell carcinoma (SCC) is highly prevalent in Pakistan than the rest of the world. Five-year survival rate is 80% if SCC is diagnosed at an early stage. The survival rate declines to 20% if diagnosed at a later stage. The objective of the present study was to find out the usefulness of oral brush cytology in detecting oral lesions. Material and Methods: In the present prospective observational study, 88 samples were collected from Maxillofacial Surgery Out-Patient Department (OPD), Liaquat University Hospital and ISRA University Hospital from July 2015 to December 2015. After taking written informed consent, oral brush cytology was performed and stained with standard Papanicolaou (PAP) staining protocol. The biopsy of the patients was performed by standard protocols of oral biopsy and specimen preserved in 10% buffered formalin. Cross tabulation between diagnosis of brush cytology and biopsy of same patients was done and accuracy, sensitivity and specificity were calculated. Results: According to the distribution of patients on brush cytology, 59.1% patients were diagnosed with malignant tumors, whereas 17.1% had benign tumors. On biopsy of the same patients, squamous cell carcinoma was confirmed in 72.7% and benign tumors were found in 17% of the patients. Comparison of brush cytology with biopsy of same patients revealed no significant difference. Accuracy, sensitivity and specificity of brush cytology of the oral cavity for detection of malignant tumor were calculated as 86.36%, 81.25% and 100% respectively. Whereas accuracy, sensitivity and specificity of brush cytology of the oral cavity for detection of benign and inflammatory conditions were 100%. Conclusion: Oral brush cytology has good accuracy, sensitivity and specificity for detection of oral epithelial lesions and can be useful in early detection of oral cancer as well as other lesions. Moreover, as an easy-to-do, painless and non-invasive procedure, it can be a good screening method for detection of oral lesions