Cytologic and DNA-cytometric early diagnosis of oral cancer

Objective. The aim of this prospective study was to report on the diagnostic accuracy of conventional oral exfoliative cytology taken from white-spotted, ulcerated or other suspi-cious oral lesions in our clinic. In addition we checked DNA-image cytometry as an adjuvant diagnostic tool. Our hypoth-esis is that DNA-aneuploidy is a sensitive and specific marker for the early identification of tumor cells in oral brushings. Study design. 251 cytological diagnoses obtained from ex-foliative smears of 181 patients from macroscopically suspi-cious lesions of the oral mucosa and from clinically seem-ingly benign oral lesions which were exisiced for establish-ing histological diagnoses were compared with histological and/or clinical follow-ups of the respective patients. Addi-tionally nuclear DNA-contents were measured after Feulgen restaining using a TV image analysis system. Results. Sensi-tivity of our cytological diagnosis on oral smears for the de-tection of cancer cells was 94.6%, specificity 99.5%, positive predictive value 98.1 % and negative predictive value 98.5%. DNA-aneuploidy was assumed if abnormal DNA-stemlines or cells with DNA-content greater 9c were observed. On this basis the prevalence of DNA-aneuploidy in smears of oral squamous cell carcinomas in situ or invasive carcinomas was 96.4%. Sensitivity of DNA-aneuploidy in oral smears for th