Background: Oral/Oropharyngeal cancers, particularly
oropharyngeal squamous cell carcinoma (OPSCC) comprise about 85% of the head
and neck cancers. At present, these cancers constitute the sixth leading cause
of cancer related deaths around the globe. With the advent of HPV as a
causative agent of oral/oropharyngeal cancers associated with good prognosis,
the search for adjunctive tests for diagnosis of these lesions have received a
great deal of interest.
Aims and Objectives: This study was conducted to study the
efficacy of brush cytology in the diagnosis of potentially malignant and
malignant oral/ oropharyngeal lesions in adjunct with p16INK4a
Immunocytochemistry.
Materials and Methods: This is a prospective study performed
in a tertiary care hospital in 50 patients attending the outpatient department
of Otorhinolaryngology with suspected oral/oropharyngeal lesions from Jun
2018-January 2020.In all the selected cases, brush cytology material was
obtained from the suspicious lesions and subjected to cytological examination.
Histopathological examination of the punch biopsy specimens of respective
lesions of all the selected cases was done. Cytopathology and histopathology
findings were compared. Sensitivity, specificity, positive and negative
predictive values were calculated Immunocytochemical staining for p16 was
performed. Comparison of clinicopathological parameters with the p16 status was
done.
Results: In our series of 50 patients, 35(70%) were males
and 15(30%) were females. The age range was 31-90 years with a mean age of 51
years. Using the brush cytology technique, the cases detected were 27(54%) of
squamous cell carcinomas, 13(26%) of epithelial dysplasia and 4(8%) of
verrucous carcinoma, 4 (8%) leukoplakia, 2 cases were inconclusive. The
sensitivity of brush cytology method was found to be 94% and the specificity
was 94%, false positive rate was 6% and false negative rate was 6% witha
diagnostic accuracy of 94%. Considering p16 as the surrogate marker of HPV
infection, it was found to be positive in 28(56%) of cases by ICC.
Statistically significant relation was found between the detection of p16
expression by ICC and the cytological diagnosis (p< 0.05).
Conclusion: Brush cytology provides a reliable diagnoses
that is consistent with the final histopathological diagnosis. It is an
efficacious technique that offers a less invasive and cost effective adjunctive
assessment and is also appropriate for monitoring of patients with
premalignant/malignant oral lesions in the long run.
Author(s) Details:
Srijana Subba,
District Hospital Namchi, South Sikkim, India.
Chhanda
Das,
Department
of Pathology, Burdwan Medical College, West Bengal, India.
Madhumita Mukhopadhyay,
Department of Pathology, Saroj Gupta Cancer Center & Research
Institute, Kolkata, West Bengal, India.
Please see the link here: https://stm.bookpi.org/ANUMS-V4/article/view/13253
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