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Oral potentially malignant lesions: first‐level micro‐histological diagnosis from tissue fragments sampled in liquid‐based diagnostic cytology
Author(s) -
Navone Roberto,
Pentenero Monica,
Rostan Isabella,
Burlo Paola,
Marsico Andrea,
Broccoletti Roberto,
Scully Crispian,
Gandolfo Sergio
Publication year - 2008
Publication title -
journal of oral pathology and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.887
H-Index - 83
eISSN - 1600-0714
pISSN - 0904-2512
DOI - 10.1111/j.1600-0714.2008.00636.x
Subject(s) - biopsy , medicine , dysplasia , curette , sampling (signal processing) , carcinoma , pathology , radiology , filter (signal processing) , computer science , computer vision
Background: Scalpel biopsy may under‐diagnose oral dysplasia/carcinoma in potentially malignant lesions (PMLs) because samples represent only one or a few sites. It is possible that small tissue specimens obtained from over the whole area of PMLs, by scraping with a dermatological curette, could be treated histologically and used as ‘micro’ biopsies. This study values the accuracy of micro‐biopsies in the detection of dysplasia/carcinoma in oral PMLs. Methods: A prospective study was carried out on 164 patients with PMLs, with both scalpel and micro‐biopsies, for the presence of dysplasia/carcinoma. The most severe diagnosis (obtained by either method) was used as the reference standard. The presence/absence of the basement membrane zone (BMZ) in the micro‐biopsy specimens correlated with the site, the clinical features of the PMLs and the operator. Results: Micro‐biopsy gave six of 164 (3.66%) inadequate specimens. Of 158 of 164 adequate samples, dysplasia/carcinoma was diagnosed in 85 of 158 cases; micro‐biopsy diagnosis was in agreement with scalpel biopsy in 144 of 158 (91.14%) cases and showed a better sensitivity than did scalpel biopsy (97.65% vs. 85.88%), corresponding to two of 158 false‐negative cases by micro‐biopsy vs. 12 of 158 by scalpel biopsy. The BMZ was observed in 110 of 158 (69.62%) of all micro‐biopsies and had no relationship with the sampling site, the clinical features of the PMLs or the operator. Conclusions: The negative predictive value (97.33%) suggests that micro‐biopsy may well be an effective first‐level diagnostic procedure for PMLs (especially in follow‐ups and multiple lesions); moreover, in carcinoma (17% of cases) a definitive diagnosis could be made without further investigation.