Cytologic and DNA-cytometric very early diagnosis of oral cancer

BACKGROUND: The aim of this study was to evaluate the diagnostic accuracy of exfoliative cytology (EC) and DNA-image cytometry applied to suspicious oral lesions compared with synchronous histology. METHODS: Brush- and scalpel biopsies were obtained from 98 patients with suspicious oral lesions. In cases, in which EC revealed malignant or suspicious cells, nuclear DNA-contents were measured using a TV image analysis system. RESULTS: Among 98 oral lesions both cytological and histological diagnosis showed no sign of malignancy or dysplasia in 75. In 23 cases cytology yielded tumor cell-positive (15), suspicious (four) or doubtful (four) results. DNA-cytometry showed aneuploidy in 19 of these. The comparison between cytological diagnosis combined with DNA-cytometry and biopsy-histology resulted in a sensitivity of 100% and a specificity of 97.4%. CONCLUSION: In conclusion, cytology with DNA-cytometry is a highly sensitive, specific and non-invasive method for the early diagnosis of oral epithelial neoplasia, showing excellent compliance among patients.