Comparative Study of Cell Findings by Conventional Smear and Liquid-Based Cytology for Oral Exfoliative Cytology

Background: Liquid-based cytology (LBC) is a method of manufacturing cyto-diagnostic specimens. Improved accuracy is expected from standardizing specimen production and use of this method is rapidly spreading in oral cytology. On the other hand, LBC reportedly requires training to show peculiar cell findings compared to those of conventional smear cytology (CVC). Few studies have compared detailed cell findings for oral CVC and LBC. Objectives: The aim of this study was to compare cytological findings between CVC and LBC using cytomorphological image analysis. Materials and Methods: Cytological specimens were collected from 20 patients (negative for squamous neoplasia in 10, dysplasia in 5, squamous cell carcinoma in 5) and 5 controls of the tongue between January 2017 and December 2018. Two different preparation techniques were investigated cytomorphologically for CVC and LBC (BD CytorichTM). Results: LBC showed significantly higher cell numbers than CVC for all lesions. LBC-to-CVC ratio ranged from 9.52 (hyperkeratosis) to 1.87 (deep cells in oral squamous cell carcinoma (OSCC)). Nuclear area of normal, hyperkeratosis, and inflammation were significantly higher in LBC than those of CVC. Hyperchromasia was significantly more frequent with CVC than with LBC for hyperkeratosis, inflammation, dysplasia and OSCC. There was no significant difference in circularity between CVC and LBC among all lesions. Conclusion: Only one cytomorphological disadvantage was seen with LBC, in the form of decreased hyperchromasia. Further clarification of the advantages and disadvantages of LBC is needed, including management of precision and screening practices.

Antral exfoliative cytology for the detection of Helicobacter pylori in the stomach

AIM: To evaluate the efficacy of antral exfoliative cytology method in the diagnosis of Helicobacter pylori (H pylori)infection in the stomach.METHODS: Fifty patients were submitted to upper digestivetract endoscopy due to complaints of dyspepsia. Thematerial for exfoliative cytology was obtained by extensive brushing of the gastric antral mucosa and Papanicolaou stain was used to identify the bacteria. The authors also performed gastric biopsies to collect material for urease tests and histologic studies, with hematoxylin-eosin and fucsin stains in order to identify the microorganism. The gold standard used to detect the presence of H pylori was an analysis of the combined results from the gastric biopsies by urease test and histological method. RESULTS: Antral exfoliative cytology method exhibited 90.3% sensitivity, 66.6% specificity, accuracy of 81.6%, positive predictive value of 82.3% and negative predictive value of 80.0%, in this population with a prevalence of 63.3%.CONCLUSION: Antral exfoliative cytology was demonstrated to be a sensitive, accurate and easy to perform method for investigating H pylori infection in the stomach.

Effect observation of exfoliative cytology combined with CEA,CA125,CA15-3 and CA19-9 examinations in the diagnosis of malignant serous effusion

Objective:To study the effect of exfoliative cytology combined with CEA,CA125,CA15-3 and CA19-9 examinations on the diagnosis of malignant serous effusion.Methods:236 cases of patients who were diagnosed as serous effusion during inpatient in our hospital from January of 2015 to January of 2017 were selected as research objects.According to biopsy and pathological examinations,the diagnostic results were cleared that there were 136 cases of patients with benign serous effusion(benign group)and 100 cases of patients with malignant serous effusion(malignant group).Two groups of patients were both given exfoliative cytology combined with CEA,CA125,CA15-3 and CA19-9 examinations for tumor markers to analyze the effect of exfoliative cytology combined with CEA,CA125,CA15-3 and CA19-9 examinations on the diagnosis of malignant serous effusion.Results:The levels of tumor markers CEA,CA125,CA15-3 and CA19-9 in the benign group were all lower than those in the malignant group,and the difference was of statistical significance(p<0.05).In addition,exfoliative cytology combined with CEA,CA125,CA15-3 and CA19-9 examinations showed a higher sensitivity,specificity and accuracy than any of the above examinations alone,and the difference was of statistical significance(p<0.05).Conclusions:Exfoliative cytology combined with CEA,CA125,CA15-3 and CA19-9 examinations can effectively improve the diagnostic accuracy of malignant serous effusion and is worthy of being spread clinically.

DIAGNOSTIC VALUE OF DENSITY GRADIENT CENTRIFU-GATION FOR EXFOLIATIVE TUMOR CELLS IN MALIG-NANT PLEURAL EFFUSIONS

Objective To find out a specific method for diagnosis of malignant pleural effusions (MPEs)with higher sensitivity and practicality. Methods The diagnosis of MPEs were made using density gradient cen-trifugation(DGC) , smear cytologic examination( SCE) and pleural needle biopsy (PNB). Comparisons between these results and those of benign pleural effusions were also made. Results The positive rates of DGC,SCE and PNB for diagnosing MPEs were 94. 3% ,62. 9% and 44. 6% , respectively, and the positive rate of SCE combined with PNB for diagnosing MPEs was 73. 2%. The positive rate of the exfoliative tumor cells ( ETCs ) by DGC was much higher than that of SCE or/and PNB with no false-positive. Conclusion The ETCs isolated by DGC from the MPEs is quite specific for the diagnosis of malignant tumors with higher sensitivity and practicality in clinico-patho-logical practice.

Cytomorphological Analysis of Keratinocytes in Oral Smears from Tobacco Users and Oral Squamous Cell Carcinoma Lesions—A Histochemical Approach

Aim To analyse the cytomorphological features of kerati- nocytes in smears obtained from the oral mucosa of tobacco users and from oral squamous cell carcinoma lesions. Methodology Oral smears were obtained from clinically, normal appearing mucosa of oral squamous cell carcinoma patients （n=20） and from the mucosa of smokers （n=20）, and apparently healthy individuals （n=20） were used as controls. The smears were histochemically stained and cytomorphological assessment of the keratinocytes was carried out. One-way ANOVA （Analysis of Variance） was used for comparing the parameters among multiple groups and Tukey-HSD test was used to compare the mean values between groups. Results The mean nuclear area of keratinocytes from the mucosa of tobacco users was 46 ± 2.57 and that of the oral squamous cell carcinoma lesion was 81.54±4.31. While there was a significant （P=0.001） reduction in the cellular area of keratinocytes from oral squamous cell carcinoma lesion when compared with those from oral smears of tobacco users. Conclusion Cytomorphometric analysis of keratinocytes can serve as a useful adjunct in the early diagnosis of oral squamous cell carcinomas.