Role of exfoliative cytology in diagnosis of oral lesions: With special reference to rule out malignancy

Abstract

Oral malignancy is very common in India because of the excessive use of tobacco chewing and smoking. Procedure of Cytology is inexpensive and unchallenging that can be carried out effortlessly at outdoor patient department to diagnose malignancy at early stage. The present study was carried out to detect cancer pre-invasive stage by use of exfoliative cytology and to probe the probability of using this technique in diagnosis of other oral lesions thought as premalignant ones. A total 102 patients referred from OPD and Surgery Department of a Private Hospital, Dispensary and Cancer Hospital, Delhi, between August 2019 to April 2020 , were included in this study. Two smears were taken by scrap method, from each patient and were prepared after air dried stained with RAPID PAP stain. According to the Papanicolaou classification the smear were assessed along with clinical, epidemiological data and classified in group I to IV. In our result 25 cases were normal, leukoplakia 47 cases with mean age 47.5 years, 85% male. Predominantly 53% Smear show anucleated squames. 06 cases were Oral submucous fibrosis ,66.7% were female with mean age 38.3 years and, the present smear revealed rarification of nuclei in 66% cases. 02 cases of mucosal hyperemia (Erythema), one-one case of traumatic ulcer and granular buccal mucosa were included. Out of 12 cases of malignancy, male were 75% with mean age of 46 year. Buccal mucosa and tongue were the common site with incidence of 60%. The smear showed inflammatory cells in 100%, malignant cells in 75% cases either in groups or in singles. The third type of cells 60%, 37% the undifferentiated cells, and 5% cases Tadpole cells. In this study 75% cases were positive for cancer, 10% were suspicious for cancer and remaining 15% were given as negative for cancer. For the diagnosis of presence or absence of malignancy in a lesion with high accuracy rate Cytology is reliable diagnostic tool. The oral cytologic technique is effortless to do and can provide the help of surgeon/physician, instead of performing an invasive procedure, like a biopsy, or desire more information regarding a lesion before referring the patient.