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Confocal microscopy and exfoliative cytology.

Shyam Prasad Reddy1, Pratibha Ramani, Purshotam Nainani

  • 1Department of Oral Pathology, Staff Quarters, Sarda Estate, Aditya Dental College and Hospital, Beed, Maharashtra, India.

Journal of Oral and Maxillofacial Pathology : JOMFP
|November 20, 2013
PubMed
Summary

Confocal microscopy with acridine orange stain offers a rapid and objective method for detecting oral cancer cells in exfoliative cytology, demonstrating high sensitivity comparable to the PAP stain.

Keywords:
Acridine orange stainingPAP (Papanicolaou) stainconfocal microscopyexfoliative cytologysquamous cell carcinoma

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Area of Science:

  • Cytopathology
  • Optical Microscopy
  • Oncology

Background:

  • Early detection of oral squamous cell carcinoma (OSCC) is crucial for improved patient outcomes.
  • Subtle cellular changes indicative of neoplastic transformation can be visualized using advanced imaging techniques.
  • Confocal microscopy presents a rapid and reliable method for exfoliative cytology.

Purpose of the Study:

  • To evaluate the efficacy of confocal microscopy for cytological diagnosis of oral lesions.
  • To compare the diagnostic performance of confocal microscopy with the standard Papanicolaou (PAP) stain.

Main Methods:

  • Buccal mucosa smears from OSCC patients and healthy controls were prepared.
  • Smears were stained with acridine orange (AO) and examined using confocal microscopy.
  • A parallel set of smears was stained using the rapid PAP stain kit for comparison.

Main Results:

  • Confocal microscopy revealed increased nuclear fluorescence intensity in malignant cells of OSCC patients.
  • Acridine orange confocal microscopy demonstrated 93% sensitivity and specificity in identifying malignant cells.
  • The technique effectively visualized nuclear alterations associated with neoplastic transformation.

Conclusions:

  • Confocal microscopy with AO stain is a sensitive method for identifying malignant cells in exfoliative cytology, comparable to the PAP method.
  • This technique offers rapid specimen processing and screening, saving valuable time.
  • Confocal microscopy enhances objectivity in the cytological diagnostic process.