Oral rinse-based cytology and conventional exfoliative cytology: a comparative study

Simple screening test for resource-challenged areas.

To compare specimen adequacy and diagnostic agreement between oral rinse-based smears and conventional smears in oral cancer, oral leukoplakia, and normal controls.

Twenty-five histologically confirmed cases of oral cancer, 29 clinically diagnosed cases of oral leukoplakia, and 54 normal controls were subjected to the oral rub-and-rinse technique and the conventional exfoliative cytology.

Smears were consequently stained with the Papanicolaou (PAP) stain and were examined independently by two different cytopathologists in a double-blind fashion. The results were classified as: Negative, atypical, positive, and unsatisfactory. Furthermore, they were compared, to assess the sample adequacy, cellular distribution, staining, leucocytes/inflammation and cellular clarity in both the smears.

Chi square test and Wilcoxon-matched pairs signed rank test (P ≤ 0.05).

Among the cancer cases, 84% showed positive, 8% atypical, and 8% unsatisfactory, after using the conventional technique, whereas, the oral rinse technique showed 80% positive, 16% atypical, and 4% unsatisfactory cases. The conventional technique showed 44.82, 37.93, and 6.89% and the oral rinse technique showed 48.27, 31.03, and 20.68% negative, positive, and atypical cases, respectively, among the leukoplakia cases. Among the normal controls, 9.26 and 90.74% and with the oral rinse technique 3.70 and 96.29% showed atypical and negative cases with the conventional technique. Sample adequacy and cellular clarity showed a statistically significant difference between both techniques.

Both smears were diagnostically reliable, however, the oral rinse-based method showed an overall improvement in sample adequacy and cellular clarity.