Introduction: Incidence of oral epithelial dysplasia and oral squamous cell carcinoma (SCC) is very high in south Asian countries as compared to western population owing to a greater use of tobacco in these regions. While visual examination and exfoliative cytology are the most common screening and diagnostic modalities at present, it is a subjective analysis. Quantitative analyses such as nuclear size, cell size, and nuclear-to-cytoplasmic ratio may provide an accurate diagnosis and improve reproducibility. The aim of the study was to evaluate the role of morphometry as a diagnostic adjunct to exfoliative cytology and to derive a significant cutoff to identify the population at risk for development of SCC among chronic tobacco users. Material and Methods: This was an outpatient-based prospective study done in a tertiary hospital over a period of 2 years. Hundred and fifty cases with a history of chronic tobacco use for a minimum period of 5 years were evaluated. Visual inspection using acetic acid was done. Oral scrapes were taken for cytological and morphometric analysis followed by incision biopsy for histopathological evaluation, wherever possible. Results: On morphometrical analysis, mean nuclear area and nuclear:cytoplasmic (N:C) ratio increased, while the cytoplasmic area decreased from smears with normal cytology to oral dysplasia to SCC. Analysis of variance and post hoc Tukey’s honest significant difference test showed a statistically significant difference among the 3 groups (p value #x3c;0.05). A cutoff value for a significant N:C ratio was calculated as ≥0.08 using Youden’s index with a sensitivity and a specificity of 88% and 94%, respectively. Conclusion: In high-risk cases, morphometry can be a useful adjunct to exfoliative cytology and visual examination for an early and accurate diagnosis and timely intervention in oral potentially malignant and malignant lesions, thereby improving the prognosis.
Acta Cytologica

中文翻译：

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细胞形态计量学联合视觉检查和脱落细胞学在口腔癌前病变和恶性病变早期诊断中的评价和量化

简介：与西方人口相比，南亚国家的口腔上皮发育不良和口腔鳞状细胞癌 (SCC) 的发病率非常高，因为这些地区烟草使用较多。虽然目视检查和脱落细胞学检查是目前最常见的筛查和诊断方式，但它是一种主观分析。诸如核大小、细胞大小和核质比等定量分析可以提供准确的诊断并提高可重复性。该研究的目的是评估形态计量学作为剥脱性细胞学诊断辅助手段的作用，并得出一个重要的临界值，以确定慢性烟草使用者患 SCC 的风险人群。材料与方法：这是一项在三级医院进行的为期 2 年的基于门诊的前瞻性研究。对至少 5 年有慢性烟草使用史的 150 例病例进行了评估。使用乙酸进行目视检查。口腔刮片用于细胞学和形态学分析，然后在可能的情况下进行切口活检以进行组织病理学评估。结果：在形态计量学分析中，平均核面积和核：细胞质（N：C）比增加，而细胞质面积从细胞学正常的涂片到口腔发育不良再到 SCC 减少。方差分析和post hoc Tukey's诚实显着性差异检验显示3组间差异有统计学意义（p值 #x3c;0.05)。使用 Youden 指数计算显着 N:C 比值的临界值≥0.08，敏感性和特异性分别为 88% 和 94%。结论：在高危病例中，形态计量学可作为脱落细胞学和视觉检查的有用辅助手段，对口腔潜在恶性和恶性病变进行早期准确诊断和及时干预，从而改善预后。
细胞学学报