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Ishii S, Sakaguchi W, Sugai M, Nagumo T, Koeda S, Ozawa M, Kitamura T, Yamamura M, Akiyama H, Tsukinoki K, Nakamura A. Analysis of false-negatives in exfoliative cytology in oral potentially malignant disorders: A retrospective cohort study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e390-e395. [PMID: 35134591 DOI: 10.1016/j.jormas.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Keratinized lesions have been a conceivable false-negative (FN) factor in oral exfoliative cytology (OEC); however, other factors are poorly analyzed. In this study, we aimed to identify the factors influencing the accuracy of OEC and FNs focusing on the lesion characteristics, patient background, and surgeon factors in oral potentially malignant disorders (OPMD). MATERIAL AND METHODS We retrospectively studied 44 patients who underwent both OEC and histopathological diagnosis. Sensitivity, specificity, FN rate, false-positive (FP) rate, and prevalence of both methods were compared. Similarly, accuracy indices were compared among clinical diagnosis groups (leukoplakia vs. other diagnosis). The association between patient and surgeon-related factors influencing FN OEC results were investigated using Fisher's exact test and a multiple logistic regression analysis. RESULTS Overall, the sensitivity; specificity; and FN, FP, and prevalence rates of OEC were 31.8%, 82.1%, and 68.8%, 17.9%, and 36.4%, respectively. Leukoplakia was significantly more common in clinical diagnosis (P = 0.007) with sensitivity, specificity, and FN rates of 20.0%, 95.2%, and 80.0%, respectively. Contrarily, non-keratinized lesions had sensitivity, specificity, and FN of 83.3%, 85.7%, and 16.7%, respectively. In the prevalent group, leukoplakia and anucleate squamous cells were significantly associated with FN cases (P = 0.013, P = 0.050). On multivariate analysis in OEC negative patients, age ≤64 (P = 0.050) and location on the tongue (P = 0.047) was independently associated with FNs. CONCLUSION FN of OEC was conceivable to be due to poor deep-seated cell sampling, which was associated with leukoplakia, age, and location. Therefore, these factors may be considered in the evaluation of OEC results.
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Affiliation(s)
- Shigeru Ishii
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
| | - Wakako Sakaguchi
- Department of Environmental Pathology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan.
| | - Masafune Sugai
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
| | - Tatsuhito Nagumo
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
| | - Satoko Koeda
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
| | - Manami Ozawa
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
| | - Toru Kitamura
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
| | - Makiko Yamamura
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
| | - Hiroki Akiyama
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
| | - Keiichi Tsukinoki
- Department of Environmental Pathology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan.
| | - Atsushi Nakamura
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Kanagawa 221-0835, Japan.
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Surboyo MDC, Santosh ABR, Hariyani N, Ernawati DS, Cecilia PH. Clinical utility of dermoscopy on diagnosing pigmented papillary fungiform papillae of the tongue: A systematic review. J Oral Biol Craniofac Res 2021; 11:618-623. [PMID: 34729344 PMCID: PMC8546920 DOI: 10.1016/j.jobcr.2021.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/16/2021] [Accepted: 09/11/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION The practice of dermoscopy in dental and oral examination is low due to less popularity and not well established of the diagnostic tool in dental practice. The dermoscopy examination provides a specific dermoscopes details for pigmented papillary fungiform of tongue (PPFT) as cobblestone appearance and rose-petal appearance. With this dermoscopes details serves as a non-invasive diagnostic tool and prevents biopsy procedure. OBJECTIVE We performed a systematic review to evaluate the published papers related to pigmented papillary fungiform on the tongue, aiming to understand the diagnostic role of dermoscopy examination in pigmented papillary fungiform. DATA SYNTHESIS Initial result was 136 studies. Final exclusion of 27 articles was made based on the following factors: reports with no clinical images, studies that did not confirm the diagnosis of PPFT and studies that did not use the dermoscopes details. Finally, seventeen studies with nineteen cases, reported of pigmented papillary fungiform of the tongue. Six studies (consist six cases) reported the dermoscopy and histopathology diagnosis of pigmented papillary fungiform, eleven studies (consist thirteen cases) reported only the dermoscopy. The dermoscopy examination presented cobblestone appearance is 47.37% and rose petal appearance is 52.63%. The comparation study by histopathology diagnosis was done, revealed no specific appearances. CONCLUSIONS The clinical appearance and dermoscopy is the key for diagnosis of the papillary fungiform on the tongue. Further research is needed for determining the etiology and predisposing factor in papillary fungiform so that the possibility of developing this condition can be predicted and proper treatment could be performed.
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Affiliation(s)
| | | | - Ninuk Hariyani
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia
| | - Diah Savitri Ernawati
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia
| | - Pamela Handy Cecilia
- Bachelor of Dental Surgery, Faculty of Dental Medicine, Bachelor of Dental Science Degree, Universitas Airlangga, Surabaya, 60132, Indonesia
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