Fluorescence microscopy in exfoliative cytology: an evaluation of its application to cancer screening

Comparative cytopathologic evaluation using acridine orange with Papanicolaou stain in psychoactive substances abusers with potentially malignant and malignant disorders

Introduction:

Oral cancer is a major health problem and its early detection is advantageous for therapeutic purposes. According to available evidence, the risks of oral malignancies increase with the usage of tobacco and other psychoactive substances (PSs). The present study showed expression pattern of nuclear and cytoplasmic changes from normal individuals without habit to oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) in PS abusers with the help of fluorescence acridine orange (AO) stain and Papanicolaou (PAP) stain.

Aim and Objectives:

This study aimed to investigate and compare diagnostic efficacy of fluorescence microscopic evaluation of AO stain in cytological smears with PAP staining under light microscopy in PS abusers having oral potentially malignant and malignant lesions.

Materials and Methods:

Oral smears from 120 individuals among which 40 from potentially malignant disorders, 40 from oral malignancy and 40 normal buccal mucosa smears were prepared. One set of smears was stained by AO staining and the other by PAP staining and examined under fluorescence and light microscope, respectively. The results of both the stainings were evaluated by grading cytology smears in class-I to class-V cytology.

Results:

The AO fluorescence stain reliably demonstrated malignant cells based on the differential fluorescence. The efficacy of AO fluorescence stain was higher than PAP stain in screening of oral lesions suspicious of malignancy. The sensitivity of PAP staining and AO staining is 57.50% and 61.25%, respectively.

Conclusion:

As compared to PAP staining method, fluorescent AO method is more effective in screening of OPMD and OSCC in PS abusers.

Acridine Orange Fluorescence Method for Cytodiagnosis of Uterine Cancer

A group of 1064 patients seen at the gynecological clinic of the National Cancer Institute of Milan, have been taken into consideration. Vaginal smears of each patient were stained with the method of Papanicolaou and with acridine orange for microscopy fluorescence. The data obtained and the histological reports showed that the acridine orange fluorescence microscopy method is valid in selecting doubtful and positive cases of malignant tumors, provided the examination is performed by experienced cytologist. The method supplies on the whole results slightly more reliable than the Papanicolaou method but in some cases tha latter has proved superior to the former. Therefore, the best solution is to apply both methods contemporarily.