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Diagnostic Cytometry

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Oral Cytology

Abstract

While oral lesions that macroscopically are highly suspicious for cancer shall be submitted to scalpel-biopsy and histologic evaluation, the majority of facultatively precancerous lesions, such as leuko- and erythroplakias or even persistent lichen planus lesions, may be assessed by brush-biopsy and cytology. As this non-invasive procedure is well tolerated by patients, more lesions may be screened and thus more oral cancers may be found in early, curable stages. Oral brush-biopsies can easily be performed by dentists, dental surgeons and general practitioners. While sensitivity of exfoliative cytology alone is about 4 % lower than bioptic histology, the combination of the latter with DNA-image-cytometry reaches the same diagnostic accuracy as the former (sensitivity 97.8–100 %, specificity, 97.4–100 %). As clonal chromosomal- and DNA-aneuploidy mostly precede cytological and histological evidence of malignancy in the squamous epithelium, its detection allows the diagnosis of oral squamous cell carcinomas up to 2 years earlier. Moreover, the additional use of DNA-image cytometry is a reasonable tool for the assessment of the resection margins of squamous cell carcinomas. DNA-image-cytometry could help to find the appropriate treatment option for patients and thus might improve their prognosis. Diagnostic DNA-image-cytometry is an objective method and has internationally been standardized.

Here for the first time we describe the performance of a device for automated screening of oral brush-biopsy-smears, based on a cascaded diagnostic strategy: (1) Automated selection of morphologically suspicious nuclei, (2) Interactive control and correction of these on digital image galleries, (3) DNA-measurements on these only, (4) Final diagnosis on DNA-histograms and nuclear morphology.

Alfred Bocking and David Friedrich have contributed equally to this manuscript.

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Author information

Authors and Affiliations

  1. Institute of Pathology, City-Hospital Düren, Roon Strasse 30, 52309, Düren, Germany

    Alfred Böcking

  2. Institute of Image Analysis and Computer Vision, RWTH Aachen University, Aachen, Germany

    David Friedrich, André Bell, Thomas Würflinger, Dietrich Meyer-Ebrecht, Yu Zhang & Til Aach

  3. Motic China Company, Xiamen, People’s Republic of China

    Chen Jin & Richard Yeung

  4. Institute of Cytopathology, Heinrich-Heine-University, Düsseldorf, Germany

    Stefan Biesterfeld, Natalia Pomjanski & Leonid Berynskyy

  5. Department of Cranio- and Maxillofacial Surgery, Heinrich-Heine-University, Düsseldorf, Germany

    Jörg Handschel

  6. British Columbia Cancer Agency and University of British Columbia, Vancouver, Canada

    Branko Palcic

Authors
  1. Alfred Böcking
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  2. David Friedrich
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  3. Chen Jin
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  4. André Bell
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  7. Yu Zhang
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  8. Stefan Biesterfeld
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  9. Natalia Pomjanski
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  10. Leonid Berynskyy
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  11. Richard Yeung
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  12. Jörg Handschel
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  13. Branko Palcic
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  14. Til Aach
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Corresponding author

Correspondence to Alfred Böcking .

Editor information

Editors and Affiliations

  1. Director, I-7, Sector - 39, Institute of Cytology and Preventive Onc, Noida - 201301, Allahabad, 211001, Uttar Pradesh, India

    Ravi Mehrotra

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Böcking, A. et al. (2013). Diagnostic Cytometry. In: Mehrotra, R. (eds) Oral Cytology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5221-8_9

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  • DOI: https://doi.org/10.1007/978-1-4614-5221-8_9

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-5220-1

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