Oral Cytology pp 125-145 | Cite as

Diagnostic Cytometry

  • Alfred Böcking
  • David Friedrich
  • Chen Jin
  • André Bell
  • Thomas Würflinger
  • Dietrich Meyer-Ebrecht
  • Yu Zhang
  • Stefan Biesterfeld
  • Natalia Pomjanski
  • Leonid Berynskyy
  • Richard Yeung
  • Jörg Handschel
  • Branko Palcic
  • Til Aach
Chapter

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.

Keywords

Migration Attenuation Expense Paraffin 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Alfred Böcking
    • 1
  • David Friedrich
    • 2
  • Chen Jin
    • 3
  • André Bell
    • 2
  • Thomas Würflinger
    • 2
  • Dietrich Meyer-Ebrecht
    • 2
  • Yu Zhang
    • 2
  • Stefan Biesterfeld
    • 4
  • Natalia Pomjanski
    • 4
  • Leonid Berynskyy
    • 4
  • Richard Yeung
    • 3
  • Jörg Handschel
    • 5
  • Branko Palcic
    • 6
  • Til Aach
    • 2
  1. 1.Institute of PathologyCity-Hospital DürenDürenGermany
  2. 2.Institute of Image Analysis and Computer VisionRWTH Aachen UniversityAachenGermany
  3. 3.Motic China CompanyXiamenPeople’s Republic of China
  4. 4.Institute of CytopathologyHeinrich-Heine-UniversityDüsseldorfGermany
  5. 5.Department of Cranio- and Maxillofacial SurgeryHeinrich-Heine-UniversityDüsseldorfGermany
  6. 6.British Columbia Cancer Agency and University of British ColumbiaVancouverCanada

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