Utility of Indigenous Cytology Technique in the Diagnosis of Oral Cavity Lesions using Normal Saline as a Processing Fluid: A Comparative Study

BACKGROUND: Oral cancer is a major health problem in developing countries. Cytology has been widely accepted as a tool in the early diagnosis of cancer. OBJECTIVES: To evaluate the diagnostic utility of four different cytology techniques, that is, modified brush cytology (BR) technique, brush cytology cytocentrifugation (BRCC) technique, modified scrape cytology (SR) technique, and scrape cytology cytocentrifugation (SRCC) technique and correlate the cytopathological diagnosis with the available histopathological diagnosis. MATERIALS AND METHODS: It was a prospective observational study of oral cavity lesions conducted from January 2018 to December 2018 at a rural tertiary care referral institute. Smears prepared by four different techniques, that is, BR technique, BRCC technique, SR technique and SRCC technique were evaluated using a scoring system. Normal saline was used as a processing fluid for cytocentrifugation techniques, and the cytological diagnosis was compared with an available histopathological diagnosis for concordance. RESULTS: Twenty-seven cases of oral cavity lesions were analyzed. Squamous cell carcinoma (55.56%) constituted the most common lesion diagnosed by cytology. Total concordance was 95.65%. Brush cytology techniques were better technique than scrape cytology techniques. Cytocentrifugation techniques were better than modified brush cytology technique and modified scrape cytology technique and the values were statistically highly significant (P<0.0001). CONCLUSION: The utility of only normal saline as a processing fluid for cytocentrifugation may be considered an unexplored and prudent endeavor. This indigenously designed technique may be employed to improve the quality of cytological preparation for the evaluation of oral cavity lesions.