Exfoliative cytology in screening for malignant and premalignant lesions in the buccal mucosa.

OBJECTIVE: To test the efficacy of exfoliative cytology in the detection of oral premalignant and malignant lesions.

DESIGN: Cytological diagnosis of lesions of the buccal mucosa assessed using histopathological diagnosis of the same lesions as the gold standard.

SUBJECTS: Patients with buccal lesions clinically diagnosed as leukoplakia (n = 91) and squamous cell carcinoma (SCC, n = 59), and healthy subjects (n = 40) in whom buccal mucosa appeared clinically normal.

SETTING: Oral and Maxillo-facial Unit, General Hospital, Kandy and Department of Pathology, Faculty of Medicine, University of Peradeniya.

RESULTS: A sensitivity of 77%, specificity of 100% and accuracy of 92% were obtained for leukoplakia. SCC gave a sensitivity of 94%, specificity of 100% and an accuracy of 95%.

CONCLUSIONS: Oral exfoliative cytology is a useful method for detecting oral premalignant and malignant lesions. Anucleated squames in a smear is non-diagnostic.