The role of exfoliative cytology in diagnosis of oral lesions

Objectives: The study aimed to evaluate the use of oral exfoliative cytology and highlight its limited effectiveness in diagnosing oral diseases.

Materials and methods: A total of 1000 consecutive cases of oral cytology were retrieved from the files of an Oral Pathology Service, comprising the period between January 2002 and December 2022. Patient data and clinical details of the lesions were collected, and all slides were reviewed. Categorical data were presented in absolute and relative frequency (%), while numerical data were expressed as the median with minimum and maximum values. The Chi-square (X²) test was employed for frequency comparisons, with a significance level of 5%.

Results: Men constituted 64.6% (n = 646) of the cases, with a statistically significant predominance of white individuals (69.4%; n = 694). Of the 1000 evaluated cases, 87.8% (n = 878) were graded using Papanicolaou staining. Regarding provisional diagnoses, most clinicians (79.1%) suspected fungal lesions (n = 817). Analysis of the agreement between provisional and final cytological diagnoses revealed a statistically significant disagreement.

Conclusions: This work reinforces the limited use of exfoliative cytology in diagnosing oral lesions.

Clinical relevance: Exfoliative oral cytology should be restricted to specific cases, particularly for diagnosing fungal disease, and occasionally when oral cancer is suspected, but a biopsy cannot be performed at that time.