Comparison between liquid based cytology and conventional exfoliative cytology in the diagnosis of oral candidoses
Comparação entre a citologia em base líquida e a citologia esfoliativa convencional no diagnóstico da candidose bucal
Sandrin, Rodrigo; Campagnoli, Eduardo Bauml; França, Beatriz Helena Sottile; Lima, Antonio Adilson Soares de
Rev. odontol. UNESP, vol.39, n1, p.33-39, 2010
Abstract
The aim of this study was to compare the efficiency of the liquid based cytology (LBC) and conventional exfoliative cytology (CEC) in the diagnosis of oral candidosis. Material and method: The sample was divided in two groups: a) experimental group – composed by 27 individuals with oral candidosis (submitted to LBC and CEC) and b) control group – composed by 30 individuals with no oral lesion (submitted to LBC). Besides, the quality of the cytological smears; the association between hyphae and/or pseudohyphae with the type of epithelial cell; and the efficacy of the two methods after the treatment with antifungal medication were evaluated. The smears were processed in the laboratory, analyzed by light microscopy and submitted to statistical analysis using Chi‑square test (P < 0.05). Result: There were more smears exhibiting hyphaes and/or pseudohyphaes in LBC than CEC. Besides, the quantity and the more uniform dispersion of the epithelial cells on the slide were more present. Thus, this method showed the best quality of the cytological smears. When the association between hyphae and/or pseudohyphae with the type of epithelial cell was analyzed, both LBC (experimental and control groups) and CEC demonstrated that these structures were more associated with nucleated superficial and intermediary epithelial cells. Conclusion: Even so LBC has been technically superior than CEC to the preparing of best quality slides and favoring to the detection of hyphae and/or pseudohyphae. Nevertheless, it did not show satisfactory results as a safe method to the diagnosis of oral candidosis.
Keywords
Cytology, candidiasis, oral diagnosis, mouth mucosa, oral health.
Resumo
Objetivo: O objetivo deste estudo foi comparar a eficácia da citologia esfoliativa em base-líquida (CBL) e da citologia esfoliativa convencional (CEC) no diagnóstico da candidose bucal. Material e método: a amostra foi dividida em dois grupos: a) grupo experimental – formado por 27 indivíduos com candidose bucal (submetidos a CBL e CEC) e b) grupo controle – composto por 30 indivíduos sem nenhuma lesão bucal (submetidos a CBL). Além de avaliar a eficácia dos métodos no diagnóstico de candidose bucal, procurou-se comparar a qualidade das imagens microscópicas, a associação da presença de hifas e/ou pseudohifas com o tipo de célula epitelial e a eficácia de aplicação dos dois métodos após o tratamento com antifúngico. Os esfregaços foram processados em laboratório, analisados por microscopia de luz e submetidos à análise estatística por meio do teste do Qui-quadrado (p < 0,05). Resultado: Os resultados mostraram que a CBL foi mais eficaz do que a CEC devido ao maior número de lâminas contendo hifas e/ou pseudohifas, bem como pela quantidade e dispersão mais uniformes das células epiteliais, o que caracterizou a qualidade superior das imagens neste método. Ao se avaliar a associação de hifas e/ou pseudohifas com o tipo de célula epitelial mais encontrado, observou-se que tanto na CBL quanto na CEC as referidas estruturas estavam mais associadas com células das camadas superficial nucleada e intermediária. Conclusão: embora a
citologia em base líquida tenha sido tecnicamente superior à citologia esfoliativa convencional na confecção de lâminas com melhor qualidade e favorecendo a detecção de hifas e pseudohifas, a CBL não demonstrou resultados satisfatórios como um método seguro para o diagnóstico da candidose oral.
citologia em base líquida tenha sido tecnicamente superior à citologia esfoliativa convencional na confecção de lâminas com melhor qualidade e favorecendo a detecção de hifas e pseudohifas, a CBL não demonstrou resultados satisfatórios como um método seguro para o diagnóstico da candidose oral.
Palavras-chave
Citologia, candidíase, diagnóstico bucal, mucosa bucal, saúde bucal.
Referências
1. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral & maxillofacial pathology. 2nd. ed. Philadelphia: W B Saunders; 2002.
2. Odds FC. Mycology in oral pathology. Acta Stomatol Belgica. 1997;94:75-80.
3. Lamey PJ, Samaranayake LP. Oral candidosis: 2. diagnosis and management. Dent Update. 1988;15:328-31.
4. Silverman S Jr, Becks H, Farber SM. The diagnostic value of intraoral cytology. J Dent Res. 1958;37:195-205.
5. Kaugars GE, Silverman S, Ray AD, Page EG, Abbey LM, Burns JC, et al. The use of exfoliative cytology for the early diagnosis of oral cancers: is there a role for it in education and private practice? J Cancer Educ. 1998;13:85-9.
6. Dabelsteen E, Roed-Petersen B, Smith CJ, Pindborg JJ. The limitations of exfoliative cytology for the detection of epithelial atypia in oral leukoplakias. Br J Cancer. 1971;25: 21-4.
7. Silva MCA. Citopatologia: um recurso auxiliar na prevenção do câncer bucal em pacientes do sexo masculino [dissertação mestrado]. Porto Alegre: Universidade Federal do Rio Grande do Sul; 1997.
8. Hutchinson ML, Zahniser DJ, Sherman ME, Herrero R, Alfaro M, Bratti MC, et al. Utility of liquid-based cytology for cervical carcinoma screening: results of a population-based study conducted in a region of Costa Rica with a high incidence of cervical carcinoma. Cancer. 1999;87:48-55.
9. Linder J. Recent advances in thin-layer cytology. Diagn Cytopathol. 1998;18:24-32.
10. Carpenter AB, Davey DD. ThinPrep Pap Test: performance and biopsy follow-up in a University Hospital. Cancer (Cancer Cytopathol). 1999;87:106-12.
11. Michael CW, McConnel J, Pecoitt J, Afity AM, Al-Khafaji B. Comparison of ThinPrep and TriPath Prep Liquid-Based preparations in nongynecologic specimens: a pilot study. Diagn Cytopathol. 2001;25:177-84.
12. Nasutti JF, Tam D, Gupta PK. Diagnostic value of liquid-based (Thinprep) preparations in nongynecologic cases. Diagn Cytopathol. 2001;24:137-41.
13. Rossi ED, Mulè A, Russo RM, Pierconti F, Fadda G. Application of liquid-based preparation to non-gynaecologic exfoliative cytology. Pathologica. 2008;100:461-5.
14. Apgar BS. New tests for cervical cancer screening. Am F Phys. 2001;64:729-31.
15. McKee GT. Citopatologia. São Paulo: Artes Médicas; 2001.
16. Ogden GR, Cowpe JG, Green M. Cytobrush and wooden spatula for oral exfoliative cytology. A comparison. Acta Cytol. 1992;36:706‑10.
17. Burzlaff JB, Bohrer PL, Paiva RL, Visioli F, Sant’Ana Filho M, Silva VD, et al. Exposure to alcohol or tobacco affects the pattern of maturation in oral mucosal cells: a cytohistological study. Cytopathology. 2007;18:367-75.
18. Fotos PG, Hellstein JW. Candida and candidosis. Epidemiology, diagnosis and therapeutic management. Dent Clin North Am. 1992;36:857‑78.
19. Lemos MMC, Miranda JL, Souza MSGS. Estudo clínico, microbiológico e histopatológico da estomatite por dentadura. Rev Bras Patol Oral. 2003;2:3-10.
20. Arendorf TM, Walker DM. Oral candidal populations in health and disease. Br Dent J. 1979;147:267-72.
21. Jones AC, Migliorati CA, Stewart CM. Oral cytology: indications, contraindications, and technique. Gen Dent. 1995;43:74-7.
22. Jones AC, Pink FE, Sandow PL, Stewart CM, Migliorati CA, Baughman RA. The cytobrush plus cell collector in oral cytology. Oral Surg Oral Med Oral Pathol. 1994;77:95-9.
23. Kahn MA. Oral exfoliative cytology procedures: conventional, brush biopsy and thinprep. J Tenn Dent Assoc. 2001;81:17-20.
24. Payne N, Chilcott J, McGoogan E. Liquid-based cytology for cervical screening. Cytopathology. 2000;11:469-70.
25. Michael CW, McConnel J, Pecott J, Afify AM, Al-Khafaji B. Comparison of ThinPrep and TriPath PREP liquid-based preparations in nongynecologic specimens: a pilot study. Diagn Cytopathol. 2001;25:177-84.
26. Williams DW, Walker R, Lewis MA, Allison RT, Potts AJ. Adherence of Candida albicans to oral epithelial cells differentiated by Papanicolaou staining. J Clin Pathol. 1999;52:529-31.
27. Brasileiro Filho G. Bogliolo patologia geral. 4ª. ed Rio de Janeiro: Guanabara Koogan; 2009.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email