RT Journal Article
T1 Accuracy of cytological methods in early detection of oral squamous cell carcinoma and potentially malignant disorders: A systematic review and meta-analysis
A1 Tayebi Hillali, Hoda
A1 Lorenzo Pouso, Alejandro Ismael
A1 Marichalar Mendía, Xabier
A1 Gándara Vila, Pilar
A1 Reboiras López, Dolores
A1 Blanco Carrión, Andrés
A1 Coppini, Martina
A1 Alberto Caponio, Vito Carlo
A1 Pérez-Sayáns García, Mario
K1 Cytology
K1 Diagnostic accuracy
K1 Leukoplakia
K1 Meta‐analysis
K1 Mouth neoplasm
K1 Oral lichen planus
K1 Oral potentially malignant disorders
AB Introduction: Oral squamous cell carcinoma (OSCC) carries significant global mortality rates. Brush cytology presents a potential adjunctive tool for early detection and monitoring of OSCC and oral potentially malignant disorders (OPMDs). This study aims to systematically evaluate the diagnostic accuracy of cytology for detecting OSCC and OPMDs compared to histopathology as the reference standard. We conducted a systematic review and meta-analysis following PRISMA-DTA guidelines.Material and methods: We searched PubMed, Embase, Scopus, Cochrane Library, and Web of Science from inception to January 2023 (updated in March 2025). Eligible studies included cohort studies evaluating cytology versus histopathological diagnosis. Two reviewers independently screened studies, extracted data, and assessed risk of bias using QUADAS-2. We used the Hierarchical Summary Receiver Operating Characteristic model for meta-analysis.Results: Of 2603 identified studies, 53 met inclusion criteria, comprising 13,249 patients. Cytology demonstrated a pooled sensitivity of 0.914 (95% CI: 0.878-0.941) and specificity of 0.960 (95% CI: 0.937-0.975). The diagnostic odds ratio was 137.502 (95% CI: 79.733-237.127), with a positive likelihood ratio of 11.970 (95% CI: 9.005-15.912) and negative likelihood ratio of 0.096 (95% CI: 0.059-0.158). Subgroup analysis showed improved performance when exfoliative cytology was combined with DNA analysis or when using a metal spatula. Both conventional and liquid-based cytology were effective, with the latter showing modest advantages. Heterogeneity was substantial across studies (I2 = 86.26%).Conclusion: Cytology demonstrates good diagnostic accuracy for detecting OSCC and OPMDs and may serve as a valuable adjunctive screening tool. However, it does not replace histopathological examination as the diagnostic gold standard. Further research should focus on standardizing collection techniques and interpretation criteria.Registration: PROSPERO CRD42023438610.
PB Wiley
SN 0904-2512
YR 2025
FD 2025-08
LK https://hdl.handle.net/10347/47274
UL https://hdl.handle.net/10347/47274
LA eng
NO Tayebi-Hillali, H., Lorenzo-Pouso, A. I., Marichalar-Mendía, X., Gándara-Vila, P., Reboiras-López, D., Blanco-Carrión, A., Coppini, M., Caponio, V. C. A., & Pérez-Sayáns, M. (2025). Accuracy of Cytological Methods in Early Detection of Oral Squamous Cell Carcinoma and Potentially Malignant Disorders: A Systematic Review and Meta-Analysis. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 54(7), 507–527. https://doi.org/10.1111/jop.70010
NO The authors received no specific funding for this work.
DS Minerva
RD 23 may 2026