Application of Transepithelial Brush Biopsy for Oral Mucosal Lesions

Abstract

Objective: For cases with suspicious lesions in the oral cavity, this study presents an understanding and evaluation of the clinically relevant information that can be provided from oral mucosal brush biopsy in making treatment plan decisions.

Method: Between 2008 and 2010, patients with suspicious lesions were evaluated with an oral mucosal brush biopsy prior to making treatment plans. Decision tree analysis was performed, and clinical relevancy of the information was provided by the pathologist. Clinical interventions with the oral cytology findings were correlated.

Results: During the evaluation period, 38 patients used the test. The oral mucosal brush biopsy provided the following clinically relevant information: 31% contained dysplasia or abnormal cells, 2% fungal organisms, 33% inflammation, 33% no cellular abnormality, and 1% other findings. In cases where inflammation was identified in conjunction with absence of abnormal or dysplastic cells, patients were placed on an observation protocol. In cases where the brush biopsy showed abnormal cells, the patient was scheduled for a surgical biopsy. A decision tree will be presented.

Conclusion: An oral mucosal brush biopsy can provide clinically relevant information about lesions prior to treatment decisions. The information provided from brush biopsy can be used as one of the factors considered with other clinical information to assist doctors in making definitive selections in a clinical management plan.