The feasibility of oral mucosa TCT tests for lung cancer screening

Objectives: To evaluate the feasibility of oral mucosa TCT tests for early detection of lung cancer. Materials and Methods: From July 2013 to January 2014, eighty four chronic and heavy smokers with lung nodule after low-dose or plain chest computed tomography (CT) were given oral mucosa Thinprep cytological tests (TCT) and contrast-enhanced thoracic CT. Those suspected to suffer from lung tumors after contrast-enhanced thoracic CTs were undergone bronchoscopes and/or surgical resections to acquire pathological diagnosis. Oral mucosa was collected using Thinprep and AutoCyte Prep technology. Statistical analyses were performed by SPSS 11.0 software. Results: According to TCT outcomes, thirty cases (30/84, 35.7%) were identified with abnormal TCT results in oral mucosa and allocated to TCT (+) group, and 27 of them were identified with atypical hyperplasia and three with low grade lesions. The residual 54 cases with normal TCT results were allocated to TCT (-) group. In TCT (+) group, 22 cases (22/30, 73.3%) were diagnosed with cancer by contrast-enhanced thoracic CT, which was significantly higher than that in TCT (-) group (1/54, 1.9%), P = 0.001. According to bronchoscopes and/or surgical resections, 18 cases were diagnosed with lung cancer and all of them were in the TCT (+) group. The sensitivity, specificity, positive and negative predictive values of TCT on screening lung cancer were 100%, 81.8%, 60% and 100% respectively. Conclusion: As a preliminary tool of screening lung cancer on chronic smokers with a high risk of developing lung cancer, the oral mucosa TCT has a high sensitivity as well as a good specificity, and the test can be easily conducted.