DefinePK

Research Objective

To estimate the efficacy of the Leishman Giemsa cocktail stain, Giemsa stain, and Papanicolaou stain for the screening of potentially malignant lesions by exfoliative cytology.

Methodology

A comparative study conducted at the Department of Oral Pathology, Isra Dental College, Hyderabad, Pakistan, from February 1, 2022, to January 31, 2023. 90 participants were enrolled: 30 healthy individuals (Group-I) and 60 patients with diagnosed potentially malignant lesions (Oral submucous Fibrosis, Oral Lichen Planus, and Leukoplakia) (Group II). Samples were collected using a brush from the oral mucosa. Three smears were prepared from each sample: one fixed with biofix spray and stained with Papanicolaou stain, and two air-dried smears stained with Leishman-Giemsa cocktail and Giemsa stain. Stained slides were observed under a microscope and interpreted.

Methodology Flowchart

                        graph TD
    A["Enroll 90 Participants 30 Healthy, 60 Lesion Patients"] --> B["Collect Oral Cytology Samples"];
    B --> C["Prepare 3 Smears per Sample"];
    C --> D["Stain Smears"];
    D --> D1["Papanicolaou Stain Fixed"];
    D --> D2["Leishman-Giemsa Cocktail Air-dried"];
    D --> D3["Giemsa Stain Air-dried"];
    D1 --> E["Microscopic Observation & Interpretation"];
    D2 --> E;
    D3 --> E;
    E --> F["Analyze Staining Efficacy & Compare Stains"];
    F --> G["Draw Conclusions"];                    

Discussion

Exfoliative cytology is a valuable, inexpensive, and non-invasive tool for detecting oral premalignant and malignant lesions. The Leishman-Giemsa cocktail stain demonstrated superior staining for both nuclear and cytoplasmic details in healthy and potentially malignant lesions compared to Papanicolaou and Giemsa stains. While Papanicolaou stain is effective, its multi-step and time-consuming nature makes the Leishman-Giemsa cocktail stain a more practical and cost-effective alternative for screening.

Key Findings

In Group-I (healthy individuals), the Leishman-Giemsa cocktail stain showed highly significant cytoplasmic staining (mean 1.16) compared to Papanicolaou (mean 1.0) and Giemsa stain (mean 0.52). In Group II (potentially malignant lesions), the Leishman-Giemsa cocktail stain also showed higher mean cytoplasmic staining (1.16) compared to Papanicolaou (1.10) and Giemsa stain (0.67). No significant difference was found in the mean score of cytoplasmic staining between Group-I and Group-II. The Leishman-Giemsa cocktail stain and Papanicolaou stain were found to be more significant than the Giemsa stain in potentially malignant lesions.

Conclusion

The Leishman-Giemsa cocktail stain is a better staining technique for screening potentially malignant lesions, offering a more appropriate and cost-effective alternative to the Papanicolaou stain due to its simpler, one-step procedure.

Fact Check

1. Study Period: The study was conducted from February 1, 2022, to January 31, 2023. (Confirmed in the text).
2. Participant Numbers: A total of 90 participants were enrolled, with 30 in Group-I (healthy) and 60 in Group-II (potentially malignant lesions). (Confirmed in the text).
3. Stain Efficacy: The Leishman-Giemsa cocktail stain showed a mean cytoplasmic staining value of 1.16 in Group-I and 1.16 in Group-II, which was higher than Papanicolaou (1.0 and 1.10 respectively) and Giemsa (0.52 and 0.67 respectively). (Confirmed in the text).

Mind Map