Buccal micronuclei evaluation with VELscope and LBC: Cytology in a new light

Background: Micronuclei are biomarkers of chromosomal damage used in cancer risk assessment. This study evaluates the efficacy of centrifuged liquid-based cytology with aceto-orcein staining for micronuclei detection by comparing smokers and non-smokers. It also assesses the diagnostic accuracy of VELscope fluorescence screening in enhancing the detection of oral potentially malignant disorders. A new screening technique VELscope system will be utilized for fluorescence visualization to enhance the detection of potential mucosal abnormalities.Materials and Methods: Exfoliated buccal cells were collected from OPMDS participants and were processed using centrifuged LBC. Samples were stained using aceto-orcein stain (DNA-specific). Micronuclei count scored following established cytological criteria. MN counts were statistically analyzed to determine significant differences between velscope and cytology and to evaluate staining efficacy. The reliability of VELscope fluorescence screening in detecting oral mucosal abnormalities, and its accuracy were confirmed through exfoliative cytology and micronuclei assessment. Result: In this study, the Chi-square test showed no statistically significant difference between the two staining methods (p > 0.05), indicating their equivalence in detecting OPMDs. VELscope demonstrated 100% sensitivity, effectively identifying all micronuclei-positive cases, but low specificity (29.4%), highlighting the need for confirmatory diagnostic testing.Conclusion: This study demonstrated that VELscope fluorescence screening is a useful adjunct for the early detection of OPMDs by identifying oral mucosal abnormalities not evident on conventional examination. It also showed that centrifuged LBC with micronuclei assessment using aceto-orcein staining is a reliable, non-invasive, and cost-effective method for detecting genotoxic changes in oral epithelial cells.