Periodic acid–Schiff staining in oral exfoliative cytology of diabetic patients: The odyssey for noninvasive screening – A systematic review and meta‑analysis

Abstract

Background: Diabetes mellitus is a dominant metabolic disorder in the current fast paced culture;
its prevalence is escalating worldwide and among all age groups. Guidelines recommend universal
screening for diabetes; however, the uptake of these tests in individuals suggests challenges owing
to invasive nature of blood collection. Thus, there arises the need for a noninvasive investigation
for diabetes screening with a minimum paraphilia and for all medical settings.
Materials and Methods: We have thus conducted a systematic review and meta‑analysis according
to Preferred Reporting Items for Systematic Reviews and Meta‑Analysis guidelines, to quantify the
association between diabetes and effectiveness of periodic acid–Schiff staining of exfoliative cytology
as a screening method. MEDLINE, EMBASE, Cochrane, Scopus, Web of science, CINAHL, and Google
Scholar were searched systematically for publications dated till July 20, 2022. Six studies (case–
control cross‑sectional) were selected and evaluated in depth. The statistical evaluation was done
with a forest plot with odds ratio and weightage examined.
Results: It was proved that exfoliative cytology with periodic acid–Schiff (PAS) staining can be used
as a screening test for diabetic status evaluation. The findings suggest that the aforesaid noninvasive
test is a conclusive screening practice for diabetics.
Conclusion: This systematic review and meta‑analysis suggest that PAS staining in exfoliative
cytology can be used as a noninvasive screening in diabetic individuals to assess the current level of
blood glucose. Given the increased risk of diabetes worldwide, higher quality prospective evidence
is suggested in larger sample sizes with other metabolic disorders, ethnicity, and oral disorders to
further evaluate the plausibility of the results.
Key Words: Cytology, diabetes mellitus, diagnosis, exfoliative cytology, noninvasive, periodic
acid–Schiff staining

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K. Yesoda Aniyan: Pubmed,Google Scholar