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Utility of toluidine blue as a diagnostic adjunct in the detection of potentially malignant disorders of the oral cavity--a clinical and histological assessment.

Abstract

BACKGROUND
 The value of chairside adjunctive tests in the detection of oral potentially malignant disorders (OPMDs) remains uncertain.
OBJECTIVES
 To determine the effectiveness of toluidine blue in detecting leukoplakia and erythroplakia and its accuracy in identifying cases with oral epithelial dysplasia.
MATERIALS AND METHODS
 Ninety-two patients attending two oral medicine clinics in London, presenting with white and red patches of the oral mucosa, were investigated by the application of toluidine blue. Eighty-two patients were clinically diagnosed as OPMDs and 10 were frictional keratoses. A surgical biopsy was performed to assess epithelial dysplasia.
RESULTS
Of 64 oral leukoplakias, 34 (53.1%) were positive for toluidine blue and among nine erythroplakias seven stained positive. Of 41 oral dysplasia cases, a little more than half of the lesions (n = 23) were stain positive, an estimated sensitivity of 56.1%. TBlue test had a higher sensitivity for detecting higher-grade dysplastic lesions (5/8 moderate dysplasia, sensitivity 62.5%; 5/7 severe dysplasia; sensitivity 71.4%) compared with lower grades of dysplasia, but the differences were not significant (P = 0.60).
CONCLUSIONS
We report here the utility of TBlue for the detection of oral leukoplakia and erythroplakia. The test has the potential to detect OPMDs and yielded a sensitivity of 56.1% and specificity of 56.9% to detect oral epithelial dysplasia.

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  • Publisher Full Text

    • Authors

    Awan Kh, Yang Y, Morgan P, Warnakulasuriya S

    Institution

    Oral Medicine and Head & Neck Pathology, Department of Clinical & Diagnostic Sciences, King's College London Dental Institute, London, UK.

    Source

    Oral diseases 18:8 2012 Nov pg 728-33

    MeSH

    Acetic Acid
    Alcohol Drinking
    Biopsy
    Coloring Agents
    Cytodiagnosis
    Epithelium
    Erythroplasia
    Female
    Humans
    Leukoplakia, Oral
    Male
    Mouth Mucosa
    Mouth Neoplasms
    Precancerous Conditions
    Sensitivity and Specificity
    Smoking
    Tolonium Chloride

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    22524200