Role of vital staining in diagnosis oral cancers

Dr. Nupur Agarwal, M.D.S., completed her post graduation in the Department of Oral Medicine and Radiology from Institute of Dental Sciences, India. She has worked on oral cancer for more than five years and is presently working as Assitant Professor at Teerthankar Mahaveer Dental College and Research Centre, India.

Oral cancer is a common cancer of global concern. It is the sixth most common malignancy worldwide. Oral Leukoplakia has been studied for many years and is commonly agreed upon as representing the most common premalignant oral mucosal lesion. The study group consisted of 50 patients, out of which 25 patients were diagnosed clinically as leukoplakia and erosive lichen planus and 25 patients were diagnosed clinically as malignant lesions. In the present study the sensitivity of Toluidine blue in detecting premalignant or malignant lesions was 98% and overall specificity of TB was found to be 60%.The PPV and NPV Were 96% and 75% respectively. In our study the overall sensitivity of lugol s iodine when used consecutively with toluidine blue in detecting dysplasia or malignant lesions was 93% while specificity was 60% and PPV and NPV and Diagnostic accuracy was 93%, 40% and 90% respectively. Toluidine Blue staining helps in diagnosing premalignant lesions and is highly reliable source for the detection of in situ and invasive carcinomas. Lugol s iodine when used with Toluidine blue helps in delineating the borders of the lesion thus helps in determining the extent of the lesion.