A CLINICOPATHOLOGICAL STUDY FOR EARLY DIAGNOSIS OF ORAL PRECANCEROUS AND CANCEROUS LESIONS USING TOLUIDINE BLUE AND CONFIRMING WITH HISTOPATHOLOGICAL EXAMINATION
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Keywords
Oral cancer, Toluidine blue staining, Early detection, Histopathology, Diagnostic tools
Abstract
Background: Oral cancer, the sixth most common malignancy globally, has one of the lowest 5-year survival rates, primarily due to delayed diagnosis. Early detection and intervention are critical for improving survival, yet current diagnostic methods often fall short. This study aimed to evaluate the effectiveness of a 1% Toluidine blue solution for detecting dysplastic oral lesions and to compare its results with histopathological findings.
Methods: A prospective analytical study was conducted with 100 patients presenting with symptoms of oral premalignant or malignant lesions at the Department of Otorhinolaryngology, Index Medical College Hospital and Research Centre, Indore. Each patient underwent Toluidine blue staining followed by biopsy for histopathological evaluation. The diagnostic performance of Toluidine blue was assessed for sensitivity, specificity, PPV and NPV.
Results: The mean age of participants was 45.55 ± 12.08 years, with a predominance of males (71.0%) and rural residents (77.0%). Lesions were most frequently located on the buccal mucosa (36.0%) and the lateral border of the tongue (35.0%). Toluidine blue staining was positive in 74% of cases. The sensitivity of Toluidine blue staining for detecting precancerous or cancerous lesions was 80.6%, with a specificity of 75.0%. The PPV was 95.9%, and the NPV was 34.6%. A Cohen's kappa value of 0.370 (p < 0.05) indicated fair agreement between Toluidine blue staining results and histopathological diagnoses.
Conclusion: Toluidine blue staining is a simple, non-invasive method effective in detecting high-risk oral lesions and aiding early oral cancer diagnosis. Further research is needed to enhance its diagnostic accuracy and evaluate its use in various healthcare settings.
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Dr Navin Agrawal
Professor & HOD, Department of Otorhinolaryngology, Index Medical College Hospital & Research Centre, Indore.
Dr Chhavi Agrawal
Professor, Department of Otorhinolaryngology, Index Medical College Hospital & Research Centre, Indore.
Dr Rishi Mahor
Junior Resident, Department of Otorhinolaryngology, Index Medical College Hospital & Research Centre, Indore
Dr Harsh Dudhat
Junior Resident, Department of Otorhinolaryngology, Index Medical College Hospital & Research Centre, Indore
Dr Rohit Maheshwari
Junior Resident, Department of Otorhinolaryngology, Index Medical College Hospital & Research Centre, Indore
Dr Paras Singhal
Junior Resident, Department of Otorhinolaryngology, Index Medical College Hospital & Research Centre, Indore
Dr Arsh Jodhawat
Junior Resident, Department of Otorhinolaryngology, Index Medical College Hospital & Research Centre, Indore