Detection of field alterations using useful tools for oral squamous cell carcinoma

Abstract

Summary It is known that a region of epithelial dysplasia cannot easily be distinguished macroscopically from normal looking area surrounding early oral squamous cell carcinoma (OSCC). In 1953, Slaughter emphasized field cancerization and the importance of examining the fields surrounding OSCC. Since 1997, we have used vital staining with iodine for detecting surgical margin and investigated the usefulness of this method. From a pathological point of view, various types of dysplasia in iodine unstained area (IU) surrounding OSCC was found. In oral mucosa, iodine–glycogen reaction does not occur in dysplastic mucosa due to the lack of glycogen granules in the cytoplasm of those cells. This area has high positive PCNA and p53 cells with malignant potentiality. More recently, since 2010, we have used fluorescence visualization (FV) with vital staining with iodine. This device can visualize epithelial dysplasia surrounding OSCC as fluorescence visualization loss (FVL). FVL has high positive Ki-67 and p53 cells with malignant potentiality. We suggest that FV has delineated various types of dysplasia and the delineation of surgical margin is the same or better than vital staining with iodine. Moreover, compared to vital staining with iodine, it is simple to use with no invasion.