Abstract
The objective was to compare toluidine blue (TB) and autofluorescence (AF) for the detection of oral dysplasia and squamous cell carcinoma (OSCC) in clinically suspicious lesions according to conventional examination. Fifty-six clinically suspicious lesions were subjected to AF and TB examination. Data were compared using two different scenarios: in the first, mild dysplasia was considered as positive, while in the second, it was considered as negative. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), accuracy, and concordance were calculated. AF sensitivity and specificity were 70.0 and 57.7%, respectively, while TB showed a sensitivity of 80% and a specificity of 61.5%. The sensitivity increased in the second scenario in both AF (76.5%) and TB (88.2%). The specificity decreased in AF and TB, showing the same value (51.3%). PPV was higher in TB than in AF (70.6 versus 65.6%) and similarly for NPV (72.7 versus 62.5%). In the second scenario, TB PPV was 44.1% and NPV was 90.9%; AF PPV was 40.6% and NPV was 83.3%. TB showed greater accuracy than AF in the first scenario (62.5 versus 58.9%). AF and TB are both sensitive but not specific in OSCC and dysplasia diagnosis.
Highlights
Survival rates for oral squamous cell carcinoma (OSCC) have not shown significant improvement over the past 50 years: the 5-year and 10-year relative survival rates are 59 and 48%, respectively.[1]
The aim of this study was to compare Toluidine blue (TB) and AF in the detection of oral dysplasia and oral dysplasia and squamous cell carcinoma (OSCC) in clinically suspicious lesions according to conventional light examination
The histopathologic evaluation revealed the absence of dysplasia and/or OSCC in 26 lesions (46.4%)
Summary
Survival rates for oral squamous cell carcinoma (OSCC) have not shown significant improvement over the past 50 years: the 5-year and 10-year relative survival rates are 59 and 48%, respectively.[1] This is paradoxical if we consider that an effective screening for OSCC is a simple noninvasive procedure, which needs only a 5-min visual inspection of the oral mucosa with lighting, gauze, and gloves.[2] Adjunctive screening technologies have contributed in the last decades to the decrease of death rates in several malignant pathologies. Additional noninvasive techniques for the OSCC have been proposed to increase the visual inspection sensitivity and specificity.[3]. Introduced in 1964 by Niebel and Chomet, TB can be considered as the dean of the auxiliary techniques employed in the detection of OSCC. Positive lesions are stained in royal blue, while the negative ones appear pale blue or do not capture the dye.[5]
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