Quantitative evaluation of consistency of early invasive carcinoma of the tongue

Abstract

Background. This study quantitatively evaluated the consistency of early invasive carcinoma of the tongue to enable the early detection of tongue cancer. Methods. The study population comprised 18 patients with early invasive squamous cell carcinoma of the tongue, 8 with lichen planus, 27 with leukoplakia, and 56 with advanced squamous cell carcinoma. All patients were examined with an instrument that measured consistency as a function of the load (in grams) needed to displace tongue mucosa by 2.0 mm, with a probe 2.0 mm in diameter. The consistency of early invasive carcinoma was compared with the consistency of normal mucosa and the consistency of the other tongue disease lesions. Consistency was also analyzed in relation to lesion size (diameter), clinical type, and histologic characteristics (grade of keratinization in the surface keratinized layer, degree of lymphoplasmacytic infiltration, and tumor thickness). Results. The mean values for the consistency of early invasive carcinoma, normal mucosa, lichen planus, leukoplakia, and advanced carcinoma lesions were 11.6 ± 2.3, 4.9 ± 0.7, 5.1 ± 0.4, 8.3 ± 2.0, and 25.4 ± 8.5 g, respectively. Early invasive carcinoma was firmer than normal mucosa (P < 0.001), lichen planus (P = 0.017), and leukoplakia (P = 0.087). Advanced carcinoma was firmer than early invasive carcinoma (P < 0.001). In early invasive carcinoma, tumors more than 1-mm-thick were significantly firmer than those less than 1-mm-thick (P = 0.013). Conclusions. This study demonstrated differences in consistency between early invasive carcinoma of the tongue and the lesions of other tongue diseases. Preoperative quantification of tumor consistency by this method could be helpful for the clinical diagnosis of early carcinoma of the tongue.