USE OF FLUORESCEIN DYE IN DETECTION OF ORAL DYSPLASIA AND ORAL CANCER

Abstract

Objectives Photodetection has played role in detection and localization of various tumors of the body like ovarian cancer, breast cancer etc. but there is paucity of information regarding its use to identify oral cancer and dysplasia. Thus, we hypothesized that fluorescence dye can be helpful in detecting early potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) after topical application. Findings We included 83 individuals of Indian origin which comprised 33 OPMD, 30 OSCC and 20 controls in the study. After obtaining ethical clearance from institutional review board, all patients recruited in study were examined by the investigators regarding the lesion location and extent. After application of Fluorescein dye (0.25 ml of 20 % Fluorescein diluted in 4 ml of saline), the mouth was examined by the blue light to see the fluorescence and incisional biopsy was taken from the respective lesion and evaluated histologically. Moderate to intense fluorescein staining was seen in 83% histopathologically confirmed cases of Squamous cell carcinoma (25/30 cases) and 90% of dysplasia (9/10 cases) and 61% of hyperkeratosis (8/13 cases). Mild or no fluorescein staining was seen in 50% of mild dysplasia (3/6), 50% of OSMF (4/8), 67% of OLP (2/3) and 38% of hyperkeratosis (5/13) cases. No fluorescein staining was seen in 100% of control group. Test was found to be highly significant in diagnosing dysplasia and carcinoma compared to controls (p Conclusions We concluded that fluorescein dye staining is a simple, non-invasive test of the oral mucosa, which can help the experienced clinician to find oral precursor malignant lesions. It is a cost-effective measure and can be used for mass screening programs. It might help to identify most appropriate site of biopsy.