Chemiluminescence and Toluidine Blue as Diagnostic Tools for Detecting Early Stages of Oral Cancer: An invivo Study

Abstract

Background: There is a need for development and use of diagnostic aids that help the dental specialist more readily identify and assess Potentially Malignant Epithelial Lesions (PMELs) and Oral Squamous Cell Carcinoma (OSCC). This study was done to assess the value of two such commercially available tools: chemiluminescent light kit or ViziLite and 1% toluidine blue.

Aims and objectives: a) To detect epithelial dysplastic changes using chemiluminescene (commercially available as ViziLite) and toluidine blue staining in PMELs and OSCC patients and compare the results obtained with histopathological examination. b) To determine whether these techniques can be used to detect early epithelial dysplastic changes in clinically normal appearing oral mucosa of high risk (with habits) patients.

Materials and methods: A total of 60 patients- 25 patients with PMELs, specifically oral leukoplakia, 10 patients with clinically diagnosed OSCC and 25 high risk patients with no clinically visible lesion, were screened with ViziLite and toluidine blue staining; followed by incisional biopsy.

Results: Sensitivity and specificity of ViziLite were calculated to be 95.45% and 84.6% respectively. ViziLite detected early epithelial dysplastic changes in one high risk patient with clinically normal appearing oral mucosa. Sensitivity and specificity of toluidine blue were calculated to be 86.36% and 76.9% respectively.

Conclusion: ViziLite was relatively reliable in screening PMELs compared to toluidine blue, and was a useful chair side diagnostic aid.

Keywords: Chemiluminescence; OSCC; PMELs; Toluidine blue; ViziLite.

[Table/Fig-1]:

Traumatic ulcer on lateral border of tongue, suspected of malignancy;

[Table/Fig-2]:

Aceto-white delineation of borders on ViziLite testing;

[Table/Fig-3]:

Retention of toluidine blue stain in the floor of the ulcer

[Table/Fig-4]:

Histopathological picture of Squamous Cell Carcinoma;

[Table/Fig-7]:

No clinically visible lesion

[Table/Fig-8]:

Aceto-white appearance seen on commissure of lip, on ViziLite testing

[Table/Fig-9]:

Retention of toluidine blue stain in commissure of lip

[Table/Fig-10]:

Histopathological picture of mild dysplasia