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. 2025 Jun;17(Suppl 2):S1310-S1312.
doi: 10.4103/jpbs.jpbs_1951_24. Epub 2025 Jun 18.

Comparative Analysis of Different Staining Techniques for Diagnosing Oral Cancer in Tissue Sections

George Jacob  1 , Deena C Thomas  2 , Shiana Jo  3 , Aswathy Kallaliel Vijayan  3 , Amitha Mohan  4 , Sonu M Mohan  5
Affiliations

Comparative Analysis of Different Staining Techniques for Diagnosing Oral Cancer in Tissue Sections

George Jacob et al. J Pharm Bioallied Sci. 2025 Jun.

Abstract

Background: Oral cancer remains a significant health concern, often diagnosed at advanced stages due to delayed and inadequate diagnostic approaches. Histological staining techniques play a pivotal role in early and accurate detection. This study aims to compare the efficacy of hematoxylin and eosin (H and E), Periodic Acid-Schiff (PAS), and immunohistochemical (IHC) staining methods in identifying oral cancer in tissue sections.

Materials and methods: A total of 60 tissue samples were collected from patients with clinically and histologically confirmed oral cancer. These samples were divided into three groups, each stained with H and E, PAS, and IHC markers (p53 and Ki-67), respectively. The stained sections were evaluated for cellular morphology, nuclear detail, and differentiation grade by three independent pathologists. Quantitative and qualitative assessments were performed using a scoring system based on sensitivity, specificity, and overall diagnostic accuracy.

Results: H and E staining demonstrated a diagnostic accuracy of 85%, effectively identifying cellular morphology but lacking specificity for poorly differentiated carcinoma. PAS staining showed moderate diagnostic value, with 78% accuracy, primarily highlighting glycogen and mucopolysaccharides in tumor cells. IHC staining yielded the highest diagnostic accuracy at 93%, offering detailed nuclear and cytoplasmic features and aiding in identifying specific biomarkers (P < 0.05). Interobserver agreement was highest for IHC staining (κ = 0.92).

Conclusion: IHC staining proved to be the most reliable method for diagnosing oral cancer, with superior sensitivity and specificity compared to H and E and PAS techniques. The integration of IHC into routine diagnostic workflows can enhance early detection and improve treatment outcomes.

Keywords: Diagnostic techniques; hematoxylin and eosin; histological staining; immunohistochemistry; oral cancer; periodic acid-Schiff.

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Conflict of interest statement

There are no conflicts of interest.

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