Kh Awan1, Yh Yang, Pr Morgan, S Warnakulasuriya. 1. Oral Medicine and Head & Neck Pathology, Department of Clinical & Diagnostic Sciences, King's College London Dental Institute, London, UK.
Abstract
BACKGROUND: The value of chairside adjunctive tests in the detection of oral potentially malignant disorders (OPMDs) remains uncertain. OBJECTIVES: To determine the effectiveness of toluidine blue in detecting leukoplakia and erythroplakia and its accuracy in identifying cases with oral epithelial dysplasia. MATERIALS AND METHODS: Ninety-two patients attending two oral medicine clinics in London, presenting with white and red patches of the oral mucosa, were investigated by the application of toluidine blue. Eighty-two patients were clinically diagnosed as OPMDs and 10 were frictional keratoses. A surgical biopsy was performed to assess epithelial dysplasia. RESULTS: Of 64 oral leukoplakias, 34 (53.1%) were positive for toluidine blue and among nine erythroplakias seven stained positive. Of 41 oral dysplasia cases, a little more than half of the lesions (n = 23) were stain positive, an estimated sensitivity of 56.1%. TBlue test had a higher sensitivity for detecting higher-grade dysplastic lesions (5/8 moderate dysplasia, sensitivity 62.5%; 5/7 severe dysplasia; sensitivity 71.4%) compared with lower grades of dysplasia, but the differences were not significant (P = 0.60). CONCLUSIONS: We report here the utility of TBlue for the detection of oral leukoplakia and erythroplakia. The test has the potential to detect OPMDs and yielded a sensitivity of 56.1% and specificity of 56.9% to detect oral epithelial dysplasia.
BACKGROUND: The value of chairside adjunctive tests in the detection of oral potentially malignant disorders (OPMDs) remains uncertain. OBJECTIVES: To determine the effectiveness of toluidine blue in detecting leukoplakia and erythroplakia and its accuracy in identifying cases with oral epithelial dysplasia. MATERIALS AND METHODS: Ninety-two patients attending two oral medicine clinics in London, presenting with white and red patches of the oral mucosa, were investigated by the application of toluidine blue. Eighty-two patients were clinically diagnosed as OPMDs and 10 were frictional keratoses. A surgical biopsy was performed to assess epithelial dysplasia. RESULTS: Of 64 oral leukoplakias, 34 (53.1%) were positive for toluidine blue and among nine erythroplakias seven stained positive. Of 41 oral dysplasia cases, a little more than half of the lesions (n = 23) were stain positive, an estimated sensitivity of 56.1%. TBlue test had a higher sensitivity for detecting higher-grade dysplastic lesions (5/8 moderate dysplasia, sensitivity 62.5%; 5/7 severe dysplasia; sensitivity 71.4%) compared with lower grades of dysplasia, but the differences were not significant (P = 0.60). CONCLUSIONS: We report here the utility of TBlue for the detection of oral leukoplakia and erythroplakia. The test has the potential to detect OPMDs and yielded a sensitivity of 56.1% and specificity of 56.9% to detect oral epithelial dysplasia.
Authors: Richard Macey; Tanya Walsh; Paul Brocklehurst; Alexander R Kerr; Joseph L Y Liu; Mark W Lingen; Graham R Ogden; Saman Warnakulasuriya; Crispian Scully Journal: Cochrane Database Syst Rev Date: 2015-05-29
Authors: Tanya Walsh; Richard Macey; Alexander R Kerr; Mark W Lingen; Graham R Ogden; Saman Warnakulasuriya Journal: Cochrane Database Syst Rev Date: 2021-07-20
Authors: Craig Murdoch; Brian H Brown; Vanessa Hearnden; Paul M Speight; Katy D'Apice; Anne M Hegarty; John A Tidy; T Jamie Healey; Peter E Highfield; Martin H Thornhill Journal: Int J Nanomedicine Date: 2014-09-23