The application of toluidine blue as a diagnostic adjunct in the detection of epithelial dysplasia

Martin, I.C.; Kerawala, Cyrus; Reed, Malcolm

doi:10.1016/s1079-2104(98)90071-3

Cited by 120 publications

(66 citation statements)

References 10 publications

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“…Toluidine blue is highly sensitive and moderately specific for malignant lesions. The sensitivity is decreased for premalignant lesions with up to 58% false negative reported for identifying mildto-moderate dysplasia [42,43]. Rosenberg and Cretin stated that the sensitivity of toluidine blue staining in oral cancer screening has been found to range from 93.5% to 97.8%, and to specificity ranged from 73.3% to 92.9% [44].…”

Section: Toluidine Blue (Tb)mentioning

confidence: 99%

The Outline of Prognosis and New Advances in Diagnosis of Oral Squamous Cell Carcinoma (OSCC): Review of the Literature

Omar

2013

Journal of Oral Oncology

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Objective. Oral squamous cell carcinoma (OSCC) has a remarkable incidence over the world and a fairly strenuous prognosis, encouraging further research on the prognostic factors and new techniques for diagnosis that might modify disease outcome. Data Sources. A web-based search for all types of articles published was initiated using Medline/Pub Med, with the key words such as oral cancer, prognostic factors of oral cancer, diagnostic method of oral cancer, and imaging techniques for diagnosis of oral cancer. The search was restricted to articles published in English, with no publication date restriction (last update April, 2013). Review Methods. In this paper, I approach the factors of prognosis of OSCC and the new advances in diagnostic technologies as well. I also reviewed available studies of the tissue fluorescence spectroscopy and other noninvasive diagnostic aids for OSCC. Results. The outcome is greatly influenced by the stage of the disease (especially TNM). Prognosis also depends or varies with tumour primary site, nodal involvement, tumour thickness, and the status of the surgical margins. Conclusion. Tumour diameter is not the most accurate when compared to tumour thickness or depth of invasion, which can be related directly to prognosis. There is a wide agreement on using ultrasound guided fine needle aspiration biopsies in the evaluation of lymph node metastasis.

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Section: Toluidine Blue (Tb)mentioning

confidence: 99%

The Outline of Prognosis and New Advances in Diagnosis of Oral Squamous Cell Carcinoma (OSCC): Review of the Literature

Omar

2013

Journal of Oral Oncology

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“…It is noteworthy that, there were equivocal or weakly staining results in several studies of toluidine blue, which were controversial to be defined as positive or negative results. 6,16,21,26,31 In study of Epstein et al, 6 there were 20 equivocal results in 81 lesions, relatively large proportion of equivocal results might confuse the clinicians to accurately evaluate its efficacy.…”

Section: Discussionmentioning

confidence: 99%

Rose bengal staining in detection of oral precancerous and malignant lesions with colorimetric evaluation: A pilot study

Chen

et al. 2007

Intl Journal of Cancer

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Early detection of oral precancerous and malignant lesions is still a diagnostic challenge for most of clinicians, and ideal adjuncts for detection of these lesions are currently unavailable. Our preliminary study has indicated that rose bengal (RB) staining might have the potency as a diagnostic aid; however, its clinical significance and reliability in hospital-based population are still not clear. In the present study, we investigated the efficacy of RB staining in detection of oral precancerous and malignant lesions. RB staining was conducted in 132 patients, and staining results were determined by a 4-graded shade guide, which had been quantitatively measured in the 1976 CIEL*a*b* space by instrumental colorimetry. Histological examination was performed in 128 of 132 patients after RB staining. The sensitivity and specificity to detect epithelial dysplasia (DP) and oral squamous cell carcinoma were 93.9 and 73.7%, respectively. The positive and negative likelihood ratios were 3.570 and 0.082, respectively. Moreover, RB staining seemed promising to detect DP in oral leukoplakia, lichen planus and leukokeratosis. In this study, 5 of 6 DP or oral squamous cell carcinoma were identified by RB staining before histological examination. In conclusion, RB staining may be a valuable diagnostic test in detection of oral precancerous and malignant lesions. ' 2007 Wiley-Liss, Inc.Key words: rose bengal; early detection; oral squamous cell carcinoma; epithelial dysplasia; colorimetry It was estimated that cancer of the head and neck, including all oral, laryngeal and pharyngeal sites, is the fifth most common cancer, accounting for about 615,000 new cases annually. 1 About 40% of head and neck malignancies are known to be squamous cell carcinomas (SCCs) arising in the oral cavity, 1 and it has one of the lowest survival rates, 50%, within a 5-year period. 2 These survival rates have remained relatively unchanged for the past 3 decades, probably because of late recognition of the disease. Consequently, emphasis has been placed on early detection and diagnosis of precancerous lesions and early stages of oral cancer. Nevertheless, oral epithelial lesions have many different presentations, such that clinical variants require diagnostic tests beyond visual examination to obtain definitive diagnoses. [3][4][5] Adjuncts for detection of lesions and selection of biopsy sites include toluidine blue staining, exfoliative cytology and other recently emerging techniques. But because of various reasons, such as less effective when used in oral precancerous lesions, inevitably bewildered when equivocal results occurred, 4,6 these techniques have not been accepted all over the world at present.Rose bengal (RB), the 4,5,6,7-tetrachloro-2 0 ,4 0 ,5 0 ,7 0 -tetraiododerivative of fluorescein, has been widely used to diagnose various ocular surface disorders. 7 It has been believed to stain desquamated ocular epithelial cells, dead or degenerated cells but not healthy epithelial cells, or wherever there is poor protection of the surface e...

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“…In vivo, Toluidine Blue stains deoxyribonucleic and nucleic acids and may be retained in intracellular spaces of dysplastic epithelium [53][54][55][56].…”

Section: Disadvantagesmentioning

confidence: 99%

Diagnostic Modalities for Squamous Cell Carcinoma: An Extensive Review of Literature-Considering Toluidine Blue as a Useful Adjunct

Chhabra

Sapra

2014

J. Maxillofac. Oral Surg.

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Introduction Oral Squamous Cell Carcinomas have been considered as the most prevalent malignancies in the head and neck region and are frequently undiagnosed until symptomatic with an advanced stage of disease. So there is an urgent need to device methods for the detection of oral premalignant lesions and oral cancer at an early stage in order to improve the survival rate for patients. A number of tests have been done for the detection of oral cancer which include oral brush biopsy, the Vizilite, oral autofluorescence including chemiluscence, photodynamic detection, toluidine blue staining, methylene blue staining, incisional biopsy and many more. Material The article reviews various diagnostic modalities available at present for detection of squamous cell carcinomas and oral epithelial dysplasias based on advanced PUBMED search of the English language literature from the year 1972 to present in order to help us select the most suitable among them fulfilling the desired criteria of being non-invasive, highly specific and sensitive, economically viable, having a scope to be used for mass screening, easy to process, having low inter examiner variability and possibly not requiring high expertise to conduct and interpret the results. Conclusion After reviewing various diagnostic modalities, we conclude that toluidine blue staining emerges as a clear winner among all these and it can act as a valuable adjunct to incisional biopsy in detection of oral cancer and may not substitute it except in certain circumstances when its results are carefully correlated with the patient history and clinical characteristics of the mucosal disorder, considering the fact that incisional biopsy has been reported to cause dissemination of cancer cells in the circulation there by increasing the possibility of metastasis. We must emphasize that toludine blue is a screening modality and not a diagnostic procedure like biopsy and hence cannot replace a confirmatory biopsy as a whole

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The application of toluidine blue as a diagnostic adjunct in the detection of epithelial dysplasia

Cited by 120 publications

References 10 publications

The Outline of Prognosis and New Advances in Diagnosis of Oral Squamous Cell Carcinoma (OSCC): Review of the Literature

The Outline of Prognosis and New Advances in Diagnosis of Oral Squamous Cell Carcinoma (OSCC): Review of the Literature

Rose bengal staining in detection of oral precancerous and malignant lesions with colorimetric evaluation: A pilot study

Diagnostic Modalities for Squamous Cell Carcinoma: An Extensive Review of Literature-Considering Toluidine Blue as a Useful Adjunct

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