Comparative study on the efficacy of tissue autofluorescence (visually enhanced lesion scope) and toluidine blue as a screening method in oral potentially malignant and malignant lesions

Objective and Study Design: Early identification of high-risk disease could greatly reduce both mortality and morbidity due to oral cancer. Hence, screening of such lesions and their early detection could improve prognosis. Metachromatic dye toluidine blue, which stains nuclear material in dysplastic epithelium, is widely used for screening of potentially malignant lesions. Visually enhanced lesion scope (VELscope) that identifies reduction in tissue fluorescence in dysplasia can also prove to be effective in screening for potentially malignant lesions. Hence, this study was done to compare the reliability of VELscope and toluidine blue as a screening tool in the diagnosis of malignant and potentially malignant lesions as compared to histopathological diagnosis which is gold standard. Materials and Methods: 90 patients with tobacco associated hyperkeratotic red and white lesion, ulcerative lesion, and frank malignancy included in study. Patients were subject to Tissue Autofluorescence (Visually Enhanced Lesion Scope) and Toluidine Blue stain tests. Nature of Autofluorescence and Toluidine Blue staining of tissue was recorded. Based on findings tissue was biopsied and examined under microscope from confirmatory diagnosis. Results: In this study, ninety patients with malignant and potentially malignant lesions were studied, VELscope showed 85.36% sensitivity and 75% specificity as compared to toluidine blue which showed 83.13% sensitivity and 87.5% specificity. The results were statistically significant (P < 0.001) with a mean deviation of ± 3. Conclusion: From the study, we concluded that VELscope was more effective as a screening tool for the detection of oral malignant lesions as compared to toluidine blue.

Abstract licence: CC BY-NC-SA

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