The application of acetic acid in the detection of oral squamous cell carcinoma.
BACKGROUND
Oral cancer is the fourth most common cancer in males and the seventh most common cancer in females in Thailand. The survival rates and quality of life of oral cancer patients will significantly be improved if they receive treatment for lesions that are less advanced or premalignant. Early diagnosis is therefore of paramount importance. A number of techniques have been developed to supplement clinical examination for oral malignancy. One interesting screening method is the application of 3% to 5% acetic acid, which has been used for cervical cancer screening.


OBJECTIVE
The primary objective of this study was to assess the sensitivity, specificity, and accuracy of using vinegar (5% acetic acid) for the examination of oral cancer. The secondary objective was to investigate the association between clinical examination using acetic acid and expression of the tumor marker, p53.


METHODS
The study included 30 participants suspected of having oral squamous cell carcinoma. Five percent acetic acid was applied to the lesions, followed by incisional biopsy. The specimens were microscopically examined for pathological diagnosis and p53 immunohistochemical investigation.


RESULTS
The sensitivity, specificity, and accuracy of using acetic acid for oral cancer examination were 83.33%, 84.21%, and 83.64%, respectively. There was a statistically significant association between clinical examination using acetic acid and expression of p53 protein (P = .000).


CONCLUSIONS
The results of this study suggest that 5% acetic acid has high sensitivity, specificity, and accuracy in detecting oral squamous cell carcinoma and might be used as an adjunct for oral cancer examination.
Bhalang
Kanokporn
K
Department of Oral Medicine, Chulalongkorn University, Bangkok, Thailand. Bhalangk@dentistry.unc.edu
Suesuwan
Anocha
A
Dhanuthai
Kittipong
K
Sannikorn
Phakdee
P
Luangjarmekorn
Lakana
L
Swasdison
Somporn
S
D019342:Acetic Acid; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013785:Thailand; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis*
D016159:Tumor Suppressor Protein p53; D019342:Acetic Acid