title: The use of toluidine blue in the detection of pre-malignant and malignant oral lesions.
abstract: BACKGROUND
  The purpose of this study was to evaluate the efficacy of the toluidine blue (TB) test as a diagnostic tool in the detection of malignant and dysplastic lesions of the oral cavity. This study was carried out because of a lack of consensus among different authors on the utility of TB, as well as to determine useful adjuncts to detect oral pre-cancer and cancer.
  
  
  METHODS
  The study included 160 patients with oral mucosal disorders that included suspicious or malignant lesions detected at clinical visual examination, confirmed by histopathological evaluation. All lesions were submitted to TB staining.
  
  
  RESULTS
  The sensitivity and specificity for the detection of malignant or dysplastic lesions by this test were 65.5% and 73.3%, respectively. Overall, the detection rate with TB (sensitivity) was slightly lower compared with those reported by other authors but the specificity was comparable to several reports. Positive predictive value (35.2%) was also lower than previous studies, whereas negative predictive value (90.6%) was similar.
  
  
  CONCLUSIONS
  The simplicity of the test procedure and the validity of derived values suggest TB staining can be a valuable adjunct to the diagnostic process, as long as it is carefully correlated with the clinical characteristics of the mucosal disorder and histopathological diagnosis.
authors.affiliation: Faculty of Dentistry, Department of Medicine and Buccofacial Surgery, Complutense University of Madrid, Madrid, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Cancela-Rodríguez
authors.forename: Rocío
authors.initials: R
authors.lastname: Cerero-Lapiedra
authors.forename: Germán
authors.initials: G
authors.lastname: Esparza-Gómez
authors.forename: Silvia
authors.initials: S
authors.lastname: Llamas-Martínez
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D004396:Coloring Agents; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014048:Tolonium Chloride; D055815:Young Adult
chemical_list: D004396:Coloring Agents; D014048:Tolonium Chloride