title: Acetic acid as an adjunct vital stain in diagnosis of tobacco-associated oral lesions: A pilot study.
abstract: BACKGROUND
  One of the most important risk factors for oral precancer and cancer in India is the use of tobacco. In chronic tobacco users, the mucosa may appear clinically healthy, however, changes are observed histologically. Screening of such tobacco users for an early diagnosis is, therefore, of paramount importance. Several adjunctive diagnostic modalities have been used in the past, but none has been conclusively validated as confirmative and cost-effective screening methodology. The aim of this study was to evaluate the use of 5% acetic acid as a vital staining agent in tobacco-associated oral lesions.
  
  
  METHODS
  The study subjects were divided into two groups. Group I (n = 40) subjects with a history of chronic tobacco use and clinically apparent normal mucosa. Group II (n = 40) subjects suspected of having oral cancer, 5% acetic acid was applied to the mucosa/lesions, followed by incisional biopsy for confirmatory diagnosis.
  
  
  RESULTS
  The sensitivity and specificity for Groups I and II were 97%, 50% and 95%, 60%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) of Group I were 0.95 and 0.66. Group II showed PPV and NPV of 0.95 and 0.60.
  
  
  CONCLUSIONS
  The results of this study suggest that acetic acid holds promise for future. Hence, further studies are needed to be undertaken on a large scale to assess its potential as a screening tool for high-risk individuals and oral cancer.
authors.affiliation: Department of Oral Pathology and Microbiology, Buraydah Private Dental College, Qassim, Kingdom of Saudi Arabia.
authors.forename: D P
authors.initials: DP
authors.lastname: Vinuth
authors.affiliation: Department of Oral Medicine and Radio Diagnosis, Buraydah Private Dental College, Qassim, Kingdom of Saudi Arabia.
authors.forename: Poonam
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: Department of Oral Pathology and Microbiology, KLE VK Dental College, Belgaum, Karnataka, India.
authors.forename: Alka D
authors.initials: AD
authors.lastname: Kale
authors.affiliation: Department of Oral Pathology and Microbiology, KLE VK Dental College, Belgaum, Karnataka, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Hallikeramath
authors.affiliation: Department of Oral Pathology, AIIMS, New Delhi, India.
authors.forename: Deepika
authors.initials: D
authors.lastname: Shukla
keywords: Acetic acid; oral cancer; precancer; tobacco; vital stain