title: Methylene Blue as a Diagnostic Aid in the Early Detection of Potentially Malignant and Malignant Lesions of Oral Mucosa.
abstract: BACKGROUND
  In vivo stains are the prompt resources, which have emerged in recent years to aid as clinical diagnostic tools in detecting early potentially malignant and malignant lesions. Toluidine blue, by its property of retaining in the increased DNA and RNA cellular activity areas, aids in delineating the suspicious areas. However, it is hazardous if swallowed, and has been shown to have toxicity to fibroblasts. Methylene blue has a similar chemical structure and exhibits similar physicochemical properties as toluidine blue. It is less toxic to the human body and has recently been proposed for screening some gastrointestinal or prostate tumors. The application of this material in detecting oral lesions has so far not been addressed. The objective of this study was to evaluate the sensitivity and reliability of in vivo staining with methylene blue as a diagnostic adjunct in screening for oral malignant or potentially malignant lesions.
  
  
  METHODS
  The present study involved the examination of 75 patients suspected of having oral malignant or potentially malignant lesions by methylene blue staining. The results of methylene blue uptake were compared with a simultaneous biopsy of these lesions.
  
  
  RESULTS
  The overall sensitivity was 95% (100% for malignancy and 92% for potentially malignant lesions) and specificity was 70%. The positive predictive value was 91% and negative predictive value of 80% was observed in the study.
  
  
  CONCLUSIONS
  We consider that methylene blue staining is a useful diagnostic adjunct in a large, community-based oral cancer screening program for high-risk individuals.
authors.affiliation: SDM College of Dental Sciences and Hospital, Dharwad.
authors.forename: Abraham
authors.initials: A
authors.lastname: Lejoy
authors.affiliation: Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi.
authors.forename: Rai
authors.initials: R
authors.lastname: Arpita
authors.affiliation: SDM College of Dental Sciences and Hospital, Dharwad.
authors.forename: Burde
authors.initials: B
authors.lastname: Krishna
authors.affiliation: SDM College of Dental Sciences and Hospital, Dharwad.
authors.forename: Naikmasur
authors.initials: N
authors.lastname: Venkatesh
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell; D003679:Deglutition; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008751:Methylene Blue / Q000009:adverse effects; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000175:diagnosis*; D012306:Risk; D014048:Tolonium Chloride / Q000633:toxicity; D055815:Young Adult
chemical_list: D014048:Tolonium Chloride; D008751:Methylene Blue
keywords: Methylene blue; Oral malignant; Potentially malignant