Reliability of toluidine blue and colposcopy in determining biopsy site among patients with oral leukoplakia – A comparative study

Abstract

Background: To date, no simple and reliable method can replace oral biopsy site detection using Toluidine blue for early identification and treatment of potentially malignant oral disorders (OPMDs). Aims and Objectives: The study was conducted to assess the feasibility of using the colposcope and compare the findings with the toluidine blue staining method for selecting the biopsy site. Materials and Methodology: Study group included 30 patients; five patients dropped out as regression was seen in the lesion. Twenty patients with homogenous leucoplakia and five patients with nonhomogenous Leukoplakia formed a study group. An area with the most extensive cell change in the colposcopic examination was selected by the first version, Image J 1. x Software. After toluidine, blue staining was done. Dark blue-stained sites were considered positive, and site selection for the biopsy was made. Results: Normal vascular pattern in six (24%) cases, 10 (40%) cases showing punctuate vascular pattern, four (16%) of cases showed the mosaic vascular pattern, five (20%) of cases were with the atypical vascular pattern were assessed in colposcopic examination with statistically significant P value (0.009). Fourteen cases out of 20 cases of homogenous and all five cases of nonhomogenous leukoplakia were correctly diagnosed for the biopsy site with both toluidine blue and colposcopic techniques. Conclusion: In this study, Toluidine blue and colposcopic technique showed 76% accuracy for detecting the biopsy site. So colposcope can be an alternative diagnostic aid to toluidine blue in detecting biopsy sites for PMD.

Keywords

• biopsy
• colposcope
• oral potentially malignant disorders
• toluidine blue