Published: 2019-10-23

The study of use of toluidine blue as an adjunctive tool to clinical examination in early diagnosis of clinically suspicious oral premalignant and malignant lesions: a study of fifty cases

Himanshu Chhagan Bayad, Sanjeev Bhagat, Dimple Sahni, Navneet Kaur, Ravinder Singh, Dinesh Kumar Sharma, Baldev Singh


Background: Oral carcinoma is among the most prevalent malignancies of head and neck region and is often diagnosed in the advanced stage with significant morbidity and treatment cost. Thus, there is a need for early detection of oral premalignant and malignant lesions. Toluidine blue staining can be used for early detection of these lesions.

Methods: The study included 50 patients with clinically suspicious oral premalignant and malignant lesions. These lesions were subjected to toluidine blue staining and biopsy. Diagnoses were confirmed by histopathological examination.  

Results: Sensitivity and specificity of toluidine blue for oral premalignant lesions was 92.30% and 80% respectively with the positive predictive value of 92.30%, negative predictive value of 80% and accuracy of 88.88%. Sensitivity and specificity of toluidine blue for oral malignant lesions was 96.30% and 80% respectively with the positive predictive value of 96.30%, negative predictive value of 80% and accuracy of 93.75%.

Conclusions: The simplicity of toluidine blue staining and its accuracy suggest that it can be a useful adjunctive tool to diagnosis of oral lesions. Results should be carefully evaluated and correlated with clinical findings and histopathological diagnosis.


Toluidine blue, Leukoplakia, Erythroplakia, Squamous cell carcinoma, Early detection, Adjunctive tool

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