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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 14  |  Issue : 5  |  Page : 182-184  

Evaluation of efficiency of dyes in detection of cancer cells: An original research


1 Department of Oral and Maxillofacial Surgery, Gitam Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
2 Department of Oral and Maxillofacial and Diagnostic Science, Faculty of Dentistry, Taif University, Taif, Kingdom of Saudi Arabia
3 Department of Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
4 Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, Qassim, Kingdom of Saudi Arabia
5 Executive MHA Student, IIHMR University, Jaipur, Rajasthan, India
6 Final Year Student, Master of Public Health, Parul Univeristy, Vadodara, Gujrat, India

Date of Submission08-Jan-2022
Date of Decision18-Jan-2022
Date of Acceptance14-Feb-2022
Date of Web Publication13-Jul-2022

Correspondence Address:
Sanjay D Gabhale
Department of Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune - 411 018, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_60_22

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   Abstract 


Introduction: The early detection of the cancer will dramatically improve the prognosis. There are many diagnostic aids that can be employed for screening. Hence, in our study, we aim to evaluate the efficiency of dyes in detection of cancer cells. Materials and Methods: We piloted a prospective clinical study among 30 subjects to detect the efficiency of two dyes—Lugol's iodine and toluidine blue. They were grouped equally for potentially malignant and malignant lesions. The areas were analyzed for the diagnostic accuracy of the dyes using the histopathological examination and compared using chi square test deliberating P < 0.05 as significant. Results: We observed that both the dyes showed a diagnostic accuracy of over 90% when used alone or in combination. Both the dyes had greater sensitivity while specificity was 20%. Conclusion: The combination of these two dyes can be used as an efficient screening aid for the identification of the cancer cells.

Keywords: Cancer, Lugol's iodine, screening, toluidine blue


How to cite this article:
Ravindranath KV, Karpe T, Gabhale SD, Dutta SD, Tiwari RV, Javed MQ, Tiwari HD. Evaluation of efficiency of dyes in detection of cancer cells: An original research. J Pharm Bioall Sci 2022;14, Suppl S1:182-4

How to cite this URL:
Ravindranath KV, Karpe T, Gabhale SD, Dutta SD, Tiwari RV, Javed MQ, Tiwari HD. Evaluation of efficiency of dyes in detection of cancer cells: An original research. J Pharm Bioall Sci [serial online] 2022 [cited 2022 Aug 9];14, Suppl S1:182-4. Available from: https://www.jpbsonline.org/text.asp?2022/14/5/182/350472




   Introduction Top


Among the many cancers that affect the human body, majority if detected early are preventable. The oral cancer is one among such preventable cancers. The occurrence of the oral cancer is also on the raise in the southeast continents.[1],[2] Many studies have concluded the significance of the early detection in the prevention of the various cancers. There are various methods of the detection of the potentially malignant lesions that are common in the oral cancers. The detection using the dyes has been practiced for the screening of the cervical cancers.[3],[4] The dyes, Lugol's iodine and toluidine blue, are commonly used for the identification of the dysplastic cells that can be used in the screening of the oral cancers also.[5],[6] Hence, in our study, we aim to evaluate the efficiency of these dyes in detection of cancer cells.


   Materials and Methods Top


We piloted a prospective clinical study among 30 subjects with oral clinical suspicious lesions. The ethics clearance was obtained for the study. The subjects were explained of the study and the written consent was taken for the study. We selected the subjects of both the genders between the age groups 35 and 60 years. The red and white lesions that were suspicious of the malignancy (N = 15) and the malignant lesions (N = 15) were selected. The lesional area was prepared with 1% acetic acid later rinsed with water. Following the protocols, the dyes, Lugol's iodine and toluidine blue, were applied. After 20 s, photos were taken and biopsies performed. Later, the lesional areas were biopsied and checked for the severity. The retention was checked for all the slides. The values were compared using the IBM SPSS ver 20 applying chi square test deliberating P < 0.05 as significant.


   Results Top


The potentially malignant lesions constituted lichen planus, leukoplakia, and oral sub mucous fibrosis and the malignant lesions were of oral squamous cell carcinoma that was of various levels of differentiation. Both the stains were retained in 28 of the lesional areas that were confirmed as dysplastic. In 100% and 20%, we observed the sensitivity and specificity, respectively. The positive and negative predictive values were 95% and 98%, respectively. The diagnostic accuracy for individual stain retained was 92% and when both were used was 94%. There was a significant variation in the retention of the Lugol's iodine for the various grades of malignant lesions, where it was retained better in well and moderately differentiated lesions better than the poor differentiated lesions [Table 1].
Table 1: Comparison of the various lesions for the staining

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   Discussion Top


The in-vivo staining helps in the separation of the abnormal tissue that might have been overlooked otherwise. There are various dyes for the identification of the cancerous lesions in the oral tissues. However, very few are safe and biocompatible.],[4],[5],[6],[7] The two dyes used in our study have been previously proved to be safe for the in-vivo staining in cervical cancers and hence were applied in our study for the oral cancer identification. The diagnostic accuracy of both the dyes for the potentially malignant or the malignant lesions was over 90%. This is in comparison with the studies of Nagaraju K et al.[6] Our study is one of the few studies to compare both the dyes for the various grades of differentiation and hence comparison with other studies was challenging. There were few limitations in our study like a small sample size and there were no controls to check how the dye stained normal and inflammatory tissues.[6],[7]


   Conclusion Top


Within the limitations of the study, the dyes, Lugol's iodine and toluidine blue, can be used efficiently for the identification of the cancers. Further studies with the larger sample size are suggested to corroborate our findings.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Mehta FS, Hamner JE. Tobacco Related Oral Mucosal Lesions and Conditions in India. Bombay: Basic Dental Research Unit, TATA Institute of Fundamental Research; 1993. p. 27-46.  Back to cited text no. 1
    
2.
Prabhu SR, Wilson DT, Daftary DK, Johnson NW. Oral Diseases in the Tropics. Delhi: Oxford Universal Press; 1993. p. 402-28.  Back to cited text no. 2
    
3.
Martin IC, Kerawala CJ, Reed M. The application of toluidine blue as a diagnostic adjunct in the detection of epithelial dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:444-6.  Back to cited text no. 3
    
4.
Epstein JB, Scully C, Spinelli J. Toluidine blue and Lugol'siodine application in the assessment of oral malignant disease and lesions at risk of malignancy. J Oral Pathol Med 1992;21:160-3.  Back to cited text no. 4
    
5.
Reibel J. Prognosis of oral premalignant lesions: Significance of clinical, histopathological, and molecular biological characteristics. Crit Rev Oral Biol Med 2003;14:47-62.  Back to cited text no. 5
    
6.
Nagaraju K, Prasad S, Ashok L. Diagnostic efficiency of toluidine blue with Lugol's iodine in oral premalignant and malignant lesions.Indian J Dent Res 2010;21:218-23.  Back to cited text no. 6
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7.
Peng G, Long Q, Wu Y, Zhao J, Chen L, Li X. Evaluation of double vital staining with Lugol'siodine and methylene blue in diagnosing superficial esophageal lesions.Scand J Gastroenterol 2011;46:406-13.  Back to cited text no. 7
    



 
 
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