Comparison of chemiluminescence and toluidine blue in the diagnosis of dysplasia in leukoplakia: a cross-sectional study

Aims: The early diagnosis and treatment of oral cancer at a potentially-malignant stage would reduce morbidity and improve the survival rates and quality of life of patients. Leukoplakia is the most common potentially-malignant disorder. Clinical examination alone cannot differentiate between dysplastic and non-dysplastic leukoplakia. Chemiluminescence and toluidine blue are adjuncts to conventional examination for the early detection of dysplasia. The present study was conducted to compare the efficacies of chemiluminescence and toluidine blue for the diagnosis of dysplasia in leukoplakia. Methods: One hundred patients with leukoplakia were subjected to conventional oral examination, chemiluminescent examination with ViziLite and toluidine blue test, followed by histopathological confirmation of dysplasia. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of chemiluminescence was 84.84%, 41.17%, 73.68%, 58.33%, and 70%, respectively. For toluidine blue it was 42.4%, 88.23%, 87.50%, 44.11%, and 58% respectively. Conclusions: Both the techniques have adjunctive utility in the diagnosis of dysplasia in leukoplakia, but toluidine blue was more effective in identifying the more severe grades of dysplasia, and thus it effectively discriminated high-risk from low-risk lesions.