Efficacy of in vivo stainging in the early detection of oral potentially malignant and malignant disorders in comparison with expression of ki-67 proliferative marker

Introduction: Oral squamous cell carcinoma has a potential fatal outcome that accounts for 90% of oral cancers diagnosed worldwide. A variety of new emerging diagnostic aids and adjunctive techniques are currently being used in the screening of oral potentially malignant disorders (OPMDs). In vivo Staining methods namely, toluidine blue(TB), and methylene blue (MB), are advocated as simple, inexpensive and fairly sensitive, chair side investigative method for OPMDs detections. Aims: To determine and compare the diagnostic efficacy and reliability of TB and MB in early detection of OPMDs and Malignant disorders (MDs), with expression of Ki-67 antigen proliferative marker. Materials and Methods: The study group diagnosed as OPMDs and MDs included 20 patients and were equally divided into two groups of 10 randomly selected subjects who were stained with either TB or MB. The biopsy site was chosen where stain retention was positive. Histopathological evaluation for grades of dysplasia and carcinoma were determined and further subjected for Ki-67 proliferative marker evaluation and were graded accordingly as mild, moderate and severe proliferation index. The data collected was subjected to statistical analysis. Results: The overall diagnostic accuracy in distinguishing OPMDs and MDs with expression of Ki-67 proliferative marker showed statistically significant (p=0.003) results with TB stain, while MB stain showed insignificant results (p=0.414). Conclusion: The diagnostic efficiency of TB with expression of Ki-67 proliferative marker was found to be better than MB and thus, can be recommended as an adjunct diagnostic tool for diagnosis of OPMDs and MDs.