A Clinical Trail Of Rose Bengal Staining As A Screening Method Of Early Oral Squamous Cell Carcinoma And Premalignant Lesions

Object Oral squamous cell carcinoma is the most common cancer of the head and neck, and the prognosis is not good when advanced to late stage. Therefore, early detection, early diagnosis, and early treatment are of great importance. Previous study showed rose Bengal (RB) staining was effective as an assistant diagnostic method of oral squamous cell carcinoma and premalignant lesions. The present study will choose various types of clinical lesions and further evaluate the efficiency of RB staining as an assistant diagnostic method of oral squamous cell carcinoma and premalignant lesions.Material and methods This study involved 133 cases from Department of Oral Medicine, including 60 males and 73 females, the clinical types of the lesions were oral squamous cell carcinoma, leukoplakia, lichen planus, leukokeratosis etc. The reagent and staining method were the same as the previous study, then the stain areas were compared with the standard shade guide, the staining results were recorded from 1 to 5 grades, respectively. According to blind design, one researcher recorded the staining and clinical diagnosis results, then biopsy of all 133 cases were taken from the most staining areas, and tissues were soon sent to a pathologist of Department of Oral Pathology for histological diagnosis, who was blind to the staining results. Histological diagnosis was taken as gold standard, epithelial dysplasia, carcinoma in situ, and invasive squamous cell carcinoma were defined as histologically positive (recorded as +) , and consistent with lichen planus, epithelial hyperplasia, chronic inflammation and other benign lesions were defined as histologically negative (recorded as-) , data was analysed by X2 test.Results According to the histological diagnosis, there were 28 cases (21.0%) invasive squamous cell carcinoma, 5 cases (3.7%) epithelial dysplasia, 32 cases (24.1% ) lichen planus, 44 cases (33.1%) epithelial hyperplasia, 15 cases (11.3% ) chronic inflammation, and 9 cases (6.8%) other benign lesions in all 133 cases. the whole sensitivity and specificity of this study were 93.9% and 74.0%, the positive likelihood ratio and negative likelihood ratio were 3.6 and 0.08, respectively. The efficiency of the RB staining method is satisfied on the whole.Conclusions1. RB staining method is an easy, applicable and efficient assistant diagnostic method for screening of early stage oral squamous cell carcinoma and premalignant lesions. Grading of staining results was accurate and reliable, and the efficiency of the diagnostic test was satisfied on the whole. The sensitivity and specificity of the whole study were 93.9% and 74.0%, respectively, the positive and negative likelihood ratio were 3.6 and 0.08, respectively, which showed RB staining is an efficient assistant diagnostic method.2. RB staining is an effective method for early detection of oral squamous cell carcinoma in high-risk population.3. The staining result in leukoplakia was similar to the whole result, it can detect epithelial dysplasia and squamous cell carcinoma, or exclude non-dysplastic lesions. But its ability of early detection of epithelia dysplasia need further confirmation due to the insufficient cases of leukoplakia.4. RB staining method is useful in differential diagnosis of non-dysplastic lesions.