Use of Lugol’s Iodine Solution in Screening of Oral Premalignant and Malignant Lesions
International Journal of Dental Medicine
Volume 1, Issue 1, April 2015, Pages: 8-12
Received: Apr. 15, 2015;
Accepted: Apr. 21, 2015;
Published: Apr. 24, 2015
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Md. Abdul Alim, Department of Oral and Maxillofacial Surgery, MH Samorita Medical College & Dental Unit, Dhaka, Bangladesh
Quazi Billur Rahman, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Shakhawat Hossain, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Background: This study also will help to identify the specific site of biopsy of oral pre-malignant and malignant lesions and to correlate lugol’s iodine solution staining of oral tissue with histological findings. Objective: The aim of this study to detect any suspicious of oral cancerous and pre-cancerous lesions as an early diagnostic tool. Methods: Sixty cases of oral lesions were selected irrespective of age, sex, religion or socioeconomic status of the patient considering the inclusion and exclusion criteria. Patient selection was based on history, clinical examination and oral ulcers that do not heal more than two weeks. After staining of oral ulcer by Lugol’s iodine, histopathological examination was done from lightly staining area (Lugol’s iodine positive area) and another was deeply brown staining area (Lugol’s iodine negative area). Results: Out of 60 patients, 59(98.3%) patients were lightly stain, out of 59 patients, 35 were diagnosed as squamous cell carcinoma (34 squamous cell carcinoma and one verrucous carcinoma), 22(36.7%) patients were pre-malignant (17 leukoplakias, 4 oral lichen planus and one erythroplakia) and 2(3.3%) patients were others (one hyperplastic change and one normal oral epithelium).One patient was deeply brown stain which was histopathologically normal oral epithelium. According to early screening of oral pre malignant and malignant lesions by Lugol’s iodine enhanced attention of the clinician to a suspicious site of malignant and pre-malignant lesions in oral cavity. Conclusion: Lugol’s iodine staining is more accurate than clinical or visual diagnosis.
Md. Abdul Alim,
Quazi Billur Rahman,
Use of Lugol’s Iodine Solution in Screening of Oral Premalignant and Malignant Lesions, International Journal of Dental Medicine.
Vol. 1, No. 1,
2015, pp. 8-12.
Sankaranarayanan R. Oral cancer in Indian epidemiologic and clinical review, Oral Surg Oral Med Oral Pathol 1990; 69:325-330.
WHO. Smoking control strategies in developing countries, Report of a WHO Expert Committee1983; Technical Report Series-695:7-10.
Epstein JB, Silverman S, Epstein JD, Lonky SA, Bride MA. Analysis of oral lesion biopsies identified and evaluated by visual examination, chemiluminescence and toluideine blue, Oral Oncology 2007; 44(6): 538-44.
Waldron CW & Shafer WF. Leukoplakia revisited, a clinicopathologic study of 3256 oral leukoplakias. Cancer 1975; 36: 1386-92.
Neville BW, Damm DD, Allen CM & Bouquot JE; Oral and Maxillofacial Pathology. 2nd edn. Philadelphia: WB Saunders 2002.
Epstein JB, Scully C and Spinelli JJ. Toluidine blue and Lugol’s iodine application in the assessment of oral malignant diseases and lesions at risk of malignancy, J Oral Pathol Med 1992; 21:160-163.
Mashberg A. Final evaluation of tolonium chloride rinse for screening of high risk patients with asymptomatic carcinoma, J AM Dent Assoc 1983:106:319-323.
Lingen MW, Kalmar JR, Karrison T and Speight PM. Critical evaluation of diagnostic aids for the detection of oral cancer, Oral oncol 2008; 44:10-22.
Smith RA, Cokkinides V & Brooks D. Cancer screening in the United States, A review of current American Cancer Society guidelines and issues in cancer screening, CA Cancer J Clin 2011; 61:8-30.
Brocklehurst P, Kujan O & Glenny AM. Screening programmes for the early detection and prevention of oral cancer, Cochrane Database Syst Rev 2010;:11:CD004150.
Su WW, Yen AM & Chiu SY. A community-based RCT for oral cancer screening with toluidine blue, J Dent Res 2010; 89:933-7.
Fennerty MB. Tissue staining, Gastrointest Endosc Clin N Am 1994; 4:297-311.
Silverman S, Barbosa J & Kearns G. Ultrastructural and histochemical localization of glycogen in human normal and hyperkeratotic oral epithelium, Arch Oral Biol 1971; 16:423-34.
Maeda K, Yamashiro M, Michi Y, Suzuki T, Ohyma Y, Okada N et al. Effective staining method with iodine for leukoplakia and lesions surrounding squamous cell carcinomas of the tongue assessed by colorimetric analysis, J Med Dent Sci 2009; 56: 123-30.
Kurita H& Kurashina K. Vital staining iodine solution in delineating the border of oral dysplastic lesions, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 81:275-80.
McMahon J, Devine Jc, Mccaul Ja, Mclellan, Farrow A. Use of Lugol’s iodine in the resection of oral and oro-pharyngeal squamous cell carcinoma, Br J Oral Maxillofac Surg 2010; 48:84-7.
Sankaranarayanan R. A case control investigation of cancer of the oral tongue and the floor of the mouth in Southern India, Int. J. Cancer 1989; 44:617-621.
Chiba I, Muthumala M, Yamazaki Y, Zaman AU, Tadashi I & Amemiya A. Characteristics of mutatons in the p53 gene of oral squamous cell carcinomas associated with betel quid chewing in Sri Lanka. Int, J Cancer 1998; 77: 839-42.
Merletti F. Role of tobacco and alcoholic beverages in the etiology of cancer of the oral cavity/oropharynx in Torino, Italy, Cancer Research 1989; 49:4919-24.
Shopland DR, Eyre HJ, Pechacek TF. Smoking-attributable cancer mortality : is lung cancer now the leading cause of death among smokers in the United States? J Natl Cancer Inst 1991; 83:1142-8.
Van Wyk CW, Stander I, Pandaychee A & Groblerrable AF. The areca nut chewing habit and oral squamous cell carcinoma in South African Indians. S Afr Med J 1993; 83:425-429.
Merchant A. Paan without tobacco: an independent risk factors for oral cancer, Int J Cancer 2000; 86:128-131.
Inoue H, Rey JF, Lightdale CJ. Lugol chromoendoscopy for oesophageal squamous cell cancer. Endoscopy 2001; 33:75-9.
Shiozaki H, Tahara H, Kobayashi K, Yano H, Tamura S, Lmamoto H. Endoscopic screening of early esophageal cancer with the Lugol dye method in patients with head and cancer. Cancer 1990;66:2068-71.
Report of a WHO Expert Committee. Smoking control strategies in developing countries, Technical Report 1983; Series-695, pp. 7-15.
Nagaraju K, Prasad S & Ashok L. Diagnostic efficiency of Lugol’s iodine and toludine blue in oral premalignant and malignant lesions, Indian J Dent Res 2010; 21:218-23.