RESUMO
INTRODUCTION: - Early detection plays a major role to reduce the mortality of oral squamous cell carcinoma (OSCC). Many adjunctive techniques have emerged with claims of differentiating high risk oral potentially malignant disorders (OPMDs) from benign lesions. Toluidine blue (TB) test has been established as a diagnostic adjunct in detecting high risk OPMDs and early asymptomatic OSCCs. As majority of OSCC are preceded by OPMDs, recognition of them at an early stage is important in the management of this devastating disease. METHODS: -This study was conducted as a multi-center study prospectively for a period of 2 years. Sixty five patients presented with OPMDs were selected and TB test was performed followed by a biopsy for histopathological confirmation. Criterion validity was assessed with histological diagnosis of the incisional biopsy of the OPMD as a gold standard test verses TB test results. RESULTS: The sensitivity of the TB test was 68.3% and the specificity 63.1% with a false positive rate of 36.8% and false negative rate of 31.7%. However, the predictive value of the positive test was 80%. CONCLUSION: - TB testing might be a potential adjunct diagnostic aid in identifying high risk OPMDs. Further studies with extensive sample size and different demographics are needed to validate our findings.
RESUMO
BACKGROUND: While the protective role of antioxidant nutrients against cancer is well established, data on Asian diets in patients with oral cancer are meagre. METHODS: A total of 1029 subjects over 30 years of age were investigated on their dietary practices in the Sabaragamuwa province (Sri Lanka) in 2006-07. Data collection tools were an interviewer-administered questionnaire, a three-day food diary and an examination of the oral cavity. Subjects identified with Oral Potentially Malignant Disorders (OPMD) and disease-free controls were analysed in a case-control fashion. Among the OPMDs, those with leukoplakia were separately considered. A further subgroup analysis was undertaken for ß-carotene-rich foods. The analysis was stratified by portions of fruit/vegetables consumed as five or more portions and two or more portions daily. RESULTS: A low BMI (<18.5) was a significant independent risk factor for the development of OPMD. More than half of both cases and controls consumed less than two portions of fruit/vegetables per day and only 20 subjects consumed more than five portions per day. Intake of more than two portions per day of ß-carotene-containing fruits/vegetables significantly reduced the risk of having an OPMD and leukoplakia (OR = 0.5; 95% CI, 0.3-0.9). The significant differences observed with BMI and fruits/vegetables were attenuated when adjusted for betel quid chewing, smoking and alcohol use. CONCLUSIONS: This study discloses prevailing under-nutrition in this rural population with very low daily consumption of fruit/vegetables. Cancer preventive properties in their diets are limited and are swamped by the known carcinogenic agents associated with use of betel quid, tobacco and alcohol.
