Maria Noor, Yaser Ishaq, Asma Aftab, Saadia Ata, Salima Naveed Manji and Malik Adeel Anwar
Background and objectives: The successful surgical treatment of oral cancer depends upon the stage of disease at diagnosis and adequate resection of tumor. Residual disease after surgery is responsible for early recurrence and poor prognosis. Complete removal of lesion with adequate safe margins is therefore of paramount importance. A variety of aids are used to ensure the complete removal of lesion. The present study was aimed to determine the diagnostic accuracy of Lugol’s iodine staining in detection of safe margins of oral squamous cell carcinoma, taking histopathology as gold standard. Patients and methods: This study was conducted in the Department of Oral and Maxillofacial Surgery, Mayo Hospital, Lahore. Data was collected from 50 patients using non-probability sampling technique. After informed consent, appropriate pre-operative preparation was done. Diagnosed cases of oral squamous cell carcinoma were included in the study. All patients were treated under general anesthesia. Staining with Lugol’s iodine was done and margins were taken as guided by the staining pattern. Histolopathologic examination of margins was done and results of clinical staining and histopatholgoic reports were recorded. Results: The most common site of occurrence was buccal mucosa (n=20), followed by tongue (n=12) and lower vestibule (n=9). Other less common sites were upper vestibule (n=4), lip (n=3) and maxillary sinus (n=2). A 2X2 contingency table was generated for sensitivity, specificity, positive predictive value, and negative predictive value by using staining pattern and histopathology reports. Sensitivity of Lugol’s iodine was 91 % and specificity was 92.3%. Positive predicative and negative predictive values were 77% and 92% respectively. Conclusion: Lugol’s iodine is one of the diagnostic adjuncts that can be effectively used for detection of safe margins of oral squamous cell carcinoma as it is a simple, cost effective, noninvasive, and quick with good diagnostic accuracy.
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