甲苯胺蓝活体染色在口腔癌早期诊断中的临床价值

Evaluation of Clinic Value of Toluidine Blue Staining in Early Diagnosis of Oral Cancer

对８４例子期口腔病损患者用１％甲苯胺蓝染色，观察着色情况，与病理结果对照。结果显示甲苯胺蓝对口腔癌诊断的敏感性为９７．３％，特异性为４１．２％，假阳性率４２．２％，假阴性率５．０％；白斑癌变及上皮异常增生性白斑的染色阳性率明显高于上皮单纯增生性白斑（Ｐ＜０．０５）；４３例溃疡病变都呈阳性染色，炎性溃疡染色周界与恶性溃疡无显著性差异（Ｐ＞０．０５）．此染色法在口腔癌早期诊断中的临床价值在于：①发现并指示癌变部位，指导活检。②口腔癌高危人群普查及口腔癌术后或放疗后患者定期检查，辅助发现口腔癌及癌肿复发。③筛选白斑早期癌变及监测白斑。

cases of small oral lesions had been observed after using 1% toluidine blue staining.The staining results were contrasted with their pathological results.The results showed that the sensitivity of toluidine blue ataining in diagnosis of early oral cancer was 97.3%, the specificity was 41.2%.the false positive rate was 42.2%, the false negative rate was 5.0%. The positive stain of leukoplakia which was malignancy change or epithelial dysplasia pathologically was higher significantly than that of leukoplakia which was epithelial hyperplasia (P<0.05). All of 43 ulcer lesions showed positive stain, and the figures of positive staining regions were not significantly different between malignancy ulcer lesions and inflammatory ulcer lesions (P>0. 05). It was suggested that the clinic value of toluidine blue staining in dignosis of early oral cancer was: 1. to show cancerizational fields of diffuse lesions, so as to increase biopsy accuracy; 2. to use high-risk populations of oral cancer and the patients who are postsurgical or postirradiation tumour as a simple, fast, and noninvasive screen method, so as to discovery early oral cancer and recognize cancer recurrence ; 3.to screen and survey patients with leukoplakia, so as to detect early malignant change.