甲苯胺蓝活体染色发现早期口腔粘膜癌变的评价

The evaluation of toluidine blue stain in vivo for detecting oral musosa premalignant lesions

目的 为早期发现口腔粘膜斑纹类疾病中的可疑癌变者 ,试用Oratest试剂 ,并对其敏感性和准确率进行评价。方法 采用英国ZILA公司提供的Oratest试剂盒 ,对 19例口腔粘膜斑纹类疾病作常规染色 ,切取染色后可疑病损区作组织病理检查 ,将病理诊断结果与染色结果对照比较 ,研究其相关性。结果 19例中病理诊断有上皮异常增生 8例 ,其中染色阳性 6例 ,阴性 2例 ;无上皮异常增生 7例 ,其染色阳性 2例 ,阴性 5例 ;原位癌 4例 ,其染色阳性 3例 ,阴性 1例。观察发现上皮异常增生或原位癌中染色阴性者 ,其临床表现都有高度增殖性角化现象 ;而无上皮异常增生的染色阳性者 ,其临床表现有糜烂或溃疡。结论 Oratest不仅可以有效地提示粘膜癌变 ,而且对异常增生的上皮细胞也有较高的亲和力。由于上皮异常增生是口腔粘膜由正常跨入癌变的第一步 ,因而对Oratest染色阳性者应引起高度警惕 ,其敏感性可达 75 % ,准确率达 74%。

Objective This study was designed to detect the suspectable carcinogenesis in the patch or stria lesions of human oral mucosa at early stage.Oratest kits were applied for this purpose.The sensitivity and accuracy of this method was also evaluated. Methods 19 patch or stria lesions of human oral mucosa were tested by using Oratest kits which were kindly donated by ZILA Ltd.Com.Biopsies were also conducted in the suspected regions.The correlation analysis between staining and pathological examination was performed. Results 8 samples dysplasia which were revealed by 6 positive and 2 negative staining by using this Oratest examination.While the 7 samples with no dysplasia consisted of 2 positive and 5 negative staining.4 samples were confirmed to be cancer in situ.This included 3 positive and 1 negative staining. Conclusion It indicates that Oratest examination as an adjunct to clinical examination and biopsy,might detect malignant lesions and lesions of dysplasia.The sensitivity and accuracy reach the level of 75% and 74% respectively.It suggestes that Oratest examination be of sound clinical significance.