Farah Camile S, McCullough Michael J
Department of Oral Medicine and Pathology, School of Dentistry, The University of Queensland, Brisbane QLD 4072, Australia.
Oral Oncol. 2007 Sep;43(8):820-4. doi: 10.1016/j.oraloncology.2006.10.005. Epub 2006 Dec 13.
Conventional screening practice for oral lesions involves visual scrutiny of the oral tissues with the naked eye under projected incandescent or halogen illumination. Visualisation is the principal strategy used to assess patients' lesions at risk for malignant transformation; hence, any procedure which highlights such lesions should aid the clinician. The aim of this pilot study was to examine the efficacy of acetic acid wash and chemiluminescent light (ViziLite) in enhancing visualisation of oral mucosal white lesions, and its ability to highlight malignant and potentially malignant lesions. Fifty five patients referred for assessment of an oral white lesion, were prospectively screened with ViziLite, and an incisional scalpel biopsy performed for a definitive diagnosis. The size, location, ease of visibility, border distinctness, and presence of satellite lesions were recorded. The ViziLite tool enhanced intra-oral visualisation of 26 white lesions. Indeed, all lesions appeared "aceto-white", regardless of the definitive diagnosis. Examination of the oral tissues with ViziLite illumination did not change the provisional diagnosis, nor alter the biopsy site. ViziLite illumination does not discriminate between keratotic, inflammatory, malignant or potentially malignant oral mucosal white lesions and thus, a high index of suspicion, expert clinical judgment, and scalpel biopsy are still essential for proper patient care.
传统的口腔病变筛查方法是在投射的白炽灯或卤素灯照明下,用肉眼对口腔组织进行目视检查。可视化是用于评估患者有恶变风险病变的主要策略;因此,任何能突出此类病变的程序都应对临床医生有所帮助。这项初步研究的目的是检验醋酸冲洗和化学发光灯(ViziLite)在增强口腔黏膜白色病变可视化方面的效果,以及其突出恶性和潜在恶性病变的能力。55名因口腔白色病变前来评估的患者,前瞻性地接受了ViziLite筛查,并进行了切开式手术刀活检以明确诊断。记录病变的大小、位置、可见度、边界清晰度以及卫星病变的存在情况。ViziLite工具增强了26个白色病变的口腔内可视化。实际上,无论最终诊断如何,所有病变均呈现“醋酸白”。用ViziLite照明检查口腔组织并未改变初步诊断,也未改变活检部位。ViziLite照明无法区分角化性、炎症性、恶性或潜在恶性的口腔黏膜白色病变,因此,高度的怀疑指数、专业的临床判断和手术刀活检对于妥善的患者护理仍然至关重要。