Nagaraju Kamarthi, Prasad Shiva, Ashok L
Department of Oral Medicine and Radiology, Subharti Dental College, NH-58, Subharti Puram, Meerut-250 002, India.
Indian J Dent Res. 2010 Apr-Jun;21(2):218-23. doi: 10.4103/0970-9290.66633.
In vivo stains are prompt resources, which have emerged, in the recent years, to aid as clinical diagnostic tools in detecting early premalignant and malignant lesions. The aim of the study was to determine the diagnostic efficiency of toluidine blue with Lugol's iodine in oral premalignancies and malignancies and to evaluate the reliability of in vivo staining with toluidine blue and Lugol's iodine in the lesions at risk of malignancy.
The study group comprised 30 subjects with clinically suspicious premalignant lesions and 30 subjects with clinically suspicious malignant lesions. All the lesions were stained consecutively with toluidine blue and Lugol's iodine and the dye retention were recorded with photographs. Depending on the retention of the dyes, the biopsy site was determined. The biopsy specimens were sent for histological confirmation and results were statistically analyzed.
The overall diagnostic accuracy of Lugol's iodine when used consecutively with toluidine blue stain in distinguishing premalignant lesions and malignant lesions was 90%. As the degree of differentiation of malignant lesions progressed toward more severity, they failed to show the retention of Lugol's iodine and the result was highly significant statistically, with a P value < 0.001.
Lugol's iodine when used with toluidine blue helped in delineating the inflammatory lesions and was the mean source in determining clinically the degrees of differentiation of malignant lesions as the poorly differentiated malignant lesions without glycogen content failed to show Lugol's iodine retention. Toluidine blue with Lugol's iodine can be used as a pretherapeutic assessment of the biologic aggressiveness of the disease.
近年来，活体染色作为临床诊断工具应运而生，可用于检测早期癌前病变和恶性病变。本研究旨在确定甲苯胺蓝联合卢戈氏碘在口腔癌前病变和恶性病变中的诊断效率，并评估甲苯胺蓝和卢戈氏碘活体染色在有恶变风险病变中的可靠性。
研究组包括30例临床可疑癌前病变患者和30例临床可疑恶性病变患者。所有病变均依次用甲苯胺蓝和卢戈氏碘染色，并用照片记录染料保留情况。根据染料保留情况确定活检部位。将活检标本送去进行组织学确诊，并对结果进行统计学分析。
卢戈氏碘与甲苯胺蓝染色联合使用时，区分癌前病变和恶性病变的总体诊断准确率为90%。随着恶性病变分化程度向更严重发展，它们未显示出卢戈氏碘的保留，结果在统计学上具有高度显著性，P值<0.001。
卢戈氏碘与甲苯胺蓝联合使用有助于区分炎性病变，并且是临床上确定恶性病变分化程度的主要依据，因为无糖原含量的低分化恶性病变未显示卢戈氏碘保留。甲苯胺蓝联合卢戈氏碘可用于对疾病的生物学侵袭性进行治疗前评估。
