Rahman Farzan, Tippu Shoaib R, Khandelwal Suneet, Girish K L, Manjunath B C, Bhargava Akshay
Department of Oral Pathology and Microbiology, Jaipur Dental College and Hospital, Kukas, Dhand, Jaipur, India.
Quintessence Int. 2012 Jan;43(1):51-9.
Recent advances in techniques for detecting oral premalignant lesions and oral squamous cell carcinoma have improved the chances of early diagnosis. Adjuncts for detection of lesions include toluidine blue staining and cytologic examination. The primary objective of this study was to assess the efficacy of 1% toluidine blue (modified Mashberg technique) and cytology in detection of oral premalignant lesions and oral squamous cell carcinoma.
The study included 86 participants suspected of having oral premalignant lesions or oral squamous cell carcinoma. One percent toluidine blue was applied to the lesions, followed by cytology. A biopsy was then performed on the tissue. Histopathologically proven oral premalignant lesions/oral squamous cell carcinoma lesions were analyzed for sensitivity, specificity, postive predictive value, and negative predictive value of both screening techniques. The association of screening techniques and histopathologic diagnosis among the oral premalignant lesions, oral squamous cell carcinoma, and benign groups were analyzed using the Fisher exact test. P < .05 was considered significant.
The specificity and sensitivity for oral squamous cell carcinoma and oral premalignant lesions detection of 1% toluidine blue was 81.35% and 66.67%, respectively, while cytology attained 77.97% and 70.37%, respectively. Negative predictive value and positive predictive value were 84.21% and 62.06% for 1% toluidine blue and 85.18% and 59.37% for cytologic examination, respectively. Comparison of 1% toluidine blue and cytology with histopathologic diagnosis shows a significant difference between carcinoma/epithelial dysplasia and no dysplasia and carcinoma/epithelial dysplasia and benign lesions (all, P < .05).
The results of this study suggest that 1% toluidine blue and cytology have high sensitivity, specificity, and accuracy in detecting oral premalignant lesions and oral squamous cell carcinoma and can be used as an adjunct for early detection of such lesions.
检测口腔癌前病变和口腔鳞状细胞癌的技术最近取得的进展提高了早期诊断的几率。病变检测的辅助手段包括甲苯胺蓝染色和细胞学检查。本研究的主要目的是评估1%甲苯胺蓝（改良Mashberg技术）和细胞学检查在检测口腔癌前病变和口腔鳞状细胞癌方面的效果。
该研究纳入了86名疑似患有口腔癌前病变或口腔鳞状细胞癌的参与者。将1%甲苯胺蓝应用于病变部位，随后进行细胞学检查。然后对组织进行活检。对经组织病理学证实的口腔癌前病变/口腔鳞状细胞癌病变分析两种筛查技术的敏感性、特异性、阳性预测值和阴性预测值。使用Fisher精确检验分析口腔癌前病变、口腔鳞状细胞癌和良性组中筛查技术与组织病理学诊断之间的关联。P < 0.05被认为具有统计学意义。
1%甲苯胺蓝检测口腔鳞状细胞癌和口腔癌前病变的特异性和敏感性分别为81.35%和66.67%，而细胞学检查分别为77.97%和70.37%。1%甲苯胺蓝的阴性预测值和阳性预测值分别为84.21%和62.06%，细胞学检查分别为85.18%和59.37%。1%甲苯胺蓝和细胞学检查与组织病理学诊断的比较显示，癌/上皮发育异常与无发育异常以及癌/上皮发育异常与良性病变之间存在显著差异（均P < 0.05）。
本研究结果表明，1%甲苯胺蓝和细胞学检查在检测口腔癌前病变和口腔鳞状细胞癌方面具有较高的敏感性、特异性和准确性，可作为此类病变早期检测的辅助手段。
