Mojsa Izabela, Kaczmarzyk Tomasz, Zaleska Malgorzata, Stypulkowska Jadwiga, Zapala-Pospiech Agnieszka, Sadecki Daniel
Department of Oral Surgery, Jagiellonian University Medical College, Krakow, Poland.
J Craniofac Surg. 2012 Mar;23(2):e162-4. doi: 10.1097/SCS.0b013e31824cdbea.
The aim of the study was to assess the value of the chemiluminescent light and 1% tolonium chloride as a diagnostic aid in the early detection of oral cancer/premalignant epithelial lesions. Thirty consecutive patients with 41 visually identified oral lesions suggestive of being premalignant underwent chemiluminescence and tolonium chloride examination followed by incisional biopsy with histopathologic evaluation. The biopsies of 34 lesions (82.92%) revealed no dysplasia, 3 lesions (7.32%) revealed mild dysplasia, 3 lesions (7.32%) demonstrated severe dysplasia, and 1 lesion (2.44%) was malignant (squamous cell carcinoma). The chemiluminescent examination improved the brightness (58.54% of the cases), sharpness (56.1% of the cases), texture (60.98% of the cases), and size of the lesion (53.66% of the cases). With references to serious pathologies, 7 cases (100.0%) were brighter, and size was more visualized in 6 cases (85.71%) when using chemiluminescence examination than under incandescent light. Twenty-five (73.53%) of nonserious pathology and 7 (100.0%) of serious pathology (6 dysplasias, 1 squamous cell carcinoma) were positively stained by toluidine blue. Three (8.82%) of nonserious pathology and 0 (0.0%) of serious pathology lesions were identified as true negatives when toluidine blue staining was used. The overall toluidine blue sensitivity and specificity were 81.8% and 37.5%, respectively. Chemiluminescent light demonstrates better visualization (brightness, size) of serious pathology lesions in comparison with conventional clinical oral examination under incandescent light. Toluidine blue demonstrates 100% sensitivity in staining serious pathology. The ViziLite Plus system may help the practitioner to visualize oral pathologies that are not readily detectable with conventional incandescent lighting.
本研究的目的是评估化学发光和1%的甲苯胺蓝作为诊断辅助手段在口腔癌/癌前上皮病变早期检测中的价值。连续30例有41个经肉眼识别提示为癌前病变的口腔病变患者接受了化学发光和甲苯胺蓝检查，随后进行切取活检并进行组织病理学评估。34个病变（82.92%）的活检显示无发育异常，3个病变（7.32%）显示轻度发育异常，3个病变（7.32%）显示重度发育异常，1个病变（2.44%）为恶性（鳞状细胞癌）。化学发光检查改善了病变的亮度（58.54%的病例）、清晰度（56.1%的病例）、质地（60.98%的病例）和大小（53.66%的病例）。对于严重病变，与在白炽灯下相比，使用化学发光检查时7例（100.0%）更亮，6例（85.71%）病变大小更易观察到。25例（73.53%）非严重病变和7例（100.0%）严重病变（6例发育异常，1例鳞状细胞癌）甲苯胺蓝染色呈阳性。使用甲苯胺蓝染色时，3例（8.82%）非严重病变和0例（0.0%）严重病变被判定为真阴性。甲苯胺蓝的总体敏感性和特异性分别为81.8%和37.5%。与在白炽灯下进行的传统临床口腔检查相比，化学发光能更好地观察严重病变的情况（亮度、大小）。甲苯胺蓝对严重病变染色的敏感性为100%。ViziLite Plus系统可能有助于从业者观察到用传统白炽灯照明不易发现的口腔病变。
