Junaid Montasir, Suhail Anwar, Umer Beena, Nawaz Ahmad, Ikram Mubasher, Sobani Zain-ul-Abedeen, Ali Naeem Sultan
Jinnah Medical College Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2013 Jul;63(7):835-7.
To use toluidine blue intra-operatively to identify tumour involved margins after the removal of oral cavity squamous cell carcinoma, and to compare the findings with those of final histopathology.
The study was conducted at the Aga Khan University Hospital from December 1, 2009, to March 14, 2010, and comprised 56 consecutive patients with biopsy-proven squamous cell carcinoma of oral cavity regardless of grade and stage of tumour. Intra-operatively toluidine blue was used on the resected tumour margins and the staining patterns were assessed. Results were then compared with the final histopathology report.
A total of 11(19.64%) margins were positive with toluidine blue staining out of which 8 (14.28%) were false positive. Sensitivity and specificity was found to be 100% and 84.9% respectively with a positive predictive value of 27.2%; a negative predictive value of 100%; and diagnostic accuracy of 85.71%.
Toluidine blue costs only Rs25 (USD 0.30) and takes only 5 minutes for application and interpretation. It can be used with significant confidence in smaller lesions (T-l and T-II) as an alternative to frozen sections in developing countries where facilities are unavailable. Its use in larger lesions (T-lll and TIV) remains the topic of controversy and awaits a multi centre trial with a larger cohort.
术中使用甲苯胺蓝识别口腔鳞状细胞癌切除术后肿瘤累及的切缘，并将结果与最终组织病理学结果进行比较。
该研究于2009年12月1日至2010年3月14日在阿迦汗大学医院进行，纳入56例经活检证实为口腔鳞状细胞癌的连续患者，无论肿瘤的分级和分期如何。术中在切除的肿瘤切缘使用甲苯胺蓝，并评估染色模式。然后将结果与最终组织病理学报告进行比较。
共有11个（19.64%）切缘甲苯胺蓝染色呈阳性，其中8个（14.28%）为假阳性。发现敏感性和特异性分别为100%和84.9%，阳性预测值为27.2%；阴性预测值为100%；诊断准确性为85.71%。
甲苯胺蓝成本仅为25卢比（0.30美元），应用和解读仅需5分钟。在缺乏相关设备的发展中国家，对于较小的病变（T-1和T-II期），它可作为冰冻切片的替代方法，使用时具有较高的可信度。其在较大病变（T-III和T-IV期）中的应用仍存在争议，有待进行更大样本量的多中心试验。
