荧光染色与常规 KOH 涂片在口腔念珠菌病快速诊断中的比较——一项诊断性试验。

Fluorescence staining vs. routine KOH smear for rapid diagnosis of oral candidiasis-A diagnostic test.

机构信息

Department of Oral Medicine, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.

Department of Oral Medicine, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China.

出版信息

Oral Dis. 2020 Jul;26(5):941-947. doi: 10.1111/odi.13293. Epub 2020 Feb 16.

DOI:10.1111/odi.13293

PMID:32011074

Abstract

OBJECTIVE

A diagnostic test was designed to evaluate the accuracy and applicability of fluorescence staining with fluorescein-labelled chitinase versus routine 10% potassium hydroxide (KOH) smear for rapid diagnosis of oral candidiasis.

METHODS

In total, 124 subjects with suspected oral candidiasis symptoms/signs were sequentially enrolled in this study. The diagnostic efficacy indexes (sensitivity, specificity, Youden index, predictive value, likelihood ratio, diagnostic odds ratio, diagnostic accuracy and area under the curve [AUC]) were compared between 10% KOH smear and fluorescence staining.

RESULTS

The sensitivity (85.48% vs. 64.52%) and specificity (91.94% vs. 72.58%) of fluorescence staining were higher than those of KOH smear. The AUC of fluorescence staining (0.887) was remarkably higher than that of 10% KOH smear (0.685), demonstrating that the diagnostic efficacy of fluorescence staining is significantly higher than that of KOH smear (p = .0005). Furthermore, fluorescence staining showed higher sensitivity than that of KOH smear (84.75% vs. 62.71%) in diagnosis of erythematous type oral candidiasis, which is the most common type and the type most challenging to differentially diagnose.

CONCLUSION

The advantages of fluorescence staining with fluorescein-labelled chitinase in rapid diagnosis of oral candidiasis and its ease of operation suggest its potential use in clinical practice.

摘要

目的

设计了一种诊断检测方法，以评估荧光素标记几丁质酶荧光染色与常规 10%氢氧化钾（KOH）涂片在快速诊断口腔念珠菌病方面的准确性和适用性。

方法

本研究共纳入 124 例疑似口腔念珠菌病症状/体征的患者。比较了 10%KOH 涂片和荧光染色的诊断效能指标（敏感性、特异性、约登指数、预测值、似然比、诊断优势比、诊断准确性和曲线下面积[AUC]）。

结果

荧光染色的敏感性（85.48% vs. 64.52%）和特异性（91.94% vs. 72.58%）均高于 KOH 涂片。荧光染色的 AUC（0.887）明显高于 10%KOH 涂片（0.685），表明荧光染色的诊断效能明显高于 KOH 涂片（p=0.0005）。此外，荧光染色在诊断红斑型口腔念珠菌病（最常见且最具鉴别诊断挑战性的类型）方面的敏感性也高于 KOH 涂片（84.75% vs. 62.71%）。