Otolaryngology, Department of Health Science, University Magna Graecia of Catanzaro, Viale Europa, Germaneto, 88100 Catanzaro, Italy.
Anatomic Pathology Unit, Pugliese-Ciaccio Hospital General Hospital, Interdipartimental Sevice Center, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy.
Medicina (Kaunas). 2020 Jul 3;56(7):334. doi: 10.3390/medicina56070334.
: Transoral laser microsurgery (TLM) is widely accepted for its advantages, which consist of a brief hospital stay, rapid functional recovery, low management costs and the fact that it can be easily repeated in cases of recurrence. However, a high incidence of positive or narrow surgical margins has been reported in the literature, even if controversy still exists on the prognostic significance of positive resection margins. The aim of the study was to evaluate the utility of toluidine blue staining in defining the resection margins of early glottic cancer (T1a-T2) treated with TLM. : This retrospective study was conducted on patients with early glottic cancer (T1a-T2) managed by TLM. A group of patients treated between 2010 and 2014 underwent toluidine blue staining (TB group) of the lesions before starting the cordectomy by TLM, and a group of patients treated by TLM between 2006 and 2009 was considered the control group. : A total of 44 subjects were included in this study: 41 were men, and 3 were women. The mean age was 58 ± 9.0 years (median 59.0, range 41-77). Twenty-three of the 44 patients were included in the TB group and 21 in the case control group. In the TB group, only the positivity of the deep margin was a predictor of local recurrence ( = 0.037), while in the control group, positive or close margins and the type of cordectomy were predictive factors of local recurrence ( 0.049). Considering the TB group and control cases, the 5-year local recurrence-free survival was 95.6% and 80.9%, respectively ( 0.14). : From this first study, toluidine blue staining seems to be a useful modality to improve the rate of the negative resection margins of early glottic cancer (T1a-T2) treated by TLM.
经口激光微创手术（TLM）因其具有住院时间短、功能恢复快、管理成本低以及在复发时易于重复的优点而被广泛接受。然而，文献中报道的阳性或狭窄手术切缘的发生率较高，即使在阳性切缘对预后的意义上仍存在争议。本研究旨在评估甲苯胺蓝染色在定义经 TLM 治疗的早期声门癌（T1a-T2）的切除边界中的效用。
这项回顾性研究是在经 TLM 治疗的早期声门癌（T1a-T2）患者中进行的。一组于 2010 年至 2014 年接受 TLM 治疗的患者在开始经 TLM 行声带切除术之前对病变进行甲苯胺蓝染色（TB 组），另一组于 2006 年至 2009 年接受 TLM 治疗的患者被认为是对照组。
本研究共纳入 44 例患者：41 例男性，3 例女性。平均年龄为 58 ± 9.0 岁（中位数 59.0，范围 41-77）。44 例患者中有 23 例纳入 TB 组，21 例纳入病例对照组。在 TB 组中，只有深层切缘的阳性是局部复发的预测因素（ = 0.037），而在对照组中，阳性或接近的切缘和声带切除术的类型是局部复发的预测因素（ 0.049）。考虑到 TB 组和对照组，5 年局部无复发生存率分别为 95.6%和 80.9%（ 0.14）。
从这项初步研究来看，甲苯胺蓝染色似乎是一种有用的方法，可以提高经 TLM 治疗的早期声门癌（T1a-T2）的阴性切缘率。
