Department of Otolaryngology-Head and Neck Surgery, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Otolaryngol Head Neck Surg. 2021 Feb;164(2):271-276. doi: 10.1177/0194599820947686. Epub 2020 Aug 4.
To evaluate the accuracy of methylene blue (MB) for diagnosing oral cancer and precancer.
PubMed, Cochrane Database, Embase, Web of Science, SCOPUS, and Google Scholar.
Two authors working independently reviewed 6 databases from their dates of inception until April 2020. Studies exploring oral mucosal disorders as detected by MB were assessed. True-positive, true-negative, false-positive, and false-negative data were extracted for each study. Methodological quality was evaluated with the Quality Assessment of Diagnostic Accuracy Studies tool (v 2).
Seven prospective and retrospective studies (N = 493) were included. The diagnostic odds ratio of MB was 20.017 (95% CI, 10.65-37.63, = 23%). The area under the summary receiver operating characteristic curve was 0.699. Sensitivity was 0.903 (95% CI, 0.84-0.94, = 54%), and specificity was 0.68 (95% CI, 0.60-0.75, = 0%). The correlation between the sensitivity and the false-positive rate was -0.17, indicating an absence of heterogeneity.
Regarding diagnostic accuracy, MB had high sensitivity but low specificity, suggesting that it cannot be recommended as a replacement for the currently used standard of a scalpel biopsy with histologic assessment. Instead, it should be used as an adjunct to conventional assessment because of its low toxicity and price.
评估亚甲蓝（MB）诊断口腔癌和癌前病变的准确性。
PubMed、Cochrane 数据库、Embase、Web of Science、SCOPUS 和 Google Scholar。
两名作者独立检索了从建库至 2020 年 4 月的 6 个数据库。评估了通过 MB 检测口腔黏膜疾病的研究。为每项研究提取了真阳性、真阴性、假阳性和假阴性数据。采用诊断准确性研究质量评估工具（第 2 版）评估方法学质量。
纳入 7 项前瞻性和回顾性研究（N=493）。MB 的诊断优势比为 20.017（95%CI，10.65-37.63， = 23%）。汇总受试者工作特征曲线下面积为 0.699。敏感度为 0.903（95%CI，0.84-0.94， = 54%），特异度为 0.68（95%CI，0.60-0.75， = 0%）。敏感度和假阳性率之间的相关性为-0.17，表明无异质性。
就诊断准确性而言，MB 具有较高的敏感度但较低的特异度，提示不能将其推荐作为目前使用的手术刀活检联合组织学评估的替代方法。相反，由于其毒性低、价格低廉，应将其作为常规评估的辅助手段。
