Department of Oral Medicine and Radiology, Institute of Dental Sciences, Sehora, Jammu, India.
Department of Oral Medicine and Radiology, Swami Devi Dyal Hospital and Dental College, Barwala, Haryana, India.
Indian J Dent Res. 2021 Jul-Sep;32(3):310-315. doi: 10.4103/ijdr.IJDR_291_19.
Early detection of dysplasia in oral potentially malignant disorders (PMD) might facilitate screening for possible subsequent malignant transformation. Vital staining is a non-invasive clinical adjunct used for determining the biopsy site, which facilitates early detection of dysplastic changes in PMD. Some authors suggested that double staining method has superior results over staining with a single dye.
The aim of the study was to evaluate the accuracy of in vivo staining with methylene blue (MB) and Lugol's iodine (LI) double staining method in comparison with MB staining alone.
Fifty patients of oral leukoplakia were recruited for the study. After obtaining written informed consent from the patients, the lesions were stained consecutively with 5% MB and 3% LI. The pattern of dye retention of MB alone, followed by MB and LI was noted. Incisional biopsy from the lesion was taken based on the retention of MB and the absence of staining of LI or by clinical judgement in case both stains were not retained. The clinical uptake of the stains was correlated with the degree of dysplasia on histopathological examination.
Out of 50 subjects, MB was retained in 47 cases (94%), while 3 cases (6%) failed to retain the dye. However, out of 47 cases, 20 cases had dark blue stain and were considered as MB positive, while the rest 27 cases had pale blue stain and were considered to be negative for MB staining. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) of MB staining were 57.82%, 100%, 100%, 26.53% and 46%, respectively. After applying both stains, i.e., double staining method, the outline of the lesion was better defined. Out of 50 PMD cases, 3 patients retained only LI and showed no dysplasia. Out of 47 cases which showed dysplasia, 27 cases showed pale blue retention of MB (-) and also were negative for LI. The rest 20 cases were positive for MB but negative for LI. The sensitivity, specificity, PPV and NPV with double staining technique were 100%.
The accuracy and reliability of double staining method was superior to MB staining.
Increased accuracy of double staining method aids in better detection of dysplasia and is of great help to the clinician in deciding the nature of PMD in question.
口腔潜在恶性疾病（PMD）中异型增生的早期检测可能有助于筛查可能随后发生的恶性转化。活组织染色是一种用于确定活检部位的非侵入性临床辅助手段，可促进 PMD 中异型性改变的早期发现。一些作者认为，双重染色法的结果优于单一染料染色。
本研究旨在评估亚甲蓝（MB）和卢戈氏碘（LI）双重染色法与单独使用 MB 染色相比的准确性。
招募了 50 例口腔白斑患者进行研究。在获得患者书面知情同意后，连续用 5%MB 和 3%LI 对病变进行染色。记录 MB 单独染色后以及 MB 和 LI 均染色后的染料保留模式。根据 MB 的保留情况以及 LI 染色的缺失或在两种染色均未保留的情况下根据临床判断，从病变处进行切取活检。染色的临床摄取与组织病理学检查的异型程度相关。
在 50 名受试者中，MB 在 47 例（94%）中保留，而 3 例（6%）未能保留染料。然而，在 47 例中，20 例有深蓝色染色，被认为是 MB 阳性，而其余 27 例有浅蓝色染色，被认为是 MB 染色阴性。MB 染色的灵敏度、特异性、阳性预测值（PPV）、阴性预测值（NPV）和诊断准确性（DA）分别为 57.82%、100%、100%、26.53%和 46%。应用两种染色剂（即双重染色法）后，病变的轮廓定义得更好。在 50 例 PMD 病例中，3 例仅保留 LI，无异型增生。在 47 例显示异型增生的病例中，27 例显示 MB 保留浅蓝色（-）且也对 LI 阴性。其余 20 例 MB 阳性但 LI 阴性。双重染色技术的灵敏度、特异性、PPV 和 NPV 均为 100%。
双重染色法的准确性和可靠性优于 MB 染色。
双重染色法的准确性提高有助于更好地检测异型增生，并有助于临床医生确定所关注 PMD 的性质。
