Lecturer, Department of Oral Medicine and Radiology, SRM Dental College, Ramapuram, Chennai, India.
Professor Emeritus, Department of Oral Medicine and Radiology, Saveetha Dental College, Chennai, Tamil Nadu, India.
Indian J Dent Res. 2021 Oct-Dec;32(4):459-466. doi: 10.4103/ijdr.IJDR_1004_20.
Chemiluminescence is the production of light as a result of a chemical reaction. Oral potentially malignant disorders (OPMDs) include both precancerous lesions and conditions that carry an increased risk of cancer. There are different etiological and risk factors for OPMDs such as smoking, alcohol consumption, infections such as viral and fungal, sun exposure and certain other genetic factors. The most common etiological factor for OPMDs is tobacco usage. Chemiluminescence is a light-based detection system and is very useful for detecting OPMDs for early intervention. Because it is a non-invasive procedure, it can be used to evaluate dysplastic changes in various OPMDs at their initial stage for timely intervention. Vital staining has also been used as a chair-side marker for delineating normal and dysplastic oral mucosal tissues.
To compare the efficacy of chemiluminescence with Lugol's iodine to that with toluidine blue in diagnosing dysplastic changes in tobacco associated oral lesions.
A total of 84 patients with clinically suspicious oral mucosal lesions and OPMDs with tobacco habit history were included and randomly assigned to either of the diagnostic study groups (Group A: chemiluminescence with Lugol's iodine or Group B: chemiluminescence with toluidine blue). All these patients were subjected to a histopathological examination (reference standard).
The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) were 91.7%, 66.7%, 84.6%, 80%, and 0.792 for chemiluminescence with Lugol's iodine group (P = 0.001) respectively whereas for chemiluminescence with toluidine blue, the sensitivity, specificity, PPV, NPV and ROC were 100%, 60%, 93.3%, 100% and 0.800 (P = 0.002), respectively.
The combination of chemiluminescence with toluidine blue had a better diagnostic efficiency in detecting dysplasia in tobacco-associated oral lesions when compared to the group of chemiluminescence with Lugol's iodine.
化学发光是化学反应产生光的现象。口腔潜在恶性疾病（OPMDs）包括癌前病变和增加癌症风险的情况。OPMDs 有不同的病因和危险因素，如吸烟、饮酒、病毒和真菌感染、阳光暴露和某些其他遗传因素。OPMDs 最常见的病因是烟草使用。化学发光是一种基于光的检测系统，非常有助于早期发现 OPMDs 并进行干预。由于它是一种非侵入性的程序，因此可以用于在初始阶段评估各种 OPMDs 的发育不良变化，以便及时进行干预。活力染色也已被用作描绘正常和发育不良口腔黏膜组织的椅旁标志物。
比较化学发光与卢戈氏碘液和甲苯胺蓝在诊断与烟草相关的口腔病变中发育不良变化的效果。
共纳入 84 例临床可疑口腔黏膜病变和有烟草习惯史的 OPMD 患者，并随机分配到诊断研究组（A 组：化学发光与卢戈氏碘液或 B 组：化学发光与甲苯胺蓝）。所有这些患者均接受了组织病理学检查（参考标准）。
化学发光与卢戈氏碘液组的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和接收者操作特征（ROC）分别为 91.7%、66.7%、84.6%、80%和 0.792（P=0.001），而化学发光与甲苯胺蓝组的敏感性、特异性、PPV、NPV 和 ROC 分别为 100%、60%、93.3%、100%和 0.800（P=0.002）。
与化学发光与卢戈氏碘液组相比，化学发光与甲苯胺蓝联合使用在检测与烟草相关的口腔病变中的发育不良方面具有更好的诊断效率。
