Departments of Oral Medicine, Stomatological Hospital, Southern Medical University, Guangzhou, 510260, Guangdong Province, People's Republic of China.
BMC Oral Health. 2022 Jul 5;22(1):273. doi: 10.1186/s12903-022-02309-9.
To investigate the diagnostic value of accessible fingertip mean corpuscular volume (MCV) combined with a visible "beefy red" patch in the diagnosis of vitamin B12 (VB12) deficiency in local clinics and hospitals without in-house clinical laboratories, especially in remote areas.
The medical history data of patients complaining of oral mucosal pain at the Stomatological Hospital of Southern Medical University were reviewed. All included patients underwent fingertip blood routine examination, specific serological test (serum VB12, folic acid, iron, and ferritin), and detailed oral clinical examinations. According to the results of the serum VB12 test patients were divided into case and control groups. In diagnostic test, the diagnostic value of the "beefy red" patch and elevated MCV in VB12 deficiency was evaluated by the receiver operator characteristic curve.
There were more female patients than male patients in the case group (serum VB12 level < 148 pmol/L, n = 81) and control group (serum VB12 level ≥ 148 pmol/L, n = 60), mostly middle-aged and elderly patients. There were no statistical differences in gender and age between the two groups. In the case group, the number of individuals with stomach disease was 13, the number of individuals with "beefy red" patch was 78, the number of individuals with oral ulcer was 29, the number of individuals with "MCV > 100fL" and "folic acid < 15.9 nmol/L" were respectively 68 and 5. All were more than that in control group (P < 0.05). The diagnostic test, "beefy red patch" has high sensitivity (0.963) but low specificity(0.883), "MCV > 100 fL" has high specificity (0.933) but low specificity (0.815), and "MCV > 100 fL combined with beefy red patch" has maximal specificity (0.950), and area under the curve (0.949).
Visible oral "beefy red" patch combined with accessible fingertip blood MCV could improve the rate of diagnosis in VB12 deficiency, especially in the elderly in local clinics and hospitals without in-house clinical laboratories in China, which is conducive to early disease detection and treatment.
探究在缺乏检验科的基层医院和诊所中，可触及指尖平均红细胞体积（MCV）联合可视“牛肉红”斑在诊断维生素 B12（VB12）缺乏症中的诊断价值，尤其适用于偏远地区。
回顾南方医科大学口腔医院因口腔黏膜疼痛就诊的患者的病史资料。所有纳入的患者均行指尖血常规检查、特定的血清学检查（血清 VB12、叶酸、铁和铁蛋白）和详细的口腔临床检查。根据血清 VB12 检测结果，患者分为病例组和对照组。在诊断性试验中，采用受试者工作特征曲线评估 VB12 缺乏症中“牛肉红”斑和 MCV 升高的诊断价值。
病例组（血清 VB12 水平<148 pmol/L，n=81）和对照组（血清 VB12 水平≥148 pmol/L，n=60）中女性患者多于男性患者，且多为中老年人。两组间性别和年龄差异无统计学意义。在病例组中，胃病患者 13 例，“牛肉红”斑患者 78 例，口腔溃疡患者 29 例，MCV>100 fL 患者 68 例，叶酸<15.9 nmol/L 患者 5 例。这些患者人数均多于对照组（P<0.05）。诊断性试验中，“牛肉红”斑具有高敏感性（0.963），但特异性低（0.883）；MCV>100 fL 具有高特异性（0.933），但特异性低（0.815）；MCV>100 fL 联合“牛肉红”斑具有最大特异性（0.950）和曲线下面积（0.949）。
可视口腔“牛肉红”斑联合可触及指尖血 MCV 可提高 VB12 缺乏症的诊断率，特别是在中国缺乏检验科的基层医院和诊所中，有利于早期发现和治疗疾病。
