Khangura Amberpreet K, Gupta Shally, Gulati Anubha, Mehta Manjula
Department of Oral and Maxillofacial Pathology and Oral Microbiology, M. M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India.
Department of Oral and Maxillofacial Pathology and Oral Microbiology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India.
J Oral Maxillofac Pathol. 2025 Jan-Mar;29(1):98-103. doi: 10.4103/jomfp.jomfp_117_24. Epub 2025 Mar 28.
Candida is an opportunistic fungal pathogen that frequently colonizes the oral mucosa. Depending on multiple etiological factors, Candida can transform from a harmless commensal into a pathogenic organism, leading to the development of oral potentially malignant disorders (OPMDs) and oral cancer. Although various laboratory diagnostic methods for Candida have been developed, there remains a need for more rapid and sensitive diagnostic aids for infections associated with Candida. The present study aimed to compare the efficacy of Calcofluor white and acridine orange fluorescent stains and evaluate the most efficacious stain.
Two fluorescent stains, calcofluor white and acridine orange, were used to identify Candida elements in formalin-fixed, paraffin-embedded tissue sections of oral potentially malignant disorders (n = 16), including leukoplakia without dysplasia, mild dysplasia, moderate dysplasia, severe dysplasia, oral lichen planus, and oral sub mucous fibrosis as well as oral squamous cell carcinoma (n = 16), encompassing well-differentiated, moderately differentiated, and poorly differentiated grades. All stained slides were examined using a fluorescence microscope equipped with a blue filter at 20× and 40× magnifications. The comparison between the two stains was conducted based on the expression of fungal elements or the grade of Candida within the given sections, staining quality, and cost-effectiveness.
The results of the present study confirmed that both stains produced similar outcomes in terms of the expression of fungal elements within the sections of oral potentially malignant disorders and oral squamous cell carcinoma. Using both stains, all cases were positive (n = 32), with no negative cases reported. Grade I and II Candida was identified in the sections of oral potentially malignant disorders, whereas Grade III and IV Candida were observed within the sections of oral squamous cell carcinoma and sever dysplasia. Calcofluor white stain demonstrated higher efficiency in terms of staining quality and cost-effectiveness.
Calcofluor white stain exhibited better expression of Candida elements in cases of oral potentially malignant disorders and oral cancer in terms of staining efficacy and is also more cost-effective.
念珠菌是一种机会性真菌病原体，常定植于口腔黏膜。取决于多种病因因素，念珠菌可从无害的共生菌转变为致病生物体，导致口腔潜在恶性疾病（OPMD）和口腔癌的发生。尽管已开发出多种针对念珠菌的实验室诊断方法，但仍需要更快速、灵敏的念珠菌相关感染诊断辅助手段。本研究旨在比较荧光白和吖啶橙荧光染色的效果，并评估最有效的染色剂。
使用两种荧光染色剂，即荧光白和吖啶橙，来鉴定口腔潜在恶性疾病（n = 16）福尔马林固定、石蜡包埋组织切片中的念珠菌成分，这些疾病包括无异型增生的白斑、轻度异型增生、中度异型增生、重度异型增生、口腔扁平苔藓和口腔黏膜下纤维化，以及口腔鳞状细胞癌（n = 16），涵盖高分化、中分化和低分化等级。所有染色玻片均使用配备蓝色滤光片的荧光显微镜在20倍和40倍放大倍数下进行检查。基于给定切片内真菌成分的表达或念珠菌等级、染色质量和成本效益对两种染色剂进行比较。
本研究结果证实，两种染色剂在口腔潜在恶性疾病和口腔鳞状细胞癌切片中真菌成分的表达方面产生了相似的结果。使用两种染色剂时，所有病例均为阳性（n = 32），未报告阴性病例。在口腔潜在恶性疾病切片中鉴定出I级和II级念珠菌，而在口腔鳞状细胞癌和重度异型增生切片中观察到III级和IV级念珠菌。荧光白染色在染色质量和成本效益方面表现出更高的效率。
荧光白染色在口腔潜在恶性疾病和口腔癌病例中，在染色效果方面对念珠菌成分的表达更好，且成本效益更高。
