Mashberg A
JAMA. 1981 Jun 19;245(23):2408-10.
Tolonium chloride (toluidine blue) application is useful for identifying malignant changes in squamous mucosa. However, early asymptomatic mucosal changes may remain undetected by tolonium application. A study was carried out to determine the feasibility of using a tolonium mouth rinse as a routine procedure after thorough clinical examination, to discover undetected cancers. A proved, effective tolonium application method was compared with a rinse sequence. One hundred five asymptomatic oral lesions (51 carcinomas and 54 nonmalignant lesions) that persisted for ten to 14 days were evaluated with application and rinse modalities and biopsies. There were 2% false-negatives (1/51) with the application as opposed to 5.9% (3/51) with the rinse and 9.3% false-positives (5/54) with the application as compared to 7.4% (4/54) with the rinse. Four inapparent, second primary cancers, unobserved for application, were delineated by the rinse (three oral, one pharyngeal). Tolonium blue rinse may be used to detect unobserved, asymptomatic oral mucosal cancers after clinical examination. After a positive rinse stain, a subsequent positive application stain ten to 14 days later mandates a biopsy of the lesion.
应用甲苯胺蓝对鳞状黏膜恶性病变的识别有帮助。然而，早期无症状的黏膜变化可能无法通过甲苯胺蓝检测出来。开展了一项研究，以确定在全面临床检查后将甲苯胺蓝漱口水作为常规程序使用，来发现未被检测到的癌症的可行性。将一种经证实有效的甲苯胺蓝应用方法与一种漱口程序进行比较。对持续10至14天的105个无症状口腔病变（51例癌和54例非恶性病变）采用应用和漱口方式以及活检进行评估。应用时假阴性率为2%（1/51），而漱口时为5.9%（3/51）；应用时假阳性率为9.3%（5/54），漱口时为7.4%（4/54）。漱口检测出4例应用未观察到的隐匿性第二原发癌（3例口腔癌，1例咽癌）。临床检查后，甲苯胺蓝漱口可用于检测未观察到的无症状口腔黏膜癌。漱口染色呈阳性后，10至14天后应用染色呈阳性则必须对病变进行活检。
