Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Ağız İçi Şüpheli Lezyonların Tanısında Floresan Teknolojisi ve Vital Boyama Yöntemlerinin Kullanımı: Deneysel Çalışma
The Use of Fluorescence Technology and Vital Staining Methods in the Diagnosis of Intraoral Suspicious Lesions: Experimental Study
Gediz GEDUKa, Çiğdem ŞEKERa, Hatice BİLTEKİNa, Murat İÇENb
aZonguldak Bülent Ecevit Üniversitesi Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Radyolojisi ABD, Zonguldak, Türkiye
bNevşehir Hacı Bektaş Veli Üniversitesi Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Radyolojisi ABD, Nevşehir, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(4):793-9
doi: 10.5336/dentalsci.2022-88670
Article Language: TR
Full Text
ÖZET
 Amaç: Oral kavitenin skuamöz hücreli karsinomu en sık görülen ağız kanseridir. Oral mukozal lezyonların tespitinde inspeksiyon ve palpasyon gibi intraoral muayene yöntemleri, erken tanıda önemli yer tutmakta ve mortaliteyi düşürmektedir. Bu çalışmada amaç, oral kavitede oluşabilecek mukozal lezyonların erken teşhisinde yardımcı tanı aracı olarak vital boyama testinin ve otofloresan incelemenin (OralID) histopatolojik değerlendirmeye kıyasla etkinliğini değerlendirmektir. Gereç ve Yöntemler: Çalışmaya, klinik görsel muayenede tespit edilen ve inceleme sonrası histopatolojik değerlendirme için biyopsi alınan şüpheli lezyona sahip 54 hasta dâhil edildi. İntraoral muayenede tespit edilen tüm şüpheli lezyonlar, otofloresan incelemeye ve vital boyamaya tabi tutuldu. İncelemeler sırasında lezyonlar fotoğraflandı. Lezyonlardan histopatolojik inceleme için biyopsi alındı. Histopatoloji sonuçları altın standart olarak kabul edilip, verilerin istatistiksel analizleri yapıldı. Bulgular: Histopatoloji sonuçları ile karşılaştırıldığında otofloresan tekniğinde 0,33 değerinde zayıf düzeyde uyum görülürken, vital boyama tekniğinde 0,63'lük iyi düzeyde uyum görüldü. Otofloresan inceleme ve vital boyama tekniğinin pozitif öngörü değeri sırasıyla %73,1 ve %91,7; negatif öngörü değerleri ise sırasıyla %60,7 ve %73,3 olarak görüldü. Otofloresan incelemesi %63,3 ve %70,8 duyarlılık ve özgüllük gösterirken, vital boyama tekniği %73,3 duyarlılık ve %91,7 özgüllük gösterdi. Sonuç: Vital boyama ve otofloresan inceleme, histopatolojik doğrulama yapılması şartıyla oral kavitede görülen kanserler ve displazik lezyonlar için invaziv olmayan, basit ve hızlı bir yardımcı tanı aracı olarak kullanılabilir.

Anahtar Kelimeler: Otofloresan görüntüleme; oral skuamöz hücreli karsinom; toluidin mavisi
ABSTRACT
 Objective: Squamous cell carcinoma of the oral cavity is the most common oral cancer. Intraoral examination methods such as inspection and palpation in the detection of oral mucosal lesions have an important place in early diagnosis and reduce mortality. The aim of this study is to evaluate the effectiveness of vital staining test and autofluorescence examination (OralID) as an auxiliary diagnostic tool in the early diagnosis of mucosal lesions that may occur in the oral cavity compared to histopathological evaluation. Material and Methods: Fifty-four patients with suspicious lesion detected in clinical visual examination and biopsied for histopathological evaluation after examination were included in the study. All suspicious lesions detected in intraoral examination were subjected to autofluorescence examination and vital staining. Lesions were photographed during the examinations. Biopsy was taken from the lesions for histopathological examination. Histopathology results were accepted as the gold standard and statistical analyzes of the data were performed. Results: When compared with the histopathology results, a weak agreement of 0.33 was observed in the autofluorescent technique, while a good agreement of 0.63 was observed in the vital staining technique. The positive predictive value of autofluorescence examination and vital staining technique was 73.1% and 91.7%, respectively; negative predictive values were seen as 60.7% and 73.3%, respectively. Autofluorescence examination showed 63.3% and 70.8% sensitivity and specificity, while vital staining technique showed 73.3% sensitivity and 91.7% specificity. Conclusion: Vital staining and autofluorescence examination can be used as a non-invasive, simple and rapid auxiliary diagnostic tool for oral cavity cancers and dysplasic lesions, provided that histopathological confirmation is made.

Keywords: Autofluorescence imaging; oral squamous cell carcinoma; toluidine blue
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