韩新生　谭小尧　明华伟

[摘要] 目的 研究盧戈氏碘活体染色对早期口腔癌及癌前病变的辅助诊断价值。 方法 对2013年7月～2016年7月就诊于我科高度可疑的口腔黏膜病变200例患者行2.5%卢戈氏碘染色后并在淡染或不染区行切取活检术，结果与常规病理检查结果比较。 结果 对200例患者的临床资料进行整理分析，发现早癌及癌前病变共174例，炎症6例，单纯上皮性增生20例。经染色后早癌及癌前病变主要表现为不染区和淡染区，卢戈氏碘活体染色对早期口腔癌及癌前病变辅助诊断的敏感度98.85%（172/174），特异度73.08%（19/26），差异有统计学意义（χ2=116.99，P<0.01）；卢戈氏碘活体染色对斑纹类口腔病损辅助诊断的敏感度94.29%（66/70），特异度80.00%（8/10），差异有统计学意义（χ2=32.27，P<0.01）；卢戈氏碘活体染色对溃疡口腔病损良恶性辅助诊断的敏感度96.67%（87/90），特异度6.67%（2/30），差异无统计学意义（χ2=0.07，P>0.05）。 结论 对高度可疑的口腔黏膜病变行卢戈氏碘染色对早期口腔癌及癌前病变有很好的辅助诊断价值，能很好指示病变部位，指导切取活检术。

[关键词] 卢戈氏碘染色；口腔癌；癌前病变；切取活检术；病理切片检查

[中图分类号] R739.8 [文献标识码] B [文章编号] 1673-9701（2018）20-0088-04

The adjuvant diagnostic value of Lugol's iodine vital staining in the diagnosis of early oral cancer and precancerous lesions

HAN Xinsheng TAN Xiaoyao MING Huawei ZHANG Xing'an WANG Huadong LUO Zhiyu

Department of Stomatology，Nanchong Central Hospital，No.2 School of Clinical Medicine，North Sichuan Medical College，Nanchong 637000，China

[Abstract] Objective To study the adjuvant diagnostic value of Lugol's iodine vital staining for early oral cancer and precancerous lesions. Methods 200 patients with highly suspicious oral mucosal lesions who were admitted to our department from July 2013 to July 2016 were treated with 2.5% Lugol's iodine staining and biopsy was carried out in lightly stained or unstained areas. The results were compared with the results of routine pathological examinations. Results The clinical data of 200 patients were analyzed. It was found that there were 174 cases of early cancer and precancerous lesions， 6 cases of inflammation， and 20 cases of epithelial hyperplasia alone. After staining， early cancer and precancerous lesions mainly showed non-stained and lightly stained areas. The sensitivity of Lugol's iodine vital staining to the adjuvant diagnosis of early oral cancer and precancerous lesions was 98.85%（172/174）， and the specificity was 73.08%（19/26），the difference was statistically significant（χ2=116.99， P<0.01）. The sensitivity of Lugol's iodine vital staining to the adjuvant diagnosis of speckle oral lesions was 94.29%（66/70）， and the specificity of 80.00%（8/10）， the difference was statistically significant（χ2=32.27， P<0.01）. The sensitivity of Lugol's iodine vital staining to the adjuvant diagnosis of benign or malignant lesions of ulcer was 96.67%（87/90） and the specificity was 6.67%（2/30），the difference was not statistically significant（χ2=0.07， P>0.05）. Conclusion Lugol's iodine staining for highly suspected oral mucosal lesions has a good adjuvant diagnostic value for early oral cancer and precancerous lesions. It can well indicate the location of lesions and guide biopsy.

[Key words] Lugol's iodine staining； Oral cancer； Precancerous lesions； Biopsy； Pathological section examination

口腔癌及癌前病变是口腔科常见病和多发病，口腔癌发病率居全身恶性肿瘤的第六位[1]，其中又以舌癌及颊癌最为高发，90%是上皮来源的鳞状细胞癌，口腔常见的癌前病变或状态包括白斑、红斑、黏膜下纤维化，严重危害人民的身心健康[2]。口腔癌的早发现、早诊断、早治疗是提高治愈率的关键。碘染色诊断食管、宫颈及口腔黏膜病变的机制是正常鳞状上皮细胞内含有丰富的糖原，其遇碘染色后发生化学反应使正常黏膜被染成棕褐色（碘本身的颜色），而癌和重度异常增生细胞内的糖原消耗较大、含量极低，染色后呈碘本身的黄色，称為不着色[3]。……