細胞學在口腔癌之診斷價值

Diagnostic Value of Cytology in Oral Cancer

頼德榮(Der-Rong Lai) ； 陳鴻榮(Hong-Rong Chen)

《The Kaohsiung Journal of Medical Sciences》 2卷2期 (1986/02) Pp. 122-130

https://doi.org/10.6452/KJMS.198602.0122

摘要

為了早期期發現口腔癌，採用細胞學檢查不失為一種簡易、快速而有效的技術。它雖然無法完全取代活體切片之決定性診斷，但以其低傷害性之標本取得，和篩選大量之口腔疾病患者，可見其安全與實用價值，作者等在日常醫療工作中曾遇到有疑似癌症之患者，其拒絕接受活體切片檢查與因為張口困難而無法做活體切片之情形下，唯有進行口腔細胞學檢查，才可獲得病灶之初步診斷。
所有72位經活體切片證實為口腔癌的病例，經細胞學檢查而早期發現的有3例，陽性數有67例，敏感度（sensitivity）為93.1%，假性陰性率為5.6%(4例)，懷疑的1.4%(1例)；608例非癌症患者，有1例為假陽性，特殊性(specificity)為99.84%，口腔細胞學之信賴性(reliability)約為93.0%。對於口腔癌它具有如此高的敏感度與信賴性以提高診斷的正確率，因此，在臨床上它值得推廣使用以早期發現癌症而及時治療。

並列摘要

For the early detection of oral cancer, the use of cytological examination is a simple, rapid and effective technique. Oral cytology, although is not a substitute for biopsy, has been proven to be safe and useful in both obtaining a specimen with less traumatic procedure and screening large numbers of patients for oral cancer.
At our outpatient dental clinic, we encountered patientswith suspicious oral lesions who refused to hve a biopsy and patients with limited mouth opening, which cause difficulty in the performance of a biopsy. Under these conditions. The initial evaluation of the lesion mainly relies on the cytological examination.
Among 72 oral cancer cases proved by biopsy. There were 67 positive cases, 4 false negative cases (5.6% error) and 1 suspicious case (1.4% error) when using the cytological examination. There was one false positive case among the 608 non-malignant cases, indicating the diagnostic specificity of 99.84%. Three clinically unsuspected oral malignant lesions were supported by positive cytological findings and proved to be cancerous by biopsy.
The scraping examination has a sensitivity rate of 94.1%. Needle aspiration has a 75.0% sensitivity rate. Our present studies indicte that the diagnostic sensitivity of oral cytology for malignant lesions is 93.1%, with a reliability of 93.0% in tumor disclosure.
With its high sensitivity and reliability, we recommend that the cytological technique be widely used in the dental clinic for the early detection of oral cancer and the prompt treatment of patients.

並列關鍵字

cytologic smear ； scraping ； needle aspiration