全组织显微活检(WTM)在口腔白斑研究和治疗中的可行性

A. C. Torres, Ãngel Martínez Sahuquillo Márquez, I. G. Castillo, M. J. C. Fuentes, José Ramón Armas Padrón
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摘要

白斑是最常见的潜在恶性疾病。管理和诊断需要临床和组织病理学监测。常规活组织检查会导致患者发病,而且对于普通牙医来说,这是一个复杂的过程,可能会延迟初步诊断。为了解决这些问题,我们提出了一种名为全组织显微活检(WTM)的新方法。本研究的目的是评估WTM程序获得的样品并测试其生存能力;检查它们是否适用于所有解剖部位,并将结果与常规活检结果进行比较。方法:对41例口腔白斑临床相容病变进行研究。使用WTM技术采集组织样本,之后在同一位置进行常规活检。两个样本在活力和一致性方面进行了研究和比较。结果:采用WTM方法获得的样品100%存活。95%的样本可用于检测不典型增生,85%的病例基底膜被保留。与常规活检检测癌-非典型增生的符合率为78%,对癌-非典型增生的检测灵敏度为53.8%。讨论与结论:WTM获得的样品是可行的。样本中所有上皮层,特别是基底膜的保存不受解剖面积或病变临床表现的影响。结果不符合传统的活检是由于大小的差异,而不是它的质量。
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Viability of Whole Tissue Microbiopsy (WTM) for the Study and Management of Oral Leukoplakia
Introduction : Leukoplakia is the most frequent potentially malignant disorder. Management and diagnosis requires clinical and histopathogical monitorization. Conventional biopsy generates patient morbidity and is considered a complex procedure for general dentists, which can delay initial diagnosis. To solve these problems, we have proposed a novel procedure denominated Whole Tissue Microbiopsy (WTM). The aim of this study is to evaluate the samples obtained with the WTM procedure and to test their viability; to check if they are applicable in all anatomic locations and compare the results with those obtained with conventional biopsy. Methods : We studied 41 clinically compatible lesions with oral leukoplakia. A tissue sample was taken using the WTM technique, after which, a conventional biopsy was performed on the same location. Both samples were studied and compared in terms of viability and concordance. Results : 100% of the samples obtained using the WTM procedure were viable. 95% of the samples were useful to detect dysplasia, and in 85% of cases the basal membrane was retained. Coincidence with conventional biopsy as to detect cancer-dysplasia was 78% and showed a 53.8% sensitivity regarding the detection of dysplasia-Cancer. Discussion and Conclusion : The samples obtained by the WTM are viable for study. Conservation of all epithelial layers in the sample and the basement membrane in particular is not influenced by the anatomical area or by the clinical appearance of the lesion. The results that did not coincide with the conventional biopsy were due to the difference in size and not the quality of it.
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