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Fluorescence staining vs. routine KOH smear for rapid diagnosis of oral candidiasis—A diagnostic test
Author(s) -
Hu Lijun,
Zhou Peiru,
Zhao Weiwei,
Hua Hong,
Yan Zhimin
Publication year - 2020
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.13293
Subject(s) - staining , medicine , youden's j statistic , diagnostic accuracy , fluorescein , pathology , diagnostic odds ratio , area under the curve , gastroenterology , fluorescence , receiver operating characteristic , physics , quantum mechanics
Abstract Objective A diagnostic test was designed to evaluate the accuracy and applicability of fluorescence staining with fluorescein‐labelled chitinase versus routine 10% potassium hydroxide (KOH) smear for rapid diagnosis of oral candidiasis. Methods In total, 124 subjects with suspected oral candidiasis symptoms/signs were sequentially enrolled in this study. The diagnostic efficacy indexes (sensitivity, specificity, Youden index, predictive value, likelihood ratio, diagnostic odds ratio, diagnostic accuracy and area under the curve [AUC]) were compared between 10% KOH smear and fluorescence staining. Results The sensitivity (85.48% vs. 64.52%) and specificity (91.94% vs. 72.58%) of fluorescence staining were higher than those of KOH smear. The AUC of fluorescence staining (0.887) was remarkably higher than that of 10% KOH smear (0.685), demonstrating that the diagnostic efficacy of fluorescence staining is significantly higher than that of KOH smear ( p = .0005). Furthermore, fluorescence staining showed higher sensitivity than that of KOH smear (84.75% vs. 62.71%) in diagnosis of erythematous type oral candidiasis, which is the most common type and the type most challenging to differentially diagnose. Conclusion The advantages of fluorescence staining with fluorescein‐labelled chitinase in rapid diagnosis of oral candidiasis and its ease of operation suggest its potential use in clinical practice.