[Autofluorescence for the detection of potentially malignant and malignant lesions of the oral cavity lining]

Early Diagnosis on Oral and Potentially Oral Malignant Lesions: A Systematic Review on the VELscope® Fluorescence Method

The fluorescence method is an innovative technique used by pathologists for examining body mucosa, and for the abnormalities tissue screening, potentially leading to the earlier discovery of pre-cancer, cancer or other disease processes. The early detection is one of the best mechanisms for enabling treatment success, increasing survival rates and maintaining a high quality of life. The purpose of this review is to evaluate the clinical efficiency of this diagnostic tool applied to the oral cavity (VELscope^®). A literature systematic review has been performed. The initial research provided 53 results after applying the inclusion and exclusion criteria, and after a manual screening of the abstracts by the authors, only 25 results were eligible for review. The results and data contained in all the researches, no older than 10 years, were manually evaluated, and provided useful information on this diagnostic method. The VELscope^® mean value about sensitivity and specificity resulted of 70.19% and 65.95%, respectively, by results analysis, but despite this some studies disagree about its clinical effectiveness, and this diagnostic method is still much debated in scientific and clinical medical literature. Surely being able to have efficient and effective tools from this point of view could help the clinician in the diagnosis, and also make timelier the pharmacological or surgical therapy, improving the quality of life of the patient, and in some cases guaranteeing a longer survival term.

Autofluorescence spectroscopy of betel quid chewers and oral submucous fibrosis: A pilot study

Context:

Oral lesions related to the use of commercially available tobacco (gutkha) is going to pose a major challenge for health care providers in India. Therefore, techniques that are useful for mass screening of the public for early identification of pre-cancerous lesions and conditions are necessary to overcome this challenge.

Aims:

To identify the differences in autofluorescence spectra of normal oral mucosa, mucosa of betel quid chewers, and mucosa of oral sub mucous fibrosis.

Materials and Methods:

Group I consist of 15 individuals with clinical diagnosis of oral submucous fibrosis, Group II consists of 18 individuals without oral submucous fibrosis, having the habit of betel quid (gutkha) chewing and Group III consists of 18 normal individuals without the habit of betel quid chewing. Both males and females were included in the study with their age ranging from 18 to 53 years. In vivo fluorescence spectra were obtained using an optical fibre probe attached to Fluoromax-2 spectrofluorometer in the Department of Medical Physics, Anna University, Chennai, India.

Statistical Analysis Used:

Fisher's Chi square test was used for statistical analysis. Probability value (P value) was also obtained to discriminate the statistical differences between the three groups.

Results:

The averaged emission and excitation spectra of oral submucous fibrosis was significantly less compared to normal mucosa and betel quid chewers. The statistical findings showed significant differences (P<0.001) between oral submucous fibrosis and the other two groups.

Conclusions:

Fluorescence spectroscopy can be used effectively for diagnosing the individuals affected by OSMF. However, this technique was unable to discriminate the betel chewers mucosa from normal individuals.