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Dharumalingam P, Vinayachandran D, C G, M S, A B, Selvakumar H. A Literature Review on Oral Lumenoscopy: A Non-invasive Method for Diagnosing Oral Potentially Malignant Disorders. Cureus 2024; 16:e75788. [PMID: 39822481 PMCID: PMC11735257 DOI: 10.7759/cureus.75788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Accepted: 12/16/2024] [Indexed: 01/19/2025] Open
Abstract
Dentistry still faces difficulties in diagnosing oral precancer and cancer, especially when it comes to early phase changes or disease detection, evaluation, and treatment. In essence, oral lumenography is the process of identifying oral lesions using a chemiluminescent light source and a toluidine blue labeling system. Since neoplastic epithelial cells have a changed nuclear-cytoplasmic ratio, acetic acid dehydration brings out this nuclear density and gives the tissue an "acetowhite" look. This phenomenon is further intensified when diffuse blue-white chemiluminescent illumination is created by using toluidine blue, which preferentially stains premalignant lesions, in place of ordinary lighting. In developing countries like India, oral cancer and other precancerous and malignant lesions of the oral cavity are very common. The most common diagnostic methods for oral mucosal lesions suggestive of malignancy or premalignancy are tissue samples and histological examination. There is a waiting period following this invasive operation before learning the diagnostic findings. Thus, the creation of a non-invasive screening instrument is required to detect oral cancer. Thus, the main goal of our work is to create a real-time, non-invasive diagnostic tool for oral cancer screening that is based on optical imaging methods like fluorescence emission imaging and diffuse reflectance imaging. To enhance clinical assessment and facilitate the diagnosis of premalignant and early-stage malignant lesions, numerous novel approaches have been developed. In this article, the purpose of a tissue reflectance-based analysis has been discussed. It is currently offered for sale under the ViziLite brand (Zila Pharmaceuticals, Phoenix, AZ, US) after being altered for usage in the oral cavity.
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Affiliation(s)
- Pavithra Dharumalingam
- Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology (SRMIST), Chennai, IND
| | - Divya Vinayachandran
- Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology (SRMIST), Chennai, IND
| | - Ganesh C
- Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology (SRMIST), Chennai, IND
| | - Shanthi M
- Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology (SRMIST), Chennai, IND
| | - Backiyalakshmi A
- Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology (SRMIST), Chennai, IND
| | - Haripriya Selvakumar
- Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology (SRMIST), Chennai, IND
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Pierfelice TV, D’Amico E, Cinquini C, Iezzi G, D’Arcangelo C, D’Ercole S, Petrini M. The Diagnostic Potential of Non-Invasive Tools for Oral Cancer and Precancer: A Systematic Review. Diagnostics (Basel) 2024; 14:2033. [PMID: 39335712 PMCID: PMC11431589 DOI: 10.3390/diagnostics14182033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 08/24/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
OBJECTIVES This systematic review aimed to analyse the published evidence for the use of non-invasive methods for the early detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs). METHODS The literature was systematically searched through several databases: PubMed, Cochrane Library, and Web of Science. Additional exploration was performed through cross-checks on the bibliographies of selected reviews. The inclusion criteria involved studies assessing the application of non-invasive tests on humans in the screening, diagnosis, or surveillance of OSCC or OPMDs and reporting sensitivity (SE) and specificity (SP). The Newcastle-Ottawa scale (NOS) was applied to assess the quality of the studies included. RESULTS The search strategy resulted in 8012 preliminary records. After a duplicate check, 116 titles remained. After abstract analysis, 70 papers remained. After full text analysis, only 54 of the 70 papers fit the inclusion criteria (28 were original articles and 26 were reviews). Those 26 reviews were used to manually search for further original articles. From this last search, 33 original articles were found. Thus, a total of 61 original studies were included and investigated. Findings from this systematic review indicate useful information, such as a description of the mechanisms, ease of use, limitations, and SE and SP values, to drive the choice of the optimal minimally invasive method to be utilized as an adjunctive tool to examine the suspicious lesions. CONCLUSIONS Each of the analysed tools can be improved or implemented, considering their high SE and low SP. Despite advancements, incisional biopsy continues to be the gold standard for the definitive diagnosis of oral cancer and precancerous lesions. Further research and development are essential to improving the sensitivity, specificity, and reliability of non-invasive tools for widespread clinical application.
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Affiliation(s)
- Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (T.V.P.); (E.D.); (G.I.); (C.D.); (S.D.)
| | - Emira D’Amico
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (T.V.P.); (E.D.); (G.I.); (C.D.); (S.D.)
| | - Chiara Cinquini
- Department of Surgical, Medical, Molecular Pathologies and of the Critical Needs, School of Dentistry, University of Pisa, 56100 Pisa, Italy;
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (T.V.P.); (E.D.); (G.I.); (C.D.); (S.D.)
| | - Camillo D’Arcangelo
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (T.V.P.); (E.D.); (G.I.); (C.D.); (S.D.)
| | - Simonetta D’Ercole
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (T.V.P.); (E.D.); (G.I.); (C.D.); (S.D.)
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (T.V.P.); (E.D.); (G.I.); (C.D.); (S.D.)
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Chaurasia A, Alam SI, Singh N. Oral cancer diagnostics: An overview. Natl J Maxillofac Surg 2021; 12:324-332. [PMID: 35153426 PMCID: PMC8820315 DOI: 10.4103/njms.njms_130_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/02/2020] [Accepted: 12/10/2020] [Indexed: 12/11/2022] Open
Abstract
Cancer was first mentioned in medicine texts by Egyptians. Ancient Indians studied oral cancer in great detail under Susruta. Cancer has continued to be a challenge to physicians from ancient times to the present. Over the years, cancer underwent a shift in management from radical surgeries toward a more preventive approach. Early diagnosis is vital in reducing cancer-associated mortality especially with oral cancer. Even though the mainstay of oral cancer diagnosis still continues to be a trained clinician and histopathologic examination of malignant tissues. Translating innovation in technological advancements in diagnostic aids for oral cancer will require both improved decision-making and a commitment toward optimizing cost, skills, turnover time between capturing data and obtaining a useful result. The present review describes the conventional to most advanced diagnostic modalities used as oral cancer diagnostics. It also includes the new technologies available and the future trends in oral cancer diagnostics.
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Affiliation(s)
- Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Saman Ishrat Alam
- Department of Oral Medicine and Radiology, Rama Dental College, Rama University, Kanpur, Uttar Pradesh, India
| | - Navin Singh
- Department of Radiotherapy, King George Medical University, Lucknow, Uttar Pradesh, India
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Current Insights into Oral Cancer Diagnostics. Diagnostics (Basel) 2021; 11:diagnostics11071287. [PMID: 34359370 PMCID: PMC8303371 DOI: 10.3390/diagnostics11071287] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 12/16/2022] Open
Abstract
Oral cancer is one of the most common head and neck malignancies and has an overall 5-year survival rate that remains below 50%. Oral cancer is generally preceded by oral potentially malignant disorders (OPMDs) but determining the risk of OPMD progressing to cancer remains a difficult task. Several diagnostic technologies have been developed to facilitate the detection of OPMD and oral cancer, and some of these have been translated into regulatory-approved in vitro diagnostic systems or medical devices. Furthermore, the rapid development of novel biomarkers, electronic systems, and artificial intelligence may help to develop a new era where OPMD and oral cancer are detected at an early stage. To date, a visual oral examination remains the routine first-line method of identifying oral lesions; however, this method has certain limitations and as a result, patients are either diagnosed when their cancer reaches a severe stage or a high-risk patient with OPMD is misdiagnosed and left untreated. The purpose of this article is to review the currently available diagnostic methods for oral cancer as well as possible future applications of novel promising technologies to oral cancer diagnosis. This will potentially increase diagnostic options and improve our ability to effectively diagnose and treat oral cancerous-related lesions.
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Wang R, Wang Y. Fourier Transform Infrared Spectroscopy in Oral Cancer Diagnosis. Int J Mol Sci 2021; 22:1206. [PMID: 33530491 PMCID: PMC7865696 DOI: 10.3390/ijms22031206] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/13/2022] Open
Abstract
Oral cancer is one of the most common cancers worldwide. Despite easy access to the oral cavity and significant advances in treatment, the morbidity and mortality rates for oral cancer patients are still very high, mainly due to late-stage diagnosis when treatment is less successful. Oral cancer has also been found to be the most expensive cancer to treat in the United States. Early diagnosis of oral cancer can significantly improve patient survival rate and reduce medical costs. There is an urgent unmet need for an accurate and sensitive molecular-based diagnostic tool for early oral cancer detection. Fourier transform infrared spectroscopy has gained increasing attention in cancer research due to its ability to elucidate qualitative and quantitative information of biochemical content and molecular-level structural changes in complex biological systems. The diagnosis of a disease is based on biochemical changes underlying the disease pathology rather than morphological changes of the tissue. It is a versatile method that can work with tissues, cells, or body fluids. In this review article, we aim to summarize the studies of infrared spectroscopy in oral cancer research and detection. It provides early evidence to support the potential application of infrared spectroscopy as a diagnostic tool for oral potentially malignant and malignant lesions. The challenges and opportunities in clinical translation are also discussed.
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Affiliation(s)
| | - Yong Wang
- School of Dentistry, University of Missouri–Kansas City, Kansas City, MO 64108, USA;
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Diagnostic accuracy of clinical visualization and light-based tests in precancerous and cancerous lesions of the oral cavity and oropharynx: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4145-4159. [PMID: 33392809 DOI: 10.1007/s00784-020-03746-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evaluate and compare the performance of autofluorescence, chemiluminescence, and clinical visual examination in the detection of oral potentially malignant disorders (OPMD), oral cancer (OC), and oropharyngeal cancer (OPC). MATERIALS AND METHODS A systematic review with meta-analysis based on diagnostic test studies. A literature search was carried out in the MEDLINE and EMBASE databases through August 30, 2020. For this review, the quality assessment tool of diagnostic precision studies (QUADAS-2) was used. Hierarchical regression models were used to estimate pooled diagnostic precision values in a random effects model. RESULTS A total of 40 studies were identified for this review according to each test evaluated: 5.562 samples for autofluorescence, 1.353 samples for chemiluminescence, and 1.892 samples for clinical examination. The summary measures sensitivity and specificity of the clinical examination were 63% and 78%, respectively, AUC = 0.78 95% CI (0.74-0.81). In the autofluorescence test, these were 86% and 72%, respectively, AUC = 0.86 95% CI (0.83-0.89); and the chemiluminescent test were 67% and 48%, respectively, AUC = 0.59 95% CI (0.54-0.63) CONCLUSIONS: Autofluorescence devices displayed superior accuracy levels in the identification of premalignant lesions and early neoplastic changes compared to clinical examination and chemiluminescent test. Overall, biopsy remains the gold standard for the definitive diagnosis of OPMD, OC, and OPC. CLINICAL RELEVANCE Light-based clinical methods such as autofluorescence and chemiluminescence techniques have been used in clinical diagnosis for the differentiation of OPMD and malignant and benign lesions; although detailed visual examination appears to be effective in identifying, previous systematic reviews have not evaluated a relevant number of studies and they did not evaluate the accuracy of the clinical examination.
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Early Diagnosis on Oral and Potentially Oral Malignant Lesions: A Systematic Review on the VELscope ® Fluorescence Method. Dent J (Basel) 2019; 7:dj7030093. [PMID: 31487927 PMCID: PMC6784481 DOI: 10.3390/dj7030093] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 12/14/2022] Open
Abstract
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.
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Sharma G. Diagnostic aids in detection of oral cancer: An update. World J Stomatol 2015; 4:115-120. [DOI: 10.5321/wjs.v4.i3.115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/07/2015] [Accepted: 08/17/2015] [Indexed: 02/06/2023] Open
Abstract
Oral cancer is the sixth most common malignancy with almost 500000 new cases reported worldwide annually. The diagnosis of oral cancer at an early stage has a good prognosis as the survival rate is high (around 80%). However, the majority of oral cancer cases are diagnosed at a later stage with a considerably poor 5-year survival rate of 50% according to World Health Organization statistics. Thus, an effective management strategy for oral cancer will depend on its early identification and intervention which would pave the way for superior prognosis. Despite the obvious advantage of earlier diagnosis of oral cancer, no approach has yet proven to be a reliably successful in diagnosis of oral cancer at an early stage. Currently; the primary line of screening of oral cancer is performed by visual inspection, which is a subjective examination. Among the screening tests or diagnostic aids now available for oral cancer, few (toluidine blue, brush biopsy, salivary and serum bio-markers) have been utilised and studied for many years while others have recently become commercially available. The authors in the present article review all the modalities of screening aids used in oral cancer detection and provide an update on the latest screening tools used in oral cancer detection.
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