Autofluorescence and Early Detection of Mucosal Lesions in Patients at Risk for Oral Cancer

Abstract

Loss of autofluorescence as an early phenomenon associated with tissue degeneration seems to be promising for the diagnosis of oral cancer. The method seems to make visible early structural and biochemical alterations of the oral mucosa not always evident under direct inspection of the oral cavity. For this reason, the margins of the mucosal lesions usually appear wider compared with direct visualization. Actual extension of the potentially malignant lesions must be precisely perceived to avoid any underestimation of the tumor. In this study, 32 patients at risk for oral cancer underwent autofluorescence test. Of these patients, 12 (group A) experienced potentially malignant diseases. The other 20 patients (group B) were previously operated on for oral cancer. In addition, 13 patients showed loss of autofluorescence (8 patients from group A and 5 patients from group B). Among these 13 patients, 12 were affected with lesions of relevance (in group A, 6 had squamocellular carcinoma and 2 had low-grade dysplasia; in group B, 2 patients had high-grade dysplasia, 2 had low-grade dysplasia, and 1 had an epithelial hypertrophy with inflammatory cells). Preliminary results seem to indicate that autofluorescence is a high-performing test for the individuation of oral cancer in populations at risk (sensibility up to 100% and specificity up to 93% in this study).

Margins of oral leukoplakia: autofluorescence and histopathology

“…Moro et al reported that it was possible to detect invisible extensions of visually-detected lesions with autofluorescence. 23 In contrast to our study they did not make any measurements of the size of the lesion or report on the performance of the autofluorescence, and 20/32 of their patients had a recent history of oral cancer. We noticed a loss of autofluorescence in the region around the lesion in 16 patients, and normal autofluorescence in the region around the lesion in 10.…”

Non-Invasive Techniques for Detection and Diagnosis of Oral Potentially Malignant Disorders

“…Some studies found that the VELscope can assist in screening for oral PMDs and oral cancer in populations at risk (Moro et al 2010;Scheer et al 2011). However, there is no evidence that it can distinguish between them (Balevi 2007), and no published studies have assessed VELscope as a diagnostic adjunct in general populations.…”

“…8-94.3 70.7-99.6 (McIntosh et al 2009;Ibrahim et al 2014) Orascoptic DK n/a n/a (Patton et al 2008) VELscope 30-100 15-100 (Poh et al 2006;Balevi 2007;Patton et al 2008;Trullenque-Eriksson et al 2009;Mehrotra et al 2010;Moro et al 2010;Awan et al 2011a;Balevi 2011;Fricain 2011;Lopez-Jornet and De la Mano-Espinosa 2011;Scheer et al 2011;Farah et al 2012;Marzouki et al 2012;Bhatia et al 2013) Photodynamic diagnosis 79-100 50-99 (Leunig et al 2000;Betz et al 2002;Zheng et al 2002;Chang and Wilder-Smith 2005;Sharwani et al 2006a;Driemel et al 2007;Sieron et al 2008) Optical diagnostic technologies…”

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

“…[1819] AF of the tissues is due to the presence of several endogenous fluorophores which include tissue matrix molecules and intracellular molecules such as tryptophan, collagen, and NADH. [20] When excited by a particular wave length these fluorophores emit fluorescence at a particular wavelength, for example, tryptophan gives maximum emission at 340 nm, collagen at 390 and NADH at 440 nm.…”