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

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.

Clinical characteristics of oral lichen planus and its causal context with dental restorative materials and oral health-related quality of life

“…Early diagnosis and treatment of oral mucosal diseases can reduce the impact on the quality of life of affected patients in the future [ 38 , 39 ].…”

Pancreatic Carcinoma Metastatic to the Gingiva

“…This helps to determine and to increase the chances of a successful differential diagnosis. Various technologies such as the VELscope fluorescence method are used today to help diagnose primary and metastatic lesions of the oral cavity [ 20 , 21 ]. Metastatic lesions should always be included in the differential diagnosis, so the treatment can be started more promptly.…”

May VelScope Be Deemed an Opportunistic Oral Cancer Screening by General Dentists? A Pilot Study

“…Benign and malignant oral lesions clinically appear with great variability in terms of heterogeneous morphology, onset, and clinical course; this is why histopathological examination remains the gold standard for final diagnosis. Up to now, there are unresolved medical issues in the methodology of published reports, due to selection bias of patients with different OPMDs and different prognosis and to the absence of uniformity in histological classification and description of the grade of dysplasia [ 10 ]. The heterogeneity of clinical and histological aspects among experts clearly reflects the diagnostic difficulty to screen oral lesions and does not allow data to be uniformly compared.…”