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

Abstract

Oral squamous cell carcinoma (OSCC) is the most common oral and maxillofacial malignancy, and its morbidity and mortality rates are still high in most countries. Oral potentially malignant disorders (PMDs) are used to refer to a heterogeneous group of conditions that are characterized by increased risk for malignant transformation to OSCC. Currently identified oral PMDs include leukoplakia, erythroplakia, palatal lesions associated with reverse smoking, oral lichen planus, oral submucous fibrosis, actinic keratosis, and discoid lupus erythematosus. The early detection and diagnosis of these lesions are important for cancer prevention and disease management. In recent years, there has been a growing and persistent demand for new non-invasive, practical diagnostic techniques that might facilitate the early detection of oral PMDs. The non-invasive detection techniques evaluated in this review are divided into four categories: vital staining with a solution that can be used as a mouth rinse or applied onto a suspected area of the mouth, light-based detection systems, optical diagnostic technologies that employ returned optical signals to reflect structural and morphological changes within tissues, and salivary biomarkers. Most of these techniques have shown great potential for screening and monitoring oral PMDs. In this review article, the authors critically assess these non-invasive detection techniques for oral PMDs. We also provide a summary of the sensitivity and specificity of each technique in detecting oral PMDs and oral cancer, as well as their advantages, disadvantages, clinical applications, and indications.

Diagnosis of oral lichen planus from analysis of saliva samples using terahertz time-domain spectroscopy and chemometrics

“…A high sensitivity but limited specificity of PDD in the detection of oral cancer has been shown in Ref. 22.…”

“…However, the clinical applications of RS are limited by both the difficulty of capturing weak Raman signals from tissue and the relatively slow speed of spectrum acquisitions. 22 Elastic scattering spectroscopy was shown to be sensitive to nuclear size, chromatin content, and nuclear/cytoplasmic ratio, which are of interest for detecting malignant tissue, but it is rarely used in premalignant and malignant oral tissue studies. 22 Diffusive reflectance microscopy allows analyzing tissue morphology, such as nuclear size distribution, epithelial thickness, collagen content, and the amount of oxy-and deoxyhemoglobin, all of which can vary during carcinogenesis in the epithelia.…”

Multiclass classification of autofluorescence images of oral cavity lesions based on quantitative analysis

“…It requires an incision in the tissues. These shortcomings have led clinicians to shift to non-invasive techniques such as vital staining, light-based detection and the use of optical diagnostic techniques [15].…”

Saliva as a non-invasive material for early diagnosis

“…Most of all, head and neck squamous cell carcinoma (HNSCC) is difficult to diagnose due to its inconvenient location. Therefore, the body fluids, such as saliva may be an important material for monitoring of oral tumours (Zimmermann, 2008;Yakob et al, 2014;Liu et al, 2016). Moreover, a biopsy is a quite expensive, unpleasant and time-consuming method, therefore scientists try to find an alternative way to analyse the genetic markers of tumours.…”