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Efficacy of light based detection systems for early detection of oral cancer and oral potentially malignant disorders: Systematic review

DOI:10.4317/medoral.21104 期刊:Medicina Oral Patología Oral y Cirugia Bucal 出版年份:2016 更新时间:2025-09-19 17:15:36
摘要: Background: Earlier detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is essential for dental professionals to improve patient survival rates. The aim of this systematic review is to to evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of OSCC and OPMD. Material and Methods: The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE] and Science direct. The search was for limited articles published in English or with an English abstract and articles published during the period from January 2005 to April 2014. Clinical trials utilized ViziLite, Microlux TM/DL and Visual Enhanced Light scope (VELscope) for early detection of OPMD and OSCC. Results: Twenty primary studies published satisfied our criteria for selection - 10 utilised chemiluminescence and 10 tissue autofluorescence. Senstivity of Vizilite for detecting OSCC nad OPMD ranged from 77.1 % to 100% and specificity was low that ranged from 0% to 27.8%.Most have shown that chemiluminescence increases the brightness and margins of oral mucosal white lesions and thus assist in identification of mucosal lesions not considered under Conventional visual examination. However, it preferentially detects leukoplakia and may fail to spot red patches. Clinical trials demonstrated that sensitivity of VELscope in detecting malignancy and OPMD ranged from 22 % to 100 % and specificity ranged from 16 % to 100%. Most studies concluded that VELscope can help the experienced clinician to find oral precursor malignant lesions. But it couldnot differentiate between dysplasia and benign inflammatory conditions. Conclusions: Both devices are simple, non-invasive test of the oral mucosa but are suited for clinicians with sufficient experience and training. More clinical trials in future should be conducted to establish optical imaging as an efficacious adjunct tool in early diagnosis of OSCC and OPMD.
作者: Ravleen Nagi,Yashoda-Bhoomi Reddy-Kantharaj,Nagaraju Rakesh,Sujatha Janardhan-Reddy,Shashikant Sahu
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To evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD).

Both chemiluminescence and autofluorescence devices are simple, non-invasive tests that can assist experienced clinicians in detecting oral precursor malignant lesions, but they are not reliable for discriminating high-risk lesions and have several limitations. Conventional visual inspection remains the gold standard, and future research should focus on real-time quantitative evaluation for optical biopsy.

Both devices have limited ability to discriminate high-risk lesions and have limitations such as low specificity, inability to detect some red lesions, need for a dark environment, high cost, no permanent record unless photographed, and inability to differentiate between dysplasia and benign inflammatory conditions. More clinical trials are needed to establish their efficacy.

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