Abstract
ObjectivesAutofluorescence imaging is gaining popularity as an adjunctive test for oral potentially malignant disorders (OPMD). This study evaluated the efficacy of autofluorescence imaging based on the current standard oral mucosal disorder checklist in Taiwan.Materials and methodsIn total, 126 patients suspected to have mucosal disorders at the Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei, Taiwan, were enrolled. Following a conventional oral examination by using the oral mucosal disorder checklist and an autofluorescence imaging examination, all participants underwent histopathological examination to access epithelial dysplasia.ResultsAmong 126 patients, 68 patients were diagnosis as having an OPMD and 63 having epithelial dysplasia. Autofluorescence imaging exhibited a sensitivity, specificity, positivity predictive value (PPV), negative predictive value (NPV), and accuracy of 77.94%, 35.42%, 63.10%, 53.13%, and 60.34%, respectively, for OPMD and of 88.89%, 43.86%, 63.64%, 78.13%, and 67.50%, respectively, for epithelial dysplasia. After the exclusion of 48 non-OPMD cases according to the checklist, the sensitivity, specificity, PPV, NPV, and accuracy of autofluorescence imaging became 87.50%, 72.73%, 94.23%, 53.33%, and 85.07%, respectively, for epithelial dysplasia.ConclusionThe efficacy of epithelial dysplasia identification and OPMD risk assessment can be increased after the exclusion of the non-OPMD cases through autofluorescence imaging.Clinical relevanceAutofluorescence imaging is a useful adjunct that can assist specialists in assessing OPMD patients prone to dysplasia without compromising patient care.
Highlights
The concept of oral potentially malignant disorders (OPMD) was established by Warnakulasuriya et al, who stated that they are a family of morphological alterations among whichThe current standard for the detection of OPMD, which mainly comprises leukoplakia, erythroplakia, and erythroleukoplakia, is a conventional oral examination (COE) [7]
Excited fluorophores intrinsic in the oral mucosa result in pale green autofluorescence, indicating normal tissue, whereas abnormal tissue is associated with the loss of autofluorescence, which may be caused by structural changes
A COE with location of the lesion recorded was conducted by a certified specialist to clinically diagnose nonhomogenous leukoplakia, homogenous thick leukoplakia, leukoplakia, erythroplakia, erythroleukoplakia, verrucous hyperplasia, submucosal fibrosis, lichen planus, and suspected oral cancer according to the checklist
Summary
The concept of oral potentially malignant disorders (OPMD) was established by Warnakulasuriya et al, who stated that they are a family of morphological alterations among whichThe current standard for the detection of OPMD, which mainly comprises leukoplakia, erythroplakia, and erythroleukoplakia, is a conventional oral examination (COE) [7]. The thickening of the epithelium, hyperchromatism, increased cellular or nuclear pleomorphism, and increased microvascularity all lead to the increased absorption or scattering of light; abnormal tissues with such structural changes appear dark in contrast [16, 17]. Because of this loss of autofluorescence in abnormal tissues, autofluorescence imaging is used as an adjunct tool to assess the risk of potentially malignant disorders and select optimal biopsy sites [18,19,20]
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