Abstract
Simple SummaryThe early detection of oral cancer and oral potentially malignant disorders can facilitate minimum intervention and subsequent improvements in prognosis and quality of life after treatment. Recently, several non-invasive adjunctive fluorescence-based detection systems have improved the accuracy of detection and diagnosis of oral cancer and oral potentially malignant disorders. This article summarizes current knowledge about fluorescence-based diagnostic methods and discusses their benefits and drawbacks from a clinical viewpoint.Oral health promotion and examinations have contributed to the early detection of oral cancer and oral potentially malignant disorders, leading to the adaptation of minimally invasive therapies and subsequent improvements in the prognosis/maintenance of the quality of life after treatments. However, the accurate detection of early-stage oral cancer and oral epithelial dysplasia is particularly difficult for conventional oral examinations because these lesions sometimes resemble benign lesions or healthy oral mucosa tissues. Although oral biopsy has been considered the gold standard for accurate diagnosis, it is deemed invasive for patients. For this reason, most clinicians are looking forward to the development of non-invasive diagnostic technologies to detect and distinguish between cancerous and benign lesions. To date, several non-invasive adjunctive fluorescence-based detection systems have improved the accuracy of the detection and diagnosis of oral mucosal lesions. Autofluorescence-based systems can detect lesions as a loss of autofluorescence through irradiation with blue-violet lights. Photodynamic diagnosis using 5-aminolevulinic acid (ALA-PDD) shows the presence of very early oral cancers and oral epithelial dysplasia as a red fluorescent area. In this article, currently used fluorescence-based diagnostic methods are introduced and discussed from a clinical point of view.
Highlights
Oral cancer originating from the lip and oral cavity has been ranked as the 16th most common cancer worldwide, but the global incidence rate has seen a decline
Using the Aminolevulinic acid (ALA)-Photodynamic diagnosis (PDD) method, 0.4–1% ALA solution is topically administered in the oral cavity via continuous oral rinsing for 15 min, and PDD using blue-violet light at a wavelength of 375–440 nm is performed after incubation for 1–2.5 h (Table 2)
The improvement of diagnostic techniques for oral mucosa lesions could decrease patient suffering associated with oral cancer
Summary
Oral cancer originating from the lip and oral cavity has been ranked as the 16th most common cancer worldwide, but the global incidence rate has seen a decline. Conducted a systematic review to assess the accuracy of the COE in detecting OED and oral squamous cell carcinoma (OSCC) and suggested that the sensitivity and specificity of COEs were 93% and 31%, respectively [12] This suggested that the number of false-positive cases was large, indicating that clinicians likely diagnosed several suspicious lesions as malignant lesions. Considering this point, it can be concluded that the COE alone cannot accurately detect and discriminate between OEDs or OSCC and other lesions or classify high-risk and low-risk OPMDs, even though oral cancer specialists perform the COE [7,14,15]. OPMDs are introduced, with a special emphasis on photodynamic diagnosis using 5-aminolevulinic acid (ALA-PDD), and discussed from a clinical viewpoint
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