Abstract
BackgroundGold standard for the diagnosis of oral dysplasia (OD) oral squamous cell carcinoma (OSCC) and malignant lesions is the histological examination. Several adjunctive diagnostic techniques have been proposed in order to increase the sensitivity (SE) and specificity (SP) of conventional oral examination and to improve the diagnostic first level accuracy. The aim of this study is to perform a systematic review on non-invasive tools for diagnosis of OD and early OSCC.Material and MethodsMedline, Scopus, Web of Knowledge databases were searched, using as entry terms “oral dysplasia AND diagnosis” / ”oral cancer AND diagnosis”. Data extracted from each study included number of lesions evaluated, histopathological diagnosis, SE, SP, positive and negative predictive values (PPV and NPV), diagnostic accuracy (DA) and the main conclusions.ResultsAfter title and abstract scanning of 11.080 records, we selected 35 articles for full text evaluation. Most evaluated tools were autofluorescence (AF), chemiluminescence (CL), toluidine blu (TL) and chemiluminescence associated with toluidine blue (CLTB).ConclusionsThere is a great inhomogeneity of the reported values and there is no significant evidence of superiority of one tool over the other. Further clinical trials with a higher level of evidence are necessary in order to assess the real usefulness visual diagnostic tools. Key words:Oral dysplasia, oral cancer, diagnosis, visual diagnostic tool, systematic review.
Highlights
Oral squamous cell carcinoma (OSCC) is the sixth most common malignant tumour, with an incidence of more than 500.000 cases per year (1)
Twenty-three papers were eventually selected for the present systematic review when using “oral dysplasia AND diagnosis” as entry terms
The principles of functioning of non-invasive visual diagnostic tools for oral squamous cell carcinoma (OSCC) and dysplastic lesions are very different, being based on diverse specific cellular and tissue characteristics. Such a great diversity may partly explain the impressive discrepancy of results obtained in the studies analysed
Summary
Oral squamous cell carcinoma (OSCC) is the sixth most common malignant tumour, with an incidence of more than 500.000 cases per year (1). The aim of this study is to perform a systematic review on non-invasive tools for the diagnosis of OED and OSCC, taking into account factors as SE, SP, PPV, NPV and DA. Gold standard for the diagnosis of oral dysplasia (OD) oral squamous cell carcinoma (OSCC) and malignant lesions is the histological examination. Several adjunctive diagnostic techniques have been proposed in order to increase the sensitivity (SE) and specificity (SP) of conventional oral examination and to improve the diagnostic first level accuracy. The aim of this study is to perform a systematic review on non-invasive tools for diagnosis of OD and early OSCC. Data extracted from each study included number of lesions evaluated, histopathological diagnosis, SE, SP, positive and negative predictive values (PPV and NPV), diagnostic accuracy (DA) and the main conclusions. Further clinical trials with a higher level of evidence are necessary in order to assess the real usefulness visual diagnostic tools
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