Oral Precancerous Lesions Research Articles

Perspectives on association of genetic polymorphism in Th1/Th2-related cytokines with the risk of oral precancerous lesions

Perspectives on association of genetic polymorphism in Th1/Th2-related cytokines with the risk of oral precancerous lesions

A scientometric study of betel quid chewing and oral cancer and precancerous lesions with distinct regional characteristic

Scientometric analysis is a useful tool that utilizes bibliometric data to measure scientific output of a disease or region in a particular field. In this report, we comprehensively provide bibliometric characteristics of all the papers on betel quid (BQ)-related cancer and precancerous lesions. There are 1403 papers on BQ-related cancer and precancerous lesions published until 2022 in the Scopus database. China (mainland and Taiwan region), India, United States, and United Kingdom contribute 1214 (86.5%) papers and 34,120 (91.9%) citations of all the papers. The number (457), citations (14,573), and h index (60) of the papers originated from Taiwan region stably remain in the first. The most frequent research keyword is arecoline, followed by drug, prevalence, metabolism, carcinogenesis, and pathology. Areca nut and BQ cessation program by Taiwan government has demonstrated a significant positive impact on oral cancer prevention. Collectively, the scientific output of BQ-related cancer and precancerous field represents distinct regional characteristic. BQ-related cancer prevention is still a long way off. Encouragingly, Taiwan region is well ahead in this way.

Role of Tobacco Consumption Habits in the Causation of Precancerous Lesions: A Cross Sectional Study

Oral carcinoma is quite common and increasing trend in India and worldwide. Smoking and smokeless tobacco both are increasing worldwide. The common oral precancerous lesions are oral leukoplakia, erythroplakia, nicotina palati and oral sub mucous fibrosis (OSMF). Screening is best tool to find out such lesions. The current study is conducted to know the prevalence of tobacco consumption and also to examine oral cavity of tobacco consumer to detect precancerous lesions among the staff. Method: The present study was cross sectional study carried out tertiary care hospital staff. The study was conducted over a period of 6 month from May 2017 to October 2017. Ethical clearance for study was obtained from Institutional Ethical Committee. The staff members of class 3 and class 4 of hospital were taken as a study participants involving both of sex and who provided written informed consent. Sample of 120 staff members were enrolled for the study from provided sampling frame with the use of random sampling method. Study participants with previous history of hospital admission for any systemic illness, immunodeficiency or immunosuppressive patients, and participants who already diagnosed to have malignant cancer lesions in any part of body were excluded. Result: Of 120 study participants, 40% were belongs to 31 – 40 years of age group and majority were male (80%) and belonged to Hindu (90.83%) religion. The prevalence of tobacco consumption in any of form is 85%; of them 43.33% used smokeless tobacco and 10.83% used to with smoking and 30.83% had both forms of tobacco. Oral Sub Mucosal Fibrosis (OSMF) was the most common (70.58%) precancerous lesion found in the present study, followed by leukoplakia (16.67%). Conclusion: Current study revealed the high prevalence. There is urgent need to plan de-addiction at various level. Also those having the precancerous lesion need to warn and treat accordingly.

Interactions of Betel Quid Constituents with Drug Disposition Pathways: An Overview.

Global estimates indicate that over 600 million individuals worldwide consume the areca (betel) nut in some form. Nonetheless, its consumption is associated with a myriad of oral and systemic ailments, such as precancerous oral lesions, oropharyngeal cancers, liver toxicity and hepatic carcinoma, cardiovascular distress, and addiction. Users commonly chew slivers of areca nut in a complex consumable preparation called betel quid (BQ). Consequently, the user is exposed to a wide array of chemicals with diverse pharmacokinetic behavior in the body. However, a comprehensive understanding of the metabolic pathways significant to BQ chemicals is lacking. Henceforth, we performed a literature search to identify prominent BQ constituents and examine each chemical's interplay with drug disposition proteins. In total, we uncovered over 20 major chemicals (e.g., arecoline, nicotine, menthol, quercetin, tannic acid) present in the BQ mixture that were substrates, inhibitors, and/or inducers of various phase I (e.g., CYP, FMO, hydrolases) and phase II (e.g., GST, UGT, SULT) drug metabolizing enzymes, along with several transporters (e.g., P-gp, BCRP, MRP). Altogether, over 80 potential interactivities were found. Utilizing this new information, we generated theoretical predictions of drug interactions precipitated by BQ consumption. Data suggests that BQ consumers are at risk for drug interactions (and possible adverse effects) when co-ingesting other substances (multiple therapeutic classes) with overlapping elimination mechanisms. Until now, prediction about interactions is not widely known among BQ consumers and their clinicians. Further research is necessary based on our speculations to elucidate the biological ramifications of specific BQ-induced interactions and to take measures that improve the health of BQ consumers.

Expression and significance of m6A-RNA-methylation in oral cancer and precancerous lesion.

Oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) are a series of related pathologic and molecular events involving simple epithelial hyperplasia, mild to severe dysplasia and canceration. N6-methyladenosine RNA methylation, as the most common modification of both coding mRNA and non-coding ncRNA in eukaryotes, participates in the regulation of the occurrence and development of various malignant tumors in human. However, its role in oral epithelial dysplasia (OED) and OSCC remain unclear. In this study, multiple public databases were used for bioinformatics analysis of 23 common m6A methylation regulators in head and neck squamous cell carcinoma (HNSCC). Protein expressions of IGF2BP2 and IGF2BP3 were verified accordingly in clinical cohort samples of OED and OSCC. Patients with high expression of FTO、HNRNPC、HNRNPA2B1、LRPPRC、IGF2BP1、IGF2BP2、IGF2BP3 had a poor prognosis. IGF2BP2 had a relatively high mutation rate in HNSCC, and its expression was significantly positively correlated with tumor purity, and significantly negatively correlated with the infiltration level of B cells and CD8+T cells. The expression of IGF2BP3 was significantly positively correlated with tumor purity and CD4+T cells. Immunohistochemistrically, the expression of IGF2BP2 and IGF2BP3 in oral simple epithelial hyperplasia, OED and OSCC increased gradually. Both were strongly expressed in OSCC. IGF2BP2 and IGF2BP3 were the potential biological prognostic indicators of OED and OSCC.

Chemopreventive and Anticancer Role of Resveratrol against Oral Squamous Cell Carcinoma.

Oral squamous cell carcinoma (OSCC) is one of the most prevailing and aggressive head and neck cancers, featuring high morbidity and mortality. The available conventional treatments suffer from several adverse effects and are often inefficient in terms of their survival rates. Thus, seeking novel therapeutic agents and adjuvants is of the utmost importance for modern society. Natural polyphenolic compounds have recently emerged as promising chemopreventive and anticancer agents. Specifically, the natural compound resveratrol (RSV) has recently gained momentum for this purpose. RSV is useful for treating OSCC due to its antiproliferative, antimetastatic, and proapoptotic effects. Additionally, RSV acts against tumor cells while synergically cooperating with chemotherapeutics, overcoming drug resistance phenomena. Despite these wide-spectrum effects, there are few specific investigations regarding RSV's effects against OSCC animal models that consider different routes and vehicles for the administration of RSV. Interestingly, an injectable RSV-loaded liposome-based formulation was proven to be effective against both in vitro and in vivo OSCC models, demonstrating that the development of RSV-loaded drug delivery systems for systemic and/or loco-regional applications may be the turning point in oral cancer treatment, leading to benefits from both RSV's properties as well as from targeted delivery. Given these premises, this review offers a comprehensive overview of the in vitro and in vivo effects of RSV and its main derivative, polydatin (PD), against OSCC-related cell lines and animal models, aiming to guide the scientific community in regard to RSV and PD use in the treatment of oral precancerous and cancerous lesions.

Assessment of knowledge and awareness among North Indian populations about oral precancerous lesions (OPL): A cross-sectional survey study.

A precancerous lesion is a morphologically altered tissue in which oral cancer is more likely to occur than its apparently normal counterpart. They are quite common in the Indian population due to the habitual habit of chewing tobacco. The aim of this study was to evaluate the awareness of oral precancerous lesions by a questionnaire-based survey among the study subjects having been diagnosed with it. In this descriptive study, a structured questionnaire having 11 survey questions has been used to record the response from study subjects who have been diagnosed and reported for treatment for oral premalignant lesions in the Department of Oral Medicine and Radiology. A total of 1013 study subjects were assessed for awareness about OPL and its consequences. 44.3% of the study population was addicted to smoking tobacco (cigarettes) while 57.9% of study subjects were addicted to non-smoking tobacco (Pan masala). The reason behind their addiction was reported to be stress (54.9%) and workload (25.3%). Most of the study subjects were diagnosed with oral sub-mucous fibrosis (53.4%). 78.6% of study subjects diagnosed with OPL were not aware of it and 94% were willing to quit the addiction. The awareness about OPL among patients was found to be low. Although many wanted to quit their addiction to smoking and chewing tobacco but were unable to do so. So it is a need for time to develop a national policy on tobacco use and related diseases. This policy will definitely reduce the burden of oral premalignant lesions and oral cancer in Indian population.

Role of Lasers in Orthognathic Surgery- A Review

A huge revolution that has taken place in the field of surgery is the application of lasers. In recent decades the application of lasers in medical and surgical fields has significantly raised. Orthognathic surgery is a division of oral and maxillofacial surgery wherein a patient's facial and occlusal function is altered and improved to increase the patient's confidence and self-esteem. The laser can be abbreviated as "Light amplification by stimulated emission of radiation". A laser is a device that emits a high-intensity light beam that converts electrical energy into a focused high-energy beam. Lasers have various uses in Oral and maxillofacial surgery, including removing oral mucosal lesions like leukoplakia, oral lichen planus, Fordyce granules, and precancerous lesions. It also helps in removing oral benign lesions, Hemostasis during any surgical procedures, Frenectomy and treatment of ankyloglossia. Apart from these, low-level lasers are also effective in Orthognathic surgeries. Low-level lasers have been used in orthognathic surgery to reduce pain post-operatively, for effective wound healing, and reduce inflammation and trismus. This study aims to search for scientific evidence regarding the effectiveness of lasers in the above-mentioned aspects

The Taq 1 polymorphism of Vitamin D receptor gene is associated with oral cancer and preoral cancer in North Indian population.

Oral cancer is known as one of the most common cancers, with a poor prognosis, related to delayed clinical diagnosis, either due to the lack of particular biomarkers related to the disease or costly therapeutic alternatives. In this study association of single nucleotide polymorphism (Taq1, T>C) in Vitamin D receptor gene with oral cancer and pre oral cancer was studied. Total 230 patients of precancerous oral lesions (Leukoplakia 70, Oral Sub mucous fibrosis 90, Lichen Planus 70), 72 oral cancer patients and 300 healthy control subjects were genotyped by PCR-RFLP methods. Chi-square test was used for calculation of genotype and allele frequencies. Mutant genotype CC as well as C allele were found to significantly decrease the risk of oral disease (P value=0.04, OR=0.60 and P value=0.02, OR=0.75 respectively). In particular, compared to non smokers, smokers with TC & CC genotypes were at decrease risk of oral diseases (P value=0.0001, OR=0.04). The mutant allele genotype CC as well as the mutant allele C showed protective association with leukoplakia (P value=0.01, OR=0.39 & P value=0.009, OR=0.59 respectively). However, individual with CC genotype had developed high cell differentiated grade at diagnosis (OR= 3.78, P value= 0.008). This study concludes that VDR (Taq1) polymorphism is associated with oral cancer and pre oral cancer susceptibility in North Indian population.

Research Progress on the Interaction Between Microorganisms and Macrophages and Their Role in the Mediation of the Onset and Development of Oral Cancer

Oral squamous cell carcinoma is the sixth most common malignant tumor in the world, and the clinical treatment effect is not satisfactory. Because of the special nature of its location, oral cancer is inextricably linked with a wide variety of microorganisms, and its pathogenesis and development are also extremely susceptible to microbial regulation. In addition, the mediating role of the immune system is also indispensable to the course of tumor pathogenesis and development, especially tumor-associated macrophages, which amplify the regulatory role of microorganisms, and in turn regulate the microbial population components--two complementary effects that jointly exacerbate oral cancer. Herein, we summarized the existing research on the relationship between microorganisms and macrophages, as well as the regulatory role of microorganisms and macrophages in the pathogenesis and development of oral cancer. We also discussed the current status of and gaps in research on the relationship between microorganisms and macrophages and oral cancer. Both microorganisms and macrophages are considered promising indicators for prognosis, showing potentials to be used as new therapeutic targets. Despite some research interest in the role of microorganisms and macrophages in oral cancer, very few studies have linked them to oral precancerous lesions, and the mutual regulatory relationship between microorganisms and macrophages remains unclear. Therefore, in-depth exploration of the relationship network of microorganisms, macrophages and oral cancer is expected to provide more possibilities for the early diagnosis and treatment of tumors.

Retracted: Artificial Neural Network Assisted Cancer Risk Prediction of Oral Precancerous Lesions

Retracted: Artificial Neural Network Assisted Cancer Risk Prediction of Oral Precancerous Lesions

Tobacco Use and Incidence of Adverse Oral Health Outcomes Among US Adults in the Population Assessment of Tobacco and Health Study

Evolving tobacco use patterns, including increasing electronic nicotine delivery systems (ENDS) use, warrant re-examination of the associations between tobacco use and oral health. To examine associations between tobacco product use and incidence of adverse oral health outcomes. This cohort study used nationally representative data from wave (W) 1 to W5 (2013-2019) of the Population Assessment of Tobacco and Health Study. Recruitment used a stratified address-based, area-probability household sample of the noninstitutionalized US civilian population. The W1 cohort included respondents aged 18 years and older without lifetime history of oral health outcomes at W1 or W3, depending on when the outcome was first assessed. Data analysis was performed from October 2021 to September 2022. Current (every day or someday use) established (lifetime use of at least 100 cigarettes or "fairly regular" use of other products) use of cigarettes, ENDS, cigars, pipes, hookah, snus, and smokeless tobacco, excluding snus at W1 to W4. The primary outcomes were past 12-month self-reported diagnosis of gum disease and precancerous oral lesions (W2-W5) and bone loss around teeth, bleeding after brushing or flossing, loose teeth, and 1 or more teeth removed (W4-W5). Sample sizes varied across the 6 oral health outcomes (13 149 respondents for the gum disease sample, 14 993 respondents for the precancerous oral lesions sample, 16 312 respondents for the bone loss around teeth sample, 10 286 respondents for the bleeding after brushing or flossing sample, 15 686 respondents for the loose teeth sample, and 12 061 respondents for the 1 or more teeth removed sample). Slightly more than half of adults (52%-54% across the 6 samples) were women, and the majority were of non-Hispanic White race and ethnicity. Cox proportional hazards models were developed with covariates that included time-dependent tobacco use variables mutually adjusted for each other. Cigarette smoking was positively associated with incidence of gum disease diagnosis (adjusted hazard ratio [AHR], 1.33; 95% CI, 1.11-1.60), loose teeth (AHR, 1.35; 95% CI, 1.05-1.75), and 1 or more teeth removed (AHR, 1.43; 95% CI, 1.18-1.74). Cigar smoking was positively associated with incidence of precancerous oral lesions (AHR, 2.18; 95% CI, 1.38-3.43). In addition, hookah smoking was positively associated with incidence of gum disease diagnosis (AHR, 1.78; 95% CI, 1.20-2.63), and ENDS use was positively associated with incidence of bleeding after brushing or flossing (AHR, 1.27; 95% CI, 1.04-1.54). No associations were observed between snus and smokeless tobacco excluding snus and incidence of oral health outcomes. The observed associations of combustible tobacco use with incidence of several adverse oral health outcomes and ENDS use with incidence of bleeding after brushing or flossing highlight the importance of longitudinal studies and emphasize the continued importance of tobacco cessation counseling and resources in clinical practice.

Immunoregulatory Markers in Human Saliva – A Non-Invasive Approach in the Diagnosis of Oral Precancerous and Cancerous Lesions

Abstract Oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral mucosa. Currently, the diagnosis of oral cancer is based on clinical examination and histopathological analysis. Numerous potential biomarkers have been suggested for oral cancer diagnosis, but the results are contradictory. A great achievement could be identification of biomarkers that indicate the early stage and progression of OSCC. Saliva is an easy to obtain biological fluid containing specific molecules for various pathologies. Some reliable saliva molecules described as oral biomarkers for OSCC are cytokines. A number of studies have shown that higher levels of the proinflammatory and proangiogenic cytokines, like IL-8, IL-6 and TNF-α in saliva could be used for early diagnosis of OSCC. Other studies have shown that the levels of some immunosuppressive cytokines (IL-4, IL-10, IL-13 and IL-1RA) are elevated in saliva in OSCC patients compared to controls. The importance of the immunoregulatory molecules as markers for OSCC is debated. Further studies are needed to identify clinically relevant biomarkers for screening and early detection of oral cancer.

Dermatoglyphics and Its Importance in Oral Precancerous and Cancerous Lesions - Systematic Review

Dermatoglyphics, the study of palm prints and fingerprints, is currently a precious method for the early detection of premalignant lesions, dental caries, systemic disorders, hereditary diseases, and syndromes. Palmar dermatoglyphics can indicate the development of potentially malignant lesions and help identify people at high risk of developing oral submucous fibrosis (OSMF) , and oral squamous cell carcinoma (OSSC), which cause panic and hold an excessively high ranking as killers. Another important condition that has become a major public health issue in the South Indian population is oral submucous fibrosis (OSMF), which is correlated with genetic abnormalities and is used in biomedical studies. Similarly, anthropologists and medical professionals have long found the study of the human hand fascinating, as have psychologists, novelists, artists, and chiromancers. Fingerprints do not change when the body decays, just as they change from birth to death. Our systematic review aims to assess the correlation between dermatoglyphics and oral precancerous and cancerous lesions in the human population and to investigate the embryogenesis and topology of dermatoglyphics, emphasizing the many types of research involving dermatoglyphics in many disciplines of medicine and dentistry. In our systematic review, we have collected many review papers using databases including PubMed, Medline, Scopus, Embase, and the Web of Science to determine the importance of dermatoglyphics in oral precancerous and cancerous lesions. The data from our systematic review showed a link between oral precancerous and cancerous lesions, which suggests that dermatoglyphics could be used to find precancerous and cancerous lesions in the oral cavity early.

Efficacy of optical coherence tomography in the diagnosing of oral cancerous lesion: systematic review and meta-analysis.

Non-invasive diagnostic tools that facilitate visualization of potentially malignant oral lesions and cancers have been introduced. Oral lesions detected by optical coherence tomography (OCT) were compared to reference results based on histological findings. The diagnostic odds ratio (DOR), along with summary receiver operating characteristic curve (SROC), area under SROC, sensitivity, specificity, and negative predictive values, were the outcomes. The DOR of OCT was 86.9190 (95% confidence interval [CI]: 38.7435, 194.9985), and the area under SROC was 0.951. OCT showed good sensitivity (0.9138; 95% CI: 0.8758, 0.9409) and specificity (0.9110; 95% CI: 0.8568, 0.9460), and a high negative predictive value (0.9225; 95% CI: 0.8863, 0.9478). Diagnostic sensitivity was higher when using artificial intelligence and automated algorithms compared to diagnoses made by clinicians. OCT is non-invasive, provides rapid results without radiation exposure, and can aid in the diagnosis and follow-up of oral cancer and oral precancerous lesions.

Awareness of Precancerous Lesions and Conditions among Dental Students and Fresh Graduates

The purpose of this article is to gauge the level of understanding regarding oral precancerous lesions and conditions of fresh graduates and underscore the underlying deficiencies present to amplify the early detection rate in a bid to decrease mortality associated with this disease. A precancerous lesion is a structurally altered tissue with an increased risk of conversion into cancer. Similarly, precancerous condition points toward such a multifaceted condition in which an individual has a predisposition to developing cancer. Both of these terms are linked with the statistical significance that points towards the potential of a precancerous lesion or condition to transform into a malignancy. Their timely diagnosis is the focal point that will dictate prognosis, treatment modality to be used and the morbidity associated with it. Oral cancers happen to be one of the leading causes of death worldwide and they are running rampant in Asian countries because of the increased frequency of adopting high-risk factor habits such as smoking tobacco. Dentists are a class of professional healthcare workers that are almost exclusively concerned with the head and neck region of the patient. Their advanced knowledge in regards to oral cancer can facilitate an opportune diagnosis which will substantially decrease the incidences of under-treatment and over-treatment. Diagnosing precancerous lesions is curative while a delay in interpreting the lesion timely can have far-ending consequences. Keywords: Pancreous lesions, dental students, fresh graduates

Tumor necrosis factor‐alpha genetic variants and its interaction with smoking and tobacco chewing in oral precancerous lesions and oral cancer

AbstractIntroductionOral cancer is one of the most common cancers in Northern India. Carcinogenic substances found in cigarette or tobacco can cause inflammation of the lining of oral cavity and pathogenesis of oral cavity cancer. Tumor necrosis factor is a pro‐inflammatory cytokine involved in the immunoinflammatory diseases. The aim of this research was to determine the impact of smoking and tobacco chewing and polymorphism in TNFα −238 G/A and TNFα −308 G/A, on the risk to precancerous oral lesions and oral cavity cancer.MethodsGenotyping was done by polymerase chain reaction and restriction fragment length polymorphism method in 75 patients with oral cavity cancer, 75 patients confirmed with precancerous lesions, and 100 controls.ResultsTNFα −238 G/A SNP was not associated with the risk of oral precancerous lesions or oral cavity cancer. TNFα −308 G/A was strongly associated with precancerous lesions and oral cancer. No correlation was found between smoking or tobacco chewing habits and TNFα −238 and TNFα −308 G/A polymorphism with oral precancerous lesions and oral cavity cancer.ConclusionThe study shows no significant interaction between smoking or tobacco chewing habits and polymorphism in TNFα −238 and TNFα −308 G to A with precancerous lesions and oral cancer although TNFα −308 G/A was strongly associated with precancerous lesions and oral cancer.

Artificial Neural Network Assisted Cancer Risk Prediction of Oral Precancerous Lesions.

The incidence of oral cancer is still increasing. It has become very common in patients with malignant tumors, which has forced medical personnel to continuously explore its treatment methods. What kind of method can effectively and correctly diagnose the disease in the early stage and improve the survival rate has become one of the research topics that have attracted much attention. Aiming at this problem, it has great research significance for the field of oral precancerous lesions diagnosis. With the in-depth research on oral precancerous diagnosis, the research on artificial neural network (ANN) in medical diagnosis is gradually carried out. Its performance advantage is of great significance to solve the problem of early and correct disease diagnosis. This paper aimed to investigate the application of ANN-assisted cancer risk prediction method in risk prediction of oral precancerous lesions. Through the analysis and research of ANN and oral cancer, the construction of oral cancer risk prediction model was applied to solve the problem of improving the survival rate of oral cancer patients. In this paper, ANN and oral precancerous lesions were analyzed, the performance of the algorithm was experimentally analyzed, and the relevant theoretical formulas were used to explain. The results showed that the method had higher accuracy than traditional forecasting methods. When N = 2, the output accuracy was above 90%. It can be seen that the algorithm can meet the needs of the diagnosis of high-risk groups of oral cancer lesions, and the diagnosis efficiency and patient survival rate has been greatly improved.

Optimization of examination methods in the diagnosis of precancerous and malignant oral mucosal lesions

Relevance. The prevalence of oral mucosal diseases among the Russian population varies from 3% to 20% [7]. Precancerous and malignant diseases are a particular problem. More than nine thousand new cases of malignant oral mucosal lesions are registered annually in the Russian Federation, and yearly mortality rates reach 34%. Unfortunately, despite being externally located, the rate of late-diagnosed malignant oral mucosal neoplasms reaches 60%-70% in various regions of the Russian Federation [2]. Thus, one of the most urgent problems in dentistry and oncology is the early diagnosis of precancerous and malignant oral mucosal lesions. As a rule, precancerous lesions are not diagnosed at an early stage since there are no visible clinical signs, and therefore patients do not seek medical attention [8]. An accurate diagnosis requires both basic and additional examination methods. In turn, the conventional methods include traditional inspection, which largely depends on the clinician's experience. Besides the clinical examination, additional techniques are used, namely, fluorescence examination and biopsy [9-11]. Subsequently, optimizing the diagnosis of oral mucosal lesions is the most promising direction in practical healthcare, both in the dental and oncology practice, for early detection and reduction of advanced stages of malignant oral mucosal lesions. Thus, the study confirmed that the development and application of modern approaches are necessary for the early diagnosis of oral mucosal lesions. Purpose. The study aimed to improve the outcome of oral mucosal precancerous and malignant lesion diagnosis by upgrading examination methods. Material and methods. The study included 147 patients with oral mucosal lesions, referred to the oncologists of Samara regional clinical oncology centre by the city polyclinics. The patients were divided into two groups according to the examination methods. The control group patients, 63 people, had a conventional examination by a dentist (patient interview, inspection, palpation) and an incisional biopsy by an oncologist. The main group consisted of 84 patients, who, besides conventional dental examination, were evaluated by a new – developed and put into practice – technique with point and index score and subsequent incisional biopsy performed by an oncologist. The studied patients were comparable by gender, age and localization. The study assessed the effectiveness of the new method for the diagnosis of precancerous lesions (PL) and malignant lesions (ML) by matching the Need for Histology Verification Index (NHVI) value equal to 5 points or more and histopathology results.Results. In the main group, 71 out of 84 patients scored 5 or more according to the new method, and 13 patients scored less than 5. Patients with a low score had a non-surgical treatment, 11 patients reached remission, and two patients were referred to an oncologist for a biopsy, which confirmed oral mucosa PL and ML. The patient complaints in both groups demonstrated that pain and bleeding were more frequent in the control group compared to the main one. The evaluation of clinical examination data revealed more erosions in the control group and nonremovable plaque and hyperplasia in the main group. The incisional biopsy detected more PL and ML in the main group (p = 0.001), and early malignant lesions were in 23% versus 5% in the control group. The new method specificity in oral mucosal PL and ML diagnosis was 55%, sensitivity – 97%, accuracy – 87%, whereas the conventional examination specificity was 28%, sensitivity – 84%, and accuracy – 60%.Conclusion. The administered improved method for examination of patients with oral mucosal lesions and the compulsory use of autofluorescence examination and risk factor score assessment allowed us to identify PL and ML in 88% and to diagnose more PL and ML at early stages, which explains the need to use this method in the clinical practice for the early diagnosis of lesions.

Efficacy of Artificial Intelligence-Assisted Discrimination of Oral Cancerous Lesions from Normal Mucosa Based on the Oral Mucosal Image: A Systematic Review and Meta-Analysis.

Simple SummaryEarly detection of oral cancer is important to increase the survival rate and reduce morbidity. For the past few years, the early detection of oral cancer using artificial intelligence (AI) technology based on autofluorescence imaging, photographic imaging, and optical coherence tomography imaging has been an important research area. In this study, diagnostic values including sensitivity and specificity data were comprehensively confirmed in various studies that performed AI analysis of images. The diagnostic sensitivity of AI-assisted screening was 0.92. In subgroup analysis, there was no statistically significant difference in the diagnostic rate according to each image tool. AI shows good diagnostic performance with high sensitivity for oral cancer. Image analysis using AI is expected to be used as a clinical tool for early detection and evaluation of treatment efficacy for oral cancer.The accuracy of artificial intelligence (AI)-assisted discrimination of oral cancerous lesions from normal mucosa based on mucosal images was evaluated. Two authors independently reviewed the database until June 2022. Oral mucosal disorder, as recorded by photographic images, autofluorescence, and optical coherence tomography (OCT), was compared with the reference results by histology findings. True-positive, true-negative, false-positive, and false-negative data were extracted. Seven studies were included for discriminating oral cancerous lesions from normal mucosa. The diagnostic odds ratio (DOR) of AI-assisted screening was 121.66 (95% confidence interval [CI], 29.60; 500.05). Twelve studies were included for discriminating all oral precancerous lesions from normal mucosa. The DOR of screening was 63.02 (95% CI, 40.32; 98.49). Subgroup analysis showed that OCT was more diagnostically accurate (324.33 vs. 66.81 and 27.63) and more negatively predictive (0.94 vs. 0.93 and 0.84) than photographic images and autofluorescence on the screening for all oral precancerous lesions from normal mucosa. Automated detection of oral cancerous lesions by AI would be a rapid, non-invasive diagnostic tool that could provide immediate results on the diagnostic work-up of oral cancer. This method has the potential to be used as a clinical tool for the early diagnosis of pathological lesions.