Article

Adjunctive Techniques for Oral Cancer Examination and Lesion Diagnosis: A Systematic Review of the Literature

Department of Dental Ecology, General Practice Residency Program, School of Dentistry, University of North Carolina Chapel Hill, Chapel Hill, NC 27599-7450, USA.
Journal of the American Dental Association (1939) (Impact Factor: 2.01). 08/2008; 139(7):896-905; quiz 993-4. DOI: 10.14219/jada.archive.2008.0276
Source: PubMed

ABSTRACT

Adjunctive techniques that may facilitate the early detection of oral premalignant and malignant lesions (OPML) have emerged in the past decades.
The authors undertook a systematic review of the English-language literature to evaluate the effectiveness of toluidine blue (TB), ViziLite Plus with TBlue (Zila Pharmaceuticals, Phoenix), ViziLite (Zila Pharmaceuticals), Microlux DL (AdDent, Danbury, Conn.), Orascoptic DK (Orascoptic, a Kerr Company, Middleton, Wis.), VELscope (LED Dental, White Rock, British Columbia, Canada) and OralCDx (Oral CDx Laboratories, Suffern, N.Y.) brush biopsy. They abstracted data relating to study design, sampling and characteristics of the study group, interventions, reported outcomes and diagnostic accuracy of adjunctive aids from 23 articles meeting inclusion and exclusion criteria, including availability of histologic outcomes.
The largest evidence base was for TB. A limited number of studies was available for ViziLite, ViziLite Plus with TBlue and OralCDx. Studies of VELscope have been conducted primarily to assess the margins of lesions in known OPML. The authors identified no studies of Microlux DL or Orascoptic DK. Study designs had various limitations in applicability to the general practice setting, including use of higher-risk populations and expert examiners.
There is evidence that TB is effective as a diagnostic adjunct for use in high-risk populations and suspicious mucosal lesions. OralCDx is useful in assessment of dysplastic changes in clinically suspicious lesions; however, there are insufficient data meeting the inclusion criteria to assess usefulness in innocuous mucosal lesions. Overall, there is insufficient evidence to support or refute the use of visually based examination adjuncts. Practical Implications. Given the lack of data on the effectiveness of adjunctive cancer detection techniques in general dental practice settings, clinicians must rely on a thorough oral mucosal examination supported by specialty referral and/or tissue biopsy for OPML diagnosis.

Download full-text

Full-text

Available from: Joel B Epstein, Aug 31, 2015
  • Source
    • "This cancer can be life threatening if not detected and is not treated at an early stage. For diagnosis of the oral cancer, laser-capture micro-dissection, visualization adjuncts, cytopathology and biopsy techniques can be used and these techniques require tissue specimens that are highly painful to obtain (Mehrotra and Gupta, 2011; Patton et al., 2008; Scully et al., 2008). Besides this, these methods are highly expensive, time consuming and require skilled personnel for specimen collection. "

    Full-text · Dataset · Dec 2015
  • Source
    • "For diagnosis of the oral cancer, laser-capture micro-dissection , visualization adjuncts, cytopathology and biopsy techniques can be used and these techniques require tissue specimens that are highly painful to obtain (Mehrotra and Gupta, 2011; Patton et al., 2008; Scully et al., 2008). Besides this, these methods are highly expensive, time consuming and require skilled personnel for specimen collection. "
    [Show abstract] [Hide abstract]
    ABSTRACT: We report results of the studies relating to fabrication of a non-invasive, label-free and an efficient biosensing platform for detection of the oral cancer biomarker (CYFRA-21-1). One step hydrothermal process was used for uniform decoration of nanostructured zirconia (average particle size 13nm) on reduced graphene oxide (ZrO2-RGO) to avoid coagulation of the zirconia nanoparticles and to obtain enhanced electrochemical performance of ZrO2-RGO nanocomposite based biosensor. Further, ZrO2-RGO has been functionalized using 3-aminopropyl triethoxy saline (APTES) and electrophoretically deposited on the indium tin oxide coated glass substrate at a low DC potential.The APTES/ZrO2-RGO/ITO electrode exhibits improved heterogeneous electron transfer (more than two times) with respect to that of the APTES/ZrO2/ITO electrode indicating faster electron transfer kinetics. The -NH2 containing APTES/ZrO2-RGO/ITO platform is further biofunctionalized with anti-CYFRA-21-1. The structural and morphological investigations of the ZrO2-RGO based biosensing platform have been accomplished using X-ray diffraction (XRD), electrochemical, transmission electron microscopy (TEM), atomic force microscopy (AFM) and Fourier transform infrared spectroscopy (FT-IR) studies. This immunosensor exhibits a wider linear detection range (2-22ngmL(-1)), excellent sensitivity (0.756µAmLng(-1)) and a remarkable lower detection limit of 0.122ngmL(-1). The observed results have been validated via enzyme linked immunosorbent assay (ELISA).
    Full-text · Article · Nov 2015 · Biosensors & Bioelectronics
  • Source
    • "Fluorescent imaging is based on fluorophore concentrations , fluorescent collagen cross-links, tissue scattering characteristics , hemoglobin absorption properties, and tissue thickness [42] [43] [44] [45] [46]. Thus, when exposed to various forms of light or energy, mucosal tissues reveal different absorbance, reflectance and fluorescent profiles that may assist in detection of dysplastic/neoplastic tissue [47] [48]. Various devices that utilize chemiluminescence [49] [50] [51] [52], autofluorescence [42,46,48,51,53–58] and multi-spectral imaging [59] [60] have been introduced in order to assist detection and determination to biopsy to facilitate diagnosis of PMD and OSCC with variable results. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Stage of disease at the diagnosis of oral cancer is thought to be a significant factor in prognosis and outcome (International Agency for Research on Cancer/World Health Organization, 2014). Unfortunately, we continue to diagnose almost 2/3 of these cancers at advanced stages of disease despite the ongoing research for devices/methods to aid the clinicians in detection and accurate oral mucosal lesion diagnosis. This paper explores both the nature of oral cancer and the adjuncts available for detection, and presents the current issues in diagnostic delays of oral cancer detection.
    Full-text · Article · Sep 2014 · Oral Oncology
Show more