الفهرس 
Common oral precancerous lesions
Excisional BiopsyOnly 14 pages are availabe for public view
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Abstract
The ability to control oral and oropharyngeal cancer will depend on
two cornerstones: prevention and early diagnosis.
Dentists’ knowledge and education in detecting oral cancer at its
precancerous phase is the key to prevent its progression to later stages.
Currently, the new innovative visual-based techniques show promising
results.
The present study we have investigated the efficiency of the OralID
system to give the possibility for a simple detection, and screening of oral
precancerous and early cancerous lesions.
We found that the direct visual fluorescence system utilized in our
study cannot fully replace the gold standard, i.e., the histopathology
procedure. Nonetheless, its usefulness for clinical examination, in
monitoring oral lesions, and before performing a biopsy was fully
demonstrated. This device may add sensitivity to the oral tissue examination
and considered as adjunct for high-risk patients.
Our data found no difference between CIS and invasive SCC in terms
of the FV field expansion. The information is important because the usual
recommendation for preinvasive high-grade lesions tend to be more
conservative with smaller margins of normal-looking mucosa.
The study results suggest that preinvasive lesions may have extensive
lateral fields, some occult, and as such, would require a more aggressive
therapy.
Also, the fluorescence can’t differentiate between inflammation and
carcinogenesis as, hemoglobin absorbs light and it is more abundant during
carcinogenesis as a result of increased micro vascularization. However,
hemoglobin also increases as a result of trauma or inflammation.
In our study the sensitivity in identifying malignant or dysplastic
lesions is 100% as the device showed fluorescent loss over the lesions and
the areas around in 16 cases assured by histopathology and in the rest 4 cases
it showed fluorescent retained over the lesions assured by histopathology as
no dysplastic changes only inflammation that meant sensitivity 100%.
Specificity 40% as after histopathological examination only 8 cases
was taken with a safety fluorescent margin (negative results) and 4 cases
showed mild dysplasia, 4 cases showed sever dysplasia and 4 cases showed
invasive carcinoma (positive results). This low specificity in distinguishing
high-risk lesions (dysplastic) from benign ones may limit the utility of the
device as a routine screening tool and that it cannot be used in guiding the
biopsy but in screening of dysplastic or malignant lesions its sensitivity is
100%.