Oral Cancer News

Source: cancerpreventionresearch.aacrjournals.org
Authors: Vijayvel Jayaprakash et al.

Early detection of oral premalignant lesions (OPL) and oral cancers (OC) is critical for improved survival. We evaluated if the addition of autofluorescence visualization (AFV) to conventional white-light examination (WLE) improved the ability to detect OPLs/OCs.

Sixty high-risk patients, with suspicious oral lesions or recently diagnosed untreated OPLs/OCs, underwent sequential surveillance with WLE and AFV. Biopsies were obtained from all suspicious areas identified on both examinations (n = 189) and one normal-looking control area per person (n = 60).

Sensitivity, specificity, and predictive values were calculated for WLE, AFV, and WLE + AFV. Estimates were calculated separately for lesions classified by histopathologic grades as low-grade lesions, high-grade lesions (HGL), and OCs. Sequential surveillance with WLE + AFV provided a greater sensitivity than WLE in detecting low-grade lesions (75% versus 44%), HGLs (100% versus 71%), and OCs (100% versus 80%).

The specificity in detecting OPLs/OCs decreased from 70% with WLE to 38% with WLE + AFV. Thirteen of the 76 additional biopsies (17%) obtained based on AFV findings were HGLs/OCs. Five patients (8%) were diagnosed with a HGL/OC only because of the addition of AFV to WLE. In seven patients, additional HGL/OC foci or wider OC margins were detected on AFV. Additionally, AFV aided in the detection of metachronous HGL/OC in 6 of 26 patients (23%) with a history of previously treated head and neck cancer.

Overall, the addition of AFV to WLE improved the ability to detect HGLs/OCs. In spite of the lower specificity, AFV + WLE can be a highly sensitive first-line surveillance tool for detecting OPLs/OCs in high-risk patients.

Authors:
Vijayvel Jayaprakash1,2,4, Maureen Sullivan2, Mihai Merzianu3, Nestor R. Rigual4, Thom R. Loree4, Saurin R. Popat4, Kirsten B. Moysich1, Soumya Ramananda1, Timothy Johnson5, James R. Marshall1, Alan D. Hutson6, Thomas S. Mang7, Brian C. Wilson9, Steven R. Gill8, Jennifer Frustino2, Arjen Bogaards9 and Mary E. Reid1

Authors’ Affiliations:
1 Division of Cancer Prevention and Population Sciences and Departments of 2 Dentistry and Maxillofacial Prosthetics, 3 Pathology, 4 Head and Neck Surgery, 5 Cancer Genetics, and 6 Biostatistics, Roswell Park Cancer Institute; Departments of 7 Oral and Maxillofacial Surgery and 8 Oral Biology, State University of New York at Buffalo, Buffalo, New York; and 9 Division of Biophysics and Imaging, Ontario Cancer Institute, Ontario, Canada