Juan M. Seoane, MD, DDS, PhD, MPDH.
Senior Lecturer in Oral Surgery.
Head of Department of Stomatology University of Santiago de Compostela.
National Coordinator. Campaign for Early Detection/Prevention of Oral Cancer in Spain 2011.
Summary of the presentation
Early diagnosis of oral cancer. Usefullness of non-invasive devices Early detection is widely recognised as the cornerstone to reduce diagnostic delay and, thus, to improve surviva. However, this term (early detection) is not free from confusion as can be understood either as “a relative small tumour in size at the time of detection” or as “short time interval since cancer onset to diagnosis” (diagnostic delay).
As it is difficult to detect oral cancer lesions at early stage, several ancillary diagnostic tests have been developed to improve diagnostic performance, such as toluidine blue staining, chemiluminiscence and autofluorescence. A comprehensive analysis of the current evidence suggest that toluidine blue ins good at detecting carcinomas, but its sensitivity in detecting dysplasia is significantly lower.
Light-based detection systems
- Vizilite® (Zila Pharmaceuticals, Phoenix, AZ): Some reports point that chemoluminiscence could be useful to identify lesions hidden to incandescent light sources, but no evidence supports this theory.
- Tissue fluorescence imaging : The VELscope® system- Its sensitivity ranged from 97 to 100%, and proved useful to establish safer surgical margins in tumour excision (Huber, 2009), but no methodologically sound studies back the usefulness of this system as ancillary diagnostic tool when dealing with malignant or premalignant lesions in lower-risk, primary care patients
- Tissue fluorescence spectroscopy. This device has shown a high sensitivity and specificity to differentiate healthy mucosa from malignant oral lesions.
Diagnostic procedures based on saliva analysis are also reviewed. Regardless of these promising technologies, the path until these systems enhance visual detection beyond what is achieved through conventional visual and tactile examinations is still to be covered.