Kerr A R, Sirois D A, Epstein J B
The Bluestone Center for Clinical Research, New York University College of Dentistry, New York, NY, USA.
J Clin Dent. 2006;17(3):59-63.
The purpose of this study was to describe the utility of oral chemiluminescent lighting (FDA-cleared ViziLite) as an adjunct to standard visual examination (SVE) to enhance visualization of mucosal lesions, particularly those "clinically suspicious" for oral pre-cancer or cancer. Subjects were considered at risk for oral cancer or pre-cancer if they have no a priori knowledge of the presence or absence of an oral lesion at the time of examination.
Five-hundred and one consecutive consenting subjects, over 40 years of age and with a positive tobacco history, received a standard visual examination with conventional incandescent lighting, followed by chemiluminescent lighting. All lesions were recorded, and for lesions detected by both screening modalities, comparisons were made of the subjective parameters of lesion brightness, sharpness, surface texture, and relative size.
A total of 410 epithelial lesions were detected in 270 subjects by standard visual examination, of which 127 were clinically "suspicious" for oral cancer and pre-cancer. Ninety-eight lesions were also visualized by chemiluminescent lighting as "aceto-white" (CL+), in addition to six lesions not previously seen by standard visual examination. Seventy-seven of the CL+ lesions (78.5%) were clinically suspicious; all "suspicious" lesions with an ulcerative component and ulcerated lesions consistent with trauma were CL+. Leukoplakias were significantly more likely to be CL+ than erythroplakias (p < 0.01). Overall, those lesions illuminated by chemiluminescent lighting appeared brighter, sharper, and smaller compared to incandescent illumination.
The results of this study suggest that oral chemiluminescent lighting, when used as a screening adjunct following the standard visual oral examination, provides additional visual information. Leukoplakias may be more readily visualized by chemiluminescence. Studies are underway to explore the clinical significance and predictive value of oral chemiluminescent lighting.
本研究旨在描述口服化学发光照明（经美国食品药品监督管理局批准的ViziLite）作为标准视觉检查（SVE）辅助手段，用于增强口腔黏膜病变可视化的效用，尤其是那些临床上“疑似”口腔癌前病变或癌症的病变。如果受试者在检查时事先不知道是否存在口腔病变，则被视为有患口腔癌或癌前病变的风险。
501名连续同意参与研究的受试者，年龄超过40岁且有吸烟史，先接受了传统白炽灯照明下的标准视觉检查，随后接受化学发光照明检查。记录所有病变情况，对于两种筛查方式均检测到的病变，比较病变亮度、清晰度、表面纹理和相对大小等主观参数。
通过标准视觉检查在270名受试者中总共检测到410个上皮病变，其中127个在临床上“疑似”口腔癌和癌前病变。除了6个标准视觉检查之前未发现的病变外，化学发光照明还将98个病变显示为“醋酸白色”（CL+）。77个CL+病变（78.5%）临床上可疑；所有具有溃疡成分的“可疑”病变以及与创伤一致的溃疡病变均为CL+。白斑比红斑更有可能为CL+（p < 0.01）。总体而言，与白炽灯照明相比，化学发光照明下的病变显得更亮、更清晰且更小。
本研究结果表明，口服化学发光照明在标准口腔视觉检查后用作筛查辅助手段时，可提供额外的视觉信息。化学发光可能更容易显示白斑。目前正在进行研究以探索口服化学发光照明的临床意义和预测价值。
