Kois John C, Truelove Edmond
Graduate Restorative Program, University of Washington, USA.
Dent Today. 2006 Oct;25(10):94, 96-7.
The VELscope is an important aid in patient assessment, and when added to a well-thought out clinical assessment process that takes into consideration the age of the patient and risk factors that include tobacco, alcohol, and immunologic status, it increases the clinician's ability to detect oral changes that may represent premalignant or malignant cellular transformation. False positive findings are possible in the presence of highly inflamed lesions, and it is possible that use of the scope alone may result in failure to detect regions of dysplasia, but it has been our experience that use of the VELscope improves clinical decision making about the nature of oral lesions and aids in decisions to biopsy regions of concern. Where tissue changes are generalized or cover significant areas of the mouth, use of the scope has allowed us to identify the best region for biopsy. As with all clinical diagnostic activities, no single system or process is enough, and all clinicians are advised to use good clinical practice to assess patients and to recall and biopsy lesions that do not resolve within a predetermined time frame. Lesions that are VELscope-positive and absorb light need to be followed with particular caution, and if they do not resolve within a 2-week period, then further assessment and biopsy are generally advised. It is much better to occasionally sample tissue that turns out to be benign than to fail to diagnose dysplastic or malignant lesions. In our fight to protect patients from cancer, the VELscope improves our odds for early detection, hopefully resulting in fewer deaths from oral cancer.
VELscope是患者评估中的一项重要辅助工具，当将其纳入一个经过深思熟虑的临床评估过程时，该过程会考虑患者的年龄以及包括烟草、酒精和免疫状态在内的风险因素，这会增强临床医生检测可能代表癌前或恶性细胞转变的口腔变化的能力。在存在高度炎症性病变的情况下可能会出现假阳性结果，而且仅使用该仪器有可能导致无法检测到发育异常区域，但我们的经验是，使用VELscope可改善关于口腔病变性质的临床决策，并有助于决定对可疑区域进行活检。当组织变化广泛或覆盖口腔的重要区域时，使用该仪器能让我们确定最佳的活检区域。与所有临床诊断活动一样，没有单一的系统或流程是足够的，建议所有临床医生采用良好的临床实践来评估患者，并对在预定时间内未消退的病变进行召回和活检。对VELscope呈阳性且吸收光的病变需要格外谨慎地跟踪，如果它们在两周内未消退，一般建议进行进一步评估和活检。偶尔对结果显示为良性的组织进行取样，比未能诊断出发育异常或恶性病变要好得多。在我们保护患者免受癌症侵害的斗争中，VELscope提高了我们早期发现的几率，有望减少口腔癌导致的死亡人数。
