Giovannacci I, Vescovi P, Manfredi M, Meleti M
Center of Oral Laser Surgery and Oral Medicine, Dental School. Department of Biomedical, Biotechnological and Translational Sciences, Via Gramsci, 14 - 43125 Parma, Italy
Med Oral Patol Oral Cir Bucal. 2016 May 1;21(3):e305-15. doi: 10.4317/medoral.20996.
Gold standard for the diagnosis of oral dysplasia (OD) and oral squamous cell carcinoma (OSCC) and malignant lesions is the histological examination. Several adjunctive diagnostic techniques have been proposed in order to increase the sensitivity (SE) and specificity (SP) of conventional oral examination and to improve the diagnostic first level accuracy. The aim of this study is to perform a systematic review on non-invasive tools for diagnosis of OD and early OSCC.
Medline, Scopus, Web of Knowledge databases were searched, using as entry terms "oral dysplasia AND diagnosis" / "oral cancer AND diagnosis". Data extracted from each study included number of lesions evaluated, histopathological diagnosis, SE, SP, positive and negative predictive values (PPV and NPV), diagnostic accuracy (DA) and the main conclusions.
After title and abstract scanning of 11.080 records, we selected 35 articles for full text evaluation. Most evaluated tools were autofluorescence (AF), chemiluminescence (CL), toluidine blu (TL) and chemiluminescence associated with toluidine blue (CLTB).
There is a great inhomogeneity of the reported values and there is no significant evidence of superiority of one tool over the other. Further clinical trials with a higher level of evidence are necessary in order to assess the real usefulness visual diagnostic tools.
口腔发育异常(OD)、口腔鳞状细胞癌(OSCC)及恶性病变诊断的金标准是组织学检查。为提高传统口腔检查的敏感性(SE)和特异性(SP)并改善一级诊断准确性,已提出多种辅助诊断技术。本研究旨在对OD和早期OSCC的非侵入性诊断工具进行系统评价。
检索Medline、Scopus、Web of Knowledge数据库,使用“口腔发育异常与诊断”/“口腔癌与诊断”作为检索词。从每项研究中提取的数据包括评估的病变数量、组织病理学诊断、SE、SP、阳性和阴性预测值(PPV和NPV)、诊断准确性(DA)及主要结论。
在对11080条记录进行标题和摘要筛选后,我们选择了35篇文章进行全文评估。大多数评估工具为自体荧光(AF)、化学发光(CL)、甲苯胺蓝(TL)以及与甲苯胺蓝相关的化学发光(CLTB)。
所报道的值存在很大的异质性,没有显著证据表明一种工具优于另一种工具。为评估视觉诊断工具的实际效用,有必要进行更高证据水平的进一步临床试验。