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口腔癌检测的进展。

Advances in oral cancer detection.

机构信息

School of Advanced Sciences, Vellore Institute of Technology, Vellore, India.

Centre for Nanobiotechnology, Vellore Institute of Technology, Vellore, India.

出版信息

Adv Clin Chem. 2019;91:181-200. doi: 10.1016/bs.acc.2019.03.006. Epub 2019 May 4.

Abstract

High incidence of oral carcinoma and its late-stage presentation are the major global healthcare issues. The World Health Organization (WHO) has set early diagnosis and prevention of oral cancer as their primary objective. It is important to consider the time of oral screening, as it plays a pivotal role in understanding the disease prognosis. Critical signs and symptoms that can be identified during initial oral screening can improve the chances of patient's survival. Reports suggest that socio-economic factors, lack of public awareness and delays from primary health care centers are few of the major parameters that contribute to patient's mortality and morbidity. Conventional technique of visual examination of the oral lesion can effectively monitor patient mortality when exposed to risk factors. However, several disadvantages limit the clinical utility of this technique. Thus, screening aids that efficiently differentiate between a benign and malignant lesion as well as deliver information about early OSCC can ameliorate the complications associated with oral cancer diagnosis. Recent advances in optical imaging systems, such as tissue-fluorescence imaging and optical coherence tomography have been proved to be considerably efficient. Additionally, extensive research has been directed towards nanoparticle-based immunosensors, DNA analysis, and salivary proteomics. However, lack of proper clinical trials and correlation with biopsy result hinder the usage of these screening techniques in clinics. In this review, we highlight the importance of early diagnosis of oral cancer as well as discuss about the effectiveness and limitations of the recent diagnostic aids. It can be stated that public awareness regarding routine oral examination and employing screening methods that are non-invasive, robust, and economic, would enhance early stage diagnosis of oral cancer and have a positive impact on patient's survival.

摘要

口腔癌发病率高且多数患者就诊时已处于晚期,这是全球医疗保健面临的主要问题。世界卫生组织(WHO)将早期诊断和预防口腔癌作为其主要目标。考虑口腔筛查的时间非常重要,因为这对于了解疾病的预后起着关键作用。在初始口腔筛查期间可以识别的关键体征和症状可以提高患者生存的机会。报告表明,社会经济因素、公众意识不足以及初级保健中心的延误是导致患者死亡率和发病率增加的几个主要因素。口腔病变的常规目视检查技术可以在患者暴露于危险因素时有效监测其死亡率。然而,该技术存在一些缺点,限制了其临床应用。因此,能够有效区分良性和恶性病变并提供有关早期口腔癌的信息的筛查辅助工具可以改善与口腔癌诊断相关的并发症。光学成像系统(如组织荧光成像和光相干断层扫描)的最新进展已被证明具有相当的效率。此外,已经针对基于纳米粒子的免疫传感器、DNA 分析和唾液蛋白质组学进行了广泛的研究。然而,缺乏适当的临床试验和与活检结果的相关性阻碍了这些筛查技术在临床上的应用。在这篇综述中,我们强调了早期诊断口腔癌的重要性,并讨论了最近诊断辅助工具的有效性和局限性。可以说,提高公众对常规口腔检查的认识并采用非侵入性、稳健且经济的筛查方法将提高口腔癌的早期诊断水平,并对患者的生存产生积极影响。

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