Department of Oral Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Faculty of Dentistry, SEGi University, Kota Damansara, 47810, Petaling Jaya, Malaysia.
Clin Oral Investig. 2021 Sep;25(9):5411-5419. doi: 10.1007/s00784-021-03849-0. Epub 2021 Feb 24.
This study aims to examine the ability of optical coherence tomography (OCT) to differentiate ex vivo epithelial structure of benign disorders, dysplastic, and oral squamous cell carcinoma (OSCC) in comparison with the structure of normal marginal mucosa of oral biopsies. As a secondary objective, we examined the inter- and intra-observer variations of OCT measurements of two calibrated assessors.
Oral biopsies (n = 44) were scanned using the swept source OCT (SSOCT) and grouped by pathology diagnosis to benign, dysplasia or carcinoma. Two trained and calibrated assessors scored on the five OCT variables: thickness of keratin layer (KL), epithelial layer (EL), homogeneity of lamina propria (LP), basement membrane integrity (BMI), and the degree of reflection of the epithelial layer (Ep Re). Chi-square tests and Fischer's exact method were used to compare the data.
The OCT images showed breached BM status in all the OSCC samples (100%). Epithelial reflection was noted to be hyper-reflective in all the OSCC and oral dysplasia samples (100%). An increase in KL in 66.67% of the OSCC and 100% of the oral dysplasia samples was found. EL was increased in all the OSCC samples (100%) and 85.72% of the oral dysplasias. Kappa values showed that there was very good agreement (over 0.7) when scoring individual parameters between the two assessors.
The study showed that the BM status was a key parameter in the detection of SCC and for differentiating SCC from oral dysplasia or benign disorders.
OCT is a non-invasive and non-radioactive adjunct diagnostic tool that can provide immediate results on the structure of oral mucosa. The BM status measured ex vivo was a key parameter in the detection of SCC and for differentiating SCC from oral dysplasia or benign disorders.
本研究旨在通过光学相干断层扫描（OCT）检测，比较活检正常边缘黏膜结构，比较体外良性病变、发育不良和口腔鳞状细胞癌（OSCC）的上皮结构，探讨 OCT 区分这三种病变的能力。其次，我们还检查了两名经过校准的评估员对 OCT 测量结果的组内和组间差异。
使用扫频源 OCT（SSOCT）对 44 例口腔活检组织进行扫描，根据病理诊断将样本分为良性、发育不良或癌。两名经过培训和校准的评估员对 5 个 OCT 变量进行评分：角化层（KL）厚度、上皮层（EL）厚度、固有层（LP）均匀性、基底膜完整性（BMI）和上皮层反射程度（Ep Re）。使用卡方检验和 Fisher 精确检验比较数据。
OCT 图像显示所有 OSCC 样本均存在 BM 破裂（100%）。所有 OSCC 和口腔发育不良样本的上皮反射均呈高反射（100%）。发现 66.67%的 OSCC 和 100%的口腔发育不良样本 KL 增加。所有 OSCC 样本（100%）和 85.72%的口腔发育不良样本 EL 增加。两名评估员对单个参数评分时，kappa 值显示存在极好的一致性（大于 0.7）。
本研究表明，BM 状态是 SCC 检测和 SCC 与口腔发育不良或良性病变区分的关键参数。
OCT 是一种非侵入性、无放射性的辅助诊断工具，可提供口腔黏膜结构的即时结果。体外测量的 BM 状态是 SCC 检测和 SCC 与口腔发育不良或良性病变区分的关键参数。
