Department of Head, Neck and Sense Organs, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Department of Women's, Children's and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Int J Environ Res Public Health. 2022 May 4;19(9):5579. doi: 10.3390/ijerph19095579.
Any oral potentially malignant disorders (OPMDs) must be regularly monitored through clinical examination to detect any possible malignant transformation. Conventional intraoral exams, however, can be difficult because these conditions may resemble benign lesions. For this reason, several non-invasive diagnostic technologies have been developed to help the clinician in detecting and distinguishing between cancerous and benign lesions. Epithelial dysplasia can be considered the most important predictor of malignant evolution. Therefore, in this study we aim to evaluate the ability of an optical filter for autofluorescence Glasses for Oral Cancer Curing Light Exposed (GOCCLES) and of toluidine blue staining in identifying dysplastic areas in patients with OPMDs.
In this retrospective study, medical records, photographs and videos of 25 patients with oral lesions were analyzed. Forty-two biopsy samples in 25 patients with OPMDs and at least one suspicious oral mucosa lesion that were evaluated in white light, autofluorescence with optical filter GOCCLES, toluidine blue staining and then biopsied with histopathological analysis were analyzed.
The sensitivity and specificity for the autofluorescence evaluation with GOCCLES for identifying dysplasia or carcinoma were 66% and 48%, respectively. The positive and negative predictive values were 34% and 77%, respectively, and the accuracy was 53%. The sensitivity and specificity for toluidine blue staining were 91% and 68%, respectively. The positive and negative predictive values were 55% and 95%, respectively, and the accuracy was 75%.
The optical filter for autofluorescence (GOCCLES) and toluidine blue staining are simple, inexpensive, rapid and non-invasive procedures that can assist the clinician in distinguishing OPMDs from healthy mucosa but they are not able to distinguish benign and malignant lesions.
任何口腔潜在恶性疾病（OPMD）都必须通过临床检查定期监测，以发现任何可能的恶性转化。然而，常规的口腔内检查可能很困难，因为这些情况可能类似于良性病变。出于这个原因，已经开发了几种非侵入性诊断技术来帮助临床医生检测和区分癌性和良性病变。上皮异型增生可被视为恶性演变的最重要预测因子。因此，在这项研究中，我们旨在评估用于治疗口腔癌的光疗玻璃的自动荧光滤光片（GOCCLES）和甲苯胺蓝染色在识别 OPMD 患者的异型增生区域方面的能力。
在这项回顾性研究中，分析了 25 名口腔病变患者的病历、照片和视频。对 25 名 OPMD 患者的 42 个活检样本和至少一个可疑的口腔黏膜病变进行了评估，这些病变在白光、GOCCLES 自动荧光滤光片、甲苯胺蓝染色下进行了评估，然后进行了组织病理学分析。
GOCCLES 自动荧光评估识别异型增生或癌的敏感性和特异性分别为 66%和 48%。阳性和阴性预测值分别为 34%和 77%，准确性为 53%。甲苯胺蓝染色的敏感性和特异性分别为 91%和 68%。阳性和阴性预测值分别为 55%和 95%，准确性为 75%。
自动荧光（GOCCLES）和甲苯胺蓝染色的光学滤光片是简单、廉价、快速和非侵入性的程序，可以帮助临床医生区分 OPMD 与健康黏膜，但它们无法区分良性和恶性病变。
