Pierfelice Tania Vanessa, D'Amico Emira, Cinquini Chiara, Iezzi Giovanna, D'Arcangelo Camillo, D'Ercole Simonetta, Petrini Morena
Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
Department of Surgical, Medical, Molecular Pathologies and of the Critical Needs, School of Dentistry, University of Pisa, 56100 Pisa, Italy.
Diagnostics (Basel). 2024 Sep 13;14(18):2033. doi: 10.3390/diagnostics14182033.
This systematic review aimed to analyse the published evidence for the use of non-invasive methods for the early detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs).
The literature was systematically searched through several databases: PubMed, Cochrane Library, and Web of Science. Additional exploration was performed through cross-checks on the bibliographies of selected reviews. The inclusion criteria involved studies assessing the application of non-invasive tests on humans in the screening, diagnosis, or surveillance of OSCC or OPMDs and reporting sensitivity (SE) and specificity (SP). The Newcastle-Ottawa scale (NOS) was applied to assess the quality of the studies included.
The search strategy resulted in 8012 preliminary records. After a duplicate check, 116 titles remained. After abstract analysis, 70 papers remained. After full text analysis, only 54 of the 70 papers fit the inclusion criteria (28 were original articles and 26 were reviews). Those 26 reviews were used to manually search for further original articles. From this last search, 33 original articles were found. Thus, a total of 61 original studies were included and investigated. Findings from this systematic review indicate useful information, such as a description of the mechanisms, ease of use, limitations, and SE and SP values, to drive the choice of the optimal minimally invasive method to be utilized as an adjunctive tool to examine the suspicious lesions.
Each of the analysed tools can be improved or implemented, considering their high SE and low SP. Despite advancements, incisional biopsy continues to be the gold standard for the definitive diagnosis of oral cancer and precancerous lesions. Further research and development are essential to improving the sensitivity, specificity, and reliability of non-invasive tools for widespread clinical application.
本系统评价旨在分析已发表的关于使用非侵入性方法早期检测口腔鳞状细胞癌（OSCC）和口腔潜在恶性疾病（OPMDs）的证据。
通过多个数据库对文献进行系统检索：PubMed、Cochrane图书馆和科学网。通过对所选综述的参考文献进行交叉核对进行额外探索。纳入标准包括评估非侵入性检测在OSCC或OPMDs的筛查、诊断或监测中对人类的应用并报告敏感性（SE）和特异性（SP）的研究。应用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。
检索策略产生了8012条初步记录。经过重复检查后，剩下116个标题。经过摘要分析，剩下70篇论文。经过全文分析，70篇论文中只有54篇符合纳入标准（28篇为原创文章，26篇为综述）。利用这26篇综述手动搜索更多原创文章。从最后一次搜索中，发现了33篇原创文章。因此，总共纳入并研究了61项原创研究。该系统评价的结果表明了一些有用信息，如机制描述、易用性、局限性以及SE和SP值，以推动选择最佳的微创方法作为辅助工具来检查可疑病变。
考虑到所分析工具的高SE和低SP，每种工具都可以改进或实施。尽管取得了进展，但切开活检仍然是口腔癌和癌前病变确诊的金标准。进一步的研究和开发对于提高非侵入性工具在广泛临床应用中的敏感性、特异性和可靠性至关重要。
