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口腔潜在恶性疾病中口腔癌早期检测的非侵入性辅助手段评估及基于风险的管理策略制定:一项前瞻性纵向研究方案

Evaluation of Noninvasive Adjuncts for Early Detection of Oral Cancer in Oral Potentially Malignant Disorders and Development of Risk-Based Management Strategies: Protocol for a Prospective Longitudinal Study.

作者信息

Gupta Ruchika, Ratnu Apurva, Gupta Shalini R, Hadial Hariprakash, Singh Lucky, Singh Prashant Kumar, Singh Shalini

机构信息

ICMR-National Institute of Cancer Prevention and Research, Noida, India.

Associate Professor, Faculty of Biological Sciences, Academy of Scientific and Innovative Research, Ghaziabad, India.

出版信息

JMIR Res Protoc. 2025 May 28;14:e66285. doi: 10.2196/66285.


DOI:10.2196/66285
PMID:40435493
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12159550/
Abstract

BACKGROUND: Oral potentially malignant disorders (OPMDs) constitute the most important precursors of oral cancer. Histopathological examination of a biopsy from a clinically suspicious lesion is still the gold standard for the diagnosis of oral cancer. Adjunctive techniques such as autofluorescence, toluidine blue (TB), and others have been evaluated among high-risk individuals such as chronic tobacco chewers or in patients with suspicious lesions. However, evaluation of these noninvasive adjunctive techniques has not been performed in primary health care settings. Since the first point-of-contact of individuals living in rural and semiurban areas are the primary health care workers, evaluation of these noninvasive adjuncts is likely to assist and strengthen the population-wide oral cancer screening in high-burden countries such as India. OBJECTIVE: This prospective longitudinal study aims to evaluate the noninvasive adjuncts in oral cancer screening in the field settings, specifically in detecting foci of oral cancers in various OPMDs. METHODS: After staff recruitment and training, we shall conduct oral cancer screening camps in the community for the recruitment of individuals with OPMDs after obtaining informed consent. All patients with OPMD shall undergo further screening via autofluorescence and TB staining for detection of lesions suspicious of oral cancer. Sensitivity, specificity, and negative and positive predictive values of these adjunctive techniques (autofluorescence and TB) in the detection of oral cancer shall be calculated using biopsy as the gold standard. In addition, this study will also focus on the validation of the 2022 consensus guidelines on risk-based stratification and appropriate management protocols for the OPMDs at the primary and referral health care centers. Our primary outcome is the diagnostic use of autofluorescence and TB in oral cancer detection among OPMDs as well as the robustness of the risk-based management protocols for these patients. RESULTS: Participant recruitment has been initiated at all sites. Staff recruitment and training in the oral visual examination have been conducted. Procurement of the autofluorescence device is in progress. All the study sites have begun conducting oral screening camps. CONCLUSIONS: The results of this study shall provide robust evidence for the diagnostic use of autofluorescence and TB staining in early oral cancer detection among patients with OPMD. The use of these noninvasive adjuncts by primary health care providers can significantly improve oral cancer screening in our country. The validation of risk-based stratification and management of patients with OPMD shall assist in the refinement of the national guidelines for these interventions. This study has been approved by the respective ethics committee of ICMR-National Institute of Cancer Prevention and Research and the collaborating institutes. The findings of this study shall be disseminated through scientific publications in peer-reviewed journals as well as meetings with the concerned stakeholders at the district and state health departments. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66285.

摘要

背景:口腔潜在恶性疾病(OPMDs)是口腔癌最重要的前驱病变。对临床可疑病变进行活检的组织病理学检查仍是口腔癌诊断的金标准。诸如自体荧光、甲苯胺蓝(TB)等辅助技术已在慢性嚼烟者等高风险个体或可疑病变患者中进行了评估。然而,这些非侵入性辅助技术尚未在初级卫生保健机构中进行评估。由于生活在农村和半城市地区的人们首先接触的是初级卫生保健工作者,对这些非侵入性辅助手段的评估可能有助于并加强在印度等高负担国家的全民口腔癌筛查。 目的:这项前瞻性纵向研究旨在评估现场环境下口腔癌筛查中的非侵入性辅助手段,特别是在检测各种OPMDs中的口腔癌病灶方面。 方法:在招募和培训工作人员后,我们将在社区开展口腔癌筛查活动,在获得知情同意后招募患有OPMDs的个体。所有OPMD患者都应通过自体荧光和TB染色进行进一步筛查,以检测可疑的口腔癌病变。将以活检作为金标准,计算这些辅助技术(自体荧光和TB)在口腔癌检测中的敏感性、特异性以及阴性和阳性预测值。此外,本研究还将侧重于验证2022年关于OPMDs在初级和转诊卫生保健中心基于风险分层和适当管理方案的共识指南。我们的主要结果是自体荧光和TB在OPMDs患者口腔癌检测中的诊断应用以及这些患者基于风险的管理方案的稳健性。 结果:所有地点均已开始招募参与者。已开展了口腔视觉检查的工作人员招募和培训。自体荧光设备的采购正在进行中。所有研究地点均已开始开展口腔筛查活动。 结论:本研究结果将为自体荧光和TB染色在OPMDs患者早期口腔癌检测中的诊断应用提供有力证据。初级卫生保健提供者使用这些非侵入性辅助手段可显著改善我国的口腔癌筛查。对OPMD患者基于风险的分层和管理进行验证将有助于完善这些干预措施的国家指南。本研究已获得ICMR-国家癌症预防与研究所以及合作机构各自的伦理委员会批准。本研究结果将通过在同行评审期刊上发表科学论文以及与地区和州卫生部门的相关利益相关者会面进行传播。 国际注册报告识别号(IRRID):DERR1-10.2196/66285。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5457/12159550/046e4d5b18c7/resprot_v14i1e66285_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5457/12159550/048d568fc041/resprot_v14i1e66285_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5457/12159550/046e4d5b18c7/resprot_v14i1e66285_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5457/12159550/048d568fc041/resprot_v14i1e66285_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5457/12159550/046e4d5b18c7/resprot_v14i1e66285_fig2.jpg

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本文引用的文献

[1]
Development and Evaluation of an Automated Multimodal Mobile Detection of Oral Cancer Imaging System to Aid in Risk-Based Management of Oral Mucosal Lesions.

Cancer Prev Res (Phila). 2025-4-1

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Jpn Dent Sci Rev. 2024-12

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This 'Rose' Has no Thorns-Diagnostic Utility of 'Rapid On-Site Evaluation' (ROSE) in Fine Needle Aspiration Cytology.

Indian J Surg Oncol. 2019-12

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Role of Toluidine Blue Staining in Suspicious Lesions of Oral Cavity and Oropharynx.

Indian J Otolaryngol Head Neck Surg. 2019-10

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