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Chen JJ, Yu BH, Shen TJ, Wang Y, Ren F, Yang LR, Dong Y, Zheng MJ, Hao S, Yang WT, Wu J. A prospective comparison of a modified miniaturised hand-held epifluorescence microscope and touch imprint cytology for evaluation of axillary sentinel lymph nodes intraoperatively in breast cancer patients. Cytopathology 2024; 35:136-144. [PMID: 37795924 DOI: 10.1111/cyt.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The management of axillary lymph nodes in early-stage breast cancer patients has changed considerably, with the primary focus shifting from the examination of sentinel lymph nodes (SLNs) to toward the detection of all macro-metastases. However, current methods, such as touch imprint cytology (TIC) and frozen sections, are inadequate for clinical needs. To address this issue, we proposed a novel miniaturised epifluorescence widefield microscope (MEW-M) to assess SLN status intraoperatively for improved diagnostic efficiency. METHODS A prospective, side-by-side comparison of intraoperative SLN evaluation between MEW-M and TIC was performed. RESULTS A total of 73 patients with 319 SLNs consecutive enrolled in this study. MEW-M showed significantly superior image quality compared to TIC (median score 3.1 vs 2.1, p < 0.0001) and had a shorter time to issue results (10.3 vs 19.4 min, p < 0.0001). Likelihood ratio analysis illustrated that the positive likelihood ratio value of MEW-M compared with TIC was infinitely great vs 52.37 (95% CI, 21.96-124.90) in model 1 (classifying results into negative/positive), infinitely great vs 52.37 (95% CI, 21.96-124.90) in model 2 (classifying results into macro-metastasis/others, and TIC results followed the same classification as model 1), respectively. Similarly, the negative likelihood ratio values of MEW-M compared with TIC were 0.055 (95% CI, 0.018-0.160) and 0.074 (95% CI, 0.029-0.190) in model 1; and 0.019 (95% CI, 0.003-0.130) vs 0.020 (95% CI, 0.003-0.140) in model 2, respectively. CONCLUSIONS MEW-M is a promising technique that can be utilised to provide a rapid and accurate intraoperative assessment of SLN in a clinical setting to help improve decision-making in axillary surgery.
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Affiliation(s)
- Jia-Jian Chen
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Bao-Hua Yu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | | | - Ying Wang
- Department of Thyroid and Breast Surgery, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Fei Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Li-Rui Yang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yuan Dong
- Department of Breast Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ming-Jie Zheng
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Shuang Hao
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wen-Tao Yang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jiong Wu
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Shanghai, China
- Collaborative Innovation Center for Cancer Medicine, Shanghai, China
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Yang G, Wei L, Thong BKS, Fu Y, Cheong IH, Kozlakidis Z, Li X, Wang H, Li X. A Systematic Review of Oral Biopsies, Sample Types, and Detection Techniques Applied in Relation to Oral Cancer Detection. BIOTECH 2022; 11:5. [PMID: 35822813 PMCID: PMC9245907 DOI: 10.3390/biotech11010005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 12/11/2022] Open
Abstract
Background: Early identification of the stage of oral cancer development can lead to better treatment outcomes and avoid malignant transformation. Therefore, this review aims to provide a comprehensive overview that describes the development of standardized procedures for oral sample collection, characterization, and molecular risk assessment. This can help investigators to choose the appropriate sampling method and downstream analyses for different purposes. Methods: This systematic review was conducted according to the PRISMA guidelines. Using both PubMed and Web of Science databases, four independent authors conducted a literature search between 15 and 21 June 2021. We used key search terms to broaden the search for studies. Non-conforming articles were removed using an EndNote-based and manual approach. Reviewers used a designed form to extract data. Results: This review included a total of 3574 records, after eliminating duplicate articles and excluding papers that did not meet the inclusion criteria. Finally, 202 articles were included in this review. We summarized the sampling methods, biopsy samples, and downstream analysis. The biopsy techniques were classified into tissue and liquid biopsy. The common sequential analysis of tissue biopsy includes histopathological examination such as H&E or IHC to identify various pathogenic features. Meanwhile, liquid samples such as saliva, blood, and urine are analyzed for the purpose of screening to detect mutations in cancer. Commonly used technologies are PCR, RT-PCR, high-throughput sequencing, and metabolomic analysis. Conclusions: Currently, tissue biopsies provide increased diagnostic value compared to liquid biopsy. However, the minimal invasiveness and convenience of liquid biopsy make it a suitable method for mass screening and eventual clinical adoption. The analysis of samples includes histological and molecular analysis. Metabolite analysis is rising but remains scarce.
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Affiliation(s)
- Guanghuan Yang
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Luqi Wei
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Benjamin K. S. Thong
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Yuanyuan Fu
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Io Hong Cheong
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, 69372 Lyon, France;
| | - Xue Li
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Hui Wang
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Xiaoguang Li
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
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Sharma D, Konidena A, Sharma A. Diagnostic efficiency of methylene blue and lugol's iodine double staining method in oral leukoplakia in detecting dysplasia. Indian J Dent Res 2021; 32:310-315. [PMID: 35229769 DOI: 10.4103/ijdr.ijdr_291_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives Early detection of dysplasia in oral potentially malignant disorders (PMD) might facilitate screening for possible subsequent malignant transformation. Vital staining is a non-invasive clinical adjunct used for determining the biopsy site, which facilitates early detection of dysplastic changes in PMD. Some authors suggested that double staining method has superior results over staining with a single dye. Aim The aim of the study was to evaluate the accuracy of in vivo staining with methylene blue (MB) and Lugol's iodine (LI) double staining method in comparison with MB staining alone. Materials and Methods Fifty patients of oral leukoplakia were recruited for the study. After obtaining written informed consent from the patients, the lesions were stained consecutively with 5% MB and 3% LI. The pattern of dye retention of MB alone, followed by MB and LI was noted. Incisional biopsy from the lesion was taken based on the retention of MB and the absence of staining of LI or by clinical judgement in case both stains were not retained. The clinical uptake of the stains was correlated with the degree of dysplasia on histopathological examination. Results Out of 50 subjects, MB was retained in 47 cases (94%), while 3 cases (6%) failed to retain the dye. However, out of 47 cases, 20 cases had dark blue stain and were considered as MB positive, while the rest 27 cases had pale blue stain and were considered to be negative for MB staining. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) of MB staining were 57.82%, 100%, 100%, 26.53% and 46%, respectively. After applying both stains, i.e., double staining method, the outline of the lesion was better defined. Out of 50 PMD cases, 3 patients retained only LI and showed no dysplasia. Out of 47 cases which showed dysplasia, 27 cases showed pale blue retention of MB (-) and also were negative for LI. The rest 20 cases were positive for MB but negative for LI. The sensitivity, specificity, PPV and NPV with double staining technique were 100%. Conclusion The accuracy and reliability of double staining method was superior to MB staining. Clinical Relevance Increased accuracy of double staining method aids in better detection of dysplasia and is of great help to the clinician in deciding the nature of PMD in question.
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Affiliation(s)
- Dheeraj Sharma
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Sehora, Jammu, India
| | - Aravinda Konidena
- Department of Oral Medicine and Radiology, Swami Devi Dyal Hospital and Dental College, Barwala, Haryana, India
| | - Alpna Sharma
- Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, Sehora, Jammu, India
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Oral potentially malignant disorders: clinical diagnosis and current screening aids: a narrative review. Eur J Cancer Prev 2021; 29:65-72. [PMID: 30921006 DOI: 10.1097/cej.0000000000000510] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Around 300 000 patients are estimated to have oral cancer worldwide annually, and the incidence is higher in South Asian countries. In 2005, at the Congress of WHO, the term potentially malignant disorder (PMD)/lesion was suggested as a replacement for premalignant oral lesions and conditions. PMDs are those lesions of the oral mucosa that are at an increased risk of malignant transformation compared with the healthy mucosa. PMDs consist of leukoplakia, erythroplakia, oral lichen planus, oral submucous fibrosis, and other miscellaneous lesions. A literature search was performed using PubMed, Scopus, and Web of Science without any language restrictions. There is no standardized method for identifying a site for biopsy and various methods such as toluidine blue stain, methylene blue, Lugol's iodine, and chemiluminescence have been proposed in the literature. Despite easy access to the oral cavity, there has been significant mortality associated with oral cancer as they are often diagnosed late because of the inability of healthcare professionals to identify them at early premalignant states. This article aims to provide healthcare professionals with the knowledge to identify potentially malignant disorders and to aid them in biopsy site identification.
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Singhal J, Verma S, Kumar S, Mehrotra D. Recent Advances in Nano-Bio-Sensing Fabrication Technology for the Detection of Oral Cancer. Mol Biotechnol 2021; 63:339-362. [PMID: 33638110 DOI: 10.1007/s12033-021-00306-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2021] [Indexed: 12/24/2022]
Abstract
Nanotechnology-based miniaturized devices have been a breakthrough in the pre-clinical and clinical research areas, e.g. drug delivery, personalized medicine. They have revolutionized the discovery and development of biomarker-based diagnostic devices for detection of various diseases such as tuberculosis, malaria and cancer. Nanomaterials (NMs) hold tremendous diagnostic potential due to their high surface-to-volume ratio and quantum confinement phenomenon, improving the detection limit of clinically relevant biomolecules in bio-fluids. Thus, they are helpful in the translation of bench-on platform to point-of-care (POC) screening device. The nanomaterial-based biosensor fabrication technology has also simplified and improved oral cancer (OC) or oral squamous cell carcinomas (OSCC) diagnosis. The fabrication of nano-bio sensors involves application specific modifications of NMs. The unique properties functionalized NMs have augmented their application on the nano-biosensing platform for the detection of clinically relevant biomolecules in bio-fluids. Therefore, this article summarizes the recent advancements in the process of fabrication of nano-biosensors for detection of OC.
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Affiliation(s)
- Jaya Singhal
- Department of Health Research - Multidisciplinary Research Unit, King George's Medical University, Lucknow, 226003, Uttar Pradesh, India.,Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, 226003, Uttar Pradesh, India
| | - Saurabh Verma
- Department of Health Research - Multidisciplinary Research Unit, King George's Medical University, Lucknow, 226003, Uttar Pradesh, India
| | - Sumit Kumar
- Department of Health Research - Multidisciplinary Research Unit, King George's Medical University, Lucknow, 226003, Uttar Pradesh, India.
| | - Divya Mehrotra
- Department of Health Research - Multidisciplinary Research Unit, King George's Medical University, Lucknow, 226003, Uttar Pradesh, India. .,Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, 226003, Uttar Pradesh, India.
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Non-Invasive Early Detection of Oral Cancers Using Fluorescence Visualization with Optical Instruments. Cancers (Basel) 2020; 12:cancers12102771. [PMID: 32992486 PMCID: PMC7601016 DOI: 10.3390/cancers12102771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/19/2020] [Accepted: 09/23/2020] [Indexed: 12/20/2022] Open
Abstract
Simple Summary Oral cancer has a high mortality rate. Then, oral cancer screening is needed for early detection and treatment. Fluorescence visualization is non-invasive, convenient, and in real-time, and examinations can be repeated. Our study aimed to show the usefulness of oral cancer screening with fluorescence visualization. A total of 502 patients were performed using fluorescence visualization that was analyzed using subjective and objective evaluation. Results of this study, subjective evaluation for detection oral cancer was high sensitivity and low specificity, while objective evaluation using imaging processing analysis was high sensitivity and high specificity. Therefore, oral cancer screening using fluorescence visualization is useful for the detection of oral cancer. The widespread use of this screening can reduce the mortality rate of oral cancer. Abstract Background: Oral cancer screening is important for early detection and early treatment, which help improve survival rates. Biopsy is the gold standard for a definitive diagnosis but is invasive and painful, while fluorescence visualization is non-invasive, convenient, and real-time, and examinations can be repeated using optical instruments. The purpose of this study was to clarify the usefulness of fluorescence visualization in oral cancer screening. Methods: A total of 502 patients, who were examined using fluorescence visualization with optical instruments in our hospitals between 2014 and 2019, were enrolled in this study. The final diagnosis was performed by pathological examination. Fluorescence visualization was analyzed using subjective and objective evaluations. Results: Subjective evaluations for detecting oral cancer offered 96.8% sensitivity and 48.4% specificity. Regarding the objective evaluations, sensitivity and specificity were 43.7% and 84.6% for mean green value, 55.2% and 67.0% for median green value, 82.0% and 44.2% for coefficient of variation of value, 59.6% and 45.3% for skewness, and 85.1% and 75.8% for value ratio. For the sub-analysis of oral cancer, all factors on objective and subjective evaluation showed no significant difference. Conclusions: Fluorescence visualization with subjective and objective evaluation is useful for oral cancer screening.
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Hwang SH, Kim SW, Song EA, Lee J, Kim DH. Methylene Blue as a Diagnosis and Screening Tool for Oral Cancer and Precancer. Otolaryngol Head Neck Surg 2020; 164:271-276. [DOI: 10.1177/0194599820947686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives To evaluate the accuracy of methylene blue (MB) for diagnosing oral cancer and precancer. Data Sources PubMed, Cochrane Database, Embase, Web of Science, SCOPUS, and Google Scholar. Review Methods Two authors working independently reviewed 6 databases from their dates of inception until April 2020. Studies exploring oral mucosal disorders as detected by MB were assessed. True-positive, true-negative, false-positive, and false-negative data were extracted for each study. Methodological quality was evaluated with the Quality Assessment of Diagnostic Accuracy Studies tool (v 2). Results Seven prospective and retrospective studies (N = 493) were included. The diagnostic odds ratio of MB was 20.017 (95% CI, 10.65-37.63, I2 = 23%). The area under the summary receiver operating characteristic curve was 0.699. Sensitivity was 0.903 (95% CI, 0.84-0.94, I2 = 54%), and specificity was 0.68 (95% CI, 0.60-0.75, I2 = 0%). The correlation between the sensitivity and the false-positive rate was –0.17, indicating an absence of heterogeneity. Conclusions Regarding diagnostic accuracy, MB had high sensitivity but low specificity, suggesting that it cannot be recommended as a replacement for the currently used standard of a scalpel biopsy with histologic assessment. Instead, it should be used as an adjunct to conventional assessment because of its low toxicity and price.
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Affiliation(s)
- Se Hwan Hwang
- Department of Otolaryngology–Head and Neck Surgery, Bucheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Won Kim
- Department of Otolaryngology–Head and Neck Surgery, Bucheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Otolaryngology–Head and Neck Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun A. Song
- Department of Otolaryngology–Head and Neck Surgery, Bucheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Junuk Lee
- Department of Otolaryngology–Head and Neck Surgery, Bucheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Do Hyun Kim
- Department of Otolaryngology–Head and Neck Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Madhura MG, Rao RS, Patil S, Alhazmi YA, Jafer M, Habib SR, Awan KH. Minimally invasive procedures for the recognition and diagnosis of oral precancer and cancer. Dis Mon 2020; 66:101033. [PMID: 32620265 DOI: 10.1016/j.disamonth.2020.101033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Oral cancer represents a blend of genetic and epigenetic instability. Many a times, oral cancer occurs in the background of oral potentially malignant disorders (OPMDs), which could be easily detected and diagnosed. Various diagnostic aids have been explored for early detection of oral cancer. Some of the minimally invasive (chair-side diagnostic) procedures such as vital staining and light-based systems are used widely in the clinical practice as well as in the hospital setting owing to their simple and easy operability. In addition, these chair-side diagnostic procedures offer relatively good sensitivity and specificity despite some of their limitations. These diagnostic tools could complement good clinical history and thorough examination of patients for early detection of oral precancer and cancer.
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Affiliation(s)
| | - Roopa S Rao
- Department of Oral Pathology & Microbiology, M. S. Ramaiah Dental College, Bengaluru, Karnataka, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery & Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
| | - Yaser Ali Alhazmi
- Department of Maxillofacial Surgery & Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Mohammed Jafer
- Department of Preventive dental Science, College of Dentistry Jazan University, Jazan, Saudi Arabia
| | - Syed Rashid Habib
- Department of Prosthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Kamran Habib Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah 84095, United States.
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Gupta M, Shrivastava K, Raghuvanshi V, Ojha S, Gupta A, Sasidhar S. Application of in vivo stain of methylene blue as a diagnostic aid in the early detection and screening of oral cancerous and precancerous lesions. J Oral Maxillofac Pathol 2019; 23:304. [PMID: 31516247 PMCID: PMC6714272 DOI: 10.4103/jomfp.jomfp_242_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Periodic clinical examination of the oral cavity is the mainstay for the early detection of oral cancers which can be further aided by screening individuals with high-risk factors that will identify candidates who should receive treatment to prevent cancer progression and reduce patient mortality. Among the diagnostic tools, in vivo staining is advocated as a simple, inexpensive and fairly sensitive method. Materials and Methods: The present study involved the examination of fifty patients suspected of oral malignant or precancerous lesions by methylene blue staining. The results of methylene blue uptake were compared with a simultaneous biopsy of these lesions, while benign epithelial lesions were included as the negative subjects of screening. Results: The results revealed a sensitivity of 89%, a specificity of 91%, a positive predictive value of 97% and a negative predictive value of 73%. Conclusion: We recommend that methylene blue staining is a useful diagnostic adjunct in a large, community-based oral cancer screening program for high-risk individuals.
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Affiliation(s)
- Manas Gupta
- Department of Oral Medicine and Radiology, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Kriti Shrivastava
- Department of Oral Medicine and Radiology, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Vikalp Raghuvanshi
- MDS Oral Medicine and Radiology Private Practitioner, Khargone, Madhya Pradesh, India
| | - Sakshi Ojha
- Department of Oral Medicine and Radiology, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Ankita Gupta
- Department of Public Health Dentistry, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - S Sasidhar
- Department of Oral and Maxillofacial Pathology, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
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Ratna Kumari TVN, Ahmed Mujib BR. Toluidine Blue with a Synergistic Effect in Morphological Assessment of Oral Cytosmears. J Cytol 2018; 35:8-14. [PMID: 29403163 PMCID: PMC5795738 DOI: 10.4103/joc.joc_185_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives One percent toluidine blue being the most effective adjunct is often used to detect dysplasia. Not much attention has been given to the effect of toluidine blue in enhancement of cytological smears. The present study assessed the smears before and after application of toluidine blue in smokers against non-smokers using three different stains [Papanicolaou (PAP), Hematoxylin and Eosin (H and E), and Giemsa]. Study Design Twenty-five individuals from each group participated in the study. The oral cytosmears were obtained before and after application of toluidine blue and assessed for clumping of squamous cells, cellular and nuclear pleomorphism, micronuclei, binucleation, bacterial colony units, and keratin flakes. Results In smokers, the maximum enhancement in cytological smears post-toluidine blue application was shown by Giemsa stain than PAP and H and E stains. Among the individual parameters, nuclear pleomorphism exhibited greatest significant difference between smokers and non-smokers. Conclusion Toluidine blue enhanced the staining characteristics both in terms of sensitivity and specificity and thereby was found to be synergistic in assessment of cytosmears. The cellular alterations noticed in the smears of smokers with clinically normal buccal mucosa can be used as a means of education tool in counselling for smoking cessation.
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Affiliation(s)
- T V N Ratna Kumari
- Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - B R Ahmed Mujib
- Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Lejoy A, Arpita R, Krishna B, Venkatesh N. Methylene Blue as a Diagnostic Aid in the Early Detection of Potentially Malignant and Malignant Lesions of Oral Mucosa. Ethiop J Health Sci 2017; 26:201-8. [PMID: 27358540 PMCID: PMC4913187 DOI: 10.4314/ejhs.v26i3.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In vivo stains are the prompt resources, which have emerged in recent years to aid as clinical diagnostic tools in detecting early potentially malignant and malignant lesions. Toluidine blue, by its property of retaining in the increased DNA and RNA cellular activity areas, aids in delineating the suspicious areas. However, it is hazardous if swallowed, and has been shown to have toxicity to fibroblasts. Methylene blue has a similar chemical structure and exhibits similar physicochemical properties as toluidine blue. It is less toxic to the human body and has recently been proposed for screening some gastrointestinal or prostate tumors. The application of this material in detecting oral lesions has so far not been addressed. The objective of this study was to evaluate the sensitivity and reliability of in vivo staining with methylene blue as a diagnostic adjunct in screening for oral malignant or potentially malignant lesions. METHODS The present study involved the examination of 75 patients suspected of having oral malignant or potentially malignant lesions by methylene blue staining. The results of methylene blue uptake were compared with a simultaneous biopsy of these lesions. RESULTS The overall sensitivity was 95% (100% for malignancy and 92% for potentially malignant lesions) and specificity was 70%. The positive predictive value was 91% and negative predictive value of 80% was observed in the study. CONCLUSION We consider that methylene blue staining is a useful diagnostic adjunct in a large, community-based oral cancer screening program for high-risk individuals.
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Affiliation(s)
- Abraham Lejoy
- SDM College of Dental Sciences and Hospital, Dharwad
| | - Rai Arpita
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi
| | - Burde Krishna
- SDM College of Dental Sciences and Hospital, Dharwad
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Mahmoud MM, Afifi MM. Anti-angiogenic therapy (bevacizumab) in the management of oral lichen planus. Eur J Oral Sci 2016; 124:119-26. [PMID: 26892241 DOI: 10.1111/eos.12251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 01/05/2023]
Abstract
Oral lichen planus (OLP), a mucocutaneous chronic inflammatory disease, is conventionally managed using topical corticosteroid therapy. Given the fact that OLP is strongly linked to angiogenesis, anti-angiogenic drugs, such as bevacizumab, might be introduced as an alternative treatment for contraindicated, non-responsive patients. The aim of the present study was to report the short-term effectiveness and safety of intralesional bevacizumab injection in the management of atrophic/erosive OLP. A case series study was conducted in patients with atrophic/erosive OLP in the buccal mucosa, assigned to receive either 2.5 mg of bevacizumab, by intralesional injection (n = 20, test), or topical 0.1% triamcinolone acetonide ointment (n = 20, control). The size, score, and pain intensity of the lesions were assessed pre- and post-treatment. Tissue biopsies were collected for histopathologic, immunohistochemical, and ultrastructural examination. After 1 wk, the test group had significant reductions both in lesion seize and in pain scores compared with controls. A marked decrease in vascular endothelial growth factor (VEGF) and interleukin-8 immunoexpression was noted in tissue biopsies from bevacizumab-treated lesions compared with control lesions. Furthermore, ultrastructural examination of OLP tissue specimens revealed significant healing signs associated with bevacizumab treatment. Short-term data suggest that intralesional bevacizumab injection effectively and safely achieved resolution of atrophic/erosive OLP lesions without disease exacerbations during a 3-month follow-up period.
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Affiliation(s)
- Maha M Mahmoud
- Oral Medicine, Periodontology, Radiology and Diagnosis, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Marwa M Afifi
- Oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Lokesh K, Kannabiran J, Rao MD. Salivary Lactate Dehydrogenase (LDH)- A Novel Technique in Oral Cancer Detection and Diagnosis. J Clin Diagn Res 2016; 10:ZC34-7. [PMID: 27042582 DOI: 10.7860/jcdr/2016/16243.7223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/06/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy which is a major cause for cancer morbidity and mortality worldwide. Early diagnosis and intervention improves the overall survival rate. AIM The current study was done to evaluate the accuracy of salivary LDH as a potential biomarker for diagnosis of OSCC and to correlate the levels of salivary LDH with the histological differentiation of the tumour. MATERIALS AND METHODS Thirty patients visiting the outpatient department diagnosed clinically and histologically with OSCC were selected for the study with a control group of 20 patients. Unstimulated salivary samples collected from the selected patients were centrifuged and processed. Readings of enzyme activity in the salivary samples was established through auto analysis using International Federation of Clinical Chemistry (IFCC) method. Levels of the enzyme activity in both the control and the study group were compared and statistically analysed using student t-test. The three subgroups were also compared and statistically analysed. RESULTS The results showed a mean value of 497.00 with a SD of 51.75 among the control group and a mean value of 1225.40 with a SD of 221.79 among the cases with a p-value of 0.0001 which was statistically significant. Furthermore, when the LDH values for the various grades of OSCC were compared, the mean values were 1049.07, 1309.50 and 1586.20 respectively, for well differentiated, moderately differentiated and poorly differentiated carcinoma. CONCLUSION The p-value thus obtained revealed LDH values which were significantly higher in patients with OSCC and furthermore the levels significantly correlated with the histopathological grade of the tumour.
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Affiliation(s)
| | - Jayanthi Kannabiran
- Former Professor and Head of Department, Department of Oral Medicine and Radiology, Bangalore Institute of Dental Sciences & Hospital , Bangalore, India
| | - Mahesh Dathu Rao
- Reader, Department of Oral Medicine and Radiology, Dayanand Sagar College of Dental Sciences , Bangalore, India
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Liu D, Zhao X, Zeng X, Dan H, Chen Q. Non-Invasive Techniques for Detection and Diagnosis of Oral Potentially Malignant Disorders. TOHOKU J EXP MED 2016; 238:165-77. [PMID: 26888696 DOI: 10.1620/tjem.238.165] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Dongjuan Liu
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Xin Zhao
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
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Tibbetts KM, Tan M. Role of Advanced Laryngeal Imaging in Glottic Cancer. Otolaryngol Clin North Am 2015; 48:565-84. [DOI: 10.1016/j.otc.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Bobdey S, Balasubramanium G, Kumar A, Jain A. Cancer Screening: Should Cancer Screening be Essential Component of Primary Health Care in Developing Countries? Int J Prev Med 2015; 6:56. [PMID: 26236443 PMCID: PMC4505397 DOI: 10.4103/2008-7802.160053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 07/23/2014] [Indexed: 11/13/2022] Open
Abstract
Background: Cancer is a fatal disease and is on the rise across the globe. In India, breast, cervix and the oral cavity are the leading cancer sites, but, unfortunately, in-spite of availability of screening tools, there is no organized cancer screening program in India. The main objective of this study was to review the performance of various cancer screening modalities in a resource poor setting. Methods: MEDLINE and web of science electronic database was searched from January 1990 to December 2013, using keywords such as “breast cancer, cervical cancer, oral cancer and their corresponding mesh terms were also used in combination with Boolean operators OR, AND.” Two authors independently selected studies published in English and conducted in India. A total of 16 studies was found relevant and eligible for the review. The data on sensitivity and specificity of various screening tool was extracted and analyzed. Results: Most of the reported screening trails in India are on cervical cancer and few on breast and oral cancer screening. The pooled estimates of sensitivity and specificity of cervical cancer screening test such as visual inspection with acetic acid, magnified visual inspection with acetic acid, visual inspection with Lugol's iodine, cytology (Papanicolaou smear) and human papillomavirus deoxyribonucleic acid was found to be 68.76% and 84.02%, 63.27% and 85.43%, 81.86% and 87.03%, 63.25% and 93.17% and 75.04% and 91.66%, respectively. Sensitivity and specificity of clinical breast examination was found to be 94.30% and 94.30%, respectively. Oral cancer screening through visual inspection by trained health care worker was found to have 87.90% sensitivity and 92.05% specificity. Conclusions: Our study highlights the availability and success of visual screening tools in early detection and mortality reduction of major neoplasia in resource-poor health care settings and recommends implementation of oral and cervical cancer screening as part of assured primary health care package in developing countries.
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Affiliation(s)
- Saurabh Bobdey
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Ganesh Balasubramanium
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Abhinendra Kumar
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Aanchal Jain
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Carreras-Torras C, Gay-Escoda C. Techniques for early diagnosis of oral squamous cell carcinoma: Systematic review. Med Oral Patol Oral Cir Bucal 2015; 20:e305-15. [PMID: 25662554 PMCID: PMC4464918 DOI: 10.4317/medoral.20347] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/01/2014] [Indexed: 02/04/2023] Open
Abstract
Background and objectives The diagnosis of early oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) is of paramount clinical importance given the mortality rate of late stage disease. The aim of this study is to review the literature to assess the current situation and progress in this area. Material and Methods A search in Cochrane and PubMed (January 2006 to December 2013) has been used with the key words “squamous cell carcinoma”, “early diagnosis” “oral cavity”, “Potentially Malignant Disorders” y “premalignant lesions”. The inclusion criteria were the use of techniques for early diagnosis of OSCC and OPMD, 7 years aged articles and publications written in English, French or Spanish. The exclusion criteria were case reports and studies in other languages. Results Out of the 89 studies obtained initially from the search 60 articles were selected to be included in the systematic review: 1 metaanalysis, 17 systematic reviews, 35 prospective studies, 5 retrospective studies, 1 consensus and 1 semi-structured interviews. Conclusions The best diagnostic technique is that which we have sufficient experience and training. Definitely tissue biopsy and histopathological examination should remain the gold standard for oral cancer diagnose. In this systematic review it has not been found sufficient scientific evidence on the majority of proposed techniques for early diagnosis of OSCC, therefore more extensive and exhaustive studies are needed. Key words:
Squamous cell carcinoma, early diagnosis, oral cavity, potentially malignant disorders, premalignant lesions.
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Abbaci M, Casiraghi O, Temam S, Ferchiou M, Bosq J, Dartigues P, De Leeuw F, Breuskin I, Laplace-Builhé C. Red and far-red fluorescent dyes for the characterization of head and neck cancer at the cellular level. J Oral Pathol Med 2015; 44:831-41. [DOI: 10.1111/jop.12316] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Muriel Abbaci
- Imaging and Cytometry Platform; UMS AMMICA; Gustave Roussy; Villejuif France
- UMR CNRS 8081- IR4M; Univ Paris-Sud; Orsay France
| | | | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery; Gustave Roussy; Villejuif France
| | - Malek Ferchiou
- Department of Pathology; Gustave Roussy; Villejuif France
| | - Jacques Bosq
- Department of Pathology; Gustave Roussy; Villejuif France
| | | | - Frederic De Leeuw
- Imaging and Cytometry Platform; UMS AMMICA; Gustave Roussy; Villejuif France
- UMR CNRS 8081- IR4M; Univ Paris-Sud; Orsay France
| | - Ingrid Breuskin
- Department of Otorhinolaryngology and Head and Neck Surgery; Gustave Roussy; Villejuif France
| | - Corinne Laplace-Builhé
- Imaging and Cytometry Platform; UMS AMMICA; Gustave Roussy; Villejuif France
- UMR CNRS 8081- IR4M; Univ Paris-Sud; Orsay France
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Diagnostic modalities for squamous cell carcinoma: an extensive review of literature-considering toluidine blue as a useful adjunct. J Maxillofac Oral Surg 2014; 14:188-200. [PMID: 26028834 DOI: 10.1007/s12663-014-0660-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 07/01/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Oral Squamous Cell Carcinomas have been considered as the most prevalent malignancies in the head and neck region and are frequently undiagnosed until symptomatic with an advanced stage of disease. So there is an urgent need to device methods for the detection of oral premalignant lesions and oral cancer at an early stage in order to improve the survival rate for patients. A number of tests have been done for the detection of oral cancer which include oral brush biopsy, the Vizilite, oral autofluorescence including chemiluscence, photodynamic detection, toluidine blue staining, methylene blue staining, incisional biopsy and many more. MATERIAL The article reviews various diagnostic modalities available at present for detection of squamous cell carcinomas and oral epithelial dysplasias based on advanced PUBMED search of the English language literature from the year 1972 to present in order to help us select the most suitable among them fulfilling the desired criteria of being non-invasive, highly specific and sensitive, economically viable, having a scope to be used for mass screening, easy to process, having low inter examiner variability and possibly not requiring high expertise to conduct and interpret the results. CONCLUSION After reviewing various diagnostic modalities, we conclude that toluidine blue staining emerges as a clear winner among all these and it can act as a valuable adjunct to incisional biopsy in detection of oral cancer and may not substitute it except in certain circumstances when its results are carefully correlated with the patient history and clinical characteristics of the mucosal disorder, considering the fact that incisional biopsy has been reported to cause dissemination of cancer cells in the circulation there by increasing the possibility of metastasis. We must emphasize that toludine blue is a screening modality and not a diagnostic procedure like biopsy and hence cannot replace a confirmatory biopsy as a whole.
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Fuller C, Camilon R, Nguyen S, Jennings J, Day T, Gillespie MB. Adjunctive diagnostic techniques for oral lesions of unknown malignant potential: Systematic review with meta-analysis. Head Neck 2014; 37:755-62. [PMID: 24596227 DOI: 10.1002/hed.23667] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 02/12/2014] [Accepted: 03/01/2014] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The purpose of this study was to critically review the published evidence concerning adjunctive diagnostic techniques in the diagnosis of oral lesions of unknown malignant potential. METHODS We conducted a systematic literature review with meta-analysis using PubMed to search for articles published from June 1993 through June 2013 to identify prospective studies evaluating any diagnostic method, with tissue biopsy confirmation, in clinically evident oral lesions of unknown malignant potential. Aggregate weighted totals and SEs for true, false-positive, false-negative, and inadequate results were calculated and compared among subgroups. RESULTS Forty-eight articles satisfying inclusion criteria were identified. Twenty-five were included in quantitative synthesis. CONCLUSION Oral cytology holds higher diagnostic value than specialist's oral examination, which holds higher value than in vivo toluidine blue staining. This study does not support the use of computer-aided or liquid-based cytology. Future studies should be designed to test multiple methods in the same patient population to allow direct comparison among various techniques.
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Affiliation(s)
- Colin Fuller
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Steffen J, Rice J, Lecuona K, Carrara H. Identification of ocular surface squamous neoplasia by in vivo staining with methylene blue. Br J Ophthalmol 2013; 98:13-5. [PMID: 24158840 DOI: 10.1136/bjophthalmol-2013-303956] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIM To evaluate the diagnostic accuracy of methylene blue used as a non-invasive in vivo stain to detect ocular surface squamous neoplasia (OSSN). METHODS A test validation study was performed according to Standards for the reporting of diagnostic accuracy studies (STARD) guidelines on 75 consecutive patients who presented with ocular surface lesions suspicious of OSSN. Methylene blue 1% was instilled in vivo following local anaesthetic. Stain results were documented photographically and read by an independent observer. Lesions were excised at the same visit and evaluated histologically by pathologists who were blind to the stain results. Sensitivity, specificity, positive and negative predictive values were determined. RESULTS Thirty-three patients had histologically malignant lesions, of which 32 stained with methylene blue, and 42 patients had benign or premalignant lesions, of which 21 stained with methylene blue. Methylene blue had a sensitivity of 97%, specificity of 50% and positive and negative predictive values of 60% and 96%, respectively. CONCLUSIONS The topical application of methylene blue is a simple, inexpensive, non-invasive diagnostic test that can be helpful in excluding malignant ocular surface lesions but cannot replace histology as gold standard for diagnosis of OSSN.
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Affiliation(s)
- Jonel Steffen
- Division of Ophthalmology, University of Cape Town, , Cape Town, Western Cape, South Africa
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Riaz A, Shreedhar B, Kamboj M, Natarajan S. Methylene blue as an early diagnostic marker for oral precancer and cancer. SPRINGERPLUS 2013; 2:95. [PMID: 23524482 PMCID: PMC3602613 DOI: 10.1186/2193-1801-2-95] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 02/25/2013] [Indexed: 11/10/2022]
Abstract
Oral cancer is one of the most common neoplasm's and is ranked eighth in the cancer incidence worldwide. Early detection is of critical importance because survival rates markedly improve. In vivo staining is a simple, inexpensive, and fairly sensitive method. Involved 120 patients (50 with Premalignant Lesion, 50 with OSCC and 20 controls) stained by Methylene Blue (MB). The results of MB uptake were compared with a simultaneous biopsy of these lesions. Pathologically confirmed precancers and cancers were the positive targets of this screening, while hyperkeratosis without dysplasia and no evidence of malignancy were sorted as negative subjects of screening. The results revealed sensitivity of 91.4%, specificity of 66.6%, positive predictive value 97.7% and negative predictive value 33% leading to diagnostic accuracy of MB stain to 90%. We state that MB staining is useful diagnostic tool in community oral cancer screening programmes for high-risk individuals.
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Affiliation(s)
- Akhtar Riaz
- Department of Oral Pathology and Microbiology, Career Post Graduate Institute of Dental Sciences and Hospital, C-1111, Indiranagar, Lucknow, 226016 India
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Arens C, Vorwerk U, Just T, Betz CS, Kraft M. [Advances in endoscopic diagnosis of dysplasia and carcinoma of the larynx]. HNO 2012; 60:44-52. [PMID: 22282010 DOI: 10.1007/s00106-011-2428-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
To improve the preoperative and intraoperative diagnosis of laryngeal cancer and its precursors, various endoscopic imaging techniques have been developed in recent years. These techniques differ markedly in their specific applications and goals. Precisely distinguishing among normal mucosa, dysplasia and invasive carcinoma with these procedures is necessary. Furthermore, the exact identification of tumor margins should be possible. The long-term goal is the development of optical biopsy. Since so far there have only been small studies regarding the evaluation of the presented methods, it is necessary to establish multi-center trials with large sample sizes to accurately estimate the value of these endoscopic imaging techniques.
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Affiliation(s)
- C Arens
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Magdeburg A.ö.R, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
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Hughes OR, Stone N, Kraft M, Arens C, Birchall MA. Optical and molecular techniques to identify tumor margins within the larynx. Head Neck 2011; 32:1544-53. [PMID: 20091681 DOI: 10.1002/hed.21321] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Failure to remove tumor cells from the larynx significantly increases the risk of local recurrence following surgical excision. Healthy tissue must be preserved to optimize long-term vocal and swallowing function. It is essential to accurately distinguish between healthy mucosa, dysplasia, and invasive carcinoma. Optical and molecular examining technologies have been developed to improve tumor margin identification in vivo. We aimed to review the efficacy of these technologies. Published articles were identified using MEDLINE, EMBASE, and Cochrane central register of controlled trials (CENTRAL). Randomized clinical trials are required to establish the benefit to patients and cost to the health service of using 5-aminolevulinic acid (ALA)-induced fluorescent imaging, contact endoscopy, and optical coherence tomography (OCT). Furthermore, primary research is required to validate other techniques, such as confocal endomicroscopy and Raman spectroscopy, and to develop their clinical applications in the larynx.
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Affiliation(s)
- Owain R Hughes
- Department of Otorhinolaryngology-Head and Neck Surgery, Royal National Throat, Nose, and Ear Hospital, London, United Kingdom.
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Wainwright M, Stanforth A, Jones R, Loughran C, Meegan K. Photoantimicrobials as a potential local approach to geriatric UTIs. Lett Appl Microbiol 2010; 50:486-92. [DOI: 10.1111/j.1472-765x.2010.02825.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Oral cancer is a fatal disease, accounting for the fourth highest incidence of malignancy in males and the seventh in females in Taiwan. The relatively high prevalence of oral cancer in Taiwan is mainly because there is a high-risk group of 2.5 million people with the habit of smoking and betel nut chewing. Unfortunately, 50% of new cases in our medical center who present with TNM stage III or IV lesions have a shorter than 5-year survival after treatment. This highlights the need for: (1) early treatment of fresh oral cancer cases; (2) screening of the high-risk population to detect new lesions; (3) careful follow-up of cases after treatment; and (4) detection of occult early neck nodal adenopathy in surgical cases. It is generally accepted that prevention and screening of oral cancer are equally important to treatment due to its location. In this review article, we describe the nature of oral cancer and highlight the various conventional and novel methods of screening for this disease and ongoing important related research. Related literature is reviewed and future work that needs to be done is detailed.
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Affiliation(s)
- Shou-Yen Kao
- Department of Stomatology, Taipei Veterans General Hospital, Taiwan, R.O.C.
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