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Ranganathan K, Kavitha L. Clinical aspects of oral cancer and potentially malignant disorders in South and Southeast Asia. Oral Dis 2024. [PMID: 38817004 DOI: 10.1111/odi.15008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/29/2024] [Accepted: 05/08/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Oral cancer and Oral Potentially Malignant Disorders (OPMD) are major health problems in South and Southeast Asia. AIMS To describe and discuss the clinical aspects of Oral Cancer and OPMD in South and Southeast Asia. MATERIALS AND METHODS Literature review of concepts and data over the last four decades. DISCUSSION Asian countries account for about two-thirds of new cases of oral cancer (OC) globally, with the highest burden in the South and Southeast Asian countries, including Pakistan and India. Habits, dietary patterns, socioeconomic status, and access to routine dental care play a crucial role in defining the demographics and clinical presentation of OC in these regions and significantly influence the morbidity and mortality of the disease. This region sees the use of different types of tobacco with or without areca nut (AN), such as pan masala, gutka, gul, snuff, mawa, and mishri. Tobacco use is high among men in Sri Lanka, Myanmar, Maldives, Bangladesh, Nepal, India and Bhutan. Areca nut is the fourth most common addictive substance globally and is frequently used in South and Southeast Asian countries, including Southeast China, Hainan Island, India, Taiwan, and the Pacific Islands, and immigrants from these regions in Africa, Europe, and North America. The use of these products results in mucosal alterations with varied clinical presentation of Oral Potentially Malignant Disorders (OPMDs) and OC. We discuss here the different types of OPMD and OC, the diagnostic aids and their relevance in clinical practice, and factors that influence their prognosis.
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Affiliation(s)
- Kannan Ranganathan
- Ragas Dental College and Hospital, Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
| | - Loganathan Kavitha
- Ragas Dental College and Hospital, Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
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Ghosh B, Chatterjee J, Paul RR, Acuña S, Lahiri P, Pal M, Mitra P, Agarwal K. Molecular histopathology of matrix proteins through autofluorescence super-resolution microscopy. Sci Rep 2024; 14:10524. [PMID: 38719976 PMCID: PMC11078950 DOI: 10.1038/s41598-024-61178-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
Extracellular matrix diseases like fibrosis are elusive to diagnose early on, to avoid complete loss of organ function or even cancer progression, making early diagnosis crucial. Imaging the matrix densities of proteins like collagen in fixed tissue sections with suitable stains and labels is a standard for diagnosis and staging. However, fine changes in matrix density are difficult to realize by conventional histological staining and microscopy as the matrix fibrils are finer than the resolving capacity of these microscopes. The dyes further blur the outline of the matrix and add a background that bottlenecks high-precision early diagnosis of matrix diseases. Here we demonstrate the multiple signal classification method-MUSICAL-otherwise a computational super-resolution microscopy technique to precisely estimate matrix density in fixed tissue sections using fibril autofluorescence with image stacks acquired on a conventional epifluorescence microscope. We validated the diagnostic and staging performance of the method in extracted collagen fibrils, mouse skin during repair, and pre-cancers in human oral mucosa. The method enables early high-precision label-free diagnosis of matrix-associated fibrotic diseases without needing additional infrastructure or rigorous clinical training.
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Affiliation(s)
- Biswajoy Ghosh
- Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, 721302, India.
- UiT - The Arctic University of Norway, 9019, Tromsø, Norway.
| | | | - Ranjan Rashmi Paul
- Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, 700114, India
| | | | - Pooja Lahiri
- Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, 721302, India
| | - Mousumi Pal
- Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, 700114, India
| | - Pabitra Mitra
- Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, 721302, India
| | - Krishna Agarwal
- UiT - The Arctic University of Norway, 9019, Tromsø, Norway.
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Gaiffe O, Mahdjoub J, Ramasso E, Mauvais O, Lihoreau T, Pazart L, Wacogne B, Tavernier L. Discrimination of vocal folds lesions by multiclass classification using autofluorescence spectroscopy: An ex vivo study. Head Neck 2024; 46:1136-1145. [PMID: 38299429 DOI: 10.1002/hed.27668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Autofluorescence spectroscopy is effective for noninvasive detection but underutilized in tissue with various pathology analyses. This study evaluates whether AFS can be used to discriminate between different types of laryngeal lesions in view of assisting in vocal fold surgery and preoperative investigations. METHODS A total of 1308 spectra were recorded from 29 vocal fold samples obtained from 23 patients. Multiclass analysis was performed on the spectral data, categorizing lesions into normal, benign, dysplastic, or carcinoma. RESULTS Through an appropriate selection of spectral components and a cascading classification approach based on artificial neural networks, a classification rate of 97% was achieved for each lesion class, compared to 52% using autofluorescence intensity. CONCLUSIONS The ex vivo study demonstrates the effectiveness of AFS combined with multivariate analysis for accurate classification of vocal fold lesions. Comprehensive analysis of spectral data significantly improves classification accuracy, such as distinguishing malignant from precancerous or benign lesions.
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Affiliation(s)
- Olivier Gaiffe
- Department of Otolaryngology - Head and Neck Surgery, CHU de Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie et Thérapeutiques, EA4662, Université de Franche-Comté, Besançon, France
| | - Joackim Mahdjoub
- Department of Otolaryngology - Head and Neck Surgery, CHU de Besançon, Besançon, France
| | - Emmanuel Ramasso
- Institut FEMTO-ST UMR61742, Université de Franche-Comté, ENSMM, CNRS, Besançon, France
| | - Olivier Mauvais
- Department of Otolaryngology - Head and Neck Surgery, CHU de Besançon, Besançon, France
| | | | | | - Bruno Wacogne
- Institut FEMTO-ST UMR61742, Université de Franche-Comté, ENSMM, CNRS, Besançon, France
- Inserm CIC 1431, CHU Besançon, Besançon, France
| | - Laurent Tavernier
- Department of Otolaryngology - Head and Neck Surgery, CHU de Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie et Thérapeutiques, EA4662, Université de Franche-Comté, Besançon, France
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Mat Lazim N, Kandhro AH, Menegaldo A, Spinato G, Verro B, Abdullah B. Autofluorescence Image-Guided Endoscopy in the Management of Upper Aerodigestive Tract Tumors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:159. [PMID: 36612479 PMCID: PMC9819287 DOI: 10.3390/ijerph20010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
At this juncture, autofluorescence and narrow-band imaging have resurfaced in the medicine arena in parallel with current technology advancement. The emergence of newly developed optical instrumentation in addition to the discovery of new fluorescence biomolecules have contributed to a refined management of diseases and tumors, especially in the management of upper aerodigestive tract tumors. The advancement in multispectral imaging and micro-endoscopy has also escalated the trends further in the setting of the management of this tumor, in order to gain not only the best treatment outcomes but also facilitate early tumor diagnosis. This includes the usage of autofluorescence endoscopy for screening, diagnosis and treatment of this tumor. This is crucial, as microtumoral deposit at the periphery of the gross tumor can be only assessed via an enhanced endoscopy and even more precisely with autofluorescence endoscopic techniques. Overall, with this new technique, optimum management can be achieved for these patients. Hence, the treatment outcomes can be improved and patients are able to attain better prognosis and survival.
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Affiliation(s)
- Norhafiza Mat Lazim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
| | - Abdul Hafeez Kandhro
- Institute of Medical Technology, Jinnah Sindh Medical University, Karachi 75510, Pakistan
| | - Anna Menegaldo
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, 31100 Treviso, Italy
| | - Giacomo Spinato
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, 31100 Treviso, Italy
- Department of Surgery, Oncology and Gastroenterology, Section of Oncology and Immunology, University of Padova, 31100 Treviso, Italy
| | - Barbara Verro
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy
| | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
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Monea M, Pop AM. The Use of Salivary Levels of Matrix Metalloproteinases as an Adjuvant Method in the Early Diagnosis of Oral Squamous Cell Carcinoma: A Narrative Literature Review. Curr Issues Mol Biol 2022; 44:6306-6322. [PMID: 36547091 PMCID: PMC9776994 DOI: 10.3390/cimb44120430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/04/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with increased mortality, in which the early diagnosis is the most important step in increasing patients' survival rate. Extensive research has evaluated the role of saliva as a source of diagnostic biomarkers, among which matrix metalloproteinases (MMPs) have shown a valuable potential for detecting even early stages of OSCC. The aim of this review was to present recent clinical data regarding the significance of salivary MMPs in the detection of early malignant transformation of the oral mucosa. A narrative review was conducted on articles published in PubMed, Cochrane Library, Web of Science, EBSCO and SciELO databases, using specific terms. Our search revealed that MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, MMP-10, MMP-12 and MMP-13 had significantly higher levels in saliva from patients with OSCC compared to controls. However, the strength of evidence is limited, as most information regarding their use as adjuvant diagnostic tools for OSCC comes from studies with a low number of participants, variable methodologies for saliva sampling and diagnostic assays, and insufficient adjustment for all covariates. MMP-1, MMP-3 and MMP-9 were considered the most promising candidates for salivary diagnosis of OSCC, but larger studies are needed in order to validate their clinical application.
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Affiliation(s)
- Monica Monea
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
- Correspondence:
| | - Anca Maria Pop
- Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
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Testing the accuracy of autofluorescence device in diagnosing oral potentially malignant disorders among people with HIV seeking dental care. Clin Oral Investig 2022; 27:1899-1906. [PMID: 36477940 DOI: 10.1007/s00784-022-04818-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Although many studies have assessed the diagnostic accuracy of autofluorescence in oral potentially malignant disorders (OPMDs), there has been a paucity of such information in high-risk populations. Our study thereby tested the accuracy of using autofluorescence in the oral examination of suspicious lesions among patients seeking care at an HIV-specialized dental clinic in Houston, Texas. MATERIALS AND METHODS We performed a prospective single-arm design in which forty-four (44) HIV-infected individuals seeking dental care at a specialized-HIV dental clinic were recruited. Each subject had their oral cavity examined under conventional lighting and then used a fluorescence light-based handheld device (OralID®). Biopsy was obtained from unresolved suspicious OPMDs at the 15-day follow-up, and histopathological analysis was conducted. The oral lesions, not the patient, were treated as the unit of analysis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated using SPSS. RESULTS The results showed that OPMDs could be identified with a sensitivity of 90%, a specificity of 18%, an NPV of 86%, a PPV of 24% using the fluorescence light-based handheld device, with a diagnostic accuracy of 55%. CONCLUSIONS Despite the low specificity, fluorescence light can complement clinical oral cancer screening and aid identification of OPMDs during biopsy procedures. CLINICAL RELEVANCE Our findings suggest that autofluorescence devices could supplement clinical oral examination and aid the identification of OPMDs during biopsy procedures, potentially improving oral cancer screening among HIV-positive patients seeking care.
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Diagnostic Accuracy of Confocal Laser Endomicroscopy for the Diagnosis of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312390. [PMID: 34886116 PMCID: PMC8657406 DOI: 10.3390/ijerph182312390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 01/22/2023]
Abstract
Background: Advances in treatment approaches for patients with oral squamous cell carcinoma (OSCC) have been unsuccessful in preventing frequent recurrences and distant metastases, leading to a poor prognosis. Early detection and prevention enable an improved 5-year survival and better prognosis. Confocal Laser Endomicroscopy (CLE) is a non-invasive imaging instrument that could enable an earlier diagnosis and possibly help in reducing unnecessary invasive surgical procedures. Objective: To present an up to date systematic review and meta-analysis assessing the diagnostic accuracy of CLE in diagnosing OSCC. Materials and Methods. PubMed, Scopus, and Web of Science databases were explored up to 30 June 2021, to collect articles concerning the diagnosis of OSCC through CLE. Screening: data extraction and appraisal was done by two reviewers. The quality of the methodology followed by the studies included in this review was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A random effects model was used for the meta-analysis. Results: Six studies were included, leading to a total number of 361 lesions in 213 patients. The pooled sensitivity and specificity were 95% (95% CI, 92–97%; I2 = 77.5%) and 93% (95% CI, 90–95%; I2 = 68.6%); the pooled positive likelihood ratios and negative likelihood ratios were 10.85 (95% CI, 5.4–21.7; I2 = 55.9%) and 0.08 (95% CI, 0.03–0.2; I2 = 83.5%); and the pooled diagnostic odds ratio was 174.45 (95% CI, 34.51–881.69; I2 = 73.6%). Although risk of bias and heterogeneity is observed, this study validates that CLE may have a noteworthy clinical influence on the diagnosis of OSCC, through its high sensitivity and specificity. Conclusions: This review indicates an exceptionally high sensitivity and specificity of CLE for diagnosing OSCC. Whilst it is a promising diagnostic instrument, the limited number of existing studies and potential risk of bias of included studies does not allow us to draw firm conclusions. A conclusive inference can be drawn when more studies, possibly with homogeneous methodological approach, are performed.
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Patil R, Mahajan A, Pradeep GL, Prakash N, Patil S, Khan SM. Expression of matrix metalloproteinase-9 in histological grades of oral squamous cell carcinoma: An immunohistochemical study. J Oral Maxillofac Pathol 2021; 25:239-246. [PMID: 34703116 PMCID: PMC8491345 DOI: 10.4103/0973-029x.325121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/18/2021] [Indexed: 12/12/2022] Open
Abstract
Context Oral squamous cell carcinoma (OSCC) is characterized by a high degree of local invasiveness and metastasis to cervical lymph nodes and distant sites. Degradation of extracellular matrix (ECM) requires the concerted action of several extracellular enzymes, the most prominent of which are matrix metalloproteinases (MMPs). Proteolytic degradation of ECM components by (MMP-9) facilitates carcinoma cell invasion, enhances angiogenesis and tumor progression. Objective To assess and correlate the immunohistochemical expression of MMP-9 with clinicopathological parameters and histological grades of OSCC. Settings and Design Thirty histopathologically diagnosed cases of OSCC including 12 cases of well-differentiated squamous cell carcinoma, 12 cases of moderately differentiated squamous cell carcinoma and 6 cases of poorly differentiated squamous cell carcinoma were included in the study group. Materials and Methods The samples were subjected to staining using monoclonal antibodies against MMP-9 and visualized using the polymer-HRP detection system. Expression of MMP-9 was assessed in tumor epithelium/parenchyma and connective tissue stroma separately, and the mean of both was considered as average MMP-9 expression. Statistical Analysis The parametric independent samples "t" test, one-way ANOVA test and Pearson's correlation test were used for the statistical analysis. Results Immunoexpression of MMP-9 increased with advancing stage and histological grade of OSCC with statistically significant results. Conclusion MMP-9 plays an important role in invasion and metastasis and can serve as an independent prognostic marker.
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Affiliation(s)
- Rekha Patil
- Department of Oral and Maxillofacial Pathology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Aarti Mahajan
- Department of Oral and Maxillofacial Pathology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - G L Pradeep
- Department of Oral and Maxillofacial Pathology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Nilima Prakash
- Department of Oral and Maxillofacial Pathology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Swapnil Patil
- Department of Pedodontics and Preventive Dentistry, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
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Sun LF, Wang CX, Cao ZY, Han W, Guo SS, Wang YZ, Meng Y, Hou CX, Zhu QH, Tang YT, Li HQ, Zhang T, Ye JH. Evaluation of autofluorescence visualization system in the delineation of oral squamous cell carcinoma surgical margins. Photodiagnosis Photodyn Ther 2021; 36:102487. [PMID: 34411738 DOI: 10.1016/j.pdpdt.2021.102487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Delineating the margins of Oral squamous cell carcinoma (OSCC) is a critical step for optimaltumor resection. The aim of this study was to evaluate the accuracy of lesion surgical margin identification using autofluorescence visualization. MATERIALS AND METHODS Thirty patients with OSCC were included in this study. For each lesion, the fluorescence loss boundary was determined using VELscope before ablative surgical resection (with a 1.5-2cm safety margin) was performed. A total of 126 samples were obtained from 30 surgical specimens, each containing the tissue from the fluorescence loss boundary to surgical margin. The status of each sample was determined by oral pathologists and the staining intensities of Ki-67, E-cadherin, and Vimentin at the fluorescence loss boundary and surgical margin were evaluated by immunohistochemistry. RESULTS Fluorescence loss regions were identified in all patients. Of the 126 samples collected, HE staining identified 77 normal epithelia (61.1%), 26 mild dysplasia (20.6%), 17 severe dysplasia (13.4%) and 6 carcinomas in situ (4.9%). A significant correlation was found between the differentiation grade of tumor cells and the pathological status of the surgical marginal specimens (P<0.05). Forty-two of the 126 samples were randomly selected for further immunohistochemical staining. No significant differences were seen in Ki-67, E-cadherin, or Vimentin expression at the fluorescence loss boundary or surgical margin, however, the proteins' expression level was positively correlated with the degree of dysplasia (P<0.01). CONCLUSION Autofluorescence visualization has potential as a simple surgical margin setting device for OSCC and may help delineate the superficial area of OSCC with acceptable accuracy. However, when considering the inherent limitations of this system, we suggest that the approach should only be applied under certain conditions, such as when dealing with superficial, well-differentiated lesions.
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Affiliation(s)
- Li-Fan Sun
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, Huaxia Stomatological Hospital Affiliated to Suzhou Health College, Suzhou 215000, China
| | - Chen-Xing Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zheng-Yao Cao
- Depatment of Stomatology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - Wei Han
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Song-Song Guo
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yi-Zhou Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ying Meng
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chen-Xing Hou
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qing-Hai Zhu
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yu-Ting Tang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Huai-Qi Li
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Tianzhu Zhang
- National Key Bioelectronics Stomatology Laboratory, School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China
| | - Jin-Hai Ye
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China.
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Wang R, Wang Y. Fourier Transform Infrared Spectroscopy in Oral Cancer Diagnosis. Int J Mol Sci 2021; 22:1206. [PMID: 33530491 PMCID: PMC7865696 DOI: 10.3390/ijms22031206] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/13/2022] Open
Abstract
Oral cancer is one of the most common cancers worldwide. Despite easy access to the oral cavity and significant advances in treatment, the morbidity and mortality rates for oral cancer patients are still very high, mainly due to late-stage diagnosis when treatment is less successful. Oral cancer has also been found to be the most expensive cancer to treat in the United States. Early diagnosis of oral cancer can significantly improve patient survival rate and reduce medical costs. There is an urgent unmet need for an accurate and sensitive molecular-based diagnostic tool for early oral cancer detection. Fourier transform infrared spectroscopy has gained increasing attention in cancer research due to its ability to elucidate qualitative and quantitative information of biochemical content and molecular-level structural changes in complex biological systems. The diagnosis of a disease is based on biochemical changes underlying the disease pathology rather than morphological changes of the tissue. It is a versatile method that can work with tissues, cells, or body fluids. In this review article, we aim to summarize the studies of infrared spectroscopy in oral cancer research and detection. It provides early evidence to support the potential application of infrared spectroscopy as a diagnostic tool for oral potentially malignant and malignant lesions. The challenges and opportunities in clinical translation are also discussed.
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Affiliation(s)
| | - Yong Wang
- School of Dentistry, University of Missouri–Kansas City, Kansas City, MO 64108, USA;
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Morikawa T, Kozakai A, Kosugi A, Bessho H, Shibahara T. Image processing analysis of oral cancer, oral potentially malignant disorders, and other oral diseases using optical instruments. Int J Oral Maxillofac Surg 2020; 49:515-521. [DOI: 10.1016/j.ijom.2019.08.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/14/2019] [Accepted: 08/20/2019] [Indexed: 11/29/2022]
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Shah S, Waknis P, Saha A, Setiya S, Ratra T, Vaswani V. The use of Velscope to assess cellular changes occuring in oral premalignancy. J Oral Biol Craniofac Res 2020; 10:99-103. [PMID: 32211285 DOI: 10.1016/j.jobcr.2020.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/10/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives To improve visualization of suspicious lesions of the oral mucosa and to assess the accuracy of Velscope in assessing cellular changes occurring in oral premalignancy for early diagnosis. Materials and methods In this prospective, randomized in-vivo clinical study a total of 250 patients who gave history of chewing tobacco were screened. The selection of the site of biopsy was taken based on the area of loss of fluorescence identified by the Velscope within the lesion. Routine blood investigations were done. A biopsy was performed to confirm the findings of clinical examination. The data was collected and analysed. Results Among 200 patients only 110 underwent incisional biopsy. Of these only 89 patients showed neoplastic changes. Of the control biopsies, none of them showed any dysplastic changes. Out of 106 who exhibited speckling under autofluorescence, only 89 showed dysplastic changes whereas only 17 showed no dysplastic changes. Out of these 17 specimens, the histopathological diagnosis of 5 was coated tongue, 3 were pigmented lesions, 3 were geographic tongue and 2 were mucositis. Of the remaining 4, the histopathological diagnosis of 1 was oral submucous fibrosis, 1 was lichen planus and 2 were frictional keratosis. Conclusion False positive findings are possible in presence of highly inflamed tissues, and it is possible that use of Velscope alone may result in failure to detect regions of dysplasia, but it has its use definitely to improve clinical decision making about the nature of oral lesions and aids in decisions to biopsy regions of concern. Use of the scope has allowed practitioners to identify the best region for biopsy. It is much better to occasionally sample tissue that turns out to be benign than to fail to diagnose dysplastic or malignant lesions. However, poor specificity is a major limitation for using it as a screening tool.
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Affiliation(s)
- Sonal Shah
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Pushkar Waknis
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Aditi Saha
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Sneha Setiya
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Tusha Ratra
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Vibha Vaswani
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
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13
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Uthoff RD, Song B, Sunny S, Patrick S, Suresh A, Kolur T, Gurushanth K, Wooten K, Gupta V, Platek ME, Singh AK, Wilder-Smith P, Kuriakose MA, Birur P, Liang R. Small form factor, flexible, dual-modality handheld probe for smartphone-based, point-of-care oral and oropharyngeal cancer screening. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-8. [PMID: 31642247 PMCID: PMC6826203 DOI: 10.1117/1.jbo.24.10.106003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/24/2019] [Indexed: 05/16/2023]
Abstract
Oral cancer is a growing health issue in low- and middle-income countries due to betel quid, tobacco, and alcohol use and in younger populations of middle- and high-income communities due to the prevalence of human papillomavirus. The described point-of-care, smartphone-based intraoral probe enables autofluorescence imaging and polarized white light imaging in a compact geometry through the use of a USB-connected camera module. The small size and flexible imaging head improves on previous intraoral probe designs and allows imaging the cheek pockets, tonsils, and base of tongue, the areas of greatest risk for both causes of oral cancer. Cloud-based remote specialist and convolutional neural network clinical diagnosis allow for both remote community and home use. The device is characterized and preliminary field-testing data are shared.
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Affiliation(s)
- Ross D. Uthoff
- The University of Arizona, College of Optical Sciences, Tucson, Arizona, United States
- Address all correspondence to Ross D. Uthoff, E-mail: ; Rongguang Liang, E-mail:
| | - Bofan Song
- The University of Arizona, College of Optical Sciences, Tucson, Arizona, United States
| | - Sumsum Sunny
- Mazumdar Shaw Medical Centre, Bangalore, Karnataka, India
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | | | - Amritha Suresh
- Mazumdar Shaw Medical Centre, Bangalore, Karnataka, India
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | - Trupti Kolur
- Mazumdar Shaw Medical Centre, Bangalore, Karnataka, India
| | | | - Kimberly Wooten
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
| | - Vishal Gupta
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
| | - Mary E. Platek
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
- D’Youville College, Buffalo, New York, United States
| | - Anurag K. Singh
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
| | - Petra Wilder-Smith
- University of California, Irvine, Beckman Laser Institute, Irvine, California, United States
| | - Moni Abraham Kuriakose
- Mazumdar Shaw Medical Centre, Bangalore, Karnataka, India
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | - Praveen Birur
- Biocon Foundation, Bangalore, Karnataka, India
- KLES Institute of Dental Sciences, Bangalore, Karnataka, India
| | - Rongguang Liang
- The University of Arizona, College of Optical Sciences, Tucson, Arizona, United States
- Address all correspondence to Ross D. Uthoff, E-mail: ; Rongguang Liang, E-mail:
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14
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Tiwari L, Kujan O, Farah CS. Optical fluorescence imaging in oral cancer and potentially malignant disorders: A systematic review. Oral Dis 2019; 26:491-510. [PMID: 30810255 DOI: 10.1111/odi.13071] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES This study aimed to systematically review the efficacy of direct optical fluorescence imaging as an adjunct to comprehensive oral examination in the clinical evaluation, risk assessment and surgical management of oral cancer and potentially malignant disorders. METHODS Studies adopting autofluorescence devices, evaluating the efficacy of comprehensive oral examination and optical fluorescence imaging in detection, visualisation or management of oral squamous cell carcinoma or oral potentially malignant disorders, as well as discriminating oral epithelial dysplasia from other mucosal lesions, were included in the literature search across bibliographic databases until October 2018. RESULTS Twenty-seven studies were found to be eligible for inclusion in qualitative analysis. Of these, only six studies demonstrated a low risk of bias across all domains of the methodological assessment tool (QUADAS-2). Optical fluorescence imaging demonstrated positive results, with higher sensitivity scores, increased lesion detection and visualisation than comprehensive oral examination alone in the clinical evaluation of oral squamous cell carcinoma and oral potentially malignant disorders. CONCLUSIONS This review provides promising evidence for the utilisation of optical fluorescence imaging as an adjunct to comprehensive oral examination in varying clinical settings. It is important that devices utilising optical fluorescence imaging are viewed strictly as clinical adjuncts and not specifically as diagnostic devices.
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Affiliation(s)
- Lalima Tiwari
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Camile S Farah
- Australian Centre for Oral Oncology Research & Education, Nedlands, Western Australia, Australia
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15
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Comparative evaluation of autofluorescence imaging and histopathological investigation for oral potentially malignant disorders in Taiwan. Clin Oral Investig 2018; 23:2395-2402. [PMID: 30302607 DOI: 10.1007/s00784-018-2691-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Autofluorescence imaging is gaining popularity as an adjunctive test for oral potentially malignant disorders (OPMD). This study evaluated the efficacy of autofluorescence imaging based on the current standard oral mucosal disorder checklist in Taiwan. MATERIALS AND METHODS In total, 126 patients suspected to have mucosal disorders at the Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei, Taiwan, were enrolled. Following a conventional oral examination by using the oral mucosal disorder checklist and an autofluorescence imaging examination, all participants underwent histopathological examination to access epithelial dysplasia. RESULTS Among 126 patients, 68 patients were diagnosis as having an OPMD and 63 having epithelial dysplasia. Autofluorescence imaging exhibited a sensitivity, specificity, positivity predictive value (PPV), negative predictive value (NPV), and accuracy of 77.94%, 35.42%, 63.10%, 53.13%, and 60.34%, respectively, for OPMD and of 88.89%, 43.86%, 63.64%, 78.13%, and 67.50%, respectively, for epithelial dysplasia. After the exclusion of 48 non-OPMD cases according to the checklist, the sensitivity, specificity, PPV, NPV, and accuracy of autofluorescence imaging became 87.50%, 72.73%, 94.23%, 53.33%, and 85.07%, respectively, for epithelial dysplasia. CONCLUSION The efficacy of epithelial dysplasia identification and OPMD risk assessment can be increased after the exclusion of the non-OPMD cases through autofluorescence imaging. CLINICAL RELEVANCE Autofluorescence imaging is a useful adjunct that can assist specialists in assessing OPMD patients prone to dysplasia without compromising patient care.
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16
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Sumi S, Umemura N, Adachi M, Ohta T, Naganawa K, Kawaki H, Takayama E, Kondoh N, Sumitomo S. The luminance ratio of autofluorescence in a xenograft mouse model is stable through tumor growth stages. Clin Exp Dent Res 2018; 4:174-181. [PMID: 30386639 PMCID: PMC6203828 DOI: 10.1002/cre2.126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/11/2018] [Accepted: 07/13/2018] [Indexed: 12/25/2022] Open
Abstract
The aim of this research was to investigate the value of autofluorescence imaging of oral cancer across different stages of tumor growth, to assist in detecting tumors. A xenograft mouse model was created with human oral squamous cell carcinoma cell line HSC-3 being subcutaneously inoculated into nude mice. Tumor imaging was performed with an autofluorescence imaging method (Illumiscan®) using the luminance ratio, which was defined as the luminance of the tumor site over the luminance of normal skin tissue normalized to a value of 1.0. This luminance ratio was continuously observed postinoculation. Tumor and normal skin tissues were harvested, and differences in the concentrations of flavin adenine dinucleotide and nicotinamide adenine dinucleotide were examined. The luminance ratio of the tumor sites was 0.85 ± 0.05, and there was no significant change in the ratio over time, even if the tumor proliferated and expanded. Furthermore, flavin adenine dinucleotide and nicotinamide adenine dinucleotide were significantly lower in tumor tissue than in normal skin tissue. A luminance ratio under 0.90 indicates a high possibility of tumor, irrespective of the tumor growth stage. However, this cutoff value was determined using a xenograft mouse model and therefore requires further validation before being used in clinical diagnosis.
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Affiliation(s)
- Shigeki Sumi
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Naoki Umemura
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Makoto Adachi
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Takahisa Ohta
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Kosuke Naganawa
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Harumi Kawaki
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Eiji Takayama
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Nobuo Kondoh
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Shinichiro Sumitomo
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
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17
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Kilin V, Mas C, Constant S, Wolf JP, Bonacina L. Health state dependent multiphoton induced autofluorescence in human 3D in vitro lung cancer model. Sci Rep 2017; 7:16233. [PMID: 29176571 PMCID: PMC5701152 DOI: 10.1038/s41598-017-16628-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/15/2017] [Indexed: 12/18/2022] Open
Abstract
Lung diseases pose the highest risk of death and lung cancer is a top killer among cancers with a mortality rate up to 70% within 1 year after diagnosis. Such a fast escalation of this cancer development makes early diagnosis and treatment a highly challenging task, and currently there are no effective tools to diagnose the disease at an early stage. The ability to discriminate between healthy and tumorous tissue has made autofluorescence bronchoscopy a promising tool for detection of lung cancer; however, specificity of this method remains insufficiently low. Here, we perform autofluorescence imaging of human lung cancer invading a human functional airway using an in vitro model of Non Small Cell Lung Cancer which combines a reconstituted human airway epithelium, human lung fibroblasts and lung adenocarcinoma cell lines, OncoCilAir™. By using two-photon laser induced autofluorescence microscopy combined with spectrally resolved imaging, we found that OncoCilAir™ provides tissue's health dependent autofluorescence similar as observed in lung tissue in patients. Moreover, we found spectral and intensity heterogeneity of autofluorescence at the edges of tumors. This metabolic related heterogeneity demonstrates ability of tumor to influence its microenvironment. Together, our result shows that OncoCilAir™ is a promising model for lung cancer research.
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Affiliation(s)
- Vasyl Kilin
- GAP, University of Geneva, 22 chemin de Pinchat, CH-1211, Geneva 4, Switzerland.
| | - Christophe Mas
- OncoTheis Sàrl, 18 chemin des aulx, CH-1228, Plan-les-Ouates, Geneva, Switzerland
| | - Samuel Constant
- OncoTheis Sàrl, 18 chemin des aulx, CH-1228, Plan-les-Ouates, Geneva, Switzerland
- Epithelix SAS, 219 Rue Laszlo Biro, 74160, Archamps, France
| | - Jean-Pierre Wolf
- GAP, University of Geneva, 22 chemin de Pinchat, CH-1211, Geneva 4, Switzerland
| | - Luigi Bonacina
- GAP, University of Geneva, 22 chemin de Pinchat, CH-1211, Geneva 4, Switzerland
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18
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Pal R, Edward K, Ma L, Qiu S, Vargas G. Spectroscopic characterization of oral epithelial dysplasia and squamous cell carcinoma using multiphoton autofluorescence micro-spectroscopy. Lasers Surg Med 2017; 49:866-873. [PMID: 28677822 DOI: 10.1002/lsm.22697] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Multiphoton autofluorescence microscopy (MPAM) has shown potential in identifying features that are directly related to tissue microstructural and biochemical changes throughout epithelial neoplasia. In this study, we evaluate the autofluorescence spectral characteristics of neoplastic epithelium in dysplasia and oral squamous cell carcinoma (OSCC) using multiphoton autofluorescence spectroscopy (MPAS) in an in vivo hamster model of oral neoplasia in order to identify unique signatures that could be used to delineate normal oral mucosa from neoplasia. MATERIALS/METHODS A 9,10-dimethyl-1,2-benzanthracene (DMBA) hamster model of oral precancer and OSCC was used for in vivo MPAM and MPAS. Multiphoton Imaging and spectroscopy were performed with 780 nm excitation while a bandpass emission 450-650 nm was used for MPAM. Autofluorescence spectra was collected in the spectral window of 400-650 nm. RESULTS MPAS with fluorescence excitation at 780 nm revealed an overall red shift of a primary blue-green peak (480-520 nm) that is attributed to NADH and FAD. In the case of oral squamous cell carcinoma (OSCC) and some high-grade dysplasia an additional prominent peak at 635 nm, attributed to PpIX was observed. The fluorescence intensity at 635 nm and an intensity ratio of the primary blue-green peak versus 635 nm peak, showed statistically significant difference between control and neoplastic tissue. DISCUSSION Neoplastic transformation in the epithelium is known to alter the intracellular homeostasis of important tissue metabolites such as NADH, FAD, and PpIX, which was observed by MPAS in their native environment. A combination of deep tissue microscopy owing to higher penetration depth of multiphoton excitation and depth resolved spectroscopy could prove to be invaluable in identification of cytologic as well as biomolecular spectral characteristic of oral epithelial neoplasia. Lasers Surg. Med. 49:866-873, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Rahul Pal
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555.,Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Kert Edward
- Department of Physics, University of the West Indies, UWI Mona, Kingston 7, Mona, Jamaica
| | - Liang Ma
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Suimin Qiu
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Gracie Vargas
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555.,Department of Neuroscience and Cell Biology, The University of Texas Medical Branch, Galveston, Texas, 77555
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