Analysis of fluorescence visualization in oral precancerous and cancerous lesions

概要

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Various specialty clinics and research centers have conducted studies of direct tissue fluorescence visualization as a screening technique for oral precancerous and early cancerous lesions. The effectiveness of the VELscope is still not well known. The objective of this study was to analyze specificity of the VELscope system for the detection of precancerous and early cancerous lesions. We studied the use of this simple handheld device that facilitates the direct visualization of oral-cavity fluorescence for the detection of precancerous and early cancerous lesions. Blue excitation light (400 to 460nm) is employed to excite green-red fluorescence from fluorophores in the oral mucosa. Tissue fluorescence is viewed directly along an optical axis collinear with the axis of excitation to reduce inter-and intraoperator variability. This robust, field-of-view device enables the direct visualization of fluorescence in the context of surrounding normal tissue. Results from 17 patients are presented. Histological examination of the lesions showed that the VELscope system has a sensitivity of 95% and specificity of 100% in discriminating normal mucosa from severe dysplasia/carcinoma in situ (CIS) or invasive carcinoma. We envisage this device as a suitable adjunct for oral cancer screening.