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| Title |
Autofluorescence in the Early Detection of Oral Carcinoma |
| Clinical Question |
In adults, how effective is Autofluorescence in diagnosing oral carcinoma, compared to histology? |
| Clinical Bottom Line |
Autofluorescence can aid in identifying malignant and potentially malignant oral lesions but, unlike histology, it is limited in differentiating benign from malignant lesions. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 21429774 | Sheer/2011 | 64 high risk patient | prospective | | Key results | Compared to histology as the gold standard, Autofluorescence was able to identify malignant and dysplastic areas with a 100% sensitivity and 80.8% specificity. The interpretation of the resulting images is highly dependent on the experience of the user. | | #2) 22217551 | Rana/2012 | 289 high risk patients | Prospective | | Key results | When autofluorescence was used as an adjunct to conventional oral exam, the sensitivity on detecting oral cancer lesions increased from 17% to 100%, but the specificity decreased from 97% to 74%. Autofluorescence could aid in identifying malignant and benign lesions, but could not differentiate between the two. | |
| Evidence Search |
Clinical Queries (Diagnosis/Narrow[filter]) AND (autofluorescence oral carcinoma histology) |
Comments on
The Evidence |
Validity: In both studies, histology was used as the gold standard and it was used on all the subjects. There was an adequate spectrum of disease severity and there were no competing interests identified.
Perspective: Although simple and non-invasive, autofluorescence has a high false positive rate. Thus a very experienced practitioner must interpret the imaging results. To decrease the false positive rate certain steps, such as delaying biopsy of suspicious lesions for 2 weeks or diascopy, could be done. One must consider that the test subjects from these studies were from high-risk patients. This may be a factor for the high sensitivity and NPV. |
| Applicability |
Autofluorescence is a helpful oral examination adjunct for identifying premaligmant and malignant oral lesions, especially for high-risk patients. It is non-invasive but training and experience are required to interpret the imaging results. |
| Specialty/Discipline |
(Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery) (Dental Hygiene) |
| Keywords |
Autofluorescence, oral carcinoma, Histology
|
| ID# |
2550 |
| Date of submission: |
08/06/2013 |
| E-mail |
gallardof@uthscsa.edu |
| Author |
Francisco Gallardo |
| Co-author(s) |
Shannon Roberts |
| Co-author(s) e-mail |
dobelbower@livemail.uthscsa.edu |
| Faculty mentor/Co-author |
James Piper, DDS |
| Faculty mentor/Co-author e-mail |
james.piper@us.af.mil |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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