ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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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) 21429774Sheer/201164 high risk patientprospective
Key resultsCompared 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) 22217551Rana/2012289 high risk patientsProspective
Key resultsWhen 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)
Keywords Autofluorescence, oral carcinoma, Histology
ID# 2550
Date of submission: 08/06/2013spacer
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
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Comments on the CAT
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