Detection of High-risk Oral Premalignant Lesions by Multi-Spectral Fluorescent Visualization

*1242 Detection of High-risk Oral Premalignant Lesions by Multi-Spectral Fluorescent Visualization*
L. ZHANG¹, S.P. NG¹, M. WILLIAMS², D. LARONDE¹, C.F. POH¹, C. MACAULAY², and M.P. ROSIN³, ¹University of British Columbia, Vancouver, Canada, ²British Columbia Cancer Agency, Vancouver, Canada, ³British Columbia Cancer Agency, Simon Fraser University, Vancouver, Canada Objectives: The prediction of cancer risk for oral premalignant lesions (OPLs) is currently based upon histological diagnosis and, more recently, molecular analysis. These approaches rely on the clinician's ability to identify lesions requiring biopsy based on clinical features, which is quite often a difficult decision. The objective of this study was to explore the feasibility of using multi-spectral fluorescent visualization (FV) for its ability to identify high-risk OPLs. Methods: This abstract describes early results from an ongoing prospective study of patients with OPLs. FV, demographics, OPL clinical features, histology and outcome were collected from 69 OPLs. Results: 42 of the 69 OPLs showed a loss of autofluorescence (FV-positive). There was no significant difference in age, gender or smoking habits for FV-positive and -negative cases. Clinical attributes were also similar with no significant difference in site, size, clinical appearance (homogeneous vs. nonhomogeneous) and toluidine staining of OPLs, although FV-positive lesions tended to be larger (352 ą 357 mm² vs. 224 ą 253, P = 0.15) and toluidine positive (55% vs. 33%, P = 0.0913). Histologically, epithelial &/or keratin thickness was similar for the two groups. FV-positive lesions were more likely to be obviously inflamed (71% vs. 37%, P = 0.0063) or ulcerated (31% vs. 4%, P = 0.0059). Strikingly, a significantly higher proportion (81%) of FV-positive lesions were dysplastic compared to the FV-negative lesions (41%, P = 0.0009). Increasing degree of dysplasia was accompanied by increasing FV positivity: 33% nondysplastic lesions, 67% of mild/moderate dysplasias and 100% of severe dysplasias were FV-positive (P = 0.0004). When the outcome was studied, all 5 OPLs that progressed into cancer were FV-positive (12% vs. 0%, P = 0.1487). Conclusion: FV could facilitate the identification of high-risk OPLs (Supported by grant R01DE13124, NIDCR).
Seq #126 - Oral Cancer and Precancer: Diagnosis and Biomarkers 10:15 AM-11:30 AM, Thursday, 11 March 2004 Hawaii Convention Center Exhibit Hall 1-2
Back to the Oral Medicine & Pathology Program Back to the IADR/AADR/CADR 82nd General Session (March 10-13, 2004)
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