Diagnostic value of objective VELscope fluorescence methods in distinguishing oral cancer from oral potentially malignant disorders (OPMDs)

Abstract

Background: The VELscope fluorescence method has been applied to the identification and detection of oral potentially malignant disorders, but autofluorescence visualization lacks objectivity and its diagnostic value varies greatly. The effectiveness of VELscope in detection of the cancer risk in oral potentially malignant disorders at different lesion sites remains unclear, given that only a few studies have investigated the value of VELscope for detecting high- and low-risk lesions in oral potentially malignant disorders. This study used the objective VELscope fluorescence method based on quantitative analysis to investigate its value in oral potentially malignant disorders for: (I) detecting oral cancer; (II) distinguishing high-risk lesions from low-risk lesions; and (III) measuring differences in oral cancer diagnostic accuracy between different sites. Methods: Conventional oral examination and subjective and objective VELscope examinations were performed on 59 oral potentially malignant disorders; autofluorescence results were compared with histopathological diagnosis. Results: The sensitivity of subjective and objective VELscope fluorescence methods for detecting oral cancer in oral potentially malignant disorders was 76.9% and 65.4%, respectively; specificity for distinguishing high-risk from low-risk lesions in oral potentially malignant disorders was 50.0% and 82.1%, respectively; and sensitivity for detecting oral cancer in oral potentially malignant disorders of lining mucosa was 81.0%, higher than that of the masticatory mucosa. Conclusions: The identification ability for low-risk lesions can be improved by combining it with objective autofluorescence. Autofluorescence has different screening abilities in different parts of the oral mucosa.