A cross-sectional study evaluating chemiluminescence and autofluorescence in the detection of clinically innocuous precancerous and cancerous oral lesions.
BACKGROUND
ViziLite Plus with TBlue system (Zila Pharmaceuticals; now Zila, a division of Tolmar, Fort Collins, Colo.) and VELscope (LED Dental, White Rock, British Columbia, Canada) are oral cancer screening aids that have been developed to assist dentists in identifying precancerous and cancerous oral lesions.


METHODS
The authors screened patients with an overhead examination light and then with VELscope or ViziLite. Patients with a clinically innocuous lesion underwent a biopsy, and the authors compared the results of tissue pathological analysis with findings from the screening aid tests to determine the sensitivity and specificity of each device. The authors tested these devices to determine their ability to aid in the decision-making process regarding whether further evaluation of a clinically innocuous lesion was required.


RESULTS
The authors examined 102 lesions with ViziLite and then biopsied them [corrected]. They found three dysplasias and one malignancy, none of which were detected with the ViziLite (sensitivity = 0 percent, confidence interval [CI] = 0-60.2 percent; specificity = 75.5 percent, CI = 66.7-82.8 percent). The authors examined another 156 lesions with VELscope and then biopsied them [corrected].They found 11 dysplasias and one malignancy, six of which were detected with VELscope (sensitivity = 50 percent, CI = 21.1-78.9 percent; specificity = 38.9 percent, CI = 30.8-46.9 percent).


CONCLUSIONS
The study results indicate that use of ViziLite or VELscope along with a conventional screening examination for lesions deemed clinically innocuous was not beneficial in identifying dysplasia or cancer. Additional clinical studies are needed before these devices can be recommended.


CONCLUSIONS
Clinicians and patients could have a false sense of security after obtaining a negative ViziLite or VELscope examination result because potentially large numbers of precancerous and cancerous lesions will be missed by both devices.
Mehrotra
Ravi
R
Department of Pathology, Moti Lal Nehru Medical College, Lowther Road, Allahabad 211 001, India. rm8509@gmail.com
Singh
Mamta
M
Thomas
Shaji
S
Nair
Preeti
P
Pandya
Shruti
S
Nigam
Niraj Shakti
NS
Shukla
Pankaj
P
D019342:Acetic Acid; D000328:Adult; D001706:Biopsy / Q000592:standards; D002277:Carcinoma / Q000175:diagnosis; D004396:Coloring Agents; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D005453:Fluorescence; D006801:Humans; D007202:Indicators and Reagents; D008163:Luminescent Measurements / Q000295:instrumentation* / Q000592:standards; D008297:Male; D008403:Mass Screening / Q000295:instrumentation* / Q000592:standards; D009062:Mouth Neoplasms / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014048:Tolonium Chloride
D004396:Coloring Agents; D007202:Indicators and Reagents; D014048:Tolonium Chloride; D019342:Acetic Acid