Fluorescence spectroscopy combined with 5-aminolevulinic acid-induced protoporphyrin IX fluorescence in detecting oral premalignancy

摘要

Background:Early detection of premalignant/malignant lesions in the oral cavity can certainly improve the patient's prognosis.This study presents fluorescence imaging with the topical application of 5-aminolevulinic as a way to improve detection of various oral tissue pathologies.This procedure depends mainly on comparing the intensity of red and green fluorescence emitted from tissues during examination.Materials and methods:Seventy-one patients who presented with clinically suspicious oral leukoplakia were recruited for this study.Each of the patients was required to have 5-aminolevulinic acid in the form of mouth rinse prior to fluorescence imaging.Following this a surgical biopsy was acquired from the exact examination site.The results of the fluorescence spectroscopy have been compared with histopathology.Results:A Student's t-test was applied to test the viability of the ratio between red and green fluorescence.The red-to-green ratio was found to increase significantly when the lesion was identified as dysplastic or carcinoma in situ.By applying a threshold line to discriminate between normal and dysplastic lesions;a sensitivity of 83-90% and specificity of 79-89% were obtained.Conclusion:Fluorescence spectroscopy combined with 5-aminolevulinic acid-induced protoporphyrin IX was found as a valuable tool in the diagnosis of oral premalignancy.This technique offers the potential to be advantageous over other non-optical techniques in terms of providing real-time diagnosis,in situ monitoring,cost effectiveness and more tolerated by patient compared to surgical biopsy.