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ORIGINAL RESEARCH
Refinement of noninvasive methods for diagnosing precancer and cancer of oral mucosa in general dental practice
1 Samara State Medical University, Samara, Russia
2 Samara Regional Clinical Cancer Center, Samara, Russia
3 Pirogov Russian National Research Medical University, Moscow, Russia
Correspondence should be addressed: Alexey G. Gabrielyan
Michurina, 138, kv. 85, Samara, 443086; ur.liam@200_leirbag
Author contribution: Postnikov MA — literature analysis; Gabrielyan AG — study planning; Trunin DA, Kopetskiy IS, Eremin DA — analysis of the obtained data; Kaganov OI — manuscript draft; Kirillova VP — analysis of patients’ records; Khamadeeva AM — interpretation of the obtained results; Osokin OV — data acquisition.
Compliance with ethical standards: the study was approved by the Ethics Committee of Samara State Medial University (Protocol № 27 dated February 12, 2018).
The search for and the application of available noninvasive methods for early diagnosis of oral mucosa (OM) neoplasia is a clinically significant problem. The aim of this study was to evaluate the effectiveness of the original score-based algorithm for assessing clinical data generated by a conventional and an autofluorescencebased examination in diagnosing OM cancer and assessing indications for a biopsy. We analyzed 134 medical histories and pathology reports of patients with oral neoplasia. The patients were assigned to 2 groups: the control group included 63 patients who underwent a standard visual and tactile examination with history taking and then were referred for an incisional biopsy followed by a histopathological examination of the specimens. In the main group consisting of 71 patients, a standard visual and tactile examination was complemented by an autofluorescence-based examination and the original score-based algorithm with the original index of required histopathological verification (RHV) were used to assess indications for a biopsy. In both groups, the most commonly affected site was the tongue (72.4%). The histopathological examination revealed that 28 patients from the main group and 14 patients from the control group had OM cancer (р = 0.051). Histologically, early-stage cancer was diagnosed in 17 patients from the main group and in 4 patients from the control group (р = 0.004). The proposed algorithm allowed us to effectively (in 90% of cases) diagnose precancer and cancer and avoid unnecessary biopsies.
Keywords: cancer, oral mucosa, precancer, required histological verification index (RHV)