Oral Cancer’s Early Diagnosis: The Contribution of Contact Endoscopy

Abstract

Objectives:

Oral cancer has high incidence and prevalence rates. Despite the fact that the oral cavity might be easily observed, the diagnosis of oral cancer is usually done later than expected. Early diagnosis is the main oral cancer challenge to decrease morbidity and mortality. Contact endoscopy allows the assessment in vivo and in situ of epithelial cells, glandular ostia, and microvascular network (60X, 150X). The authors describe the contribution of contact endoscopy in performing real time histological diagnosis and guide biopsies in an office setting.

Methods:

The authors carried out a prospective double blind study (July 2012 - February 2014) where diagnosis was made by contact endoscopy and histology (gold-standard) in a population of 122 patients with oral lesions persisting without involution for 3 weeks, considering a clinical classification: benign (n = 26), premalignant (n = 83), and malignant (n = 13). Sensitivity, specificity, negative and positive predictive values, and likelihood ratios were calculated.

Results:

Sensitivity and specificity were superior to 95%. By the identification of the cellular and vascular heterogeneous patterns characteristic of a malignant lesion, contact endoscopy allowed the definition of real cellular margins and the detection of suspicious areas without macroscopic disease.

Conclusions:

In our study, contact endoscopy allowed in an office setting a precise diagnosis with similar effectiveness of histology. This noninvasive technique was revealed to be an important guide for biopsies, an easy way to define real safety surgical margins, and a good way to improve follow-up efficiency. The authors concluded that contact endoscopy has good potential to improve oral cancer’s early diagnosis.