Direct fluorescence visualization of clinically occult high-risk oral premalignant disease using a simple hand-held device

Authors

  • Catherine F. Poh DDS, PhD,

    1. BC Cancer Agency, Cancer Control Research Program, Vancouver, British Columbia V5Z 1L3, Canada
    2. BC Cancer Agency, Oral Oncology Department, Vancouver, British Columbia V5Z 4E6, Canada
    3. Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
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    • Dr. Poh was supported by a Clinician Scientist Award from the Canadian Institutes of Health Research.

  • Samson P. Ng DMD, MSc,

    1. Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
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  • P. Michele Williams DMD,

    1. BC Cancer Agency, Oral Oncology Department, Vancouver, British Columbia V5Z 4E6, Canada
    2. Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
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  • Lewei Zhang DDS, PhD,

    1. Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
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  • Denise M. Laronde RDH, MSc,

    1. School of Kinesiology, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
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  • Pierre Lane PhD,

    1. BC Cancer Agency, Cancer Control Research Program, Vancouver, British Columbia V5Z 1L3, Canada
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  • Calum MacAulay PhD,

    1. BC Cancer Research Centre, Cancer Imaging Department, Vancouver, British Columbia V5Z 1L3, Canada
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  • Miriam P. Rosin PhD

    Corresponding author
    1. BC Cancer Agency, Cancer Control Research Program, Vancouver, British Columbia V5Z 1L3, Canada
    2. School of Kinesiology, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
    • BC Cancer Agency, Cancer Control Research Program, Vancouver, British Columbia V5Z 1L3, Canada
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Abstract

Background

A considerable proportion of oral cancer and precancer is not clinically apparent and could contribute significantly to the late diagnosis and high mortality of oral cancer. A simple method to identify such occult change is needed.

Methods

Patients in the Oral Dysplasia Clinics at British Columbia are currently being examined with a simple hand-held device that permits the direct visualization of alterations to autofluorescence in the oral cavity. Tissue showing loss of autofluorescence is biopsied.

Results

We present 3 representative cases in which occult lesions were identified with fluorescence visualization during longitudinal follow-up, resulting in the diagnosis of a primary dysplasia in case 1, a second primary cancer in case 2, and cancer recurrence in case 3.

Conclusions

This is the first report of the diagnosis of occult oral disease using a simple noninvasive device. These early examples indicate the potential value of this technology to guide the management of patients with oral lesions, facilitating the detection of high-risk changes not apparent with white-light visualization. © 2006 Wiley Periodicals, Inc. Head Neck, 2006

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