Accuracy of autofluorescence and chemiluminescence in the diagnosis of oral Dysplasia and Carcinoma: A systematic review and Meta-analysis. (October 2021)

• Record Type: Journal Article
• Authors: Moffa, Antonio; Giorgi, Lucrezia; Costantino, Andrea; De Benedetto, Luigi; Cassano, Michele; Spriano, Giuseppe; Mercante, Giuseppe; De Virgilio, Armando; Casale, Manuele
• Is Part Of: Oral oncology. Volume 121(2021)
• Publication Date: 2021-10
• Subjects: Head and neck cancer -- Squamous cell carcinoma -- Oral cavity -- Cancer -- Screening; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2021.105482
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Autofluorescence and chemiluminescence are used in the diagnosis of oral cavity lesions. Both test have a high sensitivity in the diagnosis of dysplastic and malignant lesions. Both tests have a low specificity in the diagnosis of dysplastic and malignant lesions. Both tests may have a role in the context of oral cancer screening programs. Further studies should be encouraged to clarify the cost-benefit ratio. Abstract: Objectives: To define the accuracy of autofluorescence-based (AF) and chemiluminescence-based (CL) systems in the diagnosis of oral dysplastic and malignant lesions in addition to the Conventional Oral Examination (COE). Materials and Methods: The study was performed according to the PRISMA-DTA guidelines. Results: A total of 2631 oral cavity lesions (AF, n = 2076; CL, n = 555) from 26 studies (AF = 17; CL = 9) was used for calculation of diagnostic accuracy parameters. The overall pooled sensitivity and specificity of the AF were 81.3% (95% CI: 74.3% − 87.5%) and 52.1% (95% CI: 36.9% − 67.1%), respectively. Cumulative diagnostic odds ratio (DOR) was 5.44 (95% CI: 2.29 – 10.56) with a significant heterogeneity between studies ( I 2 = 80.7%, 95% CI: 70.0% − 86.7%; p < .05). The overall pooled sensitivity and specificity for the CL were 84.9% (95% CI: 66.7% − 96.7%) and 51.8% (95% CI: 37.3% − 65.9%), respectively. The overall pooled DOR was 8.59 (95% CI: 2.11 – 22.38) with a significant heterogeneity between studies ( I 2 = 65.4%, 95% CI: 29.6% − 83.0%; p < .05). Conclusions: AF and CL present a high sensitivity in the diagnosis of dysplastic and malignant oral cavity lesions, demonstrating that diagnostic biopsies may be avoided in case of a negative test result. Both tests have a low specificity, and the reduction of the false positive rate compared to the COE alone remains poor.