Use of autofluorescence and fluorescent probes as a potential diagnostic tool for oral cancer: A systematic review

• Published in: Photodiagnosis and photodynamic therapy Vol. 33; p. 102073
• Main Authors: Lima, Igor Felipe Pereira, Brand, Luiza Meurer, de Figueiredo, José Antônio Poli, Steier, Liviu, Lamers, Marcelo Lazzaron
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-03-2021
• Subjects: Autofluorescence; Carcinoma, Squamous Cell - diagnostic imaging; Diagnosis; Early Detection of Cancer; Fluorescent Dyes; Fluorescent probes; Humans; Mouth Neoplasms - diagnostic imaging; Oral cancer; Photochemotherapy - methods; Photosensitizing Agents; Fluorescent dyes; Fluorescent probes; Diagnosis; Oral cancer; Autofluorescence
• DOI: 10.1016/j.pdpdt.2020.102073
• EISSN: 1873-1597
• ISSN: 1572-1000

Autofluorescence and fluorescent probes allow the early detection of oral cancer through the loss of tissue autofluorescence or through the selective accumulation of fluorescent molecules in tumor cells after addition of fluorescent probes.
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•Systematic review addresses the use of spectral changes for tumor cell detection.•Autofluorescence and 5-Aminolevulinic acid shows high sensitivity and specificity.•5-Aminolevulinic acid was the most used fluorescent probe.•Autofluorescence and fluorescent probes could be used for early detection of oral cancer.
The prognosis of patients with Oral squamous cell carcinoma (OSCC) are directly related to the stage of development of the tumor at the time of diagnosis, but it is estimated an average delay in diagnosis of 2–5 months. New non-invasive techniques for the early diagnosis of OSCC are being developed, such as methodologies to detect spectral changes of tumor cells. We conducted a systematic review to analyze the potential use of autofluorescence and/or fluorescent probes for OSCC diagnosis.
Four databases (PubMed, Scopus, Embase and Web of Science) were used as research sources. Protocol was registered with PROSPERO. It was included studies that evaluated tissue autofluorescence and/or used fluorescent probes as a method of diagnosing and/or treatment of oral cancer in humans.
Forty-five studies were selected for this systematic review, of which 28 dealt only with autofluorescence, 18 on fluorescent probes and 1 evaluated both methods. The VELscope® was the most used device for autofluorescence, exhibiting sensitivity (33%–100%) and specificity (12%–88.6%). 5-Aminolevulinic acid (5-ALA) was the most used fluorescent probe, exhibiting high sensitivity (90%–100%) and specificity (51.3%–96%). Hypericin, rhodamine 6 G, rhodamine 610, porphyrin and γ-glutamyl hydroxymethyl rhodamine green have also been reported.
Thus, the autofluorescence and fluorescent probes can provide an accurate diagnosis of oral cancer, assisting the dentist during daily clinical activity, but it is not yet possible to suggest that this method may replace histopathological examination.