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Diagnostic accuracy of clinical visualization and light-based tests in precancerous and cancerous lesions of the oral cavity and oropharynx: a systematic review and meta-analysis

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A Correction to this article was published on 28 January 2021

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Abstract

Objective

Evaluate and compare the performance of autofluorescence, chemiluminescence, and clinical visual examination in the detection of oral potentially malignant disorders (OPMD), oral cancer (OC), and oropharyngeal cancer (OPC).

Materials and methods

A systematic review with meta-analysis based on diagnostic test studies. A literature search was carried out in the MEDLINE and EMBASE databases through August 30, 2020. For this review, the quality assessment tool of diagnostic precision studies (QUADAS-2) was used. Hierarchical regression models were used to estimate pooled diagnostic precision values in a random effects model.

Results

A total of 40 studies were identified for this review according to each test evaluated: 5.562 samples for autofluorescence, 1.353 samples for chemiluminescence, and 1.892 samples for clinical examination. The summary measures sensitivity and specificity of the clinical examination were 63% and 78%, respectively, AUC = 0.78 95% CI (0.74–0.81). In the autofluorescence test, these were 86% and 72%, respectively, AUC = 0.86 95% CI (0.83–0.89); and the chemiluminescent test were 67% and 48%, respectively, AUC = 0.59 95% CI (0.54–0.63)

Conclusions

Autofluorescence devices displayed superior accuracy levels in the identification of premalignant lesions and early neoplastic changes compared to clinical examination and chemiluminescent test. Overall, biopsy remains the gold standard for the definitive diagnosis of OPMD, OC, and OPC.

Clinical Relevance

Light-based clinical methods such as autofluorescence and chemiluminescence techniques have been used in clinical diagnosis for the differentiation of OPMD and malignant and benign lesions; although detailed visual examination appears to be effective in identifying, previous systematic reviews have not evaluated a relevant number of studies and they did not evaluate the accuracy of the clinical examination.

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Funding

This research received no specific grant from funding agencies in the public, commercial, or non-profit sectors. The work was supported by the dental school and the research vice-rectory of the El Bosque University.

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Authors and Affiliations

  1. Unit of Oral Epidemiology Investigation-UNIECLO, School of Dentistry, Universidad El Bosque, Bogotá, Colombia

    María Rosa Buenahora

  2. School of Dentistry, Universidad El Bosque, Bogotá, Colombia

    Alberto Peraza-L

  3. Unit of Basic Oral Investigation-UIBO, School of Dentistry, Universidad El Bosque, Av. Carrera 9 No. 131 A – 02, Bogotá, Colombia

    David Díaz-Báez, Tamy Goretty Trujillo, Gloria Inés Lafaurie & Leandro Chambrone

  4. Oral Pathology Department, School of Dentistry, Universidad El Bosque, Bogotá, Colombia

    Jairo Bustillo & Iván Santacruz

  5. Basque Foundation for Health Innovation and Research, BIOEF, Barakaldo, Basque Country, Spain

    Tamy Goretty Trujillo

  6. Graduate Dentistry Program, Ibirapuera University, São Paulo, Brazil

    Leandro Chambrone

  7. Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, Almada, Portugal

    Leandro Chambrone

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Buenahora, M.R., Peraza-L, A., Díaz-Báez, D. et al. Diagnostic accuracy of clinical visualization and light-based tests in precancerous and cancerous lesions of the oral cavity and oropharynx: a systematic review and meta-analysis. Clin Oral Invest 25, 4145–4159 (2021). https://doi.org/10.1007/s00784-020-03746-y

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