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Autofluorescence imaging in recurrent oral squamous cell carcinoma

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Abstract

The survival of patients with oral cancer is decreased by locoregional recurrence after an initial multimodal treatment. In order to identify lesions in the oral cavity for a possible recurrence, clinical evaluation as well as MRI or CT scanning is advised. The evaluation of mucosa lesions is hampered by changes related to radio- and chemotherapy as well as reconstruction with tissue flaps. Several techniques for easier identification of tissue abnormalities in the oral cavity have been advocated as adjuncts in order to facilitate identification. Especially methods using altered tissue fluorescence have gained much interest during the last decade. The aim of our prospective study was to evaluate fluorescence properties of undiagnosed mucosa lesions with the VELscope device in patients with multimodal treated oral cancer prior to histological confirmation. In total, 41 patients with a history of oral squamous cell carcinomas (OSCC) (19 females and 22 males) with undiagnosed mucosa lesions where included in the study. After clinical evaluation, examination and documentation using the VELscope® device were performed. Then, an incisional biopsy was performed. An autofluorescence loss indicating a malignant or dysplastic mucosa condition could be detected in six patients (14.6 %); however, only one OSCC and one SIN revealed a complete autofluorescence loss. In four patients, OSCC was present in lesions with retained autofluorescence. Sensitivity and specificity for the VELscope® examination to identify malignant oral lesions by autofluorescence were 33.3 and 88.6 %, respectively. The positive and negative predictive values were 33.3 and 88.6 %, respectively. No statistical correlation between gender and lesion appearance versus autofluorescence loss could be detected. In contrast to mucosa lesions in patients with no prior treatment, the autofluorescence evaluation with the VELscope reveals no additional information in our analysis. Accordingly, invasive biopsies as gold standard are still needed to get sufficient evidence regarding potential malignancy in patients after multimodal treatment for oral cancer.

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References

  1. Ang KK, Harris J, Wheeler R et al (2010) Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 363:24–35

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Awan KH, Morgan PR, Warnakulasuriya S (2011) Evaluation of an autofluorescence based imaging system (VELscope) in the detection of oral potentially malignant disorders and benign keratoses. Oral Oncol 47:274–277

    Article  CAS  PubMed  Google Scholar 

  3. Bosset JF, Gignoux M, Triboulet JP et al (1997) Chemoradiotherapy followed by surgery compared with surgery alone in squamous-cell cancer of the esophagus. N Engl J Med 337:161–167

    Article  CAS  PubMed  Google Scholar 

  4. Breunig HG, Studier H, Konig K (2010) Multiphoton excitation characteristics of cellular fluorophores of human skin in vivo. Opt Express 18:7857–7871

    Article  CAS  PubMed  Google Scholar 

  5. Chen HM, Wang CY, Chen CT et al (2003) Auto-fluorescence spectra of oral submucous fibrosis. J Oral Pathol Med 32:337–343

    Article  PubMed  Google Scholar 

  6. Chen X, Sturgis EM, Lei D et al (2010) Human papillomavirus seropositivity synergizes with MDM2 variants to increase the risk of oral squamous cell carcinoma. Cancer Res 70:7199–7208

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Cooper JS, Fu K, Marks J et al (1995) Late effects of radiation therapy in the head and neck region. Int J Radiat Oncol Biol Phys 31:1141–1164

    Article  CAS  PubMed  Google Scholar 

  8. Decoro M, Wilder-Smith P (2010) Potential of optical coherence tomography for early diagnosis of oral malignancies. Expert Rev Anticancer Ther 10:321–329

    Article  PubMed Central  PubMed  Google Scholar 

  9. Fakhry C, Westra WH, Li S et al (2008) Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 100:261–269

    Article  CAS  PubMed  Google Scholar 

  10. Fan KH, Wang HM, Kang CJ et al (2010) Treatment results of postoperative radiotherapy on squamous cell carcinoma of the oral cavity: coexistence of multiple minor risk factors results in higher recurrence rates. Int J Radiat Oncol Biol Phys 77:1024–1029

    Article  PubMed  Google Scholar 

  11. Hancock PJ, Epstein JB, Sadler GR (2003) Oral and dental management related to radiation therapy for head and neck cancer. J Can Dent Assoc 69:585–590

    PubMed  Google Scholar 

  12. Hewett J, Mc Kechnie T, Sibbett W et al (2000) Fluorescence detection of superficial skin cancers. J Mod Opt 47:2021–2027

    Article  CAS  Google Scholar 

  13. Hullmann M, Kunkel M, Reichert TE (2010) Diagnostik und Therapie oraler präkanzeröser Läsionen. MKG-Chirurg 1:7–15

    Article  Google Scholar 

  14. Ingrams DR, Dhingra JK, Roy K et al (1997) Autofluorescence characteristics of oral mucosa. Head Neck 19:27–32

    Article  CAS  PubMed  Google Scholar 

  15. Koch FP, Kaemmerer PW, Biesterfeld S et al (2011) Effectiveness of autofluorescence to identify suspicious oral lesions—a prospective, blinded clinical trial. Clin Oral Investig 15:975–982

    Article  PubMed  Google Scholar 

  16. Kreppel M, Drebber U, Wedemeyer I et al (2011) Podoplanin expression predicts prognosis in patients with oral squamous cell carcinoma treated with neoadjuvant radiochemotherapy. Oral Oncol 47:873–878

    Article  CAS  PubMed  Google Scholar 

  17. Kreppel M, Eich HT, Brüggenolte C et al (2012) Preoperative vs. postoperative radiochemotherapy in patients with N2 squamous cell carcinoma of the oral cavity. Oral Oncol 48:1019–1024

    Article  PubMed  Google Scholar 

  18. Kumar A, Cascarini L, Mccaul JA et al (2013) How should we manage oral leukoplakia? Br J Oral Maxillofac Surg 51:377–383

    Article  PubMed  Google Scholar 

  19. Kunkel M, Forster GJ, Reichert TE et al (2003) Detection of recurrent oral squamous cell carcinoma by [18F]-2-fluorodeoxyglucose-positron emission tomography: implications for prognosis and patient management. Cancer 98:2257–2265

    Article  PubMed  Google Scholar 

  20. Lane PM, Gilhuly T, Whitehead P et al (2006) Simple device for the direct visualization of oral-cavity tissue fluorescence. J Biomed Opt 11:024006

    Article  PubMed  Google Scholar 

  21. Lassen P (2010) The role of human papillomavirus in head and neck cancer and the impact on radiotherapy outcome. Radiother Oncol 95:371–380

    Article  PubMed  Google Scholar 

  22. Leemans CR, Braakhuis BJ, Brakenhoff RH (2011) The molecular biology of head and neck cancer. Nat Rev Cancer 11:9–22

    Article  CAS  PubMed  Google Scholar 

  23. Leemans CR, Braakhuis BJ, Brakenhoff RH (2010) The molecular biology of head and neck cancer. Nat Rev Cancer 11:9–22

    Article  PubMed  Google Scholar 

  24. Lingen MW, Kalmar JR, Karrison T et al (2008) Critical evaluation of diagnostic aids for the detection of oral cancer. Oral Oncol 44:10–22

    Article  PubMed Central  PubMed  Google Scholar 

  25. Liu Y, Messadi DV, Wu H et al (2010) Oral lichen planus is a unique disease model for studying chronic inflammation and oral cancer. Med Hypotheses 75:492–494

    Article  PubMed Central  PubMed  Google Scholar 

  26. Lopez-Jornet P, De La Mano-Espinosa T (2011) The efficacy of direct tissue fluorescence visualization in screening for oral premalignant lesions in general practice: an update. Int J Dent Hyg 9:97–100

    Article  CAS  PubMed  Google Scholar 

  27. Mehrotra R, Singh M, Thomas S et al (2010) A cross-sectional study evaluating chemiluminescence and autofluorescence in the detection of clinically innocuous precancerous and cancerous oral lesions. J Am Dent Assoc 141:151–156

    Article  PubMed  Google Scholar 

  28. Mücke T, Konen M, Wagenpfeil S et al (2011) Low-dose preoperative chemoradiation therapy compared with surgery alone with or without postoperative radiotherapy in patients with head and neck carcinoma. Ann Surg Oncol 18:2739–2747

    Article  PubMed  Google Scholar 

  29. Mücke T, Wagenpfeil S, Kesting MR et al (2009) Recurrence interval affects survival after local relapse of oral cancer. Oral Oncol 45:687–691

    Article  PubMed  Google Scholar 

  30. Noguchi M, Kinjyo H, Kohama GI et al (2002) Invasive front in oral squamous cell carcinoma: image and flow cytometric analysis with clinicopathologic correlation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 93:682–687

    Article  PubMed  Google Scholar 

  31. Prott FJ, Handschel J, Micke O et al (2002) Long-term alterations of oral mucosa in radiotherapy patients. Int J Radiat Oncol Biol Phys 54:203–210

    Article  PubMed  Google Scholar 

  32. Remmerbach TW, Mathes SN, Weidenbach H et al (2004) Noninvasive brush biopsy as an innovative tool for early detection of oral carcinomas. Mund Kiefer Gesichtschir 8:229–236

    Article  CAS  PubMed  Google Scholar 

  33. Scheer M, Neugebauer J, Derman A et al (2011) Autofluorescence imaging of potentially malignant mucosa lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111:568–577

    Article  PubMed  Google Scholar 

  34. Schwartz GJ, Mehta RH, Wenig BL et al (2000) Salvage treatment for recurrent squamous cell carcinoma of the oral cavity. Head Neck 22:34–41

    Article  CAS  PubMed  Google Scholar 

  35. Stahl M, Wilke H, Fink U et al (1996) Combined preoperative chemotherapy and radiotherapy in patients with locally advanced esophageal cancer. Interim analysis of a phase II trial. J Clin Oncol Off J Am Soc Clin Oncol 14:829–837

    CAS  Google Scholar 

  36. Sterenborg HJCM, Motamedi M, Wagner RF et al (1994) In vivo fluorescence spectroscopy and imaging of human skin tumours. Lasers Med Sci 9:191–201

    Article  Google Scholar 

  37. Swindle LD, Thomas SG, Freeman M et al (2003) View of normal human skin in vivo as observed using fluorescent fiber-optic confocal microscopic imaging. J Investig Dermatol 121:706–712

    Article  CAS  PubMed  Google Scholar 

  38. Williams M, Poh CF, Zang L et al (2007) What do I need to know about oral cancer screening? J Can Dent Assoc 73:797–798

    Google Scholar 

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Authors and Affiliations

  1. Department for Oral and Craniomaxillo and Facial Plastic Surgery, Johannes Wesling Klinikum Minden, Hans-Nolte-Str. 1, 32429, Minden, Germany

    Martin Scheer

  2. Department for Oral and Craniomaxillo and Facial Plastic Surgery, University of Cologne, Cologne, Germany

    Juliana Fuss, Mehmet Ali Derman, Matthias Kreppel, Daniel Rothamel & Joachim E. Zoeller

  3. Dental Private Practice, Bayer, Kistler, Elbertzhagen and Colleagues, Landsberg am Lech, Germany

    Jörg Neugebauer

  4. Department of Pathology, University of Cologne, Cologne, Germany

    Uta Drebber

Authors
  1. Martin Scheer
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  2. Juliana Fuss
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  3. Mehmet Ali Derman
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  4. Matthias Kreppel
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  5. Jörg Neugebauer
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  6. Daniel Rothamel
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  7. Uta Drebber
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  8. Joachim E. Zoeller
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Correspondence to Martin Scheer.

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Martin Scheer and Juliana Fuss joined first authorship.

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Scheer, M., Fuss, J., Derman, M.A. et al. Autofluorescence imaging in recurrent oral squamous cell carcinoma. Oral Maxillofac Surg 20, 27–33 (2016). https://doi.org/10.1007/s10006-015-0520-7

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  • DOI: https://doi.org/10.1007/s10006-015-0520-7

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