A Cross-sectional study evaluating chemiluminescence and autofluorescence in the detection of clinically innocuous precancerous and cancerous oral lesions

ABSTRACTBackgroundViziLite Plus with TBlue system (Zila Pharmaceuticals; now Zila, a division of Tolmar, Fort Collins, Colo.) and VELscope (LED Dental, White Rock, British Columbia, Canada) are oral cancer screening aids that have been developed to assist dentists in identifying precancerous and cancerous oral lesions.MethodsThe authors screened patients with an overhead examination light and then with VELscope or ViziLite. Patients with a clinically innocuous lesion underwent a biopsy, and the authors compared the results of tissue pathological analysis with findings from the screening aid tests to determine the sensitivity and specificity of each device. The authors tested these devices to determine their ability to aid in the decision-making process regarding whether further evaluation of a clinically innocuous lesion was required.ResultsThe authors biopsied 102 lesions and examined them with the ViziLite. They found three dysplasias and one malignancy, none of which were detected with the ViziLite (sensitivity = 0 percent, confidence interval [CI] = 0–60.2 percent; specificity = 75.5 percent, CI = 66.7–82.8 percent). The authors biopsied another 156 lesions and examined them with VELscope. They found 11 dysplasias and one malignancy, six of which were detected with VELscope (sensitivity = 50 percent, CI = 21.1–78.9 percent; specificity = 38.9 percent, CI = 30.8–46.9 percent).ConclusionsThe study results indicate that use of ViziLite or VELscope along with a conventional screening examination for lesions deemed clinically innocuous was not beneficial in identifying dysplasia or cancer. Additional clinical studies are needed before these devices can be recommended.Clinical ImplicationsClinicians and patients could have a false sense of security after obtaining a negative ViziLite or VELscope examination result because potentially large numbers of precancerous and cancerous lesions will be missed by both devices.