Abstract
Background: Light-based detection agents using autofluorescence may be helpful in the detection
of early dysplasia, which would otherwise be misdiagnosed as nondysplastic by conventional
oral examination (COE) with white light. Visually-enhanced lesion scope (VELscope)
is one of such an aid used for the purpose. A meta-analysis was carried out on the
sensitivity and specificity of VELscope that would enable in providing evidence of
its usage in oral dysplasia. Materials and Methods: MeSH terms such as auto florescence in oral dysplasia, VELscope, Oral ID, Identifi,
in a different medical database such as PubMed, Cochrane, EBSCO, and Google scholar
was carried out by four research associates. The total articles available were 242,
of which, 230 were excluded based on strict criteria of randomized control trials
and proper design. Finally, only 12 studies were chosen for the present analysis.
Of 1643 patients from 12 studies, 1264 patients had undergone the autofluorescence
examination after the COE. Only 774 patients have shown the loss of fluorescence with
VELScope examination and 487 had retained the fluorescence. Biopsy was performed on
1176 patients after the autofluorescence examination in the areas where there was
the loss of fluorescence. The available data were subjected to software Review Manager
for analysis. Results and Discussion: Of the 11 studies analyzed, majority of them showed that the autofluorescence device
were sensitive enough > 0.70; however, the values of sensitivity and specificities
varied significantly. With the VELscope the diagnostic performance of the inexpert
examiner was not improved, obtaining a sensitivity of 0.40 (95% of confidence interval
[CI]: 0.406–0.773) and a specificity of 0.80 (95% CI: 0.614–0.923). Conclusion: The new technique may help as an adjunct to histopathology in detecting the dysplasia
initially and stop further progression to the carcinoma.
Key words
Autofluorescence - meta-analysis - visually enhanced lesion scope
