Title: 1239 - Fluorescence Technology for Oral Cancer Screening Among HIV-infected Patients
Irene Tami-Maury (Presenter)
University of Texas MD Anderson Cancer Center
Mark NIchols, Avenue 360
Miguel Brigante, University of Texas MD Anderson Cancer Center
Sanjay Shete, University of Texas MD Anderson Cancer Center
Objectives: Minimally invasive tools, such as fluorescence light devices, that can early detect premalignant and malignant oral lesions (PMMOLs) should be seriously considered for high-risk populations such as HIV-infected individuals. The purpose of our study was to assess the sensitivity and specificity of fluorescence oral examination for the screening of PMMOLs among HIV-infected patients.
Methods: We recruited 39 HIV-infected dental patients in Houston, Texas (USA). We recorded demographic characteristics, mouthwash use, alcohol consumption, tobacco use history, CD4 counts, and viral load. Conventional oral examination was performed under incandescent operatory light, recording location and clinical description (e.g., leukoplakia, erythroplakia, ulcerative, or other) of the suspicious oral lesion. Clinical examination was repeated using fluorescent light. Oral lesions not resolving within 15 days after eliminating potential irritants were biopsied. Analysis were carried out regarding how often the fluorescence oral examination enhanced detection, how often it detected new lesions, and how often it changed provisional clinical diagnosis. Sensitivity and specificity were calculated based on final histopathological diagnosis.
Results: Our study sample consisted in 80% males, mean age 35 years, 33% Caucasians, 74% using mouthwash, 13% with potential drinking problems, 51% current cigarettes smokers, 21% using other tobacco products ,11% had <200 CD4 counts, 63% had undetectable HIV-viral load, 97% were on anti-retroviral treatment. Most of the oral lesions were papillary lesions (56%) and leukoplakias (26%). Final histoplathological result confirmed severe dysplasia, carcinoma in situ, or sarcoma Kaposi in 12% of the patients. The fluorescent light detected additional oral lesions in 15% of the sample, enhanced visibility in 39%, and changed provisional diagnosis in 15% of the sample. Sensitivity and specificity for the fluorescent light were 83% and 27%, respectively.
Conclusions: The observations in this study indicate that fluorescence-light devices have limited use for screening premalignant and/or malignant oral lesions even in high-risk populations.
This abstract is based on research that was funded entirely or partially by an outside source:
Baylor- UT Houston Center for AIDS Research (CFAR) and NIH/NCI under award number P30 CA016672.
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE