Correlation of clinical optical aids and molecular markers for early detection of oral malignant and potentially malignant lesions

Oral squamous cell carcinoma (OSCC) ranks as the 6th most common malignancy worldwide, with approximately 400,000 new cases diagnosed in the year 2007. The overall survival rate for OSCC is approximately 50%, despite technological advancements in diagnostic and treatment procedures. High morbidity and mortality rates call for early detection and treatment of precancerous and cancerous lesions, but this is dependent on visualization of lesions, and stratification of benign from potentially malignant lesions. Traditionally conventional oral examination for oral cancer involving visual inspection and digital palpation of oral lesions under projected incandescent or halogen illumination has been deficient. Conventional oral examination is a poor differentiator for benign, dysplastic and malignant lesions, thereby resulting in delayed patient referral and poorer prognosis. Conventional oral examination is unable to accurately discriminate between progressive and non-progressive lesions, neither does it accurately detect precancerous lesions which present in clinically normal mucosa. These findings have driven the development of new technologies which aim at highlighting potentially malignant oral lesions in a highly sensitive and specific manner to aid clinicians in early diagnosis and treatment of these conditions. This presentation will highlight new diagnostic aids available on the market, and examine the evidence available for their use. Furthermore, correlations will be made between molecular changes noted in malignant and potentially malignant lesions and the diagnostic accuracy of the optical aids