Analysis of surgical margins in oral cancer using in situ fluorescence spectroscopy

• Published in: Oral oncology Vol. 50; no. 6; pp. 593 - 599
• Main Authors: Francisco, Ana Lucia Noronha, Correr, Wagner Rafael, Pinto, Clóvis Antônio Lopes, Filho, João Gonçalves, Chulam, Thiago Celestino, Kurachi, Cristina, Kowalski, Luiz Paulo
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.06.2014; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Alcohol Drinking; Biological and medical sciences; Case-Control Studies; Dermatology; Diagnosis; Female; Fluorescence spectroscopy; Hematology, Oncology and Palliative Medicine; Humans; Male; Medical sciences; Middle Aged; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Oral cavity; Otolaryngology; Otorhinolaryngology. Stomatology; Smoking; Spectrometry, Fluorescence - methods; Squamous cell carcinoma; Surgical margins; Tumors; Tumors of the skin and soft tissue. Premalignant lesions; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Fluorescence spectroscopy; Oral cavity; Surgical margins; Squamous cell carcinoma; Diagnosis; Skin disease; Basal cell carcinoma; Oral cancer; Stomatology; In situ; Fluorescence; Exploration; ENT; Malignant tumor; Spectrometry; Cancerology; Oral cavity disease; Surgical margin; Cancer
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2014.02.008

Summary Oral cancer is a public health problem with high prevalence in the population. Local tumor control is best achieved by complete surgical resection with adequate margins. A disease-free surgical margin correlates with a lower rate of local recurrence and a higher rate of disease-free survival. Fluorescence spectroscopy is a noninvasive diagnostic tool that can aid in real-time cancer detection. The technique, which evaluates the biochemical composition and structure of tissue fluorescence, is relatively simple, fast and, accurate. Objectives This study aimed to compare oral squamous cell carcinoma lesions to surgical margins and the mucosa of healthy volunteers by fluorescence spectroscopy. Materials and methods The sample consisted of 56 individuals, 28 with oral squamous cell carcinoma and 28 healthy volunteers with normal oral mucosa. Thirty six cases (64.3%) were male and the mean age was 60.9 years old. The spectra were classified and compared to histopathology to determine fluorescence efficiency for diagnostic discrimination of tumors. Results In the analysis of the other cases we observed discrimination between normal mucosa, injury and margins. At two-year follow up, three individuals had local recurrence, and in two cases investigation fluorescence in the corresponding area showed qualitative differences in spectra between the recurrence area and the area without recurrence at the same anatomical site in the same patient. Conclusion In situ analysis of oral mucosa showed the potential of fluorescence spectroscopy as a diagnostic tool that can aid in discrimination of altered mucosa and normal mucosa.