An Applied Research On In Vivo Imaging Of Human Oral Mucosa Potentially Malignant Disorders By Reflective Confocal Microscopy

Objective: Oral cancer is one of the most common malignant tumors,ranking sixth among all body malignant tumors.The present therapy of oral cancer is surgery combined with chemotherapy and radiotherapy,which has not improved the 5 years survival rate of oral cancer remarkably.So early diagnosis and intervention is still the most effective way to lower the mortality rate of oral cancer.Recently,with the development of photoacoustic technology,reflective confocal microscopy(RCM)is used in the detection of skin diseases,which improves the early diagnosis of skin cancers.This study is aim to explore the noninvasive detection method of oral potentially malignant disorders by reflective confocal microscopy.The imaging characteristic of oral potentially malignant disorders under RCM will be concluded so as to provide a basis for future research.Methods: 1.Randomly choose patients who are histopathologically diagnosed oral lichen planus,oral leukoplakia,oral mucous melanotic macules and oral mucous melanoma.2.Retrospectively review the RCM images of lesions.3.HE staining is performed to observe the histomorphology of lesions 4.Find the correlations between RCM images and microscopy views.Results: Specific microscopic characters were identified by RCM for each disease corresponding to pathological characters.We can see connective tissue papillae disappearing and polygonal melanocytes and roundish inflammatory cells infiltrating in oral lichen planus cases,increased melanin around connective papillae in melanotic macule cases,proliferation of nevus cells in melanocytic nevi cases,massive fusiform melanocytes gathering irregularly in melanoma,and different appearances in oral leukoplakia with epithelial dysplasia.Conclusions: Reflectance confocal microscopy seems to be a valuable tool to detect oral malignant disorders noninvasively in vivo,which could be promoted in clinic application.The detector is still not small enough to be available in whole oral cavity,so designing a smaller one is the direction of future study.