Preliminary Exploration Of Non-invasive Examination In Oral Potential Malignant Disorders

Objective: The study was conducted to explore the feasibility of two methods for the diagnosis and follow-up in potentially malignant oral potential malignant disorders,OPMDs.These two methods are autofluorescence detection techniques and salivary tumor-associated molecules(TNF-? and CA125)detection.Some non-invasive,easy-to-operate and easy-to-accept new auxiliary methods are used for diagnosis and follow-up in potentially malignant oral potential malignant disorders,OPMDs.Methods:1.we collected patients who were diagnosed with OPMDs in the clinical department of oral mucosa of our hospital from January 2019 to December 2019.We used conventional oral examination(COE),that is,traditional consultation,inspection and oral soft tissue palpation to screening the patients.The auto-fluorescence detector VELscope Vx is used to detect the lesion area of the study subject and record the imaging results.Excision biopsies were performed on patients with positive COE screening,and the results of fluorescence imaging were compared with pathological results.2.The patients whose pathological diagnosis was OPMDs were included in the OPMDs group,and healthy volunteers were collected as the normal control group.The saliva of OPMDs group and normal control group were collected,and the contents of TNF-? and CA125 in saliva were determined by ELISA.We pooled the data according to the pathological diagnosis results for statistical analysis.The groups were Control group,OLP group,OLK group,OSF group,OEK group,Dysplasia group,Without dysplasia group.Results:1.A total of 34 subjects were collected,including 15 males and 19 females,with an average age of 45.88±7.61 years;A total of 29 patients were included in the OPMDs group,including 14 males and 15 females,with an average age of 46.66±7.92 years;A total of 29 healthy volunteers were collected,including 14 males and 15 females,with an average age of 42.55±11.72 years.There were no statistically significant differences between the OPMDs and the normal control group in gender,age,smoking,drinking and living conditions,periodontal conditions(P > 0.05).2.COE detection results: The clinical diagnosis were suspected to be 27 cases of oral lichen planus,2 of oral submucous fibrosis,4 of oral leukoplakia,and 1 case of oral erythroplakia.VELscope Vx detection results: Among the 30,18 had positive pathological diagnosis results and 12 had negative results.Among the 4 patients with negative fluorescent imaging results,1 had positive histopathological results and 3 had negative results..The sensitivity of VELscope Vx for the diagnosis of OPMDs was 94.74%,the specificity 20.0%,the positive predictive value 60.0%,and the negative predictive value75.0%.3.Results of TNF-? in saliva detection:(1)The concentration of TNF-? in the saliva of the OPMDs group was 339.12 ± 46.73pg/ml,while that of the normal control group 213.50±46.45 pg/ml.The concentration of TNF-? in the saliva of the OPMDs group was significantly higher than that of the normal control group and the difference was statistically significant.(2)According to pathological diagnosis,the concentration of TNF-? in oral leukoplakia group 396.15±4.78 pg/ml,the concentration of TNF-? in oral erythema group 406.62pg/ml,the concentration of TNF-? in oral submucous fibrous variable group 311.60 pg/ml and the concentration of TNF-? in oral lichen planus group 330.32±43.82 pg/ml,the concentration of TNF-? in the Dysplasia group 336.60±47.17 pg/ml,the concentration of TNF-? in Without dysplasia group 343.90±48.02 pg/ml.There were statistically significant between the normal control group,oral lichen planus group and oral leukoplakia group.There were not statistically significant between oral lichen planus group and oral leukoplakia group.There were not statistically significant differences between Dysplasia group and Without dysplasia group.4.Results of CA125 in saliva detection:(1)The concentration of CA125 in the saliva of the OPMDs group 36.99±5.14 pg/ml,while that of the normal control group 21.79±4.28 pg/ml.The concentration of CA125 in the saliva of the OPMDs group was significantly higher than that of the normal control group,and the difference was statistically significant.(2)According to pathological diagnosis,the concentration of CA125 in oral leukoplakia group was 38.26±5.76 pg/ml,the concentration of CA125 in oral erythema group 46.02pg/ml,the concentration of CA125 in oral submucous fibrous variable group 43.59 pg/ml and the concentration of CA125 in oral lichen planus group 36.18±4.80 pg/ml,theconcentration of CA125 in the Dysplasia group 40.08±3.10,the concentration of CA125 in Without dysplasia group 31.14±2.22 pg/ml.There were statistically significant between the normal control group,oral lichen planus group and oral leukoplakia group.There were not statistically significant between oral lichen planus group and oral leukoplakia group.There were statistically significant differences between Dysplasia group and Without dysplasia group.Conclusion: Studies have shown that autofluorescence detection and saliva detection of tumor-related molecules(TNF-? and CA125)have certain feasibility in the diagnosis of OPMDs.It is a non-invasive,convenient and highly sensitive method.It is expected to play an important role in the monitoring,follow-up and early diagnosis of late-stage cancer,but its specific value still needs to be further expanded sample size and long-term follow-up study.