Colposcopy - A Novel Diagnostic Technique for Oral Mucosal Lesions
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Cited by 2 publications
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Oral squamous cell carcinoma (OSCC) accounts for nearly 90% of all oral cavity cancers 1,2. Oral cancer is usually first diagnosed when it becomes symptomatic, by which time, the disease would have progressed to an advanced stage leading to poor prognosis 3,4 .Early diagnosis could aid in treating the disease at a relatively incipient stage which in turn could aid in improving the overall prognosis 2,4 .But, diagnosis of an oral potentially malignant lesion cannot be based solely on clinical findings. Histopathological examination is also necessary 1,4,5. Accurate diagnosis depends on the biopsy site selection and thus must be a true representation of the pathological tissue 1,3,5. A non-invasive technique capable of accurately identifying the most representative biopsy site is the need of the hour. Colposcopy is a relatively simple chair-side procedure. Its non-invasive nature ensures patient compliance. Its aids in identifying the sites with subtle features which are not apparent in a routine clinical oral examination 2,4,6. The term 'colposcopy' was derived from kolpos, an Ancient Greek word. Kolpos represents "hollow, womb, and vagina". The meaning of skopos is "look at". German physician Hans Hinselmann in the year 1925 developed the procedure of colposcopy. He attached a light source to the Leitz binocular dissecting microscope specifically for the purpose of detecting early cervical cancer 3,5-8. However, only in the year 2000, colposcope was first used for examining the oral cavity for mucosal lesions 6. The colposcope looks like a pair of binoculars and is mounted on a pedestal with a light source attached to it 2,3,5,7. Illumination is provided by a halogen lamp which in turn is connected to a lens system through a fiber-optic cable. Tissue magnification of 4 to 40-fold is achievable. The tissue surfaces can be viewed as a three-dimensional image. The colposcope can be attached to portable video cameras, allowing it to be viewed on television monitor. A digital colposcope also enables the computerized manipulation of stored images 2,3,7. The primary application of colposcopy is to identify oral potentially malignant lesions and malignant tissues based on their vascular patterns 6-8 .Several factors including the pattern of vascularity, intercapillary distance, pattern of the surface, opacity, color tone, and clarity of demarcation of oral mucosal lesions 2,4,5,7. Colposcopic examination has shown a relatively high accuracy (70% and 98%) for detection of changes in the mucosa 1,3 .The sensitivity of colposcopy is dependent on a number of factors including the skills of the colposcopist, number of biopsies taken, and skills of the reading pathologist 8 .The poster presents a current review on colposcopy procedure, assessment, and interpretation of the findings while advocating it as an adjunct tool for the early diagnosis of oral potentially malignant and malignant lesions.
Oral squamous cell carcinoma (OSCC) accounts for nearly 90% of all oral cavity cancers 1,2. Oral cancer is usually first diagnosed when it becomes symptomatic, by which time, the disease would have progressed to an advanced stage leading to poor prognosis 3,4 .Early diagnosis could aid in treating the disease at a relatively incipient stage which in turn could aid in improving the overall prognosis 2,4 .But, diagnosis of an oral potentially malignant lesion cannot be based solely on clinical findings. Histopathological examination is also necessary 1,4,5. Accurate diagnosis depends on the biopsy site selection and thus must be a true representation of the pathological tissue 1,3,5. A non-invasive technique capable of accurately identifying the most representative biopsy site is the need of the hour. Colposcopy is a relatively simple chair-side procedure. Its non-invasive nature ensures patient compliance. Its aids in identifying the sites with subtle features which are not apparent in a routine clinical oral examination 2,4,6. The term 'colposcopy' was derived from kolpos, an Ancient Greek word. Kolpos represents "hollow, womb, and vagina". The meaning of skopos is "look at". German physician Hans Hinselmann in the year 1925 developed the procedure of colposcopy. He attached a light source to the Leitz binocular dissecting microscope specifically for the purpose of detecting early cervical cancer 3,5-8. However, only in the year 2000, colposcope was first used for examining the oral cavity for mucosal lesions 6. The colposcope looks like a pair of binoculars and is mounted on a pedestal with a light source attached to it 2,3,5,7. Illumination is provided by a halogen lamp which in turn is connected to a lens system through a fiber-optic cable. Tissue magnification of 4 to 40-fold is achievable. The tissue surfaces can be viewed as a three-dimensional image. The colposcope can be attached to portable video cameras, allowing it to be viewed on television monitor. A digital colposcope also enables the computerized manipulation of stored images 2,3,7. The primary application of colposcopy is to identify oral potentially malignant lesions and malignant tissues based on their vascular patterns 6-8 .Several factors including the pattern of vascularity, intercapillary distance, pattern of the surface, opacity, color tone, and clarity of demarcation of oral mucosal lesions 2,4,5,7. Colposcopic examination has shown a relatively high accuracy (70% and 98%) for detection of changes in the mucosa 1,3 .The sensitivity of colposcopy is dependent on a number of factors including the skills of the colposcopist, number of biopsies taken, and skills of the reading pathologist 8 .The poster presents a current review on colposcopy procedure, assessment, and interpretation of the findings while advocating it as an adjunct tool for the early diagnosis of oral potentially malignant and malignant lesions.
Cancer is one of the leading cause of deaths in public health and is particularly common in developing countries. The inuence of smoking, chewing tobacco and alcohol has usually been considered a relevant confounding factor for oral cancer. Oral cancer is generally preceded by some potentially malignant disorders such as leukoplakia, lichen planus, oral submucous brosis etc. However, even with meticulous follow up, early malignant changes are still overlooked. As the emphasis shifts from damage mitigation to disease prevention, the need for sensitive and accurate detection and diagnostic tools become more important. Many novel and emergent optical diagnostic modalities for the oral cavity are available with a variety of desirable attributes including non-invasiveness, absence of ionising radiation, patient friendliness, repeatability and high resolution surface. One such diagnostic aid is Colposcopy. Because of the rapid pace of innovation in this eld, the cost and ease of use of such modalities is improving rapidly. Hence, early diagnosis is of paramount importance facilitating large scale screening for high risk population. The future is promising for further development and evolution of oral cancer diagnostic aids to enhance the quality of patient care there by reducing the mortality and morbidity.
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