Efficacy of Chemiluminescence (ViziLite™) as a Screening Method in the Detection of Clinically Suspicious Oral Cancerous and Precancerous Lesions

Abstract

Several screening techniques based on light interaction with tissue have been described to aid clinicians in the detection of early oral cancerous lesions. One of the most studied techniques is chemiluminescence. This method has been used in different studies but always by Oral Medicine specialists. Objective: To evaluate the chemiluminescence system as a screening method in the detection of clinically suspicious cancerous and precancerous oral lesions when used by clinicians without an Oral Medicine Speciality. Study Design: A total of 100 patients attending the Oral Medicine Unit at the Dental School of the University of Seville were enrolled. All patients were current smokers and were above the age of 40. The clinical examination was performed by dental students who were instructed in the location and recognition of potentially malignant oral disorders, using visual examination and the chemiluminescence test ViziLite Plus (Zila Pharmaceuticals, Phoenix, AZ, USA). To assess the validity of the chemiluminescence test as a screening method, a visual exam was performed by a specialist in Oral Medicine which was used as a gold-standard. Results: Conventional oral visual examination by the Oral Medicine Specialist found 13 lesions suspicious for malignancy, out of which 7 were also detected using the chemiluminescence test. Furthermore, 87 patients were diagnosed as lesion-free, of which 49 obtained negative results during the chemiluminescence test and 38 patients had some sort of lesion. With these results, the test yielded a sensitivity of 0.56 and a specificity of 0.56. These results indicate values similar to other studies, in fact lower sensitivity values, possibly due to the lack of experience of the clinician. Conclusions: The chemiluminescence test (ViziLite Plus) did not present any advantages in terms of cost-benefit compared to conventional examination as a screening method for cancerous and precancerous oral lesions.

Current Technologies and Recent Developments for Screening of HPV-Associated Cervical and Oropharyngeal Cancers

“… se: sensitivity; sp: specificity; ppv: positive predictive value; npv: negative predictive value; HPV: human papillomavirus; VIA: visual inspection with acetic acid; a Performance when compared to tissue biopsy [ 46 ]. Note that these are comparison results from a single study; b Performance when compared to tissue biopsy [ 47 ]; c Performance characteristics for 16L1 peptide-based enzyme-linked immunosorbent assay (ELISA) for serological detection of cervical cancer [ 48 ]; d An older study on performance of unaided visual inspection or oral lesions [ 49 ]; e Performance of other tests were based on the consideration of tissue biopsy as the gold standard; f Performance characteristics for Vizilite technology when compared to biopsy [ 50 ]. …”