Diagnostic accuracy of clinical visualization and light-based tests in precancerous and cancerous lesions of the oral cavity and oropharynx: a systematic review and meta-analysis

Autores organización

• Maria Rosa Buenahora Tobar

  Autor

• David Augusto Diaz Baez

  Autor

• Jairo Alberto Bustillo Rojas

  Autor

• Ivan Armando Santacruz Chaves

  Autor

• Tamy Goretty Trujillo Escobar

  Autor

• 

  Gloria Ines Lafaurie Villamil

  Autor

Autores

• Peraza-L A
• Chambrone L

Grupos de investigación

• Unidad de Epidemiología Clínica Oral UNIECLO

  Investigador

  Maria Rosa Buenahora Tobar

• Unidad de Investigación Básica Oral UIBO

  

  Investigador

  Gloria Ines Lafaurie Villamil

Resumen

Objective: Evaluate and compare the performance of autofluorescence, chemiluminescence, and clinical visual examination in the detection of oral potentially malignant disorders (OPMD), oral cancer (OC), and oropharyngeal cancer (OPC). Materials and methods: A systematic review with meta-analysis based on diagnostic test studies. A literature search was carried out in the MEDLINE and EMBASE databases through August 30, 2020. For this review, the quality assessment tool of diagnostic precision studies (QUADAS-2) was used. Hierarchical regression models were used to estimate pooled diagnostic precision values in a random effects model. Results: A total of 40 studies were identified for this review according to each test evaluated: 5.562 samples for autofluorescence, 1.353 samples for chemiluminescence, and 1.892 samples for clinical examination. The summary measures sensitivity and specificity of the clinical examination were 63% and 78%, respectively, AUC = 0.78 95% CI (0.74–0.81). In the autofluorescence test, these were 86% and 72%, respectively, AUC = 0.86 95% CI (0.83–0.89); and the chemiluminescent test were 67% and 48%, respectively, AUC = 0.59 95% CI (0.54–0.63) Conclusions: Autofluorescence devices displayed superior accuracy levels in the identification of premalignant lesions and early neoplastic changes compared to clinical examination and chemiluminescent test. Overall, biopsy remains the gold standard for the definitive diagnosis of OPMD, OC, and OPC. Clinical Relevance: Light-based clinical methods such as autofluorescence and chemiluminescence techniques have been used in clinical diagnosis for the differentiation of OPMD and malignant and benign lesions; although detailed visual examination appears to be effective in identifying, previous systematic reviews have not evaluated a relevant number of studies and they did not evaluate the accuracy of the clinical examination. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

Keywords

• Humans; Mouth Neoplasms; Oropharynx; Precancerous Conditions; Sensitivity and Specificity; human; meta analysis; mouth tumor; oropharynx; precancer; sensitivity and specificity