Use of tissue autofluorescence in the detection of oral premalignant lesions with high risk molecular patterns

There is a pressing need for the development of visual aids to help identify oral premalignant lesions (OPLs) at risk of cancer progression. This thesis investigated whether OPLs could be identified by fluorescence visualization (FV), a simple hand-held device developed by our research team. Ninety-one oral lesions were judged by FV as showing normal fluorescence (FV retained, FVR) or FV loss (FVL). FVR and FVL lesions were assessed and compared histologically, molecularly (analysis for loss of heterozygosity, LOH, on 3p, 9p, 4q, 8p, 11q, 13q, and 17p) and by outcome. The results showed a strong association of FVL with pathologic risk (high-grade dysplasia, P < 0.0001), with high-risk molecular patterns (P = 0.02 for multiple loss; P = 0.004 for lesions with LOH at 3p &/or 9p), and with cancer progression (P = 0.07). In summary, FV may serve as an adjunct tool to assist clinicians in identifying high-risk OPLs.