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ORIGINAL ARTICLE
Year : 2022  |  Volume : 12  |  Issue : 3  |  Page : 365-375

To evaluate the efficacy of tissue autofluorescence (velscope) in the visualization of oral premalignant and malignant lesions among high-risk population aged 18 years and above in Haroli block of Una, Himachal Pradesh


1 Department of Dentistry, Dr. Radhakrishnan Govt. Medical College, Hamirpur, Himachal Pradesh, India
2 Department of Neurology, All India Institute of Medical Sciences (AIIMS), Bilaspur, Himachal Pradesh, India
3 Department of Epidemiology, National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
4 Model Rural Health Research Unit (MRHRU), Una, Himachal Pradesh, India
5 Health and Family Welfare Department, Community Health Center, Haroli, Una, Himachal Pradesh, India
6 Department of Oral and Maxillofacial Surgery, HP Government Dental College & Hospital (HPGDC), Shimla, Himachal Pradesh, India

Correspondence Address:
Dr. Anupriya Sharma
Department of Dentistry, Dr. Radhakrishnan Govt. Medical College, Hamirpur, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jispcd.JISPCD_22_22

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Introduction: Visually enhanced lesion scope (Velscope) that identifies reduction in tissue fluorescence in dysplasia can prove to be effective in screening for potentially malignant lesions. The objective of the present study was to evaluate the effectiveness of device that utilizes the principles of tissue autofluorescence (Velscope) in the detection of dysplastic and/or neoplastic changes in oral mucosal lesions using biopsy and histopathology as “gold standard.” Materials and Methods: Out of nine hundred fifty patients with suspicious oral mucosal lesions, 250 patients were subjected to conventional oral examination followed by Velscope examination. The autofluorescence characteristics of 250 patients were compared with the results of histopathology. Biopsies were obtained from all suspicious areas identified on examination. The sensitivity, specificity, positive and negative predictive values were calculated for Velscope examination. Results: The Velscope examination showed sensitivity and specificity values of 75.00% (95% CI: 69.63%-80.37%) and 61.39% (95% CI: 55.35%–67.42%) respectively while the positive and negative predictive values were 31.58% (95% CI: 25.82%-37.34%) and 91.18% (95% CI: 87.66%-94.69%) respectively. Conclusion: The definite diagnosis of the presence of dysplastic tissue changes in the oral lesions cannot be made alone with the Velscopic examination. The high number of false-positive results limits its efficiency as an adjunct despite its reasonable sensitivity. However, It can serve to alleviate patient anxiety regarding suspicious mucosal lesions in a general practice setting due to high negative predictive value. Also, a combined approach of Velscope examination and conventional oral examination may prove to be an effective diagnostic tool for early detection of malignant oral mucosal lesions.


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