Head and neck squamous cell carcinoma (HNSCC) accounts for most cancers of the mouth, pharynx and larynx. Early detection is critical There is a need to develop noninvasive techniques to screen for oral cavity cancer and improve prognosis by early detection. Studies have demonstrated that changes in natural fluorescence reflect biochemical and morphological alterations to tissues that may serve as noninvasive indicators of high-risk lesions. A hand held device, called a VELscope, has been developed to allow direct visualization of tissue autoflorescence. Objectives: To evaluate whether VELscope (a handheld device that allows direct visualization of tissue autoflorescence) enhanced exam is superior to white light exam at discriminating premalignant and malignant disease from normal oral mucosa. To determine whether VELscope is useful in localizing premalignant or malignant lesions when the oral rinse molecular panel is positive, but no visible lesions are seen by white light exam. Methods: An ongoing clinical trial of high-risk patients and patients previously treated for HNSCC. An oral rinse for each subject was collected for salivary marker analysis. The oral cavity of each subject was examined using white light and VELscope. A biopsy was performed on lesions identified either by white light exam or VELscope exam. Results: Twenty patients have been accrued to this study. Biopsy was recommended in six patients. No premalignant or malignant lesions have been identified at this point in the study. Conclusion: More evidence is needed to determine whether VELscope enhances clinical examination and improves earlier detection of premalignant lesions.
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