Volume : 6, Issue : 5, May - 2017

Colposcopy in Screening Dysplastic Lesions of Oral Cavity: A Study.

Dr. Pallavi Kesarwani, Dr. Anand Choudhary

Abstract :

<p>&nbsp;Background: Oral cancers are believed to develop from pre-existing oral premalignant lesions &amp; conditions so an early detection of these can definitely improve survival rate. The diagnosis of malignant and potentially malignant epithelial lesions (PMEL&rsquo;s) of the oral mucosa (OM) cannot be based alone on the clinical findings (CF) only histologic evaluation is the gold standard for it. Therefore, the selection of a representative biopsy site plays a significant role. However the site for the biopsy is always a subjective choice of the surgeons that may raise doubts about its representativeness. Colposcopy, a well-known gynecological diagnostic procedure, enables evaluation of changes in surface topography and vascular patterns of the lining mucosa thus helping in selecting the most appropriate site of biopsy. Aim: The present study assesses the representativeness of colposcopic guided biopsies sites from the sites selected solely on routine clinical examination in malignant and PMEL&rsquo;s. Methods: The study included 30 subjects aged between of 30-60 years comprising of 10 cases each of oral submucous fiosis (OSF) and hyperkeratotic lesions (6 homogeneous and 4 speckeld leukoplakias), 6 cases of oral lichen planus (OLP) and 4 cases of clinically suspected oral squamous cell carcinoma (OSCC). 15 healthy, age-matched individuals were kept as a control group. For each subject, a thorough clinical examination followed by colposcopic assessment was done. The biopsy was then performed on the representative site selected and later the histopathologic findings were compared in the two cases. Results: The sensitivity and specificity of biopsies performed on the basis of colposcopic examination came out to be 64% and 93% respectively with a positive predictive value of 90% &nbsp;and a negative predictive value of 75% were reported. This shows that biopsies directed on the basis of colposcopic examination were more appropriate than on the basis of CF alone. Conclusion: &nbsp;The study enlightens on the most recent insights into cancer diagnostics. To facilitate a better systematic approach, with newer methodologies that ensure patients receive a prompt diagnosis and adequate treatment.</p>