Detection of Field Alterations Using Fluorescence Visualization for Early Oral Squamous Cell Carcinoma

Objectives: It is known that a region of epithelial dysplasia cannot easily be distinguished macroscopically from normal looking area surrounding early oral squamous cell carcinoma (OSCC). Recently, we have used fluorescence visualization (FV) for the detection of surgical margin as a new device. This device can visualize epithelial dysplasia surrounding OSCC as fluorescence visualization loss (FVL). Aim of this study is to clarify the usefulness of FV for the detection of surgical margin.
Methods: We have resected 21 cases of T1 and T2 OSCC at the department of Oral and Maxillofacial Surgery, Tokyo Dental College, Japan. At the time of surgery, the surgeon outlined the boundary with FV. Surgical margin were determined at about 5 mm outside a boundary of FVL. We examined the validity of safety margin with the expression of Cytokeratin 10/13, 17, Ki – 67, p53 in and out of FVL area.
Results: FV has delineated various types of dysplasia and the delineation of surgical margin is clear. Furthermore, positive cells of cytokeratin 17, Ki - 67, p53 were significantly higher in FVL area. By contrast, positive cells of cytokeratin 10/13 were significantly lower in FVL area.
Conclusions: It is known that field alterations have malignant potential with the expression of some biomarker such as Cytokeratin 10/13, 17, Ki – 67and p53. FV is simple device to use easily for the detection of field alterations with contactless and no stimulus. FV has delineated various types of dysplasia. Furthermore, we suggest that FVL can detect oral potentiality malignant disorders and FV guided surgical margin might not only be adequate but also to be able to help prevent secondary primary tumors genetically.