Ukwas, AM; (2015) Non-invasive diagnostic aids for oral cancer. Doctoral thesis , UCL (University College London).

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Abstract

Oral cancer is a devastating disease accounting for about 1-2% of all malignancies worldwide, and commonly requires complex, invasive and costly treatment. The survival rates have shown little improvement in the last three decades, with the five-year survival rate being less than 50%. The poor prognosis of oral cancer is often attributed to the late diagnosis of the disease. A number of non-invasive commercial diagnostic adjuncts (some of which could be termed point-of-care) have been deployed -and promoted- for the early detection of oral potentially malignant and malignant diseases. The use of such techniques, if accurate, could to be a means of aiding the early detection of oral malignancy in primary care settings. However, there remains no objective, detailed analysis of their exact diagnostic accuracy and reliability. Therefore, the first original part of the present thesis was a comprehensive systematic review -with meta-analysis- of the exact diagnostic usefulness of these techniques, with objective investigation of the quality (and the reporting quality) of the clinical studies which explored their diagnostic accuracy and feasibility. Results from the meta-analysis have shown that toluidine blue has better and more consistent diagnostic accuracy measures than autofluorescence and chemiluminescence, but have also demonstrated that the studies which explored these techniques were inappropriately undertaken and/or insufficiently reported. The second original part of the thesis introduces a new system, dielectrophoresis (DEP), as a potential non-invasive, point-of-care diagnostic aid for the early detection of oral cancer that could prove to be more accurate than the aforementioned systems. Results of the clinical study have demonstrated that DEP has the potential to detect oral cancer, and to discriminate between different stages of oral mucosal neoplasia -and dysplasia- and benign diseases of the oral mucosa. On conclusion, there is insufficient evidence that commercially available, non-invasive methods will reliably detect oral cancer. The use of dielectrophoresis has some promise for such an application, but additional studies are warranted to confirm or refute this.

Type:	Thesis (Doctoral)
Title:	Non-invasive diagnostic aids for oral cancer
Language:	English
UCL classification:	UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
URI:	https://discovery.ucl.ac.uk/id/eprint/1471522

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