Acurácia do dispositivo VELscope® para diagnóstico complementar de desordens orais potencialmente malignas (DOPMs)

Abstract

The early diagnosis of oral potentially malignant disorders (OPMDs) through visual inspection followed by histopathological confirmation is a fundamental step towards reducing the rates of lesions that have undergone malignant transformation. The use of the VELscope device has been suggested as an adjuvant tool through fluorescence visualization in the early detection of OPMDs. The aim of our study was to characterize the diagnostic accuracy of the VELscope in recognizing the autofluorescence of OPMDs, correlating clinical and histopathological aspects. Fifty-six oral mucosa lesions were submitted to conventional oral examination (COE) followed by VELscope and their autofluorescence characteristics were compared with the histopathological diagnosis. Sensitivity, specificity, positive and negative predictive values, accuracy and positive and negative likelihood ratios were calculated. The VELscope test showed sensitivity and specificity values of 50% and 69%, respectively, while the positive predictive value was 47.6% and the negative predictive value 71.4%. The overall accuracy was 62.5% and the positive and negative likelihood ratios were 1.63 and 0.72, respectively. The VELscope exam alone cannot provide a definitive diagnosis regarding the presence of dysplastic tissue changes and high-risk lesions. Despite having reasonable sensitivity, the high number of false-positive and false-negative results limits its effectiveness as an adjuvant, reinforced by the unfavorable negative likelihood ratio. A comprehensive and systematic conventional oral examination, biopsy and histopathological evaluation are the reference standards for the evaluation of suspicious lesions of the oral mucosa, considering the low accuracy of the VELscope device as an auxiliary method equipment in clinical examination.