Gene expression analysis of autofluorescence margins in leukoplakia and oral carcinoma: A pilot study

Abstract

Objectives: Autofluorescence is considered a useful technique in the early detection of oral mucosal alterations. However, its efficacy to discriminate tumor margins is still under debate. The purpose of this pilot study was to confirm the existence of molecular divergence from the center of a lesion compared to white light and autofluorescence (VELscope^TM ) visualized margins in leukoplakia and oral carcinoma.

Materials and methods: Molecular divergence from the center of the lesion to white light and VELscope^TM defined margins was compared in patients with leukoplakia (n = 3) and oral carcinoma (n = 4). Expression profiling of 45 selected genes was performed through custom-made TaqMan arrays. Gene Ontology was used for biological pathway analysis.

Results: Irrespective of pathology, the greatest molecular divergence existed between the center of the lesion and both white light and VELscope^TM margins. VELscope^TM and white light margins were also molecularly distinct in oral carcinoma samples. Indeed, the white light margin retained molecular abnormalities observed in the center of the lesion thus suggesting the existence of a "partially transformed" cell population.

Conclusion: Despite the limited low number of patients, our data confirm the benefit of combining autofluorescence with conventional oral examination in identifying surgical margins during biopsy procedures for leukoplakia and oral carcinoma.

Keywords: VELscopeTM; autofluorescence; biopsy margins; gene expression profile; oral potentially malignant disorders; oral squamous cell carcinoma.