• Bruno Nikolovski Clinic for Oral surgery and implantology, University dental clinical center St. Pantelejmon in Skopje, R. North Macedonia
  • Vera Nikolovska Radojkova Clinic for Oral pathology and periodontology, Faculty of dentistry, University Ss. Cyril and Methodius, in Skopje, R. North Macedonia
  • Cena Dimova Faculty of Medical sciences, University Goce Delcev in Stip, R.North Macedonia
  • Mirjana Popovska Clinic for Oral pathology and periodontology, Faculty of dentistry, University Ss. Cyril and Methodius in Skopje, R. North Macedonia
  • Stevica Ristovska Clinic for Oral pathology and periodontology, Faculty of dentistry, University Ss. Cyril and Methodius in Skopje, R.North Macedonia
  • Ana Belazelkovska Grezhlovska Faculty of Dentistry, European University in Skopje R. North Macedonia
  • Danica Monevska Popovik University clinic for Maxillofacial surgery, Faculty of Dentistry, University Ss. Cyril and Methodius in Skopje, R.North Macedonia


Significant vital functions take place in the oral cavity and oropharynx, primarily mastication, as the initial function of the gastrointestinal system, swallowing, respiration and speech. All these vital biological functions can be endangered, ie aggravated, and even disabled by the appearance of neoplasms in that anatomical space. In the maxillofacial region, neoplasms can originate from a variety of tissues, from the mucous membranes of the oral cavity to the jaws, salivary glands, and even tumors of odontogenic origin. However, the most common tumor in the oral cavity is squamous cell carcinoma (OSSC), which originates from the oral mucosa. To determine the accuracy, sensitivity (Se) and specificity (Sp) of the Velscope screening method in the detection of premalignant and initial malignant lesions compared to the gold standard surgical biopsy. The study group consisted of 60 patients divided into two groups. The first group was formed by 30 patients with potentially malignant oral lesions (PML). Another 30 patients with preliminary diagnosis - oral cancer (OC) were included in the second group of examinees. The high sensitivity value of 92.86% and the accuracy of the method of 86.67% largely confirm the reliability and efficacy of the Velscope method in patients with highly suspected oral cancer lesions (OC), significantly more, comparing to the group of premalignant lesions.

Key words: Velscope, oral cancer, premalignant lesions, tumor. 


1. National Cancer Institute. SEER Stat Fact Sheets: Oral Cavity and Pharynx. Bethesda, MD: http://seer.cancer.gov/statfacts/html/oralcav, October 2013
2. SEER Cancer Statistics Review, 1973-1998
3. American Cancer Society. Risk Factors for Oral Cavity and Oropharyngeal Cancers, 2021. https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/risk-factors.html
4. F. Bray, J. Ferlay, I. Soerjomataram, R. L. Siegel, L. A. Torre, and A. Jemal, “Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries,” CA Cancer J. Clin. 68(6), 394–424 (2018). [CrossRef]
5. Sung, H, Ferlay, J, Siegel, RL, Laversanne, M, Soerjomataram, I, Jemal, A, Bray, F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021: 71: 209- 249. https://doi.org/10.3322/caac.21660
6. S. Müller, “Update from the 4th edition of the World Health Organization of head and neck tumours: tumours of the oral cavity and mobile tongue,” Head and Neck Pathol 11(1), 33–40 (2017). [CrossRef]
7. A. K. El-Naggar, J. K. Chan, J. R. Grandis, T. Takata, and P. J. Slootweg, WHO classification of head and neck tumours (International Agency for Research on Cancer, 2017).
8. K. Curtius, N. A. Wright, and T. A. Graham, “An evolutionary perspective on field cancerization,” Nat. Rev. Cancer 18(1), 19–32 (2018). [CrossRef]
9. S. Warnakulasuriya, O. Kujan, J. M. Aguirre-Urizar, J. V. Bagan, M. A. Gonzalez-Moles, A. R. Kerr, G. Lodi, F. W. Mello, L. Monteiro, G. R. Ogden, P. Sloan, and N. W. Johnson, “Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer,” Oral Dis., https://doi.org/10.1111/odi.13704 (2020).
10. Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin. 2012;62 1:10–29.
11. Olson CM, Burda BU, Beil T, Whitlock EP. Screening for Oral Cancer: A Targeted Evidence Update for the U.S. Preventive Services Task Force. Evidence Synthesis No. 102. AHRQ Publication No. 13-05186-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2013.
12. Slaughter DP, Southwick HW, Smejkal W. Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer. 1953;6(5):963–8.
13. Day GL, Blot WJ. Second primary tumors in patients with oral cancer 1992;70(1):14–9.
14. Lippman SM, Hong WK. Second malignant tumors in head and neck squamous cell carcinoma: the overshadowing threat for patients with early-stage disease. Int J Radiat Oncol Biol Phys. 1989;17(3):691–4.
15. Napier SS, Speight PM. Natural history of potentially malignant oral lesions and conditions: an overview of the literature. J Oral Pathol Med. 2008;7 1:1–10.
16. Mehrotra, Van der Waal I. Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management. Oral Oncol. 2009;45 4/5:317–323.
17. Fischer DJ, Epstein JB, Morton TH, Schwartz SM. Interobserver reliability in the histopathologic diagnosis of oral pre-malignant and malignant lesions. J Oral Pathol Med 2004;33(2):65-70.
18. Llewellyn CD, Johnson NW, Warnakulasuriya KA. Risk factors for squamous cell carcinoma of the oral cavity in young people- a comprehensive literature review. Oral Oncol. 2001;37 5:401–418.
19. Linjun Shi, Chenxi Li, Xuemin Shen, Zengtong Zhou, Wei Liu, Guoyao Tang. Potential role of autofluorescence imaging in determining biopsy of oral potentially malignant disorders: A large prospective diagnostic study, Oral Oncology, Vol. 98. 2019;98:176-179, ISSN 1368-8375. https://doi.org/10.1016/j.oraloncology.2019.08.006.
20. Lane PM, Gilhuly T, Whitehead P, Zeng H, Poh CF, Ng S, et al. Simple device for the direct visualization of oral-cavity tissue fluorescence. J Biomed Opt. 2006;11(2):024006
21. Poh CF, Zhang L, Anderson DW, Durham JS, Williams PM, Priddy RW, et al. Fluorescence visualization detection of field alterations in tumor margins of oral cancer patients. Clin Cancer Res; 2006;12(22):6716–22
22. Awan KH, Morgan PR, Warnakulasuriya. Evaluation of an autofluorescence based imaging system (VELscope™) in the detection of oral potentially malignant disorders and benign keratoses. Oral Oncol. 2011;47(4):274-277
23. Rana M, Zapf A, Kuehle M, Gellrich NC, Eckardt AM. Clinical evaluation of an autofluorescence diagnostic device for oral cancer detection: a prospective randomized diagnostic study. Eur J Cancer Prev. 2012;21(5):460–466 doi: 10.1097/CEJ.0b013e32834fdb6d.doi:10.1097/ CEJ.0b013e32834fdb6d. Sep. PubMed PMID: 22217551
24. Sawan D, Mashlah A. Evaluation of premalignant and malignant lesions by fluorescent light (VELscope). J Int Soc Prev Community Dent. 2015;5(3):248-54 doi: 10.4103/2231-0762.159967.
25. Marzouki HZ, Tuong VVT, Ywakim R, Chauvin P, Hanley J, Kost KM. Use of fluorescent light in detecting malignant and premalignant lesions in the oral cavity: a prospective, single-blind study. Journal of Otolaryngology-Head and Neck Surgery, 2012;41:164–168
26. Canjau S, Todea C, Sinescu C, Pricop M, Duma V. Fluorescence influence on screening decisions for oral malignant lesions. Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie. 2018;59:203-209.
27. Moro A, Di Nardo F, Boniello R, Marianetti T, Cervelli D, Gasparini G, Pelo S. Autofluorescence and Early Detection of Mucosal Lesions in Patients at Risk for Oral Cancer. Journal of Craniofacial Surgery, 2010;21(6):1899-1903, DOI: 10.1097/SCS.0b013e3181f4afb4, PMID: 21119451
28. Koch FP, Kaemmerer PW, Biesterfeld S, Kunkel M, Wagner W. Effectiveness of autofluorescence to identify suspicious oral lesions - a prospective, blinded clinical trial. Clin Oral Investig 2011;15:975-82.
How to Cite
NIKOLOVSKI, Bruno et al. TISSUE FLUORESCENCE IMAGING FOR QUICK NON-INVASIVE DIAGNOSIS IN ORAL AND MAXILLOFACIAL SURGERY. Journal of Morphological Sciences, [S.l.], v. 4, n. 3, p. 1-13, dec. 2021. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/264>. Date accessed: 21 jan. 2022.