RESUMO
Serum Raman spectroscopy (RS) has previously shown potential in oral cancer diagnosis and recurrence prediction. To evaluate the potential of serum RS in oral cancer screening, premalignant and cancer-specific detection was explored in the present study using 328 subjects belonging to healthy controls, premalignant, disease controls, and oral cancer groups. Spectra were acquired using a Raman microprobe. Spectral findings suggest changes in amino acids, lipids, protein, DNA, and ß-carotene across the groups. A patient-wise approach was employed for data analysis using principal component linear discriminant analysis. In the first step, the classification among premalignant, disease control (nonoral cancer), oral cancer, and normal samples was evaluated in binary classification models. Thereafter, two screening-friendly classification approaches were explored to further evaluate the clinical utility of serum RS: a single four-group model and normal versus abnormal followed by determining the type of abnormality model. Results demonstrate the feasibility of premalignant and specific cancer detection. The normal versus abnormal model yields better sensitivity and specificity rates of 64 and 80%; these rates are comparable to standard screening approaches. Prospectively, as the current screening procedure of visual inspection is useful mainly for high-risk populations, serum RS may serve as a useful adjunct for early and specific detection of oral precancers and cancer.
Assuntos
Biomarcadores Tumorais/sangue , Diagnóstico por Computador/métodos , Detecção Precoce de Câncer/métodos , Neoplasias Bucais/sangue , Neoplasias Bucais/diagnóstico , Análise Espectral Raman/métodos , Algoritmos , Interpretação Estatística de Dados , Humanos , Reconhecimento Automatizado de Padrão/métodos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Radicular cysts are the most common cystic lesions of the jaw. Most of these lesions involve the apex of the offending tooth and appear as well-defined periapical radiolucencies. This case presents an unusually large multilocular radicular cyst crossing the midline and involving almost the entire body of the mandible. The clinical and radiographic appearance mimicked an aggressive cyst or benign tumor. The lesion was surgically excised, and the teeth were endodontically treated without any postoperative complications.