Narrow-Band Imaging: A Useful Tool to Early Recognize Oral Lichen Planus Malignant Transformation. A Pilot Study

Abstract

Background: Oral Lichen Planus (OLP) lesions have an overall malignant transformation rate of 1.37%. The diagnosis of malignancy is made by means of a histopathological examination, executed on the basis of a clinical suspicion. Narrow Band Imaging (NBI), a promising endoscopic technique, uses a filtered light with specific wavelengths to highlight microvascular abnormalities associated with subclinical neoplastic changes of the upper aerodigestive tract epithelium. Objective: The study aims to analyze the value of NBI in selecting which patients need to undergo a biopsy before the emergence of clinical changes, allowing early detection of oral malignancies arising from OLP. Methods: A prospective study was conducted enrolling thirty-two consecutive patients with a histological diagnosis of OLP, no previous diagnosis of oral cancer, no other oral inflammatory diseases. Patients with suspicious NBI lesions underwent biopsies; other patients were included in follow-up. Results: Two patients were judged positive at NBI-evaluation; they were both histologically diagnosed of neoplastic lesions. None of the other patients developed clinical features of malignancies during follow-up. Limitations: Patients with negative NBI-evaluation did not undergo biopsies. Conclusion: NBI evaluation could both increase the accuracy of detecting subclinical neoplastic transformation in OLP lesions and help clinicians perform biopsies only in selected cases.