Optical biopsy systems for the diagnosis and monitoring of superficial cancer and precancer

Histopathology is the gold standard in the diagnosis of cancer and dysplasi a, Screening for the disease in high-risk populations(6,15) and choosing th e correct site for biopsy have implications for the choice of follow-up int ervals and therapy. SULLY & FIELD12 suggest that molecular genetic analysis , such as the polymerase chain reaction, for detecting progressive loss of heterozygosity, may be a more accurate predictor of the clinical course of oral cancer. This technique is now semi-automated and compares favourably w ith the time taken for histopathology (commonly 1-2 weeks). Recent developm ents suggest that the fluorescent and spectroscopic features may distinguis h diseased from healthy tissue, and below follows an introduction for the c linician to this fascinating and complex field. It is possible to obtain a diagnosis in real-time and, with the appropriate use of photochemicals and image enhancement, it may be possible to treat and monitor the effects of t reatment in real-time.