Abstract

Oral and Oropharyngeal Cancer Detection is Spitting Distance Away

Chamindie Punyadeera, Associate Professor/Head/Saliva Translational Research Group, Queensland University of Technology

Oral (OC) and oropharyngeal cancers (OPC) are significantly fatal; only approximately 50% of patients survive to 5 years. Surgery and chemoradiotherapy can leave survivors with pain, disfigurement and disability that further add to the burden of the disease [1 2,3]. Unfortunately, more than half of these cancers are only diagnosed at an advanced stage [4], at which stage their 5-year survival rate plummets. Therefore, there is an urgent need for a reliable early diagnostic method. Current diagnosis is usually made after clinical presentation based on symptoms from the primary cancer and/or when metastatic cervical lymph nodes become obvious. Diagnosis involves biopsy identification of Human Papilloma Virus (HPV) status and histological classification. These diagnostic methods are subjective and become problematic when tumours are too small to be visualised or they are cryptic. These issues commonly result in misdiagnosis.
The direct contact between saliva and OC and OPC lesions make the measurement of tumour markers in saliva an attractive alternative to serum and tumour tissue testing [4]. We have successfully quantified 9 miRNAs (miRNA-9, -127, -134, -191, -196a, -196b, -210, -222 and -455) at elevated levels in saliva from patients compared with saliva from healthy controls. This panel was also able to discriminate between OC and OPC patients. Saliva from late stage cancer patients showed 5-10 fold-upregulation in miRNA-9 and -191 and 2-fold upregulation in miRNA-222 compared with saliva from healthy controls. Further, elevated levels of DNA methylation (p<0.05, RASSF1a, p16, DAPK1, PCQAP and TIMP-3) was found in saliva from patients compared with saliva from healthy controls. Early detection will enable early targeted therapy thereby improving survival rates and improve quality of life for these patients.
References:
1. Adam A, Kenny LM. Interventional oncology in multidisciplinary cancer treatment in the 21st century. Nature reviews Clinical