Mouth tumors, a saliva test also discovers pre-cancerous lesions – WWN

Are approximately 4 thousand Italians who every year receive the diagnosis of oral cavity cancer and often, unfortunately, the disease is already in an advanced stage when therapies must be more invasive (with great inconvenience, given the crucial and delicate area affected by the neoplasm) and the chances of recovery they are minor. From scientific research comes an important step forward: a simple saliva test it could revolutionize early diagnosis and identify lesions, both pre-cancerous and cancerous, promptly and absolutely precision.

Watch out for these symptoms

The oral cavity includes the tongue, gums, cheeks, floor (i.e. the bottom) of the mouth, palate and lips. Swellings and growths, white or reddish lesions, and wounds that do not heal spontaneously may be the manifestation of pre-tumor or tumor lesions and often a visit to the general practitioner or dentist is enough to identify suspicious signs and begin the necessary investigations. Understanding if something is wrong is quite simple because it is clearly visible disorders, but too many people still neglect them. In current clinical practice, if specialists notice suspicious lesions during visual inspection, they invite patients to undergo a biopsy, which is essential to formulate a correct diagnosis, explains Silvio Abati, head of Oral Medicine and Pathology at the Vita Salute San Raffaele University in Milan . Not infrequently for those interested they refuse or they waste a lot of time, also for fear of an invasive test, thus allowing a possible neoplasm to progress. Without considering that oral squamous cell carcinoma is a condition that is not always easily identifiable, especially if it is precancerous in nature, adds Abati.

The new toothbrush test

This is why it is so important to have a simpler diagnostic tool, such as the test resulting from research conducted by Studium Genetics, a spin-off of the Alma Mater Studiorum – University of Bologna, which after the first years of studies chose the IRCCS San Raffaele Hospital in Milan as a partner to introduce the new methodology into the routine of clinical practice and in the field of research. Physically, the exam is carried out by passing a special toothbrush equipped with bristles over the suspected area, thus taking samples samples from the oral mucosa (tongue, cheek, palate) which are then analyzed in reference laboratories using sequencing protocols and bioinformatic analyses. The new epigenetic test is based on the quantitative analysis of the level of DNA methylation of 13 geneswhich has been found to be altered in oral carcinomas, and allows for early identification of both patients at risk of developing oral squamous cell carcinoma and its precursor, severe dysplasia — clarifies Luca Morandi, associate of the Department of Biomedical and Neuromotor Sciences of the Alma Mater Studiorum-University of Bologna, developer of the test —. A calculation is performed on the sample taken from the patient which, using a patented algorithm, generates a risk score for developing oral cancer. a non-invasive technique capable of providing diagnostic, prognostic and follow-up information, with a high degree of precision: in a multicenter study, published in the journal Head & Neckone has been reached sensitivity of 97% it’s a specificity equal to 88%that is, it has a high ability to recognize both false negatives and false positives.

Who risks more

The cases of Oropharynx carcinomas have increased by 300% in the last 30 years. The main risk factors are alcohol and tobacco, which cause approximately 75% of cases; People who use both run exponentially higher risks. Also not to be underestimated is the Papillomavirus (HPV), responsible for a growing number of cases. The test can prove particularly useful for those most at risk of getting ill: people over the age of 40, who consume alcohol or smoke regularly, patients with leukoplakia, erythroplakia, oral lichen planus or any suspicious oral lesion – adds Morandi -. It is an important tool in the control examinations of patients previously treated for oral cancer, as it is useful for the identification of relapses, which are very frequent and increase the risk of death of these patients. The initial stages (I and II) of oral squamous cell carcinoma normally have good survival compared to the advanced stages (III and IV), which have a high rate of recurrence and a mortality of 50% within five years – concludes Giorgio Gastaldi, responsible for maxillofacial prosthetic rehabilitation in cancer patients at San Raffaele in Milan. Unfortunately, two thirds of tumors are diagnosed at an advanced stage, where demolitive and reconstructive surgery can have a very strong impact on the anatomy, functionality, but also on the psyche of the patient himself. The real challenge today is to be able to be very early in the diagnosis: the sooner we manage to intercept the tumor in the initial phase, the more the prognosis will not only be positive, but it will be possible to intervene in a less invasive way, without compromising the patient’s quality of life. patient.

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