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

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

2023-11-21 08:17:49

by Vera Martinella

Samples were collected with a toothbrush and then analyzed in the laboratory. The test (quick, simple and precise) can predict who is at risk of developing both oral cancer and its precursor, severe dysplasia. Also useful for checks on sick people

Approximately 4 thousand Italians are diagnosed with oral cavity cancer every year 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 are lower. An important step forward comes from scientific research: a simple saliva test could revolutionize early diagnosis and identify lesions, both pre-cancerous and cancerous, promptly and with absolute 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 can be the manifestation of pre-cancerous or tumorous lesions and often a visit to the GP or dentist is enough to identify suspicious signs and start the necessary investigations. Understanding if something is wrong is quite simple because they are clearly visible disorders, but too many people still overlook 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 those interested refuse or 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. Materially, the exam is carried out by passing a special toothbrush equipped with bristles over the suspected area, thus taking 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 genes, which have been discovered to be altered in oral carcinomas, and allows for the 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 & Necka sensitivity of 97% and a specificity of 88% were achieved, i.e. it has a high ability to recognize both false negatives and false positives.

Who risks more

Cases of oropharyngeal cancer 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 identifying recurrences, 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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November 21, 2023 (modified November 21, 2023 | 07:17)

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