2023-11-08 00:07:00
Professors Castaldi-Abbati of San Raffaele: “We are convinced that this revolutionary technology can help us win this challenge”
A simple one test SALIVARY could revolutionize the early diagnosis of oral cancer, not only identifying them promptly but also with absolute precision. The discovery is the result of research conducted by Studium Geneticsspin-off dell’Alma Mater of Studies – University of Bolognawho chose IRCCS San Raffaele Hospital from Milan (San Donato Group) as a partner to introduce the new methodology into clinical practice and research.
I study
The new test epigenetico is based on the quantitative analysis of the DNA methylation level of 13 genes, which were found to be altered in oral carcinomasand allows you to identify patients early at risk of developing oral squamous cell carcinoma (OSCC) and its precursor, severe dysplasia. It’s about 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 & Neck, a sensitivity of 97% and a specificity of 88% were achieved.
In the current clinical practiceoral cancer screening is performed exclusively through visual inspection by specialists which, in the presence of suspicious lesions, invite patients to undergo a biopsy, which is essential to formulate a correct diagnosis. However, the same patient often refuses to undergo an invasive test such as a biopsy, thus allowing any disease to progress. Furthermore, OSCC is a condition that is not always easily identifiable, especially if it is precancerous in nature.
The new test
Il test developed by Studium Geneticswhich could revolutionize the diagnostics and treatment paradigm of this type of tumor, is quick and simple to perform: once the suspicious lesion has been identified, samples are collected from the oral mucosa (tongue, cheek, palate) by simply passing a special toothbrush equipped with bristles. The sample is collected in a test tube and inserted into a storage solution that keeps it at room temperature, ensuring its stability over time and facilitating transport. The sample is then processed in reference laboratories using sequencing protocols and bioinformatics analysis, quantifying the level of DNA methylation in the 13 genes associated with the disease. A calculation is then performed which, using a patented algorithm, generates a risk score for developing oral cancer.
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Oral carcinoma
Oral squamous cell carcinoma is one important challenge for public healthwith beyond 745,000 almost reported worldwide and a mortality rateat 5 years old, of about 60%. Additionally, the risk of recurrence after surgery, which ranges from 17% to 30%, is higher than any other type of cancer and is the leading cause of death.
There are four stages of OSCC, from I to IV, which indicate its growing severity.
“Stages I and II of oral squamous cell carcinoma normally have good survival compared to stages III and IV, which have a high recurrence rate and 50% mortality within five years. Unfortunately, 2/3 of cases are diagnosed at stage III and IV in an advanced stage, where demolitive and reconstructive surgery can have a very 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 quality of life. of the patient. We are convinced that this revolutionary technology can help us overcome this challenge”, declared the professor Giorgio Gastaldiresponsible for maxillofacial prosthetic rehabilitation in cancer patients together with professor Silvio Abati responsible for Oral Medicine and Pathology, both professors at the Vita Salute San Raffaele University belonging to the Department of Dentistry of the IRCCS San Raffaele Hospital directed by Prof. Enrico Gherlone.
“The partnership between our university, its spin-off Studium Genetics and the IRCCS San Raffaele Hospital, one of the reference centers in the diagnosis and treatment of oral cancer, strengthens our bet on the identification of epigenetic modifications of DNA methylation, as a new frontier of modern oncology medicine. We are certain that we have provided a fundamental tool to patients suffering from oral cancer, giving them new concrete hope. The future prospect is to extend the collaboration to the Vita-Salute San Raffaele University, an institution of excellence in research on oral cavity pathologies” concludes the professor Luca Morandiassociate of the Department of Biomedical and Neuromotor Sciences of the Alma Mater Studiorum-University of Bologna, test developerwhich is operating in Europe and being approved in the United States, China and Brazil.
The test is particularly useful for people of aged over 40, who consume alcohol or smoke regularly, patients who have leukoplakia, erythroplakia, oral lichen planus or any suspicious oral lesion. Finally, the test represents an indispensable tool in the follow-up of patients previously treated for OSCC, as it is useful for identifying relapses, which are very frequent and increase the risk of death of these patients. In any case, the indication for the actual use of this approach is left exclusively to the evaluation of the specialist.
Oral cancers do not just involve a cost social relevantbut they also represent a huge healthcare expenditure item – between hospitalization, intervention and rehabilitation – which, thanks to the introduction of this test for early diagnosis, it could be greatly scaled down.
Read also: Tumors, prevention (also) depends on oral health
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