Research team discovers new method to test for oral cancer

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US researchers have discovered a non-invasive, low-cost test to detect oral cancer, monitor precancerous lesions and determine when a biopsy is warranted.

The findings of the research team led by a clinician scientist at the Case Western Reserve University School of Dental Medicine—and published in Cell Reports Medicine—are based on a scoring system linked to the levels of two proteins in cells brushed from suspicious oral lesions of patients at dental clinics or the ear, nose and throat department at University Hospitals (UH).

One of the proteins (human beta defensin 3 or hBD-3) is expressed at high levels in early-stage oral cancer, while the second (hBD-2) is low or unchanged.

The ratio of hBD-3 to hBD-2 in the lesion site—over the ratio of the two proteins on the opposite, normal site—generates a score, called the beta defensin index (BDI).

A score above a predetermined threshold implies cancer; anything below does not. Determining the levels of the proteins and quantifying the BDI is done routinely in a lab.

The BDI was independently validated using identical protocols at CWRU/UH, University of Cincinnati Medical Center and West Virginia University School of Dentistry.

“When we first discovered hBD-3, we saw it acted as a ‘good guy’, involved in wound-healing and killing microbes,” lead researcher Dr Aaron Weinberg said. 

“When we found it was regulated the same way certain cells grow uncontrollably, we started studying hBD-3 in the context of oral cancer. Imagine our surprise when this Dr Jekyll turned out to be Mr Hyde.

“We found it was not only promoting tumor growth but was overexpressed in the early stages of the disease, while another member, hBD-2, wasn’t changing. This difference in levels of expression of the two proteins compared to the opposite side in the same patient led us to examine the BDI’s ability to distinguish cancer from benign lesions.”

The study’s lab-based approach, which is now patented, can reduce biopsies in primary care clinics by 95 per cent because it can tell clinicians who actually needs a biopsy.

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