Researchers from Queen Mary, University of London have
developed a new gene test that can detect pre-cancerous cells in patients with
benign-looking mouth lesions. The test could potentially allow at-risk patients
to receive earlier treatment, significantly improving their chance of survival.
The study, published online in the International Journal of
Cancer, showed that the quantitative Malignancy Index Diagnostic System (qMIDS)
test had a cancer detection rate of 91-94 per cent when used on more than 350
head and neck tissue specimens from 299 patients in the UK and Norway. Mouth
cancer affects more than 6,200 people in the UK each year and more than half a
million people worldwide, with global figures estimated to rise above one
million a year by 2030*. The majority of cases are caused by either smoking or
chewing tobacco and drinking alcohol.
Mouth lesions are very common and only five to 30 per cent
may turn into cancers. If detected in the early stages treatment can be
curative, but until now no test has been able to accurately detect which
lesions will become cancerous.
The current diagnostic gold standard is histopathology -
where biopsy tissue taken during an operation is examined under a microscope by
a pathologist . This is a relatively invasive procedure and many mouth cancers
are being diagnosed at later stages when the chances of survival are
significantly reduced. For patients presenting with advanced disease, survival
rates are poor (10-30 per cent at five years).
Lead investigator and inventor of the test Dr Muy-Teck Teh,
from the Institute of Dentistry at Queen Mary, University of London, said:
"A sensitive test capable of quantifying a patient's cancer risk is needed
to avoid the adoption of a 'wait-and-see' intervention. Detecting cancer early,
coupled with appropriate treatment can significantly improve patient outcomes,
reduce mortality and alleviate long-term public healthcare costs."
The qMIDS test measures the levels of 16 genes which are
converted, via a diagnostic algorithm, into a "malignancy index"
which quantifies the risk of the lesion becoming cancerous. It is less invasive
than the standard histopathology methods as it requires only a 1-2 mm piece of
tissue (less than half a grain of rice), and it takes less than three hours to
get the results, compared to up to a week for standard histopathology.
Consultant oral and maxillofacial surgeon, Professor Iain
Hutchison, founder of Saving Faces and co-author on the study, said: "We
are excited about this new test as it will allow us to release patients with
harmless lesions from regular follow-up and unnecessary anxiety, whilst
identifying high-risk patients at an early stage and giving them appropriate
treatment. Mouth cancer, if detected early when the disease is most receptive
to surgical treatment, has a very high cure rate."
Dr Catherine Harwood, a consultant dermatologist and a
co-author on the study, said: "Our preliminary studies have shown
promising results indicating that the test can potentially also be used for
identifying patients with suspicious skin or vulva lesions, offering the
opportunity of earlier and less invasive treatments."
Whilst this proof-of-concept study validates qMIDS as a
diagnostic test for early cancer detection, further clinical trials are
required to evaluate the long-term clinical benefits of the test for mouth
cancers.
With further development it could potentially be applied to
other cancer types as the test is based on a cancer gene - FOXM1 - which is
highly expressed in many cancer types. In this study the researchers used the
qMIDS test to detect early cancer cells in vulva and skin specimens with
promising results.
Article from: Medical News Today
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