The diagnostic kit, created and patented by Guy Adami and Joel Schwartz of the UIC College of Dentistry, uses a small brush to collect cells from potentially cancerous lesions inside the mouth. The sample is then analysed for genetic signals of oral squamous cell carcinoma, the ninth most prevalent cancer globally.
This new screening method, which is currently seeking commercialisation partnerships, improves upon the current diagnostic standard of surgical biopsies — an extra referral step that risks losing patients who sometimes don’t return until the cancer progresses to more advanced, hard-to-treat stages.
Guy, associate professor of oral medicine and diagnostic sciences, said, “So many patients get lost; they don’t follow up. We’ve tried to keep our focus mainly on early Stage 1 and 2 cancers, so it actually works with the cancers that you want to detect.”
The detection system works by looking for small segments of genetic material called microRNA that regulate the expression of genes. Research conducted by Guy and Joel found an expression signature of 40 microRNA sequences that can distinguish between a tumour and normal tissue with over 90 per cent accuracy.
Importantly, their test also worked using epithelial cells, the outermost layer of cells in a patient’s mouth. These cells can be easily collected in less than a minute of gentle brushing — no numbing required — by a dentist or nurse, who then places the brush in a tube of solution and sends it to a lab for microRNA analysis. Results can be returned to the clinic in days with the current version of the diagnostic test.
“We were the first to observe that brush biopsy samples actually work quite well when you use microRNA,” Guy said. “All you need is a good light and the brushes.”
In addition to the convenience of the collection method, the authors said that brush biopsy also provides several other advantages. Surgical biopsies often collect a mixture of cell types, making subsequent analysis more complicated and risk spreading cancerous cells to other areas of the mouth. Unlike blood tests that survey generally for genetic signals of cancer, the brush method only collects cells from a single site where treatment can be focused if a malignancy is detected.
Joel, professor of oral medicine and diagnostic sciences, said, “If you compare what we do, which is site-specific targeting of tissue, to the other tests out there, they don’t have a targeting of where the tumours actually are. That makes it harder to start treatment rapidly after detection.”
The inventors hope that the test will make screening easier to perform, particularly in patients who don’t receive regular dental care or have a higher incidence of oral squamous cell carcinoma. Usage of the invention in nonclinical settings would allow earlier cancer detection in high-risk populations.
The technology may also eventually be useful in diagnosing other oral diseases through their own unique microRNA signatures, the authors said.
“There are 600 different diseases that occur in the mouth, and a number of these have already been characterised with microRNAs,” Joel said. “We could use the same approach and really have a profound impact on these kinds of disease.”