Today a variety of oral precancers are rather successfully evaluated and managed as a routine facet of oral health care, despite residual or ongoing controversies of some significance. Ironically, one of the major advances in this field has been the simple recognition that a premalignancy is not guaranteed to eventually transform into cancer. Most, in fact, do so in only a small proportion of cases and a premalignant (precancerous) lesion is now defined as an identifiable, benign tissue or cellular alteration associated with a greater than normal risk of malignant transformation or "degeneration." Much of contemporary oral oncology research is focused on the identification of clinical, histopathologic and molecular biological parameters of oral precancers and early cancers which might aid in the recognition of those lesions with the highest risk of transformation.. Because of the potentially fatal consequences of mistakes relating to premalignant lesions, this work is extremely important, but the state of the art at present leaves much to be desired.
The gentle touch of a lesion on the tongue or cheek with a brush can help detect oral cancer with success rates comparable to more invasive techniques, according to preliminary studies by researchers at Rice University, the University of Texas Health Science Centers at Houston and San Antonio and the University of Texas M.D. Anderson Cancer Center.
The test that uses Rice's diagnostic nano-bio-chip was found to be 97 percent "sensitive" and 93 percent specific in detecting which patients had malignant or premalignant lesions, results that compared well with traditional tests.
The study appeared online in the journal Cancer Prevention Research.
"One of the key discoveries in this paper is to show that the miniaturized, noninvasive approach produces about the same result as the pathologists do," said John McDevitt, the Brown-Wiess Professor of Chemistry and Bioengineering at Rice. His lab developed the novel nano-bio-chip technology at the university's BioScience Research Collaborative.
Oral cancer afflicts more than 300,000 people a year, including 35,000 in the United States alone. The five-year survival rate is 60 percent, but if cancer is detected early, that rate rises to 90 percent.
McDevitt and his team are working to create an inexpensive chip that can differentiate premalignancies from the 95 percent of lesions that will not become cancerous.
The minimally invasive technique would deliver results in 15 minutes instead of several days, as lab-based diagnostics do now; and instead of an invasive, painful biopsy, this new procedure requires just a light brush of the lesion on the cheek or tongue with an instrument that looks like a
electric toothbrush.
