From the Guidelines
Early biomarkers for oral cancer detection before invasive stages include protein biomarkers such as CSTB, NDRG1, LTA4H, PGK1, COL6A1, and ITGAV, which have been identified as good predictors of disease outcomes. From a pathology perspective, identification begins with careful examination of potentially malignant disorders like leukoplakia, erythroplakia, and oral submucous fibrosis. Histopathological assessment remains the gold standard, revealing cellular atypia, nuclear pleomorphism, and altered nuclear-cytoplasmic ratios. Molecular techniques have enhanced detection capabilities, with salivary biomarkers offering particular promise as non-invasive screening tools.
- Key biomarkers include:
- CSTB
- NDRG1
- LTA4H
- PGK1
- COL6A1
- ITGAV These biomarkers were identified in a study published in Nature Protocols in 2021 1, which used proteomics and immunohistochemistry to analyze tissue samples from patients with oral cancer. The study found that the expression of these proteins alone or in combination is a good predictor of disease outcomes and could lead to potential diagnostic assays. Regular oral examinations by dental professionals, particularly for high-risk individuals (tobacco users, alcohol consumers), remain crucial for early detection, as these biomarkers are most valuable when incorporated into systematic screening protocols that can identify malignant transformation at its earliest stages.
- The importance of early detection is highlighted by the fact that oral cancer has a high mortality rate if left untreated, and that treatment outcomes are significantly improved when the disease is detected at an early stage.
- Therefore, the use of these biomarkers in combination with regular oral examinations and histopathological assessment can help to improve the early detection and treatment of oral cancer, ultimately reducing morbidity and mortality.
From the Research
Early Biomarkers for Oral Cancer
The early detection of oral cancer is crucial for improving survival rates and quality of life for patients. From a pathological perspective, several biomarkers have been identified as potential indicators of oral cancer before it becomes invasive. These include:
- CCND1 from the tumor 2
- Human papillomavirus, HSP70, and IL-17 from the peripheral blood 2
- High density of CD45RO+ tumor-infiltrating lymphocytes 2
- Salivary biomarkers such as CYFRA 21-1, CA 19-9, lactate dehydrogenase (LDH), total proteins, and amylase 3, 4
Salivary Biomarkers
Saliva has gained interest as an alternative biofluid for non-invasive diagnostics, and several salivary biomarkers have been proposed for oral cancer detection. These include:
- CYFRA 21-1 3, 4
- CA 19-9 3, 4
- Lactate dehydrogenase (LDH) 3, 4
- Total proteins 3, 4
- Amylase 3, 4 These biomarkers can be detected using various sensing technologies, including biosensors and point-of-care devices 5, 3
Point-of-Care Detection
Point-of-care (POC) devices have emerged as non- or minimally invasive tools for the diagnosis of oral cancer at an early stage. Various POC platforms have been developed for the detection of oral cancer biomarkers, including optical imaging methods and cytological adjuncts 5. These devices have the potential to improve diagnostic accuracy and reduce patient discomfort, especially in resource-limited settings 5