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Ahire MS, Nagar SR, D’souza ZI, Tupkari JV, Dalvi SM. Expression of Minichromosome Maintenance Protein 2 (MCM2) in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma: A Systematic Review. Indian J Otolaryngol Head Neck Surg 2023; 75:183-192. [PMID: 37007886 PMCID: PMC10050670 DOI: 10.1007/s12070-022-03296-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 11/21/2022] [Indexed: 12/31/2022] Open
Abstract
The histopathological investigations of oral lesions are a basic approach for diagnosing ongoing cancer or pre-cancer associated pathological attributes in the dissected biopsy. The early detection and management of potentially malignant disorders of the lip and oral cavity that require intervention may reduce malignant transformations, or in case any malignancy is detected during surveillance, the appropriate treatment may improve survival rates. This would guide the clinicians to decide the appropriate treatment modality or lesion to achieve a more favorable prognosis. MCM2 protein is involved in DNA replication providing additional information about the prognosis of neoplasms. Some authors have pointed out that MCM proteins have been inversely correlated with salivary tumour differentiation and therefore could be an indicator of proliferation potential. Therefore, it is essential to find the expression of the MCM2 gene in oral leukoplakia and oral squamous cell carcinoma. Electronic databases like Ebscohost, Livivo, Google Scholar and PubMed were searched. Based on the inclusion and exclusion criteria, 2 reviewers (MS and SN) independently selected the relevant articles. Any disagreement was discussed until a consensus was reached. We used the QUADAS-2 tool to assess the quality of the included studies over four key domains: patient selection, index test, reference standard and flow and timing of participants through the study. 10 out of 57 titles were found to meet the eligibility criteria. Biopsied tissue with immunohistochemical staining or advanced diagnostic studies were included. A total of 901 samples were included in the study and different groups were normal oral mucosa (NOM), oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). MCM2 proteins are useful diagnostic markers for distinguishing malignant from benign epithelial dysplasia and for early detection and diagnosis of OSCC as an adjunct to clinicopathological parameters. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03296-7.
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Affiliation(s)
- Manisha S. Ahire
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, PD’Mello Road, St.George Hospital Campus, Near Chatrapati Shivaji Terminus, Mumbai, Maharashtra 400001 India
| | - Saurabh R. Nagar
- Department of Pathology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute, Mumbai, 400012 India
| | - Zaneta Ivy D’souza
- Department of Oral Pathology & Microbiology, Nair Hospital Dental College, Dr. A.L.Nair Road, Mumbai Central, Mumbai, 400008 India
| | - J. V. Tupkari
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, PD’Mello Road, St.George Hospital Campus, Near Chatrapati Shivaji Terminus, Mumbai, Maharashtra 400001 India
| | - Shubhangi M. Dalvi
- Department of Biochemistry, Grant Government Dental College & Hospital, JJ Marg, Nagpada, Byculla, Mumbai, Maharashtra 400008 India
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Molecular Signatures of Tumour and Its Microenvironment for Precise Quantitative Diagnosis of Oral Squamous Cell Carcinoma: An International Multi-Cohort Diagnostic Validation Study. Cancers (Basel) 2022; 14:cancers14061389. [PMID: 35326543 PMCID: PMC8945999 DOI: 10.3390/cancers14061389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Heterogeneity in oral potentially malignant disorder (OPMD) poses a problem for accurate prognosis that impacts on treatment strategy and patient outcome. A holistic assessment based on gene expression signatures from both the tumour cells and their microenvironment is necessary to provide a more precise prognostic assessment than just tumour cell signatures alone. METHODS We reformulated our previously established multigene qPCR test, quantitative Malignancy Index Diagnostic System (qMIDS) with new genes involved in matrix/stroma and immune modulation of the tumour microenvironment. An algorithm calculates and converts a panel of 16 gene mRNA expression levels into a qMIDS index to quantify risk of malignancy for each sample. RESULTS The new qMIDSV2 assay was validated in a UK oral squamous cell carcinoma (OSCC) cohort (n = 282) of margin and tumour core samples demonstrating significantly better diagnostic performance (AUC = 0.945) compared to previous qMIDSV1 (AUC = 0.759). Performance of qMIDSV2 were independently validated in Chinese (n = 35; AUC = 0.928) and Indian (n = 95; AUC = 0.932) OSCC cohorts. Further, 5-year retrospective analysis on an Indian dysplastic lesion cohort (n = 30) showed that qMIDSV2 was able to significantly differentiate between lesions without transformation and those with malignant transformation. CONCLUSIONS This study validated a novel multi-gene qPCR test on a total of 535 tissue specimens from UK, China and India, demonstrating a rapid minimally invasive method that has a potential application for dysplasia risk stratification. Further study is required to establish if qMIDSV2 could be used to improve OPMD patient management, guide treatment strategy and reduce oral cancer burden.
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Human Papillomaviruses-Associated Cancers: An Update of Current Knowledge. Viruses 2021; 13:v13112234. [PMID: 34835040 PMCID: PMC8623401 DOI: 10.3390/v13112234] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/21/2022] Open
Abstract
Human papillomaviruses (HPVs), which are small, double-stranded, circular DNA viruses infecting human epithelial cells, are associated with various benign and malignant lesions of mucosa and skin. Intensive research on the oncogenic potential of HPVs started in the 1970s and spread across Europe, including Croatia, and worldwide. Nowadays, the causative role of a subset of oncogenic or high-risk (HR) HPV types, led by HPV-16 and HPV-18, of different anogenital and head and neck cancers is well accepted. Two major viral oncoproteins, E6 and E7, are directly involved in the development of HPV-related malignancies by targeting synergistically various cellular pathways involved in the regulation of cell cycle control, apoptosis, and cell polarity control networks as well as host immune response. This review is aimed at describing the key elements in HPV-related carcinogenesis and the advances in cancer prevention with reference to past and on-going research in Croatia.
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Güzel C, van Sten-Van't Hoff J, de Kok IMCM, Govorukhina NI, Boychenko A, Luider TM, Bischoff R. Molecular markers for cervical cancer screening. Expert Rev Proteomics 2021; 18:675-691. [PMID: 34551656 DOI: 10.1080/14789450.2021.1980387] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Cervical cancer remains a significant healthcare problem, notably in low- to middle-income countries. While a negative test for hrHPV has a predictive value of more than 99.5%, its positive predictive value is less than 10% for CIN2+ stages. This makes the use of a so-called triage test indispensable for population-based screening to avoid referring women, that are ultimately at low risk of developing cervical cancer, to a gynecologist. This review will give an overview of tests that are based on epigenetic marker panels and protein markers. AREAS COVERED There is a medical need for molecular markers with a better predictive value to discriminate hrHPV-positive women that are at risk of developing cervical cancer from those that are not. Areas covered are epigenetic and protein markers as well as health economic considerations in view of the fact that most cases of cervical cancer arise in low-to-middle-income countries. EXPERT OPINION While there are biomarker assays based on changes at the nucleic acid (DNA methylation patterns, miRNAs) and at the protein level, they are not widely used in population screening. Combining nucleic acid-based and protein-based tests could improve the overall specificity for discriminating CIN2+ lesions that carry a low risk of progressing to cervical cancer within the screening interval from those that carry an elevated risk. The challenge is to reduce unnecessary referrals without an undesired increase in false-negative diagnoses resulting in cases of cervical cancer that could have been prevented. A further challenge is to develop tests for low-and middle-income countries, which is critical to reduce the worldwide burden of cervical cancer.
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Affiliation(s)
- Coşkun Güzel
- Erasmus MC, Department of Neurology, University of Groningen, Rotterdam, The Netherlands
| | | | | | - Natalia I Govorukhina
- Department of Analytical Biochemistry, University of Groningen, Groningen, The Netherlands
| | | | - Theo M Luider
- Erasmus MC, Department of Neurology, University of Groningen, Rotterdam, The Netherlands
| | - Rainer Bischoff
- Department of Analytical Biochemistry, University of Groningen, Groningen, The Netherlands
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Alsabbagh A, Robins TL, Harriman A, Jackson-Boeters L, Darling MR, Khan ZA, McCord C. Surrogate markers for high-risk human papillomavirus infection in oral epithelial dysplasia: A comparison of p16, Ki-67, and ProExC. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:246-259.e1. [PMID: 31902664 DOI: 10.1016/j.oooo.2019.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/28/2019] [Accepted: 09/29/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The aim of this study was to determine the utility of surrogate markers of human papillomavirus (HPV) infection in the diagnosis of HPV-associated oral epithelial dysplasia (OED). STUDY DESIGN Twelve cases of oral dysplasia with histologic features of HPV infection were stained with surrogate markers for HPV (p16, Ki-67, and ProExC) on immunohistochemistry. A second group of 12 cases of oral dysplasia without histologic features of HPV infection was used for comparison. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to confirm the presence of high-risk HPV (HR HPV) in p16-positive cases. RESULTS All of the surrogate markers showed a statistically significant association with HPV-positive OED (P < .001). The agreement between p16 and HPV positivity was the strongest (κ = 1.00), whereas Ki-67 showed very good association with HPV (κ = 0.83), and ProExC showed good association (κ = 0.75). In each case, the agreement was statistically significant (P < .001). Overall, each of the 3 markers showed good sensitivity; however, ProExC showed the lowest specificity. CONCLUSIONS The clinicopathologic features of 12 cases of HPV OED are reported. Diffuse p16 positivity is an accurate and reliable method for predicting HR HPV infection in both high and low grade cases of epithelial dysplasia with histopathologic features of HPV OED. The use of Ki-67 and ProExC did not demonstrate any additional diagnostic benefit in the diagnosis HPV OED.
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Affiliation(s)
- Amr Alsabbagh
- Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Terry L Robins
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Ariel Harriman
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Linda Jackson-Boeters
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Mark R Darling
- Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Zia A Khan
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Christina McCord
- Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada.
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Güneri P, Epstein JB. Why are we still unable to accurately determine the malignant potential or the behavior of oral mucosal lesions? Oral Oncol 2017; 71:177-179. [PMID: 28456478 DOI: 10.1016/j.oraloncology.2017.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/12/2017] [Accepted: 04/19/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Pelin Güneri
- Ege University School of Dentistry, Department of Oral and Maxillofacial Radiology, Bornova 35100, Izmir, Turkey.
| | - Joel B Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Division of Otolaryngology and Head and Neck Surgery City of Hope National Medical Center, Duarte CA, 8500 Whilshire Blvd, Suite 800, Beverly Hills, CA 90211, USA
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