Early Diagnosis and Diagnostic Delay in Oral Cancer

Comet assay as a suitable biomarker for in vivo oral carcinogenesis: a systematic review

BACKGROUND AND OBJECTIVES

In order to detect genetic damage, different methods have been developed, such as micronuclei and comet assay. The comet assay presents some advantages when compared to the other aforementioned methods, including wide versatility, as any eukaryotic cell can be evaluated at an individual cellular level. In this context, the aim of this systematic review was designed to help further elucidate the following question: is the comet assay a suitable biomarker of in vivo oral carcinogenesis?

MATERIAL AND METHODS

The present systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Full manuscripts from 18 studies were carefully selected in this setting.

RESULTS

A total of 15 studies demonstrated positive findings for genotoxicity in peripheral blood or oral cells in patients with pre-malignant lesions or oral cancer. In the quality assessment of studies, 1 was classified as Strong, 5 were considered as Moderate, and 12 were classified as Weak.

CONCLUSION

In summary, the comet assay can be a useful biomarker for oral carcinogenesis. However, further studies with more strict parameters are suggested (with less uncontrolled confounders) in order to increase findings reliability for diagnosis of oral potentially malignant lesions.

Is placental glutathione S-Transferase (GST-P) a suitable biomarker for oral carcinogenesis: A scoping review

Placental Glutathione S-Transferase (GST-P) can be considered a useful marker of not only of preneoplastic lesion in rat hepatocarcinogenesis and hamster pancreatic carcinogen but also as a potential marker for premalignant and malignant lesions in cases of buccal pouch mucosa. In this context, the aim of this review is to elucidate the following question whether the GST-P is a suitable biomarker for oral carcinogenesis. A total of 16 studies were carefully selected. Our results demonstrate that GST-P expression is a useful and coherent marker for oral carcinogenesis. Regarding the samples, most studies evaluated hamsters, two evaluated GST-P expression in rats and three evaluated GST-P expression in human cells. All studies demonstrated positive findings allowing us to consider such studies reliable. In summary, our conclusion is that GST-P can be a suitable biomarker for oral carcinogenesis.

Evaluation of the cytotoxic, anti-proliferative, anti-metastatic and pro-apoptotic effect of aqueous leaf extract of Annona muricata on oral tongue squamous cell carcinoma cell line (SCC-15): An in vitro study

Background

Oral cancer still represents the leading cause of mortality in India. Due to the drawbacks of current treatment options, a safe, low-cost therapy is the need of the hour. Recently, novel plant extracts with anti-cancer properties have gained greater attention. One among them is Annona muricata and its leaf extract, which has been studied for its anti-cancer effect against various cancers. However, studies on oral cancer cells are very much limited and hence the study.

Aims

To evaluate the cytotoxic, anti-proliferative, anti-metastatic and pro-apoptotic effect of aqueous leaf extract of Annona muricata (ALEAM) against SCC-15 cell lines through in vitro assays.

Materials and Methods

In vitro assays such as MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide], colony formation and wound healing assays were performed. Furthermore, to evaluate the underlying mechanism, gene and protein expression analysis of apoptotic/anti-apoptotic marker genes Bax, P53 and Bcl2, were done using quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis. Student's t-test has been performed for analysis of experimental data.

Results

The results showed that ALEAM exhibited significant cytotoxic activity in a dose-dependent manner as well as inhibited colony formation and cell migration. The pro-apoptotic properties were affirmed by a highly significant drop in Bcl-2 gene expression and a highly significant rise in P53 and Bax genes in the study group compared to the control (P < 0.05).

Conclusion

The current study provides evidence that ALEAM has the potential to be developed as a novel anti-cancer drug for the treatment of SCC after further clinical studies.

Clinicopathological characteristics, treatment and prognosis of oral adenocarcinoma: a population-based study

OBJECTIVES

The aim of this study was to identify clinicopathologic features, treatment and prognosis of oral adenocarcinoma (OADC).

STUDY DESIGN

Retrospective cohort analysis.

SETTING

National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program.

METHODS

Patients diagnosed with OADC between 2000 to 2018 were identified from the SEER database. Overall survival (OS) and disease-specific survival (DSS) were assessed using Kaplan-Meier analyses and Cox regression models.

RESULTS

There were 924 OADC and 37,500 oral squamous cell carcinoma (OSCC) patients identified. Patients with OADC were more significantly associated with younger age, female gender, well differentiation and early AJCC Clinical stage. The study revealed that patients with OADC had better 10-year OS and DSS than those with OSCC (OS: 69.3% vs 40.8%, P < 0.001; DSS: 83.6% vs 53.3%, P < 0.001). The survival advantage still persisted in multivariable analyses (OS: hazard ratio [HR] = 0.427, P < 0.001; DSS: HR = 0.320, P < 0.001). For OADC, multivariable analysis showed that advanced age, stage, and histologic grade were associated with worse OS and DSS, and surgery was associated with better OS and DSS.

CONCLUSIONS

OADC has a significantly better prognosis than OSCC, with better differentiation, and more early stage. Surgery was the preferred treatment, for patients with lymph node metastasis, radiotherapy may afford a survival benefit.

Lip and Oral Cavity Cancer Burden and Related Risk Factors in China: Estimates and Forecasts from 1990 to 2049

Simple Summary

China’s lip and oral cavity cancer burden is rising. The elderly have a relatively heavy disease burden, mainly due to poor oral health awareness, the side effects of other diseases and delayed treatment. Moreover, the incidence of the elderly over 50 years old is predicted to increase further from 2020 to 2049 in China. Males have a heavier disease burden, mainly due to their smoking, drinking and work exposure. Early screening and health intervention policies incorporating key populations and risk factors may deserve the consideration of policy makers to reduce the disease burden.

Abstract

Lip and oral cavity cancer is a common malignancy faced by many developing countries, and the disease burden is high in China. This study explored this cancer burden and its risk factors using data from China in the GBD 2019, along with predicting the incidence trends in 2020–2049. Data on age-standardized rates (ASR), incidence, death and disability-adjusted life years (DALY), by sex, age and risk factors were collected from the Institute for Health Metrics and Evaluation (IHME). Joinpoint regression and Age–Period–Cohort (APC) models were selected to analyze the epidemic trend of this cancer in China, and descriptive analysis was used for the time trend and age distribution of risk factors. The Bayesian APC model was selected to foresee the incidence trend in 2020–2049. This cancer burden was found to be in an upward trend in China in 1990–2019. The upward trend was more pronounced among men than among women. These cancer deaths and DALYs are overwhelmingly attributable to smoking and drinking. On APC analysis, the younger generation in China demonstrated a lower cancer risk. In 2049, the incidence of this cancer is projected to be 3.99/100,000, 6.07/100,000, 7.37/100,000, 10.49/100,000, 14.82/100,000, 19.19/100,000, 20.71/100,000, 23.64/100,000, 16.42/100,000 and 9.91/100,000 among those aged 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, 85–89, 85–89 and over 95 years, respectively. Disease control policies and early screening should focus on men and the elderly and target different risk factors.