Non-Invasive Test Detects Oral Cancers With 92% Accuracy

Researchers have developed a new proof-of-concept test that can accurately identify people with a common oral cancer as well as pre-cancerous tissue. The study is published in the Journal of Oral Pathology and Medicine.

A non-invasive alternative?

Oral squamous cell carcinoma (OSCC) is a cancer that develops in the mouth and throat and is one of the most common cancers of the head and neck region. In 2020, around 470,000 OSCC cases were reported globally. However, delays in the diagnosis of this type of cancer is one of the major factors contributing towards its poor prognosis – current data suggests there were ~225,000 deaths in 2020, indicating a mortality rate of around 50%.

Similarly, oral epithelial dysplasia (OED) is a type of pre-cancer, in which the cells of the mouth develop abnormal features but are not yet classified as cancerous – though they can advance into cancerous cells with time. Features of these pre-cancerous cells include abnormal changes in size, shape and their arrangement in the cellular structure of the tissue.

Both OED and OSCC can be caused by lifestyle factors such as tobacco smoking, alcohol use and poor oral hygiene. The authors developed a proof-of-concept study – point-of-care analysis for non-invasive diagnosis of oral cancer (PANDORA) – with the aim of developing a new non-invasive diagnostic platform to improve the detection of oral cancers.

"Over three hundred thousand people are diagnosed with oral cancer worldwide – a disease with an alarming mortality rate of around 50%,” said Dr. Fatima Labeed, senior lecturer in human biology at the University of Surrey and one of the authors of the study. “This suggests that the scientific community doesn't have the tools available to identify oral cancer early enough, and we hope that PANDORA paves the way for more effective clinical diagnostic tools for this terrible disease.”

Putting PANDORA to the test

The University of Surrey researchers recruited 40 people with OSCC and OED into the study as well as 79 people without cancer or any other benign (non-cancerous) lesions as a control group. The researchers gathered cells from the participants using brush biopsies – a painless and non-invasive method that scrapes the tissue with a soft brush to collect cells. This means that samples could potentially be collected in a primary care setting such as a dental practice, then mailed to a facility for analysis to help identify and triage patients in need of specialist care.

The collected cells were measured and analyzed using a machine called a DEPtech 3DEP analyzer. The main aim of the PANDORA study was to develop a unique set-up or range of set-up protocols to identify OSCC and OED with the highest accuracy, in comparison to the gold-standard test currently used, which requires a surgical biopsy. The findings of the PANDORA study showed that the test was able to identify OSCC with over 92% accuracy and OED with 80% accuracy.

Validating diagnostic performance

“The DEPtech 3DEP analyser has the potential to identify OSCC and OED with notable diagnostic accuracy and warrants further investigation as a potential triage test in the primary care setting for patients who may need to progress along the diagnostic pathway and be offered a surgical biopsy,” the researchers write.

The researchers also note limitations to this proof-of-concept study, stating that “the accuracy results presented in this paper are to be considered preliminary” and that further clinical and diagnostic validation of the technology is required.

Reference: Hughes MP, Labeed FH, Hoettges KF, et al. Point-of-care Analysis for Non-invasive Diagnosis of Oral cancer (PANDORA): A technology-development proof of concept diagnostic accuracy study of dielectrophoresis in patients with oral squamous cell carcinoma and dysplasia. J Oral Pathol Med. 2023. doi: 10.1111/jop.13417

This article is a rework of a press release issued by the University of Surrey. Material has been edited for length and content.