Oral cancer is the most common neoplasm of the head and neck and the ninth most common cancer worldwide. A simple, novel genetic test may now help with early diagnosis of this disease. The most common premalignant lesion of the oral cavity is oral leukoplakia, the presence of white patches in the mouth. Leukoplakia is recognized as an increased risk for cancer but there are no reliable clinical or histologic features that can be used to predict whether it will progress to cancer.
Researchers measured the DNA content (ploidy) of 150 patients with oral leukplakia, classified as epithelial dysplasia. What they found was that ploidy could be used to predict outcome. Patients with leukoplakia containing the normal 46 chromosomes were unlikely to progress to cancer. However, a startling 84% of patients with aneuploid lesions developed squamous cell carcinoma. The test was 97% accurate in its ability to predict that a patient would not develop cancer, and 84% accurate in its ability to predict that one would.
Unfortunately, a single molecular marker or class of markers cannot be used to predict the outcome of every case of oral leukoplakia because oral cancers develop along complex molecular pathways. Further studies are needed to support these data.
Sources
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Sudbo J, Kildal W, Risberg B, Koppang H, Danielsen HE, Reith A. New England Journal of Medicine. 2001;344:1270-8.
