Azab N-A, Zahran F-M, Amin A-A, Rady N-H
Oral Medicine and Periodontology Department Faculty of Dentistry, Cairo University, Egypt 11 El-Saraya St. - Manial - Cairo, Egypt
Med Oral Patol Oral Cir Bucal. 2021 Jul 1;26(4):e445-e450. doi: 10.4317/medoral.24287.
Carcinogenesis is a dynamic process which traditional biopsying can not keep up with. Saliva as fluid in the vicinity of the tumor can offer better insights to this process. This study aimed to identify the accuracy of salivary DNA integrity index in differentiating between oral premalignant lesions and oral cancer.
This phase II diagnostic test accuracy study included 93 patients divided into three groups: 30 oral cancer patients, 33 patients with oral premalignant lesions divided into 21 oral lichen planus patients and 12 patients with leukoplakia and 30 normal individuals who acted as controls. Oral rinse was collected from all participants and they all underwent conventional visual and tactile examination, and patients with oral lesions had the diagnosis confirmed by histopathological examination of tissue biopsy. DNA integrity index was determined as the ratio between ALU247 and ALU115 measured by qPCR.
There was no statistically significant difference regarding ALU115, ALU247 and DNA integrity index between the three study groups. The index was significantly higher in the oral cancer group than the oral lichen planus patients, while no significant difference was found between the oral cancer and the leukoplakia cases. The DNA integrity index sensitivity, specificity, positive and negative predictive values were 73%, 45%, 55% and 65% respectively.
Salivary DNA integrity index showed poor diagnostic abilities in differentiating between the oral cancer and premalignant lesions.
癌症发生是一个动态过程，传统活检难以跟上其变化。唾液作为肿瘤附近的液体，可为该过程提供更好的见解。本研究旨在确定唾液DNA完整性指数在鉴别口腔癌前病变和口腔癌方面的准确性。
这项II期诊断试验准确性研究纳入了93名患者，分为三组：30名口腔癌患者、33名口腔癌前病变患者（分为21名口腔扁平苔藓患者和12名白斑患者）以及30名作为对照的正常个体。收集所有参与者的漱口水，他们均接受常规的视诊和触诊检查，口腔病变患者通过组织活检的组织病理学检查确诊。DNA完整性指数通过qPCR测定的ALU247与ALU115的比值来确定。
三个研究组在ALU115、ALU247和DNA完整性指数方面无统计学显著差异。口腔癌组的该指数显著高于口腔扁平苔藓患者，而口腔癌与白斑病例之间未发现显著差异。DNA完整性指数的敏感性、特异性、阳性和阴性预测值分别为73%、45%、55%和65%。
唾液DNA完整性指数在鉴别口腔癌和癌前病变方面显示出较差的诊断能力。
