Detection of genetic changes in oral carcinogenesis by DNA microarray analysis – Prof Van Heerden
Prof Willie van Heerden
Title of the project
Detection of genetic changes in oral carcinogenesis by DNA microarray analysis.
The annual incidence of oral cancer (OC) is estimated at 275000-400000, with the majority of these cancers occurring in developing countries. The overall five year survival rate for oral squamous cell carcinoma (OSCC) has not improved over the last few decades whereas when diagnosed early, the survival rate of OSCC is significantly better (80% compared to 50%). One of the reasons for poor prognosis is that a high number of patients with oral cancer will develop another cancer after treatment of their first cancer. These patients should be followed regularly to look for carcinomatous changes or the presence of potentially malignant lesions. This is especially relevant in the case of high-risk patients, like smokers and patients with a previous OSCC. Although little can currently be done to prevent secondary cancers, it is very important to detect these new cancers as soon as possible. The survival rate of patients with oral cancer is significantly better if it is diagnosed at an early stage. The researchers believe that correlation of the genetic detail of oral cancer with suspicious areas away from the cancer will help in identifying these secondary cancers at an early stage. This information will help clinicians with the regular follow-up that is needed for all patients at risk for oral cancer.
The main aim of the research is to determine what genetic changes take place within oral carcinogenesis in a South African patient sample and to correlate this with screening techniques of autofluorescence and toluidine blue vital staining for all pre-cancer areas within the same patient.
There can be no doubt that oral cancer requires genetic description rather than histological description-and that this will result in more effective treatment. It is hoped that this research, once published will be adopted by the surgical community, leading to more effective treatment for oral cancer sufferers and better survival rates. If this is achieved, it would be the first time in more than five decades. This study helped (and will help) tremendously to better understand the molecular changes present in the areas at risk for secondary cancer to possibly influence patient management strategies in the future. Critical evaluation of the available literature demonstrates that there is currently very little that can be done for these patients apart from trying to detect an OSCC as early as possible.