Developing a molecular diagnostic tool for oral cancer
Congratulations to CCBIO dental student Martha Rolland Jacobsen for the research dissemination prize at the research fair of the Medical Faculty’s recent Clinical Dentistry Week! Martha presented her research work, which is part of a larger research project that aims to combine the expression of 13 biomarkers known to play a role in the progression of OSCC, in order to develop a molecular diagnostic tool for oral cancer. The project represents an important part of CCBIOs effort towards ‘biomarker discovery’ and is strategically important for CCBIOs effort to contribute towards delivering point-of-care cancer diagnosis on a global level.
Need for better diagnostic methods
Oral squamous cell carcinoma(OSCC) has 50% survival over 5 years. These numbers have been stable for decades, partly due to little development in the diagnostic methods. There has been conducted several studies on biomarkers for guiding diagnosis and treatment for OSCC, but single biomarkers has not been shown to have sufficient statistical value. Therefore, in this project the group wish to combine the expression of 13 biomarkers known to play a role in the progression of OSCC, to develop a molecular diagnostic tool.
Oral cancer is clearly related to lifestyle. In Norway the risk factors are smoking and high alcohol consume, while in other parts of the world, there are varying types of chewing tobacco, areca nut or other stimulants. When choosing patient cohorts for this study, it was important to select patients with oral cancer with different etiologies, in order to make the diagnostic tool globally applicable. Through international collaboration the group has selected cohorts from Norway(230), Sudan(133), India(100) and Nepal(73). The patients have been chosen based on their tumor stage and the availability of 5 years clinical follow up data. Martha has conducted the research on the Indian cohort.
Choosing the right biomarkers
The first, and possible one of the most important parts of the project, was to choose the biomarkers. The aim was that the biomarkers combined should make out a complete picture of the tumor development. The group has therefore chosen biomarkers from the tumor, the stroma, and from the vascularization- and inflammation-perspective. All biomarkers have been visualized using immunohistochemistry and the slides were digitally scanned. At this moment, the group is finalizing the quantification of each biomarker. This has been done digitally by using Aperio, in order to get reproducible and objective results.
A selective process
After finalizing the quantification, the expression of the biomarkers is analyzed together with the clinical variables by using mathematics and bioinformatics expertise. Some biomarkers may be seen to lack prognostic value, in which case they will be excluded. The aim is to develop an algorithm that will be able to quantify patient’s risk for further progression of the disease by combining the expression of as few as possible, but prognostically strong biomarkers, so it will be feasible for clinical use even in resource-poor area.
CCBIO looks forward to the future results of the project!