ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Preliminary Results Suggest miR-139-5p Is a Viable Salivary Biomarker for Diagnosis of Tongue Squamous Cell Carcinoma (TSCC)
Clinical Question In patients with undiagnosed tongue squamous cell carcinoma, can a salivary test conducted in the dental office effectively detect tongue squamous cell carcinoma through the identification of a microRNA biomarker?
Clinical Bottom Line The cohort study conducted by Duz et. al. concludes that miR-139-5p is a feasible salivary biomarker for detection of tongue squamous cell carcinoma (TSCC). This study found that expression levels of miR-139-5p in saliva of TSCC patients were significantly decreased compared to control samples. With future studies validating sensitivity and specificity, salivary tests measuring levels of miR-139-5p expression could become a noninvasive and efficient option for early diagnosis of this aggressive and lethal carcinoma.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 26650483Duz/2015TSCC group- 19 males/6 females; Control group- 21 males/4 femalesProspective Cohort Study
Key resultsThree TSCC and four control saliva samples that met all quality criteria were chosen for microRNA microarray analyses. 419 microRNA were found to be differentially expressed between the TSCC and control groups (p<0.01, fold change >1.4). Quantitative real-time PCR was used for further confirmation of miR-139-5p expression in 25 pre-operative TSCC and 25 control saliva samples. Expression levels of miR-139-5p in TSCC samples were determined to be significantly decreased compared to the control samples (p=0.006, area under the curve [AUC] with 95% confidence interval [CI]=0.805). Saliva samples collected 4-6 weeks after surgical removal of the tumor showed no statistically significant difference in miR-139-5p expression levels when compared to the control samples (p>0.05), and possessed sufficient power to distinguish from pre-operative TSCC saliva samples (AUC with 95% CI=0.713).
Evidence Search ("saliva"[MeSH Terms] OR "saliva"[All Fields]) AND (("mouth neoplasms"[MeSH Terms] OR ("mouth"[All Fields] AND "neoplasms"[All Fields]) OR "mouth neoplasms"[All Fields] OR ("oral"[All Fields] AND "cancer"[All Fields]) OR "oral cancer"[All Fields]) AND detection[All Fields])
Comments on
The Evidence
The main drawback to this study is the small sample size (n=50) and the skewed gender differences found in the TSCC and control group. Also, the authors gave no indication as to why 4-6 weeks is an adequate amount of time prior to the collection of follow-up samples from TSCC patients after surgical treatment. Further studies are required to validate sensitivity and specificity of miR-139-5p, as well as to find other salivary biomarkers for early diagnosis of TSCC.
Applicability Oral squamous cell carcinoma is a very common human malignancy with increasing prevalence. Despite numerous technological advances in the past 50 years, the 5-year survival rate for these patients has not changed. The study conducted by Duz et al. focused on tongue squamous cell carcinoma, which accounts for 41% of these carcinomas and is highly aggressive. Discovering a novel microRNA salivary biomarker could mean earlier detection (even before phenotypic presentation) and improved patient prognosis and could be utilized to determine post-operative treatment response. This option could have the potential to be a convenient, noninvasive technique that could be performed in the dental office.
Specialty/Discipline (Public Health) (Oral Medicine/Pathology/Radiology) (General Dentistry) (Basic Science)
Keywords Tongue Squamous Cell Carcinoma, Saliva, Biomarker, miRNA, microRNA
ID# 3049
Date of submission: 03/28/2016spacer
E-mail walkercm@livemail.uthscsa.edu
Author Catherine Marie Walker
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Joseph A. Bartoloni, DMD, MPH
Faculty mentor/Co-author e-mail bartoloni@uthscsa.edu
Basic Science Rationale
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Comments on the CAT
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