• Posted March 5, 2024

Scientists Develop Biopsy-Free Means of Spotting Oral Cancers

Analysis of a "chemical score" from mouth lesion swab samples might allow patients to skip painful biopsies, getting oral cancers promptly diagnosed in a noninvasive way, scientists report.

Right now, dentists and other specialists must send excised tissues from suspicious mouth lesions to labs for standard biopsies, which are costly and invasive.

However, researchers at Case Western Reserve University in Cleveland say that simply brushing the lesion with a swab and then analyzing that sample performs just as well.

The key is to calculate the ratio of two chemicals picked up on the swab: Human beta defensin 3 (hBD-3) and human beta defensin 2 (hBD-2).

They note that when an early stage oral cancer is present, levels of hBD-3 rise sharply, while levels of hBD-2 remain unchanged.

"The ratio of hBD-3 to hBD-2 in the lesion site -- over the ratio of the two proteins on the opposite, normal site -- generates a score, called the beta defensin index (BDI)," according to the Case Western news release.

Patients whose BDI score crosses a specific threshold probably have an oral cancer, the research found.

“When we first discovered hBD-3, we saw it acted as a ‘good guy,' involved in wound-healing and killing microbes," lead researcher Aaron Weinberg noted in a Case Western news release.

“When we found it was regulated the same way certain cells grow uncontrollably, we started studying hBD-3 in the context of oral cancer," added Weinberg, who is chair of the Department of Biological Sciences at the Case Western Reserve School of Dental Medicine.

“Imagine our surprise when this Dr. Jekyll turned out to be Mr. Hyde,” he added. “We found it [hBD-3] was not only promoting tumor growth but was over-expressed in the early stages of the disease, while another member, hBD-2, wasn't changing. This difference in levels of expression of the two proteins compared to the opposite side in the same patient led us to examine the BDI's ability to distinguish cancer from benign lesions.”

The study team estimated that use of the new test (which they have patented) could reduce the need for lab-based biopsies by 90%.

Spurred by the research, Case Western engineering professor Umut Gurkan has developed a point-of-care device that can render a BDI Index score for patients within about a half-hour. That device has a patent pending, the news release said.

The new study was published online March 4 in the journal Cell Reports Medicine.

More information

Find out more about oral cancers at the American Cancer Society.

SOURCE: Case Western Reserve University, news release, March 4, 2024