title: Development of oral cancer screening test by detection of squamous cell carcinoma among exfoliated oral mucosal cells.
abstract: OBJECTIVE
  The early detection of oral cancer improves patient outcomes. However, despite our growing knowledge of oral cancers, patients often present with advanced disease. The development of simple screening methods is desirable to provide an alternative to screening examinations by specialists. Thus, we developed a method of oral cancer detection among exfoliated oral mucosal cells, and we evaluated the feasibility of implementing an oral cancer screening test that is examiner independent.
  
  
  METHODS
  The study population consisted of 185 subjects: 89 with oral cancer, 18 with oral leukoplakia, and 78 controls. We used real-time polymerase chain reaction (PCR) to detect the biomarkers serpin peptidase inhibitor B3 (SCCA1), interleukin 15 (IL-15), and thrombomodulin (THBD).
  
  
  RESULTS
  The sensitivities for the detection of oral cancer and oral leukoplakia were 72.0% (77/107) with SCCA1, 75.7% (81/107) with IL-15, and 56.1% (60/107) with THBD, and the specificities were 73.1% (57/78) with SCCA1, 64.1% (50/78) with IL-15, and 78.2% (61/78) with THBD. Analysis of the sensitivity according to tumor size revealed that sensitivity was lower for large tumors. When analyzing the sensitivity according to the clinical growth pattern, the sensitivity was observed to be low for endophytic tumors.
  
  
  CONCLUSIONS
  We developed an oral cancer screening test based on real-time PCR analysis of SCCA1 that is examiner independent, and the sensitivity and specificity were approximately 70%; therefore, we concluded that the performance of this method using a single biomarker was suboptimal.
authors.affiliation: Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Kugimoto
authors.forename: Kei-ichi
authors.initials: K
authors.lastname: Morita
authors.forename: Ken
authors.initials: K
authors.lastname: Omura
mesh_terms: D000951:Antigens, Neoplasm / Q000032:analysis; D001483:Base Sequence; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D016022:Case-Control Studies; D017931:DNA Primers; D006801:Humans; D019409:Interleukin-15 / Q000032:analysis; D007972:Leukoplakia, Oral / Q000175:diagnosis*; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000175:diagnosis*; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D015843:Serpins / Q000032:analysis; D018180:Thrombomodulin / Q000032:analysis
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D017931:DNA Primers; D019409:Interleukin-15; D015843:Serpins; D018180:Thrombomodulin; C051072:squamous cell carcinoma-related antigen