title: Clinical application of micronucleus test in exfoliated buccal cells: A systematic review and metanalysis.
abstract: The micronucleus assay in uncultured exfoliated buccal mucosa cells, involving minimally invasive sampling, was successfully applied to evaluate inhalation and local exposure to genotoxic agents, impact of nutrition and lifestyle factors. The potential use of the assay in clinics to monitor the development of local oral lesions and as an early biomarker for tumors and different chronic disorders was also investigated. A systematic review of the literature was carried out focusing on the clinical application of the assay. The literature search updated to January 2015 allowed to retrieve 42 eligible articles. Fifty three percent of investigations are related to oral, head and neck cancer, and premalignant oral diseases. Our analysis evidences a potential usefulness of the MN assay applied in buccal exfoliated cells in the prescreening and in the follow up of precancerous oral lesions. A significant excess of MN, in patients compared with matched controls was observed for subgroups of oral and neck cancer (meta-MR of 2.40, 95% CI: 2.02-2.85) and leukoplakia (meta-MR 1.88, 95% CI: 1.51-2.35). The meta-analysis of studies available on other tumors (meta-MR 2.00; 95% CI:1.66-2.41) indicates that the MN frequency in buccal cells could reflect the chromosomal instability of other organs. Increased MN frequency was also observed in small size studies on patients with chronic diseases, with Alzheimer's disease and with Down syndrome. The application of the cytome approach providing information of genotoxic, cytotoxic and cytostatic effects is suggestive of the possibility of an improvement in the predictive value of the assay and this deserves further investigations.
authors.affiliation: Environmental Carcinogenesis Unit, IRCCS A.O.U. San Martino-IST, Genoa, Italy. Electronic address: claudia.bolognesi@hsanmartino.it.
authors.forename: Claudia
authors.initials: C
authors.lastname: Bolognesi
authors.affiliation: Clinical and Molecular Epidemiology Unit, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonassi
authors.affiliation: Institute of Cancer Research, Department of Medicine I, Medical University Vienna, Borschkegasse 8a, A-1090 Vienna, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Knasmueller
authors.affiliation: Commonwealth and Scientific Industrial Research Organization, Genome Health and Personalised Nutrition Laboratory, Food and Nutrition Flagship, Adelaide, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Fenech
authors.affiliation: Clinical Epidemiology Unit, IRCCS A.O.U. San Martino-IST, Genoa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bruzzone
authors.affiliation: Clinical Epidemiology Unit, IRCCS A.O.U. San Martino-IST, Genoa, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Lando
authors.affiliation: Clinical Epidemiology Unit, IRCCS A.O.U. San Martino-IST, Genoa, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Ceppi
mesh_terms: D004249:DNA Damage / Q000235:genetics*; D006801:Humans; D015162:Micronucleus Tests / Q000379:methods*; D009061:Mouth Mucosa / Q000166:cytology* / Q000378:metabolism*; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000235:genetics*
keywords: Biomonitoring; Buccal micronucleus cytome assay; Exfoliated cells; clinical application; meta-analysis; systematic review