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【medical-news】通过漱口早期检测头颈部肿瘤
通过漱口早期检测头颈部肿瘤
Zosia Chustecka
April 17, 2007 — An oral rinse can detect head and neck squamous-cell carcinoma (HNSCC) before there is any clinically evident disease, researchers reported at the American Association for Cancer Research (AACR) in Los Angeles.
2007-4-17——坐落在洛杉机的“美国癌症研究协会”（ＡＡＣＲ）的研究者们报道，一个简单的漱口就能在出现临床病症之前发现头颈部鳞状细胞癌（HNSCC）。
To take the test, individuals take a sip of solution, swirl it around in their mouths, and then spit it out, explained Elizabeth Franzmann, MD, from the University of Miami's Sylvester Comprehensive Cancer Center, in Florida. The test is simple enough to administer at any community center, and it detects cancer about 90% of the time, she said.
佛罗里达州迈阿密Ｓｙｌｖｅｓｒｅｒ高级癌症中心大学的Ｅｌｉｚａｂｅｔｈ Ｆｒａｎｚｍａｎ解释说，该项检查只需让受检者含一口溶液，然后让溶液在口腔里打几个转，最后吐出即可。
"If put into practice, an oral rinse screening test for head and neck squamous-cell cancer could be more effective than the prostate-specific-antigen test for prostate cancer," she said. "Many lives could be saved through a test that is no more invasive than gargling."
“如果得到应用，漱口筛查头颈部肿瘤将比ＰＳＡ检测前列腺癌还有效，”她说，“一个毫无创伤的漱口将拯救许多人多生命。”
Head and neck cancer is very difficult to diagnose, Dr. Franzmann commented. It is usually detected on physical examination, but this needs specialist equipment, and even with this, the early small lesions can be missed. As a result, this cancer is usually diagnosed at an advanced stage, and cure rates are only around 50%. "Survival rates could be raised to more than 80% if the cancer were diagnosed earlier," she said.
Ｆｒａｎｚｍａｎｎ医生说，头颈部肿瘤是非常难诊断的，通常在体检时发现，但这需要专业的医生和设备，就算如此，早期的小病变也很难发现。结果就是发现癌症时往往要到晚期，治愈率只能在５０％作用。“如果癌症能早期诊断的话，生存率将会提高岛８０％，”她说。
"This is potentially very important," said Louis Weiner, MD, from the Fox Chase Cancer Center, in Philadelphia, Pennsylvania, who was moderating an AACR press conference at which the work was highlighted. "This is an easy-to-administer test that has great potential power to identify a difficult-to-treat cancer."
“这相当重要，”Ｌｏｕｉｓ Ｗｅｉｎｅｒ医学博士说，“这是一项易于操作的检测，却能发现很难治疗的肿瘤。”
Improving Accuracy of the Rinse
提高漱口检测的准确率
In developing the test, Dr. Franzmann and colleagues at first used an oral rinse that detected soluble CD44, a protein biomarker. This protein is usually integrated into the cell surface, but in HNSCC the protein is overexpressed, and levels are elevated at least 7-fold. The oral rinse flushes out the excess CD44 when it washes over cellular membranes in the throat and mouth.
在开发这项检测的时候，Ｆｒａｎｚｍａｎ医生和同事们起初检测了漱口液中的ＣＤ４４。ＣＤ４４是一种蛋白生物标记物，常表达在细胞表面，但是在ＨＮＳＣＣ，该蛋白的表达量能升高７倍。漱口能把咽喉和口腔细胞膜上大量的ＣＤ４４冲洗出来。
In the study presented at the meeting, the team used this CD44 oral rinse in 102 patients with HNSCC and 69 control patients who had benign diseases of the upper-aerodigestive tract (UADT) and a history of tobacco and alcohol use. In this control group, the test detected 2 patients with cancer before the disease was clinically evident. However, it also recorded a few false-positive results in the control group. The test detected elevated levels of CD44 in 62% of the cancer patients.
他们选择了１０２名ＨＮＳＣＣ患者和６９名患有上呼吸道和上消化道良性疾病的患者作为对照，检测他们漱口液中ＣＤ４４的量。在对照组中，检测到２名患者得了癌症，他们都没有临床表现。但是，在对照组中也有些假阳性结果的纪录。在癌症组中ＣＤ４４有６２％的阳性率。
To further increase the sensitivity of the test, without affecting specificity, the researchers added another element — testing for CD44 promoter hypermethylation by using a methylation-specific polymerase chain reaction on the oral rinses. In a pilot study conducted with 11 individuals in each group, the researchers found CD44 promoter hypermethylation in 9 of 11 HNSCC patients who had low levels of CD44, but they found no cases of hypermethylation in the control group (0/11).
为了在不影响特异性的前提下提高检测的敏感性，研究者们增加了另外一个因素——通过甲基化特异ＰＣＲ检测漱口液中的ＣＤ４４的启动子的超甲基化。在一项初步研究中，研究者在１１名ＨＮＳＣＣ患者中发现了９例ＣＤ４４启动子超甲基化，这些患者的ＣＤ４４水平偏低。但是，在对照组中，没有发现超甲基化。
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作者:admin@医学,生命科学 2010-10-25 05:11
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