Scientists have developed a gene expression panel that they claim can be used to accurately predict whether suspicious mouth lesions will become cancerous. The resulting test, called the quantitative Malignancy Index Diagnostic System (qMIDS), quantifies the expression levels of 14 genes associated with the FOXM1 cancer gene, and converts the measurements into a diagnostic score that indicates the risk of a lesion becoming cancerous. Its developers at Queen Mary, University of London, initially validated the panel on 359 head and neck cancer, dysplasia, and normal tissue specimens from 299 patients in the U.K. and Norway, and also confirmed the potential utility of the panel to diagnose (pre-)malignant human vulva and skin squamous cell carcinomas.
Histopathology represents the current gold standard for diagnosing cancer in lesions, such as those in the mouth, but the method is invasive, can require a fairly large tissue biopsy, and can take weeks to yield results that are inconclusive, explain Ahmad Waseem, M.D., Muy-Teck Teh, M.D., and colleagues. “A sensitive test capable of quantifying a patient’s cancer risk is needed to avoid the ‘wait and see’ intervention. Detecting cancer early, coupled with appropriate treatment can significantly improve patient outcomes, reduce mortality, and alleviate long-term public healthcare costs.”
In contrast, the qMIDS test requires a much smaller piece of tissue, and provides results in just three hours. The Queen Mary investigators say its trial in head and neck cancer demonstrated that the qMIDS exhibits a detection rate of up to 94%, and a false-positive rate as low as 1.3%. “We are excited about this new test as it will allow us to release patients with harmless lesions from regular follow-up and unnecessary anxiety, whilst identifying high-risk patients at an early stage and giving them appropriate treatment,” comments consultant oral and maxillofacial surgeon Iain Hutchison, co-author of the team’s published paper in the International Journal of Cancer, and founder of the Facial Surgery Research Foundation’s Saving Faces Charity, which partly funded the study.
The authors describe qMIDS and the trial in a paper titled “Exploiting FOXM1-Orchestrated molecular network for early squamous cell carcinoma diagnosis and prognosis.”