Neetha Santosh
Clinical Assistant ProfessorOral Pathology, Medicine and Radiology
ude[dot]ui[at]hsotnasn
Identification of Biomarkers in Predicting Progression of Oral Precancerous Lesions
Oral squamous cell carcinoma (OSCC) comprises 94% of oral malignancies. Timely diagnosis is crucial as early stage lesions have an 84% 5-year survival rate while late stage lesions have only 39% survival rate. OSCC often develops from premalignant lesions exhibiting oral epithelial dysplasia (OED); however, not all OEDs progress into OSCC and better understanding of the malignant transformation process is needed. We studied three promising biomarkers, cornulin, p53 and cyclin-D1 using immunohistochemistry (IHC) to identify their differential expression in patients whose OED progressed to OSCC compared to those with non-progressive OED. The longitudinal study of these biomarkers expression in oral premalignant lesions may help identify high-risk OEDs which require more aggressive management, thereby facilitating risk-stratification and personalized treatment in the prevention of OSCC. 1. Evidence-based: Differential expression of cornulin between progressive and non-progressive OED helps to identify the high grade oral premalignant lesions. Hence, cornulin is an excellent biomarker to personalize treatment for oral precancerous lesions. 2. Inter/cross disciplinary: To minimize potential bias or variation of single-center studies, the College of American Pathologists (CAP) has recently recommended that laboratories validate all IHC assays before they are used in clinical practice. The guideline includes comparing results with an independent laboratory’s validated assay to reduce test variability. This is a multi-center research project with investigators at 2 universities with expertise in oral pathology and biomarker discovery (Dr. Neetha Santosh, Indiana University School of Dentistry and Dr. John R. Kalmar and Dr. Kristin K. McNamara. Ohio State University College of Dentistry. 3) Goal oriented for the betterment of everyday life: The burden of oral squamous cell carcinoma is increasing exponentially with an estimated 54,000 new cases. Availability of few effective cancer therapies and the high cost of cancer treatment underscore the need for biomarkers that can predict oral cancer progression. The differential expression of cornulin in oral premalignant lesions that progressed to oral cancer suggest that cornulin possess significant therapeutic potential for early detection of high grade lesions and personalized treatment in everyday clinical practice.