Biomedical Engineering Reference
In-Depth Information
Tumor
FIGURE 22.4
The patient is a 66-year-old gentleman—retired boatbuilder. He has been aware of a foreign-body sensation
in the right side of his throat for up to 2 years. He had no pain, swallowing or voice problems. Dr. S. Coman
staged this case as T2N0 SCC. Histology reports “moderately differentiated” squamous cell carcinoma. Stains
for p16 are strongly evident.
(Photograph provided by Professor William B. Coman and Dr. S. Coman.)
method is reported to be more accurate than the standard EKG, which can miss up to 25% of poten-
tial heart attacks. In the oncology area, the use of saliva to isolate, characterize, and identify specific
roles for various messenger RNAs and microRNAs has already been done, and the value of saliva as
a tool to provide pure mRNA and pure miRNA for use in targeted therapies and general research
will become increasingly important over the next several years. An early application for the use of
miRNAs will be in the diagnosis of oral cancers, pancreatic cancer, and other malignancies, but the
impact will not stop there. mRNAs and miRNAs have been reported in many disease processes, so it
is expected that the role of RNA and salivary RNA in particular will expand dramatically.
Studies have also been performed confirming the detection of specific proteins such as Her-2/
neu and tumor markers such as CA-125, CA 15
3 are possible, but to date no diagnostic tests have
been developed using saliva specimens. Viral diseases represent another target area for salivary
diagnostics with a number of major disease antibodies and antigens (hepatitis A, hepatitis B, hepati-
tis C, HHV-1 to HHV-8, EBV, CMV herpes, and influenza viruses) all detectable in saliva. Oral
fluid samples have already proved useful in the evaluation of immunization efficacy, particularly in
the developing world, where immune response to measles, mumps, polio, tetanus, and rubella vac-
cines have been routinely carried out. More recently, a company from the United Kingdom,
MicroImmune, has developed a saliva-based point-of-care device for the detection of measles-
specific IgM antibodies. The group made up of scientists from the Public Health Laboratory in
Colindale (London) intend developing additional vaccine-specific rapid tests in the future.
The success of OralDNA Labs in the United States has spurred a “fever” of activity in the detec-
tion of bacterial infections using saliva specimens, and a number of companies are looking to target
the dental office as the first line of attack in our general health. These companies will provide dental
