Dental News - Tongue cancer: Researchers find possible markers for earlier diagnosis

Dental Tribune International

Tue. 9. January 2018

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CLEVELAND, Ohio, U.S.: New findings by a US research team regarding certain bacteria and fungi may make way for the development of a precautionary test for patients who carry a high risk for the squamous cell carcinoma of the tongue, also known as tongue cancer. The scientists aim to provide new tools for earlier diagnosis and treatment before pain starts or physical symptoms, such as lesions, are present. One of the reasons for a generally poor prognosis for patients is late detection.

In a new study, researchers from Case Western Reserve University School of Medicine, Cleveland Clinic and University Hospitals Cleveland Medical Center found that bacterial diversity and bacterial and fungal richness are significantly reduced in tumor tissue compared to matched non-tumor tissue. This raises the possibility that certain bacteria and fungi, in sufficient amounts and in possibly interactive ways, may play a role in the development of tongue cancer. Previous research has shown that bacteria can spur gastric and colorectal cancer and that bacterial-fungal interplay can contribute to, or exacerbate, Crohn's disease.

“Our findings mean that it may be possible to perform precautionary testing in patients at high-risk for oral tongue cancer,” said the study's co-senior author, Mahmoud A. Ghannoum, professor at the Department of Dermatology at Case Western Reserve School of Medicine and University Hospitals Cleveland Medical Center. “If the patterns that we found are present in people who are not yet showing signs of lesions, we could begin treatment early, offering the possibility of better patient outcomes.”

Tongue cancer, which arises in the anterior two-thirds of the tongue, has been rapidly increasing and is now the second most common malignancy in the oral cavity. While human papillomavirus (HPV) causes nearly ninety percent of base-of-tongue tumors, HPV is rarely found (only 2.3 percent) in tongue cancer cases. The causes of tongue cancer are unclear, however, genetic mutations probably play a role, while smoking and the chewing of tobacco, alcohol use and poor dental hygiene are also linked to the development of this type of cancer.

“Poor oral hygiene has long been associated with oral cancers, suggesting that oral bacteriome (bacterial community) and mycobiome (fungal community) could play a role,” said co-senior author Dr. Charis Eng, professor and vice chairman of the Department of Genetics and Genome Sciences at Case Western Reserve School of Medicine and Hardis Endowed Chair of the Genomic Medicine Institute at the Cleveland Clinic.

While the bacteriome is increasingly being recognized as playing an active role in health, the role of the mycobiome not been thoroughly studied and never before in the case of tongue cancer. In the new study, the researchers extracted tissue DNA from 39 paired tumor and adjacent normal tissues from patients with tongue cancer. Analysis showed that Firmicutes was the most abundant bacterial phylum and it was significantly more abundant in tumor tissue compared to non-tumor tissue—48 percent and 40 percent, respectively. In total, the abundance of 22 bacterial and seven fungal genera (types) was significantly different between the tumor and the adjacent normal tissue, including Streptococcus, which was significantly increased in the tumor group (34 percent versus 22 percent in normal tissue).

“Studies are starting to emerge demonstrating interactions between bacteria and fungi in the formation of disease,” said Ghannoum. “Thus, additional research is needed, aimed at understanding how these two communities influence or are influenced in disease settings such as oral tongue cancer.”

The study, titled “Bacteriome and mycobiome associations in oral tongue cancer”, was published on October 19 2017 in the Oncotarget journal.

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