Risk Stratification System for Oral Cancer Screening.
Risk Stratification System for Oral Cancer Screening.
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口腔癌筛查的风险分层系统。
DOI：
10.1158/1940-6207.capr-15-0200
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Franzmann,ElizabethJ
中科院分区：
文献类型：
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作者：
Pereira,LutéciaHMateus;Reis,IsildinhaM;Reategui,ErikaP;Gordon,Claudia;Saint-Victor,Sandra;Duncan,Robert;Gomez,Carmen;Bayers,Stephanie;Fisher,Penelope;Perez,Aymee;Goodwin,WJarrard;Hu,JenniferJ;Franzmann,ElizabethJ
口腔和口咽癌（口腔癌）是一种发病率不断上升的致命疾病。全世界的5年生存率只有50%，这是由于延迟干预，超过一半的诊断是在III期和IV期，而早期检测（I期和II期）的生存率高达80%至90%。唾液可溶性CD 44（CD 44），肿瘤起始标志物，和总蛋白水平可能有助于口腔癌风险评估和早期干预。这项研究采用了一种以医院为基础的设计，包括150例病例和150例频率匹配的对照，以确定口腔冲洗液中的CD 44和总蛋白水平是否与口腔癌相关，而与年龄、性别、种族、民族、烟草和酒精使用以及社会经济地位（SES）无关。接受口腔癌预防干预作为社区项目的一部分的高风险受试者（n= 150）被随访超过1年，以确定标记物的特异性和变异。CD 44 ≥5.33 ng/mL与病例状态高度相关[校正OR 14.489; 95%置信区间（CI），5.973-35.145;P<0.0001，对比参考组CD 44 <2.22 ng/mL和蛋白质<1.23 mg/mL]。总蛋白辅助预测高于单独的CD 44。频率匹配研究的敏感性和特异性分别为80%和48.7%。然而，对照组不能代表目标筛查人群，部分原因是既往癌症的发生率较高。相比之下，高风险社区的特异性为74%，在每年重新测试后达到95%。简单而廉价的唾液CD 44和总蛋白测量可能有助于从数百万参与危险行为的人中识别出口腔癌高风险的个体。©2016 AACR.
Oral cavity and oropharyngeal cancer (oral cancer) is a deadly disease that is increasing in incidence. Worldwide 5-year survival is only 50% due to delayed intervention with more than half of the diagnoses at stage III and IV, whereas earlier detection (stage I and II) yields survival rates up to 80% to 90%. Salivary soluble CD44 (CD44), a tumor-initiating marker, and total protein levels may facilitate oral cancer risk assessment and early intervention. This study used a hospital-based design with 150 cases and 150 frequency-matched controls to determine whether CD44 and total protein levels in oral rinses were associated with oral cancer independent of age, gender, race, ethnicity, tobacco and alcohol use, and socioeconomic status (SES). High-risk subjects receiving oral cancer prevention interventions as part of a community-based program (n= 150) were followed over 1 year to determine marker specificity and variation. CD44 ≥5.33 ng/mL was highly associated with case status [adjusted OR 14.489; 95% confidence interval (CI), 5.973–35.145;P< .0001, vs. reference group CD44 <2.22 ng/mL and protein <1.23 mg/mL]. Total protein aided prediction above CD44 alone. Sensitivity and specificity in the frequency-matched study was 80% and 48.7%, respectively. However, controls were not representative of the target screening population due, in part, to a high rate of prior cancer. In contrast, specificity in the high-risk community was 74% and reached 95% after annual retesting. Simple and inexpensive salivary CD44 and total protein measurements may help identify individuals at heightened risk for oral cancer from the millions who partake in risky behaviors.Cancer Prev Res; 9(6); 445–55. ©2016 AACR.