Oral cancer detection and progression prediction using noninvasive cytology‐based DNA ploidy approach

• Published in: Journal of oral pathology & medicine 2024-08, Vol.53 (7), p.434-443
• Main Authors: Liu, Kelly Y. P., Ng, Samson, Taleghani, Maryam, Zhu, Sarah Y., Carraro, Anita, Chen, Zhaoyang, Palcic, Branko, Poh, Catherine F., Guillaud, Martial
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Algorithms; aneuploidy; Biopsy; Cellular biology; Cytodiagnosis - methods; Cytology; Deoxyribonucleic acid; Disease Progression; DNA; dysplasia; Early Detection of Cancer; Female; Head & neck cancer; Humans; Lesions; Male; Middle Aged; Mouth Neoplasms - genetics; Mouth Neoplasms - pathology; Multivariate analysis; Oral cancer; Oral carcinoma; Oral cavity; oral cytology; oral squamous cell carcinoma; Ploidies; Ploidy; Precancerous Conditions - genetics; Precancerous Conditions - pathology; Prognosis; Retrospective Studies; Sensitivity analysis; Sensitivity and Specificity; Squamous cell carcinoma
• ISSN: 0904-2512; 1600-0714; 1600-0714
• DOI: 10.1111/jop.13562

Background Despite the oral cavity being readily accessible, oral cancer (OC) remains a significant burden. The objective of this study is to develop a DNA ploidy‐based cytology test for early detection of high‐risk oral lesions. Methods This retrospective study was conducted using 569 oral brushing samples collected from 95 normal and 474 clinically abnormal mucosa with biopsy diagnosis of reactive, low‐grade or high‐grade precancer or cancers. Brushing cells were processed to characterize DNA ploidy. A two‐step DNA ploidy‐based algorithm, the DNA ploidy oral cytology (DOC) test, was developed using a training set, and verified in test and validation sets to differentiate high‐grade lesions (HGLs) from normal. The prognostic value of the test was evaluated by an independent outcome cohort, including progressed and non‐progressing normal, reactive and low‐grade lesions. Classification performance was assessed by accuracy, sensitivity, and specificity, while the prognostic value was evaluated by using the Cox proportional hazards analysis on 3‐year progression‐free survival (PFS). Results The developed DOC test exhibited high accuracy for detecting HGLs in the test and validation sets, with a sensitivity of 0.97 and 0.96, respectively. Its application to the Outcome cohort demonstrated significant prognostic value for 3‐year PFS (log rank, p