Potential non-invasive low-cost test for head and neck cancer

Can screen for head and neck cancer ever be as simple as a urine or saliva test?

A team of UC Davis Health researchers hopes to develop a non-invasive, low-cost test to help screen for possible head and neck cancer (HNC). Their study, published in Diagnosticsfound that levels of three polyamine molecules in saliva and urine samples from head and neck cancer patients were significantly higher than those in healthy individuals.

Detect head and neck cancer

Head and neck cancers form in the oral cavity, throat, larynx, salivary glands, sinuses, or nasal cavity. With more than 800,000 new cases and 400,000 deaths each year, it is the seventh most common cause of death from cancer.

Andrew Birkeland

Early detection is crucial for effective treatment. In most cases, head and neck cancer is not detected clinically at an early stage.

About two-thirds of patients have advanced stage III or IV tumors at the time of diagnosis Andrew C Birkelandassistant professor at the Department of ENT-Head and Neck Surgery and co-lead author of the study. “We are always looking for better ways to detect cancer early and catch signs of potential recurrence after treatment.”

Patients usually seek medical attention after their cancer has spread to their lymphatic system, or they have symptoms related to a later-stage disease. These symptoms include pain, bleeding, ulcers, earaches, and difficulty swallowing.

Looking for signs of head and neck cancer in biofluids

Polyamines are metabolite components necessary for cell growth and tumor progression. Higher polyamine levels have been found in breast, colon and prostate cancer patients and have been linked to worse cancer outcomes.

UC Davis surgery team operates on a patient with head and neck cancer
Head and neck cancer may require surgery

Using highly sensitive techniques to study metabolites, the researchers analyzed 107 saliva and 124 urine samples from 39 HNC patients and 89 healthy participants. Nineteen of the patients had early-stage and 20 late-stage cancers. Most patients had cancer in their oral cavity or in the back of their mouth.

The team measured the levels of three polyamines: N1-acetylspermine (ASP), N8-acetylspermidine (ASD), and N1,N12-diacetylspermine (DAS).

They found higher levels of ASD and DAS polyamines in the urine and ASP in the saliva of HNC patients compared to those of healthy individuals.

“Changes in metabolite levels in biofluids such as saliva or urine may be important indicators of abnormal cell proliferation,” said Johnathon Andersonassistant professor in the ENT department and co-lead author of the study.

Saliva and urine samples can be obtained in a convenient, non-invasive and inexpensive way. Saliva testing allows patients to collect their samples at home, saving healthcare costs and providing an easy way to collect multiple samples.

Johnathan Anderson
Johnathan Anderson

“Given the non-invasive nature of saliva and urine collection and the potential cost-effective metabolite analysis options, there are opportunities to develop screening tools for patients at risk,” Anderson said.

This is a proof-of-concept study. Large-scale studies are needed to better support the preclinical and clinical development of these biomarkers for head and neck cancer screening.

“To our knowledge, this is the first study to identify elevated levels of ASP, ASD and DAS polyamines in saliva and urine samples from HNC patients,” Birkeland said. “We hope that science will advance to make testing for head and neck cancer as simple and accessible as a home pregnancy test.”

The project is a collaboration between UC Davis researchers from the West Coast Metabolomics Center and the departments of Otolaryngology-Head and Neck Surgery, Radiation Oncology and Neurology. It was funded by multiple grants from the National Institutes of Health (NIH) (K12CA138464, ES030158, T32-HL086350, T32-GM008799, U2C ES030158, R01GM099688, UL1 TR001860, KL2 TR001859). It was supported by California Institute of Regenerative Medicine (EDUC2-08390), the UC Office of the President’s Multi-campus Research Program Grant (MRP-17-454909), STAIR and STAIR-Plus subsidiesand Denny & Jeanene Dickenson Fellowship.

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