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'Swish-and-spit' test accurate for cancer

A morning gargle could someday be more than a breath freshener it could spot head and neck cancer, say scientists at the Johns Hopkins Kimmel Cancer Center. Their new study of a mouth rinse that captures genetic signatures common to the disease holds promise for screening those at high risk, including heavy smokers and alcohol drinkers.

Lead investigator Joseph Califano, M.D., says his group at Johns Hopkins asked 211 head and neck cancer patients and 527 individuals without cancers of the mouth, larynx or pharynx to brush the inside of their mouths, then rinse and gargle with a salt solution.

The researchers collected the rinsed saliva and filtered out cells thought to contain one or more of 21 bits of chemically altered genes common only to head and neck cancers. Tumor and blood samples also were collected.

The cellular mishaps occur when small molecules called methyl groups clamp on to the DNA ladder structure of a gene. In the grip of too many methyl groups, these genes can incorrectly switch on or off in a process called hypermethylation. Mass-methylation of particular genes can lead to cancer, the researchers say. Methylation mistakes in other genes could be triggered simply by aging and amount to no more than fine lines and wrinkles.

The challenge is to predict which hypermethylated genes are most specific to cancer, says Califano, an associate professor of otolaryngology head and neck cancer and oncology at Johns Hopkins. And because every cancer process involves a unique genetic fingerprint, combining several gene signatures for the disease rather than using single ones may identify a larger percentage of cancer patients.

Califano and his colleagues report in the January 1 issue of Clinical Cancer Research noted that of 21 hypermethylated genes, seven of them were the best predictors of cancer within cell-laden saliva. Of the seven best, he tested panels of three to five genes on saliva rinses.

One panel correctly iden

Contact: Vanessa Wasta
Johns Hopkins Medical Institutions

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