CU Dental 2018 - 23

suggest that down regulation of CXCL14
by HPV plays an important role in cancer
progression by suppressing antitumor
immune responses. If this important
immune modulator could be either
up regulated, or its HPV suppression
interfered with, we might in the future,
have a powerful tool for restoring
antitumor immune responses in HPV
infected head and neck cancer patients
and a novel immunotherapeutic agent for
oropharyngeal cancer.

The Future
Dr. Robert Greer and Dr. Dohun Pyeon collaborate on a five-year NIH funded project.

Screening for Oral Cancer,
a Global Perspective
There are no worldwide screening
programs for oral cancer, and only recently
has the Global Oral Cancer Forum (GOCF)
summarized the current international
status of oral cancer screening. Screening
has long been promoted as a tool that can
be used to identify early oropharyngeal
cancer. Screening tests can be measured
by their level of sensitivity, the ability of
a test to classify an individual as being
positive for the presence of disease,
and their specificity, which is effectively
the measure of any false positive rate.
Although dozens of oral cancer screening
tests have appeared over the past two
decades, including Oral CDX,® Oral
ID,™ Oralscan,® Toluidine Blue mouth
rinse, ViziLite®screening, VELscope®
screening, and Microlux/DL screening, to
name a few, most authorities report that
none of these tests, which are considered
to be adjunctive to visual examination, can
be recommended as a replacement for
the currently employed diagnostic gold
standard of scalpel biopsy and histologic
examination.
There are new, molecular, adjunctive
diagnostic tools in development, including
very promising methodologies that
evaluate saliva for tumor markers, which
may in the future serve as tools for the
enhancing the diagnosis, prognosis, and

post-operative monitoring of oral cancer
patients. These non-invasive alternatives
to serum testing may also prove to be an
effective modality for long-term patient
monitoring.
It is interesting to note that there
is insufficient evidence to demonstrate
that oral cancer screening in any of its
present forms can reduce mortality from
oral cancer, and to date there are no
standardized, well-implemented, formal
oral cancer screening programs worldwide.

In addition to our own research,
investigators
worldwide
are
busy
developing clinically applicable micro
RNA based cancer prognostic modalities
that can reliably assess cancer specific
mortality risk and guide clinicians and
investigators in identifying therapies
that are risk assessed for patients with
early squamous cell carcinoma. The
research that is on the horizon is certainly
promising, and has an achievable end
point. I remain optimistic that within the
next two decades science will make huge
inroads in the diagnosis and management
of oropharyngeal cancer. Inroads that
will dramatically reduce this cancer's
incidence, prevalence and mortality in the
worldwide population.

Oropharyngeal Cancer
Research at the University
of Colorado
Our research group has recently begun
the second year of a five-year NIH
funded project designed to evaluate
immune dysregulation by human
papillomavirus during head and
neck cancer progression. This
research project, led by Dr.
Dohun Pyeonw, of the School
of Medicine's Department of
Microbiology and Immunology,
is
designed
to
assess
how CXCL14, a chemokine
responsible for host immune
surveillance is significantly decreased
in HPV-positive oropharyngeal cancers
compared to HPV-negative cancers and
normal individuals. Our results to date

HPV viruses

DENTAL. INTEGRATED FOR HEALTH.

23



Table of Contents for the Digital Edition of CU Dental 2018

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