使用唾液中蛋白質表現量評估罹患口腔癌之風險

Abstract

口腔癌為近年來台灣男性十大癌症發生率第四名以及男性十大癌症死亡率第四名，僅次於肝癌胃癌以及大腸直腸癌，並且隨著國人飲食文化的改變，抽菸、酗酒、嚼檳榔等罹患口腔癌風險因子人口逐漸增多，口腔癌的男性死亡年齡已是所有癌症中最年輕，近20年之癌症年死亡率增幅最高者，因此及早發現口腔癌的潛在病患並給予及時治療是緩解口腔癌在台灣日趨嚴重的解決之道。癌症的早期診斷一直被視為能夠有效提升癌症治療成功率之方法，透過簡單的檢測技術以及大規模篩檢，盡早在癌症初期給予適當的治療以提升癌症癒後品質，然而目前準確率最高也最廣為使用的癌症早期檢測方式為組織切片病理篩檢，此種方法不僅檢查費用龐大，並且對於有癌前病變患者，缺乏一套罹癌風險評估方法，惟有透過定期追蹤觀察是否產生癌化現象。因此近期的口腔癌早期診斷研究為找出血液、唾液或組織中重要的基因或蛋白質，作為口腔癌早期診斷之判斷依據，而這類的研究多為探討單一基因或單一蛋白質對於口腔癌早期診斷之效果，鮮少有研究針對多基因以及多種蛋白質作為口腔癌早期診斷之判斷依據。因此本篇研究的目標為利用唾液中某種對癌症生長極為重要的蛋白質家族:基質金屬蛋白酶MMP與其專一抑制蛋白金屬蛋白酶組之抑制劑TIMP，並同時參考病人口腔癌風險因子之資料(性別、年齡、抽菸、酗酒、嚼檳榔習慣)，建立一套針對口腔有癌前病變患者之罹患口腔癌風險評估方法。

In Taiwan, oral cancer is the fourth of cancer leading cause of death in men which is second only to liver cancer, gastric cancer, and colon cancer. The main risk factors associated with oral cancer are the smoking habit, betel chewing habit, and alcohol drinking habit that make oral cancer becomes the youngest of overall age-standardized mortality rate for all cancer types and the highest cancer mortality increasing rate in the past two decades. Thus, finding potential oral cancer patients and make the treatments as early as possible becomes the best solution for decreasing oral cancer mortality rate. Cancer early detection has already reported as a good solution in cancer treatment enhancement. By a large scale screening using a simple detection technique, a good early detection system can significantly improve cancer prognostic quality. However, the mostly used oral cancer early detection method is the tissue sections and pathologic diagnosis. This method not only cost a lot in every detection, but also lacks an oral cancer risk estimating system for those who have precancerous lesions. In the last few years, establishing an oral cancer early detection platform by detecting specific gene or protein expression in blood, saliva, or tissue becomes a mainstream in oral cancer research. Most of these studies are aim to use a single gene or single protein for oral cancer early detection analysis which is prone to error in oral cancer risk estimating for precancerous patients. Therefore, the aim of this study is using the expression of Matrix Metalloproteinase, MMP family proteins, which play an important role in cancer progression, and their specific inhibitor Tissue inhibitor of metalloproteinase, TIMP family proteins, and also the consider the risk factor information of each sample to create an oral cancer risk estimating system for precancerous patients.