Oral cancer is one of the most common head and neck malignancies and has an overall 5-year survival rate that remains below 50%. Oral cancer is generally preceded by oral potentially malignant disorders (OPMDs) but determining the risk of OPMD progressing to cancer remains a difficult task. Several diagnostic technologies have been developed to facilitate the detection of OPMD and oral cancer, and some of these have been translated into regulatory-approved in vitro diagnostic systems or medical devices. Furthermore, the rapid development of novel biomarkers, electronic systems, and artificial intelligence may help to develop a new era where OPMD and oral cancer are detected at an early stage. To date, a visual oral examination remains the routine first-line method of identifying oral lesions; however, this method has certain limitations and as a result, patients are either diagnosed when their cancer reaches a severe stage or a high-risk patient with OPMD is misdiagnosed and left untreated. The purpose of this article is to review the currently available diagnostic methods for oral cancer as well as possible future applications of novel promising technologies to oral cancer diagnosis. This will potentially increase diagnostic options and improve our ability to effectively diagnose and treat oral cancerous-related lesions.
Background
Dysbiosis of oral microbiome causes chronic diseases including dental caries and periodontitis, which frequently affect older patient populations. Severely disabled individuals with impaired swallowing functions may require nutritional supply via nasogastric (NG) tubes, further impacting their oral condition and possibly microbial composition. However, little is known about the effect of NG tube on oral microbes and its potential ramification.
Methods
By using 16S rRNA amplicon sequencing, we characterized the tongue microbiome of 27 patients fed with NG tubes and 26 others fed orally.
Results
The microbial compositions of NG-tube and oral-feeding patients were substantially different, with more Gram-negative aerobes enriched in the presence of NG tube. Specifically, NG-tube patients presented more opportunistic pathogens like
Pseudomonas
and
Corynebacterium
associated with pneumonia and lower levels of commensal
Streptococcus
and
Veillonella
. Co-occurrence analysis further showed an inverse relationship between commensal and pathogenic species.
Conclusion
We present a systematic, high-throughput profiling of oral microbiome with regard to long-term NG tube feeding among the older patient population.
Dysbiosis of oral microbiome causes chronic diseases including dental caries and periodontitis, which frequently affects elderly, frail patients receiving long-term care. Severely disabled patients may require nutritional supply via nasogastric (NG) tube, which impacts patients' oral condition and possibly microbial composition. However, little is known about the effect of NG tube on oral microbes and its potential ramification. Here, by using 16S rRNA next-generation sequencing, we characterized the tongue microbiome of 27 patients fed with NG tubes and 26 others fed orally. The microbial compositions of NG-tube and oral-feeding patients were substantially different, with more Gram-negative aerobes enriched in the presence of NG tube. Specifically, NG-tube patients presented more opportunistic pathogens like Corynebacterium and Pseudomonas associated with pneumonia, and lower levels of commensal Streptococcus and Veillonella. Together, we present a systematic, high-throughput profiling of oral microbiome with regards to NG tube indwelling, providing empirical evidence for better clinical practice.
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