gms | German Medical Science

Despite the advances in oncology the rate of residual disease and second primary head and neck tumors is still very high. The reason might be the extended biological changes of the mucosa of the whole upper aero-digestive area, not restricted to the original primary tumor site. Via SELDI TOF MS we were able to identify distant mucosal changes, which correlated with the changes of the tumorcells.

5 Biopsies were taken from each patient (9 patients without and 15 patients with carcinoma). The protein-profiles were analysed via SELDI TOF MS and compared with profiles from other tumorbiopsies. The data was updated with the clinical parameters and a follow up after two years.

After identifying the average peak-intensities the protein profiles were colour coded and sorted in three different groups (class prediction analysis). Patients without tumor showed only “healthy” protein profiles, 10 of 15 patients with tumor were identified as such, although the histology of these biopsies was unsuspicious. We found field cancerization as well as skip lesions.

SELDI TOF MS seems to be an innovative method to identify patients at risk for residual disease and second primary carcinoma. The biopsies of macroscopic healthy mucosa are able to identify molecular changes. This gives the opportunity to identify patients at risk for extended therapeutic consequences and better clinical surveillance.