Huey-Shys Chen

Salivary endothelin-1 potential for detecting oral cancer in patients with oral lichen planus or oral cancer in remission.

Endothelin-1 (ET-1) is a potent vasoconstrictor involved not only in vascular biology but also in carcinogenesis. Results of a study in 2007 suggested salivary ET-1 as a potential biomarker for oral squamous cell carcinoma (OSCC), but a later study showed conflicting results. The purpose of our pilot study was to investigate feasibility of using salivary ET-1 as a biomarker for OSCC in two groups: oral lichen planus (OLP) patients and patients with OSCC in remission. Saliva samples were collected from five groups of subjects: patients with newly diagnosed, active OSCC (Group A); patients with OSCC in remission (Group B); patients with active OLP lesions (Group C); patients with OLP in remission (Group D); and normal controls (Group E). Salivary ET-1 levels were determined by enzyme-linked immunosorbent assay, and the results were analyzed by the Mann-Whitney U test. The mean salivary ET-1 level in Group A was significantly higher than that found in Group C (p=0.001), Group D (p=0.015) or Group E (p=0.004). There were no significant differences (p>0.05) in the mean salivary ET-1 levels between Groups A and B; Groups B and C; Groups B and D; Groups B and E; Groups C and D; Groups C and E; or Groups D and E. Salivary ET-1 could be a good biomarker for OSCC development in OLP patients regardless of the degree of OLP disease activity. However, it appeared not to be a good biomarker for detecting recurrence of OSCC in patients in remission.

Salivary Interleukin-6 and -8 in Patients With Oral Cancer and Patients With Chronic Oral Inflammatory Diseases

BACKGROUND Previous research has indicated that salivary interleukin (IL)-6 and IL-8 are potential biomarkers for oral squamous cell carcinoma (OSCC). However, their levels have been found to be significantly elevated in patients with chronic periodontitis (CP) or oral lichen planus (OLP). The data also showed wide variations in levels among the different studies, and no standardization procedure was ever performed. Therefore, the objective of this study is to determine whether CP or OLP confounds the use of IL-6 or IL-8 for OSCC detection. METHODS Saliva samples were collected from five groups: OSCC before treatment (n = 18); CP (n = 21); disease-active OLP (n = 21); disease-inactive OLP (n = 20); and healthy controls (n = 21). IL-6 and IL-8 concentrations (determined by enzyme-linked immunosorbent assays) were compared, using total salivary protein-standardized levels to validate the data. The Kruskal-Wallis test (α = 0.05) followed by pairwise Mann-Whitney U (post hoc) tests with Bonferroni adjustments (α = 0.00625) were used for statistical analysis. RESULTS Salivary IL-6 levels were significantly higher in patients with OSCC than in patients with CP (P <0.001), disease-active OLP (P = 0.001), disease-inactive OLP (P <0.001), and healthy controls (P <0.001). Salivary IL-8 levels were significantly higher in patients with OSCC than in patients with CP (P <0.001), but only marginally significantly higher than in healthy controls (P = 0.014). Statistical results of standardized IL-6 and IL-8 levels were consistent with the non-standardized levels in all pairs except one. CONCLUSION Salivary IL-6 may be a useful biomarker in the detection of OSCC, unconfounded by CP or OLP.

Salivary basic fibroblast growth factor in patients with oral squamous cell carcinoma or oral lichen planus

OBJECTIVE The objective of this study was to gather preliminary data concerning the feasibility of using salivary basic fibroblast growth factor (bFGF) for detecting development of oral squamous cell carcinoma (OSCC) in patients with oral lichen planus (OLP), and in patients with OSCC whose disease was in remission. STUDY DESIGN Saliva samples were collected from 5 patient groups: patients with newly diagnosed OSCC, patients with OSCC whose disease was in remission, patients with OLP in disease-active state, patients with OLP in disease-inactive state, and healthy controls. Salivary bFGF levels were determined by enzyme-linked immunosorbent assay, and data were analyzed using the Mann-Whitney U test. RESULTS Salivary bFGF levels were significantly elevated in patients with newly diagnosed OSCC compared with patients with OSCC in remission, patients with disease-active OLP, and healthy controls. No significant difference was found between patients with newly diagnosed OSCC and patients with disease-inactive OLP. CONCLUSIONS Our results suggested that salivary bFGF might be a potential biomarker for detecting OSCC development in patients with OSCC in remission, but not in patients with OLP.

Population-based study of birth prevalence and factors associated with cleft lip and/or palate in Taiwan 2002-2009.

Background Facial cleft deformities, including cleft lip with or without cleft palate (CL/P) and cleft palate (CP), are common congenital birth anomalies, especially in Asia. This study aimed to analyze the prevalence of CL/P and CP and to identify associated factors in Taiwan. Methods This population-based epidemiological study retrospectively analyzed birth data obtained from the Department of Health in Taiwan for years 2002–2009. Frequency distribution, percentages and related predictors were investigated, and findings were presented by types of cleft deformities. Logistic regression analysis was performed to identify factors associated with cleft deformities. Results Overall prevalence of cleft deformities among 1,705,192 births was 0.1% for CL/P and 0.04% for CP over the 8-year study period. Higher prevalence of CL/P or CP was observed with multiple pregnancies, being male for CL/P, being female for CP, gestational age ≤37 weeks and lower birth weight (<1.5 kg). Both CL/P and CP were significantly associated with gestational age <37 weeks and birth weight<1.5 kg (all P <0.0001). CL/P was significantly associated with multiple parities (P = 0.0004–0.002). Male newborns and female newborns were significantly associated with CL/P and CP, respectively (both P<0.0001). Conclusions Overall prevalence for congenital cleft deformities in study subjects was 0.1%, in keeping with high rates in Asia. Results suggest the need for awareness and early identification of those at high risk for cleft deformities, including newborns with gestational age <37 weeks, weighing <1.5 kg at birth and women with multiple parities, as a potential strategy to counter long-term adverse effects on speech and language in this population.

Stages of smoking acquisition of young Taiwanese adolescents: self-efficacy and decisional balance.

The objective of this study was to assess relationships of the stages of smoking acquisition with self-efficacy and decisional balance in young Taiwanese adolescents. A random sample of 401 students was recruited. Students who were at the precontemplation stage had higher self-efficacy to resist smoking initiation than those who were at the decision-making or maintenance stages. Ratings of benefits of smoking were significantly higher for those in the maintenance stage than in the precontemplation or decision-making stages. In a discriminant function analysis, self-efficacy and decisional balance correctly predicted 77.4% of membership in the three stages. Health educators could use stage-specific skills and strategies based on self-efficacy and decision balance constructs to develop smoking prevention programs.

Levels of potential oral cancer salivary mRNA biomarkers in oral cancer patients in remission and oral lichen planus patients

ObjectivesTo gather preliminary data concerning the feasibility of using seven salivary mRNAs—IL-8; IL-1β; dual specificity phosphatase 1 (DUSP1); H3 histone family 3A (H3F3A); ornithin decarboxylase antizyme 1 (OAZ1); S100 calcium-binding protein P (S100P); and spermidine/spermine N1-acetyltransferase 1 (SAT1)—for detecting development of oral squamous cell carcinoma (OSCC) in oral lichen planus (OLP) patients and OSCC patients whose disease was in remission.Materials and methodsSaliva samples were collected from five study groups (25 subjects/group): newly diagnosed OSCC, OSCC-in-remission, disease-active OLP, disease-inactive OLP, and normal controls. The salivary mRNA levels were determined by a pre-amplification RT-qPCR approach with nested gene-specific primers. Mean fold changes between each pair of study groups were analyzed by the Mann–Whitney U test.ResultsSalivary levels of OAZ1, S100P, and DUSP1 mRNAs were significantly higher in newly diagnosed OSCC patients, compared to: (1) normal controls (p = 0.003; p = 0.003; and p < 0.001, respectively); (2) OSCC-in-remission (p < 0.001; p = 0.001; and p < 0.001, respectively); (3) disease-active OLP (p < 0.001; p = 0.016; and p < 0.001, respectively); and (4) disease-inactive OLP (p = 0.043; p < 0.001; and p < 0.001, respectively). No significant differences were found in the levels of salivary IL-8, IL-1β, H3F3A, and SAT1 mRNAs between newly diagnosed OSCC patients and the normal controls (p = 0.093, 0.327, 0.764, and 0.560, respectively).ConclusionSalivary OAZ1, S100P, and DUSP1 mRNAs are candidate biomarkers for detecting OSCC development in OSCC patients in remission and in OLP patients.Clinical relevanceThe results of this study serve as the basis for a further large-scale study which may lead to a non-invasive screening method for early detection of OSCC.

The chinese version of the decisional balance scale: further validation.

Background: Although the Decisional Balance Scale (DBS) has been established to have sound psychometric properties, the reliability and validity of this instrument have not been evaluated in different populations. Objectives: The aim of this study was to conduct psychometric validations for the Chinese version of the DBS (CDBS). Methods: This research project was designed as a descriptive cross-sectional study. The CDBS was administered to children in Grades 5-9 (ages 11-17 years, n = 952) recruited from elementary and junior high schools in northern Taiwan. A random cluster sampling method was used. Results: The pros and cons subscales were supported by Cronbachs &agr; coefficients of .88 and .85, respectively. Item-to-subtotal correlation coefficients for the subscales were above .48. The results from confirmatory factor analysis, used to assess the construct validity of the CDBS, indicated that the two-factor structure was the best fit for the CDBS when it was used with Taiwanese adolescents (comparative fit index = .96). The contrasted group approach affirmed the construct validity of the pros and the cons of the CDBS. The validity and reliability of the CDBS were supported by the psychometric test results of this study. Discussion: The CDBS is congruent with the culture of Taiwanese adolescents. However, to expand the usefulness of this tool across cultures, the CDBS should continue to be tested with other Chinese-speaking populations and settings.

Psychometric Testing of the Chinese Version of the Decisional Balance Scale (CDBS)

The purpose of this study was to conduct psychometric testing on the Chinese version of the decisional balance scale (CDBS) with Taiwanese seventh, eighth,and ninth graders who were recruitedfrom the Taipei metropolitan area. A random cluster sampling method was used with 554 adolescents between the ages of 13 and 17 years. Factor analysis procedures showed two components, Pros and Cons, accounting for 74.32% of the total variances andcontrastedgroupcomparisonsaffirmedthe constructvalidityof the Pros, the Cons, andthe CDBS. Item-to-subtotalcorrelationcoefficients for the two subscales, the Pros and Cons, were greater than .50 and their reliability was supported by Cronbachs alpha coefficients, .87 and .91, respectively. The validity and reliability of the CDBS suggestedthat the CDBS was applicableto and congruentwith the culture of the Taiwanese adolescents smoking behavior. Further validation of the CDBS scale with different populations and larger sample size is suggested.

Chronic periodontitis can affect the levels of potential oral cancer salivary mRNA biomarkers.

BACKGROUND AND OBJECTIVE More than 100 salivary constituents have been found to show levels significantly different in patients with oral squamous cell carcinoma (OSCC) from those found in healthy controls, and therefore have been suggested to be potential salivary biomarkers for OSCC detection. However, many of these potential OSCC salivary biomarkers are also involved in chronic inflammation, and whether the levels of these biomarkers could be affected by the presence of chronic periodontitis was not known. The objective of this pilot study was therefore to measure the levels of seven previously reported potential OSCC salivary mRNA biomarkers in patients with chronic periodontitis and compare them to levels found in patients with OSCC and healthy controls. The seven salivary mRNAs were interleukin (IL)-8, IL-1β, dual specificity phosphatase 1, H3 histone family 3A, ornithine decarboxylase antizyme 1, S100 calcium-binding protein P (S100P) and spermidine/spermine N1-acetyltransferase 1. MATERIAL AND METHODS Unstimulated whole saliva samples were collected from a total of 105 human subjects from the following four study groups: OSCC; CPNS (chronic periodontitis, moderate to severe degree, non-smokers); CPS (chronic periodontitis, moderate to severe degree, smokers); and healthy controls. Levels of each mRNA in patient groups (OSCC or chronic periodontitis) relative to the healthy controls were determined by a pre-amplification reverse transcription-quantitative polymerase chain reaction approach with nested gene-specific primers. Results were recorded and analyzed by the Bio-Rad CFX96 Real-Time System. Mean fold changes between each pair of patient vs. control groups were analyzed by the Mann-Whitney U-test with Bonferroni corrections. RESULTS Only S100P showed significantly higher levels in patients with OSCC compared to both patients with CPNS (p = 0.003) and CPS (p = 0.007). The difference in S100P levels between patients with OSCC and healthy controls was also marginally significant (p = 0.009). There was no significant difference in the levels of salivary IL-8, IL-1β and dual specificity phosphatase 1 mRNAs between patients with OSCC and patients with CPNS (p = 0.510, 0.058 and 0.078, respectively); no significant difference in levels of salivary ornithine decarboxylase antizyme 1 and spermine N1-acetyltransferase mRNAs between patients with OSCC and patients with CPS (p = 0.318 and 0.764, respectively); and no significant difference in levels of the H3 histone family 3A mRNA between patients with OSCC and either CPS (p = 0.449) or healthy controls (p = 0.107). CONCLUSIONS Salivary S100P mRNA could be a reliable biomarker for OSCC detection, regardless of the presence of chronic periodontitis. The presence of chronic periodontitis could significantly affect the levels of the other six mRNAs, and negatively influence reliability for using them as biomarkers for oral cancer detection.