Chairside molecular imaging of aberrant glycosylation in subjects with suspicious oral lesions using fluorescently labeled wheat germ agglutinin

Head Neck. 2018 Feb;40(2):292-301. doi: 10.1002/hed.24943. Epub 2017 Sep 30.

Abstract

Background: Aberrant sialylation is accepted as a carcinogenic biomarker. In previous work, fluorescently labeled wheat germ agglutinin (WGA) distinguished between cancerous and normal oral biopsies. The purpose of this study was to investigate WGA-fluorescein isothiocyanate (FITC) as a point-of-care tool for detecting oral malignant and dysplastic lesions in vivo.

Methods: Subject recruitment was divided into two groups: (1) the clinically normal oral mucosa group; or (2) the presence of clinically suspicious oral lesion(s) group. A WGA-FITC solution was topically applied to observable lesions or to half the subject's mouth (sagittal plane) if lesions were absent. Fluorescent molecular imaging was used to evaluate WGA-FITC localization.

Results: Fluorescent imaging in 55 subjects demonstrated that WGA-FITC could detect histopathologically-confirmed cancerous and dysplastic lesions with high sensitivity (100% and 81%, respectively) and specificity (82%).

Conclusion: This study supports in vivo fluorescent molecular imaging of WGA-FITC to visualize aberrant sialic acid expression associated with carcinogenesis. This technique resulted in the immediate chairside detection of oral cancerous and dysplastic lesions.

Keywords: aberrant glycosylation; molecular imaging; oral cancer; sialic acid; wheat germ agglutinin-fluorescein isothiocyanate (WGA-FITC).

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Diagnosis, Differential
  • Female
  • Fluorescein-5-isothiocyanate / analogs & derivatives*
  • Fluorescein-5-isothiocyanate / metabolism
  • Glycosylation
  • Humans
  • Male
  • Middle Aged
  • Molecular Imaging / methods*
  • Mouth Diseases / diagnostic imaging*
  • Mouth Diseases / metabolism
  • Mouth Diseases / pathology
  • Mouth Mucosa / diagnostic imaging*
  • Mouth Mucosa / metabolism
  • Mouth Mucosa / pathology
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / metabolism
  • Mouth Neoplasms / pathology
  • N-Acetylneuraminic Acid / metabolism*
  • Staining and Labeling / methods
  • Wheat Germ Agglutinins* / metabolism
  • Young Adult

Substances

  • Wheat Germ Agglutinins
  • fluorescein isothiocyanate-wheat germ agglutinin
  • N-Acetylneuraminic Acid
  • Fluorescein-5-isothiocyanate