LONDON, England: Although most suspicious oral lesions are not malignant, determining this may require invasive scalpel biopsy, and the referral process can delay definitive diagnosis. To address this challenge, researchers have developed a non-invasive diagnostic test that may support earlier detection of oral squamous cell carcinoma and reduce unnecessary procedures for patients whose lesions are not malignant. The method is intended to support clinical triage and referral decisions.
Molecular oral oncology expert Prof. Muy-Teck explained in an interview that he has developed a new test designed to support earlier, more accurate triage of suspicious oral lesions. (Image: Prof. Muy-Teck Teh)
According to lead researcher Dr Muy-Teck Teh, professor of molecular oral oncology at the Centre for Oral Immunobiology and Regenerative Medicine of the Institute of Dentistry at Queen Mary University of London, the study builds on an earlier micro-biopsy-based test validated using tissue samples from patients in the UK, India and China. “That cross-continental validation established the robustness of the test across diverse patient populations and clinical settings. Since micro-biopsy remains an invasive test, I conducted a large case–control study to investigate whether a non-invasive brush biopsy method could be used instead,” he told Dental Tribune International.
In the study, the researchers validated the brush-based version of the test, which measures the expression of four genes, using oral brush biopsies from 545 patients with oral squamous cell carcinoma, leukoplakia or oral lichen planus. Each patient gave two brush samples: one from the suspicious lesion and one from healthy tissue on the opposite side of the mouth. According to the findings, the test clearly distinguished oral squamous cell carcinoma from the other two conditions, correctly identifying almost all cancer cases and rarely classifying leukoplakia or lichen planus as cancer.
“The test achieves performance that is highly comparable to that of its micro-biopsy predecessor. It suggests that the biological signal captured by these four genes is sufficiently strong and consistent to be detected even in the superficial exfoliated cells collected by a brush biopsy. The clinical implications are significant: patients might no longer need to undergo even a minimally invasive procedure to benefit from molecularly guided triage,” Prof. Teh commented.
“For dentistry, the test has the potential to be as transformative for oral cancer detection as cervical cytology has been for cervical cancer screening. It could shift oral cancer diagnosis from a predominantly invasive, specialist-centred process to a rapid, cost-effective, repeatable and patient-friendly molecular testing pathway, enabling earlier detection while substantially reducing unnecessary biopsies,” Prof. Teh noted.
Prof. Teh told Dental Tribune International that, if commercialised and integrated into routine clinical practice, the test could enable general dental practitioners to perform molecular risk assessment chairside or via local laboratories, improving triage decisions before referral to oral medicine or maxillofacial services. This could also reduce waiting lists and allow specialist services to focus on high-risk patients. He emphasised, however, that the test is not a replacement for histopathological diagnosis: “Positive or high-risk results would still require conventional biopsy confirmation.”
The study, titled “INHBA–S100A16 dysregulation enables a non-invasive molecular stratification platform for rapid detection of oral squamous cell carcinoma: Results from a large diagnostic case-control study”, was published online on 23 June 2026 in Biomarker Research.
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