Cancer has emerged as a major killer disease in India. By currently available statistics, approximately 9 lakh new cases of cancer are expected to develop every year in India. National cancer registry figures suggest that one out of every 10 to 16 persons from the urban population in India may get cancer in his lifetime.
Blood ScreeningIn India, the most commonly encountered cancers today Ruby Hall Clinic are the cancers of the oral cavity, oesophagus, breast and uterine cervix. Cancers of the breast, cervix and oral cavity form about 55 to 60% of the total cancer cases presented to the clinicians in the country. These cancers occur at sited which are easily accessible for observation and treatment. Fortunately, these cancers are preventable and curable if detected at an early stage.
An analysis of WHO on the control of oral cancers in developing countries like India, stresses on the need for primary prevention. For the cancer of cervix, the method widely accepted in developed countries, is the PAP smear test. However, use of this method, as a screening programme, does seem difficult in our country given the paucity of trained staff and financial constraints. Mammography used as a primary screening method in developed countries is also costly as it involves imaging technologies and complex quality control procedures with enormous cost in terms of staff and equipment. Cancer of the gastro intestinal tract is usually presented to the clinician at an advanced stage because of the fact that these lesion are not easily seen by the patients or family doctors, which in turn causes a loss of valuable time before the diagnosis is established and the treatment begins. An early detection technique can help solve this problem.
The need of the cancer clinicians in our country is thus cost–effective screening technique for the early detection of malignant tumors in the body. Sahasrabudhe et al have developed precisely such a simple blood screening technique (ELISA) using Tumor Mimetic Cell Surface Antigens (TMCS) as a marker. TMCS is patented in India and the USA. In this technique, the presence of malignant tumors in the body is detected indirectly by detecting the presence of lymphocytes sensitized specifically to tumors specific cell surface markers. The method involves the following steps:
- Collection of 5cc peripheral blood sample from the person.
- Isolation of lymphocytes from the collected blood sample.
- Blocking of endogenous peroxidase activity.
- Treatment of such lymphocytes with Tumor Mimetic Cell Surface Antigens (TMCS) tagged with enzyme peroxydase and an appropriate substrate.
- Determination of Optical Density (OD) value at 492mm without a differential filter.
During our pilot study we grouped the samples in three categories namely
- Samples from patients attending OPD for ailments other than cancers and healthy donors from the blood banks, which form the negative control group.
- Samples from patients with histopathologically proven (biopsy positive) cancers. These samples were collected pre–operatively. These constituted the positive control group.
- Samples from patients with benign lesions. These samples were tested to rule out any cross reactivity between malignant and benign lesions.
The detailed results are explained in Table I
The sensitivity and specificity values for the limited number of sample study are extremely encouraging.
The sensitivity and specificity value for Negative Control Group Sample studied is (94.8%). The sensitivity values for Oral Cancer samples (100%). Breast Cancer samples (91.3%), G. I. Tract Cancer (100%) and Uterine Cervical Cancer (100%). All the samples from patients with benign lesions were correctly diagnosed as negative with this test confirming that the test can specifically differentiate between malignant and benign lesions.
The data was presented at various national and international conferences listed below
- Poster presentation at International Cancer Congress held in New Delhi for October 30th – November 5th, 1994.
- Invited to read a paper title “Enzyme Linked Immunosorbent Assay (ELISA) for detection of cell surface antibodies on cancerons cells” at XVIII National Congress at Indian Association of Medical Microbiologists held from November 12th–14th, 1994 at CME, Pune.
- Invited to give a lecture on “Detection of cancer of the cervix” at the VIth International multi–Faculty Medical Conference held from June 24th–37th 1998 at World Trade Centre, Mumbai.
- Invited to deliver state of the art Lecture on “A newly developed blood screening technique for the early detection of the carcinoma in the cervix” at the First International Conference on Biological Therapy and Modern Cancer Treatment (ICBT and MCT) held from November 16th–21st, 1998 at Guangzhou–China and Hong Kong.
- Invited to read a paper on “Early detection of carcinoma in the oral cavity” at the 6th Internation Conference on Oral Cancer held from February 15th–18th 1999 at New Delhi.
- Invited to deliver a lecture on cancer of the cervix at the “Obstetrics and Gynaecology: Towards Next Millennium” Symposiums held from February 23rd–24th, 1999 at King Faisal Specialist Hospital and Research Centre, Riyadh Kingdom of Saudi Arabia.
The latest data on the early detection of cancer of the cervix is accepted for publication in the International Journal of Modern Cancer Therapy (Issue 1999 Vol. 2 3:1)
Evaluation of the data, shows that a successful use of this new blood screening technique using TMCS as a marker, could provide an important tool for the study of early detection of malignancies in the body. The technique is especially of great value in India as it is cost effective, time saving and easy to perform. Use of this technique for an effective mass screening programme is most likely to result in the down staging of commonly encountered cancers in our country.
As we all know, early detection is the only key factor in treating cancer patients and we hope to use this new screening technique as a proper test to screen and prevent the population against cancer.
|Negative control group||Cancer of Breast||Cancer of Cervix||Cancer of Oral GI tract||Cancer of Oral cavity||Sarcoma|
|No. of samples studied||787||23||22||32||30||07|
|No. of true Negative||961||–||–||–||–||–|
|No. of true Positive||–||21||22||32||30||07|
Mrs. M. A. Agashe
M. Sc. (Cytology),