{"id":130798,"date":"2026-09-24T07:06:00","date_gmt":"2026-09-24T10:06:00","guid":{"rendered":"https:\/\/www.ufrgs.br\/jornal\/?p=130798"},"modified":"2026-09-24T08:43:53","modified_gmt":"2026-09-24T11:43:53","slug":"artificial-intelligence-assists-in-the-early-diagnosis-of-oral-cancer","status":"publish","type":"post","link":"https:\/\/www.ufrgs.br\/jornal\/artificial-intelligence-assists-in-the-early-diagnosis-of-oral-cancer\/","title":{"rendered":"Artificial intelligence assists in the early diagnosis of oral cancer"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Health | Research carried out by the Graduate programs of Dentistry and Computer Sciences shows how technology can track oral cancer, which affects more than 15,000 people every year in Brazil<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:10px\"><em>*First published July 31, 2025<br>*Photograph: Marking of cells, nuclei, and cell clusters based on recognition by the Papanicolaou Slide \u2013 Image Examiner system (Popular Science)<br><\/em><\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">UFRGS Dentistry Graduate program professor Pantelis Varvaki Rados claims that oral cancer is curable, provided that it is diagnosed early. Rados coordinates a research project focused on developing models to investigate the initial suspicion of oral cancer. Artificial intelligence (AI) is used by professionals to help identify cellular markers indicating the risk of disease development even before more severe lesions appear.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Oral cancer is one of the most frequent types of cancer in Brazil: more than 15 thousand cases are diagnosed every year, according to a study conducted by the National Cancer Institute. This research also showed that more than six thousand people die every year from this disease. The main factors for the development of this type of cancer include tobacco and alcohol consumption, poor oral hygiene, excessive sun exposure (especially in cases of lip cancer), and HPV infection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Rados divided his research in two moments. First he carried out the manual counting of chromosomal regions associated with cell proliferation, known as nucleolar organizer regions (NORs). The increase of NORs in number indicates that the cell may be under influence of carcinogenic agents, making it a useful biomarker for risk screening.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The researchers used cytological slides collected over the years to count NORs cell by cell. This established a reliable reference standard, which enabled performance comparison through an automated system.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><em>\u201cA cell that is undergoing larger proliferation will be marked with a higher number of NORs. And that paves the way for an initial cancerous alteration to appear soon.\u201d<\/em><\/p>\n<cite><em>Pantelis Varvaki Rados<\/em><\/cite><\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\">Initially, a specific silver staining technique was used to count NORs. Without this staining process NORs remain unnoticed under the microscope, as these regions of the cell nucleus only become visible through this type of marking. \u201cNucleolar organizer regions increase in number when the cell is affected by carcinogenic agents. However, they only become visible through silver staining. \u2018Ag\u2019 stands for silver in the periodic table. That is why they are called AgNORs,\u201d Rados explains.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In the second phase, AI was used to analyse cytological slides. The images of these previously digitized slides were processed by the AgNOR Slide-Image Examiner system, trained to automatically identify and count the AgNOR regions in each cell nucleus.&nbsp;&nbsp;<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img fetchpriority=\"high\" decoding=\"async\" width=\"933\" height=\"1024\" src=\"https:\/\/www.ufrgs.br\/jornal\/wp-content\/uploads\/2025\/07\/Divulgacao-cientifica_Cancer-bucal_Arquivo-de-Pesquisa-02jpg-933x1024.jpg\" alt=\"\" class=\"wp-image-117477\" style=\"width:550px;height:auto\" srcset=\"https:\/\/www.ufrgs.br\/jornal\/wp-content\/uploads\/2025\/07\/Divulgacao-cientifica_Cancer-bucal_Arquivo-de-Pesquisa-02jpg-933x1024.jpg 933w, https:\/\/www.ufrgs.br\/jornal\/wp-content\/uploads\/2025\/07\/Divulgacao-cientifica_Cancer-bucal_Arquivo-de-Pesquisa-02jpg-273x300.jpg 273w, https:\/\/www.ufrgs.br\/jornal\/wp-content\/uploads\/2025\/07\/Divulgacao-cientifica_Cancer-bucal_Arquivo-de-Pesquisa-02jpg-107x117.jpg 107w, https:\/\/www.ufrgs.br\/jornal\/wp-content\/uploads\/2025\/07\/Divulgacao-cientifica_Cancer-bucal_Arquivo-de-Pesquisa-02jpg-768x843.jpg 768w, https:\/\/www.ufrgs.br\/jornal\/wp-content\/uploads\/2025\/07\/Divulgacao-cientifica_Cancer-bucal_Arquivo-de-Pesquisa-02jpg-465x511.jpg 465w, https:\/\/www.ufrgs.br\/jornal\/wp-content\/uploads\/2025\/07\/Divulgacao-cientifica_Cancer-bucal_Arquivo-de-Pesquisa-02jpg-455x500.jpg 455w, https:\/\/www.ufrgs.br\/jornal\/wp-content\/uploads\/2025\/07\/Divulgacao-cientifica_Cancer-bucal_Arquivo-de-Pesquisa-02jpg.jpg 1366w\" sizes=\"(max-width: 933px) 100vw, 933px\" \/><figcaption class=\"wp-element-caption\">AgNORs marking recognized by the system developed during the research, the AgNOR Slide \u2013 Image Examiner (Popular Science)<\/figcaption><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\">While the study found a strong alignment between human evaluations and the system\u2019s results, the real breakthrough came in terms of efficiency, because the use of AI reduced the analysis time from 67 hours to just 20 minutes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nevertheless, Rados explains that AI does not replace the human specialist, but rather accelerates the process and enables large-scale screenings with greater efficiency. While the system detects suspicious cytological changes, the specialist serves as a validator and directs the clinical diagnosis. Hence, both processes complement each other.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><em>\u201cIt will be possible to analyze cytological parameters for a large number of people.\u2026Then, if something falls outside the the expected range, a human reviewer will step in to conduct a case-by-case evaluation\u201d&nbsp;<\/em><\/p>\n<cite><em>Pantelis Varvaki Rados<\/em><\/cite><\/blockquote>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Results<\/strong><\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">This research showed that the statistical average number of AgNORs per cell nucleus is 3.69. Values above this cutoff should be further examined, as this was defined as the point at which a sample may be considered suspicious. This index does not constitute a definitive diagnosis, but it serves as an indicator of increased risk.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Just like other clinical parameters, such as blood pressure or blood glucose, values exceeding the expected range indicate potential risk. \u201cThis parameter is similar to the blood pressure: when it rises above 130 over 80, closer monitoring becomes necessary.\u201d, explains Rados<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In addition to silver staining for visualizing AgNORs, the study also incorporated another well-known method widely used in public health: Pap smear staining, commonly used in gynecological exams. In this research, it was adapted to identify morphological changes in oral mucosal cells.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The advantage lies in cost. While silver reagents can cost thousands of reais, Pap smear method is much more affordable and feasible for primary healthcare units. \u201cA silver container costs around BRL 3,000.00. Pap smear reagent is significantly cheaper and easier to acquire,\u201d compares professor Rados.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For him, the project\u2019s greatest promise is to use simple, accessible, and quick tests to map individual patient risk. The proposal does not replace clinical exams or biopsies, but it offers a new approach to screening and public health monitoring.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><em>\u201cCytopathology is a screening tool. The idea is to identify who is at higher risk of developing cancer and to closely monitor that person.\u201d<\/em><\/p>\n<cite><em>Pantelis Varvaki Rados<\/em><\/cite><\/blockquote>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Challenges and the Future<\/strong><\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">Despite its achievements, the project also faced significant challenges. Carried out during the COVID-19 pandemic, it required creativity to deal with social distancing, limited resources, and the emotional impact of conducting scientific research in a time of crisis. Reflecting on this period, Professor Rados recalls the path followed by the group:<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><em>\u201cThe best thing we have in this university is our minds. We worked with limited resources, in the middle of the pandemic, and still managed to develop a new model in one year or so.\u201d&nbsp;<\/em><\/p>\n<cite><em>Pantelis Varvaki Rados<\/em><\/cite><\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\">Besides the lack of substantial funding, the project faces other technical and structural barriers, such as the absence of a slide scanner, which is an equipment that could further automate the process. Another challenge is the logistical complexity of expanding the model to other research centers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The group is now working to integrate patients\u2019 clinical data with the cytological data collected, aiming to enhance the tool\u2019s predictive power. In the future, the goal is to apply AI to screen high-risk groups on a large scale, especially in primary healthcare units.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Partnership<\/strong><\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">Around 1992, the oral cytopathology research area was established at UFRGS. With the onset of the covid-19 pandemic, the integration of AI was accelerated through a partnership with the Institute of Informatics. The project\u2019s original goal was to adapt well-established techniques used in the early detection of cervical cancer to oral cancer diagnostics.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This partnership was essential to develop this new smart system, which is one of the first in Brazil to use AI for the automatic reading of cytological slides in the early detection of oral cancer. \u201cWe made significant progress in the cellular analysis part during the pandemic, because we already had a large collection of slides\u201d, says Rados.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Despite the challenges, the researcher emphasizes that the collaboration between different fields of knowledge and students\u2019 and professors\u2019 dedication were crucial for the project\u2019s progress. More than that, this partnership showed that quality science is made with courage, collaboration, and resilience.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<div class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Article:<\/strong> <a href=\"https:\/\/lume.ufrgs.br\/handle\/10183\/292728\">Cytopathological quantification of NORs using artificial intelligence to oral cancer screening<\/a><br><strong>Authors:<\/strong><a href=\"http:\/\/lattes.cnpq.br\/6016550979805838\"> Tatiana Wannmacher Lepper<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/0793800391989259\">Luara Nascimento do Amaral<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/8527135247751489\">Ana Laura Ferrares Espinosa<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/8237272563387685\">Igor Cavalcante Guedes<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/5477229417495176\">Maikel Maciel R\u00f6nnau<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/5577133875240485\">Nat\u00e1lia Batista Daroit<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/5911814779756172\">Alex Nogueira Haas<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/9633674478174126\">Fernanda Visioli<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/3083628377406351\">Manuel Menezes de Oliveira Neto<\/a>, <a href=\"http:\/\/lattes.cnpq.br\/0357994797448815\">Pantelis Varvaki Rados<\/a><br><strong>Units:<\/strong> Graduate program of Dentistry &#8211; Dentistry School and Graduate Program of Computer Sciences &#8211; Institute of Informatics.<\/p>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<p class=\"has-accent-background-color has-background wp-block-paragraph\">Translated into English by <strong>Laura Lameira Ekman<\/strong>, undergraduate student enrolled in the course \u201cSupervised Translation Training II (English)\u201d of the Undergraduate Program in Language and Literature, under the supervision and translation revision of Professor Rozane Rebechi (P.h.D.) \u2013 IL\/UFRGS.<br><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>:: Read in portuguese<\/strong><br><a href=\"https:\/\/www.ufrgs.br\/jornal\/uso-de-inteligencia-artificial-auxilia-no-diagnostico-precoce-do-cancer-de-boca\/\">Uso de intelig\u00eancia artificial auxilia no diagn\u00f3stico precoce do c\u00e2ncer de boca<\/a><\/p>\n\n\n\n<div class=\"wp-block-group alignwide\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<div class=\"wp-block-buttons alignwide is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-fe48e5de wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button has-custom-width wp-block-button__width-50 is-style-outline animated fadeInDown slow is-style-outline--1\"><a class=\"wp-block-button__link has-text-color has-link-color has-text-align-center has-custom-font-size wp-element-button\" href=\"https:\/\/www.ufrgs.br\/jornal\/category\/in-english\/\" style=\"border-radius:16px;color:#135e96;font-size:15px\">Explore the full section <strong>In English<\/strong> <\/a><\/div>\n<\/div>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Health | Research carried out by the Graduate programs of Dentistry and Computer Sciences shows how technology can track oral cancer, which affects more than 15,000 people every year in Brazil<span class=\"more-link\"><a href=\"https:\/\/www.ufrgs.br\/jornal\/artificial-intelligence-assists-in-the-early-diagnosis-of-oral-cancer\/\">Leia mais<\/a><\/span><\/p>\n","protected":false},"author":242,"featured_media":117476,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"page_builder":"","footnotes":"","_ppma_block_editor_authors":"{\"authors\":[7003],\"author_categories\":{\"7003\":\"1\"},\"fallback_author_user\":\"1\",\"ppma_author_box_select\":\"\",\"selected_authors\":[{\"id\":7003,\"display_name\":\"Marcelo Rosinski\",\"is_guest\":0,\"category_id\":\"1\"}]}"},"categories":[4495],"tags":[],"ppma_author":[7003],"class_list":["entry","author-marcelorosinski","has-excerpt","post-130798","post","type-post","status-publish","format-standard","has-post-thumbnail","category-in-english"],"pp_statuses_selecting_workflow":false,"pp_workflow_action":"current","pp_status_selection":"publish","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - 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