Assessment of Serum bilirubin as a biomarker of disease status and predictor of survival rate in oral squamous cell carcinoma

Abstract

: Carcinogenesis is a complex and multi-step process, which results from various deleterious habits, multiple environmental factors and genetic susceptibility. Inflammation can facilitate tremendous cancer progression. Identifying novel prognostic factors for OSCC is important for early diagnosis, prognosis valuation and choosing more appropriate treatment. The serum bilirubin plays a chief role in anti-inflammation, anti-oxidation, and anti-tumorigenesis. In different tumor models, thereby alleviating the oxidative stress. Decreased reactive oxygen species damages DNA structure and alters gene expression ultimately reducing cell proliferation. Abnormal level of serum bilirubin, marker of hepatobiliary was associated with patient prognosis in several human malignancies. Therefore, the current study will be carried out to evaluate the predictive value of serum bilirubin for clinicopathologic characteristics and survival of patients with oral squamous cell carcinoma (OSCC). Study was performed retrospectively and it comprised 246 cases of OSCC were selected randomly among the individuals who admitted to the hospital. The pre-operative direct bilirubin (DBIL), indirect bilirubin (IBIL), total bilirubin (TBIL) was compared and evaluate with clinical and pathological parameters. A proportional hazards regression model was used to find out the independent predictors of overall survival (OS).Significantly lower TBIL (p=0.012) & IBIL (p<0.0035) were found in OSCC patients compared with normal controls. DBIL (p = 0.008) and lymph-node metastasis (p = 0.031) were institute to be self-determining prognostic factors. Cases having lesser DBIL with lymph-node metastasis exhibited the poor OS (p = 0.001). DBIL and lymph node metastasis was regarded as a self-determining prognostic marker for individuals with OSCC.