Correlation of Soluble CD44 Expression in Saliva and CD44 Protein in Oral Leukoplakia Tissues.

Ingrīda Čēma,Regīna Kleina,Ivanda Franckevica,Madara Dzudzilo,Šimons Svirskis

doi:10.3390/cancers13225739

Ingrīda Čēma, Regīna Kleina + Show 3 more

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https://doi.org/10.3390/cancers13225739

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Abstract

Simple SummaryOne way to facilitate the detection of early malignant transformation processes in oral potentially malignant disorders, including oral leukoplakia, involves the parallel evaluation of tissue and saliva biomarkers, as such indicators may elucidate both protein CD44 expression in leukoplakia tissue and its soluble form and total protein detection in saliva. We concluded that the OncAlert® Oral Cancer Rapid test is a non-invasive and simple but only screening method which can complement clinical diagnostics methods in daily clinical practice when considering oral leukoplakia, most importantly, in order to obtain information about the potential for early malignancy.The aim of this study was to determine whether and how pan-CD44 protein expression in leukoplakia tissues correlates with positive SolCD44 test presence and their role in oral leukoplakia. SolCD44 and total protein expression in saliva were determined using an OncAlert® Oral Cancer Rapid test. Comparison of paired associations of total protein, SolCD44, mean number of CD44 expressed epithelial layers in leukoplakia tissue, and macrophages below the basement membrane between control group and patients with leukoplakia showed statistically significant results (p < 0.0001). It is shown that the total protein indicates low or elevated risk of possible malignant transformation processes in leukoplakia. Statistically significant differences between higher total protein level and clinical forms of oral leukoplakia (p < 0.0001), as well as CD44-labeled epithelial cell layer decrease (p < 0.0001), were found. This possibly points to the onset of the stemness loss in leukoplakia tissue. CD9 antigen expression in the exosomes of the oral epithelium explained the intercellular flow of SolCD44 and other fluids in the leukoplakia area. We conclude that the OncAlert® Oral Cancer Rapid test is a valuable screening method in daily clinical practice, in terms of complementing clinical diagnostics methods and to assess the potential for early malignancy.

Highlights

The results indicated that there is strong evidence that soluble CD44 and total protein are associated with cancer risk independently of tobacco or alcohol use, age, and gender [37]
We noticed that the leukoplakia in our patients was localized more often on the left side of oral cavity, followed by those localized on the floor of the mouth
More and more information is being presented on the specific tissues and salivary biomarkers that indicate early signs of malignant transformation of the oral epithelium; the definition of oral potentially malignant disorders (OPMD) will likely need to be reviewed in the future

Summary

Introduction

In Europe, according to the GLOBOCAN 2020 data, the incidence of lip and oral cancer in both sexes constituted 17.3%, 13.8% mortality, and 5-year prevalence of 20.6% [1]. In the Baltic states, the incidence rates of oral cancer (C03–06) observed in men and women in Lithuania were 2.6 and 0.4; in Latvia, 2.5 and 0.3; and in Estonia, 2.3 and 0.7, respectively [2]. The oral cavity is well visible to both the patient and any medical professional, patients tend to seek medical help late when the malignant process already affects adjacent localizations in the mouth. This means that early diagnosis—that is, in the precancerous stage—should be improved. Among oral potentially malignant disorders (OPMD), oral leukoplakia (OL) along with their clinical variants and oral erythroplakia are the most common and have the highest risk of malignant transformation [3]

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