Abstract
Over 90% of oral cancers are oral squamous cell carcinoma (OSCC). Hitherto, early detection marker for OSCC has not been available. Hence, this study aimed to evaluate the diagnostic and prognostic ability of salivary matrix-metalloproteinase-9 (MMP-9) and 8-hydroxydeoxyguanosine (8-OHdG) for OSCC. Total of 318 participants with 106 cases and 212 controls were included: OSCC cases were from Seoul National University Dental Hospital and age, sex, and smoking matched controls were from Yangpyeong cohort. Unstimulated saliva was collected to determine MMP-9 and 8-OHdG using sensitive enzyme-linked immunosorbent assay. Multivariable linear regression and analysis of covariance (ANCOVA) were applied to evaluate the adjusted association of markers with OSCC. Wilcoxon sign rank sum test and Friedman test for median were applied to evaluate follow-up level of MMP-9 after surgery. Receiver operating characteristic curve was obtained for diagnostic ability. Salivary MMP-9 was associated with OSCC (ANCOVA and multivariable linear regression, p<0.05), while 8-OHdG was not. The diagnostic ability of MMP-9 was area under curve of 0.96 (100% specificity and 89.6% sensitivity, p<0.001). MMP-9 decreased dramatically after tumor surgery (p<0.05). Salivary MMP-9 could be a critical diagnostic and prognostic marker for OSCC.
Highlights
Head and neck cancer (HNC) comprising of oral cavity, oropharynx, and larynx is the sixth most common cancer worldwide, with a high morbidity rate, and a 5-year survival rate of only 50% [1,2]
Over 90% of oral cancers are oral squamous cell carcinoma (OSCC) that arises from the squamous epithelium which are often seen on the 5th-6th decade of life [3]
The pattern was almost same for 8-OHdG except physical activity and diabetes which showed no difference between OSCC cases and controls
Summary
Head and neck cancer (HNC) comprising of oral cavity, oropharynx, and larynx is the sixth most common cancer worldwide, with a high morbidity rate, and a 5-year survival rate of only 50% [1,2]. Even though OSCC is in the most accessible area for visual examination, there is no early warning signs and symptoms for patients until the later stage. It was diagnosed mostly in advanced stages and the survival rate was low [4,5].
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