Salivary Tumour Necrosis Factor-α as a Biomarker in Oral Leukoplakia and Oral Squamous Cell Carcinoma

Document Type: Research Articles


1 Department of Oral and Maxillofacial Pathology, Government Dental College and Hospitals, Hyderabad, India.

2 Department of Oral and Maxillofacial Pathology, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Telangana, India.


Background: Oral cancer is one of the life threatening disease which requires an availability of a biomarker for its
early detection and also for effective treatment strategies. The current study is done to evaluate the efficacy of one such
biomarker i.e. TNF- α as an indicator for oral precancer and oral cancer. Objectives: To evaluate the efficacy of Tumour
necrosis factor - alpha (TNF)-α as a salivary biomarker in histopathologically diagnosed cases of oral leukoplakia and
Oral squamous cell carcinoma. To correlate the levels of TNF- α with varying histologic grading in Oral Squamous
Cell Carcinoma and dysplasia grading in Oral leukoplakia or Hyperkeratosis. Materials and Methods: The study
group included 90 subjects that were divided into three groups. OSCC (n=30), leukoplakia (n=30) and controls (n=30).
Cases were selected based on inclusion and exclusion criteria of the study. Salivary samples were then collected from
all three groups. Salivary levels of TNF-α were estimated using Enzyme Linked Immunosorbent Assay (ELISA). The
data on concentration gradients obtained were subjected to appropriate statistical analysis. Results: The results of the
present study demonstrated higher levels of salivary TNF-α in individuals with OSCC compared to leukoplakia and
healthy control subjects with a high level of statistical significance. ROC curve analysis along with diagnostic parameter
calculation also revealed that salivary TNF-α to be a better medium for detecting OSCC. There is also an increase in
the salivary TNF-α levels with increase in the histological grade of differentiation in OSCC as well as leukoplakia.
Conclusion: The present study concludes that salivary TNF – α can be used as a prognostic biomarker of OSCC. In
view of the elevated levels of TNF – α in saliva of individuals with severe dysplasia, it can also be used to monitor the
malignant transformation to leukoplakia to OSCC.


Main Subjects