Document Type: Research Articles
Department of Oral and Maxillofacial Pathology, Government Dental College and Hospitals, Hyderabad, India.
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.