ABSTRACT
The incidence of oral squamous cell carcinoma (OSCC), and its precursor, oral epithelial dysplasia (OED), is on the rise, especially in South Asia. OSCC is the leading cancer in males in Sri Lanka, with >80% diagnosed at advanced clinical stages. Early detection is paramount to improve patient outcome, and saliva testing is a promising non-invasive tool. The aim of this study was to assess salivary interleukins (lL1ß, IL6, and IL8) in OSCC, OED and disease-free controls in a Sri Lankan study cohort. A case-control study with OSCC (n = 37), OED (n = 30) patients and disease-free controls (n = 30) was conducted. Salivary lL1ß, IL6, and IL8 were quantified using enzyme-linked immuno-sorbent assay. Comparisons between different diagnostic groups and potential correlations to risk factors were assessed. Salivary levels for the three tested interleukins increased from disease-free controls through OED, and were highest in OSCC samples. Furthermore, the levels of IL1ß, IL6, and IL8 increased progressively with OED grade. The discrimination between patients (OSCC and OED) and controls, as assessed by AUC of receiver operating characteristic curves, was 0.9 for IL8 (p = 0.0001) and 0.8 for IL6 (p = 0.0001), while IL1ß differentiated OSCC from controls (AUC 0.7, p = 0.006). No significant associations were found between salivary interleukin levels and smoking, alcohol, and betel quid risk factors. Our findings suggest that salivary IL1ß, IL6, and IL8 are associated with disease severity of OED, and are potential biomarkers for predicting disease progression in OED, and the screening of OSCC.
ABSTRACT
OBJECTIVE: The aim of this study was to assess the relevance of clinical and histopathologic parameters on survival of oral squamous cell carcinoma (OSCC) patients in Sri Lanka. STUDY DESIGN: A cohort of 193 previously diagnosed OSCC patients were followed for up to 5 years. Clinical and histopathologic parameters were analyzed regarding local recurrence and 5-year survival after treatment. RESULTS: Site, stage, local recurrence, degree of differentiation, degree of keratinization, pattern of invasion, and status of the excision margins showed a significant association with the 5-year survival (P < .05). Multivariate analysis identified stage, pattern of invasion, and status of the excision margins as true independent prognostic indicators of OSCC. Pattern of invasion was the best prognosticator of both local recurrence and overall survival in the Cox regression model (P < .001). CONCLUSIONS: Stage, pattern of invasion, and status of the excision margins are superior prognostic indicators of OSCC compared with other parameters.
