EVALUATION OF SALIVARY IL-6, MMP-9, AND CYFRA 21-1 AS DIAGNOSTIC BIOMARKERS IN ORAL SQUAMOUS CELL CARCINOMA PATIENTS OF MARDAN

Abstract

Background: Oral squamous cell carcinoma (OSCC) is one of the main causes of cancer-related morbidity and mortality in Pakistan and poses a substantial public health burden.

Objective: To measure and compare salivary levels of CYFRA 21-1, MMP-9, and IL-6 in newly diagnosed OSCC patients to healthy controls; to correlate these biomarkers with tumor grade and stage; and to evaluate sensitivity and specificity separately and in combination.

Methodology: Total 30 biopsy-confirmed, untreated OSCC patients (Group A) and thirty age- and sex-matched healthy controls (Group B) from BKMC/BKCD, Mardan, were recruited for a 12-month comparative cross-sectional study. ELISA was used to measure the concentrations of biomarkers. ANOVA/Kruskal-Wallis, correlation analysis, t-test or Mann-Whitney U test, and ROC curve analysis (AUC, cutoff, sensitivity, and specificity) were among the statistical analyses.

Results: In OSCC patients, the mean salivary IL-6 was 85.4 ± 24.7 pg/mL, while in controls, it was 18.6 ± 7.8 pg/mL (p < 0.001). MMP-9 concentrations were 112.4 ± 40.1 ng/mL versus 298.2 ± 85.3 ng/mL (p < 0.001). CYFRA 21-1 levels were 1.45 ± 0.65 ng/mL versus 5.92 ± 1.95 ng/mL (p < 0.001). IL-6 and CYFRA were positively associated with higher TNM stage in OSCC patients (ρ = 0.52, p = 0.004; ρ = 0.48, p = 0.006, respectively).

Conclusion: Salivary IL-6, MMP-9, and CYFRA 21-1 were all markedly increased in OSCC, and they demonstrated good diagnostic accuracy. The combined biomarker panel enhanced discrimination even more.