DefinePK

Research Objective

To do a comparative analysis of salivary levels LDH, amylase, total protein, CYFRA 21-1 and CA19-9 in oral SCC, PML and healthy individuals.

Methodology

Retrospective study conducted in the Department of Oncology, Women Medical College Abbottabad from January 2021 to January 2022. Participants (n=200) were divided into three groups: Group I (n=90) with oral SCC, Group II (n=60) with PML, and Group III (n=50) healthy controls. Saliva samples were collected before definitive therapy. ELISA was used for CA19-9 and CYFRA 21-1, and standard kit method for amylase, LDH, and total protein. Data analysis included Chi square test, independent t-Test, ANOVA, and ROC curve analysis.

Methodology Flowchart

                        graph TD;
    A["Participant Recruitment & Grouping"] --> B["Saliva Sample Collection"];
    B --> C["Biochemical Analysis"];
    C --> D["Data Analysis Statistical Tests & ROC"];
    D --> E["Key Findings & Conclusions"];                    

Discussion

Oral cancer is a prevalent malignancy, often linked to smoking, alcohol consumption, and older age. The study's findings align with previous research identifying these risk factors. Saliva is presented as a cost-effective and non-invasive diagnostic medium. Elevated levels of CYFRA 21-1, LDH, and total proteins, along with decreased amylase in saliva, are indicative of oral SCC and PML. CYFRA 21-1 demonstrated strong potential for early detection. The study also noted a correlation between salivary biomarker levels and clinical parameters like tumor size and stage.

Key Findings

- Statistically significant association between oral lesions and alcohol (P=.0005), smoking (P=.0001), and tobacco chewing (P=.0005).
- Salivary levels of total proteins, LDH, and CYFRA 21-1 were higher, while amylase was lower in oral SCC and PML groups compared to healthy controls.
- CA19-9 levels were not significantly different across the three groups.
- CYFRA21-1 showed high diagnostic accuracy for oral malignancies (sensitivity 90%, specificity 97%).
- Higher levels of total protein, CYFRA 21-1, and LDH were associated with increased tumor size, lymph node involvement, and advanced cancer stage.

Conclusion

Patients with oral squamous cell carcinoma and pre-malignant lesions exhibit altered salivary biomarker levels (increased total protein, CYFRA 21-1, LDH; decreased amylase) compared to healthy individuals. These fluctuations are more pronounced in oral SCC. Concurrent evaluation of these salivary biomarkers can aid in the early detection of malignancy.

Fact Check

- The study included 200 patients divided into three groups: 90 with oral SCC, 60 with PML, and 50 healthy controls.
- CYFRA21-1 showed a sensitivity of 90% and specificity of 97% for identifying oral malignancies.
- Alcohol consumption was associated with oral lesions in 96.5% of patients, tobacco smoking in 86.6%, and tobacco and betel nut chewing in 96.6%.

Mind Map