The diagnostic and prognostic value of salivary sCD44 level determination in oral malignant and potentially premalignant lesions

Abstract

A key factor in the lack of improvement in prognosis of oral squamous cell carcinoma (OSCC) lesions over the years is the fact that a significant proportion are not diagnosed or treated until they reach an advanced stage. A molecular marker for malignant transformation in innocent looking oral lesions and a monitor for the aggressiveness of malignant lesions might be of help. The present study included 40 subjects: 10 healthy control subjects, 10 patients with potentially premalignant oral lesions with dysplastic changes and 10 others without, in addition to 10 patients suffering from OSCC. Levels of soluble CD44 (sCD44) were measured in whole unstimulated saliva (WUS) using an enzyme linked immuneassay (ELISA). In patients suffering from malignant lesions the salivary sCD44 level was correlating well with the grading of the lesion. Also, most of the patients with the highest salivary sCD44 levels showed postoperative relapse. A highly significant difference was found in the mean value of salivary sCD44 level between the control group and the premalignant with dysplasia and the cancer groups, and on the other hand, a non significant difference was found between the control and the premalignant without dysplasia group. Also, a highly significant difference was found between salivary sCD44 level in cancer patients and those with premalignant lesions without dysplasia, and non significant difference between the cancer patients and those with premalignant lesions with dysplasia. A ROC Curve was created to estimate salivary sCD44 level with the highest sensitivity and specificity which was 100% and 66.7% respectively. Results indicated that a level of salivary sCD44 lying within the range of 19.2 to 20.4 ng/ml could indicate malignant transformation within oral mucosal lesions.