Assessment of Salivary Biomarkers in the Early Diagnosis of Oral Squamous Cell Carcinoma

Submission: 12 July 2025 | Acceptance: 02 September 2025 | Publication: 12 November 2025

 Dr. Haroon Raja¹, Dr. Zamin Abbas², Dr. Obaidullah Khan³, Dr. Hub-e-Ali⁴, Dr. Shikoh Naz⁵, Dr. Tabassum Raja⁶ , Kashif Lodhi

1Assistant professor, Department of Radiotherapy & Nuclear Medicine Dr Faisal Masood Teaching Hospital Sargodha.

²PIMS, Islamabad

³Department of Agricultural, Food and Environmental Sciences. Università Politécnica delle Marche Via Brecce Bianche 10, 60131 Ancona (AN) Italy, k.lodhi@studenti.unibg.it

ABSTRACT:

Background: Oral squamous cell carcinoma (OSCC) is among the most widespread oral cancers that result in a huge burden of cancer morbidity and mortality in the world. Lesions in early stages are not easily diagnosed since the initial condition is normally asymptomatic, and there are no non-invasive diagnostic methods that are easily available. Saliva is a fluid which has enzymes and proteins and is known to contain nucleic acids and has been found to be a good fluid in the detection of a molecular modification related to OSCC. The salivary bio-markers testing can thus be a way of earlier diabetes diagnosis and tracking of the disease.

Aim: The objective of the study was to evaluate the value of a set of salivary biomarkers in early diagnosis of OSCC and to determine their levels in the group of patients and healthy individuals.

Methods: It is observational analytical research that was carried out at Pakistan Institute of Medical Sciences (PIMS) in Islamabad between October 2024 and March 2025 and recruit a total of 90 respondents. This group of patients consisted of 45 OSCC diagnosed patients and 45 age- and sexmatched healthy control participants. Whole saliva was also taken off under standardized conditions, in the absence of any stimuli. Enzyme-linked immunosorbent assays (ELISA) were utilized to determine the concentrations of specified biomarkers cytokines (IL 6, TNF 2), measures of oxidative stress (MDA, TAC), and tumor-related proteins (p 53, Cyfra 21 -1). The SPSS software was used in the analysis of data with statistical significance set at p less than 0.05.

Results: It was discovered that the IL-6, TNF-a MDA and Cyfra 21 1 levels in OSCC were much greater than controls (p < 0.001). On the other hand, the total antioxidant capacity (TAC) was much less in the

OSCC group (p) less than 0.05). Of all the biomarkers, IL–6 and Cyfra–21 1 were most sensitive and specific in differentiating between patients of OSCC and healthy people. The positive correlation was also observed between the levels of biomarkers and the clinical stage of the disease which means that the biomarkers can be used to measure the course the disease is going.

Conclusion: Salivary biomarkers like IL-6, TNF-A, MDA, TAC, and Cyfra 21-1 are a robust, non-invasive, and economical way of making early diagnoses of OSCC. These findings prove the inclusion of salivary biomarker screening in clinical setting to support early diagnosis, enhance prognostic, and minimize disease burden.

Keywords: Salivary biomarkers, Oral squamous cell carcinoma, Early diagnosis, Cytokines, Oxidative stress, Non-invasive detection, Cyfra 21-1, IL-6.