Evaluation of Salivary CA 125 Antigen in Patients with Oral Cancer, Oral Potentially Malignant Disorders and in Comparison, with Healthy Controls - A cross sectional study
Author(s): Pattugayathri S, Saraswathi Gopal K, Srividhya S.
Background: Oral squamous cell carcinomas (OSCC) account for more than 90% of all oral malignancies. The primary risk factors of significant concern are smoking and drinking alcohol, and their combined impact is greater than their individual effects. Oral potentially malignant disorders (OPMD) establishes clinical presentations that carry an increased risk to develop into OSCC. Achieving early detection of these conditions requires thorough examinations, where biopsy serves as the primary diagnostic tool for oral cancer. Recently, numerous studies have focused on early diagnosis and prognostic assessment of the disease through the analysis of serum and salivary biomarkers. Cancer Antigen 125 (CA 125) is one such biomarker, also known as Mucin 16, is a human protein encoded by the MUC16 gene. It is part of the mucosal glycoproteins family typically present on the cell surface of normal cells. CA 125 is secreted from cancer cell surfaces and can be detected in saliva or blood, serving as a significant cancer marker that may be increased in individuals with epithelial neoplasms like ovarian, breast, and oral carcinoma.
Aim & Objectives
• To estimate the salivary levels of CA 125 antigen in Individuals with OPMDs, OSCC and in healthy controls.
• To compare the estimated levels of CA125 antigen in Individuals with OPMDs, OSCC with healthy controls.
• To compare the estimated levels of CA125 antigen with histopathological stage of differentiation of OSCC.
Materials and methods: Totally, 45 cases separated into three categories, Group 1 – OSCC, Group 2 - OPMDs and Group 3 – Healthy controls which included 15 participants in each group. Saliva was collected from the subjects using the simple drooling method to obtain whole saliva. The saliva samples were centrifuged at 3000 rpm for 10 minutes. The concentration of CA 125 antigen was determined by using Quantitative sandwich ELISA (Enzyme linked immunosorbent assay) technique.
Results: Our study had highest salivary CA 125 antigen levels in OSCC group (7684.40U/L) and followed by OPMD group (4949.53 U/L) and lowest in healthy control group (3009.2U/L). The intergroup comparison of the concentration values was found to be statistically significant between the groups with the p value <0.001. In the present study in Oral cancer patients, the mean concentration was more in moderately differentiated OSCC and statistically significant differences between the type of differentiations against the concentration (p<0.001) were seen.
Summary and Conclusion: Our study shows that there is significant increase in salivary CA-125 antigen levels in OSCC and OPMD group compared to healthy controls. The salivary levels of CA-125 antigen also shows significant increase among type of differentiation of OSCC particularly in moderately differentiated OSCC and OPMDs.
Thus, it can be inferred that salivary CA-125 antigen can be a potential diagnostic biomarker for Oral cancer and OPMD and comparing with healthy individuals. Further studies with larger cohorts are necessary to establish the clinical effectiveness of salivary CA 125 antigen in OSCC detection and malignant potential risk of OPMDs.