Background: Oral squamous cell carcinoma (OSCC) is an important malignancy throughout the world; early detection is an important criterion for achieving high cure rate. Out of the many reported markers for OSCC, this study validated the efficacy of tumor necrosis factor-α (TNF-α) in differentially diagnosing premalignant oral lesions and OSCC. Also, the study aimed to correlate the levels of salivary and serum TNF-α with clinicopathologic factors. Materials and Methods: A prospective experimental laboratory study was designed. Serum and salivary samples from 100 subjects in each group of healthy control, premalignant disease (PMD) and OSCC were collected for the study following appropriate exclusion and inclusion criteria. Serum and salivary level of TNF-α was analysed by enzyme linked immunosorbent assay. The data obtained were subjected to appropriate statistical analysis. Results: Increased level of both serum and salivary TNF-α was observed in OSCC subjects compared to healthy control and PMD group. Receiver operator characteristic curve analysis and area under curve values showed high specificity and sensitivity for salivary TNF-α in differentiating OSCC from PMD and healthy controls. There was significant increase in TNF-α level in moderately and poorly differentiated lesion compared to well differentiated lesion and in stage IV of clinical stage. A positive correlation was observed only with histological grading of OSCC and TNF-α. Conclusions: Salivary TNF-α is proved to be superior for detecting OSCC. Increase in TNF-α with histological grading and clinical staging suggests a role in prognosis.

Background CYFRA 21‐1, a constituent of the intermediate filament proteins of epithelial cells, is known to be increased in many cancers. This study was designed to estimate the levels of salivary and serum CYFRA 21‐1 in patients with oral precancer and oral squamous cell carcinoma (OSCC) and compare them with healthy controls. Materials and methods Each group comprised of 100 subjects. Saliva and blood samples were collected from patients with OSCC, premalignant subjects, and normal healthy subjects. Serum and salivary CYFRA 21‐1 levels were measured by enzyme‐linked immunosorbent assay. Appropriate statistical tests were employed to assess diagnostic potency of CYFRA 21‐1. Results We found a significant increase in CYFRA 21‐1 level in OSCC compared with PML and healthy subjects. Salivary CYFRA 21‐1 levels in OSCC was threefold higher when compared to serum levels. PML group showed increased salivary CYFRA 21‐1 when compared to control subjects, but it was significantly lower compared with OSCC. Receiver operator characteristic curve analysis showed salivary CYFRA 21‐1 to have superior sensitivity in detecting OSCC compared with serum CYFRA 21‐1. Conclusions The outcome of this study suggests that salivary CYFRA 21‐1 can be utilized as a biomarker in early detection of oral cancer.

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