Salivary Her2/neu Levels in Differentiation of Oral Premalignant Disorders and Oral Squamous Cell Carcinomas

Abstract

Background: Oral squamous cell carcinoma (OSCC) is thought to develop from precancerous dysplastic lesions through multistep processes of carcinogenesis involving activation of oncogenes and loss of tumor suppressor genes. The human epidermal growth factor receptor 2 (Her-2/neu [erbB-2]), a cell membrane glycoprotein, is a growth factor receptor that has receptor tyrosine kinase activity. Her2/neu activation plays a central role in cell proliferation and survival. It has been shown that overexpression of Her2/neu increases the rate of cell division and growth, leading to precancerous changes. The aim of the present study was to compare the serum and salivary Her2/neu levels between cases with premalignant and malignant oral lesions. Materials and Methods: Fasting blood samples and unstimulated saliva by passive drooling were collected from three groups of healthy control (n=20), premalignant disorder (PMD) (n=20) and OSCC (n=25) subjects. The HER2 extracellular domain (HER2 ECD) levels were measured using ELISA. Results: The levels of serum Her2/neu showed no significant differences between any of the groups but on the other hand salivary Her2/neu levels were found to be significantly (p<0.05) higher when compared between control (median 68.7 pg/ml, range: 21.5 -75.8) and OSCC (median 145.6 pg/ml, range: 45.1-191.1). A similar trend was observed when comparing between PMD (median 43.3, range: 22.1 -94.7) and OSCC with a statistical significance of p<0.05. Conclusions: Our study provided evidence of increased salivary Her2/neu in OSCC when compared to PMD and control which was not the case for serum levels. This suggests that probably Her2/neu is not highly amplified as in breast cancer so as to be reflected in serum. Since saliva is in local vicinity of the OSCC, even a mild increase might be mirrored. On the whole, this study proposes Her2/neu as marker for distinguishing premalignant and malignant conditions.

Assessment of salivary levels of ErbB2 in oral squamous cell carcinoma

“…[ 25 ] Our study showed significantly elevated salivary levels of ErbB2 in OSCC with a mean value of 3.20 ng/ml when correlated with the control, that is, 2.43 ng/ml, which is consistent with the study done by Varun et al . in 2015,[ 26 ] where it showed a higher mean concentration of ErbB2 in the OSCC group than in the control group. It has been shown that overexpression of ErbB2 amplifies cell division and growth rate, leading to the occurrence of cancer.…”

Telescreening as an alternate modality for early detection of oral cancer

“…Oral cancers are among the five most common cancers in India with tobacco usage, alcohol consumption, betel quid chewing, and human papillomavirus infection being the most common causes. Majority of the oral cancers are preventable, and also easily detectable as lesions are readily visible on routine screening; still most of the cases are diagnosed in its advanced stages with resulting poor prognosis [1] . Adding to these, the recent Covid-19 pandemic has also worsened this condition in terms of delayed diagnosis and treatment.…”