Oral Oncology Center and Department of Pathology and Clinical Propedeutics, School of Dentistry of Araçatuba, UNESP, Univ Estadual Paulista, Araçatuba, São Paulo, Brazil.
J Clin Pathol. 2012 Oct;65(10):934-9. doi: 10.1136/jclinpath-2012-200695. Epub 2012 Jun 25.
Dysregulation of the hypothalamus-pituitary-adrenal axis has been observed in patients with cancer. This cross-sectional study investigated whether patients with oral and oropharyngeal squamous cell carcinoma (SCC) show changes in cortisol levels in saliva and plasma compared with three control groups, and evaluated its correlation with clinicopathological data.
Salivary and plasma cortisol levels of 34 patients with oral SCC were compared with hormonal levels of 17 oropharyngeal SCC patients, 17 oral leukoplakia patients, 27 smokers and/or drinkers and 25 healthy volunteers. Multivariate analysis was used to evaluate the impact of clinical variables on the cortisol levels.
The plasma (p<0.05) and salivary (p<0.01) cortisol levels were significantly higher in patients with oral SCC compared with all groups. Patients with oropharyngeal SCC had higher levels of salivary cortisol compared with smokers and/or drinkers (p<0.05) and patients with leukoplakia (p<0.01). Patients with advanced-stage oral SCC showed significantly higher levels of cortisol than those in an initial clinical stage. Men with oral SCC had higher salivary cortisol levels than women (p<0.05). Age, smoking, alcohol consumption, presence of teeth and awareness of cancer diagnosis had no significant effect on cortisol levels.
These results indicate a dysregulation of cortisol secretion in patients with oral cancer and suggest that this hormone can be a biomarker associated with the disease's clinical status.
已观察到癌症患者的下丘脑-垂体-肾上腺轴失调。本横断面研究调查了与三个对照组相比，口腔和口咽鳞状细胞癌（SCC）患者的唾液和血浆皮质醇水平是否发生变化，并评估其与临床病理数据的相关性。
比较了 34 例口腔 SCC 患者的唾液和血浆皮质醇水平与 17 例口咽 SCC 患者、17 例口腔白斑患者、27 例吸烟者和/或饮酒者以及 25 例健康志愿者的激素水平。采用多变量分析评估临床变量对皮质醇水平的影响。
与所有组相比，口腔 SCC 患者的血浆（p<0.05）和唾液（p<0.01）皮质醇水平显著升高。与吸烟者和/或饮酒者（p<0.05）以及白斑患者（p<0.01）相比，口咽 SCC 患者的唾液皮质醇水平更高。处于晚期口腔 SCC 患者的皮质醇水平明显高于处于初始临床阶段的患者。口腔 SCC 男性的唾液皮质醇水平高于女性（p<0.05）。年龄、吸烟、饮酒、是否有牙齿以及对癌症诊断的认识对皮质醇水平没有显著影响。
这些结果表明口腔癌患者皮质醇分泌失调，并提示该激素可能是与疾病临床状况相关的生物标志物。
