Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.
Oral Cancer Center and Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea.
PLoS One. 2021 Mar 18;16(3):e0248167. doi: 10.1371/journal.pone.0248167. eCollection 2021.
Over 90% of oral cancers are oral squamous cell carcinoma (OSCC). Hitherto, early detection marker for OSCC has not been available. Hence, this study aimed to evaluate the diagnostic and prognostic ability of salivary matrix-metalloproteinase-9 (MMP-9) and 8-hydroxydeoxyguanosine (8-OHdG) for OSCC. Total of 318 participants with 106 cases and 212 controls were included: OSCC cases were from Seoul National University Dental Hospital and age, sex, and smoking matched controls were from Yangpyeong cohort. Unstimulated saliva was collected to determine MMP-9 and 8-OHdG using sensitive enzyme-linked immunosorbent assay. Multivariable linear regression and analysis of covariance (ANCOVA) were applied to evaluate the adjusted association of markers with OSCC. Wilcoxon sign rank sum test and Friedman test for median were applied to evaluate follow-up level of MMP-9 after surgery. Receiver operating characteristic curve was obtained for diagnostic ability. Salivary MMP-9 was associated with OSCC (ANCOVA and multivariable linear regression, p<0.05), while 8-OHdG was not. The diagnostic ability of MMP-9 was area under curve of 0.96 (100% specificity and 89.6% sensitivity, p<0.001). MMP-9 decreased dramatically after tumor surgery (p<0.05). Salivary MMP-9 could be a critical diagnostic and prognostic marker for OSCC.
超过 90%的口腔癌为口腔鳞状细胞癌（OSCC）。迄今为止，OSCC 的早期检测标志物尚未问世。因此，本研究旨在评估唾液基质金属蛋白酶-9（MMP-9）和 8-羟基脱氧鸟苷（8-OHdG）对 OSCC 的诊断和预后能力。共有 318 名参与者，其中 106 例为 OSCC 病例，212 例为对照组：OSCC 病例来自首尔国立大学牙科医院，年龄、性别和吸烟情况匹配的对照组来自 Yangpyeong 队列。收集非刺激性唾液，使用敏感酶联免疫吸附试验测定 MMP-9 和 8-OHdG。多变量线性回归和协方差分析（ANCOVA）用于评估标志物与 OSCC 的调整关联。Wilcoxon 符号秩和检验和 Friedman 检验中位数用于评估手术后 MMP-9 的随访水平。获得了用于诊断能力的接收者操作特征曲线。唾液 MMP-9 与 OSCC 相关（ANCOVA 和多变量线性回归，p<0.05），而 8-OHdG 则不相关。MMP-9 的诊断能力为曲线下面积 0.96（100%特异性和 89.6%敏感性，p<0.001）。肿瘤手术后 MMP-9 显著下降（p<0.05）。唾液 MMP-9 可能是 OSCC 的重要诊断和预后标志物。
