The Relevance of a Multi-Biomarker Panel in Oral Cancer Detection

Objectives: Since the treatment of oral cancers is only partially effective, a focus on oral cancer detection and prevention, rather than treatment, would be an attractive option to arrest the progression of early lesions. The objective of this study was to identify a multi-biomarker panel that can assist in the early diagnosis and surveillance of oral cancer.
Methods: A comprehensive search for relevant biomarkers in publications and citations was performed, 1997–2017. A panel of 12 biomarkers was identified and the concentrations of 8 biomarkers were determined in the culture media of 2 cancer cell lines (SCC4 and SCC25) and 1 dysplastic oral keratinocyte cell line (DOK); saliva from 12 patients with oral cancer; and saliva from 5 normal volunteers using Multiplex immunoassays. A one-way ANOVA was fit to examine log-transformed concentrations and pairwise group comparisons were conducted using the post-hoc Tukey’s Honest Significant Differences test (alpha=0.05).
Results: IL1α, IL6, IL8, IL17F, MMP2, MMP9, TNFα, VEGFA, HMOX1, NO (iNOS), MUC1, and MUC4 were selected from 1, 210 publications and 5, 932 citations, 1997–2017. When evaluated, concentrations of IL1α, IL6, IL8, IL17F, MMP2, MMP9, TNFα, and VEGFA were elevated (p<0.05) in the media of SCC4, SCC25, and DOK cell cultures versus media alone and these elevated concentrations were not different when comparing among all three cell cultures (p>0.05). In a pilot study, these markers were also detected in differing concentrations in the saliva of normal volunteers and patients with oral cancer.
Conclusions: Twelve biomarkers formed a multi-biomarker panel for oral cancer detection. Eight biomarkers were examined further and found to be detected in culture media of DOK, SCC4, and SCC25 and in differing concentrations in the saliva of patients with oral cancer and normal volunteers. Such a panel has potential in the early diagnosis and surveillance of oral cancer.