Significantly higher serum tumor marker levels in patients with oral submucous fibrosis

Yu-Hsueh Wu; Ping-Yi Lin; Ju-Hsuan Yang; Ying-Shiung Kuo; Yang-Che Wu; Chun-Pin Chiang

doi:10.1016/j.jds.2021.02.009

Significantly higher serum tumor marker levels in patients with oral submucous fibrosis

J Dent Sci. 2021 Jul;16(3):846-853. doi: 10.1016/j.jds.2021.02.009. Epub 2021 Mar 11.

Authors

Yu-Hsueh Wu^{1

2

3}, Ping-Yi Lin³, Ju-Hsuan Yang³, Ying-Shiung Kuo³, Yang-Che Wu^{4

5}, Chun-Pin Chiang^{6

7

8}

Affiliations

¹ Department of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan.
² Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan.
³ Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁴ School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
⁵ Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.
⁶ Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁷ Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
⁸ Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Abstract

Background/purpose: Our previous study showed that carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), and ferritin are significantly higher in patients with oral potentially malignant disorders (OPMDs including oral leukoplakia, oral erythroleukoplakia, and oral verrucous hyperplasia) than in healthy controls (HCs). Oral submucous fibrosis (OSF) is also recognized as an OPMD. This study evaluated whether these three serum tumor marker levels were also significantly higher in OSF patients than in HCs.

Materials and methods: The serum CEA, SCC-Ag, and ferritin levels in 41 OSF patients and 164 HCs were measured and compared. Patients with serum CEA level ≥3 ng/mL, SCC-Ag level ≥2 ng/mL, and ferritin level ≥250 ng/mL were scored as serum positive for CEA, SCC-Ag, and ferritin, respectively.

Results: We found significantly higher mean serum CEA, SCC-Ag, and ferritin levels in 41 OSF patients than in 164 HCs (all P-values < 0.05). Moreover, 41 OSF patients had significantly higher serum positive rates of CEA (39.0%), SCC-Ag (19.5%), and ferritin (53.7%) than 164 HCs (all P-values < 0.05). Of the 41 OSF patients, 26 (63.4%), 7 (17.1%), and 2 (4.9%) had serum positivities of one, two, or three tumor markers including CEA, SCC-Ag, and ferritin, respectively.

Conclusion: There are significantly higher mean serum CEA, SCC-Ag, and ferritin levels and significantly higher serum positive rates of CEA, SCC-Ag, and ferritin in OSF patients than in HCs. The serum CEA, SCC-Ag, and ferritin levels may be served as tumor markers for evaluation of malignant potential of OSF lesions.

Keywords: Carcinoembryonic antigen; Ferritin; Oral potentially malignant disorder; Oral submucous fibrosis; Squamous cell carcinoma antigen.