Increased plasma and salivary cortisol levels in patients with oral cancer and their association with clinical stage.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Oral Oncology Center and Department of Pathology and Clinical Propedeutics, School of Dentistry of Araçatuba, UNESP, Univ Estadual Paulista, Araçatuba, São Paulo, Brazil. danielbernabe@uol.com.br
Daniel Galera
DG
Bernabé
Adriano Caires
AC
Tamae
Glauco Issamu
GI
Miyahara
Maria Lúcia Marçal
ML
Sundefeld
Sandra Penha
SP
Oliveira
Éder Ricardo
ÉR
Biasoli
D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D009367:Neoplasm Staging / Q000379:methods; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis*; D012463:Saliva / Q000737:chemistry; D013048:Specimen Handling
D014408:Biomarkers, Tumor; D006854:Hydrocortisone