title: Association and prognostic value of serum inflammation markers in patients with leukoplakia and oral cavity cancer.
abstract: BACKGROUND
  Oral cavity cancer ranks as the fourth leading cancer in men in Taiwan. The development of a serum biomarker panel for early detection and disease monitoring is, therefore, warranted.
  
  
  METHODS
  Nine inflammation-associated markers were investigated in 46 patients with leukoplakia, 151 patients with untreated oral cavity squamous cell carcinoma (OSCC), and 111 age- and gender-matched healthy controls using enzyme-linked immunosorbent assay. During a subsequent 28-month surveillance of OSCC patients, serum samples were prospectively collected at predetermined intervals following the completion of therapy.
  
  
  RESULTS
  Logistic regression analysis showed matrix metalloproteases (MMP)-2, MMP-9, C-reactive protein (CRP), transforming growth factor-β1 (TGF-β1), and E-selectin having the best discrimination power between groups and significant elevation trends of those five markers were noted from control to OSCC. By combining those five markers, a 0.888 and 0.938 area under curve by ROC curve analysis with 67.4% and 80% overall sensitivity and fixed 90% specificity for leukoplakia and OSCC groups were demonstrated. In the follow-up period, 25 OSCC patients developed recurring or secondary tumors. All examined markers had decreased in relapse-free patients following treatment. However, in patients with relapse, interleukin-6, CRP, and serum amyloid A remained at elevated levels. Statistical analysis showed that patients with CRP ≧2 mg/L and E-selectin ≧85 ng/mL at baseline had highest probability of relapse (odds ratio=3.029, p<0.05).
  
  
  CONCLUSIONS
  The results indicate that inflammation plays a crucial role in the pathogenesis process of OSCC. By examining the inflammation markers, physicians could potentially identify patients at risk of cancer transformation or relapse.
authors.affiliation: Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Taoyuan County, Taiwan.
authors.forename: Pi-Yueh
authors.initials: PY
authors.lastname: Chang
authors.forename: Yung-Bin
authors.initials: YB
authors.lastname: Kuo
authors.forename: Tsu-Lan
authors.initials: TL
authors.lastname: Wu
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Sun
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
authors.forename: Err-Cheng
authors.initials: EC
authors.lastname: Chan
mesh_terms: D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D015331:Cohort Studies; D019040:E-Selectin / Q000097:blood; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000134:cerebrospinal fluid / Q000473:pathology; D007971:Leukoplakia / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D009062:Mouth Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D053773:Transforming Growth Factor beta1 / Q000097:blood
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D019040:E-Selectin; C546936:SELE protein, human; D053773:Transforming Growth Factor beta1; D002097:C-Reactive Protein; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9