Estimation of Salivary Levels of an Inhibitory Apoptotic Protein Survivin in Oral Leukoplakia and Squamous Cell Carcinoma.

Abstract

The process of carcinogenesis is initiated by an excessive proliferation of tumor cells, accompanied by a reduction in the rate of apoptosis. A number of molecules are involved in this process, with Survivin being one such molecule that is known to control it. The expression of Survivin has been observed in a range of embryonic and adult tissues with a high rate of turnover, as well as in tissue sections of oral precancerous and cancerous lesions. However, data regarding the detection of Survivin in saliva are scarce. The aim of this study is to estimate and compare salivary Survivin levels (SSL) in normal oral mucosa (NOM), oral leukoplakia (OL), and squamous cell carcinoma (OSCC) in order to demonstrate its potential as a predictive biomarker. Whole saliva samples were collected from all subjects and assessed for salivary Survivin levels using the ELISA technique. A Kruskal-Wallis test was employed to ascertain any significant differences in SSL. The mean SSL in the control group was found to be 301.9±180.35 ng/dl, while the study groups of OL and OSCC exhibited mean values of 285±140.4 and 316.5±176.72 ng/dl, respectively. In the OL group, the highest value was observed in cases of severe dysplasia (407.4 ng/dl), while in the OSCC group, the highest value was noted in WDSCC (311.5 ng/dl). Due to the inconsistency in the distribution of the sample, our findings were found to be non-significant (p = 0.796). This study is the first to detect Survivin in normal oral mucosa (NOM). The results suggest that Survivin plays a definitive role in maintaining the normal homeostasis of oral mucosa. The gradual upregulation and downregulation of SSL in OL and OSCC can be used to predict the aggressive nature of the malignancy. Therefore, the detection of Survivin in saliva can be utilized as a predictive marker for the progression of oral precancerous and cancerous lesions.