Salivary EGF: EGFR ratio as potential early diagnostic biomarker for oral cancer detection in tobacco chewers: a preliminary cross-sectional study.

Abstract

Background: Tobacco chewing and smoking are major risk factors for oral cancer, with Oral Squamous Cell Carcinoma (OSCC), comprising approximately 90% of cases, especially in South-Central Asia. This study examines the early diagnostic value of salivary Epidermal Growth Factor (EGF) and Epidermal Growth Factor Receptor (EGFR) for OSCC in long-term chewers of tobacco.

Methods: This study assessed salivary EGF and EGFR concentrations by Enzyme-Linked Immunosorbent Assay (ELISA), in three groups: Healthy Controls (HC, n = 41), Tobacco Chewers with a 10-years history of tobacco use (TC, n = 41), and newly diagnosed OSCC patients (with tobacco chewing history of more than 10 years) with no prior history of neoplasms or anticancer treatment (OSCC, n = 19). All participants were over the age of 35.

Results: Salivary EGF levels were significantly reduced, while EGFR levels were elevated in tobacco chewers (TC) and newly diagnosed OSCC patients compared to healthy controls (HC), with no significant difference observed between TC and OSCC groups. Notably, the EGF: EGFR ratio demonstrated better diagnostic performance for OSCC in TC compared to EGF or EGFR alone. ROC analysis highlighted the potential of these biomarkers as diagnostic tools for OSCC in TC.

Conclusion: Salivary EGF: EGFR ratio may serve as an early diagnostic biomarker for OSCC in TC. Reduced EGF and elevated EGFR levels suggest their role in disease progression, warranting further large-scale studies for clinical validation.