Salivary growth differentiation factor-15 levels in oral leukoplakia and oral squamous cell carcinoma

OBJECTIVES: About 90% of oral cancers are oral squamous cell carcinomas (OSCC) whose appropriate treatment requires early diagnosis, based on knowledge about biomarkers which are expressed during the complex process of carcinogenesis. Growth differentiation factor-15 (GDF-15) has been considered an important serum and immunohistochemical marker in several cancers. Saliva has several advantages as a diagnostic biofluid. This research intends to evaluate the salivary GDF-15 levels in oral leukoplakia (OL) and in OSCC. MATERIALS AND METHODS: We estimated and compared levels of salivary GDF-15 in cases of OL, OSCC, and healthy controls. Study groups comprised 30 cases each of OL and OSCC. Control group comprised 30 healthy individuals. Saliva samples were assessed using the enzyme-Linked immunosorbent assay for GDF-15 levels. RESULTS: Salivary GDF-15 levels showed a gradual increase from healthy volunteers to cases of OL and highest GDF-15 levels were noted in OSCC group. Increase in concentration of GDF-15 was also noted with increasing grades of OSCC. CONCLUSION: Increased level of GDF-15 in premalignant cases reflects its antitumorigenic role, whereas its expression in later stages of OSCC demonstrates its protumorigenic role. The regulatory mechanism associated with GDF-15 may help in developing some novel therapeutic strategies based on its expression.