Estimation of salivary matrix metalloproteinase-9 in oral leukoplakia, oral submucous fibrosis, and healthy individuals: a comparative observational study

Abstract

Introduction: Salivary matrix metalloproteinase-9 (MMP-9) is an established diagnostic biomarker for detection and prognosis of oral cancer. Objectives: The current study aimed to estimate salivary MMP-9 in oral leukoplakia and oral submucous fibrosis (OSMF), which are considered as oral potentially malignant disorders (OPMDs). Material and methods: A comparative observational study of 60 subjects was conducted, including 20 patients diagnosed with OSMF (group A, n = 20), 20 diagnosed with oral leukoplakia (group B, n = 20), and 20 as healthy controls (group C, n = 20) according to standard criteria. Unstimulated salivary samples were collected for evaluation of MMP-9 by enzyme-linked immunosorbent assay (ELISA). One-way analysis of variance (ANOVA) test was applied for comparison of groups. Bonferroni-adjusted one-way ANOVA test was performed for intra-group comparison. Results: Descriptive statistics of the data revealed that mean age of study participants in group A, group B, and group C were 50.30 ± 9.96 years, 46.70 ± 12.59 years, and 33.30 ± 4.70 years, respectively. Mean salivary MMP-9 level in OSMF, oral leukoplakia, and control group were 9.42 ng/ml, 10.59 ng/ml, and 2.96 ng/ml, respectively, with a p-value < 0.001 between OSMF and oral leukoplakia when compared with controls. Conclusions: A significant difference was noted in salivary MMP-9 levels among patients with OPMD's compared to controls. A slightly higher value of MMP-9 was observed in oral leukoplakia. Estimation of salivary MMP-9 level is a non-invasive and a reliable biomarker in diagnosis of OPMD's and in accessing their malignant transformation.

Personalized Medicine in Oral Oncology: Imaging Methods and Biological Markers to Support Diagnosis of Oral Squamous Cell Carcinoma (OSCC): A Narrative Literature Review

“…Similarly, salivary levels of MMP-1 and MMP-3 have been proven to be up to 10-fold overexpressed in OSCC compared with healthy controls, and the increase seemed to be proportional to the OSCC stage, thus adding crucial prognostic information [ 183 ]. At the same time, MMP-2 and MMP-9 should be more indicative as screening biomarkers, peculiarly present in OSCC and those OPMDs moving toward malignant transformation [ 184 , 185 ]. Furthermore, among the proteins expressed in acute inflammation and cancer, there is broad evidence on how the inflammatory microenvironment is linked to cancer development and progression, mainly through the pathway involving COX-2 [ 164 , 165 , 186 ].…”