Serum ceruloplasmin as cancer marker in oral pre-cancers and cancers

Manisha B Patil1, T Lavanya2, C Meena Kumari3, Shishir Ram Shetty4, Khalid Gufran5, Vipin Viswanath6, C Swarnalatha7, J Suresh Babu7, Abhishek Singh Nayyar8
1Department of Oral Pathology and Microbiology, Nanded Rural Dental College and Research Center, Nanded, Maharashtra, India
2Department of Maxillofacial Surgery and Diagnostic Sciences, Majmaah University, Al Majma’ah, Kingdom of Saudi Arabia
3Department of Restorative Dentistry, College of Dentistry, Majmaah University, Al Majma’ah, Kingdom of Saudi Arabia
4Department of Oral and Craniofacial Health Sciences, Division of Oral Radiology, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
5Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
6Department of Oral and Maxillofacial Surgery, Azeezia College of Dental Science and Research, Kollam, Kerala, India
7Department of Preventive Dental Sciences, Division of Periodontology, College of Dentistry, University of Ha’il, Ha’il, Kingdom of Saudi Arabia
8Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
DOI: 10.4103/jcar.jcar_10_21


BACKGROUND AND AIM: Oxidative stress leads to a compensatory increase in levels of serum ceruloplasmin in patients with such imbalances. Greater than normal serum ceruloplasmin levels are noticed in numerous cancers including the leukemias and Hodgkin’s lymphoma. The purpose of the present study was to estimate and evaluate the efficacy of serum ceruloplasmin levels as a potential biomarker in the early detection of oral potentially malignant epithelial lesions (PMELs) including leukoplakia, oral submucous fibrosis (OSMF), and oral squamous cell carcinoma (OSCC) patients.
MATERIALS AND METHODS: The present observational study was conducted over a period of 2 years wherein 100 subjects aged between 18 to 60 years were divided into four groups with Group A consisting of 25 healthy controls, Group B and C with 25 patients each, clinically diagnosed with oral leukoplakia and OSMF and Group D with 25 patients clinically diagnosed and histopathologically proven OSCC. The patients were subjected to incisional biopsy after routine hematological investigation while the same sera samples were used for analysis of serum ceruloplasmin levels.
STATISTICAL ANALYSIS USED: Comparison of serum ceruloplasmin levels between the groups was performed using one way analysis of variance (one way ANOVA) test while P < 0.05 was considered statistically significant.
RESULTS: The mean serum ceruloplasmin levels were found to be 43.19 ± 1.90mg/dl in subjects of group A, 47.68 ± 1.51mg/dl in group B, 47.74 ± 1.45mg/dl in group C and 47.73 ± 0.74mg/dl in group D. Using one-way ANOVA, statistically significant variations were found in the values of mean serum ceruloplasmin levels in subjects of the four groups (F-value = 59.58, P = 0.0001).
CONCLUSIONS: The observations of the present study revealed that serum ceruloplasmin levels were found to be raised in all 3 study groups including oral leukoplakia, OSMF and OSCC as compared to the controls while the results were found to be statistically significant.

Keywords: Biomarker, early detection, oral potentially malignant epithelial lesions, oral squamous cell carcinoma, Serum ceruloplasmin