Salivary p53 autoantibody in patients with oral squamous cell carcinoma and its clinical significance
Objective To evaluate the clinical significance of salivary p53 autoantibody(p53-AAbs)detection in diagnosis and prognosis of postoperative recurrence in patients with oral squamous cell carcinoma.Methods Clinical records of 82 patients with oral squamous cell carcinoma who underwent radical resection from October 2020 to October 2021 were collected.Saliva samples were taken before surgery(baseline),at 3 months,6 months,and 9 months after surgery.Through the matching principle,164 volunteers were randomly selected from the periodontal health cohort as the control group,and saliva samples were collected.The level of p53-AAbs in saliva was detected by ELISA.Receiver characteristic operation(ROC)curve was used to evaluate the diagnostic efficacy of salivary p53-AAbs in oral squamous cell carcinoma.Logistic regression model was used to analyze the factors affecting the recurrence of oral squamous cell carcinoma.Survival curve was drawn by Kaplan-Meier method,and survival difference was tested by Log-rank.Results The level of p53-AAbs in saliva of healthy volunteers in control group was 0.32(0.17,0.50)U/ml,and that of oral squamous cell carcinoma patients before operation was 5.88(3.67,18.13)U/ml,with statistical significance(P<0.05).The area under the ROC curve for preoperative baseline salivary p53-AAbs diagnosis of oral squamous cell carcinoma was 0.967(sensitivity 91.52%,specificity 100.0%).Preoperative baseline salivary p53-AAbs levels were associated with extracapsular involvement and TNM stage.During the follow-up period,the level of p53-AAbs in saliva was decreased(P<0.05).The recurrence rate was 30.49%(25/82)3 years after surgery.According to the preoperative baseline median level of p53-AAbs in saliva(5.88 U/ml),the RFS of p53-AAbs group with low level was significantly higher than that of p53-AAbs group with high level(P=0.003).Univariate and multivariate Logistic regression analysis showed that surgical margin,TNM stage and preoperative baseline salivary p53-AAbs level were independent factors affecting 3-year RFS(P<0.05).Conclusion Salivary p53-AAbs may be a biomarker for diagnosis and prognosis of oral squamous cell carcinoma.
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