Oxidative stress markers as a diagnostic tool in oral cancer and premalignant lesions: A systematic review.

Background: Oral cancer is the eighth leading cause of cancer-related mortality worldwide, particularly prevalent in regions with high tobacco and betel nut consumption. The associated high mortality and morbidity rates could be reduced through early detection, prompting researchers to focus on identifying early markers of carcinogenesis. Methods: This systematic review evaluated the effectiveness of oxidative stress markers as diagnostic tools. An electronic search was conducted in PubMed and Google Scholar to identify case‒control studies published between January 2000 and June 2024 that explored the use of oxidative stress markers as diagnostic biomarkers. A manual search was also performed in relevant journals, including oral oncology and oral diseases. Initially, 38 studies were screened, and after applying the inclusion criteria, only nine studies were included. The Newcastle-Ottawa Scale (NOS) tool was used to assess the risk of bias. Results: Eight studies were conducted in India, while one was from Saudi Arabia. These studies analyzed oxidative stress markers in oral squamous cell carcinoma (OSCC), oral submucous fibrosis (OSMF), and leukoplakia. Control groups were matched based on age and sex, with only two studies also considering socioeconomic status. A significant difference ( Conclusion: Oxidative stress markers show promise as diagnostic and prognostic indicators. Standardized methodologies and therapeutic approaches targeting oxidative stress could enhance early detection and treatment, especially in resource-limited settings. However, the findings must be interpreted with caution due to methodological limitations, geographic bias, and the lack of inclusion of grey literature.