ArticleThe Saudi dental journal2026
Serum total sialic acid and carcinoembryonic antigen as biomarkers in diagnosis and stratification of oral squamous cell carcinoma, oral submucous fibrosis, and periodontitis: a prospective cross-sectional analytical study.
Article in The Saudi dental journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeOral squamous cell carcinoma (OSCC) often arises from oral submucous fibrosis (OSMF), one of the common oral potentially malignant disorders (OPMDs). Identifying reliable biomarkers for early diagnosis of both OSMF and OSCC is crucial for reducing the mortality and morbidity. This study investigates the diagnostic potential of serum carcinoembryonic antigen (CEA) and total sialic acid (TSA) in OSCC and OSMF and identifies the cut-off value to facilitate the objectivity in diagnosing. Additionally, this study highlighted the differences in serum TSA between chronic generalised periodontitis (CGP) with and without OSCC. This study also evaluated the association of serum CEA and TSA with clinicopathological features of OSMF, and OSCC.
methodsThis prospective cross-sectional analytical study included 142 participants divided into five groups. Group I, II, and III comprised of healthy individuals (n = 39), OSMF patients (n = 39), and OSCC patients (n = 39) respectively. Among group III, 25 patients having CGP were categorized as group IV and additional 25 patients having CGP but without OSCC were categorized as group V. Serum TSA and CEA levels were measured using UV spectrophotometry and electrochemiluminescence assay, respectively. The normalcy of the data was examined followed by comparison of mean serum CEA and TSA between and among the groups by Mann-Whitney U test and Kruskal-wallis test. Linear regression analysis evaluated the association of serum CEA and TSA with clinicopathological features. Receiver operating characteristic (ROC) curves plotted to identify the cutoff values of serum CEA and TSA in each group.
resultsSerum TSA levels progressively increased from Group I (0.416 ± 0.105 nmol/mg) to II (0.787 ± 0.097 nmol/mg) and III (0.869 ± 0.088 nmol/mg), with significant differences among the groups (p < 0.001). TSA levels were significantly higher in Group IV (0.917 ± 0.070 nmol/mg) compared to Group V (0.739 ± 0.123 nmol/mg; p < 0.001). Serum CEA levels also showed a progressive elevation from group I (1.77 ± 0.42 ng/mL), to II (2.90 ± 0.58 ng/mL), and III (3.62 ± 0.56 ng/mL), with significant intergroup differences (p < 0.001). Both biomarkers were significantly associated with advanced clinical stage and histopathological grade in Group II and III. TSA and CEA demonstrated high sensitivity and specificity for OSCC diagnosis, with optimal cutoff values of 0.64 nmol/mg for TSA and 2.4 ng/mL for CEA.
conclusionsSerum TSA and CEA are promising biomarkers for the early diagnosis and differentiation of OSCC and OSMF. TSA also helps distinguish periodontitis associated with OSCC from periodontitis without OSCC. Their significant association with clinical stage and histopathological grade underscores their potential role in disease progression assessment. Future studies should explore these findings in larger populations and combining the present data point of care diagnostics can be conceptualized.
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