Early detection of oral premalignant lesions which might
evolve into oral cancer by screening methods using suitable markers is
critical. Saliva as a diagnostic fluid seems to be promising and has a number
of advantages when compared to the blood-based testing. Histopathologicaldiagnosis is still gold standard when diagnosing oral premalignant lesions,
however, studies upon the role of salivary cytokines show promising results
although more studies are needed on a larger sample. Cytokines have an
important role in oral diseases and increased levels of interleukin 6 (IL-6)
and tumor necrosis factor alpha (TNF-alpha) have been reported in patients with
cancer and premalignant lesions such as oral lichen planus and oral submucous
fibrosis. Brailo et al.reported significantly increased levels of salivary IL-6
and TNF-alpha in patients with oral leukoplakia when compared to healthy
controls.
Furthermore, the levels of salivary IL-6 and TNF-alpha did not
correlate with the size of leukoplakic lesions nor with its localization.
Recently, Brailo et al.reported that salivary IL-1β and IL-6 were significantly
higher in oral cancer patients than in patients with leukoplakia and control
group. No significant differences in salivary TNF-α between either of thegroups were seen. Sharma et al.reported increased salivary IL-6 levels in
patients with leukoplakia and coexisting periodontitis and in periodontitis
patients in comparison to the healthy controls. The same authors found that in
the leukoplakia group, increased salivary IL-6 level was noticed together with
increase in the severity of dysplasia. Sharma et al.concluded that the use of
tobacco had a significant role in the elevation of salivary IL-6 which is
contrary to the results of Brailo et al.
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