Salivary Melatonin in Oral Squamous Cell Carcinoma Patients: A Cross-sectional Study
Abstract BACKGROUND: Around 55% of oral squamous cell carcinoma (OSCC) patients are diagnosed in the advanced stage. Poor sleep quality has been associated as a potential risk factor for several malignancies, including head and neck cancers. Melatonin’s role in circadian rhythm is well documented, as are its’ anti-oxidant, oncostatic and anti-inflammatory properties. The purpose of this study is to determine salivary melatonin (MLT) levels in OSCC patients, compare the salivary MLT levels with those in healthy individuals and compare the salivary and serum levels in OSCC patients. Furthermore, the aim is to evaluate sleep quality and to investigate the potential relationship between sleep quality and salivary MLT levels in OSCC patients. METHODS: Unstimulated and stimulated saliva were sampled from patients with T1N0M0 and T2N0M0 OSCC (N=34) and 33 sex and age matched healthy subjects. Serum samples were taken from 11 OSCC patients. Detailed medical history was taken before sampling and sleep quality measured using Pittsburgh Sleep Quality Index (PSQI) questionnaire. RESULTS: Melatonin levels in UWS and SWS were significantly higher in the OSCC group. Sleep quality was significantly lower in patients with OSCC (U=249.50; P = 0.0001). ROC analysis was found to be significant (P <0.001) in evaluating the MLT concentration limit in diagnosing OSCC. CONCLUSIONS: The expected relationship between sleep quality and salivary MLT levels in OSCC patients was not observed. Salivary melatonin could present a potential OSCC biomarker. However, larger prospective studies should validate the clinical utility of MLT as an OSCC biomarker.