AUTHOR=Abdul Aziz Shaikh Sabiha , Denny E Ceena , Kumarchandra Reshma , Natarajan Srikant , Sunny Johan , Shenoy Nandita , K. P Nandita TITLE=Evaluation of salivary tumor necrosis factor α as a diagnostic biomarker in oral submucosal fibrosis and squamous cell carcinoma of the oral cavity and oropharynx: a cross sectional observational study JOURNAL=Frontiers in Oral Health VOLUME=Volume 5 - 2024 YEAR=2024 URL=https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2024.1375162 DOI=10.3389/froh.2024.1375162 ISSN=2673-4842 ABSTRACT=Tumor necrosis factor α (TNFα) is known to be associated with chronic inflammation, and its expression has been shown to increase in advanced cancers. Chronic inflammation is a characteristic feature of oral submucous fibrosis (OSMF), which is a potentially malignant disorder (PMD). Squamous cell carcinoma (SCC) is associated with considerable mortality and morbidity and an early detection or monitoring would greatly help in achieving an effective cure. TNFα was thus evaluated for use as a biomarker in the present study according to the stage of OSMF and histological grade of SCC in the oral cavity and oropharynx.Methods: This study included 45 patients divided into 3 groups-OSMF group, SCC group and control group-each comprising 15 participants. Saliva samples were collected from each patient, and salivary TNF-α levels were estimated using an ELISA kit.Results: Statistical analysis revealed no significant differences in TNF-α levels among the OSMF, SCC and control groups; however, there was an increase in the salivary TNF-α level in patients with stage 3 disease according to the clinical stage of OSMF, for which the p value was 0.027.Discussion: An increase in the TNF-α concentration with increasing clinical stage suggested a role for TNF-α in the spread of OSMF involvement in anatomical structures of the oral cavity and oropharynx. No significant difference in salivary TNF-α levels was noted among the OSMF, SCC and control groups.The study showed a positive correlation TNF-α with increasing stages of OSMF but was not a reliable biomarker in the categorization of the same.