Authors
Tejal Patil, Jasmine Kalsi, Mukesh Kumar, Rahul Vc Tiwari, Ambili Remesh, Unni J Appilly
Published in
Cureus. Volume 18. Issue 5. Pages e109594. Epub May 25, 2026.
Abstract
Background Oral squamous cell carcinoma (OSCC) is a common malignancy with variable clinical outcomes and a high risk of recurrence. Conventional prognostic indicators often fail to fully capture tumor behavior. Serum growth factors and inflammatory mediators, such as the epidermal growth factor receptor (EGFR), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), may provide additional insights into disease progression and prognosis. This study aimed to evaluate the prognostic significance of serial serum levels of EGFR, IL-6, and TNF-α in patients with OSCC. Methodology This prospective cohort study included 120 patients with histopathologically confirmed OSCC. Serum samples were collected at baseline, 6 months, and 12 months and analyzed for EGFR, IL-6, and TNF-α using enzyme-linked immunosorbent assay. Clinical and pathological data were also recorded. Statistical analyses were performed. Intergroup comparisons were conducted using independent t-tests, correlations were assessed using Spearman's coefficient, and Cox proportional hazards regression analysis was used to identify predictors of recurrence-free survival. Results In total, 34 (28.33%) patients with recurrence showed significantly higher baseline levels of EGFR (82.3 ± 24.1 vs. 62.9 ± 19.4 ng/mL), IL-6 (26.4 ± 10.8 vs. 15.9 ± 7.1 pg/mL), and TNF-α (42.7 ± 16.3 vs. 28.6 ± 12.1 pg/mL) compared to non-recurrent cases (p < 0.001). Similar trends persisted at 6 and 12 months (p < 0.001). Significant positive correlations were identified between baseline biomarker levels and clinicopathological parameters. Tumor size showed moderate correlations with EGFR (r = 0.54), IL-6 (r = 0.48), and TNF-α (r = 0.42). Similarly, tumor-node-metastasis stage demonstrated strong correlations with EGFR (r = 0.61), IL-6 (r = 0.57), and TNF-α (r = 0.51). Lymph node metastasis also showed significant positive correlations with EGFR (r = 0.52), IL-6 (r = 0.49), and TNF-α (r = 0.45) (p < 0.001). Multivariate analysis identified the baseline EGFR (p < 0.001), IL-6 (p = 0.002), and TNF-α (p = 0.028) as independent predictors of recurrence of OSCC. Conclusions Serum EGFR, IL-6, and TNF-α may serve as potential prognostic indicators for OSCC. The findings of this study suggest that combining growth factors and inflammatory biomarkers could have clinical utility for improving prognostic assessment in OSCC. Serial monitoring may provide a dynamic approach for identifying patients at higher risk of recurrence, thereby facilitating timely therapeutic interventions and closer surveillance. Incorporation of these markers into routine clinical protocols might contribute to more personalized treatment strategies and potentially improve long-term outcomes. However, further large-scale studies are required to validate these findings and establish standardized clinical thresholds.
PMID:
42359221
Bibliographic data and abstract were imported from PubMed on 26 Jun 2026.
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