Salivary matrix metalloproteinase-2 as a non-invasive biomarker for oral squamous cell carcinoma: diagnostic and prognostics

ABSTRACT Background: Oral squamous cell carcinoma (OSCC) is a prevalent malignancy characterized by late-stage diagnosis and high recurrence rates, underscoring the need for reliable biomarkers. Matrix metalloproteinase-2 (MMP-2), a zinc-dependent enzyme implicated in extracellular matrix degradation, has shown potential as a biomarker for OSCC progression. Saliva, being non-invasive and accessible, offers a promising medium for MMP-2 assessment. Objectives: This study aimed to evaluate salivary MMP-2 levels in OSCC patients and healthy controls to determine its diagnostic and prognostic significance. Methods: This clinical study included 60 participants divided into three groups: healthy controls (n = 20), pre-operative OSCC patients and post-operative OSCC patients (n = 40). Saliva samples were collected, processed, and analyzed for MMP-2 levels using ELISA. Statistical analyses, including ANOVA and post-hoc Tukey tests, were performed to compare groups. Kaplan-Meier survival analysis was used to assess the prognostic impact of MMP-2 expression. Results: MMP-2 levels were significantly elevated in pre-operative OSCC patients (78.69 ± 2.65 ng/mL) compared to controls (36.20 ± 1.83 ng/mL; p < 0.0001). Post-operative patients exhibited reduced but still elevated levels (51.88 ± 4.25 ng/mL), highlighting the partial impact of surgical intervention. Kaplan-Meier analysis revealed poorer survival probabilities in patients with high MMP-2 levels, emphasizing its prognostic value. Conclusions: Salivary MMP-2 serves as a potential non-invasive biomarker for OSCC diagnosis, disease monitoring, and prognosis. Its incorporation into clinical practice could enhance early detection and treatment planning, improving patient outcomes.