Association of serum and salivary dipeptidyl peptidase-4 (DPP-4) with oral cancerous and precancerous lesions - An observational diagnostic accuracy study

Sep 21, 2026

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Enhancing oral cancer prognosis depends on early detection, motivating this study to relate serum and salivary dipeptidyl peptidase-4 (DPP-4) levels to oral squamous cell carcinoma (OSCC) and oral potentially malignant lesions (OPMLs). Forty-five systemically healthy participants were divided into OSCC, OPML, and control groups, with DPP-4 measured by ELISA. ROC analysis compared AUC, sensitivity, specificity, and diagnostic accuracy, and results assessed whether salivary DPP-4 can serve as a non-invasive early diagnostic marker.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Methodology

Results

Conclusions

Clinical trial registration

Keywords

Background

Oral cancer and need for early detection

Oral potentially malignant lesions (OPMLs)

Current diagnostic standards and biomarkers

Abdel Fattah Tarrad etal. BMCOral Health (2024) 24:1206 [https://doi.org/10.1186/s12903-024-04939-7](https://doi.org/10.1186/s12903-024-04939-7) BMC Oral Health RESEARCH Open Access Association of serum and salivary dipeptidyl peptidase-4 (DPP-4) with oral cancerous and precancerous lesions; an observational diagnostic accuracy study Nayroz Abdel Fattah Tarrad1*, Olfat Gamil Shaker2, Maha Abdelkawy3 and Sandy Hassan4 Abstract Background Enhancing the prognosis and treatment outcomes of oral cancer relies heavily on its early detection. This study aims to establish a connection between serum and salivary dipeptidyl peptidase-4 (DPP-4) levels and oralsquamous cell carcinoma (OSCC), comparing them with oral potentially malignant lesions (OPMLs) and control subjects and validating salivary DPP-4 as a diagnostic marker for the early detection of oral cancer. Methodology Forty-five systemically healthy individuals were categorized into three groups: Group I consisted of 15 patients diagnosed with OSCC, Group II comprised 15 patients with OPMLs (including leukoplakia and oral lichen planus), and Group III included 15 participants without any oral mucosal lesions. Serum and whole unstimulated salivary samples were collected from all participants to assess DPP-4 levels using an enzyme-linked immunosorbent assay (ELISA) kit. Receiver operating characteristic (ROC) analysis was conducted to determine the area under the curve (AUC), sensitivity, specificity, and diagnostic accuracy of DPP-4 . Results Both serum and salivary DPP-4 levels were highest in the healthy group, followed by OPMLs, and lowest in the OSCC group, with statistically significant differences observed. ROC analysis demonstrated excellent diagnostic accuracy of salivary DPP-4 in distinguishing OSCC from healthy individuals, OPMLs from healthy individuals, and OSCC from OPMLs, with accuracies of 100%, 100%, and 96 . 67%, respectively. Salivary DPP-4 levels also exhibited a statistically significant correlation with OSCC grades. Conclusions DPP-4 appears to play a protective, anti-oncogenic role in maintaining oral tissue health. The remarkable diagnostic accuracy of both serum and salivary DPP-4 in discriminating between OSCC, OPMLs, and healthy controls suggests its potential utility as a well-established marker for early oral cancer diagnosis. Salivary DPP-4, being non-invasive, could serve as a convenient chair-side diagnostic tool for the early detection of OSCC. Clinical trial registration The study was retrospectively registered on clinicaltrial. gov with NCT06087042, date of registration (first posted date): 17/10/2023 Keywords Oral cancer, Saliva, Serum, Dipeptidyl peptidase, Oral potentially malignant lesions *Correspondence: Nayroz Abdel Fattah Tarrad [nam05@fayoum.edu.eg](nam05@fayoum.edu.eg) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.) Abdel Fattah Tarrad etal. BMCOral Health (2024) 24:1206 Background Oral cancer (OC), ranking as the 6th most

FAQs

What was the main goal of measuring DPP-4 in serum and saliva?

To determine whether DPP-4 levels are associated with OSCC and OPMLs, and to validate salivary DPP-4 as a diagnostic marker for early oral cancer detection.

How were participants grouped in the study?

Forty-five systemically healthy individuals were split into three groups: OSCC (15), OPMLs (15, including leukoplakia and oral lichen planus), and controls without oral mucosal lesions (15).

What diagnostic performance did salivary DPP-4 show?

ROC analysis showed excellent diagnostic accuracy for distinguishing OSCC from healthy controls and OPMLs from healthy controls, with reported accuracies of 100% and 100%, and 96.67% for discriminating OSCC from OPMLs.

Sep 21, 2026

Upload by Rowan