Estimation Of Salivary Copper In Smokeless Tobacco Users With Oral Premaligancies And Malignancies: A Cross Sectional Study

Introduction: The estimation of serum bioelements for the identification of oral premalignant and malignant lesions has been extensively studied. Higher amounts of copper have been found in all smoking and Smokeless Tobacco (SLT) products, which are responsible for the higher incidence of premalignant and malignant lesions in the oral cavity. Limited studies have shown the significance and role of salivary bioelements in premalignant lesions, such as Oral Submucous Fibrosis (OSMF) and oral leukoplakia, and malignant lesions like Squamous Cell Carcinoma (SCC) of the oral cavity. Aim: To estimate salivary copper levels in premalignant and malignant lesions of the oral cavity. Materials and Methods: The preent cross-sectional study was undertaken in Tagore Dental College and Hospital in Chennai, Tamil Nadu, India for a period of 6 months, from March 2022 to August 2022. A total of 50 patients were recruited and divided into five groups of 10 patients each: Group I- control group; Group II- SLT chewing habit without any oral lesion; Group III- 10 patients with Tobacco Pouch Keratosis (TPK); Group IV- 10 patients with OSMF; and Group V- 10 patients with oral SCC. About 5 mL of salivary samples were collected and centrifuged at 3000 rpm to obtain the supernatant saliva for analysis. The levels of copper were estimated using photo calorimetry. Statistical analysis was done using One-way Analysis of Variance (ANOVA) followed by a Post-hoc test. Results: A total of 50 patients with a mean age of 40 +/- 20 years were included in present study, comprising 46% females and 54% males. There was a statistically significant difference (p <0.05) between the mean salivary copper levels in the premalignant lesions of the oral cavity. Within the premalignant group, copper levels were found to be more in OSMF (Group IV: 296.64 +/- 56.08) compared to the other groups (Group II: 202.95 +/- 125.14; Group III: 229.25 +/- 73.35). In the oral cancer patients, no significant difference (p-value=0.174; not less than 0.001) obtained in salivary copper levels. Conclusion: Compared to the control group, salivary copper levels were significantly higher in cases of OSMF, followed by cases of TPK and non lesional cases.