Salivary protein and solCD44 levels as a potential screening tool for early detection of head and neck squamous cell carcinoma

Background Head and neck squamous cell carcinoma (HNSCC) is a devastating disease usually diagnosed at a late stage when cure rates are 40%. We examined a simple and inexpensive molecular tool that may aid HNSCC detection. Methods. Building on prior findings that total protein levels are elevated in 102 HNSCC cases versus 84 control subjects, we further analyzed these levels with respect to important risk and demographic variables and compared the results to soluble CD44 (solCD44). Using multivariate adaptive regression splines (MARSs)-logit modeling and logistic regression, we determined whether total protein, solCD44, or the combination best identifies HNSCC. Results. Combined higher levels of solCD44 and protein were significantly associated with HNSCC (odds ratio [OR] 24.90; 95% confidence interval [CI], 9.04-68.57; area under the curve [AUC] 0.786). A model including protein plus solCD44 resulted in a better area (AUC 0.796) than either marker alone. Conclusion. Oral rinse levels of solCD44 and protein seem to hold promise for detection of HNSCC. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 687-695, 2012