Comparative evaluation of serum homocysteine, CYFRA 21-1 and leptin in newly diagnosed oral squamous cell carcinoma: a hospital-based observational study

Abstract

Background: Oral squamous cell carcinoma (OSCC) is the predominant malignancy of the oral cavity and is associated with morbidity and mortality. Identification of circulating biomarkers reflecting disease-associated biochemical alterations may facilitate early detection and clinical risk assessment. This study evaluated serum homocysteine, cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1), and leptin concentrations in patients with newly diagnosed OSCC and healthy controls. Methods: This hospital-based comparative observational study included 126 participants: 63 histopathologically confirmed, treatment-naïve patients with OSCC and 63 age- and sex-matched healthy controls. Serum homocysteine was determined using an automated biochemical analyser, whereas CYFRA 21-1 and leptin were estimated by enzyme-linked immunosorbent assay. Between-group comparisons were performed using Student’s independent t-test, and associations among biomarkers were assessed using Pearson’s correlation analysis. A p value <0.05 was considered statistically significant. Results: Serum homocysteine and CYFRA 21-1 concentrations were significantly higher in OSCC patients than in controls (22.87±7.24 vs 12.53±3.01 µmol/l and 4.09±1.40 vs 0.81±0.51 ng/ml, respectively; both p<0.001). Conversely, serum leptin concentrations were significantly lower in OSCC patients (4.16±3.17 vs 11.04±5.83 ng/ml; p<0.001). Homocysteine demonstrated a significant positive correlation with CYFRA 21-1, whereas leptin showed significant inverse correlations with both biomarkers. Conclusion: Newly diagnosed OSCC was characterized by elevated serum homocysteine and CYFRA 21-1 and reduced leptin concentrations. This differential biomarker profile supports their potential utility as complementary circulating markers in OSCC and warrants further prospective investigation.