Can Insulin Like Growth Factors Be Used As A Biomarkers Of Oral Cancer?-A Systematic Review

Background: Insulin like growth factor (IGF) has been linked with cancers of the gastro-intestinal and breast origin. They are involved in the proliferation of cells and have an anti-apoptotic role in cancer cells The role of serum and salivary IGF in oral cancer is not well established though, IGF-1 has been found to be elevated in the tissue levels of oral cancer sites. Methods: Electronic searches were carried out in the Embase,Medline,Scopus databases for clinical studies which measured the levels of Insulin-like growth factors in patients with oral cancer.Only studies which measured serum or salivary IGF-1 and IGFBP's in oral cancer patients were included in the search.The studies' quality was determined using the National Heart,Lung and Blood Institute (NHLBI) checklist. Results:Four studies were included in the review out of a total of 116 articles.3 of these articles reported on serum levels of the IGF and only one measured the salivary levels.The studies which measured serum IGF and IGFBP's in oral cancer patients reported decreased levels when compared to the controls,whereas the study which assessed the salivary levels concluded that there was a117% increase in the IGF-1 levels among oral cancer patients. Conclusion:With the availability of limited data, the role and utility of salivary and serum IGF-1 and IGFBP-3 as prognostic biomarkers in oral cancer patients cannot be assessed. More clinical studies designed and standardized to measure the values of IGFwith a long term follow up of the patients will give a more clearer picture of the actual role of IGF-1 and its role in oral cancer.