Abstract: PURPOSE: To investigate the relationship between serum trefoil factor 1 (TFF1), CC chemokine ligand 22 (CCL22), and transforming growth factor-β1 (TGF-β1) levels and the clinical characteristics, prognosis, and efficacy of neoadjuvant chemotherapy in patients with oral cancer. METHODS: A total of 192 oral cancer patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2022 to December 2023 were enrolled and classified into a poor-prognosis group (n=76) and a good-prognosis group (n=116) based on follow-up outcomes. Among them, 65 patients received neoadjuvant chemotherapy and were further divided into a complete response group (n=34) and an incomplete response group (n=31). Serum levels of TFF1, CCL22, and TGF-β1 were compared across patients with different clinical characteristics, prognoses, and neoadjuvant chemotherapy responses. Binary logistic regression analysis was performed to examine the relationship between these biomarker levels and patients’ prognosis, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of each marker alone or in combination for poor prognosis, using the area under the curve (AUC). RESULTS: The serum TFF1, CCL22, and TGF-β1 levels in patients with poorly differentiated, clinical stage Ⅲ-Ⅳ, and cervical lymph node metastasis were significantly higher than those in patients with well-differentiated, clinical stage Ⅰ-Ⅱ, and non-cervical lymph node metastasis (P<0.01). The levels of serum TFF1, CCL22, and TGF-β1 in the poor prognosis group of oral cancer patients were significantly higher than those in the good prognosis group, and the differences were statistically significant (P<0.01). Binary logistic regression analysis results showed that TFF1, CCL22 and TGF-β1 were independent influencing factors for poor prognosis in oral cancer patients (P<0.05). ROC curve showed that the AUC of combined detection of TFF1, CCL22 and TGF-β1 for predicting the prognosis of oral cancer patients was 0.921 (95%CI: 0.879-0.964), which was higher than that of the three tests alone. The levels of serum TFF1, CCL22 and TGF-β1 in the incomplete response group of oral cancer patients were significantly higher than those in the complete response group, and the differences were statistically significant (P<0.01). CONCLUSIONS: Serum levels of TFF1, CCL22, and TGF-β1 are closely correlated with the differentiation degree, clinical stage, and cervical lymph node metastasis in patients with oral cancer, and they are important factors affecting patients' prognosis and the efficacy of neoadjuvant chemotherapy. Combined detection of these biomarkers exhibits high prognostic predictive value.

Key words: TFF1, CCL22, TGF-β1, Oral cancer, Neoadjuvant chemotherapy