The Accuracy of Salivary Biomarkers for Detection of Oral Cancer: A Meta-Analysis
Keywords:Salivary biomarker, Oral cancer, Meta-analysis
Background: There are various studies about salivary biomarkers in oral cancer detection. Breakthrough technologies have lead to an increased discovering salivary biomarkers, which change the conclusion of accuracy in oral cancer detection. Many studies support that saliva biomarkers have a potential of being an essential tools as diagnosis, prognosis and maintenance program for oral cancer. However, sufficient evidence is still lacking. Objective: This meta-analysis has an objective to gather the results about an accuracy of the use of saliva as a detection tool of oral cancer to determine the accuracy and determine which biomarker is the most likely to use in oral cancer detection. Method: The electronic databases were searched on January 2009 to 2019. We searched Pubmed, The Cochrane Database of Systematic Reviews, Google Scholar and manual search. Result: We included 14 articles which considered saliva as a diagnostic accuracy studies are included. Statistical analysis established sensitivity and specificity with 95% confident interval of the accuracy test of the use of saliva as an oral cancer detection tools were included in this meta-analysis. These 14 articles can be divided into 30 studies, which were meta analyzed by using Hierachical model. Meta analyzed data found that the use of saliva as an oral cancer detection tools has sensitivity of 0.72 (95% CI = 0.61, 0.81), specificity of 0.78 (95% CI = 0.61, 0.81), but data is lack of homogeneity and the confident interval is wide. Conclusion: There is no sufficient evidence to support the accuracy of salivary biomarker for the early diagnosis of oral cancer. Subgroup analysis should be tested to summarize the cause of the lack of homogeneity. Overall analysis showed that protein biomarkers have higher sensitivity and specificity compared to other saliva biomarkers group. However, further clinical study with higher amount sample size and lack of bias should be studied to find out the most accurate saliva biomarker group in terms of sensitivity and specificity which can benefit in development of oral cancer detection tool.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394-424.
Sankaranarayanan R, Ramadas K, Amarasinghe H,Subramanian S, Johnson N. Oral Cancer: Prevention,Early Detection, and Treatment. In: Gelband H, Jha P,Sankaranarayanan R, Horton S, editors. Cancer: Disease Control Priorities, Third Edition (Volume 3). Washington (DC)2015.
Hospital-Based Cancer Registry 2016. Bangkok: Information Techbology Division, National Cancer institute;2018.
Allison P, Locker D, Feine JS. The role of diagnostic delays in the prognosis of oral cancer: a review of the literature. Oral Oncol 1998;34:161-70.
Liao PH, Chang YC, Huang MF, Tai KW, Chou MY. Mutation of p53 gene codon 63 in saliva as a molecular marker for oral squamous cell carcinomas. Oral Oncol 2000;36:272-6.
El-Naggar AK, Mao L, Staerkel G, Coombes MM, Tucker SL,Luna MA, et al. Genetic heterogeneity in saliva from patients with oral squamous carcinomas: implications in molecular diagnosis and screening. J Mol Diagn 2001;3:164-70.
Yoshizawa JM, Schafer CA, Schafer JJ, Farrell JJ, Paster BJ,Wong DT. Salivary biomarkers: toward future clinical and diagnostic utilities. Clin Microbiol Rev 2013;26:781-91.
Mishra A, Verma M. Cancer biomarkers: are we ready for the prime time? Cancers 2010;2:190-208.
Macey R, Walsh T, Brocklehurst P, Kerr AR, Liu JL, Lingen MW, et al. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. Cochrane Database Sys Rev 2015:CD010276.
Hu S, Arellano M, Boontheung P, Wang J, Zhou H, Jiang J, et al. Salivary proteomics for oral cancer biomarker discovery.Clin Cancer Res 2008;14:6246-52.
Guerrero-Preston R, Soudry E, Acero J, Orera M, Moreno-Lopez L, Macia-Colon G, et al. NID2 and HOXA9 promoter hypermethylation as biomarkers for prevention and early detection in oral cavity squamous cell carcinoma tissues and saliva. Cancer Prev Res 2011;4:1061-72.
Zahran F, Ghalwash D, Shaker O, Al-Johani K, Scully C. Salivary microRNAs in oral cancer. Oral Dis 2015;21:739-47.
Momen-Heravi F, Trachtenberg AJ, Kuo WP, Cheng YS.Genomewide Study of Salivary MicroRNAs for Detection of Oral Cancer. J Dent Res 2014;93(7 Suppl):86S-93.
Elashoff D, Zhou H, Reiss J, Wang J, Xiao H, Henson B, et al.Prevalidation of salivary biomarkers for oral cancer detection.Cancer Epidemiol Biomarkers Prev 2012;21:664-72.
Martin JL, Gottehrer N, Zalesin H, Hoff PT, Shaw M, Clarkson JH, et al. Evaluation of Salivary Transcriptome Markers for the Early Detection of Oral Squamous Cell Cancer in a Prospective Blinded Trial. Compend Contin Educ Dent 2015;36:365-73.
Lee LT, Wong YK, Hsiao HY, Wang YW, Chan MY, Chang KW.Evaluation of saliva and plasma cytokine biomarkers in patients with oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2018;47:699-707.
Rajkumar K, Nandhini G, Ramya R, Rajashree P, Kumar AR,Anandan SN. Validation of the diagnostic utility of salivary interleukin 8 in the differentiation of potentially malignant oral lesions and oral squamous cell carcinoma in a region with high endemicity. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;118:309-19.
Balan JJ, Rao RS, Premalatha BR, Patil S. Analysis of tumor marker CA 125 in saliva of normal and oral squamous cell carcinoma patients: a comparative study. J Contemp Dent Pract 2012;13:671-5.
Vajaria BN, Patel KR, Begum R, Shah FD, Patel JB, Shukla SN, et al. Evaluation of serum and salivary total sialic acid and alpha-l-fucosidase in patients with oral precancerous conditions and oral cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:764-71.
Wang Q, Gao P, Cheng F, Wang X, Duan Y. Measurement of salivary metabolite biomarkers for early monitoring of oral cancer with ultra performance liquid chromatography-mass spectrometry. Talanta 2014;119:299-305.
Wang Q, Gao P, Wang X, Duan Y. Investigation and identification of potential biomarkers in human saliva for the early diagnosis of oral squamous cell carcinoma. Clin Chim Acta 2014;427:79-85.
Malhotra R, Urs AB, Chakravarti A, Kumar S, Gupta VK, Mahajan B. Correlation of Cyfra 21-1 levels in saliva and serum with CK19 mRNA expression in oral squamous cell carcinoma.Tumour Biology 2016;37:9263-71.
Ghallab NA, Shaker OG. Serum and salivary levels of chemerin and MMP-9 in oral squamous cell carcinoma and oral premalignant lesions. Clin Oral Investig 2017;21:937-47.
How to Cite
ข้อความและข้อคิดเห็นต่างๆ เป็นของผู้เขียนบทความ ไม่ใช่ความเห็นของกองบรรณาธิการหรือของวารสารกรมการแพทย์