Concomitant Analysis of Salivary Tumor Markers—A New Diagnostic Tool for Oral Cancer

TLDR

Oral squamous cell carcinoma is a common malignancy, yet salivary tumor markers have rarely been examined despite the direct contact between saliva and oral lesions. The study aimed to evaluate salivary concentrations of six epithelial tumor markers in OSCC patients, finding a 400 % increase in Cyfra 21‑1, tissue polypeptide antigen, and CA125. The authors measured these markers in saliva and performed a concurrent analysis of the three significantly elevated markers, yielding sensitivity, specificity, and predictive values of 71 % and 75 %. The markedly elevated markers and their diagnostic performance support saliva as a noninvasive, potentially home‑based tool for OSCC detection.

Abstract

Oral squamous cell carcinoma (OSCC) is a common human malignancy. Circulatory epithelial tumor markers were previously investigated in the serum of OSCC patients but almost never in their saliva, in spite of the fact that there is a direct contact between the saliva and the oral cancer lesion. The purpose of the current study was to examine tumor markers in the saliva of OSCC patients.We measured the concentrations of the six most studied epithelial serum circulatory tumor markers in the saliva of OSCC (tongue) patients.Significant increases (of 400%) in salivary concentrations of Cyfra 21-1, tissue polypeptide antigen, and CA125 were shown. Salivary concentrations of CA19-9, SCC, and carcinoembryonic antigen were increased without statistical significance. A concurrent analysis of the three significantly increased markers revealed sensitivity, specificity, and negative and positive predictive values of 71%, 75%, 71%, and 75%, respectively.The increase reported in salivary tumor markers may be used as a diagnostic tool, especially when a concurrent analysis for significantly increased markers is done. Salivary testing is noninvasive, making it an attractive, effective alternative to serum testing, and the possibility of developing home testing kits would further facilitate it as a diagnostic aid, enabling patients to monitor their own health at home and is important for those who live far from their treatment centers and especially for those at risk of developing OSCC.