title: Diagnostic capability of salivary biomarkers in the assessment of head and neck cancer: A systematic review and meta-analysis.
abstract: The purpose of this systematic review and meta-analysis was to evaluate the diagnostic value of salivary biological markers in the diagnosis of head and neck carcinoma. Studies were gathered by searching Cochrane, EMBASE, LILACS, MEDLINE, and PubMed. The references were also crosschecked and a partial grey literature search was undertaken using Google Scholar. The methodology of selected studies was evaluated using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. After a two-step selection process, 15 articles were identified and subjected to qualitative and quantitative analyses. The studies were homogeneous, and all had high methodological quality. Combined biomarkers demonstrated better accuracy with higher sensitivity and specificity than those tested individually. Furthermore, the salivary biomarkers reviewed predicted the early stages of head and neck carcinoma better than the advanced stages. A restricted set of five single biomarkers (interleukin-8, choline, pipecolinic acid, l-phenylalanine, and S-carboxymethyl-l-cysteine) as well as combined biomarkers demonstrated excellent diagnostic test accuracy. The present systematic review confirms the potential value of a selected set of salivary biomarkers as diagnostic tools for head and neck carcinoma.
authors.affiliation: Department of Dentistry, Oral Histopathology Laboratory, Health Sciences Faculty, University of Brasília, Brasília, Brazil. Electronic address: elieteneves@unb.br.
authors.forename: Eliete Neves Silva
authors.initials: EN
authors.lastname: Guerra
authors.affiliation: Department of Dentistry, Oral Histopathology Laboratory, Health Sciences Faculty, University of Brasília, Brasília, Brazil.
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Acevedo
authors.affiliation: Department of Dentistry, Oral Histopathology Laboratory, Health Sciences Faculty, University of Brasília, Brasília, Brazil.
authors.forename: André Ferreira
authors.initials: AF
authors.lastname: Leite
authors.affiliation: Department of Pediatrics, The University of Chicago, IL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Gozal
authors.affiliation: Faculté de Chirurgie Dentaire, Université Paris Descartes Sorbonne Paris Cité, Paris, France; ESPCI Paris Tech, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Chardin
authors.affiliation: Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil; School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.
authors.forename: Graziela
authors.initials: G
authors.lastname: De Luca Canto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis*; D002233:Carbocysteine / Q000032:analysis; D002794:Choline / Q000032:analysis; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D016209:Interleukin-8 / Q000032:analysis; D008875:Middle Aged; D010649:Phenylalanine / Q000032:analysis; D010880:Piperidines / Q000032:analysis; D012463:Saliva / Q000737:chemistry*; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016209:Interleukin-8; D010880:Piperidines; D010649:Phenylalanine; D002233:Carbocysteine; D002794:Choline
keywords: Biological markers; Diagnosis; Head and neck cancer; Meta-analysis; Saliva; Systematic review