ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Salivary Biomarkers Are An Effective Method Of Detecting Oral Squamous Cell Carcinoma
Clinical Question In patients with oral squamous cell carcinoma, are salivary biomarkers an effective method for detecting undiagnosed disease?
Clinical Bottom Line In a meta-analysis done by Guerra (2015), five biomarkers (interleukin-8, choline, pipecolinic acid, L-phenylalanine, and s-carboxymethyl-l-cysteine) proved to have greater accuracy, specificity, and sensitivity when used in combination to predict early stages, rather than later stages, of oral squamous cell carcinomas. For patients with undiagnosed oral squamous cell carcinoma, testing of salivary bio-markers is a promising diagnostic tool. However, further research is needed to validate the use of salivary biomarkers as an accurate method for the diagnosis of early stage oral squamous cell carcinoma.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 26170140 Guerra/201515 articlesMeta-Analysis
Key resultsFor this analysis, 369 articles were initially selected but ending with only 15 articles. All articles concluded that identification of specific biomarkers was useful as a diagnostic tool. 4 studies investigating IL-8 & IL6, choline, pipecolinic acid, and others were identified as having excellent sensitivity and specificity (57%-100%) for discrimination between the non-cancerous group and the cancer group.
Evidence Search ("mouth"[MeSH Terms] OR "mouth"[All Fields] OR "oral"[All Fields]) AND ("carcinoma, squamous cell"[MeSH Terms] OR ("carcinoma"[All Fields] AND "squamous"[All Fields] AND "cell"[All Fields]) OR "squamous cell carcinoma"[All Fields] OR ("squamous"[All Fields] AND "cell"[All Fields] AND "carcinoma"[All Fields])) AND salivary[All Fields] AND ("biomarkers"[MeSH Terms] OR "biomarkers"[All Fields])
Comments on
The Evidence
Validity: There was detailed search methodology for the meta-analysis with systematic review. The articles were searched for validity, sensitivity, specificity and application to the specific topic. For example, articles excluded used other body fluids such as blood and not saliva. After two phases in the selection process and using QUADAS, only 15 articles were selected with a sample sise of 16-169 for both control and cancer patients. Perspective: In the future, salivary biomarkers may be useful in identifying oral cancer in select patient populations. It will not replace the gold standard diagnostic tests such as biopsy. Further research is crucial for validation of this very promising diagnostic process.
Applicability The selected articles are relevant to applying this diagnostic technique to a particular patient. Both healthy patients and cancer patients were evaluated in a standardized fashion. The results indicate there is enough evidence to support salivary diagnostics as a potential tool to discriminate between the two groups. However, more specific biomarkers need to be found to facilitate an accurate diagnosis. There is no toxicity and much lower discomfort, in comparison to a biopsy where tissue sampling requires a surgical procedure.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry)
Keywords Salivary Biomarkers, Oral Squamous Cell Carcinoma
ID# 3024
Date of submission: 03/22/2016spacer
E-mail ruizv@livemail.uthscsa.edu
Author Victoria Ruiz
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author H. Stan McGuff, DDS
Faculty mentor/Co-author e-mail mcguff@uthscsa.edu
Basic Science Rationale
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Comments on the CAT
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