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Meta-Analysis
. 2020 May-Jun;52(3-4):131-144.
doi: 10.1080/07853890.2020.1730431. Epub 2020 Apr 11.

Salivary biomarkers for cancer diagnosis: a meta-analysis

Óscar Rapado-González  1   2   3 , Cristina Martínez-Reglero  4 , Ángel Salgado-Barreira  4 , Bahi Takkouche  5   6 , Rafael López-López  3   7 , María Mercedes Suárez-Cunqueiro  1   3   8 , Laura Muinelo-Romay  2   3
Affiliations
Meta-Analysis

Salivary biomarkers for cancer diagnosis: a meta-analysis

Óscar Rapado-González et al. Ann Med. 2020 May-Jun.

Abstract

Background: Saliva represents a promising non-invasive source of novel biomarkers for diagnosis and prognosis cancer. This meta-analysis evaluates the diagnostic value of salivary biomarkers for detection of malignant non-oral tumours to better define the value of saliva as an alternative liquid biopsy.Materials and methods: We performed a systematic review and meta-analysis. PubMed, Embase, LILACS and the Cochrane Library were searched to identify articles that examined the potential of salivary biomarkers for the diagnosis of malignant non-oral tumours. To assess the overall accuracy, we calculated the diagnostic odds ratio (DOR), area under hierarchical summary receiver operating characteristic (AUC) curve, sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) using a random- or fixed-effects model. Heterogeneity and publication bias were assessed. Statistical tests were two-sided.Results: One hundred fifty-five study units from 29 articles with 11,153 subjects were included. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC were 0.76 (95% confidence intervals (CI), 0.74-0.77), 0.76 (95% CI, 0.75-0.77), 3.22 (95% CI, 2.92-3.55), 0.31 (95% CI, 0.28-0.34), 13.42 (95% CI, 12.28-15.96) and 0.85 (95% CI, 0.84-0.87), respectively.Conclusion: Salivary biomarkers may be potentially used for non-invasive diagnosis of malignant non-oral tumours.Key messagesThis meta-analysis evaluates the diagnostic value of salivary biomarkers for detection of malignant non-oral tumours to better define the role of saliva as an alternative liquid biopsy.Salivary biomarkers showed 85% accuracy for cancer distant to the oral cavity.Saliva represents a promising non-invasive source of novel biomarkers in cancer.

Keywords: Saliva; cancer; diagnosis; liquid biopsy; meta-analysis; salivaomics; salivary biomarkers.

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Conflict of interest statement

R.L.-L. reported Nasasbiotech during the conduct of the study; received grants and personal fees from Roche and Merck, personal fees from AstraZeneca, Pharmamar, Leo and Bayer and personal fees and non-financial support from BMS outside the submitted work. The rest of the authors have nothing to disclose.

Figures

Figure 1.
Figure 1.
Paired forest plot with the diagnostic test accuracy (sensitivity, specificity and 95% confidence interval) of each unit study for the salivary biomarkers in the diagnosis of breast cancer.
Figure 2.
Figure 2.
Paired forest plot with the diagnostic test accuracy (sensitivity, specificity and 95% confidence interval) of each unit study for the salivary biomarkers in the diagnosis of pancreatic cancer.
Figure 3.
Figure 3.
Paired forest plot with the diagnostic test accuracy (sensitivity, specificity and 95% confidence interval) of each unit study for the salivary biomarkers in the diagnosis of lung cancer.
Figure 4.
Figure 4.
Paired forest plot with the diagnostic test accuracy (sensitivity, specificity and 95% confidence interval) of each unit study for the salivary biomarkers in the diagnosis of ovarian cancer.
Figure 5.
Figure 5.
Paired forest plot with the diagnostic test accuracy (sensitivity, specificity and 95% confidence interval) of each unit study for the salivary biomarkers in the diagnosis of oesophageal cancer.
Figure 6.
Figure 6.
Paired forest plot with the diagnostic test accuracy (sensitivity, specificity and 95% confidence interval) of each unit study for the salivary biomarkers in the diagnosis of gastric cancer.
Figure 7.
Figure 7.
SROC curve with pooled estimates of sensitivity, specificity and AUC on the diagnostic value of salivary biomarkers in cancer.
Figure 8.
Figure 8.
SROC curves for subgroup analysis based on the different anatomic tumour locations.
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