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. 2024 Aug 13;16(1):105.
doi: 10.1186/s13148-024-01716-9.

DNA methylation markers for oral cancer detection in non- and minimally invasive samples: a systematic review

Óscar Rapado-González  1   2   3   4   5 , Sofia Salta  5 , Rafael López-López  2   6 , Rui Henrique  7   8   9 , María Mercedes Suárez-Cunqueiro  1   2   4   6 , Carmen Jerónimo  10   11   12
Affiliations

DNA methylation markers for oral cancer detection in non- and minimally invasive samples: a systematic review

Óscar Rapado-González et al. Clin Epigenetics. .

Abstract

More than 50% of oral cancer (OC) patients are diagnosed with advanced-stage disease associated with poor prognosis and quality of life, supporting an urgent need to improve early OC detection. The identification of effective molecular markers by minimally invasive approaches has emerged as a promising strategy for OC screening. This systematic review summarizes and evaluates the performance of the DNA methylation markers identified in non- or minimally invasive samples for OC detection. PubMed's MEDLINE, Scopus, Embase, and Cochrane Library databases were systematically searched for studies that evaluated DNA methylation markers in non-invasive and/or minimally invasive samples (oral rinse/saliva, oral brush, and blood) from OC patients. Two investigators independently extracted data on study population characteristics, candidate methylation markers, testing samples, DNA methylation assay, and performance diagnostic outcomes. Methodological study quality was assessed with the Quality Assessment for Studies of Diagnostic Accuracy-2 tool. Thirty-one studies met the inclusion criteria for this systematic review. DNA methylation markers were evaluated in oral rinse/saliva (n = 17), oral brush (n = 9), and blood (n = 7) samples. Methylation-specific PCR (MSP) and quantitative-MSP were the most common DNA methylation assays. Regarding diagnostic performance values for salivary, oral brush, and blood DNA methylation markers, sensitivity and specificity ranged between 3.4-100% and 21-100%, 9-100% and 26.8-100%, 22-70% and 45.45-100%, respectively. Different gene methylation panels showed good diagnostic performance for OC detection. This systematic review discloses the promising value of testing DNA methylation markers in non-invasive (saliva or oral rinse) or minimally invasive (oral brush or blood) samples as a novel strategy for OC detection. However, further validation in large, multicenter, and prospective study cohorts must be carried out to confirm the clinical value of specific DNA methylation markers in this setting.

Keywords: DNA methylation; Diagnosis; Epigenetics; Liquid biopsies; Oral cancer; Screening.

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Conflict of interest statement

All authors have read the journal's policy on disclosure of potential conflicts of interest and report the following: Rafael López López has received honoraria for participation in Advisory Boards from Roche, AstraZeneca, Merck, Merck Sharp & Dohme, Bayer, Bristol-Myers Squibb, Novartis, Janssen, Lilly, Pfzer, and Leo; travel, accommodations, and expenses from PharmaMar, Roche, Bristol Myers Squibb, and Pierre Fabre; research funding from Roche and Merck; and is co-founder and shareholder in Nasasbiotech, S.L., Mtrap Inc. The remaining authors have no conflicts of interest to declare.

Figures

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Fig. 1
PRISMA flow diagram
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