Investigation and identification of potential biomarkers in human saliva for the early diagnosis of oral squamous cell carcinoma

Abstract

BackgroundOral cancer is 1 of the 6 most common human cancers, with an annual incidence of >300,000 cases worldwide. This study aimed to investigate potential biomarkers in human saliva to facilitate the early diagnosis of oral squamous cell carcinoma (OSCC). MethodsUnstimulated whole saliva obtained from OSCC patients (n=30) and apparently healthy individuals (n=30) were assayed with ultra-performance liquid chromatography–mass spectrometry (UPLC–MS) in hydrophilic interaction chromatography mode. The data were analyzed using a nonparametric Mann–Whitney U test, logistic regression, and the receiver operating characteristic (ROC) to evaluate the predictive power of each of 4 biomarkers, or combinations of biomarkers, for OSCC screening. ResultsFour potential salivary biomarkers demonstrated significant differences (P<0.05) in concentrations between patients at stages I–II and the healthy individuals. The area under the curve (AUC) values in control vs OSCC I–II mode based on choline, betaine, pipecolinic acid, and l-carnitine were 0.926, 0.759, 0.994, and 0.708, respectively. Four salivary biomarkers in combination yielded satisfactory accuracy (0.997), sensitivity (100%), and specificity (96.7%) in distinguishing OSCC I–II from control. ConclusionsSalivary metabolite biomarkers for the early diagnosis of OSCC were verified in this study. The proposed approach is expected to be applied as a potential technique of preclinical screening of OSCC.