Abstract
Background Saliva evaluation could be a possible alternative to blood and/or tissue analyses, for researching specific molecules associated to the presence of systemic diseases and malignancies. The present systematic review has been designed in order to answer to the question “are there significant associations between specific salivary biomarkers and diagnosis of systemic diseases or malignancies?”. Material and Methods The Preferred Reporting Item for Systematic Reviews and Meta-analysis (PRISMA) statement was used to guide the review. The combinations of “saliva” and “systemic diseases” or “diagnosis” or “biomarkers” or “cancers” or “carcinoma” or “tumors”, were used to search Medline, Scopus and Web of Science databases. Endpoint of research has been set at May 2019. Studies were classified into 3 groups according to the type of disease investigated for diagnosis: 1) malignant tumors; 2) neurologic diseases and 3) inflammatory/metabolic/cardiovascular diseases. Assessment of quality has been assigned according to a series of questions proposed by the National Institute of Health. Level of evidence was assessed using the categories proposed in the Oxford Center for Evidence-Based medicine (CEMB) levels for diagnosis (2011). Results Seventy-nine studies met the inclusion and exclusion criteria. Fifty-one (64%) investigated malignant tumors, 14 (17.5%) neurologic and 14 (18.5%) inflammatory/cardiovascular/metabolic diseases. Among studies investigating malignant tumors, 12 (23.5%) were scored as “good” and 11 of these reported statistically significant associations between salivary molecules and pathology. Two and 5 studies were found to have a good quality, among those evaluating the association between salivary biomarkers and neurologic and inflammatory/metabolic/cardiovascular diseases, respectively. Conclusions The present systematic review confirms the existence of some “good” quality evidence to support the role of peculiar salivary biomarkers for diagnosis of systemic diseases (e.g. lung cancer and EGFR). Key words:Salivary diagnostics, biomarkers, systemic diseases, malignant tumors, early diagnosis.
Highlights
One of the most relevant targets of medicine and healthcare is early diagnosis
The present systematic review confirms the existence of some “good” quality evidence to support the role of peculiar salivary biomarkers for diagnosis of systemic diseases
The less studied salivary biomarkers are those based on DNA (3 studies) and microbiota (2 studies) analysis, despite their popularity for other aims (e.g ancestry investigations, biocompatibility for transplant, forensic analysis, dietary implications) [35,36]
Summary
One of the most relevant targets of medicine and healthcare is early diagnosis. To provide timely and targeted prevention [2] The combination of such profiles and the identification of biomarkers is leading to the development of new technologies, based on easy and non-invasive methods to collect diagnostic human specimens, possibly with a high specificity and sensitivity and customized on single patient. For such reasons, saliva evaluation could be considered as a possible alternative to blood and/or tissue analyses, for researching specific molecules (DNA, RNA, proteins and metabolites) associated to the presence of systemic diseases and malignancies [3]. The present systematic review has been designed in order to answer to the question “are there significant associations between specific salivary biomarkers and diagnosis of systemic diseases or malignancies?”, formulated according to the “Patient-InterventionComparison-Outcome” (PICO) worksheet. Level of evidence was assessed using the categories proposed in the Oxford Center for Evidence-Based medicine (CEMB) levels for diagnosis (2011)
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