Abstract
A very low percentage of lung cancer (LC) cases are discovered at an early and treatable stage of the disease, leading to an abysmally low 5-year survival rate. This underscores the immediate necessity for improved diagnostic, prognostic, and predictive biomarkers for LC. Biopsied lung tissue, blood, and plasma are common sources used for LC diagnosis and monitoring of the disease. A growing number of studies have reported saliva to be a useful biological sample for early and noninvasive detection of oral and systemic diseases. Nevertheless, salivary biomarker discovery remains underresearched. Here, we have compiled the available literature to provide an overview of the current understanding of salivary markers for LC detection and provided perspectives for future clinical significance. Valuable markers with diagnostic and prognostic potentials in LC have been discovered in saliva, including metabolic (catalase activity, triene conjugates, and Schiff bases), inflammatory (interleukin 10, C-X-C motif chemokine ligand 10), proteomic (haptoglobin, zinc-α-2-glycoprotein, and calprotectin), genomic (epidermal growth factor receptor), and microbial candidates (Veillonella and Streptococcus). In combination, with each other and with other established screening methods, these salivary markers could be useful for improving early detection of the disease and ultimately improve the survival odds of LC patients. The existing literature suggests that saliva is a promising biological sample for identification and validation of biomarkers in LC, but how saliva can be utilized most effectively in a clinical setting for LC management is still under investigation.
Highlights
Lung cancer (LC) is the leading cause of cancer-related deaths globally [1]
The two main subtypes of LC are nonsmall-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC), which account for 84% and 13% of LC, respectively [2,3,4]
NSCLC can be further divided into adenocarcinoma (AC), squamous cell carcinoma (SCC), and large cell carcinoma (LCC)
Summary
The two main subtypes of LC are nonsmall-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC), which account for 84% and 13% of LC, respectively [2,3,4]. NSCLC has a poor five-year survival rate of 25%, often related to diagnosis of the disease at a late stage with frequent distant metastasis [4, 7]. There are two subtypes of SCLC, oat cell carcinoma, and combined-SCLC. The latter subtype is defined as SCLC with components of NSCLC [5]. If LC is diagnosed at an early and localised stage, the 5-year survival rate increases to 59%. In order to improve treatment success in terms of reduced morbidity and mortality, early diagnosis of the disease is crucial
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