Abstract
BackgroundThe purpose of the present investigation was to determine if the salivary counts of 40 common oral bacteria in subjects with an oral squamous cell carcinoma (OSCC) lesion would differ from those found in cancer-free (OSCC-free) controls.MethodsUnstimulated saliva samples were collected from 229 OSCC-free and 45 OSCC subjects and evaluated for their content of 40 common oral bacteria using checkerboard DNA-DNA hybridization. DNA counts per ml saliva were determined for each species, averaged across subjects in the 2 subject groups, and significance of differences between groups determined using the Mann-Whitney test and adjusted for multiple comparisons. Diagnostic sensitivity and specificity in detection of OSCC by levels of salivary organisms were computed and comparisons made separately between a non-matched group of 45 OSCC subjects and 229 controls and a group of 45 OSCC subjects and 45 controls matched by age, gender and smoking history.ResultsCounts of 3 of the 40 species tested, Capnocytophaga gingivalis, Prevotella melaninogenica and Streptococcus mitis, were elevated in the saliva of individuals with OSCC (p < 0.001). When tested as diagnostic markers the 3 species were found to predict 80% of cancer cases (sensitivity) while excluding 83% of controls (specificity) in the non-matched group. Diagnostic sensitivity and specificity in the matched group were 80% and 82% respectively.ConclusionHigh salivary counts of C. gingivalis, P. melaninogenica and S. mitis may be diagnostic indicators of OSCC.
Highlights
The purpose of the present investigation was to determine if the salivary counts of 40 common oral bacteria in subjects with an oral squamous cell carcinoma (OSCC) lesion would differ from those found in cancer-free (OSCC-free) controls
Comparisons between the 229 OSCC-free and 45 OSCC subjects indicated that 6 common oral bacteria (P. melaninogenica, C. gingivalis, Capnocytophaga ochracea, Eubacterium saburreum, Leptotrichia buccalis and S. mitis) differed (p < 0.001)
The remaining species, including the three bacteria that were recovered in lower levels in salivary samples of OSCC patients, E. saburreum, L. buccalis, and C. ochracea, did not contribute significantly to the diagnostic test as their diagnostic sensitivity and specificity values were ≤60%
Summary
Unstimulated saliva samples were collected from 229 OSCC-free and 45 OSCC subjects and evaluated for their content of 40 common oral bacteria using checkerboard DNADNA hybridization. OSCC-free Population A total of 229 OSCC-free subjects were recruited from the patient pool at The Forsyth Institute. Exclusion criteria included: antibiotic therapy within the previous 3 months, pregnancy or lactation, systemic conditions associated with immune dysfunction (e.g., diabetes), previous chemotherapy or radiation and the presence of any oral mucosal lesions. Oral Cancer Population A total of 45 subjects diagnosed with OSCC via biopsy were recruited from the Partners' Hospitals (The Dana Farber Cancer Institute, Brigham and Women's Hospital and Massachusetts General Hospital). Inclusion criteria required that subjects be 18 years or older and immunocompetent, with a primary untreated OSCC. Exclusion criteria included systemic conditions associated with immune dysfunction (e.g., diabetes), previous chemotherapy or radiation, an inability to properly consent, and/or lesions that could not be sampled due to discomfort, anatomic location or that did not affect the surface oral epithelium. A subset of 45 controls was matched by computer for age, gender and smoking with the 45 OSCC subjects (Table 2)
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