Salivary Biomarkers vs. Conventional Biopsy for Oral Cancer Detection in India: A Comparative Study

Oral cancer, predominantly oral squamous cell carcinoma (OSCC), constitutes a major global health concern with alarmingly high-morbidity and mortality rates. Early detection is crucial for improving patient outcomes. This study aims to compare the diagnostic accuracy of salivary biomarkers against conventional biopsy in detecting oral cancer.

This prospective study recruited 120 participants with suspected oral lesions from the People's Dental Academy, Bhopal, India. Unstimulated saliva samples were collected and analyzed using enzyme-linked immunosorbent assay (ELISA) for a panel of four biomarkers: interleukin-8 (IL-8), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and matrix metalloproteinase-9 (MMP-9). The adults in the study also had a biopsy performed with a scalpel which is the standard way of doing it and served as a gold standard in the diagnosis process. Both salivary biomarkers and biopsy received sensitivity, specificity, positive predictive value, and negative predictive value calculations.

Salivary analysis revealed significantly elevated levels of all four biomarkers in patients with OSCC compared to those with benign lesions. The combined biomarker panel demonstrated a sensitivity of 88%, specificity of 80%, PPV of 76%, and NPV of 91% in detecting OSCC. In comparison, scalpel biopsy exhibited a sensitivity of 96%, specificity of 100%, PPV of 100%, and NPV of 98%.

While scalpel biopsy remains the gold standard for OSCC diagnosis, our findings suggest that salivary biomarkers, particularly when used in combination, offer a promising adjunctive tool for oral cancer detection. This non-invasive approach may prove valuable in identifying high-risk individuals who require further investigation with biopsy, potentially leading to earlier diagnosis and improved patient outcomes.