Salivary Biomarkers for Early Oral Cancer Diagnosis: Clinical Potential and Translational Challenges

Abstract

• Objective: To review the current advancements in identifying and refining a panel of soluble salivary biomarkers for the early detection and prognosis of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs).
• Methods: A comprehensive literature search was conducted across the PubMed, Google Scholar, Web of Science, and Embase databases for articles published between 2014 and 2024. Combinations of specific medical subject headings (MeSH) and keywords—including "oral cancer", "biomarker", and "whole mouth saliva"—were applied using Boolean operators (AND/OR). Original studies, systematic reviews, and critical clinical resources were scrutinized.
• Results: Saliva serves as a highly reliable, non-invasive biofluid for liquid biopsy. Over 100 molecular candidates, categorized into proteomic, genomic, transcriptomic, and metabolomic targets, have demonstrated diagnostic significance. Combining single targets into a multi-biomarker panel (e.g., IL-1β, IL-6, and IL-8) significantly increases diagnostic accuracy, though oral inflammatory conditions (e.g., periodontitis) remain a primary confounding factor causing false-positive results.
• Conclusion: Human whole mouth saliva (WMS) holds immense clinical utility for early diagnosis and treatment monitoring in oral oncology. High-sensitivity detection platforms show promise for transition into routine clinical dental practice, provided that standardized collection and pre-analytical protocols are globally implemented.