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Salivary metabolites to detect patients with cancer: a systematic review

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Abstract

Novel adjunctive screening aids are needed to reduce the morbidity and mortality related to cancer, and every effort should be made for early diagnosis. This systematic review aimed to evaluate salivary metabolites and their diagnostic value in patients with cancer.

The systematic review was performed in two phases and included studies that focused on the diagnostic value of salivary metabolites in humans with solid malignant neoplasms. Five electronic databases were searched, and the risk of bias in individual studies was evaluated using the revised Quality Assessment of Diagnostic Accuracy Studies criteria (QUADAS-2). All procedures were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Of the 1151 studies retrieved, 25 were included; 13 studies used targeted and 12 untargeted metabolomics approaches. Most studies included patients with breast and oral cancer. Except for one, all studies had case–control designs, and none fulfilled all quality assessments. Overall, 140 salivary metabolites were described. The most frequently reported metabolites were alanine, valine, and leucine. Among the 11 studies that reported diagnostic test accuracy (DTA) values, proline, threonine, and histidine in combination and monoacylglycerol alone demonstrated the highest DTA for breast cancer. Combined choline, betaine, pipecolinic acid, and l-carnitine showed better discriminatory performance for early oral cancer.

This systematic review highlights the current evidence on salivary metabolites that may be used as a future strategy to diagnose cancer. Further studies including larger sample sizes with confirmation of the results by untargeted analysis are warranted.

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Authors and Affiliations

  1. Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília, DF, 70910-900, Brazil

    Daniele Xavier Assad, Elisa Cançado Porto Mascarenhas, Caroline Lourenço de Lima, Isabela Porto de Toledo, Ana Carolina Acevedo & Eliete Neves Silva Guerra

  2. Medical Oncology Department, Hospital Sírio-Libanês, SGAS 613 Conj. E Bl. B, Brasília, DF, 70200-730, Brazil

    Daniele Xavier Assad

  3. Medical Oncology Department, Cettro-Centro de Câncer de Brasília, SMH/N Quadra 02, 12° Andar, Brasilia, DF, 70710‐904, Brazil

    Elisa Cançado Porto Mascarenhas

  4. Department of Analytical, Bioanalytical Sciences and Miniaturization (LSABM), ESPCI Paris, UMR CBI 8231, PSL Research University, 10 Rue Vauquelin, Paris, 75005, France

    Hélène Chardin & Audrey Combes

  5. Faculté de Chirurgie Dentaire, Université de Paris, 1 rue M. Arnoux, 92120, Montrouge, France

    Hélène Chardin

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  1. Daniele Xavier Assad
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Assad, D.X., Mascarenhas, E.C.P., de Lima, C.L. et al. Salivary metabolites to detect patients with cancer: a systematic review. Int J Clin Oncol 25, 1016–1036 (2020). https://doi.org/10.1007/s10147-020-01660-7

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