Saliva as a tool for oral cancer diagnosis and prognosis

Saliva testing, a non-invasive alternative to serum testing, may be an effective modality for diagnosis and for prognosis prediction of oral cancer, as well as for monitoring post therapy status, by measuring specific salivary macromolecules, examining proteomic or genomic targets such as enzymes, cytokines, growth factors, metalloproteinases, endothelin, telomerase, cytokeratines, mRNA's and DNA transcripts. Salivary analysis has been shown to be a useful diagnostic tool also for distant malignancies such as breast cancer. In recent years, significant alterations have been demonstrated in the saliva of oral cancer patients in the epithelial tumor markers - Cyfra 21-1, TPS and CA12, various oxidative stress-related salivary parameters as ROS and RNS, biochemical and immunological parameters as IGF and MMP's and RNA transcripts of IL8, IL-1B, DUSP1, HA3, OAZ1, S100P, and SAT. Collectively these accumulated data are predicted to alter the field of oral cancer diagnosis by employing highly sensitive new tools which will enable both medical professionals and the patients themselves to monitor their saliva for diagnosis and prognosis prediction, as they relate to oral cancer. At this point however, the aim of salivary analysis is mainly for screening which may be helpful in the future. (C) 2009 Elsevier Ltd. All rights reserved.