Discrimination of oral squamous cell carcinoma from oral lichen planus by salivary metabolomics

Abstract

ObjectiveThis study was conducted to distinguish salivary metabolites in oral squamous cell carcinoma (OSCC) from those in oral lichen planus (OLP) to identify practical biomarkers for the discrimination of OSCC from OLP.Subjects and MethodsWhole unstimulated saliva samples were collected from patients with OSCC (n = 34) and OLP (n = 26). Hydrophilic metabolites in the saliva samples were comprehensively analysed by capillary electrophoresis mass spectrometry. To evaluate the discrimination ability of a combination of multiple markers, a multiple logistic regression (MLR) model was developed to differentiate OSCC from OLP.ResultsFourteen metabolites were found to be significantly different between the OSCC and OLP groups. Among them, indole‐3‐acetate and ethanolamine phosphate were used to develop the MLR model. The combination of these two metabolites showed a high area under the receiver operating characteristic curve (0.856, 95% confidential interval: 0.762–0.950; p < .001) for discriminating OSCC from OLP.ConclusionsWe identified salivary metabolites for discerning between OSCC and OLP, which is clinically important for detecting the malignant transformation of OLP by both dentists and oral surgery specialists. Our candidate salivary metabolites show potential for non‐invasive screening of OSCC versus OLP.

Salivary Metabolomics: From Diagnostic Biomarker Discovery to Investigating Biological Function

“…Metabonomic studies comparing such conditions remain scarce, although multivariate analysis of data from HPLC/MS analysis of saliva has been shown to discriminate oral squamous cell carcinoma from oral lichen planus and oral leukoplakia, although peak identification was not confirmed [50]. A more recent study also found salivary metabolomics could separate lichen planus from oral cancer, finding discriminatory metabolites upregulated in oral cancer included indoleacetate, putrescine and phosphoethanolamine [51]. Oral cancer and precancerous dysplasia have also been separated from other clinically similar lesions including keratosis and inflammation [52].…”

Verification of Saliva Matrix Metalloproteinase-1 as a Strong Diagnostic Marker of Oral Cavity Cancer

“…Saliva is a biological fluid with features such as ease of sampling, cost-effectiveness, and non-invasiveness that make it a perfect diagnostic specimen, highlighting the importance of developing a method for early detection of OSCC based on validated salivary biomarkers [ 14 , 15 , 16 , 17 , 18 ]. Several well-designed studies recently reported on potential detection methods for oral cancer, suggesting analysis of salivary RNA and proteins [ 19 , 20 ], microRNAs [ 21 , 22 ], metabolites [ 23 , 24 ], glycoprotein [ 25 , 26 , 27 , 28 , 29 ], and the microbiome [ 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. However, as yet, no suitable biomarkers are regularly used in clinical practice for the management of oral cancer.…”

Saliva and Oral Diseases

“…Based on these data, the authors suggested a negative prognostic role of decreased salivary miR-125a levels in association with increased salivary miR-21 levels in OLP patients. Ishikawa et al recently suggested a metabolomics approach to distinguish OLP from OSCC [88]; the authors detected higher levels of 12 salivary metabolites in OSCC patients compared with OLP patients. More specifically, the combination of indole-3-acetate and ethanolamine phosphate showed the best statistical accuracy.…”