Liquid Biopsy for Salivary Biomarkers in Oral Cancer Detection: A Meta-Analysis

Oral cancer remains a significant global health concern, with early detection being crucial for improving survival rates. Traditional diagnostic methods, such as tissue biopsy, are invasive and resource-intensive. Liquid biopsy using salivary biomarkers has emerged as a non-invasive, cost-effective alternative for detecting oral cancer. This meta-analysis evaluates the diagnostic performance of various salivary biomarkers, including microRNAs (miRNAs), DNA methylation markers, proteins, and metabolites, across 25 studies involving 4,112 patients. The pooled sensitivity and specificity of salivary biomarkers were 89% and 91%, respectively, with an area under the curve (AUC) of 0.93, indicating excellent diagnostic accuracy. miRNAs demonstrated the highest diagnostic performance, with sensitivity and specificity of 90% and 92%, respectively. The findings suggest that salivary liquid biopsy could serve as a reliable, non-invasive tool for early oral cancer detection, offering significant advantages over traditional diagnostic methods. However, challenges such as heterogeneity across studies and potential publication bias highlight the need for further validation through large-scale, multicenter studies. Despite these challenges, the integration of salivary diagnostics into routine clinical practice has the potential to revolutionize oral cancer detection, particularly in resource-limited settings, and to advance personalized medicine approaches.