What question did this study set out to answer?

This research aims to identify molecular changes in saliva that could signal the early stages of oral potentially malignant disorders.

April 5, 2026

Abstract 5097: Salivary transcriptomic signatures reveal early molecular reprogramming in oral potentially malignant disorders: A non-invasive precision oncology approach in indian patients

Key Points

This research aims to identify molecular changes in saliva that could signal the early stages of oral potentially malignant disorders.
Cross-sectional study design with 96 participants (48 OPMD cases, 48 matched controls)
RNA sequencing performed on unstimulated saliva samples using Illumina NovaSeq 6000
Quality control, alignment, and differential expression analyses conducted using established bioinformatics tools
Diagnostic modeling applied LASSO-regularized logistic regression and ROC analysis
Identification of 1,126 significantly dysregulated genes associated with OPMD
Developed a 15-gene salivary signature with an AUC of 0.94 for distinguishing OPMD from controls
Sensitivity of 91% and specificity of 88% for the gene signature
Co-activation of TP63 and CXCL8 identified as a potential predictor of transformation risk

Abstract

Abstract Background: Oral potentially malignant disorders (OPMDs) such as oral lichen planus, leukoplakia, and erythroplakia exhibit variable malignant transformation risk, often eluding early clinical recognition. Saliva offers a non-invasive, molecularly rich biofluid for detecting transcriptomic alterations reflective of oncogenic field changes. Methods: In this cross-sectional study, unstimulated saliva samples from 96 participants (48 OPMD cases, 48 age- and sex-matched controls) were subjected to RNA sequencing using the Illumina NovaSeq 6000 platform at CSIR-IGIB, India. Quality control (FastQC), alignment (STAR), and differential expression analyses (DESeq2 and edgeR) were performed. Functional enrichment employed GSEA and Reactome pathways. Diagnostic modeling used LASSO-regularized logistic regression and ROC analysis. Results: Transcriptomic profiling revealed 1,126 significantly dysregulated genes (|log2FC| 1.5, FDR 0.05), including upregulation of MMP9, IL6, CXCL8, TP63, and downregulation of KRT13, LOR, SPRR2A. Pathway enrichment implicated PI3K/AKT, p53, and epithelial-mesenchymal transition signaling. The 15-gene salivary signature yielded an AUC = 0.94 (95% CI 0.89-0.97) for discriminating OPMD from controls, with sensitivity = 91% and specificity = 88%. Sub-analysis identified TP63-CXCL8 co-activation as a predictor of transformation potential (p = 3.2 × 10−5, adjusted p 0.01). Conclusion: High-throughput salivary transcriptomics demonstrates robust discriminatory power for identifying molecular dysregulation preceding oral carcinogenesis. This 15-gene signature may serve as a non-invasive biomarker panel for early risk stratification of OPMD, with potential application in population-level screening programs in resource-limited settings. Citation Format: Saravanan Sampoornam Pape. Salivary transcriptomic signatures reveal early molecular reprogramming in oral potentially malignant disorders: A non-invasive precision oncology approach in indian patients abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 5097.

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Abstract 5097: Salivary transcriptomic signatures reveal early molecular reprogramming in oral potentially malignant disorders: A non-invasive precision oncology approach in indian patients

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