PDF(Pubmed)
Abstract：
Oral cancer became a very common condition. WHO estimates that there are 4 cases of lip and oral cavity cancer for every 100,000 people worldwide. The early diagnosis of cancers is currently a top focus in the health sector. Recent systematic reviews and meta-analyses have identified promising biomarkers for early detection in several original research investigations. However, it is still unclear the quality of these evidence and which biomarker performs the best in terms of early detection. Therefore, the objective was, to map the methodological and reporting quality of available oral squamous cell carcinoma (OSCC) or head/neck squamous cell carcinoma (HNSCC) systematic reviews and meta-analysis. Secondly, to evaluate diagnostic accuracy of salivary biomarkers for common craniofacial cancers and to compare the diagnostic value of different salivary biomarkers. PubMed, Scopus, Web of Science, Embase and Cochrane Library electronic databases were used to map the methodological and reporting quality of the systematic reviews and meta-analysis conducted on the HNSCC, OSCC using the AMSTAR-2 checklist. The inclusion criteria were systematic reviews and meta-analysis published in the topic of HNSCC and OSCC biomarkers. Exclusion criteria were no animal studies; original primary studies, due to limitation of competency in other languages articles with language other than English were excluded. The sensitivity and specificity were calculated for salivary biomarkers and ranked according to network meta-analysis principles. A total of N = 5893 patients were included from four meta-analysis studies. All together, these included n = 37 primary studies. n = 94 biomarkers were pooled from these four meta-analyses and categorised into the stages at which they were detected (I-IV). In OSCC, Chemerin and MMP-9 displayed the highest sensitivity, registering 0.94 (95% CI 0.78, 1.00) and a balanced accuracy of 0.93. Phytosphingosine closely followed, with a sensitivity of 0.91 (95% CI 0.68, 0.99) and a balanced accuracy of 0.87. For HNSCC, the top three biomarkers are Actin, IL-1β Singleplex, and IL-8 ELISA. Actin leads with a sensitivity of 0.91 (95% CI 0.68-0.99), a specificity of 0.67, and an overall accuracy of 0.79. Subsequently, IL-1β Singleplex exhibits a sensitivity of 0.62 (95% CI 0.30-0.88), a specificity of 0.89, and an accuracy of 0.75, followed by IL-8 ELISA with a sensitivity of 0.81 (95% CI 0.54-0.97), a specificity of 0.59, and an accuracy of 0.70. In conclusion, there was highest sensitivity for MMP-9 and chemerin salivary biomarkers. There is need of further more studies to identify biomarkers for HNSCC and OSCC.
摘要：
口腔癌成为一种非常常见的疾病。世卫组织估计，全世界每10万人中就有4例唇癌和口腔癌。癌症的早期诊断目前是卫生部门的重点。最近的系统评价和荟萃分析已经在一些原始研究调查中确定了有希望的早期检测生物标志物。然而,目前尚不清楚这些证据的质量以及哪种生物标志物在早期检测方面表现最好.因此,目标是,绘制现有口腔鳞状细胞癌（OSCC）或头颈部鳞状细胞癌（HNSCC）系统评价和荟萃分析的方法学和报告质量。其次,评估唾液生物标志物对常见颅面部癌的诊断准确性，并比较不同唾液生物标志物的诊断价值。PubMed,Scopus,WebofScience,Embase和Cochrane图书馆电子数据库用于绘制对HNSCC进行的系统评价和荟萃分析的方法和报告质量图。OSCC使用AMSTAR-2检查表。纳入标准是发表在HNSCC和OSCC生物标志物主题中的系统评价和荟萃分析。排除标准没有动物研究；原始的初步研究，由于其他语言能力的限制，英语以外的语言的文章被排除在外。计算唾液生物标志物的敏感性和特异性，并根据网络荟萃分析原则进行排序。共纳入4项荟萃分析研究的N=5893例患者。一起,这些研究包括n=37项主要研究.从这四个荟萃分析中汇集了n=94个生物标志物,并将其分类为检测到它们的阶段(I-IV)。在OSCC中,Chemerin和MMP-9显示出最高的灵敏度，记录0.94（95%CI0.78，1.00），平衡精度为0.93。植物鞘氨醇紧随其后，灵敏度为0.91（95%CI0.68，0.99），平衡精度为0.87。对于HNSCC，前三个生物标志物是肌动蛋白，IL-1β单复合物，和IL-8ELISA。肌动蛋白导联灵敏度为0.91（95%CI0.68-0.99），特异性为0.67，总体准确性为0.79。随后，IL-1βSingleplex的敏感性为0.62(95%CI0.30-0.88)，特异性为0.89，准确性为0.75，其次是IL-8ELISA，灵敏度为0.81（95％CI0.54-0.97），特异性为0.59，准确性为0.70。总之,MMP-9和Chemerin唾液生物标志物的敏感性最高.需要进一步的研究来鉴定HNSCC和OSCC的生物标志物。
