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Concomitant Analysis of Salivary Tumor Markers—A New Diagnostic Tool for Oral Cancer

Authors' Affiliations: ¹ Department of Oral and Maxillofacial Surgical and Oral Biochemistry Laboratory, Rambam Medical Center and Rappaport Faculty of Medicine, Israel Institute of Technology-Technion, Haifa, Israel and ² Department of Otorhinolaryngology, Rabin Medical Center, Petah Tiqva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Requests for reprints: Rafael Nagler, Department of Oral and Maxillofacial Surgery and Oral Biochemistry Laboratory, Rambam Medical Center, Haifa, Israel. Phone: 972-4-644-2003; Fax: 972-4-654-1295; E-mail: nagler{at}tx.technion.ac.il.

Purpose: Oral squamous cell carcinoma (OSCC) is a common human malignancy. Circulatory epithelial tumor markers were previously investigated in the serum of OSCC patients but almost never in their saliva, in spite of the fact that there is a direct contact between the saliva and the oral cancer lesion. The purpose of the current study was to examine tumor markers in the saliva of OSCC patients.

Experimental Design: We measured the concentrations of the six most studied epithelial serum circulatory tumor markers in the saliva of OSCC (tongue) patients.

Results: Significant increases (of 400%) in salivary concentrations of Cyfra 21-1, tissue polypeptide antigen, and CA125 were shown. Salivary concentrations of CA19-9, SCC, and carcinoembryonic antigen were increased without statistical significance. A concurrent analysis of the three significantly increased markers revealed sensitivity, specificity, and negative and positive predictive values of 71%, 75%, 71%, and 75%, respectively.

Conclusions: The increase reported in salivary tumor markers may be used as a diagnostic tool, especially when a concurrent analysis for significantly increased markers is done. Salivary testing is noninvasive, making it an attractive, effective alternative to serum testing, and the possibility of developing home testing kits would further facilitate it as a diagnostic aid, enabling patients to monitor their own health at home and is important for those who live far from their treatment centers and especially for those at risk of developing OSCC.