Diagnostic accuracy of serum biomarkers in early oral squamous cell carcinoma: A systematic review and metanalysis

Abstract

Objective: Evaluate the diagnostic ability of various serum biomarkers for early oral squamous cell carcinoma (OSCC) diagnosis compared to histopathological investigation Method: Review was performed in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis – Diagnostic Test Accuracy (PRISMA-DTA) checklist and the review protocol is registered under PROSPERO(CRD42024625802). Databases were searched from January 2000 to September 2024 to identify the diagnostic potential of various serum biomarkers. Quality of selected studies was evaluated based on QUADAS (Quality assessment of diagnostic accuracy studies)- 2 tool. Meta-analysis was performed in Meta-Disc 1.4 software and Review Manager 5.3 using a bivariate model parameter for the sensitivity and specificity and summary points, summary receiver operating curve (SROC), confidence region, and area under curve (AUC) were calculated. Results: 23studies were included in review with data evaluated from 3309 subjects (diseased - 2069 and 1240 – controls). Included studies had presence of moderate to high risk of bias. Various biomarkers like CYFRA 21 -1, E – CADHERIN, Interleukins, (IL-6, IL-8), Protein Peaks, Matrix Metalloproteinases (MMP ,9), Vascular Endothelial Growth Factor (VEGF) and various RNA biomarkers were evaluated belonging to protein and microRNA class of biomarkers. It was found that these biomarkers had sensitivity and specificity ranging from 16% to 94% and 37% to 100% while highest accuracy was shown by IL-8 with mean sensitivity and specificity of 86.5% and 98% with highest AUC seen for CYFRA 21 -1 (0.53) suggesting that the overall diagnostic accuracy of these serum biomarkers is being moderate to good in diagnosing the desired condition.