Owecki Wojciech, Wojtowicz Karolina, Nijakowski Kacper
Student's Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland.
Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland.
Int J Nanomedicine. 2025 May 26;20:6757-6775. doi: 10.2147/IJN.S520288. eCollection 2025.
Head and neck cancer (HNC) represents approximately 10% of all cancer cases globally, posing a significant public health challenge. Despite advances in therapeutic approaches, the mortality rate associated with HNC continues to rise. A growing body of research highlights the role of extracellular vesicles in cancer progression and pathogenesis, positioning them as promising candidates for novel biomarker discovery. Concurrently, saliva has emerged as a valuable diagnostic fluid due to its non-invasive, accessible, and cost-effective collection methods. This systematic review aims to explore the potential of salivary extracellular vesicles as diagnostic tools for the early detection and monitoring of head and neck cancer. PubMed, Scopus, Web of Science, and Embase were thoroughly searched from database inception to July 16, 2024. Twenty-three eligible studies were included, focusing on original research that described salivary extracellular vesicles as biomarkers in HNC. In oral cancer - predominantly represented by the squamous cell carcinoma subtype - several proteins, including PSB7, AMER3, and LOXL2, as well as a ten-protein panel, demonstrated strong potential as diagnostic biomarkers. Additionally, the analysis of various microRNAs (miR-140, miR-143, miR-145, miR-412-3p, miR-512-3p, miR-1307-5p) and Fourier-transform infrared (FTIR) spectra has shown promising results for oral cancer detection. For oropharyngeal cancer, lactate dehydrogenase B appears to be a promising biomarker. Another potential avenue is the assessment of human papillomavirus (HPV) risk in the development of oropharyngeal cancer. Four studies investigated HNC without specifying the cancer location; however, limited or absent reporting of sensitivity and specificity hampers the reliable evaluation of potential biomarkers. In conclusion, salivary extracellular vesicles hold promise for the detection of HNC, but further research is needed to validate their diagnostic utility.
头颈癌（HNC）约占全球所有癌症病例的10%，对公共卫生构成重大挑战。尽管治疗方法有所进步，但与头颈癌相关的死亡率仍在上升。越来越多的研究强调了细胞外囊泡在癌症进展和发病机制中的作用，使其成为新型生物标志物发现的有希望的候选者。同时，由于唾液的采集方法具有非侵入性、易获取且成本效益高的特点，它已成为一种有价值的诊断液体。本系统综述旨在探讨唾液细胞外囊泡作为头颈癌早期检测和监测诊断工具的潜力。从数据库建立到2024年7月16日，对PubMed、Scopus、Web of Science和Embase进行了全面检索。纳入了23项符合条件的研究，重点关注将唾液细胞外囊泡描述为头颈癌生物标志物的原始研究。在以鳞状细胞癌亚型为主的口腔癌中，包括PSB7、AMER3和LOXL2在内的几种蛋白质以及一个十蛋白组，显示出作为诊断生物标志物的强大潜力。此外，对各种微小RNA（miR-140、miR-143、miR-145、miR-412-3p、miR-512-3p、miR-1307-5p）和傅里叶变换红外（FTIR）光谱的分析在口腔癌检测方面显示出有希望的结果。对于口咽癌，乳酸脱氢酶B似乎是一种有希望的生物标志物。另一个潜在途径是评估人乳头瘤病毒（HPV）在口咽癌发生中的风险。四项研究调查了头颈癌，但未具体说明癌症位置；然而，敏感性和特异性的报告有限或缺乏，妨碍了对潜在生物标志物的可靠评估。总之，唾液细胞外囊泡在头颈癌检测方面具有前景，但需要进一步研究来验证其诊断效用。
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