Diagnostic Accuracy of Salivary Gamma Synuclein in Oral Malignant and Potentially Malignant Lesions

Background: Cancers of the oral cavity are of the most common malignancies worldwide, they have poor prognosis and significant morbidity and mortality. Biomarkers can be helpful in cancer patients screening, to diagnose, and predict the course of disease. Saliva-based analysis can be used in diagnosis and prognosis of cancer, so it is of paramount importance to find a valid salivary diagnostic tool. The present study aimed to identify the diagnostic accuracy of gamma synuclein in differentiating between oral malignant and oral premalignant lesions. Methodology: This prospective phase II diagnostic test accuracy study included 36 patients divided into three groups: 12 oral lichen planus patients, 12 oral cancer patients and 12 healthy controls. Saliva samples were collected from all patients to measure gamma synuclein using ELISA. Tissue biopsies and histopathological examination were done for the lesions to confirm the diagnosis. Results: Salivary gamma synuclein showed high sensitivity (100%) and specificity (83.3%) in differentiating between potentially malignant lesions and oral cancer at a cut off point of (>2.01 ng/mL). Furthermore, it showed a statistically significant difference between dysplastic and non-dysplastic lesions (p=0.03). However, gamma synuclein levels had no diagnostic value in differentiating between different grades of cancer (p=0.220). Conclusion: Salivary gamma synuclein can be used as a diagnostic marker for the early cancer detection. It can also be used as a prognostic tool to detect the presence of dysplasia in oral premalignant lesions.