Identification of salivary volatile organic compounds as the potential diagnostic markers of oral cancer by the gas chromatography-mass spectrometry analysis.

BACKGROUND

Oral cancer (OC) is a major public health problem in the Indian subcontinent. As many as 90% of all OC cases are oral squamous cell carcinomas (OSCCs), often developing from oral potentially malignant disorders (OPMDs). Although the oral cavity is freely accessible, visual identification is often challenging. Biopsy and a microscopic examination is the only confirmatory diagnostic test. Recently, the analysis of volatile organic compounds (VOCs) has emerged as a new, non-invasive, rapid, and inexpensive strategy with promising potential in clinical diagnostics. The human VOCs produced in metabolic pathways, present in body fluids and the exhaled air, can be used for monitoring several oral diseases, including OC.

OBJECTIVES

The aim of the present study was to determine the potential diagnostic capabilities of salivary VOCs in OC through identifying and comparing the salivary volatilomic profiles among OSCC and OPMD subjects, as well as healthy controls, using the gas chromatography-mass spectrometry (GC-MS) analysis.

MATERIAL AND

METHODS

Unstimulated saliva samples were collected from 35 OSCC subjects, 35 OPMD subjects and 40 healthy controls. The VOCs extracted from the ZSM-5/PDMS film were condensed with 100 μL of methanol, of which 1.0 μL was subjected to the GC-MS analysis.

RESULTS

A total of 128 salivary VOCs were detected and identified among the OSCC and OPMD subjects and the healthy controls. Twenty-five metabolites were determined to be statistically significant in differentiating among the 3 groups. Organic acids, alcohols, ketones, alkanes, and acid amides were the major classes of VOCs in the OSCC subjects, while organic acids, alcohols, ketones, acid amides, heterocyclic compounds, and phenols constituted the VOC profile in the OPMD subjects. 1-chloro-dodecane and 1-tridecanol were significant VOCs observed among the controls.

CONCLUSIONS

The study demonstrates that salivary VOC profiling can reveal distinct metabolomic alterations in OSCC and OPMDs, with several VOCs emerging as potential tumor-specific biomarkers. While these findings highlight the promise of VOC-based screening, larger studies are needed to validate these markers and establish their clinical applicability.