Salivary monoacetylated polyamines as noninvasive biomarkers for early detection and stratification of oral squamous cell carcinoma: A targeted metabolomics study.

OBJECTIVES

This study aimed to evaluate salivary monoacetylated polyamines as noninvasive biomarkers for the detection and staging of oral squamous cell carcinoma (OSCC).

DESIGN

Unstimulated saliva samples were collected from healthy controls (n = 15), oral leukoplakia (OLK) patients (n = 15), and OSCC patients stratified into early (n = 28) and advanced stages (n = 46). Seven polyamines were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Diagnostic performance was assessed via receiver operating characteristic (ROC) analysis, logistic regression modeling, and multivariate clustering.

RESULTS

N1-acetylspermidine and N1-acetylspermine showed progressive elevation from OLK to advanced OSCC, with AUCs of 0.87 and 0.81, respectively. A two-marker logistic model achieved a cross-validated AUC of 0.85, demonstrating good discriminatory performance between malignant and non-malignant states. Multivariate analysis confirmed their contribution to disease stratification, while calibration plots supported model reliability.

CONCLUSIONS

Salivary N1-acetylspermidine and N1-acetylspermine are promising biomarkers for noninvasive OSCC detection and staging.