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. 2005 Jul 7:3:27.
doi: 10.1186/1479-5876-3-27.

The salivary microbiota as a diagnostic indicator of oral cancer: a descriptive, non-randomized study of cancer-free and oral squamous cell carcinoma subjects

D L Mager  1 , A D Haffajee, P M Devlin, C M Norris, M R Posner, J M Goodson
Affiliations

The salivary microbiota as a diagnostic indicator of oral cancer: a descriptive, non-randomized study of cancer-free and oral squamous cell carcinoma subjects

D L Mager et al. J Transl Med. .

Abstract

Background: The purpose of the present investigation was to determine if the salivary counts of 40 common oral bacteria in subjects with an oral squamous cell carcinoma (OSCC) lesion would differ from those found in cancer-free (OSCC-free) controls.

Methods: Unstimulated saliva samples were collected from 229 OSCC-free and 45 OSCC subjects and evaluated for their content of 40 common oral bacteria using checkerboard DNA-DNA hybridization. DNA counts per ml saliva were determined for each species, averaged across subjects in the 2 subject groups, and significance of differences between groups determined using the Mann-Whitney test and adjusted for multiple comparisons. Diagnostic sensitivity and specificity in detection of OSCC by levels of salivary organisms were computed and comparisons made separately between a non-matched group of 45 OSCC subjects and 229 controls and a group of 45 OSCC subjects and 45 controls matched by age, gender and smoking history.

Results: Counts of 3 of the 40 species tested, Capnocytophaga gingivalis, Prevotella melaninogenica and Streptococcus mitis, were elevated in the saliva of individuals with OSCC (p < 0.001). When tested as diagnostic markers the 3 species were found to predict 80% of cancer cases (sensitivity) while excluding 83% of controls (specificity) in the non-matched group. Diagnostic sensitivity and specificity in the matched group were 80% and 82% respectively.

Conclusion: High salivary counts of C. gingivalis, P. melaninogenica and S. mitis may be diagnostic indicators of OSCC.

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Figures

Figure 1
Figure 1
Salivary counts for the 40 test species in both populations. Mean counts (±SD) of 40 test species in saliva samples of 229 OSCC-free & 45 OSCC subjects (*** = p < 0.001).
Figure 2
Figure 2
Diagnostic sensitivity and specificity of 3 bacterial species in the unmatched populations. a. Diagnostic sensitivity and specificity when C. gingivalis is at different salivary counts × 105/ml and both P. melaninogenica and S. mitis = 0 b. Diagnostic sensitivity and specificity when P. melaninogenica is at different salivary counts × 105/ml, C. gingivalis ≥ 0.4 × 105/ml and S. mitis = 0 c. Diagnostic sensitivity and specificity when S. mitis is at different salivary counts × 105/ml and both C. gingivalis and P. melaninogenica ≥0.4 × 105/ml
Figure 3
Figure 3
Diagnostic sensitivity and specificity of 3 bacterial species in the matched populations. a. Diagnostic sensitivity and specificity when C. gingivalis is at different salivary counts × 105/ml and both P. melaninogenica and S. mitis = 0 b. Diagnostic sensitivity and specificity when P. melaninogenica is at different salivary counts × 105/ml, C. gingivalis ≥0.4 × 105/ml and S. mitis = 0 c. Diagnostic sensitivity and specificity when S. mitis is at different salivary counts × 105/ml and both C. gingivalis and P. melaninogenica ≥0.4 × 105/ml
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