Integrating Salivary Biomarkers Cst4 and Mir-223 With Health-Related Factors for Gastric Cancer Detection and Risk Assessment Publisher



Koopaie M ; Manafi S ; Manifar S ; Younespour S ; Kolahdooz S ; Karimipour Pareshkooh M
Source: Clinical Medicine Insights: Oncology Published:2025

Abstract

Background: Gastric cancer remains a leading cause of cancer-related death. Early detection is crucial, but effective non-invasive screening methods are lacking. This study investigates the diagnostic potential of salivary Cystatin S (CST4) and MicroRNA-223 (miR-223) biomarkers, integrated with health-related factors for early gastric cancer detection. Methods: Forty-five patients with gastric cancer and 45 healthy controls participated in this case-control study. Saliva samples were collected and analyzed for CST4 and miR-223 levels. Demographic data and health-related factors, including hot drink consumption, gastric ulcer history, Helicobacter pylori infection, body mass index (BMI), DMFT (Dental Decay, Missing, and Filled Teeth), and salty food intake, were also collected through a standardized questionnaire. Salivary CST4 levels were determined using enzyme-linked immunosorbent assay (ELISA), and miR-223 levels were quantified using real-time polymerase chain reaction (PCR). Statistical analyses, encompassing multiple logistic regression, were conducted to evaluate the diagnostic efficacy of the biomarkers alongside health-related parameters. Results: Significant differences in salivary CST4 and miR-223 levels were observed between gastric cancer patients and healthy controls (P < 0.001). Combining salivary biomarkers and health-related factors yielded high accuracy, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.89 for the model using CST4 and miR-223. Multiple logistic regression analysis identified several health-related factors, including gastric ulcer history and Helicobacter pylori infection, as significant predictors of gastric cancer risk. The inclusion of health factors, along with biomarkers, enhanced early detection’s sensitivity and specificity. Conclusions: The study highlights the potential of salivary biomarkers CST4 and miR-223 as non-invasive tools for early gastric cancer detection. Integrating these biomarkers with health-related factors, such as gastric ulcer history and Helicobacter pylori infection, enhances the risk assessment and diagnostic accuracy for gastric cancer. © 2025 Elsevier B.V., All rights reserved.