Saliva diagnostics? Saliva to replace blood test as a real diagnostic tool?

Amid new diagnostic methods and treatment options, early detection is an emerging paradigm which seeks to decrease patient morbidity and mortality. And here comes saliva diagnostics with huge potential, possibly replacing the painful pricking on fingers or on wrists.

Saliva diagnostics is emerging as the latest and easiest way to detect disease at a phase where it is easily treatable. It is likely to provide new opportunities to use saliva liquid biopsy for early assessment of lung cancer because of the clinical performance of cancer detection, non-invasive collection process and the ease of collecting, transporting and storing saliva, said researchers.

At the 96th General Session of the International Association for Dental Research (IADR), held in conjunction with the IADR Pan European Regional (PER) Congress, David Wong, University of California, Los Angeles, USA presented his research “Saliva Diagnostics and Salivaomics” as part of the symposium “Will Saliva Translate to a Real Diagnostic Tool?” on Saturday, July 28, 2018 in London.

Research conducted on using saliva to measure stress hormones, enzyme levels, developmental disease biomarkers and even cancer mutations has revealed positive outcome, said researchers. “There are a variety of scenarios with which saliva can be used,” said Wong. “One of the most exciting emerging frontiers of saliva is liquid biopsy, which is a non-invasive means to assess the presence and characteristics of cancer in a patient with an indeterminate pulmonary nodule detected by low dose computerized tomography (LDCT).”

Saliva liquid biopsy delivers the best performance in the detection of circulating tumor DNA of lung cancer. This research was presented as part of the symposium. If validated biomarkers were combined with high-quality detection tools.

saliva would open up a new frontier in high-quality healthcare allowing physicians, dentists and patients to work and together for real-time health monitoring and high-impact personalized preventative medicine, said the study.

Artificial intelligence: Is this the future of early cancer detection?

A new endoscopic system powered by artificial intelligence (AI) has today been shown to automatically identify colorectal adenomas during colonoscopy. The system, developed in Japan, has recently been tested in one of the first prospective trials of AI-assisted endoscopy in a clinical setting, with the results presented today at the 25th UEG Week in Barcelona, Spain.

AI-assisted endocytoscopy – how it works:

The new computer-aided diagnostic system uses an endocytoscopic* image – a 500-fold magnified view of a colorectal polyp – to analyse approximately 300 features of the polyp after applying narrow-band imaging (NBI) mode or staining with methylene blue. The system compares the features of each polyp against more than 30,000 endocytoscopic images that were used for machine learning, allowing it to predict the lesion pathology in less than a second. Preliminary studies demonstrated the feasibility of using such a system to classify colorectal polyps, however, until today, no prospective studies have been reported.

Prospective study in routine practice:

The prospective study, led by Dr Yuichi Mori from Showa University in Yokohama, Japan, involved 250 men and women in whom colorectal polyps had been detected using endocytoscopy1. The AI-assisted system was used to predict the pathology of each polyp and those predictions were compared with the pathological report obtained from the final resected specimens. Overall, 306 polyps were assessed real-time by using the AI-assisted system, providing a sensitivity of 94%, specificity of 79%, accuracy of 86%, and positive and negative predictive values of 79% and 93% respectively, in identifying neoplastic changes.

Speaking at the Opening Plenary at UEG Week, Dr Mori explained; “The most remarkable breakthrough with this system is that artificial intelligence enables real-time optical biopsy of colorectal polyps during colonoscopy, regardless of the endoscopists’ skill. This allows the complete resection of adenomatous polyps and prevents unnecessary polypectomy of non-neoplastic polyps.”

“We believe these results are acceptable for clinical application and our immediate goal is to obtain regulatory approval for the diagnostic system” added Dr Mori.

Moving forwards, the research team is now undertaking a multicentre study for this purpose and the team are also working on developing an automatic polyp detection system. “Precise on-site identification of adenomas during colonoscopy contributes to the complete resection of neoplastic lesions” said Dr Mori. “This is thought to decrease the risk of colorectal cancer and, ultimately, cancer-related death.”