Saliva-based genomic signatures for early detection of oral squamous cell carcinoma: the state and perspectives of translation.

Integrated genomic signatures in saliva (2020–2024) combining somatic mutations, DNA methylation, and RNA biomarkers are increasingly used for early OSCC detection, but clinical translation remains limited.

• Why it matters: Late presentation is a major limitation to survivability in oral squamous cell carcinoma, and current noninvasive options need stronger evidence for routine use.
• What they did: The review synthesizes studies using whole saliva, cell-free fractions, and extracellular vesicles, leveraging digital PCR, targeted next-generation sequencing, and computational modeling for low-abundance tumor signal detection and longitudinal monitoring.
• The result: Translation is constrained by pre-analytical heterogeneity, inflammatory confounding, batch effects, late-stage enriched cohorts, and the lack of large prospective multicenter validation, guiding a proposed roadmap for clinical integration.

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