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Exossomas salivares como biomarcadores de diagnóstico de cancro oral: revisão de escopo
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O cancro oral continua a ser um importante problema de saúde pública a nível global, frequentemente diagnosticado em fases avançadas, o que compromete o prognóstico e a taxa de sobrevivência dos doentes. A identificação de biomarcadores não invasivos que permitam o diagnóstico precoce representa, por isso, uma prioridade na oncologia oral. A saliva, enquanto fluido de fácil recolha, tem emergido como uma matriz de eleição para a deteção de alterações moleculares associadas ao desenvolvimento tumoral. Entre os componentes salivares com maior potencial diagnóstico, destacam-se os exossomas, vesículas extracelulares envolvidas na comunicação intercelular, capazes de transportar micro RNAs, proteínas e outras moléculas bioativas com relevância biomarcadora. Esta revisão de escopo teve como objetivo mapear a evidência científica existente relativamente ao uso de exossomas salivares como marcadores no diagnóstico precoce do cancro oral. A metodologia seguiu as recomendações do Joanna Briggs Institute, com base na estrutura População, Conceito, Contexto. A pesquisa bibliográfica foi realizada nas bases de dados PubMed, ScienceDirect e B-On, abrangendo publicações entre 2015 e 2024, em inglês e português. Após aplicação dos critérios de inclusão e exclusão, foram selecionados 12 estudos originais. Os resultados revelaram que os micro RNAs exossomais (nomeadamente miR-24-3p, miR-210, miR-1307-5p e miR-10b-5p), bem como determinadas proteínas associadas aos exossomas salivares, apresentam potencial para uso como biomarcadores não invasivos no diagnóstico precoce do carcinoma espinocelular oral. Apesar da diversidade metodológica observada, existe consistência na demonstração da utilidade dos exossomas enquanto ferramentas moleculares promissoras. Conclui-se que os exossomas salivares representam uma via inovadora e viável para o desenvolvimento de testes diagnósticos precoces em oncologia oral. No entanto, são necessários estudos adicionais, com maior robustez metodológica e validação clínica para consolidar a sua aplicação na prática clínica.
Oral cancer remains a significant global public health concern, frequently diagnosed at advanced stages, which compromises prognosis and patient survival. The identification of non-invasive biomarkers enabling early diagnosis is, therefore, a priority in oral oncology. Saliva, as an easily collected biological fluid, has emerged as a promising matrix for detecting molecular alterations associated with tumour development. Among the salivary components with the greatest diagnostic potential, exosomes—extracellular vesicles involved in intercellular communication—stand out for their ability to carry microRNAs, proteins and other bioactive molecules with biomarker relevance. This scoping review aimed to map the existing scientific evidence regarding the use of salivary exosomes as biomarkers for the early diagnosis of oral cancer. The methodology followed the Joanna Briggs Institute guidelines, using the Population, Concept, Context framework. A literature search was conducted in the PubMed, ScienceDirect and B-On databases, covering publications from 2015 to 2024, in English and Portuguese. After applying inclusion and exclusion criteria, 12 original studies were selected. The results revealed that exosomal microRNAs—particularly miR-24-3p, miR-210, miR-1307-5p, and miR-10b-5p—as well as specific proteins carried by salivary exosomes, show promising potential as non-invasive biomarkers for the early diagnosis of oral squamous cell carcinoma. Despite methodological heterogeneity, there is consistent evidence supporting the diagnostic value of exosomes as molecular tools. In conclusion, salivary exosomes represent an innovative and feasible avenue for the development of early diagnostic strategies in oral oncology. However, further studies with greater methodological rigour and clinical validation are required to support their implementation in clinical practice.
Oral cancer remains a significant global public health concern, frequently diagnosed at advanced stages, which compromises prognosis and patient survival. The identification of non-invasive biomarkers enabling early diagnosis is, therefore, a priority in oral oncology. Saliva, as an easily collected biological fluid, has emerged as a promising matrix for detecting molecular alterations associated with tumour development. Among the salivary components with the greatest diagnostic potential, exosomes—extracellular vesicles involved in intercellular communication—stand out for their ability to carry microRNAs, proteins and other bioactive molecules with biomarker relevance. This scoping review aimed to map the existing scientific evidence regarding the use of salivary exosomes as biomarkers for the early diagnosis of oral cancer. The methodology followed the Joanna Briggs Institute guidelines, using the Population, Concept, Context framework. A literature search was conducted in the PubMed, ScienceDirect and B-On databases, covering publications from 2015 to 2024, in English and Portuguese. After applying inclusion and exclusion criteria, 12 original studies were selected. The results revealed that exosomal microRNAs—particularly miR-24-3p, miR-210, miR-1307-5p, and miR-10b-5p—as well as specific proteins carried by salivary exosomes, show promising potential as non-invasive biomarkers for the early diagnosis of oral squamous cell carcinoma. Despite methodological heterogeneity, there is consistent evidence supporting the diagnostic value of exosomes as molecular tools. In conclusion, salivary exosomes represent an innovative and feasible avenue for the development of early diagnostic strategies in oral oncology. However, further studies with greater methodological rigour and clinical validation are required to support their implementation in clinical practice.
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Palavras-chave
Exossomas Cancro oral Cancro de cabeça e pescoço Biomarcadores salivares Marcadores de diagnóstico Diagnóstico precoce Exosomes Oral cancer Head and neck cancer Salivary biomarkers Diagnostic markers Early diagnosis