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Early detection at pre-malignant stages supports timely clinical decision-making and interventions. Eligible evidence includes original diagnostic test accuracy studies using salivary MMP-9 as the index test with biopsy-based histopathology as the reference standard. Pooled results from seven studies suggest high sensitivity and specificity, while heterogeneity, bias risk, and applicability concerns indicate the need for further pragmatic research.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/mmp-9-as-a-diagnostic-salivary-biomarker-for-early-detection-of-oral-cancers-systematic-review-and-meta-analysis/344700/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/mmp-9-as-a-diagnostic-salivary-biomarker-for-early-detection-of-oral-cancers-systematic-review-and-meta-analysis/344700.png","ImageObject",300,407,{"name":92,"@type":93},"Patrick","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-23","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the primary objective of the review?","Question",{"text":112,"@type":113},"To evaluate the diagnostic performance of salivary MMP-9 for rapid point-of-care testing of early-stage oral cancers (I, II).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What studies were included and what was used as the reference standard?",{"text":117,"@type":113},"Original diagnostic test accuracy studies on patients with lip and oral cavity cancers were included, using salivary MMP-9 levels as the index test and biopsy-based histopathology as the reference standard.",{"name":119,"@type":110,"acceptedAnswer":120},"What diagnostic accuracy results were reported for salivary MMP-9?",{"text":121,"@type":113},"The pooled sensitivity, specificity, and area under the curve were reported as 0.98, 0.96, and 0.97, with a 95% confidence interval from 0.85 to 1.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},344700,1790185170,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},549758146520,"https://ap-avatar.wpscdn.com/avatar/80002397d8c0411e94?_k=1775819394049821470","Shaukat et al. BMCOral Health (2026) 26:219 BMC Oral Health  \n[https://doi.org/10.1186/s12903-025-07513-x](https://doi.org/10.1186/s12903-025-07513-x)  \nSYSTEMATIC REVIEW Open Access  \nMMP-9 as a diagnostic salivary biomarker  for early detection of oral cancers: systematic review and meta-analysis  \nAqsa Shaukat1, Saleha Nisar 1, Mehmood Asghar1, Muhammad Kaleem 1 and Muhammad Sohail Zafar2,3,4*  \nAbstract  \nObjectives The intention of this investigation was to evaluate the diagnostic performance of salivary MMP-9 enzyme for rapid point of care testing of early stage (I, II) oral cancer. Diagnosis at early pre-malignant stages will help in making clinical decisions for timely intervention.  \nMaterials and methods Original diagnostic test accuracy (DTA) studies of any design, on patients with lip and oral cavity cancers investigating salivary MMP-9 levels as an index test and histopathological confirmation via biopsy as a reference test were eligible for inclusion. Similar studies on serum or blood were excluded. Besides, the case reports/case series, reviews, letters, book chapters, conference abstracts, in vitro, and animal studies were all excluded. Non-English papers were not excluded. The databases searched from Jan 2014 to Aug 2024 were PubMed, SCOPUS, Cochrane Library, Science Direct, and Google Scholar, without language restrictions. QUADAS-2 was used to assess the risk of bias and concerns regarding applicability. Meta-analyses were performed using a bivariate random-effects model.  \nResults Out of 18 articles identified, 7 studies with 795 patients were included. The pooled sensitivity, specificity, mean salivary MMP-9 levels, and the Summary Receivers Operating Curve were done using REVMAN 5.4 and a web application (Meta-DiSc 2 . 0) . Overall, the pooled sensitivity, specificity, and Area under the curve were 0 . 98, 0 . 96, and 0. 97, respectively with 95% confidence interval between 0.85 and 1. However, with high heterogeneity and risk of bias together with low applicability concern we need additional pragmatic designed research to back up its use in screening and diagnostic applications.  \nConclusion Within the limitations of the study, salivary MMP-9 has merit as a biomarker for identification of earlystage (I, II) oral cancer.  \nKeywords Salivary biomarkers, Oral squamous cell carcinoma, OSCC, Diagnostic accuracy studies, Matrixmetalloproteinase-9, MMP-9  \n*Correspondence:  \nMuhammad Sohail Zafar  \n[muhammad.zafar@ajman.ac.ae](muhammad.zafar@ajman.ac.ae)  \n1Department of Science of Dental Materials, AM college, NUMS, Rawalpindi, Pakistan  \n2Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates  \n3Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates  \n4School of Dentistry, University of Jordan, Amman, Jordan  \n© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.)  \nShaukat et al. BMC Oral Health (2026) 26:219  \nIntroduction  \nAccording to GLOBOCAN 2022, Lip and oral cavity cancer (LOC) is the 16th most diagnosed neopl","cbCaiozF5C6Ju0R2","https://ap.wps.com/l/cbCaiozF5C6Ju0R2","pdf",1912159,"English","# Abstract\n## Objectives\n## Materials and methods\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What was the primary objective of the review?\",\"answer\":\"To evaluate the diagnostic performance of salivary MMP-9 for rapid point-of-care testing of early-stage oral cancers (I, II).\"},{\"question\":\"What studies were included and what was used as the reference standard?\",\"answer\":\"Original diagnostic test accuracy studies on patients with lip and oral cavity cancers were included, using salivary MMP-9 levels as the index test and biopsy-based histopathology as the reference standard.\"},{\"question\":\"What diagnostic accuracy results were reported for salivary MMP-9?\",\"answer\":\"The pooled sensitivity, specificity, and area under the curve were reported as 0.98, 0.96, and 0.97, with a 95% confidence interval from 0.85 to 1.\"}]","MMP-9 as a diagnostic salivary biomarker for early detection of oral cancers - systematic review and meta-analysis | PDF",1790054966,25]