Abstract
BACKGROUND: This systematic review and meta-analysis aim to assess the diagnostic accuracy of the oral microbiome in detecting pancreatic cancer. METHODS: A comprehensive search of relevant studies was conducted using key terms across multiple databases. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies-2 (QUADAS-2). Diagnostic accuracy metrics were calculated including specificity, sensitivity, likelihood ratios, and diagnostic odds ratio (DOR). Subgroup analyses were performed to explore the effects of oral sample collection methods, bacterial taxonomy, and oral microbiome classifications. RESULTS: This systematic review included nine studies, comprising 188 study units with 6601 subjects The pooled specificity, sensitivity, and diagnostic odds ratio (DOR) for the use of a single oral microbiome were 0.70 (95% CI: 0.68-0.71), 0.65 (95% CI: 0.64-0.67), and 4.85 (95% CI: 4.11-5.74), respectively. Subgroup meta-analysis revealed that using multiple oral microbiome approaches could increase the DOR to 16.33. Subgroup analysis was performed based on bacterial phylum classification, multiple oral microbiomes, sampling methods, bacterial taxonomy, and subgenus-level taxonomy (g_Streptococcus and g_Prevotella). CONCLUSIONS: Oral microbiome holds promise as a diagnostic biomarker for pancreatic cancer, supporting its potential as a noninvasive tool for the screening and early detection of this malignancy.