Characterization of Enzymatic Biomarkers in Salivary Samples for Early Detection of Pancreatic in Kirkuk

Pancreatic cancer is one of the most aggressive malignancies, with a high mortality rate due to late-stage diagnosis and the absence of reliable early detection methods. Current diagnostic approaches, such as imaging and serum biomarkers (e.g., CA 19-9), are often invasive, expensive, and lack sufficient sensitivity and specificity. Saliva has emerged as a promising biofluid for non-invasive diagnostics, offering a unique window into systemic diseases, including cancer. This study aims to explore the potential of enzymatic biomarkers in saliva for the early detection of pancreatic cancer using a proteomic approach. This study investigates the differential expression of salivary enzymatic biomarkers in pancreatic cancer patients compared to healthy controls. The primary objective is to characterize and validate key enzymatic proteins that could serve as reliable, non-invasive diagnostic indicators for early pancreatic cancer detection. A case-control study was conducted on 100 participants (50 pancreatic cancer patients and 50 healthy controls). Unstimulated whole saliva samples were collected, processed, and analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed enzymes. Western blot and ELISA were used for biomarker validation. Statistical tests, including ROC curve, AUC, sensitivity, and specificity analysis, were performed to measure biomarker performance. Proteomic profiling revealed a significant upregulation of MMP-9, LDH, Amylase, and ALP in pancreatic cancer patients compared to healthy controls (p < 0.001). MMP-9 had the optimal diagnostic performance (AUC = 0.91, sensitivity = 89.5%, specificity = 92.1%), followed by LDH (AUC = 0.88, sensitivity = 85.2%, specificity = 88.7%). Pathway analysis linked these enzymes with extracellular matrix remodeling, inflammation, and dysregulation of metabolism, which are of crucial significance in pancreatic cancer development. The current study demonstrates that salivary enzymatic biomarkers possess vast potential as a non-invasive diagnostic tool for the early diagnosis of pancreatic cancer. The greater sensitivity and specificity of MMP-9 and LDH suggest their potential application in clinical screening programs, particularly in cases involving population at high risk. Large-scale studies need to be conducted to validate these findings and render them clinically useful.