Diagnostic Accuracy of Inflammatory Biomarkers for Salivary Gland Tumours: A Systematic Review and Meta-Analysis

Sasikumar, Radhika; Aditya, Amita; Kulkarni, Neha; Fargade, Alisha; Diwan, Vaishnavi

doi:10.31557/APJCP.2026.27.7.2447

Diagnostic Accuracy of Inflammatory Biomarkers for Salivary Gland Tumours: A Systematic Review and Meta-Analysis

Document Type : Systematic Review and Meta-analysis

Authors

¹ Department of Oral Medicine and Radiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune 411018, India.

² Department of Oral Medicine and Radiology, Dr. D. Y. Patil Dental College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, Maharashtra 411018, India.

10.31557/APJCP.2026.27.7.2447

Abstract

Background: Differentiating benign from malignant salivary gland tumors (SGTs) preoperatively remains a clinical challenge due to overlapping morphological and radiologic features. Systemic inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) have emerged as potential adjuncts reflecting tumor-associated immune dysregulation. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of these biomarkers for SGTs. Methods: A systematic search was conducted in PubMed, SCOPUS, EBSCOhost, and Google Scholar up to September 2025 following the PRISMA-DTA guidelines (PROSPERO registration: CRD420251173943). Studies assessing the diagnostic accuracy of inflammatory biomarkers with histopathology as the reference standard were included. Data on sensitivity, specificity, area under the curve (AUC), and diagnostic odds ratio (DOR) were pooled using a random-effects model, and heterogeneity was assessed using Higgins I² statistics. Results: Six studies comprising 338 patients met the inclusion criteria. The pooled sensitivity and specificity were 0.71 and 0.81 for NLR, 0.61 and 0.72 for PLR, 0.74 and 0.78 for SII, and 0.71 and 0.73 for SIRI, respectively. Corresponding AUCs ranged from 0.73 to 0.83, indicating moderate-to-excellent diagnostic accuracy. Among the evaluated indices, SIRI showed the highest pooled sensitivity, while SII demonstrated the best discriminative capacity. The integration of SIRI with fine-needle aspiration cytology (FNAC) further improved diagnostic performance (accuracy 81.2%). Heterogeneity across studies was low (I² = 0%). Conclusion: Inflammatory biomarkers, particularly SII and SIRI, exhibit promising diagnostic value for diagnosing various SGTs and may complement cytological evaluation in indeterminate cases. Prospective multicentric studies with standardized cut-offs are recommended to validate their clinical application.

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