Lack of Salivary Long Non-Coding RNA XIST Expression Is Associated with Increased Risk of Oral Squamous Cell Carcinoma: A Cross-Sectional Study

Studies have shown that there is a disparity between males and females in south-east Asia
with regard to oral cancer morbidity. A previous study found that oral cancer tissue showed loss
of heterozygosity of the X-linked lncRNA XIST gene. We suggest that XIST may play an important
role in oral cancer morbidity when associated with sex. Saliva contains proteins and RNAs that are
potential biomarkers for the diagnosis of diseases. This study investigated salivary XIST expression
and the correlation to clinical–pathological data among oral squamous cell carcinoma patients.
Salivary XIST expression was only observed in females, and a high proportion of females with OSCC
lack salivary lncRNA XIST expression (88%). The expression showed no correlation with alcohol
consumption, betel quid chewing, or cigarette smoking habits. People lacking salivary lncRNA
XIST expression had a significantly increased odds ratio of suffering from OSCC (OR = 19.556,
p < 0.001), particularly females (OR = 33.733, p < 0.001). The ROC curve showed that salivary lncRNA
XIST expression has acceptable discrimination accuracy to predict the risk of OSCC (AUC = 0.73,
p < 0.01). Lack of salivary lncRNA XIST expression was associated with an increased risk of OSCC.
We provided an insight into the role of salivary lncRNA XIST as a biomarker to predict the morbidity
of OSCC.