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Early detection is crucial, but effective non-invasive screening methods are lacking. This study investigates the diagnostic potential of salivary Cystatin S (CST4) and\n                      <jats:italic>MicroRNA-223<\/jats:italic>\n                      (\n                      <jats:italic>miR-223<\/jats:italic>\n                      ) biomarkers, integrated with health-related factors for early gastric cancer detection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Forty-five patients with gastric cancer and 45 healthy controls participated in this case-control study. Saliva samples were collected and analyzed for CST4 and\n                      <jats:italic>miR-223<\/jats:italic>\n                      levels. Demographic data and health-related factors, including hot drink consumption, gastric ulcer history,\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      infection, body mass index (BMI), DMFT (Dental Decay, Missing, and Filled Teeth), and salty food intake, were also collected through a standardized questionnaire. Salivary CST4 levels were determined using enzyme-linked immunosorbent assay (ELISA), and\n                      <jats:italic>miR-223<\/jats:italic>\n                      levels were quantified using real-time polymerase chain reaction (PCR). Statistical analyses, encompassing multiple logistic regression, were conducted to evaluate the diagnostic efficacy of the biomarkers alongside health-related parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Significant differences in salivary CST4 and\n                      <jats:italic>miR-223<\/jats:italic>\n                      levels were observed between gastric cancer patients and healthy controls (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Combining salivary biomarkers and health-related factors yielded high accuracy, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.89 for the model using CST4 and\n                      <jats:italic>miR-223<\/jats:italic>\n                      . Multiple logistic regression analysis identified several health-related factors, including gastric ulcer history and\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      infection, as significant predictors of gastric cancer risk. The inclusion of health factors, along with biomarkers, enhanced early detection\u2019s sensitivity and specificity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      The study highlights the potential of salivary biomarkers CST4 and\n                      <jats:italic>miR-223<\/jats:italic>\n                      as non-invasive tools for early gastric cancer detection. Integrating these biomarkers with health-related factors, such as gastric ulcer history and\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      infection, enhances the risk assessment and diagnostic accuracy for gastric cancer.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795549251375898","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T09:44:03Z","timestamp":1758275043000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Integrating Salivary Biomarkers CST4 and\n                    <i>miR-223<\/i>\n                    With Health-Related Factors for Gastric Cancer Detection and Risk Assessment"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9999-1443","authenticated-orcid":false,"given":"Maryam","family":"Koopaie","sequence":"first","affiliation":[{"name":"Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Manafi","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soheila","family":"Manifar","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shima","family":"Younespour","sequence":"additional","affiliation":[{"name":"Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajad","family":"Kolahdooz","sequence":"additional","affiliation":[{"name":"Universal Scientific Education and Research Network (USERN), Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Karimipour Pareshkooh","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31288-5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12102880"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-022-01527-7"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyy077"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33450"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-016-0659-4"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11154337"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2021.1845140"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms11051312"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.01.028"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2020004"},{"key":"e_1_3_2_15_2","first-page":"7","article-title":"Dietary factors associated with gastric cancer-a review","volume":"7","author":"Richa, Sharma N","year":"2022","unstructured":"Richa, Sharma N, Sageena G. 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