ReviewChildren (Basel, Switzerland)2025
Salivary Biomarkers in Pediatric Acute Appendicitis: Current Evidence and Future Directions.
Review in Children (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic Accuracy of Non-Contrast CT for Acute Appendicitis in the Emergency Department: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Emerging Approaches in Pediatric Surgery: Current Evidence and Remaining Challenges.Children (Basel, Switzerland) · 2026Article
- Comparison of C-reactive protein/albumin ratio and neutrophil/lymphocyte ratio with conventional biomarkers for predicting septic shock in pediatric sepsis.BMC pediatrics · 2026Article
- Analysis of diagnostic efficacy of serum miR-126-5p levels for stratifying severity in pediatric acute appendicitis.BMC pediatrics · 2026Article
- Impact of Trocar Position on Surgical Site Infection After Pediatric Laparoscopic Appendectomy: A 15-Year Single-Center Study.Medical sciences (Basel, Switzerland) · 2026Article
- Neonatal sepsis: any role for procalcitonin as a diagnostic marker?BMC pediatrics · 2026Article
- Routine Biomarkers in Paediatric Appendicitis Stratification: Which Add Diagnostic Value? A Retrospective Cohort Study.Children (Basel, Switzerland) · 2026Article
- The Predictive Value of Clinical and Systemic Inflammatory Biomarkers in Emergency Colic Cancer Surgery: A Retrospective Study.Journal of clinical medicine · 2026Article
- The Role of Emerging Immune-Inflammatory Indexes in the Preoperative Differentiation of Complicated and Uncomplicated Acute Appendicitis: A Single-Center Retrospective Analysis.Diagnostics (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute appendicitis is the most common surgical emergency in children, yet timely and accurate diagnosis remains challenging due to nonspecific clinical presentations and limitations of imaging and blood tests. Saliva has emerged as a promising diagnostic medium because it is non-invasive, painless, inexpensive, and highly acceptable for pediatric patients. Salivary biomarkers may provide rapid and child-friendly adjuncts to existing diagnostic pathways.
methodsA systematic literature search was performed in Ovid/MEDLINE, Scopus, Web of Science, and the Cochrane Library to identify studies assessing salivary biomarkers in pediatric appendicitis. Eligible studies included children with suspected or confirmed appendicitis and evaluated the diagnostic accuracy of salivary markers compared to clinical, laboratory, or imaging standards.
resultsTo date, only three salivary biomarkers have been investigated. Leucine-rich α-2-glycoprotein 1 (LRG1) demonstrated high specificity of 100% but low sensitivity of 35-36%, with diagnostic accuracy ranging from AUC 0.77 to 0.85. C-reactive protein (CRP) showed excellent diagnostic performance with sensitivity of 91.3% and specificity of 95.4% (AUC 0.97), and strong correlation with serum CRP (ρ = 0.96). Irisin showed sensitivity of 90% and specificity of 60% with estimated AUC around 0.75, suggesting potential as an adjunct marker but limited as a standalone test.
conclusionsSalivary biomarkers in pediatric appendicitis are promising but remain underexplored, with evidence limited to small, single-center studies totalling fewer than 300 patients. Their advantages include feasibility, tolerability, and suitability for integration into point-of-care testing. Future research should focus on multicenter validation, development of multi-marker salivary panels, and application of biosensor technologies. With further evidence, salivary diagnostics could complement existing strategies and improve the accuracy and child-friendliness of appendicitis care.
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