Oral squamous cell carcinomas: state of the field and emerging directions

A label-free fluorescence aptasensor for salivary exosomes based on a nano-micro dual-scale signal amplification strategy

Oral squamous cell carcinoma (OSCC) is the most prevalent histological subtype of oral cancer and urgently requires a noninvasive approach for timely detection to improve patients' prognose. Salivary exosome act as a promising biomarker, while the complex and expensive analytical methods impeded its popularization in clinical applications. In this study, we developed a label-free aptasensor for salivary exosomes that utilizes a "one exosome to multiple carbon dots" signal conversion method along with nano-micro dual-scale signal amplification strategy. SiO2 microspheres served as substrates, while carbon dots acted as luminophores, with CD63 aptamers functioning as selective recognition elements. Exosomes compete to bind with the aptamers, thereby leading to the release of non-specifically adsorbed carbon dots from the substrates. The concentration of exosomes is proportional to the variation in fluorescence intensity, enabling highly sensitive detection in artificial saliva samples, with a favorable linearity range of 2.5 × 102∼5 × 108 particles/mL and a relatively low LOD of 100 particles/mL. The anti-interference ability is deemed acceptable, and the fabrication process is affordable coupled with a straightforward signal output mode. The aptasensor was applied successfully to distinguish OSCC patients from healthy individuals, suggesting its potential for screening OSCC in physical examination centers and communities.

Liquid saliva analysis using optofluidic photonic crystal fiber for detection of oral potentially malignant disorders

Oral potentially malignant disorders (OPMD) serve as early indicators of oral cancer. These conditions require reliable, non-invasive and real-time diagnostic methods for effective detection and screening. Saliva, as an easily accessible and non-invasive biofluid, has emerged as a promising tool to detect OPMD-associated biomarkers. This proof-of-concept study investigated the application of suspended-core optofluidic photonic crystal fibers (PCF) for Raman spectroscopy to distinguish between saliva from healthy controls and OPMD patients. This novel approach provides enhanced Raman signals through prolonged interactions between the excitation light and the saliva sample along the length of the PCF. Raman spectra of liquid saliva samples were collected from eleven participants, including six OPMD patients and five healthy controls. Notable spectral differences were identified at 1123 cm-1, 1251 cm-1, and 1454 cm-1, which correspond to carbohydrates, proteins, and lipids, respectively. In vivo tissue measurements were recorded as a reference for comparative analysis from the same patients. Our findings suggest that PCF-based Raman spectroscopy holds promise as a non-invasive diagnostic platform for oral cancer screening by enabling the monitoring of subtle molecular changes in liquid saliva.

Tissue Biomarkers for Predicting the Risk of Oral Cancer in Patients Diagnosed With Oral Leukoplakia: A Systematic Review of the Past 4 Years

BACKGROUND

Oral potentially malignant disorders may precede the development of oral cancer, and biomarkers are being investigated for their risk assessment. We aim to provide updated information on tissue biomarkers related to the risk of malignant transformation (MT) in patients with oral leukoplakia (OL) published during the last four years.

METHODS

A search strategy was developed using the electronic databases PubMed, EBSCO, and Cochrane Library to search for articles related to this topic (published from 2020 to 2024) (CRD42024527395).

RESULTS

Of the 1385 articles identified, 14 were included, with a combined sample of 1479 patients of whom 216 suffered MT. There were 30 different biomarkers evaluated of which Bmi-1, CD3/CD8, Ki-67, p16, and DNA ploidy were evaluated in more than one study. Of the 9 studies with multivariate analysis, Bmi-1, Tipe-2, copy number alteration, DcR2, and Ki-67, PTHrP, podoplanin (PDPN), and BubR1/Mad2 biomarkers presented independent significant value on MT. In one study, adding DNA ploidy status to the grade of dysplasia increased the model's predictive power.

CONCLUSION

Although heterogeneity continues to exist, this systematic review reconfirms the role of biomarkers previously described such as PDPN and DNA ploidy and some new additional biomarkers.

E3 ligase Skp2-mediated stabilization of survivin contributes to radioresistance

Oral squamous cell carcinoma (OSCC) is a frequently occurring neck and head malignancy. Therapies for OSCC are improving, but radiotherapy resistance remains a major clinical challenge. Here, we found that the S-phase kinase-associated protein 2 (Skp2) is overexpressed in OSCC cells and tissues. Knockdown of Skp2 significantly increased the radiotherapy sensitivity of OSCC cells. Further potential mechanisms suggest that Skp2-deficient restoration of radiotherapy sensitivity in OSCC cells may induce intrinsic apoptosis through inhibition of the Akt/Wee1/CDK1 axis, which inhibits Survivin phosphorylation and promotes its ubiquitination and degradation by FBXL7. Clinicopathologic histological analysis showed that Skp2 was positively correlated with the expression of p-Akt and Survivin in OSCC tissues. Furthermore, knockdown or inhibition of Skp2 overcame the radiotherapy resistance of OSCC cells. In conclusion, our study demonstrated that targeting the Skp2-Survivin axis could serve as an attractive and promising potential therapeutic target for radiotherapy sensitization in OSCC.

Paeonol inhibits the Glycolysis in oral squamous cell carcinoma though suppressing NAT10-mediated ac4C modification

BACKGROUND

Oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral and maxillofacial regions. Paeonol, derived from Moutan Cortex, has diverse pharmacological effects including anti-inflammatory and anticancer activities. The N-acetyltransferase 10 (NAT10)-mediated N4-acetylcytidine (ac4C) modification is a newly discovered RNA epigenetic mechanism. This study aimed to investigate the role of paeonol in OSCC and its underlying mechanisms of action.

METHODS

Cell viability and migration were assessed using a cell counting kit-8 and transwell migration assays. Glycolysis-related indices were detected using commercial kits. The interaction between NAT10 and hexokinase 2 (HK2) was examined using RNA immunoprecipitation and dual-luciferase reporter assays. A tumor-bearing mouse model was established.

RESULTS

The results showed that paeonol treatment decreased the viability, migration, and glycolysis of OSCC cells. Moreover, paeonol treatment inhibited NAT10-mediated ac4C modifications in OSCC cells. In addition, NAT10 overexpression upregulates glycolysis and cell migration in OSCC cells. Moreover, NAT10 upregulated ac4C levels of HK2 in OSCC cells. Animal studies have revealed that paeonol treatment decreases OSCC tumor growth.

CONCLUSION

This study revealed that paeonol inhibited glycolysis and cell migration in OSCC by suppressing the NAT10-mediated ac4C modification of HK2.

Potential changes in microorganisms and metabolites associated with oral cancer: a preliminary study

BACKGROUND

Oral squamous cell carcinoma is a malignant tumor with high morbidity and mortality, and changes in microflora have a close relationship with tumor development. In this study, we tried to identify the changes in oral microbial characteristics and metabolite levels in OSCC patients.

METHODS

In this study, saliva samples were collected from 40 oral cancer cases and 39 healthy controls. The microbiome was analysed by 16 S rDNA gene sequencing, and the metabolome was detected by Liquid Chromatography-Mass Spectrometry (LC-MS) with metabolite traceability using the Metorigin platform. Correlations between the microbiome and metabolome were analysed using the Spearman correlation method.

RESULTS

The study found a significant difference in the β diversity of oral microbiota between the oral cancer group and healthy controls, while α diversity showed no significant difference. At the phylum level, Deferribacterota significantly increased, and Cyanobacteria significantly decreased in the oral cancer group. At the genus level, Vibrio and Lactococcus were significantly elevated, while Bifidobacterium and Faecalibacterium were significantly reduced. Metabolomic analysis identified 36 differentially abundant metabolites; 13(S)-HOTrE and 13-HODE were significantly downregulated, while docosanamide was significantly upregulated in the oral cancer group. Six bacteria-specific metabolites, including Indole, were also downregulated. Correlation analysis showed that N-Acetylneuraminic acid had a significant negative correlation with Pseudoalteromonas and Vibrio (r < -0.4).

CONCLUSION

This study found large differences in microbiome levels at the portal level, at the genus level, and significant differences in the levels of a variety of metabolites labeled by indoles, providing a new and potentially valuable direction for the diagnosis and treatment of oral squamous carcinoma.

Heat Shock Protein 70-2 is Overexpressed in Oral Leukoplakia and Oral Squamous Cell Carcinoma

OBJECTIVE

The objective of this study was to assess the correlation between the expression of HSP70-2 and the development of oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC). Furthermore, the study evaluates the potential function of HSP70-2 in the pathogenesis of malignant diseases of the oral cavity.

METHODS

Using immunohistochemistry, RT-qPCR, Western blot, indirect immunofluorescence, and flow cytometry, the expression of HSP70-2 mRNA and protein in OPMD and OSCC tissues and cells was investigated. Using liposomal vector transient transfection to specifically knock down HSP70-2 gene expression in pertinent cell lines in vitro, the role of HSP70-2 in the development of oral malignant disorders was further investigated.

RESULTS

Studies on OPMD and OSCC tissues and cell lines revealed that HSP70-2 mRNA and protein were substantially expressed. Furthermore, it was discovered that the expression levels corresponded with the degree of disease development. Downregulating the HSP70-2 gene specifically reduces the proliferation, viability, colony-forming ability, migration, and invasion of OPMD and OSCC cells. Furthermore, it will cause apoptosis and control cell cycle arrest.

CONCLUSION

HSP70-2 exhibited a significantly differential expression in both NM, OPMD, and OSCC tissues and cells. Furthermore, HSP70-2 plays a function in the development of oral malignant illnesses.

CLINICAL RELEVANCE

HSP70-2 is a promising biomarker for predicting the malignant transformation of Oral leukoplakia (OLK) and early diagnosis of OSCC. It is highly anticipated that HSP70-2 will be a potential target for the early intervention and blockage of OLK malignant transformation, given its established role in the development of oral malignant disorders. With regard to the treatment of OSCC, the same provides a referable target for siRNA-based therapeutic modalities.

Metabolomics and network pharmacology approach to identify potential bioactive compounds from Trichoderma sp. against oral squamous cell carcinoma

This study aimed to profile metabolites from five Trichoderma strains and assess their cytotoxic and pharmacological activities, particularly targeting oral squamous cell carcinoma (OSCC). UHPLC-TOF-MS analysis revealed the presence of 25 compounds, including heptelidic acid, viridiol isomers, and sorbicillinol from the different Trichoderma extracts. Pharmacokinetic analysis showed moderate permeability and low interaction with P-glycoprotein, suggesting good drug absorption with minimal interference in cellular uptake. ADME-Tox analysis indicated limited inhibition of cytochrome P450 enzymes, low renal clearance, which are favorable for maintaining therapeutic levels. Toxicity predictions revealed some compounds with potential mutagenicity, but low hepatotoxicity and skin sensitization risks. Network pharmacology identified MAPK1 as a key target for oral cancer, and molecular docking and induced fit docking studies demonstrated strong binding affinities of Trichoderma metabolites, including stachyose and harzianol, to MAPK1. In addition, molecular dynamics (MD) simulations confirmed stable interactions. In vitro studies on NIH3T3 and YD-10B cells showed significant cytotoxicity, particularly with extracts CNU-05-001 (IC50:10.15 µg/mL) and CNU-02-009 (10.00 µg/mL) against YD-10B cells. These findings underscore the potential of Trichoderma metabolites in drug discovery, particularly for cancer therapies.

TPPP3, a Good Prognostic Indicator, Suppresses Cell Proliferation and Migration in OSCC

INTRODUCTION AND AIMS

Oral squamous cell carcinoma (OSCC) is one of the most prevalent malignancy of the head and neck. Early diagnosis of OSCC is difficult and the prognosis has not improved significantly. This study aims to explore the role of tubulin polymerisation promoting protein 3 (TPPP3) in the occurrence and development of OSCC and discover new diagnostic and prognostic markers for OSCC.

METHODS

Using UALCAN, GEPIA, western blot, and quantitative real-time polymerase chain reaction, we studied TPPP3 expression and its relationship with tumour stage. Then, we detected the effect of TPPP3 on OSCC biological functions by CCK-8 and cell scratch assays, as well as correlations between TPPP3 expression and survival of different kinds of head and neck squamous cell carcinoma (HNSC) patients through Kaplan-Meier plotter. Besides, we explored coexpressed genes associated with TPPP3 in HNSC using LinkedOmics and protein-protein interaction networks of TPPP3 using STRING and Cytoscape. Furthermore, we explored possible molecular mechanisms that TPPP3 functions in HNSC using UALCAN, Kaplan-Meier plotter, and TIMER. Finally, we analysed promoter methylation level by UALCAN and mutation by cBioPortal of TPPP3 in HNSC.

RESULTS

TPPP3 was less expressed in OSCC. The TPPP3 expression level was negatively correlated with tumour stage. Furthermore, TPPP3 significantly inhibited OSCC proliferation and migration. Besides, TPPP3 high expression was significantly associated with good prognosis in different kinds of HNSC patients. Additionally, TPPP3 may regulate the occurrence and development of OSCC through the PALMD/PI3K pathway. TPPP3 methylation level in HNSC decreased. Finally, we found that TPPP3 genetic alteration was involved in TPPP3 mRNA expression change in HNSC.

CONCLUSION

TPPP3 functions as a tumour suppressor in OSCC and is associated with good prognosis in HNSC patients. TPPP3 can be used as a potential biomarker for prognosis and diagnosis of OSCC.

CLINICAL RELEVANCE

TPPP3 can be used as a potential biomarker for prognosis and diagnosis of OSCC in clinical practice.

Challenges and improvements in multi-layer mucosa-adhesive films for oral diseases treatment and prognosis

Due to the complexity of oral physiology and pathology, the treatment of oral diseases faces multiple and complex clinical requirements. Mucosa-adhesive films (MAFs) with a single layer have demonstrated considerable potential in delivering therapeutic bioactive ingredients directly to the site of oral diseases. However, their functions are often hindered by certain factors such as limited loading capacity, poor site specificity, and sensitivity to mechanical stimuli. To overcome these limitations, the development of multi-layer MAFs has become a focal point for recent research. This involves the improvement of construction methods for multi-layer MAFs to minimize potential health risks from residual solvents, and conducting comprehensive in vivo studies to evaluate their safety and therapeutic efficacy more accurately, thus paving the way for their commercialization. Additionally, the exploration of multi-layer MAFs as personalized drug delivery systems could further broaden their application prospect. Precisely, multi-layer MAFs compensate for the shortcomings of current therapeutic strategies for oral diseases to a great extent, indicating a promising future in the market.

The pan-BH-3 mimetic, obatoclax, synergistically enhances cisplatin-induced apoptosis in oral squamous cell carcinoma through a mechanism that involves degradation of the pro-survival protein Mcl-1

OBJECTIVES

The purpose of the study was to elucidate the role of the Bcl-2 family of proteins in mediating cisplatin resistance in oral squamous cell carcinoma (OSCC). The value of the BH3-mimetics venetoclax and obatoclax as sensitisers for cisplatin treatment in OSCC was also evaluated.

DESIGN

In this study the expression levels of a series of pro- and anti-apoptotic members of the Bcl-2 family in paired cisplatin-sensitive (SCC4) and resistant (SCC4cisR) tongue squamous carcinoma cell lines were examined by western blotting. The apoptotic rate induced by cisplatin and BH3-mimetics venetoclax and obatoclax alone or in combination in OSCC was also evaluated by Annexin V/Propidium Iodide double-stained flow cytometric assays.

RESULTS

Obatoclax was shown to synergistically enhance cisplatin-induced apoptosis, and this enhancement was associated with a marked degradation in pro-survival Mcl-1 and upregulation in conformationally active form of pro-apoptotic Bak.

CONCLUSIONS

Our study presents novel insights into the relationship between the Bcl-2 family and cisplatin efficacy in OSCC. It also demonstrates that targeted therapy with BH-3 mimetics, such as obatoclax, may represent a new strategy for OSCC therapy.

Association of Epstein-Barr Virus and its clinical relevance in Human Papillomavirus-negative oral squamous cell carcinoma: A cohort study from South India

OBJECTIVE

The study assessed the prevalence and clinical implications of Epstein Barr Virus (EBV)-positive but Human Papillomavirus (HPV)-negative oral squamous cell carcinoma (OSCC) in a tertiary care hospital setting. The overall goal was to elucidate the potential impact of EBV on OSCC disease progression and prognosis.

DESIGN

A total of 134 surgically resected and histopathologically confirmed OSCC tumor biopsies were collected from a tertiary care hospital. Tumor samples were analyzed for HPV and EBV using conventional and nested PCR. Clinical and demographic data, including age, sex, risk factors, tumor stage, and survival outcomes, were collected and analyzed to assess associations between EBV status and disease characteristics.

RESULTS

All the tumor samples tested negative for HPV. However, EBV was detected in 74 cases (55.3 %) using nested PCR which was confirmed by sanger sequencing. EBV prevalence was higher in males (62.1 %), and the left buccal mucosa was the most affected site, accounting for 34 % of cases. Although statistically not significant, 63.5 % (n = 47) of the EBV positive subjects had a history of consuming both tobacco and alcohol. Of these 20 subjects showing recurrence, 35 % (n = 7) were EBV positive suggesting poor prognosis for EBV positive OSCC subjects.

CONCLUSION

This study highlights a significant prevalence of EBV in HPV-negative OSCC cases, suggesting a potential oncogenic role for EBV in OSCC progression, particularly in patients with established lifestyle risk factors. These findings underscore the need for further research into EBV's molecular mechanisms in OSCC and its utility as a biomarker for prognosis and therapeutic targeting. The results advocate for region-specific strategies to better understand and manage EBV-associated OSCC, offering potential pathways to improve outcomes in high-risk populations.

Investigating the impact of Terminalia chebula, an underutilized functional fruit, on oral squamous cell carcinoma: Exploring cell death mechanisms

ETHNOPHARMALOGICAL RELEVANCE

Terminalia chebula, known for its extensive use in traditional medicinal practices among indigenous cultures, is recognized for its effectiveness in treating various oral disorders. Healers in India and China utilize the ripe fruits of T. chebula to prevent and manage conditions such as dental cavities, gingivitis, bleeding gums and stomatitis. The fruits have also been traditionally used in Ayurvedic and Siddha medicines for treatment of various diseases including anticancer properties. It is also an important component of Tibetan traditional medicine used for the treatment of cancer. Studies have demonstrated the efficacy of T. chebula against lung and colon carcinoma.

AIM OF THE STUDY

Despite its historical significance in oral health, the potential of T. chebula against oral cancer has not been explored, warranting further investigation into its bioactive properties. This study aims to explore the therapeutic potential of the hydroalcoholic extract of Terminalia chebula fruits and its fractions against oral squamous cell carcinoma (OSCC) using SCC9 cells focusing on their cytotoxicity, anti-proliferative effect and the synergistic action of its ethyl-acetate fraction with cisplatin (CP). Additionally it seeks to identify the bioactive phytoconstituents in EAF were identified using LC-ESI-QTOF-MS.

MATERIALS AND METHODS

Antioxidant activity of TYH and its fraction were assessed using DPPH and ABTS assays. Total phenolic (TPC) and total flavonoid content (TFC) were quantified via Folin-ciocalteau and alluminium chloride assays respectively. Cytotoxic and antiproliferative effects were assessed using MTT assay, clonogenic assay and cell migration assay. Apoptosis in EAF treated SCC9 cells was analysed by using DAPI, Giemsa staining and flow cytometry using Annexin V-FITC/PI apoptosis detection kit. Intracellular reactive oxygen species (ROS) was assessed using H2DCFDA, western blotting examined expression of apoptosis related proteins in SCC9 cells. Combinational effect of EAF with cisplatin (CP) was also assessed and phytochemical constituents of EAF were analysed using LC-ESI-QTOF-MS.

RESULTS

The ethyl acetate fraction (EAF) showed the highest antioxidant activity (IC50 value of 8.16 ± 0.59 μg/mL and 4.99 ± 0.82 μg/mL in DPPH and ABTS assays respectively) which reciprocated with a high TPC and TFC (528.46 ± 2.59 mgGAE/g and 49.10 ± 1.61 mgQE/g dry weight of the extract respectively) content. EAF significantly reduced cell viability with an IC50 value of 86.73 ± 0.55 μg/mL, resulted in dose dependent cell death, and prevented the proliferation and migration in SCC9 cells. Further Annexin V-PI based flow cytometric analysis and caspase-3/7 enzyme activity assay confirmed the apoptotic effect of EAF in SCC9 cells. Intrinsic pathway of apoptosis post treatment with EAF was confirmed by western blotting with marker proteins, Bax, Bcl-2, Mcl-1, cleaved caspase, procaspase and PARP. A combinatorial study of EAF with the standard drug cisplatin also indicated a synergistic effect of the fraction in cisplatin treated cells with a CI value of 0.67571. LC-ESI-QTOF-MS led to identification of the presence of phenolics and gallotannins with anticancer properties in EAF.

CONCLUSION

This study demonstrates the potential of the hydroalcoholic extract of Terminalia chebula fruits (TYH), especially its ethyl acetate fraction (EAF), as a therapeutic agent against oral squamous cell carcinoma (OSCC).

Long noncoding HOXD-AS1: a crucial regulator of malignancy

Long non-coding RNAs (lncRNAs) play a crucial role in the occurrence and progression of various cancers. HOXD-AS1, an antisense RNA 1 of the lncRNA HOXD cluster, (also known as HAGLR, MIR7704HG, Mdgt, and STEEL), is located at human chromosome 2q31.1. Recent studies have demonstrated that the abnormal expression of HOXD-AS1 is significantly correlated with the clinicopathological features of patients with various tumors. The expression of HOXD-AS1 is abnormal in various tumors, affecting tumor cell proliferation, apoptosis, metastasis, invasion, metabolism, and drug resistance. HOXD-AS1 is important for cancer diagnosis and prognosis evaluation. Detecting its expression level helps judge cancer progression and predict patient survival. It is a therapeutic target and biomarker for early diagnosis and prognosis, with good clinical application prospects. This article reviews the role, molecular mechanisms, and potential clinical value of HOXD-AS1 in malignant tumor development.

An electrochemical biosensor for the detection of microRNA-31 as a potential oral cancer biomarker

Oral cancer presents substantial challenges to global health due to its elevated mortality rates. Approximately 90% of these malignancies are oral squamous cell carcinoma (OSCC). A significant contributor to the prevalence of oral cancer is the difficulty in detecting cancerous biomarkers, further exacerbated by socioeconomic disadvantages and late-stage diagnoses. Given the critical nature of oral cancer, the early detection of biomarkers is essential for reducing mortality rates. This study investigates the application of microRNA-31 (miRNA-31) as a biomarker for the electrochemical detection of oral cancer, recognizing the considerable potential that microRNAs have demonstrated in cancer screening and diagnosis. The methodology employed includes the use of a glassy carbon electrode modified with graphene and a molecular tethering agent designed to enhance sensitivity and specificity. The biosensor exhibited a limit of detection of 10- 11 M (70 pg/mL or 6.022 × 106 copies/µL) in buffer and 10- 10 M (700 pg/mL or 6.022 × 107 copies/µL) in diluted serum for the complementary target miRNA-31 using the Six Sigma method. The efficacy of this biosensor was further validated through specificity studies utilizing a non-complementary miRNA in both buffer and human serum samples. The electrochemical biosensor displayed exceptional performance and high sensitivity in detecting miRNA-31, confirming its role as an innovative sensor for the non-invasive diagnosis of oral cancer. Furthermore, the proposed biosensor demonstrates several advantages over current methodologies, including reduced detection time, and cost-effective reagents.

Senescent vascular endothelial cells promote oral squamous cell carcinoma progression through complement C3 activation

OBJECTIVE

The tumour microenvironment (TME) plays a critical role in therapeutic response and clinical outcomes in cancer. Senescent stromal cells have been shown to promote tumour progression; however, the role of senescent vascular endothelial cells (VECs) in oral squamous cell carcinoma (OSCC) remains largely unknown. In this study, we aimed to explore the effects and potential mechanisms of senescent VECs in OSCC progression.

DESIGN

Cisplatin was used to induce senescence in two endothelial cell lines. Senescence-associated β-galactosidase (SA-β-gal) staining, immunoblotting, cell cycle and proliferation assays, and migration and invasion assays were performed to access senescence development and biological behavior. Additionally, RNA sequencing analysis, multiplex immunohistochemical staining, immunoblotting, and xenograft mouse models were used to investigate the senescence-associated secretory phenotype of senescent VECs during OSCC progression and its potential molecular mechanisms.

RESULTS

Cisplatin-induced senescent VECs exhibited senescence-related changes, including positive SA-β-gal expression and upregulation of p16, p21, and p53, along with attenuated proliferation and migration. Notably, cisplatin-induced VEC senescence promoted OSCC cell proliferation, migration, and invasion by activating complement C3. Increased gene and protein levels of C3 were observed in cisplatin-treated senescent VECs. Inhibition of C3 in vitro and in vivo reduced OSCC cell proliferation and invasion.

CONCLUSION

Senescent VECs induced by cisplatin promote OSCC proliferation and invasion through complement C3 activation. Targeting complement C3 in senescent VECs may offer a novel therapeutic strategy for OSCC treatment.

Incidence trends and projections of lip and oral cavity cancer in China 1990-2021: an age-period-cohort and decomposition analysis

OBJECTIVE

To investigate the historical trends, underlying causes, and future projections of lip and oral cavity cancer (LOCC) incidence in China.

METHODS

Annual cases and age-standardized incidence rates (ASIR) for LOCC in China from 1990 to 2021 were extracted from the Global Burden of Disease (GBD) 2021 study. Age-Period-Cohort (APC) models were employed to assess the effects of age, period, and cohort. Bayesian APC models were applied to project future incidence trends, and decomposition analysis was conducted to identify factors influencing incidence.

RESULT

From 1990 to 2021, the cases and ASIR of LOCC increased substantially in male and slightly in female. The ASIR and number of cases in male were higher than that in female during the study period. The APC model showed that the net drift of ASIR in males and females during the study period was 2.34% (95% confidence interval [CI]: 2.10% to 2.59%) and 0.26% (95% CI: 0.13 to 0.39), respectively. LOCC incidence increased the fastest among males and females aged 25-29 years. The incidence of LOCC in male and female increased with age, reaching its peak in the age group of 90-94 years (73.35/100,000 and 11.14/ 100,000, respectively). The period effect showed an increasing trend, while the birth cohort effect showed a decreasing trend. Predictions show that the incidence and cases of LOCC will continue to rise. Population growth, ageing and epidemiological factors in both male and female contributed to the rise of LOCC cases, except for a decrease in the period 1997-2013 due to changing epidemiological factors in female.

CONCLUSION

The increasing trend of LOCC in China is closely related to age, period and cohort. Future projections emphasize the need for targeted prevention focusing on high-risk groups and modifiable factors.

Microbiome Signatures and Dysbiotic Patterns in Oral Cancer and Precancerous Lesions

BACKGROUND

The oral microbiome has been shown to be associated with the development of oral squamous cell carcinoma (OSCC). Research has primarily focused on elucidating the oncogenic mechanisms of specific pathogens by comparing the microbiomes of OSCC and normal tissues. However, the characteristics of the microbiome in the precancerous state remain less understood, as does the influence of metabolic and environmental factors on OSCC-associated microbiomes.

METHODS

In this study, we analyzed mucosa-associated microbiomes in normal, precancerous, and OSCC lesions from a cohort of 51 patients using 16S rRNA amplicon sequencing. We investigated compositional changes in the microbiome, including the specific abundances and co-occurrences of OSCC-associated bacteria.

RESULTS

Our findings indicate that the microbiome associated with precancerous lesions is indistinguishable from that of the normal mucosa, whereas the OSCC microbiome significantly differs from both normal and precancerous conditions. Specifically, the OSCC microbiome harbors less Streptococcus, coupled with an increase in amino-acid-degrading anaerobes such as Fusobacterium and Prevotella. The metabolic properties of individual microbes reported suggest that the overrepresentation of OSCC-specific bacteria is a result of metabolic adaptation to tumor microenvironments, although this possibility needs to be experimentally confirmed.

CONCLUSIONS

Our results demonstrate oral microbiome patterns across OSCC progression, offering insights into microbial ecological perspectives.

From cell lines to animal models: "plant- derived chemotherapeutics unlocking new frontiers against oral squamous cell carcinoma"-a comprehensive systematic review

BACKGROUND AND AIM

Despite progress in traditional treatment methods, the overall survival rate for oral squamous cell carcinoma (OSCC) remains limited. Consequently, it is essential to investigate alternative therapeutic strategies to enhance patient outcomes. This review highlights the potential role of plant extracts as chemo preventive agents in oral cancer treatment.

METHODS

A systematic review was conducted following PRISMA guidelines, involving an extensive literature search from databases such as PubMed, Scopus, Embase, Web of science, Cochrane and CINAHL which included studies from 2010 to 2024 that explored the anticancer potential of medicinal plants for OSCC treatment. Data extraction focused on plant species, parts used, extract type, active components, dosage, and cancer cell lines or animal models used. Risk of bias was assessed using the OHAT tool for animal studies and the ROBINS-I tool for in vitro studies.

RESULTS

A total of 12 in vitro and animal studies were included, examining plants such as Allium sativum (garlic), Crocus sativus (saffron), Curcuma longa (turmeric), Scutellariabaicalensis (Baikal skullcap), etc., These studies demonstrated that bioactive components like allicin, curcumin, and baicalin significantly inhibited OSCC cell proliferation and induced apoptosis. However, there was substantial variability in the dose concentrations required, ranging from 1 µg/mL for garlic extract to 50 mg/mL for saffron nanoparticles. The risk of bias assessment indicated that four studies had a moderate risk, while one had a low risk of bias, indicating methodological rigor.

CONCLUSION

Plant extracts such as Curcuma longa and Vitis vinifera present a promising, less toxic alternative for OSCC treatment, with the potential to be integrated into conventional chemotherapeutic regimens. While in-vitro and animal studies are encouraging, further clinical trials among humans are necessary to confirm their efficacy and safety in clinical settings.

Sinomenine synergistically enhances 5-Fu anticancer effects in oral cancer through modulating the miR-140-5p-PDK1-anaerobic glycolysis pathway

Oral squamous cell carcinoma (OSCC) is a type of human malignancy with a high mortality rate worldwide. Sinomenine (SIN), an active component of sinomenium acutum, has shown potential antitumor activities in various types of cancers. This study discovered that the combination of 5-Fu and SIN treatments had synergistic inhibitory effects on OSCC cells (CI < 1). Moreover, miRNA-140-5p was significantly downregulated in OSCC tumors and cell lines. Treatment with sinomenine upregulated miR-140-5p and suppressed anaerobic glycolysis of OSCC cells. We established a 5-Fu resistant OSCC cell line (CAL33 5-Fu R), which showed elevated anaerobic glycolysis and downregulated miR-140-5p. Through western blot, luciferase assay, and rescue experiments, we identified the pyruvate dehydrogenase kinase 1 (PDK1), a key enzyme in anaerobic glycolysis, as a direct target of miR-140-5p, overexpression of which led to anaerobic glycolysis suppression and 5-Fu sensitization in OSCC cells. Furthermore, blocking the SIN-induced miR-140-5p successfully overcame the SIN-inhibited anaerobic glycolysis and 5-Fu resistance in OSCC cells. Meaningfully, results from in vivo mice xenograft experiments validated that sinomenine enhanced anti-cancer effects of 5-Fu treatment. Our findings reveal that the combination of sinomenine and 5-Fu synergistically enhances the cytotoxicity of OSCC cells by regulating the miR-140-5p-PDK1 axis.

Isoguanosine-Induced ER Stress via AMPK Enhances Chemosensitivity in OSCC

Oral squamous cell carcinoma (OSCC) is the most common malignancy of the head and neck; however, the efficacy of existing treatment is limited and new effective strategies need to be explored. Our previous work demonstrates that isoguanosine (isoG) is a promising nucleoside molecule with superior self-assembly capability and significant anti-OSCC potential. However, the antitumor mechanism of isoG remains unclear. In this study, we reveal that the antiproliferative effect of isoG is mediated by its cellular metabolite, isoguanosine 5'-monophosphate (isoGMP), which induces excessive endoplasmic reticulum (ER) stress and cell death through adenosine monophosphate-activated protein kinase (AMPK) activation. IsoG activates AMPK and induces ER stress at low concentrations, with minimal impact on cell viability at these concentrations. To further explore the therapeutic potential of isoG, we investigated its role in modulating chemosensitivity. Our findings show that AMPK activation enhances the sensitivity of OSCC cells to 5-fluorouracil (5-FU), and the combination of isoG and 5-FU exhibits a synergistic anticancer effect. Building on the self-assembly characteristics of isoG, we developed an innovative treatment platform by introducing dynamic borate ester bonds to form an isoguanosine-phenylenediboronic acid-isoguanosine (isoGPBisoG) structure. When combined with 5-FU, this platform achieved remarkable therapeutic efficacy in 2 OSCC cell-derived xenograft models, with tumor inhibition rates of 71.0% and 56.6%, respectively, compared with control. These findings establish isoG as a potent enhancer of chemotherapeutic efficacy in OSCC via AMPK activation. More importantly, the isoGPBisoG and 5-FU combination represents a significant paradigm of a synergistic therapy platform. This novel approach offers a promising direction for the development of more effective OSCC treatments.

Phytochemical analysis, antioxidant activity, and cytotoxic effects of Caulerpa lentillifera extracts inducing cell apoptosis and sub-G/G0-G1 cell cycle arrest in KON oral cancer cells

BACKGROUND

Marine algae have excellent phytoconstituents with notable biological activity and bioactive therapeutic benefits, but the anti-oral cancer activity of Caulerpa lentillifera (C. lentillifera) has not been widely studied. This study aimed to explore the anti-cancer properties of C. lentillifera to gain insights into possible treatment approaches.

METHODS

The three C. lentillifera extracts were prepared using the maceration method with methanol (CLM), ethanol (CLE), and acetone (CLA). The chemical composition of extracts of C. lentillifera was investigated. Its metabolite profiles were selectively further investigated using the LC-QTOF MS/MS technique and their antioxidative activity was evaluated. The cytotoxic effect on KON cells and MRC-5 cells was assessed using the MTT test. Morphological changes and apoptosis were examined through Hoechst 33,258 and AO double staining, while DAPI and FDA double labeling were used to observe the nucleus and cytoplasm. Using a flow cytometer, the percentage of cell cycle arrest was calculated and the fraction of cell death was examined.

RESULTS

The CLA exhibited higher quantities of TPC, TFC, chlorophyll a, and chlorophyll b compared to the CLM and CLE. The LC-QTOF MS/MS analysis revealed ten major phytochemicals in the CLA. The three C. lentillifera extracts exhibited antioxidative activity, with the CLE demonstrating significantly higher antioxidant activity compared to the CLM and CLA. In-vitro, the KON oral cancer cells exhibited sensitivity to CLA, CLE, and CLM in that order. The three extracts induced ROS-mediated cell death as well as disruption of mitochondrial membrane potential, with concentrations at IC40, IC60, and IC80 leading to apoptosis within 24 h. Furthermore, the cell cycle of KON cells was blocked in sub-G and G0-G1 by all three extracts. Notably, the extracts significantly impeded colony growth, migration, and invasion. The increase in cellular uptake was measured using the TEER test.

CONCLUSION

The findings showed that C. lentillifera has several functional metabolites, antioxidative activity, and strong anti-tumor properties. According to these results, C. lentillifera extracts may be utilized to treat oral cancer.

A Truncated Mutation of TP53 Promotes Chemoresistance in Tongue Squamous Cell Carcinoma

Tongue squamous cell carcinoma (TSCC), a subtype of head and neck squamous cell carcinoma, is characterized by frequent chemoresistance. Genetic mutations commonly observed in TSCC play a critical role in malignant progression; thus, elucidating their functional significance is essential for developing effective treatment strategies. To more accurately investigate the relationship between mutations and chemoresistance, we established low-passage TSCC cells, CTSC-1, obtained from a chemoresistant patient, and CTSC-2, from a treatment-naïve patient. Sanger sequencing revealed a specific TP53 mutation (Q331*) in CTSC-1, leading to the loss of the tetramerization and C-terminal regulatory domains. Notably, CTSC-1 cells harboring TP53-Q331* and CTSC-2 cells with TP53 knockout that have been engineered to ectopically express TP53-Q331* exhibit enhanced chemoresistance and increased cancer stem cell-like properties. Mechanistically, TP53-Q331* upregulates the expression of inhibitor of DNA binding 2 (ID2), which is crucial for maintaining the stemness of TSCC cells. Subsequently, ID2 activates the expression of nucleotide excision repair (NER) pathway-related genes ERCC4 and ERCC8, thereby enhancing the chemoresistance in TSCC. In conclusion, our study demonstrates that the TP53-Q331* mutation enhances TSCC chemoresistance through an ID2-mediated NER pathway, providing a potential prognostic marker and therapeutic target for TSCC chemotherapy resistance.

The role of molecular biomarkers in the diagnosis, prognosis, and treatment stratification of oral squamous cell carcinoma: A comprehensive review

One of the most common cancers targeting the area of the head and neck is oral squamous cell carcinoma (OSCC), carrying a heavy global health cost. With a high incidence of metastasis and recurrence, the outlook for OSCC remains dismal despite advancements in treatment. This has sparked an investigation into molecular biomarkers, which have the potential to improve early diagnosis, forecast patient outcomes, and direct therapeutic approaches. An extensive summary of the function of molecular biomarkers in OSCC diagnosis, prognosis, and medical care stratification is given in this article. Complex genetic mutations, epigenetic changes, and dysregulated signalling pathways are all part of the aetiology of OSCC. Tumor protein p53 (Tp53), Epidermal growth factor receptor (EGFR-targeted), Cyclin D1 (CCND1), and Human papilloma virus (HPV) status are examples of molecular biomarkers that have demonstrated potential in recognising disease at an early stage and identifying malignant changes. The non-invasive detection capabilities of diagnostic biomarkers such as salivary proteins, circulating tumour DNA (ctDNA), and microRNAs are being explored more and more because they may provide early intervention and better patient outcomes. Prognostically, tumour aggressiveness, recurrence risk, and overall survival have all been linked to biomarkers such as matrix metalloproteinases (MMPs), E-cadherin, and different cytokines. Furthermore, immune checkpoints such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death-ligand 1 (PD-L1) are becoming recognised as important markers of the tumour microenvironment's function in the course of the disease and its reaction to immunotherapy. The significance of biomarkers in personalised medicine has been further highlighted by the recognition of subgroups with elevated risk that might gain benefit from more aggressive treatment options thanks to the genetic profiling of OSCC. Predictive biomarkers are essential for therapy classification because they allow therapeutic regimens to be tailored. For example, (Kirsten rat sarcoma viral oncogene homologous) KRAS mutations and EGFR expression influence the effectiveness of targeted therapies, and the existence of specific epigenetic markers influences choices about radiation or chemotherapy. It is expected that the incorporation of multi-omics techniques, which integrate transcriptome, proteome, and genomic data, will improve these tactics and increase accuracy in OSCC treatment. Molecular indicators have the potential to significantly improve the medical treatment of ovarian cancer. Better patient outcomes will eventually result from earlier identification, more precise prognostication, and individualised therapy regimens made possible by advancements in biomarker research. For these biomarkers to be widely used, further research must be done on verifying them and incorporating them into standard clinical practice.

Distant metastasis of oral squamous cell carcinoma: immune escape mechanism and new perspectives on treatment

Oral squamous cell carcinoma (OSCC) is frequently observed as the predominant malignancy affecting the oral cavity, with distant metastasis greatly affecting the treatment and long-term outlook for individuals with OSCC. Immune checkpoint inhibitors are a highly promising cancer treatment strategy currently available, but they are only successful for a small fraction of individuals with OSCC. Due to the insufficient understanding of the immune escape mechanisms in OSCC, coupled with disappointing treatment outcomes for patients with highly heterogeneous metastatic diseases, there is an urgent need for further exploration of immune target therapy strategies. This review discusses the mechanisms by which OSCC cells evade immune surveillance and attack, focusing on four aspects: metastasis-initiating cells, increased immune suppression, immune escape of dormant cells, and immune stromal crosstalk during metastasis. Additionally, we explore new areas in immune therapy for OSCC. In summary, our investigation offers fresh perspectives on the relationship between the tumor microenvironment and immune molecules, highlighting the importance of overcoming immune evasion for the development of novel therapies to manage OSCC metastasis and enhance patient outcomes.

Nanotherapies Based on ROS Regulation in Oral Diseases

Oral diseases rank among the most prevalent clinical conditions globally, typically involving detrimental factors such as infection, inflammation, and injury in their occurrence, development, and outcomes. The concentration of reactive oxygen species (ROS) within cells has been demonstrated as a pivotal player in modulating these intricate pathological processes, exerting significant roles in restoring oral functionality and maintaining tissue structural integrity. Due to their enzyme-like catalytic properties, unique composition, and intelligent design, ROS-based nanomaterials have garnered considerable attention in oral nanomedicine. Such nanomaterials have the capacity to influence the spatiotemporal dynamics of ROS within biological systems, guiding the evolution of intra-ROS to facilitate therapeutic interventions. This paper reviews the latest advancements in the design, functional customization, and oral medical applications of ROS-based nanomaterials. Through the analysis of the components and designs of various novel nanozymes and ROS-based nanoplatforms responsive to different stimuli dimensions, it elaborates on their impacts on the dynamic behavior of intra-ROS and their potential regulatory mechanisms within the body. Furthermore, it discusses the prospects and strategies of nanotherapies based on ROS scavenging and generation in oral diseases, offering alternative insights for the design and development of nanomaterials for treating ROS-related conditions.

Strategy of "Controllable Ions Interference" for Boosting MRI-Guided Ferroptosis Therapy of Tumors

Chemotherapy for oral squamous cell carcinoma (OSCC) is often marred by the development of multidrug resistance and systemic adverse effects. Metal ion interference therapy (MIIT) has risen as an innovative strategy to disrupt the intracellular metal ion equilibrium in tumor cells, potentially overcoming drug resistance. However, the effectiveness of cancer treatment that relies on delivering single metal ions to tumor site is often constrained. To address this, we have developed a therapeutic nanoplatform employing hollow mesoporous manganese dioxide nanoparticles (HMON) which harness the chelating properties of tannic acid to control the loading and release of Zn2+ and Pt2+, i.e., Zn@CDDP@HMON. In acidic tumor microenvironment, Zn2+ and Pt2+ ions strategically released from nanoplatform can inhibit mitochondrial respiration and activate NADPH oxidases (NOXs), respectively, increasing superoxide anion (O2•-) and hydrogen peroxide production (H2O2). The released Mn4+ consumes intracellular glutathione (GSH) to generate Mn2+, which reacts with H2O2 in a Fenton-like reaction, producing hydroxyl radicals (•OH) and inducing lipid peroxidation (LPO). The depletion of GSH also inhibits GPX4 activity, sensitizing tumor cells to ferroptosis. Furthermore, the reduced Mn2+ facilitates T1-MRI imaging, allowing for real-time monitoring of nanoplatform distribution and accumulation in tumors.

Light-activated photosensitizer/quercetin co-loaded extracellular vesicles for precise oral squamous cell carcinoma therapy

Oral squamous cell carcinoma (OSCC) is the most common subtype of head and neck malignancies, characterized by a five-year survival rate that remains persistently below 50%, indicative of limited progress in therapeutic interventions. There is an urgent imperative to develop innovative therapeutic strategies, warranting the investigation of advanced treatment modalities. Nanocarriers offer a promising avenue by significantly enhancing drug properties and pharmacokinetics. Extracellular vesicles (EVs) are naturally occurring nanocarriers produced by cells and have become a focal point in drug delivery research. Quercetin, one of the most abundant dietary flavonoids, exhibits potent anticancer effects. However, its pharmaceutical application is hampered by poor water solubility, instability under physiological conditions, and low bioavailability. To overcome these obstacles, we propose using bio-derived EVs as carriers to co-encapsulate quercetin with the photosensitizer chlorin e6. This strategy leverages the intrinsic targeting capabilities of EVs for precise drug delivery to tumors, along with light-activated drug release, enabling rapid quercetin release under near-infrared light, effectively inhibiting cellular proliferation and inducing apoptosis in tumor cells. In vivo studies demonstrated that drug-loaded EVs exhibited robust tumor-targeting efficacy, resulting in effective and selective tumor ablation upon photoactivation in mice bearing subcutaneous MOC2 tumors.

Recent advances in CRISPR technology in the milieu of oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is a widely recognized cancer that constitutes over 90 % of all oral cancer cases [1]. Thanks to advancements in cancer treatment, such as radiation, chemotherapy, and molecular target therapy, the 5-year relative survival rate for OSCC has more than doubled in the past 26 years. However, the exact cause and molecular process of OSCC have not been fully understood, and further investigation is necessary. CRISPR/Cas technology is seen as a groundbreaking tool in molecular biology, providing unparalleled accuracy in altering genes. Its use in conditions like OSCC shows excellent potential for advancing research and treatment development. OSCC, characterized by the growth of cancer cells in the lining of the mouth, presents challenges in its treatment and control. Traditional therapies like surgery, radiation, and chemotherapy often show limited success and may lead to severe side effects. The promise of CRISPR/Cas technology in tackling critical aspects of OSCC is apparent. In this correspondence, we discuss the recent advances in CRISPR technology in the OSCC milieu.

Unique clinical features and prognostic risk factors of oral squamous cell carcinoma in patients under 30 years old

BACKGROUND

Individuals under 30 years old with oral squamous cell carcinoma (OSCC) are a relatively rare subgroup but require attention. However, literature on the clinicopathological characteristics of OSCC patients under 30 is currently lacking.

METHODS

A total of 66 OSCC patients under 30 were included in this study. We collected data on demographic characteristics, chief complaint, risk factors, pathological features, imaging, blood test, staging, neoadjuvant therapy, surgical treatment plans, and survival status. Survival curves for overall survival (OS) and disease-free survival (DFS) were generated to explore prognostic factors in patients under 30.

RESULTS

Among the 66 patients, tongue cancer was predominant, accounting for 60/66 (90.9%). Female patients had no history of smoking, alcohol consumption, or betel nut chewing, whereas all male patients with a history of betel nut chewing were smokers. Patients who sought medical attention shortly after the onset of symptoms tended to demonstrate greater disease severity. The 5-year OS for these patients was 88.9%, and the 5-year DFS was 77.2%. Smoking, drinking, betel nut chewing, staging, LNM, and tumor histological differentiation were not associated with OS and DFS, whereas high neutrophil count and high monocyte count were associated with better survival outcomes.

CONCLUSION

Our study dataset shows that OSCC patients under 30 are a subgroup with a high prevalence of tongue cancer, distinct etiological factors in females, and increasing proportions of betel nut chewing and moderately/poorly differentiated tumors. This subgroup generally has a favorable prognosis, but the prognostic factors differ from those in the general OSCC population.

Systematic analyses uncover robust salivary microbial signatures and host-microbiome perturbations in oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is a prevalent malignancy in the oral-maxillofacial region with a poor prognosis. Oral microbiomes play a potential role in the pathogenesis of this disease. However, findings from individual studies have been inconsistent, and a comprehensive understanding of OSCC-associated microbiome dysbiosis remains elusive. Here, we conducted a large-scale meta-analysis by integrating 11 publicly available data sets comprising salivary microbiome profiles of OSCC patients and healthy controls. After correcting for batch effects, we observed significantly elevated alpha diversity and distinct beta-diversity patterns in the OSCC salivary microbiome compared to healthy controls. Leveraging random effects models, we identified robust microbial signatures associated with OSCC across data sets, including enrichment of taxa such as Streptococcus, Lactobacillus, Prevotella, Bulleidia moorei, and Haemophilus in OSCC samples. The machine learning models constructed from these microbial markers accurately predicted OSCC status, highlighting their potential as non-invasive diagnostic biomarkers. Intriguingly, our analyses revealed that the age- and gender-associated signatures in normal saliva microbiome were disrupted in the OSCC, suggesting perturbations in the intricate host-microbe interactions. Collectively, our findings uncovered complex alterations in the oral microbiome in OSCC, providing novel insights into disease etiology and paving the way for microbiome-based diagnostic and therapeutic strategies. Given that the salivary microbiome can reflect the overall health status of the host and that saliva sampling is a safe, non-invasive approach, it may be worthwhile to conduct broader screening of the salivary microbiome in high-risk OSCC populations as implications for early detection.

IMPORTANCE

The oral cavity hosts a diverse microbial community that plays a crucial role in systemic and oral health. Accumulated research has investigated significant differences in the saliva microbiota associated with oral cancer, suggesting that microbiome dysbiosis may contribute to the pathogenesis of oral squamous cell carcinoma (OSCC). However, the specific microbial alterations linked to OSCC remain controversial. This meta-analysis reveals robust salivary microbiome alterations. Machine learning models using differential operational taxonomic units accurately predicted OSCC status, highlighting the potential of the salivary microbiome as a non-invasive diagnostic biomarker. Interestingly, age- and gender-associated signatures in the normal salivary microbiome were disrupted in OSCC, suggesting perturbations in host-microbe interactions.

Viral Involvement in Oral Potentially Malignant Disorders: A Scoping Review

Purpose

The purpose of this scoping review was to investigate which viruses other than HPV and EBV-associated with OPMDs and investigate whether viruses are linked solely to the etiology of OPMDs, their malignant transformation (MT), or both.

Methods

A scoping review following PRISMA-ScR methodological framework was used during the process. We conducted thorough searches in the EBSCOhost and PubMed databases. The inclusion criteria were publications that described viruses in OPMDs and identified pertinent research published between 2014 and 2023. The articles included underwent a thorough analysis and synthesis process to map out viruses in OPMDs. Pertinent characteristics such as research domains, publication dates, authors, type of research studies, sample sizes, gender ratios, types of OPMDs lesions, detected viruses, and methodological detection approaches were incorporated into the analysis.

Results

A total of twenty-eight articles were eligible for inclusion. The prevalence of viruses detected in OPMDs was found to be 78.57%. Viruses detected in this study, including HPV (0% to 86.6%), EBV (8% to 95.7%), hepatitis B virus (HBV) (6.71%) and herpes simplex virus (HSV) (1%). The biggest risk factor for OPMDs found in this study was tobacco use.

Conclusion

Given that 90% of oral cancers worldwide are attributable to OSCC, it is crucial to understand the role of viruses such as HPV, EBV, HBV, and HSV, along with unhealthy risk factors like tobacco and alcohol, which may contribute to the etiology and progression of lesions into OPMDs. Global data indicate that these viruses play varying roles in the etiology of OPMDs, with significant geographic variability, co-infections, and interactions with lifestyle factors influencing their oncogenic potential. Although this study found that virus positivity rates were higher in the malignant stage (OSCC) than in OPMDs and that there is a high prevalence of viruses in OPMDs, further research is needed to clarify the direct causality of virus-induced malignant transformation in OPMDs.

HNF1A-AS1 promotes oral squamous cell carcinoma progression via regulating miR-138/CDK6 pathway

The action and the latent mechanism of HNF1A-AS1 in oral squamous cell carcinoma (OSCC) development were probed. Levels of HNF1A-AS1, microRNA-138 (miR-138) and Cyclin-dependent kinase 6 (CDK6) were examined. In vitro assays were conducted using SCC-4 and SCC15 cells derived from a human SCC of the tongue of a 55-year-old male. In vivo assay was performed by establishing OSCC mouse models. An elevated HNF1A-AS1 was detected in OSCC, and down-expressed HNF1A-AS1 inhibited migration and invasion, and promoted apoptosis in OSCC cells in vitro. HNF1A-AS1 targeted miR-138 to positively regulate the expression of CDK6, a target of miR-138. Knockdown of miR-138 attenuated the action of HNF1A-AS1 silencing on OSCC cell malignant phenotypes. Besides that, overexpression of CDK6 weakened miR-138-mediated anti-cancer functions. Moreover, HNF1A-AS1 knockdown restrained OSCC growth in nude mice. HNF1A-AS1 promoted OSCC tumorigenesis via miR-138/CDK6 pathway, indicating the potential molecular contribution of HNF1A-AS1 on OSCC pathogenesis.

Oral Cancer Knowledge and Screening Practices Among Dental Professionals in Yemen: a Web-Based Survey

BACKGROUND

Good knowledge and screening practices of dental professionals for oral cancer (OC) will inevitably improve its prognosis. The present study sought to evaluate OC knowledge and practices among dental professionals in Yemen.

METHODS

This study was conducted among Yemeni dentists. The used tool was a prevalidated online questionnaire composed of items on the knowledge, practices, and barriers of OC screening and early detection. The data were managed and analysed using SPSS Version 28.0.

RESULTS

A total of 506 dental professionals completed the questionnaire. The participants showed moderate levels of knowledge on risk factors and clinical signs of OC. While the majority reported tobacco (89.9%) as a potential risk factor, only 76.7% and 57.5% of the subjects reported a potential role for alcohol consumption and old age. Regarding clinical signs, the majority reported that OC can present as nonhealing ulcer (90.3%) or white/red patch (87.2%), yet only 73.7% reported that it can present as swelling/lump, and around 32% reported that teeth attrition is one of its clinical signs. Concerning practices, most of the participants reported asking their patients about their tobacco habits (84%), routinely examine patients' oral mucosa (81.4%), and refer suspicious lesions to specialists (91.3%). Only 44.9% reported feeling confident regarding their knowledge and training on OC. Specialists and those who attended educational courses on OC were more knowledgeable, more confident, and showed better practices than their counterparts. Inadequate knowledge/training, lack of time, and lack of financial compensation were the most reported barriers to OC screening and early detection.

CONCLUSION

The present study indicates marked gaps in the knowledge and screening practices of OC among Yemeni dentists. Therefore, conducting periodic continuing courses along with interventional trainings are urgently recommended to address these gaps.

Expression of CSTF2 in oral squamous cell carcinoma and its relationship with immune infiltration and poor prognosis

Background

Oral squamous cell carcinoma (OSCC) is a prevalent and devastating malignancy of the oral cavity that profoundly affects patient survival and quality of life (QOL). Cleavage Stimulation Factor Subunit 2 (CSTF2) is known to influence tumor development across multiple cancer types. However, its specific association with patient prognosis and immune cell infiltration in OSCC remains insufficiently understood.

Methods

To assess the expression levels and prognostic implications of CSTF2 in OSCC, comprehensive data were acquired from The Cancer Genome Atlas (TCGA) and subsequently normalized. Immunohistochemical staining of tissue microarrays was performed to analyze CSTF2 expression in the OSCC samples. Differences in CSTF2 expression between OSCC and adjacent non-cancerous samples were evaluated using the Wilcoxon rank-sum test. Functional enrichment analyses have been performed to identify biological pathways and functions associated with CSTF2. The relationship between the infiltration of various immune cells and CSTF2 expression levels was assessed using single-sample gene set enrichment analysis (ssGSEA). Ultimately, the prognostic significance of CSTF2 was evaluated through Kaplan-Meier survival analysis, in conjunction with univariate and multivariate Cox regression analyses, as well as receiver operating characteristic (ROC) curves.

Results

High CSTF2 expression was observed in OSCC and associated with unfavorable clinicopathological variables, including histological grade and lymphnode neck dissection. Functional enrichment analysis indicated that CSTF2 plays a role in epidermal development and differentiation, immunoglobulin complexes, peptidases and endopeptidase inhibitor activity, and cytochrome P450 metabolic processes. Additionally, the overexpression of CSTF2 exhibited a negative correlation with the infiltration of immature dendritic cells (iDCs), cytotoxic cells, and plasmacytoid dendritic cells (pDCs). Notably, elevated CSTF2 expression is significantly associated with reduced patient outcomes.

Conclusion

Elevated CSTF2 expression in OSCC is associated with poor prognostic outcomes, highlighting its capacity to function as an innovative prognostic biomarker and a target for therapeutic interventions.

Hypovitaminosis D in patients with oral leukoplakia: insights from a cross-sectional study

Introduction

Oral leukoplakia is one of the most frequent oral potentially malignant disorders. The present study aims to compare serum vitamin D levels between patients with and without oral leukoplakia, by smoking habit.

Methods

This cross-sectional study involved a group of 45 cases with oral leukoplakia and a control group with 45 individuals. In both groups a pathology report was done, and for leukoplakia a binary classification of low- and high-grade epithelial dysplasia was employed. Serum 25(OH)D3 vitamin D levels, and data on smoking status, age, gender, comorbidities, and clinical and pathological characteristics were collected for both groups.

Results

vitamin D levels were lower in the oral leukoplakia group with a median of 19.1 ng/ml, while the control group had a median of 24.8 ng/ml. When subdividing each group by smoking habit, the smoking case group had a median of 19.4 ng/ml (IQR: 15.7-21.5 ng/ml), the non-smoking case group had 18.8 ng/ml (IQR: 13.6-29.2 ng/ml), the smoking control group had 21.8 ng/ml (IQR: 17.5-27.3 ng/ml), and the non-smoking control group had 25.4 ng/ml (IQR: 20.4-32.9 ng/ml) (p<0.05). When comparing serum vitamin D levels, statistically significant differences were found between the smoking case group versus the non-smoking control group and between the non-smoking case group versus the non-smoking control group (p<0.05). Serum vitamin D levels by histopathological diagnosis showed no differences between leukoplakia groups.

Discussion

This study shows that serum vitamin D levels were lower in patients with OL compared to those without OL, which was more evident in the smoking group. Patients with OL were previously observed to have hypovitaminosis D, without assessing smoking habits. This finding suggests a possible role of vitamin D deficiency in the development of OL, which could be more marked in smokers. This opens the possibility of future research on vitamin D as a chemopreventive agent in the malignant transformation of OL, and to evaluate the relationship between smoking and hypovitaminosis D.

Assessing the 53-Year Epidemiological Trends of Oral Squamous Cell Carcinoma (OSCC) in Northeastern Iran

OBJECTIVES

This study aimed to assess the epidemiological trends of oral squamous cell carcinoma (OSCC) in Northeast Iran over a 53-year period.

MATERIAL AND METHODS

In this retrospective study, we obtained data on OSCC cases in Northeast Iran spanning 53 years (1970-2022), including demographic details, such as age, sex, site, and histopathological grade. Descriptive analysis was conducted, and frequencies were compared using the chi-squared test to evaluate differences between sexes, age groups, cancer sites, and histopathological grades. Additionally, we assessed the associations of each OSCC site with age, sex, and histopathological grade. Statistical significance was set at p < 0.05, with a confidence interval of 95%.

RESULTS

This study examined 13,769 cases, among which 507 were diagnosed with OSCC, accounting for 3.68% of the total cases. The mean age was 59.27 ± 14.94 years, with a significantly higher prevalence of OSCC among individuals older than 50 years (p < 0.001). There were nearly equal proportions of males and females, with the tongue being the most common site (28.4%), followed by the gingiva (26.4%) and buccal mucosa (19.5%). Grade 1 (well differentiated) OSCC was significantly more prevalent (54%) than other grades. There was a significant association between sex and tongue SCC in females (p = 0.006) and between sex and lip SCC in males (p = 0.008). Prevalence in individuals above 50 was significant for the tongue, buccal mucosa, gingiva, and lip (p = 0.001, < 0.001, < 0.001, 0.028, respectively). In the tongue, buccal mucosa, gingiva, and floor of the mouth, grade 1 was significantly more prevalent (p < 0.001).

CONCLUSIONS

Our study revealed that OSCC predominantly affects individuals older than 50 years, with nearly equal prevalence between sexes. The most commonly affected sites are the tongue and gingiva, often exhibiting grade 1 histopathological findings. Enhanced community awareness of risk factors and regular oral examinations are essential for reducing the incidence of OSCC.

m6A-related genes ALKBH5 and RBMX as prognostic and progression biomarkers in Chinese oral squamous cell carcinoma patients

OBJECTIVE

N6-methyladenosine (m6A) RNA dysregulation is crucial for cancer development. The study aimed to explore the effects of m6A modification in oral squamous cell carcinoma (OSCC) and its potential as a biomarker and therapeutic target.

DESIGN

We first analyzed m6A-related gene expression and its impact on OSCC prognosis and progression using the TCGA database. Subsequently, a Chinese cohort of 134 samples was used for validation. Bioinformatics analysis was conducted with TCGA data, and m6A levels were measured in the validation cohort using a quantification kit. Survival analysis was performed to study the relationship between m6A-related genes and OSCC prognosis in the Chinese population. The expression of m6A-related genes was assessed by using quantitative real-time PCR, Western blot analysis, and immunohistochemistry.

RESULTS

In the TCGA database, we found dysregulated expressions of METTL14, ALKBH5, YTHDF2, HNRNPC, LRPPRC, HNRNPA2B1, IGF2BP2, and RBMX in OSCC. Based on this, we observed significantly elevated total m6A content in OSCC tissues compared to normal controls in the validation cohort. Among the m6A candidate genes, only ALKBH5 and RBMX upregulation were found to be independent prognostic risk factors for poor OSCC survival in the Chinese population. And the inclusion of these two genes had a higher area under the curve for 3-year (0.705, 0.826), and 5-year (0.715, 0.788) overall survival compared to the model that only considered clinical parameters.

CONCLUSIONS

We found the upregulation of m6A status in OSCC, of which, ALKBH5 and RBMX may serve as promising diagnostic and prognostic biomarkers for Chinese patients with OSCC.

Dichloroacetate and chloroquine in combination with arsenite suppress ROS-induced oral squamous cell carcinoma (OSCC) development and improve BALB/c mice survival

Oral squamous cell carcinoma (OSCC) is a disabling tumor with poor response to chemotherapy. Here, we sought to explore a new chemotherapeutic approach based on a combined induction of cytotoxic ROS and targeting of autophagy and aerobic glycolysis as central contributors to OSCC carcinogenesis and chemoresistance. To this end, tongue OSCC was generated in BALB/c mice using 4NQO. Treatment of mouse-derived OSSC explants with NaAsO2 resulted in a strong inhibition of MTT activity and Bcl-2 and Ki-67 expression. The addition of chloroquine (CQ) and dichloroacetate (DCA) to arsenite, resulted in additive inhibitory effects on Bcl-2 and Ki-67 expression. Whereas NaAsO2 alone inhibited aerobic glycolysis (LDHA), it also alleviated autophagy (LC3B) and ROS levels (MDA). DCA improved NaAsO2-dependent inhibition of aerobic glycolysis. CQ addition to arsenite, suppressed autophagy without affecting the Warburg effect. NaAsO2 combination with CQ and DCA improved the oxidative status balance by boosting anti-oxidative CAT and SOD and controlling pro-oxidant MDA activity. The administration of the combo to 4NQO-mice resulted in a significant survival advantage over the control group (90 % vs. 35 % survival at week 32, p < 0.02; HR (log-rank) = 0.166, CI 95 % 0.03-0.73). This effect was accompanied by a significant increase in mice's mean body weight (p < 0.009). Contrarily to the control, administration of the combo resulted in the absence of progression towards severe dysplasia and OSCC and an overrepresentation of low/mild dysplasia events (100 %). Interestingly, signs of hepatocellular and renal toxicity following combo administration were limited in comparison to control. Taken together, these results suggest that NaAsO2 combined with CQ and DCA may constitute an interesting alternative to eliminating chemo-resistant OSSC tumors by inhibiting aerobic glycolysis and autophagy and controlling ROS generation. In vivo, the drugs may provide a survival advantage by inhibiting tumor development.

Neutrophil-to-Lymphocyte Ratio and Pembrolizumab Outcomes in Oral Cavity Squamous Cell Carcinoma

OBJECTIVE

To determine the relationship between pretreatment neutrophil-to-lymphocyte ratio (NLR) and 6-month progression-free survival (PFS)/2-year overall survival (OS) among patients with recurrent or metastatic (R/M) oral cavity cancer on pembrolizumab.

STUDY DESIGN

This study was a retrospective, observational study performed at a tertiary care academic center.

SETTING

Participants included patients with oral cavity squamous cell carcinoma (OCSCC) who began pembrolizumab treatment at the University of California, San Francisco between May 2016 and May 2022.

METHODS

The primary outcome was a 6-month PFS. The secondary outcome was a 2-year OS. NLR was treated as a continuous variable. Disease progression was determined using radiographic criteria, adopted from the Response Evaluation Criteria in Solid Tumors.

RESULTS

Fifty-two patients with OCSCC were included. Immune checkpoint inhibitor (ICI) indication was recurrence/metastasis for all patients. The median pretreatment NLR was 5.7 (interquartile range: 3.6-7.6). Twenty-seven (55%) patients received pembrolizumab alone. Of those receiving treatment for R/M prior to ICI, 9 (18%) received salvage surgery and adjuvant therapy, 2 (4%) received chemotherapy alone, 1 (2%) received chemoradiation, and 10 (20%) received salvage surgery. Nineteen (36.5%) patients had distant metastases at the start of ICI. Six-month PFS was 46%. Two-year OS was 44%. NLR was independently associated with 6-month PFS [hazard ratio, HR: 1.05 (95% confidence interval, CI: 1.01-1.11), P = .028] and 2-year OS [HR: 1.12 (95% CI: 1.05-1.20), P < .001].

CONCLUSION

Higher pretreatment NLR was associated with poorer 6-month PFS and 2-year OS in OCSCC patients treated with pembrolizumab.

Evaluating H2BC9 as a potential diagnostic and prognostic biomarker in head and neck squamous cell carcinoma

BACKGROUND

Histone H2B is highly expressed in many types of cancers and is involved in cancer development. H2B clustered histone 9 (H2BC9), a member of the H2B family, plays critical roles in gene expression regulation, chromosome structure, DNA repair stability, and cell cycle regulation. However, the diagnostic and prognostic value of H2BC9 in head and neck squamous cell carcinoma (HNSCC) remains unclear. This study aimed to evaluate the potential diagnostic and prognostic value of H2BC9 in HNSCC and investigate its biological role using bioinformatics.

METHODS

The expression pattern and diagnostic value of H2BC9 in HNSCC were explored using UCSC Xena and GEO database. H2BC9 expression was validated using the Human Protein Atlas database, qRT-PCR, and western blotting. Prognostic value was assessed using Kaplan-Meier curves, Cox regression analysis, and a nomogram. Drug sensitivity was predicted using the R package pRRophetic, and molecular interactions were analyzed using the DepMap database. The impact of H2BC9 on HNSCC cells was further investigated through in vitro experiments.

RESULTS

H2BC9 was markedly upregulated in HNSCC cell lines and tissues. High expression of H2BC9 was correlated with advanced-stage disease and poor prognosis. KEGG analysis linked H2BC9 to cell cycle regulation and DNA replication. H2BC9 expression influenced the drug sensitivity of paclitaxel, docetaxel, cisplatin, and 5-fluorouracil. Key molecules, such as TONSL, PITX2, NOTCH1, and H2BC10, were positively correlated with H2BC9 expression. Silencing H2BC9 suppressed cell proliferation, induced G2/M cell cycle arrest, and enhanced apoptosis and DNA damage in HNSCC cells.

CONCLUSION

We demonstrated that H2BC9 expression may be associated with HNSCC development and prognosis. These findings may provide a potential therapeutic target for HNSCC.

Apoptosis antagonizing transcription factor expression and its validation as a potential diagnostic and prognostic biomarker in oral squamous cell carcinoma

Background

Oral squamous cell carcinoma (OSCC) is characterized by a high degree of malignancy and poor prognosis. This study aimed to investigate the expression of apoptosis antagonizing transcription factor (AATF) in OSCC, examine its correlation with clinicopathological features, assess its prognostic implications, and explore its potential role in OSCC progression.

Methods

Expression profiles and clinical data of OSCC patients were obtained from The Cancer Genome Atlas (TCGA). Immunohistochemical analysis on tissue microarrays was performed to assess AATF expression in OSCC. Functional enrichment analyses were conducted to identify potential signaling pathways and biological functions associated with AATF. Logistic regression analyses were employed to evaluate the relationship between AATF expression and clinicopathological features. Immune cell infiltration was assessed using single-sample gene set enrichment analysis (ssGSEA). The prognostic value of AATF was determined using Kaplan-Meier and Cox regression analyses. A nomogram was developed to predict overall survival (OS) rates at one, three-, and five years post-cancer diagnosis. Validation of AATF expression was performed using quantitative real-time PCR (qRT-PCR).

Results

AATF was significantly overexpressed in OSCC, and high AATF expression correlated with adverse clinicopathological features, including histologic grade and lymph node metastasis. Functional enrichment analysis revealed several enriched pathways, including epidermis development, immunoglobulin complex, antigen binding and IL-17 signaling pathway. Notably, AATF overexpression was negatively correlated with the infiltration levels of mast cells, interdigitating dendritic cells and Th 17 cells. High AATF expression significantly predicted poorer overall survival (OS) and disease-specific survival (DSS). Multivariate Cox analysis confirmed AATF as an independent negative prognostic marker of OS. Validation via qRT-PCR confirmed the overexpression of AATF in OSCC tissues.

Conclusion

Elevated expression of AATF in OSCC correlates with adverse clinicopathological features and negatively impacts immune cell infiltration. High AATF levels serve as an independent marker of poor OS and DSS. These findings support AATF as a valuable prognostic biomarker and a potential therapeutic target in OSCC, warranting further investigation.

Application of MMP-2-responsive in situ forming injectable hydrogel in preventing the recurrence of oral squamous cell carcinoma

Oral squamous cell carcinoma is one of the most common types of cancer. Surgical resection is one of the most important treatments at present. However, patients often suffer from regional recurrence after surgery. Therefore, new strategies for combination therapy need to be investigated. This work identified a smart injectable hydrogel system co-delivering DOX and sunitinib nanoparticles. The nano drugs are continuously released from the hydrogels and effectively taken up by cells. The nano drugs in the hydrogel can inhibit tumor cell viability and induce cancer cell apoptosis in vitro. The drug-loaded hydrogel could control the recurrence of subcutaneous xenograft tumors, prolong the survival time, and have no obvious toxicity in nude mice. These findings suggest that this smart injectable hydrogel system may provide new ideas for the comprehensive treatment of oral squamous cell carcinoma.

Identification of novel genetic variants associated with oral squamous cell carcinoma (OSCC) in South-West coast of India using targeted exome sequencing

Oral squamous cell carcinoma (OSCC) is a subset of head and neck squamous cell carcinoma (HNSCC). This study explores the genetic landscape of oral squamous cell carcinoma (OSCC) in a cohort of 33 patients from Southern India using targeted exome sequencing. Our analysis revealed a diverse range of mutations across the cohort, with missense mutations being the most prevalent. Pathogenic mutations, as classified by ClinVar, exhibited significant individual variation, highlighting the heterogeneity of OSCC. Seventy-five genes were identified to harbor pathogenic or potentially pathogenic mutations, with notable recurrence in genes such as TP53, PDGFRA, and RAD50 among others. Comparison with high-frequency mutation genes in HNSCC from TCGA database revealed significant overlap, emphasizing the relevance of these mutations across different populations. Additionally, several novel mutations were identified, including those in CHD8, ITPKB, and HNF1A, shedding light on potential genetic risk factors specific to this population. Functional annotation and pathway analysis underscored the involvement of these mutated genes in various cancer-related pathways. Despite limitations such as sample size and the need for further validation, this study contributes to a deeper understanding of OSCC pathogenesis and highlights potential genetic markers for prognosis and targeted interventions, especially in the Indian context.

Synthetic Vesicle-Based Drug Delivery Systems for Oral Disease Therapy: Current Applications and Future Directions

Oral diseases such as dental caries, periodontitis, and oral cancer are prevalent and present significant challenges to global public health. Although these diseases are typically treated through procedures like dental preparation and resin filling, scaling and root planning, or surgical excision, these interventions are often not entirely effective, and postoperative drug therapy is usually required. Traditional drug treatments, however, are limited by factors such as poor drug penetration, significant side effects, and the development of drug resistance. As a result, there is a growing need for novel drug delivery systems that can enhance therapeutic efficacy, reduce side effects, and improve treatment outcomes. In recent years, drug-loaded vesicles, such as liposomes, polymersomes, and extracellular vesicles (EVs), have emerged as promising drug delivery platforms due to their high drug encapsulation efficiency, controlled release properties, and excellent biocompatibility. This review provides an in-depth examination of the characteristics, advantages, and limitations of liposomes, polymersomes, and extracellular vesicles in the context of oral disease treatment. It further explores the reasons for their advantages and limitations and discusses the specific applications, development prospects, and strategies for optimizing these vesicle-based systems for improved clinical outcomes.

The Patterns of P53, E-Cadherin, β-Catenin, CXCR4 and Podoplanin Expression in Oral Squamous Cell Carcinoma Suggests a Hybrid Invasion Model: an Immunohistochemical Study on Tissue Microarrays

PURPOSE

Oral squamous cell carcinoma (OSCC) is a significant public health challenge associated with high mortality rates primarily due to its invasive and metastatic behavior. This study aimed to evaluate the expression patterns of five critical biomarkers: β-catenin, E-cadherin, podoplanin (PDPN), CXCR4, and p53 in OSCC tissues and to investigate their correlations with clinicopathologic features and patient outcomes.

METHODS

We conducted an immunohistochemical analysis utilizing tissue microarrays (TMAs) from 95 patients diagnosed with primary OSCC. The expression levels of the five biomarkers were quantified using H-scores. Statistical analyses, including Kruskal-Wallis tests, Dunn's post-hoc tests, and correlation analyses, were performed to explore the associations between biomarker expression, clinicopathologic parameters, and overall patient survival.

RESULTS

The study found that loss of E-cadherin and β-catenin expression was significantly associated with increased tumor depth and lymphatic invasion, corroborating their role in the process of epithelial-mesenchymal transition (EMT). High levels of PDPN were noted in both early and late-stage OSCC, indicating its potential involvement in initiating invasive behaviors. Notably, CXCR4 expression exhibited positive correlations with E-cadherin and β-catenin, suggesting a hybrid invasion phenotype incorporating both EMT and collective invasion strategies. Although Cox regression analysis did not reveal significant associations between biomarker expression and overall survival (OS) or disease-specific survival (DSS), factors such as alcohol consumption, tumor size, lymph node involvement, and advanced clinical stage emerged as significant negative predictors of both OS and DSS.

CONCLUSION

The expression profiles of β-catenin, E-cadherin, PDPN, CXCR4, and p53 in OSCC tissues provide valuable insights into a hybrid model of invasion that integrates mechanisms of EMT with an important rule in the tumor invasion. This nuanced understanding of OSCC progression highlights the potential of PDPN and CXCR4 as novel therapeutic targets, emphasizing the need for further investigation into their roles in OSCC biology and the development of targeted treatments that could improve patient outcomes and survival rates.

Screening Differentially Expressed Proteins in Areca Nut-Related Oral Squamous Cell Carcinoma Using Tandem Mass Tag Proteomics

OBJECTIVE

Areca nut chewing has been associated with a poor prognosis in oral squamous cell carcinoma (OSCC). This study seeks to identify differentially expressed proteins among areca nut-related OSCC,non-areca nut-related OSCC and adjacent normal epithelial tissues, with the aim of providing novel insights for the investigation of areca nut-related OSCC.

METHODS

Using Tandem mass tag (TMT)-based proteomic analysis, a comparative proteomic profiling was conducted among areca nut-related OSCC, non-areca nut-related OSCC, and adjacent normal epithelial tissues (n=15). GO and KEGG enrichment analyses were then employed to identify significant proteins pertinent to the pathogenesis of OSCC for further study. Western Blot (WB) and Immunohistochemistry (IHC) techniques were used to preliminary validate the expression patterns of LZTS1, MMP10, MYH6, MB, and TNNC1 among various groups (n=30).

RESULTS

27 differentially expressed proteins were identified when comparing the areca nut-related OSCC group with both the non-areca nut-related OSCC and normal epithelial tissue groups. Among these, 15 proteins were upregulated, while 12 were downregulated. LZTS1 and MMP10 were included in the upregulated proteins, whereas MYH6, MB, and TNNC1 were downregulated. WB and IHC analyses corroborated the proteomic findings, revealing consistent expression trends for these 5 proteins across the studied groups.

CONCLUSION

LZTS1, MMP10, MYH6, MB and TNNC1 emerge as promising biomarkers for assessing disease progression, prognosis, and potential targeted therapies in areca nut-related OSCC.

Knowledge and Awareness of Medical and Dental Students About Oral Cancer Risk Factors: A Systematic Review and Meta-Analysis

OBJECTIVE

This systematic review and meta-analysis aims to assess the knowledge and awareness of oral cancer risk factors among medical and dental students.

METHODS

This study followed the PRISMA guidelines and was registered in INPLASY (ID: 2024110035). Four databases were consulted (PubMed, Science Direct, Scopus, and Web of Science) from February 20th, 2005, to May 10th, 2024. The study selection and data extraction process was performed independently by 2 investigators. The risk of bias was assessed using the JBI tool, which can be found at: https://jbi.global/critical-appraisal-tools. A third investigator was consulted in case of disagreement. Meta-analysis results were systematically illustrated in a forest plot and expressed as odds ratio with 95% confidence interval. The I2 statistic assessed heterogeneity between studies. Funnel plot and Egger regression analysis were used for bias analysis. A P value <.05 was considered significant. All statistical analyses were performed using the STATA V.15 software.

RESULTS

After the selection process, 41 studies met the eligibility criteria, comprising a total of 14,425 participants, 22% medical students and 78% dental students, primarily female (53%). The meta-analysis showed that 98% of students demonstrated relatively good knowledge about oral cancer risk factors. The most recognized risk factor was smoking (99%), followed by advanced age (68%), UV-rays exposure (64%), and alcoholism (57%). Knowledge of several other factors was comparatively lower, with less than 50% of students recognizing them. The studies indicated significant heterogeneity (I2 = 99.8%) and publication bias (P < .001).

CONCLUSIONS

These findings suggest that while medical and dental students have a strong understanding of key risk factors for oral cancer, there are gaps in knowledge regarding other important factors. Addressing these gaps through enhanced education and training is essential to improving early detection and prevention efforts.

The potential immunotherapy effect of Ginkgolide B thwarts oral squamous cell carcinoma progression by targeting the SREBP1/KLK8/CCL22 axis

BACKGROUND

Oral cancer is a malignant tumor of the oral cavity, with regulatory T cell (Treg) infiltration associated with poor prognosis. Ginkgolide B (GB) has demonstrated effects on lipid metabolism; however, its potential immunotherapeutic effects on oral cancer have not been elaborated.

PURPOSE

This study aimed to explore the immunotherapeutic effects of Ginkgolide B (GB) in oral cancer.

STUDY DESIGN

We investigated the interactive mechanisms between Tregs and oral cancer cells in regulating sterol regulatory element-binding protein 1 (SREBP1)/ kallikrein-related peptidase 8 (KLK8)/ CC motif chemokine ligand 22 (CCL22) axis by GB treatment.

METHODS

Tissue array staining and the gene expression omnibus (GEO) database were used to identify the correlation between SREBP1/ KLK8/ CCL22 in oral cancer prognosis. The molecular effects of GB on SAS, KYSE-510, and TE-1 cells were examined by RNA sequencing. Electrophoretic mobility shift assay was used to analyse SREBF1/KLK8 transcription promoter activity. SREBP1 and KLK8 genetic engineering or recombinant proteins were used to evaluate CCL22 expression and Treg chemotactic response. An MOC-2-implanted mouse model was used to evaluate the therapeutic effects of GB and genetic engineering conditions.

RESULTS

Web-based visualization platform and tissue array data showed that SREBP1 expression was negatively correlated with oral cancer prognosis and SREBP1 and KLK8 positively correlated (R = 0.4648, p < 0.001). In addition, in vivo, ex vivo and in vitro experiments demonstrated that GB treatment or SREBP1 knockdown inhibited cancer cells proliferation, migration and Tregs chemotaxis. Mechanistically, GB treatment or SREBP1 knockdown attenuated SREBP1-regulated transcription of KLK8, reducing CCL22 secretion. Conversely, treatment with U18666a or SREBP1 transfection reversed these effects.

CONCLUSIONS

GB is a novel SREBP1 inhibitor that effectively prevents immune escape by oral cancer cells through modulation of the SREBP1/KLK8/CCL22 axis, presenting a promising new approach for oral cancer immunotherapy.

Tumor-Derived GDF15 Induces Tumor Associated Fibroblast Transformation From BMSCs and Fibroblasts in Oral Squamous Cell Carcinoma

Cancer associated fibroblasts (CAFs) are the predominant stromal cell-type in the solid tumor microenvironment, originating from various cell types and playing a crucial role in promoting tumor progression and metastasis The generation of CAFs is influenced by complex factors secreted by tumor cells, with particular emphasis on transforming growth factor-β (TGF-β). However, it remains largely unknown whether growth/differentiation factor-15 (GDF15), as a member of the TGF-β superfamily, exerts similar effects to TGF-β in oral squamous cell carcinoma (OSCC). In this study, we investigated the impact of GDF15 derived from tumor cells on CAF transformation and elucidated the underlying mechanisms. Exogenous GDF15 and OSCC cells induced the transformation of bone marrow mesenchymal stem cells (BMSCs) and human gingival fibroblasts (HGFs) into CAFs, as evidenced by α-smooth muscle actin (α-SMA) as a phenotypic marker and TGF-β, interleukin 6 (IL-6), and vascular endothelial-derived growth factor (VEGF) as functional markers. Conversely, knockdown of GDF15 in OSCC cells reversed CAF transformation. Mechanistically, extracellular signal-regulated kinases 1/2(ERK1/2) pathway was associated with GDF15-mediated promotion of CAF transformation. Furthermore, OSCC-induced CAFs enhanced migration and invasion abilities of OSCC cells; but this pro-cancer effect was abolished upon knockdown of GDF15 in OSCC cells. Subcutaneous coinjection of OSCC cells with BMSCs or HGFs into mice revealed the promoted tumor growth along with increased expression levels of α-SMA and Ki67 compared with alone OSCC cells injection; these effects were attenuated when GDF15 was knocked down in OSCC cells. Collectively, our findings suggest that tumor-derived GDF15 contributes to the progression of OSCC by promoting CAF transformation through activation of the ERK1/2 pathway.