The Prognostic Value of Human Papilloma Virus Infection in Oral Cavity Squamous Cell Carcinoma: A Meta-Analysis

Impact of Non-SMC Condensin I Complex Subunit D2 Upregulation on Oral Squamous Cell Carcinoma Prognosis

OBJECTIVE

To explore the influence of non-SMC condensin I complex subunit D2 (NCAPD2) on the prognosis of oral squamous cell carcinoma (OSCC) and the correlation between NCAPD2 and OSCC.

METHODS

In this study, NCAPD2 gene expression profiles of OSCC and normal tissues were collected from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). The real-time quantitative polymerase chain reaction (RT-qPCR) was employed to preliminarily validate OSCC cell strains and normal epithelial cell strains. Besides EdU, cell scratch, and transwell assays were performed to assess the proliferation, migration, and invasion of OSCC cell strains with the silence of NCAPD2. Moreover, immunohistochemistry (IHC) staining was utilised to measure the expression of NCAPD2 and tumour-related markers in 74 OSCC specimens. Finally, the Kaplan-Meier analysis was performed to evaluate the influence of NCAPD2 in the prognosis of OSCC.

RESULTS

The expression of NCAPD2 in OSCC tissues was higher than that in normal tissues. Inhibiting NCAPD2 can reduce the proliferation and migration of OSCC cell lines and inhibit the invasion of these cells. The IHC staining results indicated that the high expression of NCAPD2 in OSCC tissues was positively correlated with T stages, Ki67 expression, and affected sites. The Kaplan-Meier analysis results validated that the up-regulated expression of NCAPD2 was significantly correlated with the poor overall survival (OS) of OSCC patients.

CONCLUSION

NCAPD2 is a potential molecular marker for the poor prognosis of OSCC, and it is expected to become a target for the treatment of this carcinoma.

A nomogram for predicting overall survival in oral squamous cell carcinoma: a SEER database and external validation study

Purpose

Oral squamous cell carcinoma (OSCC) often presents with unsatisfactory survival outcomes, especially in advanced stages. This study aimed to develop and validate a nomogram incorporating demographic, clinicopathologic, and treatment-related factors to improve the prediction of overall survival (OS) in OSCC patients.

Methods

Data from 15,204 OSCC patients in a US database were retrospectively utilized to construct a prognostic model and generate a nomogram. External validation was performed using an independent cohort of 359 patients from a specialized cancer center in China. Prognostic factors were identified using Cox regression analysis and incorporated into the nomogram. Model performance was evaluated by concordance index (C-index), time-dependent area under the receiver operating characteristic curves (AUC), calibration plots, and decision curve analysis (DCA). A risk stratification system was developed to classify patients into high- and low-risk groups.

Results

Age, sex, primary tumor site, T and N staging, and treatment modalities (including surgery, chemotherapy, and radiotherapy) were found to be independent prognostic factors. The nomogram achieved a C-index of 0.727 in the training set and 0.6845 in the validation set, outperforming the conventional TNM staging system. The nomogram's superior predictive accuracy was confirmed by higher AUC values, better calibration, and improved clinical utility as demonstrated by DCA. Risk stratification, based on the nomogram, distinguished patients into distinct prognostic groups with significant OS differences.

Conclusions

This nomogram provides an effective, personalized tool for predicting OS in OSCC. It offers clinicians a valuable aid for treatment decision-making and improves patient management.

HPV Infection and Oral Microbiota: Interactions and Future Implications

Human papillomavirus (HPV) is a leading cause of mucosal cancers, including the increasing incidence of HPV-related head and neck cancers. The oral microbiota-a diverse community of bacteria, fungi, and viruses-play a critical role in oral and systemic health. Oral microbiota dysbiosis is increasingly linked to inflammation, immune suppression, and cancer progression. Recent studies have highlighted a complex interaction between HPV and oral microbiota, suggesting this interplay influences viral persistence, immune response and the tumor microenvironment. These interactions hold significant implications for disease progression, clinical outcomes, and therapeutic approaches. Furthermore, the oral microbiota has emerged as a promising biomarker for HPV detection and disease progress assessment. In addition, probiotic-based treatments are gaining attention as an innovative approach for preventing or treating HPV-related cancers by modulating the microbial environment. In this review, current research on the interaction between HPV and oral microbiota is provided, their clinical implications are explored, and the future potential for utilizing microbiota for diagnostic and therapeutic innovations in HPV-associated cancers is discussed.

Salivary miRNAs and cytokines associated with diagnosis and prognosis of oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is the most common malignant tumour in the oral and maxillofacial region. Early diagnosis can significantly improve the 5-year survival rate of patients with OSCC. Therefore, it is extremely important to differentiate OSCC patients early, easily and quickly. Human saliva contains a variety of components that can be used as biomarkers for the diagnosis and prognosis of OSCC. Studies have shown that salivary microRNAs (miRNAs) and cytokines are closely associated with the progression of OSCC. The aim of this review is to summarize the research progress of salivary biomarkers (miRNAs and cytokines) in the past 3 years, and to explore the possibility of using miRNAs and cytokines to improve the diagnosis and prognosis of OSCC.

Biomarkers and Prognostic Stratification of Squamous Cell Carcinoma of the Oral Cavity in Young Adults: How to Personalize Therapeutic Management?

Squamous cell carcinomas of the oral cavity in young adults represent a heterogeneous entity. New prognostic biomarkers are described in the literature. The aim of this review was to identify emerging biomarkers and prognostic stratification factors of young population. Clinical, biological, microbiological, histopathologic, and molecular markers statistically associated with overall survival (OS) and disease-free survival and were validated in literature. Young adults <40 years of age who were nonsmokers showed a marginally worse prognosis, whereas those <30 years of age showed unfavorable prognosis compared with those with >30 years of age. The high rate of neutrophil-to-lymphocyte ratio was associated with decreased 5-year disease-specific survival, PD-L1 expression correlated with improved OS and recurrence-free survival, and the presence of Fusobacterium and mutations in p53, cyclin D1, and VEGF were associated with reduced OS. Combining these markers in young adults with oral cavity squamous cell carcinomas should be used to adapt the intensification of therapy in addition to the tumor-node-metastasis classification and minor histoprognostic factors.

Histologic spectrum and outcome of Human papillomavirus (HPV)-associated oral cavity squamous cell carcinoma: a single center experience and a survey of The Cancer Genome Atlas (TGCA) cohort

While high-risk human papillomavirus (HPV) serves as an essential pathogen and an important prognostic and predictive biomarker for oropharyngeal squamous cell carcinoma, it occurs at low frequency (2.2-6%) in oral cavity squamous cell carcinoma (OCSCC). To date, the pathologic features of HPV-associated OCSCC (HPV( +)-OCSCC) have been sparsely reported and its prognosis is not well-defined. We herein described detailed clinicopathologic features and outcomes of a retrospective series of 27 HPV( +)-OCSCC, including 13 from Memorial Sloan Kettering Cancer Center (MSKCC) and 14 from The Cancer Genomic Atlas program (TCGA). The frequency of HPV positivity in OCSCC was 0.7% in MSKCC cohort and 4.9% in TCGA cohort. Although HPV( +)-OCSCC was predominantly non-keratinizing (in 81%) with various degree of maturation, its histologic spectrum was expanded to include keratinizing subtype (19%), adenosquamous carcinoma (7%), and papillary architecture (subtype, 7%). HPV( +)-OCSCC predominantly affected male patients (male:female ratio = 12.5:1) and (ex) smokers (77%). It might occur in mandibular mucosa, floor of mouth, tongue, retromolar trigone, buccal mucosa, maxillary mucosa, or hard palate. In oral cavity, positivity of HPV by RNA in situ hybridization was required, and p16 immunohistochemistry alone was insufficient to confirm the HPV + status. The positive predictive value of p16 immunopositivity in detecting HPV infection was 68%. HPV-positivity did not appear to affect outcomes, including disease specific survival and progression free survival in OCSCC.

Association between human papillomavirus and oral cancer: a literature review

HPV plays a vital role in the development of cervical cancers and oropharyngeal cancers, but it is controversial whether HPV is involved in oral cancer development and to what extent. In this review, the clinical characteristics, diagnosis, treatment, and prognosis of HPV-positive oral cancers are summarized, and the mechanisms of HPV-related oral cancer development are discussed. HPV DNA positivity rates are 20-30% in oral squamous cell carcinoma (OSCC), and HPV16 is the most common high-risk HPV. E6/E7 mRNA positivity rates are 2-6% in OSCC. Detection of both high-risk HPV DNA and E6/E7 mRNA is recommended to determine the presence of active HPV, in agreement with high-risk HPV infection in OSCC. Surgical treatment is the first-line therapy for HPV-positive and -negative oral cancer, but there is no unified view about the prognosis of HPV-positive OSCC patients. HPV16 may play a vital role in malignant transformation in oral epithelial dysplasia, and a model of synergistic carcinogenic impact of HPV and tobacco smoking is predicted. Additionally, it is hypothesized that there are different HPV-associated oral cancers, such as integrated HPV DNA-positive OSCC with stable E6/E7 expression and episomal HPV DNA-positive OSCC. In summary, the role of HPV in oral carcinogenesis seems to be limited because of the low E6/E7 positivity in OSCCs; however, episomal HPV DNA may play a vital role in the malignant transformation of HPV-positive oral premalignant lesions. Further investigation is required to promote new insights into the role of episomal HPV DNA in oral carcinogenesis.

Oral Cavity Squamous Cell Carcinoma: An Update of the Pharmacological Treatment

Oral cavity squamous cell carcinoma (OCSCC) represents a serious health and socio-economic problem in different geographical areas of the world. It is characterized by a high rate of mortality, recurrence and metastasis. Despite the therapeutic strategies implemented for its management and resolution, currently the survival estimate for locally advanced disease is about 50%. The available therapeutic options comprise surgery and pharmacological treatment. Recently, an increased emphasis has been placed on the drugs that might be of benefit in this life-threatening disease. Therefore, the aim of this present review was to offer a general survey of the current available pharmacological treatment for OCSCC. The PubMed database was used to retrieve the papers using "OCSCC" as the search terms. We limited our search to the last 5 years to give a more updated and recent picture of the state of the art, including preclinical and clinical investigations. We found that 77 out of 201 papers were on the surgical treatment of OCSCC, 43 out of 201 focused on the radiotherapy and 81 out of 201 underwent evaluation for the aim of our review. We excluded the case reports, editorial letters, observational studies and papers written in languages other than English. A total of 12 articles were included in the final review. Our results showed that nanotechnologies use to enhance the efficacy of anticancer drugs such as: cisplatin, paclitaxel, cetuximab, EGFR antagonists, MEK1/2 and immune check inhibitors combination could have promising anti-cancer activity. However, the paucity of available data on drugs suggests the urgent need to improve the pharmacological armamentarium for OCSCC treatment.

Oral infections in oral cancer survivors: A mini-review

The oral cancer survivors are a group of special individuals whose disease affect anatomical structures with a key role in identity and communication and a fundamental role in basic human functions such as speaking, eating, swallowing and breathing. Thus, quality of life of these individuals can be impaired by the consequences of disease and treatments, in particular surgery and radiotherapy. Among others, infectious conditions of any nature, bacterial, viral, fungal, are a frequent finding among oral cancer survivors. In fact, the peculiar systemic and local conditions of these subjects are known to significantly modify the microbiota, which, besides facilitating opportunistic infections, can affect the cancer microenvironment, as well as alter the effects of the anti-cancer therapies. Similarly, mouth infections can also affect the prognosis of oral cancer survivors. Among the opportunistic infections, fungal are the most common infections affecting these subjects, since neutropenia resulting from cancer, as well as chemotherapy and/or radiotherapy treatments, promote the shift from the carrier state of Candida species, to pathogen state. Treatment of oral candidiasis can be difficult in oral cancer survivors, and good evidence supports clotrimazole as the most effective for prevention, and fluconazole as the one with the best risk-benefit profile. Probiotics, although promising, need better evidence to be considered an effective treatment or preventive measure.

Prognostic Role of Combined EGFR and Tumor-Infiltrating Lymphocytes in Oral Squamous Cell Carcinoma

Background

Epidermal growth factor receptor (EGFR) is well known as a general prognostic biomarker for head and neck tumors, however the specific prognostic value of EGFR in oral squamous cell carcinoma (OSCC) is controversial. Recently, the presence of tumor-infiltrating T cells has been associated with significant survival advantages in a variety of disease sites. The present study will determine if the inclusion of T cell specific markers (CD3, CD4 and CD8) would enhance the prognostic value of EGFR in OSCCs.

Methods

Tissue microarrays containing 146 OSCC cases were analyzed for EGFR, CD3, CD4 and CD8 expression using immunohistochemical staining. EGFR and T cell expression scores were correlated with clinicopathological parameters and survival outcomes.

Results

Results showed that EGFR expression had no impact on overall survival (OS), but EGFR-positive (EGFR+) OSCC patients demonstrated significantly worse progression free survival (PFS) compared to EGFR-negative (EGFR-) patients. Patients with CD3, CD4 and CD8-positive tumors had significantly better OS compared to CD3, CD4 and CD8-negative patients respectively, but no impact on PFS. Combined EGFR+/CD3+ expression was associated with cases with no nodal involvement and significantly more favorable OS compared to EGFR+/CD3- expression. CD3 expression had no impact on OS or PFS in EGFR- patients. Combinations of EGFR/CD8 and EGFR/CD4 expression showed no significant differences in OS or PFS among the expression groups.

Conclusion

Altogether these results suggest that the expression of CD3+ tumor-infiltrating T cells can enhance the prognostic value of EGFR expression and warrants further investigation as prognostic biomarkers for OSCC.