Mouth Research Articles

The role of Fusobacterium nucleatum in cancer and its implications for clinical applications.

Fusobacterium nucleatum, a gram-negative anaerobic bacterium abundantly found in the human oral cavity, is widely recognized as a key pathobiont responsible for the initiation and progression of periodontal diseases due to its remarkable aggregative capabilities. Numerous clinical studies have linked F. nucleatum with unfavorable prognostic outcomes in various malignancies. In further research, scholars have partially elucidated the mechanisms underlying F. nucleatum's impact on various types of cancer, thus gaining a certain comprehension of the role played by F. nucleatum in cancer. In this comprehensive review, we present an in-depth synthesis of the interplay between F. nucleatum and different cancers, focusing on aspects such as tumor initiation, metastasis, chemoresistance, and modulation of the tumor immune microenvironment and immunotherapy. The implications for cancer diagnosis and treatment are also summarized. The objective of this review is to enhance our comprehension of the intricate relationship between F. nucleatum and oncogenic pathogenesis, while emphasizing potential therapeutic strategies.

Mixed Saliva Chemical Parameters Changes in Age‑Related Oral Diseases

Introduction. The prevalence of oral cavity age-related diseases, such as chronic periodontitis (CP) and oral lichen planus (OLP) increases in the elderly and senile age people. The aim of the study was to evaluate changes in the biochemical parameters of mixed saliva in age-related oral diseases and evaluate impact of correction by total protein concentration.Materials and methods. The study included 86 elderly people from 60 to 74 years. They were divided into following groups: excessive attrition of teeth patients (n = 16); moderate CP patients (n = 22); OLP patients (n = 28); healthy peoples (n = 20). Reagent strips Siemens Multistix 10 SG (USA), analyzer Siemens Clinitek Status+ (USA), chemistry analyzer Mindray BS-240Pro (China) were used. In total, 16 biochemical markers and 4 calculated indices were determined. Saliva results were expressed without any correction, and corrected by total protein concentration.Results. It was found that OLP patients differed by a higher specific gravity and an increased level of total protein and calcium from the control group. CP patients had a higher level of c-reactive protein in compared to the healthy peoples. There were no differences between groups after correction.Discussion. The data corresponded to literature sources describing mixed saliva changes in age-related oral diseases. However, correction methods practically were not used in the considered works.Conclusion. Mixed saliva chemical markers changed in age-related oral diseases. It is necessary to find the optimal correction method because dilution and viscosity can significantly affect mixed saliva research results.

Impacts of Antiretroviral Therapy on the Oral Microbiome and Periodontal Health of Feline Immunodeficiency Virus Positive Cats.

Feline immunodeficiency virus (FIV) is the domestic cat analogue of HIV infection in humans. Both viruses induce oral disease in untreated individuals, with clinical signs that include gingivitis and periodontal lesions. Oral disease manifestations in HIV patients are abated by highly effective combination antiretroviral therapy (cART), though certain oral manifestations persist despite therapy. Microorganisms associated with oral cavity opportunistic infections in patients with HIV cause similar pathologies in cats. To further develop this model, we evaluated characteristics of feline oral health and oral microbiome during experimental FIV infection over an 8-month period following cART. Using 16S metagenomics sequencing, we evaluated gingival bacterial communities at four timepoints in uninfected and FIV-infected cats treated with cART or placebo. Comprehensive oral examinations were also conducted by a veterinary dental specialist over the experimental period. Gingival inflammation was higher in FIV-infected cats treated with placebo compared to cART-treated cats and controls at study endpoint. Oral microbiome alpha diversity increased in all groups, while beta diversity differed among treatment groups, documenting a significant effect of cART therapy on microbiome community composition. This finding has not previously been reported and indicates cART ameliorates immunodeficiency virus-associated oral disease via preservation of oral mucosal microbiota. Further, this study illustrates the value of the FIV animal model for investigations of mechanistic associations and therapeutic interventions for HIV oral manifestations.

Streptococcus suis subsp. hashimotonensis subsp. nov.: Lancefield group A antigen–positive organisms isolated from human clinical specimens and wild boar oral cavity samples

Three Streptococcus suis-like strains positive for Lancefield antigen group A were isolated from human boar bite wounds and the oral cavities of boars in Hashimoto City, Wakayama Prefecture, Japan, and their taxonomic positions were investigated. Application of the VITEK2 system identified all three isolates as S. suis with > 94 % probability. The isolates were assigned to S. suis based on the results of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) analysis (Biotyper score of 2.382) but were differentiated according to the characteristic signal peaks (4709 m/z and 9420 m/z) that were not present for S. suis. Sequence analysis of the 16S rRNA and sodA genes determined that the isolates were similar to S. suis; however, these genes appeared on a phylogenetic sub-branch. Phylogenetic analysis of the whole chromosomal DNA showed that the isolate formed a cluster with S. suis but with clear divergence. The average nucleotide index using BLAST between the clinical isolate (PAGU 2482) and a closely related reference strain of S. suis was 94.75 %, which was not clearly conclusive; however, digital DNA-DNA hybridization showed a value of 61.2 %. Biochemical reactions, including those with acid phosphatase, α-chymotrypsin, and tagatose (acidification), distinguished our isolates from S. suis. Thus, based on phylogenetic, genomic, and phenotypic characteristics and MALDI-TOF-MS signal patterns, we propose that the isolate with Lancefield group A positive characteristics be designated as a novel subspecies, Streptococcus suis subsp. hashimotonensis subsp. nov., with the type strain PAGU 2482T (GTC 18290T = CCUG 77434T).

Unraveling brain aging through the lens of oral microbiota.

The oral cavity is a complex physiological community encompassing a wide range of microorganisms. Dysbiosis of oral microbiota can lead to various oral infectious diseases, such as periodontitis and tooth decay, and even affect systemic health, including brain aging and neurodegenerative diseases. Recent studies have highlighted how oral microbes might be involved in brain aging and neurodegeneration, indicating potential avenues for intervention strategies. In this review, we summarize clinical evidence demonstrating a link between oral microbes/oral infectious diseases and brain aging/neurodegenerative diseases, and dissect potential mechanisms by which oral microbes contribute to brain aging and neurodegeneration. We also highlight advances in therapeutic development grounded in the realm of oral microbes, with the goal of advancing brain health and promoting healthy aging.

Carcinoma Cuniculatum Masquerading as Eumycetoma: An Unacquainted Entity Posing a Diagnostic Dilemma.

Carcinoma cuniculatum (CC) is a rare and distinct clinicopathological variant of well-differentiated squamous cell carcinoma. It is a rare and slow-growing tumor with a peculiar infiltrative growth pattern resembling rabbit burrows (cuniculi). It usually occurs over the plantar aspect of the foot but can also occur at other sites like the oral cavity and genitals. The pathogenesis is unknown, with various hypotheses of trauma as proposed by different authors. It is essential to be aware of this entity as it commonly mimics benign and other low-grade squamous cell carcinoma (SCC). Diagnosis of CC can be challenging and requires repeated histological evaluation and clinical correlation. Herein, we present a case report of CC of the plantar and dorsal aspect of the foot in a 60-year-old male with a history of multiple chronic non-healing ulcers, which was clinically suspected as eumycetoma and remained inconclusive on numerous biopsies.

Evaluating Oral Hygiene and Caries Prevalence among Deaf and Hard of Hearing Orphans at Karya Murni Orphanage in Medan

Access to equal oral health attention is the right of all human beings, including orphan children with hearing loss or deaf and hard of hearing (DHH) conditions. Therefore, this study aimed to determine the correlation between the level of oral hygiene and caries indexing among the sub-population of DHH orphans receiving special care at Karya Murni orphanage in Medan City. A cross-sectional design was used with non-probability sampling to select 58 orphans willing to engage in the Oral Hygiene Index-Simplified (OHI-S) and mean of Decayed, Missing, and Filled Permanent Teeth (DMFT) assessment during dental and oral cavity screening after participating in counseling activities. Furthermore, the results showed a positive correlation (p=0.007) between oral hygiene and caries, suggesting that OHI-S impacted DMFT by approximately 34.9%, with both index scores presenting proportional equivalence. There is a need to conduct regular dental health monitoring along with education on visual methods and sign language among DHH orphans. Additionally, DHH orphan caregivers should actively engage in enhancing personal health behaviors, particularly to maintain oral and dental health.

Reverse Vaccinology Approach to Identify Novel and Immunogenic Targets against Streptococcus gordonii.

Streptococcus gordonii is a gram-positive, mutualistic bacterium found in the human body. It is found in the oral cavity, upper respiratory tract, and intestines, and presents a serious clinical problem because it can lead to opportunistic infections in individuals with weakened immune systems. Streptococci are the most prevalent inhabitants of oral microbial communities, and are typical oral commensals found in the human oral cavity. These streptococci, along with many other oral microbes, produce multispecies biofilms that can attach to salivary pellicle components and other oral bacteria via adhesin proteins expressed on the cell surface. Antibiotics are effective against this bacterium, but resistance against antibodies is increasing. Therefore, a more effective treatment is needed. Vaccines offer a promising method for preventing this issue. This study generated a multi-epitope vaccine against Streptococcus gordonii by targeting the completely sequenced proteomes of five strains. The vaccine targets are identified using a pangenome and subtractive proteomic approach. In the present study, 13 complete strains out of 91 strains of S. gordonii are selected. The pangenomics results revealed that out of 2835 pan genes, 1225 are core genes. Out of these 1225 core genes, 643 identified as non-homologous proteins by subtractive proteomics. A total of 20 essential proteins are predicted from non-homologous proteins. Among these 20 essential proteins, only five are identified as surface proteins. The vaccine construct is designed based on selected B- and T-cell epitopes of the antigenic proteins with the help of linkers and adjuvants. The designed vaccine is docked against TLR2. The expression of the protein is determined using in silico gene cloning. Findings concluded that Vaccine I with adjuvant shows higher interactions with TLR2, suggesting that the vaccine has the ability to induce a humoral and cell-mediated response to treat and prevent infection; this makes it promising as a vaccine against infectious diseases caused by S. gordonii. Furthermore, validation of the vaccine construct is required by in vitro and in vivo trials to check its actual potency and safety for use to prevent infectious diseases caused by S. gordonii.

Qualitative and quantitative analysis of leachables from dental composites under different extraction conditions using liquid chromatography coupled to mass spectrometry

AbstractDental caries is the most widespread form of disease, affecting over 90% of the global population. Amalgam fillings, which have been in use for nearly two centuries, will face an European Union ban by 2025. Although photocomposite fillings are a suitable alternative, health concerns persist because of potential substance release into the oral cavity. This study aimed to evaluate the release of photoinitiator substances and monomers from dental materials into various solvents at different temperatures over 30 days. Cylindrical specimens of the composite resins were submerged in different extraction solutions and incubated at 37 and 50°C. The findings demonstrated that both the extraction solvent and extraction temperature significantly influenced the quantity of leachables (p < 0.05). Furthermore, most leachables were released within the initial days, although some monomers continued to elute for over 30 days. The estimated daily intake was calculated for the worst‐case scenario, confirming the biocompatibility of the composite fillings. The weight loss of dental materials ranged up to 3.5% after 30 days, regardless of the extraction conditions and dental material (p > 0.05). In conclusion, this study contributes to filling several research gaps in the field by addressing the biocompatibility of various dental materials through quantitative and qualitative analyses supported by statistical evaluation.

Role of ERG11 and MDR1 genes in cycloheximide and multidrug resistance in Candida species.

Candida species are amongst the commensals of the mucosal surfaces of the human body which include the oral cavity, vagina, and intestinal mucosa. Fungal infections are on the rise worldwide. The overall burden of infections due to fungi is difficult to estimate because the majority of them remain undiagnosed. The present study aims to determine the burden of antifungal resistance in low socioeconomic country, Pakistan and the frequency of ERG11 and MDR1 genes involved. A total of 636 Candida isolates were obtained from various tertiary care institutions in Lahore in the form of culture on various culture plates. Sabouraud agar culture plates were used to culture the Candida spp. Antifungal resistance was determined against Fluconazole, Itraconazole, Ketoconazole, and Nystatin via disk diffusion technique. Most resistance was observed against Fluconazole followed by Itraconazole, Ketoconazole, and Nystatin. The Candida isolates recovering from CVP tip and tissue have a high resistance profile. Candida species resistant to at least two antifungals were chosen for further ERG11 and MDR1 detection through real-time PCR. Among 255 Candida isolates, 240 contained ERG11 gene while MDR1 gene is present in 149 Candida isolates. The isolates carrying both genes were tested by the broth microdilution technique for the susceptibility against cycloheximide, all of them were able to grow in cycloheximide. The genetic determinants of antifungal resistance such as ERG11 and MDR1 are as important in the multidrug resistance against a variety of compounds and antifungal drugs.

Diverse Circular DNA Viral Communities in Blood, Oral, and Fecal Samples of Captive Lemurs.

Few studies have addressed viral diversity in lemurs despite their unique evolutionary history on the island of Madagascar and high risk of extinction. Further, while a large number of studies on animal viromes focus on fecal samples, understanding viral diversity across multiple sample types and seasons can reveal complex viral community structures within and across species. Groups of captive lemurs at the Duke Lemur Center (Durham, NC, USA), a conservation and research center, provide an opportunity to build foundational knowledge on lemur-associated viromes. We sampled individuals from seven lemur species, i.e., collared lemur (Eulemur collaris), crowned lemur (Eulemur coronatus), blue-eyed black lemur (Eulemur flavifrons), ring-tailed lemur (Lemur catta), Coquerel's sifaka (Propithecus coquereli), black-and-white ruffed lemur (Varecia variegata variegata), and red ruffed lemur (Varecia rubra), across two lemur families (Lemuridae, Indriidae). Fecal, blood, and saliva samples were collected from Coquerel's sifaka and black-and-white ruffed lemur individuals across two sampling seasons to diversify virome biogeography and temporal sampling. Using viral metagenomic workflows, the complete genomes of anelloviruses (n = 4), cressdnaviruses (n = 47), caudoviruses (n = 15), inoviruses (n = 34), and microviruses (n = 537) were determined from lemur blood, feces, and saliva. Many virus genomes, especially bacteriophages, identified in this study were present across multiple lemur species. Overall, the work presented here uses a viral metagenomics approach to investigate viral communities inhabiting the blood, oral cavity, and feces of healthy captive lemurs.

Artificial intelligence facilitates clinical management of epithelial dysplasia in multiple organs

Epithelial dysplasia is a condition characterized by a spectrum of architectural and cytological alterations to the epithelium, resulting from the accumulation of genetic alterations. It is associated with an increased risk of cancer progression in a variety of organs. However, the variability of different grading systems, as well as inter- and intra-examiner variability, gives rise to concerns regarding the reliability of the results. Histopathology represents the gold standard for the diagnosis of epithelial dysplasia. The combination of big data in pathology and artificial intelligence (AI) will facilitate the achievement of accurate diagnoses and treatments, providing objective and efficient methods to integrate and refine diverse morphological, molecular, and multi-omics information. This perspective provides a summary of the existing research and prospects for the application of AI to epithelial dysplasia in multiple organs. A number of studies have been conducted with the aim of developing a grading system and prognostic identification method for epithelial dysplasia in the oral cavity, larynx, esophagus, and stomach. Digital pathology-based AI may prove useful in facilitating the clinical management of epithelial dysplasia in multiple organs. In summary, digital pathology images obtained by scanning hematoxylin & eosin-stained slides, identifying image features, and building AI models using deep learning combined with machine learning algorithms, validated with real-world data from multicenter cohorts could provide AI as a promising clinical application in the future.

3D Lagrangian Particle Tracking In A Model Of The Human Airways

The three-dimensional flow field in the trachea of a physiologically correct model of the human respiratory tract from the nasal/oral cavities up to the 6th bronchi generation is investigated. The investigations comprise steady inflow conditions, i.e., steady inhalation and oscillatory flow combining inspiration and expiration to simulate calm breathing. A realistic breathing pattern is approximated by a sinusoidal waveform for two Womersley numbers of 3 and 4.5 and two Reynolds numbers of 400 and 1200. Due to the inherent three-dimensional and asymmetric nature of the flow field, 3D particle-tracking velocimetry (3D-PTV) measurements are performed using the Shake-The-Box (StB) algorithm to determine the influence of oral and nasal inhalation and exhalation on the flow field in the lower human airways. By using a refractive-index matched fluid consisting of water and glycerin, the complex flow structures inside the trachea are fully resolved. During oscillatory inhalation/exhalation, an integration window size of 6/40 pi was chosen as it can be considered short enough to assume a steady state. The PTV measurements confirm that the nasal and/or oral cavity must be taken into account when analyzing the flow field in the lower respiratory tract. Characteristic sets of velocity profiles in the sagittal and coronal plane of the trachea as well as contour plots evidence nearly identical flow structures for both oral and nasal inhalation, but also reveal that the presence of both cavities possesses a huge impact on the flow field compared to ideal, i.e., fully developed inflow conditions

Isolation and identification of hoylesella marshii causing pleural infection: a case report

BackgroundHoylesella marshii can be isolated from human oral cavities affected by dental pulp and periodontal infections, as well as from the dental plaque of healthy individuals, making it a common bacterium within the oral microbiota. However, its role in causing pleural infections in humans is rare.Case presentationA case of purulent pleural effusion occurred shortly after discharge in an elderly patient who had undergone surgery for gastric cancer. The infection was identified as being caused by an obligate anaerobe through laboratory culture, and was further identified as Hoylesella marshii causing pleural infection through 16 S rRNA gene sequence analysis. Susceptibility testing guided precise treatment with cefoperazone-sulbactam and metronidazole. The patient’s clinical symptoms improved rapidly, laboratory test indicators gradually returned to normal, and the patient ultimately recovered.ConclusionHoylesella marshii can cause pleural infections in humans. Clinical microbiology laboratories should pay special attention to the cultivation of obligate anaerobes when routine aerobic cultures do not show bacterial growth but bacteria are visible on smear staining, and when conventional identification methods fail to identify the bacterium, analysis based on the highly conserved 16 S rRNA gene sequence can accurately and specifically identify the bacterium, guiding clinicians in formulating precise anti-infection strategies.

A novel murine model mimicking male genital Neisseria species infection using Neisseria musculi†.

With ~78 million cases yearly, the sexually transmitted bacterium Neisseria gonorrhoeae is an urgent threat to global public health due to continued emergence of antimicrobial resistance. In the male reproductive tract, untreated infections may cause permanent damage, poor sperm quality, and subsequently subfertility. Currently, few animal models exist for N. gonorrhoeae infection, which has strict human tropism, and available models have limited translatability to human disease. The absence of appropriate models inhibits the development of vital new diagnostics and treatments. However, the discovery of Neisseria musculi, a mouse oral cavity bacterium, offers much promise. This bacterium has already been used to develop an oral Neisseria infection model, but the feasibility of establishing urogenital gonococcal models is unexplored. We inoculated mice via the intrapenile route with N. musculi. We assessed bacterial burden throughout the male reproductive tract, the systemic and tissue-specific immune response 2-weeks postinfection, and the effect of infection on sperm health. Neisseria musculi was found in penis (2/5) and vas deferens (3/5) tissues. Infection altered immune cell counts: CD19+ (spleen, lymph node, penis), F4/80+ (spleen, lymph node, epididymus), and Gr1+ (penis) compared with noninfected mice. This culminated in sperm from infected mice having poor viability, motility, and morphology. We hypothesize that in the absence of testis infection, infection and inflammation in other reproductive is sufficient to damage sperm quality. Many results herein are consistent with outcomes of gonorrhoea infection, indicating the potential of this model as a tool for enhancing the understanding of Neisseria infections of the human male reproductive tract.

Using a machine learning algorithm and clinical data to predict the risk factors of disease recurrence after adjuvant treatment of advanced-stage oral cavity cancer

ABSTRACT Objectives: Head-and-neck cancer is a major cancer in Taiwan. Most patients are in the advanced stage at initial diagnosis. In addition to primary surgery, adjuvant therapy, including chemotherapy and radiotherapy, is also necessary to treat these patients. We used a machine learning tool to determine the factors that may be associated with and predict treatment outcome. Materials and Methods: We retrospectively reviewed 187 patients diagnosed with advanced-stage head-and-neck cancer who received surgery and adjuvant radiotherapy with or without chemotherapy. We used eXtreme Gradient Boosting (XGBoost) – a gradient tree-based model – to analyze data. The features were extracted from the entries we recorded from the electronic health-care system and paper medical record. The patient data were categorized into training and testing datasets, with labeling according to their recurrence status within the 5-year follow-up. The primary endpoint was to predict whether the patients had recurrent disease. The risk factors were identified by analyzing the feature importance in the model. For comparison, we also used regression to perform the variate analysis to identify the risk factors. Results: The accuracy, sensitivity, and positive predictive value of the model were 57.89%, 57.14%, and 44.44%, respectively. Pathological lymph node status was the most important feature, followed by whether the patient was receiving chemotherapy. Fraction size, early termination, and interruption were the important factors related to radiotherapy and might affect treatment outcome. The area under the curve of the receiver operating characteristic curve was 0.58. The risk factors identified by XGBoost were consistent with those found by regression. Conclusion: We found that several factors were associated with treatment outcome in advanced-stage head-and-neck cancer. In future, we hope to collect the data according to the features introduced in this study and to construct a stronger model to explain and predict outcomes.

Concentration of High-Cost Head and Neck Cancer Surgical Patients.

Health care costs are disproportionately concentrated among a small number of patients. We sought to identify variables associated with high-cost patients and high hospital concentration of high-cost patients and to examine associations with short-term outcomes in head and neck cancer (HNCA) surgery. The Nationwide Inpatient Sample was used to identify 170,577 patients who underwent HNCA surgery in 2001-2011. High-cost patients were defined as patients whose costs of care were in the top decile, and high-concentration hospitals were defined as those whose percentage of high-cost patients was in the top decile. Multivariable regression was used to evaluate associations between cost and patient and hospital variables, postoperative complications, and in-hospital mortality. Costs associated with high-cost patients were 4.47-fold greater than the remaining 90% of patients. High-concentration hospitals treated 36% of all high-cost patients. High-cost patients were more likely to be non-white (OR = 2.08 [1.45-2.97]), have oral cavity cancer (OR = 1.21 [1.05-1.39]), advanced comorbidity (OR = 1.53 [1.31-1.77]), Medicaid (OR = 1.93 [1.62-2.31]) or self-pay payor status (OR = 1.72 [1.38-2.14]), income>50th percentile (OR = 1.25 [1.05-1.51]), undergo major procedures (OR = 3.52 [3.07-4.05]) and have non-routine discharge (OR = 7.50 [6.01-9.35]). High-concentration hospitals were more likely to be teaching hospitals (OR = 3.14 [1.64-6.05]) and less likely to be urban (OR = 0.20 [0.04-0.93]). After controlling for all other variables, high-cost patients were associated with an increased odds of mortality (OR = 8.00 [5.89-10.85]) and postoperative complications (OR = 5.88 [5.18-6.68]). High-concentration hospitals were associated with an increased odds of postoperative complications (OR = 1.31 [1.08-1.61]) but were not associated with increased mortality (OR = 0.98 [0.67-1.44]). High-cost HNCA surgical patients are associated with increased postoperative morbidity and mortality, and are disproportionately concentrated at teaching hospitals. 4 Laryngoscope, 2024.

A Comprehensive Review of Advancements in Diagnostic Imaging: Unveiling Oral Cavity Malignancies Using Computed Tomography.

Early detection of oral cavity malignancies is essential for improving treatment outcomes and patient survival rates. Diagnostic imaging, particularly computed tomography (CT), plays a pivotal role in the early identification and detailed assessment of these malignancies. This comprehensive review explores the advancements in CT imaging and its application in diagnosing oral cavity cancers. It discusses the anatomy and physiology of the oral cavity, the clinical characteristics of common malignancies, and the principles and protocols of CT imaging. The review highlights the diagnostic features of oral malignancies on CT, including distinguishing benign from malignant lesions and staging criteria. Emerging technologies, such as higher-resolution imaging, integration with other modalities, and the potential of artificial intelligence, are examined for their role in enhancing diagnostic accuracy. The clinical implications, challenges, and future directions in the use of CT imaging for oral cavity malignancies are also discussed. This review underscores the importance of continued research and technological advancements in optimizing the use of CT for early detection and effective management of oral cavity cancers.

A rare case of a vascular benign tumor in oral cavity – Case report

Leiomyomas are benign tumors arising from smooth muscle and can be classified as solid, epithelioid, and vascular leiomyoma (angioleiomyoma). Angioleiomyoma frequently occurs on the skin. Due to the lack of smooth muscle in the oral cavity, this tumor is rarely located in the mouth. This study aims to present a rare case of a 36-year-old woman with a painless submucosal nodule in the left cheek mucosa, measuring approximately 2 cm x 1 cm, with 5-years of evolution. Morphological and histochemical examination evidenced the proliferation of smooth muscle around the blood vessels of various calibers. The diagnosis of angioleiomyoma was confirmed, the tumor was surgically removed, and the patient had no further complications after 9-months of follow-up. The diagnosis of oral angioleiomyoma is challenging since this tumor is rare and can mimic or transform into malignancy. For this reason, histological examination in association with immunohistochemical is invaluable to establishing an accurate diagnosis and delivering suitable treatment.

The Role of Biomarkers in HPV-Positive Head and Neck Squamous Cell Carcinoma: Towards Precision Medicine.

Head and neck cancer (HNC) represents a significant global health challenge, with squamous cell carcinomas (SCCs) accounting for approximately 90% of all HNC cases. These malignancies, collectively referred to as head and neck squamous cell carcinoma (HNSCC), originate from the mucosal epithelium lining the larynx, pharynx, and oral cavity. The primary risk factors associated with HNSCC in economically disadvantaged nations have been chronic alcohol consumption and tobacco use. However, in more affluent countries, the landscape of HNSCC has shifted with the identification of human papillomavirus (HPV) infection, particularly HPV-16, as a major risk factor, especially among nonsmokers. Understanding the evolving risk factors and the distinct biological behaviors of HPV-positive and HPV-negative HNSCC is critical for developing targeted treatment strategies and improving patient outcomes in this complex and diverse group of cancers. Accurate diagnosis of HPV-positive HNSCC is essential for developing a comprehensive model that integrates the molecular characteristics, immune microenvironment, and clinical outcomes. The aim of this comprehensive review was to summarize the current knowledge and advances in the identification of DNA, RNA, and protein biomarkers in bodily fluids and tissues that have introduced new possibilities for minimally or non-invasive cancer diagnosis, monitoring, and assessment of therapeutic responses.