UNASSIGNED: To reduce mortality, the Taiwan government has vigorously promoted free cancer screening and preventive health screening services. Cancers are usually advanced by the time they are discovered in the emergency department. Through this study, we aimed to understand the characteristics of cancer patients diagnosed through the emergency department and thus identify high-risk populations by comparing cancer staging and survival rates in patients diagnosed in the emergency department and those diagnosed in the non-emergency department.
UNASSIGNED: The retrospective study enrolled a total of 389,043 patients over the age of 20 who were newly diagnosed with one of the five major cancers (including lung cancer, colorectal cancer, breast cancer, prostate cancer, and oral cancer) between 2008 and 2017 and analyzed their diagnostic pathway, cancer stage at diagnosis, and survival time.
UNASSIGNED: Of the study participants, 59,423 patients (about 15.3%) were diagnosed with cancer through the emergency department. We found that a sizable proportion of older people and patients with low education and low incomes were diagnosed through emergency department visits, and those with a health condition comorbidity severity of 3 had the highest proportion diagnosed by the emergency department, advanced stages at diagnosis, and risk of death. These can be classified as high-risk groups. In addition, 76.4% of patients diagnosed in the emergency department had advanced cancer, and the risk of death was 1.46 times higher than that of patients diagnosed in the non-emergency department. Although cancer screening is available, it does not reduce the proportion of patients with advanced cancer who are diagnosed through or at the time of diagnosis in the emergency department.
UNASSIGNED: The present study found that the government\'s cancer screening did not affect the proportion or number of cancers diagnosed through emergency department visits. Therefore, the government should focus on more cancer screening, health education in high-risk groups, and strengthening the link between emergency and oncology departments to reduce the risk of death for patients diagnosed through emergency department visits.

Purpose: Identify the hypoxia genes related to chemotherapy resistance of oral cancer, and construct a chemotherapy response model by machine learning algorithm. Methods: 72 oral cancer patients with complete chemotherapy records and chemotherapy reactions were screened from the Cancer Genome Atlas (TCGA) database. According to the chemotherapy reactions, they were divided into chemotherapy sensitive group and chemotherapy resistant group. The differential genes were screened by Limma package. Then the chemotherapy response gene were screened by univariate analysis. Based on the gene expression profile of chemotherapy response, four machine learning algorithms were used to construct the prediction model of chemotherapy response. The core genes were screened by lasso regression analysis. Finally, the prognosis and immune infiltration of the core genes were analyzed. The results were verified by immunohistochemistry (IHC). Results: We obtained 22 hypoxia related differential genes. Univariate analysis found 6 Chemotherapy response genes. Machine learning algorithms show that XGBoost have the best predictive performance for chemotherapy response. ALDOA is the core gene of chemotherapy resistance. Conclusions: Successfully constructed a chemotherapy prediction model for oral cancer by machine learning algorithm. Under hypoxia, the high expression of ALDOA is associated with chemotherapy resistance in oral cancer.

OBJECTIVE: This study is aimed to investigate the causal relationship between plasma proteins and oral cancer risk using two-sample MR (Mendelian randomization).
METHODS: Summary-level GWAS (genome-wide association study) data on plasma protein levels (4,907 proteins) and oral cancer (6,034 cases, 6,585 controls) of European ancestry were utilized. SNPs (single nucleotide polymorphisms) associated with proteins at genome-wide significance were selected as instrumental variables. Multiple MR methods including IVW (inverse-variance weighted), MR-Egger, weighted median, simple mode and weighted mode were applied to estimate causal effects. Sensitivity analyses were conducted.
RESULTS: Eight plasma proteins (CCDC167, MID2, NDRG4, PEAR1, PIAS4, RCAN1, SAMHD1 and TNMD) were identified to have significant causal associations with oral cancer risk. NDRG4, RCAN1, SAMHD1 and TNMD were associated with increased oral cancer risk while PEAR1 was associated with decreased risk. The causal estimates were consistent across different methods. Sensitivity analyses indicated the results were robust without significant heterogeneity or horizontal pleiotropy. Multivariable MR adjusting for smoking, alcohol intake and periodontal disease showed CCDC167, MID2, NDRG4, PEAR1, PIAS4 and SAMHD1 still had direct effects on oral cancer.
CONCLUSIONS: This two-sample MR study provides evidence for potentially causal effects of several plasma proteins on oral cancer risk. The identified proteins may serve as biomarkers and shed light on biological mechanisms underlying oral carcinogenesis. Further research is warranted to validate and extend these findings.

OBJECTIVE: To study the effects of losartan, an angiotensin II receptor blocker, in the SCC4 and SCC25 human tongue squamous cell carcinoma cell lines.
METHODS: Cell proliferation was measured by MTS/PMS activity and trypan blue exclusion assays. The levels of the cell proliferation marker, cyclin D1, were analyzed by western blotting. Apoptosis was assessed by caspase-3 activation and Annexin V-FITC/propidium iodide double staining. Activation of epidermal growth factor receptor (EGFR) and ERK1/2 was validated by western blotting.
RESULTS: Moderate concentrations of losartan enhanced the proliferation of SCC4 and SCC25 cells. However, high losartan concentrations induced apoptosis in SCC4 cells. Losartan activated the EGFR/ERK1/2/cyclin D1 signaling axis, which in turn promoted cell proliferation. Afatinib (EGFR inhibitor) and U0126 (ERK1/2 inhibitor) abolished losartan-induced cell proliferation. In contrast, UC2288 (p21 inhibitor) enhanced it.
CONCLUSIONS: Losartan exhibited dual effects on tongue squamous cell carcinoma cells. Moderate losartan concentrations facilitated cell proliferation, whereas high concentrations induced cytotoxicity in tongue carcinoma cells.

Genetics plays a significant role in determining an individual\'s susceptibility to dental diseases, the response to dental treatments, and the overall prognosis of dental interventions. Here, the authors explore the various genetic factors affecting the prognosis of dental treatments focusing on dental caries, orthodontic treatment, oral cancer, prosthodontic treatment, periodontal disease, developmental disorders, pharmacogenetics, and genetic predisposition to faster wound healing. Understanding the genetic underpinnings of dental health can help personalize treatment plans, predict outcomes, and improve the overall quality of dental care.

BACKGROUND: The prevalence of oral human papillomavirus (HPV) in the healthy population and patients with oral diseases such as oral squamous cell carcinoma (OSCC), oral potentially malignant disorders (OPMDs), and oral benign lesions (BL), is not consistently described in the literature, with scarce and often heterogeneous data. In addition, the efficacy of HPV prophylactic vaccines in preventing HPV-related oral disorders has been scarcely investigated.
METHODS: The prevalence of HPV and the potential impact of vaccines were analyzed in 1,415 oral rinse specimens, collected over 10 years and grouped into four categories based on histological/clinical diagnosis.
RESULTS: HPV prevalence in OSCC, OPMD, and BL patients and in healthy individuals potentially exposed to HPV (HPE) was comparable (12.7 vs. 27.2% vs. 13.5 vs. 9%). Statistical analysis of the vaccine impact involved calculating high and low estimates and showed a significant difference only for the low effect. The nonavalent vaccine had higher low estimates than the bivalent vaccine in OSCC and HPE patients (29.6 vs. 51.9%, p < 0.05; 18.2 vs. 42.4%, p < 0.05), while for OPMD and BL, the frequency of bivalent low estimates was lower than that of quadrivalent and nonavalent (48.6 vs. 68.6%, p < 0.05 and 48.6 vs. 77.1%, p < 0.05; 23.9 vs. 50.7%, p < 0.05, and 23.9 vs. 63.4%, p < 0.05).
CONCLUSIONS: This study provided new insights into the prevalence of oral HPV and showed that the nonavalent vaccine may provide better protection than the other vaccines in the presence of an OSCC diagnosis. Conversely, the quadrivalent vaccine may be sufficient to prevent OPMD and BL.

Oral cavity and larynx cancers are generally associated with tobacco consumption, alcohol abuse or both. Mouthwashes are liquid antiseptic solutions that decrease the microbial load in the oral cavity. Alcohol is often used in mouthwashes for its antiseptic functions and as a carrier for some active ingredients, including menthol or thymol, helping them penetrate the plaque. There is some evidence for alcohol-containing mouthwash use which is associated with the potential risk of developing carcinoma of oral cavity. The results are inconclusive, as actual mouthwash use patterns may be inconsistent and cannot be easily quantified. Based on the available data, there is no sufficient evidence to accept the proposition that the use of mouthwashes containing alcohol can influence the development of oral cancer.

The severe complication in oral cancer patients receiving radiation therapy is osteoradionecrosis. The reported incidence of ORN is highly variable, ranging from 0 to 37.5%. Diverse treatment protocols underscore the complexity of managing ORN. This study aims to address the surgical factors and their association with the formation of ORN in patients with oral squamous cell carcinoma undergoing surgery. Data of 17 patients who received definitive surgery and post-operative adjuvant radiotherapy (using the 3D CRT technique alone) to the head and neck from January 2016 to December 2023 presented with post-operative changes, which shows clinical evidence of ORN confirmed by radiographic investigations collected. Among 17 patients, 10 patients (58.8%) had posterior segmental mandibulectomy and seven patients (41.1%) had undergone marginal mandibulectomy with coronoidectomy respectively. Only two patients (11.7%) had regional flap reconstruction using PMMC flap, and for one patient (5.8%), surgical defect closed primarily; the remaining 14 (82.3%) patients underwent free flap reconstruction. Among free flaps, six patients (35.2%) had fibula and seven patients had radial forearm (41.1%) reconstruction. Only one patient (5.8%) underwent reconstruction using an anterolateral thigh flap. Along with consideration of radiation dose, dental extraction, oral hygiene, etc. do anticipate ORN and contemplate surgical risk factors during surgical planning in the management of head and neck cancer.

OBJECTIVE: This study investigated risk factors contributed to benign and malignant oral tumors using longitudinal cohort big data.
METHODS: We included individuals aged ≥40 years who participated in the National Health Examination in South Korea between 2003 and 2004. National Health Insurance claims data after 16 years were used to determine the incidence of oral tumors and the related risk factors. Hazard ratios were calculated using the Cox proportional hazard regression.
RESULTS: A total of 5,992,671 participants were included. The incidence of oral cancer was significantly higher in men and increased with age, whereas that of benign tumors was unaffected by sex and decreased with age. Periodontal disease was associated with the incidence of oral cancer but not benign tumors. Soft tissue diseases were associated with both benign and malignant tumors. Various systemic diseases influence the development of oral tumors. Light alcohol consumption reduced the incidence of oral tumors, whereas heavy alcohol consumption increased the incidence of malignant tumors only. Smoking increased the incidence of benign but not malignant tumors.
CONCLUSIONS: Recognized risk factors such as sex, age, comorbidities, and dental diseases were associated with oral tumors. Alcohol consumption and smoking were not significantly associated with malignant tumors.

BACKGROUND: Oral cancer (OC) is a common malignancy in clinical practice. Saliva testing is a convenient and noninvasive early diagnostic technique for OC. Several salivary cytokines have been identified as potential biomarkers for OC, including IL-8, IL-6, TNF-α, IL-1β, and IL-10. Nonetheless, the optimal cytokine for OC diagnosis remains inconclusive and highly contentious.
METHODS: PubMed, Embase, Web of Science, and Cochrane Library databases were comprehensively retrieved to collect all case-control studies on OC. A meta-analysis was performed to compare the levels of salivary IL-8, IL-6, IL-10, TNF-α, and IL-1β in OC patients and healthy controls. Network meta-analysis (NMA) was carried out to probe into the accuracy of these salivary cytokines in diagnosing OC.
RESULTS: This analysis included 40 studies, encompassing 1280 individuals with OC and 1254 healthy controls. Significantly higher levels of salivary IL-8, IL-6, TNF-α, IL-1β, and IL-10 were observed in patients with OC in comparison to healthy controls. The results of NMA showed that TNF-α had the highest diagnostic accuracy for OC, with a sensitivity of 79% and a specificity of 92%, followed by IL-6 (sensitivity: 75%, specificity: 86%) and IL-8 (sensitivity: 80%, specificity: 80%).
CONCLUSIONS: This study suggests that IL-8, IL-6, IL-10, TNF-α, and IL-1β may be potential diagnostic biomarkers for OC. Among them, TNF-α, IL-6, and IL-8 are highly accurate in the diagnosis of OC. Nevertheless, further studies that eliminate other confounding factors are warranted, and more standardized procedures and large-scale studies are needed to support the clinical use of saliva testing.