Personalized Medicine in Oral Oncology: Imaging Methods and Biological Markers to Support Diagnosis of Oral Squamous Cell Carcinoma (OSCC): A Narrative Literature Review

Abstract

For decades, oral squamous cell carcinoma (OSCC) has been one of the most prevalent and mortal cancers worldwide. The gold standard for OSCC diagnosis is still histopathology but this narrative multidisciplinary review has the aim to explore the literature about conventional OSCC prognostic indicators related to the pTNM stage at the diagnosis such as the depth of invasion and the lymphovascular invasion associated with distant metastasis as indicators of poor life expectancy. Despite its multifactorial nature and recognizable precursors, its diagnosis at the early stages is still challenging. We wanted to highlight the importance of the screening as a primary weapon that a stomatologist should consider, intercepting all at-risk conditions and lesions associated with OSCC and its early stages. This narrative review also overviews the most promising imaging techniques, such as CT, MRI, and US-echography, and their application related to clinical and surgical practice, but also the most-investigated prognostic and diagnostic tissue and salivary biomarkers helpful in OSCC diagnosis and prognostic assessment. Our work highlighted remarkable potential biomarkers that could have a leading role in the future. However, we are still far from defining an appropriate and concrete protocol to apply in clinical practice. The hope is that the present and future research will overcome these limitations to benefit patients, clinicians, and welfare.

Identification of Stage-Specific microRNAs That Govern the Early Stages of Sequential Oral Oncogenesis by Strategically Bridging Genetics and Epigenetics

“…Despite some advancements in diagnosis and treatment, the outlook for OSCC remains bleak, as indicated by its approximately 40% five-year survival rate [2,[6][7][8], while recurrence or metastasis is extremely likely to develop within the first two years post-treatment [1][2][3][4]. Late diagnosis is one of the main obstacles that contributes to the high mortality rates associated with OSCC, with one in two patients diagnosed in an advanced stage [1,7,8].…”

“…Oral cancer, encompassing areas such as the lips, gums, tongue, and palate, is one of the most frequently occurring malignancies, ranking 6th in terms of frequency around the globe [1][2][3]. More than 90% of oral cancer cases are histologically represented by oral squamous cell carcinoma (OSCC), which originates from the stratified squamous cell epithelial lining the oral cavity, where it can develop from clinically normal mucosa or premalignant lesions [4,5]. OSCC is considered a highly prevalent and lethal malignancy due to its highly aggressive behavior, marked by invasive growth and a bold propensity for metastasis.…”

“…OSCC is considered a highly prevalent and lethal malignancy due to its highly aggressive behavior, marked by invasive growth and a bold propensity for metastasis. Only in 2023, 377.713 new OSCC cases, as well as 177.757 deaths were globally reported [4][5][6]. Despite advancements in treatment, the prognosis for OSCC remains OSCC-derived specimens, to functionally document their putative regulatory role in OSCC development, through the inverse relations between miRNA levels and the expression of their targetgenes [8].…”