Muthusamy Mudiyayirakkani, Ramani Pratibha, Poothakulath Krishnan Reshma, K Hemashree, Sukumaran Gheena, Ramasubramanian Abilasha
Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Chennai, IND.
Cureus. 2023 Jan 9;15(1):e33560. doi: 10.7759/cureus.33560. eCollection 2023 Jan.
The oral cavity has the second largest and most diverse microflora. A wide variety of bacteria, viruses, and fungi are present in the oral cavity. A significant number of studies have shown the important role of oral microflora in the initiation and pathogenesis of oral squamous cell carcinoma (OSCC). Microorganisms like , , , , , , Herpes Simplex Virus I (HSV-1), Epstein-Barr Virus (EBV), Human Papilloma Virus (HPV), plays an important role in OSCC. Increased microbial load affects tumor initiation and progression through direct effects on the tumor cells and indirectly through manipulation of the immune system. But the mechanisms describing the steps of oral microflora initiating the OSCC remain an enigma. This systematic review aims to understand the potential carcinogenic effect of oral microflora on OSCC. A systematic literature search was done in PubMed and Google Scholar databases, and six studies were obtained, comprising 1267 participants. The incidence was evaluated as an odds ratio (OR) with a 95% confidence interval (95% CI) using review manager 5.2 software. Oral microflora increased 2.10-fold risk of oral squamous cell carcinoma (OR=2.10, 95% CI: 0.76, 5.84, P= 0.15, I=86%, P<0.00001). In our subgroup analysis, there is a significant relation between Fusobacterium and oral squamous cell carcinoma (OR= 4.86, 95% CI: 0.99, 23.82, P=0.05, I=0%, P= 0.84). Individuals with Epstein-Barr Virus infection exhibit increased incidence of oral squamous cell carcinoma (OR= 3.72, 95% CI: 1.97, 7.04, P=<0.0001, I=0%, P= 0.82). The meta-analysis revealed that oral microflora increases the risk of oral squamous cell carcinoma.
口腔拥有第二大且最为多样的微生物群落。口腔中存在各种各样的细菌、病毒和真菌。大量研究表明口腔微生物群落在口腔鳞状细胞癌（OSCC）的发生和发病机制中发挥着重要作用。诸如具核梭杆菌、牙龈卟啉单胞菌、中间普氏菌、齿垢密螺旋体、福赛坦氏菌、微小微单胞菌、单纯疱疹病毒I（HSV - 1）、爱泼斯坦 - 巴尔病毒（EBV）、人乳头瘤病毒（HPV）等微生物在OSCC中起重要作用。微生物负荷增加通过对肿瘤细胞的直接影响以及通过操纵免疫系统间接影响肿瘤的发生和进展。但描述口腔微生物群引发OSCC步骤的机制仍是一个谜。本系统评价旨在了解口腔微生物群对OSCC的潜在致癌作用。在PubMed和谷歌学术数据库中进行了系统的文献检索，获得了六项研究，共1267名参与者。使用Review Manager 5.2软件将发病率评估为比值比（OR）及95%置信区间（95%CI）。口腔微生物群使口腔鳞状细胞癌风险增加2.10倍（OR = 2.10，95%CI：0.76，5.84，P = 0.15，I² = 86%，P < 0.00001）。在我们的亚组分析中，具核梭杆菌与口腔鳞状细胞癌之间存在显著关联（OR = 4.86，95%CI：0.99，23.82，P = 0.05，I² = 0%，P = 0.84）。感染爱泼斯坦 - 巴尔病毒的个体口腔鳞状细胞癌发病率增加（OR = 3.72，95%CI：1.97，7.04，P = <0.0001，I² = 0%，P = 0.82）。荟萃分析表明口腔微生物群会增加口腔鳞状细胞癌的风险。
