Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Head Neck. 2023 Aug;45(8):2120-2135. doi: 10.1002/hed.27422. Epub 2023 May 30.
The relationship between head and neck squamous cell carcinoma (HNSCC) and the oral microbiome has been drawn in various studies. Microbial diversities, microbiome profiles, metagenomic analysis, and host-pathogen interactions were collected from these studies to highlight similarities and account for inconsistencies. We also evaluate the possible clinical applications of the microbiome regarding screening and diagnosis of HNSCC.
Systematic analysis of studies regarding HNSCC and the microbiome was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Articles were retrieved from four databases (PubMed, ScienceDirect, CUHK Full-Text Journals, and Cochrane database) and were screened using predefined criteria.
Twenty studies were chosen after screening for full-text review. α-diversity comparison was inconsistent whereas β-diversity between HNSCC and normal samples showed distinct clustering. Microbial dysbiosis characterized by change in the relative abundances of several bacterial species were also seen in HNSCC patients. At a phylum level, inconsistencies were seen between studies using HNSCC tumor tissue samples and saliva samples. At a genus level, Fusobacterium, Peptostreptococcus, Alloprevotella, Capnocytophaga, Catonella, and Prevotella were differentially enriched in HNSCC while Streptococcus, Actinomyces Veillonella, and Rothia were differentially depleted. Co-occurrence network analysis revealed a positive correlation of HNSCC with periodontal pathogens and a negative correlation with commensal bacteria. Metagenomic analysis of microbiota revealed a differential enrichment of pro-inflammatory genomic pathways which was consistent across various studies. Microbial dysbiosis was applied in clinical use as a tool for HNSCC screening. Random-forest analysis was adopted to differentiate between tumor and normal tissue, at 95.7% and 70.0% accuracies respectively in two studies. Microbial dysbiosis index was also used to predict prognosis.
Oral microbial dysbiosis could be a promising tool for HNSCC screening and diagnosis. However, more research should be conducted pertaining to clinical applications to improve diagnostic accuracy and explore other clinical uses.
头颈部鳞状细胞癌（HNSCC）与口腔微生物组的关系在各种研究中都有涉及。从这些研究中收集了微生物多样性、微生物组谱、宏基因组分析和宿主-病原体相互作用，以突出相似之处并解释不一致之处。我们还评估了微生物组在 HNSCC 筛查和诊断方面的可能临床应用。
根据系统评价和荟萃分析的首选报告项目（PRISMA）声明指南，对头颈部鳞状细胞癌和微生物组的研究进行系统分析。从四个数据库（PubMed、ScienceDirect、香港中文大学全文期刊和 Cochrane 数据库）中检索文章，并使用预定义标准进行筛选。
经过全文审查筛选后，选择了 20 项研究。α多样性比较不一致，而 HNSCC 和正常样本之间的β多样性显示出明显的聚类。HNSCC 患者也存在微生物失调，表现为几种细菌相对丰度的变化。在门水平上，使用 HNSCC 肿瘤组织样本和唾液样本的研究之间存在不一致。在属水平上， Fusobacterium、Peptostreptococcus、Alloprevotella、Capnocytophaga、Catonella 和 Prevotella 在 HNSCC 中丰度增加，而 Streptococcus、Actinomyces、Veillonella 和 Rothia 则丰度减少。共现网络分析显示，HNSCC 与牙周病原体呈正相关，与共生细菌呈负相关。微生物组的宏基因组分析显示，促炎基因组途径的差异富集在各种研究中是一致的。微生物失调被应用于临床，作为 HNSCC 筛查的工具。两项研究中，随机森林分析分别在 95.7%和 70.0%的准确率下区分肿瘤和正常组织。微生物失调指数也用于预测预后。
口腔微生物失调可能是 HNSCC 筛查和诊断的有前途的工具。然而，应该进行更多的研究以提高诊断准确性并探索其他临床用途。
