Semiz Volkan, Aksoy Rahmi A, Altun Zekiye
Radiation Oncology, İzmir City Hospital, Izmir, TUR.
Radiation Oncology, Izmir City Hospital, Izmir, TUR.
Cureus. 2025 Apr 30;17(4):e83242. doi: 10.7759/cureus.83242. eCollection 2025 Apr.
The global impact of oral cavity cancer (OCC) is substantial, given its five-year survival rate of nearly 50%. Tobacco, alcohol, and betel nut consumption are primary risk factors, but OCC can also develop in individuals without these exposures. Recent studies increasingly indicate that the oral microbiome may contribute to the pathogenesis of OCC, especially in the context of poor oral hygiene and periodontal disease. The oral microbiome consists of hundreds of bacterial and fungal species, influenced by factors such as smoking, alcohol, diet, and medications. Smoking disrupts microbial balance and epithelial barriers, contributing to dysbiosis. Studies have linked periodontal pathogens like , , and to OCC, while certain species may have protective effects. Microbial alterations are observed in both OCC and precancerous lesions, suggesting a role in early carcinogenesis. The oral microbiome may facilitate carcinogenesis through multiple interrelated mechanisms, including the generation of carcinogenic byproducts (e.g., nitrosamines, acetaldehyde, hydrogen sulfide), persistent inflammatory signaling, immune evasion, resistance to apoptosis, and the activation of epithelial-mesenchymal transition pathways. These factors contribute to DNA damage, genomic instability, and tumor progression. A deeper understanding of how the oral microbiome influences OCC may offer novel strategies for both prevention and clinical management. Future research should focus on microbiome-targeted interventions to reduce OCC risk and improve clinical outcomes.
口腔癌（OCC）的全球影响巨大，其五年生存率接近50%。烟草、酒精和槟榔消费是主要风险因素，但无这些暴露因素的个体也可能发生口腔癌。最近的研究越来越表明，口腔微生物群可能促成口腔癌的发病机制，尤其是在口腔卫生差和患有牙周病的情况下。口腔微生物群由数百种细菌和真菌组成，受吸烟、酒精、饮食和药物等因素影响。吸烟会破坏微生物平衡和上皮屏障，导致生态失调。研究已将诸如牙龈卟啉单胞菌、伴放线聚集杆菌和具核梭杆菌等牙周病原体与口腔癌联系起来，而某些链球菌属物种可能具有保护作用。在口腔癌和癌前病变中均观察到微生物改变，表明其在早期致癌过程中发挥作用。口腔微生物群可能通过多种相互关联的机制促进致癌作用，包括产生致癌副产物（如亚硝胺、乙醛、硫化氢）、持续的炎症信号传导、免疫逃逸、抗细胞凋亡以及上皮-间质转化途径的激活。这些因素导致DNA损伤、基因组不稳定和肿瘤进展。深入了解口腔微生物群如何影响口腔癌可能为预防和临床管理提供新策略。未来的研究应侧重于针对微生物群的干预措施，以降低口腔癌风险并改善临床结果。
