Bonilla Marco, Peñalver Irene, Mesa-López María José, Mesa Francisco
Department of Periodontics, School of Dentistry, University of Granada, 18071 Granada, Spain.
School of Dentistry, University of Granada, 18071 Granada, Spain.
J Clin Med. 2025 Sep 8;14(17):6334. doi: 10.3390/jcm14176334.
Chronic periodontitis has emerged as a potential modifiable risk factor for several tumors, yet its role remains underexplored beyond epidemiological associations. This perspective review examines the immunological and molecular interplay between periodontitis and various cancers-including prostate, colorectal, oral squamous cell carcinoma, and oral potentially malignant disorders-highlighting shared inflammatory mediators and immune dysregulation. Special attention is given to immune cell profiles, cytokine expression, dysbiosis, and common miRNA signatures. Recent evidence suggests that periodontitis may act not only as a co-factor in tumor development but also, in some contexts, as a marker of therapeutic response, particularly in patients undergoing immune checkpoint inhibitor therapy. In our view, future research should prioritize mechanistic studies to define common immune-inflammatory pathways and clarify whether periodontitis functions as a field cancerization process or as a facilitator of malignant transformation in already compromised tissues. The relationship between cancer and periodontitis underscores the need to integrate oral health into oncologic care and immunotherapy management.
慢性牙周炎已成为多种肿瘤潜在的可改变风险因素，但其作用在流行病学关联之外仍未得到充分探索。本综述探讨了牙周炎与各种癌症（包括前列腺癌、结直肠癌、口腔鳞状细胞癌和口腔潜在恶性疾病）之间的免疫和分子相互作用，强调了共同的炎症介质和免疫失调。特别关注免疫细胞谱、细胞因子表达、生态失调和常见的微小RNA特征。最近的证据表明，牙周炎不仅可能作为肿瘤发展的辅助因素，而且在某些情况下，还可能作为治疗反应的标志物，特别是在接受免疫检查点抑制剂治疗的患者中。我们认为，未来的研究应优先进行机制研究，以确定共同的免疫炎症途径，并阐明牙周炎是作为场癌化过程，还是作为已经受损组织中恶性转化的促进因素。癌症与牙周炎之间的关系强调了将口腔健康纳入肿瘤护理和免疫治疗管理的必要性。
