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Accepted Articles of Congress

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  • Oral Microbiome–Driven Inflammatory Pathways in Head and Neck Squamous Cell Carcinoma: A Systematic Review

  • Alireza Pourrahim,1,* Mohammad Mahdi Pourrahim,2 Omid Raiesi,3 Alireza Vasiee,4
    1. Student Research Committee, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
    2. Student Research Committee, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
    3. Omid Raiesi
    4. Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran


  • Introduction: Head and neck squamous cell carcinoma (HNSCC) exhibits a distinct oral microbial dysbiosis that may drive tumor-promoting inflammation via cytokine release and NF-κB activation. Elucidating quantitative links between specific bacterial taxa, inflammatory mediators, and clinical outcomes could identify prognostic biomarkers and therapeutic targets.
  • Methods: We searched PubMed, EMBASE, Web of Science, and Cochrane Library up to June 2025 using (“oral microbiome”) AND (“head and neck squamous cell carcinoma”) AND (“inflammation” OR “cytokine” OR “NF-κB”) and their related MeSH terms. Eligible studies reported quantitative associations between microbial relative abundance and inflammatory pathway markers in HNSCC tissue or saliva. Two reviewers independently screened 1,392 records, extracted data on standardized mean differences (SMD), odds ratios (OR), hazard ratios (HR), and assessed quality using the Newcastle–Ottawa Scale (NOS).
  • Results: Seven observational studies (n = 1,042 HNSCC patients; NOS median score 7/9; follow-up median Thirty-six months) were included. Pooled relative abundance of Fusobacterium nucleatum in tumor versus non-tumor samples showed an SMD of 0.84 (95% CI 0.62–1.06; p < 0.02). Porphyromonas gingivalis abundance yielded an SMD of 0.91 (95% CI 0.68–1.14; p < 0.05). Elevated interleukin-6 expression in high-abundance cohorts demonstrated an SMD of 1.12 (95% CI 0.90–1.34; p < 0.01). Presence of key oral pathogens was associated with increased NF-κB activation (OR 2.30; 95% CI 1.75–3.02; p < 0.05). A combined microbiome-inflammation signature predicted poorer overall survival (HR 1.78; 95% CI 1.34–2.36; p < 0.05).
  • Conclusion: Oral dysbiosis in HNSCC, marked by overrepresentation of F. nucleatum and P. gingivalis, correlates with heightened IL-6 levels, NF-κB pathway activation, and nearly twofold increased mortality risk. These findings support integration of microbiome-driven inflammatory markers into prognostic models and warrant exploration of microbiome-targeted interventions.
  • Keywords: head and neck squamous cell carcinoma; oral microbiome; Fusobacterium nucleatum

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