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Oral Squamous Cell Carcinoma: Insights into Molecular Pathways and Emerging Therapeutic Approaches

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Oncology".

Deadline for manuscript submissions: closed (20 January 2026) | Viewed by 7332

Special Issue Editor


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Guest Editor
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
Interests: oral squamous cell carcinoma; epigenetics; transcriptional regulation; molecular biomarkers; targeted therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Oral squamous cell carcinoma (OSCC) represents a prevalent and aggressive form of malignancy arising from the epithelial cells of the oral cavity. It accounts for the majority of oral cancer cases, with a higher incidence in adults, particularly those with significant risk factors such as tobacco and alcohol use and human papillomavirus.

Despite advances in treatment modalities, managing aggressive forms of OSCC remains a considerable challenge, particularly in achieving the long-term control of localized tumors. The prognosis for patients with advanced or metastatic OSCC continues to be poor. However, recent technological innovations are facilitating a deeper understanding of the molecular drivers behind OSCC development and progression. Disruptions in key regulatory mechanisms, such as transcriptional, post-transcriptional, and post-translational processes, have been identified as being crucial to OSCC behavior. These molecular dysregulations reveal potential therapeutic vulnerabilities and offer new opportunities for biomarker discovery and targeted treatments.

For this Special Issue, we invite submissions of high-quality original research and review articles focused on fundamental and translational research that sheds light on the regulatory networks driving OSCC pathogenesis and progression. We particularly welcome studies that explore novel mechanisms related to radiotherapy and drug resistance, with the goal of advancing therapeutic strategies and improving patient outcomes.

This Special Issue invites submissions of high-quality original research articles and reviews that explore the molecular and translational aspects of OSCC. We encourage studies that uncover novel regulatory mechanisms contributing to OSCC pathogenesis and progression, with a focus on improving therapeutic outcomes and the development of innovative treatment strategies.

Dr. Silvia Pomella
Guest Editor

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Keywords

  • oral squamous cell carcinoma
  • epigenetics
  • molecular genetics
  • gene expression targeted therapy
  • molecular biomarkers

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Published Papers (5 papers)

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Research

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12 pages, 1786 KB  
Article
Expression of NOTCH1 Is Correlated with Expression of Cancer Stem Cell Markers and miR-150 in Oral Epithelial Dysplasia
by Emanuela Boštjančič, Gašper Grubelnik, Nina Zidar and Katarina Dimnik
Int. J. Mol. Sci. 2026, 27(4), 1946; https://doi.org/10.3390/ijms27041946 - 18 Feb 2026
Viewed by 514
Abstract
NOTCH1 is associated with various tumors, including oral squamous cell carcinoma (OSCC), with a complex role depending on cellular contexts. Our aim was to analyze the expression of NOTCH1, several stem cell markers, and selected microRNAs in preneoplastic lesion of the oral cavity, [...] Read more.
NOTCH1 is associated with various tumors, including oral squamous cell carcinoma (OSCC), with a complex role depending on cellular contexts. Our aim was to analyze the expression of NOTCH1, several stem cell markers, and selected microRNAs in preneoplastic lesion of the oral cavity, oral epithelial dysplasia (OAD). Our study included formalin-fixed paraffin-embedded biopsy samples of 36 cases of OAD and 15 cases of normal oral mucosa. Expression of NOTCH1, stem cell markers (AGR2, KLF4, NANOG, OCT4, SOX2), and miR-27a, miR-34a, miR-128, miR-145, miR-150, and miR-335 was analyzed by quantitative PCR (qPCR). Expression of NOTCH1 protein was analyzed by immunohistochemistry. In OAD compared to normal mucosa, we found a significant increase in mRNA levels of NOTCH1, stem cell markers AGR2, NANOG, OCT4, and SOX2, and miR-150 and miR-128. NOTCH1 mRNA positively correlated with all five stem cell markers’ mRNA levels and miR-150. Immunohistochemistry showed variable expression patterns of NOTCH1 in OAD and normal mucosa. Our results support the role of NOTCH1 in early phases of OSCC development, with a potential contributory role in stemness, in association with AGR2, NANOG, OCT4, and SOX2, miR-150 and miR-128. These results support a complex role of NOTCH1 in carcinoma development, i.e., from oncogenic to tumor suppressor roles and stemness maintenance, not only in invasive OSCC but also in its precursor—OED. Full article
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17 pages, 11192 KB  
Article
Mechanism of Tumor Budding in Patient-Derived Metachronous Oral Primary Squamous Cell Carcinoma Cell Lines
by Takayuki Omae, Yuji Omori, Yuna Makihara, Koji Yamanegi, Soutaro Hanawa, Kyohei Yoshikawa, Kazuma Noguchi and Hiromitsu Kishimoto
Int. J. Mol. Sci. 2025, 26(7), 3347; https://doi.org/10.3390/ijms26073347 - 3 Apr 2025
Cited by 4 | Viewed by 1634
Abstract
Tumor budding (TB) occurs at the deepest site of tumor invasion and is a significant prognostic indicator of cervical metastasis in oral squamous cell carcinoma (OSCC). The mechanism of TB, however, remains unclear. This study investigated the roles of the tumor microenvironment and [...] Read more.
Tumor budding (TB) occurs at the deepest site of tumor invasion and is a significant prognostic indicator of cervical metastasis in oral squamous cell carcinoma (OSCC). The mechanism of TB, however, remains unclear. This study investigated the roles of the tumor microenvironment and partial epithelial–mesenchymal transition (p-EMT) in TB expression using molecular and cellular physiological analyses. We established oral metachronous carcinoma cell lines (gingival carcinoma: 020, tongue carcinoma with high TB expression: 020G) from two cancers with pathologically different TB in the same patient and subjected them to exome analysis to detect gene mutations related to carcinogenesis and malignancy. Differences in EMT expression induced by transforming growth factor-β (TGF-β) between 020 and 020G were analyzed by Western blotting and reverse transcription polymerase chain reaction, and TGF-β-induced changes in cell morphology, proliferation, migration, and invasive ability were also examined. TGF-β expression was observed in the deepest tumor invasion microenvironment. TGF-β also induced the expression of several p-EMT markers and increased the migration and invasive abilities of 020G compared with 020 cells. In conclusion, TGF-β in the deep-tumor microenvironment can induce p-EMT in tumor cells, expressed as TB. Full article
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12 pages, 4505 KB  
Communication
Increased Expression of Superoxide Dismutase 2 Is an Indicator of Worse Prognosis of Oropharyngeal Cancer
by Yoshitaka Aoki, Satoru Kondo, Eiji Kobayashi, Makiko Moriyama-Kita, Hirotomo Dochi, Shigetaka Komura, Yosuke Nakanishi, Kazuhira Endo, Naohiro Wakisaka and Tomokazu Yoshizaki
Int. J. Mol. Sci. 2025, 26(7), 3223; https://doi.org/10.3390/ijms26073223 - 30 Mar 2025
Viewed by 1424
Abstract
Human papillomavirus (HPV) is a known risk factor for oropharyngeal cancer (OPC), with distinct HPV-positive and HPV-negative subtypes. Reactive oxygen species have been implicated in the carcinogenesis of several malignancies. Superoxide dismutase 2 (SOD2), a mitochondrial enzyme, is highly influenced by oxidative stress. [...] Read more.
Human papillomavirus (HPV) is a known risk factor for oropharyngeal cancer (OPC), with distinct HPV-positive and HPV-negative subtypes. Reactive oxygen species have been implicated in the carcinogenesis of several malignancies. Superoxide dismutase 2 (SOD2), a mitochondrial enzyme, is highly influenced by oxidative stress. This study investigated whether SOD1 and SOD2 expression in OPC affects primary tumor progression, lymph node metastasis, stage, and overall survival (OS). Biopsy or surgically resected specimens from 72 patients with OPC were analyzed via immunohistochemical staining for SOD1 and SOD2. The proportion of stained cells within the tumor area was assessed. Associations between SOD1 and SOD2 expression, T classification, N classification, and stage were evaluated. Factors correlated with OS in OPC were also examined. No significant differences in SOD1 or SOD2 expression were observed concerning T or N classification, or stage. However, high SOD2 expression was identified as a significant poor prognostic factor for OS. Regardless of HPV status, SOD2 expression predicts poor prognosis in OPC. Evaluating SOD2 expression may help predict OPC prognosis. Full article
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16 pages, 3267 KB  
Article
Connexin 43 Expression as Biomarker of Oral Squamous Cell Carcinoma and Its Association with Human Papillomavirus 16 and 18
by Jose Roberto Gutierrez-Camacho, Lorena Avila-Carrasco, Idalia Garza-Veloz, Joel Monárrez-Espino, Maria Calixta Martinez-Vazquez, Roxana Araujo-Espino, Perla M. Trejo-Ortiz, Rosa B. Martinez-Flores, Reinaldo Gurrola-Carlos, Lorena Troncoso-Vazquez and Margarita L. Martinez-Fierro
Int. J. Mol. Sci. 2025, 26(3), 1232; https://doi.org/10.3390/ijms26031232 - 30 Jan 2025
Cited by 1 | Viewed by 1955
Abstract
Oral squamous cell carcinoma (OSCC) is the main form of head and neck cancer. Gap junctions (GJs) are communication channels involved in cell proliferation control; they consist of hemichannels formed by connexin (Cx) proteins. The abnormal expression/function of Cx43 has been associated with [...] Read more.
Oral squamous cell carcinoma (OSCC) is the main form of head and neck cancer. Gap junctions (GJs) are communication channels involved in cell proliferation control; they consist of hemichannels formed by connexin (Cx) proteins. The abnormal expression/function of Cx43 has been associated with tumor progression. Also, some human papillomaviruses (HPVs) have been linked to squamous cell cancer. Therefore, this study aimed at assessing Cx43 as a potential OSCC biomarker and exploring its association with histopathological differentiation and HPV infection. OSCC samples were inspected using hematoxylin and eosin staining, and Cx43 expression and HPV 16/18 were tested by immunofluorescence. Pearson correlation tests, ANOVA, and Kaplan–Meier curves were used in the analysis. Samples from 39 patients with OSCC were studied. Most had well-differentiated histology and 61.5% were HPV+. Cx43 expression was significantly associated with HPV infection (p = 0.047), differentiation (p < 0.001), and survival (p = 0.009), and HPV positivity was also associated with the degree of differentiation (p = 0.012). Cx43 shows potential as a prognostic biomarker for OSCC. Lower Cx43 expression, correlated with poorer differentiation, is associated with an unfavorable prognosis. Further studies are needed to confirm its clinical utility. Full article
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Review

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23 pages, 2600 KB  
Review
Immunological Analysis of Oral Cytobrush Specimens for Early Detection of Oral Cancer Biomarkers: A Comprehensive Review
by Reem Hanna, Alberto Luigi Rebaudi, Saman Warnakulasuriya, Senada Koljenovic, Maria Menini, Francesco Laganà, Bernardo Bianchi, Paolo Iacoviello, Mauro Labanca, Marco Greppi, Federico Rebaudi, Silvia Pesce, Alberto Rebaudi and Emanuela Marcenaro
Int. J. Mol. Sci. 2026, 27(4), 2059; https://doi.org/10.3390/ijms27042059 - 23 Feb 2026
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Abstract
Early identification of the risk of malignant transformation in oral potentially malignant disorders (OPMDs) is critical for improving outcomes in oral squamous cell carcinoma (OSCC). This comprehensive review examines immunological biomarkers obtained from minimally invasive oral cytobrush (OCB) specimens for the early detection [...] Read more.
Early identification of the risk of malignant transformation in oral potentially malignant disorders (OPMDs) is critical for improving outcomes in oral squamous cell carcinoma (OSCC). This comprehensive review examines immunological biomarkers obtained from minimally invasive oral cytobrush (OCB) specimens for the early detection of OSCC within a precision medicine framework. The objectives were to (1) identify and characterise key immunological biomarkers associated with early oral carcinogenesis; (2) evaluate the diagnostic utility of OCB sampling for detecting these biomarkers; and (3) explore the potential of OCB-based profiling to support personalised screening and patient management. The review highlights the potential advantages of OCB compared with conventional diagnostic methods, as reported in the literature, particularly its ability to capture early malignant changes through immunological analysis. Evidence is discussed for biomarker pathways related to cell-cycle and differentiation dysregulation (p53, Ki-67, CKs), inflammation-driven epithelial transformation (IL-1β, IL-6, IL-8, TNF-α), and immune suppression and checkpoint activation (PD-L1, B7-H6). OCB provides reliable and patient-friendly cyto-salivary samples that are suitable for immunological and molecular analyses. Aberrant biomarker expression detected in OCB specimens correlates with epithelial dysplasia and reflects early non-invasive neoplastic transformation, supporting the diagnostic value of integrated biomarker panels. Overall, OCB-based immunoanalysis represents a practical, non-invasive approach for the early detection of OSCC. Emerging technologies, including AI and multi-omics approaches, may further support the precision and predictive values of immunological analysis for OSCC. When combined with relevant biomarker pathways reflecting tumour biology and host immune responses, this strategy could offer a strong foundation for precision-medicine screening. It may also support personalised monitoring in patients with OPMDs. Full article
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