Role of Candida in the Pathogenesis of Oral Squamous Cell Carcinoma: A Systematic Review
Bibliographic record
Abstract
Introduction: Oral Squamous Cell Carcinoma (OSCC) is the sixteenth most prevalent cancer globally, with a significant proportion of cases originating in India. The progression from healthy oral mucosa to OSCC often involves Oral Potentially Malignant Disorders (OPMDs). However, recent classification updates have excluded chronic candidiasis from the list of OPMDs. Despite this, Candida species are frequently associated with cases of severe dysplasia and OSCC, suggesting a potential role in the pathogenesis of OSCC. By exploring specific pathways through which Candida may promote carcinogenesis, this review highlights the importance of recognising chronic candidiasis as an OPMD for early diagnosis and improved patient outcomes. Aim: The present systematic review aimed to consolidate evidence on the potential association between chronic Candida infections and the pathogenesis of OSCC. Materials and Methods: The present systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Original studies involving tumour tissues or archival blocks from patients with oral cancer and those addressing OSCC pathogenesis were included; case reports, case series, and studies using only saliva samples or oral swabs were excluded. A comprehensive search across PubMed, Scopus, and Web of Science was performed up to December 10, 2023. Study quality was assessed using the Newcastle-Ottawa Scale, with modifications to fit the review’s objectives. Data extraction included information on Candida species and diagnostic approaches, with results synthesised narratively due to variability among studies. Results: The search strategy yielded 624 articles from multiple databases (PubMed: 263; Scopus: 204; Web of Science: 157). After applying the inclusion and exclusion criteria, only 13 studies were selected for the review. Candida prevalence in Oral Leukoplakia (OL) ranged from 6.8 to 100%, with three studies reporting malignant transformation rates of 2.5%, 6.5%, and 28.7%. C. albicans was the most frequently detected species, followed by C. dubliniensis, C. glabrata, C. guilliermondii, and C. krusei. Some studies identified additional fungal species, though they were considered potential contaminants. Histological analysis revealed Candida hyphae penetrating deep into OSCC tissues, suggesting a role in tumour progression. Conclusion: The review highlights the importance of recognising chronic candidiasis as an OPMD due to its potential role in the pathogenesis of OSCC. Early identification and management of chronic Candida infections could serve as a preventive strategy in high-risk populations. The findings advocate for the inclusion of chronic candidiasis in future classifications of OPMDs to enhance early diagnosis and improve patient outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".