New advances in oral microbiology and tumor research

Abstract

Cancer remains a major global health concern, with escalating incidence and mortality rates underscoring the urgent need for novel diagnostic and therapeutic strategies. Increasing evidence has identified the oral microbiota as a critical contributor to tumorigenesis, thereby expanding the understanding of cancer pathogenesis beyond conventional risk factors such as tobacco use and genetic predisposition. This review summarizes recent progress in elucidating the complex relationship between the oral microbiota and various malignancies, particularly oral squamous cell carcinoma, esophageal adenocarcinoma, and pancreatic ductal adenocarcinoma. Pathogenic bacteria, including Porphyromonas gingivalis and Fusobacterium nucleatum, have been implicated in promoting tumor progression through mechanisms involving chronic inflammation, the production of metabolic toxins, and immune evasion. The dysbiosis of the oral microbiota, often driven by lifestyle factors such as poor diet, tobacco use, and alcohol consumption, further exacerbates these carcinogenic processes. Emerging therapeutic approaches including probiotics, oral microbiota transplantation, and CRISPR-based bacterial editing are under investigation for their potential to restore microbial homeostasis and suppress pathogenic species. Additionally, saliva-based microbial biomarkers have shown promise for non-invasive cancer screening. The integration of multi-omics technologies and artificial intelligence-driven platforms is further advancing the development of precision oncology. This review aims to consolidate fragmented findings concerning the oral microbiota-cancer axis and address existing gaps in mechanistic understanding. The review’s significance lies in the translational potential of microbial research to clinical applications, offering opportunities to reduce the global cancer burden through early detection and microbiota-targeted therapies.

Keywords: Oral microbiota; Tumorigenesis; Cancer; Microbial dysbiosis; Multi-omics integration; Precision medicine

Core Tip: This review synthesizes recent progress in understanding the complex interactions between the oral microbiota and various cancers, particularly oral squamous cell carcinoma, esophageal adenocarcinoma, and pancreatic ductal adenocarcinoma. It highlights the roles of pathogenic bacteria such as Porphyromonas gingivalis and Fusobacterium nucleatum in promoting tumor progression through chronic inflammation, metabolic toxin production, and immune evasion. The review also explores innovative therapeutic strategies, including probiotics, oral microbiota transplantation, and CRISPR-based bacterial editing, while emphasizing the potential of saliva-based microbial biomarkers for non-invasive cancer screening. This work aims to translate microbial-related research into clinical applications, with the goal of mitigating the global cancer burden through early diagnosis and microbiome-targeted therapy.