BRIDGING BIOLOGY AND BIOMARKERS IN ORAL CANCER: THE EPIGENETIC AND MICROENVIRONMENTAL NEXUS

Abstract

Oral squamous cell carcinoma (OSCC) accounts for well over 90 percent of oral cancers and remains a stubborn global health problem. Its knack for deep tissue invasion, frequent relapse, and poor survival grows from three inter-locking forces: hard-wired genetic errors, flexible but persistent epigenetic changes, and a tumor micro-environment (TME) that quietly cheers the disease on. In this review we look at that environment in detail-immune cells that should attack but often stand down, cancer-associated fibroblasts that rebuild the extracellular matrix as a launch pad, and blood vessels that deliver both oxygen and escape routes. We then trace how epigenetic tweaks-extra methyl groups on DNA, shuffled histone marks, and chatty non-coding RNAs-silence tumor-suppressor genes while switching on growth and survival pathways. What has been missing until now is a clear picture of how those epigenetic shifts and micro-environmental cues talk to one another in OSCC. By stitching together the latest molecular evidence, we highlight that conversation and point to practical pay-offs: early-detection markers, druggable checkpoints, and combination strategies that could finally move the needle toward precision care.