Abstract
BACKGROUND: Oral squamous cell carcinoma (OSCC) is one of the most aggressive cancers in the oral cavity, often diagnosed at advanced stages, leading to significantly reduced survival rates. Traditional diagnostic methods, such as clinical examination and histopathology, have limitations in detecting early stages and assessing tumor variability. Molecular biomarkers, however, have shown great potential in overcoming these limitations by improving early diagnosis, prognosis, and personalized treatment. These biomarkers, when integrated with the TNM staging system, may provide more accurate and personalized clinical management. MATERIAL AND METHODS: A systematic review was conducted by searching PubMed, Scopus, and Web of Science databases for studies on biomarkers in OSCC published between January 2018 and December 2024. The studies were selected based on strict inclusion and exclusion criteria, focusing on those that investigated biomarkers related to OSCC diagnosis, prognosis, and therapeutic implications. RESULTS: This review includes 10 studies involving 1024 patients with OSCC. Key biomarkers such as Ki67, HSP60, Survivin, E-cadherin, and PD-L1 were significantly associated with tumor progression, lymph node metastasis, and poor prognosis. The combined use of these biomarkers with traditional histopathological methods could enhance diagnostic accuracy, allowing for better patient stratification and more targeted treatment approaches. Additionally, saliva-based biomarkers have emerged as a promising, non-invasive diagnostic tool with high sensitivity and specificity for early detection of OSCC. CONCLUSIONS: The identification of specific biomarkers can significantly enrich the diagnostic, prognostic, and therapeutic management of OSCC, complementing the TNM staging system. These biomarkers are linked to critical clinical variables such as metastasis, survival, and response to treatment. Saliva-based biomarkers hold promise due to their non-invasive nature, but further validation through multicenter studies and standardization is required for their widespread clinical adoption.