Abstract
BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is a common malignancy with high rate of lymph node metastasis (LNM), which significantly impacts prognosis. This study aims to evaluate the potential utility of Fusobacterium nucleatum (F. nucleatum) and interleukin-32 (IL-32) as co-predictors for cervical LNM in HNSCC, enhancing preoperative assessment of metastatic status in patients. METHODS: Clinical information, tissue, and plasma samples were collected from a cohort of 254 HNSCC patients. IL-32 expression was assessed using immunohistochemistry (IHC), while fluorescence in situ hybridization (FISH) was used to evaluate F. nucleatum enrichment in both tumor and paracancer tissue. Univariate and multivariate analyses identified significant risk factors. RESULTS: IL-32 levels were higher in tumor tissue compared to paracancer tissue (P<0.001). Patients with high F. nucleatum enrichment had higher IL-32 expression (P=0.04). Through univariate and multivariate analyses, alcohol, Ki-67 (antigen Kiel-67) expression, F. nucleatum enrichment and IL-32 expression were identified as significant risk factors of LNM. The comparison of receiver operating characteristic (ROC) curves for these factors showed that the combined use of all chosen indicators resulted in the highest diagnostic accuracy. CONCLUSIONS: The enrichment of F. nucleatum in cancer tissue is positively correlated with high expression of IL-32, suggesting that these two novel indicators, F. nucleatum and IL-32, along with Ki-67 and alcohol, may serve as preoperative predictors for LNM in HNSCC. This discovery holds great potential to facilitate the development of more precise and personalized surgical strategies for patients.