Molecular Biomarkers of Malignant Transformation in Head and Neck Dysplasia

SIMPLE SUMMARY: Head and neck cancer patients face significant morbidity and mortality. Early detection and diagnosis of disease followed by timely intervention is necessary for improving clinical management for these patients. There remains a need to be able to identify whether an early pre-cancerous lesion at the dysplasia stage will progress to invasive cancer. Biomarkers are biological molecules found in blood or tissue that are measurable at early stages of disease and can be applied to predict the progression of such lesions. The aim of this review is to comprehensively present the available evidence on the most frequently altered tumor molecular biomarkers present in head and neck dysplasia as well as their potential clinical applications. ABSTRACT: Head and neck squamous cell carcinoma (HNSCC) and its treatments are associated with substantial morbidity, often resulting in cosmetic deformity and loss of physiologic functions including speech and swallowing. Despite advancements in treatment, 5-year survival rates for mucosal malignancies remain below 70%. Effective prevention of HNSCC demands an understanding of the molecular pathways of carcinogenesis. Specifically, defining features of pre-cancerous dysplastic lesions that indicate a better or worse prognosis is necessary to help identify patients who are likely to develop a carcinoma and allow a more aggressive approach to management. There remains a need for identification of biomarkers that can provide both early prognostic and predictive value in clinical decision-making by serving as both therapeutic targets as well as predictors of therapy response. Here, we comprehensively review the most frequently altered molecular biomarkers of malignant transformation in head and neck dysplasia. These markers are involved in a wide range of cellular processes in head and neck carcinogenesis, including extracellular matrix degradation, cell motility and invasion, cell–cell adhesion, solute transport, immortalization, metabolism, the cell cycle and apoptosis, transcription, and cell signaling.