International Journal of Molecular Medical Science, 2025, Vol.15, No.1, 9-19 http://medscipublisher.com/index.php/ijmms 10 assess their feasibility for clinical application. By exploring new genomic detection technologies and their applications in early diagnosis, this study seeks to promote the development of more efficient, non-invasive, and precise screening methods for oral cancer. The goal is to provide a basis for personalized treatment approaches, ultimately reducing the incidence and mortality rates of oral cancer globally. 2 Emerging Genomic Biomarkers for Early Detection 2.1 DNA-based biomarkers DNA-based biomarkers focus on genetic and epigenetic alterations, such as mutations and methylation changes in tumor suppressor genes, that occur early in oral cancer development. Hypermethylation of tumor suppressor genes like p16INK4a, RASSF1A, TIMP3, and PCQAP/MED15 has been identified as a promising indicator of oral cancer presence. A study by Liyanage et al. (2019) demonstrated that a panel of these methylated genes could differentiate oral cancer patients from healthy controls with high sensitivity and specificity when detected in saliva, emphasizing their potential in non-invasive early detection (Liyanage et al., 2019). Next-Generation Sequencing (NGS) has facilitated the detection of mutations directly from biological fluids, enhancing the ability to identify genetic alterations associated with Oral Squamous Cell Carcinoma (OSCC). Campos-Carrillo et al. (2019) explored the use of targeted DNA sequencing to detect key oncogenic mutations in saliva, revealing that this approach could effectively identify early-stage tumors that traditional methods might miss. This provides a molecular basis for integrating DNA-based biomarker screening into routine clinical practice (Campos-Carrillo et al., 2019). Furthermore, methylation-specific PCR assays have proven effective in identifying aberrant DNA methylation patterns in the promoter regions of critical genes. A meta-analysis by Adeoye et al. (2021) highlighted the potential of using combined methylation markers in saliva for early screening of OSCC, showing a sensitivity of 86.2% and specificity of 90.6% (Adeoye et al., 2021). These findings support the value of DNA-based methylation biomarkers as reliable tools for early diagnosis, particularly in high-risk populations. 2.2 RNA-based biomarkers (MicroRNAs and lncRNAs) MicroRNAs (miRNAs) have emerged as key players in the early detection of oral cancers due to their role in regulating gene expression and tumorigenesis. Certain miRNAs, such as miR-222-3p, miR-150-5p, and miR-423-5p, have been identified as being differentially expressed in plasma samples from patients with OSCC compared to healthy controls. Chang et al. (2018) demonstrated that a three-miRNA panel could distinguish oral leukoplakia from OSCC with high accuracy (AUC=0.88), suggesting its potential as a non-invasive diagnostic tool (Chang et al., 2018). Long non-coding RNAs (lncRNAs) also play a crucial role in the early detection of oral cancers. Recent studies have highlighted the diagnostic potential of lncRNAs such as GHET1 and ZXF2, which are significantly upregulated in OSCC tissues. Li et al. (2020) identified a set of six novel lncRNAs that, when combined into a diagnostic model, could differentiate OSCC patients from healthy individuals with high sensitivity and specificity (Li et al., 2020). These lncRNAs could serve as early biomarkers for OSCC, offering a more targeted approach to early diagnosis. Moreover, combining lncRNAs with miRNAs in a competitive endogenous RNA (ceRNA) network can further enhance diagnostic precision. Yin et al. (2020) constructed a ceRNA network that included lncRNA HCG22, showing its strong potential as a diagnostic marker for oral cancer. This integrative approach allows for a deeper understanding of the molecular interactions in OSCC and offers a promising path for future biomarker development (Yin et al., 2020). 2.3 Protein-based biomarkers Protein-based biomarkers, particularly those detectable in saliva, provide another non-invasive option for the early detection of OSCC. Cytokeratin fragment 21.1 (Cyfra 21.1) has been identified as a potential biomarker, with elevated levels correlating with the presence of oral cancer. Jafari and Hasanzadeh (2020) developed an
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