Oral Microbiome Dynamics in Head and Neck Cancer Patients Undergoing Oral Healthcare: Implications for Prognosis and early diagnosis

Abstract

Background: This study aims to investigate the influence of two oral mouthwash interventions on the oral microbiome of HNC patients at multiple time points, while simultaneously assessing their prognostic significance. Additionally, it seeks to identify distinctive oral microbiome biomarkers that are linked to different subtypes of HNC. Methods: Patients with HNC were subjected to random allocation into two distinct oral mouthwash intervention groups: the normal saline group denoted as N and the yikou gargle group employing chlorhexidine, represented as Y. Saliva samples were collected at three time points: baseline, post-operation, and before discharge from hospital. We employed 16S rRNA sequencing to comprehensively profile the composition of the oral microbiome, conducted an in-depth comparison of community diversity, and pinpointed enriched taxa within each oral mouth wash intervention group. Simultaneously, we conducted an investigation into the potential correlation between specific oral microbes and oral prognostic outcomes. Results: This study included 80 patients diagnosed with HNC scheduled for surgical intervention, and 30 patients underwent tracheostomy. Initially, both treatment groups had similar oral microbiome diversity. However, after surgery, the Y group exhibited a higher Shannon index and greater pronounced clustering variation compared to the N group. The genus Streptococcus dominated the oral microbiomes of both groups. The Y group showed a heightened abundance of taxa immediately after surgery when compared to the N group. In terms of implications for oral healthcare on oral prognosis, a notable finding was the significantly reduced severity of dental issues among patients in Y group when underwent tracheostomy as opposed to those in N group (p = 0.019). Conclusion: Our study provides insights into the impact of oral mouthwash interventions on the oral microbiome of HNC patients and their potential implications for prognosis. Understanding the role of the oral microbiome in HNC may pave the way for innovative therapeutic strategies that target the oral microbiota to improve treatment outcomes. Disparities in the oral microbiome among various types of HNC also suggest the potential for straightforward and non-invasive diagnostic approaches utilizing the oral microbiome.