BackgroundPeripheral blood analysis is a non‐invasive and low‐cost technique of prognostic value for several diseases, including oral cancer. Considering the role of inducible nitric oxide synthase in tumor‐associated inflammation, this study purposed to evaluate the influence of this enzyme on peripheral blood parameters and systemic inflammatory biomarkers during murine oral carcinogenesis.MethodsA 50 μg/mL solution of 4‐nitroquinoleine‐N‐oxide was provided to 15 C57BL/6J (Nos2+/+) and 16 B6.129P2‐Nos2tm1Lau/J (Nos2−/−) for 16 weeks. Animals were followed for 8 weeks after treatment. Blood samples and tongues were collected for hematological and histopathological analyses. Red blood cells, white blood cells, and platelet cell parameters were analyzed. The neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and the systemic immune‐inflammation index were also calculated. The depth of invasion of all carcinomas was measured.ResultsDifferences were found in several blood parameters. The depth of invasion in Nos2−/− was lower than in Nos2+/+ (p = 0.009), and strong correlations were found between depth of invasion and neutrophil count (ρ = −0.68, p = 0.017), lymphocyte count (ρ = 0.72, p = 0.011), neutrophil‐to‐lymphocyte ratio (ρ = −0.65, p = 0.025), platelet‐to‐lymphocyte ratio (ρ = −0.73, p = 0.013), and systemic immune‐inflammation index (ρ = −0.67, p = 0.037) in Nos2−/− mice.ConclusionInducible nitric oxide synthase seems to have an important role in OSCC invasion and progression, which might be associated to alterations in immune‐inflammatory cell dynamics evidenced by peripheral blood and systemic inflammatory biomarkers.