Background: Oral squamous cell carcinoma (OSCC) is characterized by an immunosuppressive tumor microenvironment. Their plasma-derived exosomes deliver immunomodulatory molecules and cargo that correlate significantly with clinical parameters. This study aims to assess the exosomal profile as a potential tool for early detection of relapse and long-term outcomes in OSCC patients undergoing conventional therapy. Methods: 27 OSCC patients with a median 38-month follow-up were included in this study. The relationship between NTA-derived parameters and clinical pathological parameters was examined, and receiver operating characteristic (ROC) curves were utilized to evaluate the diagnostic efficacy of these values in detecting cancer relapse. Results: Plasmatic levels of exosomes prior to surgery showed a drastic reduction after surgical intervention (8.08E vs. 1.41 × 109particles/mL,p= 0.006). Postsurgical concentrations of exosomes were higher in patients who experienced relapse compared to those who remained disease-free (2.97 × 109vs. 1.11 × 109particles/mL,p= 0.046). Additionally, patients who relapsed exhibited larger exosome sizes after surgery (141.47 vs. 132.31 nm,p= 0.03). Patients with lower concentrations of exosomes prior to surgery demonstrated better disease-free survival compared to those with higher levels (p= 0.012). ROC analysis revealed an area under the curve of 0.82 for presurgical exosome concentration in identifying relapse. Conclusions: Presurgical exosomal plasmatic levels serve as independent predictors of early recurrence and survival in OSCC. All in all, our findings indicate that the detection of peripheral exosomes represents a novel tool for the clinical management of OSCC, with potential implications for prognosis assessment.
背景：口腔鳞状细胞癌（OSCC）的肿瘤微环境具有免疫抑制特性。其血浆来源的外泌体携带免疫调节分子及内容物，这些成分与临床参数显著相关。本研究旨在评估外泌体特征作为潜在工具，用于早期检测接受常规治疗的OSCC患者复发及长期预后。方法：本研究纳入27例OSCC患者，中位随访时间为38个月。通过分析纳米颗粒跟踪分析（NTA）参数与临床病理参数的关系，并采用受试者工作特征（ROC）曲线评估这些指标在检测癌症复发中的诊断效能。结果：术前血浆外泌体水平在手术干预后显著下降（8.08E⁹ vs. 1.41×10⁹颗粒/毫升，p=0.006）。与无复发患者相比，复发患者术后外泌体浓度更高（2.97×10⁹ vs. 1.11×10⁹颗粒/毫升，p=0.046）。此外，复发患者术后外泌体尺寸更大（141.47 vs. 132.31纳米，p=0.03）。术前外泌体浓度较低的患者相比浓度较高者表现出更好的无病生存期（p=0.012）。ROC分析显示，术前外泌体浓度在识别复发时的曲线下面积为0.82。结论：术前血浆外泌体水平可作为OSCC早期复发和生存的独立预测因子。总体而言，我们的研究结果表明，外周血外泌体检测为OSCC的临床管理提供了新工具，对预后评估具有潜在意义。
肿瘤(癌症)患者之家