Head and neck cancers (HNCs) are the seventh most common cancer worldwide, accounting for 4–5% of all malignancies. Salivary metabolites, which serve as key metabolic intermediates and cell-signalling molecules, are emerging as potential diagnostic biomarkers for HNC. While current research has largely concentrated on these metabolites as biomarkers, a critical gap remains in understanding their fluctuations before and after treatment, as well as their involvement in oral side effects. Recent studies emphasise the role of the oral microbiome and its metabolic activity in cancer progression and treatment efficacy by bacterial metabolites and virulence factors. Oral bacteria, such asP. gingivalisandF. nucleatum, contribute to a pro-inflammatory environment that promotes tumour growth. Additionally,F. nucleatumenhances its virulence through flagellar assembly and iron transport mechanisms, facilitating tumour invasion and survival. Moreover, alterations in the oral microbiome can influence chemotherapy efficacy and toxicity through the microbiota–host irinotecan axis, highlighting the complex interplay between microbial communities and therapeutic outcomes. Salivary metabolite profiles are influenced by factors such as gender, methods, and patient habits like smoking—a major risk factor for HNC. Radiotherapy (RT), a key treatment for HNC, often causes side effects such as xerostomia, oral mucositis, and swallowing difficulties which impact survivors’ quality of life. Intensity-modulated radiotherapy (IMRT) aims to improve treatment outcomes and minimise side effects but can still lead to significant salivary gland dysfunction and associated complications. This review underscores the microbial and host interactions affecting salivary metabolites and their implications for cancer treatment and patient outcomes.
头颈部癌症是全球第七大常见癌症，占所有恶性肿瘤的4-5%。唾液代谢物作为关键的代谢中间体和细胞信号分子，正逐渐成为头颈部癌症潜在的诊断生物标志物。尽管当前研究主要集中于将这些代谢物作为生物标志物，但在理解其治疗前后的波动及其在口腔副作用中的作用方面仍存在关键空白。近期研究强调口腔微生物组及其代谢活动通过细菌代谢产物和毒力因子在癌症进展和治疗效果中的作用。口腔细菌，如牙龈卟啉单胞菌和具核梭杆菌，通过促炎环境促进肿瘤生长。此外，具核梭杆菌通过鞭毛组装和铁转运机制增强其毒力，促进肿瘤侵袭和存活。此外，口腔微生物组的改变可通过微生物-宿主伊立替康轴影响化疗效果和毒性，突显了微生物群落与治疗结果之间复杂的相互作用。唾液代谢物谱受性别、方法以及吸烟等患者习惯的影响，吸烟是头颈部癌症的主要风险因素。放射治疗作为头颈部癌症的关键治疗方法，常引起口干症、口腔黏膜炎和吞咽困难等副作用，影响幸存者的生活质量。调强放射治疗旨在改善治疗效果并减少副作用，但仍可能导致显著的唾液腺功能障碍及相关并发症。本综述强调了影响唾液代谢物的微生物与宿主相互作用，及其对癌症治疗和患者预后的影响。
肿瘤(癌症)患者之家