{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:40:58Z","timestamp":1792654858082,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine whether DNA\u2010adduct burden, chromosomal instability, epithelial\u2010mesenchymal transition, and glutathione S\u2010transferase M1 (GSTM1) genotype are independently associated with advanced\u2010stage oral squamous cell carcinoma or overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 160 patients with histologically confirmed oral squamous cell carcinoma. DNA\u2010adduct burden was measured by 32P\u2010postlabeling, validated against mass spectrometry in 50 patients; chromosomal instability by fluorescence in\u00a0situ hybridization of chromosomes 7, 9, and 11; epithelial\u2010mesenchymal transition by E\u2010cadherin\/vimentin immunohistochemistry; and GSTM1 genotype by multiplex polymerase chain reaction. Logistic and Cox regression were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DNA\u2010adduct burden and epithelial\u2010mesenchymal transition score were strongly correlated (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.923,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), but neither differed by tumor stage. None of the four markers was independently associated with advanced\u2010stage disease. During follow\u2010up, 48 patients died. Nodal positivity (hazard ratio 3.84, 95% confidence interval 2.00\u20137.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and Stage IV disease (hazard ratio 7.82, 95% confidence interval 2.12\u201328.84,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) were independently associated with poorer survival. The combined clinical\u2010molecular model showed modest discrimination (AUC 0.689).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nodal status and advanced stage were the dominant independent determinants of survival, with routine nodal assessment improving prognostic discrimination beyond stage alone. The four molecular markers tracked with disease characteristics but added no independent prognostic value, warranting replication in larger, prospective cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70554","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:05:26Z","timestamp":1792652726000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>DNA<\/scp>\n                    Adducts, Chromosomal Instability,\n                    <scp>EMT<\/scp>\n                    , and\n                    <scp>GSTM1<\/scp>\n                    in Oral Squamous Cell Carcinoma"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7927-4253","authenticated-orcid":false,"given":"Sharareh Gholami","family":"Kheiri","sequence":"first","affiliation":[{"name":"Department of Oral Medicine School of Dentistry and Dental Research Center, Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6051-6561","authenticated-orcid":false,"given":"Kazem","family":"Ghodsi","sequence":"additional","affiliation":[{"name":"Department of Genetics Medical School, Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9660-3286","authenticated-orcid":false,"given":"Zahra","family":"Tayarani\u2010Najaran","sequence":"additional","affiliation":[{"name":"Medical Toxicology Research Center Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5550-5125","authenticated-orcid":false,"given":"Ahad","family":"Kamelan","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Cell Biology, Faculty of Medicine Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"AJCC Cancer Staging Manual","author":"Amin M. 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