{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:02:13Z","timestamp":1792134133897,"version":"4.4.0"},"reference-count":85,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Autoimmune polyendocrine syndrome type 1 (APS-1, APECED) is a rare monogenic disorder caused by biallelic AIRE mutations and is classically associated with chronic mucocutaneous candidiasis (CMC), hypoparathyroidism, and adrenal insufficiency. Apart from the autoimmune manifestations, APS-1 is associated with an increased risk of squamous cell carcinoma (SCC), particularly in the oral cavity and esophagus. However, the evidence is patchy and has not yet been systematically reviewed. We conducted a scoping review according to the PRISMA-ScR guidelines. Pub-Med, Scopus, and Web of Science were searched using the terms APS-1\/APECED and malignancy until July 2025. Eligible studies reported on APS-1 patients with histologically confirmed head, neck or esophageal cancer. Clinical, pathological, genetic and outcome data were summarized narratively. Nine publications described 19 APS-1 patients with 26 tumors. The mean age at cancer diagnosis was 35 years, with a latency period of ~24 years from the onset of APS-1. Tumors occurred most frequently in the oral cavity (65%), followed by the lip (19%) and esophagus (15%). In 96% of cases, the tumors were SCC. The grade of the tumor varied, and almost half of the cases were diagnosed at an advanced stage. As far as reported, the usual risk factors were not particularly pronounced; many patients did not smoke or drink alcohol. The main treatment consisted of surgery, often in combination with radiotherapy or chemoradiotherapy, alongside long-term antifungal therapy. Despite the multimodal treatment, outcomes were poor: the overall survival rate was ~50%, with recurrence occurring in 38% of cases and a second primary tumor in 26%. A further 14 cases were reported from another Italian cohort, which together with the national cohort dana suggest a risk of approximately ~10% with APS-1; however, the true lifetime risk remains uncertain. Head and neck malignancies in APS-1 occur early, often without classic risk factors, and have a high recurrence and mortality rate. Lifelong surveillance, antifungal stewardship and increased clinical awareness, ideally as part of multidisciplinary treatment pathways, are critical to improving outcomes in this rare but high-risk population.<\/jats:p>","DOI":"10.3390\/ijms26188969","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T08:56:46Z","timestamp":1758013006000},"page":"8969","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Head and Neck Malignancies in Autoimmune Polyendocrine Syndrome Type 1 (APS-1\/APECED): A Scoping Review of Molecular Pathogenesis, Clinical Features, and Outcomes"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4173-1278","authenticated-orcid":false,"given":"Marko","family":"Tarle","sequence":"first","affiliation":[{"name":"Department of Maxillofacial Surgery, Dubrava University Hospital, 10000 Zagreb, Croatia"},{"name":"School of Dental Medicine, University of Zagreb, Gunduli\u0107eva 5, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Ragu\u017e","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Dubrava University Hospital, 10000 Zagreb, Croatia"},{"name":"School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9138-2037","authenticated-orcid":false,"given":"Ivica","family":"Luk\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, Dubrava University Hospital, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, \u0160alata 3, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3546","DOI":"10.1210\/jc.2017-00139","article-title":"Expanding the Phenotypic and Genotypic Landscape of Autoimmune Polyendocrine Syndrome Type 1","volume":"102","author":"Orlova","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"103135","DOI":"10.1016\/j.autrev.2022.103135","article-title":"Autoimmune polyendocrine syndrome type 1: Clinical manifestations, pathogenetic features, and management approach","volume":"21","author":"Bjorklund","year":"2022","journal-title":"Autoimmun. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1038\/nri.2016.9","article-title":"AIRE expands: New roles in immune tolerance and beyond","volume":"16","author":"Anderson","year":"2016","journal-title":"Nat. Rev. Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"eaav6778","DOI":"10.1126\/sciimmunol.aav6778","article-title":"AIRE expression controls the peripheral selection of autoreactive B cells","volume":"4","author":"Sng","year":"2019","journal-title":"Sci. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.autrev.2017.11.012","article-title":"The immunobiology and clinical features of type 1 autoimmune polyglandular syndrome (APS-1)","volume":"17","author":"Guo","year":"2018","journal-title":"Autoimmun. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e28037","DOI":"10.1016\/j.heliyon.2024.e28037","article-title":"Novel homozygous mutations in AIRE leading to APS-1 and potential mechanisms based on bioinformatics analysis","volume":"10","author":"Wu","year":"2024","journal-title":"Heliyon"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1056\/NEJMra1713301","article-title":"Autoimmune Polyendocrine Syndromes","volume":"378","author":"Husebye","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1056\/NEJM199006283222601","article-title":"Clinical variation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in a series of 68 patients","volume":"322","author":"Ahonen","year":"1990","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2975","DOI":"10.1210\/jc.2016-1821","article-title":"A Longitudinal Follow-up of Autoimmune Polyendocrine Syndrome Type 1","volume":"101","author":"Bruserud","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.1002\/hed.27193","article-title":"Systemic conditions associated with increased risk to develop oral squamous cell carcinoma: Systematic review and meta-analysis","volume":"44","author":"Normando","year":"2022","journal-title":"Head Neck"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Nokovitch, L., Maquet, C., Crampon, F., Taihi, I., Roussel, L.M., Obongo, R., Virard, F., Fervers, B., and Deneuve, S. (2023). Oral Cavity Squamous Cell Carcinoma Risk Factors: State of the Art. J. Clin. Med., 12.","DOI":"10.3390\/jcm12093264"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1084\/jem.20091983","article-title":"Autoantibodies against IL-17A, IL-17F, and IL-22 in patients with chronic mucocutaneous candidiasis and autoimmune polyendocrine syndrome type I","volume":"207","author":"Puel","year":"2010","journal-title":"J. Exp. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Yu, D., and Liu, Z. (2022). The research progress in the interaction between Candida albicans and cancers. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.988734"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1038\/s41467-019-09915-2","article-title":"Candidalysin activates innate epithelial immune responses via epidermal growth factor receptor","volume":"10","author":"Ho","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1093\/intimm\/dxaa078","article-title":"IL-6 in inflammation, autoimmunity and cancer","volume":"33","author":"Hirano","year":"2021","journal-title":"Int. Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Meager, A., Visvalingam, K., Peterson, P., Moll, K., Murumagi, A., Krohn, K., Eskelin, P., Perheentupa, J., Husebye, E., and Kadota, Y. (2006). Anti-interferon autoantibodies in autoimmune polyendocrinopathy syndrome type 1. PLoS Med., 3.","DOI":"10.1371\/journal.pmed.0030289"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1007\/s40618-021-01585-6","article-title":"Autoimmune polyendocrine syndrome type 1: An Italian survey on 158 patients","volume":"44","author":"Garelli","year":"2021","journal-title":"J. Endocrinol. Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e2207","DOI":"10.1210\/clinem\/dgaa140","article-title":"Patients With APECED Have Increased Early Mortality Due to Endocrine Causes, Malignancies and infections","volume":"105","author":"Borchers","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1001\/archderm.1975.01630170083013","article-title":"Candidiasis and multiple endocrinopathy. With oral squamous cell carcinoma complications","volume":"111","author":"Richman","year":"1975","journal-title":"Arch. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S0901-5027(97)80845-4","article-title":"Oral squamous cell carcinoma in a young person with candidosis endocrinopathy syndrome: A case report","volume":"26","author":"Firth","year":"1997","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.oraloncology.2006.07.005","article-title":"Oral and oesophageal squamous cell carcinoma--a complication or component of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED, APS-I)","volume":"43","author":"Rautemaa","year":"2007","journal-title":"Oral Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.jaad.2009.06.061","article-title":"Oral mucous squamous cell carcinoma-an anticipated consequence of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED)","volume":"62","author":"Bockle","year":"2010","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e36","DOI":"10.1016\/j.oooo.2012.04.013","article-title":"Multiple oral squamous cell carcinomas associated with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy","volume":"114","author":"Shephard","year":"2012","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1007\/s11605-012-1879-5","article-title":"Management of squamous cell cancer of the oesophagus in a patient with a polyglandular endocrinopathy (APECED) and achalasia","volume":"16","author":"Timlin","year":"2012","journal-title":"J. Gastrointest. Surg."},{"key":"ref_26","first-page":"e240","article-title":"Fatal Esophageal Squamous Cell Carcinoma at a Young Age as a Complication of Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy","volume":"1","author":"Awad","year":"2015","journal-title":"AACE Clin. Case Rep."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Bruserud, O., Costea, D.E., Laakso, S., Garty, B.Z., Mathisen, E., Makitie, A., Makitie, O., and Husebye, E.S. (2018). Oral Tongue Malignancies in Autoimmune Polyendocrine Syndrome Type 1. Front. Endocrinol., 9.","DOI":"10.3389\/fendo.2018.00463"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1038\/s41572-020-00224-3","article-title":"Head and neck squamous cell carcinoma","volume":"6","author":"Johnson","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Fasano, M., D\u2019Onofrio, I., Belfiore, M.P., Angrisani, A., Caliendo, V., Della Corte, C.M., Pirozzi, M., Facchini, S., Caterino, M., and Guida, C. (2022). Head and Neck Squamous Cell Carcinoma in Elderly Patients: Role of Radiotherapy and Chemotherapy. Cancers, 14.","DOI":"10.3390\/cancers14030472"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Tarle, M., and Luksic, I. (2024). Pathogenesis and Therapy of Oral Carcinogenesis. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25126343"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1177\/01945998221098011","article-title":"Changing Epidemiology of Oral Cavity Cancer in the United States","volume":"168","author":"Stepan","year":"2023","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S1368-8375(98)00101-8","article-title":"Primary oral squamous cell carcinoma: An analysis of 703 cases in southern Taiwan","volume":"35","author":"Chen","year":"1999","journal-title":"Oral Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Desai, M.K., and Brinton, R.D. (2019). Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan. Front. Endocrinol., 10.","DOI":"10.3389\/fendo.2019.00265"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1111\/eva.13167","article-title":"Why women have more autoimmune diseases than men: An evolutionary perspective","volume":"14","author":"Kronzer","year":"2021","journal-title":"Evol. Appl."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"104112","DOI":"10.1016\/j.critrevonc.2023.104112","article-title":"Oral cavity cancer in young, non-smoking, and non-drinking patients: A contemporary review","volume":"190","author":"Tran","year":"2023","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Barsouk, A., Aluru, J.S., Rawla, P., Saginala, K., and Barsouk, A. (2023). Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma. Med. Sci., 11.","DOI":"10.3390\/medsci11020042"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Di Cosola, M., Cazzolla, A.P., Charitos, I.A., Ballini, A., Inchingolo, F., and Santacroce, L. (2021). Candida albicans and Oral Carcinogenesis. A Brief Review. J. Fungi, 7.","DOI":"10.3390\/jof7060476"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.oraloncology.2015.04.006","article-title":"Cancer stem cells and field cancerization of oral squamous cell carcinoma","volume":"51","author":"Simple","year":"2015","journal-title":"Oral Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2849","DOI":"10.1007\/s00784-019-02958-1","article-title":"The synergistic effect of tobacco and alcohol consumption on oral squamous cell carcinoma: A systematic review and meta-analysis","volume":"23","author":"Mello","year":"2019","journal-title":"Clin. Oral Investig."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1016\/j.ijom.2022.04.005","article-title":"Early-onset oral cancer as a clinical entity: Aetiology and pathogenesis","volume":"51","author":"Kolegova","year":"2022","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.coi.2016.07.003","article-title":"AIRE-mutations and autoimmune disease","volume":"43","author":"Bruserud","year":"2016","journal-title":"Curr. Opin. Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kaleviste, E., Ruhlemann, M., Karner, J., Haljasmagi, L., Tserel, L., Org, E., Trebusak Podkrajsek, K., Battelino, T., Bang, C., and Franke, A. (2020). IL-22 Paucity in APECED Is Associated With Mucosal and Microbial Alterations in Oral Cavity. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00838"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.coi.2021.08.001","article-title":"Candidiasis in patients with APS-1: Low IL-17, high IFN-gamma, or both?","volume":"72","author":"Philippot","year":"2021","journal-title":"Curr. Opin. Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Vadovics, M., Ho, J., Igaz, N., Alfoldi, R., Rakk, D., Veres, E., Szucs, B., Horvath, M., Toth, R., and Szucs, A. (2021). Candida albicans Enhances the Progression of Oral Squamous Cell Carcinoma In Vitro and In Vivo. mBio, 13.","DOI":"10.1101\/2021.03.31.437836"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Talapko, J., Mestrovic, T., Dmitrovic, B., Juzbasic, M., Matijevic, T., Bekic, S., Eric, S., Flam, J., Belic, D., and Petek Eric, A. (2023). A Putative Role of Candida albicans in Promoting Cancer Development: A Current State of Evidence and Proposed Mechanisms. Microorganisms, 11.","DOI":"10.3390\/microorganisms11061476"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1111\/jop.13014","article-title":"The role of Candida albicans candidalysin ECE1 gene in oral carcinogenesis","volume":"49","author":"Ahmad","year":"2020","journal-title":"J. Oral Pathol. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"650","DOI":"10.3390\/pathophysiology29040051","article-title":"Role of Candida albicans in Oral Carcinogenesis","volume":"29","author":"Ayuningtyas","year":"2022","journal-title":"Pathophysiology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.1600-0714.2012.01203.x","article-title":"Production of carcinogenic acetaldehyde by Candida albicans from patients with potentially malignant oral mucosal disorders","volume":"42","author":"Nieminen","year":"2013","journal-title":"J. Oral Pathol. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3796","DOI":"10.1038\/s41467-023-39284-w","article-title":"Candida albicans exploits N-acetylglucosamine as a gut signal to establish the balance between commensalism and pathogenesis","volume":"14","author":"Yang","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2057178X19828229","DOI":"10.1177\/2057178X19828229","article-title":"Role of Candida Infection in the Malignant Transformation of Oral Leukoplakia: A Systematic Review of Observational Studies","volume":"4","author":"Shukla","year":"2019","journal-title":"Transl. Res. Oral Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e114","DOI":"10.1038\/cti.2016.71","article-title":"Chronic mucocutaneous candidiasis disease associated with inborn errors of IL-17 immunity","volume":"5","author":"Okada","year":"2016","journal-title":"Clin. Transl. Immunol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2640","DOI":"10.1038\/jid.2008.139","article-title":"Patients with chronic mucocutaneous candidiasis exhibit reduced production of Th17-associated cytokines IL-17 and IL-22","volume":"128","author":"Eyerich","year":"2008","journal-title":"J. Investig. Dermatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e70021","DOI":"10.1111\/sji.70021","article-title":"Longitudinal Immune Profiling in Autoimmune Polyendocrine Syndrome Type 1","volume":"101","author":"Kucuka","year":"2025","journal-title":"Scand. J. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1016\/j.jaci.2024.02.012","article-title":"Increased type 1 inflammation in gynecologic cervicovaginal samples in patients with APS-1","volume":"153","author":"Hetemaki","year":"2024","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/j.semarthrit.2021.09.009","article-title":"Risk of malignancy in patients with systemic lupus erythematosus: Systematic review and meta-analysis","volume":"51","author":"Clarke","year":"2021","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2147\/OARRR.S167783","article-title":"Sjogren\u2019s syndrome and systemic lupus erythematosus: Links and risks","volume":"11","author":"Pasoto","year":"2019","journal-title":"Open Access Rheumatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"adv18487","DOI":"10.2340\/actadv.v104.18487","article-title":"Risk of Head and Neck Cancer in Patients with Psoriasis: A Nationwide Population-based Study","volume":"104","author":"Huh","year":"2024","journal-title":"Acta Derm. Venereol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1001\/jamadermatol.2019.3056","article-title":"Association of Psoriasis With the Risk of Developing or Dying of Cancer: A Systematic Review and Meta-analysis","volume":"155","author":"Trafford","year":"2019","journal-title":"JAMA Dermatol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Ladjevac, N., Milovanovic, M., Jevtovic, A., Arsenijevic, D., Stojanovic, B., Dimitrijevic Stojanovic, M., Stojanovic, B., Arsenijevic, N., Arsenijevic, A., and Milovanovic, J. (2023). The Role of IL-17 in the Pathogenesis of Oral Squamous Cell Carcinoma. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24129874"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1111\/bjd.14426","article-title":"Elevation of serum squamous cell carcinoma antigen 2 in patients with psoriasis: Associations with disease severity and response to the treatment","volume":"174","author":"Watanabe","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Honma, M., and Nozaki, H. (2021). Molecular Pathogenesis of Psoriasis and Biomarkers Reflecting Disease Activity. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153199"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"347","DOI":"10.12659\/AJCR.902828","article-title":"Rapidly Developed Multiple Face and Neck Skin Cancers in a Patient with Sjogren\u2019s Syndrome: A Case Report","volume":"18","author":"Teh","year":"2017","journal-title":"Am. J. Case Rep."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"471","DOI":"10.46497\/ArchRheumatol.2024.10748","article-title":"The hidden oncological challenge in Sjogren\u2019s syndrome with a focus on pharyngeal cancer","volume":"39","author":"Yoo","year":"2024","journal-title":"Arch. Rheumatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3390\/rheumato4040017","article-title":"Pathogenesis, Epidemiology, and Risk Factors of Malignant Tumors in Systemic Lupus Erythematosus","volume":"4","author":"Blachut","year":"2024","journal-title":"Rheumato"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.oraloncology.2017.03.012","article-title":"Malignant transformation of oral lichen planus and oral lichenoid lesions: A meta-analysis of 20095 patient data","volume":"68","author":"Aghbari","year":"2017","journal-title":"Oral Oncol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Li, J.-W., Li, K.Y., Chan, B.W.A., McGrath, C.P., and Zheng, L.-W. (2023). Rate of Malignant Transformation Differs Based on Diagnostic Criteria for Oral Lichenoid Conditions: A Systematic Review and Meta-Analysis of 24,277 Patients. Cancers, 15.","DOI":"10.3390\/cancers15092537"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"L\u00fcdecke, C., Neumann, H., and Remmerbach, T.W. (2025). The Early Detection of Malignant Transformation of Potentially Malignant Disorders: Oral Lichen Planus. Cancers, 17.","DOI":"10.3390\/cancers17091489"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.oraloncology.2019.07.012","article-title":"Malignant transformation risk of oral lichen planus: A systematic review and comprehensive meta-analysis","volume":"96","author":"Ayen","year":"2019","journal-title":"Oral Oncol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1200\/JCO.19.00370","article-title":"Evolution of the Oropharynx Cancer Epidemic in the United States: Moderation of Increasing Incidence in Younger Individuals and Shift in the Burden to Older Individuals","volume":"37","author":"Tota","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.oraloncology.2015.03.010","article-title":"Racial disparities in squamous cell carcinoma of the oral tongue among women: A SEER data analysis","volume":"51","author":"Joseph","year":"2015","journal-title":"Oral Oncol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"549","DOI":"10.4081\/oncol.2022.549","article-title":"Molecular drivers of oral cavity squamous cell carcinoma in non-smoking and non-drinking patients: What do we know so far?","volume":"16","author":"Uddin","year":"2022","journal-title":"Oncol. Rev."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"103458","DOI":"10.1016\/j.critrevonc.2021.103458","article-title":"Oral cancer in non-smoker non-drinker patients. Could comparative pet oncology help to understand risk factors and pathogenesis?","volume":"166","author":"Grigolato","year":"2021","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"105803","DOI":"10.1016\/j.oraloncology.2022.105803","article-title":"Young non-smokers with oral cancer: What are we missing and why?","volume":"127","author":"Valero","year":"2022","journal-title":"Oral Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1111\/jop.13218","article-title":"Autoimmune disease and oral squamous cell carcinoma: A systematic review","volume":"50","author":"Pillai","year":"2021","journal-title":"J. Oral Pathol. Med."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Humbert, L., Cornu, M., Proust-Lemoine, E., Bayry, J., Wemeau, J.L., Vantyghem, M.C., and Sendid, B. (2018). Chronic Mucocutaneous Candidiasis in Autoimmune Polyendocrine Syndrome Type 1. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.02570"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1128\/CMR.00029-06","article-title":"Epidemiology of invasive candidiasis: A persistent public health problem","volume":"20","author":"Pfaller","year":"2007","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Zhang, M.R., Zhao, F., Wang, S., Lv, S., Mou, Y., Yao, C.L., Zhou, Y., and Li, F.Q. (2020). Molecular mechanism of azoles resistant Candida albicans in a patient with chronic mucocutaneous candidiasis. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-4856-8"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.chom.2017.03.006","article-title":"Autoreactive T Cells and Chronic Fungal Infection Drive Esophageal Carcinogenesis","volume":"21","author":"Zhu","year":"2017","journal-title":"Cell Host Microbe"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/civ933","article-title":"Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America","volume":"62","author":"Pappas","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"3026","DOI":"10.1111\/cas.16236","article-title":"ACSL4 upregulates IFI44 and IFI44L expression and promotes the proliferation and invasiveness of head and neck squamous cell carcinoma cells","volume":"115","author":"Rupa","year":"2024","journal-title":"Cancer Sci."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Civico-Ortega, J.L., Gonzalez-Ruiz, I., Ramos-Garcia, P., Cruz-Granados, D., Samayoa-Descamps, V., and Gonzalez-Moles, M.A. (2023). Prognostic and Clinicopathological Significance of Epidermal Growth Factor Receptor (EGFR) Expression in Oral Squamous Cell Carcinoma: Systematic Review and Meta-Analysis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241511888"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Tarle, M., Ragu\u017e, M., Muller, D., and Luk\u0161i\u0107, I. (2023). Nuclear Epidermal Growth Factor Receptor Overexpression as a Survival Predictor in Oral Squamous Cell Carcinoma. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24065816"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Satgunaseelan, L., Porazinski, S., Strbenac, D., Istadi, A., Willet, C., Chew, T., Sadsad, R., Palme, C.E., Lee, J.H., and Boyer, M. (2021). Oral Squamous Cell Carcinoma in Young Patients Show Higher Rates of EGFR Amplification: Implications for Novel Personalized Therapy. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.750852"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/nrc.2018.11","article-title":"The molecular landscape of head and neck cancer","volume":"18","author":"Leemans","year":"2018","journal-title":"Nat. Rev. Cancer"},{"key":"ref_85","first-page":"n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2020","journal-title":"BMJ"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/18\/8969\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:45:44Z","timestamp":1760035544000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/18\/8969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":85,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["ijms26188969"],"URL":"https:\/\/doi.org\/10.3390\/ijms26188969","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,15]]}}}