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. 2025 Apr 1;17(1):2487644.
doi: 10.1080/20002297.2025.2487644. eCollection 2025.

Intratumoral Fusobacterium nucleatum is associated with better cancer-specific survival in head and neck cancer patients

José Guilherme Datorre  1 , Mariana Bisarro Dos Reis  1 , Bruna Pereira Sorroche  1 , Gustavo Ramos Teixeira  2   3 , Silveli Suzuki Hatano  1 , Ana Carolina de Carvalho  1 , Ricardo Ribeiro Gama  4 , Lidia Maria Rebolho Batista Arantes  1 , Rui Manuel Reis  1   5
Affiliations

Intratumoral Fusobacterium nucleatum is associated with better cancer-specific survival in head and neck cancer patients

José Guilherme Datorre et al. J Oral Microbiol. .

Abstract

Background: The oral microbiome, particularly Fusobacterium nucleatum (Fn), has been implicated in head and neck cancers (HNC), influencing local immunity and Human Papillomavirus (HPV) status. Here, we evaluated the presence of Fn and its association with HPV infection, TERT promoter (TERTp) mutations, and patient outcomes.

Materials and methods: We analyzed 94 formalin-fixed paraffin-embedded (FFPE) tumor tissues from HNC patients previously evaluated for TERTp mutations. Fn DNA was detected using droplet digital PCR (ddPCR), and HPV status was determined via p16 immunohistochemistry in pre-treatment samples. Associations between Fn presence, clinicopathological features, HPV, and TERTp mutation status were assessed.

Results: Tumors primarily originated from the oropharynx (70.2%) and oral cavity (29.8%). Tobacco and alcohol use were reported in 87.2% and 79.8% of cases, respectively. Fn was present in 59.6% of cases, with higher prevalence in oropharyngeal (62.1%) than oral cavity (53.6%) tumors. No significant associations were found between Fn and clinicopathological features, TERTp, or HPV status. However, patients with Fn positivity showed significantly improved cancer-specific survival (61.5% vs. 39.1%, p = 0.013), similar to HPV-positive patients (72.7% vs. 42.7%, p = 0.014).

Conclusion: The presence of Fusobacterium nucleatum in HNC correlates with longer survival, highlighting its potential as a prognostic marker.

Keywords: Biomarker; Brazil; Fusobacterium nucleatum; droplet digital PCR; head and neck cancer.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
(a) Representative examples of negative (left) and positive (right) p16 immunostaining in head and neck cancer (HNC). (b) Absolute amount of Fusobacterium nucleatum (Fn) in HNC patients. A total of 94 samples were analyzed by ddPCR. Dot plots represent samples, and the dotted line represents the limit of detection (LoD) used to classify samples as negative (below the LoD) and positive (above the LoD). (c) Kaplan-Meier curve of HNC cancer-specific survival for patients based on the presence or absence of Fn.
See this image and copyright information in PMC

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