Journal of Vaccine Research, 2025, Vol.15, No.1, 23-33 http://medscipublisher.com/index.php/jvr 26 4.2 Diagnostic methods The diagnosis of oral cancer usually begins with a comprehensive examination by a doctor, followed by biopsy of suspected lesion sites. This remains a reliable method for determining whether it is cancer (Borse et al., 2020). Through pathological analysis, that is, observing tissue cells under a microscope, the type and development stage of cancer can be determined, among which squamous cell carcinoma is the most common (Rutkowska et al., 2020; Olmos et al., 2021). Nowadays, the method of determining whether oral cancer is caused by HPV by detecting the DNA of the HPV virus or examining the conditions of specific proteins in cancer cells is increasingly used and can also help formulate treatment plans. In addition, with the aid of advanced imaging techniques and the detection of immune-related indicators (such as the expression of PD-L1 protein), the characteristics of tumors can be understood more clearly, especially for patients with recurrent or advanced diseases, which can provide important references for treatment (Borse et al., 2020; Olmos et al., 2021). 4.3 Treatment response and disease progression The therapeutic effect of HPV-related oral cancer varies from person to person. However, some case reports show that emerging treatment methods, such as immunotherapy before surgery, have shown very good results. They can increase the number of immune cells at the tumor site and even cause tumor necrosis (Olmos et al., 2021). However, at present, traditional treatment methods such as surgical resection, radiotherapy and chemotherapy remain the mainstream. Whether the final treatment effect is good or not largely depends on the severity of the condition at the time of diagnosis (Figure 1) (Peter et al., 2023). If the disease is detected and treated in its early stage, the five-year survival rate of patients is approximately 50%. If it is not discovered until the late stage, the five-year survival rate is only 20% (Langdon et al., 1977). Figure 1 Histopathology findings from the biopsy taken from the lateral border of the tongue (Adopted from Peter et al., 2023) Image caption: Figure A showing a fragment of focally haemorrhagic tissue covered by thickened stratified squamous epithelium. The underlying desmoplastic stroma is infiltrated by malignant squamous cells; (H&E, ×4). Figures B and C show at higher magnification (H&E×20) the cords and clusters of malignant squamous cells infiltrating into the desmoplastic stroma (Adopted from Peter et al., 2023) If a patient is diagnosed relatively late, their condition usually deteriorates more rapidly, the possibility of cancer recurrence is higher, and the chance of survival is smaller. Therefore, it is crucial to detect the disease early and make an accurate diagnosis. Because if treatment is not initiated until the disease has developed to an advanced stage, not only will the effect be poor, but the risk of death will also increase significantly. This is also sufficient to prove how important it is to deal with HPV-related oral cancer in a timely manner (Langdon et al., 1977; Rutkowska et al., 2020; Peter et al., 2023). 5 HPV Vaccination: Effectiveness and Current limitations 5.1 Coverage rates of existing vaccines and high-risk HPV types At present, there are three approved HPV vaccines on the market: Bivalent vaccine (for preventing HPV-16 and HPV-18), quadrivalent vaccine (for preventing HPV-6, 11, 16, 18), and nonavalent vaccine (for preventing HPV-6, 11, 16, 18, 31, 33, 45, 52, 58) (St Laurent et al., 2018). All three vaccines can effectively prevent most carcinogenic HPV types, especially HPV-16 and HPV-18. These two viruses are the main causes of various cancers (such as oral cancer, cervical cancer and oropharyngeal cancer) (Kamolratanakul and Pitisutithum, 2021).
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