Quantifying Lesion Biomechanics During Oral Carcinogenesis Via Optical Coherence Elastography

Oral cancer is the sixth most common cancer globally, necessitating improved early detection strategies for oral potentially malignant disorders (OPMDs) to reduce incidence. This study investigates ultrastructural and biomechanical changes during tongue cancer development in Sprague-Dawley rats using optical coherence elastography (OCE), evaluating its feasibility as a non-invasive diagnostic tool. Carcinogenesis was induced via 4-nitroquinoline-1-oxide in SD rats, categorizing tissues into normal, hyperplasia, low-grade dysplasia (LGD), moderate-high-grade dysplasia (M-HGD), carcinoma-in-situ (CIS), and squamous cell carcinoma (SCC). In vivo Shaker-OCE was used to assess biomechanical properties and stromal alterations, complemented by histological analysis of collagen, elastic fibers, and cancer-associated fibroblast marker α-smooth muscle actin (α-SMA). OCE distinguished tissue stages with significant biomechanical differences (P<0.05). Collagen content increased progressively (r=0.353, P<0.05), while elastic fibers decreased (r=-0.776, P<0.05). α-SMA expression was significantly elevated in CIS/SCC compared to earlier stages (P<0.05), correlating with malignant progression. OCE enables real-time, label-free characterization of tongue tissue mechanics and structural changes during carcinogenesis. Its ability to resolve early-stage lesions and monitor disease dynamics supports clinical translation, bridging biomechanical properties and histopathological evolution. This work underscores OCE’s potential as an adjunctive tool for oral cancer detection and management.