In one respect, CCL18 in TME binds to its receptors (PITPNM3 12, CCR6 28 and CCR8 29-31) on the membrane of tumor cells, activates multiple carcinogenesis associated signaling pathways including NF-κB, PI3K/Akt, Wnt/β-catenin and mTOR etc, which in turn accelerates the progression of diverse human cancers including head and neck cancer 13, 14. This evidence concerns the gene CCL18 and head and neck cancer.