TGF-β1 activates EMT in HNSCC through a SMAD-dependent pathway [51,55,56,57,58] and is instrumental in the formation of tumor buds that detach from primary tumors in oral SCC (OSCC) via activation of ZEB1 and paired-related homeobox 1 protein PRRX1 [59]. Here, PRRX1 is linked to neoplasm.