TP53 and pachyonychia congenita: Of note, Fusobacterium, Haemophilus, Leptotrichia, and Porphyromonas are also suggested to be sensitive in distinguishing patients with PC.203 Mechanistically, the oral microbiome can promote pancreatic carcinogenesis by migrating to the pancreas through the natural digestive tract or the circulation during bacteremia, disrupting the pancreatic microenvironment.200 One of the most studied oral microbes, P. gingivalis, was speculated to increase p53 and Kras mutations following degradation through peptidyl-arginine deiminase enzyme secretion.204