PTGS2 and neoplasm: This finding aligns with the proposed role of COX-2 in promoting tumor growth through prostaglandin-mediated proliferation, angiogenesis, and suppression of apoptosis.27,28 The correlation between COX-2 and advanced T-stage suggests that COX-2 may drive the local expansion of OSCC, potentially through interactions with CAFs and immune cells in the TME.7 This reinforces the rationale for targeting COX-2 in adjuvant therapies, particularly in patients with large tumors, as its inhibition could disrupt tumor-promoting signaling pathways.28-31