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Genetics can also play a part as many people may have genes that do not produce antioxidant enzymes efficiently

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The MT group mainly affected the metabolism pathway of phenylalanine, while the FMT group had more impact on arachidonic acid metabolism, niacin and niacinamide metabolism, and metabolism of alanine, aspartate, and glutamate

Molecular biomarkers such as CD44, CD133 and ALDH1 have been extensively validated for their prognostic significance for HNSCC cancer stem cells (CSC) [14, 15]