4-nitroquinoline-1-oxide (4NQO) induced oral carcinogenesis: A systematic literature review

Objective: Based on a critical review of published studies, we aimed to develop a good practice guide for using 4nitroquinoline-1-oxide (4NQO) as an inducer of oral carcinogenesis in Wistar rats. Design: A systematic search was performed on Medline Ovid, PubMed, Embase, Web of Science, and Scopus databases. The SYRCLE's risk of bias tool was used to assess the quality of the studies. Results: Thirty-five articles met the selection criteria; 22 (62.9%) of them administered 4NQO systemically in drinking water, with a mean concentration of 30.2 ppm (SD +/- 15.9) and during a mean period of 20.8 (SD +/- 7.8) weeks. The other 13 (37.1%) studies performed topical applications of 4NQO painting the oral mucosa of the animals three times a week (100%) with a mean period of administration of 16.8 (SD +/- 7.0) weeks. Different 4NQO concentrations used for other periods achieved significant tumor development. Most studies didn't perform quantitative clinical analysis, and the histopathological diagnosis/grading criteria varied considerably. Conclusions: A poor description of solution care, adverse effects, and the number of losses were observed, and the reporting of these features needs to be improved. Suggestions to guide the development of future research are provided.