BACKGROUNDWe evaluated the performance of TargetScan, miRDB, and miRWalk for predicting miRNA-mRNA interactions in HNSCC. Based on clinical tumor and cancer-free tissue data, miRWalk emerged as the most comprehensive tool. Validation using NanoString technology and MiRTarBase confirmed key predictions, highlighting the important roles of the PI3K-Akt and Wnt pathways. This study underscores the importance of integrating bioinformatics and experimental data to better understand HNSCC.BACKGROUND■ miRWalk had the highest predicted interactions and validated miRNA networks in HNSCC.BACKGROUND■ Around 3.3% of interactions overlapped across tools, emphasizing the need for multitool approaches.BACKGROUND■ Dysregulated genes and miRNAs were tied to cancerdriving PI3K-Akt and Wnt pathways.BACKGROUND■ The validated approach highlights the importance of integrating computational and molecular data.OBJECTIVEHead and neck squamous cell carcinoma (HNSCC) has a poor prognosis largely due to late diagnosis and a lack of reliable biomarkers. MicroRNAs (miRNAs), small non-coding RNAs that regulate gene expression, are promising biomarkers for HNSCC. This study evaluated miRNA-mRNA interactions in HNSCC using conventional computational tools and validated the results using molecular data.METHODSWe compared three miRNA-mRNA interaction prediction tools, TargetScan, miRDB, and miRWalk, using differentially expressed miRNAs and mRNAs from HNSCC and cancer-free tissues. NanoString nCounter was used to measure miRNA and mRNA expression and the miRTarBase database was used to validate the predicted miRNA-mRNA interactions.RESULTSTargetScan and miRWalk provide a comprehensive overview of potential interactions, whereas miRDB provides functional insights. Our results identified 77 and 154 differentially expressed miRNAs and mRNAs in HNSCC, respectively. miRWalk predicted the highest number of miRNA-mRNA interactions, followed by miRDB and TargetScan. Only 3.3% of interactions were common among the tools. The MiRTarBase analysis confirmed a small subset of the predictions. Biological pathway analysis highlighted the dysregulation of PI3K-Akt and Wnt signaling; miRWalk was the best for elucidating how miRNAs modulate target mRNAs in these key pathways during HNSCC progression.CONCLUSIONmiRWalk emerged as the most robust tool for predicting miRNA-mRNA interactions. Our findings highlight the importance of integrating bioinformatics predictions with experimental data to better understand the regulatory networks in HNSCC and identify potential biomarkers for diagnosis and therapy.