## 5 Conclusions  
The pilot study expounded upon in this report lays the groundwork by furnishing essential histopathological data, serving as a pivotal springboard for an exhaustive exploration into the intricate mechanisms governing the involvement of heat shock proteins (HSPs), specifically Hsp10, Hsp27, Hsp60, and Hsp90, in the progression of squamous cell carcinoma affecting the vocal cords. A discernible correlation has been identified between the levels of these four chaperones and the sequential advancement of malignancy, tracing its trajectory from dysplasia to fully fledged cancer. The potential significance of these biomolecular assessments goes beyond mere observation, presenting a promising avenue for their expeditious application as indispensable biomarkers in the realms of diagnostic procedures, prognostic evaluations, and continuous patient monitoring. This reservoir of scientific evidence concurrently establishes a robust foundation, paving the way for subsequent analyses poised to validate the earlier reported outcomes. The envisaged substantiation not only augurs well for the credibility of the initial findings but also instill confidence in the prospective classification of the heat shock protein family as pivotal biomarkers, significantly contributing to the nuanced landscape of pathological evaluations and clinical diagnoses. The data gleaned from this study propel our understanding of the dynamic interplay between heat shock proteins and the progression of vocal cord squamous cell carcinoma. The observed correlation provides a tangible link between the levels of these proteins and the evolving stages of malignancy. This nuanced insight positions heat shock proteins as potential indicators of disease severity and progression. Furthermore, the implications extend to the clinical arena, where the identified biomarkers hold promise for refining diagnostic accuracy, prognostic assessments, and the development of targeted therapeutic strategies. As these findings are integrated into the broader scope of cancer research, the scientific community is poised to unlock new dimensions in the comprehension and management of squamous cell carcinoma, potentially paving the way for more personalized and effective treatment modalities. In conclusion, this pilot study serves as a crucial cornerstone in unraveling the intricacies of heat shock protein involvement in vocal cord squamous cell carcinoma. The correlation established here sets the stage for a more comprehensive exploration and application of these biomarkers in clinical settings, fostering advancements that may revolutionize the landscape of cancer diagnostics and treatment. Conceptualization, F.R. and G.I. ; methodology, G.I., C.V. and S.B. ; software, F.R. ; validation, F.R. ; formal analysis, F.R. ; investigation, G.I., A.F., M.D.M. and V.L.L. ; resources, A.P., V.L.L. and M.D.M. ; data curation, F.R. and G.I. ; writing--original draft preparation, G.I. and F.C. ; writing--review and editing, F.R., G.I. and A.F. ; visualization, F.R. and A.P. ; supervision, F.R. and A.P. ; project administration F.R. and A.P. ; funding acquisition, A.P. All authors have read and agreed to the published version of the manuscript. This research received no external funding. All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the \"Comitato di bioetica\", University of Palermo; approval code: 122/2023; date of approval: 26-01-2023. **Informed Consent Statement:** The cases chosen and analysed within this study were selected from the archives of the \"Ospedali Riuniti VILLA SOFIA-CERVELLO\" hospital in Palermo. Therefore, each individual patient had already provided informed consent at the time of surgery. **Data Availability Statement:** The data presented in this study are available in article. **Acknowledgments:** We are grateful to [PERSON], [PERSON], [PERSON], and [PERSON] for their critical revision and suggestions.