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Kim SI, Lee YC, Cha W, Jung AR, Jang JY, Choi JS, Lee DK, Lee HH, Kwon MS, Lee YS, Eun YG. Efficacy and safety of fexuprazan in patients with symptoms and signs of laryngopharyngeal reflux disease: a randomized clinical trial. Eur Arch Otorhinolaryngol 2024; 281:5873-5883. [PMID: 39115573 DOI: 10.1007/s00405-024-08877-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/26/2024] [Indexed: 10/28/2024]
Abstract
PURPOSE Laryngopharyngeal reflux disease (LPRD) is mainly treated with proton pump inhibitors (PPI) such as esomeprazole, which have shortcomings like delayed absorption and increased osteoporosis. Fexuprazan is a novel potent potassium-competitive acid blocker that inhibits gastric acid secretion with rapid onset and long duration of action. To assess the efficacy and safety of fexuprazan compared to esomeprazole in patients with LPRD. METHODS This prospective, randomized, double-blinded, multicenter, active-controlled trial was conducted in nine otolaryngologic clinics. Patients with reflux symptom index (RSI) ≥ 13 and reflux finding score (RFS) ≥ 7 were randomly assigned to the fexuprazan or esomeprazole groups, and received fexuprazan 40-mg or esomeprazole 40-mg once daily for 8 weeks. The outcomes were (1) mean change, change rate, and valid rate in RSI, RFS, and LPR-related questionnaires; and (2) adverse events. RESULTS A total of 136 patients (fexuprazan n = 68, esomeprazole n = 68) were followed up for ≥ 1 month. Each parameter significantly improved after 4 and 8 weeks in each group, with no significant differences between the two groups. For those with severe symptoms (RSI ≥ 18), the fexuprazan group (n = 32) showed more improvement in the mean change and change rate in the RSI than esomeprazole group (n = 31) after 4 weeks (p = .036 and .045, respectively). This phenomenon was especially observed in hoarseness and troublesome cough. CONCLUSION Fexuprazan improved symptoms and signs without no serious adverse events in patients with LPRD. In patients with severe symptoms, fexuprazan resulted in a faster symptom improvement than PPI. TRIAL REGISTRATION KCT0007251, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=22100 .
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Affiliation(s)
- Su Il Kim
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ah Ra Jung
- Department of Otolaryngology-Head and Neck Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Jeon Yeob Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Jeong-Seok Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon, Korea
| | - Dong Kun Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Hwan Ho Lee
- Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
| | - Min Su Kwon
- Department of Otolaryngology-Head and Neck Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea
| | - Yoon Se Lee
- Department of Otolaryngology-Head and Neck Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
| | - Young-Gyu Eun
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, Korea.
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Rhi H, Choi HG, Kang JW. Impact of statin use in head and neck cancer: a nested case-control study. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-09020-1. [PMID: 39441362 DOI: 10.1007/s00405-024-09020-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 09/30/2024] [Indexed: 10/25/2024]
Abstract
PURPOSE Dyslipidemia and statin use are associated with an increased risk of various cancers. However, the association in head and neck cancer (HNC) remains unclear. Therefore, this study aimed to investigate the impact of dyslipidemia and statin use on the development of HNC. METHODS Using data from the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2019, we compared two groups HNC patients (n = 1006) and matched control participants (n = 4024) after propensity score overlap weighted balancing. The odds ratios (ORs) for HNC development according to dyslipidemia and statin use duration were assessed using propensity score overlap-weighted multivariable logistic regression. RESULTS Individuals with untreated dyslipidemia had significantly lower odds of developing HNC than those of normal participants (OR 0.70, 95% confidence interval [CI] 0.59-0.82). Conversely, patients with dyslipidemia who received statin therapy (< 60 days) showed a nearly two-fold increase in the odds of HNC (OR 1.94, 95% CI 1.29-2.90). Long-term statin use (≥ 60 days) aligned the odds with those of normal participants (OR 0.89, 95% CI 0.76-1.04). CONCLUSIONS The adverse effect of short-term statin use on HNC development requires further study, and long-term statin use for dyslipidemia treatment does not increase the odds of HNC.
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Affiliation(s)
- Haewon Rhi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Anyang, 14068, Republic of Korea
| | - Hyo Geun Choi
- Suseo Seoul ENT Clinic and MD Analytics, 10, Bamgogae-ro 1-gil, Gangnam-gu, Seoul, 06349, Republic of Korea
| | - Jeong Wook Kang
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, #22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang, 14068, Republic of Korea.
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Zhao P, Liang LL, Luo YB, Liang QK, Xiang BD. Effectiveness of prophylactic central compartment neck dissection following Hemithyroidectomy in papillary thyroid cancer: a meta-analysis. ANZ J Surg 2024. [PMID: 39435979 DOI: 10.1111/ans.19210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 07/15/2024] [Accepted: 08/06/2024] [Indexed: 10/23/2024]
Abstract
INTRODUCTION In this study, we aimed to assess the effect of prophylactic central compartment neck dissection (pCCND) in conjunction with hemithyroidectomy (HT) for clinically low-risk node-negative (cN0) papillary thyroid carcinoma (PTC). METHODS A thorough literature search was performed utilizing PubMed and EMBASE for articles published until October 2023. Subsequently, a meta-analysis was performed on studies involving patients with cN0 PTC, with postoperative locoregional recurrence (LRR) and survival data, treated with HT + pCCND or HT. The study was registered with PROSPERO (CRD42024560962). RESULTS We included seven studies in this meta-analysis, including 2132 patients who met the inclusion criteria: six retrospective cohort studies and one randomized controlled trial. The HT + pCCND group consisted of 1090 cases, and the HT group had 1042 cases. The LRR rates after HT with or without pCCND were similar (3.58% vs. 4.51%; odds ratio (OR) = 0.65; 95% confidence interval (CI) = 0.41-1.03). Five of the seven studies provided prognostic and survival data, particularly the log hazard ratio (log HR) of disease-free survival (DFS) between the two groups. There was also no significant difference in terms of DFS between the HT + pCCND and HT groups (OR = 0.67; 95% CI = 0.42-1.07). CONCLUSIONS There was no significant difference in LRR and DFS between the HT + pCCND and HT groups. pCCND did not demonstrate significant efficacy in improving oncological outcomes for low-risk patients with cN0 PTC. Therefore, for patients with low-risk cN0 PTC, thyroid surgeons should make reasonable and individualized decisions regarding the extent of surgical removal.
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Affiliation(s)
- P Zhao
- Department of Head and Neck Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People's Republic of China
| | - L-L Liang
- Pathology Department, The Second Nanning People's Hospital, Nanning, Guangxi, People's Republic of China
| | - Y-B Luo
- Department of Head and Neck Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People's Republic of China
| | - Q-K Liang
- Department of Head and Neck Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People's Republic of China
| | - B-D Xiang
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People's Republic of China
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Samuels TL, Aoun J, Husain I, Figueredo E, Richards D, Johnston N. Advances in laryngopharyngeal reflux: Etiology, diagnosis, and management. Ann N Y Acad Sci 2024. [PMID: 39420555 DOI: 10.1111/nyas.15242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
Laryngopharyngeal reflux (LPR) manifests as a variety of nonspecific upper aerodigestive tract symptoms. Rather than a single disorder, LPR may be conceived of as a spectrum of subtypes with varying clinical presentations. LPR signs and symptoms arise from the direct and/or indirect effects of refluxate, physical and molecular injury of the mucosa, and neurologic responses to esophageal events. Specific constituents of refluxate exert distinct mucosal responses and immediate or delayed effects resulting in transient or persistent symptoms and/or laryngeal hypersensitivity. While the complex etiology of LPR presents challenges to its diagnosis and management, tools that aid the identification of LPR subtypes can provide insight into treatment decision-making. Hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring provides detailed analysis of reflux events, enabling the development of individualized treatment plans, yet cost and availability limit its widespread use. Alginates offer temporary symptom relief and antireflux surgery may provide benefit when symptoms are recalcitrant to other approaches. Pepsin inhibitors hold promise as a medical therapy when surgery is not an option. Laryngeal hypersensitivity should be considered as part of a comprehensive therapeutic approach. Promising medical and scientific research continues to yield new insights into the complex etiology of LPR and novel strategies for its diagnosis and management.
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Affiliation(s)
- Tina L Samuels
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jennifer Aoun
- Department of Gastroenterology and Hepatology, CHU Saint-Pierre, Brussels, Belgium
| | | | - Edgar Figueredo
- Department of General Surgery, University of Washington, Seattle, Washington, USA
| | - David Richards
- Division of Internal Medicine, Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, Houston, Texas, USA
| | - Nikki Johnston
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Chung SH, Jeon SY, Eun YG. Association Between Height and Laryngopharyngeal Reflux: Analysis Using the 24-Hour Hypopharyngeal-Esophageal Multichannel Intraluminal Impedance-pH Monitoring. J Voice 2024:S0892-1997(24)00302-3. [PMID: 39419707 DOI: 10.1016/j.jvoice.2024.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/11/2024] [Accepted: 09/06/2024] [Indexed: 10/19/2024]
Abstract
OBJECTIVE Height has the strongest correlation with esophageal length among the external anthropometric indices. Based on the association between laryngopharyngeal reflux (LPR) and the upper esophageal sphincter, this study aimed to investigate the relationship between height and LPR. METHODS Retrospective chart analysis of patients who visited an outpatient clinic with symptoms of LPR and underwent a 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH (24-hr HEMII-pH) monitoring. The study analyzed the relationship between height and LPR by (1) in total of 219 patients, (2) in males and females, and (3) in patients under age 60 and over age 60. RESULTS The relationship between height and LPR was analyzed for a total of 219 patients. There was no statistical significance between the number of pharyngeal reflux episodes and the height of subjects. When same analysis was done according to gender, the number of pharyngeal reflux episodes decreased as height increased in males, which was statistically significant, but not in females. Further analysis was done according to age in male and female, respectively. In male under age 60, there was statistical significance between the number of pharyngeal reflux episodes and the height of subjects, but not in over age 60. Also, in female under age 60 and over age 60, there was no statistical significance between the number of pharyngeal reflux episodes and the height of subjects. CONCLUSIONS This study suggests a correlation between height and pharyngeal reflux events in males and individuals under 60 years old tested with the 24-hr HEMII-pH monitoring.
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Affiliation(s)
- Seok-Hwan Chung
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul, South Korea
| | - So-Young Jeon
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul, South Korea
| | - Young-Gyu Eun
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul, South Korea.
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Lee MK, Woo SR, Noh JK, Min S, Kong M, Lee YC, Ko SG, Eun YG. Prognostic Significance of SASP-Related Gene Signature of Radiation Therapy in Head and Neck Squamous Cell Carcinoma. Mol Cancer Ther 2024; 23:1348-1359. [PMID: 38959066 DOI: 10.1158/1535-7163.mct-23-0738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/20/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
In this study, we developed and validated the clinical significance of senescence-associated secretory phenotype (SASP)-related gene signature and explored its association with radiation therapy (RT) in patients with head and neck squamous cell carcinoma (HNSCC). First, we searched the three published review literature associated with SASP and selected all 81 genes to develop SASP-related gene signature. Then, 81 SASP-related genes were adapted to gene expression dataset from The Cancer Genome Atlas (TCGA). Patients with HNSCC of TCGA were classified into clusters 1 and 2 via unsupervised clustering according to SASP-related gene signature. Kaplan-Meier plot survival analysis showed that cluster 1 had a poorer prognosis than cluster 2 in 5-year overall survival and recurrence-free survival. Similarly, cluster 1 showed a worse prognosis than cluster 2 in three validation cohorts (E-MTAB-8588, FHCRC, and KHU). Cox proportional hazards regression observed that the SASP-related signature was an independent prognostic factor for patients with HNSCC. We also established a nomogram using a relevant clinical parameter and a risk score. Time-dependent receiver operating characteristic analysis was carried out to assess the accuracy of the prognostic risk model and nomogram. Senescence SASP-related gene signature was associated with the response to RT. Therefore, subsequent, in vitro experiments further validated the association between SASP-related gene signature and RT in HNSCC. In conclusion, we developed a SASP-related gene signature, which could predict survival of patients with HNSCC, and this gene signature provides new clinical evidence for the accurate diagnosis and targeted RT of HNSCC.
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Affiliation(s)
- Min Kyeong Lee
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seon Rang Woo
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Joo Kyung Noh
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Soonki Min
- Department of Radiation Oncology, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Moonkyoo Kong
- Department of Radiation Oncology, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Young-Gyu Eun
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
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Lin Y, Huang Y, Yang B, Zhang Y, Ji N, Li J, Zhou Y, Shen YQ, Chen Q. Precision therapy targeting CAMK2 to overcome resistance to EGFR inhibitors in FAT1-mutated oral squamous cell carcinoma. Chin Med J (Engl) 2024:00029330-990000000-01204. [PMID: 39227322 DOI: 10.1097/cm9.0000000000003217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) is a prevalent type of cancer with a high mortality rate in its late stages. One of the major challenges in OSCC treatment is the resistance to epidermal growth factor receptor (EGFR) inhibitors. Therefore, it is imperative to elucidate the mechanism underlying drug resistance and develop appropriate precision therapy strategies to enhance clinical efficacy. METHODS To evaluate the efficacy of the combination of the Ca2+/calmodulin-dependent protein kinase II (CAMK2) inhibitor KN93 and EGFR inhibitors, we performed in vitro and in vivo experiments using two FAT atypical cadherin 1 (FAT1)-deficient (SCC9 and SCC25) and two FAT1 wild-type (SCC47 and HN12) OSCC cell lines. We assessed the effects of EGFR inhibitors (afatinib or cetuximab), KN93, or their combination on the malignant phenotype of OSCC in vivo and in vitro. The alterations in protein expression levels of members of the EGFR signaling pathway and SRY-box transcription factor 2 (SOX2) were analyzed. Changes in the yes-associated protein 1 (YAP1) protein were characterized. Moreover, we analyzed mitochondrial dysfunction. Besides, the effects of combination therapy on mitochondrial dynamics were also evaluated. RESULTS OSCC with FAT1 mutations exhibited resistance to EGFR inhibitors treatment. The combination of KN93 and EGFR inhibitors significantly inhibited the proliferation, survival, and migration of FAT1-mutated OSCC cells and suppressed tumor growth in vivo. Mechanistically, combination therapy enhanced the therapeutic sensitivity of FAT1-mutated OSCC cells to EGFR inhibitors by modulating the EGFR pathway and downregulated tumor stemness-related proteins. Furthermore, combination therapy induced reactive oxygen species (ROS)-mediated mitochondrial dysfunction and disrupted mitochondrial dynamics, ultimately resulting in tumor suppression. CONCLUSION Combination therapy with EGFR inhibitors and KN93 could be a novel precision therapeutic strategy and a potential clinical solution for EGFR-resistant OSCC patients with FAT1 mutations.
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Affiliation(s)
- Yumeng Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences, Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
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Cao H, Lan T, Kuang S, Wang L, Li J, Li Q, Li Y, Xu Q, Chen Q, Ren S, Lan C, Ouyang N, Liao J, Huang Y, Li J. FAT1 as a tumor mutation burden specific gene affects the immunotherapy effect in head and neck squamous cell cancer. Drug Resist Updat 2024; 76:101095. [PMID: 38986165 DOI: 10.1016/j.drup.2024.101095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Response to immunotherapy is the main challenge of head and neck squamous cancer (HNSCC) treatment. Previous studies have indicated that tumor mutational burden (TMB) is associated with prognosis, but it is not always a precise index. Hence, investigating specific genetic mutations and tumor microenvironment (TME) changes in TMB-high patients is essential for precision therapy of HNSCC. METHODS A total of 33 HNSCC patients were enrolled in this study. We calculated the TMB score based on next-generation sequencing (NGS) sequencing and grouped these patients based on TMB score. Then, we examined the immune microenvironment of HNSCC using assessments of the bulk transcriptome and the single-cell RNA sequence (scRNA-seq) focusing on the molecular nature of TMB and mutations in HNSCC from our cohort. The association of the mutation pattern and TMB was analyzed in The Cancer Genome Atlas (TCGA) and validated by our cohort. RESULTS 33 HNSCC patients were divided into three groups (TMB-low, -medium, and -high) based on TMB score. In the result of 520-gene panel sequencing data, we found that FAT1 and LRP1B mutations were highly prevalent in TMB-high patients. FAT1 mutations are associated with resistance to immunotherapy in HNSCC patients. This involves many metabolism-related pathways like RERE, AIRE, HOMER1, etc. In the scRNA-seq data, regulatory T cells (Tregs), monocytes, and DCs were found mainly enriched in TMB-high samples. CONCLUSION Our analysis unraveled the FAT1 gene as an assistant predictor when we use TMB as a biomarker of drug resistance in HNSCC. Tregs, monocytes, and dendritic cells (DCs) were found mainly enriched in TMB-high samples.
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Affiliation(s)
- Haotian Cao
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510010, China.
| | - Tianjun Lan
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510010, China
| | - Shijia Kuang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510010, China
| | - Liansheng Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510010, China
| | - Jintao Li
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510010, China
| | - Qunxin Li
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510010, China
| | - Yanyan Li
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510010, China
| | - Qiuping Xu
- Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Qian Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Shuwei Ren
- Department of Clinical Laboratory, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China
| | - Chunhong Lan
- Department of Bioinformatics, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Nengtai Ouyang
- Cellular & Molecular Diagnostics Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Jianwei Liao
- Cellular & Molecular Diagnostics Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
| | - Yongsheng Huang
- Cellular & Molecular Diagnostics Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
| | - Jinsong Li
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510010, China.
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Babayid Y, Gökçay Canpolat A, Elhan AH, Ceyhan K, Çorapçıoğlu D, Şahin M. Should there be a paradigm shift for the evaluation of isthmic thyroid nodules? J Endocrinol Invest 2024; 47:2225-2233. [PMID: 38366076 PMCID: PMC11369056 DOI: 10.1007/s40618-024-02313-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 01/12/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE Although the thyroid isthmus seems like a rudimentary structure that connects bilateral lobes, it is an undiscovered area that needs to be explored. Currently, the data is evolving that the increase in the risk of malignancy is higher in the isthmic nodules, and extrathyroidal extensions and lymph node metastases are more common in isthmic-derived malignant thyroid nodules. Therefore, we aimed to compare the malignancy rate of isthmic and lobar nodules, the ultrasonographic features of isthmic and lobar nodules, and presence of lymph node metastases, distant metastases, and extrathyroidal invasions in malignant isthmic nodules. METHODS In this retrospective study, we enrolled patients between the ages of 18-80 years, who had thyroid nodule/nodules cytology and/or pathology results from January 2009 to November 2022. 9504 nodules were selected for the analysis of US findings, cytopathology results, and malignancy rates. RESULTS A mean ± SD age of 55.3 ± 13.0 years with a female to male ratio of [7618 (80.2%)/1886(19.8%)] were included in the study. 962 of the nodules were at isthmic localization; whereas 8542 nodules were at lobar localization. 1188 nodules were resulted as malignant from histopathological evaluation. Of the 1188 malignant nodules, 986 nodules were (83.0%) PTC, 114 nodules (9.6%) were FTC, 55 nodules were (4.6%) MTC, 16 nodules 1.3% were Hurtle cell carcinoma, 8 nodules (0.7%) were anaplastic thyroid carcinoma, and 9 nodules (0.8%) were thyroid tumors of uncertain malignant potential (TT-UMP). 156 of the malignant nodules (13.1%) were located in the isthmus, whereas the majority of the malignant nodules (n = 1032, 86.9%) were located at the lobar parts (right or left) of the thyroid. When the metastasis patterns of isthmic and lobar thyroid cancers were examined, no significant relationship was found between isthmic and lobar cancers in terms of capsule invasion (p = 0.435), muscle invasion (p = 0.294), and lymph node metastasis (p = 0.633). A significant relation was found between nodule localization (isthmus-upper-middle and lower lobes) and malignancy (p < 0.001). In our logistic regression analysis, isthmic and upper pole nodule localizations, age and TI-RADS were evaluated as independent risk factors for malignancy (p < 0.001 for all factors). CONCLUSION We recommend nodule localization has to be considered an additional risk factor when performing a Fine Needle Aspiration Biopsy for the increased malignancy risk in this localization.
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Affiliation(s)
- Yağmur Babayid
- Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Asena Gökçay Canpolat
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey.
| | - Atilla Halil Elhan
- Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
| | - Koray Ceyhan
- Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey
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Ma L. Characteristics and risk factors of cervical lymph node metastasis in cN0 papillary thyroid microcarcinoma of the isthmus. Updates Surg 2024; 76:1413-1423. [PMID: 38530608 DOI: 10.1007/s13304-024-01760-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/16/2024] [Indexed: 03/28/2024]
Abstract
The surgical resection range of papillary thyroid microcarcinoma of the isthmus (PTMCI) is controversial, and the guidelines do not fully guide the central lymph node dissection (CLND).We retrospectively studied the comparison of PTMCI (Group A, n = 65 cases) and non-PTMCI (Group B, n = 80 cases). Based on whether central lymph node metastasis (CLNM) was further detected, they were further divided into the PTMCI with CLNM (group C, n = 42 cases), the PTMCI without CLNM (group D, n = 23 cases), the non-PTMCI with CLNM (group E, n = 45 cases), the non-PTMCI without CLNM (group F, n = 35 cases). All patients underwent total thyroidectomy and CLND. The CLNM pathological examination was divided into right recurrent laryngeal nerve superficial lymph nodes (Right VI a), right recurrent laryngeal nerve deep lymph nodes (Right VI b), left VI area lymph nodes (Left VI), prelaryngeal lymph node, and pretracheal lymph node. The extent of lymph node metastasis and risk factors of PTMCI were analyzed by univariate and multivariate analysis. The ROC curve was used to calculate the maximum diameter of the tumor and the Youden index was calculated to analyze the impact of diameter on the risk factors for CLNM in PTMCI. To construct a prediction model of transfer risk of high risk factors by Nomogram, there were significant differences in prelaryngeal lymph nodes (p = 0.034) and pretracheal lymph nodes ( n = 0.035) between group A and group B, and the risk factors of lymph node metastasis were tumor invasion (p = 0.003), multifocality (p = 0.001), and the maximum tumor diameter≧6.5 mm. PTMCI is more prone to metastasis of pretracheal lymph nodes and prelaryngeal lymph nodes, and the presence of tumor invasion, multifocality, and tumor diameter≧6.5 mm are high risk factors for metastasis in PTMCI. According to the prediction model, with all risk factors the risk of cervical lymph node metastasis is up to 90%.
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Affiliation(s)
- Linjie Ma
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment Center, Cancer Hospital of University of Electronic Science and Technology School of Medicine, No. 55 Section4, Renming South Road, Chengdu, China.
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11
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Zhang C, Jun J, Liu Z, Liu L, Wang J, Zhao J, Li J. The Consistency Between Symptom Scales and Multi-time Point Salivary Pepsin Test for Diagnosing Laryngopharyngeal Reflux Disease. J Voice 2024:S0892-1997(24)00224-8. [PMID: 39054188 DOI: 10.1016/j.jvoice.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To investigate the screening diagnostic value of reflux symptom index (RSI) and reflux symptom score (RSS) for laryngopharyngeal reflux disease (LPRD). METHODS Fifty-two patients hospitalized in the Department of Otolaryngology-Head and Neck Surgery at The Sixth Medical Center of PLA General Hospital between October 2022 and April 2023 were enrolled in the study. These patients completed the RSS, RSI scales, as well as underwent the multi-time point salivary pepsin test (MTPSPT). Cohen's kappa test and receiver operating characteristic analysis were utilized to assess and compare the diagnostic values of the RSI and RSS. RESULTS A total of 52 patients, comprising 37 males and 15 females, with a mean age of 44 ± 12 years, were enrolled in the study. The Kappa values between RSS, RSI, and MTPSPT were found to be 0.403 (P < 0.05) and 0.192 (P < 0.05), respectively. When considering MTPSPT as the diagnostic criterion, the sensitivity and specificity of RSS were determined to be 76.70% and 76.90%, respectively, while those of RSI were 41.10% and 42.30%. Additionally, the negative predictive values for RSS and RSI stood at 77.70% and 64.70%, respectively, and their positive predictive values were 94.20% and 57.10%. Furthermore, the area under the curves (AUC) for RSS and RSI were calculated to be 0.677 (95% confidence interval [CI]: 0.464-0.742) and 0.609 (95% CI: 0.533-0.800), respectively. CONCLUSIONS RSS had a better concordance with multi-time point salivary pepsin test results and AUC values when screening for LPRD.
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Affiliation(s)
- Chun Zhang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China; Department of Otolaryngology, School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Ju Jun
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Zhi Liu
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Lianlian Liu
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Jiasen Wang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Jing Zhao
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Jinrang Li
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China; Department of Otolaryngology, School of Medicine, South China University of Technology, Guangzhou 510006, China.
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12
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Bang JH, Lee SG, Kwon KJ, Lee SA, Eun YG, Lee YC. Effect of Proton Pump Inhibitor on the Outcome of Laryngeal Microsurgery in Patients With Vocal Fold Mucosal Disease With Reflux Symptoms. J Voice 2024; 38:931-935. [PMID: 35153121 DOI: 10.1016/j.jvoice.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To evaluate the effect of proton pump inhibitor (PPI) after laryngeal microsurgery (LMS) in patients with benign vocal fold (VF) mucosal disease and in patients with overt reflux symptom according to subjective and objective voice assessment. METHODS The improvement of voice handicap index-10 (VHI-10) score, reflux symptom index (RSI) score, grade, roughness, breathiness, asthenia, and strain (GRBAS) score, Jitter, Shimmer, noise to harmonics ratio (NHR), maximum phonation time of acoustic voice analysis RESULTS: A total of 47 patients (PPI group [n = 24] and non-PPI group [n = 23]) completed the study. The scores for VHI-10, RSI, GRBAS, and acoustic parameters significantly improved in both groups after surgery. In the subgroup analysis of patients with overt reflux symptoms (RSI ≥ 13; non-PPI group [n = 12], PPI group [n = 15]), significant between-group differences were observed in terms of the improvement in NHR and the strain factor. CONCLUSION Postoperative PPI administration in patients with VF benign mucosal disease with reflux symptoms might improve subjective and objective voice outcomes after LMS.
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Affiliation(s)
- Je Ho Bang
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sun Gyu Lee
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ki Jin Kwon
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seul Ah Lee
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young-Gyu Eun
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young Chan Lee
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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13
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Ram Kumar RM, Joghee S, Puttaraju MK. Impact of exosomes in oral lichen planus: A review with insights into pathogenesis and biomarkers. J Dent Sci 2024; 19:1320-1327. [PMID: 39035313 PMCID: PMC11259680 DOI: 10.1016/j.jds.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/13/2024] [Indexed: 07/23/2024] Open
Abstract
Oral Lichen Planus (OLP) presents a significant challenge in diagnosis due to its varied clinical manifestations and the absence of specific biomarkers. Timely and accurate diagnosis is crucial, particularly given its association with oral squamous cell carcinoma (OSCC). This review aims to explore the potential role of exosomes, small extracellular vesicles, in the pathogenesis of OLP and their utility as diagnostic biomarkers. Exosomes facilitate the exchange of information between cells and modulate immune responses by carrying various bioactive molecules such as proteins, lipids, and nucleic acids. In the context of OLP, exosomes derived from affected tissues or immune cells are thought to contribute to disease progression by mediating the transfer of pro-inflammatory molecules, including cytokines like interleukin-6 and tumour necrosis factor-alpha and chemokines such as CCL2, CCL5 and microRNAs such as miR-155, miR-146a, miR-21, and miR-34a, etc. Additionally, the distinct molecular contents of exosomes derived from OLP lesions may accurately represent the pathological changes occurring in these tissues. This suggests the potential of exosomes to be used as non-invasive biomarkers for diagnosing and tracking the progression of the disease. Understanding the immune microenvironment of OLP and the role of exosomes within this context is critical for advancing our knowledge of OLP pathogenesis and identifying new diagnostic and therapeutic strategies. However, challenges remain in identifying and characterising exosomes and their clinical translation. Further research is warranted to address these challenges and fully exploit exosomes' diagnostic and therapeutic potential in OLP and other inflammatory oral diseases.
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Affiliation(s)
- Ram Mohan Ram Kumar
- Department of Pharmaceutical Biotechnology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Suresh Joghee
- Department of Pharmacognosy, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Mahesh Kagarae Puttaraju
- Department of Oral Medicine and Radiology, JSS Dental College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
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Kim BH, Park H, Shin CM, Huh G, Jung YH, Jeong WJ. Prediction of the efficacy of proton-pump inhibitors in patients with contact granuloma using 24-hour combined dual channel pH/impedance monitoring. Auris Nasus Larynx 2024; 51:548-552. [PMID: 38537558 DOI: 10.1016/j.anl.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVES We aimed to evaluate the treatment outcomes of proton-pump inhibitors (PPIs) in patients with contact granuloma (CG) and to investigate the parameters of 24 h combined dual channel pH/impedance (24 h pH/MII) monitoring, which are reliable for predicting the response to PPI of CG patients. METHODS We reviewed the medical records of patients with CG who had been treated with PPIs and had completed more than 6 months of follow-up. We classified the patients into two groups (cured vs. persistent), according to their PPI treatment outcomes. Reflux events were categorized into three groups based on pharyngeal pH during reflux: 1) acid reflux (pH < 4), 2) weak acid reflux (4 < pH < 7), and 3) weak alkaline reflux (pH >7), as detected by a proximal probe. We compared the results of 24h-pH/MII between the two groups and used receiver operating characteristic curve (ROC) analysis to determine the cutoff values of significant parameters for predicting responses to PPIs. RESULTS Among 22 patients who completed at least 6 months of PPI treatment and follow-up, weak acid reflux events were more frequently observed in persistent group than in the cured group (p = 0.046), and the proportion of weak acid reflux was also higher in the persistent group (p = 0.031) than in the cured group. Reliable parameters predictive of a poor response to PPIs were a number of weak acid reflux events ≥ 11 (area under the curve [AUC], 0.775; p = 0.03) and a proportion of weak acid reflux events ≥ 56.7 % (AUC, 0.763; p = 0.038) in ROC analyses. CONCLUSION Weak acid reflux was identified as a significant factor associated with the treatment outcomes of PPIs in patients with CG. A number of weak acid reflux events ≥ 11 is considered to be the most reliable predictor of a poor response to PPIs in patients with CG.
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Affiliation(s)
- Bo Hae Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Hanaro Park
- Department of Otorhinolaryngology, Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Cheol Min Shin
- Internal Medicine, Seoul National University Bundang Hospital, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Gene Huh
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent's Hospital, Suwon, South Korea
| | - Young Ho Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, Seoul, South Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, South Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, South Korea.
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15
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Wang TL, Miao XJ, Shuai YR, Sun HP, Wang X, Yang M, Zhang N. FAT1 inhibits the proliferation of DLBCL cells via increasing the m 6A modification of YAP1 mRNA. Sci Rep 2024; 14:11836. [PMID: 38782965 PMCID: PMC11116375 DOI: 10.1038/s41598-024-62793-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/21/2024] [Indexed: 05/25/2024] Open
Abstract
Emerging evidence shows that FAT atypical cadherin 1 (FAT1) mutations occur in lymphoma and are associated with poorer overall survival. Considering that diffuse large B cell lymphoma (DLBCL) is the category of lymphoma with the highest incidence rate, this study aims to explore the role of FAT1 in DLBCL. The findings demonstrate that FAT1 inhibits the proliferation of DLBCL cell lines by downregulating the expression of YAP1 rather than by altering its cellular localization. Mechanistic analysis via meRIP-qPCR/luciferase reporter assays showed that FAT1 increases the m6A modification of YAP1 mRNA 3'UTR and the subsequent binding of heterogeneous nuclear ribonucleoprotein D (HNRNPD) to the m6A modified YAP1 mRNA, thus decreasing the stability of YAP1 mRNA. Furthermore, FAT1 increases YAP1 mRNA 3'UTR m6A modification by decreasing the activity of the TGFβ-Smad2/3 pathway and the subsequent expression of ALKBH5, which is regulated at the transcriptional level by Smad2/3. Collectively, these results reveal that FAT1 inhibits the proliferation of DLBCL cells by increasing the m6A modification of the YAP1 mRNA 3'UTR via the TGFβ-Smad2/3-ALKBH5 pathway. The findings of this study therefore indicate that FAT1 exerts anti-tumor effects in DLBCL and may represent a novel target in the treatment of this form of lymphoma.
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MESH Headings
- Humans
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- YAP-Signaling Proteins/metabolism
- YAP-Signaling Proteins/genetics
- Cell Proliferation
- Transcription Factors/metabolism
- Transcription Factors/genetics
- Cell Line, Tumor
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Adaptor Proteins, Signal Transducing/metabolism
- Adaptor Proteins, Signal Transducing/genetics
- Gene Expression Regulation, Neoplastic
- 3' Untranslated Regions
- Cadherins/metabolism
- Cadherins/genetics
- Adenosine/metabolism
- Adenosine/analogs & derivatives
- Signal Transduction
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Affiliation(s)
- Tian-Long Wang
- Department of Medical, People's Liberation Army The General Hospital of Western Theater Command, Chengdu, 610083, China
| | - Xiao-Juan Miao
- Department of Hematology, People's Liberation Army The General Hospital of Western Theater Command, Sichuan Clinical Research Center for Hematological Disease, Branch of National Clinical Research Center for Hematological Disease, Chengdu, 610083, China
| | - Yan-Rong Shuai
- Department of Hematology, People's Liberation Army The General Hospital of Western Theater Command, Sichuan Clinical Research Center for Hematological Disease, Branch of National Clinical Research Center for Hematological Disease, Chengdu, 610083, China
| | - Hao-Ping Sun
- Department of Hematology, People's Liberation Army The General Hospital of Western Theater Command, Sichuan Clinical Research Center for Hematological Disease, Branch of National Clinical Research Center for Hematological Disease, Chengdu, 610083, China
| | - Xiao Wang
- Department of Hematology, People's Liberation Army The General Hospital of Western Theater Command, Sichuan Clinical Research Center for Hematological Disease, Branch of National Clinical Research Center for Hematological Disease, Chengdu, 610083, China.
| | - Min Yang
- Department of Traditional Chinese Medicine, People's Liberation Army The General Hospital of Western Theater Command, Chengdu, 610083, China.
| | - Nan Zhang
- Department of Hematology, People's Liberation Army The General Hospital of Western Theater Command, Sichuan Clinical Research Center for Hematological Disease, Branch of National Clinical Research Center for Hematological Disease, Chengdu, 610083, China.
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Zhao H, Liu CH, Lu Y, Liu SZ, Yeerkenbieke P, Cao Y, Xia Y, Gao LY, Liu YW, Liu ZW, Chen SG, Liang ZY, Li XY. BRAF V600E mutation does not predict lymph node metastases and recurrence in Chinese papillary thyroid microcarcinoma patients. Oral Oncol 2024; 152:106755. [PMID: 38547780 DOI: 10.1016/j.oraloncology.2024.106755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [ |