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Hou D, Tan JN, Zhou SN, Yang X, Zhang ZH, Zhong GY, Zhong L, Yang B, Han FH. A novel prognostic signature based on cuproptosis-related lncRNA mining in colorectal cancer. Front Genet 2022; 13:969845. [PMID: 36105091 PMCID: PMC9465626 DOI: 10.3389/fgene.2022.969845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Colorectal cancer (CRC) is a common malignant tumor that affects the large bowel or the rectum. Cuproptosis, recently discovered programmed cell death process, may play an important role in CRC tumorigenesis. Long non-coding RNAs (lncRNAs) can alter the proliferation of colorectal cancer cells through the control and activation of gene expression. To date, cuproptosis-related lncRNAs, have not been investigated as potential predictive biomarkers in colorectal cancer. Methods: The mRNA and lncRNA expression data of colorectal cancer were gathered from The Tumor Genome Atlas (TCGA) database, and Pearson correlation analysis and univariate Cox regression analysis were used to identify the lncRNAs with differential prognosis. Colorectal cancer was classified using consistent clustering, and the clinical significance of different types, tumor heterogeneity, and immune microenvironment differences was investigated. The differential lncRNAs were further screened using LASSO regression to develop a risk scoring model, which was then paired with clinicopathological variables to create a nomogram. Finally, the copy number changes in the high-risk and low-risk groups were compared. Results: Two clusters were formed based on the 28 prognostic cuproptosis-related lncRNAs, and the prognosis of cluster 2 was found to be significantly lower than that of cluster 1. Cluster 1 showed increased immune cell infiltration and immunological score, as well as strong enrichment of immune checkpoint genes. Next, LASSO regression was used to select 11 distinctive lncRNAs, and a risk score model was constructed using the training set to distinguish between high and low-risk groups. Patients in the high-risk group had a lower survival rate than those in the low-risk group, and both the test set and the total set produced consistent results. The AUC value of the ROC curve revealed the scoring model’s efficacy in predicting long-term OS in patients. Moreover, the model could be used as an independent predictor when combined with a multivariate analysis of clinicopathological features, and our nomogram could be used intuitively to predict prognosis. Conclusion: Collectively, we developed a risk model using 11 differential lncRNAs and demonstrated that the model has predictive value as well as clinical and therapeutic implications for predicting prognosis in CRC patients.
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Affiliation(s)
| | | | | | | | | | | | | | - Bin Yang
- *Correspondence: Bin Yang, ; Fang-hai Han,
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Prognostic Value of Molecular Intratumor Heterogeneity in Primary Oral Cancer and Its Lymph Node Metastases Assessed by Mass Spectrometry Imaging. Molecules 2022; 27:molecules27175458. [PMID: 36080226 PMCID: PMC9458238 DOI: 10.3390/molecules27175458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 11/22/2022] Open
Abstract
Different aspects of intra-tumor heterogeneity (ITH), which are associated with the development of cancer and its response to treatment, have postulated prognostic value. Here we searched for potential association between phenotypic ITH analyzed by mass spectrometry imaging (MSI) and prognosis of head and neck cancer. The study involved tissue specimens resected from 77 patients with locally advanced oral squamous cell carcinoma, including 37 patients where matched samples of primary tumor and synchronous lymph node metastases were analyzed. A 3-year follow-up was available for all patients which enabled their separation into two groups: with no evidence of disease (NED, n = 41) and with progressive disease (PD, n = 36). After on-tissue trypsin digestion, peptide maps of all cancer regions were segmented using an unsupervised approach to reveal their intrinsic heterogeneity. We found that intra-tumor similarity of spectra was higher in the PD group and diversity of clusters identified during image segmentation was higher in the NED group, which indicated a higher level of ITH in patients with more favorable outcomes. Signature of molecular components that correlated with long-term outcomes could be associated with proteins involved in the immune functions. Furthermore, a positive correlation between ITH and histopathological lymphocytic host response was observed. Hence, we proposed that a higher level of ITH revealed by MSI in cancers with a better prognosis could reflect the presence of heterotypic components of tumor microenvironment such as infiltrating immune cells enhancing the response to the treatment.
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Zhang S, Zhang L, Lu H, Yao Y, Liu X, Hou J. A cuproptosis and copper metabolism–related gene prognostic index for head and neck squamous cell carcinoma. Front Oncol 2022; 12:955336. [PMID: 36072790 PMCID: PMC9441563 DOI: 10.3389/fonc.2022.955336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe purpose of this study was to identify the prognostic value of cuproptosis and copper metabolism–related genes, to clarify their molecular and immunological characteristics, and to elucidate their benefits in head and neck squamous cell carcinoma (HNSCC).MethodsThe details of human cuproptosis and copper metabolism–related genes were searched and filtered from the msigdb database and the latest literature. To identify prognostic genes associated with cuproptosis and copper metabolism, we used least absolute shrinkage and selection operator regression, and this coefficient was used to set up a prognostic risk score model. HNSCC samples were divided into two groups according to the median risk. Afterwards, the function and immune characteristics of these genes in HNSCC were analyzed.ResultsThe 14-gene signature was constructed to classify HNSCC patients into low-risk and high-risk groups according to the risk level. In the The Cancer Genome Atlas (TCGA) cohort, the overall survival (OS) rate of the high-risk group was lower than that of the low-risk group (P < 0.0001). The area under the curve of the time-dependent Receiver Operator Characteristic (ROC) curve assessed the good performance of the genetic signature in predicting OS and showed similar performance in the external validation cohort. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment assays and Protein-Protein Interaction (PPI) protein networks have been used to explore signaling pathways and potential mechanisms that were markedly active in patients with HNSCC. Furthermore, the 14 cuproptosis and copper metabolism-related genes were significantly correlated with the immune microenvironment, suggesting that these genes may be linked with the immune regulation and development of HNSCC.ConclusionsOur results emphasize the significance of cuproptosis and copper metabolism as a predictive biomarker for HNSCC, and its expression levels seem to be correlated with immune- related features; thus, they may be a possible biomarker for HNSCC prognosis.
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Affiliation(s)
- Shuaiyuan Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Lujin Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Huanzi Lu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yihuan Yao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyong Liu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Jingsong Hou
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Jingsong Hou,
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Ruiz-Ranz M, Lequerica-Fernández P, Rodríguez-Santamarta T, Suárez-Sánchez FJ, López-Pintor RM, García-Pedrero JM, de Vicente JC. Prognostic implications of preoperative systemic inflammatory markers in oral squamous cell carcinoma, and correlations with the local immune tumor microenvironment. Front Immunol 2022; 13:941351. [PMID: 35958590 PMCID: PMC9360320 DOI: 10.3389/fimmu.2022.941351] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/15/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of this study was to investigate the prognostic significance of preoperative inflammatory markers in peripheral blood of patients with oral squamous cell carcinoma (OSCC), and to establish correlations with the infiltrate of macrophages and lymphocytes in the local immune tumor microenvironment (TME). Materials and Methods Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and systemic immune-inflammation index (SII) were retrospectively evaluated in a cohort of 348 OSCC patients, and correlated with overall (OS) and disease-specific survival (DSS). Immunohistochemical analysis of tumoral and stromal infiltration of CD8+, CD4+, FOXP3+ and CD20+ lymphocytes and CD68+ and CD163+ macrophages was performed in a subset of 119 OSCC patient samples, and correlations further assessed. Results NLR, SII, and LMR were significantly associated with a poorer OS in univariate analysis; however, only NLR remained a significant independent predictor in the multivariate analysis (HR = 1.626, p = 0.04). NLR and SII were inversely and significantly correlated with stromal infiltration of CD8+, CD4+, and CD20+ lymphocytes. Moreover, a significant correlation between LMR was also found to significantly associate with stromal infiltration of CD8+, CD4+, and CD20+ lymphocytes, stromal CD68+ and CD163+ macrophages, and also tumoral infiltration of CD4+ and CD20+ lymphocytes. Conclusions Preoperative NLR, SII, and LMR may serve as valuable systemic markers to predict OSCC patient survival, with NLR emerging as an independent predictor of poor OS. Moreover, strong significant correlations were exclusively observed between systemic inflammatory markers and the local stromal infiltration of lymphocytes in the TME.
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Affiliation(s)
- Marta Ruiz-Ranz
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Paloma Lequerica-Fernández
- Department of Biochemistry, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
| | - Tania Rodríguez-Santamarta
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
| | | | - Rosa M. López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Juana M. García-Pedrero
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Department of Otolaryngology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Juan C. de Vicente, ; Juana M. García-Pedrero,
| | - Juan C. de Vicente
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Department of Surgery, University of Oviedo, Oviedo, Spain
- *Correspondence: Juan C. de Vicente, ; Juana M. García-Pedrero,
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Wongpattaraworakul W, Gibson-Corley KN, Choi A, Buchakjian MR, Lanzel EA, Rajan KD A, Simons AL. Prognostic Role of Combined EGFR and Tumor-Infiltrating Lymphocytes in Oral Squamous Cell Carcinoma. Front Oncol 2022; 12:885236. [PMID: 35957892 PMCID: PMC9357911 DOI: 10.3389/fonc.2022.885236] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 06/22/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundEpidermal growth factor receptor (EGFR) is well known as a general prognostic biomarker for head and neck tumors, however the specific prognostic value of EGFR in oral squamous cell carcinoma (OSCC) is controversial. Recently, the presence of tumor-infiltrating T cells has been associated with significant survival advantages in a variety of disease sites. The present study will determine if the inclusion of T cell specific markers (CD3, CD4 and CD8) would enhance the prognostic value of EGFR in OSCCs.MethodsTissue microarrays containing 146 OSCC cases were analyzed for EGFR, CD3, CD4 and CD8 expression using immunohistochemical staining. EGFR and T cell expression scores were correlated with clinicopathological parameters and survival outcomes.ResultsResults showed that EGFR expression had no impact on overall survival (OS), but EGFR-positive (EGFR+) OSCC patients demonstrated significantly worse progression free survival (PFS) compared to EGFR-negative (EGFR-) patients. Patients with CD3, CD4 and CD8-positive tumors had significantly better OS compared to CD3, CD4 and CD8-negative patients respectively, but no impact on PFS. Combined EGFR+/CD3+ expression was associated with cases with no nodal involvement and significantly more favorable OS compared to EGFR+/CD3- expression. CD3 expression had no impact on OS or PFS in EGFR- patients. Combinations of EGFR/CD8 and EGFR/CD4 expression showed no significant differences in OS or PFS among the expression groups.ConclusionAltogether these results suggest that the expression of CD3+ tumor-infiltrating T cells can enhance the prognostic value of EGFR expression and warrants further investigation as prognostic biomarkers for OSCC.
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Affiliation(s)
- Wattawan Wongpattaraworakul
- Department of Oral Pathology, Radiology, and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, United States
- Department of Pathology, College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Katherine N. Gibson-Corley
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Allen Choi
- Department of Pathology, College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Marisa R. Buchakjian
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
- Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Emily A. Lanzel
- Department of Oral Pathology, Radiology, and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, United States
- Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Anand Rajan KD
- Department of Pathology, College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Andrean L. Simons
- Department of Oral Pathology, Radiology, and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, United States
- Department of Pathology, College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
- Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
- Iowa City Veterans Affairs Health Care System, Iowa City, IA, United States
- *Correspondence: Andrean L. Simons,
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Zhao Y, Tang Y, Qin H, Feng K, Hu C. The efficient circulating immunoscore predicts prognosis of patients with advanced gastrointestinal cancer. World J Surg Oncol 2022; 20:233. [PMID: 35820903 PMCID: PMC9277963 DOI: 10.1186/s12957-022-02693-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/29/2022] [Indexed: 11/12/2022] Open
Abstract
Background Immunoscore from tumor tissues was initially established to evaluate the prognosis of solid tumor patients. However, the feasibility of circulating immune score (cIS) for the prognosis of advanced gastrointestinal cancers (AGC) has not been reported. Material and methods Peripheral venous blood was collected from 64 untreated AGC patients. We utilized flow cytometry to determine several immune cell subpopulations, including CD8+ and CD4+ T cells, NK cells, and CD4 + CD25 + CD127low Tregs. The circulating immune score 1 (cIS1) was assessed according to the proportions of CD4+, CD8+ T cells, and NK cell, whereas circulating immune score 2 (cIS2) was derived from the proportions of CD4+, CD8+ T cell, and CD4 + CD25 + CD127low Tregs. The prognostic role of cIS for progression-free survival (PFS) and overall survival (OS) was analyzed using Kaplan–Meier curves and Cox multivariate models. Receiver operating characteristic (ROC) curves were depicted to compare the prognostic values of cIS1 and cIS2. Results AGC patients with high cIS1(≥ 2) and cIS2(≥ 2) had significantly longer PFS (cIS1: median PFS, 11 vs. 6.7 months, P = 0.001; cIS2: 12 vs. 5.8 months, P < 0.0001) and OS (cIS1: median OS, 12 vs. 7.9 months, P = 0.0004; cIS2: 12.8 vs. 7.4 months, P < 0.0001) than those with low cIS1 and low cIS2. The areas under ROC curves (AUROCs) of cIS1 and cIS2 for OS were 0.526 (95% confidence interval; 95% CI 0.326–0.726) and 0.603 (95% CI 0.427–0.779, P = 0.332), whereas AUROC of cIS2 for PFS was larger than that of cIS1 0.735 (95% CI 0.609–0.837) vs 0.625 (95% CI 0.495–0.743) (P = 0.04)). Conclusion The cIS can be applied to predict the prognosis of untreated AGC patients. Compared with cIS1, cIS2 displayed superior prognostic value for PFS prediction.
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Affiliation(s)
- Yamei Zhao
- Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230031, People's Republic of China.
| | - Yan Tang
- Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230031, People's Republic of China
| | - Hanlin Qin
- Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230031, People's Republic of China
| | - Kehai Feng
- Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230031, People's Republic of China
| | - Changlu Hu
- Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230031, People's Republic of China
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Wu H, Wang H, Chen Y. Pan-cancer analysis of tumor mutation burden sensitive tumors reveals tumor-specific subtypes and hub genes related to immune infiltration. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04139-2. [PMID: 35780251 DOI: 10.1007/s00432-022-04139-2] [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: 03/30/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND High tumor mutation burden (TMB) failed to serve as a favorable prognostic biomarker for immunotherapy across all tumors. This study aimed to explore TMB-sensitive tumors on a pan-cancer level and construct their immune infiltration phenotypes in TMB-high groups. METHODS Pan-cancer patients were separated into TMB-high and TMB-low groups based on the median TMB values per tumor. TMB-related genes were identified using differently expressed genes (DEGs) and differently mutated genes (DMGs) between the above two TMB groups. CIBERSORT algorithm was used to estimate the abundance of 22 tumor immune infiltrating cells (TIICs). Consensus clustering analysis was applied to predict molecular subtypes. Cox regression analysis was performed to evaluate the correlations between hub genes and TIICs and immunomodulator genes. RESULTS Nine TMB-sensitive tumors were identified by high-frequency of TMB-related genes. A total of 126 tumor-specific hub genes (1 in BLCA, 19 in BRCA, 4 in COAD, 4 in HNSC, 25 in LUAD, 2 in LUSC, 27 in SKCM, 37 in STAD, and 7 UCEC) were identified. In five out of nine TMB-sensitive tumors, the molecular subtypes based on hub gene expression were characterized by TMB values, prognostic values and tumor-specific TIICs levels. In TMB-high groups, hub genes associated immune infiltration phenotypes were constructed with key TIICs and immunomodulators spanning TMB-sensitive tumors. CONCLUSIONS Our tumor-specific analysis revealed hub genes associated immune infiltration features may serve as potential therapeutic targets and prognostic markers of immunotherapy, providing the potential underlying mechanism of immune infiltration in TMB-high groups across TMB-sensitive tumors.
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Affiliation(s)
- Huan Wu
- Department of Medical Laboratory, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China.,Integrated Chinese and Western Medicine Postdoctoral Research Station, Jinan University, Guangzhou, 510632, China
| | - Hanchu Wang
- The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China
| | - Yue Chen
- Department of Medical Laboratory, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China.
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Prognostic and Predictive Relevance of Tumor-Infiltrating Lymphocytes in Squamous Cell Head-Neck Cancer Patients Treated with Radical Radiotherapy/Chemo-Radiotherapy. Curr Oncol 2022; 29:4274-4284. [PMID: 35735451 PMCID: PMC9222114 DOI: 10.3390/curroncol29060342] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/11/2022] [Accepted: 06/12/2022] [Indexed: 01/10/2023] Open
Abstract
Microenvironmental conditions control the entrance and thriving of cytotoxic lymphocytes in tumors, allowing or preventing immune-mediated cancer cell death. We investigated the role of tumor-infiltrating lymphocyte (TIL) density in the outcome of radiotherapy in a series of squamous cell head−neck tumors (HNSCC). Moreover, we assessed the link between markers of hypoxia and TIL density. One-hundred twenty-one patients with HNSCC treated prospectively with radical radiotherapy/chemo-radiotherapy were analyzed. The assessment of TIL density was performed on hematoxylin and eosin biopsy sections before radiotherapy. TIL density ranged from 0.8 to 150 lymphocytes per ×40 optical field (median 27.5). Using the median value, patients were grouped into two categories of low and high TIL density. Early T-stage tumors had a significantly higher TIL density (p < 0.003), but we found no association with N-stage. Overexpression of HIF1α, HIF2α, and CA9 was significantly linked with poor infiltration by TILs (p < 0.03). A significant association of high TIL density with better disease-specific overall survival and improved locoregional relapse-free survival was noted (p = 0.008 and 0.02, respectively), which was also confirmed in multivariate analysis. It is concluded that HNSCC phenotypes that allow for the intratumoral accumulation of lymphocytes have a better outcome following radical radiotherapy/chemo-radiotherapy. Intratumoral-activated HIF- and CA9-related pathways characterize immunologically cold tumors and may be used as targets for therapeutic interventions.
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Abstract
Cancer is one of the leading causes of death in the world, which is the second after heart diseases. Adenoviruses (Ads) have become the promise of new therapeutic strategy for cancer treatment. The objective of this review is to discuss current advances in the applications of adenoviral vectors in cancer therapy. Adenoviral vectors can be engineered in different ways so as to change the tumor microenvironment from cold tumor to hot tumor, including; 1. by modifying Ads to deliver transgenes that codes for tumor suppressor gene (p53) and other proteins whose expression result in cell cycle arrest 2. Ads can also be modified to express tumor specific antigens, cytokines, and other immune-modulatory molecules. The other strategy to use Ads in cancer therapy is to use oncolytic adenoviruses, which directly kills tumor cells. Gendicine and Advexin are replication-defective recombinant human p53 adenoviral vectors that have been shown to be effective against several types of cancer. Gendicine was approved for treatment of squamous cell carcinoma of the head and neck by the Chinese Food and Drug Administration (FDA) agency in 2003 as a first-ever gene therapy product. Oncorine and ONYX-015 are oncolytic adenoviral vectors that have been shown to be effective against some types of cancer. The Chiness FDA agency has also approved Oncorin for the treatment of head and neck cancer. Ads that were engineered to express immune-stimulatory cytokines and other immune-modulatory molecules such as TNF-α, IL-2, BiTE, CD40L, 4-1BBL, GM-CSF, and IFN have shown promising outcome in treatment of cancer. Ads can also improve therapeutic efficacy of immune checkpoint inhibitors and adoptive cell therapy (Chimeric Antigen Receptor T Cells). In addition, different replication-deficient adenoviral vectors (Ad5-CEA, Ad5-PSA, Ad-E6E7, ChAdOx1-MVA and Ad-transduced Dendritic cells) that were tested as anticancer vaccines have been demonstrated to induce strong antitumor immune response. However, the use of adenoviral vectors in gene therapy is limited by several factors such as pre-existing immunity to adenoviral vectors and high immunogenicity of the viruses. Thus, innovative strategies must be continually developed so as to overcome the obstacles of using adenoviral vectors in gene therapy.
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Affiliation(s)
- Sintayehu Tsegaye Tseha
- Lecturer of Biomedical Sciences, Department of Biology, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Park JC, Krishnakumar HN, Saladi SV. Current and Future Biomarkers for Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma. Curr Oncol 2022; 29:4185-4198. [PMID: 35735443 PMCID: PMC9221564 DOI: 10.3390/curroncol29060334] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/15/2022] Open
Abstract
With the introduction of immunotherapy, significant improvement has been made in the treatment of head and neck squamous cell carcinoma (HNSCC). However, only a small subset of patients with HNSCC benefit from immunotherapy. The current biomarker, a programmed cell death protein ligand 1 (PD-L1) expression that is widely used in treatment decision making for advanced HNSCC, has only a moderate predictive value. Additionally, PD-L1-based assay has critical inherent limitations due to its highly dynamic nature and lack of standardization. With the advance in molecular techniques and our understanding of biology, more reliable, reproducible, and practical novel biomarkers are being developed. These include but are not limited to neoantigen/mutation characteristics, immune transcriptomes, tumor-infiltrating immune cell composition, cancer epigenomic, proteomics and metabolic characteristics, and plasma-based and organoid assays.
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Affiliation(s)
- Jong Chul Park
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA;
| | | | - Srinivas Vinod Saladi
- Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA
- Correspondence: ; Tel.: +1-807-7881
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Getz KR, Bellile E, Zarins KR, Chinn SB, Taylor JMG, Rozek LS, Wolf GT, Mondul AM. The association between inflammatory biomarkers and statin use among patients with head and neck squamous cell carcinoma. Head Neck 2022; 44:1393-1403. [PMID: 35338544 PMCID: PMC9088158 DOI: 10.1002/hed.27040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/08/2022] [Accepted: 03/09/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Tumor-infiltrating lymphocytes (TILs) and cytokines are associated with prognosis among patients with head and neck squamous cell carcinoma (HNSCC). Statins (cholesterol-lowering drugs) may improve HNSCC prognosis, particularly in human papillomavirus (HPV)-positive cases, but the mechanism remains unclear. METHODS Statin use was collected from medical records for HNSCC cases (2008-2014). TILs were counted in tumor tissue, and a total weighted score (TILws) was created. Cytokines were measured in blood. The associations between statins and biomarkers were estimated using logistic (biomarker categories: <median, ≥median) and linear regression models (log-transformed continuous biomarkers) adjusted for age, smoking, and comorbidities. RESULTS We observed a positive association between statins and TILs among HPV-positive patients (TILws odds ratio [OR] = 2.80; 95% CI = 1.03-7.61), but no association among HPV-negative patients. We observed no association between statins and cytokines. CONCLUSIONS Statins may influence TILs in HPV-positive patients. This may be the mechanism through which they improve prognosis in HPV-positive HNSCC patients.
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Affiliation(s)
- Kayla R Getz
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Emily Bellile
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Steven B Chinn
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeremy M G Taylor
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Gregory T Wolf
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Identification of Significant Secreted or Membrane-Located Proteins in Laryngeal Squamous Cell Carcinoma. J Immunol Res 2022; 2022:9089397. [PMID: 35655921 PMCID: PMC9153386 DOI: 10.1155/2022/9089397] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 12/27/2022] Open
Abstract
Background. This study is aimed at investigating the expressions and prognostic values of secreted or membrane-located proteins (SMPs) in laryngeal squamous cell carcinoma (LSCC). The correlations between the expressions of SMPs and immune cells’ infiltrations were also investigated. Methods. The expression data of normal laryngeal and LSCC samples were obtained from the TCGA and GEO datasets. The differentially expressed SMPs were identified, and their prognostic values were analyzed. The biological functions of differentially expressed and worse-survival-related SMPs were explored. LASSO regression, Cox multivariate analysis, and nomogram were used to construct a model to predict the survival. Then, the infiltrations of the 24 immune cell populations were calculated using the GSVA method, and the correlations between the expression of SMPs and the immune infiltration were investigated. Results. 122 samples (12 normal and 120 LSCC) of the TCGA database and 114 samples (57 normal and 57 LSCC) of GSE127165 were included. We identified that 138 SMPs were significantly upregulated in LSCC samples of both the TCGA and GEO datasets, among which 52 SMPs were significantly correlated with worse survival. GO and KEGG analyses revealed those 52 SMPs significantly participate in tumor microenvironment and immune cells’ communication. Nine of 52 SMPs (ABCC5, ATP1B3, CLEC11A, FLNA, FSTL3, MMP1, NME1, OAS3, and PHLDB2) were included in the nomogram to effectively and accurately predict the LSCC patients’ survival. The expressions of most SMPs, such as MMP1 and FSTL3, were significantly positively correlated with the immune infiltration of LSCC. Conclusions. In this study, the expression, prognostic values, and correlations with immune infiltration of SMPs were analyzed in LSCC samples. Our analyses identified several significant SMPs differentially expressed between normal laryngeal and LSCC samples, correlated with worse survival, and related to the immune infiltration.
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Obradovic A, Graves D, Korrer M, Wang Y, Roy S, Naveed A, Xu Y, Luginbuhl A, Curry J, Gibson M, Idrees K, Hurley P, Jiang P, Liu XS, Uppaluri R, Drake CG, Califano A, Kim YJ. Immunostimulatory Cancer-Associated Fibroblast Subpopulations Can Predict Immunotherapy Response in Head and Neck Cancer. Clin Cancer Res 2022; 28:2094-2109. [PMID: 35262677 PMCID: PMC9161438 DOI: 10.1158/1078-0432.ccr-21-3570] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/15/2021] [Accepted: 03/07/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Cancer-associated fibroblasts (CAF) have been implicated as potential mediators of checkpoint immunotherapy response. However, the extensive heterogeneity of these cells has precluded rigorous understanding of their immunoregulatory role in the tumor microenvironment. EXPERIMENTAL DESIGN We performed high-dimensional single-cell RNA sequencing (scRNA-seq) on four patient tumors pretreatment and posttreatment from a neoadjuvant trial of patients with advanced-stage head and neck squamous cell carcinoma that were treated with the αPD-1 therapy, nivolumab. The head and neck CAF (HNCAF) protein activity profiles, derived from this cohort of paired scRNA-seq, were used to perform protein activity enrichment analysis on the 28-patient parental cohort of clinically annotated bulk transcriptomic profiles. Ex vivo coculture assays were used to test functional relevance of HNCAF subtypes. RESULTS Fourteen distinct cell types were identified with the fibroblast population showing significant changes in abundance following nivolumab treatment. Among the fibroblast subtypes, HNCAF-0/3 emerged as predictive of nivolumab response, while HNCAF-1 was associated with immunosuppression. Functionally, HNCAF-0/3 were found to reduce TGFβ-dependent PD-1+TIM-3+ exhaustion of CD8 T cells, increase CD103+NKG2A+ resident memory phenotypes, and enhance the overall cytolytic profile of T cells. CONCLUSIONS Our findings demonstrate the functional importance of distinct HNCAF subsets in modulating the immunoregulatory milieu of human HNSCC. In addition, we have identified clinically actionable HNCAF subtypes that can be used as a biomarker of response and resistance in future clinical trials.
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Affiliation(s)
- Aleksandar Obradovic
- Columbia Center for Translational Immunology (CCTI), Columbia University Irving Medical Center (CUMC), New York, NY, USA
- Department of Systems Biology, HICC, New York, NY, USA
| | - Diana Graves
- Department of Pathology, Microbiology & Immunology, Vanderbilt University, Nashville, TN, USA
| | - Michael Korrer
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yu Wang
- Department of Biostatistics, Vanderbilt University Medical Center. Nashville, TN, USA
| | - Sohini Roy
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Abdullah Naveed
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yaomin Xu
- Department of Biostatistics, Vanderbilt University Medical Center. Nashville, TN, USA
| | - Adam Luginbuhl
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joseph Curry
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Michael Gibson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kamran Idrees
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paula Hurley
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Peng Jiang
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - X. Shirley Liu
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ravindra Uppaluri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Charles G. Drake
- Columbia Center for Translational Immunology (CCTI), Columbia University Irving Medical Center (CUMC), New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Andrea Califano
- Department of Systems Biology, HICC, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
- Department of Biochemistry and Molecular Biophysics, Columbia University, New York, NY, USA
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
- J.P. Sulzberger Columbia Genome Center, New York, NY, USA
| | - Young J. Kim
- Department of Pathology, Microbiology & Immunology, Vanderbilt University, Nashville, TN, USA
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Regeneron Pharmaceutical, Tarrytown, NY, USA
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Yang Y, Yang X, Wang Y, Xu J, Shen H, Gou H, Qin X, Jiang G. Combined Consideration of Tumor-Associated Immune Cell Density and Immune Checkpoint Expression in the Peritumoral Microenvironment for Prognostic Stratification of Non-Small-Cell Lung Cancer Patients. Front Immunol 2022; 13:811007. [PMID: 35222387 PMCID: PMC8866234 DOI: 10.3389/fimmu.2022.811007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/20/2022] [Indexed: 11/19/2022] Open
Abstract
Given the complexity and highly heterogeneous nature of the microenvironment and its effects on antitumor immunity and cancer immune evasion, the prognostic value of a single immune marker is limited. Here, we show how the integration of immune checkpoint molecule expression and tumor-associated immune cell distribution patterns can influence prognosis prediction in non-small-cell lung cancer (NSCLC) patients. We analyzed tissue microarray (TMA) data derived from multiplex immunohistochemistry results and measured the densities of tumor-infiltrating CD8+ and FOXP3+ immune cells and tumor cells (PanCK+), as well as the densities of programmed cell death 1 (PD-1)+ and programmed cell death ligand 1 (PD-L1)+ cells in the peritumor and intratumor subregions. We found a higher density of infiltrating CD8+ and FOXP3+ immune cells in the peritumoral compartment than in the intratumoral compartment. In addition, unsupervised hierarchical clustering analysis of these markers revealed that the combination of high CD8/FOXP3 expression, low PD-1 and PD-L1 immune checkpoint expression, and lack of epidermal growth factor receptor (EGFR) mutation could be a favorable predictive marker. On the other hand, based on the clustering analysis, low CD8/FOXP3 and immune checkpoint (PD-1 and PD-L1) expression might be a marker for patients who are likely to respond to strategies targeting regulatory T (Treg) cells. Furthermore, an immune risk score model was established based on multivariate Cox regression, and the risk score was determined to be an independent prognostic factor for NSCLC patients. These results indicate that the immune context is heterogeneous because of the complex interactions of different components and that using multiple factors in combination might be promising for predicting the prognosis of and stratifying NSCLC patients.
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Affiliation(s)
- Yong Yang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaobao Yang
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yichao Wang
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jingsong Xu
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hanyu Shen
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongquan Gou
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiong Qin
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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Yan L, Song X, Yang G, Zou L, Zhu Y, Wang X. Identification and Validation of Immune Infiltration Phenotypes in Laryngeal Squamous Cell Carcinoma by Integrative Multi-Omics Analysis. Front Immunol 2022; 13:843467. [PMID: 35281069 PMCID: PMC8907422 DOI: 10.3389/fimmu.2022.843467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022] Open
Abstract
Background Laryngeal squamous cell carcinoma (LSCC) is one of the world’s most common head and neck cancer. However, the immune infiltration phenotypes of LSCC have not been well investigated. Methods The multi-omics data of LSCC were obtained from the TCGA (n=111) and GEO (n=57) datasets. The infiltrations of the 24 immune cell populations were calculated using the GSVA method. Then LSCC samples with different immune cell infiltrating patterns were clustered, and the multi-omics differences were investigated. Results Patients were clustered into the high-infiltration and low-infiltration groups. The infiltration scores of most immune cells were higher in the high-infiltration group. Patients with high-infiltration phenotype have high N and TNM stages but better survival, as well as less mutated COL11A1 and MUC17. Common targets of immunotherapies such as PD1, PDL1, LAG3, and CTLA4 were significantly up-regulated in the high-infiltration group. The differentially expressed genes were mainly enriched in several immune-related GOs and KEGG pathways. Based on the genes, miRNAs, and lncRNAs differentially expressed in both the TCGA and GEO cohorts, we built a ceRNA network, in which BTN3A1, CCR1, miR-149-5p, and so on, located at the center. A predictive model was also constructed to calculate a patient’s immune infiltration phenotype using 16 genes’ expression values, showing excellent accuracy and specificity in the TCGA and GEO cohorts. Conclusions In this study, the immune infiltration phenotypes of LSCC and the corresponding multi-omics differences were explored. Our model might be valuable to predicting immunotherapy’s outcome.
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Affiliation(s)
- Li Yan
- Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xiaole Song
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Gang Yang
- Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Lifen Zou
- Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yi Zhu
- Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xiaoshen Wang
- Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, China
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Magnetic Resonance Guided Radiotherapy for Head and Neck Cancers. J Clin Med 2022; 11:jcm11051388. [PMID: 35268479 PMCID: PMC8911481 DOI: 10.3390/jcm11051388] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Radiotherapy is an integral component of head/neck squamous cell carcinomas (HNSCCs) treatment, and technological developments including advances in image-guided radiotherapy over the past decades have offered improvements in the technical treatment of these cancers. Integration of magnetic resonance imaging (MRI) into image guidance through the development of MR-guided radiotherapy (MRgRT) offers further potential for refinement of the techniques by which HNSCCs are treated. This article provides an overview of the literature supporting the current use of MRgRT for HNSCC, challenges with its use, and developing research areas.
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68
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Gharzai LA, Pakela J, Jaworski EM, El Naqa I, Shah J, Hawkins PG, Spector ME, Bradford CR, Chinn SB, Malloy K, Kupfer R, Shuman A, Morrison R, Stucken CL, Rosko A, Prince ME, Casper K, Eisbruch A, Wolf G, Swiecicki PL, Worden F, Mierzwa ML. Imaging response assessment for predicting outcomes after bioselection chemotherapy in larynx cancer: A secondary analysis of two prospective trials. Clin Transl Radiat Oncol 2022; 33:30-36. [PMID: 35024462 PMCID: PMC8728046 DOI: 10.1016/j.ctro.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/20/2021] [Accepted: 12/19/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND PURPOSE Bioselection with induction chemotherapy in larynx cancer is associated with excellent larynx preservation and disease-specific survival but requires visual inspection of the primary tumor. We retrospectively compare clinical and imaging response in bioselected patients to develop predictive models of surgeon-assessed response (SR), laryngectomy-free survival (LFS), and overall survival (OS) in bioselected patients. MATERIALS AND METHODS In a secondary analysis of patients on two single-institution bioselection trials, model building used a regularized regression model (elastic-net) and applied nested cross-validation. Logistic regression-based model was used to predict SR and Cox proportional hazard-based models were used to predict LFS and OS. RESULTS In 115 patients with a median age of 57 years, most patients had supraglottic tumors (73.0%) and T3/T4 disease (94.8%). Definitive treatment was chemoradiation in 76.5% and laryngectomy in 23.5%. Change in primary tumor (OR = 5.78, p < 0.001) and N-classification (OR = 1.64, p = 0.003) predicted SR (AUC 0.847). Change in tumor volume (HR = 0.58, p < 0.001) predicted LFS (c-index 0.724). N-classification (HR = 1.48, p = 0.04) and pre-chemotherapy tumor volume (HR = 1.30, p = 0.174) predicted OS (c-index 0.552). CONCLUSIONS Imaging offers a non-invasive opportunity to evaluate response to induction chemotherapy, complementary to surgeon assessment. Further evaluation of approaches to bioselection that optimize generalizability of this paradigm are needed, and clinical trials utilizing imaging to predict outcomes including LFS are warranted.
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Affiliation(s)
- Laila A. Gharzai
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Julia Pakela
- Applied Physics Program, University of Michigan, Ann Arbor, MI, United States
| | - Elizabeth M. Jaworski
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Issam El Naqa
- Applied Physics Program, University of Michigan, Ann Arbor, MI, United States
| | - Jennifer Shah
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Peter G. Hawkins
- Department of Radiation Oncology, The Kaiser Permanente Medical Group, Rohnert Park, CA, United States
| | - Matthew E. Spector
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Carol R. Bradford
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Steven B. Chinn
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Kelly Malloy
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Robbi Kupfer
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Andrew Shuman
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Robert Morrison
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Chaz L. Stucken
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Andrew Rosko
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Mark E. Prince
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Keith Casper
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Avraham Eisbruch
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Gregory Wolf
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Paul L. Swiecicki
- Department of Medical Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Francis Worden
- Department of Medical Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Michelle L. Mierzwa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
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Heft Neal ME, Smith JD, Birkeland AC, Haring CT, Chinn SB, Shuman AG, Casper KA, Malloy KM, Stucken CL, Mclean SA, Rosko AJ, Mierzwa ML, Shah J, Schonewolf C, Swiecicki PL, Worden FP, Wolf GT, Bradford CR, Prince MEP, Chad Brenner J, Spector ME. Tumor-Infiltrating Lymphocytes in Patients With Advanced Laryngeal Cancer Undergoing Bioselection. Otolaryngol Head Neck Surg 2022; 166:498-505. [PMID: 34030495 PMCID: PMC8613299 DOI: 10.1177/01945998211013765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Bioselection to assess tumor response after induction chemotherapy has been introduced as an alternative treatment strategy to total laryngectomy for patients with advanced larynx squamous cell carcinoma (LSCC). Tumor-infiltrating lymphocytes (TILs) have proven to serve as prognostic biomarkers in head and neck cancer but have not been evaluated as a way to select patients for treatment paradigms. The aim of this study is to evaluate the role of pretreatment TILs in patients with advanced LSCC undergoing the bioselection paradigm. STUDY DESIGN Retrospective study. SETTING Tertiary care hospital. METHODS Patients with advanced LSCC treated with bioselection and available tissue were included (N = 76). Patients were stratified into CD8-low and CD8-high cohorts by using the median TIL count. Kaplan-Meier survival analysis and multivariate cox regression were performed with SPSS version 26 (IBM). RESULTS After controlling for tobacco use, tumor site, and stage, a high CD8 TIL count was an independent predictor of improved 5-year disease-specific survival (hazard ratio, 0.17 [95% CI, 0.03-0.84]; P = .03). CD8 TIL counts did not predict response to induction chemotherapy; however, subgroup analysis of patients treated with chemoradiation therapy revealed that CD8 TIL count was significantly associated with degree of response (P = .012). CONCLUSION These findings support prior data published by our group showing that TILs are predictive of disease-specific survival in patients with head and neck cancer. CD8 TIL counts were significantly associated with degree of clinical response after induction chemotherapy. These results suggest that pretreatment assessment of tumor-infiltrating CD8 cells could be useful in selecting patients.
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Affiliation(s)
- Molly E Heft Neal
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Joshua D Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Andrew C Birkeland
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis, Sacramento, CA
| | - Catherine T Haring
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Steven B Chinn
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Andrew G Shuman
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Keith A Casper
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Kelly M Malloy
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Chaz L Stucken
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Scott A Mclean
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Andrew J Rosko
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | | | - Jennifer Shah
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | | | - Paul L Swiecicki
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - Francis P Worden
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - Gregory T Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Carol R Bradford
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH
| | - Mark EP Prince
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - J Chad Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Matthew E Spector
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
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Meyer HJ, Höhn AK, Surov A. Associations Between ADC and Tumor Infiltrating Lymphocytes, Tumor-Stroma Ratio and Vimentin Expression in Head and Neck Squamous Cell Cancer. Acad Radiol 2022; 29 Suppl 3:S107-S113. [PMID: 34217611 DOI: 10.1016/j.acra.2021.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 12/23/2022]
Abstract
RATIONALE AND OBJECTIVES The present study used diffusion-weighted imaging (DWI) to elucidate possible associations with tumor-infiltrating lymphocytes (TIL), tumor-stroma ratio and vimentin expression in head and neck squamous cell cancer (HNSCC). MATERIALS AND METHODS 30 patients with primary HNSCC of different localizations were involved in the study. DWI was obtained on a 3 T scanner. Apparent diffusion coefficients (ADC) images were analyzed with a whole lesion measurement using a histogram approach. TIL- and vimentin-expression was calculated on biopsy samples before any form of treatment. RESULTS Tumor-stroma ratio correlated with ADC kurtosis (r = 0.46, p = 0.01) and ADC skewness (r = 0.42, p = 0.02). Several ADC parameters were significantly different between stroma rich und tumor rich tumors. ADC entropy correlated significantly with the expression of TIL within the tumor compartment (r = 0.44, p = 0.01). No associations were identified between ADC parameters and vimentin expression. CONCLUSION ADC skewness and kurtosis histogram parameters can reflect tumor compartments in HNSCC. ADC entropy was associated with TIL of the tumor compartment but not with those of the stroma compartment, which emphasizes the ability of ADC histogram parameters to reflect distinctive differences of tumors.
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CW. Wong K, Johnson D, Hui EP, CT. Lam R, BY. Ma B, TC. Chan A. Opportunities and Challenges in Combining Immunotherapy and Radiotherapy in Head and Neck Cancers. Cancer Treat Rev 2022; 105:102361. [DOI: 10.1016/j.ctrv.2022.102361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 02/06/2023]
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Solis RN, Silverman DA, Birkeland AC. Current Trends in Precision Medicine and Next-Generation Sequencing in Head and Neck Cancer. Curr Treat Options Oncol 2022; 23:254-267. [PMID: 35195839 PMCID: PMC9196261 DOI: 10.1007/s11864-022-00942-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 12/20/2022]
Abstract
OPINION STATEMENT As the field of oncology enters the era of precision medicine and targeted therapies, we have come to realize that there may be no single "magic bullet" for patients with head and neck cancer. While immune check point inhibitors and some targeted therapeutics have shown great promise in improving oncologic outcomes, the current standard of care in most patients with head and neck squamous cell carcinoma (HNSCC) remains a combination of surgery, radiation, and/or cytotoxic chemotherapy. Nevertheless, advances in precision medicine, next-generation sequencing (NGS), and targeted therapies have a potential future in the treatment of HNSCC. These roles include increased patient treatment stratification based on predictive biomarkers or targetable mutations and novel combinatorial regimens with existing HNSCC treatments. There remain challenges to precision medicine and NGS in HNSCC, including intertumor and intratumor heterogeneity, challenging targets, and need for further trials validating the utility of NGS and precision medicine. Additionally, there is a need for evidence-based practice guidelines to assist clinicians on how to appropriately incorporate NGS in care for HNSCC. In this review, we describe the current state of precision medicine and NGS in HNSCC and opportunities for future advances in this challenging but important field.
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Affiliation(s)
- Roberto N Solis
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, 2521 Stockton Blvd., Suite 7200, Sacramento, CA, 95817, USA
| | - Dustin A Silverman
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, 2521 Stockton Blvd., Suite 7200, Sacramento, CA, 95817, USA
| | - Andrew C Birkeland
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, 2521 Stockton Blvd., Suite 7200, Sacramento, CA, 95817, USA.
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73
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van Duijvenvoorde M, Derks S, Bahce I, Leemans CR, van de Ven R, Fransen MF. Comparison of the tumor microenvironments of squamous cell carcinoma at different anatomical locations within the upper aerodigestive tract in relation to response to ICI therapy. Clin Transl Immunology 2022; 11:e1363. [PMID: 35035956 PMCID: PMC8747970 DOI: 10.1002/cti2.1363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022] Open
Abstract
Immunotherapy with immune checkpoint inhibitors (ICI) has improved treatment outcomes in many cancer types and has focused attention on cancer immunity and the role of the tumor microenvironment (TME). Studies into efficacy of immunotherapy and TME are generally restricted to tumors in one anatomical location, while the histological type may have substantial influence on the contexture of the TME, perhaps more so than anatomical location, and subsequently to the response to immunotherapy. This review aims to focus on the TME in ICI‐treated tumors of the same histological type, namely carcinogen‐induced squamous cell carcinoma developing within the aerodigestive tract, at three locations, i.e. head and neck (HNSCC), esophagus (ESCC) and lung (LUSC).
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Affiliation(s)
- Maurice van Duijvenvoorde
- Department of Pulmonary Diseases Amsterdam UMC, location VUmc Cancer Center Amsterdam and Amsterdam Institute for Infection and Immunity Amsterdam The Netherlands.,Department of Otolaryngology Head and Neck Surgery Amsterdam UMC, location VUmc Cancer Center Amsterdam and Amsterdam Institute for Infection and Immunity Amsterdam The Netherlands
| | - Sarah Derks
- Department of Medical Oncology Amsterdam UMC, location VUmc Cancer Center Amsterdam and Amsterdam Institute for Infection and Immunity Amsterdam The Netherlands.,Oncode Institute Utrecht The Netherlands
| | - Idris Bahce
- Department of Pulmonary Diseases Amsterdam UMC, location VUmc Cancer Center Amsterdam and Amsterdam Institute for Infection and Immunity Amsterdam The Netherlands
| | - C René Leemans
- Department of Otolaryngology Head and Neck Surgery Amsterdam UMC, location VUmc Cancer Center Amsterdam and Amsterdam Institute for Infection and Immunity Amsterdam The Netherlands
| | - Rieneke van de Ven
- Department of Otolaryngology Head and Neck Surgery Amsterdam UMC, location VUmc Cancer Center Amsterdam and Amsterdam Institute for Infection and Immunity Amsterdam The Netherlands
| | - Marieke F Fransen
- Department of Pulmonary Diseases Amsterdam UMC, location VUmc Cancer Center Amsterdam and Amsterdam Institute for Infection and Immunity Amsterdam The Netherlands
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74
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Fu ZM, Zhang DJ, Guo YY, Han S, Guo F, Bai J, Wan YN, Guan GF, Sun KW, Yang N. Expression of PD‑L1 and CD4+ tumor‑infiltrating lymphocytes predict survival in head and neck squamous cell carcinoma. Mol Clin Oncol 2022; 16:59. [PMID: 35111324 PMCID: PMC8771311 DOI: 10.3892/mco.2022.2492] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 12/10/2021] [Indexed: 11/05/2022] Open
Abstract
The clinical efficacy of immune checkpoint blockade has been recently demonstrated in a variety of cancer types. The aim of the present study was to characterize the expression profile of tumor-infiltrating lymphocytes (TILs) and programmed death-ligand 1 (PD-L1) in head and neck squamous carcinoma (HNSCC). A total of 63 patients with HNSCC were enrolled in the present study. CD3+ and CD4+ TILs and the expression of PD-L1 were detected by immunohistochemistry. PD-L1 mRNA levels were evaluated by reverse transcription-quantitative PCR analysis. The association of TILs and PD-L1 with patient clinicopathological characteristics was also assessed. CD3+ and CD4+ TILs were detected in 100% of the samples. CD3+ was the predominant subset of TILs. PD-L1 was expressed in 53 of 61 (86%) patients when a score of ≥1 on tumor cells was considered positive and in 28 patients (45.2%) when a score of >5 on tumor cells was considered positive. PD-L1 mRNA levels were determined to be significantly correlated with PD-L1 protein expression. Survival analysis demonstrated that high CD4+ TILs were associated with improved overall survival (OS) and disease-free survival (DFS), and furthermore, the association of high PD-L1 expression with unfavorable OS and DFS was statistically significant. Multivariate analysis identified CD4+ TILs and PD-L1 as prognostic markers for HNSCC. The results of the present study suggested that increased CD4+ TILs in HNSCC may be associated with improved outcomes, while high expression of PD-L1 may indicate unfavorable OS and DFS; thus, these factors may serve as predictors of the response to immune checkpoint therapy.
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Affiliation(s)
- Ze-Ming Fu
- Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - De-Jun Zhang
- Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Ying-Yuan Guo
- Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Shuang Han
- Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Fang Guo
- Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Jie Bai
- Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Yi-Ning Wan
- Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Guo-Fang Guan
- Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Ke-Wei Sun
- Department of Otolaryngology‑Head and Neck Surgery, Changchun Center Hospital, Changchun, Jilin 130041, P.R. China
| | - Na Yang
- Department of Otolaryngology‑Head and Neck Surgery, Changchun Center Hospital, Changchun, Jilin 130041, P.R. China
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75
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Raina R, Singhal M, Jain A, Shetty D. Does a well-differentiated oral squamous cell carcinoma always behave well? A case series. J Microsc Ultrastruct 2022. [DOI: 10.4103/jmau.jmau_35_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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76
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Chakrabarti S, Dasgupta S, Deb A. Tumor infiltrating lymphocytes in head and neck squamous cell carcinoma – Evaluation and clinical impact. J Cancer Res Ther 2022; 18:49-54. [DOI: 10.4103/jcrt.jcrt_830_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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77
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Kulchavenya EV, Myshkova EP, Dementieva EI, Baranchukova AA. Tongue cancer in a patient with pulmonary tuberculosis. Case report. CONSILIUM MEDICUM 2021. [DOI: 10.26442/20751753.2021.12.201288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Tuberculosis and malignant neoplasms are a global threat, these diseases claim millions of lives and cause tremendous suffering to people worldwide. Tuberculosis can mask cancer and create preconditions for carcinogenesis. The article presents a clinical case of tongue cancer in a patient with pulmonary tuberculosis. Patient B.N., 45 years old, was admitted to the FSBI Novosibirsk Tuberculosis Research Institute with complaints of a "sore place" on the tongue, pain in the right half of the tongue, enlargement of the submandibular lymph nodes on the right The tongue hurts for about 1,5 years, but over the last 2 months, condition has worsened. The patient noticed an increase in the size of lesion on the tongue and increased pain, especially during meals (he can eat only after pain relief, for which he takes Nimesulide 4 pills a day). In recent days, he felt also epigastric pain for which he didnt visit a doctor. Tongue biopsy was performed, and histological analysis revealed cancer. The patient was diagnosed with fibrous-cavernous tuberculosis of the upper lobe of the right lung, infiltration and seeding phase; mycobacterium tuberculosis (+); broad drug resistance (HRSECmKmPasCsOfl); gastric ulcer (0,5 cm), exacerbation stage; chronic erosive gastritis, exacerbation stage; malignant neoplasm of the floor of the mouth on the right T3(4)N1M1. With this diagnosis, the patient was discharged for further treatment by oncologists. Physicians need to have a high alertness for cancer in patients with tuberculosis, especially those in the high-risk group. A minimum of standard diagnostic procedures will allow you to verify the diagnosis timely.
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Meyer HJ, Höhn AK, Surov A. Associations between dynamic-contrast enhanced MRI and tumor infiltrating lymphocytes and tumor-stroma ratio in head and neck squamous cell cancer. Cancer Imaging 2021; 21:60. [PMID: 34801089 PMCID: PMC8606096 DOI: 10.1186/s40644-021-00429-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/01/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives The present study used dynamic-contrast enhanced MRI (DCE-MRI) to elucidate possible associations with tumor-infiltrating lymphocytes (TIL), stroma ratio and vimentin expression in head and neck squamous cell cancer (HNSCC). Methods Overall, 26 patients with primary HNSCC of different localizations were involved in the study. DCE-MRI was obtained on a 3 T MRI and analyzed with a whole lesion measurement using a histogram approach. TIL- and vimentin-expression was calculated on bioptic samples before any form of treatment. P16 staining was used to define HPV-status. Results Tumor-stroma ratio correlated with entropy derived from Ktrans (r = − 0.52, p = 0.0071) and with kurtosis derived from Ve (r = − 0.53, p = 0.0058). Several Ve derived parameters correlated with expression of TIL within the stroma compartment. TIL within the tumor compartment correlated with entropy derived from Ktrans (r = 0.39, p = 0.047), p90 derived from Ve (r = 0.41, p = 0.036) and skewness derived from Ve (r = 0.41, p = 0.037). Furthermore, these associations were different between HPV positive and negative tumors. Conclusions DCE-MRI might be able to reflect tumor compartments and TIL expression in HNSCC. The most promising parameters were values derived from Ktrans and Ve.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany.
| | | | - Alexey Surov
- Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
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79
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Lu W, Wu Y, Huang S, Zhang D. A Ferroptosis-Related Gene Signature for Predicting the Prognosis and Drug Sensitivity of Head and Neck Squamous Cell Carcinoma. Front Genet 2021; 12:755486. [PMID: 34745224 PMCID: PMC8566369 DOI: 10.3389/fgene.2021.755486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/07/2021] [Indexed: 01/20/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers worldwide and has a high mortality. Ferroptosis, an iron-dependent form of programmed cell death, plays a crucial role in tumor suppression and chemotherapy resistance in cancer. However, the prognostic and clinical values of ferroptosis-related genes (FRGs) in HNSCC remain to be further explored. In the current study, we constructed a ferroptosis-related prognostic model based on the Cancer Genome Atlas database and then explored its prognostic and clinical values in HNSCC via a series of bioinformatics analyses. As a result, we built a four-gene prognostic signature, including FTH1, BNIP3, TRIB3, and SLC2A3. Survival analysis showed that the high-risk group presented significantly poorer overall survival than the low-risk group. Moreover, the ferroptosis-related signature was found to be an independent prognostic predictor with high accuracy in survival prediction for HNSCC. According to immunity analyses, we found that the low-risk group had higher anti-tumor immune infiltration cells and higher expression of immune checkpoint molecules and meanwhile corelated more closely with some anti-tumor immune functions. Meanwhile, all the above results were validated in the independent HSNCC cohort GSE65858. Besides, the signature was found to be remarkably correlated with sensitivity of common chemotherapy drugs for HNSCC patients and the expression levels of signature genes were also significantly associated with drug sensitivity to cancer cells. Overall, we built an effective ferroptosis-related prognostic signature, which could predict the prognosis and help clinicians to perform individualized treatment strategy for HNSCC patients.
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Affiliation(s)
- Wei Lu
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yihua Wu
- Department of Oral Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shengyun Huang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dongsheng Zhang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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80
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Assessment of Immune Cell Populations in Tumor Tissue and Peripheral Blood Samples from Head and Neck Squamous Cell Carcinoma Patients. ACTA ACUST UNITED AC 2021; 2021:2328218. [PMID: 34692375 PMCID: PMC8536455 DOI: 10.1155/2021/2328218] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/08/2021] [Indexed: 02/07/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a common type of cancer worldwide. Strong connections have been revealed between immune cells and the pathogenesis of HNSCC. Important differences regarding the levels of immune cell subpopulations in both peripheral circulation and tumor microenvironment were emphasized, with some of them having prognostic significance. In our study, we performed an analysis of immune changes in the tumor tissue and the peripheral blood of untreated HNSCC patients, investigating the proportions of different immune cell populations in these two compartments. The local infiltrating lymphocytes were mainly cytotoxic T cells (CD8+). We have also revealed an increased level of B lymphocytes (CD19+) in the tumor microenvironment. In peripheral blood, the most important lymphocyte subtype was represented by the helper T lymphocytes (CD4+). We also found an increased proportion of circulating NK cells (CD56+). Our results showed significant differences between all investigated lymphocyte subtypes in the peripheral blood and the tumor tissue of untreated HNSCC patients, suggesting that the local and systemic expressions of antitumor immune responses are different and that investigation of immune cell proportions in peripheral circulation has different cues that do not reflect the immune infiltrate pattern within the tumor microenvironment. Further studies are necessary to unveil the complex interplay involving local and systemic events in the immune system's fight against cancer.
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81
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Ida S, Takahashi H, Kawabata-Iwakawa R, Mito I, Tada H, Chikamatsu K. Tissue-resident memory T cells correlate with the inflammatory tumor microenvironment and improved prognosis in head and neck squamous cell carcinoma. Oral Oncol 2021; 122:105508. [PMID: 34507204 DOI: 10.1016/j.oraloncology.2021.105508] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/29/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Tumor-infiltrating T cell (TIL) is a major cell type involved in tumor eradication in the tumor microenvironment (TME). Among TILs, tissue-resident memory T cells (TRMs) have been recognized as a subset capable of continuous immunosurveillance to afford long-term immunity. In the present study, we comprehensively profiled TRM in patients with head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS We analyzed RNA-sequencing (RNA-seq) data obtained from The Cancer Genome Atlas (TCGA) database. Based on the gene expression of CD69 and CD4/CD8A, we identified TRM-enriched patients and evaluated their clinical and biological significance. In addition, we analyzed peripheral blood mononuclear cells (PBMCs) obtained from 60 patients with HNSCC to evaluate the presence of TRM-like cells in the peripheral circulation. RESULTS TCGA analysis revealed that TRM-enriched tumors correlated with early T factor, human papillomavirus-positive status, the proportion of oropharynx lesion, upregulated inflammatory pathways, upregulation of immunostimulatory and immune checkpoint molecule genes, and favorable overall survival. Moreover, we clarified the presence of CD69 + TRM-like cells that highly express PD-1 and TIM-3 in the peripheral circulation of patients with HNSCC. CONCLUSION We highlighted the clinical and transcriptomic significance of TRM in patients with HNSCC. Further characterization of TRM could lead to the development of novel biomarkers, especially for immune checkpoint therapies.
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Affiliation(s)
- Shota Ida
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Hideyuki Takahashi
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan.
| | - Reika Kawabata-Iwakawa
- Division of Integrated Oncology Research, Gunma University Initiative for Advanced Research, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Ikko Mito
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Hiroe Tada
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Kazuaki Chikamatsu
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
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82
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Caruntu A, Moraru L, Lupu M, Taubner L, Caruntu C, Tanase C. The Hidden Treasures of Preoperative Blood Assessment in Oral Cancer: A Potential Source of Biomarkers. Cancers (Basel) 2021; 13:cancers13174475. [PMID: 34503285 PMCID: PMC8430940 DOI: 10.3390/cancers13174475] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary In this study, we assess the prognostic potential of immune and inflammatory elements determined preoperatively in the peripheral blood of patients with oral squamous cell carcinoma (OSCC). Preoperative plasma fibrinogen (Fib) and platelet-to-lymphocyte ratio (PLR) show strong correlations with patients’ outcomes. Analyzed together, in a new parameter named Fibrinogen-PLR Algorithm (FiPLA), predictive power increases significantly. Clinicians can use this new, easy, cost-effective, and globally available tool for risk stratification of patients with OSCC, as early as from the moment of diagnosis. Abstract (1) Background: Oral squamous cell carcinoma (OSCC) is a common malignancy, and the impact of immune and inflammatory mechanisms in its development and progression are of major interest. The aim of our study is to assess the prognostic potential of circulating immune and inflammatory elements determined preoperatively in patients with OSCC, as well as the development of a new compound parameter with predictive value. (2) Methods: We assessed preoperative fibrinogen (Fib) and the platelet-to-lymphocyte ratio (PLR) in 111 OSCC patients. Using a mathematic algorithm, we determined a composite parameter with cumulative information from Fib and PLR, named Fibrinogen-PLR Algorithm (FiPLA). Survival analysis, followed by bivariate and multivariate analyses, was subsequently conducted. (3) Results: Increased preoperative Fib and PLR levels were associated with poor outcome in OSCC (p = 0.0001 and p = 0.0015, respectively). Preoperative FiPLA values were also associated with poor patient survival (p < 0.0001). Multivariate analysis confirmed the independent prognostic role for FiPLA only (CI95% 1.232–67.770, p = 0.03), showing the superior predictive value of FiPLA compared to its individual components. (4) Conclusions: Preoperative assessments of circulating immune and inflammatory elements can provide high-quality prognostic information, and they represent valuable tools in clinical practice, facilitating the early risk stratification of patients with OSCC.
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Affiliation(s)
- Ana Caruntu
- Department of Oral and Maxillofacial Surgery, Carol Davila Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.C.); (L.M.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Liliana Moraru
- Department of Oral and Maxillofacial Surgery, Carol Davila Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.C.); (L.M.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Mihai Lupu
- Dermatology Research Laboratory, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Lacramioara Taubner
- Clinical Laboratory, Carol Davila Central Military Emergency Hospital, 010825 Bucharest, Romania;
| | - Constantin Caruntu
- Department of Physiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Dermatology, Prof. N.C. Paulescu National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
- Correspondence: ; Tel.: +40-745-086-978
| | - Cristiana Tanase
- Biochemistry-Proteomics Department, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania;
- Proteomics Department, Cajal Institute, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
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Song W, Ren J, Yuan W, Xiang R, Ge Y, Fu T. N6-Methyladenosine-Related lncRNA Signature Predicts the Overall Survival of Colorectal Cancer Patients. Genes (Basel) 2021; 12:genes12091375. [PMID: 34573357 PMCID: PMC8472391 DOI: 10.3390/genes12091375] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 02/07/2023] Open
Abstract
Background: The N6-methyladenosine (m6A) RNA modification can modify long non-coding RNAs (lncRNAs), thereby affecting the tumorigenesis and progression of tumors. However, the underlying role of m6A-modified lncRNAs in colorectal cancer (CRC) remains largely unknown. Therefore, our aim was to assess the prognostic value of m6A-modified lncRNAs in CRC patients. Methods: The gene expression and clinicopathological data of CRC were extracted from The Cancer Genome Atlas (TCGA) database. Pearson correlation analysis was used to investigate the m6A-modified lncRNAs. Consensus clustering was conducted to identify molecular subtypes of CRC, and the clinical significance of molecular subtypes was identified. The least absolute shrinkage and selection operator analysis (LASSO) was applied to establish a risk signature. Finally, a prognostic nomogram with risk score and clinicopathological variables was established. Results: In total, 29 m6A-modified lncRNAs were identified as prognostic lncRNAs. Two molecular clusters were identified and significant differences were found with respect to clinicopathological features and prognosis. Cluster1 is associated with poor overall survival (OS), down-regulation of Programmed cell death ligand-1 (PD-L1) expression, lower immune score, and less immune cell infiltration. Then, an m6A-modified lncRNA signature for predicting OS was constructed in the TCGA training cohort. The signature demonstrated favorable prediction performance in both training and validation sets. Compared with low-risk patients, patients with high risk showed worse clinical outcomes, lower immune scores, and downregulated PD-L1 expression. Further analysis indicated that the signature was an independent prognostic indicator, and then a prognostic nomogram based on risk score, tumor location, and tumor stage was established. Conclusions: Our study identified a seven m6A-modified lncRNA signature and established a prognostic nomogram that reliably predicts OS in CRC. These findings may improve the understanding of m6A modifications in CRC and provide insights into the prognosis and treatment strategy of CRC.
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Affiliation(s)
| | | | | | | | | | - Tao Fu
- Correspondence: ; Tel./Fax: +86-027-88041911-81333
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84
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Bai Y, Yue C, Lu Z, Li P, Liu H. The role of α-smooth muscle actin in confirming the microinvasion of laryngeal squamous cell carcinoma. Ann Diagn Pathol 2021; 54:151804. [PMID: 34419855 DOI: 10.1016/j.anndiagpath.2021.151804] [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: 05/14/2021] [Revised: 07/06/2021] [Accepted: 07/25/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The diagnosis of microinvasive laryngeal squamous cell carcinoma (LSCC) is not always straightforward and sometimes can be very challenge in daily clinical practice. The focus lies in the confirmation of microinvasion. Cancer-associated fibroblasts (CAFs), as the major element of reactive tumor stroma, are believed to participate actively in the growth and invasion of tumor cells. OBJECTIVES To evaluate the diagnostic role of α-smooth muscle actin (α-SMA) labelling CAFs in microinvasive LSCC. METHODS A total of 81 laryngeal biopsy specimens were retrieved, including 41 cases of microinvasive LSCC with depth of invasion no more than 3 mm, 20 laryngeal squamous intraepithelial lesion (SIL), and 20 benign pseudoepitheliomatous hyperplasia (PEH). All cases were stained for immunohistochemistry, using antibody against the α-SMA antigen. The correlation between the presence of CAFs in microinvasive LSCC and tumor histological characteristics was investigated. RESULTS Immunoreactivity of α-SMA was detected in twenty-nine microinvasive LSCC (29/41, 71%), while no reactivity was observed in laryngeal SIL (0/20, 0%), and rarely in PEH (2/20, 10%). The α-SMA expression pattern in stroma of microinvasive LSCC was significantly different from that of SIL (χ2 = 26.966, p = 0.000) and PEH (χ2 = 19.838, p = 0.000). In addition, there seemed to be a certain correlation between the histological characteristics of microinvasive LSCC and the presence of interstitial CAFs. CONCLUSIONS This study highlights the practical role of utilizing α-SMA in the pathological diagnosis of microinvasive LSCC, with emphasis on variable histomorphologic features of microinvasive LSCC.
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Affiliation(s)
- Yuping Bai
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Changli Yue
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Zhichun Lu
- Department of Pathology and Laboratory Medicine, Boston Medical Center/Boston University School of Medicine, Boston, MA, United States
| | - Pingdong Li
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Honggang Liu
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
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Fasano M, Perri F, Della Corte CM, Di Liello R, Della Vittoria Scarpati G, Cascella M, Ottaiano A, Ciardiello F, Solla R. Translational Insights and New Therapeutic Perspectives in Head and Neck Tumors. Biomedicines 2021; 9:1045. [PMID: 34440249 PMCID: PMC8391435 DOI: 10.3390/biomedicines9081045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 01/10/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is characterized by a high mortality rate owing to very few available oncological treatments. For many years, a combination of platinum-based chemotherapy and anti-EGFR antibody cetuximab has represented the only available option for first-line therapy. Recently, immunotherapy has been presented an alternative for positive PD-L1 HNSCC. However, the oncologists' community foresees that a new therapeutic era is approaching. In fact, no-chemo options and some molecular targets are on the horizon. This narrative review addresses past, present, and future therapeutic options for HNSCC from a translational point of view.
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Affiliation(s)
- Morena Fasano
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.F.); (C.M.D.C.); (R.D.L.); (F.C.)
| | - Francesco Perri
- Medical and Experimental Head and Neck Oncology Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, Via M. Semmola, 80131 Naples, Italy
| | - Carminia Maria Della Corte
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.F.); (C.M.D.C.); (R.D.L.); (F.C.)
| | - Raimondo Di Liello
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.F.); (C.M.D.C.); (R.D.L.); (F.C.)
| | | | - Marco Cascella
- Division of Anesthesia, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80100 Naples, Italy;
| | - Alessandro Ottaiano
- SSD Innovative Therapies for Abdominal Metastases, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80100 Naples, Italy;
| | - Fortunato Ciardiello
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.F.); (C.M.D.C.); (R.D.L.); (F.C.)
| | - Raffaele Solla
- Italian National Research Council, Institute of Biostructure & Bioimaging, 80131 Naples, Italy;
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86
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Comprehensive analysis of immune cell enrichment in the tumor microenvironment of head and neck squamous cell carcinoma. Sci Rep 2021; 11:16134. [PMID: 34373557 PMCID: PMC8352955 DOI: 10.1038/s41598-021-95718-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/28/2021] [Indexed: 01/10/2023] Open
Abstract
Head and neck squamous carcinoma (HNSCC) is highly infiltrated by immune cells, including tumor-infiltrating lymphocytes and myeloid lineage cells. In the tumor microenvironment, tumor cells orchestrate a highly immunosuppressive microenvironment by secreting immunosuppressive mediators, expressing immune checkpoint ligands, and downregulating human leukocyte antigen expression.
In the present study, we aimed to comprehensively profile the immune microenvironment of HNSCC using gene expression data obtained from public database. We calculated enrichment scores of 33 immune cell types based on gene expression data of HNSCC tissues and adjacent non-cancer tissues. Based on these scores, we performed non-supervised clustering and identified three immune signatures—cold, lymphocyte, and myeloid/dendritic cell (DC)—based on the clustering results. We then compared the clinical and biological features of the three signatures. Among HNSCC and non-cancer tissues, human papillomavirus (HPV)-positive HNSCCs exhibited the highest scores in various immune cell types, including CD4+ T cells, CD8+ T cells, B cells, plasma cells, basophils, and their subpopulations. Among the three immune signatures, the proportions of HPV-positive tumors, oropharyngeal cancers, early T tumors, and N factor positive cases were significantly higher in the lymphocyte signature than in other signatures. Among the three signatures, the lymphocyte signature showed the longest overall survival (OS), especially in HPV-positive patients, whereas the myeloid/DC signature demonstrated the shortest OS in these patients. Gene set enrichment analysis revealed the upregulation of several pathways related to inflammatory and proinflammatory responses in the lymphocyte signature. The expression of PRF1, IFNG, GZMB, CXCL9, CXCL10, PDCD1, LAG3, CTLA4, HAVCR2, and TIGIT was the highest in the lymphocyte signature. Meanwhile, the expression of PD-1 ligand genes CD274 and PDCD1LG2 was highest in the myeloid/DC signature. Herein, our findings revealed the transcriptomic landscape of the immune microenvironment that closely reflects the clinical and biological significance of HNSCC, indicating that molecular profiling of the immune microenvironment can be employed to develop novel biomarkers and precision immunotherapies for HNSCC.
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87
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Yang L, Liu G, Li Y, Pan Y. The emergence of tumor-infiltrating lymphocytes in nasopharyngeal carcinoma: Predictive value and immunotherapy implications. Genes Dis 2021; 9:1208-1219. [PMID: 35873027 PMCID: PMC9293699 DOI: 10.1016/j.gendis.2021.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/09/2022] Open
Abstract
The clinical study of nasopharyngeal carcinoma (NPC) often reveals a large number of lymphocytes infiltrating the primary tumor site. As an important part of the tumor microenvironment, tumor-infiltrating lymphocytes (TILs) do not exist alone but as a complex multicellular population with high heterogeneity. TILs play an extremely significant role in the occurrence, development, invasion and metastasis of NPC. The latest research shows that they participate in tumorigenesis and treatment, and the composition, quantity, functional status and distribution of TILs subsets have good predictive value for the prognosis of NPC patients. TILs are an independent prognostic factor for TNM stage and significantly correlated with better prognosis. Additionally, adoptive immunotherapy using anti-tumor TILs has achieved good results in a variety of solid tumors including NPC. This review evaluates recent clinical and preclinical studies of NPC, summarizes the role of TILs in promoting and inhibiting tumor growth, evaluates the predictive value of TILs, and explores the potential benefits of TILs-based immunotherapy in the treatment of NPC.
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88
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Berele BA, Cai Y, Yang G. Prognostic Value of Tumor Infiltrating Lymphocytes in Nasopharyngeal Carcinoma Patients: Meta-Analysis. Technol Cancer Res Treat 2021; 20:15330338211034265. [PMID: 34323154 PMCID: PMC8330464 DOI: 10.1177/15330338211034265] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: To evaluate the prognostic value of tumor infiltrating lymphocytes (TILs) in nasopharyngeal carcinoma (NPC) patients. Method: Meta-analysis was performed on eligible studies that was identified by systematic searching of Google scholar, MEDLINE, CNKI, Scopus, PubMed, PMC, Embase and Web of Science databases. The study protocol was registered in International Platform of Registered Systematic Review and Meta-Analysis Protocols-INPLASY (registration number: INPLASY202160014). Databases were searched from inception to January 20, 2020 to identify eligible studies. Those studies that evaluated survival in the form of hazard ratio (HR) in TILs of NPC patients was analyzed. All statistical analysis was performed by using STATA version 16.0 software. Result: Fourteen studies with a total of 3025 patients was analyzed. The pooled result showed that high TILs was significantly associated with favorable overall survival (OS) (HR = 0.55; 95%CI = 0.39-0.77; P = 0.001) and disease free survival (DFS) (HR = 0.60; 95%CI = 0.44-0.81; P = 0.04). Interestingly, high intratumoral TILs had relatively better OS (HR = 0.45; 95%CI = 0.35-0.58; P = 0.006) than stromal TILs (HR = 0.59; 95%CI = 0.36-0.97; P = 0.03). Moreover, an increased level of CD4+ cells infiltration was correlated with favorable OS (HR = 0.4; 95%CI = 0.18-0.85; P = 0.01). CD3+, CD8+ and FoxP3+ lymphocyte’s better prognosis was not statistically significant for OS (P = 0.09; P = 0.07; P = 0.52) and for DFS (P = 0.13; P = 0.29) respectively. However, subgroup analysis of intratumoral CD3+ (HR = 0.48; 95%CI = 0.33-0.70; P = 0.05) and intratumoral CD8+ (HR = 0.32; 95%CI = 0.16-0.62; P = 0.001) was significantly associated with improved OS, but not significant in stromal CD3+ (HR = 0.66; 95%CI = 0.20-2.20; P = 0.62). Conclusion: TILs were variably correlated with better prognosis depending on their microanatomic location and subset of TILs in NPC patients. CD4+, intratumoral CD3+ and intratumoral CD8+ lymphocytes could predict favorable patient outcome which suggest that their role in mediating antitumor immune response could potentially be exploited in the treatment of NPC patients. Future large study on the prognostic value of microanatomic location of TILs is needed for confirmation.
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Affiliation(s)
| | - Yuxiang Cai
- Department of Pathology, 89674Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Guifang Yang
- Department of Pathology, 89674Zhongnan Hospital of Wuhan University, Wuhan, China
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Almangush A, Bello IO, Heikkinen I, Hagström J, Haglund C, Kowalski LP, Coletta RD, Mäkitie AA, Salo T, Leivo I. Improving Risk Stratification of Early Oral Tongue Cancer with TNM-Immune (TNM-I) Staging System. Cancers (Basel) 2021; 13:cancers13133235. [PMID: 34209490 PMCID: PMC8267637 DOI: 10.3390/cancers13133235] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Some patients with early-stage oral tongue cancer suffer from poor survival. The currently used classification requires further improvement to better predict the prognosis. Immune-related parameters (such as assessment of infiltrating lymphocytes) can be used as a modifier for the classification and that can aid in improving the prognostication. We included 290 cases of early-stage oral tongue cancer in this study. Lymphocytes were scored and divided as low or high and incorporated in the traditional tumor-node-metastasis (TNM) classification to form our proposed TNM-Immune staging system. The TNM-Immune staging system allowed for a significant distinction between T1 and T2. The TNM-Immune staging system showed a powerful ability to identify cases with poor survival. TNM-Immune staging forms a step towards a more personalized classification of early-stage oral tongue cancer. Abstract Although patients with early-stage oral tongue squamous cell carcinoma (OTSCC) show better survival than those with advanced disease, there is still a number of early-stage cases who will suffer from recurrence, cancer-related mortality and worse overall survival. Incorporation of an immune descriptive factor in the staging system can aid in improving risk assessment of early OTSCC. A total of 290 cases of early-stage OTSCC re-classified according to the American Joint Committee on Cancer (AJCC 8) staging were included in this study. Scores of tumor-infiltrating lymphocytes (TILs) were divided as low or high and incorporated in TNM AJCC 8 to form our proposed TNM-Immune system. Using AJCC 8, there were no significant differences in survival between T1 and T2 tumors (p > 0.05). Our proposed TNM-Immune staging system allowed for significant discrimination in risk between tumors of T1N0M0-Immune vs. T2N0M0-Immune. The latter associated with a worse overall survival with hazard ratio (HR) of 2.87 (95% CI 1.92–4.28; p < 0.001); HR of 2.41 (95% CI 1.26–4.60; p = 0.008) for disease-specific survival; and HR of 1.97 (95% CI 1.13–3.43; p = 0.017) for disease-free survival. The TNM-Immune staging system showed a powerful ability to identify cases with worse survival. The immune response is an important player which can be assessed by evaluating TILs, and it can be implemented in the staging criteria of early OTSCC. TNM-Immune staging forms a step towards a more personalized classification of early OTSCC.
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Affiliation(s)
- Alhadi Almangush
- Department of Pathology, University of Helsinki, 00014 Helsinki, Finland; (I.O.B.); (I.H.); (J.H.); (T.S.)
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland;
- Institute of Biomedicine, Pathology, University of Turku, 20520 Turku, Finland;
- Faculty of Dentistry, Misurata University, Misurata 2478, Libya
- Correspondence: ; Tel.: +358-45-2044668
| | - Ibrahim O. Bello
- Department of Pathology, University of Helsinki, 00014 Helsinki, Finland; (I.O.B.); (I.H.); (J.H.); (T.S.)
- Department of Oral Medicine and Diagnostic Sciences, King Saud University College of Dentistry, Riyadh 11545, Saudi Arabia
| | - Ilkka Heikkinen
- Department of Pathology, University of Helsinki, 00014 Helsinki, Finland; (I.O.B.); (I.H.); (J.H.); (T.S.)
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
| | - Jaana Hagström
- Department of Pathology, University of Helsinki, 00014 Helsinki, Finland; (I.O.B.); (I.H.); (J.H.); (T.S.)
- Research Programs Unit, Translational Cancer Medicine, University of Helsinki, 00014 Helsinki, Finland;
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, 20520 Turku, Finland
| | - Caj Haglund
- Research Programs Unit, Translational Cancer Medicine, University of Helsinki, 00014 Helsinki, Finland;
- Department of Surgery, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo 01509-900, Brazil;
| | - Ricardo D. Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo 13083-970, Brazil;
| | - Antti A. Mäkitie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland;
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, 00130 Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, 17177 Stockholm, Sweden
| | - Tuula Salo
- Department of Pathology, University of Helsinki, 00014 Helsinki, Finland; (I.O.B.); (I.H.); (J.H.); (T.S.)
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
- Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, 90220 Oulu, Finland
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, 20520 Turku, Finland;
- Turku University Hospital, 20521 Turku, Finland
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90
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Caruntu A, Moraru L, Lupu M, Ciubotaru DA, Dumitrescu M, Eftimie L, Hertzog R, Zurac S, Caruntu C, Voinea OC. Assessment of Histological Features in Squamous Cell Carcinoma Involving Head and Neck Skin and Mucosa. J Clin Med 2021; 10:2343. [PMID: 34071843 PMCID: PMC8199467 DOI: 10.3390/jcm10112343] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/16/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND squamous cell carcinoma (SCC) is the second most common type of malignancy worldwide. Skin and mucosa of the head and neck areas are the most frequently affected. An aggressive behavior in SCC is not easily detected, and despite all efforts, mortality in these types of cancer did not show major improvements during recent decades. In this study, we aim to determine the role of histological features available through standard pathology assessment in SCC and their relation with tumor behavior and patients' survival. METHOD in a group of one hundred patients diagnosed with SCC involving the head and neck areas, we assessed the presence of four histological features (tumor/stroma ratio, immune infiltration at the front of invasion, tumor-budding activity, and tumor necrosis), their correlations with tumor type (mucosal or cutaneous), tumor clinicopathological characteristics, and their prognostic potential. RESULTS the comparison between histological features in cutaneous versus mucosal SCC reveals no significant differences for any of the four parameters assessed. We found significant correlations between tumor/stroma ratio and lymphatic metastasis (p = 0.0275), perineural invasion (p = 0.0006), and clinical staging (p = 0.0116). Immune infiltration at the front of invasion revealed similar correlations with lymph node involvement (p = 0.002), perineural invasion (p = 0.0138), and clinical staging (p = 0.0043). Tumor budding and tumor necrosis correlated with the size of the tumor (p = 0.0077 and p = 0.0004) and the clinical staging (p = 0.0039 and p = 0.0143). In addition, tumor budding was significantly correlated with perineural invasion (p = 0.0454). In mucosal SCC, patients with improved outcome revealed high values for the tumor/stroma ratio (p = 0.0159) and immune infiltration at the front of invasion (p = 0.0274). However, the multivariate analysis did not confirm their independent prognostic roles. CONCLUSIONS extended histological assessments that include features such as tumor/stroma ratio, immune infiltration at the front of invasion, tumor budding, and tumor necrosis can be an easy, accessible method to collect additional information on tumor aggressiveness in skin and mucosa SCC affecting the head and neck areas.
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Affiliation(s)
- Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.C.); (L.M.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Liliana Moraru
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.C.); (L.M.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Mihai Lupu
- Dermatology Research Laboratory, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Diana Alina Ciubotaru
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Marius Dumitrescu
- Department of Pathology, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (M.D.); (L.E.)
| | - Lucian Eftimie
- Department of Pathology, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (M.D.); (L.E.)
| | - Radu Hertzog
- “Cantacuzino” National Medico-Military Institute for Research and Development, 050096 Bucharest, Romania; (R.H.); (O.C.V.)
| | - Sabina Zurac
- Department of Pathology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Oana Cristina Voinea
- “Cantacuzino” National Medico-Military Institute for Research and Development, 050096 Bucharest, Romania; (R.H.); (O.C.V.)
- Department of Pathology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Getz KR, Bellile E, Zarins KR, Rullman C, Chinn SB, Taylor JM, Rozek LS, Wolf GT, Mondul AM. Statin use and head and neck squamous cell carcinoma outcomes. Int J Cancer 2021; 148:2440-2448. [PMID: 33320960 PMCID: PMC8203748 DOI: 10.1002/ijc.33441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 02/02/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a morbid cancer with poor outcomes. Statins possess anticancer properties such as immunomodulatory and anti-inflammatory effects. The objective of our study is to identify the association between statin use among untreated HNSCC patients and overall death, disease-specific death and recurrence. HNSCC patients were recruited to participate in the University of Michigan Head and Neck Cancer Specialized Program of Research Excellence (SPORE) from 2003 to 2014. Statin use data were collected through medical record review. Participants were considered a statin user if they used a statin at or after diagnosis. Outcome data were collected through medical record review, Social Security Death Index or LexisNexis. Our analytic cohort included 1638 participants. Cox proportional hazard models were used to estimate the association between ever statin use and HNSCC outcomes. Statin use was seen in 36.0% of participants. We observed a statistically significant inverse association between ever using a statin and overall death (HR = 0.75, 95% CI = 0.63-0.88) and HNSCC-specific death (HR = 0.79, 95% CI = 0.63-0.99) and a nonstatistically significant inverse association for recurrence (HR = 0.85, 95% CI = 0.70-1.04). When investigating the association between statin use and HNSCC outcomes utilizing interaction terms between statin use and human papillomavirus (HPV), statistically significant interactions for HNSCC-specific death and recurrence were identified (HNSCC-specific death: HPV-positive HR = 0.41, 95% CI = 0.21-0.84; HPV-negative HR = 1.04, 95% CI = 0.71-1.51; p-int=0.02; recurrence: HPV-positive HR = 0.49, 95% CI = 0.29-0.84; HPV-negative HR = 1.03, 95% CI = 0.74-1.43; p=int-0.02). Statin use may be protective for adverse outcomes in HNSCC patients, particularly those with HPV-positive disease. If true, these findings could have a meaningful impact on tertiary prevention for this cancer.
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Affiliation(s)
- Kayla R. Getz
- Department of Epidemiology, University of Michigan School
of Public Health, Ann Arbor, Michigan
| | - Emily Bellile
- Department of Biostatistics, University of Michigan School
of Public Health, Ann Arbor, Michigan
| | - Katie R. Zarins
- Department of Environmental Health Sciences, University of
Michigan School of Public Health, Ann Arbor, Michigan
| | - Cailey Rullman
- Department of Epidemiology, University of Michigan School
of Public Health, Ann Arbor, Michigan
| | - Steven B. Chinn
- Department of Otolaryngology-Head and Neck Surgery,
University of Michigan, Ann Arbor Michigan
| | - Jeremy M.G. Taylor
- Department of Biostatistics, University of Michigan School
of Public Health, Ann Arbor, Michigan
| | - Laura S. Rozek
- Department of Environmental Health Sciences, University of
Michigan School of Public Health, Ann Arbor, Michigan
- Department of Otolaryngology-Head and Neck Surgery,
University of Michigan, Ann Arbor Michigan
| | - Gregory T. Wolf
- Department of Otolaryngology-Head and Neck Surgery,
University of Michigan, Ann Arbor Michigan
| | - Alison M. Mondul
- Department of Epidemiology, University of Michigan School
of Public Health, Ann Arbor, Michigan
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92
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Xu B, Salama AM, Valero C, Yuan A, Khimraj A, Saliba M, Zanoni DK, Ganly I, Ghossein R, Patel SG, Katabi N. Histologic evaluation of host immune microenvironment and its prognostic significance in oral tongue squamous cell carcinoma: a comparative study on lymphocytic host response (LHR) and tumor infiltrating lymphocytes (TILs). Pathol Res Pract 2021; 228:153473. [PMID: 34059347 DOI: 10.1016/j.prp.2021.153473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Host immune microenvironment is a key component of anti-tumoral immune response, influencing tumor progression, regression, and treatment responses. There is a need for simple and reliable histologic measurements of host immune response in routine histopathologic diagnosis. METHODS The prognostic value of lymphocytic host response (LHR), a qualitative histologic grading scheme, was compared to stromal/intratumoral TIL (sTIL/iTIL) percentage, a quantitative measurement in a retrospective study of 329 patients with oral tongue squamous cell carcinoma (OTSCC) of 4 cm or less in size. RESULTS High sTIL predicted improved distant recurrence free survival on univariate survival analysis and was an independent prognostic factor for better overall survival on multivariate analysis. LHR and iTIL were not associated with the risk of nodal metastasis or outcome. CONCLUSIONS sTIL appears to be a superior quantitative histologic measurement for the host immune microenvironment compared with the qualitative LHR grading scheme. sTIL is an independent prognostic factor for overall survival in OTSCC.
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Affiliation(s)
- Bin Xu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Abeer M Salama
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cristina Valero
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Avery Yuan
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anjanie Khimraj
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maelle Saliba
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniella K Zanoni
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ian Ganly
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ronald Ghossein
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Snehal G Patel
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Nora Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Caruntu A, Moraru L, Lupu M, Vasilescu F, Dumitrescu M, Cioplea M, Popp C, Dragusin A, Caruntu C, Zurac S. Prognostic Potential of Tumor-Infiltrating Immune Cells in Resectable Oral Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:2268. [PMID: 34066837 PMCID: PMC8125877 DOI: 10.3390/cancers13092268] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/19/2021] [Accepted: 05/04/2021] [Indexed: 12/12/2022] Open
Abstract
(1) Background: The immune microenvironment plays an important role in carcinogenesis and has prognostic potential in many types of cancer. In this study we assess the prognostic character of tumor-infiltrating immune cells CD4+, CD8+ and CD56+ in resectable oral squamous cell carcinoma (OSCC); (2) Methods: We have evaluated the densities of CD4+, CD8+ and CD56+ in two distinct compartments, intratumor and invasion front, in 90 patients with OSCC; (3) Results: Significant differences were found between the tumor compartments for the CD4+ and CD8+ lymphocytes. An improved outcome (OS) was seen in patients with high densities of intratumor CD8+ lymphocytes (p = 0.0086), CD8+ lymphocytes at the front of invasion (p = 0.0011) and for intratumor CD56+ cells (p = 0.0016). Multivariate analysis confirmed the independent prognostic role of CD8+ at the front of invasion (OR = 3.75, CI95% 1.17-12.35, p = 0.026) and for intratumor CD56+ cells (OR = 3.669, CI95% 1.09-15.37, p = 0.035); (4) Conclusions: Tumor-infiltrating CD8+ lymphocytes at the front of invasion and CD56+ in the intratumor compartment display predictive traits in OSCC. A reach immune infiltration with these types of cells is associated with an improved patient outcome.
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Affiliation(s)
- Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.C.); (L.M.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Liliana Moraru
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.C.); (L.M.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Mihai Lupu
- Dermatology Research Laboratory, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Florina Vasilescu
- Department of Pathology, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (F.V.); (M.D.)
| | - Marius Dumitrescu
- Department of Pathology, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (F.V.); (M.D.)
| | - Mirela Cioplea
- Department of Pathology, “Carol Davila” University of Medicine and Pharmacy, 020125 Bucharest, Romania; (M.C.); (A.D.); (S.Z.)
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania;
| | - Cristiana Popp
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania;
| | - Alexandra Dragusin
- Department of Pathology, “Carol Davila” University of Medicine and Pharmacy, 020125 Bucharest, Romania; (M.C.); (A.D.); (S.Z.)
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania;
| | - Constantin Caruntu
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Sabina Zurac
- Department of Pathology, “Carol Davila” University of Medicine and Pharmacy, 020125 Bucharest, Romania; (M.C.); (A.D.); (S.Z.)
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania;
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Meyer HJ, Höhn AK, Surov A. Histogram parameters derived from T1 and T2 weighted images correlate with tumor infiltrating lymphocytes and tumor-stroma ratio in head and neck squamous cell cancer. Magn Reson Imaging 2021; 80:127-131. [PMID: 33971242 DOI: 10.1016/j.mri.2021.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE The present study used histogram analysis values derived from T1- and T2- weighted (w) images to elucidate possible associations with Tumor-infiltrating lymphocytes (TIL) and Vimentin expression in head and neck squamous cell cancer (HNSCC). MATERIALS AND METHODS Overall, 28 patients (n = 8 female patient, 28.6%) with primary HNSCC of different localizations were involved in the study. Magnetic resonance imaging (MRI) was obtained on a 3 T MRI. The images were analyzed with a whole lesion measurement using a histogram approach. TIL- and vimentin-expression was calculated on biopsy samples before any form of treatment. RESULTS Several T1-derived parameters correlated with the expression of TIL within the stroma compartment: mean (r = 0.42, p = 0.025), p10 (r = 0.50, p = 0.007), p25 (r = 0.42, p = 0.025), median (r = 0.39, p = 0.036), and mode (r = 0.39, p = 0.04). No T2-derived parameter correlated with the TIL within the stroma compartment. Several T2-derived parameters correlated with the expression of TIL within the tumor compartment: mean (r = -0.52, p = 0.004), max (r = -0.43, p = 0.02), p10 (r = -0.38, p = 0.04), p25 (r = -0.53, p = 0.004), p75 (r = -0.52, p = 0.004), p90 (r = -0.48, p = 0.009), median (r = -0.52, p = 0.004), mode (r = -0.40, p = 0.03). Kurtosis derived from T2w images had significant higher values in tumor-rich tumors, compared to stroma-rich tumors, (mean 5.5 ± 0.5 versus 4.2 ± 1.2, p = 0.028). CONCLUSIONS Histogram analysis parameters derived from T1w and T2w images might be able to reflect tumor compartments and TIL expression in HNSCC.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany.
| | - Anne Kathrin Höhn
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany; Department of Pathology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
| | - Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Magdeburg, Leipzigerstraße 44, 39120 Magdeburg, Germany
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Rodrigo JP, Sánchez-Canteli M, López F, Wolf GT, Hernández-Prera JC, Williams MD, Willems SM, Franchi A, Coca-Pelaz A, Ferlito A. Tumor-Infiltrating Lymphocytes in the Tumor Microenvironment of Laryngeal Squamous Cell Carcinoma: Systematic Review and Meta-Analysis. Biomedicines 2021; 9:biomedicines9050486. [PMID: 33925205 PMCID: PMC8145951 DOI: 10.3390/biomedicines9050486] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 02/08/2023] Open
Abstract
The presence of tumor-infiltrating lymphocytes (TIL) in the tumor microenvironment has been demonstrated to be of prognostic value in various cancers. In this systematic review and meta-analysis, we investigated the prognostic value of TIL in laryngeal squamous cell carcinoma (LSCC). We performed a systematic search in PubMed for publications that investigated the prognostic value of TIL in LSCC. A meta-analysis was performed including all studies assessing the association between TIL counts in hematoxylin-eosin (HE)-stained sections, for CD8+ and/or CD3+/CD4+ TIL and overall survival (OS) or disease-free survival (DFS). The pooled meta-analysis showed a favorable prognostic role for stromal TIL in HE sections for OS (HR 0.57, 95% CI 0.36–0.91, p = 0.02), and for DFS (HR 0.56, 95% CI 0.34–0.94, p = 0.03). High CD8+ TIL were associated with a prolonged OS (HR 0.62, 95% CI 0.4–0.97, p = 0.04) and DFS (HR 0.73, 95% CI 0.34–0.94, p = 0.002). High CD3+/CD4+ TIL demonstrated improved OS (HR 0.32, 95% CI 0.16–0.9, p = 0.03) and DFS (HR 0.23, 95% CI 0.10–0.53, p = 0.0005). This meta-analysis confirmed the favorable prognostic significance of TIL in LSCC. High stromal TIL evaluated in HE sections and intra-tumoral and stromal CD3+, CD4+ and/or CD8+ TIL might predict a better clinical outcome.
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Affiliation(s)
- Juan P. Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias-Instituto de Salud del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.-C.); (F.L.); (A.C.-P.)
- IUOPA-University of Oviedo, 33006 Oviedo, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence:
| | - Mario Sánchez-Canteli
- Department of Otolaryngology, Hospital Universitario Central de Asturias-Instituto de Salud del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.-C.); (F.L.); (A.C.-P.)
- IUOPA-University of Oviedo, 33006 Oviedo, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias-Instituto de Salud del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.-C.); (F.L.); (A.C.-P.)
- IUOPA-University of Oviedo, 33006 Oviedo, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Gregory T. Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, MI 48109, USA;
| | | | - Michelle D. Williams
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA;
| | - Stefan M. Willems
- Department of Pathology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - Alessandro Franchi
- Department of Translational Research, School of Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias-Instituto de Salud del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.-C.); (F.L.); (A.C.-P.)
- IUOPA-University of Oviedo, 33006 Oviedo, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, 35125 Padua, Italy;
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Kaufmann J, Biscio CAN, Bankhead P, Zimmer S, Schmidberger H, Rubak E, Mayer A. Using the R Package Spatstat to Assess Inhibitory Effects of Microregional Hypoxia on the Infiltration of Cancers of the Head and Neck Region by Cytotoxic T Lymphocytes. Cancers (Basel) 2021; 13:cancers13081924. [PMID: 33923522 PMCID: PMC8072547 DOI: 10.3390/cancers13081924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/27/2021] [Accepted: 04/12/2021] [Indexed: 11/27/2022] Open
Abstract
Simple Summary Progress in the field of in situ proteomics allows for the simultaneous detection of multiple biomarkers within one cancer tissue specimen. As a result, biological hypotheses previously only assessable ex vivo can now be studied in human cancer tissue. However, methods for objective analysis have so far been lacking behind. In this study, we established a free, objective, and entirely open-source-based method for the analysis of multiplexed immunofluorescence specimens. This will gain further importance with the availability of more advanced multiplexing methods in the future. Abstract (1) Background: The immune system has physiological antitumor activity, which is partially mediated by cytotoxic T lymphocytes (CTL). Tumor hypoxia, which is highly prevalent in cancers of the head and neck region, has been hypothesized to inhibit the infiltration of tumors by CTL. In situ data validating this concept have so far been based solely upon the visual assessment of the distribution of CTL. Here, we have established a set of spatial statistical tools to address this problem mathematically and tested their performance. (2) Patients and Methods: We have analyzed regions of interest (ROI) of 22 specimens of cancers of the head and neck region after 4-plex immunofluorescence staining and whole-slide scanning. Single cell-based segmentation was carried out in QuPath. Specimens were analyzed with the endpoints clustering and interactions between CTL, normoxic, and hypoxic tumor areas, both visually and using spatial statistical tools implemented in the R package Spatstat. (3) Results: Visual assessment suggested clustering of CTL in all instances. The visual analysis also suggested an inhibitory effect between hypoxic tumor areas and CTL in a minority of the whole-slide scans (9 of 22, 41%). Conversely, the objective mathematical analysis in Spatstat demonstrated statistically significant inhibitory interactions between hypoxia and CTL accumulation in a substantially higher number of specimens (16 of 22, 73%). It showed a similar trend in all but one of the remaining samples. (4) Conclusion: Our findings provide non-obvious but statistically rigorous evidence of inhibition of CTL infiltration into hypoxic tumor subregions of cancers of the head and neck. Importantly, these shielded sites may be the origin of tumor recurrences. We provide the methodology for the transfer of our statistical approach to similar questions. We discuss why versions of the Kcross and pcf.cross functions may be the methods of choice among the repertoire of statistical tests in Spatstat for this type of analysis.
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Affiliation(s)
- Justus Kaufmann
- Department of Radiation Oncology, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (J.K.); (H.S.)
| | - Christophe A. N. Biscio
- Department of Mathematical Sciences, Aalborg University, Skjernvej 4A, 9220 Aalborg East, Denmark; (C.A.N.B.); (E.R.)
| | - Peter Bankhead
- Edinburgh Pathology, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XR, UK;
| | - Stefanie Zimmer
- Institute of Pathology and Tissue Biobank, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany;
| | - Heinz Schmidberger
- Department of Radiation Oncology, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (J.K.); (H.S.)
| | - Ege Rubak
- Department of Mathematical Sciences, Aalborg University, Skjernvej 4A, 9220 Aalborg East, Denmark; (C.A.N.B.); (E.R.)
| | - Arnulf Mayer
- Department of Radiation Oncology, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (J.K.); (H.S.)
- Correspondence: ; Tel.: +49-6131-173576
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Wang L, Sparks-Wallace A, Casteel JL, Howell MEA, Ning S. Algorithm-Based Meta-Analysis Reveals the Mechanistic Interaction of the Tumor Suppressor LIMD1 With Non-Small-Cell Lung Carcinoma. Front Oncol 2021; 11:632638. [PMID: 33869018 PMCID: PMC8044451 DOI: 10.3389/fonc.2021.632638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/15/2021] [Indexed: 12/25/2022] Open
Abstract
Non-small-cell lung carcinoma (NSCLC) is the major type of lung cancer, which is among the leading causes of cancer-related deaths worldwide. LIMD1 was previously identified as a tumor suppressor in lung cancer, but their detailed interaction in this setting remains unclear. In this study, we have carried out multiple genome-wide bioinformatic analyses for a comprehensive understanding of LIMD1 in NSCLC, using various online algorithm platforms that have been built for mega databases derived from both clinical and cell line samples. Our results indicate that LIMD1 expression level is significantly downregulated at both mRNA and protein levels in both lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), with a considerable contribution from its promoter methylation rather than its gene mutations. The Limd1 gene undergoes mutation only at a low rate in NSCLC (0.712%). We have further identified LIMD1-associated molecular signatures in NSCLC, including its natural antisense long non-coding RNA LIMD1-AS1 and a pool of membrane trafficking regulators. We have also identified a subgroup of tumor-infiltrating lymphocytes, especially neutrophils, whose tumor infiltration levels significantly correlate with LIMD1 level in both LUAD and LUSC. However, a significant correlation of LIMD1 with a subset of immune regulatory molecules, such as IL6R and TAP1, was only found in LUAD. Regarding the clinical outcomes, LIMD1 expression level only significantly correlates with the survival of LUAD (p<0.01) but not with that of LUSC (p>0.1) patients. These findings indicate that LIMD1 plays a survival role in LUAD patients at least by acting as an immune regulatory protein. To further understand the mechanisms underlying the tumor-suppressing function of LIMD1 in NSCLC, we show that LIMD1 downregulation remarkably correlates with the deregulation of multiple pathways that play decisive roles in the oncogenesis of NSCLC, especially those mediated by EGFR, KRAS, PIK3CA, Keap1, and p63, in both LUAD and LUSC, and those mediated by p53 and CDKN2A only in LUAD. This study has disclosed that LIMD1 can serve as a survival prognostic marker for LUAD patients and provides mechanistic insights into the interaction of LIMD1 with NSCLC, which provide valuable information for clinical applications.
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Affiliation(s)
- Ling Wang
- Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States.,Center of Excellence for Inflammation, Infectious Diseases and Immunity, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States
| | - Ayrianna Sparks-Wallace
- Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States
| | - Jared L Casteel
- Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States
| | - Mary E A Howell
- Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States
| | - Shunbin Ning
- Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States.,Center of Excellence for Inflammation, Infectious Diseases and Immunity, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States
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98
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Zhao Y, Chen C, Xu X, Ge X, Ding K, Zheng S, Wang J, Sun L. An Efficient Prognostic Immune Scoring System For Colorectal Cancer Patients With Peritoneal Metastasis. Oncoimmunology 2021; 10:1901464. [PMID: 33796414 PMCID: PMC7993154 DOI: 10.1080/2162402x.2021.1901464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Immunoscore can accurately predict the prognosis of patients with stage I–III colorectal cancer. However, whether it can be used to predict the prognosis of colorectal cancer peritoneal metastases (CRCPM) remains to be validated. We analyzed peritoneal and ovarian metastases in 68 patients with CRCPM. The immunoscore (IS) was based on the infiltration level of CD3+ and CD8+ T cells, whereas the TBM score was derived from the infiltration level of CD3+, CD8+, CD20+ and CD163+ cells to tumor microenvironment (TME). The predictive value of IS and TBM scores for relapse-free survival (RFS) and overall survival (OS) of patients with CRCPM was analyzed using Kaplan Meier curve and Cox multivariate models. Significant difference in the infiltration levels of different immune cell subtypes in primary lesions, peritoneal metastasis and ovarian metastasis were compared using t-test.CRCPM patients with high IS (>1), high TBM1 score (≥2) or high TBM2 score (≥2) had a significantly longer OS (IS: median OS, not reached vs 23 months, p = .0078; TBM1: not reached vs 21.5 months, p = .013; TBM2: 39.3 months vs 15.2 months, p = .001). On the other hand, patients with high IS had a trend of improved RFS (13.4 months vs 11.0 months, p = .067). However, TBM1 and TBM2 score has no predictive utility for RFS. Multivariate analysis revealed that IS, TBM1 and TBM2 can accurately predict OS, but not RFS. Finally, the infiltration level of CD3+ T cells, CD8+ T cells, CD20+ B cells, and CD68+ macrophage was significantly higher in peritoneal metastatic tissue and ovarian metastatic tissue, relative to primary tumor tissues.The IS and TBM score of peritoneal metastases could effectively predict OS of patients with CRCPM. Peritoneal metastasis of colorectal cancer decreased the infiltration level of T and B cells.
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Affiliation(s)
- Yamei Zhao
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.,Department of Medical Oncology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, People's Republic of China
| | - Chao Chen
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - Xiaoming Xu
- Department of Pathology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - Xiaoxu Ge
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.,Department of Cancer Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - Kefeng Ding
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - Shu Zheng
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.,Department of Cancer Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - Jian Wang
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - Lifeng Sun
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
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Rühle A, Grosu AL, Wiedenmann N, Stoian R, Haehl E, Zamboglou C, Baltas D, Werner M, Kayser G, Nicolay NH. Immunohistochemistry-based hypoxia-immune prognostic classifier for head-and-neck cancer patients undergoing chemoradiation - Post-hoc analysis from a prospective imaging trial. Radiother Oncol 2021; 159:75-81. [PMID: 33753155 DOI: 10.1016/j.radonc.2021.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE As both tumor hypoxia and an immunosuppressing tumor microenvironment hamper the anti-tumor activity of radiotherapy in head-and-neck squamous cell carcinoma (HNSCC), we aimed to develop an immunohistochemistry-based hypoxia-immune classifier. METHODS 39 patients receiving definitive chemoradiation for HNSCC within a prospective trial were included in this analysis. Baseline tumor samples were analyzed for the hypoxia marker carbonic anhydrase IX (CAIX) and tumor-infiltrating lymphocytes (TILs) and were correlated with [18F]-misonidazole ([18F]FMISO) PET measurements. The impact of the biomarkers on the locoregional control (LRC) was examined using Cox analyses and concordance index statistics. RESULTS Low CAIX (HR = 0.352, 95%CI 0.124-1.001, p = 0.050) and high TIL levels (HR = 0.308, 95%CI 0.114-0.828, p = 0.020) were independent parameters for improved LRC and did not correlate with each other (Spearman's ρ = 0.034, p = 0.846). Harrell's C was 0.66 for CAIX and TIL levels alone and 0.71 for the combination. 2-year LRC was 73%, 62% and 11% for the prognostically good (CAIXlow/TILhigh), intermediate (CAIXlow/TILlow or CAIXhigh/TILhigh) and poor groups (CAIXhigh/TILlow), respectively (p = 0.001). Focusing on T lymphocytes, the hypoxia-immune classifier could still stratify between favorable (CAIXlow/CD3 + TILhigh), intermediate (CAIXlow/CD3 + TILlow or CAIXhigh/CD3 + TILhigh) and poor subgroups (CAIXhigh/CD3 + TILlow) with a 2-year LRC of 80%, 59% and 14%, respectively (p = 0.001). There was a positive correlation between baseline CAIX levels and [18F]FMISO SUV in week 2 of chemoradiation (ρ = 0.324, p = 0.050), indicating an association between higher baseline CAIX expression and tumor hypoxia persistence. CONCLUSION We developed a clinically feasible hypoxia-immune prognostic classifier for HNSCC patients based on pre-treatment immunohistochemistry. However, external validation is required to determine the prognostic value and the potential usage for personalized radiation oncology.
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Affiliation(s)
- Alexander Rühle
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anca-L Grosu
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicole Wiedenmann
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Raluca Stoian
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Erik Haehl
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Constantinos Zamboglou
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dimos Baltas
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martin Werner
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute of Surgical Pathology, Department of Pathology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Gian Kayser
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute of Surgical Pathology, Department of Pathology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Nils H Nicolay
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Caruntu A, Scheau C, Tampa M, Georgescu SR, Caruntu C, Tanase C. Complex Interaction Among Immune, Inflammatory, and Carcinogenic Mechanisms in the Head and Neck Squamous Cell Carcinoma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1335:11-35. [PMID: 33650087 DOI: 10.1007/5584_2021_626] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Inflammation is deeply involved in the development of most types of cancer. Many studies focus on the interaction between immune-inflammatory mechanisms and tumorigenesis in the head and neck squamous cell carcinoma (HNSCC). In this chapter, we emphasize the complexity of processes underlying this interaction and discuss the mechanisms of carcinogenesis in HNSCC with a special focus on metabolic changes, inflammation, and the immune landscape. Unveiling complex connections between immuno-inflammatory processes and tumor initiation, promotion, and progression will open new directions in the reliable identification of predictive factors and therapeutic targets in HNSCC.
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Affiliation(s)
- Ana Caruntu
- Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, Bucharest, Romania.,Faculty of Dental Medicine, "Titu Maiorescu" University, Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Mircea Tampa
- Department of Dermatology, "Victor Babes" Clinical Hospital for Infectious Diseases, Bucharest, Romania. .,Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
| | - Simona Roxana Georgescu
- Department of Dermatology, "Victor Babes" Clinical Hospital for Infectious Diseases, Bucharest, Romania.,Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. .,Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition, and Metabolic Diseases, Bucharest, Romania.
| | - Cristiana Tanase
- Faculty of Dental Medicine, "Titu Maiorescu" University, Bucharest, Romania.,Department of Biochemistry-Proteomics, "Victor Babes" National Institute of Pathology, Bucharest, Romania
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