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Eloranta R, Vilén ST, Keinänen A, Salo T, Qannam A, Bello IO, Snäll J. Oral squamous cell carcinoma: Effect of tobacco and alcohol on cancer location. Tob Induc Dis 2024; 22:TID-22-112. [PMID: 38895166 PMCID: PMC11185050 DOI: 10.18332/tid/189303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/12/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION The underlying factors of oral squamous cell cancers (OSCC) have been elucidated, but studies have focused little on etiological differences in affected oral cavity sites. The aim of this retrospective study was to clarify the role of carcinogen exposure in OSCC of different oral cavity areas. METHODS A cross-sectional study of patients with primary OSCC was conducted retrospectively, based on patient records from Helsinki University Hospital, Finland, between January 2016 and December 2020. The patients' self-reported history of tobacco smoking and alcohol use was explained by tumor site, age, sex, tumor size, and lymph node status in a logistic regression model. The information on smoking and alcohol use was compiled from a patient background form. RESULTS In 519 patients, tumors occurred most often in the tongue (51%), gingiva (21%), or floor of the mouth (FOM; 15%). FOM had 26-fold greater odds for a history of smoking and alcohol use than other tumor sites (OR=25.78; 95% CI: 8.02-82.95; p<0.001). Gingival and buccal sites were associated significantly less with smoking and alcohol use (OR=0.43, 95% CI: 0.28-0.67; p<0.001 and OR=0.47; 95% CI: 0.25-0.92; p<0.026, respectively). Patients of older age were less likely to have a history of smoking and alcohol use (AOR=0.95; 95% CI: 0.94-0.97; p<0.001) than younger patients. Tumor size (T3-4) and FOM increased the odds for history of smoking and alcohol use (AOR=1.73; 95% CI: 1.15-2.60; p=0.009 and AOR=26.15; 95% CI: 8.01-84.84; p<0.001, respectively). CONCLUSIONS OSCC of oral cavity sites has notable differences in etiology. FOM seems to be related almost exclusively to conventional smoking and heavy alcohol use.
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Affiliation(s)
- Riikka Eloranta
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Suvi-Tuuli Vilén
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, Kymenlaakso Central Hospital Kotka, Kotka, Finland
| | - Arvi Keinänen
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Translational Immunology Research Program (TRIMM), University of Helsinki, Helsinki, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Pathology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Ahmed Qannam
- Department of Oral Medicine and Diagnostic Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Ibrahim O. Bello
- Department of Oral Medicine and Diagnostic Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
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2
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Peltonen J, Nikkilä R, Al-Samadi A, Mäkitie A, Martinsen JI, Kjaerheim K, Lynge E, Sparen P, Tryggvadottir L, Weiderpass E, Salo T, Pukkala E. Occupation and tongue cancer in Nordic countries. BMC Oral Health 2024; 24:506. [PMID: 38685000 PMCID: PMC11059716 DOI: 10.1186/s12903-024-04172-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/21/2024] [Indexed: 05/02/2024] Open
Abstract
PURPOSE Almost 200,000 tongue cancers were diagnosed worldwide in 2020. The aim of this study was to describe occupational risk variation in this malignancy. METHODS The data are based on the Nordic Occupational Cancer (NOCCA) study containing 14.9 million people from the Nordic countries with 9020 tongue cancers diagnosed during 1961-2005. The standardized incidence ratio (SIR) of tongue cancer in each occupational category was calculated using national incidence rates as the reference. RESULTS Among men, the incidence was statistically significantly elevated in waiters (SIR 4.36, 95% confidence interval (CI) 3.13--5.92), beverage workers (SIR 3.42, 95% CI 2.02-5.40), cooks and stewards (SIR 2.55, 95% CI 1.82-3.48), seamen (SIR 1.66, 95% CI 1.36-2.00), journalists (SIR 1.85, 95% CI 1.18-2.75), artistic workers (SIR 2.05, 95% CI 1.54-2.66), hairdressers (SIR 2.17, 95% CI 1.39-3.22), and economically inactive persons (SIR 1.57, 95% CI 1.42-1.73). Among women, the SIR was statistically significantly elevated only in waitresses (SIR 1.39, 95% CI 1.05-1.81). Statistically significant SIRs ≤ 0.63 were observed in male farmers, gardeners, forestry workers and teachers, and in female launderers. CONCLUSIONS These findings may be related to consumption of alcohol and tobacco, but the effect of carcinogenic exposure from work cannot be excluded.
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Affiliation(s)
- Johanna Peltonen
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
- Translational Immunology Research Program (TRIMM), University of Helsinki, Helsinki, Finland.
| | - Rayan Nikkilä
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki, HUS Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program (TRIMM), University of Helsinki, Helsinki, Finland
- Institute of Dentistry, School of Medicine, Faculty of Health Sciences, University of Eastern Finland , Kuopio, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki, HUS Helsinki University Hospital, Helsinki, Finland
- Division of Ear, Nose, and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jan Ivar Martinsen
- The Cancer Registry of Norway at the Norwegian Institute of Public Health, Oslo, Norway
| | - Kristina Kjaerheim
- The Cancer Registry of Norway at the Norwegian Institute of Public Health, Oslo, Norway
| | - Elsebeth Lynge
- Zealand University Hospital, Nykøbing Falster, University of Copenhagen, Denmark, Copenhagen, Denmark
| | - Par Sparen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program (TRIMM), University of Helsinki, Helsinki, Finland
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
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3
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Sengüven Toközlü B, Sapkota D, Vallenari EM, Schreurs O, Søland TM. Cortactin expression in a Norwegian cohort of human papilloma virus negative oral squamous cell carcinomas of the mobile tongue. Eur J Oral Sci 2023; 131:e12925. [PMID: 36790139 DOI: 10.1111/eos.12925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/26/2023] [Indexed: 02/16/2023]
Abstract
Oral squamous cell carcinoma of the tongue (OTSCC) is the most common malignancy among oral squamous cell carcinomas and is frequently associated with an unfavorable prognosis. Local spread and distant metastasis are important causes of poor prognosis in OTSCC. Cortactin amplification and overexpression, a common molecular alteration in oral squamous cell carcinomas, have been linked to invasion and metastasis of tumor cells. However, the intra-tumor expression pattern and prognostic significance of cortactin in human papillomavirus (HPV) negative OTSCC is not fully investigated. Immunohistochemical analysis using tissue microarray consisting of formalin-fixed and paraffin-embedded HPV negative OTSCC (n = 123) specimens showed overexpression of cortactin at tissue cores from invading fronts as compared to the corresponding center cores. High overall cortactin expression was found to be associated with advanced (larger) tumor size and the occurrence of distance metastasis. Kaplan-Meier survival analysis showed that patients with high overall cortactin expression were associated with reduced 5-year survival. Multivariate Cox regression analysis identified high cortactin expression to be an independent prognostic factor in OTSCC. Additionally, siRNA-mediated silencing of cortactin was found to suppress the proliferative and invasive abilities of OTSCC cells in an organotypic co-culture model. Overexpression of cortactin is a promising prognostic marker in HPV-negative OTSCC.
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Affiliation(s)
- B Sengüven Toközlü
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Oslo, Turkey
| | - D Sapkota
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - E M Vallenari
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - O Schreurs
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - T M Søland
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Badwelan M, Muaddi H, Ahmed A, Lee KT, Tran SD. Oral Squamous Cell Carcinoma and Concomitant Primary Tumors, What Do We Know? A Review of the Literature. Curr Oncol 2023; 30:3721-3734. [PMID: 37185396 PMCID: PMC10136780 DOI: 10.3390/curroncol30040283] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Head and neck cancer is among the top ten cancers worldwide, with most lesions in the oral cavity. Oral squamous cell carcinoma (OSCC) accounts for more than 90% of all oral malignancies and is a significant public health concern. Patients with OSCC are at increased risk for developing concomitant tumors, especially in the oral cavity, due to widely genetically susceptible mucosa to carcinogenic factors. Based on fulfilling specific criteria, these concomitant tumors can be called second primary tumors (SPTs), which can be further categorized into metachronous and synchronous tumors. This research reviews the literature that investigated the concurrent OSCC with second or multiple primaries to improve understanding of the definition, classification guidelines, and its effect on cancer survival. It also highlights the current investigation methods, the variation of standard treatment approaches due to such a phenomenon, and preventive measures discussed in the literature.
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5
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Søland TM, Solhaug MB, Bjerkli IH, Schreurs O, Sapkota D. The prognostic role of combining Krüppel-like factor 4 score and grade of inflammation in a Norwegian cohort of oral tongue squamous cell carcinomas. Eur J Oral Sci 2022; 130:e12866. [PMID: 35363406 PMCID: PMC9321830 DOI: 10.1111/eos.12866] [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: 12/17/2021] [Accepted: 03/09/2022] [Indexed: 11/27/2022]
Abstract
Krüppel-like factor 4 (KLF4) is a zinc-finger transcription factor involved in inflammation, cancer development, and progression. However, the relationship between KLF4, inflammation, and prognosis in oral cancer is not fully understood. KLF4 expression levels were examined in a multicenter cohort of 128 oral squamous cell carcinoma (OSCC) specimens from the tongue (OTSCC) using immunohistochemistry. In two external KLF4 mRNA datasets (The Cancer Genome Atlas/The Genotype-Tissue Expression Portal), lower KLF4 mRNA expression was found in OSCC and head and neck squamous cell carcinomas (HNSCC) than in control oral epithelium. These data indicate that down-regulation of KLF4 mRNA is linked to OSCC/HNSCC progression. Using Cox-multivariate analysis, a significantly favorable 5-year disease-specific survival rate was observed for a subgroup of patients with a combination of high levels of KLF4 expression and inflammation. OSCC cell lines exposed to IFN-γ showed a significant upregulation of nuclear KLF4 expression, indicating a link between inflammation and KLF4 expression in OSCC. Overall, the current data suggest a functional link between KLF4 and inflammation. The combination of high KLF4 nuclear expression and marked/moderate stromal inflammation might be useful as a favorable prognostic marker for a subgroup of OTSCC patients.
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Affiliation(s)
- Tine M Søland
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.,Department of Pathology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Maren B Solhaug
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Inger-Heidi Bjerkli
- Department of Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway.,Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Olav Schreurs
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Dipak Sapkota
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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6
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Molecular Research on Oral Diseases and Related Biomaterials: A Journey from Oral Cell Models to Advanced Regenerative Perspectives. Int J Mol Sci 2022; 23:ijms23095288. [PMID: 35563679 PMCID: PMC9105421 DOI: 10.3390/ijms23095288] [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: 03/28/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 02/05/2023] Open
Abstract
Oral diseases such as gingivitis, periodontitis, and oral cancer affect millions of people worldwide. Much research has been conducted to understand the pathogenetic mechanisms of these diseases and translate this knowledge into therapeutics. This review aims to take the reader on a journey from the initial molecular discoveries to complex regenerative issues in oral medicine. For this, a semi-systematic literature search was carried out in Medline and Web of Science databases to retrieve the primary literature describing oral cell models and biomaterial applications in oral regenerative medicine. First, an in vitro cell model of gingival keratinocytes is discussed, which illustrates patho- and physiologic principles in the context of oral epithelial homeostasis and carcinogenesis and represents a cellular tool to understand biomaterial-based approaches for periodontal tissue regeneration. Consequently, a layered gradient nonwoven (LGN) is described, which demonstrates that the key features of biomaterials serve as candidates for oral tissue regeneration. LGN supports proper tissue formation and obeys the important principles for molecular mechanotransduction. Furthermore, current biomaterial-based tissue regeneration trends, including polymer modifications, cell-based treatments, antimicrobial peptides and optogenetics, are introduced to represent the full spectrum of current approaches to oral disease mitigation and prevention. Altogether, this review is a foray through established and new concepts in oral regenerative medicine and illustrates the process of knowledge translation from basic molecular and cell biological research to future clinical applications.
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7
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Pandey S, Søland TM, Bjerkli IH, Sand LP, Petersen FC, Costea DE, Senguven B, Sapkota D. Combined loss of expression of involucrin and cytokeratin 13 is associated with poor prognosis in squamous cell carcinoma of mobile tongue. Head Neck 2021; 43:3374-3385. [PMID: 34338386 DOI: 10.1002/hed.26826] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/29/2021] [Accepted: 07/22/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the prognostic significance of expression levels of involucrin (IVL), cytokeratin (CK)-10 and -13 at different intratumor sites (tumor center and invading area) of oral tongue squamous cell carcinoma (OTSCC). METHODS IVL, CK13 and CK10 expression levels were examined in a multicenter cohort of 146 OTSCCs using immunohistochemistry. External mRNA datasets were used for expression analysis and/or to validate survival associations. RESULTS External transcriptomic datasets showed downregulation of IVL and KRT13 in oral malignancies including OTSCC as compared to normal controls. The combined loss of IVL and CK13 expression at the invading core but not at the center core was significantly associated with poor differentiation and reduced 5-year overall survival. Multivariate Cox analysis confirmed the loss of CK13 and IVL expression to be an independent prognostic factor. Transcriptomic dataset corroborated immunohistochemistry results. CONCLUSIONS Combined expression levlels of IVL and CK13 might be useful as prognostic biomarkers in OTSCC.
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Affiliation(s)
- Sushma Pandey
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tine Merete Søland
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.,Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Inger Heidi Bjerkli
- Department of Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway.,Department of Tromsø Medical Biology, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Lars Peter Sand
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | | | - Daniela Elena Costea
- The Gade Laboratory for Pathology, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Bergen, Norway.,Department of Pathology, Haukeland University Hospital, Bergen, Norway.,Centre for Cancer Biomarkers (CCBIO), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Burcu Senguven
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.,Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Dipak Sapkota
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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8
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Erira AT, Navarro AFR, Robayo DAG. Human papillomavirus, Epstein-Barr virus, and Candida albicans co-infection in oral leukoplakia with different degrees of dysplasia. Clin Exp Dent Res 2021; 7:914-923. [PMID: 34101999 PMCID: PMC8543472 DOI: 10.1002/cre2.435] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To identify human papillomavirus (HPV), Epstein-Barr virus (EBV), and Candida albicans in oral leukoplakia with different degrees of dysplasia. MATERIALS AND METHODS An observational, cross-sectional, descriptive study was performed using 30 formalin-fixed and paraffin-embedded tissues from patients with clinical suspicion of leukoplakia and confirmed diagnosis of oral dysplasia. Histological analyses were performed by two pathologists (interobserver) and dysplasias were classified as mild, moderate, or severe. Conventional PCR was used to detect HPV and EBV viruses and C. albicans. To determine the association between each microorganism with different degrees of dysplasia a Chi-square test was employed. RESULTS The tongue was the most common site for leukoplakias (71.4%) in females with a mean age of 50 years (ranging between 30 to 50 years old; 57.1%). EBV was the most frequently detected (73.3%), followed by HPV (43.3%), mainly of type 16 (40%), and C. albicans (23.3%). Significant differences were observed between degrees of dysplasia and HPV presence (p = 0.005). In lesions positive for HPV, EBV, and C. albicans the most frequent histological changes were hyperkeratosis, irregular interpapillary ridges, and loss of basal stratum cell polarity. CONCLUSION Co-infection with human papillomavirus, Epstein Barr virus, and Candida albicans in oral leukoplakia could be associated with dysplastic changes.
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Affiliation(s)
- Alveiro T Erira
- Facultad de Odontología, Universidad Cooperativa de Colombia, Bogotá, Colombia
| | | | - Dabeiba Adriana García Robayo
- Centro de Investigaciones Odontológicas - Facultad de Odontología, Pontificia Universidad Javeriana, Bogotá, Colombia
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9
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Wirsing AM, Bjerkli IH, Steigen SE, Rikardsen O, Magnussen SN, Hegge B, Seppola M, Uhlin-Hansen L, Hadler-Olsen E. Validation of Selected Head and Neck Cancer Prognostic Markers from the Pathology Atlas in an Oral Tongue Cancer Cohort. Cancers (Basel) 2021; 13:cancers13102387. [PMID: 34069237 PMCID: PMC8156750 DOI: 10.3390/cancers13102387] [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: 04/12/2021] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022] Open
Abstract
The Pathology Atlas is an open-access database that reports the prognostic value of protein-coding transcripts in 17 cancers, including head and neck cancer. However, cancers of the various head and neck anatomical sites are specific biological entities. Thus, the aim of the present study was to validate promising prognostic markers for head and neck cancer reported in the Pathology Atlas in oral tongue squamous cell carcinoma (OTSCC). We selected three promising markers from the Pathology Atlas (CALML5, CD59, LIMA1), and analyzed their prognostic value in a Norwegian OTSCC cohort comprising 121 patients. We correlated target protein and mRNA expression in formalin-fixed, paraffin-embedded cancer tissue to five-year disease-specific survival (DSS) in univariate and multivariate analyses. Protein expression of CALML5 and LIMA1 were significantly associated with five-year DSS in the OTSCC cohort in univariate analyses (p = 0.016 and p = 0.043, respectively). In multivariate analyses, lymph node metastases, tumor differentiation, and CALML5 were independent prognosticators. The prognostic role of the other selected markers for head and neck cancer patients identified through unbiased approaches could not be validated in our OTSCC cohort. This underlines the need for subsite-specific analyses for head and neck cancer.
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Affiliation(s)
- Anna Maria Wirsing
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
| | - Inger-Heidi Bjerkli
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
- Department of Otorhinolaryngology, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Sonja Eriksson Steigen
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
- Department of Clinical Pathology, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Oddveig Rikardsen
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
- Department of Otorhinolaryngology, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Synnøve Norvoll Magnussen
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
| | - Beate Hegge
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
| | - Marit Seppola
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
| | - Lars Uhlin-Hansen
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
- Department of Clinical Pathology, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Elin Hadler-Olsen
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (A.M.W.); (I.-H.B.); (S.E.S.); (O.R.); (S.N.M.); (B.H.); (M.S.); (L.U.-H.)
- The Public Dental Health Service Competence Centre of Northern Norway, 9019 Tromsø, Norway
- Correspondence: ; Tel.: +47-48-06-72-49
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10
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Tagliabue M, Belloni P, De Berardinis R, Gandini S, Chu F, Zorzi S, Fumagalli C, Santoro L, Chiocca S, Ansarin M. A systematic review and meta-analysis of the prognostic role of age in oral tongue cancer. Cancer Med 2021; 10:2566-2578. [PMID: 33760398 PMCID: PMC8026930 DOI: 10.1002/cam4.3795] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 12/18/2022] Open
Abstract
While evidence suggests an increasing incidence of tongue cancer in young adults, published findings regarding the prognostic role of age at diagnosis are inconsistent. We performed a meta-analysis of the literature to highlight key points that might help in understanding the association between age of oral tongue cancer patients at diagnosis and their prognosis. According to age at diagnosis, a systematic literature review of all published cohort studies assessing the recurrence risks and mortality associated with tongue cancer was conducted. We compared the risk estimates between patients aged >45 years and those aged <45 years at diagnosis. Random-effects models were used to calculate summary relative risk estimates (SRRs) according to different clinical outcomes and sources of between-study heterogeneity (I2 ) and bias. We included 31 independent cohort studies published between 1989 and 2019; these studies included a total of 28,288 patients. When risk estimations were not adjusted for confounders, no significant association was found between age at diagnosis and overall survival (OS). Conversely, after adjustment for confounders, older age at diagnosis was associated with a significantly increased risk of mortality. The difference between SRRs for adjusted and unadjusted estimates was significant (p < 0.01). Younger patients had a significantly higher risk of local recurrence. Younger patients with oral tongue cancer have better OS but a greater risk of recurrence than older patients. These findings should be validated in a large prospective cohort study which considers all confounders and prognostic factors.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Pietro Belloni
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
- Department of Statistical SciencesUniversity of PaduaPaduaItaly
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Sara Gandini
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Francesco Chu
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Stefano Zorzi
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | | | | | - Susanna Chiocca
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
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Søland TM, Bjerkli IH, Georgsen JB, Schreurs O, Jebsen P, Laurvik H, Sapkota D. High-risk human papilloma virus was not detected in a Norwegian cohort of oral squamous cell carcinoma of the mobile tongue. Clin Exp Dent Res 2020; 7:70-77. [PMID: 33140903 PMCID: PMC7853882 DOI: 10.1002/cre2.342] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES The presence of and the causative role of high-risk human papilloma virus (HPV) is a subject of controversy in oral squamous cell carcinoma (OSCC). The disagreement can be related to the misclassification of OSCC as oropharyngeal squamous cell carcinoma and/or lack of standard detection methods. This study aimed to examine the presence of transcriptionally active high-risk HPV in a homogenous Norwegian cohort of primary and second primary OSCC of the mobile tongue (oral tongue squamous cell carcinoma-OTSCC). METHODS Tissue microarrays containing formalin-fixed and paraffin-embedded cores of 146 OTSCC from the anterior 2/3 of the tongue (n = 128 primary and n = 18 second primary) from a multicentric Norwegian cohort were examined for the presence of high-risk HPV by DNA- and RNA-in situ hybridization (ISH) assays and p16 immunohistochemistry. RESULTS Transcriptionally active HPV (E6/E7 mRNA) was not identified in any of the OTSCC specimens. In parallel, no tumors were positive for HPV by DNA ISH. Although, 61 (42%) OTSCC demonstrated p16 positivity with varying staining intensity and subcellular localization, only two cases demonstrated strong and uniform p16-staining (both cytoplasmic and nuclear) in >70% of cancer cells. The absence of transcriptionally active high-risk HPV in this cohort of OTSCC indicates that high-risk HPV is an unlikely causative factor in the present material.
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Affiliation(s)
- Tine M Søland
- Faculty of Dentistry, Institute of Oral Biology, University of Oslo, Oslo, Norway.,Department of Pathology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Inger-Heidi Bjerkli
- Department of Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway.,Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Olaf Schreurs
- Faculty of Dentistry, Institute of Oral Biology, University of Oslo, Oslo, Norway
| | - Peter Jebsen
- Department of Pathology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Helene Laurvik
- Department of Pathology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Dipak Sapkota
- Faculty of Dentistry, Institute of Oral Biology, University of Oslo, Oslo, Norway
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