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Mobaraki G, Shi S, Liu D, Smits KM, Severens K, Lommen K, Rennspiess D, Speel EJM, Winnepenninckx V, Klufah F, Samarska I, zur Hausen A. Mapping of Human Polyomavirus in Renal Cell Carcinoma Tissues. Int J Mol Sci 2024; 25:8213. [PMID: 39125783 PMCID: PMC11312419 DOI: 10.3390/ijms25158213] [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: 06/18/2024] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Worldwide, the incidence of renal cell carcinoma (RCC) is rising, accounting for approximately 2% of all cancer diagnoses and deaths. The etiology of RCC is still obscure. Here, we assessed the presence of HPyVs in paraffin-embedded tissue (FFPE) resected tissue from patients with RCC by using different molecular techniques. Fifty-five FFPE tissues from 11 RCC patients were included in this study. Consensus and HPyV-specific primers were used to screen for HPyVs. Both PCR approaches revealed that HPyV is frequently detected in the tissues of RCC kidney resections. A total of 78% (43/55) of the tissues tested were positive for at least one HPyV (i.e., MCPyV, HPyV6, HPyV7, BKPyV, JCPyV, or WUyV). Additionally, 25 tissues (45%) were positive for only one HPyV, 14 (25%) for two HPyVs, 3 (5%) for three HPyVs, and 1 one (1%) tissue specimen was positive for four HPyVs. Eleven (20%) RCC specimens were completely devoid of HPyV sequences. MCPyV was found in 24/55 RCC tissues, HPyV7 in 19, and HPyV6 in 8. The presence of MCPyV and HPyV6 was confirmed by specific FISH or RNA-ISH. In addition, we aimed to confirm HPyV gene expression by IHC. Our results strongly indicate that these HPyVs infect RCC and nontumor tissues, possibly indicating that kidney tissues serve as a reservoir for HPyV latency. Whether HPyVs possibly contribute to the etiopathogenesis of RCC remains to be elucidated.
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Affiliation(s)
- Ghalib Mobaraki
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Shuai Shi
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Dan Liu
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Kim M. Smits
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Kim Severens
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Kim Lommen
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Dorit Rennspiess
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Ernst-Jan M. Speel
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Véronique Winnepenninckx
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Faisal Klufah
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Albaha 65525, Saudi Arabia
| | - Iryna Samarska
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
| | - Axel zur Hausen
- Department of Pathology, GROW-Research Institute for Oncology & Reproduction, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (G.M.); (S.S.); (D.L.); (K.M.S.); (K.S.); (K.L.); (D.R.); (E.-J.M.S.); (V.W.); (F.K.); (I.S.)
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Gopalani SV, Saraiya M, Huang B, Tucker TC, Mix JM, Chaturvedi AK. Population-level incidence of human papillomavirus-positive oropharyngeal, cervical, and anal cancers, by smoking status. J Natl Cancer Inst 2024; 116:1173-1177. [PMID: 38429996 DOI: 10.1093/jnci/djae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
We estimated the population-level incidence of human papillomavirus (HPV)-positive oropharyngeal, cervical, and anal cancers by smoking status. We combined HPV DNA genotyping data from the Centers for Disease Control and Prevention's Cancer Registry Sentinel Surveillance System with data from the Kentucky Cancer Registry and Behavioral Risk Factor Surveillance System across smoking status. During 2004-2005 and 2014-2015 in Kentucky, most cases of oropharyngeal (63.3%), anal (59.7%), and cervical (54.9%) cancer were among individuals who ever smoked. The population-level incidence rate was higher among individuals who ever smoked than among those who never smoked for HPV-positive oropharyngeal (7.8 vs 2.1; adjusted incidence rate ratio = 2.6), cervical (13.7 vs 6.8; adjusted incidence rate ratio = 2.0), and anal (3.9 vs 1.6; adjusted incidence rate ratio = 2.5) cancers. These findings indicate that smoking is associated with increased risk of HPV-positive oropharyngeal, cervical, and anal cancers, and the population-level burden of these cancers is higher among individuals who ever smoked.
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Affiliation(s)
- Sameer V Gopalani
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Mona Saraiya
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Bin Huang
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Thomas C Tucker
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Jacqueline M Mix
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Anil K Chaturvedi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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3
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Ghosh U, Tripathy R, Lenka A, Turuk J, Mohapatra D. Immunohistochemical Evaluation of p16 and p53 in Oral and Oropharyngeal Squamous Cell Carcinoma with Special Regard to Human Papillomavirus Status. J Microsc Ultrastruct 2023; 11:172-178. [PMID: 38025188 PMCID: PMC10679831 DOI: 10.4103/jmau.jmau_84_21] [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: 10/19/2021] [Revised: 02/02/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Incidence of human papillomavirus (HPV)-associated oral and oropharyngeal squamous cell carcinomas (OSCC and OPSCC) is on a rising trend globally and has specific therapeutic implications. HPV-related tumors have a distinct pathogenetic mechanism targeting p16 and p53 both. However, there are limited studies evaluating p16 and p53 expression in combination. Aim The aim of the study is to evaluate p16 and p53 immunohistochemical expression pattern in OSCC and OPSCC, with special reference to HPV association. Study Design This was a hospital-based prospective study done over 22 months (September 2018 to June 2020), including a total of 54 cases of OSCC and OPSCC. They were subjected to clinicopathological evaluation, p16 and p53 immunohistochemistry, and DNA polymerase chain reaction testing for testing of HPV association, followed by analysis of data by statistical methods. Results Out of 54, 43 cases were OSCC and 11 cases were OPSCC. A total of nine cases were HPV positive. HPV association was found to be significant with tonsil as primary site, age range between 40 and 60 years, and absence of tobacco or alcohol habit. Presence of HPV infection was also significantly associated with p16 overexpression, in combination with p53 negativity. The findings indicate that p16 overexpression combined with a negative p53 expression can be used for HPV detection and the former alone may be used as diagnostic marker in OPSCC only. Conclusion HPV-associated OSCC and OPSCC are a unique subset of cancers, and using combination of molecular biomarkers could help in diagnosis and prognosis.
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Affiliation(s)
- Urvashi Ghosh
- Department of Pathology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
| | - Rajashree Tripathy
- Department of Pathology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
| | - Anasuya Lenka
- Department of Pathology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
| | - Jyotirmayee Turuk
- Indian Council of Medical Research, Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Debahuti Mohapatra
- Department of Pathology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
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Patel R, Didzbalis CJ, Tseng CC, Talmor G, Park RCW. Facility volume and survival: Human papilloma virus positive oropharyngeal squamous cell carcinoma. Am J Otolaryngol 2023; 44:103762. [PMID: 36628908 DOI: 10.1016/j.amjoto.2022.103762] [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: 11/03/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND To analyze the impact of facility volume on survival for human papilloma virus positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) patients. METHODS Patients treated for HPV+ OPSCC from 2010 to 2017 were queried from the National Cancer Database. Facilities of average annual case volume <50th percentile were categorized as low-volume (LV) and >95th percentile as high-volume (HV). RESULTS 11,546 were included, with 10,305 patients (89.3 %) treated at LV and 1241 (10.7 %) at HV facilities. A greater proportion of cases involving resection of base of tongue and lingual tonsil were treated at HV (30.3 %) compared to LV (22.3 %) facilities (p < 0.001). Patients treated at a HV facility had greater percentage of clinical T4 (11.2 % vs. 8.6 %, p = 0.001) and N+ disease (90.5 % vs. 85.7 %, p < 0.001) patients. Survival analysis showed no statistically significant difference between five-year overall survival rates by facility volume (p = 0.388) for all patients. On multivariable analysis, facility volume was not associated with survival (HR: 0.968 [0.758-1.235], p = 0.791). These trends were found for both patients undergoing primary surgery or chemoradiotherapy. CONCLUSION Our data indicates that patients with HPV+ OPSCC do not experience a survival benefit with treatment at HV facility, suggesting these patients may be adequately treated at LV centers.
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Affiliation(s)
- Rushi Patel
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Christopher J Didzbalis
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Christopher C Tseng
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Guy Talmor
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Richard Chan Woo Park
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
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5
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Li D, Thomas C, Shrivastava N, Gersten A, Gadsden N, Schlecht N, Kawachi N, Schiff BA, Smith RV, Rosenblatt G, Augustine S, Gavathiotis E, Burk R, Prystowsky MB, Guha C, Mehta V, Ow TJ. Establishment of a diverse head and neck squamous cancer cell bank using conditional reprogramming culture methods. J Med Virol 2023; 95:e28388. [PMID: 36477880 PMCID: PMC10168123 DOI: 10.1002/jmv.28388] [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: 07/31/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 12/14/2022]
Abstract
Most laboratory models of head and neck squamous cell cancer (HNSCC) rely on established immortalized cell lines, which carry inherent bias due to selection and clonality. We established a robust panel of HNSCC tumor cultures using a "conditional reprogramming" (CR) method, which utilizes a rho kinase inhibitor (Y-27632) and co-culture with irradiated fibroblast (J2 strain) feeder cells to support indefinite tumor cell survival. Sixteen CR cultures were successfully generated from 19 consecutively enrolled ethnically and racially diverse patients with HNSCC at a tertiary care center in the Bronx, NY. Of the 16 CR cultures, 9/16 were derived from the oral cavity, 4/16 were derived from the oropharynx, and 3/16 were from laryngeal carcinomas. Short tandem repeat (STR) profiling was used to validate culture against patient tumor tissue DNA. All CR cultures expressed ΔNp63 and cytokeratin 5/6, which are markers of squamous identity. Human papillomavirus (HPV) testing was assessed utilizing clinical p16 staining on primary tumors, reverse transcription polymerase chain reaction (RT-PCR) of HPV16/18-specific viral oncogenes E6 and E7 in RNA extracted from tumor samples, and HPV DNA sequencing. Three of four oropharyngeal tumors were p16 and HPV-positive and maintained HPV in culture. CR cultures were able to establish three-dimensional spheroid and murine flank and orthotopic tongue models. CR methods can be readily applied to all HNSCC tumors regardless of patient characteristics, disease site, and molecular background, providing a translational research model that properly includes patient and tumor diversity.
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Affiliation(s)
- Daniel Li
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carlos Thomas
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nitisha Shrivastava
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Adam Gersten
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicholas Gadsden
- Department of Anesthesiology, Columbia University, New York, NY, USA
| | - Nicolas Schlecht
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Nicole Kawachi
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Bradley A. Schiff
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard V. Smith
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Surgery, Montefiore Medical Center/ Albert Einstein College of Medicine, Bronx, NY USA
| | - Gregory Rosenblatt
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stelby Augustine
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Robert Burk
- Department of Pediatrics, Montefiore Medical Center/ Albert Einstein College of Medicine, Bronx, NY USA
| | - Michael B. Prystowsky
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Chandan Guha
- Department of Radiation Oncology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Vikas Mehta
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
| | - Thomas J Ow
- Department of Pathology, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY, USA
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Lai YH, Su CC, Wu SY, Hsueh WT, Wu YH, Chen HHW, Hsiao JR, Liu CH, Tsai YS. Impact of Alcohol and Smoking on Outcomes of HPV-Related Oropharyngeal Cancer. J Clin Med 2022; 11:6510. [PMID: 36362736 PMCID: PMC9655073 DOI: 10.3390/jcm11216510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate the impact of adverse lifestyle factors on outcomes in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). METHODS From 2010 to 2019, 150 consecutive non-metastatic OPSCC patients receiving curative treatment in our institution were retrospectively enrolled. HPV positivity was defined as p16 expression ≥75%. The effects of adverse lifestyle factors on overall survival (OS) and disease-free survival (DFS) on OPSCC patients were determined. RESULTS The median follow-up duration was 3.6 years. Of the 150 OPSCCs, 51 (34%) patients were HPV-positive and 99 (66%) were HPV-negative. The adverse lifestyle exposure rates were 74.7% (n = 112) alcohol use, 57.3% (n = 86) betel grid chewing, and 78% (n = 117) cigarette smoking. Alcohol use strongly interacted with HPV positivity (HR, 6.00; 95% CI, 1.03-35.01), leading to an average 26.1% increased risk of disease relapse in patients with HPV-positive OPSCC. Heavy smoking age ≥30 pack-years was associated with increased risk of death (HR, 2.05; 95% CI, 1.05-4.00) and disease relapse (HR, 1.99; 95% CI, 1.06-3.75) in OPSCC patients. In stratified analyses, the 3-year absolute risk of disease relapse in HPV-positive OPSCC patients reached up to 50% when alcohol use and heavy smoking for ≥30 pack-years were combined. CONCLUSIONS Alcohol acted as a significant treatment-effect modifier for DFS in HPV-positive OPSCC patients, diluting the favorable prognostic effect of HPV positivity. Heavy smoking age ≥30 pack-years was an independent adverse prognostic factor of OS and DFS in OPSCC patients. De-intensification treatment for HPV-related OPSCC may be avoided when these adverse lifestyle factors are present.
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Affiliation(s)
- Yu-Hsuan Lai
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Clinical Innovation and Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Chien-Chou Su
- Clinical Innovation and Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Shang-Yin Wu
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Wei-Ting Hsueh
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Yuan-Hua Wu
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Helen H. W. Chen
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Jenn-Ren Hsiao
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Ching-Hsun Liu
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Yi-Shan Tsai
- Clinical Innovation and Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
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7
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Sharkey Ochoa I, O’Regan E, Toner M, Kay E, Faul P, O’Keane C, O’Connor R, Mullen D, Nur M, O’Murchu E, Barry-O’Crowley J, Kernan N, Tewari P, Keegan H, O’Toole S, Woods R, Kennedy S, Feeley K, Sharp L, Gheit T, Tommasino M, O’Leary JJ, Martin CM. The Role of HPV in Determining Treatment, Survival, and Prognosis of Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2022; 14:4321. [PMID: 36077856 PMCID: PMC9454666 DOI: 10.3390/cancers14174321] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 12/02/2022] Open
Abstract
Human papillomavirus (HPV) infection has been identified as a significant etiological agent in the development of head and neck squamous cell carcinoma (HNSCC). HPV's involvement has alluded to better survival and prognosis in patients and suggests that different treatment strategies may be appropriate for them. Only some data on the epidemiology of HPV infection in the oropharyngeal, oral cavity, and laryngeal SCC exists in Europe. Thus, this study was carried out to investigate HPV's impact on HNSCC patient outcomes in the Irish population, one of the largest studies of its kind using consistent HPV testing techniques. A total of 861 primary oropharyngeal, oral cavity, and laryngeal SCC (OPSCC, OSCC, LSCC) cases diagnosed between 1994 and 2013, identified through the National Cancer Registry of Ireland (NCRI), were obtained from hospitals across Ireland and tested for HPV DNA using Multiplex PCR Luminex technology based in and sanctioned by the International Agency for Research on Cancer (IARC). Both overall and cancer-specific survival were significantly improved amongst all HPV-positive patients together, though HPV status was only a significant predictor of survival in the oropharynx. Amongst HPV-positive patients in the oropharynx, surgery alone was associated with prolonged survival, alluding to the potential for de-escalation of treatment in HPV-related OPSCC in particular. Cumulatively, these findings highlight the need for continued investigation into treatment pathways for HPV-related OPSCC, the relevance of introducing boys into national HPV vaccination programs, and the relevance of the nona-valent Gardasil-9 vaccine to HNSCC prevention.
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Affiliation(s)
- Imogen Sharkey Ochoa
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Esther O’Regan
- Trinity St James Cancer Institute, Trinity College Dublin, D08 NHY1 Dublin, Ireland
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Mary Toner
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Elaine Kay
- Department of Pathology, Beaumont University Hospital, D09 V2N0 Dublin, Ireland
| | - Peter Faul
- Department of Pathology, University Hospital Limerick, V94 F858 Limerick, Ireland
| | - Connor O’Keane
- Department of Pathology, Mater University Hospital, D07 R2WY Dublin, Ireland
| | - Roisin O’Connor
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Dorinda Mullen
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Mataz Nur
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Eamon O’Murchu
- National Cancer Registry of Ireland, T12 CDF7 Cork, Ireland
| | - Jacqui Barry-O’Crowley
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Niamh Kernan
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Prerna Tewari
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Helen Keegan
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Sharon O’Toole
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Robbie Woods
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Susan Kennedy
- Department of Pathology, St Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Kenneth Feeley
- Department of Pathology, University Hospital Kerry, V92 NX94 Tralee, Ireland
| | - Linda Sharp
- Faculty of Medical Sciences, Newcastle University, Newcastle NE1 7RU, UK
| | - Tarik Gheit
- Infections and Cancer Biology Laboratory, International Agency for Research on Cancer, 69008 Lyon, France
| | - Massimo Tommasino
- Dipartimento di Farmacia-Scienze del Farmaco, University of Bari, 70121 Bari, Italy
| | - John J. O’Leary
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, D08 NHY1 Dublin, Ireland
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Cara M. Martin
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, D08 NHY1 Dublin, Ireland
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
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8
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FBXL7 Body Hypomethylation Is Frequent in Tumors from the Digestive and Respiratory Tracts and Is Associated with Risk-Factor Exposure. Int J Mol Sci 2022; 23:ijms23147801. [PMID: 35887149 PMCID: PMC9316635 DOI: 10.3390/ijms23147801] [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: 05/17/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023] Open
Abstract
Squamous cell carcinoma is the main histological tumor type in the upper aerodigestive tract (UADT), including the esophagus (ESCC) and the head and neck sites, as well as the oral cavity (OCSCC), larynx (LSCC) and oropharynx (OPSCC). These tumors are induced by alcohol and tobacco exposure, with the exception of a subgroup of OPSCC linked to human papillomavirus (HPV) infection. Few genes are frequently mutated in UADT tumors, pointing to other molecular mechanisms being involved during carcinogenesis. The F-box and leucine-rich repeat protein 7 (FBXL7) is a potential tumor-suppressing gene, one that is frequently hypermethylated in pancreatic cancer and where the encoded protein promotes the degradation of AURKA, BIRC5 and c-SRC. Thus, the aim of this study was to evaluate the methylation and expression profile of FBXL7 in the UADT and the gene’s association with the clinical, etiological and pathological characteristics of patients, as well as the expression of its degradation targets. Here we show that the FBXL7 gene’s body is hypomethylated in the UADT, independently of histology, but not in virus-associated tumors. FBXL7 body methylation and gene expression levels were correlated in the ESCC, LSCC, OCSCC and OPSCC. Immunohistochemistry analysis showed that FBXL7 protein levels are not correlated with the levels of its degradation targets, AURKA and BIRC5, in the UADT. The high discriminatory potential of FBXL7 body hypomethylation between non-tumor and tumor tissues makes it a promising biomarker.
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9
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Aggarwal P, Nader M, Gidley PW, Pratihar R, Jivani S, Garden AS, Mott FE, Goepfert RP, Ogboe CW, Charles C, Fuller CD, Lai SY, Gunn GB, Sturgis EM, Hanna EY, Hutcheson KA, Shete S. Association of hearing loss and tinnitus symptoms with health-related quality of life among long-term oropharyngeal cancer survivors. Cancer Med 2022; 12:569-583. [PMID: 35695117 PMCID: PMC9844619 DOI: 10.1002/cam4.4931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/28/2022] [Accepted: 05/02/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This study investigated the association of hearing loss and tinnitus with overall health-related quality of life (HRQoL) among long-term oropharyngeal cancer (OPC) survivors. METHODS This study included OPC survivors treated between 2000 and 2013 and surveyed from September 2015 to July 2016. Hearing loss and tinnitus were measured by asking survivors to rate their "difficulty with hearing loss and/or ringing in the ears" from 0 (not present) to 10 (as bad as you can imagine). Hearing loss and tinnitus scores were categorized as follows: 0 for none, 1-4 for mild, and 5-10 for moderate to severe. The primary outcome was the mean score of MD nderson Symptom Inventory Head & Neck module interference component as a HRQoL surrogate dichotomized as follows: 0 to 4 for none to mild and 5 to 10 for moderate to severe interference. RESULTS Among 880 OPC survivors, 35.6% (314), reported none, 39.3% (347) reported mild, and 25.1% (221) reported moderate to severe hearing loss and tinnitus. On multivariable analysis, mild (OR, 5.83; 95% CI; 1.48-22.88; p = 0.012) and moderate (OR, 30.01; 95% CI; 7.96-113.10; p < 0.001) hearing loss and tinnitus were associated with higher odds of reporting moderate to severe symptom interference scores in comparison to no hearing loss and tinnitus. This association of hearing dysfunction was consistent with all domains of HRQoL. CONCLUSIONS Our findings provide preliminary evidence to support the need for continued audiological evaluations and surveillance to detect hearing dysfunction, to allow for early management and to alleviate the long-term impact on QoL.
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Affiliation(s)
- Puja Aggarwal
- Department of EpidemiologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Marc‐Elie Nader
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Paul W. Gidley
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Raj Pratihar
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Shirin Jivani
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Adam S. Garden
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Frank E. Mott
- Department of Thoracic Head and Neck Medical OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Ryan P. Goepfert
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | | | - Camille Charles
- Department of EpidemiologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Clifton D. Fuller
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Stephen Y. Lai
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA,Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - G. Brandon Gunn
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Erich M. Sturgis
- Department of Otolaryngology‐Head and Neck SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Ehab Y. Hanna
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Katherine A. Hutcheson
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA,Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Sanjay Shete
- Department of EpidemiologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA,Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHoustonTexasUnited States,Division of Cancer Prevention and Population SciencesThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
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10
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Wahle BM, Zolkind P, Ramirez RJ, Skidmore ZL, Anderson SR, Mazul A, Hayes DN, Sandulache VC, Thorstad WL, Adkins D, Griffith OL, Griffith M, Zevallos JP. Integrative genomic analysis reveals low T-cell infiltration as the primary feature of tobacco use in HPV-positive oropharyngeal cancer. iScience 2022; 25:104216. [PMID: 35494251 PMCID: PMC9044176 DOI: 10.1016/j.isci.2022.104216] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/20/2021] [Accepted: 04/05/2022] [Indexed: 11/15/2022] Open
Abstract
Although tobacco use is an independent adverse prognostic feature in HPV(+) oropharyngeal squamous cell carcinoma (OPSCC), the biologic features associated with tobacco use have not been systematically investigated. We characterized genomic and immunologic features associated with tobacco use through whole exome sequencing, mRNA hybridization, and immunohistochemical staining in 47 HPV(+) OPSCC tumors. Low expression of transcripts in a T cell-inflamed gene expression profile (TGEP) was associated with tobacco use at diagnosis and lower overall and disease-free survival. Tobacco use was associated with an increased proportion of T > C substitutions and a lower proportion of expected mutational signatures, but not with increases in mutational burden or recurrent oncogenic mutations. Our findings suggest that rather than increased mutational burden, tobacco's primary and clinically relevant association in HPV(+) OPSCC is immunosuppression of the tumor immune microenvironment. Quantitative assays of T cell infiltration merit further study as prognostic markers in HPV(+) OPSCC.
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Affiliation(s)
- Benjamin M. Wahle
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, Campus Box 8115, 660 South Euclid Avenue, St. Louis, MO 63110, USA
| | - Paul Zolkind
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, Campus Box 8115, 660 South Euclid Avenue, St. Louis, MO 63110, USA
| | - Ricardo J. Ramirez
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, Campus Box 8115, 660 South Euclid Avenue, St. Louis, MO 63110, USA
| | - Zachary L. Skidmore
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Sydney R. Anderson
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Angela Mazul
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, Campus Box 8115, 660 South Euclid Avenue, St. Louis, MO 63110, USA
| | - D. Neil Hayes
- Department of Medicine, Division of Hematology-Oncology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Vlad C. Sandulache
- Bobby R. Alford Department of Otolaryngology Head and Neck Surgery, Baylor College of Medicine, Houston, TX 77030, USA
- ENT Section, Operative Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030
- Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030
| | - Wade L. Thorstad
- Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO 63108, USA
| | - Douglas Adkins
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - Obi L. Griffith
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO 63108, USA
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110 USA
- Department of Genetics, Washington University School of Medicine, St Louis, Missouri
| | - Malachi Griffith
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO 63108, USA
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110 USA
- Department of Genetics, Washington University School of Medicine, St Louis, Missouri
| | - Jose P. Zevallos
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, Campus Box 8115, 660 South Euclid Avenue, St. Louis, MO 63110, USA
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11
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Straetmans JMJAA, Stuut M, Lacko M, Hoebers F, Speel EJM, Kremer B. Additional parameters to improve the prognostic value of the 8th edition of the UICC classification for human papillomavirus-related oropharyngeal tumors. Head Neck 2022; 44:1799-1815. [PMID: 35579041 PMCID: PMC9544856 DOI: 10.1002/hed.27084] [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: 09/28/2021] [Revised: 02/17/2022] [Accepted: 04/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background The prognostic reliability of the UICC's TNM classification (8th edition) for human papillomavirus (HPV)‐positive tonsillar squamous cell carcinomas (TSCCs) compared to the 7th edition was explored, and its improvement by using additional anatomical and nonanatomical parameters. Methods One hundred and ten HPV‐positive and 225 HPV‐negative TSCCs were retrospectively analyzed. Survival was correlated with patient and tumor characteristics (7th and 8th edition UICC TNM classification). Results In HPV‐positive TSCCs, the 8th edition UICC's TNM classification correlated better with prognosis than the 7th edition. Also, smoking status was a stronger prognosticator of survival than UICC staging. Non‐ or former smokers had a 5‐year overall survival of 95.1% regardless of tumor stage. Furthermore, age (>65 years), cN3, and M1 classification were significant prognostic factors. Conclusion The prognostic value of the 8th edition UICC's TNM classification improved significantly when compared to the 7th edition. Nonetheless, further improvement is possible by adding nonanatomical factors (smoking, age >65 year) and separating N0‐N2 from N3.
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Affiliation(s)
- Jos M J A A Straetmans
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.,Department of Otorhinolaryngology and Head and Neck Surgery, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Marijn Stuut
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martin Lacko
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Ernst-Jan M Speel
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
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12
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Itami J, Kobayashi K, Mori T, Honma Y, Kubo Y, Murakami N, Omura G, Okuma K, Inaba K, Takahashi K, Kashihara T, Shimizu Y, Takahashi A, Nakayama Y, Matsumoto F, Yoshimoto S, Igaki H. Non-Robustness of Ang’s Risk Classification in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma in Japanese Patients. Cancers (Basel) 2022; 14:cancers14102442. [PMID: 35626047 PMCID: PMC9139843 DOI: 10.3390/cancers14102442] [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: 04/15/2022] [Revised: 05/13/2022] [Accepted: 05/13/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Validity of the risk classification by Ang for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) remains to be studied in the patients treated by modalities other than chemoradiotherapy and in Japanese patients. Materials and Methods: Between 2010 and 2018, 122 patients with HPV-related OPSCC in stages III and IV by the TNM classification 7th edition (TNM-7) were treated curatively at a single institution in Japan. The median age was 62.7 years. Over 50% of the patients underwent surgery with or without adjuvant therapy. The influence of multiple factors on survival was analyzed. Results: The amount of smoking dichotomized at 10 pack-year, which was used in Ang’s risk classification, was not predictive of prognosis, and Ang’s risk classification was not significantly influential on prognosis in multivariate analysis. In the patients treated with definitive radiation therapy, Ang’s risk classification was not predictive of the prognosis in univariate analysis. The impact of smoking was significant only in the patients undergoing the definitive operation. Conclusions: Ang’s risk classification was not robust in predicting the prognosis of general Japanese HPV-related OPSCC patients. The amount of smoking might have different prognostic influences depending on the therapeutic method.
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Affiliation(s)
- Jun Itami
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
- Shin-Matsudo Accuracy Radiation Therapy Center, Shin-Matsudo Central General Hospital, Chiba 270-0034, Japan
- Correspondence: ; Tel.: +81-47-345-1111
| | - Kenya Kobayashi
- Department of Head and Neck Surgical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (K.K.); (G.O.); (F.M.); (S.Y.)
| | - Taisuke Mori
- Department of Pathology, National Cancer Center Hospital, Tokyo 104-0045, Japan;
| | - Yoshitaka Honma
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan;
| | - Yuko Kubo
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan;
| | - Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Go Omura
- Department of Head and Neck Surgical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (K.K.); (G.O.); (F.M.); (S.Y.)
| | - Kae Okuma
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Koji Inaba
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Kana Takahashi
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Tairo Kashihara
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Yuri Shimizu
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Ayaka Takahashi
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Yuko Nakayama
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Fumihiko Matsumoto
- Department of Head and Neck Surgical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (K.K.); (G.O.); (F.M.); (S.Y.)
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (K.K.); (G.O.); (F.M.); (S.Y.)
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
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13
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Aggarwal P, Hutcheson KA, Yu R, Wang J, Fuller CD, Garden AS, Goepfert RP, Rigert J, Mott FE, Lu C, Lai SY, Gunn GB, Chambers MS, Li G, Wu CC, Hanna EY, Sturgis EM, Shete S. Genetic susceptibility to patient-reported xerostomia among long-term oropharyngeal cancer survivors. Sci Rep 2022; 12:6662. [PMID: 35459784 PMCID: PMC9033773 DOI: 10.1038/s41598-022-10538-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/29/2022] [Indexed: 12/04/2022] Open
Abstract
Genetic susceptibility for xerostomia, a common sequela of radiotherapy and chemoradiotherapy for head and neck cancer, is unknown. Therefore, to identify genetic variants associated with moderate to severe xerostomia, we conducted a GWAS of 359 long-term oropharyngeal cancer (OPC) survivors using 579,956 autosomal SNPs. Patient-reported cancer treatment-related xerostomia was assessed using the MD Anderson Symptom Inventory. Patient response was dichotomized as moderate to severe or none to mild symptoms. In our study, 39.2% of OPC survivors reported moderate to severe xerostomia. Our GWAS identified eight SNPs suggestively associated with higher risk of moderate to severe xerostomia in six genomic regions (2p13.3, rs6546481, Minor Allele (MA) = A, ANTXR1, P = 4.3 × 10-7; 5p13.2-p13.1, rs16903936, MA = G, EGFLAM, P = 5.1 × 10-6; 4q21.1, rs10518156, MA = G, SHROOM3, P = 7.1 × 10-6; 19q13.42, rs11882068, MA = G, NLRP9, P = 1.7 × 10-5; 12q24.33, rs4760542, MA = G, GLT1D1, P = 1.8 × 10-5; and 3q27.3, rs11714564, MA = G, RTP1, P = 2.9 × 10-5. Seven SNPs were associated with lower risk of moderate to severe xerostomia, of which only one mapped to specific genomic region (15q21.3, rs4776140, MA = G, LOC105370826, a ncRNA class RNA gene, P = 1.5 × 10-5). Although our small exploratory study did not reach genome-wide statistical significance, our study provides, for the first time, preliminary evidence of genetic susceptibility to xerostomia. Further studies are needed to elucidate the role of genetic susceptibility to xerostomia.
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Affiliation(s)
- Puja Aggarwal
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert Yu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jian Wang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adam S Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jillian Rigert
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Frank E Mott
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles Lu
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mark S Chambers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guojun Li
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chih-Chieh Wu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Erich M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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14
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Nishikawa D, Hanai N, Ozawa T, Kitahara T, Hasegawa Y. Role of Human Papilloma Virus and Lifestyle Factors in Overall Survival of Patients with Oropharyngeal Squamous Cell Carcinoma. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58040557. [PMID: 35454395 PMCID: PMC9027196 DOI: 10.3390/medicina58040557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/07/2022] [Accepted: 04/13/2022] [Indexed: 11/25/2022]
Abstract
Background: Patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) have a significantly better treatment response and overall survival (OS) rates than non-HPV-associated OPSCC. Objectives: We conducted the present study to further characterize the interplay between lifestyle risk factors, which are not only HPV status, but also smoking history and alcohol consumption, and the OS to optimize the treatment of patients with OPSCC. Materials and Methods: Between January 2006 and December 2013, 94 patients newly diagnosed with OPSCC were treated with curative intent at Aichi Cancer Center Hospital (Nagoya, Japan). To determine negative prognostic factors associated with the OS, univariate and multivariable Cox regression analyses were performed. Results: Of the 94 OPSCC patients, 53 (56.4%) were positive for HPV. The univariate analysis revealed that T classification, smoking history, alcohol consumption, and HPV status were significant determinants of the OS. In the multivariate analysis, adjusted for the clinical stage, smoking history, alcohol consumption, HPV status, and a smoking history of >10 pack-years was an independent negative prognostic factor for the OS among patients with OPSCC (HR: 10.4, 95 %CI: 1.34−80.6, p < 0.05). Conclusions: Smoking is a very important negative prognostic factor even in cases of HPV-associated OPSCC. The impact of smoking needs to be reaffirmed when deciding on treatment plans and de-escalation trials in OPSCC, even in cases of HPV-associated OPSCC.
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Affiliation(s)
- Daisuke Nishikawa
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijocho, Kashihara 634-8522, Nara, Japan; (D.N.); (T.K.)
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusaku, Nagoya 464-8681, Aichi, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusaku, Nagoya 464-8681, Aichi, Japan
- Correspondence:
| | - Taijiro Ozawa
- Department of Otolaryngology, Toyohashi Municipal Hospital, 50 Hakken-Nishi, Aotakecho, Toyohashi 441-8570, Aichi, Japan;
| | - Tadashi Kitahara
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijocho, Kashihara 634-8522, Nara, Japan; (D.N.); (T.K.)
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Asahi University Hospital, 3-23 Hashimotocho, Gifu 500-8523, Gifu, Japan;
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15
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Hypopharyngeal Reconstruction: Possibilities, Outcomes, and Updates for Improving the Human Health for Quality of Life. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:6132481. [PMID: 35178078 PMCID: PMC8847029 DOI: 10.1155/2022/6132481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/03/2022] [Accepted: 01/08/2022] [Indexed: 11/17/2022]
Abstract
Hypopharyngeal carcinoma is usually present at late stages, necessitating an aggressive line of management consisting of surgical procedures, chemotherapy, and radiation therapy, depending on the case. Practitioners tend to support total laryngectomies or total esophagostomies for most cases of hypopharyngeal carcinoma. The extensive procedures needed will most probably require, depending on the residual defect, a follow-up reconstructive procedure that might require utilizing flaps. Types of reconstructive methods and types of grafts or flaps used could be divided into a multitude of categories depending on the magnitude, shape, extension, and whether the underlying defect that is being reconstructed is circumferential or not. These reconstructive procedures are aimed at improving the quality of life, improving the aesthetic outcome, and restoring the functionality of the pharyngoesophageal segment. When it comes to hypopharyngeal cancer, the most common kind is squamous cell carcinoma (SCC), which has the worst prognosis of all the head and neck malignancies. Overall, the 5-year survival rate remains low, despite recent advancements in diagnostic imaging, radiation, and chemotherapy, as well as enhanced surgical methods and techniques. Hypopharyngeal malignancies are more probable than other tumors to present with advanced primary illness, with nodal metastasis a distinct possibility. The size and amount of local dissemination of the original carcinoma, as well as the extent of involvement of regional lymph nodes, are the most critical factors in predicting prognosis. Hypopharyngeal cancers are more likely than other head and neck cancers to manifest with distant metastases at the time of diagnosis. The appearance of second primary tumors, as well as the development of distant metastases, is a contributing factor to poor survival rate. Imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) with contrast remain the gold standard for evaluating hypopharyngeal carcinoma in the early stages. In most cases, imaging leads to an increase in the tumor stage at the time of presentation. Objectives. The main objectives are to review the research published about flaps, outline the optimum situations that will dictate the usage of a few of the most often used flaps for the rebuilding of the hypopharyngeal segment defects, and outline some of the complications associated with reconstruction. Methods. The processing was carried out with the title-specific search of the PubMed database using the query terms “hypopharyngeal carcinoma” and “reconstruction” to identify the most relevant articles without restricting publication dates. Information about the types of defects and methods of reconstruction was extracted from the reviewed articles. Two books were also reviewed, which were Regional and Free Flaps for Head and Neck Reconstruction (second edition) and Head and Neck Reconstruction: A Defect-Oriented Approach. Conclusion. Deciding the appropriate approach to a case should be individualized and should depend on the capabilities of the center, the defect's size and status, and lastly, the surgeon's training. The use of interpretation in the diagnosis of flaps can offer the best results in restoring functionality and vascularity and might also offer improved cosmesis.
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16
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Zheng S, Magliocca KR, Reid MD, Kaka AS, Lubin D. Metastatic HPV-Mediated Adenocarcinoma Arising from a Base of Tongue Primary: A Case Report with Cytomorphology and Molecular Findings with Review of the Literature. Head Neck Pathol 2022; 16:893-901. [PMID: 35015191 PMCID: PMC9424432 DOI: 10.1007/s12105-021-01407-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/20/2021] [Indexed: 01/13/2023]
Abstract
Human papillomavirus (HPV)-mediated squamous cell carcinomas of the oropharynx are common, however only rare cases of HPV-mediated oropharyngeal adenocarcinoma have been reported to date. In this report, we describe a 50 year old nonsmoking male who originally presented with an enlarging neck mass. Fine needle aspiration cytology confirmed an HPV-mediated adenocarcinoma. Subsequent surgery identified a 0.7 cm base of tongue primary HPV-mediated carcinoma with focal glandular differentiation and a 4.0 cm cystic lymph node metastasis demonstrating entirely glandular differentiation. Next generation sequencing of the metastasis detected a pathogenic NOTCH1 mutation.
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Affiliation(s)
- Stephanie Zheng
- grid.411929.60000 0004 0441 5764Department of Pathology, Emory University Hospital Midtown, 550 Peachtree Street NE, Atlanta, GA 30308 USA
| | - Kelly R. Magliocca
- grid.411929.60000 0004 0441 5764Department of Pathology, Emory University Hospital Midtown, 550 Peachtree Street NE, Atlanta, GA 30308 USA
| | - Michelle D. Reid
- grid.411929.60000 0004 0441 5764Department of Pathology, Emory University Hospital Midtown, 550 Peachtree Street NE, Atlanta, GA 30308 USA
| | - Azeem S. Kaka
- grid.411929.60000 0004 0441 5764Department of Otolaryngology, Head and Neck Surgery, Emory University Hospital Midtown, 550 Peachtree Street NE, Atlanta, GA 30308 USA
| | - Daniel Lubin
- grid.411929.60000 0004 0441 5764Department of Pathology, Emory University Hospital Midtown, 550 Peachtree Street NE, Atlanta, GA 30308 USA ,grid.412162.20000 0004 0441 5844Pathology and Laboratory Medicine, Emory University Hospital, Room H-184, 1364 Clifton Road NE, Atlanta, GA 30322 USA
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17
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Trembley JH, Li B, Kren BT, Peltola J, Manivel J, Meyyappan D, Gravely A, Klein M, Ahmed K, Caicedo-Granados E. Identification of high protein kinase CK2α in HPV(+) oropharyngeal squamous cell carcinoma and correlation with clinical outcomes. PeerJ 2022; 9:e12519. [PMID: 34993017 PMCID: PMC8675248 DOI: 10.7717/peerj.12519] [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: 08/30/2021] [Accepted: 10/27/2021] [Indexed: 12/27/2022] Open
Abstract
Background Oropharyngeal squamous cell carcinoma (OPSCC) incidence is rising worldwide, especially human papillomavirus (HPV)-associated disease. Historically, high levels of protein kinase CK2 were linked with poor outcomes in head and neck squamous cell carcinoma (HNSCC), without consideration of HPV status. This retrospective study examined tumor CK2α protein expression levels and related clinical outcomes in a cohort of Veteran OPSCC patient tumors which were determined to be predominantly HPV(+). Methods Patients at the Minneapolis VA Health Care System with newly diagnosed primary OPSCC from January 2005 to December 2015 were identified. A total of 119 OPSCC patient tumors were stained for CK2α, p16 and Ki-67 proteins and E6/E7 RNA. CK2α protein levels in tumors and correlations with HPV status and Ki-67 index were assessed. Overall survival (OS) analysis was performed stratified by CK2α protein score and separately by HPV status, followed by Cox regression controlling for smoking status. To strengthen the limited HPV(−) data, survival analysis for HPV(−) HNSCC patients in the publicly available The Cancer Genome Atlas (TCGA) PanCancer RNA-seq dataset was determined for CSNK2A1. Results The patients in the study population were all male and had a predominant history of tobacco and alcohol use. This cohort comprised 84 HPV(+) and 35 HPV(−) tumors. CK2α levels were higher in HPV(+) tumors compared to HPV(−) tumors. Higher CK2α scores positively correlated with higher Ki-67 index. OS improved with increasing CK2α score and separately OS was significantly better for those with HPV(+) as opposed to HPV(−) OPSCC. Both remained significant after controlling for smoking status. High CSNK2A1 mRNA levels from TCGA data associated with worse patient survival in HPV(−) HNSCC. Conclusions High CK2α protein levels are detected in HPV(+) OPSCC tumors and demonstrate an unexpected association with improved survival in a strongly HPV(+) OPSCC cohort. Worse survival outcomes for high CSNK2A1 mRNA levels in HPV(−) HNSCC are consistent with historical data. Given these surprising findings and the rising incidence of HPV(+) OPSCC, further study is needed to understand the biological roles of CK2 in HPV(+) and HPV(−) HNSCC and the potential utility for therapeutic targeting of CK2 in these two disease states.
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Affiliation(s)
- Janeen H Trembley
- Research Service, Minneapolis VA Health Care System, Minneapolis, MN, United States of America.,Department of Laboratory Medicine and Pathology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America.,Masonic Cancer Center, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America
| | - Bin Li
- Otolaryngology Section, Minneapolis VA Health Care System, Minneapolis, MN, United States of America.,Department of Otolaryngology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America.,Current affiliation: Kaiser Permanente Roseville Medical Center, Department of Head and Neck Surgery, Roseville, CA, United States of America
| | - Betsy T Kren
- Research Service, Minneapolis VA Health Care System, Minneapolis, MN, United States of America.,Masonic Cancer Center, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America
| | - Justin Peltola
- Department of Laboratory Medicine and Pathology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America.,Laboratory Medicine and Pathology Service, Minneapolis VA Health Care System, Minneapolis, MN, United States of America
| | - Juan Manivel
- Department of Laboratory Medicine and Pathology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America.,Laboratory Medicine and Pathology Service, Minneapolis VA Health Care System, Minneapolis, MN, United States of America
| | - Devi Meyyappan
- Hematology and Oncology Section, Minneapolis VA Health Care System, Minneapolis, MN, United States of America.,Current affiliation: University of Texas Medical Branch, University Blvd, Galveston, TX, United States of America
| | - Amy Gravely
- Research Service, Minneapolis VA Health Care System, Minneapolis, MN, United States of America
| | - Mark Klein
- Masonic Cancer Center, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America.,Hematology and Oncology Section, Minneapolis VA Health Care System, Minneapolis, MN, United States of America.,Department of Medicine, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America
| | - Khalil Ahmed
- Research Service, Minneapolis VA Health Care System, Minneapolis, MN, United States of America.,Department of Laboratory Medicine and Pathology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America.,Masonic Cancer Center, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America.,Department of Otolaryngology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America
| | - Emiro Caicedo-Granados
- Masonic Cancer Center, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America.,Otolaryngology Section, Minneapolis VA Health Care System, Minneapolis, MN, United States of America.,Department of Otolaryngology, University of Minnesota - Twin Cities Campus, Minneapolis, MN, United States of America
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18
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Aggarwal P, Hutcheson KA, Garden AS, Mott FE, Lu C, Goepfert RP, Fuller CD, Lai SY, Gunn GB, Chambers MS, Sturgis EM, Hanna EY, Shete S. Determinants of patient-reported xerostomia among long-term oropharyngeal cancer survivors. Cancer 2021; 127:4470-4480. [PMID: 34358341 DOI: 10.1002/cncr.33849] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND This study was conducted to identify clinicodemographic risk factors for xerostomia among long-term oropharyngeal cancer (OPC) survivors. METHODS This cross-sectional study included 906 disease-free, adult OPC survivors with a median survival duration at the time of survey of 6 years (range, 1-16 years); self-reported xerostomia scores were available for 877 participants. Study participants had completed curative treatment between January 2000 and December 2013 and responded to a survey administered from September 2015 to July 2016. The primary outcome variable was cancer patient-reported xerostomia measured with the MD Anderson Symptom Inventory Head and Neck Cancer Module. Clinicodemographic risk factors for moderate to severe xerostomia were identified via multivariable logistic regression. RESULTS Moderate to severe xerostomia was reported by 343 of the respondents (39.1%). Female sex (odds ratio [OR], 1.82; 95% CI, 1.22-2.71; P = .003; Bayesian false-discovery probability [BFDP] = 0.568), high school or lower education (OR, 1.73; 95% CI, 1.19-2.52; P = .004; BFDP = 0.636), and current cigarette smoking at the time of survey (OR, 2.56; 95% CI, 1.19-5.47; P = .016; BFDP = 0.800) were risk factors for moderate to severe xerostomia, and bilateral intensity-modulated radiotherapy (IMRT) combined with proton therapy and ipsilateral IMRT were protective. CONCLUSIONS In this large xerostomia study, modern radiotherapy was a protective factor, and continued cigarette smoking at the time of survey, female sex, and high school or lower education were identified as other contributing risk factors associated with moderate to severe xerostomia. Importantly, these findings need to be confirmed in prospective studies. These results can inform future research and targeted patient-centered interventions to monitor and manage radiation therapy-associated xerostomia and preserve quality of life among patients with OPC.
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Affiliation(s)
- Puja Aggarwal
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adam S Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Frank E Mott
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Charles Lu
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark S Chambers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
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19
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Uehara T, Doi H, Ishikawa K, Inada M, Tatsuno S, Wada Y, Oguma Y, Kawakami H, Nakamatsu K, Hosono M, Nishimura Y. Serum lactate dehydrogenase is a predictive biomarker in patients with oropharyngeal cancer undergoing radiotherapy: Retrospective study on predictive factors. Head Neck 2021; 43:3132-3141. [PMID: 34268826 PMCID: PMC8457164 DOI: 10.1002/hed.26814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/08/2021] [Accepted: 07/07/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The present study aimed to evaluate the prognostic factors in human papillomavirus (HPV)-positive and HPV-negative oropharyngeal cancer (OPC) treated with definitive radiotherapy. METHODS We retrospectively evaluated 101 patients with OPC who underwent definitive radiotherapy between 2008 and 2018. RESULTS The median follow-up period of the surviving patients was 68 months (range, 8-164 months). The 5-year overall survival rate was 69.8%. Univariate analyses revealed that poor survival was associated with male sex, smoking ≥30 pack-years, Eastern Cooperative Oncology Group performance status ≥1, tumor-node-metastasis (TNM) stage III-IV (8th edition), HPV-negativity, serum lactate dehydrogenase (LDH) ≥202, C-reactive protein/albumin ratio ≥0.15, and lymphocyte-to-monocyte ratio <2.90. In multivariate analyses, poor survival was independently correlated with smoking ≥30 pack-years (p < 0.01) and LDH ≥202 (p = 0.02). CONCLUSIONS The present study suggested that high LDH levels predicted poor survival after definitive radiotherapy for patients with both HPV-positive and HPV-negative OPC.
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Affiliation(s)
- Takuya Uehara
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Hiroshi Doi
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Kazuki Ishikawa
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Masahiro Inada
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Saori Tatsuno
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Yutaro Wada
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Yasuo Oguma
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Hisato Kawakami
- Department of Medical Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Kiyoshi Nakamatsu
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Makoto Hosono
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
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20
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Human papillomavirus co-infection and survival in oral and oropharyngeal squamous cell carcinoma: A study in 235 Brazilian patients. Auris Nasus Larynx 2021; 49:258-270. [PMID: 34274177 DOI: 10.1016/j.anl.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES While unknown for oropharyngeal squamous cell carcinoma (OPSCC) and oral squamous cell carcinoma (OSCC), some studies assessing cervical carcinoma have shown that human papillomavirus (HPV) co-infection can be associated with its prognosis. METHODS Through in situ hybridization (HPV and Epstein-Barr virus [EBV] probes) and immunohistochemistry (p16INK4a, cyclin D1, p53, and Ki-67 antibodies), 126 OPSCC and 109 OSCC samples were assessed. RESULTS All patients were EBV-negative. OPSCC (25%) showed a significant association with HPV compared to OSCC (11%). Almost all HPV-associated cases were p16INK4a-positive. Regarding OPSCC and OSCC, 23 and 7 cases were positive for high-risk HPV (HRHPV) only, 6 and 3 cases for low-risk HPV (LRHPV) only, and 3 and 2 cases for HRHPV/LRHPV, respectively. HPV-associated carcinomas showed a significantly higher proliferative index than HPV-unassociated carcinomas. Both carcinomas showed a similar overall survival rate, which was not affected by the HPV status. However, when comparing HPV-associated subgroups, patients with HRHPV/LRHPV-associated carcinomas showed worse survival. CONCLUSION LRHPV-associated and HRHPV/LRHPV-associated cases can also be detected when assessing OSCC and OPSCC. Further studies, especially in populations with a high prevalence of HPV-associated OPSCC, are necessary to understand the clinicopathological behavior of these neoplasm subgroups.
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21
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Santos Carvalho R, Scapulatempo-Neto C, Curado MP, de Castro Capuzzo R, Marsico Teixeira F, Cardoso Pires R, Cirino MT, Cambrea Joaquim Martins J, Almeida Oliveira da Silva I, Oliveira MA, Watanabe M, Guimarães Ribeiro A, Caravina de Almeida G, Reis RM, Ribeiro Gama R, Lopes Carvalho A, de Carvalho AC. HPV-Induced Oropharyngeal Squamous Cell Carcinomas in Brazil: Prevalence, Trend, Clinical, and Epidemiologic Characterization. Cancer Epidemiol Biomarkers Prev 2021; 30:1697-1707. [PMID: 34155066 DOI: 10.1158/1055-9965.epi-21-0016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/23/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Tobacco or human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCC) represent different clinical and epidemiologic entities. This study investigated the prevalence of HPV-positive and HPV-negative OPSCC in a reference cancer hospital in Brazil and its association with clinical and demographic data, as well as its impact on overall survival. METHODS HPV infection was determined by p16-IHC in pre-treatment formalin-fixed paraffin-embedded samples from all patients with OPSCC diagnosed at Barretos Cancer Hospital between 2008 and 2018. The prevalence of HPV-positive cases and its temporal trend was assessed, and the association of clinical and demographic data with HPV infection and the impact on patient overall survival was evaluated. RESULTS A total of 797 patients with OPSCC were included in the study. The prevalence of HPV-associated tumors in the period was 20.6% [95% confidence interval, 17.5-24.0] with a significant trend for increase of HPV-positive cases over the years (annual percentage change = 12.87). In a multivariate analysis, the variables gender, level of education, smoking, tumor sublocation, region of Brazil, and tumor staging had a significant impact in HPV positivity, and a greater overall survival (OS) was observed in HPV-positive patients (5-year OS: 47.9% vs. 22.0%; P = 0.0001). CONCLUSIONS This study represents the largest cohort of Brazilian patients with OPSCC characterized according to HPV status. We report significant differences in demographics and clinical presentation according to HPV status, and an increasing trend in prevalence for HPV-induced tumors. IMPACT These findings can potentially contribute to a better stratification and management of patients as well as assist in prevention strategies.
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Affiliation(s)
| | - Cristovam Scapulatempo-Neto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.,Pathology and Molecular Diagnostics Service, Diagnósticos da América-DASA, São Paulo, Brazil
| | - Maria Paula Curado
- Epidemiology and Statistics Nucleus, International Research Center, A.C. Camargo Cancer Center, São Paulo, Brazil
| | | | | | | | | | | | | | | | - Marcel Watanabe
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Gisele Caravina de Almeida
- Pathology and Molecular Diagnostics Service, Diagnósticos da América-DASA, São Paulo, Brazil.,Department of Pathology, Barretos Cancer Hospital, Barretos, Brazil
| | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.,Life and Health Sciences Research Institute (ICVS), Medical School, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
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22
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Alotaibi M, Valova V, HÄnsel T, Stromberger C, Kofla G, Olze H, Piwonski I, Albers A, Ochsenreither S, Coordes A. Impact of Smoking on the Survival of Patients With High-risk HPV-positive HNSCC: A Meta-analysis. In Vivo 2021; 35:1017-1026. [PMID: 33622897 DOI: 10.21873/invivo.12345] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM High risk Human papillomavirus (hr-HPV) and smoking are independant risk factors for head and neck squamous cell carcinomas (HNSCC). While hr-HPV+ HNSCC has a better prognosis than smoking-associated HNSCC no systematic data are yet available about the combined risk. PATIENTS AND METHODS We performed a meta-analysis to assess the overall survival of HNSCC patients relative to the hr-HPV and smoking status. A literature review up to November 2019 was conducted in PubMed and Cochrane Library using the search terms 'HPV, Smoking and HNSCC'. RESULTS Nine out of 748 articles were included, 1,436 out of 2,080 patients were hr-HPV+ The prevalence of hr-HPV+ smokers was 36%. The meta-analysis showed a significantly better 5-year overall survival for HPV+ non-smokers compared to smokers with risk ratio of 1.94 (95% confidence intervaI=1.46-2.58). CONCLUSION Smoking is a negative prognostic factor for overall survival in patients with hr-HPV+ HNSCC and should thus be an important part of staging and treatment.
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Affiliation(s)
- Moonef Alotaibi
- Department of Otorhinolaryngology, Head and Neck Surgery (CVK and CCM), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,King Fahad Medical City, Department of Otorhinolaryngology, Head and Neck Surgery, Riyadh, Kingdom of Saudi Arabia
| | - Valeria Valova
- Department of Otorhinolaryngology, Head and Neck Surgery (CVK and CCM), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Toni HÄnsel
- Department of Otorhinolaryngology, Head and Neck Surgery (CVK and CCM), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carmen Stromberger
- Department of Radiooncology (CVK), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Grzegorz Kofla
- Department of Oncology (CVK), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Heidi Olze
- Department of Otorhinolaryngology, Head and Neck Surgery (CVK and CCM), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Iris Piwonski
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Albers
- Department of Otorhinolaryngology (CBF), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sebastian Ochsenreither
- Department of Oncology (CBF), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Charité Comprehensive Cancer Center, Berlin, Germany
| | - Annekatrin Coordes
- Department of Otorhinolaryngology, Head and Neck Surgery (CVK and CCM), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany;
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23
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Magnes T, Wagner S, Kiem D, Weiss L, Rinnerthaler G, Greil R, Melchardt T. Prognostic and Predictive Factors in Advanced Head and Neck Squamous Cell Carcinoma. Int J Mol Sci 2021; 22:4981. [PMID: 34067112 PMCID: PMC8125786 DOI: 10.3390/ijms22094981] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease arising from the mucosa of the upper aerodigestive tract. Despite multimodality treatments approximately half of all patients with locally advanced disease relapse and the prognosis of patients with recurrent or metastatic HNSCC is dismal. The introduction of checkpoint inhibitors improved the treatment options for these patients and pembrolizumab alone or in combination with a platinum and fluorouracil is now the standard of care for first-line therapy. However, approximately only one third of unselected patients respond to this combination and the response rate to checkpoint inhibitors alone is even lower. This shows that there is an urgent need to improve prognostication and prediction of treatment benefits in patients with HNSCC. In this review, we summarize the most relevant risk factors in the field and discuss their roles and limitations. The human papilloma virus (HPV) status for patients with oropharyngeal cancer and the combined positive score are the only biomarkers consistently used in clinical routine. Other factors, such as the tumor mutational burden and the immune microenvironment have been highly studied and are promising but need validation in prospective trials.
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Affiliation(s)
- Teresa Magnes
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
| | - Sandro Wagner
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
| | - Dominik Kiem
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
| | - Lukas Weiss
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), 5020 Salzburg, Austria
| | - Gabriel Rinnerthaler
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), 5020 Salzburg, Austria
| | - Richard Greil
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), 5020 Salzburg, Austria
| | - Thomas Melchardt
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), 5020 Salzburg, Austria
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Bonelli P, Borrelli A, Tuccillo FM, Buonaguro FM, Tornesello ML. The Role of circRNAs in Human Papillomavirus (HPV)-Associated Cancers. Cancers (Basel) 2021; 13:1173. [PMID: 33803232 PMCID: PMC7963196 DOI: 10.3390/cancers13051173] [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: 01/19/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 12/28/2022] Open
Abstract
Circular RNAs (circRNAs) are a new class of "non-coding RNAs" that originate from non-sequential back-splicing of exons and/or introns of precursor messenger RNAs (pre-mRNAs). These molecules are generally produced at low levels in a cell-type-specific manner in mammalian tissues, but due to their circular conformation they are unaffected by the cell mRNA decay machinery. circRNAs can sponge multiple microRNAs or RNA-binding proteins and play a crucial role in the regulation of gene expression and protein translation. Many circRNAs have been shown to be aberrantly expressed in several cancer types, and to sustain specific oncogenic processes. Particularly, in virus-associated malignancies such as human papillomavirus (HPV)-associated anogenital carcinoma and oropharyngeal and oral cancers, circRNAs have been shown to be involved in tumorigenesis and cancer progression, as well as in drug resistance, and some are useful diagnostic and prognostic markers. HPV-derived circRNAs, encompassing the HPV E7 oncogene, have been shown to be expressed and to serve as transcript for synthesis of the E7 oncoprotein, thus reinforcing the virus oncogenic activity in HPV-associated cancers. In this review, we summarize research advances in the biogenesis of cell and viral circRNAs, their features and functions in the pathophysiology of HPV-associated tumors, and their importance as diagnostic, prognostic, and therapeutic targets in anogenital and oropharyngeal and oral cancers.
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Affiliation(s)
- Patrizia Bonelli
- Molecular Biology and Viral Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (F.M.T.); (F.M.B.); (M.L.T.)
| | - Antonella Borrelli
- Innovative Immunological Models, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy;
| | - Franca Maria Tuccillo
- Molecular Biology and Viral Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (F.M.T.); (F.M.B.); (M.L.T.)
| | - Franco Maria Buonaguro
- Molecular Biology and Viral Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (F.M.T.); (F.M.B.); (M.L.T.)
| | - Maria Lina Tornesello
- Molecular Biology and Viral Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (F.M.T.); (F.M.B.); (M.L.T.)
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25
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Sabiq F, Huang K, Patel A, Banerjee R, Debenham B, Lau H, Skarsgard D, Chen G, Lysack JT, Quon HC. Novel imaging classification system of nodal disease in human papillomavirus-mediated oropharyngeal squamous cell carcinoma prognostic of patient outcomes. Head Neck 2021; 43:1854-1863. [PMID: 33638232 DOI: 10.1002/hed.26657] [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: 09/16/2020] [Revised: 01/21/2021] [Accepted: 02/09/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Matted nodes in human papillomavirus (HPV)-mediated oropharyngeal squamous cell carcinoma (OPC) is an independent predictor of distant metastases and decreased overall survival. We aimed to classify imaging patterns of metastatic lymphadenopathy, analyze our classification system for reproducibility, and assess its prognostic value. METHODS The metastatic lymphadenopathy was classified based on radiological characteristics for 216 patients with HPV-mediated OPC. Patient outcomes were compared and inter-rater reliability was calculated. RESULTS The presence of ≥3 abutting lymph nodes with imaging features of surrounding extranodal extension (ENE), one subtype of matted nodes, was associated with worse 5-year overall survival, overall recurrence-free survival, regional recurrence-free survival, and distant recurrence-free survival (p ≤ 0.03). Other patterns were not significantly associated with outcome measures. Overall inter-rater agreement was substantial (κ = 0.73). CONCLUSION One subtype of matted nodes defined by ≥3 abutting lymph nodes with imaging features of surrounding ENE is the radiological marker of worst prognosis.
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Affiliation(s)
- Farahna Sabiq
- Department of Radiology, Division of Neuroradiology, University of Calgary, Calgary, Alberta, Canada
| | - Kitty Huang
- Department of Radiation Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Adarsh Patel
- Department of Radiology, Division of Neuroradiology, University of Calgary, Calgary, Alberta, Canada
| | - Robyn Banerjee
- Department of Radiation Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Brock Debenham
- Department of Radiation Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Harold Lau
- Department of Radiation Oncology, University of Calgary, Calgary, Alberta, Canada
| | - David Skarsgard
- Department of Radiation Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Guanmin Chen
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - John T Lysack
- Department of Radiology, Division of Neuroradiology, University of Calgary, Calgary, Alberta, Canada
| | - Harvey C Quon
- Department of Radiation Oncology, University of Calgary, Calgary, Alberta, Canada
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Fomin I, Hughes I, Bhuta S. Oropharyngeal squamous cell carcinomas: Can imaging findings predict HPV status? J Med Imaging Radiat Oncol 2021; 65:175-181. [PMID: 33591580 DOI: 10.1111/1754-9485.13140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/08/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE This is first Australian population-based retrospective study in HPV-induced OPSCCs utilising CT. Contrast enhanced computed tomography (CECT) was utilised to assess if imaging findings of metastatic cystic lymph nodes (LNs) can predict human papillomavirus (HPV) status, as defined by p16 immunostaining of oropharyngeal squamous cell carcinomas (OPSCCs). MATERIALS AND METHODS The location and p16 status of primary tumours and LNs were recorded. Metastatic LNs were assessed for size, shape, margins and cystic changes. Hounsfield Units (HU) value of primary tumours and LNs were measured and tabulated. p16-positive and p16-negative groups were compared with respect to these variables. The two-sample t test and two-sample Mann-Whitney test was used. RESULTS A total of 364 CECT scans were reviewed with 209 patients (187 p16 positive and 22 p16 negative). Primary sites of OPSCCs were tonsils (58.8%), base of tongue (37.4%) and other oropharyngeal sites (3.8%). The HU values of p16-positive OPSCCs with mean of 78.6HU; 95% CI (76.5-80.8) were lower for p16-negative tumours, mean 96.0 HU CI 95% (85.5-106.6) for all oropharyngeal sub-sites. The mean HU values of p16-positive and p16-negative metastatic LNs were 38.8 HU 95% CI: (13-103 HU) versus 88.7 HU 95% CI: (54-131) (P < 0.0001). CONCLUSIONS The association between p16-positive status and the tonsillar cancer site is very high. Imaging features of p16-positive metastatic LNs include relatively large cystic neck nodes with low HU values. This is an imaging signature of p16-positive OPSCCs and can potentially influence patient's early diagnosis and prognosis.
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Affiliation(s)
- Igor Fomin
- Department of Medical Imaging, Gold Coast University Hospital, Southport, Queensland, Australia.,School of Medicine, Griffith University, Southport, Queensland, Australia
| | - Ian Hughes
- Department of Research Governance and Development, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Sandeep Bhuta
- Department of Medical Imaging, Gold Coast University Hospital, Southport, Queensland, Australia.,School of Medicine, Griffith University, Southport, Queensland, Australia
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Green Salad Intake Is Associated with Improved Oral Cancer Survival and Lower Soluble CD44 Levels. Nutrients 2021; 13:nu13020372. [PMID: 33530399 PMCID: PMC7911809 DOI: 10.3390/nu13020372] [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: 12/18/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 12/24/2022] Open
Abstract
Deficiencies in fruit and vegetable intake have been associated with oral cancer (oral cavity and oropharyngeal). Salivary rinses contain measurable biomarkers including soluble CD44 (solCD44) and total protein, which are known markers of oral cancer risk. This study investigates the effect of nutritional factors on solCD44 and protein levels to evaluate oral cancer risk and survival. We evaluated solCD44 and protein levels from 150 patients with oral and oropharyngeal squamous cell carcinoma and 150 frequency-matched controls. We subsequently characterized the effect of food group consumption and these biomarkers on progression-free survival (PFS) and overall survival (OS). Patients reported eating fewer servings of salad (p = 0.015), while controls reported eating fewer servings of potatoes (p < 0.001). Oral cancer patients who consumed at least one serving per week of green salad were found to have significantly lower CD44 levels than those who ate salad less frequently (mean of log2[solCD44]1.73 versus 2.25, p = 0.014). Patients who consumed at least one serving per week of “salad or other vegetables” had significantly longer PFS (median 43.5 versus 9.1 months, p = 0.003, adjusted hazard ratio (HR) = 0.39 p = 0.014) and OS (median 83.6 versus 10 months, p = 0.008, adjusted HR = 0.04 p = 0.029). These findings suggest that dietary factors, namely greater green salad and vegetable intake, may be associated with lower CD44 levels and better prognosis in oral cancer patients.
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Gupta S, Kumar P, Das BC. HPV +ve/-ve oral-tongue cancer stem cells: A potential target for relapse-free therapy. Transl Oncol 2021; 14:100919. [PMID: 33129107 PMCID: PMC7590584 DOI: 10.1016/j.tranon.2020.100919] [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: 07/22/2020] [Revised: 09/27/2020] [Accepted: 10/12/2020] [Indexed: 12/12/2022] Open
Abstract
The tongue squamous cell carcinoma (TSCC) is a highly prevalent head and neck cancer often associated with tobacco and/or alcohol abuse or high-risk human papillomavirus (HR-HPV) infection. HPV positive TSCCs present a unique mechanism of tumorigenesis as compared to tobacco and alcohol-induced TSCCs and show a better prognosis when treated. The poor prognosis and/or recurrence of TSCC is due to presence of a small subpopulation of tumor-initiating tongue cancer stem cells (TCSCs) that are intrinsically resistant to conventional chemoradio-therapies enabling cancer to relapse. Therefore, targeting TCSCs may provide efficient therapeutic strategy for relapse-free survival of TSCC patients. Indeed, the development of new TCSC targeting therapeutic approaches for the successful elimination of HPV+ve/-ve TCSCs could be achieved either by targeting the self-renewal pathways, epithelial mesenchymal transition, vascular niche, nanoparticles-based therapy, induction of differentiation, chemoradio-sensitization of TCSCs or TCSC-derived exosome-based drug delivery and inhibition of HPV oncogenes or by regulating epigenetic pathways. In this review, we have discussed all these potential approaches and highlighted several important signaling pathways/networks involved in the formation and maintenance of TCSCs, which are targetable as novel therapeutic targets to sensitize/eliminate TCSCs and to improve survival of TSCC patients.
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Affiliation(s)
- Shilpi Gupta
- Stem Cell and Cancer Research Lab, Amity Institute of Molecular Medicine & Stem Cell Research (AIMMSCR), Amity University Uttar Pradesh, Sector-125, Noida 201313, India; National Institute of Cancer Prevention and Research (NICPR), I-7, Sector-39, Noida 201301, India
| | - Prabhat Kumar
- Stem Cell and Cancer Research Lab, Amity Institute of Molecular Medicine & Stem Cell Research (AIMMSCR), Amity University Uttar Pradesh, Sector-125, Noida 201313, India
| | - Bhudev C Das
- Stem Cell and Cancer Research Lab, Amity Institute of Molecular Medicine & Stem Cell Research (AIMMSCR), Amity University Uttar Pradesh, Sector-125, Noida 201313, India.
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Schiavetto CM, de Abreu PM, von Zeidler SV, de Jesus LM, Carvalho RS, Cirino MT, Carloni AC, Oliveira C, Scapulatempo-Neto C, de Almeida GC, de Menezes NS, Carvalho AL, Reis RM, de Carvalho AC. Human Papillomavirus DNA Detection by Droplet Digital PCR in Formalin-Fixed Paraffin-Embedded Tumor Tissue from Oropharyngeal Squamous Cell Carcinoma Patients. Mol Diagn Ther 2020; 25:59-70. [PMID: 33245553 DOI: 10.1007/s40291-020-00502-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION High-risk human papillomavirus infection impacts staging and prognosis of oropharyngeal squamous cell carcinomas (OPSCCs). Determination of HPV status in tumor tissue by p16-immunohistochemistry (p16-IHC) can be challenging; therefore, complementary methodologies could be useful in a clinical setting. OBJECTIVE To test for accuracy and clinical relevance of HPV-DNA detection in formalin-fixed and paraffin-embedded (FFPE) tumor samples by droplet digital PCR (ddPCR). MATERIALS AND METHODS Fifty OPSCCs were tested for p16-IHC status followed by HPV-16/18 DNA detection/quantification in FFPE-recovered DNA using ddPCR. Accuracy for HPV status determination and association with patient information were also evaluated. RESULTS 32.0% (16/50) of the cases were p16-IHC positive (p16 +), 42.0% (21/50) had detectable levels of HPV-16 DNA, and none were positive for HPV-18 DNA. A higher median viral load of HPV-16 DNA was observed in p16 + cases (p < 0.0001). Concordance between p16-IHC and HPV-16 DNA ranged from 78.0 to 86.0% and accuracy rates were between 78.0 and 86.0%. P16-IHC and HPV-16 DNA detection was associated with gender, smoking status, and tumor subsite, while only HPV-16 DNA was associated with cT stage. The combination of HPV positivity by p16-IHC and ddPCR showed higher overall survival rates in comparison with p16 + /HPV-DNA- and p16 - /HPV-DNA- results. CONCLUSIONS Type-specific HPV-DNA detection by ddPCR is highly specific but moderately sensitive for the determination of HPV status and showed clinical relevance, mainly when associated with p16-IHC status. Results highlight the importance of performing HPV-DNA testing in combination with p16-IHC for proper identification of HPV-associated OPSCC and to improve clinical management of OPSCC patients.
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Affiliation(s)
- Camila Marques Schiavetto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil
| | - Priscila Marinho de Abreu
- Programa de Pós-Graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Sandra Ventorin von Zeidler
- Programa de Pós-Graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Laís Machado de Jesus
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil
| | | | - Maria Thereza Cirino
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil
| | - Adriana Cruvinel Carloni
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil
| | - Cristina Oliveira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil
| | - Cristovam Scapulatempo-Neto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil.,Pathology and Molecular Diagnostics Service, Diagnósticos da América-DASA, São Paulo, Brazil
| | - Gisele Caravina de Almeida
- Pathology and Molecular Diagnostics Service, Diagnósticos da América-DASA, São Paulo, Brazil.,Department of Pathology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | - André Lopes Carvalho
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil
| | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil.,Medical School, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ana Carolina de Carvalho
- Molecular Oncology Research Center, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Barretos, SP, 14784-400, Brazil.
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Mulder FJ, Pierssens DDCG, Baijens LWJ, Kremer B, Speel EJM. Evidence for different molecular parameters in head and neck squamous cell carcinoma of nonsmokers and nondrinkers: Systematic review and meta-analysis on HPV, p16, and TP53. Head Neck 2020; 43:303-322. [PMID: 33098216 PMCID: PMC7756438 DOI: 10.1002/hed.26513] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/30/2020] [Accepted: 10/13/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The goal of this review was to present an overview of the currently identified molecular parameters in head and neck squamous cell carcinoma (HNSCC) of nonsmokers and nondrinkers (NSND). METHODS Following the PRISMA guidelines, a systematic search was performed using the electronic databases PubMed, Embase, and Google Scholar. RESULTS Of the 902 analyzed unique studies, 74 were included in a quantitative synthesis and 24 in a meta-analysis. Human papillomavirus (HPV) was reported as a molecular parameter in 38 studies, followed by p16 and TP53 (23 and 14 studies, respectively). The variety of other molecular parameters concerned sporadic findings in small numbers of NSND. CONCLUSIONS HNSCC in NSND is more often related to HPV and p16 overexpression compared to tumors of smokers-drinkers. In a third of virus-negative tumors, TP53 mutations were detected with a mutational profile associated with aging and ultraviolet light exposure rather than to tobacco consumption.
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Affiliation(s)
- Frans J Mulder
- Department of Otorhinolaryngology and Head & Neck Surgery, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Damiana D C G Pierssens
- Department of Oral and Cranio-Maxillofacial Surgery, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Laura W J Baijens
- Department of Otorhinolaryngology and Head & Neck Surgery, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology and Head & Neck Surgery, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Ernst-Jan M Speel
- Department of Pathology, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
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31
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Chen SY, Massa S, Mazul AL, Kallogjeri D, Yaeger L, Jackson RS, Zevallos J, Pipkorn P. The association of smoking and outcomes in HPV-positive oropharyngeal cancer: A systematic review. Am J Otolaryngol 2020; 41:102592. [PMID: 32521295 DOI: 10.1016/j.amjoto.2020.102592] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/06/2020] [Accepted: 05/25/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE While smoking is linked to worse outcomes for human papillomavirus (HPV)-related oropharyngeal squamous cell cancer (OPSCC), the magnitude of this association and the amount of smoking exposure necessary to confer clinically significant differences in outcomes is unclear. Recent studies suggested that greater tobacco exposure results in higher risk of cancer progression and death. Our study objective was to perform a systematic review of the association between smoking and HPV-related OPSCC outcomes. MATERIALS AND METHODS A literature search was conducted in April 2019 to identify relevant articles using Embase, Medline, Scopus, CENTRAL, and Cochrane databases. All studies were independently screened by two investigators to identify studies that assessed HPV-positive patients as an independent cohort, specified smoking measures, and reported locoregional recurrence (LRR), overall survival (OS), disease-specific survival (DSS), or disease-free survival (DFS) in association with smoking. RESULTS Of 1130 studies identified, 10 met final inclusion criteria with 2321 total patients, mean age 57.5 years. Smoking measures included ever vs never, current vs never/former smokers, ≤10 vs >10 pack-year, and continuous pack-years. Of these studies, 8 (80%) showed a significant effect of smoking on increasing recurrence and mortality. Adjusted HRs for LRR ranged from 0.6 to 5.2, OS from 1.3 to 4.0, DSS from 2.3 to 7.2, and DFS from 1.02 to 4.2 among heavier smokers compared to lighter/non-smokers. CONCLUSIONS While there was significant variability in smoking metrics and reported outcomes, all studies reporting statistically significant HRs showed that smoking was associated with worse outcomes. Further studies using uniform smoking measures are necessary to better understand this association.
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Klufah F, Mobaraki G, Chteinberg E, Alharbi RA, Winnepenninckx V, Speel EJM, Rennspiess D, Olde Damink SW, Neumann UP, Kurz AK, Samarska I, zur Hausen A. High Prevalence of Human Polyomavirus 7 in Cholangiocarcinomas and Adjacent Peritumoral Hepatocytes: Preliminary Findings. Microorganisms 2020; 8:microorganisms8081125. [PMID: 32726909 PMCID: PMC7464213 DOI: 10.3390/microorganisms8081125] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/17/2020] [Accepted: 07/23/2020] [Indexed: 02/07/2023] Open
Abstract
Cholangiocarcinoma (CCA) is a rare biliary-duct malignancy with poor prognosis. Recently, the presence of the human polyomavirus 6 (HPyV6) has been reported in the bile of diverse hepatobiliary diseases, particularly in the bile of CCA patients. Here, we investigated the presence of novel HPyVs in CCA tissues using diverse molecular techniques to assess a possible role of HPyVs in CCA. Formalin-Fixed Paraffin-Embedded (FFPE) tissues of 42 CCA patients were included in this study. PCR-based screening for HPyVs was conducted using degenerated and HPyV-specific primers. Following that, we performed FISH, RNA in situ hybridization (RNA-ISH), and immunohistochemistry (IHC) to assess the presence of HPyVs in selected tissues. Of all 42 CCAs, 25 (59%) were positive for one HPyV, while 10 (24%) CCAs were positive for 2 HPyVs simultaneously, and 7 (17%) were negative for HPyVs. Of the total 35 positive CCAs, 19 (45%) were positive for HPyV7, 4 (9%) for HPyV6, 2 (5%) for Merkel cell polyomavirus (MCPyV), 8 (19%) for both HPyV7/MCPyV, and 2 (5%) for both HPyV6/HPyV7 as confirmed by sequencing. The presence of viral nucleic acids was confirmed by specific FISH, while the RNA-ISH confirmed the presence of HPyV6 on the single-cell level. In addition, expression of HPyV7, HPyV6, and MCPyV proteins were confirmed by IHC. Our results strongly indicate that HPyV7, HPyV6, and MCPyV infect bile duct epithelium, hepatocytes, and CCA cells, which possibly suggest an indirect role of these viruses in the etiopathogenesis of CCA. Furthermore, the observed hepatotropism of these novel HPyV, in particular HPyV7, might implicate a role of these viruses in other hepatobiliary diseases.
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Affiliation(s)
- Faisal Klufah
- Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (F.K.); (G.M.); (E.C.); (V.W.); (E.J.M.S.); (D.R.); (I.S.)
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Albaha University, Albaha 65779, Saudi Arabia;
| | - Ghalib Mobaraki
- Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (F.K.); (G.M.); (E.C.); (V.W.); (E.J.M.S.); (D.R.); (I.S.)
- Department of Medical Laboratories Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Emil Chteinberg
- Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (F.K.); (G.M.); (E.C.); (V.W.); (E.J.M.S.); (D.R.); (I.S.)
| | - Raed A. Alharbi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Albaha University, Albaha 65779, Saudi Arabia;
| | - Véronique Winnepenninckx
- Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (F.K.); (G.M.); (E.C.); (V.W.); (E.J.M.S.); (D.R.); (I.S.)
| | - Ernst Jan M. Speel
- Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (F.K.); (G.M.); (E.C.); (V.W.); (E.J.M.S.); (D.R.); (I.S.)
| | - Dorit Rennspiess
- Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (F.K.); (G.M.); (E.C.); (V.W.); (E.J.M.S.); (D.R.); (I.S.)
| | - Steven W. Olde Damink
- Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands; (S.W.O.D.); (U.P.N.)
- Department of General Visceral and Transplantation Surgery, RWTH University Hospital Aachen, 52074 Aachen, Germany
| | - Ulf P. Neumann
- Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands; (S.W.O.D.); (U.P.N.)
- Department of General Visceral and Transplantation Surgery, RWTH University Hospital Aachen, 52074 Aachen, Germany
| | - Anna Kordelia Kurz
- Department of Internal Medicine IV, RWTH Aachen University Hospital, 52074 Aachen, Germany;
| | - Iryna Samarska
- Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (F.K.); (G.M.); (E.C.); (V.W.); (E.J.M.S.); (D.R.); (I.S.)
| | - Axel zur Hausen
- Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University, Medical Centre+, 6229 HX Maastricht, The Netherlands; (F.K.); (G.M.); (E.C.); (V.W.); (E.J.M.S.); (D.R.); (I.S.)
- Correspondence: ; Tel.: +31-433-874-634
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Rahimi S. HPV-related squamous cell carcinoma of oropharynx: a review. J Clin Pathol 2020; 73:624-629. [PMID: 32499224 DOI: 10.1136/jclinpath-2020-206686] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 01/05/2023]
Abstract
In early 1930, R. E. Shope paved the way for the recognition of human papillomavirus (HPV) as a causative agent of some types of cancers. In early 2000, the relationship between HPV and a subset of head and neck cancers, mostly located in the oropharynx, was discovered. In the last 20 years, we have made great progress in the recognition and treatment of HPV-positive head and neck cancers. However, there are still grey areas that leave room to subjective interpretation and need to be addressed. The majority of high risk (HR) HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) shows a 'basaloid' morphology, and despite the variegated morphological spectrum of this malignancy, highlighted by some very recent publications, there is a lack of consensus on a universal morphological classification of HPV-OPSCC. The advent of immunohistochemistry with p16 ink4a (p16) protein made the diagnosis of HPV-related OPSCC more straightforward; currently patients with OPSCC are stratified in p16-positive and p16-negative. Although p16 is an excellent surrogate of HR HPV infection, it is not the direct demonstration of the presence of virus. At present, there is no univocal 'gold-standard' technique for the detection of oncogenic HPV infection. It is well known that HR HPV-related (OPSCC) bear significantly better survival outcome than HPV-negative cases. Consequently, the eighth edition of the American Joint Committee on Cancer and the Union for International Cancer Control now have separate staging systems for these two distinct malignancies. The present review discusses the salient features of HR HPV-driven OPSCC.
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Affiliation(s)
- Siavash Rahimi
- Frontier Pathology-Histopathology, Brighton and Sussex University Hospitals NHS Trust, Brighton, Brighton and Hove, UK .,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, Hampshire, UK
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An Integrated Genomic Strategy to Identify CHRNB4 as a Diagnostic/Prognostic Biomarker for Targeted Therapy in Head and Neck Cancer. Cancers (Basel) 2020; 12:cancers12051324. [PMID: 32455963 PMCID: PMC7281299 DOI: 10.3390/cancers12051324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/19/2020] [Indexed: 12/28/2022] Open
Abstract
Although many studies have shown the association between smoking and the increased incidence and adverse prognosis of head and neck squamous cell carcinoma (HNSCC), the mechanisms and pharmaceutical targets involved remain unclear. Here, we integrated gene expression signatures, genetic alterations, and survival analyses to identify prognostic indicators and therapeutic targets for smoking HNSCC patients, and we discovered that the FDA-approved drug varenicline inhibits the target for cancer cell migration/invasion. We first identified 18 smoking-related and prognostic genes for HNSCC by using RNA-Seq and clinical follow-up data. One of these genes, CHRNB4 (neuronal acetylcholine receptor subunit beta-4), increased the risk of death by approximately threefold in CHRNB4-high expression smokers compared to CHRNB4-low expression smokers (log rank, p = 0.00042; hazard ratio, 2.82; 95% CI, 1.55–5.14), former smokers, and non-smokers. Furthermore, we examined the functional enrichment of co-regulated genes of CHRNB4 and its 246 frequently occurring copy number alterations (CNAs). We found that these genes were involved in promoting angiogenesis, resisting cell death, and sustaining proliferation, and contributed to much worse outcomes for CHRNB4-high patients. Finally, we performed CHRNB4 gene editing and drug inhibition assays, and the results validate these observations. In summary, our study suggests that CHRNB4 is a prognostic indicator for smoking HNSCC patients and provides a potential new therapeutic drug to prevent recurrence or distant metastasis.
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Abstract
Human papillomavirus (HPV) is the most common sexually transmitted pathogen, and high-risk HPVs contribute to 5% of human cancers, including 25% of head and neck squamous cell carcinomas (HNSCCs). Despite the significant role played by HPVs in HNSCC, there is currently no available in vivo system to model the process from papillomavirus infection to virus-induced HNSCC. In this paper, we describe an infection-based HNSCC model, utilizing a mouse papillomavirus (MmuPV1), which naturally infects laboratory mice. Infections of the tongue epithelium of two immunodeficient strains with MmuPV1 caused high-grade squamous dysplasia with early signs of invasive carcinoma over the course of 4 months. When combined with the oral carcinogen 4-nitroquinoline-1-oxide (4NQO), MmuPV1 caused invasive squamous cell carcinoma (SCC) on the tongue of both immunodeficient and immunocompetent mice. These tumors expressed markers of papillomavirus infection and HPV-associated carcinogenesis. This novel preclinical model provides a valuable new means to study how natural papillomavirus infections contribute to HNSCC.IMPORTANCE The species specificity of papillomavirus has limited the development of an infection-based animal model to study HPV-associated head and neck carcinogenesis. Our study presents a novel in vivo model using the mouse papillomavirus MmuPV1 to study papillomavirus-associated head and neck cancer. In our model, MmuPV1 infects and causes lesions in both immunodeficient and genetically immunocompetent strains of mice. These virally induced lesions carry features associated with both HPV infections and HPV-associated carcinogenesis. Combined with previously identified cancer cofactors, MmuPV1 causes invasive squamous cell carcinomas in mice. This model provides opportunities for basic and translational studies of papillomavirus infection-based head and neck disease.
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'Good cancer gone bad': a narrative review of HPV oropharyngeal cancer and potential poor outcomes. Eur Arch Otorhinolaryngol 2020; 277:2185-2191. [PMID: 32333138 DOI: 10.1007/s00405-020-05991-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/15/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Oropharyngeal cancer (OPC) remains a significant health burden and about 15-30% of these have been attributed to the human papillomavirus (HPV). Human papillomavirus-related oropharyngeal cancer (HPV OPC) includes tumours which are detected to be p16INK4A positive or have the HPV DNA detected by in situ hybridisation or polymerase chain reaction. HPV OPC is generally believed to have a relatively good prognosis. More recently, there is a recognised pattern of atypical spread in a highly aggressive subset of HPV OPC. These are HPV OPCs which develop distant metastasis or recurrence. This review raises awareness of this subset of HPV OPC and factors associated with poor outcomes. METHODS A review of the literature available on HPV OPC was carried out. Studies were sourced from PubMed with searching of relevant headings and sub-headings and cross-referencing. RESULTS Factors associated with highly aggressive HPV OPC include nodal stage and nodal morphology, alcohol and tobacco use, age and biological characteristics. Treatment options in cases of disease recurrence include salvage resection radiotherapy and/or chemotherapy and management options vary depending on the nature of recurrence and initial treatment. Recent updates in HPV OPC staging have made staging and treatment of tumours more accurate. CONCLUSION While HPV OPC overall carries a relatively good prognosis, it is important for clinicians to be aware of potentially highly aggressive cases of HPV OPC and to be aware of factors that should prompt close monitoring.
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Visualization of mucosal field in HPV positive and negative oropharyngeal squamous cell carcinomas: combined genomic and radiology based 3D model. Sci Rep 2020; 10:40. [PMID: 31913295 PMCID: PMC6949264 DOI: 10.1038/s41598-019-56429-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/22/2019] [Indexed: 01/24/2023] Open
Abstract
The aim of this study was to visualize the tumor propagation and surrounding mucosal field in radiography-based 3D model for advanced stage HNSCC and combine it with HPV genotyping and miRNA expression characterization of the visualized area. 25 patients with T1-3 clinical stage HNSCC were enrolled in mapping biopsy sampling. Biopsy samples were evaluated for HPV positivity and miR-21-5p, miR-143, miR-155, miR-221-5p expression in Digital Droplet PCR system. Significant miRNA expression differences of HPV positive tumor tissue biopsies were found for miR-21-5p, miR-143 and miR-221-5p compared to the HPV negative tumor biopsy series. Peritumoral mucosa showed patchy pattern alterations of miR-21-5p and miR-155 in HPV positive cases, while gradual change of miR-21-5p and miR-221-5p was seen in HPV negative tumors. In our study we found differences of the miRNA expression patterns among the HPV positive and negative tumorous tissues as well as the surrounding mucosal fields. The CT based 3D models of the cancer field and surrounding mucosal surface can be utilized to improve proper preoperative planning. Complex evaluation of HNSCC tissue organization field can elucidate the clinical and molecular differentiation of HPV positive and negative cases, and enhance effective organ saving therapeutic strategies.
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Lepore S, Lettini G, Condelli V, Sisinni L, Piscazzi A, Simeon V, Zoppoli P, Pedicillo MC, Natalicchio MI, Pietrafesa M, Landriscina M. Comparative Gene Expression Profiling of Tobacco-Associated HPV-Positive versus Negative Oral Squamous Carcinoma Cell Lines. Int J Med Sci 2020; 17:112-124. [PMID: 31929745 PMCID: PMC6945558 DOI: 10.7150/ijms.35133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 11/05/2019] [Indexed: 12/14/2022] Open
Abstract
Background: HPV-positive oral squamous cell carcinomas (OSCCs) are specific biological and clinical entities, characterized by a more favorable prognosis compared to HPV-negative OSCCs and occurring generally in non-smoking and non-drinking younger individuals. However, poor information is available on the molecular and the clinical behavior of HPV-positive oral cancers occurring in smoking/drinking subjects. Thus, this study was designed to compare, at molecular level, two OSCC cell lines, both derived from drinking and smoking individuals and differing for presence/absence of HPV infection. Methods: HPV-negative UPCI-SCC-131 and HPV16-positive UPCI-SCC-154 cell lines were compared by whole genome gene expression profiling and subsequently studied for activation of Wnt/βCatenin signaling pathway by the expression of several Wnt-target genes, βCatenin intracellular localization, stem cell features and miRNA let-7e. Gene expression data were validated in head and neck squamous cell carcinoma (HNSCC) public datasets. Results: Gene expression analysis identified Wnt/βCatenin pathway as the unique signaling pathway more active in HPV-negative compared to HPV-positive OSCC cells and this observation was confirmed upon evaluation of several Wnt-target genes (i.e., Cyclin D1, Cdh1, Cdkn2a, Cd44, Axin2, c-Myc and Tcf1). Interestingly, HPV-negative OSCC cells showed higher levels of total βCatenin and its active form, increase of its nuclear accumulation and more prominent stem cell traits. Furthermore, miRNA let-7e was identified as potential upstream regulator responsible for the downregulation of Wnt/βCatenin signaling cascade since its silencing in UPCI-SCC-154 cell resulted in upregulation of Wnt-target genes. Finally, the analysis of two independent gene expression public datasets of human HNSCC cell lines and tumors confirmed that Wnt/βCatenin pathway is more active in HPV-negative compared to HPV-positive tumors derived from individuals with smoking habit. Conclusions: These data suggest that lack of HPV infection is associated with more prominent activation of Wnt/βCatenin signaling pathway and gain of stem-like traits in tobacco-related OSCCs.
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Affiliation(s)
- Silvia Lepore
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Giacomo Lettini
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Valentina Condelli
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Lorenza Sisinni
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Annamaria Piscazzi
- Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Vittorio Simeon
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
- Medical Statistics Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pietro Zoppoli
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Maria Carmela Pedicillo
- Anatomic Pathology Unit, Department of Clinic and Experimental Medicine; University of Foggia, Italy
| | | | - Michele Pietrafesa
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Matteo Landriscina
- Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
- Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
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Budde MK, Kuhn W, Keyver-Paik MD, Bootz F, Kalff JC, Müller SC, Bieber T, Brossart P, Vatter H, Herrlinger U, Wirtz DC, Schild HH, Kristiansen G, Pietsch T, Aretz S, Geiser F, Radbruch L, Reich RH, Strassburg CP, Skowasch D, Essler M, Ernstmann N, Landsberg J, Funke B, Schmidt-Wolf IGH. A matched-pair analysis on survival and response rates between German and non-German cancer patients treated at a Comprehensive Cancer Center. BMC Cancer 2019; 19:1024. [PMID: 31666035 PMCID: PMC6822384 DOI: 10.1186/s12885-019-6241-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 10/02/2019] [Indexed: 12/14/2022] Open
Abstract
Background Research shows disparities in cancer outcomes by ethnicity or socio-economic status. Therefore, it is the aim of our study to perform a matched-pair analysis which compares the outcome of German and non-German (in the following described as ‘foreign’) cancer patients being treated at the Center for Integrated Oncology (CIO) Köln Bonn at the University Hospital of Bonn between January 2010 and June 2016. Methods During this time, 6314 well-documented patients received a diagnosis of cancer. Out of these patients, 219 patients with foreign nationality could be matched to German patients based on diagnostic and demographic criteria and were included in the study. All of these 438 patients were well characterized concerning survival data (Overall survival, Progression-free survival and Time to progression) and response to treatment. Results No significant differences regarding the patients’ survival and response rates were seen when all German and foreign patients were compared. A subgroup analysis of German and foreign patients with head and neck cancer revealed a significantly longer progression-free survival for the German patients. Differences in response to treatment could not be found in this subgroup analysis. Conclusions In summary, no major differences in survival and response rates of German and foreign cancer patients were revealed in this study. Nevertheless, the differences in progression-free survival, which could be found in the subgroup analysis of patients with head and neck cancer, should lead to further research, especially evaluating the role of infectious diseases like human papillomavirus (HPV) and Epstein-Barr virus (EBV) on carcinogenesis and disease progression.
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Affiliation(s)
- Marie K Budde
- Department of Integrated Oncology, Center for Integrated Oncology (CIO), University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Walther Kuhn
- Department of Gynecology and Obstetrics, University Hospital Bonn, Bonn, Germany
| | | | - Friedrich Bootz
- Department of Otorhinolaryngology, University Hospital of Bonn, Bonn, Germany
| | - Jörg C Kalff
- Department of Surgery, University Hospital of Bonn, Bonn, Germany
| | - Stefan C Müller
- Department of Urology, University Hospital Bonn, Bonn, Germany
| | - Thomas Bieber
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - Peter Brossart
- Department of Internal Medicine III, University Hospital Bonn, Bonn, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - Dieter C Wirtz
- Department of Orthopedic and Trauma Surgery, University Hospital Bonn, Bonn, Germany
| | - Hans H Schild
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | | | - Thorsten Pietsch
- Department of Neuropathology, University Hospital Bonn, Bonn, Germany
| | - Stefan Aretz
- Institute of Human Genetics, University Hospital Bonn, Bonn, Germany
| | - Franziska Geiser
- Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | - Rudolf H Reich
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Bonn, Bonn, Germany
| | | | - Dirk Skowasch
- Department of Internal Medicine II, University Hospital Bonn, Bonn, Germany
| | - Markus Essler
- Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Jennifer Landsberg
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Funke
- Department of Integrated Oncology, Center for Integrated Oncology (CIO), University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Ingo G H Schmidt-Wolf
- Department of Integrated Oncology, Center for Integrated Oncology (CIO), University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
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Aggarwal P, Zaveri JS, Goepfert RP, Shi Q, Du XL, Swartz M, Gunn GB, Lai SY, Fuller CD, Hanna EY, Rosenthal DI, Lewin JS, Piller LB, Hutcheson KA. Symptom Burden Associated With Late Lower Cranial Neuropathy in Long-term Oropharyngeal Cancer Survivors. JAMA Otolaryngol Head Neck Surg 2019; 144:1066-1076. [PMID: 30193299 DOI: 10.1001/jamaoto.2018.1791] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Importance Lower cranial neuropathy (LCNP) is a rare but potentially disabling result of radiotherapy and other head and neck cancer therapies. Survivors who develop late LCNP may experience profound functional impairment, with deficits in swallowing, speech, and voice. Objective To investigate the association of late LCNP with severity of cancer treatment-related symptoms and subsequent general functional impairment among oropharyngeal cancer (OPC) survivors. Design, Setting, and Participants This cross-sectional survey study analyzed 889 OPC survivors nested within a retrospective cohort of OPC survivors treated at MD Anderson Cancer Center from January 1, 2000, to December 31, 2013. Eligible survey participants were disease free and completed OPC treatment 1 year or more before the survey. Data analysis was performed from October 10, 2017, to March 15, 2018. Exposures Late LCNP defined by onset 3 months or more after cancer therapy. Main Outcomes and Measures The primary outcome variable was the mean of the top 5 most severely scored symptoms of all 22 core and head and neck cancer-specific symptoms from the MD Anderson Symptom Inventory Head and Neck Cancer Module (MDASI-HN). Secondary outcomes included mean MDASI-HN interference scores and single-item scores of the most severe symptoms. Multivariate models regressed MDASI-HN scores on late LCNP status, adjusting for clinical covariates. Results Overall, 36 of 889 OPC survivors (4.0%) (753 [84.7%] male; 821 [92.4%] white; median [range] age, 56 [32-84] years; median [range] survival time, 7 [1-16] years) developed late LCNP. Late LCNP was significantly associated with worse mean top 5 MDASI-HN symptom scores (coefficient, 1.54; 95% CI, 0.82-2.26), adjusting for age, survival time, sex, therapeutic modality, T stage, subsite, type of radiotherapy, smoking, and normal diet before treatment. Late LCNP was also significantly associated with single-item scores for difficulty swallowing or chewing (coefficient, 2.25; 95% CI, 1.33-3.18), mucus (coefficient, 1.97; 95% CI, 1.03-2.91), fatigue (coefficient, 1.35; 95% CI, 0.40-2.21), choking (coefficient, 1.53; 95% CI, 0.65-2.41), and voice or speech symptoms (coefficient, 2.30; 95% CI, 1.60-3.03) in multivariable models. Late LCNP was not significantly associated with mean interference scores after correction for multiple comparisons (mean interference coefficient, 0.72; 95% CI, 0.09-1.35). Conclusions and Relevance In this large survey study, OPC survivors with late LCNP reported worse cancer treatment-related symptoms, a finding suggesting an association between late LCNP and symptom burden. This research may inform the development and implementation of strategies for LCNP surveillance and management.
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Affiliation(s)
- Puja Aggarwal
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston.,Division of Epidemiology & Disease Control, School of Public Health, The University of Texas, Houston
| | - Jhankruti S Zaveri
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston
| | - Qiuling Shi
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston
| | - Xianglin L Du
- Division of Epidemiology & Disease Control, School of Public Health, The University of Texas, Houston
| | - Michael Swartz
- Division of Epidemiology & Disease Control, School of Public Health, The University of Texas, Houston
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston
| | - C David Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Jan S Lewin
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston
| | - Linda B Piller
- Division of Epidemiology & Disease Control, School of Public Health, The University of Texas, Houston
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston
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Basheeth N, Patil N. Biomarkers in Head and Neck Cancer an Update. Indian J Otolaryngol Head Neck Surg 2019; 71:1002-1011. [PMID: 31742110 PMCID: PMC6848420 DOI: 10.1007/s12070-019-01683-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/04/2019] [Indexed: 12/30/2022] Open
Abstract
The study is aimed at establishing the purpose of tumour markers, their application, classification, diagnostic and therapeutic roles in the management of head and neck cancer. A literature review using Medline, Scopus, Google Scholar, the Cochrane Database of Systematic Reviews and the Cochrane central register of controlled trials for articles published between 1993 and 2016 on tumour markers and their role in head and neck cancer was performed. A broader search of prognostic markers in head and neck cancer was also carried out to avoid missing other pertinent markers. Natural history, tumour biology, stage and prognostic factors influence the outcome of management in patients with Head and Neck Squamous cell carcinoma (HNSCC). Evaluation of the cellular lineage and histogenic origin of diverse neoplasms can be done using tumour biomarkers. Identifying predictive tumour markers can lead to improvement in preventive management of HNSCC. There has been remarkable advancement in molecular technology with gene expression and proteomic profiling. Integration of specific tumour markers into routine clinical practice requires substantiation through well designed clinical trials. The investigation of tumour markers is imperative as they influence the prognosis of HNSCC and provide the potential to improve outcomes of treatment through targeted therapy. We have outlined recent tumour biomarkers in this review which have significant role in diagnosis, screening and prognostication in HNSCC. Recent advancement in clinical applications, therapeutic strategies of tumour markers has been highlighted.
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Affiliation(s)
- Naveed Basheeth
- Otolaryngology and Head and Neck Surgery, Royal College of Surgeons in Ireland, 123 St.Stephens Green, Dublin-2, Ireland
| | - Naishadh Patil
- Otolaryngology and Head and Neck Surgery, Sligo University Hospital, Sligo, Ireland
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Tumour Cell Anaplasia and Multinucleation as Prognosticators in Oropharyngeal Squamous Cell Carcinoma. Head Neck Pathol 2019; 14:606-615. [PMID: 31552619 PMCID: PMC7413948 DOI: 10.1007/s12105-019-01081-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 09/16/2019] [Indexed: 01/23/2023]
Abstract
Human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCC) tend to have good outcomes, however a subset does not share this favourable prognosis. The aim of this paper is to investigate the utility of tumour cell anaplasia and multinucleation as prognostic markers in oropharyngeal squamous cell carcinoma. Retrospective review of 104 patients with OPSCC or squamous cell carcinoma of unknown primary site (SCCUP) who underwent primary resection and/or lymph node dissection. Slides of both primary and nodal metastatic disease were assessed for the presence of anaplasia and multinucleation. 53 patients were HPV-positive. Anaplasia was more frequent in males (p = 0.005), smokers (p = 0.003), and HPV-negative disease (p = 0.04). HPV status and > 10 pack-year smoking history were independent predictors of recurrence-free survival (RFS) and disease-specific survival (DSS). Neither anaplasia, nor multinucleation, at the primary site or in cervical metastases, had any significant impact on RFS or DSS. We did not find either anaplasia or multinucleation to have any significant prognostic impact in OPSCC. However, given the small number of adverse events in the HPV-positive cohort, we may have lacked sufficient power to detect significance in what was the subgroup of primary interest. Our study highlights the challenge of identifying markers of poor prognosis in HPV-positive OPSCC.
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Grønhøj C, Jensen JS, Wagner S, Dehlendorff C, Friborg J, Andersen E, Wittekindt C, Würdemann N, Sharma SJ, Gattenlöhner S, Klussmann JP, von Buchwald C. Impact on survival of tobacco smoking for cases with oropharyngeal squamous cell carcinoma and known human papillomavirus and p16-status: a multicenter retrospective study. Oncotarget 2019; 10:4655-4663. [PMID: 31384393 PMCID: PMC6659794 DOI: 10.18632/oncotarget.27079] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/29/2019] [Indexed: 12/26/2022] Open
Abstract
Background Human papilloma virus (HPV) and tobacco smoking are important risk factors for development of oropharyngeal squamous cell carcinoma (OPSCC). Aims/objectives To evaluate the impact of tobacco smoking on survival for cases with OPSCC with known HPV- and p16INK4A(p16)-status. Materials and Methods OPSCC cases at the University Hospital of Copenhagen, Rigshospitalet, Denmark (2000–2014) and at University Hospital of Giessen, Germany (2000–2009) were included. Survival was illustrated with Kaplan-Meier plots. The effect of smoking exposure on survival was evaluated by Cox-regression models. HPV-positivity was defined as positivity for both HPV-DNA and p16. Results We included 1316 OPSCC cases from 2000–2014 (48% HPV-positive). Smokers had a poorer outcome compared to non-smokers. Considering continuous smoking exposure, adding 10 pack-years of smoking increased hazard ratios irrespective of HPV-status. We observed a tendency to a greater impact on survival for cases with HPV-neg. tumours compared to cases with HPV-pos. tumours at low numbers of pack-years, yet the survival was similar at high numbers of pack-years. There was no significant difference in the impact of HPV-status on survival for non-smokers, however a highly significant difference for smokers. Conclusions and Significance Smoking-status and number of pack-years at time of diagnosis impact survival for cases with OPSCC independent of HPV-status.
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Affiliation(s)
- Christian Grønhøj
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Schmidt Jensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Wagner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Christian Dehlendorff
- Department of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jeppe Friborg
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elo Andersen
- Department of Oncology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus Wittekindt
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Nora Würdemann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Shachi Jenny Sharma
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | | | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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44
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Ren J, Xu W, Su J, Ren X, Cheng D, Chen Z, Bender N, Mirshams M, Habbous S, de Almeida JR, Perez-Ordonez B, Goldstein DP, Wang JR, Bratman SV, Huang SH, Jang R, Zhao Y, Waterboer T, Hung RJ, Liu G. Multiple imputation and clinico-serological models to predict human papillomavirus status in oropharyngeal carcinoma: An alternative when tissue is unavailable. Int J Cancer 2019; 146:2166-2174. [PMID: 31269236 DOI: 10.1002/ijc.32548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/28/2019] [Accepted: 02/12/2019] [Indexed: 02/05/2023]
Abstract
In cancer epidemiological studies, determination of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) typically depends on the availability of tumor tissue testing, and/or tumor tissue access. Identifying alternative methods for estimating HPV status can improve the quality of such studies when tissue is unavailable. We developed multiple predictive models for tumor HPV status and prognosis by combining both clinico-epidemiological variables and either serological multiplex assays of HPV or multiple imputation of HPV status (HPVmi ). Sensitivity, specificity and accuracy of these methods compared to either p16 immunostaining (p16 IHC) or survival were assessed. When compared to a reference of tumor tissue p16 IHC in 783 OPSCC patients, the clinic-HPVsero model incorporating a composite of 20 HPV serological antibodies (HPVsero ) and 4 clinical factors (c-index: 0.96) performed better than using HPVsero (c-index: 0.92) or HPVmi (c-index: 0.76) alone. However, the model that contained a single HPV16 E6 antibody combined with four clinical variables, performed extremely well (clinic-s1-16E6; c-index: 0.95). When defining HPV status by HPVsero , s1-16E6, HPVmi or through p16 IHC, each of these definitions demonstrated improved overall and disease-free survival in HPV-positive OPSCC patients, when compared to HPV-negative patients (adjusted hazard ratios between 0.25 and 0.63). Our study demonstrates that when blood samples are available, a model that utilizes a single s1-16E6 antibody combined with several clinical features has excellent test performance characteristics to estimate HPV status and prognosis. When neither blood nor tumor tissue is available, multiple imputation, calibrated on local population characteristics, remains a viable, but suboptimal option.
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Affiliation(s)
- Jianjun Ren
- Department of Otolaryngology - Head and Neck Surgery, and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.,Medical Biophysics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Jie Su
- Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Xue Ren
- Department of Economic Statistics, School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, China
| | - Dangxiao Cheng
- Medical Biophysics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Zhuo Chen
- Medical Biophysics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Noemi Bender
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Maryam Mirshams
- Medical Biophysics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Steven Habbous
- Medical Biophysics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - John R de Almeida
- Department of Otolaryngology- Head and Neck Surgery, Princess Margaret Cancer Centre - University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Bayardo Perez-Ordonez
- Department of Laboratory Medicine and Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David P Goldstein
- Department of Otolaryngology- Head and Neck Surgery, Princess Margaret Cancer Centre - University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer R Wang
- Department of Otolaryngology- Head and Neck Surgery, Princess Margaret Cancer Centre - University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Scott V Bratman
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Shao Hui Huang
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Raymond Jang
- Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Yu Zhao
- Department of Otolaryngology - Head and Neck Surgery, and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rayjean J Hung
- Prosserman Centre for Population Health Research, Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Geoffrey Liu
- Medical Biophysics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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45
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Yang Z, Gomez‐Fernandez C, Lora Gonzalez M, Esebua M, Kerr DA. HPV testing through p16 immunocytochemistry in neck‐mass FNA and its correlation with tissue samples. Cancer Cytopathol 2019; 127:458-464. [DOI: 10.1002/cncy.22156] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/05/2019] [Accepted: 04/09/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Zhongbo Yang
- Department of Pathology University of Miami Hospital/Jackson Memorial Hospital Miami Florida
| | - Carmen Gomez‐Fernandez
- Department of Pathology University of Miami Hospital/Jackson Memorial Hospital Miami Florida
| | - Manuel Lora Gonzalez
- Department of Pathology University of Miami Hospital/Jackson Memorial Hospital Miami Florida
| | - Magda Esebua
- Department of Pathology University of Missouri Columbia Missouri
| | - Darcy A. Kerr
- Department of Pathology University of Miami Hospital/Jackson Memorial Hospital Miami Florida
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46
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Villepelet A, Hugonin S, Atallah S, Job B, Baujat B, Lacau St Guily J, Lacave R. Effects of tobacco abuse on major chromosomal instability in human papilloma virus 16-positive oropharyngeal squamous cell carcinoma. Int J Oncol 2019; 55:527-535. [PMID: 31268157 DOI: 10.3892/ijo.2019.4826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/31/2019] [Indexed: 11/05/2022] Open
Abstract
A substantial number of patients with oropharyngeal squamous cell carcinoma (OPSCC) have two oncogenic risk factors: Human papilloma virus (HPV) infection and tobacco use. These factors can be competitive or synergistic at the chromosomal and genomic levels, with strong prognostic and therapeutic implications. HPV16 has been shown in vitro to be a high‑risk HPV that induces low rates of chromosomal copy number alterations. However, chromosomal instability can be increased by smoking. Evaluating chromosomal instability in HPV‑positive patients according to their smoking status is therefore critical for assessing the prognosis and therapeutic impact. The aim of this study was to assess chromosomal instability in patients with HPV‑positive OPSCC according to smoking status. Chromosomal instability was investigated with array‑based comparative genomic hybridization (aCGH) in 50 patients with OPSCC. Differences in chromosomal alterations were examined according to the HPV and smoking status of the patients. HPV‑positive tumors (24/26 were HPV16‑positive) had fewer genomic aberrations (P=0.0082) and fewer breakpoints (P=0.048) than HPV‑negative tumors. We confirmed the association between HPV‑positive OPSCC and chromosomal losses at 11q. We verified the association between HPV‑negative OPSCC and losses at 3p and 9p and gains at 7q and 11q13. In the patients with OPSCC who were HPV‑positive, the total number of chromosomal aberrations per tumor was significantly higher in the group of patients who were smokers (P=0.003). However, the cytobands did not differ significantly according to the smoking status. On the whole, the data of this study may help to improve the stratification of HPV‑positive OPSCC patients and must be supplemented by next‑generation sequencing studies in order to describe the mutational and transcriptomic profiles of such patients according to smoking status.
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Affiliation(s)
- Aude Villepelet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France
| | - Sylvain Hugonin
- Assistance Publique-Hôpitaux de Paris (AP-HP), Tumors Genomic Unit, Tenon Hospital, 75020 Paris, France
| | - Sarah Atallah
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France
| | - Bastien Job
- INSERM US23, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Bertrand Baujat
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France
| | - Jean Lacau St Guily
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France
| | - Roger Lacave
- Faculty of Medicine, Sorbonne University, GRC10, 75013 Paris, France
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47
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Christensen JT, Grønhøj C, Zamani M, Brask J, Kjær EKR, Lajer H, von Buchwald C. Association between oropharyngeal cancers with known HPV and p16 status and cervical intraepithelial neoplasia: a Danish population-based study. Acta Oncol 2019; 58:267-272. [PMID: 30626248 DOI: 10.1080/0284186x.2018.1546059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Persistent infection with high-risk genotypes of human papillomavirus (HPV) is the main risk factor in the development of uterine cervical precancerous lesions and cervical cancer (CC), and cases of HPV-induced oropharyngeal squamous cell carcinoma (OPSCC) is increasing in the Western world. We investigated the association between HPV and p16 status and previous results of cervical examinations, including cytological and histological tests, in females with OPSCC. MATERIAL AND METHODS We included females diagnosed with an OPSCC in Eastern Denmark from 2000 to 2014. OPSCCs were assessed for p16-overexpression and HPV DNA PCR. History of cervical tests was obtained from the Danish Pathology Registry. The cytology and histological results were categorized in accordance with the 2014 Bethesda System (TBS) and WHO. Hence, we divide the cervical results into two groups. Group I were negative for intraepithelial lesion or malignancy and group II had epithelial cell abnormalities and subdivided after increasingly neoplastic severity from A-D. Chi2-tests and Fischer's exact tests were performed to compare the two groups. RESULTS A total of 417 women with OPSCC were identified; 203 with HPV-positive tumors (49%) of which cervical cytology or histology were available in 172 women (85%). Among these, 22 (13%) patients had a cervical history of ≥ IIC. A total of 171 out of 214 women in the HPV-negative group (80%) were examined with cytology and 17 had a history of ≥ IIC. No significant difference in diagnoses of (pre)cancerous lesions between the OPSCC HPV-positive and negative groups were observed (χ2 test p = .28, Fischer's exact test p = .29). CONCLUSION HPV status in oropharyngeal tumors was not correlated with a history of ≥ IIC in cervical examinations. The effect on cervical dysplasia may be masked by a higher incidence of smoking among the OPSCC HPV-negative group.
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Affiliation(s)
- Julie T. Christensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian Grønhøj
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Martin Zamani
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Julie Brask
- Department of Pathology, Rigshospitalet University of Copenhagen, Copenhagen, Denmark
| | - Eva K. R. Kjær
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Lajer
- Department of Gynocology, Rigshospitalet University of Copenhagen, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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48
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Geiger JL, Ku JA. Postoperative Treatment of Oropharyngeal Cancer in the Era of Human Papillomavirus. Curr Treat Options Oncol 2019; 20:20. [DOI: 10.1007/s11864-019-0620-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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49
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HPV-driven oropharyngeal squamous cell cancer in Croatia - Demography and survival. PLoS One 2019; 14:e0211577. [PMID: 30707715 PMCID: PMC6358070 DOI: 10.1371/journal.pone.0211577] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/16/2019] [Indexed: 02/06/2023] Open
Abstract
Objectives Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Main HNSCC risk factors are tobacco, alcohol, and high-risk human papillomavirus (HPV). HPV+ oropharyngeal squamous cell cancer (OPSCC) usually have different etiology, increasing incidence and often show an improved survival when compared to HPV-negative cases. The objective of the current study was to retrospectively examine the influence of HPV on the survival of OPSCC patients in a non-Western population setting. Materials and methods We determined the presence of HPV DNA and/or RNA in 99 formalin-fixed paraffin embedded (FFPE) tissue samples of OPSCC patients treated between 2002 and 2015. Patients were compared based on laboratory, demographic, clinical, life style characteristics and survival. Results HPV RNA was found in 29.3% cases. However, groups based on HPV data (either RNA, DNA or retrospectively collected p16 staining) did not show significant differences. Overall, 5-year survival was 30% with minimal influence of the HPV positivity. Conclusions The HPV influence on survival of OPSCC patients is not identical between populations probably due to other factors overshadowing the HPV effect. This should be taken into account when treatment or policy decisions are made in each particular setting.
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50
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Ghasemi F, Prokopec SD, MacNeil D, Mundi N, Gameiro SF, Howlett C, Stecho W, Plantinga P, Pinto N, Ruicci KM, Khan MI, Yoo J, Fung K, Sahovaler A, Palma DA, Winquist E, Mymryk JS, Barrett JW, Boutros PC, Nichols AC. Mutational analysis of head and neck squamous cell carcinoma stratified by smoking status. JCI Insight 2019; 4:123443. [PMID: 30626742 DOI: 10.1172/jci.insight.123443] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/20/2018] [Indexed: 12/14/2022] Open
Abstract
Smoking has historically been recognized as a negative prognostic factor in head and neck squamous cell carcinoma (HNSCC). This study aimed to assess the mutational differences between heavy smokers (>20 pack years) and never smokers among the HNSCC patients within The Cancer Genome Atlas (TCGA). Single nucleotide variation and copy number aberration differences between heavy smokers and never smokers were compared within human papillomavirus-positive (HPV-positive) (n = 67) and HPV-negative (n = 431) TCGA cohorts with HNSCC, and the impact of these mutations on survival were assessed. No genes were differentially mutated between smoking and never-smoking patients with HPV-positive tumors. By contrast, in HPV-negative tumors, NSD1 and COL1A11 were found to be more frequently mutated in heavy smokers, while CASP8 was more frequently altered in never smokers. HPV-negative patients with NSD1 mutations experienced significantly improved overall survival compared with NSD1 WT patients. This improved prognosis was validated in an independent cohort of 77 oral cavity cancer patients and a meta-analysis that included 2 additional data sets (688 total patients, hazard ratio for death 0.44, 95% CI, 0.30-0.65). NSD1 mutations are more common in HPV-negative heavy smokers, define a cohort with favorable prognosis, and may represent a clinically useful biomarker to guide treatment deintensification for HPV-negative patients.
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Affiliation(s)
- Farhad Ghasemi
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | | | - Danielle MacNeil
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.,Department of Oncology
| | - Neil Mundi
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | | | - Christopher Howlett
- Department of Pathology University of Western Ontario, London, Ontario, Canada
| | - William Stecho
- Department of Pathology University of Western Ontario, London, Ontario, Canada
| | - Paul Plantinga
- Department of Pathology University of Western Ontario, London, Ontario, Canada
| | - Nicole Pinto
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.,Department of Oncology
| | - Kara M Ruicci
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.,Department of Oncology
| | - Mohammed Imran Khan
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | - John Yoo
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.,Department of Oncology
| | - Kevin Fung
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.,Department of Oncology
| | - Axel Sahovaler
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | | | | | - Joe S Mymryk
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.,Department of Oncology.,Department of Microbiology & Immunology, and
| | - John W Barrett
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.,Department of Oncology
| | - Paul C Boutros
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada.,Department of Medical Biophysics and.,Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Anthony C Nichols
- Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.,Department of Oncology
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