Laryngeal cancer and passive smoking: the neglected factor?

Gender-related incidence, risk factors exposure and survival rates of laryngeal cancers - the 10-years analysis of trends from one institution

OBJECTIVES

The aim of the study was the analysis of the epidemiology of laryngeal cancer over 10 years in relation to known risk factors and to assess the current survival rates in this group of patients.

METHODS

The data were retrospectively collected from patients' medical records, then entered in the database using dedicated software and a statistical analysis was performed.

RESULTS

512 subjects - 443 men (86.5%) and 69 women (13.5%) were enrolled into the study. The male-to-female ratio was 6.4:1. There were 97.1% smoking women and 98% smoking men, however the history of more than 20 cigarettes per day smoking admitted 81.1 % of women and 94.6% of men. Heavy alcohol consumption was the case in 14 (20.3%) women and in 307 (69.3%) men. For both the size of heavy alcohol consumption and the size of excessive tobacco use, there was found statistically significant difference between women and men with laryngeal cancer (p<0.05). In the majority of male and female subjects, the tumour was located in the supraglottis/glottis area. Apparently this tumour location was much more common among women, accounting for 60.9% of cases , while in men was confirmed in 39.3% of cases. The stages of the laryngeal cancer were similarly of high advancement for both the men and women - stages III and IV were confirmed in 82.6% of women and in 77.6% of men. The over 5-year survival rate was 39.1% among women and 37.2% among men. Conclusions Contradictory to decreased exposure to risk factors and the shorter period for diagnosis, the higher stages of cancer were observed in women. Although in women the advancement was higher and the majority of cases were located in unfavourable supraglottic area, the survival rates were higher. Key words: laryngeal cancer, epidemiology, men and women, risk factors.

Association of genetic polymorphisms with laryngeal carcinoma prognosis in a Chinese population

We analyzed the effects of single-nucleotide polymorphisms (SNPs) on laryngeal carcinoma (LC) risk and overall survival (OS) in 170 Chinese male LC patients followed for 10 years. After assessment of clinical characteristics (age, laryngectomy, neck dissection, tumor differentiation, TNM status), the patients were genotyped for 24 SNPs associated with risk in multiple cancers. LC risk was assessed using log-rank test and Cox proportional hazard models. The median OS time was 48 months. By the follow-up deadline, OS was 41.2%. Kaplan-Meier analysis indicated 1-, 3-, and 5-year survival rates to be 84.7%, 57.2%, and 47.1%, respectively. Five LC clinicopathological characteristics, namely total laryngectomy (TL), low differentiation (LD), T3-T4, N1-N2, and clinical stage III-IV were associated with worse OS (HR: 2.35, p < 0.001; HR: 2.39, p = 0.02; HR: 2.17, p < 0.001; HR: 2.39, p < 0.001; and HR: 3.29, p < 0.001, respectively). Univariate cox regression analysis indicated that four SNPs were associated (p < 0.05) with LC OS in the codominant genetic model compared to patients with the homozygous wild-type genotype: rs10088262 G/A (HR = 1.57), rs1665650 A/G (HR = 0.65); rs3802842 C/C (HR = 2.18), and rs59336 T/A and T/T (HR = 0.61 and 2.61, respectively).

A risk factor-based model for upper aerodigestive tract cancers in India: predicting and validating the receiver operating characteristic curve

BACKGROUND

A study was conducted to develop and validate a screening model using risk scores to identify individuals at high risk for developing upper aerodigestive tract (UADT) cancers in an Indian population.

METHODS

A hospital-based case-control study (n = 480) was conducted in Pune, India. We assessed risk factors for UADT cancers by administering a questionnaire through face-to-face interviews. We developed a risk factor model based on the statistically significant risk factors in multiple logistic regression. A total, single risk score was calculated per individual based on the adjusted odds ratio for each of their risk factors. Standard receiver operator characteristic curve was plotted for the total score and the presence of UADT cancers. The stratification ability of the model was determined using the c-statistic. The optimal criterion value was determined at the point on curve at which the Youden's index was maximal. Confidence intervals were calculated by bootstrapping.

RESULTS

Total risk score for each individual ranged from 0 to 26. Area under the receiver operating characteristic curve (95.8; P < 0.001) suggests strong predictive ability. A risk score criterion value of ≤10 produced optimal sensitivity (93.5%), specificity (71.1%), false-positive rate (28.8%), false-negative rate (6.4%), positive predictive value (74.8%), and negative predictive value (96.6%).

CONCLUSION

This risk factor-based model has the potential of satisfactorily screening and detection of UADT cancers at its early stage in a high-risk population like India. The identified at-risk individuals can then be targeted for clinical examination and for focused preventive/treatment measures at the hospital.

MicroRNA-133a suppresses the proliferation, migration, and invasion of laryngeal carcinoma cells by targeting CD47

The study aims to investigate the possible mechanisms of microRNA-133a (miR-133a) targeting CD47 on cell proliferation, apoptosis, migration, and invasion in laryngeal carcinoma. Forty-two laryngeal carcinoma tissue specimens confirmed by pathological examination from laryngeal carcinoma patients as the case group were collected, and 20 chronic laryngitis tissues were gathered as the control group. The human laryngeal carcinoma cell line Hep-2 was marked as the miR-133a mimic, negative control (NC), miR-133a inhibitor, CD47-siRNA, miR-133a inhibitor + CD47-siRNA, and Mock groups. The expression of CD47 protein and miR-133a was detected by immunohistochemistry (IHC) and qRT-PCR. Dual luciferase assay system was used to determine the relationship between CD47 and miR-133a. Western blotting was used to measure the protein expression of CD47 and miR-133a. 5-Ethynyl-2'-deoxyuridine (EDU) method was used to detect the cell proliferation, and flow cytometry and Transwell were used to measure the cell apoptosis and migration and invasion, respectively. The miR-133a expression in laryngeal carcinoma tissues was significantly lower, while the CD47 expression was higher than that in chronic laryngitis tissues (both P < 0.01). The expression of miR-133a in the miR-133a mimic group was significantly higher than that in other groups (P < 0.05), and the messenger RNA (mRNA) and protein expression of CD47 in the CD47-siRNA and miR-133a mimic groups were significantly lower than those in the Mock and NC group (all P < 0.05), while the mRNA and protein expression of CD47 in the miR-133a inhibitor group were higher than in other groups (all P < 0.05). After transfection, the CD47-siRNA group had the strongest inhibitory activity, while the number of living cells in the miR-133a inhibitor group was significantly higher than that in other groups (all P < 0.05). The apoptosis rates in the miR-133a mimic and CD47-siRNA groups were significantly higher than that in the Mock and NC groups (all P < 0.05). The cell numbers that penetrated membrane in the miR-133a mimic and CD47-siRNA groups were less than in the Mock and NC groups (all P < 0.05). Upregulated miR-133a could inhibit proliferation, invasion, and migration and promote cell apoptosis in laryngeal carcinoma by targeting CD47. miR-133a targeting CD47 could be a new direction in the diagnosis and treatment of laryngeal carcinoma.

Independent and joint exposure to passive smoking and cooking oil fumes on oral cancer in Chinese women: a hospital-based case-control study

CONCLUSIONS

Passive smoking and COF exposure are independent risk factors for oral cancer in Chinese women, with the multiplicative interactions from combined exposures. Avoiding exposure to environmental tobacco smoke and COF may contribute to the prevention of oral cancer in Chinese women.

OBJECTIVE

To evaluate the independent and joint effects of passive smoking and cooking oil fumes (COF) on oral cancer in Chinese women.

METHODS

A case-control study was performed including 238 female patients with pathologically confirmed oral cancer and 470 controls as age-matched controls. Face-to-face interviews were conducted based on a structured questionnaire. The effects of passive smoking and COF exposure were analyzed using non-conditional logistic regression models.

RESULTS

Passive smoking significantly increased the risk of oral cancer in Chinese women: adjusted ORs were 2.12 (95% CI = 1.11-4.07) for those only exposed before age 18, 1.52 (95% CI = 1.01-2.31) for those only exposed after age 18, and 2.38 (95% CI = 1.47-3.85) for those both exposed before and after age 18. In addition, COF exposure was significantly associated with a risk of oral cancer (adjusted ORs were 1.69 (95% CI = 1.03-2.78) for light exposure and 2.06 (95% CI = 1.21-3.50) for heavy exposure). Furthermore, there was a significantly multiplicative interaction between passive smoking and COF for oral cancer.

Treatment and predictive factors in patients with recurrent laryngeal carcinoma: A retrospective study

The aim of the present retrospective analysis was to evaluate the treatment results for recurrent laryngeal cancer and to analyze the factors that may affect survival. A retrospective review was performed in 309 patients with recurrent laryngeal carcinoma, 224 of whom were treated between 1996 and 2009 at Sun Yat-Sen University Cancer Center (Guangzhou, Guangdong, China) and 85 of whom were treated between 2006 and 2013 at Zhejiang Cancer Hospital (Hangzhou, Zhejiang, China). The Kaplan-Meier method with the log-rank computation was used for the analysis of survival. The Cox proportional hazards model was applied to identify covariates that were significantly associated with overall survival. The actuarial 3-, 5- and 10-year survival rates were 68.9, 53.6 and 35.7%, respectively. Univariate analysis indicated that the following factors were associated with survival: Age, smoking index, tumor grade, primary tumor site, nodal status of the primary tumor, initial T stage, initial Union for International Cancer Control stage, initial treatment (radiotherapy or chemotherapy), disease-free interval, eligibility for surgery and extent of recurrence. Multivariate analysis of these factors indicated that the initial T stage, tumor grade, nodal status, disease-free interval and eligibility for surgery were significantly associated with survival. Overall, these results indicate that initial tumor stage T1 or T2, a high differentiation rate, no initial cervical lymph node metastasis, a long disease-free interval and a strong indication for salvage surgery are good prognostic factors for the survival of patients with recurrent laryngeal carcinoma.

In vitro biological characterization of DCUN1D5 in DNA damage response

BACKGROUND

Novel prognostic biomarkers or therapeutic molecular targets for laryngeal squamous cell carcinoma (LSCC) are an urgent priority. We here sought to identify multiple novel LSCC-associated genes.

METHODS

Using high-density microarray expression profiling, we identified multiple genes that were significantly altered between human LSCCs and paired normal tissues. Potential oncogenic functions of one such gene, DCUN1D5, were further characterized in vitro.

RESULTS

Our results demonstrated that DCUN1D5 was highly expressed in LSCCs. Overexpression of DCUN1D5 in vitro resulted in 2.7-fold increased cellular migration, 67.5% increased invasive capacity, and 2.6-fold increased proliferation. Endogenous DCUN1D5 expression was decreased in a time-dependent manner after genotoxic stress, and silencing of DCUN1D5 by siRNA decreased the number of cells in the S phase by 10.2% and increased apoptosis by 11.7%.

CONCLUSION

Our data suggest that DCUN1D5 in vitro might have vital roles in DNA damage response, but further studies are warranted to assess its significance in vivo.

Helicobacter pylori infection of the larynx may be an emerging risk factor for laryngeal squamous cell carcinoma

INTRODUCTION

Several studies have implicated Helicobacter pylori as a risk factor in laryngeal cancer, but other studies disagree. It is fundamental that the relationship between Helicobacter pylori and laryngeal cancer be verified in order to provide evidence of ways to prevent the initiation and development of this carcinoma.

MATERIALS AND METHODS

In total, 81 patients with laryngeal squamous cell carcinoma and 75 control subjects were enrolled in a case-control study. Semi-nested polymerase chain reaction techniques were applied to detect Helicobacter pylori in the laryngeal mucosa and enzyme-linked immunosorbent assays were used to detect serum antibodies against Helicobacter pylori. Risk factors associated with laryngeal carcinoma were analyzed using logistic regression models.

RESULTS

The presence of Helicobacter pylori in the larynx was higher in patients with laryngeal cancer than in control subjects (71.6 vs. 25.3 %, p < 0.001). Among patients with laryngeal carcinoma, rates of Helicobacter pylori infection were higher in normal laryngeal tissues than in tumor tissues. After adjusting for confounding factors, regression analysis indicated that the microbe was an independent risk factor for laryngeal cancer (OR = 7.15, 95 % CI [3.29, 15.53], p < 0.001).

CONCLUSIONS

This study suggests that Helicobacter pylori is present in the mucosa of the larynx. The microorganism may be an independent risk factor for laryngeal squamous cell carcinoma. The laryngeal mucosa thus provides a reservoir for the bacteria possibly, and is a likely staging place for its transmission to other areas.

Does passive smoking have an effect on nasal mucociliary clearance?

OBJECTIVE

The aim of this study is to review the literature about nasal mucociliary clearance (MCC) and passive smoking in otorhinolaryngology by clearly explaining their relationship in a cross-sectional study.

STUDY DESIGN AND SETTING

This cross-sectional study was conducted at the Umraniye Education and Research Hospital in Turkey. Umraniye Education and Research Hospital Ethical Committee approved the study, and informed consents of the patients were obtained.

METHODS

Our study consisted of patients who presented to the Ear-Nose-Throat Department of Istanbul Umraniye Education and Research Hospital between February 2011 and July 2011. Three groups of subjects were evaluated: 15 passive smokers (group 1), 17 active smokers (group 2), and 15 healthy matched controls (group 3). All patients were asked to answer our questions regarding their smoking history, and nasal MCC time was assessed for all individuals of the 3 groups.

RESULTS

The mean MCC value was 23.59 ± 12.41 in the smoking group, 12.6 ± 4.67 in the passive smoking group, and 6.4 ± 1.55 in the healthy group. The comparison of MCC values between the smoking group and passive smoking group and between the smoking group and healthy group revealed statistically significant differences (P < .01). There was also a significant difference between the MCC values of the passive smoking group and the healthy group (P < .01). In addition, we compared MCC values according to exposure number of cigarettes.

CONCLUSION

In this study, we conclude that passive smoking affects nasal MCC. Both active and passive smoking increases nasal MCC time when compared with healthy controls.