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Uchida S, Hiraoka SI, Kawamura K, Sakamoto K, Akiyama R, Tanaka S. Machine Learning Analysis of Gaze Data for Enhanced Precision in Diagnosing Oral Mucosal Diseases. J Clin Med 2023; 13:136. [PMID: 38202143 PMCID: PMC10780288 DOI: 10.3390/jcm13010136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
The diagnosis of oral mucosal diseases is a significant challenge due to their diverse differential characteristics. Risk assessment of lesions by visual examination is a complex process due to the lack of definitive guidelines. This study aimed to improve this process by creating a diagnostic algorithm using gaze data acquired during oral mucosal disease examinations. A total of 78 dentists were included in this study. Tobii Pro Nano® (Tobii Technology) was used to acquire gaze data during clinical photographic visual examinations. Advanced analysis tools such as support vector machines and heatmaps were used to visualize the gazing tendencies of a group of skilled oral surgeons, focusing on the number of gazes per region and the gazing time ratios. The preliminary findings showed the possibility of visualizing gazing tendencies and identifying areas of importance for diagnosis. The classification of intraoral photographs based on gross features revealed the existence of an optimal examination method for each category and diagnostically significant areas. This novel approach to analyzing gaze data has the potential to refine diagnostic techniques and increase both accuracy and efficiency.
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Tian A, Wang X, Xu Y, Morejon V, Huang Y, Nwapuda C, Deng W. EGFR signaling controls directionality of epithelial multilayer formation upon loss of cell polarity. EMBO J 2023; 42:e113856. [PMID: 37953688 PMCID: PMC10711663 DOI: 10.15252/embj.2023113856] [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: 02/22/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
Apical-basal polarity is maintained by distinct protein complexes that reside in membrane junctions, and polarity loss in monolayered epithelial cells can lead to formation of multilayers, cell extrusion, and/or malignant overgrowth. Yet, how polarity loss cooperates with intrinsic signals to control directional invasion toward neighboring epithelial cells remains elusive. Using the Drosophila ovarian follicular epithelium as a model, we found that posterior follicle cells with loss of lethal giant larvae (lgl) or Discs large (Dlg) accumulate apically toward germline cells, whereas cells with loss of Bazooka (Baz) or atypical protein kinase C (aPKC) expand toward the basal side of wildtype neighbors. Further studies revealed that these distinct multilayering patterns in the follicular epithelium were determined by epidermal growth factor receptor (EGFR) signaling and its downstream target Pointed, a zinc-finger transcription factor. Additionally, we identified Rho kinase as a Pointed target that regulates formation of distinct multilayering patterns. These findings provide insight into how cell polarity genes and receptor tyrosine kinase signaling interact to govern epithelial cell organization and directional growth that contribute to epithelial tumor formation.
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Affiliation(s)
- Aiguo Tian
- Department of Biochemistry and Molecular BiologyTulane University School of Medicine, Louisiana Cancer Research CenterNew OrleansLAUSA
- Tulane Aging CenterTulane University School of MedicineNew OrleansLAUSA
| | - Xian‐Feng Wang
- Department of Biochemistry and Molecular BiologyTulane University School of Medicine, Louisiana Cancer Research CenterNew OrleansLAUSA
| | - Yuting Xu
- Department of Biochemistry and Molecular BiologyTulane University School of Medicine, Louisiana Cancer Research CenterNew OrleansLAUSA
| | - Virginia Morejon
- Department of Biochemistry and Molecular BiologyTulane University School of Medicine, Louisiana Cancer Research CenterNew OrleansLAUSA
| | - Yi‐Chun Huang
- Department of Biochemistry and Molecular BiologyTulane University School of Medicine, Louisiana Cancer Research CenterNew OrleansLAUSA
| | - Chidi Nwapuda
- Department of Biochemistry and Molecular BiologyTulane University School of Medicine, Louisiana Cancer Research CenterNew OrleansLAUSA
| | - Wu‐Min Deng
- Department of Biochemistry and Molecular BiologyTulane University School of Medicine, Louisiana Cancer Research CenterNew OrleansLAUSA
- Tulane Aging CenterTulane University School of MedicineNew OrleansLAUSA
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PD-L1 and CD8-Tumor-Infiltrating Lymphocytes Expression in Laryngeal Squamous Cell Carcinoma. ARS MEDICA TOMITANA 2021. [DOI: 10.2478/arsm-2020-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Studies in recent years have shown that the immune system plays an important role in the prognosis of patients with different types of malignancies. The tumor immune microenvironment has been studied in various cancers in an attempt to find new antitumoral therapies. The therapeutic blockade of PD-1/PD-L1 has revolutionized the treatment of oncological pacients, with anti-PD-L1 monoclonal antibodies having remarkable results in malignant melanoma, cervical, renal and lung cancer. In laryngeal cancer, few reports are available on the immune microenvironment and PD-L1 expression. Considering these, we retrospectively review 23 laryngeal cancer patients with laryngectomy performed in the Otorhinolaryngology Department - Emergency County Clinical Hospital St Andrew Constanta. The aim of our research was to evaluate the immunohistochemical expression of PD-L1, using combined positive score which includes both viable tumoral cells and intratumoral lymphocytes, as well as the level of CD8 intratumoral lymphocytes and to analise the corelation between these markers and the clinicopathological characteristics of the pacients, in order to set these two parameters, in the near future, as new biomarkers. PD-L1 expression was shown to be a prognostic factor for disease-free survival in laryngeal cancer patients (p = 0.006) and was higher in tumors with elevated CD8 lymphocyte levels, with a significant correlation correlation between the two parameters (p = 0.019). The level of CD8 lymphocytes was also a predictive factor for free-disease survival, correlated with patient smoker status (p = 0.04), being higher in non-smoking patients.
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Suga T, Tu TTH, Takenoshita M, Mikuzuki L, Umezaki Y, Shimamoto H, Michi Y, Hong C, Abiko Y, Ikeda T, Uzawa N, Harada H, Toyofuku A. Case Report: Hidden Oral Squamous Cell Carcinoma in Oral Somatic Symptom Disorder. Front Psychiatry 2021; 12:651871. [PMID: 33868058 PMCID: PMC8046933 DOI: 10.3389/fpsyt.2021.651871] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Burning mouth syndrome (BMS) is a common condition of predominant oral pain without evident cause, that maxillofacial surgeons and otolaryngologists often refer to psychiatrists as somatic symptom disorder. In very rare cases, its typical burning symptom mimics those of other diseases in which serious fatal comorbidities may be missed. We encountered three rare cases of oral squamous cell carcinoma (OSCC) with the first symptom of burning tongue. Case Presentation: Case 1: A 68-year-old woman had burning pain on the left lingual margin for 8 years. Antidepressant treatment was not efficacious. Cytology and biopsy revealed OSCC. Case 2: A 70-year-old man had burning sensation and paralysis of the tongue for 6 months. Magnetic resonance imaging (MRI) revealed a 37 × 23-mm mass under the floor of the mouth and enlargement of lymph nodes on both sides. Case 3: A 90-year-old man had burning sensation of the tongue for 1 year. MRI revealed a 12 × 12-mm mass on the mandible with bone absorption. Conclusion: This case series suggests that psychiatrists must always be careful in regarding BMS as somatic symptom disorder and be cautious of the possibility of OSCC, especially in elderly patients.
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Affiliation(s)
- Takayuki Suga
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Trang Thi Huyen Tu
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Miho Takenoshita
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Lou Mikuzuki
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yojiro Umezaki
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Hiroaki Shimamoto
- Division of Oral Health Sciences, Department of Oral and Maxillofacial Surgery, Oral Restitution, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuyuki Michi
- Division of Oral Health Sciences, Department of Oral and Maxillofacial Surgery, Oral Restitution, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chaoli Hong
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihiro Abiko
- Division of Oral Medicine and Pathology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Tohru Ikeda
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Narikazu Uzawa
- Department of Oral and Maxillofacial Surgery 2, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Hiroyuki Harada
- Division of Oral Medicine and Pathology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Karpathiou G, Casteillo F, Giroult JB, Forest F, Fournel P, Monaya A, Froudarakis M, Dumollard JM, Prades JM, Peoc'h M. Prognostic impact of immune microenvironment in laryngeal and pharyngeal squamous cell carcinoma: Immune cell subtypes, immuno-suppressive pathways and clinicopathologic characteristics. Oncotarget 2017; 8:19310-19322. [PMID: 28038471 PMCID: PMC5386686 DOI: 10.18632/oncotarget.14242] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 12/02/2016] [Indexed: 01/01/2023] Open
Abstract
Background Immune system affects prognosis of various malignancies. Anti-immune pathways like PD-L1 and CTLA4 are used by the tumor to overcome immune system and they serve as immunotherapy targets. The immune microenvironment of head-and-neck squamous cell carcinoma (SCCHN) has not been sufficiently studied. Patients and Methods 152 SCCHN were immunohistochemically studied for the expression of CD3, CD8, CD57, CD4, granzyme b, CD20, CD163, S100, PD-L1, CTLA4 and CXCR4. Results CD3, CD8, CD57 and stromal S100 higher density is a good prognostic factor (p=0.02, 0.01, 0.02, 0.03 respectively). CTLA4 tumor expression is a poor prognostic factor (p=0.05). The rest immune cells do not affect prognosis. CD3 and CD8 density does not correlate with clinicopathological factors or p16/p53 expression, while CD57 and CD4 higher density is associated with the absence of distant metastases (p=0.03 and 0.07, respectively). Higher CD20 and S100 density is associated with lower T stage (p=0.04 and 0.03, respectively). PD-L1 expression is higher in CD3, CD8, and CD163 infiltrated tumors and in histologically more aggressive tumors. Response to neoadjuvant chemotherapy is better in highly CD3 infiltrated tumors and in tumors with less intraepithelial macrophages. Conclusion Rich T-lympocytic and dendritic cell response is a good prognostic factor in SCCHN, whereas tumors expressing CTLA4 show poor prognosis. PDL1 expression does not affect prognosis, but it is expressed in histologically more aggressive tumors and in T-cells rich tumors. Response to induction chemotherapy is better in tumors less infiltrated by macrophages and mostly infiltrated by T cells.
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Affiliation(s)
- Georgia Karpathiou
- Department of Pathology, North Hospital, University Hospital of St-Etienne, St-Etienne, France
| | - Francois Casteillo
- Department of Pathology, North Hospital, University Hospital of St-Etienne, St-Etienne, France
| | - Jean-Baptiste Giroult
- Department of Head and Neck Surgery, North Hospital, University Hospital of St-Etienne, St-Etienne, France
| | - Fabien Forest
- Department of Pathology, North Hospital, University Hospital of St-Etienne, St-Etienne, France
| | | | - Alessandra Monaya
- Department of Pathology, North Hospital, University Hospital of St-Etienne, St-Etienne, France
| | - Marios Froudarakis
- Department of Pneumonology, North Hospital, University Hospital of St-Etienne, St-Etienne, France
| | - Jean Marc Dumollard
- Department of Pathology, North Hospital, University Hospital of St-Etienne, St-Etienne, France
| | - Jean Michel Prades
- Department of Head and Neck Surgery, North Hospital, University Hospital of St-Etienne, St-Etienne, France
| | - Michel Peoc'h
- Department of Pathology, North Hospital, University Hospital of St-Etienne, St-Etienne, France
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Surucu M, Shah KK, Mescioglu I, Roeske JC, Small W, Choi M, Emami B. Decision Trees Predicting Tumor Shrinkage for Head and Neck Cancer: Implications for Adaptive Radiotherapy. Technol Cancer Res Treat 2015; 15:139-45. [PMID: 25731804 DOI: 10.1177/1533034615572638] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 01/22/2015] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To develop decision trees predicting for tumor volume reduction in patients with head and neck (H&N) cancer using pretreatment clinical and pathological parameters. METHODS Forty-eight patients treated with definitive concurrent chemoradiotherapy for squamous cell carcinoma of the nasopharynx, oropharynx, oral cavity, or hypopharynx were retrospectively analyzed. These patients were rescanned at a median dose of 37.8 Gy and replanned to account for anatomical changes. The percentages of gross tumor volume (GTV) change from initial to rescan computed tomography (CT; %GTVΔ) were calculated. Two decision trees were generated to correlate %GTVΔ in primary and nodal volumes with 14 characteristics including age, gender, Karnofsky performance status (KPS), site, human papilloma virus (HPV) status, tumor grade, primary tumor growth pattern (endophytic/exophytic), tumor/nodal/group stages, chemotherapy regimen, and primary, nodal, and total GTV volumes in the initial CT scan. The C4.5 Decision Tree induction algorithm was implemented. RESULTS The median %GTVΔ for primary, nodal, and total GTVs was 26.8%, 43.0%, and 31.2%, respectively. Type of chemotherapy, age, primary tumor growth pattern, site, KPS, and HPV status were the most predictive parameters for primary %GTVΔ decision tree, whereas for nodal %GTVΔ, KPS, site, age, primary tumor growth pattern, initial primary GTV, and total GTV volumes were predictive. Both decision trees had an accuracy of 88%. CONCLUSIONS There can be significant changes in primary and nodal tumor volumes during the course of H&N chemoradiotherapy. Considering the proposed decision trees, radiation oncologists can select patients predicted to have high %GTVΔ, who would theoretically gain the most benefit from adaptive radiotherapy, in order to better use limited clinical resources.
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Affiliation(s)
- Murat Surucu
- Department of Radiation Oncology, Loyola University Chicago, Maywood, IL, USA
| | - Karan K Shah
- Department of Radiation Oncology, Loyola University Chicago, Maywood, IL, USA
| | - Ibrahim Mescioglu
- Department of Management Information Systems, Lewis University, Romeoville, IL, USA
| | - John C Roeske
- Department of Radiation Oncology, Loyola University Chicago, Maywood, IL, USA
| | - William Small
- Department of Radiation Oncology, Loyola University Chicago, Maywood, IL, USA
| | - Mehee Choi
- Department of Radiation Oncology, Loyola University Chicago, Maywood, IL, USA
| | - Bahman Emami
- Department of Radiation Oncology, Loyola University Chicago, Maywood, IL, USA
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Wallis SP, Stafford ND, Greenman J. Clinical relevance of immune parameters in the tumor microenvironment of head and neck cancers. Head Neck 2014; 37:449-59. [DOI: 10.1002/hed.23736] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/19/2013] [Accepted: 05/03/2014] [Indexed: 12/12/2022] Open
Affiliation(s)
| | - Nicholas D. Stafford
- Hull York Medical School, Daisy Laboratories, Castle Hill Hospital; Hull United Kingdom
| | - John Greenman
- School of Biological, Biomedical and Environmental Sciences, University of Hull; Hull United Kingdom
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