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Solis-Torres N, Braverman-Diaz I, Rivera-Morales LA, Perez-Sanchez JJ, Perez-Bravo VS, Neris-Sanchez AJ, Vera A, Diaz-Algorri Y. Medical students' knowledge about human papillomavirus (HPV), HPV vaccine and head and neck cancer. Hum Vaccin Immunother 2024; 20:2344248. [PMID: 38659106 PMCID: PMC11057669 DOI: 10.1080/21645515.2024.2344248] [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: 11/08/2023] [Accepted: 04/13/2024] [Indexed: 04/26/2024] Open
Abstract
The Human Papillomavirus (HPV) is a sexually transmitted infection that significantly affects the population worldwide. HPV preventive methods include vaccination, prophylactics, and education. Different types of cancers associated with HPV usually take years or decades to develop after infections, such as Head and Neck Cancer(HNC). Therefore, HPV prevention can be considered cancer prevention. A sample of medical students in Puerto Rico was evaluated to assess their knowledge about HPV, HPV vaccine, and HNC through two previously validated online questionnaires composed of 38 dichotomized questions, we measured HPV, HPV vaccination(HPVK), and HNC knowledge (HNCK). Out of 104 students surveyed, the mean HPVK score obtained was 20.07/26, SD = 3.86, while the mean score for HNCK was 6.37/12, SD = 1.78. Bidirectional stepwise regression showed study year and HPV Vaccine name had been the most influential variables on HPVK and HNCK. MS1 participants scored lower than MS2-MS4 participants, with no significant difference between MS2-MS4 scores. The results reveal knowledge gaps in HPV/HPV Vaccine and HNC among surveyed medical students. Our findings also suggest an association between knowledge of personal vaccination status, self-perceived risk, and how uncertainty in these factors may affect the medical students' understanding of HPV, HPV vaccination, and associated cancers.
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Affiliation(s)
| | - Isardo Braverman-Diaz
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Luis A. Rivera-Morales
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Jose J. Perez-Sanchez
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Valeria S. Perez-Bravo
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Angel J. Neris-Sanchez
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Alexis Vera
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Yaritza Diaz-Algorri
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
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Lopes-Nunes J, Oliveira PA, Cruz C. Enhanced targeted liposomal delivery of imiquimod via aptamer functionalization for head and neck cancer therapy. Colloids Surf B Biointerfaces 2024; 243:114121. [PMID: 39094208 DOI: 10.1016/j.colsurfb.2024.114121] [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: 04/22/2024] [Revised: 07/21/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
The incidence of head and neck cancers, particularly those associated with Human Papillomavirus (HPV) infections, has been steadily increasing. Conventional therapies exhibit limitations and drawbacks, prompting the exploration of new strategies over the years, with nanomedicine approaches, especially liposomes gaining relevance. Additionally, the functionalization of liposomes with aptamers enables selective delivery to target cells. For instance, AT11 can serve as a targeting moiety for cancer cells due to its high affinity for nucleolin, a protein overexpressed on the cancer cell's surface. In this study, liposomes functionalized with AT11 are proposed as drug delivery systems for imiquimod (IQ), aiming to maximize its potential as an anticancer agent for HPV-related cancers. To this end, firstly liposomes were produced through the ethanol injection method, functionalized with AT11-TEG-Cholesteryl, and characterized using dynamic light scattering. The obtained liposomes presented suitable properties for cancer therapy (with sizes from 120 to 140 nm and low polydispersity PDI < 0.16) and were further evaluated in terms of potential anticancer effects. AT11 IQ-associated liposomes allowed a selective delivery of IQ towards a tongue cancer cell line (UPCI-SCC-154) relative to the non-malignant cell line (Het1A). Specifically, they induced a selective reduction of the cell viability (∼52 % versus ∼113 %; p < 0.0001), proliferation (∼68 % versus ∼102 %; p<0.0001) and increased cell death (∼7-fold increase; p < 0.0001)). Additionally, they decreased the migration (from ∼24 % to ∼8 %; p < 0.0001) and invasion (to 11 %; p = 0.0047) capacities of the cancer cells. In summary, the produced liposomes represent a promising approach to enhance the anticancer potential of IQ in head and neck cancer, particularly in tongue cancer.
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Affiliation(s)
- Jéssica Lopes-Nunes
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Paula A Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; Inov4Agro, Institute for Innovation, Capacity Building and Sustainability of Agri-food Production, Vila Real, Portugal
| | - Carla Cruz
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; Departamento de Química, Universidade da Beira Interior, Rua Marquês de Ávila e Bolama, Covilhã 6201-001, Portugal.
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Balk M, Rak A, Rupp R, Sievert M, Müller S, Koch M, Iro H, Gostian M, Putz F, Weißmann T, Allner M, Gostian AO. Impact of Cancer Localization on Symptom Burden and Quality of Life in Head and Neck Cancers: A Comparative Study. EAR, NOSE & THROAT JOURNAL 2024:1455613241274025. [PMID: 39292947 DOI: 10.1177/01455613241274025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2024] Open
Abstract
Background: Head and neck cancer (HNC) is a critical concern in oncology, with notable disparities in survival rates. While the long-term symptom burden in HNC survivors and its impact on quality of life (QoL) has been explored, there is limited understanding of the influence of cancer localizations on these aspects. This study aims to elucidate the role of cancer localizations in shaping long-term outcomes in HNC patients. Methods: A cross-sectional study was conducted at the University Hospital Erlangen's Department of Otolaryngology, exploring the impact of cancer localization on symptom burden and QoL in 138 HNC patients using the University of Washington Quality of Life Questionnaire Version 4. Results: In our study of HNC patients, we investigated symptom burden across different cancer localizations, including oral cavity, oropharyngeal, hypopharyngeal, laryngeal, and cancer of unknown primary (CUP). While we found no significant variations in parameters such as pain, appearance, and activity, notable differences emerged in swallowing, speech, and salivation. Patients with oral cavity and laryngeal carcinomas had significantly higher swallowing and salivation scores compared to those with oropharyngeal carcinoma and CUP, while speech-related symptoms were lower for oral cavity and laryngeal carcinoma patients. Importantly, these symptom differences did not significantly impact health-related and overall QoL. These findings emphasize the nuanced interplay between symptomatology and QoL in different HNC cancer localizations. Conclusion: The research highlights significant disparities in post-treatment symptoms across different HNC localizations and underscores the need for personalized treatment and management strategies to address unique challenges associated with each HNC type, ultimately aiming to enhance post-treatment QoL.
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Affiliation(s)
- Matthias Balk
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Atina Rak
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Robin Rupp
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Sarina Müller
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Magdalena Gostian
- Department of Anesthesiology and Intensive Care Medicine, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany
| | - Florian Putz
- Department of Radiotherapy and Radiation Oncology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Thomas Weißmann
- Department of Radiotherapy and Radiation Oncology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Moritz Allner
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Germany
| | - Antoniu-Oreste Gostian
- Department of Otorhinolaryngology, Head & Neck Surgery, Merciful Brothers Hospital St. Elisabeth, Straubing, Germany
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Zhao BY, Hirayama S, Goss D, Zhao Y, Faden DL. Human Papillomavirus-Associated Nasopharyngeal Carcinoma: A Systematic Review and Meta-Analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.09.10.24313140. [PMID: 39314950 PMCID: PMC11419204 DOI: 10.1101/2024.09.10.24313140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Objective Human papillomavirus (HPV) is known to affect head and neck sites beyond the oropharynx, including the nasopharynx. Unlike HPV-associated oropharyngeal squamous cell carcinoma (HPV+OPSCC), HPV-associated nasopharyngeal carcinoma (HPV+NPC) is not well characterized and the true prevalence in non-endemic regions is poorly described. Here, we sought to obtain a global point prevalence of HPV in NPC, stratified by geographic region. Data Sources EMBASE, OVID Medline, and Web of Science were systematically searched for available evidence on September 21, 2022 for articles published between January 1, 1990 and September 21, 2022. Review Methods We reviewed the literature for all studies examining NPC and HPV status in adult patients that provided a quantitative HPV prevalence. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Main outcome and measures included HPV+NPC prevalence estimates stratified by geographic region, along with other clinical and demographic features. Results Of the 1567 citations retrieved, 46 studies encompassing 6314 NPC patients were eligible for statistical analysis. The global prevalence of HPV+NPC was 0.18 (95% CI 0.14-0.23). When stratified by geographic region, prevalence was highest in North America (0.25, 95% CI 0.17-0.36), which is a non-endemic region for NPC and also has highest prevalence for HPV+OPSCC. Asia, an endemic area, had the lowest HPV prevalence estimate (0.13, 95% CI 0.08-0.22). HPV 16 (44%) and 18 (33%) were the predominant genotypes in HPV+NPC, dissimilar to HPV+OPSCC. Conclusion This systematic review and meta-analysis provides a global point prevalence of HPV+NPC stratified by geographic region and suggests that HPV is a significant etiological factor of NPC in North America.
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[The multicenter registry "oropharyngeal cancer" of the German ENT Study Center - First Results]. Laryngorhinootologie 2024. [PMID: 39168130 DOI: 10.1055/a-2374-2310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
BACKGROUND The number of oropharyngeal squamous cell carcinomas (OPSCC) caused by human papillomavirus (HPV) has increased significantly in recent years. However, no robust data exist on the incidence of HPV-associated OPSCC as well as their treatment in central Europe. AIM OF THE WORK The aim is to establish an epidemiological register of patients with OPSCC in central Europe. MATERIAL AND METHODS To close the evidence gap on p16-positive OPSCC, a prospective multicenter registry on incidence, risk factors and treatment of OPSCC in certified Head and Neck Tumor Centers according to the German Cancer Society was established. Data collection was pseudonymously performed using the web-based Research Electronic Data Capture (REDCap). RESULTS In 2022 and 2023, 1312 patients with OPSCC from 34 centers were included. 720 patients (58.2 %) were p16-positive. The most common locations of p16-positive primary tumors were the tonsil (49.9 %) and the base of the tongue (28.7 %). 63.1 % of p16-positive OPSCC received primary surgical treatment, whereas only 48.0 % of p16-negative tumors received primary surgery. Differences are also evident in the adjuvant therapy: 58 % of p16-negative OPSCC did not receive adjuvant therapy after surgery, compared with 37.1 % of p16-positive OPSCC. CONCLUSION The start of the OPSCC registry study was technically smooth. This registry provides an insight into the current care situation of OPSCC in German-speaking countries and will gain importance through the participation of more centers.
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Espressivo A, Pan ZS, Usher-Smith JA, Harrison H. Risk Prediction Models for Oral Cancer: A Systematic Review. Cancers (Basel) 2024; 16:617. [PMID: 38339366 PMCID: PMC10854942 DOI: 10.3390/cancers16030617] [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: 11/25/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
In the last 30 years, there has been an increasing incidence of oral cancer worldwide. Earlier detection of oral cancer has been shown to improve survival rates. However, given the relatively low prevalence of this disease, population-wide screening is likely to be inefficient. Risk prediction models could be used to target screening to those at highest risk or to select individuals for preventative interventions. This review (a) systematically identified published models that predict the development of oral cancer and are suitable for use in the general population and (b) described and compared the identified models, focusing on their development, including risk factors, performance and applicability to risk-stratified screening. A search was carried out in November 2022 in the Medline, Embase and Cochrane Library databases to identify primary research papers that report the development or validation of models predicting the risk of developing oral cancer (cancers of the oral cavity or oropharynx). The PROBAST tool was used to evaluate the risk of bias in the identified studies and the applicability of the models they describe. The search identified 11,222 articles, of which 14 studies (describing 23 models), satisfied the eligibility criteria of this review. The most commonly included risk factors were age (n = 20), alcohol consumption (n = 18) and smoking (n = 17). Six of the included models incorporated genetic information and three used biomarkers as predictors. Including information on human papillomavirus status was shown to improve model performance; however, this was only included in a small number of models. Most of the identified models (n = 13) showed good or excellent discrimination (AUROC > 0.7). Only fourteen models had been validated and only two of these validations were carried out in populations distinct from the model development population (external validation). Conclusions: Several risk prediction models have been identified that could be used to identify individuals at the highest risk of oral cancer within the context of screening programmes. However, external validation of these models in the target population is required, and, subsequently, an assessment of the feasibility of implementation with a risk-stratified screening programme for oral cancer.
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Affiliation(s)
- Aufia Espressivo
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK; (Z.S.P.); (J.A.U.-S.); (H.H.)
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de Chauveron J, Unger M, Lescaille G, Wendling L, Kurtz C, Rochefort J. Artificial intelligence for oral squamous cell carcinoma detection based on oral photographs: A comprehensive literature review. Cancer Med 2024; 13:e6822. [PMID: 38164652 PMCID: PMC10807632 DOI: 10.1002/cam4.6822] [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: 10/17/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Oral squamous cell carcinoma (OSCC) presents a significant global health challenge. The integration of artificial intelligence (AI) and computer vision holds promise for the early detection of OSCC through the analysis of digitized oral photographs. This literature review explores the landscape of AI-driven OSCC automatic detection, assessing both the performance and limitations of the current state of the art. MATERIALS AND METHODS An electronic search using several data base was conducted, and a systematic review performed in accordance with PRISMA guidelines (CRD42023441416). RESULTS Several studies have demonstrated remarkable results for this task, consistently achieving sensitivity rates exceeding 85% and accuracy rates surpassing 90%, often encompassing around 1000 images. The review scrutinizes these studies, shedding light on their methodologies, including the use of recent machine learning and pattern recognition approaches coupled with different supervision strategies. However, comparing the results from different papers is challenging due to variations in the datasets used. DISCUSSION Considering these findings, this review underscores the urgent need for more robust and reliable datasets in the field of OSCC detection. Furthermore, it highlights the potential of advanced techniques such as multi-task learning, attention mechanisms, and ensemble learning as crucial tools in enhancing the accuracy and sensitivity of OSCC detection through oral photographs. CONCLUSION These insights collectively emphasize the transformative impact of AI-driven approaches on early OSCC diagnosis, with the potential to significantly improve patient outcomes and healthcare practices.
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Affiliation(s)
- Jérôme de Chauveron
- Equipe Microenvironnement Immunitaire et Immunothérapie, CIMI Paris, INSERM U1135Sorbonne universitéPARISFrance
- UFR Mathématiques et Informatique, département informatique, laboratoire LIPADEUniversité Paris CitéParisFrance
- ANALOGIES
| | | | - Géraldine Lescaille
- Equipe Microenvironnement Immunitaire et Immunothérapie, CIMI Paris, INSERM U1135Sorbonne universitéPARISFrance
- UFR d'OdontologieUniversité Paris CitéParisFrance
- Département de Médecine bucco‐dentaireHôpital Pitié Salpêtrière, APHPPARISFrance
| | - Laurent Wendling
- UFR Mathématiques et Informatique, département informatique, laboratoire LIPADEUniversité Paris CitéParisFrance
| | - Camille Kurtz
- UFR Mathématiques et Informatique, département informatique, laboratoire LIPADEUniversité Paris CitéParisFrance
| | - Juliette Rochefort
- Equipe Microenvironnement Immunitaire et Immunothérapie, CIMI Paris, INSERM U1135Sorbonne universitéPARISFrance
- UFR d'OdontologieUniversité Paris CitéParisFrance
- Département de Médecine bucco‐dentaireHôpital Pitié Salpêtrière, APHPPARISFrance
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Cunha ARD, Compton K, Xu R, Mishra R, Drangsholt MT, Antunes JLF, Kerr AR, Acheson AR, Lu D, Wallace LE, Kocarnik JM, Fu W, Dean FE, Pennini A, Henrikson HJ, Alam T, Ababneh E, Abd-Elsalam S, Abdoun M, Abidi H, Abubaker Ali H, Abu-Gharbieh E, Adane TD, Addo IY, Ahmad A, Ahmad S, Ahmed Rashid T, Akonde M, Al Hamad H, Alahdab F, Alimohamadi Y, Alipour V, Al-Maweri SA, Alsharif U, Ansari-Moghaddam A, Anwar SL, Anyasodor AE, Arabloo J, Aravkin AY, Aruleba RT, Asaad M, Ashraf T, Athari SS, Attia S, Azadnajafabad S, Azangou-Khyavy M, Badar M, Baghcheghi N, Banach M, Bardhan M, Barqawi HJ, Bashir NZ, Bashiri A, Benzian H, Bernabe E, Bhagat DS, Bhojaraja VS, Bjørge T, Bouaoud S, Braithwaite D, Briko NI, Calina D, Carreras G, Chakraborty PA, Chattu VK, Chaurasia A, Chen MX, Cho WCS, Chu DT, Chukwu IS, Chung E, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darvishi Cheshmeh Soltani R, Darwesh AM, Debela SA, Derbew Molla M, Dessalegn FN, Dianati-Nasab M, Digesa LE, Dixit SG, Dixit A, Djalalinia S, El Sayed I, El Tantawi M, Enyew DB, Erku DA, Ezzeddini R, Fagbamigbe AF, Falzone L, Fetensa G, Fukumoto T, Gaewkhiew P, Gallus S, Gebrehiwot M, Ghashghaee A, Gill PS, Golechha M, Goleij P, Gomez RS, Gorini G, Guimaraes ALS, Gupta B, Gupta S, Gupta VB, Gupta VK, Haj-Mirzaian A, Halboub ES, Halwani R, Hanif A, Hariyani N, Harorani M, Hasani H, Hassan AM, Hassanipour S, Hassen MB, Hay SI, Hayat K, Herrera-Serna BY, Holla R, Horita N, Hosseinzadeh M, Hussain S, Ilesanmi OS, Ilic IM, Ilic MD, Isola G, Jaiswal A, Jani CT, Javaheri T, Jayarajah U, Jayaram S, Joseph N, Kadashetti V, Kandaswamy E, Karanth SD, Karaye IM, Kauppila JH, Kaur H, Keykhaei M, Khader YS, Khajuria H, Khanali J, Khatib MN, Khayat Kashani HR, Khazeei Tabari MA, Kim MS, Kompani F, Koohestani HR, Kumar GA, Kurmi OP, La Vecchia C, Lal DK, Landires I, Lasrado S, Ledda C, Lee YH, Libra M, Lim SS, Listl S, Lopukhov PD, Mafi AR, Mahumud RA, Malik AA, Mathur MR, Maulud SQ, Meena JK, Mehrabi Nasab E, Mestrovic T, Mirfakhraie R, Misganaw A, Misra S, Mithra P, Mohammad Y, Mohammadi M, Mohammadi E, Mokdad AH, Moni MA, Moraga P, Morrison SD, Mozaffari HR, Mubarik S, Murray CJL, Nair TS, Narasimha Swamy S, Narayana AI, Nassereldine H, Natto ZS, Nayak BP, Negru SM, Nggada HA, Nouraei H, Nuñez-Samudio V, Oancea B, Olagunju AT, Omar Bali A, Padron-Monedero A, Padubidri JR, Pandey A, Pardhan S, Patel J, Pezzani R, Piracha ZZ, Rabiee N, Radhakrishnan V, Radhakrishnan RA, Rahmani AM, Rahmanian V, Rao CR, Rao SJ, Rath GK, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Rezaei N, Rezaei N, Rezaei N, Rezapour A, Riad A, Roberts TJ, Romero-Rodríguez E, Roshandel G, S M, S N C, Saddik B, Saeb MR, Saeed U, Safaei M, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Samy AM, Santric-Milicevic MM, Sathian B, Satpathy M, Šekerija M, Senthilkumaran S, Seylani A, Shafaat O, Shahsavari HR, Shamsoddin E, Sharew MM, Sharifi-Rad J, Shetty JK, Shivakumar KM, Shobeiri P, Shorofi SA, Shrestha S, Siddappa Malleshappa SK, Singh P, Singh JA, Singh G, Sinha DN, Solomon Y, Suleman M, Suliankatchi Abdulkader R, Taheri Abkenar Y, Talaat IM, Tan KK, Tbakhi A, Thiyagarajan A, Tiyuri A, Tovani-Palone MR, Unnikrishnan B, Vo B, Volovat SR, Wang C, Westerman R, Wickramasinghe ND, Xiao H, Yu C, Yuce D, Yunusa I, Zadnik V, Zare I, Zhang ZJ, Zoladl M, Force LM, Hugo FN. The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol 2023; 9:1401-1416. [PMID: 37676656 PMCID: PMC10485745 DOI: 10.1001/jamaoncol.2023.2960] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/04/2023] [Indexed: 09/08/2023]
Abstract
Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning. Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates. Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019. Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia. Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.
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Affiliation(s)
| | - Kelly Compton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rixing Xu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Data and Tooling, Sage Bionetworks, Seattle, Washington
| | - Rashmi Mishra
- Department of Oral Medicine, School of Dentistry, University of Washington, Seattle
| | - Mark Thomas Drangsholt
- Department of Oral Medicine, School of Dentistry, University of Washington, Seattle
- Oral Medicine Clinic, School of Dentistry, University of Washington, Seattle
| | | | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, College of Dentistry, New York University, New York, New York
| | - Alistair R Acheson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dan Lu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Lindsey E Wallace
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Jonathan M Kocarnik
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Weijia Fu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Frances E Dean
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Mathematics, University of California, Berkeley
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hannah Jacqueline Henrikson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts
| | - Tahiya Alam
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emad Ababneh
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sherief Abd-Elsalam
- Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Meriem Abdoun
- Department of Medicine, University of Setif Algeria, Setif, Algeria
| | - Hassan Abidi
- Laboratory Technology Sciences Department, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Hiwa Abubaker Ali
- Department of Banking and Finance, University of Human Development, Sulaymaniyah, Iraq
| | - Eman Abu-Gharbieh
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Tigist Demssew Adane
- Department of Clinical and Psychosocial Epidemiology, University of Groningen, Groningen, the Netherlands
| | - Isaac Yeboah Addo
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
- Quality and Systems Performance Unit, Cancer Institute NSW, Sydney, New South Wales, Australia
| | - Aqeel Ahmad
- Department of Medical Biochemistry, Shaqra University, Shaqra, Saudi Arabia
| | - Sajjad Ahmad
- Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan
| | - Tarik Ahmed Rashid
- Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Hanadi Al Hamad
- Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fares Alahdab
- Evidence-Based Practice Center Program, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Yousef Alimohamadi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Alireza Ansari-Moghaddam
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sumadi Lukman Anwar
- Department of Surgery, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | | | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Applied Mathematics, College of Arts & Sciences, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Raphael Taiwo Aruleba
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Malke Asaad
- Department of Plastic Surgery, University of Texas, Houston
| | - Tahira Ashraf
- University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
| | | | - Sameh Attia
- Department of Oral and Maxillofacial Surgery, Justus Liebig University of Giessen, Giessen, Germany
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Azangou-Khyavy
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Muhammad Badar
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
| | - Nayereh Baghcheghi
- Department of Nursing, Saveh University of Medical Sciences, Saveh, Iran
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Mainak Bardhan
- Department of Molecular Microbiology and Bacteriology, National Institute of Cholera and Enteric Diseases, Kolkata, India
- Department of Molecular Microbiology, Indian Council of Medical Research, New Delhi, India
| | - Hiba Jawdat Barqawi
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Nasir Z Bashir
- School of Oral and Dental Sciences, University of Bristol, Bristol, England, United Kingdom
| | - Azadeh Bashiri
- Health Information Management, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Habib Benzian
- Department of Epidemiology and Health Promotion, College of Dentistry, New York University, New York, New York
| | - Eduardo Bernabe
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, England, United Kingdom
| | - Devidas S Bhagat
- Department of Forensic Chemistry, Government Institute of Forensic Science, Aurangabad, India
| | - Vijayalakshmi S Bhojaraja
- Department of Anatomy, Royal College of Surgeons in Ireland Medical, University of Bahrain, Busaiteen, Bahrain
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Souad Bouaoud
- Department of Medicine, University Ferhat Abbas of Setif, Setif, Algeria
- Department of Epidemiology and Preventive Medicine, University Hospital Saadna Abdenour, Setif, Algeria
| | - Dejana Braithwaite
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville
- Cancer Control and Population Sciences Program, University of Florida Health Cancer Center, Gainesville
| | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence-Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Daniela Calina
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Vijay Kumar Chattu
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Sawangi, India
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
| | - Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, King George's Medical University, Lucknow, India
| | - Meng Xuan Chen
- Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - William C S Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam
| | | | - Eunice Chung
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Natália Cruz-Martins
- Department of Therapeutic and Diagnostic Technologies, Polytechnic and University Higher Education Cooperative, Gandra, Portugal
- Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
- Indian Council of Medical Research, New Delhi, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Parnaz Daneshpajouhnejad
- Department of Pathology, Johns Hopkins Medicine, Baltimore, Maryland
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Fikadu Nugusu Dessalegn
- Department of Public Health, College of Medicine, Madda Walabu University, Bale Goba, Ethiopia
| | - Mostafa Dianati-Nasab
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Lankamo Ena Digesa
- Department of Comprehensive Nursing, Arba Minch University, Arba Minch, Ethiopia
| | - Shilpi Gupta Dixit
- Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, India
| | - Abhinav Dixit
- Department of Physiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shirin Djalalinia
- Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Iman El Sayed
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Daniel Asfaw Erku
- Centre for Applied Health Economics, Griffith University, Gold Coast, Queensland, Australia
| | - Rana Ezzeddini
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Adeniyi Francis Fagbamigbe
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Luca Falzone
- Epidemiology and Biostatistics Unit, National Cancer Institute IRCCS Fondazione G. Pascale, Naples, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Getahun Fetensa
- Department of Nursing, College of Medical and Health Sciences, Wollega University, Nekemte, Ethiopia
| | | | - Piyada Gaewkhiew
- Department of Community Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Thailand
- Population and Patient Health Group, King's College London, London, England, United Kingdom
| | - Silvano Gallus
- Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ahmad Ghashghaee
- School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Paramjit Singh Gill
- Warwick Medical School, University of Warwick, Coventry, England, United Kingdom
| | - Mahaveer Golechha
- Department of Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
| | - Pouya Goleij
- Department of Genetics, Sana Institute of Higher Education, Sari, Iran
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Giuseppe Gorini
- Oncological Network, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | | | - Bhawna Gupta
- Department of Public Health, Torrens University Australia, Melbourne, Victoria, Australia
| | - Sapna Gupta
- Toxicology Department, Shriram Institute for Industrial Research, Delhi, India
| | - Veer Bala Gupta
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Vivek Kumar Gupta
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Arvin Haj-Mirzaian
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esam S Halboub
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
- School of Dentistry, Sana'a University, Sana'a, Yemen
| | - Rabih Halwani
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Asif Hanif
- University Institute of Public Health, The University of Lahore, Lahore, Pakistan
| | - Ninuk Hariyani
- Department of Dental Public Health, Airlangga University, Surabaya, Indonesia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Mehdi Harorani
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Hamidreza Hasani
- Department of Ophthalmology, Iran University of Medical Sciences, Karaj, Iran
| | - Abbas M Hassan
- Department of Plastic Surgery, University of Texas, Houston
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammed Bheser Hassen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- National Data Management Center for Health (NDMC), Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China
| | | | - Ramesh Holla
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Nobuyuki Horita
- Department of Pulmonology, Yokohama City University, Yokohama, Japan
- National Human Genome Research Institute (NHGRI), National Institutes of Health, Bethesda, Maryland
| | - Mehdi Hosseinzadeh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
| | - Salman Hussain
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Masaryk University, Brno, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Olayinka Stephen Ilesanmi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Irena M Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Abhishek Jaiswal
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chinmay T Jani
- Department of Internal Medicine, Mount Auburn Hospital, Harvard University, Cambridge, Massachusetts
| | - Tahereh Javaheri
- Health Informatics Lab, Boston University, Boston, Massachusetts
| | - Umesh Jayarajah
- Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Department of Surgery, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Shubha Jayaram
- Department of Biochemistry, Government Medical College, Mysuru, India
| | - Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Vidya Kadashetti
- Department of Oral and Maxillofacial Pathology, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, India
| | - Eswar Kandaswamy
- Department of Periodontics, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans
| | | | - Ibraheem M Karaye
- School of Health Professions and Human Services, Hofstra University, Hempstead, New York
| | - Joonas H Kauppila
- Surgery Research Unit, University of Oulu, Oulu, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | | | - Mohammad Keykhaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Himanshu Khajuria
- Amity Institute of Forensic Sciences, Amity University, Noida, India
| | - Javad Khanali
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahalaqua Nazli Khatib
- Global Consortium for Public Health Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India
| | | | - Mohammad Amin Khazeei Tabari
- Department of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- MAZUMS Office, Universal Scientific Education and Research Network, Tehran, Iran
| | - Min Seo Kim
- Department of Genomics and Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Seoul, South Korea
- Public Health Center, Ministry of Health and Welfare, Wando, South Korea
| | - Farzad Kompani
- Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Koohestani
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Om P Kurmi
- Faculty of Health and Life Sciences, Coventry University, Coventry, England, United Kingdom
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Iván Landires
- Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Ministry of Health, Herrera, Panama
| | - Savita Lasrado
- Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
| | - Caterina Ledda
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Yo Han Lee
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Stefan Listl
- Department of Dentistry, Radboud University, Nijmegen, the Netherlands
- Department of Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| | - Platon D Lopukhov
- Department of Epidemiology and Evidence-Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ahmad R Mafi
- Department of Clinical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rashidul Alam Mahumud
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Ahmad Azam Malik
- University Institute of Public Health, The University of Lahore, Lahore, Pakistan
- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Manu Raj Mathur
- Department of Health Policy Research, Public Health Foundation of India, Gurugram, India
- Institute of Population Health Sciences, University of Liverpool, Liverpool, England, United Kingdom
| | - Sazan Qadir Maulud
- Department of Biology, College of Science, Salahaddin University, Erbil, Iraq
| | - Jitendra Kumar Meena
- Department of Preventive Oncology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Tomislav Mestrovic
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Reza Mirfakhraie
- Department of Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Awoke Misganaw
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- National Data Management Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Mokhtar Mohammadi
- Department of Information Technology, Lebanese French University, Erbil, Iraq
| | - Esmaeil Mohammadi
- Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Mohammad Ali Moni
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paula Moraga
- Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Shane Douglas Morrison
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Medicine, Wuhan University, Wuhan, China
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | | | | | | | - Hasan Nassereldine
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Oral Health Policy and Epidemiology, School of Dental Medicine, Harvard University, Boston, Massachusetts
| | | | - Serban Mircea Negru
- Department of Oncology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Haruna Asura Nggada
- Department of Histopathology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
- Department of Human Pathology, University of Maiduguri, Maiduguri, Nigeria
| | - Hasti Nouraei
- Department of Medical Mycology and Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Virginia Nuñez-Samudio
- Unit of Microbiology and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Department of Public Health, Ministry of Health, Herrera, Panama
| | - Bogdan Oancea
- Department of Applied Economics and Quantitative Analysis, University of Bucharest, Bucharest, Romania
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, Faculty of Clinical Science, University of Lagos, Lagos, Nigeria
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
| | | | - Jagadish Rao Padubidri
- Department of Forensic Medicine and Toxicology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, England, United Kingdom
| | - Jay Patel
- Global Health Governance Programme, University of Edinburgh, Edinburgh, Scotland, United Kingdom
- School of Dentistry, University of Leeds, Leeds, England, United Kingdom
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine, University of Padova, Padova, Italy
- Associazione Italiana Ricerca Oncologica di Base (AIROB), Padova, Italy
| | | | - Navid Rabiee
- School of Engineering, Macquarie University, Sydney, New South Wales, Australia
- Pohang University of Science and Technology, Pohang, South Korea
| | | | | | - Amir Masoud Rahmani
- Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Vahid Rahmanian
- Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Chythra R Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Sowmya J Rao
- Department of Oral Pathology and Microbiology, Sharavathi Dental College and Hospital, Shimogga, India
| | - Goura Kishor Rath
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, England, United Kingdom
- Inovus Medical, St Helens, England, United Kingdom
| | - Salman Rawaf
- Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, London, England, United Kingdom
- Academic Public Health England, Public Health England, London, England, United Kingdom
| | - Reza Rawassizadeh
- Department of Computer Science, College of Arts & Sciences, Boston University, Boston, Massachusetts
| | - Mohammad Sadegh Razeghinia
- Department of Immunology and Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
- Department of Immunology, Kerman University of Medical Sciences, Kerman, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abanoub Riad
- Department of Public Health, Masaryk University, Brno, Czech Republic
- Czech National Centre for Evidence-based Healthcare and Knowledge Translation, Masaryk University, Brno, Czech Republic
| | - Thomas J Roberts
- Department of Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Esperanza Romero-Rodríguez
- Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Manjula S
- Department of Oral and Maxillofacial Surgery, JSS Academy of Higher Education and Research, Mysore, India
| | - Chandan S N
- Department of Oral and Maxillofacial Surgery, JSS Academy of Higher Education and Research, Mysore, India
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohammad Reza Saeb
- Department of Polymer Technology, Faculty of Chemistry, Gdańsk University of Technology, Gdańsk, Poland
| | - Umar Saeed
- International Center of Medical Sciences Research, Islamabad, Pakistan
- Multidisciplinary Laboratory Foundation University School of Health Sciences (FUSH), Foundation University, Islamabad, Pakistan
| | - Mohsen Safaei
- Advanced Dental Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Sahebazzamani
- Department of Medical Biochemistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Medical Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Abdallah M Samy
- Department of Entomology, Faculty of Science, Ain Shams University, Cairo, Egypt
- Medical Ain Shams Research Institute (MARSI), Ain Shams University, Cairo, Egypt
| | - Milena M Santric-Milicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Brijesh Sathian
- Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, England, United Kingdom
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
| | - Mario Šekerija
- Department of Medical Statistics, University of Zagreb, Zagreb, Croatia
- Department of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Omid Shafaat
- Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, Maryland
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid R Shahsavari
- Department of Chemistry, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan, Iran
| | - Erfan Shamsoddin
- Department of Oral Health, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
- Non-Communicable Diseases Committee, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | | | | | - Jeevan K Shetty
- Department of Biochemistry, Royal College of Surgeons in Ireland Medical University of Bahrain, Busaiteen, Bahrain
| | - K M Shivakumar
- Department of Public Health Dentistry, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, India
| | - Parnian Shobeiri
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of International Studies, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
| | - Seyed Afshin Shorofi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sunil Shrestha
- School of Pharmacy, Monash University, Selangor Darul Ehsan, Malaysia
| | | | - Paramdeep Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Jasvinder A Singh
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
- Department of Medicine Service, US Department of Veterans Affairs, Birmingham, Alabama
| | - Garima Singh
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India
- Department of Community Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Yonatan Solomon
- Department of Nursing, Dire Dawa University, Dire Dawa, Ethiopia
| | - Muhammad Suleman
- Center for Biotechnology and Microbiology, University of Swat, Mingora, Pakistan
- School of Life Sciences, Xiamen University, Xiamen, China
| | | | | | - Iman M Talaat
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- Pathology Department, Alexandria University, Alexandria, Egypt
| | - Ker-Kan Tan
- Department of Surgery, National University of Singapore, Singapore, Singapore
| | - Abdelghani Tbakhi
- Department of Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman, Jordan
| | - Arulmani Thiyagarajan
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Amir Tiyuri
- Department of Epidemiology and Biostatistics, Birjand University of Medical Sciences, Birjand, Iran
- Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran
| | - Marcos Roberto Tovani-Palone
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
- Modestum LTD, Eastbourne, England, United Kingdom
| | - Bhaskaran Unnikrishnan
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Bay Vo
- Faculty of Information Technology, Ho Chi Minh City University of Technology (HUTECH), Ho Chi Minh City, Vietnam
| | - Simona Ruxandra Volovat
- Department of Medical Oncology, University of Medicine and Pharmacy "Grigore T Popa" Iaşi, Iaşi, Romania
- Department of Medical Oncology, Regional Institute of Oncology, Iaşi, Romania
| | - Cong Wang
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Ronny Westerman
- Competence Center of Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
| | - Nuwan Darshana Wickramasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Hong Xiao
- School of Public Health, Zhejiang University, Zhejiang, China
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Medicine, Wuhan University, Wuhan, China
| | - Deniz Yuce
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Iman Zare
- Research and Development Department, Sina Medical Biochemistry Technologies, Shiraz, Iran
| | - Zhi-Jiang Zhang
- School of Medicine, Faculty of Medical Sciences, Wuhan University, Wuhan, China
| | - Mohammad Zoladl
- Department of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Lisa M Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Division of Hematology-Oncology, Department of Pediatrics, University of Washington, Seattle
| | - Fernando N Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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9
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Charters E, Pelham C, Novakovic D, Madill C, Clark J. Velopharyngeal incompetence following transoral robotic surgery for oropharyngeal carcinoma: A scoping review. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:540-548. [PMID: 35975948 DOI: 10.1080/17549507.2022.2104927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Following transoral robotic surgery (TORS) for oropharyngeal carcinoma (OPC), velopharyngeal incompetence (VPI) is a known consequence that may contribute to swallowing and speech disorders. As the incidence of OPC increases affecting a younger demographic, a better understanding of VPI is required to support speech and swallowing rehabilitation. METHOD A scoping review was conducted using Arskey & O'Malley's framework. Studies were identified from five databases between 2007 and 2020. The methodological quality was measured with the RevMan Risk of Bias Tool by two independent evaluators. RESULT A total of seven studies met the inclusion criterion. There was a combined total of 306 participants, their average age was 59.2 years. A high risk of bias and degree of heterogeneity across all seven cohort studies was observed. Validated and instrumental evaluations of VPI were present in two papers, with the majority only reporting the presence or absence of VPI. The incidence of VPI reported in each study ranged from 0 to 53%, (median 3.5%). CONCLUSION There are few high-quality studies and considerable heterogeneity in the terminology, inclusion criteria and measurement of VPI. Instrumentation, to date, has been rarely used but is necessary for a normed and validated approach to VPI. Based on this review, there is considerable need for larger studies which instrumentally and longitudinally assess VPI as a consequence of TORS, in order to guide patient education and management prior to, and following their surgery.
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Affiliation(s)
- Emma Charters
- Department of Speech Pathology, Chris O'Brien Lifehouse, Sydney, Australia
| | - Claire Pelham
- Department of Speech Pathology, Chris O'Brien Lifehouse, Sydney, Australia
| | - Daniel Novakovic
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia
| | - Cate Madill
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jonathan Clark
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia
- Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, Australia
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10
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Fan Z, Wu X, Li C, Chen H, Liu W, Zheng Y, Chen J, Li X, Sun H, Jiang T, Grzegorzek M, Li C. CAM-VT: A Weakly supervised cervical cancer nest image identification approach using conjugated attention mechanism and visual transformer. Comput Biol Med 2023; 162:107070. [PMID: 37295389 DOI: 10.1016/j.compbiomed.2023.107070] [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: 02/23/2023] [Revised: 04/27/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
Cervical cancer is the fourth most common cancer among women, and cytopathological images are often used to screen for this cancer. However, manual examination is very troublesome and the misdiagnosis rate is high. In addition, cervical cancer nest cells are denser and more complex, with high overlap and opacity, increasing the difficulty of identification. The appearance of the computer aided automatic diagnosis system solves this problem. In this paper, a weakly supervised cervical cancer nest image identification approach using Conjugated Attention Mechanism and Visual Transformer (CAM-VT), which can analyze pap slides quickly and accurately. CAM-VT proposes conjugated attention mechanism and visual transformer modules for local and global feature extraction respectively, and then designs an ensemble learning module to further improve the identification capability. In order to determine a reasonable interpretation, comparative experiments are conducted on our datasets. The average accuracy of the validation set of three repeated experiments using CAM-VT framework is 88.92%, which is higher than the optimal result of 22 well-known deep learning models. Moreover, we conduct ablation experiments and extended experiments on Hematoxylin and Eosin stained gastric histopathological image datasets to verify the ability and generalization ability of the framework. Finally, the top 5 and top 10 positive probability values of cervical nests are 97.36% and 96.84%, which have important clinical and practical significance. The experimental results show that the proposed CAM-VT framework has excellent performance in potential cervical cancer nest image identification tasks for practical clinical work.
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Affiliation(s)
- Zizhen Fan
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Xiangchen Wu
- Suzhou Ruiqian Technology Company Ltd., Suzhou, China
| | - Changzhong Li
- Suzhou Ruiqian Technology Company Ltd., Suzhou, China
| | - Haoyuan Chen
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Wanli Liu
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Yuchao Zheng
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Jing Chen
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Xiaoyan Li
- Cancer Hospital of China Medical University, Liaoning Cancer Hospital, Shenyang, China
| | - Hongzan Sun
- Shengjing Hospital, China Medical University, Shenyang, China.
| | - Tao Jiang
- School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China; International Joint Institute of Robotics and Intelligent Systems, Chengdu University of Information Technology, Chengdu, China
| | - Marcin Grzegorzek
- Institute of Medical Informatics, University of Luebeck, Luebeck, Germany; Department of Knowledge Engineering, University of Economics in Katowice, Katowice, Poland
| | - Chen Li
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China.
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11
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Choi J, Kim S, Lee SJ, Bae S, Kim S. Human Papillomavirus (HPV) Vaccination Intent among Mothers of Adolescent Sons: A National Survey on HPV Knowledge, Attitudes and Beliefs in South Korea. World J Mens Health 2023; 41:413-421. [PMID: 35791296 PMCID: PMC10042655 DOI: 10.5534/wjmh.210262] [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: 12/29/2021] [Revised: 03/01/2022] [Accepted: 03/20/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Human papillomavirus (HPV) is one of the most common sexually transmitted infections affecting both males and females but there is an apparent lack of knowledge and apprehension towards male HPV vaccination South Korea. The purpose of the present study was to examine the associations between knowledge and perceptions of male HPV vaccination and vaccination intent among Korean mothers of adolescent sons. MATERIALS AND METHODS We conducted a cross-sectional study using a nationwide online survey. The independent variables were mothers' sociodemographic characteristics, history of HPV diagnosis, general HPV knowledge, HPV vaccine knowledge, and attitudes and beliefs towards male HPV vaccination. The outcome variable was mothers' intent to vaccinate their sons, which was classified into three categories: non-intent, undecided and intend to vaccinate. We performed univariate analysis and multinomial logistic regression analysis. RESULTS A total of 906 eligible mothers completed the survey. Mothers received low scores on the HPV-related knowledge scales with low ratings on the scale measuring perceived risk of HPV. Approximately 10% of the mothers intended to vaccinate their sons against HPV, 61.0% were undecided and 1.5% already had their sons vaccinated. According to the multinominal logistic regression analysis, having a daughter in the family, mothers' previous diagnosis with HPV, general HPV knowledge, influence, harm, and risk were significantly associated with being undecided and having intentions to vaccinate their sons (p<0.05). CONCLUSIONS Our study revealed that Korean mothers are generally less aware of male HPV vaccination, have low perceived risk of HPV, and remain highly hesitant on vaccinating their sons against HPV. It is therefore important to raise public awareness about male HPV vaccination and alleviate vaccine hesitancy. Such efforts will contribute to improving parents' vaccination intent, increasing vaccine uptake among male adolescents and prevention of HPV-associated diseases.
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Affiliation(s)
- Jihye Choi
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Seyoung Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Seung-Ju Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sangrak Bae
- Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sooyoun Kim
- Institute of Health and Environment, Seoul National University, Seoul, Korea.
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12
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Kim RY, Vincent AG, Shokri T, Ducic Y. Does Bulky Adenopathy in Human Papilloma Virus-Positive Oropharyngeal Squamous Cell Carcinoma Require a Planned Post-Treatment Neck Dissection for Occult Residual Disease? J Oral Maxillofac Surg 2023; 81:248-253. [PMID: 36528082 DOI: 10.1016/j.joms.2022.11.013] [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: 08/15/2022] [Revised: 11/21/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE A planned neck dissection was traditionally considered for a large nodal disease after definitive chemoradiation, yet controversy exists for the human papilloma virus-positive oropharyngeal squamous cell carcinoma (HPV OPSCC). We aimed to measure the frequency of persistent occult neck disease in planned neck dissection for HPV OPSCC presenting with a large (≥3.0 cm) nodal burden. METHODS We designed a retrospective cohort study at a single tertiary referral institution. The study population was sampled from 2006 to 2018 and subjects with HPV OPSCC and adenopathy ≥3.0 cm. Inclusion criteria encompassed subjects who completed primary chemoradiation therapy (CRT) or primary radiation therapy (RT), and subsequently underwent a planned neck dissection. We excluded subjects who did not complete therapy or had less than 1-year follow-up. Our primary predictor variable was the size of cervical adenopathy on presentation (3.0-3.9 cm, 4.0-4.9 cm, 5.0-5.9 cm, and ≥6.0 cm). Our primary outcome of interest was the presence of disease based on the histopathology review. Other variables included the demographics, primary treatment with CRT or RT, and post-treatment clinical or radiographic evidence of disease. Chi-square testing was used to compare rates of persistent disease, with varying sizes of cervical adenopathy on presentation. The alpha level for statistical significance was set at 0.05. RESULTS A total of 86 subjects were analyzed, with forty-one females and forty-five males, ranging from 36 to 77 years (mean 54.6 years). From the total study sample, 35% showed persistent disease, and 67% of those subjects had occult disease at the time of planned neck dissection. Greater than 20% of subjects had persistent disease when the nodal burden was ≥3.0 cm at presentation. Furthermore, there was a statistically significant difference in the rates of persistent microscopic disease among subjects with nodal burden of different sizes based on chi-square testing (P = .01, χ2 = 10.66). CONCLUSIONS Our data suggest that subjects with HPV OPSCC presenting with a nodal burden ≥3.0 cm are likely to have 23% chance of persistent occult neck disease after primary CRT or RT. These findings may support the routine treatment of these subjects with a planned neck dissection after initial therapy to confirm or surgically complete disease eradication.
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Affiliation(s)
- Roderick Y Kim
- Director of Fellowship in Maxillofacial Oncology and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, John Peter Smith Health Network, Fort Worth, TX.
| | - Aurora G Vincent
- Deputy Chief of Surgery, Facial Plastic and Reconstructive Surgery, Department of Surgery, Eisenhower Army Medical Center, Fort Gordon, GA
| | - Tom Shokri
- Assistant Professor of Surgery, Department of Facial Plastic and Reconstructive Surgery, George Washington University, Washington, DC
| | - Yadranko Ducic
- Fellowship Director, Facial Plastic Surgery, Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX
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Ferris RL, Westra W. Oropharyngeal Carcinoma with a Special Focus on HPV-Related Squamous Cell Carcinoma. ANNUAL REVIEW OF PATHOLOGY 2023; 18:515-535. [PMID: 36693202 PMCID: PMC11227657 DOI: 10.1146/annurev-pathmechdis-031521-041424] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Human papillomavirus-positive oropharyngeal squamous cell carcinoma (HPV-OPSCC) has one of the most rapidly increasing incidences of any cancer in high-income countries. The most recent (8th) edition of the Union for International Cancer Control/American Joint Committee on Cancer staging system separates HPV-OPSCC from its HPV-negative counterpart to account for the improved prognosis seen in the former. Indeed, owing to its improved prognosis and greater prevalence in younger individuals, numerous ongoing trials are examining the potential for treatment deintensification as a means to improve quality of life while maintaining acceptable survival outcomes. Owing to the distinct biology of HPV-OPSCCs, targeted therapies and immunotherapies have become an area of particular interest. Importantly, OPSCC is often detected at an advanced stage, highlighting the need for diagnostic biomarkers to aid in earlier detection. In this review, we highlight important advances in the epidemiology, pathology, diagnosis, and clinical management of HPV-OPSCC and underscore the need for a progressive understanding of the molecular basis of this disease toward early detection and precision care.
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Affiliation(s)
| | - William Westra
- Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
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14
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Rochefort J, Karagiannidis I, Baillou C, Belin L, Guillot-Delost M, Macedo R, Le Moignic A, Mateo V, Soussan P, Brocheriou I, Teillaud JL, Dieu-Nosjean MC, Bertolus C, Lemoine FM, Lescaille G. Defining biomarkers in oral cancer according to smoking and drinking status. Front Oncol 2023; 12:1068979. [PMID: 36713516 PMCID: PMC9875375 DOI: 10.3389/fonc.2022.1068979] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Oral Squamous Cell Carcinomas (OSCC) are mostly related to tobacco consumption eventually associated to alcohol (Smoker/Drinker patients: SD), but 25-30% of the patients have no identified risk factors (Non-Smoker/Non-Drinker patients: NSND). We hypothesized that these patients have distinguishable immune profiles that could be useful for prognosis. Materials and Methods Cells present in immune tumor microenvironment (TME) and blood from 87 OSCC HPV-negative patients were analyzed using a multiparameter flow cytometry assay, in a prospective case-control study. Cytokine levels in tumor supernatants and blood were determined by a cytometric bead array (CBA) assay. Results Normal gingiva and blood from healthy donors (HD) were used as controls. A significant increase of granulocytes (p<0.05 for blood), of monocytes-macrophages (p<0.01 for blood) and of CD4+ T cells expressing CD45RO and CCR6 (p<0.001 for blood; p<0.0001 for TME) as well as higher levels of IL-6 (p<0.01 for sera, p<0.05 for tumor supernatant) were observed in SD patients as compared to NSND OSCC patients and HD. High percentages of CD4+ T cells expressing CD45RO and CCR6 cells in tumor tissue (p=0.05) and blood (p=0.05) of SD OSCC patients were also associated with a poorer prognosis while a high percentage of regulatory T cells (Treg) in tumor tissue was associated with a more favorable prognostic factor (p=0.05). Also, a higher percentage of blood CD8+ T lymphocytes among CD45+ cells in NSND patients was associated with a better disease-free survival (p=0.004). Conclusion Granulocytes, monocytes-macrophages, and CD4+ T cells expressing CD45RO and CCR6 in blood and TME as well as serum IL-6 can therefore distinguish OSCC SD and NSND patients. Quantifying the proportion of CD4+ T cells expressing CD45RO and CCR6 and of Treg in SD patients and CD8+ T cells in NSND patients could help defining the prognostic of OSCC patients.
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Affiliation(s)
- Juliette Rochefort
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France,Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe hospitalier Pitié-Salpêtrière, Department of Odontology, Paris, France,Faculty of Odontology Université Paris Cité, Paris, France,*Correspondence: Juliette Rochefort,
| | - Ioannis Karagiannidis
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France
| | - Claude Baillou
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France
| | - Lisa Belin
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Département de Santé Publique, Paris, France
| | - Maude Guillot-Delost
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France
| | - Rodney Macedo
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France
| | - Aline Le Moignic
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France
| | - Véronique Mateo
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France
| | | | - Isabelle Brocheriou
- AP-HP, Groupe hospitalier Pitié-Salpêtrière, Department of Pathology, Paris, France
| | - Jean-Luc Teillaud
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France
| | - Marie-Caroline Dieu-Nosjean
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France
| | - Chloé Bertolus
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France,AP-HP, Groupe hospitalier Pitié-Salpêtrière, Department of Maxillo-Facial Surgery, Paris, France
| | - Francois Michel Lemoine
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France,AP-HP, Groupe hospitalier Pitié-Salpêtrière, Department of Immunology, Paris, France
| | - Géraldine Lescaille
- Sorbonne Université, Inserm U.1135, Center of Immunology and Infectious Diseases (Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris), Paris, France,Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe hospitalier Pitié-Salpêtrière, Department of Odontology, Paris, France,Faculty of Odontology Université Paris Cité, Paris, France
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15
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Wang A, Zhou Y, Chen Y, Zhou J, You X, Liu H, Liu Y, Ding P, Qi Y, Liang C, Zhu X, Zhang Y, Liu E, Zhang G. Electrochemical immunosensor for ultrasensitive detection of human papillomaviruse type 16 L1 protein based on Ag@AuNPs-GO/SPA. Anal Biochem 2023; 660:114953. [PMID: 36243135 DOI: 10.1016/j.ab.2022.114953] [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: 06/21/2022] [Revised: 09/30/2022] [Accepted: 10/07/2022] [Indexed: 12/14/2022]
Abstract
Human papillomaviruse type 16 (HPV16) is a high-risk serotype. As the main protective antigen protein, L1 protein is also the target protein for diagnosis. A simple label free electrochemical immunosensor (ECIS) was fabricated for ultrasensitive detection of HPV16 L1 protein in this work. Quasi-spherical Ag@Au core-shell nanoparticles on graphene oxide (Ag@AuNPs-GO) was developed as current response amplifier and characterized by UV-Vis Spectroscopy, Transmission Electron Microscopy and energy dispersive X-ray spectroscopy. Staphylococcal protein A was decorated on the modified electrode and utilized to immobilized the Fc portion of the monoclonal antibody specific for HPV16 L1 protein. Cyclic Voltammetry, Differential Pulse Voltammetry and Electrochemical Impedance Spectroscopy were used to verify the electrochemical performance and interfacial kinetic property. The increased concentration of HPV16 L1 protein led to slow electron transport and linearly decreased differential pulse voltammetry peak current with a detection limit of 0.002 ng mL-1 and a wide linear relationship in the range of 0.005-400 ng mL-1at a regression coefficient (R2) of 0.9948. Furthermore, this ECIS demonstrated acceptable accuracy with good reproducibility, stability and selectivity, suggesting a promising immunological strategy for HPV typing and early screening.
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Affiliation(s)
- Aiping Wang
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China; College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China
| | - Yiting Zhou
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Yumei Chen
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Jingming Zhou
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Xiaojuan You
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Hongliang Liu
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Yankai Liu
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Peiyang Ding
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Yanhua Qi
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Chao Liang
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Xifang Zhu
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Ying Zhang
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Enping Liu
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China
| | - Gaiping Zhang
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450000, China; Longhu Laboratory, Zhengzhou, 451100, China; School of Advanced Agricultural Sciences, Peking University, Beijing, 100871, China; College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China.
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Smith CDL, McMahon AD, Ross A, Inman GJ, Conway DI. Risk prediction models for head and neck cancer: A rapid review. Laryngoscope Investig Otolaryngol 2022; 7:1893-1908. [PMID: 36544947 PMCID: PMC9764804 DOI: 10.1002/lio2.982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/26/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background Cancer risk assessment models are used to support prevention and early detection. However, few models have been developed for head and neck cancer (HNC). Methods A rapid review of Embase and MEDLINE identified n = 3045 articles. Following dual screening, n = 14 studies were included. Quality appraisal using the PROBAST (risk of bias) instrument was conducted, and a narrative synthesis was performed to identify the best performing models in terms of risk factors and designs. Results Six of the 14 models were assessed as "high" quality. Of these, three had high predictive performance achieving area under curve values over 0.8 (0.87-0.89). The common features of these models were their inclusion of predictors carefully tailored to the target population/anatomical subsite and development with external validation. Conclusions Some existing models do possess the potential to identify and stratify those at risk of HNC but there is scope for improvement.
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Affiliation(s)
- Craig D. L. Smith
- School of Medicine, Dentistry, and NursingUniversity of GlasgowGlasgowUK
- Institute of Cancer SciencesUniversity of GlasgowGlasgowUK
| | - Alex D. McMahon
- School of Medicine, Dentistry, and NursingUniversity of GlasgowGlasgowUK
| | - Alastair Ross
- School of Medicine, Dentistry, and NursingUniversity of GlasgowGlasgowUK
| | - Gareth J. Inman
- Institute of Cancer SciencesUniversity of GlasgowGlasgowUK
- Cancer Research UK Beatson InstituteGlasgowUK
| | - David I. Conway
- School of Medicine, Dentistry, and NursingUniversity of GlasgowGlasgowUK
- Institute of Cancer SciencesUniversity of GlasgowGlasgowUK
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Xu C, Li M, Li G, Zhang Y, Sun C, Bai N. Cervical Cell/Clumps Detection in Cytology Images Using Transfer Learning. Diagnostics (Basel) 2022; 12:2477. [PMID: 36292166 PMCID: PMC9600700 DOI: 10.3390/diagnostics12102477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 12/04/2022] Open
Abstract
Cervical cancer is one of the most common and deadliest cancers among women and poses a serious health risk. Automated screening and diagnosis of cervical cancer will help improve the accuracy of cervical cell screening. In recent years, there have been many studies conducted using deep learning methods for automatic cervical cancer screening and diagnosis. Deep-learning-based Convolutional Neural Network (CNN) models require large amounts of data for training, but large cervical cell datasets with annotations are difficult to obtain. Some studies have used transfer learning approaches to handle this problem. However, such studies used the same transfer learning method that is the backbone network initialization by the ImageNet pre-trained model in two different types of tasks, the detection and classification of cervical cell/clumps. Considering the differences between detection and classification tasks, this study proposes the use of COCO pre-trained models when using deep learning methods for cervical cell/clumps detection tasks to better handle limited data set problem at training time. To further improve the model detection performance, based on transfer learning, we conducted multi-scale training according to the actual situation of the dataset. Considering the effect of bounding box loss on the precision of cervical cell/clumps detection, we analyzed the effects of different bounding box losses on the detection performance of the model and demonstrated that using a loss function consistent with the type of pre-trained model can help improve the model performance. We analyzed the effect of mean and std of different datasets on the performance of the model. It was demonstrated that the detection performance was optimal when using the mean and std of the cervical cell dataset used in the current study. Ultimately, based on backbone Resnet50, the mean Average Precision (mAP) of the network model is 61.6% and Average Recall (AR) is 87.7%. Compared to the current values of 48.8% and 64.0% in the used dataset, the model detection performance is significantly improved by 12.8% and 23.7%, respectively.
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Affiliation(s)
- Chuanyun Xu
- School of Artificial Intelligence, Chongqing University of Technology, Chongqing 400054, China
- College of Computer and Information Science, Chongqing Normal University, Chongqing 401331, China
| | - Mengwei Li
- School of Artificial Intelligence, Chongqing University of Technology, Chongqing 400054, China
| | - Gang Li
- School of Artificial Intelligence, Chongqing University of Technology, Chongqing 400054, China
| | - Yang Zhang
- College of Computer and Information Science, Chongqing Normal University, Chongqing 401331, China
| | - Chengjie Sun
- School of Artificial Intelligence, Chongqing University of Technology, Chongqing 400054, China
| | - Nanlan Bai
- School of Artificial Intelligence, Chongqing University of Technology, Chongqing 400054, China
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Dental health in patients with and without HPV-positive oropharyngeal and tongue cancer. PLoS One 2022; 17:e0274813. [PMID: 36137133 PMCID: PMC9499192 DOI: 10.1371/journal.pone.0274813] [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: 03/31/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Human papilloma virus is associated with oral and oropharyngeal cancer. Our aim was to examine oral health in patients with oropharyngeal (OPSCC) and oral tongue cancer (OTSCC), expecting better oral health among OPSCC patients. Material and methods Fifty-five OPSCC patients with known HPV status and 59 OTSCC patients were randomly selected from a list of consecutive patients of the Helsinki University Hospital, Finland. Oral health was assessed from panoramic jaw radiographs. Total Dental Index (TDI) summarizing the dental health status was calculated and Finnish population study data were used for comparison. Descriptive statistics were used for analyses. Results Patients with HPV-positive OPSCC had higher periapical lesion index compared with HPV-negative OPSCC patients or with OTSCC patients. Residual roots were more common among OPSCC patients compared with OTSCC patients, because of their higher occurrence among HPV-negative OPSCC patients compared with OTSCC patients. Similarly, modified TDI score was significantly higher among OPSCC patients than among OTSCC patients, because of higher TDI score among HPV-negative OPSCC patients compared with OTSCC patients. OPSCC patients more often used a removable prosthesis than OTSCC patients. Dental health of the cancer patients was poorer when compared with the population data. Conclusions Our study hypothesis was only partly confirmed. Periapical lesions were more prevalent among HPV-positive OPSCC patients, compared with the other groups. The number of residual roots was higher among HPV-negative subgroup. Thus, OPSCC patients had worse oral health parameters than OTSCC patients.
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Gorphe P, Blanchard P, Garcia GCTE, Classe M, Even C, Temam S, Breuskin I. 2011-2021 rising prevalence of HPV infection among oropharyngeal carcinoma in France. BMC Cancer 2022; 22:1000. [PMID: 36127667 PMCID: PMC9490895 DOI: 10.1186/s12885-022-10091-8] [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: 06/30/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022] Open
Abstract
Background The objective of our study was to investigate changes over the past decade in patient age and the prevalence of HPV in the population of patients with oropharyngeal carcinoma (OPC) treated at our center. Methods We performed a retrospective cohort study of patients treated at our cancer center for OPC between 2011 and 2021. Tissue biopsies were assessed for HPV status based on p16 staining for all patients. Results There were 1,365 treated patients. The proportion of p16-positive patients increased from 43% in 2011 to 57.3% in 2021 (p = 0.01). The sex ratio was 3.6 M/1F for p16-positive and 3.7 M/1F for p16-negative patients (p = 0.94). The mean age increased from 60.2 y in 2011 to 63.6 y in 2021. The mean ages were 61.9 y for p16-positive and 61.7 y for p16-negative patients (p = 0.71), but there was a broader age distribution for the p16-positive patients (p = 0.03). The proportion of patients older than 70 y increased from 11% in 2011 to 28.2% in 2021, and this aging was similar between p16-positive (30.7% in 2021) and p16-negative (26.3% in 2021) patients. The 2-year and 5-year OS rates were 73.7% and 56.5% for the entire cohort. p16-positive patients had 2-year and 5-year OS rates of 86.8% and 77.4%, respectively, whereas p16-negative patients had 2-year and 5-year OS rates of 63.9% and 40.5%. Conclusions Assessment of the change over the past decade in the population of patients with OPC at our center showed that HPV-positive OPC now appear to have overtaken HPV-negative cases in France, with 57.3% in 2021, and showed significant aging, with almost thirty percent of patients now older than 70 years. Those combined changes emphasize some of the challenges to be addressed in future OPC management.
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Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy, University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif, France.
| | - Pierre Blanchard
- Department of Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Gabriel C T E Garcia
- Department of Radiology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Marion Classe
- Department of Pathology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Caroline Even
- Department of Head and Neck Oncology, Gustave Roussy, University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy, University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy, University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif, France
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Cao Y, Gilbert RJ, Quon H. Advances and Challenges in Treatment De-Intensification of HPV-Associated Oropharyngeal Squamous Cell Carcinoma. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00425-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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21
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Andersson BÅ, Nilsson M, Oliva D. Impact of single nucleotide polymorphisms and cigarette smoking on cancer risk and survival of patients with head and neck squamous cell carcinoma. Biomarkers 2022; 27:694-700. [PMID: 35830713 DOI: 10.1080/1354750x.2022.2102210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a disease involving genetic and lifestyle risk factors such as smoking or high-risk papillomavirus (HR-HPV) infections. This study analyzed 92 single nucleotide polymorphisms (SNPs) associated with smoking and HPV on HNSCC cancer risk and survival among HNSCC patients. Eighty-six HNSCC patients (48 non-smoking and 38 smoking) were consecutively included. Differences were detected in the analysis of survival and SNP genotypes located in the CXCR2 and COMT. Five SNPs in genes PRKDC, TGFb, XRCC1, Cyp2A6 and CTLA4 were found to be different when comparing SNP genotypes in all patients and all controls as a risk of HNSCC. When comparing SNP genotypes among smoking patients and smoking controls, six SNPs in the genes PFR1, IL10, CCL4, IL6, Ku70, and PRF1 were detected. When comparing SNP genotypes, nine SNPs in CHRNA3, PRKDC, CHARNA5, IFN-γ, ESR1, XRCC1, Cyp2A6, CTLA4, and COMT were different in non-smoking patients and non-smoking controls. No association was found between SNP distribution or patient survival and the impact of HR-HPV. The SNPs differed between smokers and non-smokers and could indicate a possible interaction between genetics and smoking. This could play an important role in a better understanding of the pathogenesis of HNSCC.
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Affiliation(s)
- Bengt-Åke Andersson
- Department of Natural Science and Biomedicine, School of Welfare, Jönköping University, Jönköping, Sweden
| | - Mats Nilsson
- Department of Health, Medicine and Caring, Linköping University, Linköping, Sweden
| | - Delmy Oliva
- Department of Oncology, Region Jönköping County, Jönköping, Sweden and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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22
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de Miranda Vargas DG, da Cunha AR, Probst LF, Zafalon EJ, Pereira PZ, da Silva Tagliaferro EP, De-Carli AD. Characteristics and in-hospital morbidity trends associated with oral and oropharyngeal cancers in Brazil. BMC Oral Health 2022; 22:276. [PMID: 35794558 PMCID: PMC9261028 DOI: 10.1186/s12903-022-02312-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Brazil experienced an expansion of the population's access to oral health policies after the creation of the Unified Health System (SUS, Sistema Único de Saúde). Through public policies, the consolidation of Primary Health Care (PHC) and the incorporation of dental care into primary and hospital care took place. The objective of this study was to identify epidemiological aspects, including the temporal trend, of hospital morbidity from oral and oropharyngeal cancer in Brazil, considering hospitalizations for this neoplasm in a hospital network linked to the public care system. METHODS Observational study based on information on hospital admissions for oral cancer throughout Brazil. The research used data from the Brazilian Cancer Registry Information System. For the temporal series analysis, generalized linear regression model was used with the Prais-Winsten method. RESULTS Of the 121,971 patients hospitalized with oral and oropharyngeal cancers, 76.40% were male and 23.60% were female, resulting in a M:F ratio of 3.24:1. Regarding the anatomical region of involvement among hospitalized patients with oral cavity neoplastic lesions, there was a predominance in non-specific places in the mouth, such as the floor of the mouth, soft and hard palate, among others (32.68%), followed by lesions in the region of tongue (28.89%). In this population, the predominant age group was between the fifth decade (31.09%) and sixth decade of life (24.99%); men presented neoplastic lesions of oral and oropharyngeal cancers at an earlier age than women. In all regions of the country, the staging of cases diagnosed in the tertiary health network accredited to the José Alencar Gomes da Silva National Cancer Institute (INCA) was late, with higher tendency for metastasis. The temporal trend of the adjusted in-hospital morbidity rates showed to be increasing in the Northeast, South and Midwest regions for the male gender. For females, they were increasing in the Northeast and South regions. CONCLUSIONS It is concluded that the distribution of in-hospital morbidity rates of oral and oropharyngeal cancers in the country is irregular. There is a greater number of cases identified by the study in male patients and in the Southeast and South regions; with an increasing tendency of this coefficient in both genders.
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Affiliation(s)
| | - Amanda Ramos da Cunha
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Livia Fernandes Probst
- Unidade de Avaliação de Tecnologias em Saúde, Hospital Alemão Oswaldo Cruz (HAOC), São Paulo, Brazil
| | - Edílson José Zafalon
- Faculdade de Odontologia, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Brazil
| | - Paulo Zárate Pereira
- Faculdade de Odontologia, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Brazil
| | | | - Alessandro Diogo De-Carli
- Programa de Pós-Graduação em Saúde da Família, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Brazil
- Faculdade de Odontologia, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Brazil
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Cheung VKY, Hulme K, Schifter M, Palme C, Low THH, Clark J, Gupta R. Oral Epithelial Dysplasia: A Review of Diagnostic Criteria for Anatomic Pathologists. Adv Anat Pathol 2022; 29:227-240. [PMID: 35435865 DOI: 10.1097/pap.0000000000000343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Oral epithelial dysplasia (OED) represents a spectrum of histologic changes in the oral cavity mucosa that has the potential to transform into oral squamous cell carcinoma. Predicting the risk of malignant transformation is predominantly based on clinicopathologic correlation, histologic examination and grading. OED often poses a diagnostic challenge, primarily due to its histologic mimics and a large number of terminologies used in the literature. The grading system for OED is also fraught with significant interobserver variability. This review summarizes the essential clinical and histopathologic features of OED and its mimics. Practical preanalytical, analytical, and postanalytical considerations for anatomic pathologists are discussed to improve the diagnostic accuracy and increase the reproducibility in the grading of OED.
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Affiliation(s)
- Veronica K Y Cheung
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital
- Faculty of Medicine and Health, Sydney Medical School
| | - Katherine Hulme
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital
| | - Mark Schifter
- Westmead Centre for Oral Health, Westmead Hospital, a Teaching Hospital of the Sydney Dental School, Faculty of Medicine and Health, University of Sydney
- The Skin Hospital, Darlinghurst (Sydney)
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse
| | - Carsten Palme
- Faculty of Medicine and Health, Sydney Medical School
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse
| | - Tsu-Hui Hubert Low
- Faculty of Medicine and Health, Sydney Medical School
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse
- Department of Otolaryngology - Head & Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University
| | - Jonathan Clark
- Faculty of Medicine and Health, Sydney Medical School
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital
- Faculty of Medicine and Health, Sydney Medical School
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Kurani S, MacLaughlin KL, Jacobson RM, St Sauver JL, Jenkins GD, Fan C, Jacobson DJ, Inselman J, Zhu X, Griffin JM, Finney Rutten LJ. Socioeconomic disadvantage and human papillomavirus (HPV) vaccination uptake. Vaccine 2022; 40:471-476. [PMID: 34916103 PMCID: PMC8778948 DOI: 10.1016/j.vaccine.2021.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 01/26/2023]
Abstract
IMPORTANCE Despite availability of safe and effective human papillomavirus (HPV) vaccines, vaccination uptake remains low in the U.S. Research examining the impact of neighborhood socioeconomic status on HPV vaccination may help target interventions. OBJECTIVE To examine the association between area deprivation and HPV vaccine initiation and completion. DESIGN, SETTING, PARTICIPANTS Retrospective cohort study of individuals aged 11-18 years residing in the upper Midwest region. Receipt of HPV vaccination was examined over a three-year follow-up period (01/01/2016-12/31/2018). MAIN OUTCOMES AND MEASURES Outcomes of interest were initiation and completion of HPV vaccination. Demographic data were collected from the Rochester Epidemiology Project (REP). Area-level socioeconomic disadvantage was measured by calculating an Area Deprivation Index (ADI) score for each person, a measure of socioeconomic disadvantage derived from American Community Survey data. Multivariable mixed effect Cox proportional hazards models were used to examine the association of ADI quartiles (Q1-Q4) with HPV vaccine series initiation and completion, given initiation. RESULTS Individuals residing in census block groups with higher deprivation had significantly lower likelihood of HPV vaccine initiation (Q2: HR = 0.91, 0.84-0.99 Q3: HR = 0.83, 0.76-0.90; Q4: HR = 0.84, 0.74-0.96) relative to those in the least-deprived block groups (Q1). Similarly, those living in block groups with higher deprivation had significantly lower likelihood of completion (Q2: HR = 0.91, 0.86-0.97; Q3: HR = 0.87, 0.81-0.94; Q4: HR = 0.82, 0.74-0.92) compared to individuals in the least-deprived block groups (Q1). CONCLUSIONS AND RELEVANCE Lower probability of both HPV vaccine-series initiation and completion were observed in areas with greater deprivation. Our results can inform allocation of resources to increase HPV vaccination rates in our primary care practice and provide an example of leveraging public data to inform similar efforts across diverse health systems.
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Affiliation(s)
- Shaheen Kurani
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Kathy L MacLaughlin
- Department of Family Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA; Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Jennifer L St Sauver
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Gregory D Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Chun Fan
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Debra J Jacobson
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Jonathan Inselman
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Xuan Zhu
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Joan M Griffin
- Division of Health Care Delivery Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
| | - Lila J Finney Rutten
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
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The Predictive Model of Oral Squamous Cell Survival Carcinoma: A Methodology of Validation. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5436894. [PMID: 34904115 PMCID: PMC8665892 DOI: 10.1155/2021/5436894] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/02/2021] [Indexed: 11/20/2022]
Abstract
Background Cancer is primarily caused by smoking, alcohol, betel quit, a series of genetic alterations, and epigenetic abnormalities in signaling pathways, which result in a variety of phenotypes that favor the development of OSCC. Oral squamous cell carcinoma (OSCC) is the most common type of oral cancer, accounting for 80–90% of all oral malignant neoplasms. Oral cancer is relatively common, and it is frequently curable when detected and treated early enough. The tumor-node-metastasis (TNM) staging system is used to determine patient prognosis; however, geographical inaccuracies frequently occur, affecting management. Objective To determine the additional relationship between factors discovered by searching for sociodemographic and metastasis factors, as well as treatment outcomes, which could help improve the prediction of the survival rate in cancer patients. Material and Methods. A total of 56 patients were recruited from the ambulatory clinic at the Hospital Universiti Sains Malaysia (USM). In this retrospective study, advanced computational statistical modeling techniques were used to evaluate data descriptions of several variables such as treatment, age, and distant metastasis. The R-Studio software and syntax were used to implement and test the hazard ratio. The statistics for each sample were calculated using a combination model that included methods such as bootstrap and multiple linear regression (MLR). Results The statistical strategy showed R demonstrates that regression modeling outperforms an R-squared. It demonstrated that when data is partitioned into a training and testing dataset, the hybrid model technique performs better at predicting the outcome. The variable validation was determined using the well-established bootstrap-integrated MLR technique. In this case, three variables are considered: age, treatment, and distant metastases. It is important to note that three things affect the hazard ratio: age (β1: -0.006423; p < 2e − 16), treatment (β2: -0.355389; p < 2e − 16), and distant metastasis (β3: -0.355389; p < 2e − 16). There is a 0.003469102 MSE for the linear model in this scenario. Conclusion In this study, a hybrid approach combining bootstrapping and multiple linear regression will be developed and extensively tested. The R syntax for this methodology was designed to ensure that the researcher completely understood the illustration. In this case, a hybrid model demonstrates how this critical conclusion enables us to better understand the utility and relative contribution of the hybrid method to the outcome. The statistical technique used in this study, R, demonstrates that regression modeling outperforms R-squared values of 0.9014 and 0.00882 for the predicted mean squared error, respectively. The conclusion of the study establishes the superiority of the hybrid model technique used in the study.
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The Prevalence of High- and Low-Risk Types of HPV in Patients with Squamous Cell Carcinoma of the Head and Neck, Patients with Chronic Tonsillitis, and Healthy Individuals Living in Poland. Diagnostics (Basel) 2021; 11:diagnostics11122180. [PMID: 34943415 PMCID: PMC8699972 DOI: 10.3390/diagnostics11122180] [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: 09/21/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 12/05/2022] Open
Abstract
Human papillomavirus (HPV) is a virus with the potential to infect human epithelial cells and an etiological agent of many types of cancer, including head and neck cancer. The aim of the study was to determine the prevalence of HPV infection in patients with head and neck squamous cell carcinoma (HNSCC), patients with chronic tonsillitis, and healthy individuals, and to establish high- and low-risk HPV genotypes in these groups. The objectives also comprised the delineation of the relationship between the infection with high- or low-risk HPV subtypes and clinicopathological and demographic characteristics of the study groups. This study was composed of 76 patients diagnosed with HNSCC, 71 patients with chronic tonsillitis, and 168 cases without either of these conditions (the control group). HPV detection and identification of subtypes were performed on isolated DNA using a test which allowed detection of 33 common high-risk and low-risk HPV subtypes. The prevalence of HPV infection was 42.1%, 25.4%, and 37.5% in HNSCC, chronic tonsillitis, and control groups, respectively. HPV 16 was the most prevalent genotype in all groups and the non-oncogenic HPV 43/44 was frequent in HNSCC patients. This analysis provides insight into the prevalence of oral oncogenic and non-oncogenic HPVs in patients with head and neck cancer, patients with chronic tonsillitis and healthy individuals, and leads to the conclusion that further investigations are warranted to examine a larger cohort of patients focusing on high- and low-risk HPV genotypes. Efforts should be focused on screening and prevention strategies, and therefore, it is important to introduce tools for effective detection of HPV genotypes. Furthermore, given the role of vaccines against oral HPV infection, our observations lead to the suggestion that HPV vaccination should be of considerable importance in public health strategies.
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Charters E, Clark J. Intensive dysphagia rehabilitation program for patients with head and neck cancer. ANZ J Surg 2021; 92:505-510. [PMID: 34791759 DOI: 10.1111/ans.17365] [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: 07/24/2021] [Revised: 09/15/2021] [Accepted: 10/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND In response to the pathophysiology and expected trajectory of dysphagia that arises following treatment for head and neck cancer (HNC), an intensive and progressive approach to dysphagia is warranted. This pilot study evaluates the recovery of swallowing function following the implementation of an exercise-based approach to dysphagia rehabilitation. METHODS Consecutive recruitment was carried out prospectively at a quaternary referral centre. Participants were aged 18 years and older and had completed treatment for HNC. Dysphagia was assessed pre and post a 10-week rehabilitation program using videofluoroscopy swallow study (VFSS) and clinician-and patient-reported outcomes. RESULTS Ten participants were recruited over a 6-month period, all of whom had oropharyngeal dysphagia confirmed on VFSS. At the conclusion of the 10-week intervention period, DIGEST (Dynamic Imaging Grade of Swallowing Toxicity) scores improved significantly for both safety and efficiency components. Four of seven participants who had a percutaneous endoscopic gastrostomy tube at baseline were no longer reliant on it for their nutrition, hydration or medication at the completion of the therapeutic period. While four participants continued to aspirate on thin fluids, none developed aspiration pneumonia. CONCLUSION Oropharyngeal dysphagia as a consequence of HNC treatment is challenging to rehabilitate; however, in selected patients, it is responsive to intensive and individualized rehabilitation programs.
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Affiliation(s)
- Emma Charters
- Department of Allied Health, Speech Pathology, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Jonathan Clark
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.,Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
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Bagher Ebadian H, Siddiqui F, Ghanem A, Zhu S, Lu M, Movsas B, Chetty IJ. Radiomics outperforms clinical factors in characterizing human papilloma virus (HPV) for patients with oropharyngeal squamous cell carcinomas. Biomed Phys Eng Express 2021; 8. [PMID: 34781281 DOI: 10.1088/2057-1976/ac39ab] [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: 08/05/2021] [Accepted: 11/15/2021] [Indexed: 11/11/2022]
Abstract
Purpose:To utilize radiomic features extracted from CT images to characterize Human Papilloma Virus (HPV) for patients with oropharyngeal cancer squamous cell carcinoma (OPSCC).Methods:One hundred twenty-eight OPSCC patients with known HPV-status (60-HPV+ and 68-HPV-, confirmed by immunohistochemistry-P16-protein testing) were retrospectively studied. Radiomic features (11 feature-categories) were extracted in 3D from contrast-enhanced (CE)-CT images of gross-tumor-volumes using 'in-house' software ('ROdiomiX') developed and validated following the image-biomarker-standardization-initiative (IBSI) guidelines. Six clinical factors were investigated: Age-at-Diagnosis, Gender, Total-Charlson, Alcohol-Use, Smoking-History, and T-Stage. A Least-Absolute-Shrinkage-and-Selection-Operation (Lasso) technique combined with a Generalized-Linear-Model (Lasso-GLM) were applied to perform regularization in the radiomic and clinical feature spaces to identify the ranking of optimal feature subsets with most representative information for prediction of HPV. Lasso-GLM models/classifiers based on clinical factors only, radiomics only, and combined clinical and radiomics (ensemble/integrated) were constructed using random-permutation-sampling. Tests of significance (One-way ANOVA), average Area-Under-Receiver-Operating-Characteristic (AUC), and Positive and Negative Predictive values (PPV and NPV) were computed to estimate the generalization-error and prediction performance of the classifiers.Results:Five clinical factors, including T-stage, smoking status, and age, and 14 radiomic features, including tumor morphology, and intensity contrast were found to be statistically significant discriminators between HPV positive and negative cohorts. Performances for prediction of HPV for the 3 classifiers were: Radiomics-Lasso-GLM: AUC/PPV/NPV=0.789/0.755/0.805; Clinical-Lasso-GLM: 0.676/0.747/0.672, and Integrated/Ensemble-Lasso-GLM: 0.895/0.874/0.844. Results imply that the radiomics-based classifier enabled better characterization and performance prediction of HPV relative to clinical factors, and that the combination of both radiomics and clinical factors yields even higher accuracy characterization and predictive performance.Conclusion:Albeit subject to confirmation in a larger cohort, this pilot study presents encouraging results in support of the role of radiomic features towards characterization of HPV in patients with OPSCC.
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Affiliation(s)
- Hassan Bagher Ebadian
- Department of Radiation Oncology , Henry Ford Hospital, 2799 West Grand Blvd., Detroit, Detroit, Michigan, 48202, UNITED STATES
| | - Farzan Siddiqui
- Radiation Oncology, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, Michigan, 48202, UNITED STATES
| | - Ahmed Ghanem
- Radiation Oncology, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, Michigan, 48202, UNITED STATES
| | - Simeng Zhu
- Radiation Oncology, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, Michigan, 48202, UNITED STATES
| | - Mei Lu
- Henry Ford Hospital, 2799 West Grand Blvd., Detroit, Michigan, 48202, UNITED STATES
| | - Benjamin Movsas
- Dept of Radiation Oncology, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, 48202, UNITED STATES
| | - Indrin J Chetty
- Dept of Radiation Oncology, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202-2689, USA, Detroit, Michigan, 48202, UNITED STATES
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Liu W, Li C, Rahaman MM, Jiang T, Sun H, Wu X, Hu W, Chen H, Sun C, Yao Y, Grzegorzek M. Is the aspect ratio of cells important in deep learning? A robust comparison of deep learning methods for multi-scale cytopathology cell image classification: From convolutional neural networks to visual transformers. Comput Biol Med 2021; 141:105026. [PMID: 34801245 DOI: 10.1016/j.compbiomed.2021.105026] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 11/19/2022]
Abstract
Cervical cancer is a very common and fatal type of cancer in women. Cytopathology images are often used to screen for this cancer. Given that there is a possibility that many errors can occur during manual screening, a computer-aided diagnosis system based on deep learning has been developed. Deep learning methods require a fixed dimension of input images, but the dimensions of clinical medical images are inconsistent. The aspect ratios of the images suffer while resizing them directly. Clinically, the aspect ratios of cells inside cytopathological images provide important information for doctors to diagnose cancer. Therefore, it is difficult to resize directly. However, many existing studies have resized the images directly and have obtained highly robust classification results. To determine a reasonable interpretation, we have conducted a series of comparative experiments. First, the raw data of the SIPaKMeD dataset are pre-processed to obtain standard and scaled datasets. Then, the datasets are resized to 224 × 224 pixels. Finally, 22 deep learning models are used to classify the standard and scaled datasets. The results of the study indicate that deep learning models are robust to changes in the aspect ratio of cells in cervical cytopathological images. This conclusion is also validated via the Herlev dataset.
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Affiliation(s)
- Wanli Liu
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Chen Li
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China.
| | - Md Mamunur Rahaman
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Tao Jiang
- School of Control Engineering, Chengdu University of Information Technology, Chengdu, 610225, China
| | - Hongzan Sun
- Shengjing Hospital, China Medical University, Shenyang, 110001, China
| | - Xiangchen Wu
- Suzhou Ruiguan Technology Company Ltd., Suzhou, 215000, China
| | - Weiming Hu
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Haoyuan Chen
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Changhao Sun
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China; Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, 110169, China
| | - Yudong Yao
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, Hoboken, NJ, 07030, USA
| | - Marcin Grzegorzek
- Institute of Medical Informatics, University of Luebeck, Luebeck, Germany
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Pharaon RR, Xing Y, Agulnik M, Villaflor VM. The Role of Immunotherapy to Overcome Resistance in Viral-Associated Head and Neck Cancer. Front Oncol 2021; 11:649963. [PMID: 34336649 PMCID: PMC8322686 DOI: 10.3389/fonc.2021.649963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/28/2021] [Indexed: 12/26/2022] Open
Abstract
A subset of head and neck cancers arising in the oropharynx and the nasopharynx are associated with human papillomavirus or Epstein-Barr virus. Unfortunately, limited treatment options exist once patients develop recurrent or metastatic disease in these cancers. Interest has risen in utilizing novel strategies including combination immune checkpoint inhibitors, vaccines, and adoptive cellular therapy, to improve treatment response and outcomes. Several ongoing studies are investigating the potential to overcome resistance to standard of care chemoradiation therapy with monotherapy or combination immunotherapy strategies in these viral-associated head and neck cancers.
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Affiliation(s)
| | | | | | - Victoria M. Villaflor
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, United States
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Dickey BL, Sirak B, Martin-Gomez L, Reich RR, Abrahamsen M, Isaacs-Soriano K, Chung CH, Giuliano AR. Oral secretory leukocyte protease inhibitor (SLPI): Associations with oropharyngeal cancer and treatment outcome. PLoS One 2021; 16:e0254161. [PMID: 34214131 PMCID: PMC8253433 DOI: 10.1371/journal.pone.0254161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 06/21/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Rates of oropharyngeal cancer (OPC) associated with alcohol & tobacco use have decreased, while human papillomavirus (HPV) associated OPC has increased among men in the US. Secretory leukocyte protease inhibitor (SLPI), detectable in a variety of secretions, has been implicated in cancers of the head and neck, associated with tumor progression and anti-viral activity. Using the recently verified oral gargle specimen, this study aimed to assess the association of salivary SLPI expression with risk of OPC and response to treatment. METHODS A case-control study design compared levels of salivary SLPI among OPC cases to age and tobacco smoking matched healthy controls. Oral HPV DNA and SLPI was quantified from oral gargle specimens. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for associations of oral SLPI and risk of OPC and treatment outcomes. RESULTS In crude and adjusted analyses of 96 OPC cases and 97 age- and smoking-matched controls, OPC was not significantly associated with oral gargle SLPI levels. Among cases, oral SLPI was associated with tonsillectomy (p = 0.018) and among controls oral SLPI was associated with HPV in the oral gargle (p = 0.008). Higher concentrations of SLPI was significantly associated with increased odds of incomplete treatment response (T2: OR: 12.39; 95% CI: 1.44-106.72; T3: OR: 9.86; 95% CI: 1.13-85.90) among all cases, but not among P16+ cases. CONCLUSIONS Salivary SLPI was not associated with OPC risk but was associated with higher odds of an incomplete treatment response.
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Affiliation(s)
- Brittney L. Dickey
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
| | - Bradley Sirak
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
| | - Laura Martin-Gomez
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
| | - Richard R. Reich
- Biostatistics and Bioinformatics Shared Resource, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, United States of America
| | - Martha Abrahamsen
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
| | - Kimberly Isaacs-Soriano
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
| | - Christine H. Chung
- Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, United States of America
| | - Anna R. Giuliano
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
- * E-mail:
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Findlay M, White K, Lai M, Luo D, Bauer JD. The Association Between Computed Tomography-Defined Sarcopenia and Outcomes in Adult Patients Undergoing Radiotherapy of Curative Intent for Head and Neck Cancer: A Systematic Review. J Acad Nutr Diet 2021; 120:1330-1347.e8. [PMID: 32711854 DOI: 10.1016/j.jand.2020.03.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 03/29/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Computed tomography (CT)-defined sarcopenia is a demonstrated poor prognostic factor in patients with cancer; however, its influence on outcomes for patients with head and neck cancer (HNC) has not been established. OBJECTIVE This review synthesizes current knowledge regarding the association between CT-defined sarcopenia and outcomes for adult patients undergoing radiotherapy with or without other treatment modalities of curative intent for HNC. METHODS A systematic review of the literature published between January 2004 and June 2019 was conducted in Medline, Embase, Cumulative Index of Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and PubMed. Empirical studies of CT-defined sarcopenia in adult patients (≥18 years) with HNC who had completed radiotherapy of curative intent with or without other treatment modalities were included. Outcomes reported included survival, prolonged radiotherapy breaks, and chemotherapy toxicity. Study quality was assessed using the American Academy of Nutrition and Dietetics Quality Criteria Checklist. Synthesis of outcomes and clinical relevance was performed using the Grading of Recommendations Assessment, Development, and Evaluation system. RESULTS Of 11 studies (n = 3,461) identified, 3 were positive and 8 were neutral quality. Studies were heterogeneous in HNC diagnosis, ethnicity, definition of sarcopenia, CT level of evaluation, and skeletal muscle index threshold value. Eight definitions for sarcopenia were identified with pretreatment prevalence of 6.6% to 70.9% and posttreatment prevalence of 12.4% to 65.8%. Pretreatment sarcopenia was independently associated with reduced: overall survival (OS), 3-year OS, disease-free survival, prolonged radiotherapy breaks, and chemotherapy-related toxicities. Posttreatment sarcopenia was independently associated with reduced OS and 5-year OS. The overall certainty of evidence according to Grading of Recommendations Assessment, Development and Evaluation criteria was low for OS; 3-year, 5-year, and 10-year OS; locoregional control; locoregional failure; progression-free survival; metastasis-free survival, disease-specific survival; and disease-free survival and very low for distant metastasis, prolonged radiotherapy breaks, and chemotherapy toxicity-related outcomes. CONCLUSIONS CT-defined sarcopenia is independently associated with reduced OS and treatment completion in patients with HNC and holds a clinically meaningful prognostic value. The certainty of the evidence requires strengthening with further research. Understanding the impact sarcopenia has on outcomes for these patients has implications for informing potential nutrition interventions and facilitating individualized care.
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Trinh JM, Thomas J, Salleron J, Henrot P. Differences in clinical and imaging characteristics between p16-positive non-smokers and p16-positive smokers or p16-negative patients in oropharyngeal carcinoma. Sci Rep 2021; 11:3314. [PMID: 33558647 PMCID: PMC7870833 DOI: 10.1038/s41598-021-82999-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/25/2021] [Indexed: 11/24/2022] Open
Abstract
The eighth edition of the TNM classifies oropharyngeal squamous cell carcinomas (OSCCs) depending on p16 status. Some imaging features are reportedly associated more frequently with p16-positive (P16+) OSCC than p16-negative (p16−) OSCC. However, classical risk factors such as tobacco use were not specifically considered when assessing these imaging features. We aimed to evaluate whether P16+ OSCCs have different epidemiological, clinical, prognostic and imaging features depending on smoking status, and to compare P16+ and p16− groups. A retrospective study of data from 85 patients with P16+ OSCC (41 non-smokers, 44 smokers) and 36 with p16− OSCC from 2011 to 2020 was carried out, assessing epidemiological data, clinical aspects of the tumour and presence of adenopathy. Staging was assessed according to the seventh and eighth editions of the TNM. Compared with P16+ OSCC non-smokers, P16+ OSCC smokers had tumours that were less well-defined (36.6% vs 77.8%, p < 0.001), more ulcerated (85.4% vs 44.4%, p < 0.001) and more necrotic (53.7% vs 25%, p = 0.012). There was also less downstaging from N2 or N3 of the seventh edition of the TNM to N1 of the eighth edition for smokers than non-smokers (22.7% vs 43.9%, p = 0.042). Compared with p16− tumours, more P16+ tumours had well-defined contours (55.8% vs 22.2%, p = 0.001), were exophytic (89.6% vs 72.2%, p = 0.023), less necrotic (40.3% vs 80.6%, p < 0.001), less ulcerated (97.2% vs 66.2%, p = 0.006) and involved less muscle tissue (26.0% vs 47.2%, p = 0.027).P16+ OSCCs of smokers show clinical, imaging and prognostic differences with P16+ OSCCs of non-smokers.
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Affiliation(s)
- Jean-Michel Trinh
- Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54519, Vandœuvre-lès-Nancy, France.
| | - Jacques Thomas
- Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54519, Vandœuvre-lès-Nancy, France
| | - Julia Salleron
- Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54519, Vandœuvre-lès-Nancy, France
| | - Philippe Henrot
- Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54519, Vandœuvre-lès-Nancy, France
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High-Risk Human Papillomaviruses and DNA Repair. Recent Results Cancer Res 2020. [PMID: 33200365 DOI: 10.1007/978-3-030-57362-1_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Human papillomaviruses (HPVs) are small DNA viruses that infect basal epithelial cells and are the causative agents of cervical, anogenital, as well as oral cancers. High-risk HPVs are responsible for nearly half of all virally induced cancers. Viral replication and amplification are intimately linked to the stratified epithelium differentiation program. The E6 and E7 proteins contribute to the development of cancers in HPV positive individuals by hijacking cellular processes and causing genetic instability. This genetic instability induces a robust DNA damage response and activating both ATM and ATR repair pathways. These pathways are critical for the productive replication of high-risk HPVs, and understanding how they contribute to the viral life cycle can provide important insights into HPV's role in oncogenesis. This review will discuss the role that differentiation and the DNA damage responses play in productive replication of high-risk HPVs as well as in the development of cancer.
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Crotty TJ, Keane E, Cousins G, Brennan S, Kinsella J, Moran T. Sexual Behaviour and Human Papillomavirus-Positive Oral Cavity and Oropharyngeal Cancer: An Irish Perspective. Cureus 2020; 12:e11410. [PMID: 33194506 PMCID: PMC7657314 DOI: 10.7759/cureus.11410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Characterization of the sexual behaviours and lifestyle factors associated with human papillomavirus (HPV)-positive oral cavity and oropharyngeal squamous cell carcinoma (OPSCC) is crucial to optimal counselling. Our study aims to investigate the relationship between sexual behaviours, lifestyle factors and HPV-positive OPSCC in an Irish population. Methods We performed a case-control study of 60 patients with newly diagnosed HPV-positive and HPV-negative oral cavity and OPSCC. Results Oral sexual activity was more common in the HPV-positive tumour subgroup; however, this association was insignificant on multivariate analysis. No association between age of onset of sexual activity, number of sexual partners or practicing anal sex and HPV-positivity was found. The HPV-positive tumour subgroup had significantly less tobacco use than their HPV-negative counterparts (OR 0.93, 95% CI 0.90-0.97). Conclusion The emergence of HPV-positive OPSCC means head and neck surgeons must adopt new roles as counsellors of sexually transmitted disease, in addition to their previous role of delivering a cancer diagnosis.
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Affiliation(s)
- Thomas J Crotty
- Department of Otolaryngology, Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, IRL
| | - Emma Keane
- Department of Otolaryngology, Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, IRL
| | - Grainne Cousins
- Department of Pharmacy, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Sinead Brennan
- Department of Radiation Oncology, St. James University Hospital, Dublin, IRL
| | - John Kinsella
- Department of Otolaryngology, Head and Neck Surgery, St. James University Hospital, Dublin, IRL
| | - Tom Moran
- Department of Otolaryngology, Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, IRL
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Pitones-Rubio V, Chávez-Cortez EG, Hurtado-Camarena A, González-Rascón A, Serafín-Higuera N. Is periodontal disease a risk factor for severe COVID-19 illness? Med Hypotheses 2020; 144:109969. [PMID: 32592918 PMCID: PMC7303044 DOI: 10.1016/j.mehy.2020.109969] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
Periodontal disease (PD) comprises a group of diseases involving inflammatory aspects of the host and dysbiotic events that affect periodontal tissues and could have systemic implications. Diverse factors and comorbidities have been closely associated with PD such as diabetes, obesity, aging, hypertension, and so on; although, underlying mechanisms or causal associations have not been established completely. Interestingly, these same factors have been widely associated with progression or severe coronavirus disease 2019 (COVID-19), an illness caused by coronavirus SARS-CoV-2. Since inflammatory and dysbiotic factors as well as comorbidities affect systemic health, it is possible that periodontal status indicates the risk of complication of COVID-19. However, assessment of oral health history including periodontal status in COVID-19 patients has not been reported. Knowing PD is associated with severe COVID-19 could help identify risk groups and establish pertinent recommendations.
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Affiliation(s)
- Viviana Pitones-Rubio
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - E G Chávez-Cortez
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Angélica Hurtado-Camarena
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Anna González-Rascón
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Nicolás Serafín-Higuera
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico.
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Cobzeanu BM, Cobzeanu MD, Moscalu M, Palade OD, Rădulescu L, Negru D, Moisii LG, Cobzeanu LM, Ungureanu LB, Vonica P, Matei DV, Rusu DC, Volovaț C, Costan VV. Predictive Value of HPV, p53, and p16 in the Post-Treatment Evolution of Malignant Tumors of the Oropharynx and Retromolar Trigone-Oropharynx Junction. ACTA ACUST UNITED AC 2020; 56:medicina56100542. [PMID: 33076537 PMCID: PMC7602815 DOI: 10.3390/medicina56100542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: Knowledge of the interactions and influences of infectious, genetic, and environmental factors on the evolution and treatment response of malignant tumors is essential for improving the management of the disease and increasing patient survival. The objective of this study was to establish the contribution of human papillomavirus (HPV), as well as p53 and p16 tumor markers, alongside associated factors (smoking and alcohol consumption), in the progression of malignancies located in the oropharynx and at the retromolar trigone–oropharyngeal junction. Materials and Methods: We performed a prospective study including 50 patients with malignant tumors of the oropharynx and retromolar trigone–oropharyngeal junction. In all patients, the presence and type of HPV were determined, as well as the status of the tumor markers p53 and p16. The associated risk factors, biopsy results, treatment method, and post-treatment evolution were all documented. Statistical analyses were performed to evaluate the correlations between the determining factors and their influence on the post-treatment evolution. An overall increased survival rate was found in HPV(+) patients. Results: Our study outlined the prevalence of different high-risk subtypes of HPV from the ones presented by other studies, suggesting a possible geographic variation. Correlations between the p53 and p16 statuses and patient survival could be established. The association of smoking and alcohol consumption strongly correlated with an unfavorable evolution. Conclusions: Awareness of the differences in the post-treatment evolution of the patients in relation to the presence of the factors determined in our study could change the future management of such cases for ensuring improved treatment outcomes.
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Sex Differences in the Heterogeneous Dynamic Incidence of Oral Cancer: A Comparison between Taiwan and Thailand. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9321246. [PMID: 33015186 PMCID: PMC7512095 DOI: 10.1155/2020/9321246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/03/2020] [Indexed: 12/24/2022]
Abstract
Background This study aims at investigating differences in oral cancer (OC) incidence trends between two populations in Taiwan and Thailand. Methods We used the population-based cancer registry data from Taiwan (1979-2016) and Khon Kaen (KK), Thailand (1985-2016). We performed joinpoint analyses to detect the trend change points for the OC incidence and to quantify the time trends in both sexes and regions. Age-period-cohort curves were plotted to explain the incidence trends. Results In Taiwan, the estimated annual increases in OC were approximately 6.0% in males, although the increase slowed after 2009, and 2.6% in females. In KK, the OC incidence steadily decreased by -2.5% per year in females, but there was no obvious change in males. A strong period effect observed in those aged 45-69 years in Taiwanese males resulted in a peak incidence in the middle age group. Decreased period and cohort effects were observed in females in KK. Conclusions Taiwanese males are the predominant sex affected by OC in Taiwan, and the trend has decelerated since 2009. Age, period, and cohort effects were different between males and females in the two regions.
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Evolving Profile of HPV-Driven Oropharyngeal Squamous Cell Carcinoma in a National Cancer Institute in Italy: A 10-Year Retrospective Study. Microorganisms 2020; 8:microorganisms8101498. [PMID: 33003378 PMCID: PMC7599861 DOI: 10.3390/microorganisms8101498] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 11/17/2022] Open
Abstract
Globally, 30% of oropharyngeal carcinomas (OPSCC) are caused by Human Papillomavirus (HPV). Recently, increasing incidence trends for HPV-driven OPSCC have been reported in many countries and changes in the typical HPV-positive OPSCC patient have been recorded, with an increase in the median age and diagnoses in women. We investigated the characteristics of the OPSCC patients attending an Italian Cancer Institute from 2010 to 2019 and assessed possible changes overtime of demographic, behavioral, and clinico-pathologic variables of HPV-driven OPSCC. Overall, 339 OPSCCs were evaluated. HPV-DNA and p16 positivity were 48.7% and 55.2%, respectively, with an HPV-driven fraction (i.e., HPV-DNA+/p16+) of 48.3%. We observed a significant increase overtime in the rate of HPV-associated cases (53.7% in 2015–2019 vs. 40.3% in 2010–2014, p = 0.019). The rate of HPV-driven cases was significantly higher among women, never smokers, patients with T1–T2 tumors, and with nodal involvement. A trend was also observed toward an increase in HPV-driven OPSCCs among patients >61 years, women, former smokers, and patients with no nodal involvement in 2015–2019. Our findings consolidate the observation that HPV-associated OPSCCs are also increasing in Italy. Moreover, they suggest that the profile of the HPV-driven OPSCC patient might be changing.
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An Analysis and Comparison of Survival and Functional Outcomes in Oropharyngeal Squamous Cell Carcinoma Patients Treated with Concurrent Chemoradiation Therapy within City of Hope Cancer Center Sites. J Clin Med 2020; 9:jcm9103083. [PMID: 32987866 PMCID: PMC7601157 DOI: 10.3390/jcm9103083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 12/02/2022] Open
Abstract
Oropharyngeal squamous cell carcinoma (OPSCC) is a subset of head and neck cancers that can arise due to human papillomavirus (HPV) infection. We designed a retrospective analysis to determine differences in outcomes of OPSCC patients treated at City of Hope (COH) Cancer Center’s main campus versus selected satellite sites with COH-associated faculty and facilities. Patients diagnosed with OPSCC and treated with concurrent chemoradiation therapy (n = 94) were identified and included in the study. Patients underwent treatment at the COH main campus site (n = 50) or satellite sites (n = 44). The majority of patients were Caucasian, male, and diagnosed with p16 positive stage IV locally advanced OPSCC by AJCC 7th edition. Most patients completed their prescribed cumulative radiation therapy dose and had a complete response to treatment. No significant difference in overall survival and progression-free survival was observed between the main campus and the satellite sites. Our study demonstrates successful treatment completion rates as well as comparable recurrence rates between the main campus and COH-associated satellite sites. A trend toward significant difference in feeding tube dependency at 6-months was observed. Differences in feeding tube placement and dependency rates could be addressed by the establishment of on-site supportive services in satellite sites.
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Kähler J, Hafner S, Popp T, Hermann C, Rump A, Port M, Steinestel K, Eder S. Heterogeneous nuclear ribonucleoprotein K is overexpressed and contributes to radioresistance irrespective of HPV status in head and neck squamous cell carcinoma. Int J Mol Med 2020; 46:1733-1742. [PMID: 32901844 PMCID: PMC7521550 DOI: 10.3892/ijmm.2020.4718] [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: 05/07/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022] Open
Abstract
Radiotherapy is a major treatment option for head and neck squamous cell carcinoma (HNSCC). However, the success of radiotherapy is limited by tumor cell resistance to ionizing radiation (IR). Clinical studies have demonstrated an overall improved prognosis and higher susceptibility to radiotherapy of high‑risk human papillomavirus (HPV)‑associated HNSCC compared with classic HNSCC, as well as worse overall survival for male HNSCC patients. Overexpression of heterogeneous nuclear ribonucleoprotein (hnRNP) K has been associated with resistance to radiotherapy in melanoma and colorectal carcinoma. The aim of the present study was to analyze the impact of hnRNP K expression on the aggressiveness and radioresistance of HNSCC with respect to patient sex and HPV status. Immunohistochemical staining of HNSCC tissue specimens revealed elevated hnRNP K levels compared with those in the non‑neoplastic epithelium. Cytoplasmic hnRNP K accumulation was associated with advanced tumor stage and male sex. Exposure of HNSCC cells to IR was followed by rapid upregulation of hnRNP K at the protein level, along with re‑localization from the tumor cell nucleus to the cytoplasm. siRNA‑based knockdown of hnRNP K induced apoptosis and abolished tumor formation after xenotransplantation of HNSCC cells onto the chick egg chorioallantoic membrane (CAM). The observed effects were independent of the respective HPV status of the cell lines. These results indicated a tumorigenic and anti‑apoptotic role of hnRNP K in HNSCC, which appeared to be enhanced in male patients and contributed to the radioresistance of these tumors. However, the radioprotective effects of hnRNP K were found to be independent of the tumor's HPV status.
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Affiliation(s)
- Justus Kähler
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
| | - Susanne Hafner
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, University of Ulm, D‑89081 Ulm, Germany
| | - Tanja Popp
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
| | | | - Alexis Rump
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
| | - Konrad Steinestel
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, D‑89081 Ulm, Germany
| | - Stefan Eder
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
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Influences of Semaphorin 3A Expression on Clinicopathological Features, Human Papillomavirus Status, and Prognosis in Oropharyngeal Carcinoma. Microorganisms 2020; 8:microorganisms8091286. [PMID: 32842711 PMCID: PMC7565979 DOI: 10.3390/microorganisms8091286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/13/2022] Open
Abstract
Human papillomavirus (HPV) infection is now identified as a major etiologic factor for oropharyngeal cancer (OPC), and HPV positivity is well established better prognostic marker in OPC. Now, predictable markers for the prognosis of the patients who are stratified by HPV has been investigated in. Semaphorin 3A (SEMA3A) is a well-known axon guidance molecule in the nervous system. It is also known as a tumor suppressor in various cancers. In the present study, we examined the relationships between SEMA3A and clinicopathologic features, especially HPV status, and neoangiogenesis, and its prognostic significance for OPC patients. Thirty-two OPC patients and 17 normal patients were analyzed for SEMA3A expression by immunohistochemical analysis. We also analyzed 22 OPC specimens for CD34 expression as a marker of neoangiogenesis. SEMA3A was significantly downregulated in OPC compared with chronic tonsillitis tissues (p = 0.005). SEMA3A expression was negatively correlated with CD34 expression (r = −0.466, p = 0.033). Moreover, the higher SEMA3A expression cohort showed better survival than the lower SEMA3A expression cohort regardless of HPV status (p = 0.035). These results suggest that SEMA3A expression is a prognostic marker for survival regardless of HPV status and is associated with anti-angiogenesis in OPC.
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Cunha ARD, Prass TS, Hugo FN. Mortality from oral and oropharyngeal cancer in Brazil, between 2000 and 2013: trends by sociodemographic strata. CIENCIA & SAUDE COLETIVA 2020; 25:3075-3086. [PMID: 32785543 DOI: 10.1590/1413-81232020258.31282018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/22/2018] [Indexed: 12/31/2022] Open
Abstract
Generalized observations of temporal trends in mortality could mask consistent specific patterns. This study aims to analyze the trend of oral and oropharyngeal cancer mortality rates in Brazil, from 2000 to 2013, considering the differences by gender, anatomical site, age group and ethnicity. Data on oral and oropharyngeal cancer mortality were retrieved from the Mortality Information System. The trend of historical series mortality rates by stratum was estimated through a generalized linear regression by the Prais-Winsten method. In total, 61,190 deaths from oral and oropharyngeal cancer were recorded in the 2000-2013 period (mean of coefficients: 3.50 deaths/100 thousand inhabitants/year). The trend of mortality rates was stable for males and increasing for females (1.31%/year). A growing pattern was identified for men aged 20-29 years (2.92%/year) and brown men (20.36%/year). The increasing pattern was also identified for white women (2.70%/year) and brown women (8.24%/year). We can conclude that surveillance of this condition should consider the sociodemographic differences of the population for equitable planning of care strategies because they reflected in different trends of oral and oropharyngeal cancer mortality rates in Brazil.
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Affiliation(s)
- Amanda Ramos da Cunha
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2492, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
| | | | - Fernando Neves Hugo
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2492, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
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Abstract
AbstractHead-and-neck cancers pose a serious economic burden, with most countries investing significant resources to reduce the incidence, primarily focusing on understanding addictive etiologies. The traditional literature focused on tobacco and alcohol use, with few studies on contemporary factors such as e-cigarette, waterpipe smoking, and human papillomavirus. This article attempts to collate and present an update on the globally identified etiologic factors.The aim of this study was to identify and review the addictive etiologic factors causing head-and-neck cancers.An electronic search was performed on Medline, Embase, and Google Scholar to identify the etiologies causing head-and-neck cancers and narrowed down on those driven by addiction. Further, we identified their constituents, mechanism of action, and the risks attributable to various forms of products.Substances identified included smoked and chewed tobacco, alcohol, mate, marijuana, areca nut and betel quid, and viruses. An alarming majority of youth are now utilizing these substances. Furthermore, migrant movements have led to the spread of traditional practices across the regions, especially from the Asian subcontinent.Ironically, despite modern advances and technology, we still see that a large proportion of population succumb to these cancers, emphasizing the need for more effective and targeted policies to combat this menace at the grassroots level.
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Sexual behavior and its association with persistent oral lesions: analysis of the POP-Brazil study. Clin Oral Investig 2020; 25:1107-1116. [PMID: 32583241 PMCID: PMC7878220 DOI: 10.1007/s00784-020-03407-0] [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: 02/19/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
Abstract
Objectives To investigate whether the presence of persistent self-reported oral lesions (PSOLs) is associated with sexual behaviors and with the presence of sexually transmitted infections (STIs) in individuals aged 16–25 years in the state capitals of Brazil. Materials and Methods Data from the POP-Brazil study were analyzed. An association analysis was performed by Poisson regression with the presence of PSOLs as the outcome. The exposure variables were the age at first sexual intercourse, the number of partners, oral sex practice, and aspects of condom use for model 1, and the presence of a self-reported STI or a positive rapid test for HIV/syphilis and the presence of genital human papillomavirus (HPV) for model 2. The results were adjusted for socioeconomic variables. Results The prevalence of PSOLs was 76% higher among individuals who had two or more sexual partners in the past year (p = 0.046) and 68% higher in those who reported not using condoms for contraception (p = 0.032). The group with HIV/syphilis or self-reported STI had a 140% higher PSOL prevalence (p = 0.003). Conclusions The self-report of oral lesions in adolescents and young adults may suggest risky sexual behavior and the presence of STI. Clinical relevance It is necessary to contextualize the reality of the young person to optimize oral health care.
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DRH1 - a novel blood-based HPV tumour marker. EBioMedicine 2020; 56:102804. [PMID: 32535546 PMCID: PMC7300133 DOI: 10.1016/j.ebiom.2020.102804] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/15/2020] [Accepted: 05/05/2020] [Indexed: 12/31/2022] Open
Abstract
Background To date, no studies have successfully shown that a highly specific, blood-based tumour marker to detect clinically relevant HPV-induced disease could be used for screening, monitoring therapy response or early detection of recurrence. This study aims to assess the clinical performance of a newly developed HPV16-L1 DRH1 epitope-specific serological assay. Methods In a multi-centre study sera of 1486 patients (301 Head and Neck Squamous Cell Carcinoma (HNSCC) patients, 12 HIV+ anal cancer patients, 80 HIV-positive patients, 29 Gardasil-9-vaccinees, 1064 healthy controls) were tested for human HPV16-L1 DRH1 antibodies. Analytical specificity was determined using WHO reference-sera for HPV16/18 and 29 pre- and post-immune sera of Gardasil-9-vaccinees. Tumour-tissue was immunochemically stained for HPV-L1-capsidprotein-expression. Findings The DRH1-competitive-serological-assay showed a sensitivity of 95% (95% CI, 77.2–99.9%) for HPV16-driven HNSCC, and 90% (95% CI, 55.5–99.7%) for HPV16-induced anal cancer in HIV-positives. Overall diagnostic specificity was 99.46% for men and 99.29% for women ≥ 30 years. After vaccination, antibody level increased from average 364 ng/ml to 37,500 ng/ml. During post-therapy-monitoring, HNSCC patients showing an antibody decrease in the range of 30–100% lived disease free over a period of up to 26 months. The increase of antibodies from 2750 to 12,000 ng/ml mirrored recurrent disease. We can also show that the L1-capsidprotein is expressed in HPV16-DNA positive tumour-tissue. Interpretation HPV16-L1 DRH1 epitope-specific antibodies are linked to HPV16-induced malignant disease. As post-treatment biomarker, the assay allows independent post-therapy monitoring as well as early diagnosis of tumour recurrence. An AUC of 0.96 indicates high sensitivity and specificity for early detection of HPV16-induced disease. Funding The manufacturer provided assays free of charge.
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Buexm LA, Soares-Lima SC, Brennan P, Fernandes PV, de Souza Almeida Lopes M, Nascimento de Carvalho F, Santos IC, Dias LF, de Queiroz Chaves Lourenço S, Ribeiro Pinto LF. Hpv impact on oropharyngeal cancer patients treated at the largest cancer center from Brazil. Cancer Lett 2020; 477:70-75. [PMID: 32087309 DOI: 10.1016/j.canlet.2020.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/16/2020] [Accepted: 02/14/2020] [Indexed: 12/24/2022]
Abstract
Oropharyngeal squamous cell carcinoma (OSCC) is a fatal and highly incident disease. Although tobacco and alcohol consumption are the main risk factors associated with OSCC, a recent significant increase in OSCC HPV16 positive cases in high-income countries has been observed. However, it is not clear whether this change is also present in low- and middle-income countries. In this study, we evaluated HPV16 prevalence in 346 OSCC cases diagnosed in the largest Brazilian oncology public hospital by using the combination of two techniques, HPV16 E6 detection by qPCR and p16 immunohistochemistry. In total, 11.9% of cases were HPV16 E6 positive, 9.2% were p16 positive and 6.1% were positive in both analyses. There was a predominance of keratinizing-SCC, with only four HPV-positive cases showing basaloid-like or non-keratinizing-SCC. HPV infection had no impact on disease-free or overall survival, while alcohol use was an independent prognostic factor for overall survival. Most cases reported a high frequency of tobacco (94.6%) and alcohol consumption (88.2%), were of low education level, and typically presented at advanced clinical stages, indicating that the profile of Brazilian OSCC patients has not changed.
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Affiliation(s)
- Luisa Aguirre Buexm
- Oncology Graduate Program, Molecular Carcinogenesis Program, Research Center, Brazilian National Cancer Institute. Rua André Cavalcanti, 37, Centro, 20231-050, Rio de Janeiro, Brazil.
| | - Sheila Coelho Soares-Lima
- Molecular Carcinogenesis Program, Brazilian National Cancer Institute. Rua André Cavalcanti, 37, Centro, 20231-050, Rio de Janeiro, Brazil.
| | - Paul Brennan
- International Agency for Research on Cancer. 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France.
| | - Priscila Valverde Fernandes
- Pathology Division, Brazilian National Cancer Institute, Rua Cordeiro da Graça, 156, Santo Cristo, 20220-400, Rio de Janeiro, Brazil.
| | - Monique de Souza Almeida Lopes
- Molecular Carcinogenesis Program, Brazilian National Cancer Institute. Rua André Cavalcanti, 37, Centro, 20231-050, Rio de Janeiro, Brazil.
| | - Flávia Nascimento de Carvalho
- Molecular Carcinogenesis Program, Brazilian National Cancer Institute. Rua André Cavalcanti, 37, Centro, 20231-050, Rio de Janeiro, Brazil.
| | - Izabella Costa Santos
- Department of Head and Neck Surgery, Cancer Hospital I, Brazilian National Cancer Institute, Praça da Cruz Vermelha, 23, Centro, 20230-130, Rio de Janeiro, Brazil.
| | - Luiz Fernando Dias
- Department of Head and Neck Surgery, Cancer Hospital I, Brazilian National Cancer Institute, Praça da Cruz Vermelha, 23, Centro, 20230-130, Rio de Janeiro, Brazil.
| | - Simone de Queiroz Chaves Lourenço
- Department of Pathology, Dental School, Fluminense Federal University, Rua Mario Santos Braga, 30, Centro, 24040-110, Niterói, Brazil.
| | - Luis Felipe Ribeiro Pinto
- Molecular Carcinogenesis Program, Brazilian National Cancer Institute. Rua André Cavalcanti, 37, Centro, 20231-050, Rio de Janeiro, Brazil.
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Fujima N, Andreu-Arasa VC, Meibom SK, Mercier GA, Truong MT, Sakai O. Prediction of the human papillomavirus status in patients with oropharyngeal squamous cell carcinoma by FDG-PET imaging dataset using deep learning analysis: A hypothesis-generating study. Eur J Radiol 2020; 126:108936. [PMID: 32171912 DOI: 10.1016/j.ejrad.2020.108936] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/22/2020] [Accepted: 03/02/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To assess the diagnostic accuracy of imaging-based deep learning analysis to differentiate between human papillomavirus (HPV) positive and negative oropharyngeal squamous cell carcinomas (OPSCCs) using FDG-PET images. METHODS One hundred and twenty patients with OPSCC who underwent pretreatment FDG-PET/CT were included and divided into the training 90 patients and validation 30 patients cohorts. In the training session, 2160 FDG-PET images were analyzed after data augmentation process by a deep learning technique to create a diagnostic model to discriminate between HPV-positive and HPV-negative OPSCCs. Validation cohort data were subsequently analyzed for confirmation of diagnostic accuracy in determining HPV status by the deep learning-based diagnosis model. In addition, two radiologists evaluated the validation cohort image-data to determine the HPV status based on each tumor's imaging findings. RESULTS In deep learning analysis with training session, the diagnostic model using training dataset was successfully created. In the validation session, the deep learning diagnostic model revealed sensitivity of 0.83, specificity of 0.83, positive predictive value of 0.88, negative predictive value of 0.77, and diagnostic accuracy of 0.83, while the visual assessment by two radiologists revealed 0.78, 0.5, 0.7, 0.6, and 0.67 (reader 1), and 0.56, 0.67, 0.71, 0.5, and 0.6 (reader 2), respectively. Chi square test showed a significant difference between deep learning- and radiologist-based diagnostic accuracy (reader 1: P = 0.016, reader 2: P = 0.008). CONCLUSIONS Deep learning diagnostic model with FDG-PET imaging data can be useful as one of supportive tools to determine the HPV status in patients with OPSCC.
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Affiliation(s)
- Noriyuki Fujima
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States; Research Center for Cooperative Projects, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - V Carlota Andreu-Arasa
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Sara K Meibom
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Gustavo A Mercier
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Minh Tam Truong
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Osamu Sakai
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States; Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States; Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States.
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Threshold for interpretation of p16 immunostaining in fine-needle aspirate specimens of metastatic oropharyngeal squamous cell carcinoma. J Am Soc Cytopathol 2020; 9:177-184. [PMID: 32115376 DOI: 10.1016/j.jasc.2020.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Human papilloma virus (HPV)-associated oropharyngeal squamous cell carcinoma (HPV-OPSCC) has been recognized to have an excellent response to treatment and has a distinct pathologic staging. For this reason, HPV testing is recommended in cytology specimens of metastatic OPSCC, although the guidelines for testing are not clearly defined. The aim of the current study was to establish a threshold for interpretation of p16 in aspirates from metastatic OPSCC. MATERIALS AND METHODS Cases diagnosed as metastatic SCC by cytology in neck lymph nodes with concurrent p16 on cytology and on paired surgical specimen or an in situ hybridization (ISH) for HPV were included in the study. Stain intensity and percentage positive cells for p16 was compared with p16 on paired surgical pathology specimens and/or ISH RNA for HPV on cytology specimens. RESULTS Of the 52 cases diagnosed as metastatic SCC on neck aspirates, paired surgical pathology specimens and/or ISH HPV was available in 17 cases. A p16 expression in ≥10%-15% cells resulted in a sensitivity and negative predictive value of 66% and 37%, respectively. However, when even minimal expression in tumor fragments is considered positive, the negative predictive value increases to 100%. CONCLUSIONS We recommend that even minimal nuclear expression for p16 in viable tumor fragments must be considered as positive in cytology specimens. Expression limited to only background single tumor cells or in a necrotic specimen must be interpreted with caution.
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Veyer D, Wack M, Mandavit M, Garrigou S, Hans S, Bonfils P, Tartour E, Bélec L, Wang‐Renault S, Laurent‐Puig P, Mirghani H, Rance B, Taly V, Badoual C, Péré H. HPV circulating tumoral DNA quantification by droplet‐based digital PCR: A promising predictive and prognostic biomarker for HPV‐associated oropharyngeal cancers. Int J Cancer 2019; 147:1222-1227. [DOI: 10.1002/ijc.32804] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/29/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022]
Affiliation(s)
- David Veyer
- Laboratoire de VirologieHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
| | - Maxime Wack
- Département d'Informatique Médicale, Biostatistiques et Santé PubliqueHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
- INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université Paris Descartes, Sorbonne Paris CitéUniversité Paris Descartes Paris France
| | - Marion Mandavit
- INSERM U970, PARCC, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris DescartesUniversité Paris Descartes Paris France
| | - Sonia Garrigou
- INSERM UMR‐S1147, eDIAG platform, CNRS SNC5014, Université Paris Descartes, Equipe labellisée Ligue Nationale Contre le Cancer Paris France
| | - Stéphane Hans
- Service d'ORL et Chirurgie Cervico‐FacialeHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
| | - Pierre Bonfils
- Service d'ORL et Chirurgie Cervico‐FacialeHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
| | - Eric Tartour
- INSERM U970, PARCC, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris DescartesUniversité Paris Descartes Paris France
- Laboratoire d'Immunologie BiologiqueHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
| | - Laurent Bélec
- Laboratoire de VirologieHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
- INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université Paris Descartes, Sorbonne Paris CitéUniversité Paris Descartes Paris France
| | - Shu‐Fang Wang‐Renault
- INSERM UMR‐S1147, eDIAG platform, CNRS SNC5014, Université Paris Descartes, Equipe labellisée Ligue Nationale Contre le Cancer Paris France
| | - Pierre Laurent‐Puig
- INSERM UMR‐S1147, eDIAG platform, CNRS SNC5014, Université Paris Descartes, Equipe labellisée Ligue Nationale Contre le Cancer Paris France
| | - Haitham Mirghani
- Service d'ORL et Chirurgie Cervico‐FacialeHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
| | - Bastien Rance
- Département d'Informatique Médicale, Biostatistiques et Santé PubliqueHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
- INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université Paris Descartes, Sorbonne Paris CitéUniversité Paris Descartes Paris France
| | - Valérie Taly
- INSERM UMR‐S1147, eDIAG platform, CNRS SNC5014, Université Paris Descartes, Equipe labellisée Ligue Nationale Contre le Cancer Paris France
| | - Cécile Badoual
- INSERM U970, PARCC, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris DescartesUniversité Paris Descartes Paris France
- Laboratoire d'Anatomo‐CytopathologieHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
| | - Hélène Péré
- Laboratoire de VirologieHôpital Européen Georges Pompidou, and Assistance Publique ‐ Hôpitaux de Paris Paris France
- INSERM U970, PARCC, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris DescartesUniversité Paris Descartes Paris France
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