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Biswal D, Brijwal M, Choudhary A, Kakkar A, Pramanik R, Thakar A, Dar L. Association of Epstein-Barr virus (EBV) with nasopharyngeal carcinoma: Experience from a North Indian tertiary care hospital. Indian J Med Microbiol 2024; 51:100699. [PMID: 39111666 DOI: 10.1016/j.ijmmb.2024.100699] [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: 02/29/2024] [Revised: 07/28/2024] [Accepted: 08/04/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION Nasopharyngeal carcinoma (NPC), arising from nasopharyngeal epithelium is caused by Epstein-Barr virus (EBV). It is common in South China, South East Asia and North East India. The aim and objectives of this study were to determine the prevalence of EBV in formalin-fixed paraffin-embedded (FFPE) tissue sections of clinically suspected NPC patients, correlate the results of polymerase chain reaction (PCR) with histopathology findings, and to determine the utility of tissue EBV DNA as a diagnostic bio-marker. MATERIALS AND METHODS 31 FFPE tissue samples were collected from clinically suspected NPC patients from April 2018-December 2019. Histopathological diagnosis was done by examination of Hematoxylin and Eosin stained slides. Presence of EBV was detected by EBNA-1 PCR. IHC was performed using EBV Latent Membrane Protein 1. RESULTS Of the 31 clinically suspected NPC cases, 15 (48.4 %) were histopathological confirmed NPC. Of these15, 13 (86.6 %) were non-keratinising undifferentiated NPC, and one each were keratinising NPC and non-keratinising differentiated NPC respectively. EBV EBNA1 PCR was positive in 35.5 % (11/31) of clinically suspected NPC cases. Of the 11 PCR positive cases, 9 (81.8 %) were histopathological confirmed NPC. Of the 31 clinically suspected NPC cases, IHC was indicated in 23 biopsies. Of which, 12 (52.2 %) were positive for LMP1 in the abnormal cells. Of the 12 IHC positive samples, 10 were NPC cases. CONCLUSION EBV DNA as an indicator towards NPC among clinically suspected cases had a sensitivity of 60 % and specificity of 87.5 %. In this study, addition of EBV DNA detection by PCR from FFPE tissue sections could confirm EBV association in 20 % of cases where it was not detected by EBV LMP1 IHC, thus helped in increasing the detection of EBV positivity in NPC cases. Early diagnosis of NPC will improve the cure rate and hence reduce the morbidity and mortality rates.
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Affiliation(s)
- Debasish Biswal
- Department of Microbiology, Amrita Institute of Medical Sciences and Research Centre, Faridabad, Haryana, India.
| | - Megha Brijwal
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Aashish Choudhary
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
| | - Raja Pramanik
- Department of Medical Oncology, Dr. B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India.
| | - Alok Thakar
- Department of Otolaryngology & Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Lalit Dar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India; Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
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Mody MD, Rocco JW, Yom SS, Haddad RI, Saba NF. Head and neck cancer. Lancet 2021; 398:2289-2299. [PMID: 34562395 DOI: 10.1016/s0140-6736(21)01550-6] [Citation(s) in RCA: 318] [Impact Index Per Article: 106.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/10/2021] [Accepted: 06/27/2021] [Indexed: 12/13/2022]
Abstract
Head and neck cancer is the seventh most common type of cancer worldwide and comprise of a diverse group of tumours affecting the upper aerodigestive tract. Although many different histologies exist, the most common is squamous cell carcinoma. Predominant risk factors include tobacco use, alcohol abuse, and oncogenic viruses, including human papillomavirus and Epstein-Barr virus. Head and neck malignancies remain challenging to treat, requiring a multidisciplinary approach, with surgery, radiotherapy, and systemic therapy serving as key components of the treatment of locally advanced disease. Although many treatment principles overlap, treatment is generally site-specific and histology-specific. This Seminar outlines the current understanding of head and neck cancer and focuses on treatment principles, while also discussing future directions to improve the outcomes of patients with these malignancies.
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Affiliation(s)
- Mayur D Mody
- Department of Hematology and Medical Oncology, The Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - James W Rocco
- The Ohio State University Comprehensive Cancer Center-James, Columbus, OH, USA
| | - Sue S Yom
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Robert I Haddad
- Harvard Medical School and Dana Farber Cancer Institute, Boston, MA, USA
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute, Emory University, Atlanta, GA, USA.
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3
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Djaoud Z, Parham P. Dimorphism in the TCRγ-chain repertoire defines 2 types of human immunity to Epstein-Barr virus. Blood Adv 2020; 4:1198-1205. [PMID: 32211881 PMCID: PMC7160271 DOI: 10.1182/bloodadvances.2019001179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/22/2020] [Indexed: 02/02/2023] Open
Abstract
Humans form 2 groups based on their innate immunity to Epstein-Barr virus (EBV). Group 1 makes a strong natural killer (NK)-cell and γδ T-cell response, whereas group 2 makes a strong NK-cell response, but a weak γδ T-cell response. To investigate the underlying basis for this difference in γδ T-cell immunity to EBV, we used next-generation sequencing to compare the γδ T-cell receptor (TCR) repertoires of groups 1 and 2. In the absence of EBV, group 1 TCRγ chains are enriched for complementarity determining region 3 (CDR3s) containing JγP, whereas group 2 TCRγ chains are enriched for CDR3s containing Jγ2. In group 1 donors, EBV activates many γδ T cells expressing Vγ9JγP, inducing proliferation that produces a large population of activated effector cells. The TCRs using Vγ9JγP are closely related to the TCRs of γδ T cells that respond to phosphoantigens. In group 2 donors, EBV activates a small subpopulation of γδ T cells, most expressing Vγ9JγP. In conclusion, we find that differences in the TCRγ-chain repertoire underlie the differential response of group 1 and group 2 to EBV.
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Affiliation(s)
- Zakia Djaoud
- Department of Structural Biology and
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA
| | - Peter Parham
- Department of Structural Biology and
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA
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4
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Straetmans JMJAA, Stuut M, Wagemakers S, Hoebers F, Kaanders JHAM, Speel EJM, Melchers WJG, Slootweg P, Kremer B, Lacko M, Takes RP. Tumor control of cervical lymph node metastases of unknown primary origin: the impact of the radiotherapy target volume. Eur Arch Otorhinolaryngol 2020; 277:1753-1761. [PMID: 32100130 DOI: 10.1007/s00405-020-05867-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Debate on the extent of treatment of neck metastasis of cancer of unknown primary tumors (CUPs) is still ongoing. In two Dutch tertiary referral centers, the post-surgical radiation target volume changed from the bilateral neck including the pharyngeal axis to the unilateral neck only, in the course of the last decade. This study aims to investigate the outcome of patients with CUP before and after de-escalation of post-surgical radiotherapy. METHODS Data of two Dutch tertiary referral centers were merged. Disease-free survival (DFS), overall survival (OS), and regional control rate (RCR) of 80 patients diagnosed with CUP (squamous cell and undifferentiated carcinomas) between 1990 and 2009 were retrospectively analyzed. RESULTS Thirty patients received bilateral neck and pharyngeal axis radiotherapy and 42 patients ipsilateral radiotherapy only. In another eight patients, the postsurgical radiation target volume was expanded to the contralateral neck or to the pharyngeal axis, due to suspicious lesions on imaging. The 5-year DFS, OS and RCR were 60%, 51.2%, and 80%, respectively, in the total patient population. RCR did not differ in patients treated with ipsilateral as compared to bilateral radiotherapy nor did 5-year OS and DFS. No tumors occurred in the pharyngeal axis. CONCLUSION In this study, omitting elective treatment of the contralateral neck and pharyngeal axis did not lead to a decrease in locoregional control or survival rates when treating patients with CUP.
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Affiliation(s)
- Jos M J A A Straetmans
- Department of Otorhinolaryngology and Head and Neck Surgery, Research Institute GROW, Maastricht University Medical Center, P.O. BOX 5800, 6202 AZ, Maastricht, The Netherlands. .,Department of Otorhinolaryngology and Head and Neck Surgery, Zuyderland Medical Center, H. Dunantstraat 5, 6419 PC, Heerlen, The Netherlands.
| | - Marijn Stuut
- Department of Otorhinolaryngology and Head and Neck Surgery, Research Institute GROW, Maastricht University Medical Center, P.O. BOX 5800, 6202 AZ, Maastricht, The Netherlands
| | - Sanne Wagemakers
- Department of Otorhinolaryngology and Head and Neck Surgery, Research Institute GROW, Maastricht University Medical Center, P.O. BOX 5800, 6202 AZ, Maastricht, The Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (MAASTRO), Research Institute GROW, Maastricht University, Maastricht, The Netherlands
| | - Johannes H A M Kaanders
- Department of Radiation Oncology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 22, 6525 GA, Nijmegen, The Netherlands
| | - Ernst Jan M Speel
- Department of Pathology, Research Institute GROW, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Willem J G Melchers
- Department of Medical Microbiology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 22, 6525 GA, Nijmegen, The Netherlands
| | - Piet Slootweg
- Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 22, 6525 GA, Nijmegen, The Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology and Head and Neck Surgery, Research Institute GROW, Maastricht University Medical Center, P.O. BOX 5800, 6202 AZ, Maastricht, The Netherlands
| | - Martin Lacko
- Department of Otorhinolaryngology and Head and Neck Surgery, Research Institute GROW, Maastricht University Medical Center, P.O. BOX 5800, 6202 AZ, Maastricht, The Netherlands
| | - Robert P Takes
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 22, 6525 GA, Nijmegen, The Netherlands
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Roy Chattopadhyay N, Das P, Chatterjee K, Choudhuri T. Higher incidence of nasopharyngeal carcinoma in some regions in the world confers for interplay between genetic factors and external stimuli. Drug Discov Ther 2019; 11:170-180. [PMID: 28867748 DOI: 10.5582/ddt.2017.01030] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Nasopharyngeal carcinoma (NPC) is a rare variety of head and neck cancers. The risk factors include three major causes: genetic factors, viral infection, and environmental and dietary factors. The types of NPC show strong ethnic and geographic variations. The keratinizing and non-keratinizing types are prevalent in the lower incidence regions like North America and Europe; whereas the undifferentiated type is mostly found in the regions with higher incidences like China, North Africa, Arctic, and Nagaland of North-East India. These suggest a possible major role of the internal genetic factors for generation and promotion of this disease. Viral infections might accelerate the process of carcinogenesis by helping in cellular proliferation and loss of apoptosis. Diet and other environmental factors promote these neoplastic processes and further progression of the disease occurs.
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Affiliation(s)
| | - Piyanki Das
- Department of Biotechnology, Visva-Bharati, Siksha Bhavana
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Mohammed MA, Ghani MKA, Hamed RI, Ibrahim DA. Analysis of an electronic methods for nasopharyngeal carcinoma: Prevalence, diagnosis, challenges and technologies. JOURNAL OF COMPUTATIONAL SCIENCE 2017; 21:241-254. [DOI: 10.1016/j.jocs.2017.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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7
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Lao TD, Nguyen DH, Nguyen TM, Le TAH. Molecular Screening for Epstein-Barr virus (EBV): Detection of Genomic EBNA-1, EBNA-2, LMP-1, LMP-2 Among Vietnamese Patients with Nasopharyngeal Brush Samples. Asian Pac J Cancer Prev 2017; 18:1675-1679. [PMID: 28670888 PMCID: PMC6373812 DOI: 10.22034/apjcp.2017.18.6.1675] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Epstein-Bar virus (EBV) is considered to be intimately associated with development of nasopharyngeal carcinoma (NPC), the most common and high incidence cancer of the head and neck in Asian countries, especially in Vietnam. In this study, we validated associations between highly conserved segments of the EBV genome, including EBNA-1, EBNA-2, LMP-1, LMP-2 and nasopharyngeal cancer, with the aim of applications with non-invasive brush samples for early diagnosis and as a prognostic biomarker. The polymerase chain reaction (PCR) was performed to assess the presence of EBNA-1, EBNA-2, LMP-1, LMP-2 in nasopharyngeal brush samples from Vietnamese NPC patients and non-cancer controls. Positive rates for EBNA-1, EBNA-2, LMP-1, LMP-2 were 46.3%, 49.5% and 45.3%, and 47.4%, respectively, in cancer cases, much higher than the low frequencies found in non-cancer samples. Notably, at least one of the four (PI ≥ 0.25) was found in 57. 9%. Significance was reached when computing the odds ratio (OR) and relative risk (RR). Our detection of candidate genes. in nasopharyngeal brush samples collected from Vietnamese patients reduces the need for invasive biopsies and fulfills the characteristics of a non-invasive, specific screening method suitable for routine, NPC risk assessment for EBV-infected populations. Notably, this procedure may be useful for confirmatory screening with large oral brush swabs.
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Affiliation(s)
- Thuan Duc Lao
- Faculty of Biology and Biotechnology, University of Science, Vietnam National University, Vietnam
- Faculty of Biotechnology, Ho Chi Minh City Open University, Ho Chi Minh City, Vietnam.
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8
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Müller von der Grün J, Tahtali A, Ghanaati S, Rödel C, Balermpas P. Diagnostic and treatment modalities for patients with cervical lymph node metastases of unknown primary site - current status and challenges. Radiat Oncol 2017; 12:82. [PMID: 28486947 PMCID: PMC5424363 DOI: 10.1186/s13014-017-0817-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/03/2017] [Indexed: 11/29/2022] Open
Abstract
Background and Purpose This review aims to provide a comprehensive overview of the literature and elucidate open questions for future clinical trials concerning diagnostics and treatment modalities for cervical cancer of unknown primary (CUP). Methods A literature search for head and neck CUP was performed with focus on diagnostics and therapies as well as molecular markers. Results High level evidence on CUP is limited. However, it seems that a consensus exists regarding the optimal diagnostic procedures. The correct implementation of biomarkers for patient stratification and treatment remains unclear. An even greater dispute dominates about the ideal treatment with publications ranging from sole surgery to surgery with postoperative bilateral radiotherapy with inclusion of the mucosa and concomitant chemotherapy. Conclusions Cervical CUP represents a very heterogeneous malignant disease. On this account many aspects concerning treatment optimization remain unclear, despite a considerable number of publications in the past. Future research in form of prospective randomized trials is needed in order to better define patient stratification criteria and enable tailored treatment.
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Affiliation(s)
- Jens Müller von der Grün
- Department of Radiation Oncology, University Hospital, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Aykut Tahtali
- Department of Otolaryngology and Head and Neck Surgery, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Shahram Ghanaati
- Department of Maxillofacial Surgery, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Claus Rödel
- Department of Radiation Oncology, University Hospital, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), Frankfurt, Germany
| | - Panagiotis Balermpas
- Department of Radiation Oncology, University Hospital, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany. .,German Cancer Research Center (DKFZ), Heidelberg, Germany. .,German Cancer Consortium (DKTK), Frankfurt, Germany.
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9
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Djaoud Z, Guethlein LA, Horowitz A, Azzi T, Nemat-Gorgani N, Olive D, Nadal D, Norman PJ, Münz C, Parham P. Two alternate strategies for innate immunity to Epstein-Barr virus: One using NK cells and the other NK cells and γδ T cells. J Exp Med 2017; 214:1827-1841. [PMID: 28468758 PMCID: PMC5460997 DOI: 10.1084/jem.20161017] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 02/02/2017] [Accepted: 03/28/2017] [Indexed: 01/24/2023] Open
Abstract
Djaoud et al. show that Epstein–Barr virus infection triggers two types of human innate immune response, one mediated by the combination of NK cells and γδ T cells and the other committed to a strong NK cell response with little involvement of γδ T cells. Most humans become infected with Epstein–Barr virus (EBV), which then persists for life. Infrequently, EBV infection causes infectious mononucleosis (IM) or Burkitt lymphoma (BL). Type I EBV infection, particularly type I BL, stimulates strong responses of innate immune cells. Humans respond to EBV in two alternative ways. Of 24 individuals studied, 13 made strong NK and γδ T cell responses, whereas 11 made feeble γδ T cell responses but stronger NK cell responses. The difference does not correlate with sex, HLA type, or previous exposure to EBV or cytomegalovirus. Cohorts of EBV+ children and pediatric IM patients include both group 1 individuals, with high numbers of γδ T cells, and group 2 individuals, with low numbers. The even balance of groups 1 and 2 in the human population points to both forms of innate immune response to EBV having benefit for human survival. Correlating these distinctive responses with the progress of EBV infection might facilitate the management of EBV-mediated disease.
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Affiliation(s)
- Zakia Djaoud
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA 94305 .,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305
| | - Lisbeth A Guethlein
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA 94305.,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305
| | - Amir Horowitz
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA 94305.,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305
| | - Tarik Azzi
- Experimental Infectious Disease and Cancer Research, Children's Research Center, University Children's Hospital of Zurich, 8032 Zurich, Switzerland
| | - Neda Nemat-Gorgani
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA 94305.,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305
| | - Daniel Olive
- Team Immunity and Cancer, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut National de la Santé et de la Recherche Médicale, U1068; Centre National de la Recherche Scientifique, UMR7258, Institut Paoli-Calmettes; Aix-Marseille University, UM 105, 13284 Marseille, France
| | - David Nadal
- Experimental Infectious Disease and Cancer Research, Children's Research Center, University Children's Hospital of Zurich, 8032 Zurich, Switzerland
| | - Paul J Norman
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA 94305.,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305
| | - Christian Münz
- Viral Immunobiology, Institute of Experimental Immunology, University of Zurich, 8006 Zurich, Switzerland
| | - Peter Parham
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA 94305 .,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305
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Shahani T, Makvandi M, Samarbafzadeh A, Teimoori A, Ranjbar N, saki N, Nikakhlagh S, Neisi N, Hosseini Z, Pourrezaei S, Shabani A, Radmehr H, Mehravaran H, Kiani H, Haghi A. Frequency of Epstein Barr Virus Type 1 Among Nasopharyngeal Carcinomas in Iranian Patients. Asian Pac J Cancer Prev 2017; 18:327-331. [PMID: 28345327 PMCID: PMC5454723 DOI: 10.22034/apjcp.2017.18.2.327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Around 95% of the world’s population are infected with the Epstein-Barr virus (EBV), which can persist latent in B lymphocytes and epithelial cells life-long. EBV has been linked with lymphoid and epithelial cancers and persistence of EBV infection in lymphoid or epithelial cells may result in virus-associated B-cell tumors or nasopharyngeal carcinomas (NPC). This study was conducted to determine the frequency of EBV DNA in nasopharyngeal carcinoma tissue of Iranian patients. Materials and methods: A total of 50 blocks of formalin-fixed paraffin-embedded tissue of NPCs from 38 (76 %) male and 12 (24%) female patients were collected from archives of Ahvaz hospitals. Sections were cut at 5 μm and DNA was extracted for detection of EBV DNA and EBV typing by mested PCR. DNA sequencing was performed to confirm PCR results. The distribution of EBV DNA was compared among WHO histological subtypes of NPC. Results: Some 3 female and 11 (22%) male NPC samples showed positive for EBV DNA type 1, 2/14(22.2%)WHO histological type II and 12/41(29.3%) WHO histological type III. Conclusions: The frequency of EBV DNA among NPCs in Iranian patients was found to be 28%, EBV type I predominating. Both WHO histological type II and III NPC subtypes demonstrated approximately the same detection prevalence.
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Affiliation(s)
- Toran Shahani
- Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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11
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Arosio AD, Pignataro L, Gaini RM, Garavello W. Neck lymph node metastases from unknown primary. Cancer Treat Rev 2016; 53:1-9. [PMID: 28027480 DOI: 10.1016/j.ctrv.2016.11.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/23/2016] [Accepted: 11/29/2016] [Indexed: 11/18/2022]
Abstract
Metastatic cervical carcinoma from unknown primary is a metastatic disease in the lymph nodes of the neck without any evidence of a primary tumour after appropriate investigation. The condition is rare and definite evidence is lacking for both diagnosis and treatment. In this review of the literature, we tried to draw some clinical indications based on the few available studies. We ultimately came to the following conclusions: (1) a thorough and accurate diagnostic work-up should be systematically offered. It includes accurate inspection with fibroscopy, CT or MRI, fine needle aspiration, panendoscopy and positron emission tomography, (2) Patients with low-volume neck disease, N1 and N2a stage and without extracapsular extension on histopathological examination should receive single modality treatment. Radiotherapy and surgery may be similarly effective but, if possible, surgery (excisional biopsy, neck dissection and tonsillectomy) should be favoured because it consents a more precise staging, (3) patients with more advanced conditions require combined treatment in the form of either resection followed by adjuvant radiation (±chemotherapy) or primary chemoradiation (±post-therapy neck dissection).
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Affiliation(s)
- Alberto Daniele Arosio
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Lorenzo Pignataro
- Department of Otorhinolaryngology, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Renato Maria Gaini
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
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Xu XF, Lu RQ, Xiao R, Zhou L, Zhao XM, Hu XC, Gao X, Guo L. Rta-IgG as a biomarker for diagnosis and post treatment prognostic of nasopharyngeal carcinoma. Cancer Biomark 2016; 16:467-76. [DOI: 10.3233/cbm-160586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Xiao-Feng Xu
- Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ren-Quan Lu
- Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ran Xiao
- Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Lei Zhou
- Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xin-Min Zhao
- Department of Medical Oncology, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Xi-Chun Hu
- Department of Medical Oncology, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Xiang Gao
- Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Lin Guo
- Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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13
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Chen JJ, Liu TC, Liang QN, Dong ZN, Wu YS, Li M. Development of a time-resolved fluorescence immunoassay for Epstein-Barr virus nuclear antigen 1-immunoglobulin A in human serum. J Med Virol 2015; 87:1940-5. [PMID: 26129643 DOI: 10.1002/jmv.24247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/23/2015] [Indexed: 12/26/2022]
Abstract
Enzyme-linked immunosorbent assay (ELISAs) specific for Epstein-Barr virus nuclear antigen 1 (EBNA1)-immunoglobulin A (IgA) are most commonly used in the clinical diagnosis of EBV infection. But they have a low sensitivity and the enzyme-labeled antibodies are unstable. In this study, a novel immunoassay based on an indirect time-resolved fluoroimmunoassay (TRFIA) was developed. Microtiter plates were coated with recombinant EBNA1. We used Eu(3) (+)-labeled anti-human IgA as probe. The precision, sensitivity, specificity, and stability were evaluated, and comparison with traditional and commercially available ELISAs was also made. The cut-off value for our TRFIA was 2.7. Intra- and inter-assay coefficients of variation for the TRFIA were 1.56-4.99% and 3.92-6.95%, respectively; whereas those for the ELISA were 4.54-8.16% and 7.07-10.52%, respectively. Sensitivity was obviously better than traditional ELISA when diluted positive samples serially. Additionally, stability, specificity test and comparison of sensitivity and specificity between the TRFIA and commercial ELISAs all proved satisfactory. In conclusion, the results demonstrated that EBNA1 IgA TRFIA was a sensitive immunoassay and had potential value in large-scale screening of human serum samples in developing countries.
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Affiliation(s)
- Juan-Juan Chen
- State Key Laboratory of Organ Failure Research, School of Biotechnology, Institute of Antibody Engineering, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Tian-Cai Liu
- State Key Laboratory of Organ Failure Research, School of Biotechnology, Institute of Antibody Engineering, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Qian-Ni Liang
- State Key Laboratory of Organ Failure Research, School of Biotechnology, Institute of Antibody Engineering, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Zhi-Ning Dong
- State Key Laboratory of Organ Failure Research, School of Biotechnology, Institute of Antibody Engineering, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Ying-Song Wu
- State Key Laboratory of Organ Failure Research, School of Biotechnology, Institute of Antibody Engineering, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Ming Li
- State Key Laboratory of Organ Failure Research, School of Biotechnology, Institute of Antibody Engineering, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
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14
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Mrizak D, Martin N, Barjon C, Jimenez-Pailhes AS, Mustapha R, Niki T, Guigay J, Pancré V, de Launoit Y, Busson P, Moralès O, Delhem N. Effect of nasopharyngeal carcinoma-derived exosomes on human regulatory T cells. J Natl Cancer Inst 2014; 107:363. [PMID: 25505237 DOI: 10.1093/jnci/dju363] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Regulatory T cells (Treg) and tumor-exosomes are thought to play a role in preventing the rejection of malignant cells in patients bearing nasopharyngeal carcinoma (NPC). METHODS Treg recruitment by exosomes derived from NPC cell lines (C15/C17-Exo), exosomes isolated from NPC patients' plasma (Patient-Exo), and CCL20 were tested in vitro using Boyden chamber assays and in vivo using a xenograft SCID mouse model (n = 5), both in the presence and absence of anti-CCL20 monoclonal antibodies (mAb). Impact of these NPC exosomes (NPC-Exo) on Treg phenotype and function was determined using adapted assays (FACS, Q-PCR, ELISA, and MLR). Experiments were performed in comparison with exosomes derived from plasma of healthy donors (HD-Exo). The Student's t test was used for group comparisons. All statistical tests were two-sided. RESULTS CCL20 allowed the intratumoral recruitment of human Treg. NPC-Exo also facilitated Treg recruitment (3.30 ± 0.34 fold increase, P < .001), which was statistically significantly inhibited (P < .001) by an anti-CCL20 blocking mAb. NPC-Exo also recruited conventional CD4(+)CD25(-) T cells and mediated their conversion into inhibitory CD4(+)CD25(high) cells. Moreover, NPC-Exo enhanced (P = .0048) the expansion of human Treg, inducing the generation of Tim3(Low) Treg with increased expression of CD25 and FOXP3. Finally, NPC-Exo induced an overexpression of cell markers associated with Treg phenotype, properties and recruitment capacity. For example, GZMB mean fold change was 21.45 ± 1.75 (P < .001). These results were consistent with a stronger suppression of responder cells' proliferation and the secretion of immunosuppressive cytokines (IL10, TGFB1). CONCLUSION Interactions between NPC-Exo and Treg represent a newly defined mechanism that may be involved in regulating peripheral tolerance by tumors and in supporting immune evasion in human NPC.
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Affiliation(s)
- Dhafer Mrizak
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Nathalie Martin
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Clément Barjon
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Anne-Sophie Jimenez-Pailhes
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Rami Mustapha
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Toshiro Niki
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Joël Guigay
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Véronique Pancré
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Yvan de Launoit
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Pierre Busson
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG)
| | - Olivier Moralès
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG).
| | - Nadira Delhem
- CNRS UMR 8161, Institut de Biologie de Lille, Université de Lille, Institut Pasteur de Lille, IFR142, Lille, France (DM, NM, RM, VP, YdL, OM, ND); Université Paris-sud, CNRS UMR 8126 and Institut Gustave Roussy, Villejuif, France (CB, ASJP, PB); GalPharma Co., Ltd. 884-3-302, Fuseishi-Cho, Takamatsu-shi, Kagawa 761-8071 Japan (TN); Department of Immunology, Kagawa University. 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793 Japan (TN); Department of head and Neck Oncology, Institut Gustave Roussy, Villejuif, France (JG).
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15
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Control of the inflammatory response mechanisms mediated by natural and induced regulatory T-cells in HCV-, HTLV-1-, and EBV-associated cancers. Mediators Inflamm 2014; 2014:564296. [PMID: 25525301 PMCID: PMC4267219 DOI: 10.1155/2014/564296] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 06/18/2014] [Accepted: 07/30/2014] [Indexed: 02/07/2023] Open
Abstract
Virus infections are involved in chronic inflammation and, in some cases, cancer development. Although a viral infection activates the immune system's response that eradicates the pathogen mainly through inflammatory mechanisms, it is now recognized that this inflammatory condition is also favorable to the development of tumors. Indeed, it is well described that viruses, such as hepatitis C virus (HCV), Epstein Barr virus (EBV), human papillomavirus (HPV) or human T-cell lymphotropic virus type-1 (HTLV-1), are important risk factors for tumor malignancies. The inflammatory response is a fundamental immune mechanism which involves several molecular and cellular components consisting of cytokines and chemokines that are released by various proinflammatory cells. In parallel to this process, some endogenous recruited components release anti-inflammatory mediators to restore homeostasis. The development of tools and strategies using viruses to hijack the immune response is mostly linked to the presence of regulatory T-cells (Treg) that can inhibit inflammation and antiviral responses of other effector cells. In this review, we will focus on current understanding of the role of natural and induced Treg in the control and the resolution of inflammatory response in HCV-, HTLV-1-, and EBV-associated cancers.
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16
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Yap LF, Ahmad M, Zabidi MMA, Chu TL, Chai SJ, Lee HM, Lim PVH, Wei W, Dawson C, Teo SH, Khoo ASB. Oncogenic effects of WNT5A in Epstein-Barr virus‑associated nasopharyngeal carcinoma. Int J Oncol 2014; 44:1774-80. [PMID: 24626628 DOI: 10.3892/ijo.2014.2342] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 02/27/2014] [Indexed: 11/06/2022] Open
Abstract
The molecular events that drive the progression of Epstein-Barr virus (EBV)-associated nasopharyngeal carcinoma (NPC) are still to be elucidated. Here, we report for the first time the pathogenic significance of an NPC-associated gene, wingless-type MMTV integration site family, member 5A (WNT5A) and the contribution of EBV to its expression. WNT5A is a representative Wnt protein that activates non-canonical Wnt signalling. With regard to its role in carcinogenesis, there is conflicting evidence as to whether WNT5A has a tumour-promoting or tumour-suppressive role. We show that WNT5A is upregulated in primary NPC tissue samples. We also demonstrate that WNT5A expression was dramatically increased in NPC cell lines expressing the EBV-encoded LMP2A gene, suggesting that this EBV-encoded latent gene is responsible for upregulating WNT5A in NPC. In addition, in vitro WNT5A overexpression promotes the proliferation, migration and invasion of NPC cells. Our results not only reveal pro-tumorigenic effects of WNT5A in NPC but also suggest that WNT5A could be an important therapeutic target in patients with EBV-associated disease.
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Affiliation(s)
- Lee Fah Yap
- Department of Oral Biology and Biomedical Sciences and Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Munirah Ahmad
- Molecular Pathology Unit, Cancer Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | | | - Tai Lin Chu
- Molecular Pathology Unit, Cancer Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - San Jiun Chai
- Cancer Research Initiatives Foundation, Selangor, Malaysia
| | - Hui Min Lee
- Department of Oral Biology and Biomedical Sciences and Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Wenbin Wei
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | | | - Soo-Hwang Teo
- Cancer Research Initiatives Foundation, Selangor, Malaysia
| | - Alan Soo Beng Khoo
- Molecular Pathology Unit, Cancer Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
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17
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Strojan P, Ferlito A, Medina JE, Woolgar JA, Rinaldo A, Robbins KT, Fagan JJ, Mendenhall WM, Paleri V, Silver CE, Olsen KD, Corry J, Suárez C, Rodrigo JP, Langendijk JA, Devaney KO, Kowalski LP, Hartl DM, Haigentz M, Werner JA, Pellitteri PK, de Bree R, Wolf GT, Takes RP, Genden EM, Hinni ML, Mondin V, Shaha AR, Barnes L. Contemporary management of lymph node metastases from an unknown primary to the neck: I. A review of diagnostic approaches. Head Neck 2011; 35:123-32. [PMID: 22034046 DOI: 10.1002/hed.21898] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2011] [Indexed: 12/31/2022] Open
Abstract
In an era of advanced diagnostics, metastasis to cervical lymph nodes from an occult primary tumor is a rare clinical entity and accounts for approximately 3% of head and neck malignancies. Histologically, two thirds of cases are squamous cell carcinomas (SCCs), with other tissue types less common in the neck. With modern imaging and tissue examinations, a primary tumor initially undetected on physical examination is revealed in >50% of patients and the site of the index primary can be predicted with a high level of probability. In the present review, the range and limitations of diagnostic procedures are summarized and the optimal diagnostic workup is proposed. Initial preferred diagnostic procedures are a fine-needle aspiration biopsy (FNAB) and imaging. This allows directed surgical biopsy (such as tonsillectomy), based on the preliminary findings, and prevents misinterpretation of postsurgical images. When no primary lesion is suggested after imaging and panendoscopy, and for patients without a history of smoking and alcohol abuse, molecular profiling of an FNAB sample for human papillomavirus (HPV) and/or Epstein-Barr virus (EBV) is important.
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Affiliation(s)
- Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
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18
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Kimura Y, Suzuki D, Tokunaga T, Takabayashi T, Yamada T, Wakisaka N, Yoshizaki T, Murata H, Miwa K, Shoujaku H, Watanabe Y, Yamada N, Ito Y, Yuta A, Takeuchi K, Hosokawa S, Mineta H, Hasegawa Y, Fujimoto Y, Nakashima T, Fujieda S. Epidemiological analysis of nasopharyngeal carcinoma in the central region of Japan during the period from 1996 to 2005. Auris Nasus Larynx 2011; 38:244-9. [DOI: 10.1016/j.anl.2010.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 07/24/2010] [Accepted: 07/29/2010] [Indexed: 10/19/2022]
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19
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Chute DJ, Stelow EB. Cytology of head and neck squamous cell carcinoma variants. Diagn Cytopathol 2010; 38:65-80. [PMID: 19582815 DOI: 10.1002/dc.21134] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The most common diagnosis rendered with head and neck fine needle aspiration (FNA) biopsy is metastatic squamous cell carcinoma (SCC). While most cases of metastatic SCC pose little diagnostic difficulty, the diagnosis of metastatic histologic variants of SCC, often coupled with less common etiologies, can be more problematic. This manuscript reviews the clinicopathologic features of the histologic variants of upper aerodigestive tract SCC (verrucous, papillary, spindle cell, undifferentiated, acantholytic, and basaloid) and uncommon etiologies of head and neck SCC (human papillomavirus, Epstein-Barr Virus, and NUT midline carcinomas). Particular attention is paid to the cytologic features of these lesions. Differential diagnoses and the use of ancillary testing are discussed.
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Affiliation(s)
- Deborah J Chute
- Department of Pathology, University of Virginia, Charlottesville, Virginia 22908, USA
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20
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Zhai HL, Chang YT, Wu CC, Yu JS. An approach to the elimination of inter-individual variability in tumor detection. Analyst 2010; 135:875-9. [DOI: 10.1039/b927473a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Abstract
Epstein-Barr virus (EBV) infects various cell types in a wide spectrum of benign and malignant diseases. Laboratory tests for EBV have improved and are increasingly used in diagnosis, prognosis, prediction, and prevention of diseases ranging from infectious mononucleosis to selected subtypes of lymphoma, sarcoma, and carcinoma. Indeed, the presence of EBV is among the most effective tumor markers supporting clinical management of cancer patients. In biopsies, localization of EBER transcripts by in situ hybridization remains the gold standard for identifying latent infection. Other RNA- and protein-based assays detect lytic viral replication and can distinguish carcinoma-derived from lymphocyte-derived EBV in saliva or nasopharyngeal brushings. Analysis of blood using EBV viral load and serology reflects disease status and risk of progression. This review summarizes prior research in the context of basic virologic principles to provide a rational strategy for applying and interpreting EBV tests in various clinical settings. Such assays have been incorporated into standard clinical practice in selected settings such as diagnosis of primary infection and management of patients with immune dysfunction or nasopharyngeal carcinoma. As novel therapies are developed that target virus-infected cells or overcome the adverse effects of infection, laboratory testing becomes even more critical for determining when intervention is appropriate and the extent to which it has succeeded.
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Affiliation(s)
- Margaret L Gulley
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599-7525, USA.
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