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Xu M, Lu X, Zhu F, Sun X, Yao H, Zhang J, Chen W, Zhu H, Liu F, Shi SL, Deng X. BRG1 mediates epigenetic regulation of TNFα-induced CCL2 expression in oral tongue squamous cell carcinoma cells. J Cell Biochem 2024; 125:e30535. [PMID: 38348687 DOI: 10.1002/jcb.30535] [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: 08/23/2023] [Revised: 12/02/2023] [Accepted: 01/30/2024] [Indexed: 04/11/2024]
Abstract
Strong evidence has indicated that upregulation of chemokine (CC motif) ligand-2 (CCL2) expression and the presence of an inflammatory tumor microenvironment significantly contribute to the migratory and invasive properties of oral squamous cell carcinoma, specifically oral tongue squamous cell carcinoma (OTSCC). However, the precise epigenetic mechanism responsible for enhanced CCL2 expression in response to the inflammatory mediator tumor necrosis factor alpha (TNF-α) in OTSCC remains inadequately elucidated. We have demonstrated that the production of CCL2 can be induced by TNF-α, and this induction is mediated by the chromatin remodel protein BRG1. Through the use of a chromatin immunoprecipitation (ChIP) assay, we have found that BRG1 was involved in the recruitment of acetylated histones H3 and H4 at the CCL2 promoter, thereby activating TNF-α-induced CCL2 transcription. Furthermore, we have observed that recruitment of NF-κB p65 to the CCL2 promoter was increased following BRG1 overexpression and decreased after BRG1 knockdown in OTSCC cells. Our Re-ChIP assay has shown that BRG1 knockdown completely inhibits the recruitment of both acetylated histone H3 or H4 and NF-κB to the CCL2 promoter. In summary, the findings of our study demonstrate that BRG1 plays a significant role in mediating the production of CCL2 in OTSCC cells in response to TNF-α stimulation. This process involves the cooperative action of acetylated histone and NF-κB recruitment to the CCL2 promoter site. Our data suggest that BRG1 serves as a critical epigenetic mediator in the regulation of TNF-α-induced CCL2 transcription in OTSCC cells.
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Affiliation(s)
- Mingyan Xu
- School of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Implantology, Stomatological Hospital of Xiamen Medical College & Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Xuemei Lu
- Department of Basic Medical Science, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Feixiang Zhu
- Department of Basic Medical Science, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Xue Sun
- Department of Basic Medical Science, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Hongfa Yao
- Department of Implantology, Stomatological Hospital of Xiamen Medical College & Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Junling Zhang
- Department of Basic Medical Science, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Weishi Chen
- Department of Stomatology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang, China
| | - Haohao Zhu
- Department of Pathology, The 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Nanchang, Jiangxi, China
| | - Fan Liu
- Department of Basic Medical Science, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Song Lin Shi
- Department of Basic Medical Science, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Xiaoling Deng
- Department of Basic Medical Science, School of Medicine, Xiamen University, Xiamen, Fujian, China
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Files R, Santos C, Queiroga FL, Silva F, Delgado L, Pires I, Prada J. Investigating Cox-2 and EGFR as Biomarkers in Canine Oral Squamous Cell Carcinoma: Implications for Diagnosis and Therapy. Curr Issues Mol Biol 2024; 46:485-497. [PMID: 38248333 PMCID: PMC10814971 DOI: 10.3390/cimb46010031] [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: 12/06/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Oral squamous cell carcinoma (OSCC) is a common and highly aggressive dog tumor known for its local invasiveness and metastatic potential. Understanding the molecular mechanisms driving the development and progression of OSCC is crucial for improving diagnostic and therapeutic strategies. Additionally, spontaneous oral squamous cell carcinomas in dogs are an excellent model for studying human counterparts. In this study, we aimed to investigate the significance of two key molecular components, Cox-2 and EGFR, in canine OSCC. We examined 34 tumor sections from various dog breeds to assess the immunoexpression of Cox-2 and EGFR. Our findings revealed that Cox-2 was highly expressed in 70.6% of cases, while EGFR overexpression was observed in 44.1%. Cox-2 overexpression showed association with histological grade of malignancy (HGM) (p = 0.006) and EGFR with vascular invasion (p = 0.006). COX-2 and EGFR concurrent expression was associated with HGM (p = 0.002), as well as with the presence of vascular invasion (p = 0.002). These data suggest that Cox-2 and EGFR could be promising biomarkers and potential therapeutic targets, opening avenues for developing novel treatment strategies for dogs affected by OSCC. Further studies are warranted to delve deeper into these findings and translate them into clinical practice.
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Affiliation(s)
- Rita Files
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (R.F.); (C.S.); (F.L.Q.); (F.S.); (J.P.)
| | - Catarina Santos
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (R.F.); (C.S.); (F.L.Q.); (F.S.); (J.P.)
| | - Felisbina L. Queiroga
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (R.F.); (C.S.); (F.L.Q.); (F.S.); (J.P.)
- Animal and Veterinary Research Centre (CECAV), Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Centre for the Study of Animal Science, CECA-ICETA, University of Porto, 4200-427 Porto, Portugal
| | - Filipe Silva
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (R.F.); (C.S.); (F.L.Q.); (F.S.); (J.P.)
- Animal and Veterinary Research Centre (CECAV), Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Leonor Delgado
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences—CESPU (IUCS-CESPU), 4585-116 Gandra, Portugal;
- Pathology Department, INNO Serviços Especializados em Veterinária, 4710-503 Braga, Portugal
| | - Isabel Pires
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (R.F.); (C.S.); (F.L.Q.); (F.S.); (J.P.)
- Animal and Veterinary Research Centre (CECAV), Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Justina Prada
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (R.F.); (C.S.); (F.L.Q.); (F.S.); (J.P.)
- Animal and Veterinary Research Centre (CECAV), Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
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MiR-199a-5p-Regulated SMARCA4 Promotes Oral Squamous Cell Carcinoma Tumorigenesis. Int J Mol Sci 2023; 24:ijms24054756. [PMID: 36902184 PMCID: PMC10003091 DOI: 10.3390/ijms24054756] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/19/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
SWI/SNF related, matrix associated, actin-dependent regulator of chromatin, subfamily a, member 4 (SMARCA4, also known as BRG1), an ATPase subunit of the switch/sucrose non-fermentable (SWI/SNF) chromatin remodeling complex, plays an important regulatory role in many cytogenetic and cytological processes during cancer development. However, the biological function and mechanism of SMARCA4 in oral squamous cell carcinoma (OSCC) remain unclear. The present study aimed to investigate the role of SMARCA4 in OSCC and its potential mechanism. Using a tissue microarray, SMARCA4 expression was found to be highly upregulated in OSCC tissues. In addition, SMARCA4 upregulate expression led to increased migration and invasion of OSCC cells in vitro, as well as tumor growth and invasion in vivo. These events were associated with the promotion of epithelial-mesenchymal transition (EMT). Bioinformatic analysis and luciferase reporter assay confirmed that SMARCA4 is a target gene of microRNA miR-199a-5p. Further mechanistic studies showed that the miR-199a-5p regulated SMARCA4 can promote the invasion and metastasis of tumor cells through EMT. These findings indicate that the miR-199a-5p- SMARCA4 axis plays a role in tumorigenesis by promoting OSCC cell invasion and metastasis through EMT regulation. Our findings provide insights into the role of SMARCA4 in OSCC and the mechanism involved, which may have important implications for therapeutic purposes.
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Qin SY, Li B, Chen M, Qin MQ, Liu JM, Lv QL. MiR-32-5p promoted epithelial-to-mesenchymal transition of oral squamous cell carcinoma cells via regulating the KLF2/CXCR4 pathway. Kaohsiung J Med Sci 2021; 38:120-128. [PMID: 34741382 DOI: 10.1002/kjm2.12450] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/26/2021] [Accepted: 08/17/2021] [Indexed: 11/07/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is one of the most common carcinomas of the oral cavity. However, the regulatory mechanisms on miR-32-5p remain poorly understood in OSCC. The expression of miR-32-5p, Krüppel-like factor 2 (KLF2), C-X-C motif chemokine receptor 4 (CXCR4), and epithelial-to-mesenchymal transition (EMT)-related proteins (E-cadherin, Vimentin, N-cadherin, and Snail) were evaluated were assessed using RT-qPCR and Western blot. 3-(4, 5-Dimethylthiazolyl2)-2, 5-diphenyltetrazolium bromide assay, wound healing assay, and transwell assay were employed to detect cell proliferation, migration, and invasion of OSCC cells. Finally, dual-luciferase reporter assay was performed to verify the binding relationship between KLF2 and miR-32-5p. MiR-32-5p was highly expressed while KLF2 was lowly expressed in OSCC cells, and miR-32-5p knockdown or KLF2 overexpression could markedly reduce cell proliferation, migration, invasion, and EMT of OSCC cells. What is more, KLF2 was the target of miR-32-5p, and knockdown of KLF2 abolished the inhibitory effect of miR-32-5p inhibitor on progression of OSCC. Finally, CXCR4 expression was negatively regulated by KLF2, and inhibition of CXCR4 obviously alleviated the biological effects of si-KLF2 on the progression of OSCC. MiR-32-5p could enhance cell proliferation, migration, invasion, and EMT of OSCC cells, and the discovery of miR-32-5p/KLF2/CXCR4 axis might provide potential therapeutic targets for OSCC.
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Affiliation(s)
- Shi-Yu Qin
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guilin Medical University, Guilin, China
| | - Bo Li
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guilin Medical University, Guilin, China
| | - Mei Chen
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guilin Medical University, Guilin, China
| | - Ming-Qun Qin
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guilin Medical University, Guilin, China
| | - Ji-Mu Liu
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guilin Medical University, Guilin, China
| | - Qiu-Li Lv
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guilin Medical University, Guilin, China
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Ferreli F, Festa BM, Costantino A, Malvezzi L, Colombo G, Spriano G, Mercante G, De Virgilio A. Prevalence of occult level 2b nodal metastases in cN0 squamous cell carcinoma of the oral cavity: A systematic review and meta-analysis. Oral Oncol 2021; 122:105540. [PMID: 34598036 DOI: 10.1016/j.oraloncology.2021.105540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 01/22/2023]
Abstract
Elective neck dissection of levels I, II and III is being increasingly used for detecting occult node metastases in patients with oral squamous cell carcinoma (OSCC) and clinically negative neck (cN0). The most frequent potential long-term complication of this procedure is shoulder dysfunction, because of micro- or macroscopic damage to the spinal accessory nerve (SAN). In particular, many studies have reported an association between SAN damage and dissection of level 2b. Furthermore, level 2b dissection is a technically demanding and time-consuming procedure. Our study aims to clarify whether level 2b sparing in cN0 patients with OSCC can be oncologically justifiable. The PubMed, Cochrane and Scopus databases were searched by three different authors for articles on this topic. The primary endpoint of the meta-analysis was the overall prevalence of occult metastases in cervical level 2b nodes in patients with OSCC and clinically negative neck. The meta-analysis was performed using R version 4.0.1. A total of 13 studies and 937 patients were included. The cumulative rate of occult nodal metastases in level 2b was 0.8% (n = 937, 95% CI: 0.1% - 2.2%, τ2 = 0.004). No isolated level 2b metastases was found among the patients with positive level 2b, and in the six studies that reported this association, all patients with nodal disease in level 2b had a positive level 2a. This meta-analysis highlights how level 2b can be safely spared in supraomohyoid neck dissection (SOHND) of patients with OSCC and clinically negative neck, reducing the risk of postoperative shoulder dysfunction.
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Affiliation(s)
- Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Bianca Maria Festa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Luca Malvezzi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Giovanni Colombo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
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6
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Lundberg AP, Boudreau MW, Selting KA, Chatkewitz LE, Samuelson J, Francis JM, Parkinson EI, Barger AM, Hergenrother PJ, Fan TM. Utilizing feline oral squamous cell carcinoma patients to develop NQO1-targeted therapy. Neoplasia 2021; 23:811-822. [PMID: 34246985 PMCID: PMC8274297 DOI: 10.1016/j.neo.2021.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/10/2021] [Indexed: 02/06/2023] Open
Abstract
Developing effective therapies for the treatment of advanced head-and-neck squamous cell carcinoma (HNSCC) remains a major challenge, and there is a limited landscape of effective targeted therapies on the horizon. NAD(P)H:quinone oxidoreductase 1 (NQO1) is a 2-electron reductase that is overexpressed in HNSCC and presents as a promising target for the treatment of HNSCC. Current NQO1-targeted drugs are hindered by their poor oxidative tolerability in human patients, underscoring a need for better preclinical screening for oxidative toxicities for NQO1-bioactivated small molecules. Herein, we describe our work to include felines and feline oral squamous cell carcinoma (FOSCC) patients in the preclinical assessment process to prioritize lead compounds with increased tolerability and efficacy prior to full human translation. Specifically, our data demonstrate that IB-DNQ, an NQO1-targeted small molecule, is well-tolerated in FOSCC patients and shows promising initial efficacy against FOSCC tumors in proof-of-concept single agent and radiotherapy combination cohorts. Furthermore, FOSCC tumors are amenable to evaluating a variety of target-inducible couplet hypotheses, evidenced herein with modulation of NQO1 levels with palliative radiotherapy. The use of felines and their naturally-occurring tumors provide an intriguing, often underutilized tool for preclinical drug development for NQO1-targeted approaches and has broader applications for the evaluation of other anticancer strategies.
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Affiliation(s)
- Alycen P Lundberg
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Matthew W Boudreau
- Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kim A Selting
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Lindsay E Chatkewitz
- Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jonathan Samuelson
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Joshua M Francis
- Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Elizabeth I Parkinson
- Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Anne M Barger
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Paul J Hergenrother
- Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Timothy M Fan
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
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7
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Zhu Z, Ying Z, Zeng M, Zhang Q, Liao G, Liang Y, Li C, Zhang C, Wang X, Jiang W, Luan P, Sha O. Trichosanthin cooperates with Granzyme B to restrain tumor formation in tongue squamous cell carcinoma. BMC Complement Med Ther 2021; 21:88. [PMID: 33750370 PMCID: PMC7944607 DOI: 10.1186/s12906-021-03266-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 02/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Tongue squamous cell carcinoma (TSCC) is a common type of oral cancer, with a relatively poor prognosis and low post-treatment survival rate. Various strategies and novel drugs to treat TSCC are emerging and under investigation. Trichosanthin (TCS), extracted from the root tubers of Tian-Hua-Fen, has been found to have multiple biological and pharmacological functions, including inhibiting the growth of cancer cells. Granzyme B (GrzB) is a common toxic protein secreted by natural killer cells and cytotoxic T cells. Our group has reported that TCS combined with GrzB might be a superior approach to inhibit liver tumor progression, but data relating to the use of this combination to treat TSCC remain limited. The aim of this study was to examine the effectiveness of TCS on TSCC processes and underlying mechanisms. METHODS First, we screened the potential antitumor activity of TCS using two types of SCC cell lines. Subsequently, a subcutaneous squamous cell carcinoma xenograft model in nude mice was established. These model mice were randomly divided into four groups and treated as follows: control group, TCS treatment group, GrzB treatment group, and TCS/GrzB combination treatment group. Various tumorigenesis parameters, such as Ki67, PCNA, caspase-3, Bcl-2 and VEGFA, et al., were performed to determine the effects of these treatments on tumor development. RESULTS Screening confirmed that the SCC25 line exhibited greater sensitivity than the SCC15 line to TCS in vitro studies. TCS or GrzB treatment significantly inhibited tumor growth compared with the inhibition seen in the control group. The TCS/GrzB combination inhibited tumor growth more than either drug alone. TCS treatment inhibited tumor proliferation by downregulating Ki67 and Bcl2 protein expression while accelerating tumor apoptosis. In the TCS/GrzB-treated group, expression of Ki67 was further downregulated, while the level of activated caspase-3 was increased, compared with their expression in either of the single drug treatment groups. CONCLUSION These results suggest that the TCS/GrzB combination could represent an effective immunotherapy for TSCC.
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Affiliation(s)
- Zeyao Zhu
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China
- School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen, China
| | - Zhenguang Ying
- School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen, China
| | - Meiqi Zeng
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China
| | - Qiang Zhang
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China
- The Shenzhen Stomatology Hospital, Shenzhen, China
| | - Guiqing Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yunliu Liang
- School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen, China
| | - Chunman Li
- School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen, China
| | - Chengfei Zhang
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Xia Wang
- School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen, China
| | - Weipeng Jiang
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China
| | - Ping Luan
- School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen, China.
| | - Ou Sha
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China.
- School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen, China.
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8
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Harman RM, Das SP, Bartlett AP, Rauner G, Donahue LR, Van de Walle GR. Beyond tradition and convention: benefits of non-traditional model organisms in cancer research. Cancer Metastasis Rev 2020; 40:47-69. [PMID: 33111160 DOI: 10.1007/s10555-020-09930-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/01/2020] [Indexed: 02/07/2023]
Abstract
Traditional laboratory model organisms are indispensable for cancer research and have provided insight into numerous mechanisms that contribute to cancer development and progression in humans. However, these models do have some limitations, most notably related to successful drug translation, because traditional model organisms are often short-lived, small-bodied, genetically homogeneous, often immunocompromised, are not exposed to natural environments shared with humans, and usually do not develop cancer spontaneously. We propose that assimilating information from a variety of long-lived, large, genetically diverse, and immunocompetent species that live in natural environments and do develop cancer spontaneously (or do not develop cancer at all) will lead to a more comprehensive understanding of human cancers. These non-traditional model organisms can also serve as sentinels for environmental risk factors that contribute to human cancers. Ultimately, expanding the range of animal models that can be used to study cancer will lead to improved insights into cancer development, progression and metastasis, tumor microenvironment, as well as improved therapies and diagnostics, and will consequently reduce the negative impacts of the wide variety of cancers afflicting humans overall.
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Affiliation(s)
- Rebecca M Harman
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Sanjna P Das
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Arianna P Bartlett
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Gat Rauner
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Leanne R Donahue
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Gerlinde R Van de Walle
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA.
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9
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Sugahara K, Koyama Y, Koyachi M, Matsunaga S, Odaka K, Kitamura K, Nakajima K, Matsuzaka K, Abe S, Katakura A. Relationship between the immunohistological examination and fluorescence visualization of oral squamous cell carcinoma. Oncol Lett 2020; 20:2153-2160. [PMID: 32782532 PMCID: PMC7400981 DOI: 10.3892/ol.2020.11772] [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: 12/18/2019] [Accepted: 04/27/2020] [Indexed: 11/14/2022] Open
Abstract
Disorders of the oral mucosa are considered easy to diagnose since they can be visualized and examined directly. A change in the color of the oral mucosa reflects histopathological changes and is an important diagnostic parameter. However, the subjective perception of color varies. To determine the extent of resection for oral mucosa conditions, it is necessary to digitize the color and perform objective assessments. In recent years, fluorescence visualization devices and analysis software that measure tissue luminance G have been employed for the identification of oral mucosa diseases. Fluorescence visualization is presumably based on the decrease in epithelial flavin adenine dinucleotide content and luminance G values due to the destruction of collagen cross-links [fluorescence visualization loss (FVL)]. However, cases with differences between luminance values and histopathological presentation exist. Therefore, additional factors may affect fluorescence visualization. The present study used a portable, non-contact oral mucosa fluorescence visualization device for luminance measurements in seven patients with oral squamous cell carcinoma. Furthermore, Picro-Sirius Red and immunohistochemical staining were performed for CK13, CK17, Ki67, p53 and E-cadherin in the FVL(+) (lesion) and FVL(−) (resection stump) areas to elucidate the principle of fluorescence visualization. Fluorescence was significantly lower in the FVL(+) than in the FVL(−) areas, and the mean luminance G value was 56. The Picro-Sirius Red stain revealed collagen destruction in the FVL(+) areas but no collagen disruption in the FVL(−) areas. CK13 was negative in the FVL(+) and positive in the FVL(−) areas, whereas the opposite pattern was observed for CK17. In the FVL(+) area, p53 staining was positive. E-cadherin expression was enhanced in the FVL(−) areas and reduced in the FVL(+) areas. Furthermore, the luminance G value tended to be lower in cases with weaker E-cadherin staining. The aforementioned results suggest that decreased E-cadherin expression may be a factor that regulates fluorescence visualization.
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Affiliation(s)
- Keisuke Sugahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo 101-0061, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Yu Koyama
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Masahide Koyachi
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Satoru Matsunaga
- Oral Health Science Center, Tokyo Dental College, Tokyo 101-0061, Japan.,Department of Anatomy, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Kento Odaka
- Oral and Maxillofacial Radiology, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Kei Kitamura
- Histology and Developmental Biology, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Kei Nakajima
- Clinical Pathophysiology, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Kenichi Matsuzaka
- Clinical Pathophysiology, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo 101-0061, Japan
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10
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Predictors for distant metastasis in head and neck cancer, with emphasis on age. Eur Arch Otorhinolaryngol 2020; 278:181-190. [PMID: 32542417 PMCID: PMC7811512 DOI: 10.1007/s00405-020-06118-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/08/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Distant metastasis (DM) in patients with head and neck squamous cell carcinoma (HNSCC) is uncommon, but strongly deteriorates prognosis. Controversy exists regarding age as a predictor for the presence and development of DM. The aim of this study was to investigate age and other predictors for DM in HNSCC patients. METHODS From 1413 patients diagnosed with a primary HNSCC between 1999 and 2010 in a tertiary referral centre, patient, disease and pathological characteristics were extracted from patient files. Uni- and multivariable Cox regression analyses were performed to identify risk factors for DM as primary outcome. RESULTS DM occurred in 131 (9.3%) patients, of which 27 (1.9%) were diagnosed simultaneously with the primary tumour, 27 (1.9%) were diagnosed synchronous, and 77 (5.4%) were diagnosed metachronous. The most common site of DM was lung (51.1%), followed by bone (19.1%) and liver (11.5%). Multivariable analysis identified male gender (HR = 1.95, 95% CI 1.23-3.10) hypopharyngeal tumours (HR = 3.28, 95% CI 1.75-6.14), advanced T-stage (HR = 1.61, 95% CI 1.09-2.38), poor differentiation grade (HR = 2.49, 95% CI 1.07-5.78), regional lymph node metastasis (HR = 5.35, 95% CI 3.25-8.79) and extranodal extension of regional lymph nodes metastasis (HR = 3.06, 95% CI 1.39-6.72) as independent prognostic factors for the presence or development of DM. No relation with age was found. CONCLUSION Age is not related to the presence or development of DM. This study emphasizes the importance of screening for DM, especially in males, patients with hypopharyngeal tumours, advanced T-stage, histopathological poor differentiation grade, regional lymph node metastasis and extranodal extension.
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11
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Oh LJ, Phan K, Kim SW, Low TH, Gupta R, Clark JR. Elective neck dissection versus observation for early-stage oral squamous cell carcinoma: Systematic review and meta-analysis. Oral Oncol 2020; 105:104661. [PMID: 32244173 DOI: 10.1016/j.oraloncology.2020.104661] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Oral squamous cell carcinoma (OSCC) is the seventh most common cancer globally, and has been identified as a growing health concern. This study aims to evaluate the current literature comparing elective neck dissection to observation in the treatment of early-stage tongue SCC, focusing on nodal recurrence, overall survival, disease specific survival statistics from randomised controlled trials comparing the two interventions. METHODS Systematic review and meta-analysis was conducted according to PRISMA guidelines. The odds ratio (OR) was used as a summary statistic. RESULTS From 8 studies, there was a total of 372 cases of recurrence, 98 (15.1%) in END group and 274 (41.5%) in the Observation group. There was a significantly lower rate of recurrence in the END group compared to observation (OR 0.25, 95% CI 0.16-0.39, I2 = 54%, P < 0.00001). END was associated with higher overall survival rates when compared with observation (OR 1.95, 95% CI 1.40-2.73, I2 = 14%, P < 0.0001). END was also associated with higher disease-specific survival compared with observation (OR 1.88, 95% CI 1.21-2.93), I2 = 47%, P = 0.005), with no significant heterogeneity noted. CONCLUSIONS END was associated with significantly lower recurrence rates and higher overall and disease-specific survival compared to a conservative observation approach in early-stage oral SCC with clinically N0 neck.
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Affiliation(s)
- L J Oh
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia.
| | - K Phan
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - S W Kim
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - T H Low
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia
| | - R Gupta
- Central Clinical School, University of Sydney, Sydney, Australia; Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | - J R Clark
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia
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12
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Wei D, Wang W, Shen B, Zhou Y, Yang X, Lu G, Yang J, Shao Y. MicroRNA‑199a‑5p suppresses migration and invasion in oral squamous cell carcinoma through inhibiting the EMT‑related transcription factor SOX4. Int J Mol Med 2019; 44:185-195. [PMID: 31059001 PMCID: PMC6559314 DOI: 10.3892/ijmm.2019.4174] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/19/2019] [Indexed: 01/26/2023] Open
Abstract
MicroRNAs (miRs) are small, non-coding RNAs that can act as oncogenes or tumor suppressor genes in human cancer. Recent studies have revealed that miR-199a-5p is abnormally expressed in various types of human cancer; however, the potential role of miR-199a-5p in oral squamous cell carcinoma (OSCC) remains elusive. The present study investigated the role of miR-199a-5p in OSCC cells and explored the potential molecular mechanism. Reverse transcription-quantitative polymerase chain reaction was used to measure miR-199a-5p expression in OSCC tissues and adjacent normal oral epithelial tissues. Cell invasion and migration were evaluated using Transwell invasion and wound-healing assays in OSCC cells post-transfection with miR-199a-5p mimics or negative control mimics. In addition, a luciferase reporter assay was conducted to identify the target gene of miR-199a-5p in OSCC cells. The results demonstrated that miR-199a-5p expression was significantly downregulated in OSCC tissues and cell lines, and was associated with tumor progression in OSCC. Furthermore, overexpression of miR-199a-5p inhibited cell invasion and migration, and blocked the epithelial-mesenchymal transition (EMT) cascade. Notably, the results revealed that the EMT-related transcription factor SRY-box 4 (SOX4) was a direct target gene of miR-199a-5p, as determined by the direct binding of miR-199a-5p with the 3′-untranslated region of SOX4. In addition, knockdown of SOX4 by small interfering RNA-SOX4 suppressed proliferation, migration and invasion of OSCC cells. Conversely, overexpression of SOX4 rescued the suppressive effects of miR-199a-5p on cell migration and invasion. Collectively, these data indicated that miR-199a-5p may inhibit the migration and invasion of OSCC cells via targeting the EMT-related transcription factor SOX4, thus suggesting that miR-199a-5p may serve as a prognostic biomarker and therapeutic target in the treatment of OSCC.
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Affiliation(s)
- Dongyi Wei
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Weixin Wang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Baohong Shen
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Yanjun Zhou
- Clinical Laboratory, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Xiaodong Yang
- Clinical Laboratory, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Guangjian Lu
- Clinical Laboratory, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Jianbin Yang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Yuebao Shao
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
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13
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Cruz-Gregorio A, Martínez-Ramírez I, Pedraza-Chaverri J, Lizano M. Reprogramming of Energy Metabolism in Response to Radiotherapy in Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2019; 11:cancers11020182. [PMID: 30764513 PMCID: PMC6406552 DOI: 10.3390/cancers11020182] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/24/2019] [Accepted: 02/01/2019] [Indexed: 12/26/2022] Open
Abstract
Head and neck cancer (HNC) is the sixth cause of cancer-related death worldwide. Head and neck squamous cells carcinoma (HNSCC) is the most frequent subtype of HNC. The development of HNSCC is associated to alcohol consumption, smoking or infection by high-risk human Papillomavirus (HR-HPV). Although the incidence of cancers associated with alcohol and tobacco has diminished, HNSCC associated with HR-HPV has significantly increased in recent years. However, HPV-positive HNSCC responds well to treatment, which includes surgery followed by radiation or chemoradiation therapy. Radiation therapy (RT) is based on ionizing radiation (IR) changing cell physiology. IR can directly interact with deoxyribonucleic acid (DNA) or produce reactive oxygen and nitrogen species (RONS), provoking DNA damage. When DNA damage is not repaired, programmed cell death (apoptosis and/or autophagy) is induced. However, cancer cells can acquire resistance to IR avoiding cell death, where reprogramming of energy metabolism has a critical role and is intimately connected with hypoxia, mitochondrial physiology, oxidative stress (OS) and autophagy. This review is focused on the reprogramming of energy metabolism in response to RT in HPV-positive and HPV-negative HNSCC, showing their differences in cellular metabolism management and the probable direction of treatments for each subtype of HNSCC.
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Affiliation(s)
- Alfredo Cruz-Gregorio
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, San Fernando No. 22, Col. Sección XVI, Tlalpan, Ciudad de México 14080, México.
| | - Imelda Martínez-Ramírez
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, San Fernando No. 22, Col. Sección XVI, Tlalpan, Ciudad de México 14080, México.
| | - José Pedraza-Chaverri
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, Ciudad de México 04510, México.
| | - Marcela Lizano
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, San Fernando No. 22, Col. Sección XVI, Tlalpan, Ciudad de México 14080, México.
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Ciudad de México 04510, México.
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14
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Abu-Helil B, van der Weyden L. Metastasis in the wild: investigating metastasis in non-laboratory animals. Clin Exp Metastasis 2019; 36:15-28. [PMID: 30739231 PMCID: PMC6394581 DOI: 10.1007/s10585-019-09956-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/29/2019] [Indexed: 01/13/2023]
Abstract
Humans are not the only species to spontaneously develop metastatic cancer as cases of metastasis have been reported in a wide range of animals, including dinosaurs. Mouse models have been an invaluable tool in experimental and clinical metastasis research, with the use of genetically-engineered mouse models that spontaneously develop metastasis or ectopic/orthotopic transplantation of tumour cells to wildtype or immunodeficient mice being responsible for many key advances in our understanding of metastasis. However, are there other species that can also be relevant models? Similarities to humans in terms of environmental exposures, life-span, genetics, histopathology and available therapeutics are all factors that can be considered when looking at species other than the laboratory mouse. This review will explore the occurrence of metastasis in multiple species from a variety of domestic, captive and free-living veterinary cases to assist in identifying potential alternative experimental and clinical research models relevant to humans.
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Affiliation(s)
- Bushra Abu-Helil
- Experimental Cancer Genetics (T113), Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK.
| | - Louise van der Weyden
- Experimental Cancer Genetics (T113), Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
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15
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Wei D, Shen B, Wang W, Zhou Y, Yang X, Lu G, Yang J, Shao Y. MicroRNA‑199a‑5p functions as a tumor suppressor in oral squamous cell carcinoma via targeting the IKKβ/NF‑κB signaling pathway. Int J Mol Med 2019; 43:1585-1596. [PMID: 30720059 PMCID: PMC6414152 DOI: 10.3892/ijmm.2019.4083] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 01/16/2019] [Indexed: 12/19/2022] Open
Abstract
MicroRNAs (miRNAs) have been shown to have a significant role in the progression of several types of cancer, including oral squamous cell carcinoma (OSCC). However, the biological function and regulatory mechanisms of miRNAs in OSCC remain to be fully elucidated. The aim of the present study was to investigate the role of miRNAs in OSCC and the relevant mechanism. Using a microarray, it was found that miRNA (miR)-199a-5p was one of the most downregulated miRNAs in OSCC tissues. A low expression of miR-199a-5p was closely associated with tumor differentiation, lymph node metastasis, tumor-node-metastasis stage, and overall survival rate. Functionally, the overexpression of miR-199a-5p suppressed cell proliferation, induced G0/G1 cell cycle arrest, and promoted the apoptosis of Tca8113 and SCC-4 cells. Subsequently, inhibitor of nuclear factor-κB (NF-κB) kinase β (IKKβ), an important regulator of NF-κB activation, was identified as a direct target of miR-199-5p. An inverse correlation was found between miR-199a-5p and IKKβ in tumor tissues. Further investigations revealed that the overexpression of IKKβ efficiently abrogated the influences caused by the overexpression of miR-199a-5p. It was also found that the miR-199a-5p-mediated anticancer effects were dependent on the inhibition of NF-κB activation. These findings indicate that miR-199a-5p functions as a tumor suppressor through regulation of the NF-κB pathway by targeting IKKβ in OSCC.
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Affiliation(s)
- Dongyi Wei
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Baohong Shen
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Weixin Wang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Yanjun Zhou
- Clinical Laboratory, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Xiaodong Yang
- Clinical Laboratory, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Guangjian Lu
- Clinical Laboratory, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Jianbin Yang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
| | - Yuebao Shao
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, P.R. China
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16
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Faccin TC, Cargnelutti JF, Rodrigues FDS, de Menezes FR, Piazer JVM, de Melo SMP, Lautert BF, Flores EF, Kommers GD. Bovine upper alimentary squamous cell carcinoma associated with bracken fern poisoning: Clinical-pathological aspects and etiopathogenesis of 100 cases. PLoS One 2018; 13:e0204656. [PMID: 30256853 PMCID: PMC6157896 DOI: 10.1371/journal.pone.0204656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 09/12/2018] [Indexed: 12/23/2022] Open
Abstract
Upper digestive tract (UDT) cancer is rare in cattle, however in Southern Brazil, the UDT squamous cell carcinomas (SCCs) are relatively common and have been associated with bracken fern consumption and the presence of papillomas. Although a theory of pathogenesis considers bovine papillomavirus type 4 (BPV-4) as a cofactor in the development of these SCCs, some aspects of the etiopathogenesis of this disease need to be more investigated. In fact, detection of BPV-4 in UDT papillomas is scarce in other regions of the world and has not been performed in Brazil. Therefore, this study had two aims: 1) to analyze the epidemiological, clinical and pathological aspects of 100 natural cases of SCCs in the UDT of cattle grazing on bracken fern (Pteridium arachnoideum) highly contaminated areas, investigating the associations between these parameters; and 2) to investigate the presence of papillomavirus DNA by polymerase chain reaction (PCR) in the UDT papillomas (n = 47) from 30 cattle that also had UDT SCCs. There were statistically significant associations between clinical signs and tumor localization in the UDT; between histological grade of differentiation and tumor localization; and a trend towards significant association between histological grade of differentiation and presence of metastases. The average age of cattle with oropharyngeal SCCs was 7.39 years, with statistically significant difference comparing to cattle with esophageal SCCs (8.6 years). No statistical association was observed among other clinical-pathological parameters (growth pattern and primary site of the tumor) analyzed. No BPV DNA was detected in papillomas by PCR. Therefore, these results suggest the possibility that papillomas of the UDT are not necessarily associated with BPV infection.
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Affiliation(s)
- Tatiane Cargnin Faccin
- Departamento de Patologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Juliana Felipetto Cargnelutti
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Fernando de Souza Rodrigues
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | | | | | | | - Betina Fabis Lautert
- Departamento de Patologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Eduardo Furtado Flores
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Glaucia Denise Kommers
- Departamento de Patologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
- * E-mail:
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17
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Vidotto A, Polachini GM, de Paula-Silva M, Oliani SM, Henrique T, López RVM, Cury PM, Nunes FD, Góis-Filho JF, de Carvalho MB, Leopoldino AM, Tajara EH. Differentially expressed proteins in positive versus negative HNSCC lymph nodes. BMC Med Genomics 2018; 11:73. [PMID: 30157864 PMCID: PMC6114741 DOI: 10.1186/s12920-018-0382-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 08/02/2018] [Indexed: 12/21/2022] Open
Abstract
Background Lymph node metastasis is one of the most important prognostic factors in head and neck squamous cell carcinomas (HNSCCs) and critical for delineating their treatment. However, clinical and histological criteria for the diagnosis of nodal status remain limited. In the present study, we aimed to characterize the proteomic profile of lymph node metastasis from HNSCC patients. Methods In the present study, we used one- and two-dimensional electrophoresis and mass spectrometry analysis to characterize the proteomic profile of lymph node metastasis from HNSCC. Results Comparison of metastatic and non-metastatic lymph nodes showed 52 differentially expressed proteins associated with neoplastic development and progression. The results reinforced the idea that tumors from different anatomical subsites have dissimilar behaviors, which may be influenced by micro-environmental factor including the lymphatic network. The expression pattern of heat shock proteins and glycolytic enzymes also suggested an effect of the lymph node environment in controlling tumor growth or in metabolic reprogramming of the metastatic cell. Our study, for the first time, provided direct evidence of annexin A1 overexpression in lymph node metastasis of head and neck cancer, adding information that may be useful for diagnosing aggressive disease. Conclusions In brief, this study contributed to our understanding of the metastatic phenotype of HNSCC and provided potential targets for diagnostic in this group of carcinomas. Electronic supplementary material The online version of this article (10.1186/s12920-018-0382-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alessandra Vidotto
- Departamento de Biologia Molecular, Faculdade de Medicina (FAMERP), Av. Brigadeiro Faria Lima, 5416, Vila São Pedro, São José do Rio Preto, SP, CEP 15090-000, Brazil
| | - Giovana M Polachini
- Departamento de Biologia Molecular, Faculdade de Medicina (FAMERP), Av. Brigadeiro Faria Lima, 5416, Vila São Pedro, São José do Rio Preto, SP, CEP 15090-000, Brazil
| | - Marina de Paula-Silva
- Departamento de Biologia, Instituto de Biociências, Letras e Ciências Exatas (IBILCE), Universidade Estadual Paulista (UNESP), R. Cristóvão Colombo, 2265, São José do Rio Preto, SP, CEP 15054-000, Brazil
| | - Sonia M Oliani
- Departamento de Biologia, Instituto de Biociências, Letras e Ciências Exatas (IBILCE), Universidade Estadual Paulista (UNESP), R. Cristóvão Colombo, 2265, São José do Rio Preto, SP, CEP 15054-000, Brazil
| | - Tiago Henrique
- Departamento de Biologia Molecular, Faculdade de Medicina (FAMERP), Av. Brigadeiro Faria Lima, 5416, Vila São Pedro, São José do Rio Preto, SP, CEP 15090-000, Brazil
| | - Rossana V M López
- Instituto do Câncer de São Paulo Octavio Frias de Oliveira - ICESP, Av. Dr. Arnaldo, 251 - Cerqueira César, São Paulo, SP, CEP 01246-000, Brazil
| | - Patrícia M Cury
- Faculdade Ceres (Faceres), Av. Anísio Haddad, 6751, São José do Rio Preto, SP, CEP 15090-305, Brazil
| | - Fabio D Nunes
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, Av. Prof. Lineu Prestes, 2227, São Paulo, SP, CEP 05508-000, Brazil
| | - José F Góis-Filho
- Instituto do Câncer Arnaldo Vieira de Carvalho, R. Dr Cesário Mota Jr, 112, São Paulo, SP, CEP 01221-020, Brazil
| | - Marcos B de Carvalho
- Departamento de Cirurgia de Cabeça e Pescoço, Hospital Heliópolis, R. Cônego Xavier, 276, São Paulo, SP, CEP 04231-030, Brazil
| | - Andréia M Leopoldino
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, Avenida do Café, s/n, Ribeirão Preto, SP, CEP 14040-903, Brazil
| | - Eloiza H Tajara
- Departamento de Biologia Molecular, Faculdade de Medicina (FAMERP), Av. Brigadeiro Faria Lima, 5416, Vila São Pedro, São José do Rio Preto, SP, CEP 15090-000, Brazil. .,Departamento de Genética e Biologia Evolutiva, Instituto de Biociências, Universidade de São Paulo, R. do Matão, 321, São Paulo, SP, CEP 05508-090, Brazil.
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18
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Pu YM, Yang Y, Wang YJ, Ding L, Huang XF, Wang ZY, Ni YH, Hu QG. Postoperative radiotherapy is dispensable for OSCC patients with micrometastases in lymph nodes. Virchows Arch 2018; 472:797-805. [PMID: 29629513 DOI: 10.1007/s00428-018-2351-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 03/25/2018] [Accepted: 03/28/2018] [Indexed: 01/31/2023]
Abstract
Lymph node metastasis is a decisive factor for performing postoperative radiotherapy for oral squamous cell carcinoma (OSCC). However, whether OSCC patients with only micrometastasis need postoperative radiotherapy is unclear. In this study, OSCC patients (n = 311) with negative (n = 247), only micrometastasis (n = 44) and macrometastasis (n = 20) were detected and selected by HE staining. Micrometastasis was re-assessed using immunohistochemical staining of cytokeratin (CK) in HE-negative patients to find out the false negative cases. The results indicated that, among the negative lymph node cases (n = 247), the positive rate of CK was 4.94% (n = 12). Besides, the clinical features of the primary tumor in relation to the only micrometastatic status and the value of the postoperative radiotherapy on the only micrometastasis patients were evaluated. Patients with only micrometastasis had higher T stage and inferior worst pattern of invasion (WPOI) than patients without micrometastasis, but they had longer overall survival (OS), metastasis-free survival (MFS), and disease-free survival (DFS) than macrometastasis patients. However, the survival time of only micrometastasis patients with or without postoperative radiotherapy was comparable, even in patients with inferior WPOI. Radiotherapy, however, may only benefit patients with IV/V levels of micrometastasis. These data indicated that postoperative radiotherapy is dispensable for only micrometastasis OSCC patients.
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Affiliation(s)
- Y M Pu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, People's Republic of China
| | - Y Yang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, People's Republic of China
| | - Y J Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, People's Republic of China
| | - L Ding
- Nanjing Stomatological Hospital and The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, People's Republic of China
| | - X F Huang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, People's Republic of China
| | - Z Y Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, People's Republic of China
| | - Y H Ni
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, People's Republic of China. .,Department of Central Laboratory, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, People's Republic of China.
| | - Q G Hu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, People's Republic of China.
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19
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Amano Y, Matsubara D, Yoshimoto T, Tamura T, Nishino H, Mori Y, Niki T. Expression of protein arginine methyltransferase-5 in oral squamous cell carcinoma and its significance in epithelial-to-mesenchymal transition. Pathol Int 2018; 68:359-366. [PMID: 29603824 DOI: 10.1111/pin.12666] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 03/01/2018] [Indexed: 12/14/2022]
Abstract
Protein arginine methyltransferases (PRMT) 5, a member of type II arginine methyltransferases, catalyzes the symmetrical dimethylation of arginine residues on histone and non-histone substrates. Although the overexpression of PRMT5 has been reported in various cancers, its role in oral squamous cell carcinoma (OSCC) has not been elucidated. In the present study, we immunohistochemically examined the expression of PRMT5 in surgically resected oral epithelial dysplasia (OED, n = 8), oral intraepithelial neoplasia (OIN)/carcinoma in situ (CIS) (n = 11) and OSCC (n = 52) with or without contiguous OED lesions. In the normal epithelium, PRMT5 was weakly expressed in the cytoplasm of basal layer cells. In OED, OIN/CIS, and OSCC, its expression consistently and uniformly increased in the cytoplasm of dysplastic and cancer cells. Moreover, nuclear and cytoplasmic localization was detected in the invasive front of cancer cells, particularly in cases showing poor differentiation or aggressive invasion patterns. The concomitant nuclear and cytoplasmic expression of PRMT5 correlated with the loss of E-cadherin and cytokeratin 17, and the upregulation of vimentin, features that are both indicative of epithelial-to-mesenchymal transition. PRMT5 may play a role from early oncogenesis through to the progression of OSCC, particularly in the aggressive mode of stromal invasion.
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Affiliation(s)
- Yusuke Amano
- Department of Integrative Pathology, Jichi Medical University, Shimotsuke, Japan
| | - Daisuke Matsubara
- Department of Integrative Pathology, Jichi Medical University, Shimotsuke, Japan
| | - Taichiro Yoshimoto
- Department of Integrative Pathology, Jichi Medical University, Shimotsuke, Japan
| | - Tomoko Tamura
- Department of Integrative Pathology, Jichi Medical University, Shimotsuke, Japan
| | - Hiroshi Nishino
- Department of Otolaryngology, Jichi Medical University, Shimotsuke, Japan
| | - Yoshiyuki Mori
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Toshiro Niki
- Department of Integrative Pathology, Jichi Medical University, Shimotsuke, Japan
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20
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Liu Y, Li R, Yin K, Ren G, Zhang Y. The crucial role of SEMA3F in suppressing the progression of oral squamous cell carcinoma. Cell Mol Biol Lett 2017; 22:32. [PMID: 29299034 PMCID: PMC5745788 DOI: 10.1186/s11658-017-0064-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 12/15/2017] [Indexed: 01/19/2023] Open
Abstract
Background Oral squamous cell carcinoma (OSCC) is one of the most common types of malignancy. Semaphorin 3F (SEMA3F) is highly conserved but present at a lower level in various cancers than in healthy tissues. While it has been reported that SEMA3F is involved in cancer cell proliferation, migration and invasion, its function in OSCC remains unknown. Methods The expression of SEMA3F in OSCC tissues and OSCC-derived cells was analyzed using qRT-PCR and western blotting. Using SAS and HSC2 cells, we also monitored the effect of SEMA3F on OSCC cell proliferation, migration and invasion using MTT, colony formation and transwell assays. The function of SEMA3F in OSCC tumor formation was also assessed in vivo. Results SEMA3F was significantly downregulated in OSCC tissues and OSCC-derived cells. SEMA3F shows growth inhibitory activity in SAS and HSC2 cells and may act as a tumor suppressor. It can inhibit the migration and invasion potential of OSCC cells. Our results also demonstrate that SEMA3F can suppress the growth of OSCC cells in vivo. Conclusions This study revealed that SEMA3F plays a role as a tumor suppressor in OSCC cell proliferation, migration and invasion. Our finding provides new insight into the progression of OSCC. Therapeutically, SEMA3F has some potential as a target for OSCC treatment, given sufficient future research.
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Affiliation(s)
- Yi Liu
- Department of Stomatology, Tianjin First Center Hospital, Tianjin, 300192 People's Republic of China
| | - Ronghua Li
- Department of Stomatology, Tianjin First Center Hospital, Tianjin, 300192 People's Republic of China
| | - Kai Yin
- Department of Stomatology, Tianjin First Center Hospital, Tianjin, 300192 People's Republic of China
| | - Gang Ren
- Department of Stomatology, Tianjin First Center Hospital, Tianjin, 300192 People's Republic of China
| | - Yongdong Zhang
- Department of Stomatology, Tianjin First Center Hospital, Tianjin, 300192 People's Republic of China
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21
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Schutt CA, Mirandola L, Figueroa JA, Nguyen DD, Cordero J, Bumm K, Judson BL, Chiriva-Internati M. The cancer-testis antigen, sperm protein 17, a new biomarker and immunological target in head and neck squamous cell carcinoma. Oncotarget 2017; 8:100280-100287. [PMID: 29245977 PMCID: PMC5725019 DOI: 10.18632/oncotarget.22213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/15/2017] [Indexed: 12/04/2022] Open
Abstract
Head and Neck Squamous Cell Carcinoma is a deadly and locally aggressive malignancy that frequently portends a poor prognosis. Since current treatment modalities including surgery, chemotherapy and radiation are heavily debilitating and often result in recurrence intense efforts have been put into the development of novel less toxic and more lasting treatment strategies. Recently, immunotherapy has been proposed as a promising alternative that could potentially meet these requirements. SP17 is a validated cancer-testis antigen in multiple myeloma, ovarian cancer and non-small cell lung cancer. We aim at studying SP17 expression in HNSCC and its immunogenicity as a possible future target for HNSCC therapeutic vaccines. SP17 expression was evaluated in tissue specimens of HNSCC patients and controls. Moreover, SP17 immunogenicity was studied by generating autologous dendritic cells in vitro from the peripheral blood mononucleated cells of HNSCC patients and testing their ability to induce SP17 specific cytotoxic lymphocytes capable of killing autologous tumor cells in vitro. SP17specific immune responses were also evaluated in HNSCC patients as circulating anti-SP17 autoantibodies. SP17 was expressed in HNSCC tissues of HNSCC patients. Autologous dendritic cells pulsed with SP17 antigen induced powerful SP17 MHC class-I restricted, perforin-dependent, cytotoxic T-cells capable of efficiently killing autologous tumor cells in vitro. SP17-specific autoantibodies were detectable in the serum of HNSCC patients irrespective of tumor site or TNM stage. In conclusion, SP17 is an ideal immunotherapeutic target for HNSCC and a potential serological biomarker of the disease.
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Affiliation(s)
- Christopher A Schutt
- Division Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | | | | | | | | | - Klauss Bumm
- CaritasKlinikum Saarbrücken, Saarbrücken, Germany
| | - Benjamin L Judson
- Division Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Maurizio Chiriva-Internati
- Kiromic, Inc., Houston, TX, USA.,Department of Multiple Myeloma & Lymphoma, University of Texas, MDACC, Houston, TX, USA
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22
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Jin X, Xu H, Wu X, Li T, Li J, Zhou Y, Dan H, Jiang L, Zeng X, Ji P, Chen Q. KDM4A as a prognostic marker of oral squamous cell carcinoma: Evidence from tissue microarray studies in a multicenter cohort. Oncotarget 2017; 8:80348-80357. [PMID: 29113308 PMCID: PMC5655203 DOI: 10.18632/oncotarget.18302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 04/07/2017] [Indexed: 02/05/2023] Open
Abstract
Purpose Previous studies have identified histone demethylase KDM4A to be a key epigenetic priming factor for the invasive squamous cell carcinoma growth and metastasis. The purpose of this study was to examine KDM4A as an independent prognostic marker in oral squamous cell carcinoma, using multicenter tissue microarrays. Results The expression of KDM4A was significantly correlated with lymph node metastasis and TNM stage. KDM4A overexpression was associated with poor overall survival, and it was found to be a statistically significant independent predictor of all-cause mortality. These findings are validated by external TCGA HNSCC data. Addition of KDM4A expression improved the discriminatory accuracy of standard clinicopathologic features for prediction of cancer-specific survival (Model 4, area under the curve = 0.740, 95% confidence interval = 0.685 to 0.795, and Model 3, AUC = 0.695, 95% CI = 0.637 to 0.753, respectively). Materials and Methods KDM4A expression was measured by immunohistochemistry, using tissue microarrays of OSCC samples collected from 313 patients. Kruskal-Wallis and chi-square tests were applied to investigate the correlation between KDM4A expression and clinicopathological factors. Overall survival analysis was performed using the Kaplan-Meier and multivariable logistic regression models, and the predictive ability of KDM4A in combination with known OSCC risk factors was evaluated. Receiver operating characteristic curves were used to assess discriminatory accuracy of these models. Additionally, disease-free survival was analyzed in patients with head and neck SCC reported on The Cancer Genome Atlas database. Conclusions KDM4A expression is an independent predictor for the survival time of patients with OSCC and may be a valuable consideration to postoperative treatment options.
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Affiliation(s)
- Xin Jin
- College of Stomatology, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hao Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xingyu Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Taiwen Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ping Ji
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.,College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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23
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Ohshima M, Sugahara K, Kasahara K, Katakura A. Metabolomic analysis of the saliva of Japanese patients with oral squamous cell carcinoma. Oncol Rep 2017; 37:2727-2734. [PMID: 28393236 DOI: 10.3892/or.2017.5561] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/01/2017] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to characterize the metabolic systems in Japanese patients with oral squamous cell carcinoma (OSCC) using capillary electrophoresis-mass spectrometry (CE-MS) metabolome analysis of saliva samples. A previous study showed variations among ethnicities and tumor sites in the saliva metabolome of patients with OSCC using CE-MS. In the present study, saliva was obtained from 22 Japanese patients with OSCC and from 21 healthy controls who visited the Department of Dentistry, Oral and Maxillofacial Surgery, Tokyo Dental Collage Ichikawa General Hospital, Tokyo, Japan, and all samples were subject to comprehensive quantitative metabolome analysis using CE-MS. A total of 499 metabolites were detected as CE-MS peaks in the saliva tested from the two groups. A total of 25 metabolites were revealed as potential markers to discriminate between patients with OSCC and healthy controls: Choline, p-hydroxyphenylacetic acid, and 2-hydroxy-4-methylvaleric acid (P<0.001); valine, 3-phenyllactic acid, leucine, hexanoic acid, octanoic acid, terephthalic acid, γ-butyrobetaine, and 3-(4-hydroxyphenyl)propionic acid (P<0.01); and isoleucine, tryptophan, 3-phenylpropionic acid, 2-hydroxyvaleric acid, butyric acid, cadaverine, 2-oxoisovaleric acid, N6,N6,N6-trimethyllysine, taurine, glycolic acid, 3-hydroxybutyric acid, heptanoic acid, alanine, and urea (P<0.05, according to the Wilcoxon rank sum test). A previous study by Sugimoto and co-workers detected 24 discriminatory metabolites, 7 of which (taurine, valine, leucine, isoleucine, choline, cadaverine, and tryptophan) were also detected in the present study. In the present study, however, choline, metabolites in the branched chain amino acids (BCAA) cycle, urea, and 3-hydroxybutyric acid were also characterized. Choline and metabolites of the BCAA cycle have previously been reported in OSCC using metabolome analysis. To the best of our knowledge, no previous reports have identified urea and 3-hydroxybuyric acid in the metabolome of patients with OSCC. These findings suggest the usefulness of metabolites as salivary biomarkers for Japanese patients with OSCC. Further studies using larger patient cohorts should be conducted to validate these results.
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Affiliation(s)
- Mitsuyoshi Ohshima
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Chiyoda, Tokyo 101-0061, Japan
| | - Keisuke Sugahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Chiyoda, Tokyo 101-0061, Japan
| | - Kiyohiro Kasahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Chiyoda, Tokyo 101-0061, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Chiyoda, Tokyo 101-0061, Japan
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24
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Kim N, Lee J, Kim KH, Park JW, Lee CG, Keum KC. Early hypopharyngeal cancer treated with different therapeutic approaches: a single-institution cohort analysis. Radiat Oncol J 2016; 34:280-289. [PMID: 28030898 PMCID: PMC5207370 DOI: 10.3857/roj.2016.01711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/06/2016] [Accepted: 09/01/2016] [Indexed: 12/12/2022] Open
Abstract
Purpose Early hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment. Materials and Methods Thirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection. Results At a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08). Conclusion This study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.
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Affiliation(s)
- Nalee Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Jeongshim Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Hwan Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Won Park
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Geol Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Chang Keum
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
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25
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Jin X, Liu D, Zhao X, Zhou Y, Jiang L, Li J, Zeng X, Chen Q. Analysis of clinicopathological characteristics associated with the outcome of oral squamous cell carcinoma and the establishment of tissue microarrays. Oncol Lett 2016; 12:3175-3182. [PMID: 27899978 PMCID: PMC5103915 DOI: 10.3892/ol.2016.5120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 08/12/2016] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to evaluate clinicopathological risk factors associated with the fatal outcome of oral squamous cell carcinoma (OSCC) in a large cohort of Chinese patients, and to construct tissue microarrays (TMAs) using this cohort. Univariate and multiple logistic regression analyses were performed to evaluate the predictors of poor prognosis in a cohort of 232 patients with OSCC, after which the patient tumor tissues were used to construct TMAs. Univariate logistic regression analysis indicated that a poor outcome of OSCC was associated with the male gender, a history of smoking, the tumor-node-metastasis stage and lymph node metastasis. Multiple logistic regression analysis demonstrated that an increased risk of mortality in patients with OSCC was significantly and independently associated with lymph node metastasis (odds ratio, 3.421; 95% confidence interval, 1.609-7.273). Therefore, the results of the present study suggested that lymph node metastasis is an independent risk factor associated with a poor prognosis of OSCC patients. TMAs of OSCC were successfully constructed, and are the first TMAs to be reported in mainland Chinese patients.
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Affiliation(s)
- Xin Jin
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China; College of Stomatology, Chongqing Medical University, Chongqing 400016, P.R. China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P.R. China
| | - Dongjuan Liu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xin Zhao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Jing Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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26
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Cho JK, Hyun SH, Choi JY, Choi N, Kim MJ, Lee SH, Baek KH, Jeong HS. Prognostic significance of clinical and 18 F-FDG PET/CT parameters for post-distant metastasis survival in head and neck squamous cell carcinoma patients. J Surg Oncol 2016; 114:888-894. [PMID: 27546387 DOI: 10.1002/jso.24412] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/03/2016] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Distant metastasis (M1) to vital organs remains a major cause of death in patients with head and neck squamous cell carcinomas (HNSCC). Clinically the survival periods vary in individual M1 HNSCC patients and a prognostic indicator has not been fully studied. Here, we evaluated the prognostic factors for survival including 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in M1 HNSCC patients. METHODS The study included 108 patients with newly diagnosed M1 HNSCC (68 during clinical courses, 40 at presentation) who underwent FDG PET/CT. Maximum standardized uptake value (SUVmax) of metastatic tumors was measured by FDG PET/CT. Associations of primary tumor or metastatic tumor variables with overall survival were assessed with Cox regression models. RESULTS Multivariate analyses demonstrated that nasopharynx primary and incomplete response of loco-regional disease to treatment were significant prognostic factors. In addition, adverse prognostic factors included short distant metastasis-free period (<10 months), high number (≥5), and high PET SUVmax (≥6.3) of metastatic lesions. The patients with at least one of these adverse features had a median survival <14 months. CONCLUSION PET SUVmax of the metastatic tumors in M1 HNSCC patients can be a good predictor for survival. J. Surg. Oncol. 2016;114:888-894. © 2016 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jae-Keun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Inje University Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Republic of Korea
| | - Seung Hyup Hyun
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Nayeon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Min-Ji Kim
- Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Se-Hoon Lee
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kwan-Hyuck Baek
- Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Gyeonggi, Republic of Korea.
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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27
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Ren X, Liu H, Zhang M, Wang M, Ma S. Co-expression of ING4 and P53 enhances hypopharyngeal cancer chemosensitivity to cisplatin in vivo. Mol Med Rep 2016; 14:2431-8. [PMID: 27484725 PMCID: PMC4991689 DOI: 10.3892/mmr.2016.5552] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 06/14/2016] [Indexed: 01/09/2023] Open
Abstract
Hypopharyngeal cancer is a distinct type of malignant head and neck tumor, which exhibits low sensitivity to anti-cancer drugs. The importance of developing methods for reducing chemotherapy resistance, and improving and enhancing prognosis has previously been emphasized and is considered a challenge for effective clinical treatment of hypopharyngeal cancer. The current study investigated the effects of co-expression of inhibitor of growth protein 4 (ING4) and P53, a tumor suppressor gene, on chemosensitivity to cisplatin in human hypopharyngeal cancer xenografts in vivo, and the potential molecular mechanisms involved. A tumor model was established by injecting athymic nude mice with FADU human hypopharyngeal cancer cells. Five days after intratumoral and peritumoral injections of an empty adenoviral vector (Ad), Ad-ING4-P53, cisplatin, or a combination of Ad-ING4-P53 and cisplatin (Ad-ING4-P53 + cisplatin) every other day for 5 days, the mice were euthanized and their tumors, livers, and kidneys were removed. The tumor weights were used to calculate the inhibition rate, and the expression levels of ING4 and P53 were detected by reverse transcription-polymerase chain reaction. Additionally, apoptotic cells were detected using terminal deoxynucleotidyl transferase dUTP nick end labeling, and immunohistochemistry determined the levels ING4, P53, B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) protein expression. The results demonstrated increased expression of ING4 and P53 in the Ad-ING4-P53 groups compared with PBS and Ad groups, indicating successful introduction of the genes into the tumor cells. Notably, the Ad-ING4-P53 + cisplatin group exhibited a higher inhibition rate compared with the four other groups. The results of immunohistochemistry analysis demonstrated that Bax expression was increased and Bcl-2 was decreased in the Ad-ING4-P53 + cisplatin group. This suggested that the enhanced cisplatin chemosensitivity with Ad-ING4-P53 gene therapy in hypopharyngeal cancer xenografts may be associated with apoptosis induction through upregulation of Bax expression and downregulation of Bcl-2. The results of the present study indicated that gene therapy combined with cisplatin treatment may be a promising treatment for human hypopharyngeal cancer.
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Affiliation(s)
- Xin Ren
- Department of Otolaryngology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233030, P.R. China
| | - Hao Liu
- Faculty of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, P.R. China
| | - Mingjie Zhang
- Department of Otolaryngology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233030, P.R. China
| | - Mengjun Wang
- Department of Otolaryngology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233030, P.R. China
| | - Shiyin Ma
- Department of Otolaryngology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233030, P.R. China
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Yoshihama R, Yamaguchi K, Imajyo I, Mine M, Hiyake N, Akimoto N, Kobayashi Y, Chigita S, Kumamaru W, Kiyoshima T, Mori Y, Sugiura T. Expression levels of SOX2, KLF4 and brachyury transcription factors are associated with metastasis and poor prognosis in oral squamous cell carcinoma. Oncol Lett 2015; 11:1435-1446. [PMID: 26893757 DOI: 10.3892/ol.2015.4047] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 11/06/2015] [Indexed: 02/05/2023] Open
Abstract
The prognosis of oral squamous cell carcinoma (OSCC) patients is affected by tumor recurrence and metastasis, and cancer stem cells are hypothesized to be involved in these processes. Thus, the aim of the present study was to determine whether the expression levels of five stem cell-related transcription factors, sex determining region Y-box 2 (SOX2), octamer-binding transcription factor 4 (Oct4), avian myelocytomatosis viral oncogene homolog (c-Myc), Krüppel-like factor 4 (KLF4) and brachyury, are associated with metastasis and survival in OSCC. Immunohistochemistry was performed to analyze the expression of these proteins in biopsy specimens obtained from 108 OSCC patients. The results revealed that the expression of SOX2, Oct4, KLF4 and brachyury were significantly associated with lymph node metastasis (P=0.002, P=0.031, P=0.003 and P=0.007, respectively). In addition, the expression of KLF4 and brachyury were significantly associated with distant metastasis (P=0.014 and P=0.012, respectively). Furthermore, multivariate analysis revealed that SOX2 and KLF4 are predictive factors for lymph node metastasis [odds ratios (ORs), 4.526 and 4.851, respectively], and KLF4 is also a predictive factor for distant metastasis (OR, 9.607). In addition, OSCC patients with low co-expression of SOX2, KLF4 and brachyury exhibited a significantly lower disease-specific survival rate (78.6 vs. 100%; P=0.025; χ2=5.033) and disease-free survival rate (60.7 vs. 90.9%; P=0.015; χ2=5.897) when compared with OSCC patients with high co-expression of these factors. The results indicate that SOX2, KLF4 and brachyury serve important roles in tumor progression, and these transcription factors may thus represent clinically useful prognostic markers for OSCC.
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Affiliation(s)
- Rumi Yoshihama
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Koujiro Yamaguchi
- Department of Maxillofacial Diagnostic and Surgical Science, Graduate School of Dental Science, Kagoshima University, Kagoshima 890-8544, Japan
| | - Ikumi Imajyo
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Mariko Mine
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Naomi Hiyake
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Naonari Akimoto
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Yosuke Kobayashi
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Satomi Chigita
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Wataru Kumamaru
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Tamotsu Kiyoshima
- Department of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Yoshihide Mori
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Tsuyoshi Sugiura
- Department of Maxillofacial Diagnostic and Surgical Science, Graduate School of Dental Science, Kagoshima University, Kagoshima 890-8544, Japan
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29
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Cho JH, Lee YS, Sun DI, Kim MS, Cho KJ, Nam IC, Kim CS, Kim SY, Park YH, Joo YH. Prognostic impact of lymph node micrometastasis in oral and oropharyngeal squamous cell carcinomas. Head Neck 2015; 38 Suppl 1:E1777-82. [DOI: 10.1002/hed.24314] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 08/31/2015] [Accepted: 09/20/2015] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jung-Hae Cho
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - Youn-Soo Lee
- Department of Hospital Pathology; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - Dong-Il Sun
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - Min-Sik Kim
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - Kwang-Jae Cho
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - In-Chul Nam
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - Choung-Soo Kim
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - Sang-Yeon Kim
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - Young-Hak Park
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
| | - Young-Hoon Joo
- Department of Otolaryngology - Head and Neck Surgery; College of Medicine, The Catholic University of Korea; Seoul Korea
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Subramaniam N, Hiremath B. Leukemoid reaction as a paraneoplastic syndrome in hypopharyngeal squamous cell carcinoma with cutaneous metastasis: an exceedingly rare occurrence. BMJ Case Rep 2015; 2015:bcr-2015-211007. [PMID: 26670890 DOI: 10.1136/bcr-2015-211007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Head and neck squamous cell carcinoma is considered a locoregional disease, with a distinct chance of metastasis, however, skin is an unusual site. Haematological paraneoplastic syndromes are even rarer, and may be the only presenting feature in these malignancies, producing diagnostic confusion. Cutaneous metastasis, in addition to signifying poor response to treatment and prognosis, can cause diagnostic difficulty if the metastasis is located with an occult primary, and is associated with a higher incidence of multiple synchronous primaries. This article describes a 52-year-old patient with multiple swellings on the left side of the neck and hoarseness of voice. On evaluation, the multiple swellings were found to be cutaneous metastasis from a hypopharyngeal squamous cell carcinoma, with a leukemoid reaction. He opted for palliative radiotherapy and succumbed to his illness within 3 months of presentation. This article discusses the importance of this unusual presentation and diagnostic difficulties associated with it.
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Affiliation(s)
- Narayana Subramaniam
- Department of General Surgery, M S Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
| | - Bharati Hiremath
- Department of General Surgery, M S Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
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31
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Supsavhad W, Dirksen WP, Martin CK, Rosol TJ. Animal models of head and neck squamous cell carcinoma. Vet J 2015; 210:7-16. [PMID: 26965084 DOI: 10.1016/j.tvjl.2015.11.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 11/02/2015] [Accepted: 11/11/2015] [Indexed: 12/18/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the most common oral cancer worldwide. Local bone invasion into the maxilla or mandible and metastasis to regional lymph nodes often result in a poor prognosis, decreased quality of life and shortened survival time for HNSCC patients. Poor response to treatment and clinical outcomes are the major concerns in this aggressive cancer. Multiple animal models have been developed to replicate spontaneous HNSCC and investigate genetic alterations and novel therapeutic targets. This review provides an overview of HNSCC as well as the traditional animal models used in HNSCC preclinical research. The value and challenges of each in vivo model are discussed. Similarity between HNSCC in humans and cats and the possibility of using spontaneous feline oral squamous cell carcinoma (FOSCC) as a model for HNSCC in translational research are highlighted.
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Affiliation(s)
- Wachiraphan Supsavhad
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, 1925 Coffey Road, Columbus, OH 43210, USA
| | - Wessel P Dirksen
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, 1925 Coffey Road, Columbus, OH 43210, USA
| | - Chelsea K Martin
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island C1A 4P3, Canada
| | - Thomas J Rosol
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, 1925 Coffey Road, Columbus, OH 43210, USA.
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Wang XC, Ma Y, Meng PS, Han JL, Yu HY, Bi LJ. miR-433 inhibits oral squamous cell carcinoma (OSCC) cell growth and metastasis by targeting HDAC6. Oral Oncol 2015; 51:674-82. [DOI: 10.1016/j.oraloncology.2015.04.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 03/04/2015] [Accepted: 04/15/2015] [Indexed: 12/22/2022]
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Severino P, Oliveira LS, Andreghetto FM, Torres N, Curioni O, Cury PM, Toporcov TN, Paschoal AR, Durham AM. Small RNAs in metastatic and non-metastatic oral squamous cell carcinoma. BMC Med Genomics 2015; 8:31. [PMID: 26104160 PMCID: PMC4479233 DOI: 10.1186/s12920-015-0102-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 05/29/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Small non-coding regulatory RNAs control cellular functions at the transcriptional and post-transcriptional levels. Oral squamous cell carcinoma is among the leading cancers in the world and the presence of cervical lymph node metastases is currently its strongest prognostic factor. In this work we aimed at finding small RNAs expressed in oral squamous cell carcinoma that could be associated with the presence of lymph node metastasis. METHODS Small RNA libraries from metastatic and non-metastatic oral squamous cell carcinomas were sequenced for the identification and quantification of known small RNAs. Selected markers were validated in plasma samples. Additionally, we used in silico analysis to investigate possible new molecules, not previously described, involved in the metastatic process. RESULTS Global expression patterns were not associated with cervical metastases. MiR-21, miR-203 and miR-205 were highly expressed throughout samples, in agreement with their role in epithelial cell biology, but disagreeing with studies correlating these molecules with cancer invasion. Eighteen microRNAs, but no other small RNA class, varied consistently between metastatic and non-metastatic samples. Nine of these microRNAs had been previously detected in human plasma, eight of which presented consistent results between tissue and plasma samples. MiR-31 and miR-130b, known to inhibit several steps in the metastatic process, were over-expressed in non-metastatic samples and the expression of miR-130b was confirmed in plasma of patients showing no metastasis. MiR-181 and miR-296 were detected in metastatic tumors and the expression of miR-296 was confirmed in plasma of patients presenting metastasis. A novel microRNA-like molecule was also associated with non-metastatic samples, potentially targeting cell-signaling mechanisms. CONCLUSIONS We corroborate literature data on the role of small RNAs in cancer metastasis and suggest the detection of microRNAs as a tool that may assist in the evaluation of oral squamous cell carcinoma metastatic potential.
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Affiliation(s)
- Patricia Severino
- Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil.
| | - Liliane Santana Oliveira
- Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil.
| | - Flávia Maziero Andreghetto
- Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil.
| | - Natalia Torres
- Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil.
| | - Otávio Curioni
- Hospital Heliopolis, Departamento de Cirurgia e Otorrinolaringologia, Sao Paulo, SP, Brazil.
| | | | - Tatiana Natasha Toporcov
- Departamento de Epidemiologia, Faculdade de Saúde Pública, University of Sao Paulo, Sao Paulo, SP, Brazil.
| | | | - Alan Mitchell Durham
- Instituto de Matemática e Estatística, University of Sao Paulo, Sao Paulo, SP, Brazil.
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Cho JK, Hyun SH, Choi N, Kim MJ, Padera TP, Choi JY, Jeong HS. Significance of lymph node metastasis in cancer dissemination of head and neck cancer. Transl Oncol 2015; 8:119-25. [PMID: 25926078 PMCID: PMC4415144 DOI: 10.1016/j.tranon.2015.03.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/05/2015] [Accepted: 03/09/2015] [Indexed: 01/13/2023] Open
Abstract
Lymph node metastasis (LNM) in many solid cancers is a well-known prognostic factor; however, it has been debated whether regional LNM simply reflects tumor aggressiveness or is a source for further tumor dissemination. Similarly, the metastatic process in head and neck cancer (HNC) has not been fully evaluated. Thus, we aimed to investigate the relative significance of LNM in metastatic cascade of HNC using functional imaging of HNC patients and molecular imaging in in vivo models. First, we analyzed 18Fluorodeoxyglucose positron emission tomography (PET) parameters of 117 patients with oral cancer. The primary tumor and nodal PET parameters were measured separately, and survival analyses were conducted on the basis of clinical and PET variables to identify significant prognostic factors. In multivariate analyses, we found that only the metastatic node PET values were significant. Next, we compared the relative frequency of lung metastasis in primary ear tumors versus lymph node (LN) tumors, and we tested the rate of lung metastasis in another animal model, in which each animal had both primary and LN tumors that were expressing different colors. As a result, LN tumors showed higher frequencies of lung metastasis compared to orthotopic primary tumors. In color-matched comparisons, the relative contribution to lung metastasis was higher in LN tumors than in primary tumors, although both primary and LN tumors caused lung metastases. In summary, tumors growing in the LN microenvironment spread to systemic sites more commonly than primary tumors in HNC, suggesting that the adequate management of LNM can reduce further systemic metastasis.
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Affiliation(s)
- Jae-Keun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University, Pusan, Korea
| | - Seung Hyup Hyun
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nayeon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min-Ji Kim
- Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Timothy P Padera
- Edwin L. Steele Laboratory, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Role of intraoral color Doppler sonography in predicting delayed cervical lymph node metastasis in patients with early-stage tongue cancer: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:246-53. [DOI: 10.1016/j.oooo.2014.10.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 08/13/2014] [Accepted: 10/29/2014] [Indexed: 01/15/2023]
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36
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Ma H, Lian M, Feng L, Li P, Hou L, Chen X, Huang Z, Fang J. Factors contributing to lymph node occult metastasis in supraglottic laryngeal carcinoma cT2-T4 N0M0 and metastasis predictive equation. Chin J Cancer Res 2015; 26:685-91. [PMID: 25561766 DOI: 10.3978/j.issn.1000-9604.2014.12.06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 10/16/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate factors that contribute to lymph node metastasis (LNM) from clinical cT2-T4 N0M0 (cN0) supraglottic laryngeal carcinoma (SLC), and to predict the risk of occult metastasis before surgery. METHODS A total of 121 patients who received surgery were retrospectively analyzed. Relevant factors regarding cervical LNM were analyzed. Multivariate analyses were conducted to predict the region where the metastasis occurred and prognosis. RESULTS The overall metastatic rate of cN0 SLC was 28.1%. Metastatic rates were 15.4%, 32.5% and 35.7% for T2, T3 and T4, respectively. Metastatic rates for SLC levels II, III and IV were 19.6%, 17.2% and 3.6%, respectively. A regression equation was formulated to predict the probability of metastasis in cN0 SLC as follows: Pn=e((-3.874+0.749T3+1.154T4+1.935P1+1.750P2))/[1+e((-3.874+0.749T3+1.154T4+1.935P1+1.750P2))]. Approximately 0.2% of patients experienced LNM with no recurrence of laryngeal cancer. Comparison of the intergroup survival curves between patients with and without LNM indicated a statistically significant difference (P=0.029). CONCLUSIONS Cervical lymph node metastatic rates tended to increase in tandem with T stage in patients with LNM in cN0 SLC, and neck dissection is advised for these patients. Moreover, cervical LNM in cN0 SLC showed a sequential pattern and may be predicted.
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Affiliation(s)
- Hongzhi Ma
- 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Meng Lian
- 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Ling Feng
- 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Pingdong Li
- 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Lizhen Hou
- 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Xiaohong Chen
- 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Zhigang Huang
- 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Jugao Fang
- 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
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Cisplatin induces Bmi-1 and enhances the stem cell fraction in head and neck cancer. Neoplasia 2014; 16:137-46. [PMID: 24709421 DOI: 10.1593/neo.131744] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 02/03/2014] [Accepted: 02/06/2014] [Indexed: 12/17/2022] Open
Abstract
Recent evidence has unveiled a subpopulation of highly tumorigenic, multipotent cells capable of self-renewal in head and neck squamous cell carcinomas (HNSCCs). These unique cells, named here cancer stem cells (CSCs), proliferate slowly and might be involved in resistance to conventional chemotherapy. We have shown that CSCs are found in perivascular niches and rely on endothelial cell-secreted factors [particularly interleukin-6 (IL-6)] for their survival and self-renewal in HNSCC. Here, we hypothesized that cisplatin enhances the stem cell fraction in HNSCC. To address this hypothesis, we generated xenograft HNSCC tumors with University of Michigan-squamous cell carcinoma 22B (UM-SCC-22B) cells and observed that cisplatin treatment increased (P = .0013) the fraction of CSCs [i.e., aldehyde dehydrogenase activity high and cluster of differentiation 44 high (ALDH(high)CD44(high))]. Cisplatin promoted self-renewal and survival of CSCs in vitro, as seen by an increase in the number of orospheres in ultralow attachment plates and induction in B lymphoma Mo-MLV insertion region 1 homolog (Bmi-1) and octamer-binding transcription factor 4 expression. Cisplatin-resistant cells expressed more Bmi-1 than cisplatin-sensitive cells. IL-6 potentiated cisplatin-induced orosphere formation generated when primary human HNSCC cells were sorted for ALDH(high)CD44(high) immediately after surgery and plated onto ultralow attachment plates. IL-6-induced signal transducer and activator of transcription 3 (STAT3) phosphorylation (indicative of stemness) was unaffected by treatment with cisplatin in UM-SCC-22B cells, whereas IL-6-induced extracellular signal-regulated kinase (ERK) phosphorylation (indicative of differentiation processes) was partially inhibited by cisplatin. Notably, cisplatin-induced Bmi-1 was inhibited by interleukin-6 receptor blockade in parental and cisplatin-resistant cells. Taken together, these results demonstrate that cisplatin enhances the fraction of CSCs and suggest a mechanism for resistance to cisplatin therapy in head and neck cancer.
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Ohmura G, Tsujikawa T, Yaguchi T, Kawamura N, Mikami S, Sugiyama J, Nakamura K, Kobayashi A, Iwata T, Nakano H, Shimada T, Hisa Y, Kawakami Y. Aberrant Myosin 1b Expression Promotes Cell Migration and Lymph Node Metastasis of HNSCC. Mol Cancer Res 2014; 13:721-31. [PMID: 25421751 DOI: 10.1158/1541-7786.mcr-14-0410] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 11/12/2014] [Indexed: 11/16/2022]
Abstract
UNLABELLED Lymph node metastasis is the major clinicopathologic feature associated with poor prognosis in patients with head and neck squamous cell carcinoma (HNSCC). Here, web-based bioinformatics meta-analysis was performed to elucidate the molecular mechanism of lymph node metastasis of human HNSCC. Preferential upregulation of Myosin 1b (MYO1B) transcript in HNSCC datasets was identified. Myo1b mRNA was highly expressed in human HNSCC cells and patient tissue specimens compared with their normal counterparts as shown by quantitative PCR (qPCR) analyses. Immunohistochemistry (IHC)-detected Myo1b expression was significantly correlated with lymph node metastases in patients with oral cancer of the tongue. HNSCC with high expression of Myo1b and chemokine receptor 4 (CCR4), another metastasis-associated molecule, was strongly associated with lymph node metastasis. RNA interference (RNAi) of Myo1b in HNSCC cells, SAS and HSC4, significantly inhibited migratory and invasive abilities through decreased large protrusion formation of cell membranes. Finally, Myo1b knockdown in SAS cells significantly inhibited in vivo cervical lymph node metastases in a cervical lymph node metastatic mouse model system. IMPLICATIONS Myo1b is functionally involved in lymph node metastasis of human HNSCC through enhanced cancer cell motility and is an attractive target for new diagnostic and therapeutic strategies for patients with HNSCC.
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Affiliation(s)
- Gaku Ohmura
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan. Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto City, Kyoto, Japan
| | - Takahiro Tsujikawa
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan. Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto City, Kyoto, Japan
| | - Tomonori Yaguchi
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Naoshi Kawamura
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shuji Mikami
- Division of Diagnostic Pathology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Juri Sugiyama
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kenta Nakamura
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Asuka Kobayashi
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Takashi Iwata
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Nakano
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto City, Kyoto, Japan
| | - Taketoshi Shimada
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto City, Kyoto, Japan
| | - Yasuo Hisa
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto City, Kyoto, Japan
| | - Yutaka Kawakami
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
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Yoshitake Y, Fukuma D, Yuno A, Hirayama M, Nakayama H, Tanaka T, Nagata M, Takamune Y, Kawahara K, Nakagawa Y, Yoshida R, Hirosue A, Ogi H, Hiraki A, Jono H, Hamada A, Yoshida K, Nishimura Y, Nakamura Y, Shinohara M. Phase II clinical trial of multiple peptide vaccination for advanced head and neck cancer patients revealed induction of immune responses and improved OS. Clin Cancer Res 2014; 21:312-21. [PMID: 25391695 DOI: 10.1158/1078-0432.ccr-14-0202] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The peptides derived from ideal cancer-testis antigens, including LY6K, CDCA1, and IMP3 (identified using genome-wide cDNA microarray analyses), were used in immunotherapy for head and neck squamous cell cancer (HNSCC). In this trial, we analyzed the immune response to and safety and efficacy of vaccine therapy. EXPERIMENTAL DESIGN A total of 37 patients with advanced HNSCC were enrolled in this trial of peptide vaccine therapy, and the OS, PFS, and immunologic response were evaluated using enzyme-linked ImmunoSpot (ELISPOT) and pentamer assays. The peptides were subcutaneously administered weekly with IFA. The primary endpoints were evaluated on the basis of differences between HLA-A*2402-positive [A24(+)] patients treated with peptide vaccine therapy and -negative [A24(-)] patients treated without peptide vaccine therapy among those with advanced HNSCC. RESULTS Our cancer vaccine therapy was well tolerated. The OS of the A24(+) vaccinated group (n = 37) was statistically significantly longer than that of the A24(-) group (n = 18) and median survival time (MST) was 4.9 versus 3.5 months, respectively; P < 0.05. One of the patients exhibited a complete response. In the A24(+) vaccinated group, the ELISPOT assay identified LY6K-, CDCA1-, and IMP3-specific CTL responses in 85.7%, 64.3%, and 42.9% of the patients, respectively. The patients showing LY6K- and CDCA1-specific CTL responses demonstrated a longer OS than those without CTL induction. Moreover, the patients exhibiting CTL induction for multiple peptides demonstrated better clinical responses. CONCLUSIONS The immune response induced by this vaccine may improve the prognosis of patients with advanced HNSCC.
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Affiliation(s)
- Yoshihiro Yoshitake
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. Itoh Dento-Maxillofacial Hospital, Kumamoto, Japan.
| | - Daiki Fukuma
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Akira Yuno
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. Department of Immunogenetics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masatoshi Hirayama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. Department of Immunogenetics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideki Nakayama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takuya Tanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masashi Nagata
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. Minamata City General Hospital and Medical Center, Minamata, Japan
| | - Yasuo Takamune
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenta Kawahara
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshihiro Nakagawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Ryoji Yoshida
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Akiyuki Hirosue
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hidenao Ogi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Akimitsu Hiraki
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirofumi Jono
- Department of Pharmacy, Kumamoto University Hospital and Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Akinobu Hamada
- Department of Pharmacy, Kumamoto University Hospital and Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan. Department of Clinical Pharmacology Group for Translational Research Support Core National Cancer Center Research Institute, Tokyo, Japan
| | - Koji Yoshida
- Laboratory of Molecular Medicine, Human Genome Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan. OncoTherapy Science Incorporation, Research and Development Division, Kanagawa, Japan
| | - Yasuharu Nishimura
- Department of Immunogenetics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yusuke Nakamura
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Masanori Shinohara
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Role of EGFR as a prognostic factor for survival in head and neck cancer: a meta-analysis. Tumour Biol 2014; 35:2285-95. [PMID: 24234257 DOI: 10.1007/s13277-013-1303-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 10/08/2013] [Indexed: 12/30/2022] Open
Abstract
The prognostic role of epidermal growth factor receptor (EGFR) in head and neck squamous cell carcinoma (HNSCC) remains controversial. The goal of this study was to summarize existing evidence regarding whether EGFR overexpression is a prognostic factor in HNSCC. Relevant studies were identified using Pubmed, Ovid, and Web of Science databases. A meta-analysis was conducted on the prognostic value of EGFR expression for overall survival (OS) and disease-free survival (DFS). Thirty-seven studies were included. Primary analysis indicated that EGFR overexpression was associated with reduced OS (hazard ratio [HR]: 1.694, 95% confidence interval [CI]: 1.432–2.004). DFS, on the other hand, was not associated with EGFR expression after adjusting for publication bias (HR: 1.084, 95% CI: 0.910–1.290). Subgroup analysis gave a statistically significant pooled HR for OS in laryngeal carcinoma (HR: 2.519, 95% CI: 1.615–3.928) and in oropharyngeal carcinoma (HR: 2.078, 95% CI: 1.605–2.690). The pooled HR was statistically significant for DFS with respect to oropharyngeal carcinoma (HR: 1.055, 95% CI: 1.020–1.092), but not laryngeal carcinoma (HR: 1.750, 95% CI: 0.911–3.360). When dividing studies based on the immunohistochemistry (IHC) scoring system, only the group that evaluated EGFR expression according to the intensity and extent of staining showed no between-study heterogeneity for both OS and DFS. Overall, EGFR overexpression was associated with shortened OS, but not DFS. Future studies are needed that stratify patients by specific tumor sites. Furthermore, when estimating protein level by the IHC method, it is advisable to consider both intensity and extent of staining.
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Li-Ting C, Chung-Ho C, Yi-Hsin Y, Pei-Shan H. The development and validation of oral cancer staging using administrative health data. BMC Cancer 2014; 14:380. [PMID: 24884513 PMCID: PMC4049423 DOI: 10.1186/1471-2407-14-380] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 05/15/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral cancer is a major global health problem. The complexity of histological prognosticators in oral cancer makes it difficult to compare the benefits of different treatment regimens. The Taiwanese National Health database provides an opportunity to assess correlations between outcome and treatment protocols and to compare the effects of different treatment regimens. However, the absence of indices of disease severity is a critical problem. The aim of this study was to ascertain how accurately we could assess the severity of oral cancer at the time of initial diagnosis on the basis of variables in a national database. METHODS In the cancer registry database of a medical center in Taiwan, we identified 1067 histologically confirmed cases of oral cancer (ICD9 codes 140, 141 and 143-145) that had been first diagnosed and subjected to initial treatment in this hospital. The clinical staging status was considered as the gold standard and we used concordance (C)-statistics to assess the model's predictive performance. We added the predictors of treatment modality, cancer subsite, and age group to our models. RESULTS Our final overall model included treatment regimen, site, age, and two interaction terms; namely, interactions between treatment regimen and age and those between treatment regimen, site, and age. In this model, the C-statistics were 0.82-0.84 in male subjects and 0.96-0.99 in female subjects. Of the models stratified by age, the model that considered treatment regimen and site had the highest C-statistics for the interaction term, this value being greater than 0.80 in male subjects and 0.9 in female subjects. CONCLUSION In this study, we found that adjusting for sex, age at first diagnosis, oral cancer subsite, and therapy regimen provided the best indicator of severity of oral cancer. Our findings provide a method for assessing cancer severity when information about staging is not available from a national health-related database.
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Affiliation(s)
| | | | | | - Ho Pei-Shan
- Faculty of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Chinn SB, Darr OA, Owen JH, Bellile E, McHugh JB, Spector ME, Papagerakis SM, Chepeha DB, Bradford CR, Carey TE, Prince MEP. Cancer stem cells: mediators of tumorigenesis and metastasis in head and neck squamous cell carcinoma. Head Neck 2014; 37:317-26. [PMID: 24415402 DOI: 10.1002/hed.23600] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 10/06/2013] [Accepted: 01/07/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Cancer stem cells (CSCs) represent a subpopulation of cells responsible for tumor growth. Their role in head and neck squamous cell carcinoma (HNSCC) tumorigenesis and metastasis remains uncertain. METHODS Wound healing and an orthotopic animal model were used to study cells expressing the CSC phenotype (CD44(high) and aldehyde dehydrogenase [ALDH](+)) and assess mobility, tumorigenesis, and metastasis. A prospective collection of 40 patient-derived primary HNSCC specimens were analyzed for CSC-proportion compared to clinical variables. RESULTS CSCs exhibited significantly faster wound closure and greater tumorigenesis and regional metastasis in vivo than non-CSCs. In primary patient tumors, size and advanced stage were correlated with elevated proportion of CSCs, however, not with survival. CONCLUSION HNSCC stem cells mediate tumorigenesis and regional metastasis in vivo. In primary patient tumors, CSC-proportion was associated with tumor size and stage, but not with metastatic spread or survival. CSC burden alone may only represent a minor variable in understanding CSCs and metastasis.
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Affiliation(s)
- Steven B Chinn
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
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Allen CT, Law JH, Dunn GP, Uppaluri R. Emerging insights into head and neck cancer metastasis. Head Neck 2012; 35:1669-78. [PMID: 23280716 DOI: 10.1002/hed.23202] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2012] [Indexed: 01/09/2023] Open
Abstract
The purpose of this review was to provide biological concepts of head and neck cancer metastasis. To attain this goal, we analyzed peer-reviewed articles related to head and neck cancer metastasis obtained though PubMed and archived articles. Articles related to the biologic principles of head and neck cancer metastasis were reviewed and summarized. As locoregional control has improved for patients with head and neck cancer, rates of distant metastasis have not decreased. As patients live longer, many will die of complications related to the development of disease at sites below the clavicles. Emerging evidence now suggests a more complicated framework of metastatic behavior for head and neck cancer. Here, we review the role of regional lymph nodes in containing advanced head and neck cancer, evidence for active as opposed to passive tumor cell metastasis, and clinical implications these concepts have on both treatment of head and neck cancer and future research.
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Affiliation(s)
- Clint T Allen
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
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Tsujikawa T, Yaguchi T, Ohmura G, Ohta S, Kobayashi A, Kawamura N, Fujita T, Nakano H, Shimada T, Takahashi T, Nakao R, Yanagisawa A, Hisa Y, Kawakami Y. Autocrine and paracrine loops between cancer cells and macrophages promote lymph node metastasis via CCR4/CCL22 in head and neck squamous cell carcinoma. Int J Cancer 2012. [PMID: 23180648 DOI: 10.1002/ijc.27966] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Lymph node metastasis is a poor prognostic factor for patients with head and neck squamous cell carcinoma (HNSCC). However, its molecular mechanism has not yet been fully understood. In our study, we investigated the expression of CCR4 and its ligand CCL22 in the HNSCC tumor microenvironment and found that the CCR4/CCL22 axis was involved in lymph node metastasis of HNSCC. CCR4 was expressed in 20 of 31 (64.5%) human tongue cancer tissues, and its expression was significantly correlated with lymph node metastasis (p < 0.01) and lymphatic invasion (p < 0.05). CCR4 was expressed in three of five human HNSCC cell lines tested. CCR4(+) HNSCC cells, but not CCR4(-) cells, showed enhanced migration toward CCL22, indicating that functional CCR4 was expressed in HNSCC cell lines. CCL22 was also expressed in cancer cells (48.4% of tongue cancer tissues) or CD206(+) M2-like macrophages infiltrated in tumors and draining lymph nodes. CCL22 produced by cancer cells or CD206(high) M2-like macrophages increased the cell motility of CCR4(+) HNSCC cells in vitro in an autocrine or paracrine manner. In the mouse SCCVII in vivo model, CCR4(+) cancer cells, but not CCR4(-) cells, metastasized to lymph nodes which contained CCL22 producing M2-like macrophages. These results demonstrate that lymph node metastasis of CCR4(+) HNSCC is promoted by CCL22 in an autocrine or M2-like macrophage-dependent paracrine manner. Therefore, the CCR4/CCL22 axis may be an attractive target for the development of diagnostic and therapeutic strategies for patients with HNSCC.
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Affiliation(s)
- Takahiro Tsujikawa
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan
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Wan XC, Egloff AM, Johnson J. Histological assessment of cervical lymph node identifies patients with head and neck squamous cell carcinoma (HNSCC): who would benefit from chemoradiation after surgery? Laryngoscope 2012; 122:2712-22. [PMID: 23060119 DOI: 10.1002/lary.23572] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2012] [Indexed: 01/18/2023]
Abstract
OBJECTIVES/HYPOTHESIS Postoperative chemoradiation (CRT) has been shown to be more effective than postoperative radiotherapy (RT) alone in high risk head and neck squamous cell carcinoma (HNSCC) patients. Multimodality therapy is associated with more treatment related-toxicity. In this study, we assessed cervical lymph node histological characteristics to detect prognostic and predictive value differences to help guide therapeutic decision making. STUDY DESIGN Retrospective analysis of Cancer Registry data. METHODS HNSCC surgical patients who had tumor resection and neck dissection at our institution from 1980 to 2008 were identified (n=1510). Multivariable Cox proportional hazards regression models were developed to identify significant predictors of three outcomes: overall survival (OS), disease-specific survival (DSS), and neck disease recurrence (NDR). Hazard ratios were estimated for the number of cervical nodal metastases and presence of extracapsular spread (ECS) by adjuvant treatment after controlling for significant covariates. RESULTS Increasing number of positive nodes was significantly associated with poorer outcomes in OS, DSS, and NDR models (p<0.0001, p<0.0001, p=0.0002, respectively). OS and DSS associated with adjuvant treatment (none, RT, or CRT) were modified by number of positive nodes, ECS status, and cancer site. The presence of ECS was associated with reduced OS and DSS (p=0.077, p=0.001 respectively), but not significantly associated with NDR (p=0.179). Nodal positive patients benefited from adjuvant therapy regardless of ECS status. CRT consistently conferred a survival advantage over RT across all nodal categories, although the difference was not statistically significant. CONCLUSIONS We observed a consistent survival advantage with CRT over RT for patients with positive cervical nodal metastasis, although the difference was not statistically significant.
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Affiliation(s)
- Xiao Chloe Wan
- School of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Wiegand S, Wiemers C, Murthum T, Zimmermann AP, Bette M, Mandic R, Werner JA. Risk of lymph node metastases after en bloc cold steel, en bloc laser-, and piecemeal laser surgical resection of auricular VX2 carcinoma. Lasers Med Sci 2012; 28:1137-41. [PMID: 23053248 DOI: 10.1007/s10103-012-1211-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 09/24/2012] [Indexed: 11/28/2022]
Abstract
There is some controversy in the literature if lymph vessels are enduring sealed during piecemeal CO2 laser surgery of squamous cell carcinomas of the head and neck or a propagation of tumor cells into the lymphatics occurs. The aim of the present study was to analyze the incidence of lymph node and distant metastases after different methods of resection of a VX2 carcinoma in an animal model. A solid auricular VX2 carcinoma was induced in 200 rabbits. Seven days later, an en bloc cold steel (group A), en bloc laser surgical resection with CO2 laser in continuous wave mode with 2 W (group B), or piecemeal laser surgical resection after transection of the tumor with CO2 laser in continuous wave mode with 2 W (group C) or 20 W (group D) was performed. The animals were killed and the incidence of lymph node and distant metastases was compared between the different groups. Of the rabbits, 21.1 % developed lymph node metastases and 10 % pulmonary metastases. The incidence of lymph node metastases was 17.4 % in group A, 20.4 % in group B, 26 % in group C, and 20 % in group D. These differences were not statistically significant. En bloc cold steel, en bloc laser-, or piecemeal laser surgical resections include similar risk of postoperative metastases. Propagation of tumor cells cannot be excluded with certainty by any of these methods.
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Affiliation(s)
- Susanne Wiegand
- Department of Otolaryngology, Head and Neck Surgery, UKGM, Baldingerstrasse, 35037, Marburg, Germany.
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Takes RP, Rinaldo A, Silver CE, Haigentz M, Woolgar JA, Triantafyllou A, Mondin V, Paccagnella D, de Bree R, Shaha AR, Hartl DM, Ferlito A. Distant metastases from head and neck squamous cell carcinoma. Part I. Basic aspects. Oral Oncol 2012; 48:775-9. [DOI: 10.1016/j.oraloncology.2012.03.013] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 03/09/2012] [Accepted: 03/17/2012] [Indexed: 11/24/2022]
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Immunotherapy with dendritic cells in an animal model of early pulmonary metastatic squamous cell carcinoma. Laryngoscope 2012; 122:2442-6. [DOI: 10.1002/lary.23257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 01/13/2012] [Accepted: 01/30/2012] [Indexed: 11/07/2022]
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Hyperfractionated radiotherapy with concurrent cisplatin/5-Fluorouracil for locoregional advanced head and neck cancer: analysis of 105 consecutive patients. Int J Otolaryngol 2012; 2012:754191. [PMID: 22778748 PMCID: PMC3388433 DOI: 10.1155/2012/754191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 04/09/2012] [Indexed: 11/30/2022] Open
Abstract
Objective. We reviewed a cohort of patients with previously untreated locoregional advanced head and neck squamous cell carcinoma (HNSCC) who received a uniform chemoradiotherapy regimen. Methods. Retrospective review was performed of 105 patients with stage III or IV HNSCC treated at Greater Baltimore Medical Center from 2000 to 2007. Radiation included 125 cGy twice daily for a total 70 Gy to the primary site. Chemotherapy consisted of cisplatin (12 mg/m2/h) daily for five days and 5-fluorouracil (600 mg/m2/20 h) daily for five days, given with weeks one and six of radiation. All but seven patients with N2 or greater disease received planned neck dissection after chemoradiotherapy. Primary outcomes were overall survival (OS), locoregional control (LRC), and disease-free survival (DFS). Results. Median followup of surviving patients was 57.6 months. Five-year OS was 60%, LRC was 68%, and DFS was 56%. Predictors of increased mortality included age ≥55, female gender, hypopharyngeal primary, and T3/T4 stage. Twelve patients developed locoregional recurrences, and 16 patients developed distant metastases. Eighteen second primary malignancies were diagnosed in 17 patients. Conclusions. The CRT regimen resulted in favorable outcomes. However, locoregional and distant recurrences cause significant mortality and highlight the need for more effective therapies to prevent and manage these events.
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Sentinel lymph node biopsy versus selective neck dissection for detection of metastatic oral squamous cell carcinoma. Clin Exp Metastasis 2012; 29:693-8. [DOI: 10.1007/s10585-012-9492-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 05/20/2012] [Indexed: 10/28/2022]
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