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Jaiswal R, Goel MM, Mishra A. Microvessel density (Cluster of Differentiation-34 & Vascular Endothelial growth factor) in Nasopharyngeal Angiofibroma: Clinical correlation. Int J Pediatr Otorhinolaryngol 2023; 174:111746. [PMID: 37801829 DOI: 10.1016/j.ijporl.2023.111746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/03/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND The literature on microvessel density (MVD) signifying neoangiogenesis/tumour-activity in juvenile nasopharyngeal angiofibroma (JNA) is limited. Accordingly, this study evaluates and correlates MVD characteristics with clinical parameters/aggressiveness/recurrence. MATERIAL AND METHODS Sixty-two paraffin blocks of JNA were studied histopathologically and MVD was assessed following immunohistochemistry using VEGF and CD34 as vascular markers. A clinical correlation of MVD was undertaken in 43 cases. RESULTS MVD scores of VEGF and CD34 showed strong inter-correlation. The 'age', 'duration of disease' and 'haemoglobin%' were the only clinical parameters that revealed significance with MVD. Significantly higher MVD scores were appreciated in recurrent cases as well as some other clinical differences from upfront cases. CONCLUSION This is the first study of MVD with CD34 and VEGF simultaneously depicting clinical correlation. The strong correlation, supports a prognostic role of MVD scores in JNA and this can be better established in a larger multicentre study involving comprehensive examination of tumour dimensions.
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Affiliation(s)
- Riddhi Jaiswal
- Departments of Pathology, King George Medical University, Lucknow, India
| | - Madhu Mati Goel
- Departments of Pathology, King George Medical University, Lucknow, India
| | - Anupam Mishra
- Otorhinolaryngology and Head and Neck Surgery, King George Medical University, Lucknow, India.
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Lim AE, Hurley R, Slim MAM, Melia L. A Narrative Review of Flutamide in Juvenile Nasopharyngeal Angiofibroma. Indian J Otolaryngol Head Neck Surg 2023; 75:2707-2712. [PMID: 37636686 PMCID: PMC10447844 DOI: 10.1007/s12070-023-03581-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/16/2023] [Indexed: 08/29/2023] Open
Abstract
The detection of androgen receptors within Juvenile Nasopharyngeal Angiofibroma (JNA) has prompted investigation of the role of Flutamide. The aim of this review is to evaluate Flutamide as a possible neo-adjuvant treatment for JNA. Literature searches were conducted using MEDLINE, EMBASE and Web of Science. The Joanna Briggs Institute (JBI) checklist was used to assess risk of bias. The Oxford Centre of Evidence-Based Medicine (OCEBM) Levels of Evidence was used to stratify the evidence level. Literature searches were conducted using MEDLINE, EMBASE and Web of Science. Flutamide as neo-adjuvant treatment potentially causes a reduction in JNA tumor volume by ≥ 25%. Based on the current limited evidence, Flutamide has a limited role in JNA management and further research is required. Its utilization should only follow discussion with the patient, their families, and within the multidisciplinary team.
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Affiliation(s)
- Alison Emily Lim
- Department of Ear, Nose and Throat, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF UK
| | - Rhona Hurley
- Department of Ear, Nose and Throat, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF UK
| | - Mohd Afiq Mohd Slim
- Department of Ear, Nose and Throat, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF UK
| | - Louise Melia
- Department of Ear, Nose and Throat, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF UK
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Pankaj P, Anupam M, Amita P, Veerendra V, Shivani P. Pseudogenes in Juvenile Nasopharyngeal Angiofibroma: First Pilot Observation. Indian J Otolaryngol Head Neck Surg 2022; 74:1237-1241. [PMID: 36452697 PMCID: PMC9702465 DOI: 10.1007/s12070-020-02336-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/14/2020] [Indexed: 11/30/2022] Open
Abstract
To investigate the role of Pseudogenes (PG) in juvenile nasopharyngeal angiofibroma (JNA) that were once considered to be junk-DNA or 'genomic fossils'. Five to 10 fresh JNA samples were analyzed for molecular expressions of 5 PG/respective parent genes (VEGFR1P1/VEGFR; FGFR3P1/FGFR3; PDGFAP1/PDGFA; IL6RP1/IL6R; POU5F1B/POU5F1) and clinical details correlated. IL6R, PDGFA, VEGFR2, FGF3 and their respective PG (VEGFR1P1, PDGFAP1, IL6RP1, FGFR3P1) were highly expressed but POU5F1/POU5F1B were not. The difference in expression between IL6R & IL6RP1 was substantially larger compared with other 4 pairs. While VEGFR1P1, PDGFAP1 & POU5F1B were expressed more than their respective parent genes; IL6RP1 & FGFR3P1 showed reduced expression. No clinical significance was apparent in any parameter nor was any difference noted between recurrent and upfront cases. A definite implication of pseudogene in JNA is evident in this ever first global study but future studies are needed to validate the current findings as well as further characterize its role/profile in larger sample. This may explain extreme variability of JNA, its heterogenous etiopathogenesis, evolving patterns and molecular characterization for possible targeted therapy.
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Affiliation(s)
- Pandey Pankaj
- Department of Otorhinolaryngology and Head & Neck Surgery, King George’s Medical University, A-1/19, Sector H, Aliganj, Lucknow India
| | - Mishra Anupam
- Department of Otorhinolaryngology and Head & Neck Surgery, King George’s Medical University, A-1/19, Sector H, Aliganj, Lucknow India
| | - Pandey Amita
- Department of Obstetrics/Gynecology, King George’s Medical University, Aliganj, Lucknow India
| | - Verma Veerendra
- Department of Otorhinolaryngology and Head & Neck Surgery, King George’s Medical University, A-1/19, Sector H, Aliganj, Lucknow India
| | - Pandey Shivani
- Department of Biochemistry, King George’s Medical University, Aliganj, Lucknow India
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Jadhav S, Khandaitkar S, Mitra K, Chaudhari S, Dhok AP. Juvenile Nasopharyngeal Angiofibroma: An Aberrant Case Report. Cureus 2022; 14:e24350. [PMID: 35607527 PMCID: PMC9124007 DOI: 10.7759/cureus.24350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/05/2022] Open
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Olfaction in Juvenile Nasopharyngeal Angiofibroma: The first study. Am J Otolaryngol 2020; 41:102298. [PMID: 32451287 DOI: 10.1016/j.amjoto.2019.102298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/09/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND To study the pattern of olfactory dysfunction/recovery in juvenile nasopharyngeal angiofibroma (JNA). METHODS Olfactory assessment was undertaken in 30 patients (category1) both pre- & post-operatively and in another 18 (category 2) only postoperative. All patients underwent transpalatal excision and variables of interest included age, radiological stage/parameters & tumor size. RESULTS Objective olfactory dysfunction was seen in 60% while involvement of olfactory strip was suggested in 50%. Despite some marginal trends only noted between size/age with change of olfaction, Pearson's correlation test did not reveal any significance amongst multiple variables. However a better recovery of olfaction following surgery was evident in Category-2 where Chi-Square test (p < 0.05) significantly revealed this to be a function of postoperative duration. This regenerative course in JNA suggests an optimum period of 4 years for full recovery after surgery. CONCLUSION In this first study of olfaction in JNA many new trends have been appreciated. In general, deteriorations of olfaction were seen due to 'vascular-concussion' effect in early postoperative phase where post-surgical clearance of airway showed minimal effect in terms of improvement. The hypervascularity of olfactory epithelium with possible hormonal effects may be responsible for the unique pattern of olfactory function and recovery in JNA.
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Schreiber A, Bertazzoni G, Ferrari M, Ravanelli M, Rampinelli V, Mattavelli D, El‐Naggar A, Nicolai P. Management of persistent juvenile angiofibroma after endoscopic resection: Analysis of a single institution series of 74 patients. Head Neck 2018; 41:1297-1303. [DOI: 10.1002/hed.25555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/12/2018] [Accepted: 11/09/2018] [Indexed: 01/21/2023] Open
Affiliation(s)
- Alberto Schreiber
- Unit of Otorhinolaryngology – Head and Neck SurgeryUniversity of Brescia Brescia Italy
| | - Giacomo Bertazzoni
- Unit of Otorhinolaryngology – Head and Neck SurgeryUniversity of Brescia Brescia Italy
| | - Marco Ferrari
- Unit of Otorhinolaryngology – Head and Neck SurgeryUniversity of Brescia Brescia Italy
| | | | - Vittorio Rampinelli
- Unit of Otorhinolaryngology – Head and Neck SurgeryUniversity of Brescia Brescia Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology – Head and Neck SurgeryUniversity of Brescia Brescia Italy
| | - Ahmed El‐Naggar
- Unit of Otorhinolaryngology – Head and Neck SurgeryUniversity of Brescia Brescia Italy
- Unit of OtorhinolaryngologyTanta University Tanta Egypt
| | - Piero Nicolai
- Unit of Otorhinolaryngology – Head and Neck SurgeryUniversity of Brescia Brescia Italy
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Clinical correlation of molecular (VEGF, FGF, PDGF, c-Myc, c-Kit, Ras, p53) expression in juvenile nasopharyngeal angiofibroma. Eur Arch Otorhinolaryngol 2018; 275:2719-2726. [DOI: 10.1007/s00405-018-5110-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 08/27/2018] [Indexed: 12/19/2022]
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Song X, Yang C, Zhang H, Wang J, Sun X, Hu L, Liu Z, Wang D. Hypoxia-Inducible Factor-1α (HIF-1α) Expression on Endothelial Cells in Juvenile Nasopharyngeal Angiofibroma: A Review of 70 cases and Tissue Microarray Analysis. Ann Otol Rhinol Laryngol 2018; 127:357-366. [PMID: 29717655 DOI: 10.1177/0003489418765563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the expression of hypoxia-inducible factor-1α (HIF-1α) and its related molecules (cellular repressor of E1A-stimulated genes [CREG], osteopontin [OPN], proto-oncogene tyrosine-protein kinase Src [c-Src], and vascular endothelial growth factor [VEGF]) in juvenile nasopharyngeal angiofibroma (JNA) and explore the correlation between clinical prognosis and HIF-1α expression. METHODS The study performed a retrospective review of the clinical records of patients with JNA treated between 2003 and 2007. Specimens were analyzed by immunohistochemistry for HIF-1α, CREG, OPN, c-Src, and VEGF expression, and microvessel density (MVD) was assessed by tissue microarray. The correlation between expression levels and clinicopathological features including age, tumor stage, intraoperative blood loss, and recurrence was analyzed. RESULTS HIF-1α, CREG, OPN, c-Src, and VEGF were upregulated in endothelial cells (ECs) of patients with JNA, and strong correlations in the expression of these molecules were observed. HIF-1α expression was higher in young patients ( P = .032) and in recurrent cases ( P = .01). Survival analysis showed that low HIF-1α levels in ECs predicted longer time to recurrence (log rank test P = .006). Receiver operating characteristic curve analysis showed that HIF-1α was a prognostic factor for recurrence (area under the curve = 0.690, P = .019). No correlation was found between the expression of molecules and Radkowski stage or intraoperative blood loss. CONCLUSION In cases of JNA treated surgically, HIF-1α expression in ECs is a useful prognostic factor for tumor recurrence.
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Affiliation(s)
- Xiaole Song
- 1 Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Chenhe Yang
- 1 Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Huankang Zhang
- 1 Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Jingjing Wang
- 1 Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Xicai Sun
- 1 Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Li Hu
- 2 Department of Experimental Center, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Zhuofu Liu
- 1 Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Dehui Wang
- 1 Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
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