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Karlsson C, Bohm N, Andersson JS, Finizia C, Almståhl A. Prospective study on health-related quality of life, oral mucositis and oral health on during treatment of head and neck cancer. BMC Oral Health 2024; 24:697. [PMID: 38879501 PMCID: PMC11180409 DOI: 10.1186/s12903-024-04466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 06/07/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Few studies have examined health related Quality of Life (HR-QoL) during the treatment of head and neck cancer (HNC) with even fewer focusing on the impact of oral mucositis (OM) on HR-QoL. Studies performed during treatment of HNC makes it possible to follow fluctuations in HR-QoL, OM and other treatment related side effects. The aim was to prospectively analyze HR-QoL, changes in clinical variables and the impact of OM on HR-QoL during HNC treatment. MATERIALS AND METHODS Patients were recruited before commencing curative cancer treatment and were given professional oral care weekly during oncologic treatment. HR-QoL was reported before, during (week 2, 4 and 6) and three months after treatment using the EORTC Quality of Life questionnaires C30 and H&N35 and the stimulated whole salivary secretion rate was determined at the same time-points. OM (erythema and ulceration) was registered using the Oral Mucositis Assessment Scale (OMAS), at baseline, weekly during treatment and post treatment. Differences in HR-QoL between different timepoints were analyzed. To analyze the impact of OM on HR-QoL the patients were categorized into two groups: no/mild OM (OMAS ulceration score 0-1) or severe OM (OMAS ulceration score ≥ 2) and HR-QoL was compared between the two OM groups at three timepoints during treatment. RESULTS Fifty-seven patients (43 men, 14 women), with a mean age of 58 years were included. Patients reported progressively impaired HR-QoL, with peak issues noted at weeks 4 and 6, particularly in social eating, senses, appetite loss, sticky saliva, and decreasing salivary secretion rates were determined. Patients with severe OM reported worse HR-QoL compared to those with no/mild OM. Persistent problems 3 months post treatment were appetite loss, dry mouth, senses (smell and taste) and problems with social eating. CONCLUSION Patients experienced exacerbated symptoms and problems weeks 4 and 6 of oncological treatment, especially among those with severe OM, stressing the importance of clinically monitoring the patients to reduce and alleviate their symptoms. Persistent problems three months post treatment are likely associated with the reduced salivary secretion rate indicating that patients should be monitored also after completed oncological treatment.
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Affiliation(s)
- Charlott Karlsson
- Section 4- Oral Health, Malmö University, Malmö, Sweden.
- Department of Oral and Maxillofacial Surgery, Institute for Postgraduate Dental Education, Jönköping, Sweden.
| | - Niklas Bohm
- Deptartment of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Jessica Skoogh Andersson
- Deptartment of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annica Almståhl
- Section 4- Oral Health, Malmö University, Malmö, Sweden
- Deptartment of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Bourdillon AT, Shah HP, Cohen O, Hajek MA, Mehra S. Novel Machine Learning Model to Predict Interval of Oral Cancer Recurrence for Surveillance Stratification. Laryngoscope 2022. [DOI: 10.1002/lary.30351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 12/24/2022]
Affiliation(s)
| | - Hemali P. Shah
- Yale University School of Medicine New Haven Connecticut U.S.A
| | - Oded Cohen
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut U.S.A
| | - Michael A. Hajek
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut U.S.A
| | - Saral Mehra
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut U.S.A
- Yale Cancer Center New Haven Connecticut U.S.A
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3
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Seminerio I, Descamps G, Dupont S, de Marrez L, Laigle JA, Lechien JR, Kindt N, Journe F, Saussez S. Infiltration of FoxP3+ Regulatory T Cells is a Strong and Independent Prognostic Factor in Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2019; 11:cancers11020227. [PMID: 30781400 PMCID: PMC6406934 DOI: 10.3390/cancers11020227] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 02/08/2019] [Accepted: 02/13/2019] [Indexed: 02/06/2023] Open
Abstract
Head and Neck Squamous Cell Carcinomas (HNSCC) are characterized by a large heterogeneity in terms of the location and risk factors. For a few years now, immunotherapy seems to be a promising approach in the treatment of these cancers, but a better understanding of the immune context could allow to offer a personalized treatment and thus probably increase the survival of HNSCC patients. In this context, we evaluated the infiltration of FoxP3+ Tregs on 205 human formalin-fixed paraffin-embedded HNSCC and we assessed its prognostic value compared to other potential prognostic factors, including HPV infection. First, we found a positive correlation of FoxP3+ Treg infiltration between the intra-tumoral (IT) and the stromal (ST) compartments of the tumors (p < 0.0001). A high infiltration of these cells in both compartments was associated with longer recurrence-free (ST, RFS, p = 0.007; IT, RFS, p = 0.019) and overall survivals (ST, OS, p = 0.002; ST, OS, p = 0.002) of HNSCC patients. Early tumor stage (OS, p = 0.002) and differentiated tumors (RFS, p = 0.022; OS, p = 0.043) were also associated with favorable prognoses. Multivariate analysis revealed that FoxP3+ Treg stromal infiltration, tumor stage and histological grade independently influenced patient prognosis. In conclusion, the combination of these three markers seem to be an interesting prognostic signature for HNSCC.
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Affiliation(s)
- Imelda Seminerio
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
| | - Géraldine Descamps
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
| | - Sophie Dupont
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
| | - Lisa de Marrez
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
| | - Jean-Alexandre Laigle
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
| | - Jérôme R Lechien
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
| | - Nadège Kindt
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
| | - Fabrice Journe
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
| | - Sven Saussez
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium.
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4
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Götz C, Bischof C, Wolff KD, Kolk A. Detection of HPV infection in head and neck cancers: Promise and pitfalls in the last ten years: A meta-analysis. Mol Clin Oncol 2019; 10:17-28. [PMID: 30655973 PMCID: PMC6313947 DOI: 10.3892/mco.2018.1749] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/09/2018] [Indexed: 12/16/2022] Open
Abstract
The current controversial discussion on the disease-specific survival of patients with human papillomavirus (HPV)-positive (+) and -negative (-) squamous cell carcinoma (SCC) of the head neck region was the motivation for the present meta-analysis. Different detection methods for HPV are available, though these often lack sensitivity. As a consequence, there may be false interpretation of HPV positivity. A bias concerning HPV status and therefore also survival rates is serving a non-durable relevance in the discussion of tailored therapies. A literature search was performed via the online database PubMed/NCBI, and data extraction and statistical analysis were conducted. A total of 139 studies published between 2004 and 2014 were evaluated in the present meta-analysis. The HPV detection methods, patient characteristics, tumor localizations and stages, as well as (neo-) adjuvant therapies and survival times were analyzed. The average incidence rates of HPV+ patients with oropharyngeal tumors were higher than those of patients with cancers of other regions of the head and neck. Upon evaluating the results of different detection methods no significant differences were identified. We have compared the HPV incidence rates of each detection method, when studies have used more than one. Regarding overall survival, the pooled adjusted hazard ratio (HR) for oropharyngeal SCC was 0.31 [95% confidence interval (CI)=0.27-0.36]. Unfortunately, only 3 equivalent studies were available on nonoropharyngeal tumors, for which the pooled adjusted HR was 1 (95% CI=0.73-1.36). Overall, the evaluation demonstrated that the survival rates reported in numerous studies were not evaluated multifactorially and important confounders were excluded from the statistics. The HPV detection methods used were often not sufficient in representing HPV positivity. In addition, oropharyngeal and oral SCCs were assessed together in the localization. The widely differing number of HPV+ patients in each of the various studies may be explained by insufficient detection methods and by a lack of localization distinction. The considerations of a tailored therapy according to HPV status should be rejected based on the present information. The previously published studies should be read critically and do not represent a basis for therapeutic decisions.
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Affiliation(s)
- Carolin Götz
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Clara Bischof
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
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Shingler E, Robles LA, Perry R, Penfold C, Ness AR, Thomas S, Lane JA, Martin RM. Systematic review evaluating randomized controlled trials of smoking and alcohol cessation interventions in people with head and neck cancer and oral dysplasia. Head Neck 2018; 40:1845-1853. [PMID: 29603464 PMCID: PMC6120449 DOI: 10.1002/hed.25138] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/08/2017] [Accepted: 02/01/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Smoking and alcohol increase the risk of head and neck cancer and affect treatment outcomes. Interventions modifying these behaviors may improve posttreatment outcomes and survival. We systematically reviewed evidence of the effectiveness of smoking/alcohol interventions in head and neck cancer and oral dysplasia. METHODS The AMED, CINAHL, Embase, MEDLINE, and Web of Science databases were searched for randomized controlled trials (RCTs) of smoking/alcohol interventions in people with head and neck cancer. A qualitative synthesis of the studies was conducted. RESULTS Three RCTs were identified: 2 smoking interventions and 1 smoking and alcohol intervention. One intervention, which was comprised of a smoking intervention based on Cognitive Behavioral Therapy and pharmacologic management compared to usual care, reduced smoking prevalence. CONCLUSION Further research is required into the underlying mechanisms that lead to cessation and interventions that include both pharmacological and behavioral therapy. Future RCTs should include suitable control conditions and sufficient power to assess clinical outcomes.
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Affiliation(s)
- Ellie Shingler
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
| | - Luke A. Robles
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
- Bristol Medical School: Population Health SciencesUniversity of BristolBristolUnited Kingdom
| | - Rachel Perry
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
| | - Chris Penfold
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
| | - Andy R. Ness
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
| | - Steve Thomas
- Department of Maxillofacial SurgeryUniversity of BristolBristolUnited Kingdom
| | - J. Athene Lane
- Bristol Medical School: Population Health SciencesUniversity of BristolBristolUnited Kingdom
- Department of Randomised Trials CollaborationUniversity of Bristol, School of Social and Community MedicineBristolUnited Kingdom
| | - Richard M. Martin
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
- Bristol Medical School: Population Health SciencesUniversity of BristolBristolUnited Kingdom
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6
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Leoncini E, Vukovic V, Cadoni G, Giraldi L, Pastorino R, Arzani D, Petrelli L, Wünsch-Filho V, Toporcov TN, Moyses RA, Matsuo K, Bosetti C, La Vecchia C, Serraino D, Simonato L, Merletti F, Boffetta P, Hashibe M, Lee YCA, Boccia S. Tumour stage and gender predict recurrence and second primary malignancies in head and neck cancer: a multicentre study within the INHANCE consortium. Eur J Epidemiol 2018; 33:1205-1218. [PMID: 29779202 PMCID: PMC6290648 DOI: 10.1007/s10654-018-0409-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 05/09/2018] [Indexed: 12/23/2022]
Abstract
Recurrence and second primary cancer (SPC) continue to represent major obstacles to long-term survival in head and neck cancer (HNC). Our aim was to evaluate whether established demographics, lifestyle-related risk factors for HNC and clinical data are associated with recurrence and SPC in HNC. We conducted a multicentre study by using data from five studies members of the International Head and Neck Cancer Epidemiology consortium—Milan, Rome, Western Europe, Sao Paulo, and Japan, totalling 4005 HNC cases with a median age of 59 (interquartile range 52–67). Multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for recurrence and SPC. During follow-up, 1161 (29%) patients had recurrence and 343 (8.6%) developed SPC. Advanced tumour stage was associated with increased risk of recurrence in HNC overall (HR = 1.76, 95% CI 1.41–2.19). Women with laryngeal cancer had a reduced risk of recurrence compared to men (HR = 0.39, 95% CI: 0.24–0.74). Concerning predictors of SPC, advanced age (HR = 1.02; 95% CI: 1.00–1.04) and alcohol consumption (> 1 drink per day, HR = 2.11; 95% CI: 1.13–3.94) increased the risk of SPC among patients with laryngeal cancer. Additionally, women were at higher risk of SPC, in HNC overall group (HR = 1.68; 95% CI: 1.13–2.51) and oropharyngeal cancer group (HR = 1.74; 95% CI: 1.02–2.98). Tumour stage and male gender (larynx only) were positive predictors of cancer recurrence in HNC patients. Predictors of SPC were advanced age and alcohol use among laryngeal cancer cases, and female gender for oropharyngeal and HNC overall.
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Affiliation(s)
- Emanuele Leoncini
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vladimir Vukovic
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriella Cadoni
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Giraldi
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dario Arzani
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Livia Petrelli
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Raquel Ayub Moyses
- Cirurgia de Cabeça e Pescoço (LIM 28), Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | | | - Cristina Bosetti
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Diego Serraino
- SOC Epidemiologia e Biostatistica, IRCCS Centro di Riferimento Oncologico, Aviano, Italy
| | - Lorenzo Simonato
- Laboratory of Public Health and Population Studies, Department of Molecular Medicine, Padua, Italy
| | - Franco Merletti
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute of Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Stefania Boccia
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Agostino Gemelli" IRCCS, Largo F. Vito, 1, 00168, Rome, Italy.
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Regenbogen E, Mo M, Romeiser J, Shroyer ALW, Escobar-Hoyos LF, Burke S, Shroyer KR. Elevated expression of keratin 17 in oropharyngeal squamous cell carcinoma is associated with decreased survival. Head Neck 2018; 40:1788-1798. [PMID: 29626364 DOI: 10.1002/hed.25164] [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: 08/09/2017] [Revised: 12/07/2017] [Accepted: 02/08/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Overexpression of keratin 17 (K17) is highly associated with poor prognosis in squamous cell carcinoma (SCC) of the cervix. This study was performed to (1) determine whether K17 may be a prognostic biomarker in head and neck squamous cell carcinoma (HNSCC) and (2) to establish if K17 expression is associated with human papillomavirus (HPV) status. METHODS Immunohistochemical staining was performed for K17 of oral, oropharyngeal, and laryngeal SCCs, and normal oropharyngeal mucosa. The HPV status was determined using polymerase chain reaction (PCR). RESULTS Elevated K17 expression was significantly associated with an overall decreased patient survival (P = .02) and, more specifically, in patients with oropharyngeal SCC (P = .01). When controlling for HPV status and tumor location K17 was still a significant predictor of survival (P = .01). CONCLUSION Therefore, K17 is a novel prognostic biomarker of poor survival for patients with HNSCCs, controlling for anatomic site and HPV status.
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Affiliation(s)
- Elliot Regenbogen
- Department of Surgery, Stony Brook School of Medicine, Stony Brook, New York
| | - Michelle Mo
- Department of Pathology, Stony Brook School of Medicine, Stony Brook, New York.,Department of Surgery, Stony Brook School of Medicine, Stony Brook, New York
| | - Jamie Romeiser
- Department of Surgery, Stony Brook School of Medicine, Stony Brook, New York
| | - A Laurie W Shroyer
- Department of Surgery, Stony Brook School of Medicine, Stony Brook, New York
| | | | - Stephanie Burke
- Department of Pathology, Stony Brook School of Medicine, Stony Brook, New York
| | - Kenneth R Shroyer
- Department of Pathology, Stony Brook School of Medicine, Stony Brook, New York
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Götz C, Drecoll E, Straub M, Bissinger O, Wolff KD, Kolk A. Impact of HPV infection on oral squamous cell carcinoma. Oncotarget 2018; 7:76704-76712. [PMID: 27732948 PMCID: PMC5363542 DOI: 10.18632/oncotarget.12501] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 09/13/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Head and neck squamous cell carcinomas (HNSCC) are often divided by their aetiology. Noxae associated collectives are compared with the human papilloma virus (HPV)-associated group, whereas different localisations of oral (OSCC) and oropharyngeal (OPSCC) squamous cell carcinomas are mostly discussed as one single group. Our aim was to show that classification by aetiology is not appropriate for OSCC. RESULTS HPV DNA was detected by PCR in 7 (3.47%) patients, and we identified 12 (5.94%) positive (+) cases by p16INK4a immunostaining. Only 4 (1.98%) of the p16INK4a+ cases were + for HPV using PCR. Our homogenous collective of OSCC allowed us to compare HPV+ and HPV negative (-) patients without creating bias for tumour localisation, age, gender or tumour stage. MATERIALS AND METHODS After testing OSCC samples for HPV positivity, we compared the results of two commonly used HPV detection methods, p16INK4a immunostaining and HPV DNA-related PCR, on 202 OSCC patients. HPV subtypes were determined with an HPV LCD Array Kit. Clinicopathological features of the patients were analysed, and the disease specific survival rates (DSS) for HPV+ and HPV- patients were obtained. CONCLUSIONS p16INK4a immunostaining is a not a reliable HPV detection method for OSCC. Positive p16INK4a immunostaining did not agree with + results from PCR of HPV DNA. Furthermore, the influence of HPV-related oncogenic transformation in OSCC is overestimated. The significance of HPV infection remains clinically unclear, and its influence on survival rates is not relevant to OSCC cases.
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Affiliation(s)
- Carolin Götz
- Department of Maxillofacial and Oral Surgery, Technical University Munich, 81675 München, Germany
| | - Enken Drecoll
- Department of Pathology, Technical University Munich, 81675 München, Germany
| | - Melanie Straub
- Department of Pathology, Technical University Munich, 81675 München, Germany
| | - Oliver Bissinger
- Department of Maxillofacial and Oral Surgery, Technical University Munich, 81675 München, Germany
| | - Klaus-Dietrich Wolff
- Department of Maxillofacial and Oral Surgery, Technical University Munich, 81675 München, Germany
| | - Andreas Kolk
- Department of Maxillofacial and Oral Surgery, Technical University Munich, 81675 München, Germany
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Shingler E, Robles LA, Perry R, Penfold C, Ness A, Thomas S, Athene Lane J, Martin RM. Tobacco and alcohol cessation or reduction interventions in people with oral dysplasia and head and neck cancer: systematic review protocol. Syst Rev 2017; 6:161. [PMID: 28793926 PMCID: PMC5551025 DOI: 10.1186/s13643-017-0555-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/01/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Head and neck cancers include malignancies of the mouth, larynx and oropharynx. Tobacco use and alcohol consumption are associated with increased risks of developing and dying from head and neck cancer. The aim of this review is to examine the effectiveness of smoking and alcohol cessation interventions on disease-related outcomes, quality of life and behavioural change in adults with head and neck cancer and oral dysplasia. METHODS The Cochrane library, CINAHL, Embase, MEDLINE, PsycINFO and Web of Science databases will be searched for randomised controlled trials investigating the effects of smoking or alcohol interventions on patients with either head and neck cancer or oral dysplasia. The primary outcomes are disease-free survival and, for participants with oral dysplasia, malignant transformation to cancer. Secondary outcomes are disease recurrence and progression, quality of life and behavioural change. The quality of included studies will be assessed using the 'Cochrane Collaborations tool for assessing risk of bias'. A qualitative synthesis of the results will be reported, and a meta-analysis of the outcome data conducted, where appropriate. DISCUSSION This systematic review will identify the extent of the current research on smoking and alcohol cessation interventions in patients with head and neck cancer and oral epithelial dysplasia. The findings have the potential to inform which interventions have been successful and how future behavioural change interventions should be conducted within these populations. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016038237.
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Affiliation(s)
- Ellie Shingler
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol Research & Education Centre, Level 3, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Luke A. Robles
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol Research & Education Centre, Level 3, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Rachel Perry
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol Research & Education Centre, Level 3, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Chris Penfold
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol Research & Education Centre, Level 3, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Andy Ness
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol Research & Education Centre, Level 3, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Steve Thomas
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol Research & Education Centre, Level 3, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - J. Athene Lane
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol Research & Education Centre, Level 3, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Richard M. Martin
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol Research & Education Centre, Level 3, Upper Maudlin Street, Bristol, BS2 8AE UK
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10
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Kindt N, Descamps G, Seminerio I, Bellier J, Lechien JR, Pottier C, Larsimont D, Journé F, Delvenne P, Saussez S. Langerhans cell number is a strong and independent prognostic factor for head and neck squamous cell carcinomas. Oral Oncol 2016; 62:1-10. [PMID: 27865360 DOI: 10.1016/j.oraloncology.2016.08.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/17/2016] [Accepted: 08/30/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Head and neck squamous cell carcinomas (HNSCCs) exhibit great biological heterogeneity and relatively poor prognosis. Tobacco and alcohol consumption is involved in the cause of the majority of these cancers, but over the last several years, Human Papilloma Virus (HPV) infection has increased specifically in oropharyngeal cancers and become an additional risk factor. Here, we evaluated the number of Langerhans cells (LCs) in HNSCC and reporting its prognostic power in comparison to other risk factors. MATERIALS AND METHODS Our clinical series was composed of 25 tumor-free peritumoral epithelium, 64 low-grade dysplasia, 54 high-grade dysplasia and 125 carcinoma samples. HPV was detected by E6/E7 qPCR and p16 immunohistochemistry. CD1a-positive LCs were counted in intra-tumoral and stromal compartments as well as lymph nodes. MIP-3α was assessed in carcinomas using immunohistochemistry. RESULTS Univariate Cox regression analyses demonstrated that high LC number is associated with longer recurrence-free survival in both intra-tumoral and stromal compartments and longer overall survival in stromal compartment. Tobacco and alcohol habits, but not HPV status, are also correlated with poor prognoses in terms of recurrence. Multivariate analyses reported stromal LC number as a strong prognostic factor independent of tobacco, alcohol and HPV status. Moreover, LC number is higher in tumors and invaded lymph nodes than dysplastic lesions but it decreases in HPV-positive cancer patients. Further, LC number correlates with MIP-3α expression. CONCLUSION These findings suggest that LC number is a significant and independent prognostic factor for HNSCC. LC infiltration is increased in cancer lesions but decrease with HPV infection.
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Affiliation(s)
- Nadège Kindt
- Laboratory of Anatomy and Cellular Biology, Research Institute for Health Sciences and Technology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium
| | - Géraldine Descamps
- Laboratory of Anatomy and Cellular Biology, Research Institute for Health Sciences and Technology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium
| | - Imelda Seminerio
- Laboratory of Anatomy and Cellular Biology, Research Institute for Health Sciences and Technology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium
| | - Justine Bellier
- Laboratory of Anatomy and Cellular Biology, Research Institute for Health Sciences and Technology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium
| | - Jérôme R Lechien
- Laboratory of Anatomy and Cellular Biology, Research Institute for Health Sciences and Technology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium
| | - Charles Pottier
- Department of Pathology, C.H.U. - SART TILMAN, University of Liège, 4000 Liège, Belgium
| | - Denis Larsimont
- Department of Anatomopathology, Institut Jules Bordet, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Fabrice Journé
- Laboratory of Anatomy and Cellular Biology, Research Institute for Health Sciences and Technology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium; Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Philippe Delvenne
- Department of Pathology, C.H.U. - SART TILMAN, University of Liège, 4000 Liège, Belgium
| | - Sven Saussez
- Laboratory of Anatomy and Cellular Biology, Research Institute for Health Sciences and Technology, Faculty of Medicine and Pharmacy, University of Mons, 7000 Mons, Belgium; Department of Oto-Rhino-Laryngology, Faculty of Medicine, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium.
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11
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Descamps G, Karaca Y, Lechien JR, Kindt N, Decaestecker C, Remmelink M, Larsimont D, Andry G, Hassid S, Rodriguez A, Khalife M, Journe F, Saussez S. Classical risk factors, but not HPV status, predict survival after chemoradiotherapy in advanced head and neck cancer patients. J Cancer Res Clin Oncol 2016; 142:2185-96. [PMID: 27370781 PMCID: PMC5018052 DOI: 10.1007/s00432-016-2203-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/24/2016] [Indexed: 01/22/2023]
Abstract
Purpose Despite the advent of concomitant chemoradiotherapy (CCRT), the prognosis of advanced head and neck squamous cell carcinoma (HNSCC) patients remains particularly poor. Classically, HNSCC, especially oropharyngeal carcinomas, associated with human papillomavirus (HPV) exhibits better treatment outcomes than HNSCCs in non-infected patients, eliciting a call for the de-escalation of current therapies. To improve the management of HNSCC patients, we aimed to determine the impact of active HPV infection on patient response, recurrence and survival after CCRT in a population of heavy tobacco and alcohol consumers. Methods Paraffin-embedded samples from 218 advanced HNSCC patients, mostly smokers and/or drinkers treated by CCRT, were tested for the presence of HPV DNA by surrogate type-specific E6/E7 qPCR and p16 immunohistochemistry. Associations between the response to CCRT and patient outcomes according to HPV status and clinical data were evaluated by Kaplan–Meier analysis and both univariate and multivariate Cox regression. Results Type-specific E6/E7 PCR demonstrated HPV positivity in 20 % of HNSCC. Regarding HPV status, we did not find any significant relation with response to therapy in terms of progression-free survival or overall survival. However, we observed a significantly worse prognosis for consumers of alcohol and tobacco compared to nondrinkers (p = 0.003) and non-smokers (p = 0.03). Survival analyses also revealed that the outcome is compromised in stage IV patients (p = 0.007) and, in particular, for oral cavity, hypopharynx and oropharynx carcinoma patients (p = 0.001). Conclusion The risk of death from HNSCC significantly increases when patients are exposed to tobacco and alcohol during their therapy, regardless of HPV status.
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Affiliation(s)
- Géraldine Descamps
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium
| | - Yasemin Karaca
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium
| | - Jérôme R Lechien
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium
| | - Nadège Kindt
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium
| | - Christine Decaestecker
- Laboratories of Image, Signal Processing and Acoustics, Ecole polytechnique de Bruxelles, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Myriam Remmelink
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Denis Larsimont
- Department of Pathology, Bordet Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Guy Andry
- Department of Head and Neck Surgery, Bordet Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Samantha Hassid
- Department of Oto-Rhino-Laryngology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Alexandra Rodriguez
- Department of Oto-Rhino-Laryngology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | - Fabrice Journe
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium.,Laboratory of Oncology and Experimental Surgery, Bordet Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Sven Saussez
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium. .,Department of Oto-Rhino-Laryngology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium. .,Department of Head and Neck Surgery, EpiCURA, Baudour, Belgium.
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12
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Innovative perspectives of immunotherapy in head and neck cancer. From relevant scientific rationale to effective clinical practice. Cancer Treat Rev 2016; 43:113-23. [PMID: 26827699 DOI: 10.1016/j.ctrv.2016.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/17/2015] [Accepted: 01/06/2016] [Indexed: 01/05/2023]
Abstract
It is now well established that head and neck cancer carcinogenesis is characterized by genetic instability and several immune defects, leading to unique host-tumor interactions. In such condition, recent improved comprehension and relevant findings could lead to identification of innovative molecular therapeutic targets, achieving considerable clinical and translational research. This review aims to summarize and to highlight most recent and relevant scientific rationale in this era of immunotherapy revival, and to correlate it to the near future clinical practice for the management of this challenging disease.
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Simão TP, Lopes Chaves EDC, Campos de Carvalho E, Nogueira DA, Carvalho CC, Ku YL, Iunes DH. Cultural adaptation and analysis of the psychometric properties of the Brazilian version of the Spiritual Distress Scale. J Clin Nurs 2015; 25:231-9. [PMID: 26769210 DOI: 10.1111/jocn.13060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 11/27/2022]
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Sharp L, McDevitt J, Carsin AE, Brown C, Comber H. Smoking at Diagnosis Is an Independent Prognostic Factor for Cancer-Specific Survival in Head and Neck Cancer: Findings from a Large, Population-Based Study. Cancer Epidemiol Biomarkers Prev 2014; 23:2579-90. [DOI: 10.1158/1055-9965.epi-14-0311] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Annertz K, Rosenquist K, Andersson G, Jacobsson H, Hansson BG, Wennerberg J. High-risk HPV and survival in patients with oral and oropharyngeal squamous cell carcinoma - 5-year follow up of a population-based study. Acta Otolaryngol 2014; 134:843-51. [PMID: 24930912 DOI: 10.3109/00016489.2014.890289] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CONCLUSION No statistically significant 5-year survival difference was seen in patients with oral and oropharyngeal squamous cell carcinoma (OOPSCC) between high-risk HPV-positive and -negative groups in this population-based study. OBJECTIVES To see if the formerly observed higher risk for recurrence or second primary tumour (SPT) in high-risk HPV-positive patients with OOPSCC corresponds to worse survival. METHODS A total of 128 consecutive, previously untreated patients with OOPSCC, who were part of a population-based case-control study in southern Sweden during 2000-2004, were included. A mouthwash sample was collected and exfoliated cells were collected with cotton-tipped swabs from the tonsillar fossa and the tumour. Specimens were analysed for HPV DNA using nested polymerase chain reaction (PCR). Disease-specific survival (DSS) and DSS difference between HPV-negative and HPV-positive patients were calculated. The relationship between age, stage, high-risk HPV status and DSS was assessed. Oral and oropharyngeal tumours were assessed separately. RESULTS Mean DSS in months was 80.7/68.6 (high-risk HPV-negative/high-risk HPV-positive) for oral cavity tumours (p = 0.18) and 67.6/78.3 (high-risk HPV-negative/high-risk HPV-positive) for oropharyngeal tumours (p = 0.47). For oral cavity tumours, age, T status, N status and stage all showed significant differences in DSS. For oropharyngeal tumours, no significant difference regarding DSS was found.
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Affiliation(s)
- Karin Annertz
- Division of Otorhinolaryngology/Head & Neck Surgery, Department of Clinical Sciences, Lund University , Lund
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16
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Proteomic study of HPV-positive head and neck cancers: preliminary results. BIOMED RESEARCH INTERNATIONAL 2014; 2014:430906. [PMID: 24719866 PMCID: PMC3955617 DOI: 10.1155/2014/430906] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/20/2014] [Accepted: 01/23/2014] [Indexed: 11/17/2022]
Abstract
Human papillomavirus (HPV) was recently recognized as a new risk factor for head and neck squamous cell carcinoma. For oropharyngeal cancers, an HPV+ status is associated with better prognosis in a subgroup of nonsmokers and nondrinkers. However, HPV infection is also involved in the biology of head and neck carcinoma (HNC) in patients with a history of tobacco use and/or alcohol consumption. Thus, the involvement of HPV infection in HN carcinogenesis remains unclear, and further studies are needed to identify and analyze HPV-specific pathways that are involved in this process. Using a quantitative proteomics-based approach, we compared the protein expression profiles of two HPV+ HNC cell lines and one HPV- HNC cell line. We identified 155 proteins that are differentially expressed (P < 0.01) in these three lines. Among the identified proteins, prostate stem cell antigen (PSCA) was upregulated and eukaryotic elongation factor 1 alpha (EEF1α) was downregulated in the HPV+ cell lines. Immunofluorescence and western blotting analyses confirmed these results. Moreover, PSCA and EEF1 α were differentially expressed in two clinical series of 50 HPV+ and 50 HPV- oral cavity carcinomas. Thus, our study reveals for the first time that PSCA and EEF1 α are associated with the HPV-status, suggesting that these proteins could be involved in HPV-associated carcinogenesis.
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Perney P, Duny Y, Nalpas B, Lallemant B, Rigole H, Cartier C, Garrel R, Azria TAOSGD, Blanc F, Duhamel O, Neka M, Ichou M, Le Bars Y, Pelletier S, Quantin X, Stoebner A. Feasibility and Efficacy of an Addiction Treatment Program in Patients With Upper Aerodigestive Tract Cancer. Subst Use Misuse 2014; 49:103-109. [PMID: 23919435 DOI: 10.3109/10826084.2013.821660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Continuing to smoke or to drink after the treatment of an upper aerodigestive tract (UADT) cancer is known to worsen the prognosis. We assessed the feasibility and efficacy of an addiction treatment program integrated into the cancer treatment. METHOD In four units devoted to UADT tumors, we proposed an addiction treatment to all patients still drinking or smoking at the end of the cancer treatment; the abstinence rate was assessed 6 and 12 months later. RESULTS One hundred and sixteen patients were included. Among the 73 patients still drinking and/or smoking at the end of the cancer treatment, 46.6% accepted an addiction treatment. In the latter, abstinence rate was increased, 52.2% versus 31.03% ( p = .07) at M12. In patients both drinking and smoking, addiction treatment doubled the rate of abstinence of both products (31% vs. 14%). CONCLUSION Offering addiction treatment to patients with UADT cancer improves abstinence rate and helps maintain long-term withdrawal.
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Affiliation(s)
- Pascal Perney
- a 1 Service d'Addictologie, CHU Caremeau , Place du Pr R. Debré, Nîmes, France
| | - Yohan Duny
- a 1 Service d'Addictologie, CHU Caremeau , Place du Pr R. Debré, Nîmes, France
| | - Bertrand Nalpas
- a 1 Service d'Addictologie, CHU Caremeau , Place du Pr R. Debré, Nîmes, France.,b 2 Inserm U 1016, Institut Cochin , 14 rue Méchain, Paris, France
| | | | - Hélène Rigole
- d 4 Service de Médecine Interne , Hôpital St Eloi, Montpellier, France
| | - César Cartier
- e 5 Service ORL, Hôpital Gui de Chauliac , Montpellier, France
| | - Renaud Garrel
- e 5 Service ORL, Hôpital Gui de Chauliac , Montpellier, France
| | | | - François Blanc
- d 4 Service de Médecine Interne , Hôpital St Eloi, Montpellier, France
| | | | - Meissa Neka
- a 1 Service d'Addictologie, CHU Caremeau , Place du Pr R. Debré, Nîmes, France
| | - Marc Ichou
- e 5 Service ORL, Hôpital Gui de Chauliac , Montpellier, France
| | - Yves Le Bars
- a 1 Service d'Addictologie, CHU Caremeau , Place du Pr R. Debré, Nîmes, France
| | - Stéphanie Pelletier
- a 1 Service d'Addictologie, CHU Caremeau , Place du Pr R. Debré, Nîmes, France
| | - Xavier Quantin
- e 5 Service ORL, Hôpital Gui de Chauliac , Montpellier, France
| | - Anne Stoebner
- e 5 Service ORL, Hôpital Gui de Chauliac , Montpellier, France
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18
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Druesne-Pecollo N, Keita Y, Touvier M, Chan DSM, Norat T, Hercberg S, Latino-Martel P. Alcohol drinking and second primary cancer risk in patients with upper aerodigestive tract cancers: a systematic review and meta-analysis of observational studies. Cancer Epidemiol Biomarkers Prev 2013; 23:324-31. [PMID: 24307268 DOI: 10.1158/1055-9965.epi-13-0779] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We conducted a systematic review and meta-analysis of existing data from observational studies to assess the strength of the association of alcohol drinking with second primary cancer risk in patients with upper aerodigestive tract (UADT; oral cavity, pharynx, larynx, and esophagus) cancer. METHODS PubMed and Embase were searched up to July 2012 and the reference lists of studies included in the analysis were examined. Random-effects models were used to estimate summary relative risks (RR) and 95% confidence interval (CI). RESULTS Nineteen studies, 8 cohort and 11 case-control studies, were included. In highest versus lowest meta-analyses, alcohol drinking was associated with significantly increased risk of UADT second primary cancers (RR, 2.97; 95% CI, 1.96-4.50). Significantly increased risks were also observed for UADT and lung combined (RR, 1.90; 95% CI, 1.16-3.11) and all sites (RR, 1.60; 95% CI, 1.22-2.10) second primary cancers. For an increase in the alcohol intake of 10 grams per day, dose-response meta-analysis resulted in a significantly increased RR of 1.09 (95% CI, 1.04-1.14) for UADT second primary cancers. CONCLUSIONS Alcohol drinking in patients with UADT cancer is associated with an increased risk of second primary cancers. Studies conducted in alcohol drinking patients with UADT cancer and evaluating the effect of alcohol cessation on second primary cancer and other outcomes are needed. IMPACT Our results emphasize the importance of prevention policies aiming to reduce alcohol drinking. Health-care professionals should encourage alcohol drinking patients with UADT cancer to reduce their consumption and reinforce the surveillance of this at-risk subpopulation.
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Affiliation(s)
- Nathalie Druesne-Pecollo
- Authors' Affiliations: Sorbonne Paris Cité Research Center, Nutritional Epidemiology Research Team, Inra, Inserm, Cnam, Paris 13 University; Department of Public Health, Avicenne Hospital, Bobigny, France; and Department of Epidemiology and Public Health, Imperial College, London, United Kingdom
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DURAY ANAËLLE, DESCAMPS GÉRALDINE, DECAESTECKER CHRISTINE, SIRTAINE NICOLAS, GILLES ANDRÉ, KHALIFÉ MOHAMAD, CHANTRAIN GILBERT, DEPUYDT CHRISTOPHEE, DELVENNE PHILIPPE, SAUSSEZ SVEN. Human papillomavirus predicts the outcome following concomitant chemoradiotherapy in patients with head and neck squamous cell carcinomas. Oncol Rep 2013; 30:371-6. [DOI: 10.3892/or.2013.2415] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 12/27/2012] [Indexed: 11/06/2022] Open
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20
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Badoual C, Péré H, Roussel H, Si Mohamed A, Tartour É. [Cancers of the upper aerodigestive tract associated with human papillomavirus]. Med Sci (Paris) 2013; 29:83-8. [PMID: 23351698 DOI: 10.1051/medsci/2013291017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Carcinomas of the aerodigestive tract are most often secondary to alcohol and tobacco intoxication. However, it is shown that the oncogenic human papillomavirus (HPV) have an increasing role in the carcinogenesis of these cancers. Patients with HPV+ carcinoma are generally younger and not alcohol and tobacco users. These carcinomas are mainly localized in the oropharynx and in particular at the tonsil. HPV is found in 40 to 90 % of the cancers in the oropharynx, depending on the country. These HPV+ carcinomas have a better prognosis with better radio or chemosensitivity. To date, no change of treatment is recommended, however, several trials are underway. Preventive vaccination of boys is a real public health issue, especially since it is recommended in some countries. Moreover, a better understanding of the tumor microenvironment will ultimately offer therapeutic vaccination.
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Affiliation(s)
- Cécile Badoual
- Service d'anatomie pathologique, hôpital européen Georges Pompidou, 20-40, rue Leblanc, 75015 Paris, France.
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Klozar J, Koslabova E, Kratochvil V, Salakova M, Tachezy R. Nodal status is not a prognostic factor in patients with HPV-positive oral/oropharyngeal tumors. J Surg Oncol 2012. [DOI: 10.1002/jso.23292] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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O'Rorke MA, Ellison MV, Murray LJ, Moran M, James J, Anderson LA. Human papillomavirus related head and neck cancer survival: a systematic review and meta-analysis. Oral Oncol 2012; 48:1191-201. [PMID: 22841677 DOI: 10.1016/j.oraloncology.2012.06.019] [Citation(s) in RCA: 294] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 06/18/2012] [Accepted: 06/29/2012] [Indexed: 01/22/2023]
Abstract
Human Papillomavirus (HPV) related oropharyngeal squamous cell carcinomas (OPSCCs) are reported to have improved prognosis and survival in comparison to other head and neck squamous cell cancers (HNSCCs). This systematic review and meta-analysis examines survival differences in HPV-positive HNSCC and OPSCC subtypes including tonsillar carcinoma in studies not previously investigated. Four electronic databases were searched from their inception till April 2011. A random effects meta-analysis was used to pool study estimates evaluating disease-specific (death from HNSCC), overall (all-cause mortality), progression-free and disease-free (recurrence free) survival outcomes in HPV-positive vs. HPV-negative HNSCCs. All statistical tests were two-sided. Forty-two studies were included. Patients with HPV-positive HNSCC had a 54% better overall survival compared to HPV-negative patients HR 0.46 (95% CI 0.37-0.57); the pooled HR for tonsillar cancer and OPSCC was 0.50 (95% CI 0.33-0.77) and HR 0.47 (95% CI 0.35-0.62) respectively. The pooled HR for disease specific survival was 0.28 (95% CI 0.19-0.40); similar effect sizes were found irrespective of the adjustment for confounders, HPV detection methods or study location. Both progression-free survival and disease-free survival were significantly improved in HPV-positive HNSCCs. HPV-positive HNSCCs and OPSCCs patients have a significantly lower disease specific mortality and are less likely to experience progression or recurrence of their cancer than HPV-negative patients; findings which have connotations for treatment selection in these patients.
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Affiliation(s)
- M A O'Rorke
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queens University Belfast, Belfast, UK.
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Mitchell O, Durrani A, Price R. Rehabilitation of patients following major head and neck cancer surgery. ACTA ACUST UNITED AC 2012; 21:S31-7. [DOI: 10.12968/bjon.2012.21.sup10.s31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Amer Durrani
- Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge
| | - Richard Price
- Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge
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Duray A, Descamps G, Decaestecker C, Remmelink M, Sirtaine N, Lechien J, Ernoux-Neufcoeur P, Bletard N, Somja J, Depuydt CE, Delvenne P, Saussez S. Human papillomavirus DNA strongly correlates with a poorer prognosis in oral cavity carcinoma. Laryngoscope 2012; 122:1558-65. [PMID: 22532307 DOI: 10.1002/lary.23298] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 12/30/2011] [Accepted: 02/22/2012] [Indexed: 12/18/2022]
Abstract
OBJECTIVES/HYPOTHESIS The prevalence of human papillomavirus (HPV) in a clinical series of 162 patients with oral squamous cell carcinoma (OSCC) was studied. Furthermore, we analyzed the correlation between the immunohistochemical expression of p16, p53, epidermal growth factor receptor (EGFR), and HPV status to predict survival in OSCC patients. STUDY DESIGN Retrospective study. METHODS Paraffin-embedded samples from OSCC patients (n = 162) were evaluated for the presence of HPV DNA using both GP5+/GP6+ consensus polymerase chain reaction (PCR) and type-specific E6/E7 PCR to detect HPV types 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, and 68. Immunohistochemical staining for p16, p53, and EGFR was also performed. RESULTS The type-specific E6/E7 PCR demonstrated that 65 of the 147 OSCC patients (44%) presented with high-risk (hr) HPV types and that 38 of the 147 OSCC patients (26%) presented with low-risk (lr) HPV types. Comparable p53 and EGFR expression levels were observed in the hr HPV+ group (41.5% p53+, 92% EGFR+) and the lr HPV+ group (57% p53+, 92% EGFR+). Conversely, a slight increase in the proportion of p16+ tumors was observed in the hr HPV+ group (65%) compared with the lr HPV+ group (44%). In regard to patient outcome, the presence of HPV was correlated with a worse prognosis (P = .007). CONCLUSIONS A high prevalence of hr and lr HPV infections was detected in the OSCC patients included in the study. Moreover, hr HPV positivity was correlated with a decreased 5-year disease-free survival rate compared with HPV- and lr HPV+.
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Affiliation(s)
- Anaëlle Duray
- Laboratory of Anatomy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
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Pinto FR, Matos LLD, Gumz Segundo W, Vanni CMRS, Rosa DS, Kanda JL. Tobacco and alcohol use after head and neck cancer treatment: influence of the type of oncological treatment employed. Rev Assoc Med Bras (1992) 2012; 57:171-6. [PMID: 21537703 DOI: 10.1590/s0104-42302011000200014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2010] [Accepted: 12/27/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the cigarette smoking and alcohol intake maintenance rate in patients treated for head and neck squamous cell carcinoma and to compare the observed outcome with the type of oncological treatment employed. METHODS One hundred and ten patients treated for high aero-digestive tract squamous cell carcinoma were included and divided into a surgical group, treated with a surgery, and a medical group, treated with chemotherapy and/or radiation. The patients were interviewed to determine whether or not they had persisted with the smoking and drinking behavior after treatment. The habit maintenance rate was compared with the treatment modality employed. The relationship between the oncological status of the patients and the cigarette smoking and alcohol intake rates found was also tested. RESULTS Among smokers, 35% maintained the habit after treatment. The medical group had a significantly higher percentage of patients maintaining smoking compared with the surgical group (58.3% vs 25.0%; p = 0.004). Among alcohol users, 16.6% kept drinking alcoholic beverages, with a percentage also shown higher for the medical group (23.8% vs 13,3%), but with no statistically significant difference. The oncological status of patients was not related to the maintenance of the habits studied. CONCLUSION Smoking and alcoholism maintenance rates are high after head and neck squamous cell carcinoma is treated, especially if we consider smoking in patients treated with chemotherapy and/or radiation. A more effective multidisciplinary approach is required in order to obtain better rates of tobacco and alcohol quitting, especially in patients undergoing non-surgical treatments.
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Lindenbergh-van der Plas M, Brakenhoff RH, Kuik DJ, Buijze M, Bloemena E, Snijders PJF, Leemans CR, Braakhuis BJM. Prognostic significance of truncating TP53 mutations in head and neck squamous cell carcinoma. Clin Cancer Res 2011; 17:3733-41. [PMID: 21467160 DOI: 10.1158/1078-0432.ccr-11-0183] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE TP53 is a key gene in cellular homeostasis and is frequently mutated in head and neck squamous cell carcinoma (HNSCC). There is a variety of TP53 mutations, each with its own biological and clinical implication. Aim of the study was to assess the prognostic significance of TP53 mutations in HNSCCs and to identify the most relevant mutation. EXPERIMENTAL DESIGN TP53 mutation status was investigated in 141 consecutive HNSCCs treated by surgery with radiotherapy when indicated and with a known human papilloma virus status. The type of mutation was correlated with overall and progression-free survival in a multivariate two-sided Cox regression analysis with wild type as reference. RESULTS A TP53 mutation was found in 88 (62.4%) of the carcinomas and was not significantly associated with overall survival (HR = 1.65, P = 0.11). Patients with a mutation resulting in a truncated protein (n = 36, 25.5%) had a significantly worse overall survival (HR = 2.54, P = 0.008) and progression-free survival (HR = 2.65, P = 0.002). Four of these mutations were at a splice site, 13 were nonsense mutations (produces stop codon), and 19 were insertions or deletions resulting in a frameshift. After multivariate analysis, a truncating mutation remained a significant prognosticator. A missense (i.e., nontruncating) mutation did not influence prognosis. Other ways of classification (disruptive vs. nondisruptive, hotspot vs. nonhotspot, and DNA binding vs. non-DNA binding) were less discriminative. CONCLUSION In HNSCCs, a truncating TP53 mutation is associated with a poor prognosis. This patient group seems as a target population for adjuvant therapy with chemoradiation or viral vector-mediated TP53 gene transfer.
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Affiliation(s)
- Marlon Lindenbergh-van der Plas
- Departments of Otolaryngology/Head-Neck Surgery, Epidemiology and Biostatistics, and Pathology, VU University Medical Center, Amsterdam, the Netherlands
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Immune suppression in head and neck cancers: a review. Clin Dev Immunol 2011; 2010:701657. [PMID: 21437225 PMCID: PMC3061296 DOI: 10.1155/2010/701657] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 12/20/2010] [Accepted: 12/27/2010] [Indexed: 12/16/2022]
Abstract
Head and neck squamous cell carcinomas (HNSCCs) are the sixth most common cancer in the world. Despite significant advances in the treatment modalities involving surgery, radiotherapy, and concomitant chemoradiotherapy, the 5-year survival rate remained below 50% for the past 30 years. The worse prognosis of these cancers must certainly be link to the fact that HNSCCs strongly influence the host immune system. We present a critical review of our understanding of the HNSCC escape to the antitumor immune response such as a downregulation of HLA class I and/or components of APM. Antitumor responses of HNSCC patients are compromised in the presence of functional defects or apoptosis of T-cells, both circulating and tumor-infiltrating. Langerhans cells are increased in the first steps of the carcinogenesis but decreased in invasive carcinomas. The accumulation of macrophages in the peritumoral areas seems to play a protumoral role by secreting VEGF and stimulating the neoangiogenesis.
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Tobacco and alcohol use after head and neck cancer treatment: influence of the type of oncological treatment employed. Rev Assoc Med Bras (1992) 2011. [DOI: 10.1016/s0104-4230(11)70039-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Rodriguez-Bruno K, Ali MJ, Wang SJ. Role of panendoscopy to identify synchronous second primary malignancies in patients with oral cavity and oropharyngeal squamous cell carcinoma. Head Neck 2010; 33:949-53. [DOI: 10.1002/hed.21561] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2010] [Indexed: 11/10/2022] Open
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Combined analysis of HPV DNA, p16, p21 and p53 to predict prognosis in patients with stage IV hypopharyngeal carcinoma. J Cancer Res Clin Oncol 2010; 137:173-81. [PMID: 20376678 PMCID: PMC3015171 DOI: 10.1007/s00432-010-0871-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Accepted: 03/19/2010] [Indexed: 02/08/2023]
Abstract
PURPOSE We examined p16, p21 and p53 expression in combination with the presence of human papillomavirus (HPV) DNA as molecular markers to predict survival in patients with stage IV hypopharyngeal squamous cell carcinoma (HSCC). METHODS Paraffin-embedded tumours from HSCC patients (n = 75) were evaluated for p16, p21 and p53 expression by immunohistochemistry. HPV DNA was detected by GP5+/6+ consensus PCR and subsequent genotyping by E6/E7 type-specific PCR for HPV types 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68. RESULTS Among the 61 specimens that tested positive for the β-globin, HPV typing identified 50 patients with high-risk (hr) HPV types. HPV 16E7 DNA was detected in 74% (37 cases) of these specimens. Twelve patients were found to be infected with multiple HPV types. However, the presence of hrHPV DNA was not found to correlate with the proportion of disease-free patients. The 5-year disease-free survival rate was 73% in p53- tumours versus 48% in p53+ tumours (P = 0.008). CONCLUSION In our series of patients with stage IV HSCC, the hrHPV+ subgroup had a similar prognosis (in terms of recurrence risk) as the HPV- subgroup. p53 overexpression was associated with a worse prognosis.
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MAGE-A antigens in lesions of the oral mucosa. Clin Oral Investig 2010; 15:315-20. [PMID: 20174843 DOI: 10.1007/s00784-010-0387-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 01/28/2010] [Indexed: 01/31/2023]
Abstract
Oral squamous cell carcinoma develops continuously out of predamaged oral mucosa. For the physician and pathologist, difficulties arise in distinguishing precancerous from cancerous lesions. MAGE-A antigens are tumor antigens that are found solely in malignant transformed cells. These antigens might be useful in distinguishing precancerous from cancerous lesions. The aim of this study was to verify this assumption by comparing MAGE-A expression in benign, precancerous, and cancerous lesions of the oral mucosa. Retrospectively, biopsies of different oral lesions were randomly selected. The lesions that were included are 64 benign oral lesions (25 traumatic lesions (oral ulcers), 13 dental follicles, and 26 epulis), 26 oral lichen planus, 123 epithelial precursor lesions (32 epithelial hyperplasia found in leukoplakias, 24 epithelial dysplasia found in leukoplakias, 26 erythroplasia with oral epithelial dysplasia, and 41 carcinomas in situ in erythroleukoplakias). The lesions were immunohistochemically stained with the poly-MAGE-A antibody 57B, and the results were compared. Biopsies of oral lichen planus, oral ulcers, dental follicles, epulis, and leukoplakia without dysplasia showed no positive staining for MAGE-A antigens. Leukoplakia with dysplasia, dysplasia, and carcinomata in situ displayed positive staining in 33%, 65%, and 56% of the cases, respectively. MAGE-A antigens were not detectable via immunohistochemistry in benign lesions of the oral mucosa. The staining rate of dysplastic precancerous lesions or malignant lesions ranged from 33% to 65%. The MAGE-A antigens might facilitate better differentiation between precancerous and cancerous lesions of the oral mucosa.
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Braakhuis BJ, Brakenhoff RH, Meijer CJ, Snijders PJ, Leemans CR. Human papilloma virus in head and neck cancer: The need for a standardised assay to assess the full clinical importance. Eur J Cancer 2009; 45:2935-9. [DOI: 10.1016/j.ejca.2009.08.018] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 08/20/2009] [Accepted: 08/21/2009] [Indexed: 11/28/2022]
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Simonato LE, Garcia JF, Sundefeld MLMM, Mattar NJ, Veronese LA, Miyahara GI. Detection of HPV in mouth floor squamous cell carcinoma and its correlation with clinicopathologic variables, risk factors and survival. J Oral Pathol Med 2008; 37:593-8. [DOI: 10.1111/j.1600-0714.2008.00704.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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