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Han B, Sun M, Zhao Y, Baranova A, Cao H, Liu S, Shen X, Hou L, Fang J, Lian M. Genetic predisposition to milder forms of COVID-19 may provide some resilience to head and neck cancers. Front Oncol 2024; 14:1384061. [PMID: 39040446 PMCID: PMC11260674 DOI: 10.3389/fonc.2024.1384061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024] Open
Abstract
Introduction The impact of the COVID-19 pandemic on head and neck cancer (HNC) has been suggested, but the causal relationship remains unclear. Methods We explore this connection by utilizing the Mendelian randomization (MR) approach applied to publicly available genome-wide association study (GWAS) summary datasets for COVID-19 and HNC. The datasets included critical COVID-19 (13,769 cases, 1,072,442 controls), hospitalized COVID-19 (32,519 cases, 2,062,805 controls), SARS-CoV-2 infection (122,616 cases, 2,475,240 controls), and HNC (2,131 cases, 287,137 controls). Mechanistic underpinnings of the causal relationships identified by MR analysis were explored through functional annotation augmented by AI-based literature data mining. Results Surprisingly, a genetic predisposition to contracting a milder form of COVID-19 substantially reduced the risks of developing HNC (OR: 0.52, 95% CI: 0.35-0.78, p = 1.42E-03), with no significant association between genetic liability to severe COVID-19 and the risk of HNC detected. Additionally, our findings highlighted 14 genes linked to SARS-CoV-2 infection, potentially playing a protective role in the context of HNC. These genes include OAS1, LOC107985887, BCL11A, DPP9, LOC107984685, LINC02326, MUC4, NXPE3, IFNAR2, LZTFL1, LOC105372437, NAPSA, LOC105376622, LOC107986082, and SLC6A20. Conclusion Our study emphasizes the protective role of the genetic liability to milder COVID-19 in reducing the risk of HNC while refuting a causal relationship between severe COVID-19 and HNC.
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Affiliation(s)
- Boxuan Han
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Minghong Sun
- Department of Otorhinolaryngology Head and Neck Surgery, Qingdao Municipal Hospital, Qingdao, China
| | - Yanming Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ancha Baranova
- School of Systems Biology, George Mason University, Manassas, VA, United States
- Research Centre for Medical Genetics, Moscow, Russia
| | - Hongbao Cao
- School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Shaokun Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xixi Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lizhen Hou
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jugao Fang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Meng Lian
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Alam R, Fan X, Hippe DS, Tachiki LM, Gong E, Huynh E, Nghiem P, Park SY. Lack of Clinically Significant Relationships of Age or Body Mass Index with Merkel Cell Carcinoma Immunotherapy Outcomes. Cancers (Basel) 2024; 16:2480. [PMID: 39001542 PMCID: PMC11240446 DOI: 10.3390/cancers16132480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/02/2024] [Accepted: 07/03/2024] [Indexed: 07/16/2024] Open
Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with a high risk of metastasis. The development of anti-PD-1/PD-L1 immunotherapy has improved outcomes for advanced MCC, yet about 50% of such patients do not achieve durable responses. This study analyzed the effects of age and body mass index (BMI) on immunotherapy response in 183 advanced MCC patients from a single-center longitudinal database. Using Fine-Gray or Cox regression models, treatment response, progression-free survival (PFS), MCC-specific survival, and overall survival (OS) were evaluated. Age showed a significant non-linear relationship with treatment response (p = 0.04), with patients much older or younger than 70 years less likely to respond. However, age was not significantly associated with PFS (p = 0.21), MCC-specific survival (p = 0.72), or OS (p = 0.36). Similarly, BMI was not significantly correlated with treatment response (p = 0.41), PFS (p = 0.52), MCC-specific survival (p = 0.78), or OS (p = 0.71). Unlike previous studies suggesting that obesity and advanced age improve outcomes in other cancers, these associations were not observed in MCC. These findings suggest that age and BMI should not influence eligibility for immunotherapy in MCC patients, emphasizing the importance of unbiased patient selection for this treatment.
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Affiliation(s)
- Rian Alam
- Department of Dermatology, University of Washington, Seattle, WA 98109, USA; (R.A.)
| | - Xinyi Fan
- Fred Hutchinson Cancer Center, Clinical Research Division, Seattle, WA 98109, USA
| | - Daniel S. Hippe
- Fred Hutchinson Cancer Center, Clinical Research Division, Seattle, WA 98109, USA
| | - Lisa M. Tachiki
- Fred Hutchinson Cancer Center, Clinical Research Division, Seattle, WA 98109, USA
- Division of Hematology/Oncology, Department of Medicine, University of Washington, Seattle, WA 98109, USA
| | - Emily Gong
- Department of Dermatology, University of Washington, Seattle, WA 98109, USA; (R.A.)
| | - Emily Huynh
- Department of Dermatology, University of Washington, Seattle, WA 98109, USA; (R.A.)
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA 98901, USA
| | - Paul Nghiem
- Department of Dermatology, University of Washington, Seattle, WA 98109, USA; (R.A.)
| | - Song Youn Park
- Department of Dermatology, University of Washington, Seattle, WA 98109, USA; (R.A.)
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Stang A, Möller L, Wellmann I, Claaßen K, Kajüter H, Ugurel S, Becker JC. Incidence and Relative Survival of Patients with Merkel Cell Carcinoma in North Rhine-Westphalia, Germany, 2008-2021. Cancers (Basel) 2024; 16:2158. [PMID: 38893275 PMCID: PMC11171844 DOI: 10.3390/cancers16112158] [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: 05/17/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND To date, only a few population-representative studies have been carried out on the rare Merkel cell carcinoma (MCC). We provide incidence and survival estimates of MCC, including the conditional relative survival. METHODS We analyzed data from the cancer registry of North Rhine-Westphalia, Germany, 2008-2021, covering a population of 18 million. We included all newly diagnosed MCCs and calculated age-standardized (old European Standard population) incidence rates and unconditional and conditional relative survival. RESULTS Our analysis included 2164 MCC patients. The age-standardized incidence of MCC was 5.2 (men) and 3.8 (women) per million person-years. The 5-year relative survival was 58.8% (men) and 70.7% (women). Survival was lower among men than women in all age-sex groups and was highest for MCC of the upper extremity in both men (68.2%) and women (79.3%). The sex difference in survival is particularly due to the better survival of women with MCC of the head and neck. In terms of survival, the first two years are particularly critical. CONCLUSIONS Our data validate the worse survival among men and highlights a more favorable prognosis for MCCs located on the limbs. The first two years after diagnosis of MCC are the years with the highest excess mortality.
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Affiliation(s)
- Andreas Stang
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
- School of Public Health, Department of Epidemiology, Boston University, 715 Albany St, Boston, MA 02118, USA
- Cancer Registry of North Rhine-Westphalia, Gesundheitscampus 10, 44801 Bochum, Germany; (L.M.); (I.W.); (K.C.); (H.K.)
| | - Lennart Möller
- Cancer Registry of North Rhine-Westphalia, Gesundheitscampus 10, 44801 Bochum, Germany; (L.M.); (I.W.); (K.C.); (H.K.)
| | - Ina Wellmann
- Cancer Registry of North Rhine-Westphalia, Gesundheitscampus 10, 44801 Bochum, Germany; (L.M.); (I.W.); (K.C.); (H.K.)
| | - Kevin Claaßen
- Cancer Registry of North Rhine-Westphalia, Gesundheitscampus 10, 44801 Bochum, Germany; (L.M.); (I.W.); (K.C.); (H.K.)
| | - Hiltraud Kajüter
- Cancer Registry of North Rhine-Westphalia, Gesundheitscampus 10, 44801 Bochum, Germany; (L.M.); (I.W.); (K.C.); (H.K.)
| | - Selma Ugurel
- Department of Dermatology, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany; (S.U.); (J.C.B.)
| | - Jürgen C. Becker
- Department of Dermatology, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany; (S.U.); (J.C.B.)
- German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Hufelandstr. 55, 45147 Essen, Germany
- Translational Skin Cancer Research, University Medicine Essen, Hufelandstr. 55, 45147 Essen, Germany
- Faculty of Biology, University of Duisburg-Essen, Universitätsstrasse S05 T05 B24, 45117 Essen, Germany
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Chen X, Song X, Huang H, Zhang L, Song Z, Yang X, Lei S, Zhai Z. Merkel cell carcinoma overlapping Bowen's disease: two cases report and literature review. J Cancer Res Clin Oncol 2024; 150:217. [PMID: 38668799 PMCID: PMC11052806 DOI: 10.1007/s00432-024-05743-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/04/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin, which mainly occurs in the sun exposed sites of white patients over 65 years, with a higher recurrence and metastasis rate. Clinically, MCC overlapping Bowen's disease (BD) is a very rare subtype of MCC. Few cases in the literature have been described and the management is not well defined. We summarize and update the epidemiology, clinical and histopathological features, metastasis characteristics, local recurrence rate and management of it by presenting two cases of MCC overlapping BD and reviewing the literature over the last 11 years. DESIGN We consulted databases from PubMed, ResearchGate and Google Scholar by MeSh "Merkel cell carcinoma" and "Bowen's disease", "Bowen disease" or "squamous cell carcinoma in situ", from January 2013 to December 2023 and reviewed the literatures. We reported two additional cases. RESULTS Total 13 cases of MCC overlapping BD were retrospectively analyzed, in whom mainly in elderly women over 70 years, the skin lesions were primarily located on the faces, followed by the extremities and trunk. Most of them were asymptomatic, firm, dark red nodules arising on rapidly growing red or dark brown patches, or presenting as isolated nodules. Dermoscopy evaluation was rarely performed in the pre-operative diagnostic setting. All cases were confirmed by histopathology and immunohistochemistry. The most definitive treatment was extended local excision, but local recurrences were common. Of the 13 cases, 4 cases experienced local or distant metastasis. One suffered from an in-transit recurrence of MCC on the ipsilateral leg after local excision and lymph node dissection, whose metastasis completely subsided after avelumab treatment and without recurrence or metastasis during 6 months of follow-up. CONCLUSIONS MCC overlapping BD is a very rare skin tumor mainly predisposed on the faces, with high misdiagnosis rate and recurrence rate. Advanced disease at diagnosis is a poor prognostic factor, suggesting that earlier detection may improve outcome. The acronym, AEIOUN, has been proposed to aid in clinical identification. Our reports and the literature review can provide a better awareness and management of it.
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Affiliation(s)
- Xueqin Chen
- Department of Dermatology, Southwest Hospital, Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Xiao Song
- Department of Dermatology, Southwest Hospital, Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Hui Huang
- Department of Dermatology, Southwest Hospital, Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Lian Zhang
- Department of Dermatology, Southwest Hospital, Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Zhiqiang Song
- Department of Dermatology, Southwest Hospital, Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Xichuan Yang
- Department of Dermatology, Southwest Hospital, Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Shanchuan Lei
- Department of Dermatology, Yongchuan Hospital of Chongqing Medical University, No. 439, Xuanhua Road, Yongchuan District, Chongqing, 402160, China.
| | - Zhifang Zhai
- Department of Dermatology, Southwest Hospital, Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
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Koumaki D, Manios G, Papadakis M, Doxastaki A, Zacharopoulos GV, Katoulis A, Manios A. Color Analysis of Merkel Cell Carcinoma: A Comparative Study with Cherry Angiomas, Hemangiomas, Basal Cell Carcinomas, and Squamous Cell Carcinomas. Diagnostics (Basel) 2024; 14:230. [PMID: 38275477 PMCID: PMC10814937 DOI: 10.3390/diagnostics14020230] [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: 11/19/2023] [Revised: 01/11/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Merkel cell carcinoma (MCC) is recognized as one of the most malignant skin tumors. Its rarity might explain the limited exploration of digital color studies in this area. The objective of this study was to delineate color alterations in MCCs compared to benign lesions resembling MCC, such as cherry angiomas and hemangiomas, along with other non-melanoma skin cancer lesions like basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), utilizing computer-aided digital color analysis. This was a retrospective study where clinical images of the color of the lesion and adjacent normal skin from 11 patients with primary MCC, 11 patients with cherry angiomas, 12 patients with hemangiomas, and 12 patients with BCC/SCC (totaling 46 patients) were analyzed using the RGB (red, green, and blue) and the CIE Lab color system. The Lab color system aided in estimating the Individual Typology Angle (ITA) change in the skin, and these results are documented in this study. It was demonstrated that the estimation of color components can assist in the differential diagnosis of these types of lesions because there were significant differences in color parameters between MCC and other categories of skin lesions such as hemangiomas, common skin carcinomas, and cherry hemangiomas. Significant differences in values were observed in the blue color of RGB (p = 0.003) and the b* parameter of Lab color (p < 0.0001) of MCC versus cherry angiomas. Similarly, the mean a* value of Merkel cell carcinoma (MCC) compared to basal cell carcinoma and squamous cell carcinoma showed a statistically significant difference (p < 0.0001). Larger prospective studies are warranted to further validate the clinical application of these findings.
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Affiliation(s)
- Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, 71110 Heraklion, Greece;
| | - Georgios Manios
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35100 Lamia, Greece;
| | - Marios Papadakis
- Department of Surgery II, Witten/Herdecke University, Heusnerstrasse 40, 42283 Witten, Germany;
| | - Aikaterini Doxastaki
- Dermatology Department, University Hospital of Heraklion, 71110 Heraklion, Greece;
| | | | - Alexander Katoulis
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, 12462 Athens, Greece;
| | - Andreas Manios
- Plastic Surgery Unit, Surgical Oncology Department, University Hospital of Heraklion, 71110 Heraklion, Greece; (G.V.Z.); (A.M.)
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