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Togni L, Furlani M, Belloni A, Riberti N, Giuliani A, Notarstefano V, Santoni C, Giorgini E, Rubini C, Santarelli A, Mascitti M. Biomolecular alterations temporally anticipate microarchitectural modifications of collagen in oral tongue squamous cell carcinoma. iScience 2024; 27:110303. [PMID: 39040062 PMCID: PMC11261445 DOI: 10.1016/j.isci.2024.110303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/03/2024] [Accepted: 06/16/2024] [Indexed: 07/24/2024] Open
Abstract
High resolution analysis of collagen bundles could provide information on tumor onset and evolution. This study was focused on the microarchitecture and biomolecular organization of collagen bundles in oral tongue squamous cell carcinoma (OTSCC). Thirty-five OTSCC biopsy samples were analyzed by synchrotron-based phase-contrast microcomputed tomography and Fourier transform infrared imaging (FTIRI) spectroscopy. PhC-microCT evidenced the presence of reduced and disorganized collagen in the tumor area compared to the extratumoral (ExtraT) one. FTIRI also revealed a reduction of folded secondary structures in the tumor area, and highlighted differences in the peritumoral (PeriT) areas in relation with the OTSCC stage, whereby a significantly lower amount of collagen with less organized fibers was found in the PeriT stroma of advanced-OTSCC stages. Interestingly, no significant morphometrical mismatches were detected in the same region by PhC-microCT analysis. These results suggest that biomolecular alterations in the OTSCC stroma temporally anticipate structural modifications of collagen bundle microarchitecture.
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Affiliation(s)
- Lucrezia Togni
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, via Tronto 10, 60126 Ancona, Italy
| | - Michele Furlani
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, via Tronto 10, 60126 Ancona, Italy
| | - Alessia Belloni
- Department of Life and Environmental Science, Marche Polytechnic University, via Brecce Bianche, Ancona, Italy
| | - Nicole Riberti
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, via dei Vestini 31, 66013 Chieti, Italy
| | - Alessandra Giuliani
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, via Tronto 10, 60126 Ancona, Italy
| | - Valentina Notarstefano
- Department of Life and Environmental Science, Marche Polytechnic University, via Brecce Bianche, Ancona, Italy
| | - Chiara Santoni
- Department of Life and Environmental Science, Marche Polytechnic University, via Brecce Bianche, Ancona, Italy
| | - Elisabetta Giorgini
- Department of Life and Environmental Science, Marche Polytechnic University, via Brecce Bianche, Ancona, Italy
| | - Corrado Rubini
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, via Tronto 10, Ancona, Italy
| | - Andrea Santarelli
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, via Tronto 10, 60126 Ancona, Italy
- Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, via Tronto 10, 60126 Ancona, Italy
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, via Tronto 10, 60126 Ancona, Italy
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Jain PV, Mallick I, Manikantan K, Chatterjee S, Arun I, Roy P, Zameer L, Arun P. Prognostic triad: a novel method for decision-making for adjuvant treatment in stage I-II oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00215-7. [PMID: 39003151 DOI: 10.1016/j.ijom.2024.07.004] [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: 10/27/2023] [Revised: 06/21/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024]
Abstract
This study proposes a scoring system for adjuvant irradiation for stage I/II oral squamous cell carcinoma (OSCC). Derivation cohort (119 patients, operated between 2011 and 2014) and a validation cohort (204 patients, operated between 2016 and 2019) were included. In derivation cohort, on univariate analysis, tumor size >2 cm [3-year Disease Free Survival (DFS) 72.5% vs 95.6%, P = 0.039], lymphovascular invasion (58.3% vs 83.6%, P = 0.024), perineural invasion (75% vs 85.6%, P = 0.013), and depth of invasion ≥0.5 cm (73.8% vs 97.5%, P = 0.017) predicted 3-year DFS. Tongue lesions and poor differentiation were added as poor prognosticators based on previously published reports. Patients were grouped as low risk (<3 risk factors) and high risk (≥3 risk factors), with only high-risk group receiving adjuvant irradiation in validation cohort. Overall, 47/119 (39.5%) patients in the derivation cohort and 50/204 (24.5%) patients in validation cohort received adjuvant irradiation. In derivation cohort, 3-year DFS was 93% and 72.5% in the low and high-risk group, respectively. 3-year DFS was 90.7% and 85.8% in the low and high-risk group, respectively for validation cohort. The proposed scoring system reduced the use of adjuvant irradiation by 38%, with similar DFS.
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Affiliation(s)
- P V Jain
- Department of Head and Neck Surgery, Tata Medical Centre, Kolkata, West Bengal, India.
| | - I Mallick
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - K Manikantan
- Department of Head and Neck Surgery, Tata Medical Centre, Kolkata, West Bengal, India.
| | - S Chatterjee
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - I Arun
- Department of Pathology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - P Roy
- Department of Pathology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - L Zameer
- Department of Pathology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - P Arun
- Department of Head and Neck Surgery, Tata Medical Centre, Kolkata, West Bengal, India.
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Xu Y, Li J, Wang J, Deng F. A novel CAF-cancer cell crosstalk-related gene prognostic index based on machine learning: prognostic significance and prediction of therapeutic response in head and neck squamous cell carcinoma. J Transl Med 2024; 22:645. [PMID: 38982511 PMCID: PMC11234636 DOI: 10.1186/s12967-024-05447-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Cancer-associated fibroblast (CAF)-cancer cell crosstalk (CCCT) plays an important role in tumor microenvironment shaping and immunotherapy response. Current prognostic indexes are insufficient to accurately assess immunotherapy response in patients with head and neck squamous cell carcinoma (HNSCC). This study aimed to develop a CCCT-related gene prognostic index (CCRGPI) for assessing the prognosis and response to immune checkpoint inhibitor (ICI) therapy of HNSCC patients. METHODS Two cellular models, the fibroblast-cancer cell indirect coculture (FCICC) model, and the fibroblast-cancer cell organoid (FC-organoid) model, were constructed to visualize the crosstalk between fibroblasts and cancer cells. Based on a HNSCC scRNA-seq dataset, the R package CellChat was used to perform cell communication analysis to identify gene pairs involved in CCCT. Least absolute shrinkage and selection operator (LASSO) regression was then applied to further refine the selection of these gene pairs. The selected gene pairs were subsequently subjected to stepwise regression to develop CCRGPI. We further performed a comprehensive analysis to determine the molecular and immune characteristics, and prognosis associated with ICI therapy in different CCRGPI subgroups. Finally, the connectivity map (CMap) analysis and molecular docking were used to screen potential therapeutic drugs. RESULTS FCICC and FC-organoid models showed that cancer cells promoted the activation of fibroblasts into CAFs, that CAFs enhanced the invasion of cancer cells, and that CCCT was somewhat heterogeneous. The CCRGPI was developed based on 4 gene pairs: IGF1-IGF1R, LGALS9-CD44, SEMA5A-PLXNA1, and TNXB-SDC1. Furthermore, a high CCRGPI score was identified as an adverse prognostic factor for overall survival (OS). Additionally, a high CCRGPI was positively correlated with the activation of the P53 pathway, a high TP53 mutation rate, and decreased benefit from ICI therapy but was inversely associated with the abundance of various immune cells, such as CD4+ T cells, CD8+ T cells, and B cells. Moreover, Ganetespib was identified as a potential drug for HNSCC combination therapy. CONCLUSIONS The CCRGPI is reliable for predicting the prognosis and immunotherapy response of HSNCC patients and may be useful for guiding the individualized treatment of HNSCC patients.
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Affiliation(s)
- Yuming Xu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China
| | - Junda Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China
| | - Jinming Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China.
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China.
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Cela I, Caponio VCA, Capone E, Pinti M, Mascitti M, Togni L, Lo Muzio L, Rubini C, De Laurenzi V, Lattanzio R, Perrotti V, Sala G. LGALS3BP is a potential target of antibody-drug conjugates in oral squamous cell carcinoma. Oral Dis 2024; 30:2039-2050. [PMID: 37649401 DOI: 10.1111/odi.14719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/29/2023] [Accepted: 08/15/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The aim of the present study was to evaluate the expression of intracellular and vesicular LGALS3BP in oral squamous cell carcinoma (OSCC) patients and available cell lines to explore its potential as a target for antibody-drug conjugate (ADC) therapy. METHODS Free and vesicular LGALS3BP expression levels were evaluated in cancer tissues from a cohort of OSCC patients as well as in a panel of OSCC cell lines through immunohistochemistry, qRT-PCR, Western Blot analysis, and ELISA. RESULTS LGALS3BP resulted in being highly expressed in the cytoplasm of tumour cells in OSCC patient tissues. A strong correlation was found between high LGALS3BP expression levels and aggressive histological features of OSCC. Biochemistry analysis performed on OSCC cell lines showed that LGALS3BP is expressed in all the tested cell lines and highly enriched in cancer-derived extracellular vesicles. Moreover, LGALS3BP high-expressing HOC621 and CAL27 OSCC cell lines showed high sensitivity to the ADC-payload DM4, with an IC50 around 0.3 nM. CONCLUSIONS The present study highlights that LGALS3BP is highly expressed in OSCC suggesting a role as a potential diagnostic biomarker and therapeutic target for ADC-based therapy.
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Affiliation(s)
- Ilaria Cela
- Department of Innovative Technologies in Medicine & Dentistry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | | | - Emily Capone
- Department of Innovative Technologies in Medicine & Dentistry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Morena Pinti
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Lucrezia Togni
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Corrado Rubini
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Vincenzo De Laurenzi
- Department of Innovative Technologies in Medicine & Dentistry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Rossano Lattanzio
- Department of Innovative Technologies in Medicine & Dentistry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Gianluca Sala
- Department of Innovative Technologies in Medicine & Dentistry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Wang S, Li K, Zhao T, Sun Y, Zeng T, Wu Y, Ding L, Huang X, Celentano A, Yang X, Hu Q, Ni Y. Oral tongue squamous cell carcinoma diagnosis from tissue metabolic profiling. Oral Dis 2024; 30:2158-2165. [PMID: 37486619 DOI: 10.1111/odi.14696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/15/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE Disease metabolomes have been studied for identifying diagnostic and predictive biomarkers of pathology. Oral tongue squamous cell carcinoma (OTSCC) is one of the most prevalent subtypes of head and neck squamous cell carcinoma, yet the profile and diagnostic value of its tissue metabolite are unclear. SUBJECTS AND METHODS Tumor tissue samples and matched normal mucosal tissue samples were collected from 40 OTSCC patients. Untargeted metabolic analysis by liquid chromatography-mass spectrometry/mass spectrometry, in positive and negative ion modes, was used to identify dysregulated metabolites in OTSCC. Further, utilizing LASSO regression and receiver operating characteristic analyses, biomarker metabolites were selected and validated, and a diagnostic model was established. RESULTS One hundred and ninety metabolites were detected. The OTSCC had a total of 89 dysregulated metabolites, of which 73 were elevated. A diagnostic panel of nine metabolites was subsequently created that could accurately identify OTSCC with 100% sensitivity of 100%, 100% specificity and an AUC of 1.00. CONCLUSIONS This study identified distinct metabolic characteristics of OTSCC and established a diagnostic model. Our research also contributes to the investigation of the pathogenesis of OTSCC.
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Affiliation(s)
- Shuai Wang
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Ke Li
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Tong Zhao
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yawei Sun
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Tao Zeng
- State Key Lab of Pharmaceutical Biotechnology, College of Life Sciences, Nanjing University, Nanjing, Jiangsu, China
| | - Yan Wu
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Oral Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Liang Ding
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaofeng Huang
- Department of Oral Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Antonio Celentano
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - Xihu Yang
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Qingang Hu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yanhong Ni
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
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Knief J, Herber K, Muenscher A, Thorns C, Moeckelmann N. Tumor-stroma ratio in preoperative biopsies and matched surgical specimens in oral squamous cell carcinoma: Concordance and impact on recurrence-free and overall survival. Pathol Res Pract 2024; 255:155211. [PMID: 38368663 DOI: 10.1016/j.prp.2024.155211] [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: 11/04/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
Stroma-richness is commonly associated with decreased survival times as well as advanced tumor stages in various malignant tumors. A previous study on laryngeal squamous cell carcinomas showed very good agreement for tumor-stroma ratio assessment between pre-treatment biopsies and resection specimens. We therefore aimed to determine whether similar results could be shown for oral squamous cell carcinomas. 107 preoperative biopsies and matched surgical specimens were obtained from the histological archive, dating from 2011-2022. Tumor-stroma ratio was determined on all samples and cases were divided into stroma-rich (≥50% stroma) and stroma-poor (<50% stroma). Results were then correlated with recurrence-free and overall survival. Tumor-stroma ratio showed substantial agreement between preoperative biopsies and surgical specimens with a kappa correlation coefficient of 0.643. Concerning preoperative biopsies, 28 cases were stroma-rich (26.2%), in the group of tumor resections, 32 cases were stroma-rich (29.9%). No association with either recurrence-free or overall survival could be shown for both groups (p-values 0.158-0.495). Concordance between pre-treatment biopsies and resections was substantial in our study, however, as no association with survival times could be demonstrated, the prognostic significance in our cohort remains unclear. This might be attributable to the fact that almost 75% of our patients presented with early-stage tumors, which sometimes seem to show a less pronounced prognostic effect of the tumor-stroma ratio.
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Affiliation(s)
- Juliana Knief
- Department of Pathology, MVZ am Marienkrankenhaus gGmbH, Alfredstraße 9, Hamburg 22087, Germany.
| | - Katrin Herber
- Department of Otorhinolaryngology, Katholisches Marienkrankenhaus gGmbH, Alfredstraße 9, Hamburg 22087, Germany
| | - Adrian Muenscher
- Department of Otorhinolaryngology, Katholisches Marienkrankenhaus gGmbH, Alfredstraße 9, Hamburg 22087, Germany
| | - Christoph Thorns
- Department of Pathology, MVZ am Marienkrankenhaus gGmbH, Alfredstraße 9, Hamburg 22087, Germany
| | - Nikolaus Moeckelmann
- Department of Otorhinolaryngology, Katholisches Marienkrankenhaus gGmbH, Alfredstraße 9, Hamburg 22087, Germany
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Obayashi F, Koizumi K, Ito N, Higaki M, Ishida Y, Hamada A, Yamasaki S, Tani R, Yanamoto S. A Study of the Prognostic Factors for Late Cervical Lymph Node Metastasis and Distant Metastasis in Patients with cT1-2N0 Tongue Cancer. J Clin Med 2024; 13:976. [PMID: 38398289 PMCID: PMC10889310 DOI: 10.3390/jcm13040976] [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: 01/02/2024] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Early-stage tongue cancer has a good prognosis in general; however, high-risk patients with late cervical lymph node and distant metastases have a poor prognosis. Elective neck dissection and postoperative chemoradiotherapy are considered for these patients, although no clear criteria have been identified for their evaluation. Methods: This retrospective observational study aimed to determine the predictive factors for late cervical lymph node and distant metastases in 102 patients with cT1-2N0 tongue cancer. The data regarding the demographic characteristics, as well as the depth of invasion, tumor budding, histological grade, and tumor-stromal ratio, among other things, were extracted from medical records. Results: We found that the potential lymph node metastasis rate was 27.5%. The significant clinical predictors of late cervical lymph node metastasis were the tumor thickness and endophytic growth pattern and the significant histopathological factors were poorly and moderately differentiated tumors and ≥3 tumor buds. In addition, the prognostic factors for distant metastasis included ≥4 lymph node metastases, ≥7 tumor budding, and moderate and poor tumor differentiation. Conclusions: The usefulness of tumor budding as a predictor of metastasis for tongue cancer was suggested. The findings of this study can help establish the criteria for evaluating the metastasis risk and prognosis of patients with tongue cancers.
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Affiliation(s)
- Fumitaka Obayashi
- Department of Oral Oncology, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8553, Japan
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Verma L, Singh K, Pujani M, Jain M, Chandoke R, Agarwal C, Chauhan V, Raychaudhuri S, Jain A. A Correlation of Tumour Budding and Tumour-Stroma Ratio with Clinicopathological Factors in Oral Squamous Cell Carcinoma. Sultan Qaboos Univ Med J 2024; 24:52-57. [PMID: 38434449 PMCID: PMC10906775 DOI: 10.18295/squmj.9.2023.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/01/2023] [Accepted: 08/30/2023] [Indexed: 03/05/2024] Open
Abstract
Objectives This study aimed to analyse the association of tumour budding (TB) and tumour-stroma ratio (TSR) with clinicopathological parameters that can be easily viewed on routine haematoxylin and eosin (H&E)-stained slides to provide an easy and cost-effective method for prognosticating oral squamous cell carcinoma (OSCC). Methods This study was conducted at the ESIC Medical College and Hospital in Faridabad, India, from July 2022 to October 2022. In patients with histologically diagnosed OSCC, TB and TSR were evaluated via routine H&E-stained sections and correlated with clinicopathological parameters. Statistical analysis was performed using Chi-squared test. Results A total of 50 patients were included. The mean age of participants was 61 ± 12.72, and the male-to-female ratio was 7.1:1. Most of the tumours were located on the tongue (46%), followed by the buccal mucosa (26%), gingivobuccal sulcus (12%) and retromolar trigone (8%). The palate and alveolus were the other sites involved, constituting 4% each. TB and TSR were both found to be significantly associated with the tumour grade, lymph node metastasis and tumour size. A highly significant correlation was also found between TB and TSR (P = 0.001). Conclusions Both TB and TSR can be easily evaluated on routine H&E sections; they are highly reproducible and were found to be reliable independent prognostic markers in OSCC. Therefore, this simple and cost-effective method of prognostication, which is currently lacking in clinical practice, will help clinicians to identify patients with poor prognosis and thus individualise their treatment plan.
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Affiliation(s)
| | - Kanika Singh
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Mukta Pujani
- Department of Pathology, ESIC Medical College, Faridabad, India
| | - Manjula Jain
- Department of Pathology, ESIC Medical College, Faridabad, India
| | - R.K. Chandoke
- Department of Pathology, ESIC Medical College, Faridabad, India
| | - Charu Agarwal
- Department of Pathology, ESIC Medical College, Faridabad, India
| | - Varsha Chauhan
- Department of Pathology, ESIC Medical College, Faridabad, India
| | | | - Avani Jain
- Department of Otorhinolaryngology, ESIC Medical College, Faridabad, India
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Silva FFVE, Caponio VCA, Pérez-Sayáns M, Padín-Iruegas ME, Mascitti M, Chamorro-Petronacci CM, Suaréz-Peñaranda JM, Lorenzo-Pouso AI. Tumor budding is a prognostic factor in head and neck squamous cell carcinoma: A comprehensive meta-analysis and trial sequential analysis. Crit Rev Oncol Hematol 2024; 193:104202. [PMID: 37989426 DOI: 10.1016/j.critrevonc.2023.104202] [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: 06/05/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Mortality is linked to tumor budding (TB) in certain neoplasms. TB as a relevant histopathological feature is conditioned by tumor site, a specific study on head and neck squamous cell carcinoma (HNSCC) is needed. METHODS A comprehensive meta-analysis was undertaken to investigate the relationship between TB and HNSCC-related outcomes. RESULTS Overall 42 studies were included. Patients harboring high TB reported an Overall Survival (OS) Hazard Ratio (HR) of 2.63 (95% confidential interval (CI) 2.04-3.39; p-value < 0.001), Disease-free Survival (DFS) HR of 1.88 (95%CI 1.57-2.24; p-value <0.001) and Disease-specific Survival (DSS) HR of 2.14 (95%CI 1.81-2.52; p-value <0.001). Lymph Node Metastasis (LNM) studies harbored null heterogeneity and marked association with TB (Odds Ratio (OR) = 4.48, 95%CI 2.97-6.76; p-value < 0.001). Trial Sequential Analysis (TSA) supported definitive results for DSS. CONCLUSION The study has provided compelling evidence that there is a significant association between TB and a worse prognosis for HNSCC.
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Affiliation(s)
- Fábio França Vieira E Silva
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain
| | | | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain
| | - María Elena Padín-Iruegas
- ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain; Human Anatomy and Embriology Area, Departament of Funcional Biology and Health Sciences, University of Vigo, Lagoas-Marcosende, s/n, 36310 Vigo, Spain.
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Cintia Micaela Chamorro-Petronacci
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain
| | - José Manuel Suaréz-Peñaranda
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain
| | - Alejandro Ismael Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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10
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Tan A, Taskin T. Tumor Budding Should Be in Oral Cavity Cancer Reporting: A Retrospective Cohort Study Based on Tumor Microenvironment. Cancers (Basel) 2023; 15:3905. [PMID: 37568721 PMCID: PMC10416929 DOI: 10.3390/cancers15153905] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/01/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
The utility of histological grading, which is useful in predicting prognosis in many tumors, is controversial for oral squamous cell carcinoma (OSCC). Therefore, new histopathological parameters should be added to histopathology reports of OSCCs. The study aimed to evaluate the parameters of worst invasion pattern (WPOI) and tumor budding in patients with OSCC, to compare them with other histopathological parameters, clinical data and overall survival, and to evaluate these results within the literature. A total of 73 OSCC cases with excisional biopsies were included in this study. WPOI, tumor budding, cell nest size, tumor-stroma ratio, stromal lymphocyte infiltration and stroma type, as well as classical histopathological parameters, were evaluated on hematoxylin-eosin-stained sections. Perineural invasion, lymph node metastases, advanced stage, presence of more than five buds and single cell invasion pattern in univariate survival analyses are characterized by a shortened overall survival time. While there was no significant difference between WPOI results and survival in the survival analysis, WPOI 5 was associated with more frequent lymph node metastasis and advanced stage at the time of diagnosis compared to WPOI 4. We concluded that tumor budding and single-cell invasion should be considered prognostic histopathologic parameters in OSCC.
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Affiliation(s)
- Ayca Tan
- Department of Pathology, Manisa Celal Bayar University, Manisa 45030, Turkey
| | - Toros Taskin
- Department of Pathology, Agri Training and Research Hospital, Agri 04200, Turkey
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11
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Pyo JS, Kim NY, Min KW, Kang DW. Significance of Tumor-Stroma Ratio (TSR) in Predicting Outcomes of Malignant Tumors. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1258. [PMID: 37512068 PMCID: PMC10384099 DOI: 10.3390/medicina59071258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/17/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: The present study aimed to elucidate the distribution and the prognostic implications of tumor-stroma ratio (TSR) in various malignant tumors through a meta-analysis. Materials and Methods: This meta-analysis included 51 eligible studies with information for overall survival (OS) or disease-free survival (DFS), according to TSR. In addition, subgroup analysis was performed based on criteria for high TSR. Results: The estimated rate of high TSR was 0.605 (95% confidence interval (CI) 0.565-0.644) in overall malignant tumors. The rates of high TSR ranged from 0.276 to 0.865. The highest rate of high TSR was found in endometrial cancer (0.865, 95% CI 0.827-0.895). The estimated high TSR rates of colorectal, esophageal, and stomach cancers were 0.622, 0.529, and 0.448, respectively. In overall cases, patients with high TSR had better OS and DFS than those with low TSR (hazard ratio (HR) 0.631, 95% CI 0.542-0.734, and HR 0.564, 95% CI 0.0.476-0.669, respectively). Significant correlations with OS were found in the breast, cervical, colorectal, esophagus, head and neck, ovary, stomach, and urinary tract cancers. In addition, there were significant correlations of DFS in breast, cervical, colorectal, esophageal, larynx, lung, and stomach cancers. In endometrial cancers, high TSR was significantly correlated with worse OS and DFS. Conclusions: The rate of high TSR was different in various malignant tumors. TSR can be useful for predicting prognosis through a routine microscopic examination of malignant tumors.
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Affiliation(s)
- Jung-Soo Pyo
- Department of Pathology, Uijeongbu Eulji University Hospital, Eulji University School of Medicine, Uijeongbu-si 11759, Republic of Korea
| | - Nae Yu Kim
- Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Republic of Korea
| | - Kyueng-Whan Min
- Department of Pathology, Uijeongbu Eulji University Hospital, Eulji University School of Medicine, Uijeongbu-si 11759, Republic of Korea
| | - Dong-Wook Kang
- Department of Pathology, Chungnam National University Sejong Hospital, 20 Bodeum 7-ro, Sejong 30099, Republic of Korea
- Department of Pathology, Chungnam National University School of Medicine, 266 Munhwa Street, Daejeon 35015, Republic of Korea
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12
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Lin YW, Kang WP, Hong CQ, Huang BL, Qiu ZH, Liu CT, Chu LY, Xu YW, Guo HP, Wu FC. Nutritional and immune-related indicators-based Nomogram for predicting overall survival of surgical oral tongue squamous cell carcinoma. Sci Rep 2023; 13:8525. [PMID: 37237026 DOI: 10.1038/s41598-023-35244-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Oral tongue squamous cell carcinoma (OTSCC) is one of the most aggressive oral tumors. The aim of this study was to establish a nomogram to predict overall survival (OS) of TSCC patients after surgery. 169 TSCC patients who underwent surgical treatments in the Cancer Hospital of Shantou University Medical College were included. A nomogram based on Cox regression analysis results was established and internally validated using bootstrap resampling method. pTNM stage, age and total protein, immunoglobulin G, factor B and red blood cell count were identified as independent prognostic factors to create the nomogram. The Akaike Information Criterion and Bayesian Information Criterion of the nomogram were lower than those of pTNM stage, indicating a better goodness-of-fit of the nomogram for predicting OS. The bootstrap-corrected concordance index of nomogram was higher than that of pTNM stage (0.794 vs. 0.665, p = 0.0008). The nomogram also had a good calibration and improved overall net benefit. Based on the cutoff value obtained from the nomogram, the proposed high-risk group had poorer OS than low-risk group (p < 0.0001). The nomogram based on nutritional and immune-related indicators represents a promising tool for outcome prediction of surgical OTSCC.
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Affiliation(s)
- Yi-Wei Lin
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
- Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Wei-Piao Kang
- Department of Otolaryngology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Chao-Qun Hong
- Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
- Department of Oncological Laboratory Research, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Bin-Liang Huang
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
- Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Zi-Han Qiu
- The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Can-Tong Liu
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
- Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Ling-Yu Chu
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
- Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Yi-Wei Xu
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China.
- Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China.
- Guangdong Esophageal Cancer Institute, Shantou University Medical College, Shantou, 515041, China.
| | - Hai-Peng Guo
- Department of Head and Neck Surgery, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China.
| | - Fang-Cai Wu
- Department of Radiation Oncology, the Cancer Hospital of Shantou University Medical College, Shantou, 515041, China.
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13
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Wang S, Si Q, Wu Y, Sun Y, Zhang W, Huang X, Zeng T, Chen S, Yang X, Ni Y, Hu Q. Multiperspective quantitative tumor-stroma ratio reveals histological areas associated with poor outcomes in oral squamous cell carcinoma. Cancer Med 2023. [PMID: 37184217 DOI: 10.1002/cam4.5909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/06/2023] [Accepted: 03/26/2023] [Indexed: 05/16/2023] Open
Abstract
AIMS Different regions of oral squamous cell carcinoma (OSCC) have particular histopathological characteristics, and the individual histological characteristics of the tumors are poorly understood. Therefore, calculating the proportion of tumor cells in different regions that allow assessment of the prognostic outcomes for OSCC patients would be of great clinical significance. METHODS AND RESULTS We established an open-source software-based analytic pipeline that defines the inner tumor and invasive tumor front (ITF) in pancytokeratin-stained whole slide images (WSIs) and quantifies the tumor-stroma ratio (TSR) within the two regions. We applied this method to 114 patients with OSCC and predicted patient prognosis by the TSR. The proportion of tumor area in the inner tumor was generally higher than that in the ITF (p < 0.0001). TSR was an independent prognostic factor for overall survival (OS) (p = 0.016), disease-free survival (DFS) (p = 0.026), and relapse-free survival (RFS) (p = 0.037) in inner tumor, and TSR was an independent prognostic factor for OS (p = 0.00052), DFS (p = 0.035), and metastasis-free survival (MFS) (p = 0.038) in the ITF. Tumor-low status was associated with poorer prognosis. There was a significant correlation between the TSR and perineural invasion (PNI) in the inner tumor (p = 0.009). CONCLUSIONS The histopathological characteristics of different regions of OSCC may be used to develop the potential prognostic markers. The TSR of the inner tumor is more targeted in predicting prognosis and accurately assesses the risk of PNI+.
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Affiliation(s)
- Shuai Wang
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Qian Si
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
- Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Yan Wu
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
- Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Yawei Sun
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Weixian Zhang
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Xiaofeng Huang
- Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Tao Zeng
- State Key Lab of Pharmaceutical Biotechnology, College of Life Sciences, Nanjing University, Nanjing, Jiangsu, China
| | - Sheng Chen
- Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Xihu Yang
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Yanhong Ni
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Qingang Hu
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
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14
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Caponio VCA, Troiano G, Togni L, Zhurakivska K, Santarelli A, Laino L, Rubini C, Lo Muzio L, Mascitti M. Pattern and localization of perineural invasion predict poor survival in oral tongue carcinoma. Oral Dis 2023; 29:411-422. [PMID: 33964054 DOI: 10.1111/odi.13900] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Survival rate for oral tongue squamous cell carcinoma (OTSCC) is still poor and, despite Tumor-Node-Metastasis staging system has been recently updated, patients included under the same stage still show difference in prognosis. Perineural invasion (PNI) emerged to be an indicator of tumor aggressive behavior and unfortunate events. In this study, we investigate the clinic and prognostic value of PNI in a cohort of OTSCC patients. METHODS About 200 patients with OTSCC were retrospectively evaluated the presence of PNI. PNI was furtherly descripted as uni-/multifocal and as intra-/peritumoral. Disease-Specific and Relapse-Free Survival (DSS; RFS) were estimated; moreover, we included PNI in the current AJCC 8th Staging System, improving the prognostication model. RESULTS Perineural invasion was found in 40.5% of patients. Intratumoral PNI predicted patients at high risk of being diagnosed with lymph-node metastasis. Tumors with positive PNI reported a worse DSS (Hazard Ratio=1.878, p-value = 0.008). Moreover, patients exhibiting both multifocal intra- and peritumoral PNI reported poorest DSS (Hazard Ratio = 2.409, p-value = 0.010). Patients were reclassified in a new staging system in case of multifocal PNI, providing better stratification capacity. CONCLUSIONS Perineural invasion might serve as an additional prognostic factor in OTSCC, and by integrating PNI in the staging system, further improvements in prognostication might be reached.
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Affiliation(s)
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lucrezia Togni
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Andrea Santarelli
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy.,Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, Ancona, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Corrado Rubini
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
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15
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Cai L, Li X, Wu L, Wang B, Si M, Tao X. A Prognostic Model Generated from an Apparent Diffusion Coefficient Ratio Reliably Predicts the Outcomes of Oral Tongue Squamous Cell Carcinoma. Curr Oncol 2022; 29:9031-9045. [PMID: 36547122 PMCID: PMC9777250 DOI: 10.3390/curroncol29120708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/07/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
This study aimed to develop an apparent diffusion coefficient (ADC) ratio-based prognostic model to predict the recurrence and disease-free survival (DFS) of oral tongue squamous cell carcinoma (OTSCC). A total of 188 patients with cT1-2 oral tongue squamous cell carcinoma were enrolled retrospectively. Clinical and laboratory data were extracted from medical records. The ADC values were measured at the regions of interest of the tumor and non-tumor tissues of the MRI images, and the ADC ratio was used for comparison between the patient with recurrence (n = 83 case, 44%) and patients without recurrence (n = 105 cases, 56%). Cox proportional hazards models were generated to analyze the risk factors of cancer recurrence. A nomogram was developed based on significant risk factors to predict 1-, 5- and 10-year DFS. The receiver operator characteristic (ROC) curves of predictors in the multivariable Cox proportional hazards prognostic model were generated to predict the recurrence and DFS. The integrated areas under the ROC curve were calculated to evaluate discrimination of the models. The ADC ratio, tumor thickness and lymph node ratio were reliable predictors in the final prognostic model. The final model had a 71.1% sensitivity and an 81.0% specificity. ADC ratio was the strongest predictor of cancer recurrence in prognostic performance. Discrimination and calibration statistics were satisfactory with C-index above 0.7 for both model development and internal validation. The calibration curve showed that the 5- and 10-year DFS predicted by the nomogram agreed with actual observations.
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Affiliation(s)
- Lingling Cai
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Xiaoguang Li
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Disease, Shanghai 201999, China
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Lizhong Wu
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Bocheng Wang
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Mingjue Si
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
- Correspondence: (M.S.); (X.T.)
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
- Correspondence: (M.S.); (X.T.)
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16
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Insight into Classification and Risk Stratification of Head and Neck Squamous Cell Carcinoma in Era of Emerging Biomarkers with Focus on Histopathologic Parameters. Cancers (Basel) 2022; 14:cancers14225514. [PMID: 36428607 PMCID: PMC9688658 DOI: 10.3390/cancers14225514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/04/2022] [Accepted: 11/05/2022] [Indexed: 11/12/2022] Open
Abstract
Tumor-node-metastasis (TNM) staging system is the cornerstone for treatment planning of head and neck squamous cell carcinoma (HNSCC). Many prognostic biomarkers have been introduced as modifiers to further improve the TNM classification of HNSCC. Here, we provide an overview on the use of the recent prognostic biomarkers, with a focus on histopathologic parameters, in improving the risk stratification of HNSCC and their application in the next generation of HNSCC staging systems.
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17
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Tumor-stroma ratio can predict lymph-node metastasis in cT1/2N0 oral tongue squamous cell carcinoma independent of tumor budding grade. Int J Clin Oncol 2022; 27:1818-1827. [PMID: 36197545 DOI: 10.1007/s10147-022-02249-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 09/24/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND cT1/2 oral tongue squamous cell carcinoma (OTSCC) often metastasizes to cervical lymph nodes. However, predicting neck lymph-node metastasis (NLM) remains challenging. Pathomorphological evaluation of tumor budding grade (TBG) and tumor-stroma ratio (TSR) reportedly can predict lymph-node metastases. Hence, this study aimed to evaluate TBG and TSR in OTSCC and investigate their relationship to occult NLM and cancer relapse. METHODS Clinicopathological data of patients with cT1/2N0 OTSCC treated at the University of Tokyo Hospital between 2007 and 2017 were collected. TBG and TSR were evaluated using hematoxylin-eosin staining and cytokeratin AE1/AE3 immunostaining. RESULTS Out of 70 patients, 16 underwent elective neck dissection in addition to primary-tumor resection, whereas 54 did not. During follow-up, NLM was found in 35 patients. NLM correlated with the pathological depth of invasion (pDOI) (p < 0.001), TBG (p = 0.008), and TSR (p < 0.001) in univariate analysis and pDOI (p = 0.01) and TSR (p = 0.02) in multivariate analysis. The 5-year recurrence-free survival rate (RFS) was 78% for patients with a pDOI ≤ 5 mm and stroma-poor tumors and 33% for patients with a pDOI > 5 mm and stroma-rich tumors. CONCLUSION Patients with a pDOI > 5 mm and stroma-rich tumors have a high risk for cancer relapse. TSR and pDOI may be promising NLM predictors in cT1/2N0 OTSCC.
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18
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Ablahad AA, Mousa HD, Jalal JA. Novel Correlations among the Histopathological Components of Oral Squamous Cell Carcinoma. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Oral squamous cell carcinoma (OSCC) is an aggressive tumor with high mortality and morbidity rates.
Aims:In this study, we aimed to probe whether there is association between stromal histopathological parameters with patient data, as well as, the correlation of these parameters with each other.
MaterialsandMethods:This study was performed at University of Duhok, College of Dentistry, the practical section was carried out between February 2022 and June 2022 as follow:A group of 86 formalin fixed paraffin embedded (FFPE) samples of OSCC and 20 FFPE samplesof healthy gingiva were stained with Hematoxylin and eosin(H&E) and Mason’s trichrome (MT)stains. Tumor/ stroma ratio(TSR), stromal tumor-infiltrating lymphocytes(sTIL), budding activity (BA), cell nest size (CNS), orientation and packing of collagen fibers and collagen fibercontent(CFC) were evaluated. These histomorphological parameters were correlated with clinicopathological characteristics and with each other.
Statistical Analysis Used: Chi square test, fisher exacts test and spearman’s rank correlation coefficient were used for analyzing our study data.
Results: Tumor/ stroma ratio, BA, CNS, orientation and packing of collagen fibers, and CFC were significantly associated with pT stage of the tumor. Moreover, significant correlations were observed among TSR, BA, CNS and CFC. In addition, orientation and packing of collagen fibers were significantly correlated with each other.
Conclusions: Novel correlations were found between collagen fiber features with TSR, BA, and CNS in an easy and cost- effective methods.
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19
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The Emerging Impact of Tumor Budding in Oral Squamous Cell Carcinoma: Main Issues and Clinical Relevance of a New Prognostic Marker. Cancers (Basel) 2022; 14:cancers14153571. [PMID: 35892830 PMCID: PMC9332070 DOI: 10.3390/cancers14153571] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023] Open
Abstract
Tumor Budding (TB) represents a single cancer cell or a small cluster of less than five cancer cells on the infiltrative tumor front. Accumulating evidence suggests TB is an independent prognostic factor in oral squamous cell carcinoma (OSCC). However, its exact role is not yet elucidated, and a standardized scoring system is still necessary. The study aims to extensively review the literature data regarding the prognostic role of TB in OSCC. The results of TB are an independent prognostic factor of poor survival outcomes in OSCC. To date, the manual detection of hematoxylin and eosin-staining or pancytokeratin-immunostaining sections are the most commonly used methods. Between the several cut-offs, the two-tier system with five buds/field cut-offs provides better risk stratification. The prognostic role of the BD model in predicting survival outcomes was extensively validated; however, the inclusion of DOI, which is already a staging parameter, encouraged other authors to propose other models, integrating TB count with other adverse risk factors, such as the tumor–stroma ratio and tumor-infiltrated lymphocytes. The prognostic relevance of TB in OSCC highlights its evaluation in daily pathological practice. Therefore, the TB detection method and the TB scoring system should be validated based on tumor stage and site.
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20
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Elseragy A, Bello IO, Wahab A, Coletta RD, Mäkitie AA, Leivo I, Almangush A, Salo T. Emerging histopathologic markers in early-stage oral tongue cancer: A systematic review and meta-analysis. Head Neck 2022; 44:1481-1491. [PMID: 35229398 PMCID: PMC9545479 DOI: 10.1002/hed.27022] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022] Open
Abstract
Although there are many histopathologic prognosticators, grading of early oral tongue squamous cell carcinoma (OTSCC) is still based on morphological cell differentiation which has low prognostic value. Here we summarize the emerging histopathological markers showing powerful prognostic value, but are not included in pathology reports. Using PubMed, Scopus, Ovid Medline, and Web of Science databases, a systematic literature search was preformed to identify early OTSCC studies that investigated the prognostic significance of hematoxylin–eosin‐based histopathologic markers. Our meta‐analysis showed that tumor budding was associated with overall survival (hazard ratio [HR] 2.32; 95% CI 1.40–3.84; p < 0.01) and disease‐specific survival (DSS) (1.89; 95% CI 1.13–3.15; p = 0.02). Worst pattern of invasion was associated with disease‐free survival (DFS) (1.95; 95% CI 1.04–3.64; p = 0.04). Tumor–stroma ratio was also associated with DFS (1.75, 95% CI 1.24–2.48; p < 0.01) and DSS (1.69; 95% CI 1.19–2.42; p < 0.01). Tumor budding, worst pattern of invasion, and tumor–stroma ratio have a promising prognostic value in early OTSCC. The evaluation and reporting of these markers is cost‐effective and can be incorporated in daily practice.
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Affiliation(s)
- Amr Elseragy
- Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Ibrahim O Bello
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Department of Oral Medicine and Diagnostic Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Awais Wahab
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil.,Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland.,Turku University Central Hospital, Turku, Finland
| | - Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Institute of Biomedicine, Pathology, University of Turku, Turku, Finland.,Faculty of Dentistry, Misurata University, Misurata, Libya
| | - Tuula Salo
- Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland
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21
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Noda Y, Ishida M, Ueno Y, Fujisawa T, Iwai H, Tsuta K. Novel pathological predictive factors for extranodal extension in oral squamous cell carcinoma: a retrospective cohort study based on tumor budding, desmoplastic reaction, tumor-infiltrating lymphocytes, and depth of invasion. BMC Cancer 2022; 22:402. [PMID: 35418058 PMCID: PMC9006434 DOI: 10.1186/s12885-022-09393-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/09/2022] [Indexed: 12/24/2022] Open
Abstract
Background Extranodal extension (ENE) is a poor prognostic factor for oral squamous cell carcinoma (OSCC). Identifying ENE by clinical and/or radiological examination is difficult, thereby leading to unnecessary neck dissections. Currently, no definitive predictors are available for ENE. Thus, we aimed to determine the histological predictors of ENE by routine histopathological examination using biopsy and surgically resected specimens. Methods This retrospective study included 186 surgically resected OSCC and 83 matched biopsy specimens. Clinical features associated with the tumor microenvironment, including desmoplastic reaction (DR), tumor budding (TB), and tumor-infiltrating lymphocytes (TILs), were evaluated using hematoxylin and eosin-stained primary OSCC and neck dissection specimens. These histological features were divided into two groups: DR-immature (DR-I) and DR-mature (DR-M); TB-high (TB-H) and TB-low (TB-L); and TILs-low (TILs-L) and TILs-high (TILs-H). Clinical depth of invasion (cDOI) and pathological DOI (pDOI) were adapted for biopsies and resections, respectively; DOI was evaluated as DOI > 10 mm and DOI ≤ 10 mm. The clinicopathological relationships between these histopathological features and ENE and the independent risk factors for ENE were analyzed. The histological predictors of ENE were evaluated. Results The histological status of DR, TILs, and TB present in biopsy and resection specimens showed high accuracy with that of ENE. DR-I, TILs-L, and TB-H were significantly associated with lymph node metastasis, cDOI, and pDOI. Bivariate and multivariate analyses revealed that TB-H and pDOI > 10 mm in resections were independent factors for the presence of ENE (ENE +). The combination of TB-H/pDOI > 10 mm in resection specimens showed high specificity (91%) and accuracy (83%) regarding ENE + . Although there proved to be no independent factors in biopsies, DR-I and TILs-L were significantly associated with ENE + (p < 0.001). The combination of DR-I/TILs-L/cDOI > 10 mm in biopsies exhibited high sensitivity and specificity with ENE + (70% and 77%, respectively, p < 0.001). These histological predictors could detect even minor ENE (< 2 mm). Conclusions The tumor microenvironment status in primary OSCC was significantly associated with that of ENE, and TB-H was an independent risk factor for ENE. The histological status of DR-I/TILs-L/cDOI > 10 mm in biopsy specimens and TB-H/pDOI > 10 mm in resection specimens is a useful predictor of ENE. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09393-8.
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Affiliation(s)
- Yuri Noda
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
| | - Mitsuaki Ishida
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Yasuhiro Ueno
- Department of Radiology, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan
| | - Takuo Fujisawa
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan
| | - Hiroshi Iwai
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan
| | - Koji Tsuta
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
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22
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Jingjian Q, Jiang E, Shang Z. Prognostic value of tumor-stroma ratio in oral carcinoma: role of cancer associated fibroblasts. Oral Dis 2022. [PMID: 35388593 DOI: 10.1111/odi.14203] [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: 02/15/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Tumor-stroma Ratio(TSR) is a promising parameter representing the abundance of the stroma which has been validated in many solid tumors. However, it is still not clear which part of stroma mainly contribute to the prognostic value of TSR. The aim of this study is to confirm the prognostic value of TSR in a large cohort of oral squamous cell carcinoma (OSCC) and further demonstrated that cancer associated fibroblasts (CAFs)-stroma ratio (CSR) contributed to the prognostic value of TSR. MATERIALS AND METHODS TSR was evaluated on hematoxylin and eosin-stained tissue samples from 581 patients with OSCC, which divides patients into high (>50%) and low (<50%) stroma. Then, CSR was estimated on immunohistochemical staining slides of 100 patients selected from 581patients. RESULTS In multivariate analysis, TSR was identified as an independent prognostic factor for disease-free survival (DFS) (P < 0.001) and oral cancer-specific survival (OCSS) (P < 0.001). The interaction term reached statistical significance for histological grade for DFS and OCSS separately. Furthermore, the high-stroma group had a higher CSR than the low-stroma group. CONCLUSION The prognostic value of TSR is validated in OSCC particularly in moderate and high differentiation. And CSR palys its part in the prognosis of TSR.
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Affiliation(s)
- Qiu Jingjian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine of Ministry of education (KLOBM), School & Hospital of Stomatology, Wuhan University, Wuhan, 430089, China
| | - Erhui Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine of Ministry of education (KLOBM), School & Hospital of Stomatology, Wuhan University, Wuhan, 430089, China.,Department of Oral and Maxillofacial-Head and Neck Oncology, School of Stomatology-Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhengjun Shang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine of Ministry of education (KLOBM), School & Hospital of Stomatology, Wuhan University, Wuhan, 430089, China.,Department of Oral and Maxillofacial-Head and Neck Oncology, School of Stomatology-Hospital of Stomatology, Wuhan University, Wuhan, China
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23
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Meyer HJ, Höhn AK, Surov A. Associations Between ADC and Tumor Infiltrating Lymphocytes, Tumor-Stroma Ratio and Vimentin Expression in Head and Neck Squamous Cell Cancer. Acad Radiol 2022; 29 Suppl 3:S107-S113. [PMID: 34217611 DOI: 10.1016/j.acra.2021.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 12/23/2022]
Abstract
RATIONALE AND OBJECTIVES The present study used diffusion-weighted imaging (DWI) to elucidate possible associations with tumor-infiltrating lymphocytes (TIL), tumor-stroma ratio and vimentin expression in head and neck squamous cell cancer (HNSCC). MATERIALS AND METHODS 30 patients with primary HNSCC of different localizations were involved in the study. DWI was obtained on a 3 T scanner. Apparent diffusion coefficients (ADC) images were analyzed with a whole lesion measurement using a histogram approach. TIL- and vimentin-expression was calculated on biopsy samples before any form of treatment. RESULTS Tumor-stroma ratio correlated with ADC kurtosis (r = 0.46, p = 0.01) and ADC skewness (r = 0.42, p = 0.02). Several ADC parameters were significantly different between stroma rich und tumor rich tumors. ADC entropy correlated significantly with the expression of TIL within the tumor compartment (r = 0.44, p = 0.01). No associations were identified between ADC parameters and vimentin expression. CONCLUSION ADC skewness and kurtosis histogram parameters can reflect tumor compartments in HNSCC. ADC entropy was associated with TIL of the tumor compartment but not with those of the stroma compartment, which emphasizes the ability of ADC histogram parameters to reflect distinctive differences of tumors.
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24
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Lin YW, Kang WP, Huang BL, Qiu ZH, Wei LF, Zhang B, Ding TY, Luo Y, Liu CT, Chu LY, Guo HP, Xu YW, Peng YH. Nomogram based on clinical characteristics and serological inflammation markers to predict overall survival of oral tongue squamous cell carcinoma patient after surgery. BMC Oral Health 2021; 21:667. [PMID: 34961504 PMCID: PMC8711158 DOI: 10.1186/s12903-021-02028-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/14/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Oral tongue squamous cell carcinoma (OTSCC) is a prevalent malignant disease that is characterized by high rates of metastasis and postoperative recurrence. The aim of this study was to establish a nomogram to predict the outcome of OTSCC patients after surgery. METHODS We retrospectively analyzed 169 OTSCC patients who underwent treatments in the Cancer Hospital of Shantou University Medical College from 2008 to 2019. The Cox regression analysis was performed to determine the independent prognostic factors associated with patient's overall survival (OS). A nomogram based on these prognostic factors was established and internally validated using a bootstrap resampling method. RESULTS Multivariate Cox regression analysis revealed the independent prognostic factors for OS were TNM stage, age, lymphocyte-to-monocyte ratio and immunoglobulin G, all of which were identified to create the nomogram. The Akaike Information Criterion and Bayesian Information Criterion of the nomogram were lower than those of TNM stage (292.222 vs. 305.480; 298.444 vs. 307.036, respectively), indicating a better goodness-of-fit of the nomogram for predicting OS. The bootstrap-corrected of concordance index (C-index) of nomogram was 0.784 (95% CI 0.708-0.860), which was higher than that of TNM stage (0.685, 95% CI 0.603-0.767, P = 0.017). The results of time-dependent C-index for OS also showed that the nomogram had a better discriminative ability than that of TNM stage. The calibration curves of the nomogram showed good consistency between the probabilities and observed values. The decision curve analysis also revealed the potential clinical usefulness of the nomogram. Based on the cutoff value obtained from the nomogram, the proposed high-risk group had poorer OS than low-risk group (P < 0.0001). CONCLUSIONS The nomogram based on clinical characteristics and serological inflammation markers might be useful for outcome prediction of OTSCC patient.
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Affiliation(s)
- Yi-Wei Lin
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Wei-Piao Kang
- Department of Otolaryngology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Bin-Liang Huang
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Zi-Han Qiu
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Lai-Feng Wei
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Biao Zhang
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Tian-Yan Ding
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Yun Luo
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Can-Tong Liu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Ling-Yu Chu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Hai-Peng Guo
- Department of Head and Neck Surgery, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
| | - Yi-Wei Xu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
| | - Yu-Hui Peng
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
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25
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Liu YH, Chen YL, Lai TY, Ko YC, Chou YF, Chen PR, Hsiao JR, Chang JY, Shiah SG, Lee JW, Yang JL, Lin SF. Identification of Prognostic Biomarkers Originating From the Tumor Stroma of Betel Quid-Associated Oral Cancer Tissues. Front Oncol 2021; 11:769665. [PMID: 34869001 PMCID: PMC8637169 DOI: 10.3389/fonc.2021.769665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/29/2021] [Indexed: 01/06/2023] Open
Abstract
Background Partial epithelial-mesenchymal transition (p-EMT) is a distinct clinicopathological feature prevalent in oral cavity tumors of The Cancer Genome Atlas. Located at the invasion front, p-EMT cells require additional support from the tumor stroma for collective cell migration, including track clearing, extracellular matrix remodeling and immune evasion. The pathological roles of otherwise nonmalignant cancer-associated fibroblasts (CAFs) in cancer progression are emerging. Methods Gene set enrichment analysis was used to reveal differentially enriched genes and molecular pathways in OC3 and TW2.6 xenograft tissues, representing mesenchymal and p-EMT tumors, respectively. R packages of genomic data science were executed for statistical evaluations and data visualization. Immunohistochemistry and Alcian blue staining were conducted to validate the bioinformatic results. Univariate and multivariate Cox proportional hazards models were performed to identify covariates significantly associated with overall survival in clinical datasets. Kaplan–Meier curves of estimated overall survival were compared for statistical difference using the log-rank test. Results Compared to mesenchymal OC3 cells, tumor stroma derived from p-EMT TW2.6 cells was significantly enriched in microvessel density, tumor-excluded macrophages, inflammatory CAFs, and extracellular hyaluronan deposition. By translating these results to clinical transcriptomic datasets of oral cancer specimens, including the Puram single-cell RNA-seq cohort comprising ~6000 cells, we identified the expression of stromal TGFBI and HYAL1 as independent poor and protective biomarkers, respectively, for 40 Taiwanese oral cancer tissues that were all derived from betel quid users. In The Cancer Genome Atlas, TGFBI was a poor marker not only for head and neck cancer but also for additional six cancer types and HYAL1 was a good indicator for four tumor cohorts, suggesting common stromal effects existing in different cancer types. Conclusions As the tumor stroma coevolves with cancer progression, the cellular origins of molecular markers identified from conventional whole tissue mRNA-based analyses should be cautiously interpreted. By incorporating disease-matched xenograft tissue and single-cell RNA-seq results, we suggested that TGFBI and HYAL1, primarily expressed by stromal CAFs and endothelial cells, respectively, could serve as robust prognostic biomarkers for oral cancer control.
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Affiliation(s)
- Yi-Hong Liu
- Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan.,National Institute of Cancer Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Yu-Lian Chen
- National Institute of Cancer Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Ting-Yu Lai
- National Institute of Cancer Research, National Health Research Institutes, Miaoli County, Taiwan.,Institute of Bioinformatics and Structural Biology, National Tsing Hua University, Hsinchu, Taiwan
| | - Ying-Chieh Ko
- National Institute of Cancer Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Yu-Fu Chou
- Department of Otolaryngology, Tzu Chi University Hospital, Hualien, Taiwan
| | - Peir-Rong Chen
- Department of Otolaryngology, Tzu Chi University Hospital, Hualien, Taiwan
| | - Jenn-Ren Hsiao
- Department of Otolaryngology, Head and Neck Collaborative Oncology Group, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jang-Yang Chang
- National Institute of Cancer Research, National Health Research Institutes, Miaoli County, Taiwan.,Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Shine-Gwo Shiah
- National Institute of Cancer Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Jeng-Woei Lee
- Department of Life Sciences, Tzu Chi University, Hualien, Taiwan
| | - Jia-Ling Yang
- Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan
| | - Su-Fang Lin
- National Institute of Cancer Research, National Health Research Institutes, Miaoli County, Taiwan
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26
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Meyer HJ, Höhn AK, Surov A. Associations between dynamic-contrast enhanced MRI and tumor infiltrating lymphocytes and tumor-stroma ratio in head and neck squamous cell cancer. Cancer Imaging 2021; 21:60. [PMID: 34801089 PMCID: PMC8606096 DOI: 10.1186/s40644-021-00429-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/01/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives The present study used dynamic-contrast enhanced MRI (DCE-MRI) to elucidate possible associations with tumor-infiltrating lymphocytes (TIL), stroma ratio and vimentin expression in head and neck squamous cell cancer (HNSCC). Methods Overall, 26 patients with primary HNSCC of different localizations were involved in the study. DCE-MRI was obtained on a 3 T MRI and analyzed with a whole lesion measurement using a histogram approach. TIL- and vimentin-expression was calculated on bioptic samples before any form of treatment. P16 staining was used to define HPV-status. Results Tumor-stroma ratio correlated with entropy derived from Ktrans (r = − 0.52, p = 0.0071) and with kurtosis derived from Ve (r = − 0.53, p = 0.0058). Several Ve derived parameters correlated with expression of TIL within the stroma compartment. TIL within the tumor compartment correlated with entropy derived from Ktrans (r = 0.39, p = 0.047), p90 derived from Ve (r = 0.41, p = 0.036) and skewness derived from Ve (r = 0.41, p = 0.037). Furthermore, these associations were different between HPV positive and negative tumors. Conclusions DCE-MRI might be able to reflect tumor compartments and TIL expression in HNSCC. The most promising parameters were values derived from Ktrans and Ve.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany.
| | | | - Alexey Surov
- Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
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27
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Togni L, Mascitti M, Sartini D, Campagna R, Pozzi V, Salvolini E, Offidani A, Santarelli A, Emanuelli M. Nicotinamide N-Methyltransferase in Head and Neck Tumors: A Comprehensive Review. Biomolecules 2021; 11:1594. [PMID: 34827592 PMCID: PMC8615955 DOI: 10.3390/biom11111594] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 12/31/2022] Open
Abstract
The head and neck tumors (HNT) are a heterogeneous group of diseases ranging from benign to malignant lesions, with distinctive molecular and clinical behaviors. Several studies have highlighted the presence of an altered metabolic phenotype in HNT, such as the upregulation of nicotinamide N-methyltransferase (NNMT). However, its biological effects have not been completely disclosed and the role of NNMT in cancer cell metabolism remains unclear. Therefore, this comprehensive review aims to evaluate the available literature regarding the biological, diagnostic, and prognostic role of NNMT in HNT. NNMT was shown to be significantly overexpressed in all of the evaluated HNT types. Moreover, its upregulation has been correlated with cancer cell migration and adverse clinical outcomes, such as high-pathological stage, lymph node metastasis, and locoregional recurrences. However, in oral squamous cell carcinoma (OSCC) these associations are still debated, and several studies have failed to demonstrate the prognostic significance of NNMT. The shRNA-mediated gene silencing efficiently suppressed the NNMT gene expression and exhibited a clear inhibitory effect on cell proliferation, promoting the expression of apoptosis-related proteins and modulating the cell cycle. NNMT could represent a new molecular biomarker and a new target of molecular-based therapy, although further studies on larger patient cohorts are needed to explore its biological role in HNT.
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Affiliation(s)
- Lucrezia Togni
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (D.S.); (R.C.); (V.P.); (E.S.); (M.E.)
| | - Marco Mascitti
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (D.S.); (R.C.); (V.P.); (E.S.); (M.E.)
| | - Davide Sartini
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (D.S.); (R.C.); (V.P.); (E.S.); (M.E.)
| | - Roberto Campagna
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (D.S.); (R.C.); (V.P.); (E.S.); (M.E.)
| | - Valentina Pozzi
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (D.S.); (R.C.); (V.P.); (E.S.); (M.E.)
| | - Eleonora Salvolini
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (D.S.); (R.C.); (V.P.); (E.S.); (M.E.)
| | - Annamaria Offidani
- Department of Clinical and Molecular Sciences, Marche Polytechnic University, 60126 Ancona, Italy;
| | - Andrea Santarelli
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (D.S.); (R.C.); (V.P.); (E.S.); (M.E.)
- Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, 60126 Ancona, Italy
| | - Monica Emanuelli
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (D.S.); (R.C.); (V.P.); (E.S.); (M.E.)
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28
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Togni L, Mascitti M, Vignigni A, Alia S, Sartini D, Barlattani A, Emanuelli M, Santarelli A. Treatment-Related Dysgeusia in Oral and Oropharyngeal Cancer: A Comprehensive Review. Nutrients 2021; 13:nu13103325. [PMID: 34684326 PMCID: PMC8536976 DOI: 10.3390/nu13103325] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 01/23/2023] Open
Abstract
Oral cancer is the most common tumor of the head and neck region. Its management is based on surgical and systemic therapies. Taste disorders represent the most common side effect of these treatments; indeed, dysgeusia is noted by 70% of oral cancer patients. Despite survival remaining the primary endpoint of cancer patients, taste impairments can cause psychological distress. This comprehensive review describes the last decade’s knowledge from the literature regarding taste alterations in patients with oral and oropharyngeal squamous cell carcinoma. A total of 26 articles in English, including prospective, cross-sectional, and case–control studies, and clinical trials were evaluated. Literature analysis shows that anti-cancer treatments can destroy taste cells, decrease and alter their receptors, and interrupt nerve transmission. Furthermore, the tumour itself can destroy the oral mucosal lining, which encloses the taste buds. Dysgeusia typically occurs in 3–4 weeks of treatments, and usually taste sensation is recovered within 3–12 months. However, some patients exhibit incomplete or no recovery, even several years later. Thus, dysgeusia can become a chronic issue and negatively influence patients’ quality of life, worsening their dysphagia and their nutritional status. Physicians should be focused on preventing oncological treatment-related symptoms, offering the most suitable personalized support during therapy.
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Affiliation(s)
- Lucrezia Togni
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (S.A.); (D.S.); (M.E.); (A.S.)
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (S.A.); (D.S.); (M.E.); (A.S.)
| | - Arianna Vignigni
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (S.A.); (D.S.); (M.E.); (A.S.)
- Correspondence: ; Tel.: +39-0712204675
| | - Sonila Alia
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (S.A.); (D.S.); (M.E.); (A.S.)
| | - Davide Sartini
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (S.A.); (D.S.); (M.E.); (A.S.)
| | - Alberta Barlattani
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University, 00133 Rome, Italy;
| | - Monica Emanuelli
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (S.A.); (D.S.); (M.E.); (A.S.)
| | - Andrea Santarelli
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.T.); (M.M.); (S.A.); (D.S.); (M.E.); (A.S.)
- Dentistry Clinic: National Institute of Health and Science of Aging, IRCCS INRCA, 60124 Ancona, Italy
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Silveyra E, Bologna-Molina R, Gónzalez-Gónzalez R, Arocena M. The Tissue Architecture of Oral Squamous Cell Carcinoma Visualized by Staining Patterns of Wheat Germ Agglutinin and Structural Proteins Using Confocal Microscopy. Cells 2021; 10:cells10092466. [PMID: 34572115 PMCID: PMC8465371 DOI: 10.3390/cells10092466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Tissue architecture and cell morphology suffer profound alterations during oral cancer and are important markers for its progression and outcome. For precise visualization of tissue architecture in oral cancer, we used confocal microscopy to examine the staining pattern of wheat germ agglutinin, a lectin that binds membrane glycoproteins, and the staining patterns of structural proteins. MATERIALS AND METHODS Paraffin sections of oral squamous cell carcinoma were stained with fluorescently labeled wheat germ agglutinin and with antibodies against structural proteins, which were revealed by immunohistochemistry with tyramide signal amplification. RESULTS Membrane localization of wheat germ agglutinin was markedly decreased in the basal layers and in regions of tumor invasion, accompanied by cytoplasmic redistribution of E-cadherin, β-actin and syndecan-1. Wheat germ agglutinin staining clearly identified tumor clusters within the surrounding stroma, and tumor cells with elongated morphology. CONCLUSIONS Our results suggest that the wheat germ agglutinin staining pattern is indicative of the degree of cell cohesion in oral squamous cell carcinoma, which decreases in basal layers and invasive tumor clusters with more migratory morphologies. Wheat germ agglutinin staining in combination with confocal microscopy could constitute, therefore, a valuable tool for the study of tissue architecture in oral cancer.
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Affiliation(s)
- Estefania Silveyra
- Molecular Pathology, School of Dentistry Universidad de la República (UDELAR), Las Heras 1925, Montevideo 14600, Uruguay;
| | - Ronell Bologna-Molina
- Molecular Pathology, School of Dentistry Universidad de la República (UDELAR), Las Heras 1925, Montevideo 14600, Uruguay;
- Correspondence: (R.B.-M.); or (M.A.)
| | - Rogelio Gónzalez-Gónzalez
- Department of Research, School of Dentistry, Universidad Juárez del Estado de Durango, Durango 34070, Mexico;
| | - Miguel Arocena
- Biochemistry and Biophysics, School of Dentistry Universidad de la República (UDELAR), Las Heras 1925, Montevideo 14600, Uruguay
- Genomics Department, Instituto de Investigaciones Biológicas Clemente Estable (IIBCE), Montevideo 11600, Uruguay
- Correspondence: (R.B.-M.); or (M.A.)
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Saint A, Van Obberghen-Schilling E. The role of the tumor matrix environment in progression of head and neck cancer. Curr Opin Oncol 2021; 33:168-174. [PMID: 33720067 DOI: 10.1097/cco.0000000000000730] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Head and neck squamous cell carcinoma (HNSCC) tissue is composed of multiple cell types embedded in an extracellular matrix (ECM) that actively participates in disease progression, spread and treatment response. In this review, we provide an update of our current knowledge about the ECM landscape of HNSCC, its functions, methods of analysis, and nonimmunological stromal targeting strategies that modify the tumor ECM to improve conventional and emerging therapies. RECENT FINDINGS The tumor ECM differs significantly from that of normal tissue in abundance, composition, organization and mechanical properties. In HNSCC, signaling between malignant epithelial cells and stromal cells prompts the upregulation of a set of ECM components that serve as substrates for carcinoma cell migration, modulate the cytokine environment and promote immune evasion in these tumors. Advanced imaging techniques and molecular profiling at the single-cell level have provided valuable insights into our understanding of the tumor ECM and its role in malignancy, and opened new avenues for predictive and potentially actionable biomarker discovery for more effective management of the disease. SUMMARY ECM components upregulated in HNSCC can impact several cancer hallmarks by sustaining proliferative signaling, promoting angiogenesis, facilitating invasion and metastasis, modulating growth suppressor activity, and suppressing antitumoral immunity. The tumor ECM is also involved in treatment resistance, making it a potential therapeutic target.
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Affiliation(s)
- Angélique Saint
- Université Côte d'Azur, CNRS, INSERM, iBV.,Centre Antoine Lacassagne, Nice, France
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31
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Huang S, Cai H, Song F, Zhu Y, Hou C, Hou J. Tumor-stroma ratio is a crucial histological predictor of occult cervical lymph node metastasis and survival in early-stage (cT1/2N0) oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2021; 51:450-458. [PMID: 34412929 DOI: 10.1016/j.ijom.2021.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/24/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022]
Abstract
Occult cervical lymph node metastasis is a significant prognostic factor in patients with early-stage (cT1/2N0) oral squamous cell carcinoma (OSCC). The aim of this study was to investigate the potential value of the tumor-stroma ratio (TSR) as a histological predictor of occult cervical metastasis and survival in early-stage OSCC. This retrospective study included 151 patients who underwent excision of the primary lesion and elective neck dissection from 2013 to 2017. The clinicopathological features of the tumor, risk factors associated with occult neck metastasis, and prognostic factors for overall survival (OS) and disease-free survival (DFS) were studied. A significant correlation of TSR (P = 0.009) was found with occult neck metastasis in the multivariate logistic regression model. Multivariate Cox proportional hazards regression analysis showed that the TSR (P = 0.002) and perineural invasion (P = 0.011) were associated with OS. Occult neck metastasis (P = 0.032) was associated with DFS. These findings indicate that assessment of the TSR might be useful in prognostication for early-stage OSCC patients. Moreover, the TSR is effective in allowing an accurate evaluation of the risk of occult neck metastasis, and this may be easily applicable in the routine pathological diagnosis and clinical decision-making for elective neck dissection.
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Affiliation(s)
- S Huang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - H Cai
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - F Song
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Y Zhu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - C Hou
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - J Hou
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
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Caponio VCA, Togni L, Zhurakivska K, Santarelli A, Arena C, Rubini C, Lo Muzio L, Troiano G, Mascitti M. Prognostic assessment of different methods for eosinophils detection in oral tongue cancer. J Oral Pathol Med 2021; 51:240-248. [PMID: 34392572 DOI: 10.1111/jop.13236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/25/2021] [Accepted: 08/03/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND TATE has been proposed as a prognostic factor in oral cancer staging; however, the controversial literature data limit its application in the routine diagnosis. The aim of this study was to evaluate the prognostic value of TATE in patients with oral tongue cancer. The second aim was to identify any difference in the methods of eosinophil quantification or in the cutoff values reported in literature. METHODS Clinic-pathological data of 204 patients treated at "Ospedali Riuniti" Hospital, Ancona, Italy, were collected. Evaluation of TATE was performed on hematoxylin-and-eosin-stained slides and correlation with survival outcomes was evaluated. The number of eosinophils per square millimeter was evaluated by using two methods, namely density (TATE-1) and classical (TATE-2) methods. For each of the 2 methods tested, patients were stratified into two or three groups, according to the most used cutoff values reported in literature. RESULTS Regardless of the method of eosinophil quantification or the cutoff values used, patients with high TATE had a significantly better disease-specific survival. The density method (TATE-1) showed a better predictive performance, in particular when applying a single cutoff of 67 eosinophils/mm2 , two cutoffs of 10 and 100 eosinophils/mm2 , or two cutoffs of 50 and 120 eosinophils/mm2 . CONCLUSION The evaluation of TATE is simple, cost-effective, and easy to implement in daily practice with the aim of improving risk stratification of patients affected by oral tongue cancer. Results of prognostic performance analysis suggest using density (TATE-1) method as the standard approach to evaluate TATE in future studies, enhancing replicability.
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Affiliation(s)
| | - Lucrezia Togni
- Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Andrea Santarelli
- Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, Ancona, Italy.,Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, Ancona, Italy
| | - Claudia Arena
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Corrado Rubini
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Mascitti
- Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, Ancona, Italy
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Li J, Liu S, Li Z, Han X, Que L. Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Front Oncol 2021; 11:683825. [PMID: 34322385 PMCID: PMC8311439 DOI: 10.3389/fonc.2021.683825] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/24/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES A significant number of recently published research has outlined the contribution of perineural invasion (PNI) to clinical outcomes in oral tongue squamous cell carcinoma (OTSCC), but some results remain conflicting. This study aimed to determine whether patients with OTSCC with PNI have a worse prognosis than those without PNI. MATERIALS AND METHODS PubMed, Embase, and the Cochrane Library were queried for potentially eligible articles published up to December 2020. The primary outcomes were the hazard ratio (HR) for locoregional recurrence, overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS). The random-effect model was used in all analyses. RESULTS Seventeen studies (4445 patients) were included. Using adjusted HRs, the presence of PNI was associated with a higher risk of locoregional recurrence (HR=1.73, 95%CI: 1.07-2.79, P=0.025, I2 = 33.1%, Pheterogeneity=0.224), worse OS (HR=1.94, 95%CI: 1.39-2.72, P<0.001, I2 = 0.0%, Pheterogeneity=0.838), worse DFS (HR=2.13, 95%CI: 1.53-2.96, P<0.001, I2 = 48.4%, Pheterogeneity=0.071), and worse CSS (HR=1.93, 95%CI: 1.40-2.65, P<0.001, I2 = 25.5%, Pheterogeneity=0.251). PNI had an impact on locoregional recurrence in early-stage OTSCC but not in all stages, and on OS, DFS, and CSS in all-stage and early-stage OTSCC. The sensitivity analyses showed that the results were robust. CONCLUSION The presence of PNI significantly affects the locoregional recurrence and survival outcomes among patients with OTSCC.
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Affiliation(s)
- Jiajia Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shan Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhangao Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinxin Han
- Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Lin Que
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Lahiri P, Mukherjee S, Ghosh B, Das D, Lahiri B, Varshney SK, Pal M, Paul RR, Chatterjee J. Comprehensive Evaluation of PAXgene Fixation on Oral Cancer Tissues Using Routine Histology, Immunohistochemistry, and FTIR Microspectroscopy. Biomolecules 2021; 11:biom11060889. [PMID: 34203873 PMCID: PMC8232633 DOI: 10.3390/biom11060889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/06/2021] [Accepted: 06/10/2021] [Indexed: 11/25/2022] Open
Abstract
The choice of tissue fixation is critical for preserving the morphology and biochemical information of tissues. Fragile oral tissues with lower tensile strength are challenging to process for histological applications as they are prone to processing damage, such as tissue tear, wrinkling, and tissue fall-off from slides. This leads to loss of morphological information and unnecessary delay in experimentation. In this study, we have characterized the new PAXgene tissue fixation system on oral buccal mucosal tissue of cancerous and normal pathology for routine histological and immunohistochemical applications. We aimed to minimize the processing damage of tissues and improve the quality of histological experiments. We also examined the preservation of biomolecules by PAXgene fixation using FTIR microspectroscopy. Our results demonstrate that the PAXgene-fixed tissues showed significantly less tissue fall-off from slides. Hematoxylin and Eosin staining showed comparable morphology between formalin-fixed and PAXgene-fixed tissues. Good quality and slightly superior immunostaining for cancer-associated proteins p53 and CK5/6 were observed in PAXgene-fixed tissues without antigen retrieval than formalin-fixed tissues. Further, FTIR measurements revealed superior preservation of glycogen, fatty acids, and amide III protein secondary structures in PAXgene-fixed tissues. Overall, we present the first comprehensive evaluation of the PAXgene tissue fixation system in oral tissues. This study concludes that the PAXgene tissue fixation system can be applied to oral tissues to perform diagnostic molecular pathology experiments without compromising the quality of the morphology or biochemistry of biomolecules.
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Affiliation(s)
- Pooja Lahiri
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India; (S.M.); (B.G.); (D.D.); (J.C.)
- Correspondence:
| | - Suranjana Mukherjee
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India; (S.M.); (B.G.); (D.D.); (J.C.)
| | - Biswajoy Ghosh
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India; (S.M.); (B.G.); (D.D.); (J.C.)
| | - Debnath Das
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India; (S.M.); (B.G.); (D.D.); (J.C.)
| | - Basudev Lahiri
- Department of Electronics and Electrical Communication Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, India; (B.L.); (S.K.V.)
| | - Shailendra Kumar Varshney
- Department of Electronics and Electrical Communication Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, India; (B.L.); (S.K.V.)
| | - Mousumi Pal
- Guru Nanak Institute of Dental Sciences and Research (GNIDSR), Kolkata 700114, India;
| | - Ranjan Rashmi Paul
- Department of Oral & Dental Sciences, JIS University, Kolkata 700109, India;
| | - Jyotirmoy Chatterjee
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India; (S.M.); (B.G.); (D.D.); (J.C.)
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Meyer HJ, Höhn AK, Surov A. Histogram parameters derived from T1 and T2 weighted images correlate with tumor infiltrating lymphocytes and tumor-stroma ratio in head and neck squamous cell cancer. Magn Reson Imaging 2021; 80:127-131. [PMID: 33971242 DOI: 10.1016/j.mri.2021.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE The present study used histogram analysis values derived from T1- and T2- weighted (w) images to elucidate possible associations with Tumor-infiltrating lymphocytes (TIL) and Vimentin expression in head and neck squamous cell cancer (HNSCC). MATERIALS AND METHODS Overall, 28 patients (n = 8 female patient, 28.6%) with primary HNSCC of different localizations were involved in the study. Magnetic resonance imaging (MRI) was obtained on a 3 T MRI. The images were analyzed with a whole lesion measurement using a histogram approach. TIL- and vimentin-expression was calculated on biopsy samples before any form of treatment. RESULTS Several T1-derived parameters correlated with the expression of TIL within the stroma compartment: mean (r = 0.42, p = 0.025), p10 (r = 0.50, p = 0.007), p25 (r = 0.42, p = 0.025), median (r = 0.39, p = 0.036), and mode (r = 0.39, p = 0.04). No T2-derived parameter correlated with the TIL within the stroma compartment. Several T2-derived parameters correlated with the expression of TIL within the tumor compartment: mean (r = -0.52, p = 0.004), max (r = -0.43, p = 0.02), p10 (r = -0.38, p = 0.04), p25 (r = -0.53, p = 0.004), p75 (r = -0.52, p = 0.004), p90 (r = -0.48, p = 0.009), median (r = -0.52, p = 0.004), mode (r = -0.40, p = 0.03). Kurtosis derived from T2w images had significant higher values in tumor-rich tumors, compared to stroma-rich tumors, (mean 5.5 ± 0.5 versus 4.2 ± 1.2, p = 0.028). CONCLUSIONS Histogram analysis parameters derived from T1w and T2w images might be able to reflect tumor compartments and TIL expression in HNSCC.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany.
| | - Anne Kathrin Höhn
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany; Department of Pathology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
| | - Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Magdeburg, Leipzigerstraße 44, 39120 Magdeburg, Germany
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Almangush A, Alabi RO, Troiano G, Coletta RD, Salo T, Pirinen M, Mäkitie AA, Leivo I. Clinical significance of tumor-stroma ratio in head and neck cancer: a systematic review and meta-analysis. BMC Cancer 2021; 21:480. [PMID: 33931044 PMCID: PMC8086072 DOI: 10.1186/s12885-021-08222-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/12/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The clinical significance of tumor-stroma ratio (TSR) has been examined in many tumors. Here we systematically reviewed all studies that evaluated TSR in head and neck cancer. METHODS Four databases (Scopus, Medline, PubMed and Web of Science) were searched using the term tumo(u)r-stroma ratio. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. RESULTS TSR was studied in nine studies of different subsites (including cohorts of nasopharyngeal, oral, laryngeal and pharyngeal carcinomas). In all studies, TSR was evaluated using hematoxylin and eosin staining. Classifying tumors based on TSR seems to allow for identification of high-risk cases. In oral cancer, specifically, our meta-analysis showed that TSR is significantly associated with both cancer-related mortality (HR 2.10, 95%CI 1.56-2.84) and disease-free survival (HR 1.84, 95%CI 1.38-2.46). CONCLUSIONS The assessment of TSR has a promising prognostic value and can be implemented with minimum efforts in routine head and neck pathology.
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Affiliation(s)
- Alhadi Almangush
- Department of Pathology, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, Helsinki, Finland.
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland.
- Faculty of Dentistry, Misurata University, Misurata, Libya.
| | - Rasheed Omobolaji Alabi
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki, Helsinki, Finland
- Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
| | - Antti A Mäkitie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku and Turku University Hospital, Turku, Finland
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Musulin J, Štifanić D, Zulijani A, Ćabov T, Dekanić A, Car Z. An Enhanced Histopathology Analysis: An AI-Based System for Multiclass Grading of Oral Squamous Cell Carcinoma and Segmenting of Epithelial and Stromal Tissue. Cancers (Basel) 2021; 13:1784. [PMID: 33917952 PMCID: PMC8068326 DOI: 10.3390/cancers13081784] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022] Open
Abstract
Oral squamous cell carcinoma is most frequent histological neoplasm of head and neck cancers, and although it is localized in a region that is accessible to see and can be detected very early, this usually does not occur. The standard procedure for the diagnosis of oral cancer is based on histopathological examination, however, the main problem in this kind of procedure is tumor heterogeneity where a subjective component of the examination could directly impact patient-specific treatment intervention. For this reason, artificial intelligence (AI) algorithms are widely used as computational aid in the diagnosis for classification and segmentation of tumors, in order to reduce inter- and intra-observer variability. In this research, a two-stage AI-based system for automatic multiclass grading (the first stage) and segmentation of the epithelial and stromal tissue (the second stage) from oral histopathological images is proposed in order to assist the clinician in oral squamous cell carcinoma diagnosis. The integration of Xception and SWT resulted in the highest classification value of 0.963 (σ = 0.042) AUCmacro and 0.966 (σ = 0.027) AUCmicro while using DeepLabv3+ along with Xception_65 as backbone and data preprocessing, semantic segmentation prediction resulted in 0.878 (σ = 0.027) mIOU and 0.955 (σ = 0.014) F1 score. Obtained results reveal that the proposed AI-based system has great potential in the diagnosis of OSCC.
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Affiliation(s)
- Jelena Musulin
- Faculty of Engineering, University of Rijeka, Vukovarska 58, 51000 Rijeka, Croatia; (J.M.); (Z.C.)
| | - Daniel Štifanić
- Faculty of Engineering, University of Rijeka, Vukovarska 58, 51000 Rijeka, Croatia; (J.M.); (Z.C.)
| | - Ana Zulijani
- Department of Oral Surgery, Clinical Hospital Center Rijeka, Krešimirova Ul. 40, 51000 Rijeka, Croatia;
| | - Tomislav Ćabov
- Faculty of Dental Medicine, University of Rijeka, Krešimirova Ul. 40, 51000 Rijeka, Croatia
| | - Andrea Dekanić
- Department of Pathology and Cytology, Clinical Hospital Center Rijeka, Krešimirova Ul. 42, 51000 Rijeka, Croatia;
- Faculty of Medicine, University of Rijeka, Ul. Braće Branchetta 20/1, 51000 Rijeka, Croatia
| | - Zlatan Car
- Faculty of Engineering, University of Rijeka, Vukovarska 58, 51000 Rijeka, Croatia; (J.M.); (Z.C.)
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Lymphovascular invasion as a prognostic tool for oral squamous cell carcinoma: a comprehensive review. Int J Oral Maxillofac Surg 2021; 51:1-9. [PMID: 33814227 DOI: 10.1016/j.ijom.2021.03.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/01/2021] [Accepted: 03/11/2021] [Indexed: 12/20/2022]
Abstract
Oral cancer is the most common malignancy of the head and neck region, characterized by a poor prognosis. Novel prognostic markers are needed to better stratify these patients. Lymphovascular invasion (LVI) has been included in the eighth edition of the AJCC Cancer Staging Manual as an additional prognostic factor, but its influence on the recurrence risk and lymph node metastasis is relatively understudied. This is a comprehensive review of the literature on the clinical and prognostic role of LVI in oral cancer. A relevant search of the PubMed, Scopus, and Web of Science databases yielded 29 articles that satisfied the inclusion criteria. Findings indicated that LVI is an independent negative prognostic factor in oral cancer patients and appears to be associated with cervical lymph node metastasis and loco-regional recurrence. Notably, in oral tongue cancer, survival outcomes progressively worsen when LVI is associated with other adverse pathological features, especially in the early stages. Therefore, these patients could benefit from elective neck dissection and/or adjuvant therapy. The high variability of LVI prevalence hinders the comparison of literature results. Several methodological limitations were found to be present in the collected articles, including the lack of a rigorous definition for LVI, the difficult detection in routine histological section, the presence of potential confounders, the retrospective nature, and an inadequate sample size in most studies. Therefore, it is necessary to conduct prognostic studies using standardized methods to define and quantify LVI.
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Wei LF, Huang XC, Lin YW, Luo Y, Ding TY, Liu CT, Chu LY, Xu YW, Peng YH, Guo HP. A Prognostic Model Based on Clinicopathological Features and Inflammation- and Nutrition-Related Indicators Predicts Overall Survival in Surgical Patients With Tongue Squamous Cell Carcinoma. Technol Cancer Res Treat 2021; 20:15330338211043048. [PMID: 34866500 PMCID: PMC8652185 DOI: 10.1177/15330338211043048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/01/2021] [Accepted: 07/14/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives: It is reported that inflammation- and nutrition-related indicators have a prognostic impact on multiple cancers. Here we aimed to identify a prognostic nomogram model for prediction of overall survival (OS) in surgical patients with tongue squamous cell carcinoma (TSCC). Methods: The retrospective data of 172 TSCC patients were charted from the Cancer Hospital of Shantou University Medical College between 2008 and 2019. A Cox regression analysis was performed to determine prognostic factors to establish a nomogram and predict OS. The predictive accuracy of the model was analyzed by the calibration curves and the concordance index (C-index). The difference of OS was analyzed by Kaplan-Meier survival analysis. Results: Multivariate analysis showed age, tumor node metastasis (TNM) stage, red blood cell, platelets, and platelet-to-lymphocyte ratio were independent prognostic factors for OS, which were used to build the prognostic nomogram model. The C-index of the model for OS was 0.794 (95% CI = 0.729-0.860), which was higher than that of TNM stage 0.685 (95% CI = 0.605-0.765). In addition, decision curve analysis also showed the nomogram model had improved predictive accuracy and discriminatory performance for OS, compared to the TNM stage. According to the prognostic model risk score, patients in the high-risk subgroup had a lower 5-year OS rate than that in a low-risk subgroup (23% vs 49%, P < .0001). Conclusions: The nomogram model based on clinicopathological features inflammation- and nutrition-related indicators represents a promising tool that might complement the TNM stage in the prognosis of TSCC.
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Affiliation(s)
- Lai-Feng Wei
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Xu-Chun Huang
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Yi-Wei Lin
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Yun Luo
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Tian-Yan Ding
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Can-Tong Liu
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Ling-Yu Chu
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Yi-Wei Xu
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
- Yi-Wei Xu, Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China.
| | - Yu-Hui Peng
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
- Yu-Hui Peng, Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China.
| | - Hai-Peng Guo
- The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Hai-Peng Guo, Department of Head and Neck Surgery, The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, China.
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Troiano G, Rubini C, Togni L, Caponio VCA, Zhurakivska K, Santarelli A, Cirillo N, Lo Muzio L, Mascitti M. The immune phenotype of tongue squamous cell carcinoma predicts early relapse and poor prognosis. Cancer Med 2020; 9:8333-8344. [PMID: 33047888 PMCID: PMC7666743 DOI: 10.1002/cam4.3440] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In patients with squamous cell carcinoma of the oral tongue (OTSCC), current tumor node metastasis staging system fails to identify at-risk patients associated with early relapse and poor prognosis despite complete surgical resection. Given the importance of tumor-infiltrating lymphocytes (TILs) in the development of cancers, here we investigated the prognostic significance of the immune phenotype in OTSCC. METHODS Hematoxylin-eosin stained sections of OTSCCs from 211 patients were evaluated. Cancers were classified as (a) immune-inflamed when TILs were found next to tumor cell nests; (b) immune-excluded when TILs were found in the stroma, outside the tumor; and (c) immune-desert for tumors lacking lymphocyte infiltrate. The prognostic significance of these immune phenotypes classes was investigated. Data were further validated on an independent cohort from The Cancer Genome Atlas database. RESULTS Immune-desert phenotype was the least represented group of OTSCCs in our cohort (11.8%) and served as an independent prognostic factor. Patients with immune-desert tumors exhibited worse disease-specific survival (HR = 2.673; [CI: 95% 1.497-4.773]; P = .001), overall survival (HR = 2.591; [CI: 95% 1.468-4.572]; P = .001), and disease-free survival (HR = 2.313; [CI: 95% 1.118-4.786]; P = .024) at multivariate analysis. CONCLUSIONS We identified a specific subgroup of OTSCCs with poor prognosis. Tumor-infiltrating lymphocytes density and localization could serve as an integrative parameter to the current staging system and inform the selection of most appropriate treatments. In particular, the tumor immune phenotype could improve the stratification of patients with more aggressive disease.
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Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental MedicineUniversity of FoggiaFoggiaItaly
| | - Corrado Rubini
- Department of Biomedical Sciences and Public HealthMarche Polytechnic UniversityAnconaItaly
| | - Lucrezia Togni
- Department of Clinical Specialistic and Dental SciencesMarche Polytechnic UniversityAnconaItaly
| | | | | | - Andrea Santarelli
- Department of Clinical Specialistic and Dental SciencesMarche Polytechnic UniversityAnconaItaly
- Dentistry ClinicNational Institute of Health and Science of AgingINRCAAnconaItaly
| | - Nicola Cirillo
- Melbourne Dental SchoolThe University of MelbourneMelbourneVic.Australia
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental MedicineUniversity of FoggiaFoggiaItaly
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental SciencesMarche Polytechnic UniversityAnconaItaly
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