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Gao L, Chen R, Sugimoto M, Mizuta M, Zhou L, Kishimoto Y, Huang X, Omori K. The RNA Methylation Modification 5-Methylcytosine Impacts Immunity Characteristics, Prognosis and Progression of Oral Squamous Cell Carcinoma by Bioinformatics Analysis. Front Bioeng Biotechnol 2021; 9:760724. [PMID: 34957065 PMCID: PMC8696036 DOI: 10.3389/fbioe.2021.760724] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022] Open
Abstract
Disorders pertaining to 5-methylcytosine (m5C) modifications are involved in the pathological process of many diseases. However, the effect of m5C on the tumorigenesis and progression of oral squamous cell carcinoma (OSCC) remains unclear. In this study, we integrated the genomic and clinical data of 558 OSCC samples to comprehensively evaluate m5C modification patterns. Based on 16 m5C methylation regulators, two m5C modification clusters were identified with distinct tumor immune microenvironment (TIME) characteristics and prognosis in OSCC. We then performed weighted gene co-expression network analysis (WGCNA) to identify m5C modification cluster-related modules. Genes in the selected module were chosen to construct the m5Cscore scoring system for evaluating m5C modification pattern in individual OSCC patients. Patients with a high m5Cscore had higher immune, stromal, and ESTIMATE scores; lower tumor purity score; lower immune activity; and higher tumor mutational burden. The overall survival rate and progression-free survival rate were markedly worse and the tumor recurrence rate was higher in OSCC patients with a high m5Cscore. Furthermore, patients with oral leukoplakia who also had a high m5Cscore had a higher risk of deterioration to OSCC. This study demonstrated that m5C modification patterns might affect the TIME in OSCC. m5Cscore may provide a new approach for predicting the prognosis and progression of OSCC.
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Affiliation(s)
- Li Gao
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ru Chen
- Department of Medicine, Matsusaka City Hospital, Matsusaka, Japan
| | - Masahiro Sugimoto
- Research and Development Center for Minimally Invasive Therapies Health Promotion and Preemptive Medicine, Tokyo Medical University, Tokyo, Japan
| | - Masanobu Mizuta
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Lei Zhou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Yo Kishimoto
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Xinsheng Huang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Koichi Omori
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Value of Assessing Peripheral Vascularization with Micro-Flow Imaging, Resistive Index and Absent Hilum Sign as Predictor for Malignancy in Lymph Nodes in Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:cancers13205071. [PMID: 34680220 PMCID: PMC8534188 DOI: 10.3390/cancers13205071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Ultrasound-guided fine needle aspiration cytology (USgFNAC) is commonly used for N-staging in head and neck squamous cell carcinoma (HNSCC). The specificity of USgFNAC is always in the order of 100% as false positive cytology is rare. The difference in sensitivity is mainly attributable to selection of the lymph nodes to aspirate and aspiration technique. The aim of this study was to improve the selection criteria of lymph nodes to aspirate. Ultrasound features of nodes such as a short axis diameter, S/L ratio, loss of a fatty hilum sign, resistive index, and peripheral or mixed hilar and peripheral vascularization, obtained by Micro-flow imaging (MFI), which is a new technique to obtain micro-vascularization, were evaluated. To calculate the sensitivity and PPV of each feature, data of sonographic findings and cytological results of all aspirated nodes were statistically analyzed. We found that next to size, peripheral vascularisation obtained by MFI and absent hilum sign have a high predictive value for malignancy and should be added as selection criteria for fine needle aspiration in lymph nodes. Abstract Ultrasound-guided fine needle aspiration cytology (USgFNAC) is commonly used for nodal staging in head and neck squamous cell cancer (HNSCC). Peripheral vascularity is a described feature for node metastasis. Micro-flow imaging (MFI) is a new sensitive technique to evaluate micro-vascularization. Our goal is to assess the additional value of MFI to detect malignancy in lymph nodes. A total of 102 patients with HNSCC were included prospectively. USgFNAC was performed with the Philips eL18–4 transducer. Cytological results served as a reference standard to evaluate the prediction of cytological malignancy depending on ultrasound features such as resistive index (RI), absence of fatty hilum sign, and peripheral vascularization. Results were obtained for all US examinations and for the subgroup of clinically node-negative neck (cN0). USgFNAC was performed in 211 nodes. Peripheral vascularization had a positive predictive value (PPV) of 83% (cN0: 50%) and the absence of a fatty hilum had a PPV of 82% (cN0 50%) The combination of peripheral vascularization and absent fatty hilum had a PPV of 94% (cN0: 72%). RI (threshold: 0.705) had a PPV of 61% (cN0: RI-threshold 0.615, PPV 20%), whereas the PPV of short axis diameter (threshold of 6.5mm) was 59% for all patients and 19% in cN0 necks (threshold of 4 mm). Peripheral vascularization assessed by MFI and absent hilum has a high predictive value for cytological malignancy in neck metastases. Next to size, both features should be used as additional selection criteria for USgFNAC.
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Gao L, Chen R, Sugimoto M, Mizuta M, Kishimoto Y, Omori K. The Impact of m1A Methylation Modification Patterns on Tumor Immune Microenvironment and Prognosis in Oral Squamous Cell Carcinoma. Int J Mol Sci 2021; 22:ijms221910302. [PMID: 34638642 PMCID: PMC8508946 DOI: 10.3390/ijms221910302] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023] Open
Abstract
N1-methyladenosine (m1A) modification widely participates in the occurrence and progression of numerous diseases. Nevertheless, the potential roles of m1A in the tumor immune microenvironment (TIME) are still not fully understood. Based on 10 m1A methylation regulators, we comprehensively explored the m1A modification patterns in 502 patients with oral squamous cell carcinoma (OSCC). The m1A modification patterns were correlated with TIME characteristics and the m1A score was established to evaluate the effect of the m1A modification patterns on individual OSCC patients. The TIME characteristics and survival outcomes under the three m1A modification patterns were significantly distinct. OSCC patients in the high m1A score group were characterized by poorer prognosis, lower immune infiltration, lower ssGSEA score, lower expression levels of immune checkpoint molecules, and higher tumor mutation loads. The present study revealed that m1A modification might be associated with the TIME in OSCC, and has potential predictive ability for the prognosis of OSCC.
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Affiliation(s)
- Li Gao
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan; (L.G.); (M.M.); (K.O.)
| | - Ru Chen
- Matsusaka City Hospital, Matsusaka 515-8544, Japan;
| | - Masahiro Sugimoto
- Center for Minimally Invasive Therapies, Institute of Medical Science Research and Development, Tokyo Medical University, Tokyo 160-8402, Japan;
| | - Masanobu Mizuta
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan; (L.G.); (M.M.); (K.O.)
| | - Yo Kishimoto
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan; (L.G.); (M.M.); (K.O.)
- Correspondence: ; Tel.: +81-75-751-3346
| | - Koichi Omori
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan; (L.G.); (M.M.); (K.O.)
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de Koekkoek-Doll PK, Vogel W, Maas M, Castelijns J, Smit L, Zavrakidis J, Beets-Tan R, van den Brekel M. SUV max values at FDG PET-CT to predict malignancy in lymph nodes aspirated by real time image fused USgFNAC in head and neck squamous cell carcinoma. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2021; 11:178-187. [PMID: 34234996 PMCID: PMC8255217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/17/2021] [Indexed: 06/13/2023]
Abstract
18F-fluordeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET-CT) and ultrasound guided fine-needle aspiration cytology (USgFNAC) are commonly used to detect nodal metastases in head and neck squamous cell carcinoma (HNSCC). FDG PET-CT helps to guide selection of borderline suspicious nodes to aspirate using USgFNAC. Real time image fusion of FDG PET-CT with US is a new available technique and can improve this selection. The aim of this study was to determine optimal SUVmax values for USgFNAC node selection to improve USgFNAC sensitivity. 118 patients, with histopathological proven HNSCC or proven lymph nodes metastases of SCC of unknown primary, referred for staging of HNSCC with FDG PET-CT and ultrasound, were prospectively included. Additionally to standard USgFNAC of suspicious nodes fusion was performed to confirm that USgFNAC took place in FDG-positive nodes and to add Fused-USgFNAC in missed FDG-positive nodes. Fusion was performed on nodes with reported having metabolic activity. SUVmax values were measured in all Fused-USgFNAC nodes. The reference standard was cytology. In 118 patients USgFNAC was performed in 281 nodes. At fusion 22/281 (8%) nodes were FDG-negative. Out of 259 FDG-positive nodes 253 (98%) nodes were fused successfully. USgFNAC had conclusive results in 237/253 nodes (94%). In 126/237 nodes (53%) cytology proved to be tumor positive. Below SUVmax of 2.87 no fused FDG-positive nodes proved to be tumor positive at cytology. To improve sensitivity, only FDG-positive nodes with SUVmax values above 2.87 should be selected for USgFNAC. Image fusion can identify those nodes for USgFNAC selection.
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Affiliation(s)
| | - Wouter Vogel
- Department of Nuclear Medicine, The Netherlands Cancer InstituteAmsterdam, Netherlands
- Department of Radiation Oncology, The Netherlands Cancer InstituteAmsterdam, Netherlands
| | - Monique Maas
- Department of Radiology, The Netherlands Cancer InstituteAmsterdam, Netherlands
| | - Jonas Castelijns
- Department of Radiology, The Netherlands Cancer InstituteAmsterdam, Netherlands
| | - Laura Smit
- Department of Pathology, The Netherlands Cancer InstituteAmsterdam, Netherlands
| | - Joannis Zavrakidis
- Department of Epidemiology & Biostatistics, The Netherlands Cancer InstituteAmsterdam, Netherlands
| | - Regina Beets-Tan
- Department of Radiology, The Netherlands Cancer InstituteAmsterdam, Netherlands
| | - Michiel van den Brekel
- Department of Head and Neck Surgery & Oncology, The Netherlands Cancer InstituteAmsterdam, Netherlands
- Department of Maxillofacial Surgery, Amsterdam University Medical CenterAmsterdam, Netherlands
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de Koekkoek-Doll PK, Maas M, Vogel W, Castelijns J, Smit L, Zavrakidis I, Beets-Tan R, van den Brekel M. Real-Time Ultrasound Image Fusion with FDG-PET/CT to Perform Fused Image-Guided Fine-Needle Aspiration in Neck Nodes: Feasibility and Diagnostic Value. AJNR Am J Neuroradiol 2021; 42:566-572. [PMID: 33509917 DOI: 10.3174/ajnr.a6938] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/29/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE New imaging techniques such as hybrid imaging of ultrasound and FDG-PET/CT are available but not yet investigated for node staging. The aim of the study was to evaluate the feasibility and added diagnostic value of real-time image-fused ultrasound-guided fine-needle aspiration with FDG-PET/CT data for node staging. MATERIALS AND METHODS Ninety-six patients who were referred for cervical lymph node staging with FDG-PET/CT before ultrasound were prospectively included. After routine ultrasound-guided fine-needle aspiration, all FDG-PET-positive nodes were marked on FDG-PET/CT, and real-time image fusing of ultrasound and FDG-PET/CT was performed using the electromagnetic navigation system PercuNav. Already-punctured nodes were confirmed to be PET-positive, and additional fused-ultrasound-guided fine-needle aspiration was performed in previously missed PET-positive nodes. RESULTS Of 96 patients, 87 (91%) patients had suspicious nodes requiring fine-needle aspiration cytology. Ultrasound-guided fine-needle aspiration was performed in 175 nodes. Cytology was inconclusive in 9/175 (5%) nodes, and 85/166 (51%) nodes were malignant. Target planning was performed in 201 PET-positive nodes; 195/201 (97%) of those nodes were fused successfully. Twenty of 175 ultrasound-guided fine-needle aspiration nodes turned out to be FDG-PET-negative, and 149/175 (85%) of the fused ultrasound-guided fine-needle aspiration nodes were confirmed to be FDG-PET-positive. Of 201 PET-positive nodes, 46 (23%) were additionally identified, and fused ultrasound-guided fine-needle aspiration was performed. Cytology was inconclusive in 4/46 nodes (9%), and 13/42 (31%) nodes were malignant. CONCLUSIONS Real-time ultrasound image fusion with FDG-PET-positive nodes is feasible in cervical lymph nodes, and fused ultrasound-guided fine-needle aspiration increases the number of malignant nodes detected.
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Affiliation(s)
| | - M Maas
- From the Departments of Radiology (P.K.d.K.-D., M.M., J.C., R.B.-T.)
| | - W Vogel
- Nuclear Medicine (W.V.).,Radiation Oncology (W.V.)
| | - J Castelijns
- From the Departments of Radiology (P.K.d.K.-D., M.M., J.C., R.B.-T.)
| | | | - I Zavrakidis
- Epidemiology and Biostatistics (I.Z.), Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - R Beets-Tan
- From the Departments of Radiology (P.K.d.K.-D., M.M., J.C., R.B.-T.)
| | - M van den Brekel
- Head and Neck Surgery and Oncology (M.v.d.B.).,Department of Maxillofacial Surgery (M.v.d.B.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Binnal A, Rajesh G, Prakash Saxena PU, Banerjee S, Denny C, Tadakamadla SK. Health-related quality of life among oral and oropharyngeal cancer patients: An exploratory study. Oral Dis 2021; 28:585-599. [PMID: 33426716 DOI: 10.1111/odi.13772] [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: 10/01/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To comprehensively explore the effect of several sociodemographic-, patient- and tumour-related factors on the health-related quality of life (HRQoL) of oral and oropharyngeal cancer patients. METHODOLOGY Patients diagnosed with oral and oropharyngeal cancers were included in the present cross-sectional study. Information pertaining to various sociodemographic-, patient- and tumour-related factors was recorded. HRQoL was assessed using standard 12-item Short Form Health Survey version 2 (SF12V2), and oral health-related quality of life (OHRQoL) was assessed by Oral Health Impact Profile-14 (OHIP). RESULTS A total of 108 patients participated in the present study. Results revealed that nodal metastasis, histological differentiation and pain were significant predictors of OHRQoL, while site, size, stage, histological differentiation and pain were significant predictors of HRQoL. Pain was the single most significant negative determinant of HRQoL that was associated with worst total OHIP (B = 2.01, β = 0.45, p < .0001), physical (B = -0.88, β = -0.21, p = .017) and mental (B = -1.00, β = -0.22, p = .016) component summary scores. CONCLUSIONS Number of sociodemographic-, patient- and tumour-related factors emerged as significant predictors of HRQoL and OHRQoL. Study results might help in formulating targeted treatment plan, optimising patient care and follow-up.
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Affiliation(s)
- Almas Binnal
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Mangalore, India.,Manipal Academy of Higher Education, Manipal, KA, India
| | - Gururaghavendran Rajesh
- Manipal Academy of Higher Education, Manipal, KA, India.,Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, India
| | - P U Prakash Saxena
- Manipal Academy of Higher Education, Manipal, KA, India.,Department of Radiation Oncology, Kasturba Medical College, Mangalore, India
| | - Sourjya Banerjee
- Manipal Academy of Higher Education, Manipal, KA, India.,Department of Radiation Oncology, Kasturba Medical College, Mangalore, India
| | - Ceena Denny
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Mangalore, India.,Manipal Academy of Higher Education, Manipal, KA, India
| | - Santosh Kumar Tadakamadla
- National Health and Medical Research Council Early Career Fellow, School of Dentistry and Oral Health, Griffith University, Gold Coast, Qld, Australia
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Chang YJ, Chen KW, Chen L. Mitochondrial ROS1 Increases Mitochondrial Fission and Respiration in Oral Squamous Cancer Carcinoma. Cancers (Basel) 2020; 12:cancers12102845. [PMID: 33019722 PMCID: PMC7599653 DOI: 10.3390/cancers12102845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 12/26/2022] Open
Abstract
Simple Summary The clinical efficacy of anti-epidermal growth factor receptor (EGFR) antibody cetuximab for oral squamous cell carcinomas (OSCCs) is low. We previously reported that an increased oncogenic ROS proto-oncogene 1 (ROS1) is responsible for the invasiveness and metastasis of OSCC. This study demonstrates for the first time that ROS1, a receptor tyrosine kinase, can localize to mitochondria. Mitochondrial ROS1 in the highly invasive OSCC promotes mitochondrial fission, enhances mitochondrial oxidative phosphorylation and ATP production but reduces mitochondrial biogenesis. These findings highlight the novel function of ROS1 in mitochondrial morphogenesis and metabolic adaptation to promote OSCC invasiveness. Abstract Increased ROS proto-oncogene 1 (ROS1) expression has been implicated in the invasiveness of human oral squamous cell carcinoma (OSCC). The cellular distribution of ROS1 has long-been assumed at the plasma membrane. However, a previous work reported a differential cellular distribution of mutant ROS1 derived from chromosomal translocation, resulting in increased carcinogenesis. We thus hypothesized that cellular distribution of upregulated ROS1 in OSCC may correlate with invasiveness. We found that ROS1 can localize to mitochondria in the highly invasive OSCC and identified a mitochondria-targeting signal sequence in ROS1. We also demonstrated that ROS1 targeting to mitochondria is required for mitochondrial fission phenotype in the highly invasive OSCC cells. OSCC cells expressing high levels of ROS1 consumed more oxygen and had increased levels of cellular ATP levels. Our results also revealed that ROS1 regulates mitochondrial biogenesis and cellular metabolic plasticity. Together, these findings demonstrate that ROS1 targeting to mitochondria enhances OSCC invasion through regulating mitochondrial morphogenesis and cellular respiratory.
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Affiliation(s)
- Yu-Jung Chang
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu 30013, Taiwan;
- Correspondence: (Y.-J.C.); (L.C.); Tel.: +886-3-571-5131#33473 (Y.-J.C.); +886-3-574-2775 (L.C.); Fax: +886-3-571-5934 (L.C.)
| | - Kuan-Wei Chen
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu 30013, Taiwan;
| | - Linyi Chen
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu 30013, Taiwan;
- Department of Medical Science, National Tsing Hua University, Hsinchu 30013, Taiwan
- Correspondence: (Y.-J.C.); (L.C.); Tel.: +886-3-571-5131#33473 (Y.-J.C.); +886-3-574-2775 (L.C.); Fax: +886-3-571-5934 (L.C.)
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Park YM, Eo TS, Koh YW, Kim SH, Choi EC. Prognostic Significance of Lymph Node Status in p16+ Oropharyngeal Cancer After Surgical Treatment. Laryngoscope 2020; 130:1973-1979. [PMID: 32282081 DOI: 10.1002/lary.28665] [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: 01/28/2020] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS In this study, we retrospectively reviewed medical records of patients who underwent surgery for p16+ oropharyngeal cancer and analyzed the prognostic implications of pathologic lymph node (LN) status, including number of metastatic LNs, LN ratio, and location of metastatic LNs. STUDY DESIGN Retrospective case series. METHODS We retrospectively reviewed data on patients diagnosed with p16+ oropharyngeal cancer. RESULTS The study population consisted of 159 males and 29 females with a mean age of 57.2 years. The primary tumor sites were tonsils (n = 160), base of the tongue (n = 24), and soft palate (n = 4). Only recurrence-free survival (RFS) showed a significant correlation with contralateral LN metastasis on multivariate analysis. On Kaplan-Meier analysis, 5-year RFS was 92.4% in patients without contralateral LN metastasis and 68.8% in patients with contralateral LN metastasis. CONCLUSIONS Among pathologic LN status in p16+ oropharyngeal cancer, only contralateral LN metastasis showed prognostic significance in disease recurrence of p16+ oropharyngeal squamous cell carcinoma patients. LEVEL OF EVIDENCE 4 Laryngoscope, 130: 1973-1979, 2020.
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Affiliation(s)
- Young Min Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, South Korea
| | - Tae Seong Eo
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
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Bow YD, Wang YY, Chen YK, Su CW, Hsu CW, Xiao LY, Yuan SS, Li RN. Silencing of FOXA2 decreases E-cadherin expression and is associated with lymph node metastasis in oral cancer. Oral Dis 2020; 26:756-765. [PMID: 31957176 DOI: 10.1111/odi.13282] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/02/2019] [Accepted: 01/09/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES FOXA2 gene methylation links to the progression of cancers, but has not been documented in oral cancer. Herein, we explore the role of FOXA2 in the migration of oral cancer cells. MATERIAL AND METHODS Methylation-specific PCR was applied for gene methylation. Wound healing and transwell experiments were tested for cell migration. FOXA2 expression in oral cancer tissues was addressed by immunohistochemistry, followed by statistical analysis of its association with clinical manifestations and patient survival. RESULTS FOXA2 bound to the promoter of CDH1 and enhanced the expression of its gene product E-cadherin, and decreased the cancer cell migration activity. High FOXA2 expression in oral cancer tissues was associated with high E-cadherin expression, decreased lymph node metastasis, and increased patient survival. CONCLUSION FOXA2-E-cadherin link is involved in regulation of oral cancer cell metastasis and provides a new insight for the tumor suppressor activity of FOXA2 in oral cancer.
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Affiliation(s)
- Yung-Ding Bow
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Yun Wang
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yuk-Kwan Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chang-Wei Su
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Wei Hsu
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ling-Yi Xiao
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shyng-Shiou Yuan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ruei-Nian Li
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
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10
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Wang YY, Chen YK, Hu CS, Xiao LY, Huang WL, Chi TC, Cheng KH, Wang YM, Yuan SSF. MAL-PDT inhibits oral precancerous cells and lesions via autophagic cell death. Oral Dis 2019; 25:758-771. [PMID: 30620118 DOI: 10.1111/odi.13036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/30/2018] [Accepted: 01/02/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Oral cancer is a common cancer with a high mortality rate. While surgery is the most effective treatment for oral cancer, it frequently causes deformity and dysfunction in the orofacial region. In this study, methyl aminolevulinate photodynamic therapy (MAL-PDT) as a prevention tool against progression of precancerous lesion to oral cancer was explored. METHODS For in vitro studies, we evaluated the effects of MAL-PDT on viability of DOK oral precancerous cells by XTT, cell morphology by TEM, and intracellular signaling pathways by flow cytometry, Western blotting, and immunofluorescence. For in vivo study, DMBA was used to induce oral precancerous lesions in hamsters followed by MAL-PDT treatment. We measured tumor size and body weight weekly. After sacrifice, buccal pouch lesions were processed for H&E stain and immunohistochemistry analysis. RESULTS MAL-PDT induced autophagic cell death in DOK oral precancerous cells. The autophagy-related markers LC3II and p62/SQSTM1 and autophagosome formation in DOK cells were increased after MAL-PDT treatment. In vivo, Metvix® -PDT treatment decreased tumor growth and enhanced LC3II expression in hamster buccal pouch tumors induced by DMBA. CONCLUSIONS Our in vitro and in vivo results suggest that MAL-PDT may provide an effective therapy for oral precancerous lesions through induction of autophagic cell death.
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Affiliation(s)
- Yen-Yun Wang
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yuk-Kwan Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chu-Sung Hu
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ling-Yi Xiao
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Ling Huang
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsung-Chen Chi
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuang-Hung Cheng
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yun-Ming Wang
- Department of Biological Science and Technology, Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, Hsinchu, Taiwan.,Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shyng-Shiou F Yuan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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11
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Qiao X, Liu W, Cao Y, Miao C, Yang W, Su N, Ye L, Li L, Li C. Performance of different imaging techniques in the diagnosis of head and neck cancer mandibular invasion: A systematic review and meta-analysis. Oral Oncol 2018; 86:150-164. [PMID: 30409295 DOI: 10.1016/j.oraloncology.2018.09.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/06/2018] [Accepted: 09/16/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND To assess diagnostic efficacy of imaging techniques for mandibular invasion by head and neck cancer. METHODS Thirteen databases were searched. Study inclusion, data-extraction and quality assessment were performed independently. STATA 14.0 were mainly used for meta-analysis. RESULTS Forty-nine studies were included. For mandibular invasion (cortex and marrow), CBCT, SPECT, CT, MRI, orthopantomography, PET-CT and bone-scintigraphy showed pooled sensitivities of 90%, 97%, 73%, 88%, 75%, 90%, 92%, specificities of 85%, 69% 91%, 90%, 83%, 89%, 79%, AUC of 0.9461, 0.9434, 0.8995, 0.9296, 0.8761, 0.9290, 0.9207, respectively. The combined SROC curves indicated CBCT and SPECT were superior to other techniques. For mandibular medullary invasion (marrow), CT and MRI showed pooled sensitivities of 85% and 93%, specificities of 86% and 84%. CONCLUSIONS CBCT was top-priority choice for bone invasion diagnosis. SPECT was recommended for exclusion, CT and MRI were suitable for conformation. Further investigations are needed for mandibular medullary involvement.
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Affiliation(s)
- Xianghe Qiao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Wei Liu
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Yubin Cao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Cheng Miao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Wenbin Yang
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Naichuan Su
- Department of Prosthodontics, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Li Ye
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Longjiang Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
| | - Chunjie Li
- Department of Head and Neck Oncology, Department of Evidence-based Dentistry, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
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12
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Eshraghi Samani R, Shirkhoda M, Hadji M, Beheshtifard F, Hamedani SMMG, Momen A, Mollashahi M, Zendehdel K. The prognostic value of lymph node ratio in survival of head-and-neck squamous cell carcinoma. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2018; 23:35. [PMID: 29887903 PMCID: PMC5961280 DOI: 10.4103/jrms.jrms_948_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 12/14/2017] [Accepted: 01/31/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Head-and-neck squamous cell carcinoma (HNSCC) is the sixth most prevalent type of cancers in the world. Due to its relatively high rate of recurrence, the prognosis of patients is poor and the survival rate is low; therefore, identifying the prognostic factors is considered necessary for better treatment. MATERIALS AND METHODS This historical cohort study was conducted on 201 patients diagnosed with aerodigestive SCC who underwent surgery and lymph node dissection. We determined the prognostic value of lymph node ratio (LNR) on overall survival (OS), disease-free survival (DFS), and locoregional failure-free survival (LFFS). We noticed an association between LNR and survival by Kaplan-Meier analysis. Hazard ratio (HR) of LNR was determined by Cox's regression model. RESULTS Two hundred and one patients entered this study after their medical histories were evaluated. The mean of lymph node count and LNR was 14.30 (±9.50) and 0.12 (±0.23), respectively. Eighty patients (39.80%) experienced recurrence of SCC. Five-year OS, DFS, and LFFS were 32%, 21%, and 64%, respectively. The median of OS was 40.70 months and 30.11 months in patients with LNR of ≤0.06 and >0.06, respectively (P < 0.01). The LNR >0.06 was found to be a significant prognostic factor for lower OS of patients with HNSCC (HR = 2.11 [1.10, 4.40]; P = 0.04). DFS was not significantly different among patients with LNR ≤0.06 and patients with LNR >0.06 (P = 0.9). However, LFFS was slightly different among two groups (HR = 2.04 [0.90-4.80]; P < 0.1). CONCLUSION We recommend more intensive adjuvant therapies such as chemotherapy with radiotherapy and short interval follow-up for patients with LNR >0.06. Further investigations with larger sample sizes are recommended.
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Affiliation(s)
- Reza Eshraghi Samani
- Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
- Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
| | - Mohammad Shirkhoda
- Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
| | - Maryam Hadji
- Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
| | - Faramarz Beheshtifard
- Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
| | - Seyed Mohammad Mehdi Ghaffari Hamedani
- Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
- Department of Surgery, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Ali Momen
- Resident of General Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Mollashahi
- Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
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13
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Milenković A, Petrović S, Jocić M, Stojanov D, Stojanović M, Petrović F. RADIOLOGICAL DIAGNOS IS OF MALIGNANT TUMORS OF THE ORAL CAVITY. ACTA MEDICA MEDIANAE 2018. [DOI: 10.5633/amm.2018.0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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14
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Jacobi C, Rauch J, Hagemann J, Lautz T, Reiter M, Baumeister P. Prognostic value of the lymph node ratio in oropharyngeal carcinoma stratified for HPV-status. Eur Arch Otorhinolaryngol 2017; 275:515-524. [PMID: 29204919 DOI: 10.1007/s00405-017-4833-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 11/29/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Lymph node ratio (LNR) was shown to be a prognostic factor in laryngeal and oral cavity primaries. The purpose of this study was to investigate the impact of the lymph node ratio in oropharyngeal squamous cell carcinoma (OPSCC) with a high incidence of HPV-related disease. Therefore, the role of LNR was evaluated as an additional predictive parameter to the 8th edition of AJCC TNM staging system. METHODS From December 2009 to August 2015, patients diagnosed with primary oropharyngeal squamous cell carcinoma were prospectively enrolled. After tumor resection with uni- or bilateral neck dissection, patients with ≥ 1 nodal metastasis (pN+) were eligible for a retrospective LNR analysis. RESULTS 137 patients underwent tumor resection with uni- or bilateral neck dissection. The proportion of HPV-associated disease was 42%. Most patients (n = 96; 70%) presented with involved neck nodes. In p16-positive OPSCC, the rate of pN + cases was significantly increased compared to p16-negative OPSCC (86% vs. 58%, p = 0.007). Patients with LNR ≤ 10% had a significant better overall survival (OS) and disease-specific survival (DSS). However, when stratified for p16-status, LNR ≤ 10% had a significant impact on OS only for HPV-associated tumors (p = 0.027), whereas LNR of ≤ 10% was not a significant predictor for better OS in p16-negative OPSCC (p = 0.143). CONCLUSION The LNR with a cut-off value of 10% serves as an additional prognostic parameter in HPV-related OPSCC and may help to improve risk stratification in combination with the revised AJCC 8th edition TNM classification.
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Affiliation(s)
- Christian Jacobi
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, Munich, Germany.
| | - Josepha Rauch
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, Munich, Germany
| | - Jan Hagemann
- Department of Otorhinolaryngology, Head and Neck Surgery, Johannes-Gutenberg-University Medical Center, Langenbeckstraße 1, Mainz, 55131, Germany
| | - Thomas Lautz
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, Munich, Germany
| | - Maximilian Reiter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, Munich, Germany
| | - Philipp Baumeister
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, Munich, Germany.,Clinical Cooperation Group Personalized Radiotherapy in Head and Neck Cancer, Helmholtz Center, Munich, Germany
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15
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[Imaging for surgical planning : Tumor surgery including reconstructive procedures]. HNO 2017; 65:472-481. [PMID: 28353078 DOI: 10.1007/s00106-017-0343-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Alongside clinical investigation, imaging is an important diagnostic modality for guiding treatment decisions and particularly for surgical planning in head and neck cancer. The significance and type of imaging depends on localization of the primary tumor. Beside the primary tumor, each imaging procedure must also include the lymph nodes, in order to develop an overall concept of surgical treatment. In addition to the superficial growth of a tumor, it is of utmost importance that its infiltration also be detected by imaging, in order to define the extent of tumor resection and identify potentially necessary reconstructive procedures. The type of imaging needed to understand tumor localization and size, e.g., CT or MRI, depends on the region. In some cases the methods are complementary.
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16
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Murakami R, Nakayama H, Semba A, Hiraki A, Nagata M, Kawahara K, Shiraishi S, Hirai T, Uozumi H, Yamashita Y. Prognostic impact of the level of nodal involvement: retrospective analysis of patients with advanced oral squamous cell carcinoma. Br J Oral Maxillofac Surg 2017; 55:50-55. [DOI: 10.1016/j.bjoms.2016.08.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 08/31/2016] [Indexed: 01/02/2023]
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17
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Junn JC, Baugnon KL, Lacayo EA, Hudgins PA, Patel MR, Magliocca KR, Corey AS, El-Deiry M, Wadsworth JT, Beitler JJ, Saba NF, Liu Y, Aiken AH. CT Accuracy of Extrinsic Tongue Muscle Invasion in Oral Cavity Cancer. AJNR Am J Neuroradiol 2016; 38:364-370. [PMID: 28059707 DOI: 10.3174/ajnr.a4993] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/30/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Extrinsic tongue muscle invasion in oral cavity cancer upstages the primary tumor to a T4a. Despite this American Joint Committee on Cancer staging criterion, no studies have investigated the accuracy or prognostic importance of radiologic extrinsic tongue muscle invasion, the feasibility of standardizing extrinsic tongue muscle invasion reporting, or the degree of agreement across different disciplines: radiology, surgery, and pathology. The purpose of this study was to assess the agreement among radiology, surgery, and pathology for extrinsic tongue muscle invasion and to determine the imaging features most predictive of extrinsic tongue muscle invasion with surgical/pathologic confirmation. MATERIALS AND METHODS Thirty-three patients with untreated primary oral cavity cancer were included. Two head and neck radiologists, 3 otolaryngologists, and 1 pathologist prospectively evaluated extrinsic tongue muscle invasion. RESULTS Fourteen of 33 patients had radiologic extrinsic tongue muscle invasion; however, only 8 extrinsic tongue muscle invasions were confirmed intraoperatively. Pathologists were unable to determine extrinsic tongue muscle invasion in post-formalin-fixed samples. Radiologic extrinsic tongue muscle invasion had 100% sensitivity, 76% specificity, 57% positive predictive value, and 100% negative predictive value with concurrent surgical-pathologic evaluation of extrinsic tongue muscle invasion as the criterion standard. On further evaluation, the imaging characteristic most consistent with surgical-pathologic evaluation positive for extrinsic tongue muscle invasion was masslike enhancement. CONCLUSIONS Evaluation of extrinsic tongue muscle invasion is a subjective finding for all 3 disciplines. For radiology, masslike enhancement of extrinsic tongue muscle invasion most consistently corresponded to concurrent surgery/pathology evaluation positive for extrinsic tongue muscle invasion. Intraoperative surgical and pathologic evaluation should be encouraged to verify radiologic extrinsic tongue muscle invasion to minimize unnecessary upstaging. Because this process is not routine, imaging can add value by identifying those cases most suspicious for extrinsic tongue muscle invasion, thereby prompting this more detailed evaluation by surgeons and pathologists.
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Affiliation(s)
- J C Junn
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
| | - K L Baugnon
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
| | - E A Lacayo
- Department of Radiology (E.A.L.), Georgetown University, Washington, DC
| | - P A Hudgins
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
| | - M R Patel
- Otolaryngology (M.R.P., M.E.-D., J.T.W.)
| | | | - A S Corey
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
| | - M El-Deiry
- Otolaryngology (M.R.P., M.E.-D., J.T.W.)
| | | | | | | | - Y Liu
- Statistics (Y.L.), Emory University School of Medicine, Atlanta, Georgia
| | - A H Aiken
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
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18
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Gődény M, Lengyel Z, Polony G, Nagy ZT, Léránt G, Zámbó O, Remenár É, Tamás L, Kásler M. Impact of 3T multiparametric MRI and FDG-PET-CT in the evaluation of occult primary cancer with cervical node metastasis. Cancer Imaging 2016; 16:38. [PMID: 27814768 PMCID: PMC5096285 DOI: 10.1186/s40644-016-0097-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/26/2016] [Indexed: 02/06/2023] Open
Abstract
Background This study aimed to determine the ability of multimodal evaluation with multiparametric 3T-MRI (MPMRI) and positron emission tomography - computed tomography (PET/CT) to detect cancer of unknown primary origin (CUP) with neck lymph node (LN) metastasis. Methods The study group comprised 38 retrospectively analysed consecutive patients with LN metastasis in the head and neck (HN) region without known primary tumours (PTs). Statistical values of 3T-MRI and of FDG-PET/CT scans were evaluated. Results Of the 38 CUPs, conventional native T1-, T2-weighted and STIR sequences detected 6 PTs. Native sequences plus diffusion-weighted imaging (DWI) found 14-, and with fat suppression contrast-enhanced T1-weighted measurement as well as with the complex MPMRI found 15 primaries and with PET/CT 17 CUPs could be evaluated, respectively. The detection rates were 15.8, 36.8, 39.5, 39.5 and 44.7 % for conventional native MRI, native plus DWI, native with contrast-enhanced MRI (CE-MRI), for MPMRI, and for PET/CT, respectively. The overall detection rate proved by histology was 47.4 %. PET/CT provided the highest sensitivity (Sv: 94.4 %) but a lower specificity (Sp: 65.0 %), using MPMRI (Sv: 88.2 %) the specificity increased to 71.4 %. DWIincreased specificity of the native sequences (Sp: 76.2 %). Conventional native sequences plus DWI as well as 3T-MPMRI and PET/CT were same accurate (Acc: 79.0 %) and had similar likelihood ratio (LR: 3.42, 3.03 and 2.62) in detecting unknown PT sites. Conclusions The accuracy of FDG-PET/CT and MPMRI in case of CUP in finding the primary cancer in the neck regions is identical. While using PET/CT whole body information can be obtained in one examination. MPMRI shows the local soft tissue status more accurately. In cases of CUP PET/CT should be the first method of choice if it is available. MPMRI can clarify the exact primary tumor stage, and it can be advantageous in clarifying the prognostic factors, which is necessary in case of advanced tumor stage and when surgery is under consideration. In case low N stage is likely after the clinical examination and wait and see policy can be considered, MPMRI is recommended, and in this case the significance the of radiation free MPMRI is increasing. Electronic supplementary material The online version of this article (doi:10.1186/s40644-016-0097-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mária Gődény
- Department of Diagnostic Radiology, National Institute of Oncology, Ráth György street 7-9, Budapest, 1122, Hungary. .,Department of Postgraduate Education and Scientific Research, University of Medicine and Pharmacy, Tirgu Mures, Romania.
| | - Zsolt Lengyel
- Pozitron Diagnostics LTD, Hunyadi János street 9, Budapest, 1117, Hungary
| | - Gábor Polony
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Szigony u.36, Budapest, 1083, Hungary
| | - Zoltán Takácsi Nagy
- Department of Radiotherapy, National Institute of Oncology, Ráth György street 7-9, Budapest, 1122, Hungary
| | - Gergely Léránt
- Department of Diagnostic Radiology, National Institute of Oncology, Ráth György street 7-9, Budapest, 1122, Hungary
| | - Orsolya Zámbó
- Head and Neck Surgery Department, National Institute of Oncology, Ráth György street 7-9, Budapest, 1122, Hungary
| | - Éva Remenár
- Head and Neck Surgery Department, National Institute of Oncology, Ráth György street 7-9, Budapest, 1122, Hungary
| | - László Tamás
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Szigony u.36, Budapest, 1083, Hungary
| | - Miklós Kásler
- Head and Neck Surgery Department, National Institute of Oncology, Ráth György street 7-9, Budapest, 1122, Hungary.,Department of Postgraduate Education and Scientific Research, University of Medicine and Pharmacy, Tirgu Mures, Romania
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19
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Yuan Y, Wang J, Wu Y, Li G, Tao X. Prognostic value of computed tomography characteristics for overall survival in patients with maxillary cancer. BMC Cancer 2016; 16:783. [PMID: 27724942 PMCID: PMC5057221 DOI: 10.1186/s12885-016-2830-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 10/03/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Our aim was to identify the preoperative computed tomographic (CT) characteristics most efficient in predicting overall survival (OS) of patients with maxillary cancer (MC). METHODS A retrospective review of CT images was performed in 115 patients with histopathologically confirmed primary MC from January 2005 to December 2013, who were classified into 2 subtypes (epithelial and non-epithelial) according to tissue of origin. The prognostic value of CT characteristics for OS was determined firstly through univariate Kaplan-Meier survival estimates with log-rank tests. Significant predictors were further tested with multivariable Cox proportional hazard models. RESULTS CT characteristics predictive of OS in univariate survival analysis were long and short diameter of the mass, long and short diameter of the largest cervical lymph node and adjacent soft tissue infiltration (P < 0.05). In the multivariable Cox analyses, the significantly independent predictors were long diameter of mass ≥ 4.2 cm (hazard ratio [HR] 1.8; 95 % confidence interval [CI] 1.1-3.0) and short diameter of the largest lymph node ≥ 7 mm (HR 1.9; 95 % CI 1.0-3.6) for all MC patients, as well as for non-epithelial MC patients (HR 3.1; 95 % CI 1.2-8.0; HR 3.3; 95 % CI 1.3-8.7, respectively). CONCLUSIONS Preoperative CT characteristics of tumor size, lymph node size and adjacent structure infiltration are predictive of the OS time of MC patients. The information brought up in this study could be used in clinical practice to inform about the possible prognosis, and be beneficial to clinical decision making.
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Affiliation(s)
- Ying Yuan
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Jingbo Wang
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Yingwei Wu
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Guojun Li
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
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20
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Lerant G, Sarkozy P, Takacsi-Nagy Z, Polony G, Tamas L, Toth E, Boer A, Javor L, Godeny M. Dynamic Contrast-Enhanced MRI Parameters as Biomarkers in Assessing Head and Neck Lesions After Chemoradiotherapy Using a Wide-Bore 3 Tesla Scanner. Pathol Oncol Res 2015; 21:1091-9. [DOI: 10.1007/s12253-015-9942-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 04/21/2015] [Indexed: 11/30/2022]
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