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Tamas T, Dinu C, Lenghel LM, Boțan E, Tamas A, Stoia S, Leucuta DC, Bran S, Onisor F, Băciuț G, Armencea G, Băciuț M. High-Frequency Ultrasound in Diagnosis and Treatment of Non-Melanoma Skin Cancer in the Head and Neck Region. Diagnostics (Basel) 2023; 13:diagnostics13051002. [PMID: 36900146 PMCID: PMC10001019 DOI: 10.3390/diagnostics13051002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
Non-melanoma skin cancer is one of the most frequently diagnosed cancers in the human body and unfortunately the incidence continues to increase. NMSC is represented by the basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), which are the most prevalent forms, and basosquamous cell carcinomas (BSC) together with Merkel cell carcinoma (MCC), which are rare types but with a very aggressive pattern and poor prognosis. The pathological diagnosis is hard to assess without a biopsy, even by the dermoscopy. Moreover, the staging can be problematic because there is no access clinically to the thickness of the tumor and the depth of the invasion. The aim of this study was to evaluate the role of ultrasonography (US), which is a very efficient imaging method, non-irradiating and cheap, in diagnosis and treatment of non-melanoma skin cancer in the head and neck region. Thirty-one patients with highly suspicious malignant lesions of the head and neck skin were evaluated in the Oral and Maxillo-facial Surgery Department and Imaging Department in Cluj Napoca, Romania. All tumors were measured with three transducers: 13 MHz, 20 MHz and 40 MHz. Doppler examination and elastography were also used. The length, width, diameter, thickness, the presence of necrosis, status of regional lymph nodes, the presence of hyperechoic spots, strain ratio and vascularization were all recorded. After that, all patients were treated by surgical resection of the tumor and reconstruction of the defect. Immediately after surgical resection, all tumors were measured again after the same protocol. The resection margins were evaluated by all three types of transducers in order to detect malignant involvement and the results were compared with the histopathological report. We found that the 13 MHz transducers offered a big picture of the tumor but the level of details, in the form of the presence of the hyperechoic spots, is reduced. We recommend this transducer for evaluation of surgical margins or for the large skin tumors. The 20 and 40 MHz transducers are better for viewing the particularities of malignant lesions and for an accurate measurement; however, in the case of large size lesions, assessing all three dimensions of the tumor can be difficult. The intralesional hyperechoic spots are present in case of BCC and they can be used for differential diagnosis of BCC.
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Affiliation(s)
- Tiberiu Tamas
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Lavinia Manuela Lenghel
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-740423025
| | - Emil Boțan
- Department of Pathology, Emergency County Hospital, 400437 Cluj-Napoca, Romania
| | - Adela Tamas
- Doctoral School, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Sebastian Stoia
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuta
- Medical Informatics and Biostatistics Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Florin Onisor
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Grigore Băciuț
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Mihaela Băciuț
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Nolan GS, Dunne JA, Lee AE, Wade RG, Kiely AL, Pritchard Jones RO, Gardiner MD, Abbassi O, Abdelaty M, Ahmed F, Ahmed R, Ali S, Allan A, Allen L, Anderson I, Bakir A, Berwick D, Sarala BBN, Bhat W, Bloom O, Bolton L, Brady N, Campbell E, Capitelli-McMahon H, Cassell O, Chalhoub X, Chalmers R, Chan J, Chu HO, Collin T, Cooper K, Curran TA, Cussons D, Daruwalla M, Dearden A, Delikonstantinou I, Dobbs T, Dunlop R, El-Muttardi N, Eleftheriadou A, Elamin SE, Eriksson S, Exton R, Fourie LR, Freethy A, Gardner E, Geh JL, Georgiou A, Georgiou M, Gilbert P, Gkorila A, Green D, Haeney J, Hamilton S, Harper F, Harrison C, Heinze Z, Hemington-Gorse S, Hever P, Hili S, Holmes W, Hughes W, Ibrahim N, Ismail A, Jallali N, James NK, Jemec B, Jica R, Kaur A, Kazzazi D, Khan M, Khan N, Khashaba H, Khera B, Khoury A, Kiely J, Kumar S, Patel PK, Kumbasar DE, Kundasamy P, Kyle D, Langridge B, Liu C, Lo M, Macdonald C, Anandan SM, Mahdi M, Mandal A, Manning A, Markeson D, Matteucci P, McClymont L, Mikhail M, Miller MC, Munro S, Musajee A, Nasrallah F, Ng L, Nicholas R, Nicola A, Nikkhah D, O'Hara N, Odili J, Oudit D, Patel A, Patel C, Patel N, Patel P, Peach H, Phillips B, Pinder R, Pinto-Lopes R, Plonczak A, Quinnen N, Rafiq S, Rahman K, Ramjeeawon A, Rinkoff S, Sainsbury D, Schumacher K, Segaren N, Shahzad F, Shariff Z, Siddiqui A, Singh P, Sludden E, Smith JRO, Song M, Stodell M, Tanos G, Taylor K, Taylor L, Thomson D, Tiernan E, Totty JP, Vaingankar N, Toh V, Wensley K, Whitehead C, Whittam A, Wiener M, Wilson A, Wong KY, Wood S, Yeoh T, Yii NW, Yim G, Young R, Zberea D, Jain A. National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK. Br J Surg 2022; 109:1040-1043. [DOI: 10.1093/bjs/znac232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022]
Abstract
A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.
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Affiliation(s)
- Grant S Nolan
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Jonathan A Dunne
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Alice E Lee
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Ryckie G Wade
- Leeds Institute for Medical Research, University of Leeds , Leeds , UK
- Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Ailbhe L Kiely
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Rowan O Pritchard Jones
- Department of Plastic and Reconstructive Surgery, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust , Prescot , UK
| | - Matthew D Gardiner
- Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham , Slough , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
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- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
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Szewczyk M, Marszałek A, Golusiński P, Niewinski P, Kosińska A, Pazdrowski J, Dańczak-Pazdrowska A, Golusiński W. Does experience affect surgical margins in head and neck basal cell carcinoma? Otolaryngol Pol 2022; 76:1-6. [DOI: 10.5604/01.3001.0015.7117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: The aim of our study was to evaluate the impact of surgical experience in a high volume head and neck surgery department on basal cell carcinoma margin status.
Methods: A retrospective analysis of 546 patients surgically treated for primary basal cell carcinoma of the head and neck region was done. Resections were performed by 4 specialists with equal experience in head and neck surgery and 4 ENT residents at the same level of surgical training. A margin of 3-5mm was chosen, according to guidelines.
Results: The study consisted of 304 males and 242 females, mean age of 69 (range 26 – 100). Most of the tumors were located on the nose (165 pts; 30,2%) and auricle (119; 21,7%). The most common histological subtype was nodular (119; 21,7%). Tumor size was up to 20mm in 394 cases (72%). Positive surgical margins were found in 112 cases (20,5%). There was no difference in terms of positive surgical margins between residents (19/119 cases; 15,9%) and specialists (93/426; 21,8%; p=0.161).
Conclusions: The results of our study have shown that adequate surgical training in dedicated head and neck surgery department is an efficient factor in obtaining free surgical margins in head and neck basal cell carcinoma.
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Affiliation(s)
- Mateusz Szewczyk
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Andrzej Marszałek
- Zakład Patologii Nowotworów. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Paweł Golusiński
- Kliniczny Oddział Otorynolaryngologii. Uniwersytet Zielonogórski
| | - Patryk Niewinski
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Agnieszka Kosińska
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Jakub Pazdrowski
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | | | - Wojciech Golusiński
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
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Exploring the cause of the dual allosteric targeted inhibition attaching to allosteric sites enhancing SHP2 inhibition. Mol Divers 2021; 26:1567-1580. [PMID: 34338914 DOI: 10.1007/s11030-021-10286-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
SHP2 is a protein tyrosine phosphatase (PTP) that can regulate the tyrosine phosphorylation level. Overexpression of SHP2 will promote the development of cancer diseases, so SHP2 has become one of the popular targets for the treatment of cancer. Studies have reported that both SHP099 and SHP844 are inhibitors of SHP2 and bind to different allosteric sites 1 and 2, respectively. Studies have shown that combining SHP099 with SHP844 will enhance pharmacological pathway inhibition in cells. This study uses molecular dynamic simulations to explore the dual allosteric targeted inhibition mechanism. The result shows that the residues THR108-TRP112 (allosteric site 1) move to LEU236-GLN245 (αB-αC link loop in PTP domain) , the residues of GLN79-GLN87 (allosteric site 2) get close to LEU262-GLN269 (αA-αB link loop in PTP domain) and HIS458-ARG465 (P-loop) come near to ARG501-THR507 (Q-loop) in SHP2-SHP099-SHP844 system, which makes the "inactive conformation" more stable and prevents the substrate from entering the catalytic site. Meanwhile, residue GLU110 (allosteric site 1), ARG265 (allosteric site 2), and ARG501 (Q-loop) are speculated to be the key residues that causing the SHP2 protein in auto-inhibition conformation. It is hoped that this study will provide clues for the development of the dual allosteric targeted inhibition of SHP2.
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Nolan G, Kiely A, Totty J, Wormald J, Wade R, Arbyn M, Jain A. Incomplete surgical excision of keratinocyte skin cancers: a systematic review and meta‐analysis*. Br J Dermatol 2020; 184:1033-1044. [PMID: 33131067 DOI: 10.1111/bjd.19660] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Keratinocyte or nonmelanoma skin cancer (NMSC) is the commonest malignancy worldwide. The usual treatment is surgical excision. Current guidelines underestimate incomplete excision rates. OBJECTIVES We aimed to determine the risk of incomplete excision of NMSCs through a systematic review and meta-analysis of primary clinical studies. METHODS A PRISMA-compliant systematic review and meta-analysis was performed using methodology proposed by Cochrane (PROSPERO CRD42019157936). A comprehensive search strategy was applied to MEDLINE, Embase, Scopus, CINAHL, EMCare, Cochrane Library and the grey literature (January 2000-27 November 2019). All studies were included except those on Mohs micrographic surgery, frozen section or biopsies. Abstract screening and data extraction were performed in duplicate. Risk of bias was assessed using a tool for prevalence/incidence studies. The primary outcome was the proportion of incomplete surgical excisions. A random-effects model for pooling of binomial data was used. Differences between proportions were assessed by subgroup meta-analysis and meta-regression, which were presented as risk ratios (RRs). RESULTS Searching identified 3477 records, with 110 studies included, comprising 53 796 patients with 106 832 basal cell carcinomas (BCCs) and 21 569 squamous cell carcinomas (SCCs). The proportion of incomplete excisions for BCC was 11·0% [95% confidence interval (CI) 9·7-12·4] and for SCC 9·4% (95% CI 7·6-11·4). Proportions of incomplete excisions by specialty were: dermatology, BCCs 6·2% and SCCs 4·7%; plastic surgery, BCCs 9·4% and SCCs 8·2%; general practitioners, BCCs 20·4% and SCCs 18·9%. The risk of incomplete excision for general practitioners was four times that of dermatologists for both BCCs (RR 3·9, 95% CI 2·0-7·3) and SCCs (RR 4·8, 95% CI 1·0-22·8). Studies were heterogeneous (I2 = 98%) and at high risk of bias. CONCLUSIONS The proportion of incomplete excisions is higher than previously reported. Excisions performed by specialists may lower the risk of incomplete excision.
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Affiliation(s)
- G.S. Nolan
- Department of Plastic and Reconstructive Surgery Whiston HospitalSt Helens and Knowsley Teaching Hospitals NHS Trust Warrington Road Prescot Merseyside UK
| | - A.L. Kiely
- Department of Plastic and Reconstructive Surgery Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Trust Edgbaston UK
| | - J.P. Totty
- Department of Plastic and Reconstructive Surgery Hull University Teaching HospitalsCastle Hill Hospital Cottingham East Riding of Yorkshire UK
| | - J.C.R. Wormald
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
- Department of Plastic and Reconstructive Surgery Stoke Mandeville HospitalBuckinghamshire Healthcare NHS Trust Aylesbury UK
| | - R.G. Wade
- Leeds Institute for Medical Research University of Leeds Leeds UK
- Department of Plastic and Reconstructive Surgery Leeds Teaching Hospitals NHS Trust Leeds UK
| | - M. Arbyn
- Unit of Cancer Epidemiology Belgian Cancer Centre Sciensano Brussels Belgium
| | - A. Jain
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
- Department of Plastic and Reconstructive Surgery Charing Cross and St Mary’s HospitalsImperial College Healthcare NHS Trust London UK
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Capitelli-McMahon H, Hurley A, Pinder R, Matteucci P, Totty J. Characterising non-melanoma skin cancer undergoing surgical management during the COVID-19 pandemic. J Plast Reconstr Aesthet Surg 2020; 74:644-710. [PMID: 33199223 PMCID: PMC7605727 DOI: 10.1016/j.bjps.2020.10.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 10/20/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Helen Capitelli-McMahon
- Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, England.
| | - Anna Hurley
- Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, England
| | - Richard Pinder
- Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, England
| | - Paolo Matteucci
- Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, England
| | - Joshua Totty
- Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, England
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Nolan GS, Dunne JA, Kiely AL, Pritchard Jones RO, Gardiner M, Jain A. The effect of the COVID-19 pandemic on skin cancer surgery in the United Kingdom: a national, multi-centre, prospective cohort study and survey of Plastic Surgeons. THE BRITISH JOURNAL OF SURGERY 2020; 107:e598-e600. [PMID: 32936450 PMCID: PMC7929189 DOI: 10.1002/bjs.12047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/14/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Grant S Nolan
- Department of Plastic and Reconstructive Surgery, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, Warrington Road, Prescot, Merseyside, L35 5DR, UK
| | - Jonathan A Dunne
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary's Hospitals, Imperial College Healthcare NHS Trust, Praed Street, Paddington, London, W2 1NY, UK
| | - Ailbhe L Kiely
- Department of Plastic and Reconstructive Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Trust, Mindelsohn Way, Edgbaston, B15 2TH, UK
| | - Rowan O Pritchard Jones
- Department of Plastic and Reconstructive Surgery, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, Warrington Road, Prescot, Merseyside, L35 5DR, UK
| | - Matthew Gardiner
- Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Slough, SL2 4HL, UK
| | | | - Abhilash Jain
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary's Hospitals, Imperial College Healthcare NHS Trust, Praed Street, Paddington, London, W2 1NY, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY, UK
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