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Cichocka E, Górczyńska-Kosiorz S, Misiołek M, Ścierski W, Koniewska A, Stryjewska-Makuch G, Gumprecht J. DIAPH2 gene polymorphisms and laryngeal cancer risk in men. J Cancer Res Clin Oncol 2024; 150:295. [PMID: 38844723 PMCID: PMC11156712 DOI: 10.1007/s00432-024-05820-4] [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: 04/30/2024] [Accepted: 05/28/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND The DIAPH2 gene is one of the genes commonly associated with laryngeal squamous cell carcinoma (LSCC). In our study, we considered the four polymorphisms of this gene, i.e. rs5920828, rs4322175, rs12851931 and rs5921830 as potential genetic risk factors for LSCC. METHODS We determined the genotyping of the genetic variants of DIAPH2 in 230 male patients with histologically confirmed LSCC compared to the European population. Demographic and environmental exposure data of each subject were examined. To conduct the genetic tests, extraction of total DNA was performed. We genotyped all four variants in each patient and determined their frequencies. RESULTS In the case of the rs12851931 polymorphism in the DIAPH2 gene, a significant difference was observed in the distribution of the T stage depending on the polymorphism. Heterozygotes were more often associated with T2 stage, while homozygotes were more likely to have higher tumor stages. The rs12851931 homozygotes of DIAPH2 were statistically significantly more prevalent in smokers. The results suggested that rs12851931 polymorphism in DIAPH2 could increase the onset risk of LSCC. CONCLUSIONS Our results provide further information on the role of the DIAPH2 gene in the pathogenesis of LSCC.
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Salama M, Ali A, Ibrahim FAR, Elabd S. Citalopram, an antipsychotic agent, induces G1/G0 phase cell cycle arrest and promotes apoptosis in human laryngeal carcinoma HEP-2 cells. Med Oncol 2024; 41:105. [PMID: 38573558 PMCID: PMC10994997 DOI: 10.1007/s12032-024-02338-0] [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: 12/18/2023] [Accepted: 02/21/2024] [Indexed: 04/05/2024]
Abstract
Human laryngeal squamous carcinoma (LSCC) is a common malignant tumor in the head and neck. Despite the recently developed therapies for the treatment of LSCC, patients' overall survival rate still did not enhance remarkably; this highlights the need to formulate alternative strategies to develop novel treatments. The antitumor effects of antidepressant drugs such as citalopram have been reported on several cancer cells; however, they have yet to be investigated against LSCC. The current study was directed to explore the possible antitumor effects of citalopram on human laryngeal carcinoma cell lines (HEP-2). HEP-2 cells were cultured and treated with different doses of citalopram (50-400 µM) for 24, 48, and 72 h. The effects of citalopram on the viability of cancer cells were determined by the MTT assay. In addition, apoptosis and cell cycle analysis were performed by flow cytometry. Moreover, evaluation of the expression of proapoptotic and apoptotic proteins, such as cytochrome c, cleaved caspases 3 and 9, Bcl-2, and BAX, was performed by western blotting analysis. Our results revealed that citalopram significantly suppressed the proliferation of HEP-2 cells through the upregulation of p21 expression, resulting in the subsequent arrest of the cell cycle at the G0/G1 phase. Furthermore, citalopram treatment-induced HEP-2 cell apoptosis; this was indicated by the significant increase of cytochrome c, cleaved caspases 3 and 9, and BAX protein expression. On the contrary, Bcl-2 protein expression was significantly downregulated following treatment with citalopram. The ultrastructure studies were in accordance with the protein expression findings and showed clear signs of apoptosis with ring chromatin condensation upon treatment with citalopram. These findings suggest that citalopram's anti-tumor activities on HEP-2 cells entailed stimulation of the intrinsic apoptotic pathway, which was mediated via Bcl-2 suppression.
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Affiliation(s)
- Mohammed Salama
- Department of Histochemistry and Cell Biology, Medical Research Institute, Alexandria University, 165 El-Horeya Avenue, Hadara, Alexandria, Egypt.
| | - Abeer Ali
- Department of Chemical Pathology, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, Egypt
| | - Fawziya A R Ibrahim
- Department of Applied Medical Chemistry, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, Egypt
| | - Seham Elabd
- Department of Physiology, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, Egypt
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Tariq N, Mirza T, Ansari M, Nazir S. Role of Human Papilloma Virus 16/18 In Laryngeal Carcinoma with Correlation to the Expression of Cyclin D1, p53, p16 and EGFR. Pak J Med Sci 2023; 39:1768-1773. [PMID: 37936777 PMCID: PMC10626090 DOI: 10.12669/pjms.39.6.8220] [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: 04/18/2023] [Revised: 05/24/2023] [Accepted: 07/18/2023] [Indexed: 11/09/2023] Open
Abstract
Objective To investigate the role of Human Papilloma Virus (HPV) (16/18) in relation to the molecular genetic mechanisms of Cyclin D1, p53, p16, and Epidermal growth factor receptor (EGFR) in Laryngeal Squamous Cell Carcinoma (LSSC). Methods A cross-sectional study of 88 (Formalin-fixed Paraffin Embedded) FFPE laryngeal biopsies were done at Basic Medical Sciences Institute, Jinnah Postgraduate Centre, Karachi from 2010 to 2019 with the application of Polymerase chain reaction (PCR) for HPV 16/18and Immuno-histochemical staining for molecular genetic expression of proteins, Cyclin D1, p53, p16, and EGFR. Results Out of 88 cases of Laryngeal Squamous Cell Carcinoma (LSSC) there was female preponderance. Mean age of the participants was found as 50.7±12.8 years. High risk HPV 16/18 was positive in 28 cases (31.8%), largely related to Grade-II and Grade-III. Immunohistochemically, Cyclin D1 (87.5%) appeared as the most important driver mutation followed by p16 (86.4%), EGFR (65.9%), and, p53 was positive in (61.4%) of cases. Conclusion The role of high-risk HPV 16/18 is concurred in the present study strongly in correlation to p16 as a surrogate marker. Moreover, the other driver mutations of Cyclin D1, p53, and EGFR are also implicated as cumulative molecular events in tumor progression as mostly seen in higher Grades.
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Affiliation(s)
- Naila Tariq
- Naila Tariq HOD, Laboratory National Medical Center, Karachi, Pakistan
| | - Talat Mirza
- Talat Mirza Meritorious Professor of Pathology Department of Research & Molecular Medicine Ziauddin University, Karachi, Pakistan
| | - Maqsood Ansari
- Maqsood Ali Ansari. Professor & HOD, Department of Genetics, University of Karachi, Karachi, Pakistan
| | - Sobia Nazir
- Sobia Nazir, MPhil. Molecular Pathology Reliance Laboratory, Karachi, Pakistan
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Ormandjieva A, Yordanov S, Stoyanov H, Deliverska E, Shivarov V, Ivanova M. The role of non-classical and chain-related human leukocyte antigen polymorphisms in laryngeal squamous cell carcinoma. Mol Biol Rep 2023; 50:7245-7252. [PMID: 37418079 DOI: 10.1007/s11033-023-08629-5] [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: 03/27/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Laryngeal squamous cell carcinoma (LSCC) is the major pathological subtype of laryngeal cancer. It has been shown that alterations of the expression of non-classical human leukocyte antigens (HLA) and the chain-related MIC molecules by malignant cells can lead to escape from the immune system control and certain allele variants may participate in immune editing and therefore be associated with modulation of cancer risk. The aim of the present study was to investigate the role of non-classical HLA class Ib and chain-related MIC polymorphisms, determined at the allelic level by next-generation sequencing (NGS), in patients from the Bulgarian population, diagnosed with LSCC. MATERIALS AND METHODS In the present study DNA samples from 48 patients with LSCC were used. Data was compared to 63 healthy controls analysed in previous studies. HLA genotyping was performed by using the AlloSeq Tx17 early pooling protocol and the library preparation AlloSeq Tx17 kit (CareDx). Sequencing was performed on MiniSeq sequencing platform (Illumina) and HLA genotypes were assigned with the AlloSeq Assign analysis software v1.0.3 (CareDx) and the IPD-IMGT/HLA database 3.45.1.2. RESULTS The HLA disease association tests revealed a statistically significant predisposing association of HLA-F*01:01:02 (Pc = 0.0103, OR = 24.0194) with LSCC, while HLA-F*01:01:01 (Pc = 8.21e-04, OR = 0.0485) has a possible protective association. Additionally we observed several haplotypes with statistically significant protective and predisposing associations. The strongest association was observed for F*01:01:01-H*01:01:01 (P = 0.0054, haplotype score=-2.7801). CONCLUSION Our preliminary study suggests the involvement of HLA class Ib in cancer development and the possible role of the shown alleles as biomarkers of LSCC.
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Affiliation(s)
- Anastasia Ormandjieva
- Department of Clinical Immunology, Medical Faculty, Medical University, Sofia, Bulgaria.
| | | | - Hristo Stoyanov
- Department of Dental, Oral and Maxillofacial surgery, FDM, Medical University - Sofia, Sofia, Bulgaria
| | - Elitsa Deliverska
- Department of Dental, Oral and Maxillofacial surgery, FDM, Medical University - Sofia, Sofia, Bulgaria
| | - Velizar Shivarov
- Department of Experimental Research, Medical University Pleven, Pleven, Bulgaria
| | - Milena Ivanova
- Department of Clinical Immunology, Medical Faculty, Medical University, Sofia, Bulgaria
- Clinic of Clinical Immunology with Stem Cell Bank, University Hospital ''Alexandrovska'', Sofia, Bulgaria
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Rachmadi L, Laelasari E, Susanto YDB, Kusmardi K. MMP-9 and CCR7 as Possible Predictors of Lymph Node Metastasis in Laryngeal Squamous Cell Carcinoma. IRANIAN JOURNAL OF PATHOLOGY 2023; 18:156-164. [PMID: 37600570 PMCID: PMC10439748 DOI: 10.30699/ijp.2023.563014.2986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/31/2022] [Indexed: 08/22/2023]
Abstract
Background & Objective The expression of matrix metalloproteinase-9 (MMP-9) and chemokine receptor 7 (CCR7) is significantly associated with tumor invasion and metastasis. Little is known regarding the potential of these markers in predicting cancer metastasis in Laryngeal Squamous Cell Carcinoma (LSCC). Therefore, this study aimed to dissect the potential of these markers in predicting the lymph node metastasis in LSCC patients. Methods Sixty tissue samples were obtained from the patients diagnosed pathologically with LSCC who underwent partial or total laryngectomy. The expression of MMP-9 and CCR7 was measured using the immunohistochemistry staining in the tissue samples of LSCC patients. The ROC (receiver operating characteristic) curve was used to determine the most significant cut-off points of expression according to the highest sensitivity and specificity of both the markers to predict the lymph node metastasis in LSCC. Then, the relationship between the clinicopathology features and the expression of MMP-9 and CCR7 was evaluated. Results The expression of both MMP-9 and CCR7 was significantly correlated with the lymph node metastasis in LSCC (P<0.001). Furthermore, CCR7 expression exhibited the highest prediction accuracy (AUC 95.7%) and sensitivity (100%) in predicting the lymph node metastasis in LSCC compared to that of MMP-9 (AUC 92.9%, sensitivity 90%). We also found that patients with larger tumor size (> 4 cm) had significantly higher expression of MMP-9 and CCR7 (P<0.002 and P<0.001, respectively). The Elevated expression level of CCR7 statistically correlated with higher MMP-9 expression (P<0.001). Conclusion MMP-9 and CCR7 might be beneficial as predictors of lymph node metastasis in LSCC patients.
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Affiliation(s)
- Lisnawati Rachmadi
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Boia ER, Boia S, Ceausu RA, Gaje PN, Maaroufi SM, Sandru F, Raica M. The Follicular Dendritic Cells and HPV 18 Interrelation in Head and Neck Squamous Cell Carcinomas of the Larynx. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1072. [PMID: 37374276 DOI: 10.3390/medicina59061072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Even if they are cells of controversial origin (mesenchymal, perivascular, or fibroblastic), follicular dendritic cells (FDC) are present in all organs. The aim of this study was to establish the FDC expression pattern and its interrelation with HPV 18 expression in laryngeal squamous cell carcinoma (LSCC). Materials and Methods: Fifty-six cases of LSCC were evaluated by simple and double immunostaining. The following score was used: 0 (negative or few positive cells), 1 (10-30% of positive cells), 2 (30-50% of cells), and 3 (over 50% of cells). Results: The expression of CD 21-positive cells with dendritic morphology (CDM) was noticed in the intratumoral area of conventional (well and poorly differentiated types and HPV 18 positive cases with a value of 2 for the score) and papillary types (HPV-18 negative cases with a score of 1). The highest value of 2 for the score of CDM in HPV-18 positive cases was found in the peritumoral area of well- and poorly-differentiated conventional LSCCs. A significant correlation was found between scores of CDM from the intratumoral area and those of the peritumoral area (p = 0.001), between CDM and non-dendritic morphology cells (NDM) of the intratumoral area (p = 0.001), and between HPV-18 status and peritumoral NDM cells (p = 0.044). Conclusions: The FDC and NDM cell score values of intratumoral and peritumoral areas may represent important parameters of LSCCs. This may contribute to a better stratification of laryngeal carcinoma cases and the individualized selection of clinical treatment protocols.
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Affiliation(s)
- Eugen Radu Boia
- Department of ENT, Faculty of Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Simina Boia
- Department of Periodontology, Faculty of Dental Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Raluca Amalia Ceausu
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Pusa Nela Gaje
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Sarrah Mariam Maaroufi
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Florica Sandru
- Department of Dermatovenerology, "Carol Davila" of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Marius Raica
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
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Mohammed Salama ME, Abdel Tawab Yaqout M, Habib FM, Abdel-Salam SM. Topoisomerase IIalpha (TopoIIa) A New Promising Marker for Early Detection of Laryngeal Squamous Cell Carcinoma: An Immunohistochemical Study. Asian Pac J Cancer Prev 2023; 24:2135-2139. [PMID: 37378945 PMCID: PMC10505869 DOI: 10.31557/apjcp.2023.24.6.2135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE the aim of this study is evaluation of Topo IIa expression in laryngeal squamous cell carcinomas and correlation of this expression with various clinicopathological parameters. METHODS ninety cases of laryngeal squamous cell carcinoma archived paraffin blocks were collected in the form of total laryngectomies. Each paraffin block was re-cut by rotatory microtome at 4 μm thickness and stained by hematoxylin and eosin for routine histopathological examination and on charged slides for immunohistochemistry using an automated staining system with antibodies against Topo IIa. Mainly nuclear and slightly cytoplasmic staining was considered positive. Percentage of positive Topo IIa cells was graded then grouped into low expression and overexpression. RESULTS Topo IIa overexpression was seen in 91.1% of cases, while low expression was noticed in the remaining 8.9% of cases. There were statistically significant correlations between Topo IIa expression and tumor histological grade, lymph node metastasis and T stage as well as statistically significant positive correlation between Topo IIa expression as we progress from normal to dysplastic/in situ up to malignant transformation. CONCLUSION High expression of Topo IIa may indicate more aggressive tumor and may play a role in tumorogenesis in laryngeal squamous cell carcinoma.
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Ye B, Ma J, Li Z, Li Y, Han X. Ononin Shows Anticancer Activity Against Laryngeal Cancer via the Inhibition of ERK/JNK/p38 Signaling Pathway. Front Oncol 2022; 12:939646. [PMID: 35912256 PMCID: PMC9334013 DOI: 10.3389/fonc.2022.939646] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/13/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundLaryngeal cancer is a type of head and neck tumor with a poor prognosis and survival rate. The new cases of laryngeal cancer increased rapidly with a higher mortality rate around the world.ObjectiveThe current research work was focused to unveil the in vitro antitumor effects of ononin against the laryngeal cancer Hep-2 cells.MethodologyThe cytotoxic effects of ononin against the laryngeal cancer Hep-2 cells and normal HuLa-PC laryngeal cells were studied using an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The intracellular Reactive Oxygen Species (ROS) generation, apoptotic cell death, Mitochondrial Membrane Potential (MMP), and cell adhesion on the 25 and 50 µM ononin-treated Hep-2 cells were detected using respective staining assays. The levels of TBARS and antioxidants were assayed using specific kits. The expressions of c-Jun N-terminal kinase 1/2 (JNK1/2), Extracellular Signal-regulated Kinase 1/2 (ERK1/2), p38, Phosphatidylinositol-3 Kinase 1/2 (PI3K1/2), and protein kinase-B (Akt) in the ononin-treated Hep-2 cells were investigated using Reverse Transcription-Polymerase Chain Reaction (RT-PCR) assay.ResultsThe ononin treatment effectively inhibited the Hep-2 cell viability but did not affect the viability of HuLa-PC cells. Furthermore, the ononin treatment effectively improved the intracellular ROS accumulation, depleted the MMP, and triggered apoptosis in Hep-2 cells. The Thiobarbituric acid reactive substances (TBARS) were improved, and Glutathione (GSH) levels and Superoxide dismutase (SOD) were depleted in the ononin-administered Hep-2 cells. The ononin treatment substantially inhibited the JNK/ERK/p38 axis in the Hep-2 cells.ConclusionTogether, the outcomes of this exploration proved that the ononin has remarkable antitumor activity against laryngeal cancer Hep-2 cells.
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Affiliation(s)
- Ben Ye
- Department of Ear, Nose, and Throat (ENT), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan, China
| | - Jianhua Ma
- Department of Cardiology, Shandong Rongjun General Hospital, Ji’nan, China
| | - Zhaoxia Li
- Department of Ear, Nose, and Throat (ENT), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan, China
| | - Yang Li
- Department of Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiaopan Han
- Department of ENT, Central Hospital Affiliated to Shandong First Medical University, Ji’nan, China
- *Correspondence: Xiaopan Han,
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Geng D, Chen X, Zhao XG, Xu XQ, Su GY, Zhou Y, Chen HB, Wu FY. Laryngeal and hypopharyngeal squamous cell carcinoma: association between quantitative parameters derived from dual-energy CT and histopathological prognostic factors. Acta Radiol 2022:2841851221095237. [PMID: 35502811 DOI: 10.1177/02841851221095237] [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: 11/15/2022]
Abstract
BACKGROUND Dual-energy computed tomography (DECT) can provide objective evaluation of laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC). PURPOSE To investigate the relationship between quantitative parameters acquired from DECT and histopathological prognostic factors in LHSCC. MATERIAL AND METHODS A total of 65 patients with LHSCC who underwent arterial phase and venous phase DECT scans were retrospectively enrolled. Iodine concentration (IC) and normalized IC (NIC) of the tumor were calculated in both the arterial (ICA and NICA) and venous (ICV and NICV) phases, and compared among different pathological grades, T stages, and lymph node stages. Receiver operating characteristic (ROC) curves were generated to evaluate their diagnostic performance. RESULTS There were significantly differences on ICA and NICA among three pathological grades (ICA, P = 0.001; NICA, P = 0.002). For differentiating moderately and poorly differentiated from well-differentiated LHSCC using ICA and NICA, the areas under curve (AUCs) were 0.753 and 0.726, respectively. High T stage (T3/4) LHSCC showed significantly higher ICA (P = 0.012) and NICA (P = 0.005) than low T stage (T1/2) LHSCC. The AUCs of the ICA and NICA were 0.674 and 0.703, respectively, in discriminating high from low T stage LHSCC. Lymph node metastasis (LNM)-positive (N1/2/3) LHSCC showed significantly higher ICA (P = 0.008) and NICA (P = 0.003) than LNM-negative (N0) LHSCC. For discriminating the LNM-positive from the LNM-negative group using ICA and NICA, the AUCs were 0.697 and 0.744, respectively. CONCLUSION ICA and NICA might be helpful in assessing histopathological prognostic factors in patients with LHSCC.
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Affiliation(s)
- Di Geng
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xi Chen
- Department of Otolaryngology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xing-Guo Zhao
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiao-Quan Xu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Guo-Yi Su
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yan Zhou
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hai-Bing Chen
- Department of Otolaryngology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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