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Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases. J Clin Med 2022; 11:jcm11185391. [PMID: 36143035 PMCID: PMC9503025 DOI: 10.3390/jcm11185391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Predicting survival time for patients with spinal metastases is important in treatment choice. Generally speaking, six months is a landmark cutoff point. Revised Tokuhashi score (RTS), the most widely used scoring system, lost its accuracy in predicting 6-month survival, gradually. Therefore, a more precise scoring system is urgently needed. Objective: The aim of this study is to create a new scoring system with a higher accuracy in predicting 6-month survival based on the previously used RTS. Methods: Data of 171 patients were examined to determine factors that affect prognosis (reference group), and the remaining (validation group) were examined to validate the reliability of a new score, adjusted Tokuhashi score (ATS). We compared their discriminatory abilities of the prediction models using area under receiver operating characteristic curve (AUC). Results: Target therapy and the Z score of BMI (Z-BMI), which adjusted to the patients’ sex and age, were additional independent prognostic factors. Patients with target therapy use are awarded 4 points. The Z score of BMI could be added directly to yield ATS. The AUCs were 0.760 for ATS and 0.636 for RTS in the validation group. Conclusion: Appropriate target therapy use can prolong patients’ survival. Z-BMI which might reflect nutritional status is another important influencing factor. With the optimization, surgeons could choose a more individualized treatment for patients.
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Wei J, Wang Y, Xie B, Ma J, Wang Y. Cortactin and HER2 as potential markers for dural-targeted therapy in advanced gastric cancer. Clin Exp Med 2021; 22:403-410. [PMID: 34533670 DOI: 10.1007/s10238-021-00752-6] [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: 04/13/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023]
Abstract
To study the role of HER2/cortactin co-overexpression in advanced gastric cancer (GC). This study retrospectively enrolled 246 patients with stage III GC from January 2015 to December 2016 at our hospital. We explored, using immunostaining techniques, the role of the expression of cortactin and HER2 in the progression of advanced GC. The patient data, including age, sex, cortactin and HER2 expression, pathological parameters and survival, were collected. Univariate and multivariate analyses were used to analyze the characteristics, survival, and prognostic factors of the patients. The results showed that the expression of cortactin was significantly associated with vascular-lymphatic invasion (P < 0.001), N stage (P = 0.001), and TNM stage (P = 0.046). HER2 overexpression correlated with tumor size (P = 0.002), neural invasion (P = 0.002), Lauren classification (P = 0.005) and N stage (P = 0.034). Through univariate analysis using the Kaplan-Meier method, vascular-lymphatic invasion (P = 0.015), neural invasion (P = 0.021), N stage (P < 0.003), and HER2/cortactin co-overexpression (P < 0.028) were shown to be significantly associated with overall survival. Multivariate analysis demonstrated that vascular lymphatic invasion (hazard ratio = 1.481, 95% CI, 1.064 to 2.061, P = 0.020), neural invasion (hazard ratio = 1.505, 95% CI, 1.084 to 2.089, P = 0.015), N stage (N2/N1: hazard ratio = 1.655, 95% CI, 1.048 to 2.641, P < 0.031, N3/N1: hazard ratio = 2.089, 95% CI, 1.325 to 3.295, P < 0.002), and HER2/cortactin co-overexpression (hazard ratio = 1.427, 95% CI, 1.007 to 2.024, P = 0.046) were independent prognostic factors for poor overall survival. The results suggested that HER2/cortactin co-overexpression is an important predictive biomarker for GC patients. GC patients with HER2/cortactin co-overexpression may receive dual-targeted therapy to improve survival prognosis in the future.
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Affiliation(s)
- Jun Wei
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, 233000, China.
| | - Yimin Wang
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, 233000, China
| | - Bo Xie
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, 233000, China
| | - Jiachi Ma
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, 233000, China
| | - Yaguo Wang
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, 233000, China
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Koo K, Mouradov D, Angel CM, Iseli TA, Wiesenfeld D, McCullough MJ, Burgess AW, Sieber OM. Genomic Signature of Oral Squamous Cell Carcinomas from Non-Smoking Non-Drinking Patients. Cancers (Basel) 2021; 13:cancers13051029. [PMID: 33804510 PMCID: PMC7957667 DOI: 10.3390/cancers13051029] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/15/2021] [Accepted: 02/22/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary A clinically distinct cohort of non-smoking non-drinking patients who develop oral cavity squamous cell carcinomas has been identified, with previous work suggesting that these patients tend to be older, female, and have poor outcomes. Our study characterised tumour molecular alterations in these patients, identifying differences in genomic profiles as compared to patients who smoke and/or drink. Associations between molecular alterations and other clinical and pathological characteristics were also explored. Abstract Molecular alterations in 176 patients with oral squamous cell carcinomas (OSCC) were evaluated to delineate differences in non-smoking non-drinking (NSND) patients. Somatic mutations and DNA copy number variations (CNVs) in a 68-gene panel and human papilloma virus (HPV) status were interrogated using targeted next-generation sequencing. In the entire cohort, TP53 (60%) and CDKN2A (24%) were most frequently mutated, and the most common CNVs were EGFR amplifications (9%) and deletions of BRCA2 (5%) and CDKN2A (4%). Significant associations were found for TP53 mutation and nodal disease, lymphovascular invasion and extracapsular spread, CDKN2A mutation or deletion with advanced tumour stage, and EGFR amplification with perineural invasion and extracapsular spread. PIK3CA mutation, CDKN2A deletion, and EGFR amplification were associated with worse survival in univariate analyses (p < 0.05 for all comparisons). There were 59 NSND patients who tended to be female and older than patients who smoke and/or drink, and showed enrichment of CDKN2A mutations, EGFR amplifications, and BRCA2 deletions (p < 0.05 for all comparisons), with a younger subset showing higher mutation burden. HPV was detected in three OSCC patients and not associated with smoking and drinking habits. NSND OSCC exhibits distinct genomic profiles and further exploration to elucidate the molecular aetiology in these patients is warranted.
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Affiliation(s)
- Kendrick Koo
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medial Research, Parkville, VIC 3052, Australia; (K.K.); (D.M.); (A.W.B.)
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia;
| | - Dmitri Mouradov
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medial Research, Parkville, VIC 3052, Australia; (K.K.); (D.M.); (A.W.B.)
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3052, Australia
| | | | - Tim A. Iseli
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
| | - David Wiesenfeld
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia;
| | | | - Antony W. Burgess
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medial Research, Parkville, VIC 3052, Australia; (K.K.); (D.M.); (A.W.B.)
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
| | - Oliver M. Sieber
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medial Research, Parkville, VIC 3052, Australia; (K.K.); (D.M.); (A.W.B.)
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC 3800, Australia
- Correspondence:
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Götz C, Bissinger O, Nobis C, Wolff KD, Drecoll E, Kolk A. ALDH1 as a prognostic marker for lymph node metastasis in OSCC. Biomed Rep 2018; 9:284-290. [PMID: 30233780 PMCID: PMC6142035 DOI: 10.3892/br.2018.1131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/05/2018] [Indexed: 12/13/2022] Open
Abstract
Long-term survival in cases of head and neck squamous cell carcinoma, particularly oral squamous cell carcinoma (OSCC), remains a rare achievement in the field of clinical oncology. In recent years, the theory of cancer stem cells (CSCs) has emerged and been used to offer explanations for tumour recurrence and metastasis. The present aim was to investigate the role of aldehyde dehydrogenase 1 (ALDH1) as a CSC-marker for OSCC and to determine the role of p16ink4a, which is also a surrogate marker of human papilloma virus (HPV), in the expression of ALDH1. The study cohort comprised of 186 surgically-treated cases of OSCC. The primaries were located in the oral cavity. The expression of the CSC marker (CSCM) ALDH1 was evaluated via immunohistochemistry (IHC) of a tissue microarray. HPV detection was performed by polymerase chain reaction and an HPV Array kit. Furthermore, the IHC expression of p16ink4a was also analysed. Risk regression models as the Kruskal Wallis test was used to assess the association of CSCM and p16ink4a expression with tumour size and lymph node metastasis, and cox proportional hazards were analysed. Additionally, coexpression of the markers ALDH1 and p16ink4a was analysed with regard to associations with tumour classification. Overall, high expression of ALDH1 in lymph nodes was significantly associated with Union for International Cancer Control (UICC) stage IV (P=0.044) and T4 stage cancer (P=0.03). p16ink4a positivity, in cases of HPV negativity, was associated with worse survival rate compared with that of the total cohort (P=0.048). Collectively the data indicate that ALDH1 expression may be suitable for detection of unfavourable prognosis in OSCC patients, based in part on its apparent role as a marker of metastasis. HPV status was not statistically predictive of patient outcome or CSCM expression; however, p16ink4a remains a potential marker in HNSCC Further in vitro studies with ALDH1 and p16ink4a should be performed to evaluate the expression of ALDH1 and HPV in cell culture and to clarify the role of ALDH1 as a marker for increased invasiveness of OSCC cells.
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Affiliation(s)
- Carolin Götz
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, D-81675 Munich, Germany
| | - Oliver Bissinger
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, D-81675 Munich, Germany
| | - Christopher Nobis
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, D-81675 Munich, Germany
| | - Klaus Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, D-81675 Munich, Germany
| | - Enken Drecoll
- Institute of Pathology, Klinikum Rechts der Isar, Technical University of Munich, D-81675 Munich, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, D-81675 Munich, Germany
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