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Hafrén L, Mäkinen LK, Haapaniemi A, Jokela J, Saarinen R. Removal of parotid sialoliths; techniques, complications, and success rate-A cohort study. Clin Otolaryngol 2024; 49:337-342. [PMID: 38229214 DOI: 10.1111/coa.14141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 09/12/2023] [Accepted: 12/16/2023] [Indexed: 01/18/2024]
Affiliation(s)
- Lena Hafrén
- Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Pulmonology, Heart and Lung Center, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Aaro Haapaniemi
- Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Jokela
- Department of Otorhinolaryngology, Central Finland Hospital Nova, Jyväskylä, Finland
| | - Riitta Saarinen
- Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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2
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Manninen IK, Mäkinen LK, Laukka P, Klockars T, Blomgren K. Effect of head impacts and chemical irritation on elite athletes' olfaction. Eur J Sport Sci 2023; 23:278-283. [PMID: 34839784 DOI: 10.1080/17461391.2021.2008014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Limited research exists on athletes' olfaction. As diet is an elementary part of an athlete's lifestyle and training, it is important to know whether the sport discipline itself carries a risk for olfactory impairment. The aim of this study was to evaluate whether elite swimmers (chemical irritation), boxers (head impact) or soccer players (head impact) are at risk for impaired olfaction. Elite-level male swimmers (n = 30), boxers (n = 35) and soccer players (n = 30) aged 18-40 years were recruited from Finnish sport clubs. Floorball players (n = 30) were recruited as a control group. All participants filled in a questionnaire about their training history, nasal and sinonasal diseases, asthma, nasal operations and traumas, smoking and self-evaluation of olfaction and taste function. Sniffin' Sticks odour identification test with 12 different odorants and anterior rhinoscopy were performed on all participants. The mean score from the smelling test did not differ between the sport groups. Sinonasal diseases and bronchial asthma were more common among swimmers than among the other athletes. Rhinitis symptoms were common among all athletes. Boxing, soccer or swimming does not seem to affect sense of smell. The majority of our participating elite athletes had normal olfaction, even if they had had a long history of active sports.Highlights Boxing, soccer or swimming does not seem to affect sense of smell.Rhinitis symptoms were prevalent among all elite athlete groups in our study.Athletes with hyposmia can perceive their own decreased olfaction.Swimmers have more bronchial asthma and sinus diseases than other athlete groups.
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Affiliation(s)
- Iida-Kaisa Manninen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Tuomas Klockars
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karin Blomgren
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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3
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Manninen IK, Klockars T, Mäkinen LK, Blomgren K. Epidemiology and aetiology of sport-related nasal fractures: Analysis of 599 Finnish patients. Clin Otolaryngol 2023; 48:70-74. [PMID: 36054526 PMCID: PMC10087601 DOI: 10.1111/coa.13976] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/02/2022] [Accepted: 08/19/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Iida-Kaisa Manninen
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tuomas Klockars
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karin Blomgren
- HUS Joint Resources, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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4
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Sakki AJ, Mutka A, Nokso-Koivisto J, Mäkinen LK. Do tonsils regrow after partial tonsillectomy? - Histology of regrown tonsils and predisposing factors for tonsillar regrowth. Int J Pediatr Otorhinolaryngol 2022; 157:111132. [PMID: 35427998 DOI: 10.1016/j.ijporl.2022.111132] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/07/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES It has been suggested that after partial tonsillectomy, referred here as tonsillotomy (TT), the remaining tonsillar tissue might be altered, leading to scarring or chronic tonsillitis. The objectives were to compare the histology of regrown tonsillar tissues with native tonsils and to assess the incidence of reoperations and predictive factors for tonsillar regrowth after TT. METHODS Tonsillar tissues of 1) children that underwent TT and later requiring resurgery and 2) children operated on for the first time with TT were prospectively analysed. To assess the incidence of resurgery because of tonsillar regrowth and predictive factors for tonsillar regrowth, the data covering TTs and tonsillectomies performed in 2009-2020 were retrospectively retrieved. RESULTS Altogether 11 children formed the regrowth group, with the control group consisting of 19 children. In the histological analysis of tonsillar tissues, neutrophil infiltration in the epithelium and crypts and severe lymphoplasmacytic infiltration in the epithelium were significantly more frequent in samples of the regrowth group relative to the control group. The number of germinal centres was greater in the regrowth group. In the retrospective analysis of 3141 children, the incidence of resurgery after primary TT was 1.9%. Logistic regression analysis showed that age was the only significant predisposing factor for resurgery. CONCLUSION Inflammatory cells were present more often in regrown tonsillar tissues but there was no evidence of severe chronic inflammation or scarring in the regrown tonsils. The risk of resurgery after TT was low. Young age predisposed to tonsillar regrowth, no other risk factors were found.
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Affiliation(s)
- Anniina J Sakki
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Aino Mutka
- Department of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Nokso-Koivisto
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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5
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Sakki AJ, Roine RP, Mäkinen LK, Sintonen H, Nokso-Koivisto J. Impact of tonsillotomy versus tonsillectomy on health-related quality of life and healthcare costs in children with sleep-disordered breathing. J Laryngol Otol 2021; 136:1-22. [PMID: 34819188 DOI: 10.1017/s0022215121003832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveThis study aimed to explore health-related quality of life and use of healthcare services and ensuing costs before and after tonsillotomy in children with sleep-disordered breathing and to compare the results to an earlier cohort of children who had undergone tonsillectomy.MethodChildren undergoing tonsillotomy answered the 17-dimensional, standardised health-related quality of life instrument questionnaire and a questionnaire on use of healthcare services and sick leave before and after surgery. Costs of specialist care were obtained pre- and post-operatively. The data were compared with similar data collected previously from children with tonsillectomy.ResultsTonsillotomy improved mean total health-related quality of life score significantly at 6 and 12 months. Healthcare costs and number of sick-leave days diminished significantly from 3 months pre-operatively to 12 months after surgery. Tonsillotomy had similar positive effects compared with tonsillectomy regarding health-related quality of life and healthcare costs.ConclusionTonsillotomy improves health-related quality of life in children with sleep-disordered breathing and reduces healthcare service needs and sick leave similarly to tonsillectomy.
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Affiliation(s)
- Anniina J Sakki
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Risto P Roine
- Helsinki and Uusimaa Hospital Group, Group Administration, Finland and University of Eastern Finland, Department of Health and Social Management
| | - Laura K Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Johanna Nokso-Koivisto
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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6
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Seppälä M, Jauhiainen L, Tervo S, Al-Samadi A, Rautiainen M, Salo T, Lehti K, Monni O, Hautaniemi S, Tynninen O, Mäkitie A, Mäkinen LK, Paavonen T, Toppila-Salmi S. The expression and prognostic relevance of CDH3 in tongue squamous cell carcinoma. APMIS 2021; 129:717-728. [PMID: 34580913 DOI: 10.1111/apm.13176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/19/2021] [Indexed: 02/06/2023]
Abstract
P-cadherin (CDH3) is a cell-to-cell adhesion molecule that regulates several cellular homeostatic processes in normal tissues. Lack of CDH3 expression is associated with aggressive behavior in oral squamous cell carcinoma (OSCC). Previous studies have shown that CDH3 is downregulated in high-grade OSCC and its reduced expression is predictive for poorer survival. The aim of this study was to evaluate the expression and prognostic relevance of CDH3 in tongue squamous cell carcinoma (TSCC). A retrospective series of 211 TSCC and 50 lymph node samples were stained immunohistochemically with polyclonal antibody (anti-CDH3). CDH3 expression was assessed semi-quantitatively with light microscopy. Fisher's exact test was used to compare patient and tumor characteristics, and the correlations were tested by Spearman correlation. Survival curves were drawn by the Kaplan-Meier method and analyzed by the log-rank test. Univariate and multivariate Cox regression was used to estimate the association between CDH3 expression and survival. CDH3 expression did not affect TSCC patient's disease-specific survival or overall survival. Strong CDH3 expression in the primary tumor predicted poor disease-specific and overall survival in patients with recurrent disease. CDH3 expression in lymph nodes without metastasis was negative in all cases. CDH3 expression was positive in all lymph node metastases with extranodal extension. In contrast to previous report about the prognostic value of CDH3 in OSCC, we were not able to validate the result in TSCC.
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Affiliation(s)
- Miia Seppälä
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Laura Jauhiainen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Sanni Tervo
- Department of Pathology, University of Tampere, Tampere, Finland
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Markus Rautiainen
- Department of Otorhinolaryngology, Tampere University Hospital, Tampere, Finland
| | - Tuula Salo
- Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Medical Research Centre, Oulu University Hospital, Oulu, Finland.,Helsinki University Hospital, Helsinki, Finland
| | - Kaisa Lehti
- Research Programs Unit, Genome-Scale Biology, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland.,Department of Microbiology, Tumor, and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Outi Monni
- Applied Tumor Genomics Research Program, Faculty of Medicine, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland
| | - Sampsa Hautaniemi
- Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland
| | - Olli Tynninen
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki, Finland
| | - Antti Mäkitie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, HUS Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Laura K Mäkinen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Paavonen
- Department of Pathology, Fimlab Laboratories and Department of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Sanna Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, Haartman Institute University of Helsinki, University of Helsinki, Helsinki, Finland
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7
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Manninen IK, Jutila T, Hirvonen T, Mäkinen LK, Blomgren K, Hyytiä T, Klockars T. Dizzy triathlete-evidence supporting vestibular etiology. Scand J Med Sci Sports 2021; 31:2267-2271. [PMID: 34449937 DOI: 10.1111/sms.14041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
Dizziness during or after the swimming leg is a common complaint among triathletes. We hypothesized that the dizziness is caused by asymmetrical cooling of the vestibular organ. This caloric response is characterized by involuntary eye movements called nystagmus. Altogether, 125 triathletes completed an electronic questionnaire. Fifteen triathletes who had frequently experienced dizziness during the swimming leg agreed to take part in a cold water swimming test. The test comprised two cold water swimming legs, first without earplugs and then with earplugs to prevent a potential caloric response. Eye movements and possible nystagmus were recorded immediately after the swimming legs. A majority (87%, 109/125) of athletes had experienced dizziness during triathlon races or training. Of these, almost all (97%, 106/109) experienced it during or after swimming. Dizziness affected the triathlon performance in half of the athletes with dizziness (50%, 51/102). Fifteen athletes participated in a cold water swimming test. During the first leg (without earplugs), 11/15 athletes (73%) experienced dizziness. Of these, six had nystagmus (55%), four had uncertain nystagmus (36%), and one did not have nystagmus (9%). Only one of these athletes experienced dizziness during the second leg with earplugs. The prevalence of dizziness among triathletes is notable. A large part of the dizziness is likely to be caused by caloric reaction of the vestibular organ. We recommend earplug usage for triathletes suffering from dizziness during the swimming leg.
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Affiliation(s)
- Iida-Kaisa Manninen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Topi Jutila
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timo Hirvonen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karin Blomgren
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tuomas Hyytiä
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Tuomas Klockars
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Wahab A, Hyytiäinen A, Wahbi W, Tuomainen K, Tervo S, Conesa-Zamora P, Jauhiainen L, Mäkinen LK, Paavonen T, Toppila-Salmi S, Salem A, Almangush A, Salo T, Al-Samadi A. The effect of fascin 1 inhibition on head and neck squamous cell carcinoma cells. Eur J Oral Sci 2021; 129:e12819. [PMID: 34346523 DOI: 10.1111/eos.12819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/11/2022]
Abstract
Fascin 1 plays important pro-metastatic roles in head and neck carcinoma (HNSCC) migration, invasion, and metastasis. However, limited advancement in targeting metastasis remains a major obstacle in improving HNSCC patients' survival. Therefore, we assessed the therapeutic potential of fascin 1 targeted inhibition and its potential prognostic value in HNSCC patients. Using in vitro and in vivo approaches, we investigated the effect of compound G2, a novel fascin 1 inhibitor, on HNSCC cells migration, invasion, and metastasis. High-throughput screening (HTS) was used to assess cytotoxic activity of compound G2 alone or combined with irradiation. We also evaluated the prognostic potential of fascin 1 in HNSCC patients. Interestingly, compound G2 reduced carcinoma cells migration and invasion in vitro and inhibited metastasis in vivo. Moreover, HTS revealed a modest cytotoxic activity of the compound G2 on HNSCC cell lines. Irradiation did not synergistically enhance the compound G2-mediated cytotoxic activity. Survival analyses showed that high fascin 1 immunoexpression, at the tumor invasive front, was associated with cancer-specific mortality in the advanced stages of HNSCC. Collectively, our findings suggest that fascin 1 represents a promising anti-metastatic therapeutic target and a useful prognostic marker in patients with HNSCC. Novel anti-metastatic agents could provide a valuable addition to cancer therapy.
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Affiliation(s)
- Awais Wahab
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Aini Hyytiäinen
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Wafa Wahbi
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katja Tuomainen
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sanni Tervo
- Haartman Institute, University of Helsinki, Helsinki, Finland.,Department of Pathology, Faculty of Medicine and Health Technology and Fimlab Laboratories, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Pablo Conesa-Zamora
- Pathology and Histology Department, Health Faculty, Universidad Católica de Murcia, Campus de los Jerónimos, Guadalupe, Murcia, Spain.,Clinical Analysis Department, Group of Molecular Pathology and Pharmacogenetics, Biomedical Research Institute Murcia, Hospital Universitario Santa Lucía, Cartagena, Spain
| | | | - Laura K Mäkinen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Paavonen
- Department of Pathology, Faculty of Medicine and Health Technology and Fimlab Laboratories, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Sanna Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Abdelhakim Salem
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Cancer Research and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Sakki AJ, Mäkinen LK, Kanerva M, Nokso-Koivisto J. Monopolar tonsillotomy versus cold dissection tonsillectomy in children: Prospective study on postoperative recovery. Int J Pediatr Otorhinolaryngol 2021; 141:110513. [PMID: 33234329 DOI: 10.1016/j.ijporl.2020.110513] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To compare postoperative self-reported recovery results with monopolar tonsillotomy and cold dissection tonsillectomy in children. To evaluate the feasibility of the monopolar technique in tonsillotomy. METHODS Children <12 years undergoing tonsillotomy or tonsillectomy between April 2018 and March 2020 who (with a caregiver) were willing to participate in a two-week follow-up formed the study group. They filled in a questionnaire about pain-related outcomes, return to normal activities, weight changes, complications, and length of home care. RESULTS Altogether 166 patients were recruited; 103 (62%) returned the questionnaire. The first pain-free day with tonsillotomy was day 5 and with tonsillectomy day 11. After tonsillotomy, patients returned to normal activities faster, e.g. they were able to eat normally 6.5 days earlier than tonsillectomy patients. During the first postoperative week weight dropped after tonsillectomy, but not after tonsillotomy. The length of home care was 6 days with tonsillotomy and 10 days with tonsillectomy. The incidence of postoperative hemorrhage (including minor bleedings at home) was 14% after tonsillotomy and 32% after tonsillectomy. Hemorrhages needing interventions were 0% with tonsillotomy and 2% with tonsillectomy. CONCLUSION Children operated on with monopolar tonsillotomy recovered faster and had less postoperative hemorrhage than those undergoing tonsillectomy. They were able to return earlier to daycare/school and their caregivers back to work. Recovery results with monopolar tonsillotomy were equal to other tonsillotomy techniques reported in the literature, hence the monopolar technique can be considered an alternative method to perform tonsillotomy.
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Affiliation(s)
- Anniina J Sakki
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Laura K Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mervi Kanerva
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Nokso-Koivisto
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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10
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Peuraharju E, Saarinen R, Aro K, Mäkinen LK, Tarkkanen J, Mäkitie A, Haglund C, Hagström J, Atula T. Sclerosing sialadenitis of the submandibular gland is rarely an immunoglobulin G4-related disease in the Finnish population. Mod Pathol 2020; 33:551-559. [PMID: 31680120 DOI: 10.1038/s41379-019-0395-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 12/24/2022]
Abstract
Chronic sclerosing sialadenitis may represent one of many manifestations of an immunoglobulin G4-related disease. However, existing studies typically consist of small patient cohorts rarely conducted in Western populations. The clinical behavior of chronic sclerosing sialadenitis, including follow-up data, warrants further study. Thus, we aimed to determine whether chronic sclerosing sialadenitis always presents as IgG4-related disease or associates with autoimmune diseases and to determine which additional examinations patients may require. Between 2000 and 2017, 51 patients undergoing submandibular gland resection within the Helsinki University Hospital area were diagnosed with chronic sclerosing sialadenitis. We re-evaluated all specimens and performed immunostaining for IgG4. IgG and CD31 stainings were performed for IgG4-positive specimens. IgG4-related disease diagnosis was defined by the Boston consensus statement criteria. We revised clinical data, distributing a follow-up questionnaire to patients to register symptoms of IgG4-related disease or autoimmune disease during follow-up. The chronic sclerosing sialadenitis criteria were fulfilled in 34 patients, whereby 17 were diagnosed as non-sclerosing chronic sialadenitis. In 19 cases, a sialolith associated with a salivary gland lesion. In total, 12 of 51 cases were recognized as IgG4-positive, while two met the criteria for IgG4-related disease. These two cases belonged to the non-sclerosing chronic sialadenitis group, and both involved other organs. The histopathological features between chronic sclerosing sialadenitis and non-sclerosing chronic sialadenitis overlapped regarding the degree of fibrosis and inflammatory infiltrates. In the Finnish population, chronic sclerosing sialadenitis of the submandibular gland does not appear to present as IgG4-related disease. Non-sclerosing chronic sialadenitis can associate with IgG4-related disease. A histopathological distinction between chronic sclerosing sialadenitis and non-sclerosing chronic sialadenitis is not always unequivocal and the presence of a sialolith does not exclude IgG4-positivity. Therefore, immunostaining for IgG4 should be performed when dense plasma cell infiltration is present in either non-sclerosing chronic sialadenitis or chronic sclerosing sialadenitis.
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Affiliation(s)
- Elin Peuraharju
- Department of Oral and Maxillofacial Diseases, University of Helsinki, PO Box 41, FI-00014, Helsinki, Finland.
| | - Riitta Saarinen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, PO Box 263, FI-00029, Helsinki, Finland
| | - Katri Aro
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, PO Box 263, FI-00029, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, PO Box 263, FI-00029, Helsinki, Finland
| | - Jussi Tarkkanen
- Department of Pathology, University of Helsinki, HUSLAB and Helsinki University Hospital, PO Box 21, FI-00014, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, PO Box 263, FI-00029, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Caj Haglund
- Research Programs Unit, Translational Cancer Medicine, University of Helsinki, PO Box 22, FI-00014, Helsinki, Finland.,Department of Surgery, University of Helsinki and Helsinki University Hospital, PO Box 20, FI-00014, Helsinki, Finland
| | - Jaana Hagström
- Department of Pathology, University of Helsinki, HUSLAB and Helsinki University Hospital, PO Box 21, FI-00014, Helsinki, Finland.,Research Programs Unit, Translational Cancer Medicine, University of Helsinki, PO Box 22, FI-00014, Helsinki, Finland
| | - Timo Atula
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, PO Box 263, FI-00029, Helsinki, Finland
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11
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Manninen I, Blomgren K, Elokiuru R, Lehto M, Mäkinen LK, Klockars T. Cauliflower ear among Finnish high‐level male wrestlers and judokas is prevalent and symptomatic deformity. Scand J Med Sci Sports 2019; 29:1952-1956. [DOI: 10.1111/sms.13530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 07/07/2019] [Accepted: 07/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Iida‐Kaisa Manninen
- Department of Otorhinolaryngology, Head and Neck Surgery Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Karin Blomgren
- Department of Otorhinolaryngology, Head and Neck Surgery Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Rauno Elokiuru
- KIHU ‐ Research Institute for Olympic Sports Jyväskylä Finland
| | - Mika Lehto
- Heart and Lung Center Helsinki University Hospital Helsinki Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology, Head and Neck Surgery Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Tuomas Klockars
- Department of Otorhinolaryngology, Head and Neck Surgery Helsinki University Hospital and University of Helsinki Helsinki Finland
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12
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Listyarifah D, Nieminen MT, Mäkinen LK, Haglund C, Grenier D, Häyry V, Nordström D, Hernandez M, Yucel-Lindberg T, Tervahartiala T, Ainola M, Sorsa T, Hagström J. Treponema denticola chymotrypsin-like proteinase is present in early-stage mobile tongue squamous cell carcinoma and related to the clinicopathological features. J Oral Pathol Med 2018; 47:764-772. [PMID: 29747237 DOI: 10.1111/jop.12729] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Certain periodontopathogenic bacteria have been linked to cancers. Treponema denticola (Td) is associated with severe periodontitis. Chymotrypsin-like proteinase (CTLP), a major virulence factor of Td, can degrade various host proteins and peptides, and modulate inflammatory responses. However, the role of Td in the tongue carcinogenesis remains unknown. This study aimed to investigate the presence of Td-CTLP in early-stage mobile tongue squamous cell carcinoma (MTSCC) and its relation to clinical and pathological characteristics. METHODS The immunopositivity of Td-CTLP was assessed in samples obtained from 60 patients with MTSCC and associated with their clinicopathological data. Additionally, Td-CTLP expression was compared with immunoexpression of matrix metalloproteinases (MMP-8 and MMP-9), toll-like receptors (TLR-2, TLR-4, TLR-7 and TLR-9), c-Myc, Ki-67, Bmi-1 and Snail. RESULTS Treponema denticola-chymotrypsin-like proteinase was present in 95% of MTSCC tumours of which many (40.4%) showed high immunopositivity. Td-CTLP positivity was significantly associated with invasion depth, tumour diameter and the expression of TLR-7, TLR-9 and c-Myc. High Td-CTLP immunopositivity in younger patients (≤ 60 years old) predicted early relapse. CONCLUSION Our data indicate that Td and its CTLP are present in early-stage MTSCC carcinoma and may contribute to carcinogenesis, and therefore provide novel perspectives into intervention and therapeutic measures of MTSCC.
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Affiliation(s)
- Dyah Listyarifah
- Department of Medicine, Clinicum, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland.,Department of Dental Biomedical Sciences, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland
| | - Mikko T Nieminen
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Caj Haglund
- Department of Surgery, Helsinki University Hospital, HUS, Helsinki, Finland.,Research Program Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
| | - Daniel Grenier
- Faculté de Médecine Dentaire, Université Laval, Quebec City, QC, Canada
| | - Valtteri Häyry
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Dan Nordström
- Department of Internal Medicine and Rehabilitation, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Marcela Hernandez
- Laboratory of Periodontal Biology and Department of Oral Pathology and Medicine, Dentistry Unit, Faculty of Dentistry, Faculty of Health Sciences, Universidad Autónoma de Chile, University of Chile, Santiago, Chile
| | - Tülay Yucel-Lindberg
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland
| | - Mari Ainola
- Department of Medicine, Clinicum, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Jaana Hagström
- Research Program Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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13
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Almangush A, Heikkinen I, Bakhti N, Mäkinen LK, Kauppila JH, Pukkila M, Hagström J, Laranne J, Soini Y, Kowalski LP, Grénman R, Haglund C, Mäkitie AA, Coletta RD, Leivo I, Salo T. Prognostic impact of tumour-stroma ratio in early-stage oral tongue cancers. Histopathology 2018; 72:1128-1135. [PMID: 29427291 DOI: 10.1111/his.13481] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 01/30/2018] [Accepted: 02/02/2018] [Indexed: 12/20/2022]
Abstract
AIMS Oral tongue squamous cell carcinoma (OTSCC) has a relatively poor outcome, and there is a need to identify better prognostic factors. Recently, tumour-stroma ratio (TSR) has been associated with prognosis in several cancers. The aim of this multi-institutional study was to evaluate the prognostic value of TSR from original haematoxylin and eosin (HE)-stained tumour-resection slides in a series of early-stage (cT1-2N0) OTSCC patients. METHODS AND RESULTS A TSR cutoff value of 50% was used to divide the patients into stroma-rich (≥50%) and stroma-poor (<50%) groups. The relationships between TSR and clinicopathological characteristics of 311 early-stage OTSCC cases were analysed. The prognostic value of TSR in OTSCC was calculated separately and in combination with a previously published cancer cell budding and depth of invasion (BD) prognostic model. A total of 89 cases (28.6%) belonged to the stroma-rich group. In a multivariate analysis, the stroma-rich group had worse disease-free survival, with a hazard ratio (HR) of 1.81 [95% confidence interval (CI) 1.17-2.79, P = 0.008], and higher cancer-related mortality (HR 1.71, 95% CI 1.02-2.86, P = 0.03). The combination of the highest-risk parameter scores of TSR and the BD model showed significant correlations with recurrence rate (HR 3.42, 95% CI 1.71-6.82, P = 0.004) and cancer-related mortality (HR 11.63, 95% CI 3.83-35.31, P < 0.001). CONCLUSIONS We conclude that TSR is a simple histopathological feature that is useful for prognostication of early-stage OTSCC, and suggest that TSR analyses in association with BD score could be included in routine clinical pathology reports for HE-stained slides.
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Affiliation(s)
- Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Turku, Turku, Finland.,Institute of Dentistry, University of Misurata, Misurata, Libya
| | - Ilkka Heikkinen
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Nassira Bakhti
- Master of Biostatistics, Department of Statistics, Faculty of Sciences, Hasselt University, Hasselt, Belgium
| | - Laura K Mäkinen
- Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Joonas H Kauppila
- Cancer and Translational Medicine Research Unit, Medical Research Centre Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Matti Pukkila
- Department of Otorhinolaryngology and Head and Neck Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Jaana Hagström
- Department of Pathology, University of Helsinki, Helsinki, Finland.,HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland.,Research Programmes Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
| | - Jussi Laranne
- Department of Otorhinolaryngology and Head and Neck Surgery, Tampere University Hospital, Tampere, Finland
| | - Ylermi Soini
- Department of Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
| | - Luiz P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre, São Paulo-SP, Brazil
| | - Reidar Grénman
- Department of Otorhinolaryngology and Head and Neck Surgery, Turku University Hospital, University of Turku, Turku, Finland
| | - Caj Haglund
- Research Programmes Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland.,Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti A Mäkitie
- Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Ilmo Leivo
- Department of Pathology, University of Turku, Turku, Finland
| | - Tuula Salo
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Cancer and Translational Medicine Research Unit, Medical Research Centre Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
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14
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Heikkinen I, Almangush A, Hagström J, Bello IO, Kauppila JH, Mäkinen LK, Haglund C, Nieminen P, Salo T, Leivo I. Does securin expression have significance in prognostication of oral tongue cancer? A pilot study. Eur Arch Otorhinolaryngol 2016; 273:3905-3911. [DOI: 10.1007/s00405-016-3964-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 03/01/2016] [Indexed: 11/28/2022]
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15
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Mäkinen LK, Hagström J, Mäkitie A, Atula T. Cancer of the tongue - early detection improves the prognosis. Duodecim 2016; 132:2063-2070. [PMID: 29190054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Approximately 30 to 40% of all patients with tongue cancer still succumb to the disease in five years. Early diagnosis of the disease is of vital importance, because treatment will in that case cause considerably less harm. The diagnosis is confirmed with a histological specimen, which should be taken from every suspicious lesion, and can easily be taken under local anesthesia with a punch. Already when seeking treatment, as many as 25 % of patients with tongue cancer have neck metastases, which influence the prognosis. Heavy use of tobacco and alcohol are the most important risk factors of tongue cancer.
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16
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Mäkinen LK, Ahmed A, Hagström J, Lehtonen S, Mäkitie AA, Salo T, Haglund C, Atula T. Toll-like receptors 2, 4, and 9 in primary, metastasized, and recurrent oral tongue squamous cell carcinomas. J Oral Pathol Med 2015; 45:338-45. [DOI: 10.1111/jop.12373] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Laura K. Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Hospital and University of Helsinki; Helsinki Finland
| | - Abdirisak Ahmed
- Institute of Dentistry; Biomedicum 1; University of Helsinki; Helsinki Finland
| | - Jaana Hagström
- Department of Pathology; Haartman Institute; University of Helsinki; Helsinki Finland
- Department of Pathology; HUSLAB; Helsinki University Hospital; Helsinki Finland
- Department of Oral Pathology; Institute of Dentistry; University of Helsinki; Helsinki Finland
| | - Sanna Lehtonen
- Department of Pathology; Haartman Institute; University of Helsinki; Helsinki Finland
| | - Antti A. Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Hospital and University of Helsinki; Helsinki Finland
| | - Tuula Salo
- Institute of Dentistry; Biomedicum 1; University of Helsinki; Helsinki Finland
- Department of Diagnostics and Oral Medicine; Institute of Dentistry; Oulu University Hospital and; University of Oulu; Oulu Finland
| | - Caj Haglund
- Department of Surgery; Helsinki University Hospital; Helsinki Finland
- Research Programs Unit; Translational Cancer Biology; University of Helsinki; Helsinki Finland
| | - Timo Atula
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Hospital and University of Helsinki; Helsinki Finland
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17
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Almangush A, Coletta RD, Bello IO, Bitu C, Mäkinen LK, Kauppila JH, Hagström J, Soini Y, Koivunen P, Grénman R, Salo T, Leivo I. A New Prognostic Model for Early Stage Oral Tongue Cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2015. [DOI: 10.1016/j.oooo.2014.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Mäkinen LK, Atula T, Häyry V, Jouhi L, Datta N, Lehtonen S, Ahmed A, Mäkitie AA, Haglund C, Hagström J. Predictive role of toll-like receptors 2, 4, and 9 in oral tongue squamous cell carcinoma. Oral Oncol 2015; 51:96-102. [DOI: 10.1016/j.oraloncology.2014.08.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/12/2014] [Accepted: 08/24/2014] [Indexed: 01/08/2023]
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19
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Kauppila JH, Korvala J, Siirilä K, Manni M, Mäkinen LK, Hagström J, Atula T, Haglund C, Selander KS, Saarnio J, Karttunen TJ, Lehenkari PP, Salo T. Toll-like receptor 9 mediates invasion and predicts prognosis in squamous cell carcinoma of the mobile tongue. J Oral Pathol Med 2014; 44:571-7. [PMID: 25338738 DOI: 10.1111/jop.12272] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Toll-like receptor 9 (TLR9) is a cellular receptor, which recognizes bacterial and host-derived DNA. Stimulation of TLR9 induces cellular invasion via matrix metalloproteinase 13 (MMP-13). The aim of this study was to evaluate the role of TLR9 in invasion of oral tongue squamous cell carcinoma (OTSCC). METHODS The effects of TLR9 ligands on oral squamous cell carcinoma cell lines were studied with invasion and migration assays, as well as in a myoma organotypic model. RESULTS The TLR9 ligand, CpG-ODN, increased invasion and migration in OTSCC lines. These effects were reduced by TLR9 siRNA or inhibition with TLR9 antibodies. Immunohistochemical analysis of tissues from 195 patients with OTSCC revealed that TLR9 was expressed in 181/195 carcinomas. The expression of TLR9 was higher in the malignant cells than in the normal epithelium. High TLR9 expression was associated with high MMP-13 expression and poor differentiation. High TLR9 expression was also identified as an independent predictor of poor prognosis (HR 1.810, 95% CI [1.053-3.112]). CONCLUSION Toll-like receptor 9 mediates OTSCC invasion and migration in vitro and is an independent prognostic factor of OTSCC. Inhibition of TLR9 may be a novel therapeutic opportunity in oral cancer.
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Affiliation(s)
- Joonas H Kauppila
- Department of Pathology, University of Oulu, Oulu, Finland.,Department of Surgery, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
| | - Johanna Korvala
- Medical Research Center Oulu, Oulu, Finland.,Department of Dentistry, University of Oulu, Oulu, Finland
| | | | - Marika Manni
- Department of Pathology, University of Oulu, Oulu, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Helsinki, Helsinki, Finland.,Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Jaana Hagström
- Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland.,Huslab, Helsinki, Finland
| | - Timo Atula
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Helsinki, Helsinki, Finland.,Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Caj Haglund
- Research Programs Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
| | - Katri S Selander
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Juha Saarnio
- Department of Surgery, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
| | - Tuomo J Karttunen
- Department of Pathology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
| | - Petri P Lehenkari
- Department of Surgery, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland.,Anatomy and Cell biology, University of Oulu, Oulu, Finland
| | - Tuula Salo
- Medical Research Center Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland.,Department of Dentistry, University of Oulu, Oulu, Finland.,Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland
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20
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Mäkinen LK, Häyry V, Hagström J, Sorsa T, Passador-Santos F, Keski-Säntti H, Haukka J, Mäkitie AA, Haglund C, Atula T. Matrix metalloproteinase-7 and matrix metalloproteinase-25 in oral tongue squamous cell carcinoma. Head Neck 2014; 36:1783-8. [PMID: 24488688 DOI: 10.1002/hed.23539] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Predicting the clinical course of early-stage oral tongue squamous cell carcinoma (SCC) is challenging. As matrix metalloproteinases (MMPs) are enzymes associated with invasion, metastasis, and poor survival in many cancers, we examined MMP-7 and MMP-25 in oral tongue SCC. METHODS We used tissue microarray (TMA) technique and immunohistochemistry to study the expression of MMP-7 and MMP-25 in 73 patients with stage I to II oral tongue SCC and compared their immunoexpressions with clinical data. RESULTS Immunohistochemistry revealed MMP-7 and MMP-25 expression in 90% (n = 63 of 70) and 90% (n = 64 of 71) of the tumors, respectively. MMP-7 protein expression was associated with presence of occult cervical metastases (odds ratio [OR], 3.67; p = .013), increased invasion depth (OR, 4.60; p = .005), and higher tumor grade (OR, 3.30; p = .007). MMP-7 expression was predictive for poor outcome (p = .021). Immunostaining of MMP-25 did not correlate with any clinical parameters. CONCLUSION We conclude that MMP-7, but not MMP-25, expression may have prognostic significance in early-stage oral tongue SCC.
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Affiliation(s)
- Laura K Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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21
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Almangush A, Bello IO, Keski-Säntti H, Mäkinen LK, Kauppila JH, Pukkila M, Hagström J, Laranne J, Tommola S, Nieminen O, Soini Y, Kosma VM, Koivunen P, Grénman R, Leivo I, Salo T. Depth of invasion, tumor budding, and worst pattern of invasion: prognostic indicators in early-stage oral tongue cancer. Head Neck 2013; 36:811-8. [PMID: 23696499 PMCID: PMC4229066 DOI: 10.1002/hed.23380] [Citation(s) in RCA: 206] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 03/28/2013] [Accepted: 04/30/2013] [Indexed: 01/07/2023] Open
Abstract
Background Oral (mobile) tongue squamous cell carcinoma (SCC) is characterized by a highly variable prognosis in early-stage disease (T1/T2 N0M0). The ability to classify early oral tongue SCCs into low-risk and high-risk categories would represent a major advancement in their management. Methods Depth of invasion, tumor budding, histologic risk-assessment score (HRS), and cancer-associated fibroblast (CAF) density were studied in 233 cases of T1/T2 N0M0 oral tongue SCC managed in 5 university hospitals in Finland. Results Tumor budding (≥5 clusters at the invasive front of the tumor) and depth of invasion (≥4 mm) were associated with poor prognosis in patients with early oral tongue SCC (hazard ratio [HR], 2.04; 95% confidence interval [CI], 1.17–3.55; HR, 2.55; 95% CI, 1.25–5.20, respectively) after multivariate analysis. The HRS and CAF density did not predict survival. However, high-risk worst pattern of invasion (WPOI), a component of HRS, was also an independent prognostic factor (HR, 4.47; 95% CI, 1.59–12.51). Conclusion Analyzing the depth of invasion, tumor budding, and/or WPOI in prognostication and treatment planning of T1/T2 N0M0 oral tongue SCC is recommended.
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Affiliation(s)
- Alhadi Almangush
- Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland
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22
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Mäkinen LK, Häyry V, Atula T, Haglund C, Keski-Säntti H, Leivo I, Mäkitie A, Passador-Santos F, Böckelman C, Salo T, Sorsa T, Hagström J. Prognostic significance of matrix metalloproteinase-2, -8, -9, and -13 in oral tongue cancer. J Oral Pathol Med 2011; 41:394-9. [PMID: 22084953 DOI: 10.1111/j.1600-0714.2011.01110.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Oral tongue squamous cell carcinoma (OTSCC) often metastasizes to cervical lymph nodes. Mechanisms of this disease progression are not fully known. We aimed at finding new predictive markers for diagnosis and disease monitoring. METHODS Seventy-three consecutive T1N0M0 and T2N0M0 OTSCC patients treated at Helsinki University Central Hospital, Helsinki, Finland, in 1992-2002 were included. Tissue array blocks were prepared from primary tumors and immunostained. Immunoexpression of matrix metalloproteinase (MMP)-2, -8, -9, and -13 was compared with patient characteristics and outcome. RESULTS Nuclear expression of MMP-13, but not cytoplasmic expression of MMP-2, -8, and -9, was associated with invasion depth (P = 0.017) and tumor size (P = 0.008). Furthermore, high nuclear MMP-13 expression was predictive of poor outcome (P = 0.042). CONCLUSION Our results suggest that especially MMP-13 may be regarded as a prognostic biomarker in OTSCC.
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Affiliation(s)
- Laura K Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Central Hospital, HUS and University of Helsinki, Helsinki, Finland.
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23
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Böckelman C, Hagström J, Mäkinen LK, Keski-Säntti H, Häyry V, Lundin J, Atula T, Ristimäki A, Haglund C. High CIP2A immunoreactivity is an independent prognostic indicator in early-stage tongue cancer. Br J Cancer 2011; 104:1890-5. [PMID: 21610708 PMCID: PMC3111200 DOI: 10.1038/bjc.2011.167] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND No reliable prognostic markers exist for squamous cell carcinoma of the tongue, and its prognosis can even in early stages be unpredictable and survival poor despite treatment. A potential marker is oncoprotein cancerous inhibitor of PP2A (CIP2A), which acts as a prognostic marker in gastric and non-small cell lung cancers. METHODS We collected specimens of 73 stage T1N0M0 and T2N0M0 oral squamous cell carcinomas of the tongue, as well as samples from normal oral mucosa, dysplastic lesions, and invasive carcinomas (n=39). All samples were stained for CIP2A by immunohistochemistry. Survival curves were constructed according to the Kaplan-Meier method. The Cox proportional hazard model served for univariate and multivariate survival analysis. RESULTS High CIP2A immunoreactivity predicted poor survival in tongue cancer patients (P=0.027, logrank test). In multivariate survival analysis, CIP2A was an independent prognostic factor (HR 2.02, 95% confidence interval 1.07-3.82, P=0.030). Cytoplasmic CIP2A expression was higher in severe dysplasia than in mild dysplasia. CONCLUSION Our results suggest that high CIP2A expression characterises aggressive disease. Acting as a prognostic marker it might be of help when choosing patients for adjuvant treatment in tongue cancer patients.
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Affiliation(s)
- C Böckelman
- Genome-Scale Biology Research Program, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland
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24
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Häyry V, Mäkinen LK, Atula T, Sariola H, Mäkitie A, Leivo I, Keski-Säntti H, Lundin J, Haglund C, Hagström J. Bmi-1 expression predicts prognosis in squamous cell carcinoma of the tongue. Br J Cancer 2010; 102:892-7. [PMID: 20145620 PMCID: PMC2833245 DOI: 10.1038/sj.bjc.6605544] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The prognosis of squamous cell carcinoma of the oral tongue is poor and it would be beneficial to find prognostic markers to better adjust treatment. Bmi-1 controls cell cycle and self-renewal of tissue stem cells, transcription factor c-myc affects cell proliferation and apoptosis, and Snail regulates epithelial-mesenchymal transition. The expression of these markers has been connected to prognosis in many cancer types. METHODS Bmi-1, c-myc, and Snail expressions were studied in our material consisting of 73 primarily T1N0M0 oral tongue carcinoma patients. We compared the immunoexpressions of Bmi-1, c-myc, and Snail with clinical parameters including the degree of histological differentiation, tumour size, TNM classification, depth of invasion, and resection margins. In addition, survival analyses were performed, comparing disease-free survival time with the registered protein expression of the markers mentioned above. RESULTS A significant correlation between Bmi-1 protein expression and recurrence (log-rank test, P=0.005) was detected. Snail and c-myc expression did not correlate with prognosis. Snail expression correlated with histopathological grade (Fisher's exact test, P=0.007) and with the invasion depth of tumours (chi(2)-test, P=0.037). CONCLUSION Negative Bmi-1 immunoexpression might serve as a marker of poor prognosis in oral tongue carcinoma patients.
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Affiliation(s)
- V Häyry
- Department of Otolaryngology and Head and Neck Surgery, Helsinki University Central Hospital, Haartmaninkatu 4E, Helsinki, Finland
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Mäkinen LK, Sipilä M, Laranne J, Suvinen M, Pukander J. [Not Available]. Duodecim 2006; 122:2033-8. [PMID: 17115684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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