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Xu X, Zhang C, Yin J, Smajic J, Bahabri M, Lei Y, Hedhili MN, Hota MK, Shi L, Guo T, Zheng D, El-Demellawi JK, Lanza M, Costa PMFJ, Bakr OM, Mohammed OF, Zhang X, Alshareef HN. Correction to "Anisotropic Superconducting Nb 2CT x MXene Processed by Atomic Exchange at the Wafer Scale". Adv Mater 2024:e2405648. [PMID: 38767496 DOI: 10.1002/adma.202405648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
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Kalavacherla S, Poulhazan S, Funk E, Sacco AG, Guo T. Sex-Specific Survival and Treatment Delay in Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2024. [PMID: 38678390 DOI: 10.1002/ohn.795] [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: 01/05/2024] [Revised: 03/28/2024] [Accepted: 04/07/2024] [Indexed: 04/30/2024]
Abstract
OBJECTIVE As the majority of oropharyngeal squamous cell carcinoma (OPSCC) is diagnosed in males, outcomes among females are not well-characterized. We identify sex-specific factors in OPSCC to refine female prognostication. STUDY DESIGN Retrospective cohort. SETTING National Cancer Database (NCDB). METHODS OPSCC cases from the 2004 to 2019 NCDB were identified. Sociodemographic, clinical, and treatment characteristics (including timing between diagnosis and treatment administration) were compared between sexes. Multivariable Cox proportional hazard regression models were constructed to characterize survival in overall and female-only cohorts. Similar multivariable binomial logistic regression and survival models were constructed to assess odds of treatment delays and their effects on survival, respectively. RESULTS A total of 192,973 OPSCC patients were identified; 36,695 (19%) were female. Females had more human papillomavirus (HPV) negative, lower clinical T and N stage, and higher comorbidity disease. Females experienced lower survival in HPV negative (hazard ratio, HR = 1.11, P < .001) but not HPV-positive disease. Females were more likely to have any treatment initiated over the median of 28 days (odds ratio, OR = 1.04, P = .014) or delays in adjuvant radiotherapy initiation over 6 weeks (OR = 1.11, P = .032). Treatment delay over 60 days (HR = 1.17, P = .016) and delay in adjuvant therapy initiation (HR = 1.24, P = .02) were associated with worse survival among females. CONCLUSION In one of the largest analyses of OPSCC, females had poorer survival than males, specifically in HPV-negative disease, despite presentation with less advanced disease. Notably, delays in any treatment initiation and adjuvant radiotherapy initiation were more likely in HPV-negative women and associated with worse survival, highlighting potential systemic weaknesses contributing to poor prognosis among females.
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Affiliation(s)
- Sandhya Kalavacherla
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, California, USA
| | - Solene Poulhazan
- Moores Cancer Center, UC San Diego Health, La Jolla, California, USA
| | - Emily Funk
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, California, USA
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Assuntina G Sacco
- Moores Cancer Center, UC San Diego Health, La Jolla, California, USA
- Department of Internal Medicine, Division of Hematology-Oncology, UC San Diego Health, La Jolla, California, USA
| | - Theresa Guo
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, California, USA
- Moores Cancer Center, UC San Diego Health, La Jolla, California, USA
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Zhang ZY, Yang LT, Yue Q, Kang KJ, Li YJ, An HP, C G, Chang JP, Chen YH, Cheng JP, Dai WH, Deng Z, Fang CH, Geng XP, Gong H, Guo QJ, Guo T, Guo XY, He L, He SM, Hu JW, Huang HX, Huang TC, Jiang L, Karmakar S, Li HB, Li HY, Li JM, Li J, Li QY, Li RMJ, Li XQ, Li YL, Liang YF, Liao B, Lin FK, Lin ST, Liu JX, Liu SK, Liu YD, Liu Y, Liu YY, Ma H, Mao YC, Nie QY, Ning JH, Pan H, Qi NC, Ren J, Ruan XC, Singh MK, Sun TX, Tang CJ, Tian Y, Wang GF, Wang JZ, Wang L, Wang Q, Wang YF, Wang YX, Wong HT, Wu SY, Wu YC, Xing HY, Xu R, Xu Y, Xue T, Yan YL, Yi N, Yu CX, Yu HJ, Yue JF, Zeng M, Zeng Z, Zhang BT, Zhang FS, Zhang L, Zhang ZH, Zhao JZ, Zhao KK, Zhao MG, Zhou JF, Zhou ZY, Zhu JJ. Experimental Limits on Solar Reflected Dark Matter with a New Approach on Accelerated-Dark-Matter-Electron Analysis in Semiconductors. Phys Rev Lett 2024; 132:171001. [PMID: 38728703 DOI: 10.1103/physrevlett.132.171001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/22/2024] [Accepted: 03/19/2024] [Indexed: 05/12/2024]
Abstract
Recently a dark matter-electron (DM-electron) paradigm has drawn much attention. Models beyond the standard halo model describing DM accelerated by high energy celestial bodies are under intense examination as well. In this Letter, a velocity components analysis (VCA) method dedicated to swift analysis of accelerated DM-electron interactions via semiconductor detectors is proposed and the first HPGe detector-based accelerated DM-electron analysis is realized. Utilizing the method, the first germanium based constraint on sub-GeV solar reflected DM-electron interaction is presented with the 205.4 kg·day dataset from the CDEX-10 experiment. In the heavy mediator scenario, our result excels in the mass range of 5-15 keV/c^{2}, achieving a 3 orders of magnitude improvement comparing with previous semiconductor experiments. In the light mediator scenario, the strongest laboratory constraint for DM lighter than 0.1 MeV/c^{2} is presented. The result proves the feasibility and demonstrates the vast potential of the VCA technique in future accelerated DM-electron analyses with semiconductor detectors.
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Affiliation(s)
- Z Y Zhang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - L T Yang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Q Yue
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - K J Kang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y J Li
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - H P An
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
- Department of Physics, Tsinghua University, Beijing 100084
| | - Greeshma C
- Institute of Physics, Academia Sinica, Taipei 11529
| | | | - Y H Chen
- YaLong River Hydropower Development Company, Chengdu 610051
| | - J P Cheng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - W H Dai
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Z Deng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - C H Fang
- College of Physics, Sichuan University, Chengdu 610065
| | - X P Geng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - H Gong
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Q J Guo
- School of Physics, Peking University, Beijing 100871
| | - T Guo
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - X Y Guo
- YaLong River Hydropower Development Company, Chengdu 610051
| | - L He
- NUCTECH Company, Beijing 100084
| | - S M He
- YaLong River Hydropower Development Company, Chengdu 610051
| | - J W Hu
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - H X Huang
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - T C Huang
- Sino-French Institute of Nuclear and Technology, Sun Yat-sen University, Zhuhai 519082
| | - L Jiang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - S Karmakar
- Institute of Physics, Academia Sinica, Taipei 11529
| | - H B Li
- Institute of Physics, Academia Sinica, Taipei 11529
| | - H Y Li
- College of Physics, Sichuan University, Chengdu 610065
| | - J M Li
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - J Li
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Q Y Li
- College of Physics, Sichuan University, Chengdu 610065
| | - R M J Li
- College of Physics, Sichuan University, Chengdu 610065
| | - X Q Li
- School of Physics, Nankai University, Tianjin 300071
| | - Y L Li
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y F Liang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - B Liao
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - F K Lin
- Institute of Physics, Academia Sinica, Taipei 11529
| | - S T Lin
- College of Physics, Sichuan University, Chengdu 610065
| | - J X Liu
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - S K Liu
- College of Physics, Sichuan University, Chengdu 610065
| | - Y D Liu
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - Y Liu
- College of Physics, Sichuan University, Chengdu 610065
| | - Y Y Liu
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - H Ma
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y C Mao
- School of Physics, Peking University, Beijing 100871
| | - Q Y Nie
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - J H Ning
- YaLong River Hydropower Development Company, Chengdu 610051
| | - H Pan
- NUCTECH Company, Beijing 100084
| | - N C Qi
- YaLong River Hydropower Development Company, Chengdu 610051
| | - J Ren
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - X C Ruan
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - M K Singh
- Institute of Physics, Academia Sinica, Taipei 11529
- Department of Physics, Banaras Hindu University, Varanasi 221005
| | - T X Sun
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - C J Tang
- College of Physics, Sichuan University, Chengdu 610065
| | - Y Tian
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - G F Wang
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - J Z Wang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - L Wang
- Department of Physics, Beijing Normal University, Beijing 100875
| | - Q Wang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
- Department of Physics, Tsinghua University, Beijing 100084
| | - Y F Wang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y X Wang
- School of Physics, Peking University, Beijing 100871
| | - H T Wong
- Institute of Physics, Academia Sinica, Taipei 11529
| | - S Y Wu
- YaLong River Hydropower Development Company, Chengdu 610051
| | - Y C Wu
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - H Y Xing
- College of Physics, Sichuan University, Chengdu 610065
| | - R Xu
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y Xu
- School of Physics, Nankai University, Tianjin 300071
| | - T Xue
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Y L Yan
- College of Physics, Sichuan University, Chengdu 610065
| | - N Yi
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - C X Yu
- School of Physics, Nankai University, Tianjin 300071
| | - H J Yu
- NUCTECH Company, Beijing 100084
| | - J F Yue
- YaLong River Hydropower Development Company, Chengdu 610051
| | - M Zeng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - Z Zeng
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - B T Zhang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - F S Zhang
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875
| | - L Zhang
- College of Physics, Sichuan University, Chengdu 610065
| | - Z H Zhang
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - J Z Zhao
- Key Laboratory of Particle and Radiation Imaging (Ministry of Education) and Department of Engineering Physics, Tsinghua University, Beijing 100084
| | - K K Zhao
- College of Physics, Sichuan University, Chengdu 610065
| | - M G Zhao
- School of Physics, Nankai University, Tianjin 300071
| | - J F Zhou
- YaLong River Hydropower Development Company, Chengdu 610051
| | - Z Y Zhou
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413
| | - J J Zhu
- College of Physics, Sichuan University, Chengdu 610065
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Nakagawa T, Santos J, Nasamran CA, Sen P, Sadat S, Monther A, Bendik J, Ebisumoto K, Hu J, Preissl S, Guo T, Vavinskaya V, Fisch KM, Califano JA. Defining the relationship of salivary gland malignancies to novel cell subpopulations in human salivary glands using single nucleus RNA-sequencing. Int J Cancer 2024; 154:1492-1503. [PMID: 37971144 DOI: 10.1002/ijc.34790] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/26/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
Salivary glands have essential roles in maintaining oral health, mastication, taste and speech, by secreting saliva. Salivary glands are composed of several types of cells, and each cell type is predicted to be involved in the carcinogenesis of different types of cancers including adenoid cystic carcinoma (ACC), acinic cell carcinoma (AciCC), salivary duct carcinoma (SDC), myoepithelial carcinoma (MECA) and other histology. In our study, we performed single nucleus RNA-seq on three human salivary gland samples to clarify the gene expression profile of each complex cellular component of the salivary glands and related these expression patterns to expression found in salivary gland cancers (SGC) to infer cell of origin. By single nucleus RNA-seq, salivary gland cells were stratified into four clusters: acinar cells, ductal cells 1, ductal cells 2 and myoepithelial cells/stromal cells. The localization of each cell group was verified by IHC of each cluster marker gene, and one group of ductal cells was found to represent intercalated ductal cells labeled with HES1. Furthermore, in comparison with SGC RNA-seq data, acinar cell markers were upregulated in AciCC, but downregulated in ACC and ductal cell markers were upregulated in SDC but downregulated in MECA, suggesting that markers of origin are highly expressed in some SGC. Cell type expressions in specific SGC histology are similar to those found in normal salivary gland populations, indicating a potential etiologic relationship.
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Affiliation(s)
- Takuya Nakagawa
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Jessica Santos
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Chanond A Nasamran
- Center for Computational Biology and Bioinformatics, University of California San Diego, La Jolla, California, USA
| | - Prakriti Sen
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Sayed Sadat
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Abdula Monther
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Joseph Bendik
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Koji Ebisumoto
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Jingjing Hu
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Sebastian Preissl
- Center for Epigenomics, Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, California, USA
| | - Theresa Guo
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, USA
| | - Vera Vavinskaya
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Kathleen M Fisch
- Center for Computational Biology and Bioinformatics, University of California San Diego, La Jolla, California, USA
| | - Joseph A Califano
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, USA
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5
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Bredillet K, Riporto F, Guo T, Dhouib A, Multian V, Monnier V, Figueras Llussà P, Beauquis S, Bonacina L, Mugnier Y, Le Dantec R. Dual second harmonic generation and up-conversion photoluminescence emission in highly-optimized LiNbO 3 nanocrystals doped and co-doped with Er 3+ and Yb 3. Nanoscale 2024. [PMID: 38497193 DOI: 10.1039/d4nr00431k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Preparation from the aqueous alkoxide route of doped and co-doped lithium niobate nanocrystals with Er3+ and Yb3+ ions, and detailed investigations of their optical properties are presented in this comprehensive work. Simultaneous emission under femtosecond laser excitation of second harmonic generation (SHG) and up-conversion photoluminescence (UC-PL) is studied from colloidal suspensions according to the lanthanide ion contents. Special attention has been paid to produce phase pure nanocrystals of constant size (∼20 nm) thus allowing a straightforward comparison and optimization of the Er content for increasing the green UC-PL signals under 800 nm excitation. An optimal molar concentration at about 4 molar% in erbium ions is demonstrated, that is well above the concentration usually achieved in bulk crystals. Similarly, for co-doped LiNbO3 nanocrystals, different lanthanide concentrations and Yb/Er content ratios are tested allowing optimization of the green and red up-conversion excited at 980 nm, and analysis of the underlying mechanisms from excitation spectra. All together, these findings provide valuable insights into the wet-chemical synthesis and potential of doped and co-doped LiNbO3 nanocrystals for advanced applications, combining both SHG and UC-PL emissions from the particle core.
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Affiliation(s)
- K Bredillet
- Université Savoie Mont Blanc, SYMME, F-74000, Annecy, France.
| | - F Riporto
- Université Savoie Mont Blanc, SYMME, F-74000, Annecy, France.
| | - T Guo
- Université Savoie Mont Blanc, SYMME, F-74000, Annecy, France.
| | - A Dhouib
- Université Savoie Mont Blanc, SYMME, F-74000, Annecy, France.
| | - V Multian
- Université Savoie Mont Blanc, SYMME, F-74000, Annecy, France.
| | - V Monnier
- Univ. Lyon, Ecole Centrale de Lyon, CNRS, INSA Lyon, Université Claude Bernard Lyon 1, CPE Lyon, CNRS, INL, UMR5270, 69130 Ecully, France
| | - P Figueras Llussà
- Department of Applied Physics, Université de Genève, 1211 Genève 4, Switzerland
| | - S Beauquis
- Université Savoie Mont Blanc, SYMME, F-74000, Annecy, France.
| | - L Bonacina
- Department of Applied Physics, Université de Genève, 1211 Genève 4, Switzerland
| | - Y Mugnier
- Université Savoie Mont Blanc, SYMME, F-74000, Annecy, France.
| | - R Le Dantec
- Université Savoie Mont Blanc, SYMME, F-74000, Annecy, France.
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Guo T, Zamuner F, Ting S, Chen L, Rooper L, Tamayo P, Fakhry C, Gaykalova D, Mehra R. Clinical and genomic characterization of chemoradiation-resistant HPV-positive oropharyngeal squamous cell carcinoma. Front Oncol 2024; 14:1336577. [PMID: 38505587 PMCID: PMC10949886 DOI: 10.3389/fonc.2024.1336577] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/25/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction Most patients with HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) have an excellent response to chemoradiation, and trials are now investigating de-escalated treatment. However, up to 25% of patients with HPV-positive OPSCC will experience recurrence, and up to 5% will even progress through primary treatment. Currently, there are no molecular markers to identify patients with poor prognosis who would be harmed by de-escalation. Herein we report the clinical and genomic characteristics of persistent HPV-positive OPSCC after definitive platinum-based chemoradiation therapy. Methods Patients with HPV-positive OPSCC treated with curative intent platinum-based chemoradiation between 2007 and 2017 at two institutions and with a persistent locoregional disease were included. We evaluated clinical characteristics, including smoking status, age, stage, treatment, and overall survival. A subset of five patients had tissue available for targeted exome DNA sequencing and RNA sequencing. Genomic analysis was compared to a previously published cohort of 47 treatment-responsive HPV+ OPSCC tumors after batch correction. Mutational landscape, pathway activation, and OncoGPS tumor states were employed to characterize these tumors. Results Ten patients met the inclusion criteria. The tumor and nodal stages ranged from T1 to T4 and N1 to N2 by AJCC 8th edition staging. All patients were p16-positive by immunohistochemistry, and eight with available in situ hybridization were confirmed to be HPV-positive. The 1-year overall survival from the time of diagnosis was 57%, and the 2-year overall survival was 17%. TP53 mutations were present in three of five (60%) persistent tumors compared to 2% (one of 47) of treatment-responsive HPV-positive tumors (p = 0.008). Other genes with recurrent mutations in persistent HPV-positive OPSCC tumors were NF1, KMT2D, PIK3C2B, and TFGBR2. Compared to treatment-responsive HPV-positive tumors, persistent tumors demonstrated activation of DNA Repair and p53, EMT, MYC, SRC, and TGF-beta signaling pathways, with post-treatment samples demonstrating significant activation of the PI3K-EMT-Stem pathways compared to pretreatment samples. Conclusion Chemoradiation-resistant HPV-positive OPSCC occurs infrequently but portends a poor prognosis. These tumors demonstrate higher rates of p53 mutation and activation of MYC, SRC, and TGF-beta pathways. A comparison of tumors before and after treatment demonstrates PI3K-EMT-Stem pathways post-treatment in HPV-positive tumors with persistent disease after platinum-based chemoradiation.
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Affiliation(s)
- Theresa Guo
- Department of Otolaryngology, Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
| | - Fernando Zamuner
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Stephanie Ting
- Department of Medicine, Division of Hematology-Oncology, University of California, San Diego, San Diego, CA, United States
| | - Liam Chen
- Division of Neuropathology, Department of Pathology, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Lisa Rooper
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, United States
| | - Pablo Tamayo
- Department of Medicine, Division of Hematology-Oncology, University of California, San Diego, San Diego, CA, United States
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Daria Gaykalova
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, United States
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, United States
| | - Ranee Mehra
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
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Guo T, Jang SS, Ogawa R, Davis M, Ashworth E, Barback CV, Hall DJ, Vera DR. Fluorescent Guided Sentinel Lymph Mapping of the Oral Cavity with Fluorescent-Labeled Tilmanocept. Laryngoscope 2024; 134:1299-1307. [PMID: 37668315 PMCID: PMC10912359 DOI: 10.1002/lary.31014] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE With the shift toward utilization of sentinel lymph node biopsy (SLNB) in oral cavity cancer, improved techniques for intraoperative sentinel node identification are needed. This study investigates the feasibility of fluorescently labeled tilmanoscept in SLNB in an oral cancer rabbit model. METHODS An animal study was designed using 21 healthy male New Zealand rabbits. Gallium-68-labeled tilmanocept labeled with IRDye800CW was injected submucosally into the buccal mucosa (n = 6) or lateral tongue (n = 7) followed by PET imaging. One hour after injection, SLNB was performed using fluorescence imaging followed by a bilateral neck dissection and sampling of non-nodal surrounding tissue. All tissues were measured for radioactivity and fluorescence. In addition, eight rabbits were injected with delayed SLNB performed 48 h after injection. RESULTS Buccal injections all had ipsilateral SLN drainage and tongue injections exhibited 18.2% contralateral drainage. An average of 1.9 ± 1.0 SLN (range 1-5) were identified. In addition, an average of 16.9 ± 3.3 non-sentinel lymph nodes were removed per animal. SLNs had an average of 0.69 ± 0.60 percent-of-injected dose (%ID) compared with non-sentinel nodes with 0.012 ± 0.025 %ID and surrounding tissue with 0.0067 ± 0.015 %ID. There was 98.0% agreement between sentinel lymph nodes identified using fluorescence compared to radioactivity with Cohen's kappa coefficient of 0.879. In 48-h delayed SLNB, results were consistent with 97.8% agreement with radioactivity and Cohen's Kappa coefficient of 0.884. Fluorescence identified additional lymph nodes that were not identified by radioactivity, and with one false negative. CONCLUSION Fluorescent-labeled Tc-99 m-tilmanocept represents a highly accurate adjunct to enhance SLNB for oral cavity cancer. LEVEL OF EVIDENCE N/A Laryngoscope, 134:1299-1307, 2024.
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Affiliation(s)
- Theresa Guo
- Department of Otolaryngology, Head and Neck Surgery, University of California, San Diego, La Jolla, CA
- Moores Cancer Center, University of California, San Diego, La Jolla, CA
| | - Sophie S. Jang
- Department of Otolaryngology, Head and Neck Surgery, University of California, San Diego, La Jolla, CA
- Moores Cancer Center, University of California, San Diego, La Jolla, CA
| | - Ryotaro Ogawa
- Moores Cancer Center, University of California, San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
| | - Morgan Davis
- Department of Otolaryngology, Head and Neck Surgery, University of California, San Diego, La Jolla, CA
- Moores Cancer Center, University of California, San Diego, La Jolla, CA
| | - Edward Ashworth
- Moores Cancer Center, University of California, San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
| | - Christopher V. Barback
- Moores Cancer Center, University of California, San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
| | - David J. Hall
- Moores Cancer Center, University of California, San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
| | - David R. Vera
- Moores Cancer Center, University of California, San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
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8
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Kalavacherla S, Bernard B, Kim SS, Dornisch A, Blumenfeld L, Linnemeyer-Risser K, Sanghvi P, Guo T. Early Improved Functional Outcomes in Head and Neck Cancer Patients with Primary Tumor Detection. Laryngoscope 2024; 134:701-707. [PMID: 37462352 PMCID: PMC10874284 DOI: 10.1002/lary.30903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVES We characterize functional outcomes in head and neck cancer of unknown primary (CUP) based on primary site identification. METHODS In this retrospective study, CUP cases were categorized as known primaries (KP) if a tumor was localized after diagnostic workup or persisting unknown primaries (UP). Age, sex, HPV status, diagnostic methods, and treatments regimens were collected. Pretreatment and short-term posttreatment (3-6 months after completion of treatment) weights, PHQ-9, Eating Assessment Tool (EAT-10), and Voice Handicap Index (VHI-10) scores were compared between UP and KP. RESULTS Among 67 CUP patients, 35 (52.2%) had identified primaries (91.4% oropharyngeal and 8.6% nasopharyngeal). KP patients were younger (58 vs. 64, p = 0.04) and more likely to be HPV-positive (88.6% vs. 50%, p = 0.002). Overall detection rates were 16.7% for PET/CT, 34.7% for direct laryngoscopy, and 46.6% for transoral robotic oropharyngectomy. Diagnostic workup was not significantly different between groups. Patients with KP received smaller intermediate radiation dose volumes (436.5 vs. 278.9 cc, p = 0.03) and lower doses to the cricopharyngeal muscle (41.6 vs. 24.6 Gy, p = 0.03).Pretreatment weights, PHQ-9, EAT-10, and VHI-10 scores did not differ between groups. However, posttreatment, UP had greater relative weight loss (-14.1% vs. -7.6%, p = 0.032), higher EAT-10 scores (12.5 vs. 3, p = 0.004), and higher PHQ-9 scores (6 vs. 1.4, p = 0.017). Specifically, UP reported more stressful swallowing, difficulty swallowing solids and pills, and swallowing affecting public eating. CONCLUSION KP patients experienced less weight loss, depression, and reduced swallowing dysfunction, highlighting an early functional benefit of primary tumor identification likely driven by reduced radiation treatment volumes. LEVEL OF EVIDENCE 4 Laryngoscope, 134:701-707, 2024.
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Affiliation(s)
- Sandhya Kalavacherla
- School of Medicine, University of California San Diego, La Jolla, California, U.S.A
| | - Benjamin Bernard
- Department of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, California, U.S.A
| | - Sangwoo S Kim
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California, U.S.A
| | - Anna Dornisch
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California, U.S.A
| | - Liza Blumenfeld
- Department of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, California, U.S.A
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California, San Diego, California, U.S.A
| | - Kristen Linnemeyer-Risser
- Department of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, California, U.S.A
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California, San Diego, California, U.S.A
| | - Parag Sanghvi
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California, U.S.A
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California, San Diego, California, U.S.A
| | - Theresa Guo
- Department of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, California, U.S.A
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California, San Diego, California, U.S.A
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Kalavacherla S, Li V, Voora R, Victor M, Faraji F, Guo T. Factors associated with unknown primary status in head and neck squamous cell carcinoma. Oral Oncol 2024; 148:106650. [PMID: 38039876 DOI: 10.1016/j.oraloncology.2023.106650] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/22/2023] [Accepted: 11/25/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVES Head and neck cancer of unknown primary (CUP) poses significant therapeutic challenges. We compare CUP and oropharyngeal primary (OP) cases to identify factors associated with tumor detection. METHODS The 2004-2019 National Cancer Database was queried to identify CUP and OP cases based on clinical and pathologic TNM staging. Clinical and demographic characteristics were compared by primary detection and HPV status with descriptive statistics. Multivariable logistic regression models to characterize OP detection were constructed. Among HPV-positive and negative patients, respectively, OP and CUP patients were matched by clinical nodal disease. Cox proportional-hazards models were constructed using matched cohorts to characterize survival. RESULTS 81,053 CUP and OP cases were identified; 64.3 % were HPV-positive. OP detection increased over time in HPV-positive and negative disease. HPV-positive status had higher odds of OP detection (odds ratio (OR) = 1.77, p < 0.001), while females (OR = 0.95, p = 0.008), and black (OR = 0.82, p < 0.001) and Asian (OR = 0.7, p < 0.001) patients had lower odds compared to males and whites, respectively. In HPV-positive and negative disease, OP patients had higher 2 and 5-year survival rates than CUP (p < 0.001). Primary detection status conferred lower death risk in HPV-positive (hazard ratio (HR) = 0.85, p < 0.001) and negative disease (HR = 0.87, p < 0.001) when controlling for age, sex, race, comorbidities, insurance, treatment facility, and income. CONCLUSION In the largest cohort of CUP to date, we report a survival benefit in primary tumor detection regardless of HPV status. Groups with higher persistent CUP rates, including non-white, female, HPV-negative, and low income patients, may benefit from increased diagnostic workup to improve detection and treatment.
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Affiliation(s)
| | - Vivienne Li
- School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Rohith Voora
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, CA, USA
| | - Mitchell Victor
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, CA, USA; Gleiberman Head & Neck Cancer Center, Moores Cancer Center, UC San Diego Health, La Jolla, CA, USA
| | - Farhoud Faraji
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, CA, USA; Gleiberman Head & Neck Cancer Center, Moores Cancer Center, UC San Diego Health, La Jolla, CA, USA
| | - Theresa Guo
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, CA, USA; Gleiberman Head & Neck Cancer Center, Moores Cancer Center, UC San Diego Health, La Jolla, CA, USA.
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10
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Faraji F, Kumar A, Voora R, Soliman SI, Cherry D, Courtney PT, Finegersh A, Guo T, Cohen E, Califano JA, Mell L, Rose B, Orosco RK. Transoral Surgery in HPV-Positive Oropharyngeal Carcinoma: Oncologic Outcomes in the Veterans Affairs System. Laryngoscope 2024; 134:207-214. [PMID: 37255050 PMCID: PMC10687307 DOI: 10.1002/lary.30784] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 04/07/2023] [Accepted: 05/17/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Most transoral robotic surgery (TORS) literature for HPV-positive oropharyngeal squamous cell carcinoma (HPV-OPC) derives from high-volume tertiary-care centers. This study aims to describe long-term recurrence and survival outcomes among Veterans Health Administration patients. MATERIALS AND METHODS Using the US Veterans Affairs database, we identified patients with HPV-OPC treated with TORS between January 2010 and December 2016. Patients were stratified in risk categories: low (0-1 metastatic nodes, negative margins), intermediate (close margins, 2-4 metastatic nodes, lymphovascular or perineural invasion, pT3-pT4 tumor), or high (positive margins, extranodal extension (ENE), and/or ≥5 metastatic nodes). Primary outcomes included overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS). RESULTS The cohort included 161 patients of which 29 (18%) were low-risk, 45 (28%) intermediate-risk, and 87 (54%) high-risk. ENE was present in 41% of node-positive cases and 24% had positive margins. Median follow-up was 5.6 years (95% CI, 3.0-9.3). The 5-year DSS for low, intermediate, and high-risk groups were: 100%, 90.0% (95% CI, 75.4-96.1%), and 88.7% (95% CI, 78.3-94.2%). Pathologic features associated with poor DSS on univariable analysis included pT3-T4 tumors (HR 3.81, 95% CI, 1.31-11; p = 0.01), ≥5 metastatic nodes (HR 3.41, 95% CI, 1.20-11; p = 0.02), and ENE (HR 3.53, 95% CI, 1.06-12; p = 0.04). Higher 5-year cumulative incidences of recurrence were observed in more advanced tumors (pT3-T4, 33% [95% CI, 14-54%] versus pT1-T2, 13% [95% CI, 8-19%]; p = 0.01). CONCLUSIONS In this nationwide study, patients with HPV-OPC treated with TORS followed by adjuvant therapy at Veterans Affairs Medical Centers demonstrated favorable survival outcomes comparable to those reported in high-volume academic centers and clinical trials. LEVEL OF EVIDENCE 4 Laryngoscope, 134:207-214, 2024.
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Affiliation(s)
- Farhoud Faraji
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, San Diego, CA, USA
- Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Abhishek Kumar
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA
- Department of Radiation Oncology, Duke University, Durham, NC, USA
| | - Rohith Voora
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, San Diego, CA, USA
| | - Shady I. Soliman
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, San Diego, CA, USA
| | - Daniel Cherry
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA
| | - P. Travis Courtney
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA
| | - Andrey Finegersh
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, San Diego, CA, USA
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, CA, USA
| | - Theresa Guo
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, San Diego, CA, USA
- Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Ezra Cohen
- Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
- Department of Medical Oncology, University of California, San Diego, CA, USA
| | - Joseph A. Califano
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, San Diego, CA, USA
- Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Loren Mell
- Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA
| | - Brent Rose
- Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA
| | - Ryan K. Orosco
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of New Mexico
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11
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Zahavi DJ, Erbe R, Zhang YW, Guo T, Malchiodi ZX, Maynard R, Lekan A, Gallagher R, Wulfkuhle J, Petricoin E, Jablonski SA, Fertig EJ, Weiner LM. Antibody dependent cell-mediated cytotoxicity selection pressure induces diverse mechanisms of resistance. Cancer Biol Ther 2023; 24:2269637. [PMID: 37878417 PMCID: PMC10601508 DOI: 10.1080/15384047.2023.2269637] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/07/2023] [Indexed: 10/27/2023] Open
Abstract
Targeted monoclonal antibody therapy has emerged as a powerful therapeutic strategy for cancer. However, only a minority of patients have durable responses and the development of resistance remains a major clinical obstacle. Antibody-dependent cell-mediated cytotoxicity (ADCC) represents a crucial therapeutic mechanism of action; however, few studies have explored ADCC resistance. Using multiple in vitro models of ADCC selection pressure, we have uncovered both shared and distinct resistance mechanisms. Persistent ADCC selection pressure yielded ADCC-resistant cells that are characterized by a loss of NK cell conjugation and this shared resistance phenotype is associated with cell-line dependent modulation of cell surface proteins that contribute to immune synapse formation and NK cell function. We employed single-cell RNA sequencing and proteomic screens to interrogate molecular mechanisms of resistance. We demonstrate that ADCC resistance involves upregulation of interferon/STAT1 and DNA damage response signaling as well as activation of the immunoproteasome. Here, we identify pathways that modulate ADCC sensitivity and report strategies to enhance ADCC-mediated elimination of cancer cells. ADCC resistance could not be reversed with combinatorial treatment approaches. Hence, our findings indicate that tumor cells utilize multiple strategies to inhibit NK cell mediated-ADCC. Future research and development of NK cell-based immunotherapies must incorporate plans to address or potentially prevent the induction of resistance.
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Affiliation(s)
- David J. Zahavi
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, USA
| | - Rossin Erbe
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Yong-Wei Zhang
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, USA
| | - Theresa Guo
- Department of Oncology, UC San Diego School of Medicine, San Diego, USA
| | - Zoe X. Malchiodi
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, USA
| | - Rachael Maynard
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, USA
| | - Alexander Lekan
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, USA
| | - Rosa Gallagher
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Fairfax, USA
| | - Julia Wulfkuhle
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Fairfax, USA
| | - Emanuel Petricoin
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Fairfax, USA
| | - Sandra A. Jablonski
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, USA
| | - Elana J. Fertig
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Louis M. Weiner
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, USA
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12
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Guo T, Liu Y, Lvqiu S, Lei C, He WL, Jiang Y, Yang D, Wang R, Yang B, Lu C, Xu Y, Ding S, Wang L, Luo H, Peng H. A novel COL3A1 variant associated with vascular Ehlers-Danlos syndrome in a patient presents as recurrent pneumothorax with cavities. QJM 2023; 116:691-693. [PMID: 37074961 DOI: 10.1093/qjmed/hcad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Indexed: 04/20/2023] Open
Affiliation(s)
- T Guo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - Y Liu
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - S Lvqiu
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - C Lei
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - W L He
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - Y Jiang
- Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - D Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - R Wang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - B Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - C Lu
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - Y Xu
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - S Ding
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - L Wang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - H Luo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
| | - H Peng
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, Hunan 410011, China
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13
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Qualliotine JR, Nakagawa T, Rosenthal SB, Sadat S, Ballesteros-Merino C, Xu G, Mark A, Nasamran A, Gutkind JS, Fisch KM, Guo T, Fox BA, Khan Z, Molinolo AA, Califano JA. A Network Landscape of HPVOPC Reveals Methylation Alterations as Significant Drivers of Gene Expression via an Immune-Mediated GPCR Signal. Cancers (Basel) 2023; 15:4379. [PMID: 37686653 PMCID: PMC10486378 DOI: 10.3390/cancers15174379] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/17/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
HPV-associated oropharynx carcinoma (HPVOPC) tumors have a relatively low mutational burden. Elucidating the relative contributions of other tumor alterations, such as DNA methylation alterations, alternative splicing events (ASE), and copy number variation (CNV), could provide a deeper understanding of carcinogenesis drivers in this disease. We applied network propagation analysis to multiple classes of tumor alterations in a discovery cohort of 46 primary HPVOPC tumors and 25 cancer-unaffected controls and validated our findings with TCGA data. We identified significant overlap between differential gene expression networks and all alteration classes, and this association was highest for methylation and lowest for CNV. Significant overlap was seen for gene clusters of G protein-coupled receptor (GPCR) pathways. HPV16-human protein interaction analysis identified an enriched cluster defined by an immune-mediated GPCR signal, including CXCR3 cytokines CXCL9, CXCL10, and CXCL11. CXCR3 was found to be expressed in primary HPVOPC, and scRNA-seq analysis demonstrated CXCR3 ligands to be highly expressed in M2 macrophages. In vivo models demonstrated decreased tumor growth with antagonism of the CXCR3 receptor in immunodeficient but not immunocompetent mice, suggesting that the CXCR3 axis can drive tumor proliferation in an autocrine fashion, but the effect is tempered by an intact immune system. In conclusion, methylation, ASE, and SNV alterations are highly associated with network gene expression changes in HPVOPC, suggesting that ASE and methylation alterations have an important role in driving the oncogenic phenotype. Network analysis identifies GPCR networks, specifically the CXCR3 chemokine axis, as modulators of tumor-immune interactions that may have proliferative effects on primary tumors as well as a role for immunosurveillance; however, CXCR3 inhibition should be used with caution, as these agents may both inhibit and stimulate tumor growth considering the competing effects of this cytokine axis. Further investigation is needed to explore opportunities for targeted therapy in this setting.
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Affiliation(s)
- Jesse R. Qualliotine
- Department of Otolaryngology—Head and Neck Surgery, University of California San Diego, La Jolla, CA 92093, USA
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
| | - Takuya Nakagawa
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba 263-8522, Japan
| | - Sara Brin Rosenthal
- Center for Computational Biology and Bioinformatics, Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Sayed Sadat
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
| | | | - Guorong Xu
- Center for Computational Biology and Bioinformatics, Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Adam Mark
- Center for Computational Biology and Bioinformatics, Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Art Nasamran
- Center for Computational Biology and Bioinformatics, Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - J. Silvio Gutkind
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
| | - Kathleen M. Fisch
- Center for Computational Biology and Bioinformatics, Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Theresa Guo
- Department of Otolaryngology—Head and Neck Surgery, University of California San Diego, La Jolla, CA 92093, USA
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
| | - Bernard A. Fox
- Earle A. Chiles Research Institute, Providence Cancer Center, Portland, OR 97213, USA
| | - Zubair Khan
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Alfredo A. Molinolo
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
| | - Joseph A. Califano
- Department of Otolaryngology—Head and Neck Surgery, University of California San Diego, La Jolla, CA 92093, USA
- Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
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14
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Guo T, Craig L, Peacock E, Krousel-Wood M. Association of physical function with gait speed in men and women: relevance to antihypertensive medication adherence. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00189-1] [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: 01/28/2023]
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15
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Voora RS, Panuganti B, Califano J, Coffey C, Guo T. Patterns of Lymph Node Metastasis in Parotid Cancer and Implications for Extent of Neck Dissection. Otolaryngol Head Neck Surg 2023; 168:1067-1078. [PMID: 36939401 DOI: 10.1002/ohn.167] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/27/2022] [Accepted: 09/10/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The role and extent of neck dissection in primary parotid cancer are controversial. Herein, we characterize patterns of lymph node metastasis in parotid cancer. STUDY DESIGN Retrospective analysis. SETTING National Cancer Database. METHODS Patients with the 6 most common histologic subtypes of parotid cancer were selected. Primary outcomes were the distribution of positive lymph nodes by level and overall survival assessed by Cox analysis. Secondary outcomes included predictors of extended lymph node involvement (≥3 lymph nodes or Level IV/V involvement), via logistic regression. RESULTS Six thousand nine hundred seventy-seven patients with acinic cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, carcinoma ex pleomorphic adenoma (CExPA), mucoepidermoid carcinoma, and salivary duct carcinoma (SDC) were included. Among cN0 patients, 8.2% of low-grade tumor patients had occult nodal metastasis versus 30.9% in high-grade tumor patients. Elective neck dissection was not associated with an overall survival benefit (adjusted hazard ratio: 1.10; 0.94-1.30, p = .238). Among cN+ tumors, CExPA (odds ratio [OR]: 1.88, 1.05-3.39, p = .034) and high-grade pathology (OR: 3.03, 1.87-4.93, p < .001) were predictive of having ≥3 pathologic nodes. CExPA (OR: 2.13, 1.22-3.72, p = .008), adenocarcinoma (OR: 1.60, 1.11-2.31, p = .013), SDC (OR: 1.92, 1.17-3.14, p < .01), and high-grade pathology (OR: 3.61, 2.19-5.97, p < .001) were predictive of Level IV/V neck involvement. CONCLUSIONS In parotid malignancy, nodal metastasis distribution is dependent on histology and grade. High-grade tumors and certain histologies (SDC and adenocarcinoma) had a higher incidence of occult nodes. Comprehensive neck dissection should also be considered for node-positive high-grade tumors, SDC, and adenocarcinoma.
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Affiliation(s)
- Rohith S Voora
- University of California, San Diego School of Medicine, La Jolla, California, USA.,Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego School of Medicine, La Jolla, California, USA
| | - Bharat Panuganti
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego School of Medicine, La Jolla, California, USA.,Gleiberman Head and Neck Cancer Center, Moores Cancer Center, La Jolla, California, USA
| | - Joseph Califano
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego School of Medicine, La Jolla, California, USA.,Gleiberman Head and Neck Cancer Center, Moores Cancer Center, La Jolla, California, USA
| | - Charles Coffey
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego School of Medicine, La Jolla, California, USA.,Gleiberman Head and Neck Cancer Center, Moores Cancer Center, La Jolla, California, USA
| | - Theresa Guo
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego School of Medicine, La Jolla, California, USA.,Gleiberman Head and Neck Cancer Center, Moores Cancer Center, La Jolla, California, USA
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16
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Victor M, Vavinskaya V, Guo T. A Young Man Presenting With Tongue Lesions. JAMA Otolaryngol Head Neck Surg 2023; 149:89-90. [PMID: 36416858 DOI: 10.1001/jamaoto.2022.3799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A 19-year-old man presented with tongue pain of 3 months’ duration and a raised tongue lesion with slightly hairy appearance. What is your diagnosis?
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Affiliation(s)
- Mitchell Victor
- Department of Otolaryngology-Head & Neck Surgery, University of California San Diego School of Medicine, La Jolla
| | - Vera Vavinskaya
- Department of Pathology, University of California San Diego School of Medicine, La Jolla
| | - Theresa Guo
- Department of Otolaryngology-Head & Neck Surgery, University of California San Diego School of Medicine, La Jolla
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17
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Ren XT, Guo T, Yang F, Wu WY, Dou HL, Li XM. [Vogt-Koyanagi-Harada syndrome in the setting of vemurafenib therapy for metastatic melanoma: a case report]. Zhonghua Yan Ke Za Zhi 2022; 58:925-928. [PMID: 36348532 DOI: 10.3760/cma.j.cn112142-20220215-00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 53-year-old female patient complained of 1 week of bilateral visual blurring. She was previously diagnosed with metastatic melanoma of the inguinal lymph nodes and treated with the oral targeted drug vemurafenib. She exhibited aqueous flare in the left eye, and her fundus examination revealed optic disc swelling in the left eye and bilateral serious detachment of the retinal neuroepithelial layer. Fluorescein angiography showed multiple pinpoint hyperfluorescence leakage spots in the prometaphase and appeared as multilobular dye pooling in the late phase. We diagnosed her as Vogt-Koyanagi-Harada syndrome and gave glucocorticoid treatment for eyes. Oral vemurafenib was also taken intermittently under the guidance of an oncologist. After treatment, her bilateral vision improved, the anterior segment inflammation disappeared, and the retinal neuroepithelial layer reattached, with presence of the "sunset glow" fundus.
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Affiliation(s)
- X T Ren
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - T Guo
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - F Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - W Y Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - H L Dou
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - X M Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
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18
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Shirai S, Wang W, Guo T, Buryanek J, Chen L. Plasma cell neoplasm with initial presentation as an ovarian mass: a rare case report. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Plasmacytoma is a discrete, solitary mass of neoplastic plasma cells. Extramedullary plasmacytoma (EMP) is a rare entity arising in tissues other than bone and it constitutes about 1% of all plasma cell neoplasms. Most cases of reported EMPs are in the upper aerodigestive tract (~80%). We present a very rare case with the initial presentation as an ovarian mass with metastasis into the peritoneal and pleural cavity.
Methods/Case Report
This is a 66-year-old female who presented with generalized abdominal pain, unexpected weight loss, and occasional fever and night sweats. Computed tomography (CT) scan of abdomen and pelvis showed an extensive metastatic disease including bilateral cardiophrenic angle lymphadenopathy, peritoneal spread encasing the bowel loops, bladder, and uterus as well as moderate right pleural effusion. The positron emission tomography (PET)-CT showed an ill-defined soft tissue density in the pelvis with hypermetabolism. The pelvic ultrasound showed a 2.6 x 2.2 x 1.1 cm hypoechoic mass in the left adnexa. The patient's serum cancer antigen (CA-125) was elevated at 123 U/mL and the post-thoracentesis chest x-ray was unremarkable with no acute osseous abnormalities. Other clinical data were not available.
Results (if a Case Study enter NA)
Cytopathologic evaluation of the pleural fluid showed abundant atypical cells with eccentrically located nuclei, scant to moderate cytoplasm with a paranuclear hof, frequent binucleation and mitoses. The cells ranged in size from small to large. Further immunohistochemical (IHC) analysis on the cell block showed that the tumor cells diffusely positive for CD138 and lambda light chain and negative for MOC31, BerEP4, calretinin, D2-40, WT1, HHV8, ALK1, and EBER in situ hybridization (ISH). The biopsy of the left adnexal mass showed a diffuse proliferation of tumor cells with frequent mitotic figures. The IHC analysis on the biopsy specimen showed tumor cells positive for CD79a and CD56 (weak) and negative for CD20 and PAX5. Kappa/lambda ISH analysis confirmed lambda light chain restriction of the tumor cells. These morphological and immunophenotypic features were consistent with plasma cell neoplasm.
Conclusion
The ovary is an unusual location to be involved by plasma cell neoplasm. We use this case to remind the pathologists and clinicians that ovarian plasmacytoma can be the initial presentation of the plasma cell neoplasm, although rare, and to aid the patients to receive an appropriate treatment. A thorough workup is needed to make an accurate diagnosis of this entity.
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Affiliation(s)
- S Shirai
- Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston , Houston, Texas , United States
| | - W Wang
- Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston , Houston, Texas , United States
| | - T Guo
- Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston , Houston, Texas , United States
| | - J Buryanek
- Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston , Houston, Texas , United States
| | - L Chen
- Hematopathology, MD Anderson Cancer Center , Houston, Texas , United States
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19
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Park KS, Guo T, Liu CY. Cutaneous Squamous Cell Carcinoma With Orbital Extension. JAMA Ophthalmol 2022; 140:1133-1134. [PMID: 36201188 DOI: 10.1001/jamaophthalmol.2022.3919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A 72-year-old homeless man was referred for management of a recurrent cutaneous squamous cell carcinoma of the right temple and brow. He was seen again 5 months later with an enlarged crusting and ulcerating lesion of the right temple/brow. What would you do next?
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Affiliation(s)
- Kathryn S Park
- Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Viterbi Family Department of Ophthalmology, La Jolla, California
| | - Theresa Guo
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego
| | - Catherine Y Liu
- Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Viterbi Family Department of Ophthalmology, La Jolla, California
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20
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Ba C, Ni XH, Zhu GP, Yu JL, Cheng JJ, Wu JS, Xu RS, Guo T, Li YK, Zhao QM. Clinical effect of open reduction and internal fixation with a steel plate through the triceps approach in the treatment of fractures of the middle and lower 1/3 of the humerus. Eur Rev Med Pharmacol Sci 2022; 26:7413-7419. [PMID: 36314311 DOI: 10.26355/eurrev_202210_30010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The stability of fractures of the middle and lower 1/3 of the displaced humeral shaft is poor, and surgery is currently the main treatment. The posterolateral approach to the upper arm has many advantages but it is not widely used in clinical applications. The aim of the study was to investigate the clinical effect of open reduction and internal fixation with a steel plate through the triceps approach in the treatment of fractures of the middle and lower 1/3 of the humerus. PATIENTS AND METHODS A retrospective analysis was performed on 26 patients with fractures of the middle and lower 1/3 of the humerus who were admitted to our hospital from January 2018 to December 2021. According to the AO ASIF classification, 12 patients had type A, 8 patients had type B, and 6 patients had type C fractures. The posterior transtriceps approach was used for open reduction and internal fixation with a steel plate to evaluate its clinical efficacy. RESULTS All patients were followed completely, and the follow-up time was 6.0-18.0 months. Fracture nonunion occurred in 1 patient after the operation, and the other 25 patients healed well; 2 patients showed symptoms of radial nerve injury and numbness in the tiger's mouth area, which improved after 2 weeks. The average healing time of the fracture was 12.3 weeks. There were no infections or complications such as plate fractures. Elbow joint function according to Mayo scoring standards was as follows: 19 cases were excellent, 3 cases were good, 2 cases were fair, and 2 cases were poor. The excellent and good rate was 84.6%. CONCLUSIONS Open reduction through the triceps approach and internal fixation with a steel plate for the treatment of the middle and lower 1/3 of the humerus can directly expose and protect the radial nerve and its branches and reduce radial nerve damage, and plate fixation on the tension side is biomechanical and worthy of clinical application.
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Affiliation(s)
- C Ba
- Department of Orthopedics, Dafeng Hospital of Traditional Chinese Medicine, Yancheng, Jiangsu, China.
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21
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Kalavacherla S, Sanghvi P, Lin GY, Guo T. Updates in the management of unknown primary of the head and neck. Front Oncol 2022; 12:991838. [PMID: 36185196 PMCID: PMC9521035 DOI: 10.3389/fonc.2022.991838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 07/12/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
Squamous cell carcinoma (SCC) from an unknown primary tumor (SCCUP) accounts for 2.0%–5.0% of all head and neck cancers. SCCUP presents as enlarged cervical lymph nodes without evidence of a primary tumor upon physical examination. Primary site detection is important to target treatment and avoid treatment-related morbidity. In this review, we discuss updates in SCCUP management. Diagnostic workup should focus on localization of the primary tumor in SCCUP. Initial workup centers on neck biopsy to confirm the presence of SCC. Given the increasing incidence of HPV-related SCC in the oropharynx, HPV testing is crucial. An HPV-positive status can localize the tumor to the oropharynx, a common site for occult tumors. Imaging includes neck CT and/or MRI, and PET/CT. After imaging, panendoscopy, palatine tonsillectomy or diagnostic transoral robotic surgery can facilitate high rates of primary tumor localization. Primary tumor localization influences treatments administered. SCCUP has traditionally been treated aggressively with large treatment fields to all potential disease sites, which can induce weight loss and swallowing dysfunction. As a result, primary localization can reduce radiation fields and provide possible de-escalation to primary surgical management. Advances in intensity-modulated radiation therapy and dose management also have the potential to improve functional outcomes in SCCUP patients. Given the improved prognosis associated with HPV-positive SCCs, HPV tumor status may also inform future treatment de-intensification to reduce treatment-related toxicity.
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Affiliation(s)
- Sandhya Kalavacherla
- School of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Parag Sanghvi
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, San Diego, CA, United States
| | - Grace Y. Lin
- Department of Pathology, University of California, San Diego, San Diego, CA, United States
| | - Theresa Guo
- Department of Otolaryngology – Head & Neck Surgery, University of California, San Diego, San Diego, CA, United States
- *Correspondence: Theresa Guo,
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22
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Louie BH, Stramiello J, Senyei G, Weissbrod P, Boys J, Cheng G, Guo T. Necrotizing Tracheitis Complicated by Tracheal Wall Perforation. Ear Nose Throat J 2022; 101:26S-29S. [PMID: 36028929 DOI: 10.1177/01455613221123664] [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: 11/17/2022] Open
Abstract
Necrotizing tracheitis is a rare condition, mainly seen in immunocompromised patients, that may lead to pseudomembrane formation, airway obstruction and in severe cases, tracheal perforation. We present a case of a 32-year-old male with poorly controlled diabetes who presented with productive cough, dysphagia, and respiratory distress. Bronchoscopy revealed extensive tracheal necrosis along a 4-5 cm segment of cartilaginous trachea and was complicated by tracheal perforation with false passage into the anterior mediastinum. Once the airway was re-established, a multidisciplinary team discussed options for definitive airway management, including tracheal reconstruction, pulmonary stent, or tracheostomy. Ultimately, a distal XLT tracheostomy was placed. Microbiology specimens of the tracheal tissue were positive for Actinomyces. The patient was started on long-term antibiotics and diabetes management. At three-month follow-up, the trachea was patent with near complete mucosalization of the previously necrotic segment. An area of proximal tracheal stenosis was successfully managed with a customized tracheal T-tube. In conclusion, this is a case of necrotizing tracheitis complicated by tracheal perforation. Successful treatment required a multidisciplinary team for airway management as well as medical treatment of immunocompromising risk factors and antimicrobial therapy. This enabled timely healing of the trachea and a durable airway.
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Affiliation(s)
- Bryan H Louie
- Department of Otolaryngology, 8784University of California San Diego, La Jolla, CA, USA
| | - Joshua Stramiello
- Department of Otolaryngology, 8784University of California San Diego, La Jolla, CA, USA
| | - Grant Senyei
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, 8784University of California San Diego, La Jolla, CA, USA
| | - Philip Weissbrod
- Department of Otolaryngology, 8784University of California San Diego, La Jolla, CA, USA
| | - Joshua Boys
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, 8784University of California San Diego, La Jolla, CA, USA
| | - George Cheng
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, 8784University of California San Diego, La Jolla, CA, USA
| | - Theresa Guo
- Department of Otolaryngology, 8784University of California San Diego, La Jolla, CA, USA
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Abstract
In the recent years, the prevalence of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) has increased significantly. Currently, nearly 80-90% of all oropharynx tumors are HPV-positive. In addition, it is now recognized that HPV-positive tumor status is associated with good prognosis and improved response to chemoradiation. However, within this setting, there are still patients with HPV-positive OPSCC who will experience recurrence. With the increasing incidence of HPV-mediated OPSCC, recurrent HPV disease is also becoming more prevalent and there is an increasing need to understand the unique presentation and treatment of recurrent HPV-mediated disease. In this review, we will discuss epidemiology of recurrent HPV-positive OPSCC, role of surgical salvage, re-irradiation, and the role of upcoming novel treatments and immunotherapy. Historically, recurrent oropharyngeal disease has been associated with poor prognosis and high morbidity. However, recent advances have transformed the landscape for salvage treatment of HPV-mediated OPSCC. Liquid biomarkers offer potential for early detection of recurrence, robotic techniques may reduce morbidity of surgical salvage, improvements in re-irradiation approaches reduce toxicities, and novel immune based therapies on the horizon are offering promising results. These advances combined with the improved prognosis of HPV-positive disease offer to transform our approach to recurrent disease of the oropharynx.
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Affiliation(s)
- Theresa Guo
- Department of Otolaryngology-Head and Neck Cancer, Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
- *Correspondence: Theresa Guo,
| | - Stephen Y. Kang
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University Wexner Medical Center, Ohio State University, Columbus, OH, United States
| | - Ezra E. W. Cohen
- Division of Medical Oncology, Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
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24
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Haddad RI, Bischoff L, Ball D, Bernet V, Blomain E, Busaidy NL, Campbell M, Dickson P, Duh QY, Ehya H, Goldner WS, Guo T, Haymart M, Holt S, Hunt JP, Iagaru A, Kandeel F, Lamonica DM, Mandel S, Markovina S, McIver B, Raeburn CD, Rezaee R, Ridge JA, Roth MY, Scheri RP, Shah JP, Sipos JA, Sippel R, Sturgeon C, Wang TN, Wirth LJ, Wong RJ, Yeh M, Cassara CJ, Darlow S. Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022; 20:925-951. [PMID: 35948029 DOI: 10.6004/jnccn.2022.0040] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Differentiated thyroid carcinomas is associated with an excellent prognosis. The treatment of choice for differentiated thyroid carcinoma is surgery, followed by radioactive iodine ablation (iodine-131) in select patients and thyroxine therapy in most patients. Surgery is also the main treatment for medullary thyroid carcinoma, and kinase inhibitors may be appropriate for select patients with recurrent or persistent disease that is not resectable. Anaplastic thyroid carcinoma is almost uniformly lethal, and iodine-131 imaging and radioactive iodine cannot be used. When systemic therapy is indicated, targeted therapy options are preferred. This article describes NCCN recommendations regarding management of medullary thyroid carcinoma and anaplastic thyroid carcinoma, and surgical management of differentiated thyroid carcinoma (papillary, follicular, Hürthle cell carcinoma).
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Affiliation(s)
| | | | - Douglas Ball
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | - Paxton Dickson
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Quan-Yang Duh
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | | | | | - Shelby Holt
- UT Southwestern Simmons Comprehensive Cancer Center
| | - Jason P Hunt
- Huntsman Cancer Institute at the University of Utah
| | | | | | | | - Susan Mandel
- Abramson Cancer Center at the University of Pennsylvania
| | - Stephanie Markovina
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Rod Rezaee
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - Mara Y Roth
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | - Jennifer A Sipos
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - Cord Sturgeon
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | - Michael Yeh
- UCLA Jonsson Comprehensive Cancer Center; and
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Zamuner F, Chan SS, Kessler M, Vorontsov I, Danilova L, Erbe R, Kelley D, Guo T, Imada E, Fertig EJ, Kulakovskiy I, Favorov A, Gaykalova DA. Abstract 1459: Identification of transcription factor enrichments in HPV+ head and neck cancer using ChIP-seq and cistrome analysis. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The subset of head and neck squamous cell carcinomas (HNSCC) that are driven by infection with the Human Papilloma Virus (HPV+ HNSCC) are increasing in prevalence and are defined by distinct biological signatures and mechanisms, such as abnormal transcriptional regulation. Here, we use optimized protocols to perform ChIP-seq and RNA-seq on patient surgical samples, which we use to define promoter, typical-enhancer, and super-enhancer (SE) regulatory regions with differential chromatin states (i.e. H3K27ac signal) between tumor and normal samples. We then leverage publicly available transcription factor (TF) cistrome data to test 372 TFs for tumor or normal specific enrichment across these differential regulatory regions. We identify 31 tumor-specific TF enrichments, such as TP53/63/73, NKX2-1, JUNB/D, FOSL1/2, E2F1/3, KLF3/4/5, SMAD3/4, TEAD1/4, TFAP2A/C, HIF1A, PPARG, GRHL2, EPAS1, and SNAI2. A number of these enriched TFs, including TP63, TP73, FOSL1, and E2F1, show both significantly increased expression in tumors and significant transcriptional reductions after JQ1 treatment. These results provide novel insight into the regulatory biology of HPV+ HNSCC, and suggest that the transcriptional networks and feedback loops governing TF expression and dysregulation in HPV+ HNSCC can be targeted using JQ1 treatment.
Citation Format: Fernando Zamuner, Spencer S. Chan, Michael Kessler, Ilya Vorontsov, Ludmila Danilova, Rossin Erbe, Dylan Kelley, Theresa Guo, Eddie Imada, Elana J. Fertig, Ivan Kulakovskiy, Alexander Favorov, Daria A. Gaykalova. Identification of transcription factor enrichments in HPV+ head and neck cancer using ChIP-seq and cistrome analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1459.
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Affiliation(s)
| | | | - Michael Kessler
- 3Vavilov Institute of General Genetics, Moscow, Russian Federation
| | - Ilya Vorontsov
- 3Vavilov Institute of General Genetics, Moscow, Russian Federation
| | | | - Rossin Erbe
- 1Johns Hopkins Medical Institutions, Baltimore, MD
| | - Dylan Kelley
- 1Johns Hopkins Medical Institutions, Baltimore, MD
| | - Theresa Guo
- 4University of California, San Diego, San Diego, CA
| | - Eddie Imada
- 1Johns Hopkins Medical Institutions, Baltimore, MD
| | | | - Ivan Kulakovskiy
- 3Vavilov Institute of General Genetics, Moscow, Russian Federation
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26
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Abstract
The increased prevalence of temporomandibular joint osteoarthritis (TMJOA) in children and adolescents has drawn considerable attention as it may interfere with mandibular condyle growth, resulting in dento-maxillofacial deformities. However, treatments for osteoarthritis have been ineffective at restoring the damaged bone and cartilage structures due to poor understanding of the underlying degenerative mechanism. In this study, we demonstrate that Gli1+ cells residing in the subchondral bone contribute to bone formation and homeostasis in the mandibular condyle, identifying them as osteogenic progenitors in vivo. Furthermore, we show that, in a TMJOA mouse model, derivatives of Gli1+ cells undergo excessive expansion along with increased but uneven distribution of osteogenic differentiation in the subchondral bone, which leads to abnormal subchondral bone remodeling via Hedgehog (Hh) signaling activation and to the development of TMJOA. The selective pharmacological inhibition and specific genetic inhibition of Hh signaling in Gli1+ osteogenic progenitors result in improved subchondral bone microstructure, attenuated local immune inflammatory response in the subchondral bone, and reduced degeneration of the articular cartilage, providing in vivo functional evidence that targeting Hh signaling in Gli1+ osteogenic progenitors can modulate bone homeostasis in osteoarthritis and provide a potential approach for treating TMJOA.
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Affiliation(s)
- J. Lei
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
- Center for TMD & Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing, China
| | - S. Chen
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - J. Jing
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - T. Guo
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - J. Feng
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - T.V. Ho
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - Y. Chai
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
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Affiliation(s)
- L-L Fan
- From the Department of Respiratory Medicine, Diagnosis and Treatment Center of Respiratory Disease, the Second Xiangya Hospital of Central South University, No.139, Renming Road, Changsha 410011, Hunan, China
- Department of Cell Biology, Hunan Key Laboratory of Animal Models for Human Diseases, The School of Life Sciences, Central South University, No.172, Tongzipo Raod, Changsha 410013, China
| | | | - C-Y Wang
- Department of Cell Biology, Hunan Key Laboratory of Animal Models for Human Diseases, The School of Life Sciences, Central South University, No.172, Tongzipo Raod, Changsha 410013, China
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Jiang Q, Yin C, Ren Y, Zhao W, Guo T, Zhang H, Guo Y, Zhu X. Expression and Significance of Transforming Growth Factor-Beta/Smad Pathway in the Prefrontal-Hippocampal Loop in Rats with Cognitive Impairment Associated with Alcohol Dependence. Indian J Pharm Sci 2022. [DOI: 10.36468/pharmaceutical-sciences.spl.496] [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: 11/22/2022] Open
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Pang J, Nguyen N, Luebeck J, Ball L, Finegersh A, Ren S, Nakagawa T, Flagg M, Sadat S, Mischel PS, Xu G, Fisch K, Guo T, Cahill G, Panuganti B, Bafna V, Califano J. Extrachromosomal DNA in HPV-Mediated Oropharyngeal Cancer Drives Diverse Oncogene Transcription. Clin Cancer Res 2021; 27:6772-6786. [PMID: 34548317 DOI: 10.1158/1078-0432.ccr-21-2484] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/20/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Human papillomavirus (HPV) plays a major role in oncogenesis and circular extrachromosomal DNA (ecDNA) is found in many cancers. However, the relationship between HPV and circular ecDNA in human cancer is not understood. EXPERIMENTAL DESIGN Forty-four primary tumor tissue samples were obtained from a cohort of patients with HPV-positive oropharynx squamous cell carcinoma (OPSCC). Twenty-eight additional HPV oropharyngeal cancer (HPVOPC) tumors from The Cancer Genome Atlas (TCGA) project were analyzed as a separate validation cohort. Genomic, transcriptomic, proteomic, computational, and functional analyses of HPVOPC were applied to these datasets. RESULTS Our analysis revealed circular, oncogenic DNA in nearly all HPVOPC, with circular human and human-viral hybrid ecDNA present in over a third of HPVOPC and viral circular DNA in remaining tumors. Hybrid ecDNA highly express fusion transcripts from HPV promoters and HPV oncogenes linked to downstream human transcripts that drive oncogenic transformation and immune evasion, and splice multiple, diverse human acceptors to a canonical SA880 viral donor site. HPVOPC have high E6*I expression with specific viral oncogene expression pattern related to viral or hybrid ecDNA composition. CONCLUSIONS Nonchromosomal circular oncogenic DNA is a dominant feature of HPVOPC, revealing an unanticipated link between HPV and ecDNA that leverages the power of extrachromosomal inheritance to drive HPV and somatic oncogene expression.
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Affiliation(s)
- John Pang
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Nam Nguyen
- UC San Diego Jacobs School of Engineering, Department of Computer Science and Engineering, La Jolla, California
| | - Jens Luebeck
- Bioinformatics & Systems Biology Graduate Program, University of California at San Diego, La Jolla, California
| | - Laurel Ball
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Andrey Finegersh
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Shuling Ren
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Takuya Nakagawa
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Mitchell Flagg
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Sayed Sadat
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Paul S Mischel
- Stanford University School of Medicine, Department of Pathology, ChEM-H, Stanford, California
| | - Guorong Xu
- UC San Diego School of Medicine, Center for Computational Biology and Bioinformatics, La Jolla, California
| | - Kathleen Fisch
- UC San Diego School of Medicine, Center for Computational Biology and Bioinformatics, La Jolla, California
| | - Theresa Guo
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California.,Johns Hopkins University School of Medicine, Otolaryngology-Head and Neck Surgery, Baltimore, Maryland
| | - Gabrielle Cahill
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Bharat Panuganti
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California
| | - Vineet Bafna
- UC San Diego Jacobs School of Engineering, Department of Computer Science and Engineering, La Jolla, California.
| | - Joseph Califano
- UC San Diego School of Medicine, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, La Jolla, California. .,Bioinformatics & Systems Biology Graduate Program, University of California at San Diego, La Jolla, California
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Saiyed FK, Guo T, Johnson F, Myers JN. Characterizing distant metastases and survival in oropharyngeal squamous cell carcinoma. Head Neck 2021; 43:2101-2109. [PMID: 33738875 PMCID: PMC8251991 DOI: 10.1002/hed.26678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Outcomes of oropharyngeal squamous cell carcinoma (OPSCC) after development of distant metastases (DM) in the context of human papillomavirus (HPV) tumor status remain controversial in the literature. METHODS OPSCC patients with DM treated between June 2015 and March 2019 were included from a prospectively enrolled database. Characteristics of DM including sites, episodes, and timing of disease were analyzed in addition to survival after DM. RESULTS Sixty-nine HPV-positive and 18 HPV-negative OPSCC patients with DM were included. The 2-year survival after DM was higher for HPV-positive patients (54.0% vs. 11.3%, p < 0.001). HPV-positive patients did not demonstrate greater episodes or sites of DM. Multiple sites of DM, early development of DM, and Charlson comorbidity Index were independently associated with worse survival after DM. CONCLUSIONS While multiple sites, early DM, and comorbidities were poor prognostic factors, OPSCC patients with distant progression can have substantial survival after DM, including M1 patients.
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Affiliation(s)
- Faiez K. Saiyed
- Department of Otolaryngology – Head and Neck SurgeryUniversity of MarylandBaltimoreMarylandUSA
| | - Theresa Guo
- Department of Head and Neck SurgeryUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Faye Johnson
- Department of Thoracic Head and Neck Medical OncologyUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
- The University of Texas Graduate School of Biomedical SciencesHoustonTexasUSA
| | - Jeffrey N. Myers
- Department of Head and Neck SurgeryUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
- The University of Texas Graduate School of Biomedical SciencesHoustonTexasUSA
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Kumar A, Cherry DR, Voora RS, Faraji F, Courtney PT, Finegersh A, Guo T, Cohen EE, Califano JA, Mell LK, Rose BS, Orosco RK. Transoral robotic surgery for human papillomavirus-associated oropharynx squamous cell carcinoma: Recurrence and survival in the Veterans Affairs health system. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.6054] [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: 11/20/2022] Open
Abstract
6054 Background: Most transoral robotic surgery (TORS) literature comes from single and multi-institutional studies at tertiary-care academic intuitions. Long-term outcomes for patients with HPV-mediated oropharyngeal squamous cell carcinoma (HPV-OPSCC) treated with upfront TORS in other hospital settings across the United States are largely unknown. We present long-term recurrence and survival outcomes from a novel Veterans Health Administration (VHA) longitudinal dataset that includes patient-level data. Methods: Retrospective analysis of national VHA patients with p16-positive OPSCC diagnosed between January 2010 and December 2016, treated with TORS primary tumor resection with neck dissection. Outcome measures included: Cancer-specific survival (CSS), progression free survival (PFS), overall survival (OS), recurrence, extranodal extension (ENE), positive surgical margin (PSM), and adjuvant therapy regimen. Results: One hundred sixty-one patients were included of whom 29 (18%) were low-risk [0-1 metastatic lymph nodes, negative margins]; 45 (28%) intermediate-risk [close surgical margins, 2 to 4 metastatic nodes, LVI or PNI, pathologic T3 or T4 tumor]; and 87 (54%) high-risk [PSM, ENE, and/or ≥ 5 metastatic nodes]. ENE was present in 41% of cases and 24% of cases had positive surgical margins. Median follow-up was 5.6 years (95% CI 3.0-9.3). The 5-year CSS rates for low, intermediate, and high-risk groups were: 100%, 90.0% (95% CI 75.4-96.1%), and 88.7% (78.3-94.2%). On univariable analysis, pathologic factors associated with inferior CSS were: pT3-T4 tumor category (HR 3.81, 95% CI 1.31-11; p = 0.01), presence of more than four metastatic lymph nodes (HR 3.41, 95% CI 1.20-11; p = 0.02), and ENE (HR 3.53, 95% CI 1.06-12; p = 0.04). Close or PSM were not associated with CSS (HR 0.67, 95% CI 0.21 – 2.14; p = 0.50). In the low-risk group, 48% avoided adjuvant therapy and although there were five recurrences, none died from cancer. The intermediate-risk group was treated with adjuvant radiation in 64% of cases, and chemoradiation in 29% of cases; and there were five locoregional recurrences and three distant recurrences. Adjuvant chemoradiation was used in 68% of high-risk cases. Of the seven total patients with distant recurrences, six died of their disease. Conclusions: Our findings in this national cohort of Veterans with HPV-OPSCC demonstrate that TORS followed by adjuvant therapy yields favorable survival outcomes. Tumor-category, ENE, and more than four nodal metastases were the strongest adverse features in our data, and surgical margins did not have a significant impact on survival. Further investigations with large cohorts and prospective clinical trials are needed to elucidate the true oncologic implications of high-risk features and to identify patients best suited for de-intensified treatment.
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Affiliation(s)
| | | | | | | | | | | | - Theresa Guo
- University of California, San Diego, San Diego, CA
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Guo T, Zhang XJ, Cheng XL, Li H, Nie ZH, Zhang JL, Zhang LT. [Five cases of occupational contact dermatitis caused by paint]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 38:931. [PMID: 33406559 DOI: 10.3760/cma.j.cn121094-20200323-00144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Juschten J, Tuinman PR, Guo T, Juffermans NP, Schultz MJ, Loer SA, Girbes ARJ, de Grooth HJ. Between-trial heterogeneity in ARDS research. Intensive Care Med 2021; 47:422-434. [PMID: 33713156 PMCID: PMC7955690 DOI: 10.1007/s00134-021-06370-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/23/2020] [Accepted: 02/15/2021] [Indexed: 02/07/2023]
Abstract
Purpose Most randomized controlled trials (RCTs) in patients with acute respiratory distress syndrome (ARDS) revealed indeterminate or conflicting study results. We aimed to systematically evaluate between-trial heterogeneity in reporting standards and trial outcome. Methods A systematic review of RCTs published between 2000 and 2019 was performed including adult ARDS patients receiving lung-protective ventilation. A random-effects meta-regression model was applied to quantify heterogeneity (non-random variability) and to evaluate trial and patient characteristics as sources of heterogeneity. Results In total, 67 RCTs were included. The 28-day control-group mortality rate ranged from 10 to 67% with large non-random heterogeneity (I2 = 88%, p < 0.0001). Reported baseline patient characteristics explained some of the outcome heterogeneity, but only six trials (9%) reported all four independently predictive variables (mean age, mean lung injury score, mean plateau pressure and mean arterial pH). The 28-day control group mortality adjusted for patient characteristics (i.e. the residual heterogeneity) ranged from 18 to 45%. Trials with significant benefit in the primary outcome reported a higher control group mortality than trials with an indeterminate outcome or harm (mean 28-day control group mortality: 44% vs. 28%; p = 0.001). Conclusion Among ARDS RCTs in the lung-protective ventilation era, there was large variability in the description of baseline characteristics and significant unexplainable heterogeneity in 28-day control group mortality. These findings signify problems with the generalizability of ARDS research and underline the urgent need for standardized reporting of trial and baseline characteristics. Supplementary Information The online version of this article (10.1007/s00134-021-06370-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J Juschten
- Department of Intensive Care, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, mail stop ZH 7D-172, 1081HV, Amsterdam, The Netherlands. .,Research VUmc Intensive Care (REVIVE), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - P R Tuinman
- Department of Intensive Care, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, mail stop ZH 7D-172, 1081HV, Amsterdam, The Netherlands.,Research VUmc Intensive Care (REVIVE), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T Guo
- Department of Intensive Care, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, mail stop ZH 7D-172, 1081HV, Amsterdam, The Netherlands.,Research VUmc Intensive Care (REVIVE), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Division of System Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, Leiden, The Netherlands
| | - N P Juffermans
- Laboratory of Experimental Intensive Care and Anesthesiology (LEICA), Amsterdam UMC, Universiteit Van Amsterdam, Amsterdam, The Netherlands.,Department of Intensive Care, OLVG Hospital, Amsterdam, The Netherlands
| | - M J Schultz
- Department of Intensive Care, Amsterdam UMC, Universiteit Van Amsterdam, Amsterdam, The Netherlands.,Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand.,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - S A Loer
- Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A R J Girbes
- Department of Intensive Care, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, mail stop ZH 7D-172, 1081HV, Amsterdam, The Netherlands.,Research VUmc Intensive Care (REVIVE), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H J de Grooth
- Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Wei Y, Xu P, Wei T, Chen L, Wang X, Li S, Guo T, Li W. Role of Manganese Doping TiO2 Hollow Spheres under Vacuum Ultraviolet Irradiation. Kinet Catal 2021. [DOI: 10.1134/s0023158421010110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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35
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Wang M, Li S, Xue X, Wei X, Ye Z, Su Y, Li L, Xu Z, Guo T, Xie J, Wang W, Zhang L. P57.03 Pathogenic Germline Mutations of Homologous Recombination Deficiency (HRD) Genes in Chinese Lung Cancer Patients. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.947] [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: 10/21/2022]
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36
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Zhang S, Wu X, Feng Y, Wang Q, Jiang Q, Guo T, Wu D, Xu T, Li R, Tang SJ, Yang A. Resuming gastrointestinal endoscopy post-COVID-19 peak: Focus on the guidance from international and national societies. J Gastroenterol Hepatol 2021; 36:526-533. [PMID: 33073882 DOI: 10.1111/jgh.15304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/07/2020] [Accepted: 10/14/2020] [Indexed: 01/22/2023]
Affiliation(s)
- S Zhang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - X Wu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Y Feng
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Q Wang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Q Jiang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - T Guo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - D Wu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - T Xu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - R Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - S-J Tang
- Division of Digestive Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - A Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
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An P, Peng Q, Guo T, Xing PC, Zhao LD, Zhou MJ. Potential influence of miR-192 on the efficacy of saxagliptin treatment in T2DM complicated with non-alcoholic fatty liver disease. J BIOL REG HOMEOS AG 2021; 34:1411-1415. [PMID: 32829627 DOI: 10.23812/20-147-l] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P An
- Department of Emergency and Critical Care Medicine, Shanghai Sixth People's Hospital East, Shanghai, China
| | - Q Peng
- Department of Laboratory Medicine, Maternal and Child Health of Qujing Yunnan Province China
| | - T Guo
- Department of Internal Medicine, Shanghai the People's Hospital of Putuo District, Shanghai, China
| | - P C Xing
- Department of Emergency and Critical Care Medicine, Shanghai Sixth People's Hospital East, Shanghai, China
| | - L D Zhao
- Department of Emergency and Critical Care Medicine, Shanghai Sixth People's Hospital East, Shanghai, China
| | - M J Zhou
- Department of Emergency and Critical Care Medicine, Shanghai Sixth People's Hospital East, Shanghai, China
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Yao CMKL, Fu S, Tam S, Kiong KL, Guo T, Zhao H, Giordano SH, Sturgis EM, Lewis CM. Impact of provider type and number of providers on surveillance testing among survivors of head and neck cancers. Cancer 2021; 127:1699-1711. [PMID: 33471396 DOI: 10.1002/cncr.33402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/14/2020] [Revised: 11/10/2020] [Accepted: 11/30/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Guidelines for follow-up after head and neck cancer (HNC) treatment recommend frequent clinical examinations and surveillance testing. Here, the authors describe real-world follow-up care for HNC survivors and variations in surveillance testing. METHODS Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, this study examined a population-based cohort of HNC survivors between 2001 and 2011 Usage of cross-sectional head and neck imaging (CHNI), chest imaging (CI), positron emission tomography (PET), fiberoptic nasopharyngolaryngoscopy (FNPL), and, in irradiated patients, thyroid function testing (TFT) was captured over 2 consecutive surveillance years. Multivariate modeling with logistic regression analyses was used to assess variations by clinical factors, nonclinical factors, number and types of providers seen and their evolution over time. RESULTS Among 13,836 HNC survivors, the majority saw a medical, radiation, or surgical oncologist and a primary care provider (PCP; 81.7%) in their first year of surveillance. However, only 58.1% underwent either PET or CHNI, 47.8% underwent CHNI, 64.1% underwent CI, 32.5% underwent PET scans, 55.0% underwent FNPL, and 55.9% underwent TFT. In multivariate analyses, patients who followed up with more providers and those who followed up with both a PCP and an oncologist were more likely to undergo surveillance testing (P < .007). However, adjusting for providers seen did not explain the variations in surveillance testing rates based on age, race, education, income level, and place of residence. Over time, there was a gradual increase in the use of PET scans and TFT during surveillance years. CONCLUSIONS In this large SEER-Medicare data study, only half of HNC survivors received the recommended testing, and greater compliance was seen in those who followed up with both an oncologist and a PCP. More attention is needed to minimize variations in surveillance testing across sociodemographic groups.
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Affiliation(s)
- Christopher M K L Yao
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shuangshuang Fu
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Samantha Tam
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kimberley L Kiong
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Theresa Guo
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hui Zhao
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sharon H Giordano
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas
| | - Carol M Lewis
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Jiao S, Huang J, Chen Y, Song Y, Gong T, Lu J, Guo T, Zhang J, Zhang C, Chen M. Impacts of Glycemic Control on Intracranial Plaque in Patients with Type 2 Diabetes Mellitus: A Vessel Wall MRI Study. AJNR Am J Neuroradiol 2020; 42:75-81. [PMID: 33272948 DOI: 10.3174/ajnr.a6878] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE The relationship between glycemic control in patients with type 2 diabetes mellitus and intracranial atherosclerotic plaque features has remained understudied. This study aimed to investigate the association of type 2 diabetes mellitus and glycemic control with the characteristics of intracranial plaques using vessel wall MR imaging. MATERIALS AND METHODS In total, 311 patients (217 [69.8%] men; mean age, 63.24 ± 11.44 years) with intracranial atherosclerotic plaques detected on vessel wall MR imaging were enrolled and divided into 3 groups according to type 2 diabetes mellitus and glycemic control statuses: the non-type 2 diabetes mellitus group, the type 2 diabetes mellitus with good glycemic control group, and the type 2 diabetes mellitus with poor glycemic control group. The imaging features of intracranial plaque were analyzed and compared among the groups. The clinical risk factors for atherosclerosis were also analyzed using logistic regression analysis. RESULTS The plaque length and thickness were significantly higher in the type 2 diabetes mellitus with poor glycemic control group than in the non-type 2 diabetes mellitus group. The prevalence of strongly enhanced plaques was significantly higher in the type 2 diabetes mellitus with poor glycemic control group than in the non-type 2 diabetes mellitus and type 2 diabetes mellitus with good glycemic control groups (92.9%, 63.4%, and 72.7%, respectively; P < .001). Multivariate logistic regression analysis showed a significant association of poor glycemic control with the plaque length (OR = 1.966; 95% CI, 1.170-3.303; P = .011), plaque thickness (OR = 1.981; 95% CI, 1.174-3.340; P = .010), and strongly enhanced plaque (OR = 5.448; 95% CI, 2.385-12.444; P < .001). CONCLUSIONS Poor glycemic control, compared with the history of diabetes, might have a greater impact on the burden and vulnerability of intracranial atherosclerotic plaques.
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Affiliation(s)
- S Jiao
- From the Departments of Radiology (S.J., J.H., Y.S., T. Guo, J.Z., C.Z., M.C.)
| | - J Huang
- From the Departments of Radiology (S.J., J.H., Y.S., T. Guo, J.Z., C.Z., M.C.)
| | | | - Y Song
- From the Departments of Radiology (S.J., J.H., Y.S., T. Guo, J.Z., C.Z., M.C.)
| | | | - J Lu
- Neurosurgery (J.L.), Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, P.R. China, Beijing, China
| | - T Guo
- From the Departments of Radiology (S.J., J.H., Y.S., T. Guo, J.Z., C.Z., M.C.)
| | - J Zhang
- From the Departments of Radiology (S.J., J.H., Y.S., T. Guo, J.Z., C.Z., M.C.)
| | - C Zhang
- From the Departments of Radiology (S.J., J.H., Y.S., T. Guo, J.Z., C.Z., M.C.)
| | - M Chen
- From the Departments of Radiology (S.J., J.H., Y.S., T. Guo, J.Z., C.Z., M.C.)
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Li J, Guo T, Dong D, Zhang X, Chen X, Feng Y, Wei B, Zhang W, Zhao M, Wan J. Defining heart disease risk for death in COVID-19 infection. QJM 2020; 113:876-882. [PMID: 32790836 PMCID: PMC7454913 DOI: 10.1093/qjmed/hcaa246] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) was in common in coronavirus disease 2019 (COVID-19) patients and associated with unfavorable outcomes. We aimed to compare the clinical observations and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients with or without CVD. METHODS Patients with laboratory-confirmed SARS-CoV-2 infection were clinically evaluated at Wuhan Seventh People's Hospital, Wuhan, China, from 23 January to 14 March 2020. Demographic data, laboratory findings, comorbidities, treatments and outcomes were collected and analyzed in COVID-19 patients with and without CVD. RESULTS Among 596 patients with COVID-19, 215 (36.1%) of them with CVD. Compared with patients without CVD, these patients were significantly older (66 vs. 52 years) and had higher proportion of men (52.5% vs. 43.8%). Complications in the course of disease were more common in patients with CVD, included acute respiratory distress syndrome (22.8% vs. 8.1%), malignant arrhythmias (3.7% vs. 1.0%) including ventricular tachycardia/ventricular fibrillation, acute coagulopathy(7.9% vs. 1.8%) and acute kidney injury (11.6% vs. 3.4%). The rate of glucocorticoid therapy (36.7% vs. 25.5%), Vitamin C (23.3% vs. 11.8%), mechanical ventilation (21.9% vs. 7.6%), intensive care unit admission (12.6% vs. 3.7%) and mortality (16.7% vs. 4.7%) were higher in patients with CVD (both P < 0.05). The multivariable Cox regression models showed that older age (≥65 years old) (HR 3.165, 95% CI 1.722-5.817) and patients with CVD (HR 2.166, 95% CI 1.189-3.948) were independent risk factors for death. CONCLUSIONS CVD are independent risk factors for COVID-19 patients. COVID-19 patients with CVD were more severe and had higher mortality rate, early intervention and vigilance should be taken.
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Affiliation(s)
- J Li
- From the Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan 430071, China
| | - T Guo
- From the Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan 430071, China
| | - D Dong
- Department of Infectious Disease, Wuhan Seventh People’s Hospital, 6 Zhongnan 2nd Road, Wuhan 430071, China
| | - X Zhang
- From the Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan 430071, China
| | - X Chen
- From the Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan 430071, China
| | - Y Feng
- From the Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan 430071, China
| | - B Wei
- From the Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan 430071, China
| | - W Zhang
- From the Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan 430071, China
| | - M Zhao
- Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, 115 East Lake Road, Wuhan 430071, China
| | - J Wan
- From the Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan 430071, China
- correspondence to J. Wan, Department of Cardiology, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuhan, Hubei 430071, China.
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Lou HD, Wang SY, Guo T, Yang Y. Role of miR-21 in rats with proliferative diabetic retinopathy via TGF-β signaling pathway. Eur Rev Med Pharmacol Sci 2020; 23:9-16. [PMID: 31389569 DOI: 10.26355/eurrev_201908_18621] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore the effects of miR-21 on the rats with proliferative diabetic retinopathy by regulating the transforming growth factor-beta (TGF-β) signaling pathway. MATERIALS AND METHODS A total of 36 Sprague-Dawley rats were randomly divided into the normal group (n=12), model group (n=12), and inhibitor group (TGF-β signaling inhibitor) (n=12). No treatment was performed in the normal group, the diabetic retinopathy model was established in the model group, and the model was established in the inhibitor group after the intraperitoneal injection of the inhibitor. Then, the materials were sampled for detection. In each group, the retinal morphology was observed via hematoxylin-eosin (HE) staining, the expressions of TGF-β1 and Smad3 were detected via immunohistochemistry, the relative protein expression levels of phosphorylated Smad3 (p-Smad3) and TGF-β were determined via Western blotting, the expression of miR-21 was detected via quantitative Polymerase Chain Reaction (qPCR), and the hemodynamic indicators of the ocular tissues were detected using the color Doppler ultrasonography. RESULTS The HE staining results revealed that the rats in the model group had evident retinal damage, which could be effectively improved using the inhibitor. According to the immunohistochemistry detection results, the positive expression level of TGF-β1 was substantially raised in both model group and inhibitor group compared with that in the normal group (p<0.05), and it was notably lower in the inhibitor group than that in the model group (p<0.05). Moreover, the three groups did not differ in the positive expression level of Smad3 (p>0.05). The Western blotting results showed that the model and inhibitor groups had remarkably higher relative protein expression levels of p-Smad3 and TGF-β1 than the normal group (p<0.05), and they were markedly lowered in the inhibitor group compared with those in the model group (p<0.05). According to the qPCR results, the expression level of miR-21 was notably elevated in both model group and inhibitor group compared with that in the normal group (p<0.05), and there was no difference in the expression level of miR-21 between the former two groups (p>0.05). Finally, based on the color Doppler ultrasonography findings, the levels of the hemodynamic indicators substantially declined in both model group and inhibitor group compared with those in the normal group (p<0.05), and they were notably higher in the inhibitor group than those in the model group. CONCLUSIONS We found that miR-21 regulates the TGF-β signaling pathway to affect the hemodynamics in the rats with proliferative diabetic retinopathy.
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Affiliation(s)
- H-D Lou
- Department of Ophthalmology, Weifang Eye Hospital, Weifang, China.
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Messner L, Antink M, Guo T, Maas M, Beutel S. Enzymatische Hydrolyseprozesse im kontinuierlich betriebenen Keramikkapillarreaktor. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- L. Messner
- Leibniz Universität Hannover Institut für Technische Chemie Callinstr. 5 30167 Hannover Deutschland
| | - M. Antink
- Universität Bremen Institute for Advanced Ceramics Am Biologischen Garten 2 28359 Bremen Deutschland
| | - T. Guo
- Universität Bremen Institute for Advanced Ceramics Am Biologischen Garten 2 28359 Bremen Deutschland
| | - M. Maas
- Universität Bremen Institute for Advanced Ceramics Am Biologischen Garten 2 28359 Bremen Deutschland
| | - S. Beutel
- Leibniz Universität Hannover Institut für Technische Chemie Callinstr. 5 30167 Hannover Deutschland
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Ren S, Gaykalova DA, Guo T, Favorov AV, Fertig EJ, Tamayo P, Callejas-Valera JL, Allevato M, Gilardi M, Santos J, Fukusumi T, Sakai A, Ando M, Sadat S, Liu C, Xu G, Fisch KM, Wang Z, Molinolo AA, Gutkind JS, Ideker T, Koch WM, Califano JA. HPV E2, E4, E5 drive alternative carcinogenic pathways in HPV positive cancers. Oncogene 2020; 39:6327-6339. [PMID: 32848210 PMCID: PMC7529583 DOI: 10.1038/s41388-020-01431-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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] [Received: 02/19/2020] [Revised: 07/19/2020] [Accepted: 08/13/2020] [Indexed: 12/26/2022]
Abstract
The dominant paradigm for HPV carcinogenesis includes integration into the host genome followed by expression of E6 and E7 (E6/E7). We explored an alternative carcinogenic pathway characterized by episomal E2, E4, and E5 (E2/E4/E5) expression. Half of HPV positive cervical and pharyngeal cancers comprised a subtype with increase in expression of E2/E4/E5, as well as association with lack of integration into the host genome. Models of the E2/E4/E5 carcinogenesis show p53 dependent enhanced proliferation in vitro, as well as increased susceptibility to induction of cancer in vivo. Whole genomic expression analysis of the E2/E4/E5 pharyngeal cancer subtype is defined by activation of the fibroblast growth factor receptor (FGFR) pathway and this subtype is susceptible to combination FGFR and mTOR inhibition, with implications for targeted therapy.
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Affiliation(s)
- Shuling Ren
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.,Department of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Daria A Gaykalova
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Theresa Guo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Alexander V Favorov
- Division of Oncology Biostatistics, Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.,Laboratory of Systems Biology and Computational Genetics, Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Elana J Fertig
- Division of Oncology Biostatistics, Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Pablo Tamayo
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Juan Luis Callejas-Valera
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.,Cancer Biology and Immunotherapies group, Sanford Research, Sioux Falls, SD, USA
| | - Mike Allevato
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Mara Gilardi
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Jessica Santos
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Takahito Fukusumi
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Akihiro Sakai
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Mizuo Ando
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Sayed Sadat
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Chao Liu
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Guorong Xu
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Kathleen M Fisch
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Zhiyong Wang
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Alfredo A Molinolo
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - J Silvio Gutkind
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Trey Ideker
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Wayne M Koch
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Joseph A Califano
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA. .,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, CA, USA.
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Kiong KL, Lin F, Yao CMKL, Guo T, Ferrarotto R, Weber RS, Lewis CM. Impact of neoadjuvant chemotherapy on perioperative morbidity after major surgery for head and neck cancer. Cancer 2020; 126:4304-4314. [DOI: 10.1002/cncr.33103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/16/2020] [Accepted: 06/20/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Kimberley L. Kiong
- Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas
| | - Fang‐Yu Lin
- Department of Symptom Research The University of Texas MD Anderson Cancer Center Houston Texas
| | - Christopher M. K. L. Yao
- Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas
| | - Theresa Guo
- Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas
| | - Renata Ferrarotto
- Department of Thoracic Head and Neck Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas
| | - Randal S. Weber
- Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas
| | - Carol M. Lewis
- Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas
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Guo T, Kiong KL, Yao CMKL, Windon M, Zebda D, Jozaghi Y, Zhao X, Hessel AC, Hanna EY. Impact of the COVID-19 pandemic on Otolaryngology trainee education. Head Neck 2020; 42:2782-2790. [PMID: 32666664 PMCID: PMC7405272 DOI: 10.1002/hed.26368] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 01/22/2023] Open
Abstract
Background The COVID‐19 pandemic has reduced clinical volume with a negative impact on trainee education. Methods Survey study of Otolaryngology trainees in North America, during the COVID‐19 pandemic in April 2020. Results Of 216 respondents who accessed the survey, 175 (83%) completed the survey. Respondents reported a universal decrease in clinical activities (98.3%). Among participants who felt their program utilized technology well, there were significantly decreased concerns to receiving adequate educational knowledge (29.6% vs 65.2%, P = .003). However, 68% of trainees still expressed concern in ability to receive adequate surgical training. In addition, 54.7% of senior trainees felt that the pandemic had a negative impact on their ability to secure a job or fellowship after training. Conclusions Trainees universally felt a negative impact due to the COVID‐19 pandemic. Use of technology was able to alleviate some concerns in gaining adequate educational knowledge, but decreased surgical training remained the most prevalent concern.
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Affiliation(s)
- Theresa Guo
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimberley L Kiong
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Christopher M K L Yao
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Melina Windon
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Denna Zebda
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Yelda Jozaghi
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xiao Zhao
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amy C Hessel
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ehab Y Hanna
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Guo T, Zambo KDA, Zamuner FT, Ou T, Hopkins C, Kelley DZ, Wulf HA, Danilova LV, Considine M, Sidransky D, Favorov AV, Florea L, Fertig EJ, Gaykalova DA. Abstract A25: Chromatin structure regulates cancer-specific alternative splicing events in primary HPV-related oropharyngeal squamous cell carcinoma. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.aacrahns19-a25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Human papillomavirus-related oropharyngeal squamous cell carcinoma (HPV+ OPSCC) represents a unique disease entity within head and neck cancer with rising incidence. Previous work has shown that alternative splicing events (ASEs) are prevalent in HPV+ OPSCC, but further validation is needed to understand the regulation of this process and its role in these tumors. In this study, eleven ASEs (GIT2, CTNNB1, MKNK2, MRPL33, SIPA1L3, SNHG6, SYCP2, TPRG1, ZHX2, ZNF331, and ELOVL1) were selected for validation from 109 previously published candidate ASEs to elucidate the post-transcriptional mechanisms of oncogenesis in HPV+ disease. In vitro qRT-PCR confirmed differential expression of 9 of 11 ASE candidates, and in silico analysis within the TCGA cohort confirmed 8 of 11 candidates. Six ASEs (MRPL33, SIPA1L3, SNHG6, TPRG1, ZHX2, and ELOVL1) showed significant differential expression across both methods. Further evaluation of chromatin structure revealed that ASEs strongly correlated with the cancer-specific distribution of acetylated lysine 27 of histone 3 (H3K27ac). Subsequent epigenetic treatment of HPV+ HNSCC cell lines (UM-SCC-047 and UPCI-SCC-090) with JQ1 not only induced downregulation of cancer-specific ASE isoforms but also growth inhibition in both cell lines. The UPCI-SCC-090 cell line, with greater ASE expression, also showed more significant growth inhibition after JQ1 treatment. This study confirms several novel cancer-specific ASEs in HPV+OPSCC and provides evidence for the role of chromatin structure in regulation of alternative splicing in HPV+OPSCC. Our findings highlight the role of epigenetic changes in the oncogenesis of HPV+OPSCC, which represents a unique, unexplored target for biomarkers, neoantigens, and therapeutics.
Citation Format: Theresa Guo, Kristina D. A. Zambo, Fernando T. Zamuner, Tingting Ou, Christopher Hopkins, Dylan Z. Kelley, Hildegard A. Wulf, Ludmila V. Danilova, Michael Considine, David Sidransky, Alexander V. Favorov, Liliana Florea, Elana J. Fertig, Daria A. Gaykalova. Chromatin structure regulates cancer-specific alternative splicing events in primary HPV-related oropharyngeal squamous cell carcinoma [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr A25.
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Maniakas A, Jozaghi Y, Zafereo ME, Sturgis EM, Su SY, Gillenwater AM, Gidley PW, Lewis CM, Diaz E, Goepfert RP, Kupferman ME, Gross ND, Hessel AC, Pytynia KB, Nader M, Wang JR, Lango MN, Kiong KL, Guo T, Zhao X, Yao CMKL, Appelbaum E, Alpard J, Garcia JA, Terry S, Flynn JE, Bauer S, Fournier D, Burgess CG, Wideman C, Johnston M, You C, De Luna R, Joseph L, Diersing J, Prescott K, Heiberger K, Mugartegui L, Rodriguez J, Zendehdel S, Sellers J, Friddell RA, Thomas A, Khanjae SJ, Schwarzlose KB, Chambers MS, Hofstede TM, Cardoso RC, Wesson RA, Won A, Otun AO, Gombos DS, Al‐Zubidi N, Hutcheson KA, Gunn GB, Rosenthal DI, Gillison ML, Ferrarotto R, Weber RS, Hanna EY, Myers JN, Lai SY. Head and neck surgical oncology in the time of a pandemic: Subsite-specific triage guidelines during the COVID-19 pandemic. Head Neck 2020; 42:1194-1201. [PMID: 32342541 PMCID: PMC7267348 DOI: 10.1002/hed.26206] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/14/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND COVID-19 pandemic has strained human and material resources around the world. Practices in surgical oncology had to change in response to these resource limitations, triaging based on acuity, expected oncologic outcomes, availability of supportive resources, and safety of health care personnel. METHODS The MD Anderson Head and Neck Surgery Treatment Guidelines Consortium devised the following to provide guidance on triaging head and neck cancer (HNC) surgeries based on multidisciplinary consensus. HNC subsites considered included aerodigestive tract mucosa, sinonasal, salivary, endocrine, cutaneous, and ocular. RECOMMENDATIONS Each subsite is presented separately with disease-specific recommendations. Options for alternative treatment modalities are provided if surgical treatment needs to be deferred. CONCLUSION These guidelines are intended to help clinicians caring for patients with HNC appropriately allocate resources during a health care crisis, such as the COVID-19 pandemic. We continue to advocate for individual consideration of cases in a multidisciplinary fashion based on individual patient circumstances and resource availability.
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Vinh DB, Zhao X, Kiong KL, Guo T, Jozaghi Y, Yao C, Kelley JM, Hanna EY. Overview of COVID-19 testing and implications for otolaryngologists. Head Neck 2020; 42:1629-1633. [PMID: 32342570 PMCID: PMC7267427 DOI: 10.1002/hed.26213] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 01/08/2023] Open
Abstract
Background Testing for SARS‐CoV‐2 is important for decision making prior to surgery in otolaryngology. An understanding of current and developing testing methods is important for interpreting test results. Methods We performed a literature review of current evidence surrounding SARS‐CoV‐2 diagnostic testing highlighting its utility, limitations, and implications for otolaryngologists. Results The currently accepted RT‐PCR test for SARS‐CoV‐2 has varying sensitivity according to which subsite of the aerodigestive tract is sampled. Nasal swab sensitivities appear to be about 70%. Chest CT imaging for screening purposes is not currently recommended. Conclusion Due to the current sensitivity of RT‐PCR based testing for SARS‐CoV‐2, a negative test cannot rule out COVID‐19. Full PPE should be worn during high‐risk procedures such as aerosol generating procedures even if testing is negative. Patients who test positive during screening should have their surgeries postponed if possible until asymptomatic and have tested negative for SARS‐CoV‐2.
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Affiliation(s)
- Daniel B Vinh
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Xiao Zhao
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimberley L Kiong
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
| | - Theresa Guo
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
| | - Yelda Jozaghi
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
| | - Chris Yao
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
| | - James M Kelley
- Department of Laboratory Medicine, Division of Pathology and Laboratory Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
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49
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Kiong KL, Guo T, Yao CMKL, Gross ND, Hanasono MM, Ferrarotto R, Rosenthal DI, Myers JN, Hanna EY, Lai SY. Changing practice patterns in head and neck oncologic surgery in the early COVID-19 era. Head Neck 2020; 42:1179-1186. [PMID: 32459061 DOI: 10.1002/hed.26202] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 04/14/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The novel coronavirus 2019 (COVID-19) pandemic has changed health care, challenged by resource constraints and fears of transmission. We report the surgical practice pattern changes in a Head and Neck Surgery department of a tertiary cancer care center and discuss the issues surrounding multidisciplinary care during the pandemic. METHODS We report data regarding outpatient visits, multidisciplinary treatment planning conference, surgical caseload, and modifications of oncologic therapy during this pandemic and compared this data to the same interval last year. RESULTS We found a 46.7% decrease in outpatient visits and a 46.8% decrease in surgical caseload, compared to 2019. We discuss the factors involved in the decision-making process and perioperative considerations. CONCLUSIONS Surgical practice patterns in head and neck oncologic surgery will continue to change with the evolving pandemic. Despite constraints, we strive to prioritize and balance the oncologic and safety needs of patients with head and neck cancer in the face of COVID-19.
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Affiliation(s)
- Kimberley L Kiong
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Theresa Guo
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Christopher M K L Yao
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Neil D Gross
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Matthew M Hanasono
- Department of Plastics and Reconstructive Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Renata Ferrarotto
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.,Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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Guo T, Zambo KDA, Zamuner FT, Ou T, Hopkins C, Kelley DZ, Wulf HA, Winkler E, Erbe R, Danilova L, Considine M, Sidransky D, Favorov A, Florea L, Fertig EJ, Gaykalova DA. Chromatin structure regulates cancer-specific alternative splicing events in primary HPV-related oropharyngeal squamous cell carcinoma. Epigenetics 2020; 15:959-971. [PMID: 32164487 DOI: 10.1080/15592294.2020.1741757] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 02/07/2023] Open
Abstract
Human papillomavirus-related oropharyngeal squamous cell carcinoma (HPV+ OPSCC) represents a unique disease entity within head and neck cancer with rising incidence. Previous work has shown that alternative splicing events (ASEs) are prevalent in HPV+ OPSCC, but further validation is needed to understand the regulation of this process and its role in these tumours. In this study, eleven ASEs (GIT2, CTNNB1, MKNK2, MRPL33, SIPA1L3, SNHG6, SYCP2, TPRG1, ZHX2, ZNF331, and ELOVL1) were selected for validation from 109 previously published candidate ASEs to elucidate the post-transcriptional mechanisms of oncogenesis in HPV+ disease. In vitro qRT-PCR confirmed differential expression of 9 of 11 ASE candidates, and in silico analysis within the TCGA cohort confirmed 8 of 11 candidates. Six ASEs (MRPL33, SIPA1L3, SNHG6, TPRG1, ZHX2, and ELOVL1) showed significant differential expression across both methods. Further evaluation of chromatin modification revealed that ASEs strongly correlated with cancer-specific distribution of acetylated lysine 27 of histone 3 (H3K27ac). Subsequent epigenetic treatment of HPV+ HNSCC cell lines (UM-SCC-047 and UPCI-SCC-090) with JQ1 not only induced downregulation of cancer-specific ASE isoforms, but also growth inhibition in both cell lines. The UPCI-SCC-090 cell line, with greater ASE expression, also showed more significant growth inhibition after JQ1 treatment. This study confirms several novel cancer-specific ASEs in HPV+OPSCC and provides evidence for the role of chromatin modifications in regulation of alternative splicing in HPV+OPSCC. This highlights the role of epigenetic changes in the oncogenesis of HPV+OPSCC, which represents a unique, unexplored target for therapeutics that can alter the global post-transcriptional landscape.
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Affiliation(s)
- Theresa Guo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Kristina Diana A Zambo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Fernando T Zamuner
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Tingting Ou
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Christopher Hopkins
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Dylan Z Kelley
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Hildegard A Wulf
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Eli Winkler
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Rossin Erbe
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Ludmila Danilova
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore, MD, USA.,Laboratory of Systems Biology and Computational Genetics, Vavilov Institute of General Genetics, Russian Academy of Sciences , Moscow, Russia
| | - Michael Considine
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - David Sidransky
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA.,Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore, MD, USA
| | - Alexander Favorov
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore, MD, USA.,Laboratory of Systems Biology and Computational Genetics, Vavilov Institute of General Genetics, Russian Academy of Sciences , Moscow, Russia
| | - Liliana Florea
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University , Baltimore, MD, USA
| | - Elana J Fertig
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore, MD, USA.,Department of Applied Mathematics and Statistics, Johns Hopkins University , Baltimore, MD, USA.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine , MD, Baltimore, USA
| | - Daria A Gaykalova
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA.,Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore, MD, USA
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