Predictive value of comorbidity and anemia on outcome in patients with sinonasal carcinoma

Introduction

To evaluate the influence of comorbidities and anemia on outcome and survival in patients with sinonasal carcinomas.

Treatment outcome and pattern of recurrence of sinonasal squamous cell carcinoma with EGFR-mutation and human papillomavirus

The objective of our study was to clarify the clinical features of EGFR-mutated sinonasal squamous cell carcinoma (SNSCC) and human papilloma virus (HPV)-related SNSCC.Patients with SNSCC treated from April 2008 to June 2019 at our institution were retrospectively reviewed. We examined EGFR mutation and HPV status for all patients. Main outcomes were overall survival, recurrence, and outcome of each treatment modality.A total of 85 patients with SNSCC were enrolled in this study. EGFR mutations and HPV DNA were detected in 24 (28%) and 7 (8%) patients, respectively. Patients with EGFR-mutated SNSCC showed a worse overall survival (OS) than those with EGFR wild-type in the multivariate analysis (p = 0.037). No death was observed in HPV-positive SNSCC. The cumulative incidence of local recurrence was significantly higher in EGFR mutant than EGFR wild-type tumors (p = 0.03). In patients with EGFR mutations, treatment with induction chemotherapy significantly improved OS (p = 0.01).EGFR-mutated SNSCC have a high-risk feature for recurrence and requires intensive attention for treatment and observation. A new treatment approach, such as EGFR tyrosine kinase inhibitors, may be needed.     

Estimation of serum leptin in oral squamous cell carcinoma

J Oral Pathol Med (2010) 39 : 69–73
Background:  Cachexia contributes significantly to mortality in cancer patients; role of cytokines in inducing cachexia is an emerging view. Leptin, a homologous protein of cytokine family, is found to be decreased in serum with cachexia. The purpose of this study was to compare serum leptin levels of oral squamous cell carcinoma patients with that of control group and correlate it with body mass index.
Method:  Serum samples of 31 oral squamous cell carcinoma patients and that of 28 healthy individuals were subjected to evaluation of serum leptin levels (ng/ml) using enzyme-linked immunosorbent assay.
Results:  A significant reduction in leptin level of oral squamous cell carcinoma patients was observed. Definite correlation between body mass index and serum leptin and also between serum leptin levels of various histopathological variants of oral squamous cell carcinoma was observed.
Conclusion:  The results of this study suggest that evaluation of serum leptin level can provide status of cachexia in oral squamous cell carcinoma patients.     

The importance of stromal inflammation in squamous cell carcinoma of the tongue

J Oral Pathol Med (2012) 41 : 379–383 Background: Histological risk assessment evaluating worst pattern of tumour invasion (WPOI), and lymphocytic response (LR), has previously been shown to be of prognostic significance in squamous cell carcinomas of the head and neck (SCCHN). SCCHN is a heterogeneous group of tumours including tumours located in the oral cavity, of which the majority is located in the tongue. Methods: Haematoxylin/eosin–stained slides from diagnostic biopsies from 94 cases of SCC on the tongue were evaluated for WPOI and LR. Within the inflammatory infiltrate, the percentage of eosinophilic granulocytes was also estimated. Results were correlated with clinical data such as response to treatment and recurrence. Results: For WPOI the majority of patients, 84%, showed small invasive tumours islands with a size <15 cells (grade 4). No correlation with survival, response to treatment or recurrence was seen for WPOI. More than half of the patients showed a dense lymphocytic infiltrate, a factor that was significantly correlated with complete response to radio therapy. Of the patients with dense lymphoid infiltrate, the majority, 63%, did not either have a recurrence. No significant correlation with recurrence, response to treatment or any other factor was seen for presence of eosinophils. Conclusions: Data clearly showed that tongue tumours have a split invasive growth pattern and an intense inflammatory response at the tumour interface. Results also indicated that evaluation of the intensity of the inflammatory infiltrate at the tumour interface in tongue SCC could provide information of potential importance for choice of treatment and prognosis.     

Evaluation of sarcopenia and sarcopenic obesity in patients affected by oral squamous cell carcinoma: A retrospective single-center study

This retrospective single-center study aimed to evaluate the relevance of sarcopenia and sarcopenic obesity as negative prognostic factors in patients with oral squamous cell carcinoma (OSCC).The study was performed on patients who underwent oral squamous cell carcinoma resection surgery. Patients’ demographic and clinical variables were collected at diagnosis (sex, age, height, weight, comorbidities, smoke and alcohol consumption, HPV positivity, TNM-stage) and corrected for known prognostic factors (age, body mass index, TNM-stage). The Skeletal Muscle Mass (SMM) and the Cross-Sectional Area (CSA) on pre-treatment CT scans and Body Mass Index (BMI) were measured to assess sarcopenia and sarcopenic obesity correlated to overall survival (OS).Chi-square statistics were used to analyze the differences between the frequencies of each categorical variable with the presence or absence of sarcopenia and sarcopenic obesity. The cumulative overall survival was calculated by the Kaplan-Meier method, and the differences between curves were evaluated by the log-rank test. A Cox proportional hazard regression model was used for univariate and multivariate analysis of the overall survival.Within the limitations of the study, in this sample, sarcopenia did not seem to cause a statistically significant reduction in the overall survival in patients with oral squamous cell carcinoma (Log Rank χ2 = 3.67, p = 0.055; HR 0.996, 95% CI 0.732–1.354, p = 0.979), however, sarcopenic obesity showed a meaningful negative prognostic impact on it (Log Rank χ2 = 5.71, p = 0.017; HR 0.985, 95% CI 0.424–2.286, p = 0.972).Within the limitations of the study it seems that sarcopenic obesity, age, BMI, and TNM-stage are more relevant negative prognostic factors, influencing overall survival in surgically treated OSCC, than sarcopenia.     

口腔鳞状细胞癌患者血清TSGF、SCC-Ag、CEA的表达及其临床意义

目的　探讨联合检测血清中恶性肿瘤特异性生长因子(TSGF) 、鳞状细胞癌抗原(SCC-Ag)及癌胚抗原（CEA）在口腔鳞状细胞癌诊断中的价值。方法　采集58例口腔鳞状细胞癌患者、36例口腔良性肿瘤患者及30例健康人血液,分别检测血清中TSGF、SCC-Ag和CEA含量。结果　口腔鳞状细胞癌组TSGF、SCC-Ag、CEA含量明显高于口腔良性肿瘤组和健康组(P< 0.05)。口腔鳞状细胞癌组TSGF、SCC-Ag、CEA阳性率分别为74.14%、55.17%、24.14%,联合检测阳性率为86.21%。结论　血清TSGF、SCC-Ag、CEA分别检测对口腔鳞状细胞癌的诊断有一定意义,联合检测提高口腔鳞状细胞癌的诊断率。     

Relationships between squamous cell carcinoma antigen and cytokeratin 19 fragment values and renal function in oral cancer patients

Squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment (CYFRA) are used to screen and monitor oral cancer patients. However, recent studies have reported that tumour markers become elevated as renal function decreases, regardless of tumour progression. A retrospective study was performed of 423 oral cancer patients who underwent blood testing for these tumour markers and other blood analytes during a 10-year period. The values of SCC-Ag and CYFRA increased significantly with decreasing renal function (P < 0.01), and the values were abnormal at a median 2.6 ng/ml for SCC-Ag and 4.7 ng/ml for CYFRA in the group with estimated glomerular filtration rate (eGFR) values of< 30 ml/min/1.73 m². The factors that were related to the variation in tumour markers were albumin and creatinine. The cut-off values of eGFR were 59.7 ml/min/1.73 m² for SCC-Ag and 63.6 ml/min/1.73 m² for CYFRA, and the cut-off age when the tumour markers might rise due to the effect of renal function were 72 years for SCC-Ag and 73 years for CYFRA. In conclusion, decreased renal function should be taken into account when evaluating tumour markers in oral cancer. In addition, tumour markers are likely to be overestimated in patients over the age of 72–73 years.     

28例晚期口腔鳞癌患者新辅助化疗围化疗期营养状况及生活质量评估

目的: 探讨晚期口腔鳞癌患者新辅助化疗围化疗期的营养状况、生活质量变化和两者的相关性,以及化疗对营养状况和生活质量的影响。方法: 选择2019年6月—2019年12月于上海交通大学附属第九人民医院口腔颌面-头颈肿瘤科行新辅助化疗的晚期口腔鳞癌患者28例,采用队列研究方法。所有患者均以TPF方案(多西他赛+顺铂+5-氟尿嘧啶)进行化疗,化疗期间采用个体化方案进行营养支持。分析患者化疗前、后PG-SGA、QLQ-H&N35评分变化以及两者的相关性,并根据肿瘤消退情况,将患者分为有反应组(CR+PR)和无反应组(PD+SD)进行分层分析。采用 SPSS 23.0软件包对数据进行统计学分析。结果: 化疗后患者的PG-SGA评分和QLQ-H&N35评分较化疗前显著降低(P=0.0301,P=0.0015),两者之间具有显著的相关性(r=0.5953,P<0.0001)。分层分析显示,有反应组和无反应组患者的PG-SGA评分与QLQ-H&N35评分变化无统计学差异(P>0.05)。2组患者的体重、肌肉量和脂肪量变化均无统计学差异。排除女性患者后发现,2组患者体重及脂肪量变化无显著差异(P>0.05),但有反应组患者的肌肉量显著增多而无反应组患者的肌肉量显著下降(P=0.0358)。结论: 新辅助化疗能够改善晚期口腔鳞癌患者的营养状况,提高患者生活质量。     

UHRF1在口腔黏膜鳞癌中的表达及其对临床预后的价值研究

目的 分析泛素样含PHD和环指域1(ubiquitin like with PHD and ring finger domains 1,UHRF1)在口腔黏膜鳞状细胞癌中的表达及其临床意义。方法 收集2008—2016年间,于中国科学技术大学附属第一医院口腔颌面外科接受手术治疗的原发性口腔鳞癌患者,利用免疫荧光染色评估患者的肿瘤组织、癌旁正常组织及侵袭前沿中的UHRF1表达,了解其表达差异性。以免疫反应强度分布指数(immunoreactivity intensity distribution index, IRIDI)值4分为界限,将患者分为UHRF1高表达组和低表达组,分析UHRF1表达水平与患者临床病理特征之间的关系,利用Kaplan-Meier法对肿瘤组织中UHRF1表达水平与患者生存率的相关性进行分析,运用Cox风险模型对影响口腔癌患者生存率的相关危险因素进行分析。结果 与肿瘤侵袭前沿、癌旁正常组织相比,UHRF1在口腔鳞癌肿瘤组织中高表达(P<0.01)。口腔鳞癌组织中UHRF1的表达水平与患者性别、肿瘤大小、浸润深度相关(P<0.05)。UHRF1低表达组和高...     

口腔鳞状细胞癌患者血清IL-8的表达及临床意义

目的:观察免疫趋化因子白细胞介素8(IL-8)在口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)患者血清中的表达,探讨其与OSCC临床病理因素的相关性。方法:应用酶联免疫反应(enzyme-linked immunosorbentassay,ELISA)测定27例处于不同临床分期的OSCC患者和10例健康体检者血清中的IL-8水平。检测结果以x±s表示,应用SPSS 13.0软件包对数据进行t检验。结果:OSCC肿瘤组患者血清IL-8水平显著高于对照组(P<0.01),临床Ⅲ、Ⅳ期OSCC患者血清IL-8水平显著高于Ⅰ、Ⅱ期患者(P<0.01);有颈淋巴结转移的OSCC患者,血清IL-8水平显著高于无转移者(P<0.01)。结论:血清IL-8水平与口腔鳞状细胞癌的病理分级、临床分期及淋巴结转移等密切相关,是一种具有应用潜力的OSCC临床检测指标。     

超声热化疗联合根治性手术在口腔颌面部晚期鳞癌患者中的应用及护理

目的 研究超声热化疗在口腔颌面部晚期鳞癌患者中的应用效果及围术期护理。方法 以我院就诊的36例口腔颌面部晚期鳞癌患者为研究对象,将其分为对照组和实验组,每组18人。对照组只进行化疗,然后进行手术治疗。实验组采用上海熙洛有限公司生产的YUT-1超声肿瘤热疗仪热疗加化疗后实施手术方案。结果 术后一年比较治疗效果。热化疗组和化疗组的RR分别为77.8%和38.9%,热化疗组的RR明显高于化疗组（P<0.05）。结论 超声热化疗联合根治性手术共同治疗口腔颌面部的晚期鳞癌,有明显的加强和增敏效果,治疗的同时会使患者大量出汗,疲劳,甚至灼伤热疗区域的皮肤。对此,我们要加强热化疗患者的围术期护理工作,提高疗效,提高晚期癌症患者的生存质量。     

Impact of lymph node ratio on survival and recurrence outcomes in oral squamous cell carcinoma

Growing evidence supports the lymph node ratio (LNR) as a prognostic factor for survival in patients with oral squamous cell carcinoma (OSCC). However, there is a lack of data regarding its association with recurrence outcomes. Data on 163 patients with OSCC who underwent primary surgical treatment at a tertiary centre between January 2009 and December 2015 were collected retrospectively and analysed. Receiver operating characteristic curve analysis was performed to determine optimal cut-off values for the survival analyses. Survival endpoints were disease progression/relapse for disease-free time (DFT), freedom from loco-regional recurrence (FLR), and freedom from distant metastasis (FDM), and as death from any cause for overall survival (OS). Patients with a lower LNR were found to have significantly superior DFT (LNR < 14%, P < 0.001), FLR (LNR <14%, P < 0.001), FDM (LNR <16%, P = 0.004), and OS (LNR <7%, P = 0.004) in comparison to patients with a higher LNR. LNR is a good predictor of survival and recurrence outcomes in OSCC.     

The prognostic relevance of lymph node ratio in patients with oral squamous cell carcinoma treated with neoadjuvant therapy regimen and radical surgery

Background

This study aims at investigating the prognostic significance of lymph node ratio (LNR) in a cohort of patients with oral squamous cell carcinomas (OSCC), treated with neoadjuvant radiochemotherapy followed by radical surgery.