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MicroRNAs: Their Role in Metabolism, Tumor Microenvironment, and Therapeutic Implications in Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:cancers13225604. [PMID: 34830755 PMCID: PMC8615702 DOI: 10.3390/cancers13225604] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/30/2021] [Accepted: 11/05/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Head and neck squamous cell carcinoma (HNSCC), which arises from the oral epithelium, is one of the most common cancers worldwide. Despite excellent diagnosis and treatment improvements, the mortality rate associated with HNSCC is still extremely high. Current data suggest that dysregulation of exosomes and metabolic abnormalities are involved in the initiation and progression of HNSCC. Thus, approaches for targeting exosomes in the tumor microenvironment and metabolic reprogramming pathways represent potential therapeutic strategies. Moreover, some miRNAs are thought to have significant functions in regulating the progression of HNSCC. The present article aims to summarize the current knowledge concerning the important miRNAs in both exosomes and cancer metabolism, as well as discuss future perspectives regarding their future diagnostic potential and treatment recommendations. Abstract MicroRNAs (miRNAs) are endogenous small non-coding RNA molecules that negatively regulate gene expression by binding to target mRNAs. Deregulated miRNAs can act as either oncogenic miRNAs or tumor suppressor miRNAs in controlling proliferation, differentiation, apoptosis, metastasis, epithelial–mesenchymal transition, and immune responses, which are all involved in the carcinogenesis process of HNSCC. Recent findings have shown that metabolic reprogramming is an important hallmark of cancer, which is necessary for malignant transformation and tumor development. Some reprogrammed metabolisms are believed to be required for HNSCC against an unfavorable tumor microenvironment (TME). The TME is composed of various cell types embedded in the altered extracellular matrix, among which exosomes, secreted by cancer cells, are one of the most important factors. Tumor-derived exosomes reshape the tumor microenvironment and play a crucial role in cell-to-cell communication during HNSCC development. Exosomes encapsulate many biomolecules, including miRNAs, circulate in body fluids, and can transmit intercellular regulatory messages to nearby and distant sites, which indicates that exosomal miRNAs have the potential to become non-invasive biomarkers. This review aims to clarify the functions of diverse miRNAs in HNSCC metabolic reprogramming and tumor-derived exosomes. In addition, it also emphasizes the potential role of miRNA as a biomarker in the diagnosis, prognosis, and treatment of HNSCC cancer.
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Rodrigo JP, Sánchez-Canteli M, López F, Wolf GT, Hernández-Prera JC, Williams MD, Willems SM, Franchi A, Coca-Pelaz A, Ferlito A. Tumor-Infiltrating Lymphocytes in the Tumor Microenvironment of Laryngeal Squamous Cell Carcinoma: Systematic Review and Meta-Analysis. Biomedicines 2021; 9:biomedicines9050486. [PMID: 33925205 PMCID: PMC8145951 DOI: 10.3390/biomedicines9050486] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 02/08/2023] Open
Abstract
The presence of tumor-infiltrating lymphocytes (TIL) in the tumor microenvironment has been demonstrated to be of prognostic value in various cancers. In this systematic review and meta-analysis, we investigated the prognostic value of TIL in laryngeal squamous cell carcinoma (LSCC). We performed a systematic search in PubMed for publications that investigated the prognostic value of TIL in LSCC. A meta-analysis was performed including all studies assessing the association between TIL counts in hematoxylin-eosin (HE)-stained sections, for CD8+ and/or CD3+/CD4+ TIL and overall survival (OS) or disease-free survival (DFS). The pooled meta-analysis showed a favorable prognostic role for stromal TIL in HE sections for OS (HR 0.57, 95% CI 0.36–0.91, p = 0.02), and for DFS (HR 0.56, 95% CI 0.34–0.94, p = 0.03). High CD8+ TIL were associated with a prolonged OS (HR 0.62, 95% CI 0.4–0.97, p = 0.04) and DFS (HR 0.73, 95% CI 0.34–0.94, p = 0.002). High CD3+/CD4+ TIL demonstrated improved OS (HR 0.32, 95% CI 0.16–0.9, p = 0.03) and DFS (HR 0.23, 95% CI 0.10–0.53, p = 0.0005). This meta-analysis confirmed the favorable prognostic significance of TIL in LSCC. High stromal TIL evaluated in HE sections and intra-tumoral and stromal CD3+, CD4+ and/or CD8+ TIL might predict a better clinical outcome.
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Affiliation(s)
- Juan P. Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias-Instituto de Salud del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.-C.); (F.L.); (A.C.-P.)
- IUOPA-University of Oviedo, 33006 Oviedo, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence:
| | - Mario Sánchez-Canteli
- Department of Otolaryngology, Hospital Universitario Central de Asturias-Instituto de Salud del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.-C.); (F.L.); (A.C.-P.)
- IUOPA-University of Oviedo, 33006 Oviedo, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias-Instituto de Salud del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.-C.); (F.L.); (A.C.-P.)
- IUOPA-University of Oviedo, 33006 Oviedo, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Gregory T. Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, MI 48109, USA;
| | | | - Michelle D. Williams
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA;
| | - Stefan M. Willems
- Department of Pathology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - Alessandro Franchi
- Department of Translational Research, School of Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias-Instituto de Salud del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.-C.); (F.L.); (A.C.-P.)
- IUOPA-University of Oviedo, 33006 Oviedo, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, 35125 Padua, Italy;
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Immunohistochemical Differences in Squamous Precancerous and Cancerous Lesions of the Oral Cavity and the Larynx: Preliminary Data. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11052048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of this study is to assess immune cell populations in squamous precancerous (preinvasive) and cancerous lesions of the oral cavity and larynx. Qualitative and quantitative immunohistochemical analyses were performed to determine the expressions of CD4, CD8, CD15, CD57 and CD68. The expressions of programmed death-ligand 1 (PD-L1), p16 and Ki67 were also assessed. Squamous cell lesions from forty-one patients were included in the study. Sixteen samples were categorized as precancerous (preinvasive) lesions and twenty-five as invasive squamous cell carcinoma. Invasive lesions showed a negative correlation with CD57+ cells (ρ = −0.69) and a positive correlation with Ki67 (ρ = 0.61). The amount of CD4+ lymphocytes was higher in invasive lesions. There were no differences in PD-L1 and p16 immunoreactivity. Our analysis showed differences in the immunohistochemical profile between preinvasive and invasive squamous cell lesions. In the near future, this study should be useful in driving treatment strategy in both preinvasive and invasive squamous cell lesions of the oral cavity and larynx. However, studies on larger series of patients focusing on site-specific lesions are required.
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Zhang D, Tang D, Heng Y, Zhu XK, Zhou L, Tao L, Lu LM. Prognostic Impact of Tumor-Infiltrating Lymphocytes in Laryngeal Squamous Cell Carcinoma Patients. Laryngoscope 2020; 131:E1249-E1255. [PMID: 33107987 DOI: 10.1002/lary.29196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 09/13/2020] [Accepted: 10/08/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVES/HYPOTHESIS Tumor-infiltrating lymphocytes (TILs) has been shown to be associated with the prognosis of many tumors, yet few studies have investigated their roles in laryngeal squamous cell carcinoma (LSCC). We aim to investigate the prognostic values of tumor-infiltrating CD3+ /CD4+ /CD8+ /Foxp3+ T-cells and neutrophils in LSCC patients that received total or partial laryngectomy. STUDY DESIGN Retrospective case series of LSCC patients who underwent total or partial laryngectomy from 2013 to 2014 at Eye, Ear, Nose, and Throat Hospital of Fudan University. METHODS In our study, 41 tumor tissues from patients with LSCC were retrospectively assessed using immunohistochemistry for CD3+ /CD4+ /CD8+ /Foxp3+ T-cells and CD66b+ neutrophils. Overall survival (OS) and disease-free survival (DFS) were recorded using Kaplan-Meier methods. RESULTS Generally, patients with high density of TILs (CD3, CD4, CD8) showed improved OS or DFS. Specifically, high density of CD3+ TILs were associated with better OS, yet poorer OS and DFS for CD66b+ neutrophils. Patients with an Immunoscore of 0-1 experienced the worst OS and DFS, compared with Immunoscore 2-4 (P = .0111 for OS, P = .0391 for DFS). In Cox proportional hazards analysis adjusted for N stage and T stage, only stroma CD66b+ neutrophils densities were able to predict OS, with odds ratios of 4.819 (95% confidence interval [CI] 1.149-20.206; P = .032*), and DFS 2.888 (95% CI 1.043-7.997; P = .041*). CONCLUSIONS The density of TILs and CD66b+ neutrophils may help predict the prognosis of patients with LSCC after surgery. LEVEL OF EVIDENCE 3 Laryngoscope, 131:E1249-E1255, 2021.
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Affiliation(s)
- Duo Zhang
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, Shanghai, People's Republic of China.,Department of Pudong Hospital, Fudan University School of Medicine, Shanghai, People's Republic of China
| | - Di Tang
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, Shanghai, People's Republic of China.,Department of Pudong Hospital, Fudan University School of Medicine, Shanghai, People's Republic of China
| | - Yu Heng
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, Shanghai, People's Republic of China.,Department of Pudong Hospital, Fudan University School of Medicine, Shanghai, People's Republic of China
| | - Xiao-Ke Zhu
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, Shanghai, People's Republic of China.,Department of Pudong Hospital, Fudan University School of Medicine, Shanghai, People's Republic of China
| | - Liang Zhou
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, Shanghai, People's Republic of China.,Department of Pudong Hospital, Fudan University School of Medicine, Shanghai, People's Republic of China
| | - Lei Tao
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, Shanghai, People's Republic of China.,Department of Pudong Hospital, Fudan University School of Medicine, Shanghai, People's Republic of China
| | - Li-Ming Lu
- Shanghai Institute of Immunology, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
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La EM, Smyth EN, Talbird SE, Li L, Kaye JA, Lin AB, Bowman L. Treatment patterns and health care resource use in patients receiving multiple lines of therapy for metastatic squamous cell carcinoma of the head and neck in the United Kingdom. Eur J Cancer Care (Engl) 2018; 27:e12862. [PMID: 29927010 PMCID: PMC6175088 DOI: 10.1111/ecc.12862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 02/22/2018] [Accepted: 04/17/2018] [Indexed: 12/14/2022]
Abstract
This study evaluated the patterns of care and health care resource use (HCRU) in patients with metastatic squamous cell carcinoma of the head and neck (SCCHN) who received ≥3 lines of systemic therapy in the United Kingdom (UK). Oncologists (n = 40) abstracted medical records for patients with metastatic SCCHN who initiated third‐line systemic therapy during 1 January 2011–30 August 2014 (n = 220). Patient characteristics, treatment patterns and SCCHN‐related HCRU were summarised descriptively for the metastatic period; exploratory multivariable regression analyses were conducted on select HCRU outcomes. At metastatic diagnosis, most patients had an Eastern Cooperative Oncology Group performance status (PS) of 0/1 (95%). For patients with PS 0/1, the most common first‐line treatment was cisplatin+5‐fluorouracil (5‐FU); docetaxel was the most common second‐ and third‐line treatment. For patients with PS ≥ 2, the most common first‐, second‐, and third‐line treatments were carboplatin+5‐FU, cetuximab, and methotrexate, respectively. Most patients received supportive care during (85%) and after (89%) therapy. This study provides useful information, prior to the availability of immunotherapy, on patient characteristics, treatment patterns, HCRU, and survival in a real‐world UK population with metastatic SCCHN receiving ≥3 lines of systemic therapy. Patterns of care and HCRU varied among patients with metastatic SCCHN; specific systemic therapies varied by patient PS.
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Affiliation(s)
- Elizabeth M La
- Department of Health Economics, RTI Health Solutions, Research Triangle Park, NC
| | - Emily Nash Smyth
- Oncology, Global Patient Outcomes and Real World Evidence, Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN
| | - Sandra E Talbird
- Department of Health Economics, RTI Health Solutions, Research Triangle Park, NC
| | - Li Li
- Real World Analytics, Oncology, Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN
| | - James A Kaye
- Department of Epidemiology, RTI Health Solutions, Waltham, MA
| | - Aimee Bence Lin
- Early Phase Medical, Oncology, Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN
| | - Lee Bowman
- Oncology, Global Patient Outcomes and Real World Evidence, Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN
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Agarwal M, Trimble C. Cancer Vaccines for HPV Malignancies. Oncoimmunology 2018. [DOI: 10.1007/978-3-319-62431-0_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Zhang D, Zhou J, Tang D, Zhou L, Chou L, Chou KY, Tao L, Lu LM. Neutrophil infiltration mediated by CXCL5 accumulation in the laryngeal squamous cell carcinoma microenvironment: A mechanism by which tumour cells escape immune surveillance. Clin Immunol 2016; 175:34-40. [PMID: 27876461 DOI: 10.1016/j.clim.2016.11.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 11/17/2016] [Accepted: 11/18/2016] [Indexed: 12/17/2022]
Abstract
The CXCL5 chemokine is important for neutrophil accumulation in tumour tissues. In this report, we attempted to clarify whether and how infiltrating tumour-associated neutrophils (TANs) in laryngeal squamous cell carcinoma (LSCC) affect the proliferation and activation of T cells. We examined chemokine expression by real-time PCR (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) and performed an immunohistochemical analysis of LSCC microarrays. The relationship between CXCL5 and CD66b (a neutrophil marker) was investigated by immunofluorescence staining. We found that CXCL5 was upregulated in LSCC tissues, whereas CXCL5 levels were decreased in LSCC patient serum. Furthermore, high levels of CXCL5 were significantly correlated with intratumoural neutrophil infiltration. Compared with peripheral blood neutrophils (PBNs), TANs significantly inhibited T cell proliferation and decreased IFN-γ and TNF-α secretion. These data suggest that excessive neutrophil infiltration is associated with advanced clinical stages of LSCC (T3 or T4, III or IV, and N1 or N2).
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Affiliation(s)
- Duo Zhang
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, 83 Fenyang Road, Shanghai 200031, China; Department of Pudong Hospital, Fudan University School of Medicine, 2800 Gongwei Road, Shanghai 201300, China
| | - Jian Zhou
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, 83 Fenyang Road, Shanghai 200031, China; Department of Pudong Hospital, Fudan University School of Medicine, 2800 Gongwei Road, Shanghai 201300, China
| | - Di Tang
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, 83 Fenyang Road, Shanghai 200031, China; Department of Pudong Hospital, Fudan University School of Medicine, 2800 Gongwei Road, Shanghai 201300, China
| | - Lin Zhou
- Shanghai Institute of Immunology, Shanghai Jiaotong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Liang Chou
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, 83 Fenyang Road, Shanghai 200031, China; Department of Pudong Hospital, Fudan University School of Medicine, 2800 Gongwei Road, Shanghai 201300, China
| | - Kuang-Yen Chou
- Shanghai Institute of Immunology, Shanghai Jiaotong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Lei Tao
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University School of Medicine, 83 Fenyang Road, Shanghai 200031, China; Department of Pudong Hospital, Fudan University School of Medicine, 2800 Gongwei Road, Shanghai 201300, China.
| | - Li-Ming Lu
- Shanghai Institute of Immunology, Shanghai Jiaotong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China.
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Lee YS, Park JY, Cho KJ, Kim SB, Lee SW, Choi SH, Roh JL, Nam SY, Kim SY. Composition of inflammatory cells regulating the response to concurrent chemoradiation therapy for HPV (+) tonsil cancer. Oral Oncol 2015; 51:1113-9. [PMID: 26475063 DOI: 10.1016/j.oraloncology.2015.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) (+) tonsil squamous cell carcinoma (TSCC) responds well to concurrent chemoradiation therapy (CCRT) and demonstrates a favorable prognosis. However, cases of HPV (+) TSCC-related death remain unresolved. We evaluated the distribution and prognostic value of inflammatory cells in HPV (+) TSCC. METHODS We reviewed the medical records of 53 patients who were diagnosed with TSCC. HPV (+) TSCC was confirmed using HPV DNA PCR and immunohistochemical p16 overexpression. The numbers of CD4 (+), CD8 (+), and CD68 (+) stained cells were used to evaluate peritumoral lymphocyte infiltration. Patients were divided into two groups according to the mean numbers of stained cells and the mean ratios of each cell type. RESULTS HPV (+) was noted in 39 patients. During the follow-up period, 27 patients had no evidence of disease, 2 patients showed disease, and 10 patients died of disease. In this group, advanced T and N stages were not related to overall or disease-specific survival outcomes. The overall survival rate was affected by a high CD68 (+) (HR=19.8; P=0.040) and low CD8/CD4 ratio (HR=7.7, P=0.025). The disease-specific survival rate was affected by a high number of CD68 (+) cells (HR=15.2; P=0.03) and low CD8 (+)/CD4 (+) ratio (HR=3.3; P=0.04). CONCLUSIONS The number of CD68 (+) cells and the distribution of cytotoxic or immunosuppressive T lymphocytes could be determining factors for CCRT outcomes in HPV (+) TSCC patients.
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Affiliation(s)
- Yoon Se Lee
- Department of Otolaryngology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Ji Young Park
- Department of Pathology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Kyung Ja Cho
- Department of Pathology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sung Bae Kim
- Department of Internal Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sang Wook Lee
- Department of Radiation Oncology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Seung-Ho Choi
- Department of Otolaryngology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
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Oguejiofor K, Hall J, Slater C, Betts G, Hall G, Slevin N, Dovedi S, Stern PL, West CML. Stromal infiltration of CD8 T cells is associated with improved clinical outcome in HPV-positive oropharyngeal squamous carcinoma. Br J Cancer 2015; 113:886-93. [PMID: 26313665 PMCID: PMC4578081 DOI: 10.1038/bjc.2015.277] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/02/2015] [Accepted: 06/29/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) have a better prognosis than those with HPV-negative tumours. There is interest in de-escalating their treatment but strategies are needed for risk stratification to identify subsets with a poor prognosis. This study investigated tumour-infiltrating lymphocytes (TILs) in relation to HPV tumour status and patient survival. METHODS Biopsies from 218 patients diagnosed with OPSCC between 2002 and 2011, who underwent chemo/radiotherapy were analysed for HPV by PCR, in-situ hybridisation and p16 immunohistochemistry (IHC). One hundred and thirty-nine samples with concordant HPV detection were analysed for CD3, CD4, CD8 and FoxP3 expression in tumour and stromal regions using multiplexIHC and multispectral image analysis. Labelling of smooth muscle actin (SMA) identified activated stroma. RESULTS Human papillomavirus-positive compared with HPV-negative OPSCC had higher infiltration in both tumour and stromal areas of CD4 and CD8 T cells but not FoxP3 T regulatory cells. Only CD3+CD8+ stromal and not tumour area infiltration was associated with increased survival (P=0.02). There was significantly higher SMA expression in HPV-positive compared with -negative tumours, which did not correlate with survival. CONCLUSIONS Studies of TILs for risk stratification in OPSCC should assess stromal infiltration.
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Affiliation(s)
- K Oguejiofor
- Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Wilmslow Road, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, Wilmslow Road, UK
| | - J Hall
- Lymphoma Translational Research Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Wilmslow Road, Manchester, UK
| | - C Slater
- Lymphoma Translational Research Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, Manchester Medical School, University of Manchester, Wilmslow Road, Manchester, UK
| | - G Betts
- Central Manchester University Hospitals, Manchester, UK
| | - G Hall
- Central Manchester University Hospitals, Manchester, UK
| | - N Slevin
- The Christie NHS Foundation Trust, Manchester, Wilmslow Road, UK
| | - S Dovedi
- Targeted Therapy Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, the University of Manchester; Wilmslow Road, Manchester
| | - P L Stern
- Center for Women's Cancer, Institute of Cancer Sciences, University of Manchester, Paterson Building, Wilmslow Road, Manchester, M20 4BX, UK
| | - C M L West
- Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Wilmslow Road, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, Wilmslow Road, UK
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10
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Audisio RA, Icardi G, Isidori AM, Liverani CA, Lombardi A, Mariani L, Mennini FS, Mitchell DA, Peracino A, Pecorelli S, Rezza G, Signorelli C, Rosati GV, Zuccotti GV. Public health value of universal HPV vaccination. Crit Rev Oncol Hematol 2015; 97:157-67. [PMID: 26346895 DOI: 10.1016/j.critrevonc.2015.07.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 07/28/2015] [Accepted: 07/29/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The story of Human Papillomavirus vaccination demands reflection not only for its public health impact on the prophylactic management of HPV disease, but also for its relevant economic and social outcomes. Greater than ever data confirm the efficacy and support the urge for effective vaccination plans for both genders before sexual debut. METHODS A review of previous experience in gender-restricted vaccination programs has demonstrated a lower effectiveness. Limiting vaccination to women might increase the psychological burden on women by confirming a perceived inequality between genders; and even if all women were immunized, the HPV chain of transmission would still be maintained through men. RESULTS The cost-effectiveness of including boys into HPV vaccination programs should be re-assessed in view of the progressive drop of the economic burden of HPV-related diseases in men and women due to universal vaccination. The cost of the remarkable increase in anal and oropharyngeal HPV driven cancers in both sexes has been grossly underestimated or ignored. CONCLUSIONS Steps must be taken by relevant bodies to achieve the target of universal vaccination. The analysis of HPV vaccination's clinical effectiveness vs. economic efficacy are supportive of the economic sustainability of vaccination programs both in women and men. In Europe, these achievements demand urgent attention to the social equity for both genders in healthcare. There is sufficient ethical, scientific, strategic and economic evidence to urge the European Community to develop and implement a coordinated and comprehensive strategy aimed at both genders and geographically balanced, to eradicate cervical cancer and other diseases caused by HPV in Europe. Policymakers must take into consideration effective vaccination programs in the prevention of cancers.
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Affiliation(s)
| | - Giancarlo Icardi
- Department of Health Sciences, Hygiene Unit, IRCCS AOU San Martino, IST University of Genoa, Genoa, Italy.
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
| | - Carlo A Liverani
- Department of Mother and Infant Sciences, Gynecologic Oncology Unit, University of Milan, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Alberto Lombardi
- Scientific and Medical Consultant, Fondazione Giovanni Lorenzini, Milan, Italy and Houston, TX, USA.
| | - Luciano Mariani
- Department of Gynecologic Oncology, HPV Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
| | - Francesco Saverio Mennini
- Faculty of Economics, University of Rome Tor Vergata, Faculty of Statistics, University of Rome La Sapienza, Kingston University, London, UK.
| | - David A Mitchell
- Bradford Teaching Hospitals NHS Foundation Trust, St. Lukes Hospital, Bradford, UK.
| | - Andrea Peracino
- Fondazione Giovanni Lorenzini Medical Science Foundation, Milan, Italy and Houston, TX, USA.
| | | | - Giovanni Rezza
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
| | - Carlo Signorelli
- Department S.Bi.Bi.T., Unit of Public Health, University of Parma, Parma, Italy.
| | | | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Biomedical and Clinical Science Department, University of Milan, Milan, Italy.
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Circulating and disseminated tumour cells in head and neck cancer. The Journal of Laryngology & Otology 2015; 129:826-30. [PMID: 26174011 DOI: 10.1017/s0022215115001784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Multimodal treatment options in head and neck squamous cell carcinoma have allowed for greater control of locoregional disease, but this has not translated into a significant overall survival advantage for patients. This is partially because these treatment modalities have no influence over the rate of development of distant metastases. OBJECTIVE This article summarises the current methods of detecting circulating and disseminated tumour cells. It also discusses how these cells can offer prognostic value in head and neck squamous cell carcinoma, and considers questions posed by the identification of these cells. METHODS A literature search of relevant journal articles was performed using ScienceDirect and PubMed databases, and a general article search was conducted using the online search engine Google. RESULTS AND CONCLUSION The evidence presented in this article indicates that circulating tumour cells and disseminated tumour cells may be clinically useful as prognostic markers or in the assessment of response to treatment in head and neck squamous cell carcinoma.
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