1
|
Swiecicki PL, Bellile E, Dragovic AF, McHugh J, Udager A, Mierzwa ML, Shah J, Heft Neal M, Rosko A, Malloy KM, Casper K, Chinn SB, Shuman AG, Stucken C, Chepeha DB, Wolf GT, Bradford CR, Eisbruch A, Prince MEP, Worden FP, Spector ME. Upfront neck dissection for treatment selection and improvement in quality of life as a novel treatment paradigm for deintensification in HPV+ OPSCC. Clin Cancer Res 2024:741954. [PMID: 38517480 DOI: 10.1158/1078-0432.ccr-23-3247] [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] [Received: 10/22/2023] [Revised: 12/18/2023] [Accepted: 03/20/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Locoregionally advanced HPV+ oropharyngeal squamous cell carcinoma (OPSCC) has excellent cure rates, although current treatment regimens are accompanied by acute and long-term toxicities. We designed a phase II de-escalation trial for patients with HPV+OPSCC to evaluate the feasibility of an upfront neck dissection to individualize definitive treatment selection to improve quality of life without compromising survival. METHODS Patients with T1-3, N0-2 HPV+ OPSCC underwent an upfront neck dissection with primary tumor biopsy. Patients with a single lymph node less than six centimeters, with no extracapsular spread(ECS), and no primary site adverse features underwent transoral surgery (Arm A). Patients who had two or more positive lymph nodes with no ECS, or those with primary site adverse features were treated with radiation alone (Arm B). Patients who had ECS in any lymph node were treated with chemoradiation (Arm C). The primary endpoint was quality of life at 1 year compared to a matched historical control. RESULTS Thirty-four patients were enrolled and underwent selective neck dissection. Based on pathologic characteristics, 14 patients were assigned to arm A, 10 patients to arm B, and 9 to arm C. A significant improvement was observed in HNQOL compared to historical controls (-2.6 vs -11.9, p=0.034). With a median follow-up of 37 months, the 3-year overall survival was 100% and estimated 3-year estimated progression free survival was 96% (95% CI: 76-99%). CONCLUSION A neck dissection driven treatment paradigm warrants further research as a de-intensification strategy.
Collapse
Affiliation(s)
| | - Emily Bellile
- University of Michigan-Ann Arbor, Ann Arbor, United States
| | | | - Jonathan McHugh
- University of Michigan-Ann Arbor, Ann Arbor, Michigan, United States
| | - Aaron Udager
- University of Michigan Medical School, Ann Arbor, Michigan, United States
| | | | - Jennifer Shah
- University of Michigan-Ann Arbor, Ann Arbor, United States
| | - Molly Heft Neal
- University of Michigan-Ann Arbor, Ann Arbor, MI, United States
| | | | - Kelly M Malloy
- University of Michigan-Ann Arbor, Ann Arbor, Michigan, United States
| | - Keith Casper
- University of Michigan-Ann Arbor, Ann Arbor, MI, United States
| | | | - Andrew G Shuman
- University of Michigan-Ann Arbor, Ann Arbor, MI, United States
| | | | | | - Gregory T Wolf
- University of Michigan-Ann Arbor, Ann Arbor, MI, United States
| | | | - Avraham Eisbruch
- University of Michigan-Ann Arbor, Ann Arbor, Michigan, United States
| | - Mark E P Prince
- University of Michigan-Ann Arbor, ANN ARBOR, Michigan, United States
| | | | - Matthew E Spector
- University of Michigan-Ann Arbor, Pittsburgh, Pennsylvania, United States
| |
Collapse
|
2
|
McCammon N, Dunn A, Graham R, McHugh J, Lamps L, Bresler SC, Cole T, Rottmann D. Gastroblastoma of the Pylorus: A Case Report and Review of the Literature. Int J Surg Pathol 2023; 31:1516-1521. [PMID: 36823781 DOI: 10.1177/10668969231157310] [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] [Indexed: 02/25/2023]
Abstract
Gastroblastoma is an extremely rare biphasic tumor that typically occurs in the stomach in patients between the ages of 10 and 30. Only 16 cases have been reported previously. These tumors are important to diagnose and distinguish from more aggressive neoplasms; although numbers are small, prognosis appears excellent overall with complete excision, with only occasional metastasis and/or local recurrence. We report a case of gastroblastoma in a 26-year-old male arising from the pylorus and extending through the first and second portions of the duodenum. This is the first case to be reported from this specific location.
Collapse
Affiliation(s)
- Nathan McCammon
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Dunn
- Department of Pathology, Hattiesburg Clinic, Hattiesburg, MS, USA
| | - Rondell Graham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Jonathan McHugh
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Laura Lamps
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Scott C Bresler
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Thomas Cole
- Comprehensive Radiology Services, PLLC, Hattiesburg, MS, USA
| | - Douglas Rottmann
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
3
|
Kemple O, Brady S, McHugh J, Desmond R, Meade L, Enright H. 64 HIGH-DOSE STEROIDS IN HAEMATOLOGICAL MALIGNANCY: A RED FLAG FOR BONE HEALTH. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.050] [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: 11/13/2022] Open
Abstract
Abstract
Background
Bone-protective treatment should always be considered when commencing glucocorticoid therapy in individuals at high risk of fracture, as outlined in recent guidelines (National Osteoporosis Guideline Group, July 2018). Despite this, many patients receive high dose glucocorticoids (>7.5mg/kg/day or equivalent for >3 months) during treatment of haematological malignancy without formal assessment of bone health.
Methods
Twenty-five patients with Non-Hodgkin’s Lymphoma (NHL) on high dose steroid chemotherapy protocols were retrospectively assessed. The inclusion criterion was defined as any patient commenced on a cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) containing protocol from 1/8/2020 to 1/8/21. Data was collected from electronic and written patient records. Information regarding patient age, diagnosis, steroid preparation and dose, presence of risk factors for osteoporosis and calcium and vitamin D prescriptions were collected. Radiological imaging was reviewed to assess for the occurrence of fragility fractures. Each patient had a FRAX® score calculated to assess fracture risk.
Results
The mean age of patients studied was 67 years and equally distributed between males and females. All patients had NHL. 32% (n=25) of patients were identified to be at high risk for fracture (FRAX® score >20% ten-year probability of major osteoporotic fracture). 16% had already established fragility fractures prior to commencing steroid treatment. 28% of patients were females over the age of 70 years. Only 12% of patients received vitamin D and calcium supplementation. No patient commenced bone protection therapy.
Conclusion
Omission of bone health assessment prior to high dose glucocorticoid treatment is prevalent in haematological malignancy and places patients at risk of significant morbidity. Patients are not routinely considered for protective measures including calcium and vitamin D supplementation and bone protection therapy. A simple risk-assessment tool and education to staff and patients prior to glucocorticoid therapy could significantly improve practice in this area. It is now planned to introduce routine risk assessment for this cohort of patients, with re-audit following implementation.
Collapse
Affiliation(s)
- O Kemple
- Tallaght University Hospital , Dublin, Ireland
| | - S Brady
- Tallaght University Hospital , Dublin, Ireland
| | - J McHugh
- Tallaght University Hospital , Dublin, Ireland
| | - R Desmond
- Tallaght University Hospital , Dublin, Ireland
| | - L Meade
- Tallaght University Hospital , Dublin, Ireland
| | - H Enright
- Tallaght University Hospital , Dublin, Ireland
| |
Collapse
|
4
|
Benafif S, Ni Raghallaigh H, McHugh J, Eeles R. Genetics of prostate cancer and its utility in treatment and screening. Adv Genet 2021; 108:147-199. [PMID: 34844712 DOI: 10.1016/bs.adgen.2021.08.006] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Prostate cancer heritability is attributed to a combination of rare, moderate to highly penetrant genetic variants as well as commonly occurring variants conferring modest risks [single nucleotide polymorphisms (SNPs)]. Some of the former type of variants (e.g., BRCA2 mutations) predispose particularly to aggressive prostate cancer and confer poorer prognoses compared to men who do not carry mutations. Molecularly targeted treatments such as PARP inhibitors have improved outcomes in men carrying somatic and/or germline DNA repair gene mutations. Ongoing clinical trials are exploring other molecular targeted approaches based on prostate cancer somatic alterations. Genome wide association studies have identified >250 loci that associate with prostate cancer risk. Multi-ancestry analyses have identified shared as well as population specific risk SNPs. Prostate cancer risk SNPs can be used to estimate a polygenic risk score (PRS) to determine an individual's genetic risk of prostate cancer. The odds ratio of prostate cancer development in men whose PRS lies in the top 1% of the risk profile ranges from 9 to 11. Ongoing studies are investigating the utility of a prostate cancer PRS to target population screening to those at highest risk. With the advent of personalized medicine and development of DNA sequencing technologies, access to clinical genetic testing is increasing, and oncology guidelines from bodies such as NCCN and ESMO have been updated to provide criteria for germline testing of "at risk" healthy men as well as those with prostate cancer. Both germline and somatic prostate cancer research have significantly evolved in the past decade and will lead to further development of precision medicine approaches to prostate cancer treatment as well as potentially developing precision population screening models.
Collapse
Affiliation(s)
- S Benafif
- The Institute of Cancer Research, London, United Kingdom.
| | | | - J McHugh
- The Institute of Cancer Research, London, United Kingdom
| | - R Eeles
- The Institute of Cancer Research, London, United Kingdom
| |
Collapse
|
5
|
Argirion I, Arthur AE, Zarins KR, Bellile E, Crowder SL, Amlani L, Taylor JM, Wolf GT, McHugh J, Nguyen A, Mondul AM, Rozek LS. Pretreatment Dietary Patterns, Serum Carotenoids and Tocopherols Influence Tumor Immune Response in Head and Neck Squamous Cell Carcinoma. Nutr Cancer 2020; 73:2614-2626. [PMID: 33307825 DOI: 10.1080/01635581.2020.1842895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Tumor infiltrating lymphocytes (TILs) aid in informing treatment for head and neck squamous cell carcinoma (HNSCC). Nevertheless, little is known about the role of diet on TILs. METHODS Immunohistologic expression of CD4, CD8, CD68, CD103, CD104 and FOXP3 were assessed in tissue microarrays from 233 previously untreated HNSCC patients. Associations between these markers and pretreatment dietary patterns were evaluated using linear regression. Associations between baseline serum carotenoids, tocopherols and TILs were assessed using logistic regression. Cox models evaluated the association between diet and TILs on overall and recurrence-free survival. RESULTS Consumption of a Western dietary pattern was associated with lower CD8+ and FOXP3+ infiltrates (p-value:0.03 and 0.02, respectively). Multivariable logistic regression models demonstrated significantly higher CD8+ (OR:2.21;p-value:0.001) and FOXP3+ (OR:4.26;p-value:<0.0001) among patients with high gamma tocopherol. Conversely, high levels of xanthophylls (OR:0.12;p-value:<0.0001), lycopene (OR:0.36;p-value:0.0001) and total carotenoids(OR:0.31;p-value: <0.0001) were associated with significantly lower CD68+. Among those with high CD4+ (HR:1.77;p-value:0.03), CD68+ (HR:2.42;p-value:0.004), CD103+ (HR:3.64;p-value:0.03) and FOXP3+ (HR:3.09;p-value:0.05), having a high Western dietary pattern increased the risk of overall mortality when compared to a low Western dietary pattern. CONCLUSION Dietary patterns and serum carotenoids may play an important role in modifying TILs, and ultimately, outcome after diagnosis with HNSCC.
Collapse
Affiliation(s)
- Ilona Argirion
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Anna E Arthur
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,Carle Cancer Center, Carle Foundation Hospital, Urbana, Illinois, USA
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Bellile
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Sylvia L Crowder
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Lahin Amlani
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jeremy Mg Taylor
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Greg T Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jonathan McHugh
- Pathology, The University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Ariane Nguyen
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | | |
Collapse
|
6
|
Argirion I, Arthur AE, Zarins KR, Bellile E, Amlani L, Taylor JM, Wolf GT, McHugh J, Nguyen A, Mondul AM, Rozek LS. Abstract 4644: Pretreatment diet, serum carotenoids and tocopherols influence tumor immune response in head and neck squamous cell carcinoma. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-4644] [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: 11/16/2022]
Abstract
Abstract
Background: Tumor infiltrating lymphocytes (TILs) have recently emerged as an important factor in informing treatment decisions for head and neck squamous cell carcinoma (HNSCC). Nevertheless, little is known about the role of modifiable risk factors, such as diet, on TILs.
Methods: Immunohistologic expression of CD4, CD8, CD68, CD103, CD104 and FOXP3 were assessed in tissue microarrays from 233 previously untreated HNSCC patients. Associations between these markers and pre-treatment dietary patterns were then evaluated using linear regression models. Logistic regression models assessing the associations between baseline serum carotenoids, tocopherols and TILs were conducted on a smaller subset of 70 patients. Cox proportional hazard models were used to evaluate the joint association between diet and TILs on overall and recurrence free survival.
Results: High intake of a Western dietary pattern decreased CD8+ and FOXP3+ infiltrates after adjustment for age, sex and batch (p-value: 0.03 and 0.02, respectively). Multivariate logistic regression models demonstrated significant increases in CD8+ (OR: 2.21; p-value: 0.001) and FOXP3+ (OR: 4.26; p-value: <0.0001) among patients with high gamma tocopherol. Conversely, high levels of xanthophylls (OR: 0.12; p-value:<0.0001), lycopene (OR: 0.36; p-value: 0.0001) and total carotenoids (OR: 0.31; p-value: <0.0001) significantly decreased CD68+. Among those with high CD4+ (HR: 1.77; p-value: 0.03), CD68+ (HR: 2.42; p-value: 0.004), CD103+ (HR: 3.64; p-value: 0.03) and FOXP3+ (HR: 3.09; p-value: 0.05) infiltrates, having a high Western dietary pattern significantly increased the risk of overall mortality when compared to those with a low Western dietary pattern, even after adjusting for age, sex, stage, disease site, HPV status, and TMA; a similar effect was found between the high Western dietary pattern and FOXP3+ (HR: 2.93; p-value: 0.0002) on recurrence free survival in fully adjusted models.
Conclusion: Dietary patterns and serum carotenoids may play an important role in modifying TILs, and ultimately, outcome after diagnosis with HNSCC. The results of this study could inform dietary interventions among high risk individuals in an attempt to moderate risk and improve HNSCC prognosis.
Citation Format: Ilona Argirion, Anna E. Arthur, Katie R. Zarins, Emily Bellile, Lahin Amlani, Jeremy M. Taylor, Greg T. Wolf, Jonathan McHugh, Ariane Nguyen, Alison M. Mondul, Laura S. Rozek, The University of Michigan Head and Neck SPORE Program. Pretreatment diet, serum carotenoids and tocopherols influence tumor immune response in head and neck squamous cell carcinoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4644.
Collapse
Affiliation(s)
- Ilona Argirion
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Katie R. Zarins
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | - Emily Bellile
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | - Lahin Amlani
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Greg T. Wolf
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | - Jonathan McHugh
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | - Ariane Nguyen
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Laura S. Rozek
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | | |
Collapse
|
7
|
Abstract
BACKGROUND/ OBJECTIVE This study seeks to assess the utility of synovial biopsy in the diagnosis of crystal-associated arthropathies (CAAs) in a clinical setting. METHODS In this retrospective study, we reviewed biopsy reports involving synovial tissue between 1988 and 2015. We then reviewed the records of patients where the biopsy was performed for a clinical suspicion of CAA-the clinical group-and calculated the frequency of a positive diagnosis. The t test, Mann-Whitney-Wilcoxon test, and Fisher test were used to compare clinical characteristics of patients with and without a tissue diagnosis of CAA. We also reviewed cases of unexpected detection of crystalline disease involving synovial tissue-the incidental group. RESULTS Among 2786 biopsies involving the synovium, we identified 65 cases in the clinical group and 33 cases in the incidental group. In the clinical group, a relevant diagnosis was obtained from synovial tissue in 36.9%, and a CAA was diagnosed in 20%. Restricting analysis to clinical biopsies performed for a primary suspicion of CAA, a relevant diagnosis was obtained in 61.3%, and a CAA was diagnosed in 38.7%. The incidental group comprised 1.2% of all synovial biopsies and included 7 mass lesions. Basic calcium phosphate was not reported on any biopsy in the study period. CONCLUSIONS Synovial biopsy is a diagnostic option when suspected CAA is resistant to conventional modes of diagnosis. Crystalline diseases should be considered in the differential diagnosis of musculoskeletal mass lesions mimicking neoplasms.
Collapse
Affiliation(s)
- Viju Moses
- From the Division of Rheumatology and Clinical Immunology, Department of Medicine
| | - Jaya Ruth Asirvatham
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | | | - Robert Ike
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| |
Collapse
|
8
|
Langabeer SE, Haslam K, Crampe M, MacDonagh B, McHugh J. Suboptimal molecular response to tyrosine kinase inhibition associated with acquisition of a T240A ABL1 kinase domain mutation in a patient with chronic myeloid leukemia. Exp Oncol 2019; 41:82-83. [PMID: 30932408 DOI: 10.32471/exp-oncology.2312-8852.vol-41-no-1.12685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- S E Langabeer
- Cancer Molecular Diagnostics, St. James's Hospital, Dublin D08 E9P6, Ireland
| | - K Haslam
- Cancer Molecular Diagnostics, St. James's Hospital, Dublin D08 E9P6, Ireland
| | - M Crampe
- Cancer Molecular Diagnostics, St. James's Hospital, Dublin D08 E9P6, Ireland
| | - B MacDonagh
- Department of Haematology, Tallaght University Hospital, Dublin D24 NR0A, Ireland
| | - J McHugh
- Department of Haematology, Tallaght University Hospital, Dublin D24 NR0A, Ireland
| |
Collapse
|
9
|
Manton T, Tillman B, McHugh J, Bellile E, McLean S, McKean E. Sinonasal Melanoma: A Single Institutional Analysis and Future Directions. J Neurol Surg B Skull Base 2018; 80:484-492. [PMID: 31534890 DOI: 10.1055/s-0038-1676355] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 10/06/2018] [Indexed: 12/20/2022] Open
Abstract
Background Sinonasal melanoma is a rare disease with a high mortality rate. The surgical management paradigm has significantly changed over the past decade with the introduction of expanded endonasal techniques. There have also been advances in management of metastatic and locally advanced disease with the advent of immunotherapy. Methods Single-institution retrospective review of adult patients with sinonasal melanoma, surgically managed at the University of Michigan over a 9-year period. Thirty-one patients met inclusion criteria. All patients were retrospectively staged according to the 7th Edition AJCC staging system for mucosal melanoma. Parameters that may affect survival were analyzed using Cox's proportional hazard models and survival outcomes were analyzed with the Kaplan-Meier method. Additionally, a review of three patients with distant metastatic disease receiving immunotherapy is presented. Results Most patients were managed endoscopically (67%), and had stage III disease (71%). However, 57% of stage IVB tumors were successfully managed endoscopically. Stage statistically impacted overall survival whereas distant control was impacted by stage, site of origin, mitotic rate, and necrosis. The 2-year overall survival for all stages was 77% which declined with advanced disease. Two-year locoregional control and distant control showed similar trends. Conclusion Treatment of sinonasal melanoma has drastically changed over the past decade with increased use of expanded endonasal techniques. Our review revealed excellent 2-year overall survival in stage III disease with an appreciable decline in survival in more advanced disease. Immunotherapy may play a large role is future management given the high-risk of distant metastasis.
Collapse
Affiliation(s)
- Taylor Manton
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Brittny Tillman
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Jonathan McHugh
- Michigan Medicine Department of Pathology, Ann Arbor, Michigan, United States
| | - Emily Bellile
- The Center for Cancer Biostatistics, University of Michigan, M2030-28 SPH II, School of Public Health II, Ann Arbor, Michigan, United States
| | - Scott McLean
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Erin McKean
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| |
Collapse
|
10
|
Helliwell T, Chernock R, Dahlstrom JE, Gale N, McHugh J, Perez-Ordoñez B, Roland N, Zidar N, Thompson LDR. Data Set for the Reporting of Carcinomas of the Hypopharynx, Larynx, and Trachea: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting. Arch Pathol Lab Med 2018; 143:432-438. [PMID: 30500292 DOI: 10.5858/arpa.2018-0419-sa] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The International Collaboration on Cancer Reporting is a nonprofit organization whose mission is to develop evidence-based, universally available surgical pathology reporting data sets. Standardized pathologic reporting for cancers facilitates improved communication for patient care and prognosis and the comparison of data between countries to progressively improve clinical outcomes. Laryngeal cancers are often accompanied by significant morbidity, although surgical advances (such as transoral endoscopic laser microresection and transoral robotic surgery) provide new alternatives. The anatomy of the larynx is complex, with an understanding of the exact anatomic sites and subsites, along with recognizing anatomic landmarks, being crucial to classification and prognostication. This review outlines the data set developed for the histopathology reporting in Carcinomas of the Hypopharynx, Larynx and Trachea and discusses the main elements required and recommended for reporting.
Collapse
Affiliation(s)
- Tim Helliwell
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Rebecca Chernock
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Jane E Dahlstrom
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Nina Gale
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Jonathan McHugh
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Bayardo Perez-Ordoñez
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Nick Roland
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Nina Zidar
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Lester D R Thompson
- From the Department of Cellular Pathology, University of Liverpool, Liverpool, United Kingdom (Dr Helliwell); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); ANU College of Health and Medicine, Anatomical Pathology, ACT Pathology, Canberra Hospital, Woden, Australia (Dr Dahlstrom); Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Drs Gale and Zidar); the Department of Pathology, Michigan Medicine - University of Michigan, Ann Arbor (Dr McHugh); the Department of Anatomic Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Perez-Ordoñez); the Department of ENT-Head and Neck Surgery, University Hospital Aintree, Liverpool, United Kingdom (Dr Roland); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| |
Collapse
|
11
|
McHugh J, Shield RR, Tyler DA, Gadbois EA, Winblad U, Mor V. DIVERGENT APPROACHES TO POST-ACUTE CARE MANAGEMENT – A CASE FOR RELATIONAL COORDINATION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1527] [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: 11/14/2022] Open
Affiliation(s)
- J McHugh
- Mailman School of Public Health, Columbia University, New York, New York, United States
| | - R R Shield
- Brown University School of Public Health, Providence, RI
| | | | - E A Gadbois
- Brown University School of Public Health, Providence, RI, USA
| | | | - V Mor
- Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
12
|
East E, Plouffe K, Harms K, Patel R, McHugh J, Tomlins S, Udager A. Targetable GOPC-ROS1 Gene Fusion Identified in a Case of Lethal Oral Mucosal Melanoma. Am J Clin Pathol 2018. [DOI: 10.1093/ajcp/aqy090.112] [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: 11/13/2022] Open
|
13
|
Manton T, Tillman B, McHugh J, Bellile E, McKean E, McLean S. Sinonasal Melanoma: A Single-Institution Analysis and Future Directions. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633454] [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: 10/28/2022]
Affiliation(s)
- Taylor Manton
- University of Michigan, Ann Arbor, Michigan, United States
| | | | | | - Emily Bellile
- University of Michigan, Ann Arbor, Michigan, United States
| | - Erin McKean
- University of Michigan, Ann Arbor, Michigan, United States
| | - Scott McLean
- University of Michigan, Ann Arbor, Michigan, United States
| |
Collapse
|
14
|
Hanks J, Kovatch K, Ali S, McHugh J, McKean E. Highly Variable Presentation, Natural History, and Treatment in Sinonasal Phosphaturic Mesenchymal Tumors: Two Markedly Contrasting Cases. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633799] [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: 10/28/2022]
Affiliation(s)
- John Hanks
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Kevin Kovatch
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Syed Ali
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Jonathan McHugh
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, United States
| | - Erin McKean
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| |
Collapse
|
15
|
Shyu I, Wang X, Robila V, Mehra R, McHugh J, Chen YB, Udager A, Gill A, Cheng L, Amin M, Smith S. 92 Fumarate Hydratase-Deficient Renal Cell Carcinoma: Aspiration and Effusion Cytologic Features. Am J Clin Pathol 2018. [DOI: 10.1093/ajcp/aqx117.091] [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: 11/15/2022] Open
|
16
|
Divi V, Harris J, Harari PM, Cooper JS, McHugh J, Bell D, Sturgis EM, Cmelak AJ, Suntharalingam M, Raben D, Kim H, Spencer SA, Laramore GE, Trotti A, Foote RL, Schultz C, Thorstad WL, Zhang QE, Le QT, Holsinger FC. Establishing quality indicators for neck dissection: Correlating the number of lymph nodes with oncologic outcomes (NRG Oncology RTOG 9501 and RTOG 0234). Cancer 2016; 122:3464-3471. [PMID: 27419843 DOI: 10.1002/cncr.30204] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/08/2016] [Accepted: 06/13/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Prospective quality metrics for neck dissection have not been established for patients with head and neck squamous cell carcinoma. The purpose of this study was to investigate the association between lymph node counts from neck dissection, local-regional recurrence, and overall survival. METHODS The number of lymph nodes counted from neck dissection in patients treated in 2 NRG Oncology trials (Radiation Therapy Oncology Group [RTOG] 9501 and RTOG 0234) was evaluated for its prognostic impact on overall survival with a multivariate Cox model adjusted for demographic, tumor, and lymph node data and stratified by the postoperative treatment group. RESULTS Five hundred seventy-two patients were analyzed at a median follow-up of 8 years. Ninety-eight percent of the patients were pathologically N+. The median numbers of lymph nodes recorded on the left and right sides were 24 and 25, respectively. The identification of fewer than 18 nodes was associated with worse overall survival in comparison with 18 or more nodes (hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.09-1.74; P = .007). The difference appeared to be driven by local-regional failure (HR, 1.46; 95% CI, 1.02-2.08; P = .04) but not by distant metastases (HR, 1.08; 95% CI, 0.77-1.53; P = .65). When the analysis was limited to NRG Oncology RTOG 0234 patients, adding the p16 status to the model did not affect the HR for dissected nodes, and the effect of nodes did not differ with the p16 status. CONCLUSIONS The removal and identification of 18 or more lymph nodes was associated with improved overall survival and lower rates of local-regional failure, and this should be further evaluated as a measure of quality in neck dissections for mucosal squamous cell carcinoma. Cancer 2016;122:3464-71. © 2016 American Cancer Society.
Collapse
Affiliation(s)
- Vasu Divi
- Stanford University, Stanford, California
| | - Jonathan Harris
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | | | | | | | - Diana Bell
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M Sturgis
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Mohan Suntharalingam
- Marlene & Stewart Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland
| | - David Raben
- University of Colorado Denver, Aurora, Colorado
| | - Harold Kim
- Academic Radiation Oncology, Wayne State University, Detroit, Michigan
| | | | | | - Andy Trotti
- H. Lee Moffitt Cancer Center, Tampa, Florida
| | | | | | - Wade L Thorstad
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Qiang Ed Zhang
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | | | | |
Collapse
|
17
|
Sun S, Chen S, Liu F, Wu H, McHugh J, Bergin I, Gupta A, Adams D, Guan JL. Abstract LB-038: Constitutive activation of mTORC1 in endothelial cells leads to the development and progression of lymphangiosarcoma through VEGF autocrine signaling. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-lb-038] [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
Angiosarcoma/ lymphangiosarcoma is a rare malignancy with poor prognosis, for which animal models with a defined molecular pathogenesis are lacking. Here, we generated a new mouse model with an inducible endothelial cell specific deletion of Tsc1 to examine the potential role of abnormal activation of mTORC1 signaling in lymphangiosarcoma. We found that loss of Tsc1 increased EC proliferation and retinal angiogenesis in neonates. In adult mice, Tsc1 deletion led to a spectrum of endothelial proliferative lesions, ranging from vascular malformations to vascular tumors. Studies using rapamycin indicated that sustained mTORC1 signaling is required for both the development and maintenance of lymphangiosarcomas. Further analysis showed increased VEGF expression through increased activity of HIF1α and c-Myc transcription factors in tumor cells, and that blockade of autocrine VEGF signaling decreased proliferation of these cells both in vitro and in vivo. Lastly, we found significant correlations between mTORC1 activation and expression of VEGF, HIF1α and c-Myc in human angiosarcoma samples. Together, these studies demonstrate critical mechanisms of aberrant mTORC1 activation in the development of lymphangiosarcoma, and validate Tsc1iΔEC mice as a valuable novel model of lymphangiosarcoma with known molecular underpinnings for further study.
Citation Format: Shaogang Sun, Song Chen, Fei Liu, Haige Wu, Jonathan McHugh, Ingrid Bergin, Anita Gupta, Denise Adams, Jun-Lin Guan. Constitutive activation of mTORC1 in endothelial cells leads to the development and progression of lymphangiosarcoma through VEGF autocrine signaling. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-038.
Collapse
Affiliation(s)
| | - Song Chen
- 1University of Cincinnati, Cincinnati, OH
| | - Fei Liu
- 2University of Michigan, Ann Arbor, MI
| | - Haige Wu
- 1University of Cincinnati, Cincinnati, OH
| | | | | | - Anita Gupta
- 3Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Denise Adams
- 3Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | |
Collapse
|
18
|
Affiliation(s)
- Rebecca Harvey
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
| | | | - Jesse Ryan
- Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical University, Syracuse, New York
| |
Collapse
|
19
|
Birkeland A, Burgin S, Nor J, McHugh J, McLean S, McKean E, Brenner C. Pathogenetic Analysis of Sinonasal Teratocarcinosarcomas Reveal Beta-catenin Overexpression and an Actionable Beta-catenin Mutation. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579881] [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: 10/22/2022]
|
20
|
Nguyen N, Bellile E, Thomas D, McHugh J, Rozek L, Virani S, Peterson L, Carey TE, Walline H, Moyer J, Spector M, Perim D, Prince M, McLean S, Bradford CR, Taylor JMG, Wolf GT. Tumor infiltrating lymphocytes and survival in patients with head and neck squamous cell carcinoma. Head Neck 2016; 38:1074-84. [PMID: 26879675 DOI: 10.1002/hed.24406] [Citation(s) in RCA: 234] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Because immune responses within the tumor microenvironment are important predictors of tumor biology, correlations of types of tumor infiltrating lymphocytes (TILs) with clinical outcomes were determined in 278 patients with head and neck squamous cell carcinoma (HNSCC). METHODS Infiltrating levels of CD4 (helper T cells), CD8 (cytotoxic/suppressor T cells), FoxP3 (regulatory T cells), CD68 (myeloid-derived suppressor cells,) and CD1a (Langerhans) cells were measured in tissue microarrays (TMAs). Cox models tested associations with patient outcomes after adjusting for all known prognostic factors. Median follow-up was 36.6 months. RESULTS Higher CD4 and CD8 TIL levels were associated with improved overall survival (OS; hazard ratio [HR] = 0.77; 95% confidence interval [CI] = 0.65-0.93; p = .005 and HR = 0.77; 95% CI = 0.64-0.94; p = .008, respectively), and relapse-free survival (RFS; p = .03 and .05, respectively). After controlling for prognostic factors, higher CD4 levels predicted improved OS and disease-specific survival (DSS; p = .003 and p = .004, respectively). CONCLUSION The findings suggest that TILs are a significant independent prognostic factor for HNSCC that differ by treatment. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1074-1084, 2016.
Collapse
Affiliation(s)
- Nghia Nguyen
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Emily Bellile
- Center for Cancer Biostatistics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Daffyd Thomas
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jonathan McHugh
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Laura Rozek
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Shama Virani
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Lisa Peterson
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Thomas E Carey
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Heather Walline
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jeffery Moyer
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Matthew Spector
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Daniel Perim
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Mark Prince
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Scott McLean
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Carol R Bradford
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jeremy M G Taylor
- Center for Cancer Biostatistics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Gregory T Wolf
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan
| | | |
Collapse
|
21
|
Sun S, Chen S, Liu F, Wu H, McHugh J, Bergin IL, Gupta A, Adams D, Guan JL. Constitutive Activation of mTORC1 in Endothelial Cells Leads to the Development and Progression of Lymphangiosarcoma through VEGF Autocrine Signaling. Cancer Cell 2015; 28:758-772. [PMID: 26777415 PMCID: PMC4828306 DOI: 10.1016/j.ccell.2015.10.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 07/16/2015] [Accepted: 10/08/2015] [Indexed: 01/26/2023]
Abstract
Angiosarcoma/lymphangiosarcoma is a rare malignancy with poor prognosis. We generated a mouse model with inducible endothelial-cell-specific deletion of Tsc1 to examine mTORC1 signaling in lymphangiosarcoma. Tsc1 loss increased retinal angiogenesis in neonates and led to endothelial proliferative lesions from vascular malformations to vascular tumors in adult mice. Sustained mTORC1 signaling was required for lymphangiosarcoma development and maintenance. Increased VEGF expression in tumor cells was seen, and blocking autocrine VEGF signaling abolished vascular tumor development and growth. We also found significant correlations between mTORC1 activation and VEGF, HIF1α, and c-Myc expression in human angiosarcoma samples. These studies demonstrated critical mechanisms of aberrant mTORC1 activation in lymphangiosarcoma and validate the mice as a valuable model for further study.
Collapse
MESH Headings
- Angiogenesis Inhibitors/pharmacology
- Animals
- Autocrine Communication/drug effects
- Cell Movement
- Cell Proliferation
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Cell Transformation, Neoplastic/pathology
- Cells, Cultured
- Endothelial Cells/drug effects
- Endothelial Cells/enzymology
- Endothelial Cells/pathology
- Enzyme Activation
- Genotype
- Humans
- Hypoxia-Inducible Factor 1, alpha Subunit/analysis
- Hypoxia-Inducible Factor 1, alpha Subunit/genetics
- Hypoxia-Inducible Factor 1, alpha Subunit/metabolism
- Lymphangiosarcoma/drug therapy
- Lymphangiosarcoma/genetics
- Lymphangiosarcoma/metabolism
- Lymphangiosarcoma/pathology
- Mechanistic Target of Rapamycin Complex 1
- Mice, Knockout
- Mice, Nude
- Multiprotein Complexes/antagonists & inhibitors
- Multiprotein Complexes/metabolism
- Neoplasm Invasiveness
- Neovascularization, Pathologic
- Phenotype
- Protein Kinase Inhibitors/pharmacology
- Proto-Oncogene Proteins c-myc/analysis
- Proto-Oncogene Proteins c-myc/genetics
- Proto-Oncogene Proteins c-myc/metabolism
- RNA Interference
- Receptors, Vascular Endothelial Growth Factor/metabolism
- Retinal Neovascularization/genetics
- Retinal Neovascularization/metabolism
- Retinal Neovascularization/pathology
- Signal Transduction
- TOR Serine-Threonine Kinases/antagonists & inhibitors
- TOR Serine-Threonine Kinases/metabolism
- Transfection
- Tuberous Sclerosis Complex 1 Protein
- Tumor Burden
- Tumor Suppressor Proteins/genetics
- Tumor Suppressor Proteins/metabolism
- Vascular Endothelial Growth Factor A/analysis
- Vascular Endothelial Growth Factor A/antagonists & inhibitors
- Vascular Endothelial Growth Factor A/metabolism
Collapse
Affiliation(s)
- Shaogang Sun
- Department of Cancer Biology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Song Chen
- Department of Cancer Biology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Fei Liu
- Department of Biologic and Materials Sciences, University of Michigan, Ann Arbor, MI 48109, USA
| | - Haige Wu
- Department of Cancer Biology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Jonathan McHugh
- Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ingrid L Bergin
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Anita Gupta
- Department of Pathology, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Denise Adams
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Jun-Lin Guan
- Department of Cancer Biology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.
| |
Collapse
|
22
|
Abstract
Sequence-specific RNA binding proteins (RBP) are important regulators of the immune response. RBP modulate gene expression by regulating splicing, polyadenylation, localization, translation and decay of target mRNAs. Increasing evidence suggests that RBP play critical roles in the development, activation and function of lymphocyte populations in the immune system. This review will discuss the post-transcriptional regulation of gene expression by RBP during lymphocyte development, with particular focus on the Tristetraprolin family of RBP.
Collapse
Affiliation(s)
- R Newman
- Babraham Institute, Cambridge, UK
| | - J McHugh
- Babraham Institute, Cambridge, UK
| | - M Turner
- Babraham Institute, Cambridge, UK
| |
Collapse
|
23
|
McHugh J, Kenny R, Lawlor B, Kee F. O-060: Social factors predict cognitive outcomes cross-sectionally, but not longitudinally, among older Irish adults. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30073-5] [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: 11/30/2022]
|
24
|
Abstract
Deep venous thrombosis (DVT) remains a serious and common complication of surgical procedures and is therefore an issue of importance for all urologists. In the UK, pulmonary embolism (PE) following DVT in hospitalised patients causes 32,000 deaths each year. DVT and PE represent the outcome of venous thromboembolism (VTE). The total cost for management of VTE in 2005 was approximately ₤640 million. Early risk assessment and optimising modifiable risks are paramount in order to reduce the incidence of VTE. In this article we review common risk factors for VTE and emphasise specific risk factors for urological procedures. The perioperative management of urological patients who are chronically anticoagulated is discussed. We review the literature regarding anticoagulation and its relevance to all urological procedures and mention the problems associated with new anticoagulant agents. All urologists should be familiar with the new range of anticoagulant agents due to the increasing number of patients taking them.
Collapse
Affiliation(s)
- OZ Abusanad
- Department of Urology, Whiston Hospital, St Helens & Knowsley Teaching Hospitals NHS Trust, UK
| | - MS Floyd
- Department of Urology, Whiston Hospital, St Helens & Knowsley Teaching Hospitals NHS Trust, UK
| | - EU Johnson
- Department of Urology, Whiston Hospital, St Helens & Knowsley Teaching Hospitals NHS Trust, UK
| | - J McHugh
- Department of Haematology, Tallaght Hospital, Republic of Ireland
| | - JE McCabe
- Department of Urology, Whiston Hospital, St Helens & Knowsley Teaching Hospitals NHS Trust, UK
| |
Collapse
|
25
|
Fisher C, McHugh J, Harms P, Edwards P, Danciu T. Primary small cell carcinoma of the parotid gland: a case series. Oral Surg Oral Med Oral Pathol Oral Radiol 2014. [DOI: 10.1016/j.oooo.2014.05.050] [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: 11/25/2022]
|
26
|
Athanassiou-Papaefthymiou M, Shkeir O, Kim D, Divi V, Matossian M, Owen JH, Czerwinski MJ, Papagerakis P, McHugh J, Bradford CR, Carey TE, Wolf GT, Prince ME, Papagerakis S. Evaluation of CD44 variant expression in oral, head and neck squamous cell carcinomas using a triple approach and its clinical significance. Int J Immunopathol Pharmacol 2014; 27:337-49. [PMID: 25280025 DOI: 10.1177/039463201402700304] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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] Open
Abstract
Cancer stem cells possess the qualities of self-renewal, tumorigenesis and the ability to recapitulate a heterogeneous tumor. Our group was the first to isolate head and neck squamous cell carcinoma (HNSCC) stem cells using the cell surface marker CD44. CD44 is a trans-membrane glycoprotein with a multitude of key-functions that regulate cancer cell proliferation and metastasis. The variety of CD44 functions is due to tissue-specific patterns of glycosylation of the extracellular portion, and to the multiple protein isoforms (CD44 variants, CD44v) generated by alternative splicing. This study investigates the expression pattern of CD44 variants in HNSCC. Ten cell lines from the most common HNSCC locations and representative of various clinical outcomes were assayed by quantitative realtime PCR, flow cytometry and immunofluorescence comparatively with normal oral keratinocytes. The CD44 v4 and v6 were exclusively abundant in HNSCC while the isoform v1,2 was expressed in normal oral keratinocytes. Of interest, the highest level of CD44v6 expression was detected in advanced metastatic HNSCC, suggesting a link between CD44v6 expression and HNSCC metastasis, while the highest CD44v4 was detected in a stage IV HNSCC refractory to chemotherapy which developed recurrence. Oral-derived HNSCC expressed the highest CD44v4 and v6, and levels corresponded with staging, showing also an increasing tendency with recurrence and metastasis. CD44v were detected predominantly in smaller cells (a characteristic that has been associated with stem cell properties) or cells with mesenchymal morphology (a characteristic that has been associated with the migratory and invasive potential of epithelial tumor cells), suggesting that CD44v differential expression in HNSCC may be representative of the morphological changes inherent during tumor progression towards a more aggressive potential, and thus contributing to the individual tumor biology. The mechanism of CD44 variant involvement in HNSCC progression and metastasis is under investigation.
Collapse
Affiliation(s)
| | - O Shkeir
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - D Kim
- Department of Pediatric Dentistry and Orthodontics, University of Michigan, Ann Arbor, MI, USA
| | - V Divi
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - M Matossian
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - J H Owen
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - M J Czerwinski
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - P Papagerakis
- Department of Pediatric Dentistry and Orthodontics, University of Michigan, Ann Arbor, MI, USA
| | - J McHugh
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - C R Bradford
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - T E Carey
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - G T Wolf
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - M E Prince
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| | - S Papagerakis
- Department of Otolaryngology, Head & Neck Surgery, University of Michigan, Ann Arbor, MI , USA
| |
Collapse
|
27
|
Wolf GT, Chepeha DB, Bellile E, Nguyen A, Thomas D, McHugh J. Tumor infiltrating lymphocytes (TIL) and prognosis in oral cavity squamous carcinoma: a preliminary study. Oral Oncol 2014; 51:90-5. [PMID: 25283344 DOI: 10.1016/j.oraloncology.2014.09.006] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [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: 03/28/2014] [Revised: 08/29/2014] [Accepted: 09/06/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Tumor infiltrating lymphocytes (TILs) in the microenvironment reflect may tumor biology and predict outcome. We previously demonstrated that infiltrates of CD4, CD8, and FoxP3 positive lymphocytes were associated with HPV-status and survival in oropharyngeal cancers. To determine if TILs were of prognostic importance in oral cancer, TIL levels were evaluated retrospectively in 52 oral cancer patients treated with surgery and correlations with outcome determined. METHODS Complete TIL and clinical data were available for 39 patients. Levels of CD4, CD8, FoxP3 (Treg), CD68 and NK cells were assessed by immunohistochemistry in tumor cores on a tissue microarray. Associations with clinical variables, tobacco and alcohol use and histologic features were assessed using Spearman correlation coefficient and the non-parametric Kruskal-Wallis testing. Time-to-event outcomes were determined using univariate and multivariate Cox models. Median follow up was 60 months. RESULTS The ratio of CD4/CD8 (p=.01) and CD8 infiltrates (p=.05) were associated with tumor recurrence but not overall survival. Lower CD4 infiltrates were associated with alcohol use (p=.005) and poor tumor differentiation (p=.02). Interestingly, higher levels of CD68+ macrophages were found associated with positive nodes (p=.06) and poorer overall survival (p=.07). Overall and DSS survival were significantly shorter for patients with positive nodes, extracapsular spread, or perineural invasion. CONCLUSION Infiltrating immune cell levels in oral cavity cancer appear influenced by health behaviors and tumor characteristics. In contrast to oropharynx cancer, infiltrates of CD68 positive tumor associated macrophages may contribute to metastatic behavior and outcome in advanced oral cavity carcinoma.
Collapse
Affiliation(s)
- Gregory T Wolf
- Departments of Otolaryngology-Head and Neck Surgery, The University of Michigan Health System, Ann Arbor, MI 48109, United States.
| | - Douglas B Chepeha
- Departments of Otolaryngology-Head and Neck Surgery, The University of Michigan Health System, Ann Arbor, MI 48109, United States
| | - Emily Bellile
- Biostatistics, The University of Michigan Health System, Ann Arbor, MI 48109, United States
| | - Ariane Nguyen
- Departments of Otolaryngology-Head and Neck Surgery, The University of Michigan Health System, Ann Arbor, MI 48109, United States
| | - Daffyd Thomas
- Pathology, The University of Michigan Health System, Ann Arbor, MI 48109, United States
| | - Jonathan McHugh
- Pathology, The University of Michigan Health System, Ann Arbor, MI 48109, United States
| |
Collapse
|
28
|
O'Brien M, Pfeiffer E, Yen D, Keenan L, McHugh J, Doyle P, Doherty M, O'Reilly A, Hennessy B, Williams D, Horgan A, Breathnach O, Grogan W, Morris P. Assessment of Older Patients with Cancer: Edmonton Frail Scale (Efs) As a Predictor of Adverse Outcomes in a Cohort of Older Patients Undergoing Systemic Therapy. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu356.66] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
29
|
Doherty M, Keenan L, McHugh J, O'Brien M, O'Reilly A, Reilly C, Hannan E, De Golden PH, O'Connor E, Hannon D, Tierney N, Henderson R, Doyle P, McHugh C, Grogan W, Hennessy B, Morris P, Breathnach O. Patterns of Treatment and Rates of Admission in a Specialist Oncology Clinic. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu353.25] [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: 11/13/2022] Open
|
30
|
Papagerakis S, Pannone G, Zheng L, About I, Taqi N, Nguyen NPT, Matossian M, McAlpin B, Santoro A, McHugh J, Prince ME, Papagerakis P. Oral epithelial stem cells - implications in normal development and cancer metastasis. Exp Cell Res 2014; 325:111-29. [PMID: 24803391 DOI: 10.1016/j.yexcr.2014.04.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 12/18/2022]
Abstract
Oral mucosa is continuously exposed to environmental forces and has to be constantly renewed. Accordingly, the oral mucosa epithelium contains a large reservoir of epithelial stem cells necessary for tissue homeostasis. Despite considerable scientific advances in stem cell behavior in a number of tissues, fewer studies have been devoted to the stem cells in the oral epithelium. Most of oral mucosa stem cells studies are focused on identifying cancer stem cells (CSC) in oral squamous cell carcinomas (OSCCs) among other head and neck cancers. OSCCs are the most prevalent epithelial tumors of the head and neck region, marked by their aggressiveness and invasiveness. Due to their highly tumorigenic properties, it has been suggested that CSC may be the critical population of cancer cells in the development of OSCC metastasis. This review presents a brief overview of epithelium stem cells with implications in oral health, and the clinical implications of the CSC concept in OSCC metastatic dissemination.
Collapse
Affiliation(s)
- Silvana Papagerakis
- Department of Otolaryngology, Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
| | - Giuseppe Pannone
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Li Zheng
- Department of Otolaryngology, Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Imad About
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288, Marseille cedex 09, France
| | - Nawar Taqi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nghia P T Nguyen
- Department of Otolaryngology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Margarite Matossian
- Department of Otolaryngology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Blake McAlpin
- Department of Otolaryngology, Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Angela Santoro
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Jonathan McHugh
- Department of Pathology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Mark E Prince
- Department of Otolaryngology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Petros Papagerakis
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Center for Computational Medicine and Bioinformatics, School of Medicine, University of Michigan, Ann Arbor, MI, USA; Center for Organogenesis, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
31
|
Abstract
IMPORTANCE Understanding age-related changes is important when considering cartilage-based implants or grafts during rhinoplasty and nasal reconstructive surgery. OBJECTIVE To characterize the cellular and architectural changes in human nasal cartilage with aging. DESIGN Laboratory study. PARTICIPANTS Nasal septal cartilage was harvested from 50 consecutive patients undergoing septoplasty, rhinoplasty, or septorhinoplasty. INTERVENTION Cartilage specimens were stained with hematoxylin-eosin (H&E) and safranin O for cartilage. MAIN OUTCOME MEASURES A modified Mankin histologic grading scale was used to analyze each cartilage sample for H&E findings and safranin O staining. Higher H&E scores indicated more degenerative changes, while higher safranin O scores indicated reductions in proteoglycan content within the cartilage matrix, representing decreased active chondrocyte activity. Correlation between H&E and safranin O scores and patient age was determined. RESULTS There was positive correlation between safranin O staining scores and age, with higher scores seen with advancing age (P = .01). A linear regression best-fit equation was determined to calculate a potential safranin O staining score for a given age. CONCLUSIONS AND RELEVANCE We have quantitatively determined that advancing age is positively correlated with reductions in cartilage proteoglycan content and active cartilage growth. This finding not only enhances our current understanding of the natural changes that occur in cartilage with aging but may also affect surgical decision making when cartilage grafting is considered during functional, reconstructive, and aesthetic rhinoplasty. LEVEL OF EVIDENCE NR.
Collapse
Affiliation(s)
- Judy W Lee
- Center for Facial Cosmetic Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, USA.
| | | | | | | | | |
Collapse
|
32
|
Burgin S, McDaniel A, McHugh J, Sullivan S, McKean E. ACTH-Secreting Esthesioneuroblastoma Occurring after Treatment for Crooke's Cell Adenoma. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1370640] [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: 10/25/2022]
|
33
|
Eliassen A, Vandy F, McHugh J, Henke PK. Marjolin's Ulcer in a Patient With Chronic Venous Stasis. Ann Vasc Surg 2013; 27:1182.e5-8. [DOI: 10.1016/j.avsg.2013.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 02/17/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
|
34
|
Papagerakis S, Zheng L, Schnell S, Sartor MA, Somers E, Marder W, McAlpin B, Kim D, McHugh J, Papagerakis P. The circadian clock in oral health and diseases. J Dent Res 2013; 93:27-35. [PMID: 24065634 DOI: 10.1177/0022034513505768] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Most physiological processes in mammals display circadian rhythms that are driven by the endogenous circadian clock. This clock is comprised of a central component located in the hypothalamic suprachiasmatic nucleus and subordinate clocks in peripheral tissues. Circadian rhythms sustain 24-hour oscillations of a large number of master genes controlling the correct timing and synchronization of diverse physiological and metabolic processes within our bodies. This complex regulatory network provides an important communication link between our brain and several peripheral organs and tissues. At the molecular level, circadian oscillations of gene expression are regulated by a family of transcription factors called "clock genes". Dysregulation of clock gene expression results in diverse human pathological conditions, including autoimmune diseases and cancer. There is increasing evidence that the circadian clock affects tooth development, salivary gland and oral epithelium homeostasis, and saliva production. This review summarizes current knowledge of the roles of clock genes in the formation and maintenance of oral tissues, and discusses potential links between "oral clocks" and diseases such as head and neck cancer and Sjögren's syndrome.
Collapse
Affiliation(s)
- S Papagerakis
- Department of Otolaryngology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Waldorff EI, Roessler BJ, Zachos TA, Miller BS, McHugh J, Goldstein SA. Preclinical evaluation of a novel implant for treatment of a full-thickness distal femoral focal cartilage defect. J Arthroplasty 2013; 28:1421-9. [PMID: 23523501 PMCID: PMC3844131 DOI: 10.1016/j.arth.2012.11.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 11/30/2012] [Indexed: 02/01/2023] Open
Abstract
A novel, nonresorbable, monolithic composite structure ceramic, developed using a partially stabilized zirconia ceramic common to implantable devices, was used in a cementless weight-bearing articular implant to test the feasibility of replacing a region of degenerated or damaged articular cartilage in the knee as part of a preclinical study using male mongrel dogs lasting up to 24 weeks. Gross/histological cartilage observations showed no differences among control, 12-week and 24-week groups, while pull-out tests showed an increase in maximum pull-out load over time relative to controls. Hence, the use of a novel ceramic implant as a replacement for a focal cartilage defect leads to effective implant fixation within 12 weeks and does not cause significant degradation in opposing articular cartilage in the time frame evaluated.
Collapse
Affiliation(s)
- Erik I. Waldorff
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Blake J. Roessler
- Department of Internal Medicine, Rheumatology, University of Michigan, Ann Arbor, Michigan
| | - Terri A. Zachos
- College of Human Medicine, Michigan State University, Kalamazoo, Michigan
| | - Bruce S. Miller
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Jonathan McHugh
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Steven A. Goldstein
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
36
|
Dashow J, Helman J, Edwards S, McHugh J, Ward B. Keratocystic Odontogenic Tumor Recurrence Rates With Enucleation and Curettage Using Carnoy's Versus Modified Carnoy's Solution. J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.joms.2013.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
37
|
Zhao XC, McHugh J, Thorne MC. Pathology quiz case 2: extranodal Rosai-Dorfman disease (RDD)of the maxillary sinus. JAMA Otolaryngol Head Neck Surg 2013; 139:529-31. [PMID: 23681043 DOI: 10.1001/jamaoto.2013.2864a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Xue C Zhao
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | |
Collapse
|
38
|
Glazer TA, Spector ME, McHugh J, Hogikyan ND. Osteoblastoma of the thyroid cartilage treated with voice preserving laryngeal framework resection. Laryngoscope 2013; 123:1948-51. [PMID: 23729184 DOI: 10.1002/lary.23972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 11/30/2012] [Accepted: 12/12/2012] [Indexed: 01/26/2023]
Abstract
OBJECTIVES/HYPOTHESIS Osteoblastoma is a slow-growing, locally destructive benign bone neoplasm, rarely occurring in the laryngeal cartilage. We present the case of a professional voice user diagnosed with laryngeal osteoblastoma after microdirect laryngoscopy and endoscopic biopsy. Her treatment required a unique operation, with elements of partial laryngectomy and maintenance of vital endolaryngeal soft tissues, in order to optimize vocal outcome.
Collapse
Affiliation(s)
- Tiffany A Glazer
- Department of Otolaryngology Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.
| | | | | | | |
Collapse
|
39
|
Lin G, Zacharek M, Akkina S, Chinn S, McHugh J, Carey T, Prince M. Inverted Papilloma: Prognostic Factors with Implications for Resection Margins. Skull Base Surg 2013. [DOI: 10.1055/s-0033-1336192] [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: 10/27/2022]
|
40
|
Chwang WB, Jain R, Narayan A, McHugh J, Ghanem T, Seidman M, Jain R. Inflammatory Pseudotumor of the Nasopharynx and Skull Base. ACTA ACUST UNITED AC 2012; 138:765-9. [DOI: 10.1001/archoto.2012.1540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
41
|
Zheng L, Seon Y, McHugh J, Papagerakis S, Papagerakis P. Clock genes show circadian rhythms in salivary glands. J Dent Res 2012; 91:783-8. [PMID: 22699207 PMCID: PMC3398790 DOI: 10.1177/0022034512451450] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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: 02/21/2012] [Revised: 05/16/2012] [Accepted: 05/20/2012] [Indexed: 01/20/2023] Open
Abstract
Circadian rhythms are endogenous self-sustained oscillations with 24-hour periods that regulate diverse physiological and metabolic processes through complex gene regulation by "clock" transcription factors. The oral cavity is bathed by saliva, and its amount and content are modified within regular daily intervals. The clock mechanisms that control salivary production remain unclear. Our objective was to evaluate the expression and periodicity of clock genes in salivary glands. Real-time quantitative RT-PCR, in situ hybridization, and immunohistochemistry were performed to show circadian mRNA and protein expression and localization of key clock genes (Bmal1, Clock, Per1, and Per2), ion and aqua channel genes (Ae2a, Car2, and Aqp5), and salivary gland markers. Clock gene mRNAs and clock proteins were found differentially expressed in the serous acini and duct cells of all major salivary glands. The expression levels of clock genes and Aqp5 showed regular oscillatory patterns under both light/dark and complete-dark conditions. Bmla1 overexpression resulted in increased Aqp5 expression levels. Analysis of our data suggests that salivary glands have a peripheral clock mechanism that functions both in normal light/dark conditions and in the absence of light. This finding may increase our understanding of the control mechanisms of salivary content and flow.
Collapse
Affiliation(s)
- L. Zheng
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Y.J. Seon
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J. McHugh
- Department of Pathology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - S. Papagerakis
- Department of Otorhinolaryngology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - P. Papagerakis
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
42
|
Wansom D, Light E, Thomas D, Worden F, Prince M, Urba S, Chepeha D, Kumar B, Cordell K, Eisbruch A, Taylor J, Moyer J, Bradford C, D'Silva N, Carey T, McHugh J, Wolf G. Infiltrating lymphocytes and human papillomavirus-16--associated oropharyngeal cancer. Laryngoscope 2012; 122:121-7. [PMID: 22183632 DOI: 10.1002/lary.22133] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES/HYPOTHESIS Human papillomavirus-16 (HPV-16)-associated carcinoma of the oropharynx has a favorable prognosis. Such patients have elevated CD8+ T-lymphocyte levels that correlate with response to chemotherapy and survival. Tumor-infiltrating lymphocyte (TIL) subpopulations were assessed in pretreatment biopsies from a prospective patient cohort to determine if TIL subsets differed by HPV status, clinical factors, or patient outcome or correlated with peripheral blood T-cell levels. STUDY DESIGN Retrospective immunological correlative study of patients entered in a prospective Phase 2 clinical trial. METHODS Measured were CD8, CD4, CD68, and Treg (FoxP3) lymphocytes by immunohistochemistry in a tissue microarray created from patients (n=46) with advanced oropharyngeal cancer. Correlations with peripheral blood levels, HPV status, expression of epidermal growth factor receptor (EGFR), clinical tumor, and patient characteristics and outcome were determined. Median follow-up was 6.6 years. RESULTS HPV-16-positive patients had improved survival (P=.016). Degree of T-cell infiltration did not differ by HPV status but was significantly related to disease-specific survival (DSS) and overall survival (OS). Even after adjusting for HPV status, we found that CD8, FoxP3, and total T cells were significantly associated with DSS (P=.0236, P=.0040, and P=.0197, respectively) and OS (P=.0137, P=.0158, and P=.0115, respectively). Less T-cell infiltration (P=.0130) and CD4 cells in particular (P=.0792) were associated with higher EGFR expression. CONCLUSIONS Improved outcomes are associated with increased TILs independent of HPV status and suggest the local immune response may be more related to factors such as tumor size, EGFR expression, or performance status than HPV status. Further study of larger numbers of patients and infiltrates combined with functional analysis of individual subsets may be necessary to detect significant differences in local immunity in HPV-16-related cancers.
Collapse
Affiliation(s)
- Derrick Wansom
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Gallagher K, Pepper J, Light E, McKean E, Marentette L, McHugh J. Esthesioneuroblastoma: Updating Histologic Grading as It Relates to Prognosis. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1312161] [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: 10/28/2022]
|
44
|
Maxwell JH, Lezner D, McHugh J, Duvvuri U. Perineural Invasion in Early Stage Oral Tongue Cancer. Otolaryngol Head Neck Surg 2011. [DOI: 10.1177/0194599811416318a98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: 1) Determine the true incidence of perineural invasion (PNI) in patients with squamous cell carcinoma of the oral tongue (SCCOT). 2) Understand the relationship between PNI, tumor thickness, and nodal metastases. 3) Analyze the effect of PNI on overall survival (OS). Method: Tumor tissue from 47 patients with early stage SCCOT diagnosed between 1981 and 2001 at the University of Pittsburgh was prospectively analyzed for PNI, number/size of nerves involved, intraneural invasion, nodal metastases, and tumor thickness. Outcome data included overall survival, disease-specific survival, and disease recurrence. Results: PNI was found in 48.9% (23/47) of patients. At initial diagnosis, the incidence of PNI was 36.8% (7/19) among those patients evaluated for PNI. This agreement was fair (Kappa = 0.39, 95% CI:0.02, 0.76). Patients with PNI had significantly greater tumor thickness (mean = 13.2mm) than patients without PNI (mean = 6.9mm; P = .001). Three (3/23; 13%) patients with PNI had intraneural invasion. Ten of 23 (43.5%) patients with PNI had nodal metastases compared with 4 of 20 (16.7%) patients without PNI ( P = .060). Patients without PNI had better OS than patients with PNI (median = 10.1 years vs 4.2 years, respectively), although this was not significant ( P = .154). Conclusion: The true incidence of PNI is nearly 50% for SCCOT. PNI is significantly associated with greater tumor thickness. Patients with PNI have increased nodal metastases and worse overall survival compared to patients without PNI. However, these trends are not significant.
Collapse
|
45
|
Ann Byrd S, Light E, McHugh J, Bradford CR, Prince ME, Spector ME, Carey T. Clinicopathologic Review of Mucoepidermoid Carcinoma. Otolaryngol Head Neck Surg 2011. [DOI: 10.1177/0194599811415823a96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: 1) Describe the epidemiology of mucoepidermoid carcinoma (MEC) in the head and neck treated at a tertiary care hospital. 2) Determine clinical and pathologic predictors of recurrence and survival in patients with mucoepidermoid carcinoma in the head and neck treated at a tertiary care hospital. Method: Medical records of 94 patients (mean age, 50.4 years; M:F, 48:46) who underwent surgical treatment for MEC of the head and neck between 1995 and 2010 were reviewed. Main outcome measures were DFS, DSS, and OS. Clinicopathologic parameters evaluated were age, sex, TNM stage, subsite, adjuvant therapy, tumor grade, and margin status. Results: Of the 94 patients, 42 parotid, 26 palate, 12 oral, 9 submandibular/sublingual, 4 orbital, and 1 parapharyngeal tumors were identified. All patients underwent surgical resection, 32 patients had postoperative radiation and 3 postoperative chemoradiation. The 5-year OS and DSS were 79% and 90% with a median follow-up of 72 months and 45 months, respectively. The 5-year DFS was 74% with 12 patients developing recurrence. On univariate analysis, age >50 ( P = .01), male sex ( P = .008), positive nodal status ( P = .01) and high-grade histology ( P = .003) were predictive of poor prognosis. On multivariate analysis, high-grade histology ( P = .02) and male sex ( P = .04) were predictive of poor prognosis. Conclusion: The epidemiology of MEC is consistent with previous studies. High grade histology continues to be the strongest independent predictor of survival in MEC followed by male sex. Further studies into the molecular biology of MEC that may account for such clinicopathologic features are warranted.
Collapse
|
46
|
McHugh J, Abulhoul L, Boyd S. P3.15 EEG paroxysms on eye-closure and other findings in children with cytosolic urea cycle disorders. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60234-4] [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: 10/17/2022]
|
47
|
McHugh J, Reilly R, Connolly S. P5.10 Examining the reproducibility of median motor nerve excitability testing. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60274-5] [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: 11/26/2022]
|
48
|
Kang S, Lin E, McHugh J, Sullivan S, Marentette L. Esthesioneuroblastoma and Sinonasal Undifferentiated Carcinoma Recurring as Adenocarcinoma. Skull Base 2011. [DOI: 10.1055/s-2011-1274358] [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: 10/18/2022]
|
49
|
Smith EA, Styn N, Wan J, McHugh J, Dillman JR. Xanthogranulomatous pyelonephritis: an uncommon pediatric renal mass. Pediatr Radiol 2010; 40:1421-5. [PMID: 20151117 DOI: 10.1007/s00247-009-1539-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 11/24/2009] [Accepted: 12/29/2009] [Indexed: 11/28/2022]
Abstract
Xanthogranulomatous pyelonephritis (XGP) is a chronic suppurative infectious process that only rarely affects pediatric patients, and most commonly occurs in the setting of a large obstructing calculus. Histologically, XGP is characterized by the presence of chronic inflammation and lipid-laden macrophages. This case report illustrates the radiological, surgical, and pathologic findings in a young patient who presented to our institution for treatment of this uncommon condition. Although rare, xanthogranulomatous pyelonephritis is a clinically important entity that can affect pediatric patients. This condition should be considered in the differential diagnosis for an atypical-appearing renal mass.
Collapse
Affiliation(s)
- Ethan A Smith
- Department of Radiology, University of Michigan Health System, C. S. Mott Children's Hospital, 1500 E. Medical Center Dr., Ann Arbor, MI 48103, USA.
| | | | | | | | | |
Collapse
|
50
|
Wilson K, Light E, McHugh J, Bradford C. Spindle Cell Variant of Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2010. [DOI: 10.1016/j.otohns.2010.06.394] [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: 11/16/2022]
|