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Giotakis AI, Runge A, Dudas J, Glueckert R, Gottfried T, Schartinger VH, Klarer J, Randhawa A, Caimmi E, Riechelmann H. Analysis of cells of epithelial, connective tissue and immune differentiation in HPV-positive-, HPV-negative oropharyngeal carcinoma and normal oropharyngeal tissue by immunofluorescence multiplex image cytometry: a preliminary report. BMC Cancer 2023; 23:1154. [PMID: 38012597 PMCID: PMC10683252 DOI: 10.1186/s12885-023-11440-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/24/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Epithelial, connective tissue and immune cells contribute in various ways to the pathophysiology of HPV positive (HPV+) and HPV negative (HPV-) oropharyngeal squamous cell carcinoma (OPSCC). We aimed to investigate the abundance of these cell lineages and their coexpression patterns in patients with HPV + and HPV- OPSCC. METHODS We used a 4-channel immunofluorescence-microscopy technique for the simultaneous detection of three direct-conjugated antibodies (pancytokeratin, vimentin and CD45/CD18) and DAPI (4',6-Diamidin-2-phenylindole) in formalin fixed paraffin-embedded tissue samples (FFPE) of patients with HPV + and HPV- OPSCC, and of control patients. Image acquisition and analysis were performed with TissueFAXS and StrataQuest (TissueGnostics, Vienna, Austria), respectively, in tumor cell clusters/stroma in OPSCC specimens and epithelial layer/lamina propria in control specimens. Cell populations were created based on antibodies' coexpression patterns. Isotype and positive controls were examined for plausibility. RESULTS The proportion of cells of epithelial differentiation in tumor cell clusters was higher in HPV + OPSCC (55%) than in HPV- OPSCC samples (44%). The proportion of connective tissue cells in tumor cell cluster was lower in HPV + OPSCC patients (18%) than in HPV- OPSCC patients (26%). The proportion of immune cells in tumor cell clusters was higher in HPV + OPSCC patients (25%) than in HPV- OPSCC patients (18%). The percentage of anaplastic, potentially de-differentiated cells, was 2% in control patients, and it was higher in HPV- OPSCC (21%) than in HPV + OPSCC samples (6%). CONCLUSIONS This study provided the first quantitative data for the abundance of cells of epithelial, connective tissue and immune differentiation, in patients with OPSCC and control patients. The abundance of these different crucial cell populations was consistently originating from the same tissue sample. De-differentiation of tumor cells was higher in HPV- OPSCC than in HPV + OPSCC. In tumor cells clusters, the antitumoral host immune response was higher in HPV + OPSCC than in HPV- OPSCC, whereas the fibroblast response was higher in HPV- OPSCC than in HPV + OPSCC. This study contributed to the understanding of histopathologic differences between HPV + OPSCC and HPV- OPSCC patients.
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Affiliation(s)
- Aris I Giotakis
- Department of Otorhinolaryngology - Head & Neck Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Annette Runge
- Department of Otorhinolaryngology - Head & Neck Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
| | - József Dudas
- Department of Otorhinolaryngology - Head & Neck Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Rudolf Glueckert
- University Clinics Innsbruck, Tirol Kliniken, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Timo Gottfried
- Department of Otorhinolaryngology - Head & Neck Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Volker H Schartinger
- Department of Otorhinolaryngology - Head & Neck Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Johanna Klarer
- Department of Otorhinolaryngology - Head & Neck Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Avneet Randhawa
- Department of Otolaryngology, Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Eleonora Caimmi
- Department of Otorhinolaryngology - Head & Neck Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Herbert Riechelmann
- Department of Otorhinolaryngology - Head & Neck Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
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Sharma SJ, Schartinger VH, Wuerdemann N, Langer C, Möllenhoff K, Collin L, Sutton L, Riedl D, Kreuter A, Lechner M, Wieland U, Klussmann JP. Awareness of human papillomavirus (HPV) and HPV vaccination amongst the general population in Germany - lack of awareness and need for action. Oncol Res Treat 2022; 45:561-567. [PMID: 35850111 DOI: 10.1159/000525697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/22/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The oncogenic human papillomaviruses (HPV) types 16 and 18 contribute to more than 73% cases of all HPV-related cancers and commonly affect the anogenital and head and neck region, with rapidly rising incidence rates of HPV-related oropharyngeal squamous cell carcinomas (OPSCC). HPV vaccination has the potential to decrease the burden of HPV-related disease but vaccination rates remain low in many countries. We investigated the level of awareness of HPV, and HPV-OPSCC in particular, in a representative sample of the German population. MATERIALS AND METHODS As part of an online, population-based survey, an electronic questionnaire was administered to a representative sample of 1095 adult individuals with a specific emphasis on awareness of HPV, transmission, as well as indicator symptoms of oropharyngeal cancer. Statistical analysis of levels of awareness and relation of these to age, gender and socioeconomic background were conducted using the IBM SPSS Statistics Version 25.0. RESULTS 699/1095 (63.8%) subjects had never heard of HPV. Of the subjects with awareness for HPV, 210 knew that HPV could be transmitted during sex (58.3%) and 138 recognized HPV as a risk factor for OPSCC (14.2%), unrelated to gender (p=0.357), educational status (p=0.581) or family status (p=0.719). 416 subjects knew that a preventive vaccine against HPV existed (44.9%). Women were significantly more aware of HPV (34.2% vs 22.8%, p<0.001) and the vaccination (56.4% vs 32.7%, p<0.001) as were men. Younger individuals (age group 25-34) were significantly more aware of HPV (p<0.001), likely as they were offered and/or had received the HPV vaccination. There was no regional variation of HPV awareness within the German state (p=0.051). CONCLUSION Here we demonstrate a significant lack of awareness of HPV and HPV vaccination in a representative sample of the German population. Levels of awareness of the link of HPV and oropharyngeal cancer are particularly low, bearing in mind that this cancer is commonly affecting men and incidence rates are rapidly rising in many European countries and the US. Awareness programs and further education are required to tackle the low awareness rates and increase the uptake of the vaccination program not only in Germany, but also worldwide.
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Affiliation(s)
- Shachi Jenny Sharma
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Volker H Schartinger
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Nora Wuerdemann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Christine Langer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Kathrin Möllenhoff
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Lisa Collin
- Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Liam Sutton
- Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
- UCL Cancer Institute, University College London, London, United Kingdom
| | - David Riedl
- Department of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexander Kreuter
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University Witten-Herdecke, Witten, Germany
| | - Matt Lechner
- UCL Cancer Institute, University College London, London, United Kingdom
| | - Ulrike Wieland
- Institute of Virology, National Reference Center for Papilloma- and Polyomaviruses, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
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Lechner M, Takahashi Y, Turri-Zanoni M, Ferrari M, Liu J, Counsell N, Mattavelli D, Rampinelli V, Vermi W, Lombardi D, Saade R, Park KW, Schartinger VH, Franchi A, Facco C, Sessa F, Battocchio S, Fenton TR, Vaz FM, O'Flynn P, Howard D, Stimpson P, Wang S, Hannan SA, Unadkat S, Hughes J, Dwivedi R, Forde CT, Randhawa P, Gane S, Joseph J, Andrews PJ, Dave M, Fleming JC, Thomson D, Zhu T, Teschendorff A, Royle G, Steele C, Jimenez JE, Laco J, Wang EW, Snyderman C, Lacy PD, Woods R, O'Neill JP, Saraswathula A, Kaur RP, Zhao T, Ramanathan M, Gallia GL, London NR, Le QT, West RB, Patel ZM, Nayak JV, Hwang PH, Hermsen M, Llorente J, Facchetti F, Nicolai P, Bossi P, Castelnuovo P, Jay A, Carnell D, Forster MD, Bell DM, Lund VJ, Hanna EY. International Multicenter Study of Clinical Outcomes of Sinonasal Melanoma Shows Survival Benefit for Patients Treated with Immune Checkpoint Inhibitors and Potential Improvements to the Current TNM Staging System. J Neurol Surg B Skull Base 2022. [DOI: 10.1055/s-0042-1750178] [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: 10/17/2022] Open
Abstract
Abstract
Objectives Sinonasal mucosal melanoma (SNMM) is an extremely rare and challenging sinonasal malignancy with a poor prognosis. Standard treatment involves complete surgical resection, but the role of adjuvant therapy remains unclear. Crucially, our understanding of its clinical presentation, course, and optimal treatment remains limited, and few advancements in improving its management have been made in the recent past.
Methods We conducted an international multicenter retrospective analysis of 505 SNMM cases from 11 institutions across the United States, United Kingdom, Ireland, and continental Europe. Data on clinical presentation, diagnosis, treatment, and clinical outcomes were assessed.
Results One-, three-, and five-year recurrence-free and overall survival were 61.4, 30.6, and 22.0%, and 77.6, 49.2, and 38.3%, respectively. Compared with disease confined to the nasal cavity, sinus involvement confers significantly worse survival; based on this, further stratifying the T3 stage was highly prognostic (p < 0.001) with implications for a potential modification to the current TNM staging system. There was a statistically significant survival benefit for patients who received adjuvant radiotherapy, compared with those who underwent surgery alone (hazard ratio [HR] = 0.74, 95% confidence interval [CI]: 0.57–0.96, p = 0.021). Immune checkpoint blockade for the management of recurrent or persistent disease, with or without distant metastasis, conferred longer survival (HR = 0.50, 95% CI: 0.25–1.00, p = 0.036).
Conclusions We present findings from the largest cohort of SNMM reported to date. We demonstrate the potential utility of further stratifying the T3 stage by sinus involvement and present promising data on the benefit of immune checkpoint inhibitors for recurrent, persistent, or metastatic disease with implications for future clinical trials in this field.
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Affiliation(s)
- Matt Lechner
- UCL Cancer Institute, University College London, London, United Kingdom
- UCL Division of Surgery and Interventional Science, University College London, London, United Kingdom
- Department of ENT, Barts Health NHS Trust, London, United Kingdom
| | - Yoko Takahashi
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Mario Turri-Zanoni
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Jacklyn Liu
- UCL Cancer Institute, University College London, London, United Kingdom
| | - Nicholas Counsell
- Cancer Research UK and UCL Cancer Trials Centre, University College London, London, United Kingdom
| | - Davide Mattavelli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - William Vermi
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Davide Lombardi
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Rami Saade
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
- Department of Otolaryngology—Head and Neck Surgery, Lebanese American University, Beirut, Lebanon
| | - Ki Wan Park
- Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, United States
| | - Volker H. Schartinger
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Carla Facco
- Unit of Pathology, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Fausto Sessa
- Unit of Pathology, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Simonetta Battocchio
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Tim R. Fenton
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, United Kingdom
| | - Francis M. Vaz
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Paul O'Flynn
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - David Howard
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Paul Stimpson
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Simon Wang
- Department of Oncology, Haematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S. Alam Hannan
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Samit Unadkat
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Jonathan Hughes
- Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Raghav Dwivedi
- Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Cillian T. Forde
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Premjit Randhawa
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Simon Gane
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Jonathan Joseph
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Peter J. Andrews
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Manas Dave
- Division of Dentistry, University of Manchester, Manchester, United Kingdom
| | - Jason C. Fleming
- Liverpool Head & Neck Centre, University of Liverpool, Liverpool, United Kingdom
| | - David Thomson
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
- Liverpool Head & Neck Centre, University of Liverpool, Liverpool, United Kingdom
| | - Tianyu Zhu
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Shanghai, People's Republic of China
| | - Andrew Teschendorff
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Shanghai, People's Republic of China
| | - Gary Royle
- UCL Cancer Institute, University College London, London, United Kingdom
| | | | - Joaquin E. Jimenez
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, United States
| | - Jan Laco
- The Fingerland Department of Pathology, Charles University Faculty of Medicine and University Hospital Hradec Kralove, Czech Republic
| | - Eric W. Wang
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, United States
- Center for Cranial Base Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Carl Snyderman
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, United States
- Center for Cranial Base Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Peter D. Lacy
- Department of Otolaryngology—Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Robbie Woods
- Department of Otolaryngology—Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - James P. O'Neill
- Department of Otolaryngology—Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
- The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anirudh Saraswathula
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, United States
| | - Raman Preet Kaur
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, United States
| | - Tianna Zhao
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Murugappan Ramanathan
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, United States
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Gary L. Gallia
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, United States
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Nyall R. London
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, United States
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Sinonasal and Skull Base Tumor Program—Head and Neck Surgery Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, United States
| | - Quynh-Thu Le
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, California, United States
| | - Robert B. West
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, California, United States
| | - Zara M. Patel
- Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, United States
| | - Jayakar V. Nayak
- Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, United States
| | - Peter H. Hwang
- Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, United States
| | - Mario Hermsen
- Department of Head and Neck Oncology, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Jose Llorente
- Department of Head and Neck Oncology, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Fabio Facchetti
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Paolo Bossi
- Medical Oncology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Paolo Castelnuovo
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Amrita Jay
- Department of Histopathology, University College London Hospitals NHS Trust, London, United Kingdom
| | - Dawn Carnell
- Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Martin D. Forster
- UCL Cancer Institute, University College London, London, United Kingdom
| | - Diana M. Bell
- Disease Team Alignment: Head and Neck, City of Hope Medical Center, Duarte, California, United States
| | - Valerie J. Lund
- Royal National ENT Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, United Kingdom
| | - Ehab Y. Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
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4
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Lechner M, Takahashi Y, Turri-Zanoni M, Liu J, Counsell N, Hermsen M, Kaur RP, Zhao T, Ramanathan M, Schartinger VH, Emanuel O, Helman S, Varghese J, Dudas J, Riechelmann H, Sprung S, Haybaeck J, Howard D, Engel NW, Stewart S, Brooks L, Pickles JC, Jacques TS, Fenton TR, Williams L, Vaz FM, O'Flynn P, Stimpson P, Wang S, Hannan SA, Unadkat S, Hughes J, Dwivedi R, Forde CT, Randhawa P, Gane S, Joseph J, Andrews PJ, Royle G, Franchi A, Maragliano R, Battocchio S, Bewicke-Copley H, Pipinikas C, Webster A, Thirlwell C, Ho D, Teschendorff A, Zhu T, Steele CD, Pillay N, Vanhaesebroeck B, Mohyeldin A, Fernandez-Miranda J, Park KW, Le QT, West RB, Saade R, Manes RP, Omay SB, Vining EM, Judson BL, Yarbrough WG, Sansovini M, Silvia N, Grassi I, Bongiovanni A, Capper D, Schüller U, Thavaraj S, Sandison A, Surda P, Hopkins C, Ferrari M, Mattavelli D, Rampinelli V, Facchetti F, Nicolai P, Bossi P, Henriquez OA, Magliocca K, Solares CA, Wise SK, Llorente JL, Patel ZM, Nayak JV, Hwang PH, Lacy PD, Woods R, O'Neill JP, Jay A, Carnell D, Forster MD, Ishii M, London NR, Bell DM, Gallia GL, Castelnuovo P, Severi S, Lund VJ, Hanna EY. Clinical outcomes, Kadish-INSICA staging and therapeutic targeting of somatostatin receptor 2 in olfactory neuroblastoma. Eur J Cancer 2022; 162:221-236. [PMID: 34980502 PMCID: PMC9554673 DOI: 10.1016/j.ejca.2021.09.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 09/12/2021] [Accepted: 09/28/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Olfactory neuroblastoma (ONB) is a rare cancer of the sinonasal region. We provide a comprehensive analysis of this malignancy with molecular and clinical trial data on a subset of our cohort to report on the potential efficacy of somatostatin receptor 2 (SSTR2)-targeting imaging and therapy. METHODS We conducted a retrospective analysis of 404 primary, locally recurrent, and metastatic olfactory neuroblastoma (ONB) patients from 12 institutions in the United States of America, United Kingdom and Europe. Clinicopathological characteristics and treatment approach were evaluated. SSTR2 expression, SSTR2-targeted imaging and the efficacy of peptide receptor radionuclide therapy [PRRT](177Lu-DOTATATE) were reported in a subset of our cohort (LUTHREE trial; NCT03454763). RESULTS Dural infiltration at presentation was a significant predictor of overall survival (OS) and disease-free survival (DFS) in primary cases (n = 278). Kadish-Morita staging and Dulguerov T-stage both had limitations regarding their prognostic value. Multivariable survival analysis demonstrated improved outcomes with lower stage and receipt of adjuvant radiotherapy. Prophylactic neck irradiation significantly reduces the rate of nodal recurrence. 82.4% of the cohort were positive for SSTR2; treatment of three metastatic cases with SSTR2-targeted peptide-radionuclide receptor therapy (PRRT) in the LUTHREE trial was well-tolerated and resulted in stable disease (SD). CONCLUSIONS This study presents pertinent clinical data from the largest dataset, to date, on ONB. We identify key prognostic markers and integrate these into an updated staging system, highlight the importance of adjuvant radiotherapy across all disease stages, the utility of prophylactic neck irradiation and the potential efficacy of targeting SSTR2 to manage disease.
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Affiliation(s)
- Matt Lechner
- UCL Cancer Institute, University College London, London, UK; Academic Head and Neck Centre, UCL Division of Surgery and Interventional Science, University College London, London, UK; ENT Department, Barts Health NHS Trust, London, United Kingdom; Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA.
| | - Yoko Takahashi
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Mario Turri-Zanoni
- Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Jacklyn Liu
- UCL Cancer Institute, University College London, London, UK
| | - Nicholas Counsell
- Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK
| | - Mario Hermsen
- Department of Head and Neck Oncology, Instituto de Investigacio´n Sanitaria Del Principado de Asturias (ISPA), Instituto Universitario de Oncologı´a Del Principado de Asturias (IUOPA), Centro de Investigacio´n Biome´dica en Red (CIBER-ONC), Oviedo, Spain
| | - Raman Preet Kaur
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA
| | - Tianna Zhao
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Murugappan Ramanathan
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA
| | - Volker H Schartinger
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Oscar Emanuel
- UCL Cancer Institute, University College London, London, UK
| | - Sam Helman
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA
| | - Jordan Varghese
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA
| | - Jozsef Dudas
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Riechelmann
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Susanne Sprung
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Johannes Haybaeck
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria; Diagnostic & Research Center for Molecular BioMedicine, Institute of Pathology, Medical University Graz, Graz, Austria
| | - David Howard
- Head and Neck Cancer Unit, Imperial College Healthcare NHS Trust, London, UK
| | - Nils Wolfgang Engel
- Department of Oncology, Haematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Stewart
- Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Laura Brooks
- Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Jessica C Pickles
- Department of Developmental Biology and Cancer & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Thomas S Jacques
- Department of Developmental Biology and Cancer & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Tim R Fenton
- School of Biosciences, University of Kent, Canterbury, UK; School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Luke Williams
- UCL Division of Surgery and Interventional Science, University College London, London, UK
| | - Francis M Vaz
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Paul O'Flynn
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Paul Stimpson
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Simon Wang
- Institute of Nuclear Medicine, University College London, London, UK
| | - S Alam Hannan
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Samit Unadkat
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Jonathan Hughes
- Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Raghav Dwivedi
- Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Cillian T Forde
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Premjit Randhawa
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Simon Gane
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Jonathan Joseph
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Peter J Andrews
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Gary Royle
- UCL Cancer Institute, University College London, London, UK
| | | | - Roberta Maragliano
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Simonetta Battocchio
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | | | | | - Amy Webster
- UCL Cancer Institute, University College London, London, UK
| | - Chrissie Thirlwell
- UCL Cancer Institute, University College London, London, UK; College of Medicine and Health and Institute of Biomedical and Clinical Science, University of Exeter, Exeter, UK
| | - Debbie Ho
- Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - Andrew Teschendorff
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Shanghai, China
| | - Tianyu Zhu
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Shanghai, China
| | - Christopher D Steele
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | | | | | - Ahmed Mohyeldin
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, USA
| | | | - Ki Wan Park
- Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA
| | - Quynh-Thu Le
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, USA
| | - Robert B West
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, USA
| | - Rami Saade
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Peter Manes
- Department of Neurosurgery, Yale School of Medicine, New Haven, USA
| | | | - Eugenia M Vining
- Department of Neurosurgery, Yale School of Medicine, New Haven, USA
| | | | - Wendell G Yarbrough
- Department of Otolaryngology/Head and Neck Surgery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Maddalena Sansovini
- Therapeutic Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Nicolini Silvia
- Therapeutic Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Ilaria Grassi
- Therapeutic Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center (CDO-TR), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - David Capper
- Department of Neuropathology, Charite - Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ulrich Schüller
- Department of Pediatric Hematology and Oncology, Institute of Neuropathology, And Research Institute Children's Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Selvam Thavaraj
- Centre for Clinical, Oral & Translational Science, King's College London, Department of Head and Neck Pathology, Guy's Hospital, London, UK
| | - Ann Sandison
- Department of Head and Neck Pathology, Guy's Hospital, London, UK
| | | | | | - Marco Ferrari
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Fabio Facchetti
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Italy
| | - Paolo Bossi
- Medical Oncology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Oswaldo A Henriquez
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA
| | - Kelly Magliocca
- Department of Pathology, Emory University School of Medicine, Atlanta, USA
| | - C Arturo Solares
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA
| | - Sarah K Wise
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA
| | - Jose L Llorente
- Dept Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Zara M Patel
- Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA
| | - Jayakar V Nayak
- Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA
| | - Peter H Hwang
- Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA
| | - Peter D Lacy
- Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Robbie Woods
- Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - James P O'Neill
- Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland; The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Amrita Jay
- Department of Histopathology, University College London Hospitals NHS Trust, London, UK
| | - Dawn Carnell
- Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Martin D Forster
- UCL Cancer Institute, University College London, London, UK; Academic Head and Neck Centre, UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Oncology, Haematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Masaru Ishii
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA
| | - Nyall R London
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA; Sinonasal and Skull Base Tumor Program, Head and Neck Surgery Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Diana M Bell
- Department of Pathology, The University of Texas MD Anderson Cancer Center Houston, USA; Division of Anatomic Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Gary L Gallia
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Paolo Castelnuovo
- Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Stefano Severi
- Therapeutic Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Valerie J Lund
- Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK.
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA.
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5
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Emanuel O, Liu J, Schartinger VH, Nei WL, Chan YY, Tsang CM, Riechelmann H, Masterson L, Haybaeck J, Oppermann U, Willems SM, Ooft ML, Wollmann G, Howard D, Vanhaesebroeck B, Lund VJ, Royle G, Chua MLK, Lo KW, Busson P, Lechner M. SSTR2 in Nasopharyngeal Carcinoma: Relationship with Latent EBV Infection and Potential as a Therapeutic Target. Cancers (Basel) 2021; 13:4944. [PMID: 34638429 PMCID: PMC8508244 DOI: 10.3390/cancers13194944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 01/04/2023] Open
Abstract
Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor, most commonly located in the pharyngeal recess and endemic to parts of Asia. It is often detected at a late stage which is associated with poor prognosis (5-year survival rate of 63%). Treatment for this malignancy relies predominantly on radiotherapy and/or systemic chemotherapy, which can be associated with significant morbidity and impaired quality of life. In endemic regions NPC is associated with infection by Epstein-Barr virus (EBV) which was shown to upregulate the somatostatin receptor 2 (SSTR2) cell surface receptor. With recent advances in molecular techniques allowing for an improved understanding of the molecular aetiology of this disease and its relation to SSTR2 expression, we provide a comprehensive and up-to-date overview of this disease and highlight the emergence of SSTR2 as a key tumor biomarker and promising target for imaging and therapy.
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Affiliation(s)
- Oscar Emanuel
- UCL Cancer Institute, University College London, London WC1E 6BT, UK; (O.E.); (J.L.); (B.V.); (V.J.L.); (G.R.)
| | - Jacklyn Liu
- UCL Cancer Institute, University College London, London WC1E 6BT, UK; (O.E.); (J.L.); (B.V.); (V.J.L.); (G.R.)
| | - Volker H. Schartinger
- Department of Otorhinolaryngology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (V.H.S.); (H.R.)
| | - Wen Long Nei
- National Cancer Centre, Divisions of Radiation Oncology and Medical Sciences, Singapore 169610, Singapore; (W.L.N.); (M.L.K.C.)
- Oncology Academic Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Yuk Yu Chan
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong 999077, China; (Y.Y.C.); (C.M.T.); (K.W.L.)
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Chi Man Tsang
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong 999077, China; (Y.Y.C.); (C.M.T.); (K.W.L.)
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Herbert Riechelmann
- Department of Otorhinolaryngology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (V.H.S.); (H.R.)
| | - Liam Masterson
- Department of Otolaryngology, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK;
| | - Johannes Haybaeck
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Udo Oppermann
- Botnar Research Centre, University of Oxford, Oxford OX1 2JD, UK;
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, 79085 Freiburg, Germany
| | - Stefan M. Willems
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (S.M.W.); (M.L.O.)
- Department of Pathology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Marc L. Ooft
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (S.M.W.); (M.L.O.)
- King’s College Hospitals, NHS Foundation Trust, London SE5 9RS, UK
| | - Guido Wollmann
- Institute of Virology and Christian Doppler Laboratory for Viral Immunotherapy of Cancer, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - David Howard
- ENT Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London W6 9EP, UK;
- Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, London WC1E 6DG, UK
| | - Bart Vanhaesebroeck
- UCL Cancer Institute, University College London, London WC1E 6BT, UK; (O.E.); (J.L.); (B.V.); (V.J.L.); (G.R.)
| | - Valerie J. Lund
- UCL Cancer Institute, University College London, London WC1E 6BT, UK; (O.E.); (J.L.); (B.V.); (V.J.L.); (G.R.)
- Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, London WC1E 6DG, UK
| | - Gary Royle
- UCL Cancer Institute, University College London, London WC1E 6BT, UK; (O.E.); (J.L.); (B.V.); (V.J.L.); (G.R.)
| | - Melvin L. K. Chua
- National Cancer Centre, Divisions of Radiation Oncology and Medical Sciences, Singapore 169610, Singapore; (W.L.N.); (M.L.K.C.)
- Oncology Academic Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Kwok Wai Lo
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong 999077, China; (Y.Y.C.); (C.M.T.); (K.W.L.)
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Pierre Busson
- CNRS-UMR 9018-Metsy, Gustave Roussy and Université Paris-Saclay, 94805 Villejuif, France
| | - Matt Lechner
- UCL Cancer Institute, University College London, London WC1E 6BT, UK; (O.E.); (J.L.); (B.V.); (V.J.L.); (G.R.)
- Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, CA 94305, USA
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6
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Fischer N, Plaikner M, Schartinger VH, Kremser C, Riechelmann H, Schmutzhard J, Gottfried T, Dejaco D, Tauber H, Josip E, Henninger B. MRI of middle ear cholesteatoma: The importance of observer reliance from diffusion sequences. J Neuroimaging 2021; 32:120-126. [PMID: 34398501 DOI: 10.1111/jon.12919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Diffusion-weighted imaging(DWI) in MRI has been developed as an important tool for the detection of cholesteatoma. Various DWI sequences are available. This study aims to evaluate the importance of the observer's reliance level for the detection of cholesteatoma. METHODS Forty patients meeting the following criteria were included in the study: (1) chronic otitis media, (2) preoperative MRI including various DWI sequences, and (3) middle-ear surgery. The MRI protocol contained the following sequences: (1) axial and (2) coronal echoplanar imaging (EPI) readout-segmented (RESOLVE) DWI with Trace acquisition and (3) coronal non-EPI half-Fourier acquired single-shot turbo spin-echo (HASTE) DWI. Cholesteatoma diagnosis was based on standard diagnostic criteria for cholesteatoma with DWI. Additionally, the radiologists were asked to grade personal reliance on their diagnosis using a Likert-type scale from 1 = very insecure to 5 = very secure. RESULTS Axial and coronal RESOLVE DWI showed a sensitivity of 77.3% and a specificity of 72.2%, respectively. The mean reliance was 3.9 for axial and 3.8 for coronal images. HASTE DWI had a sensitivity/specificity of 81.8%/66.7% with the highest reliance of all evaluated sequences (4.4). Cases with a reliance level of 5 showed a sensitivity/specificity of 100% in all sequences. A reliance level of 5 was given in the axial and coronal RESOLVE DWI in 32.5% of cases and in the HASTE DWI in 57.5%. CONCLUSION The evaluated DWI sequences showed comparable results. The reliance level significantly improved the predictor of cholesteatoma disease with MRI techniques.
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Affiliation(s)
- Natalie Fischer
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michaela Plaikner
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Volker H Schartinger
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Kremser
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Riechelmann
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Joachim Schmutzhard
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Timo Gottfried
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniel Dejaco
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helmuth Tauber
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Ena Josip
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Benjamin Henninger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
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7
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Lechner M, Schartinger VH, Steele CD, Nei WL, Ooft ML, Schreiber LM, Pipinikas CP, Chung GTY, Chan YY, Wu F, To KF, Tsang CM, Pearce W, Morelli D, Philpott M, Masterson L, Nibhani R, Wells G, Bell CG, Koller J, Delecluse S, Yip YL, Liu J, Forde CT, Forster MD, Jay A, Dudás J, Krapp A, Wan S, Uprimny C, Sprung S, Haybaeck J, Fenton TR, Chester K, Thirlwell C, Royle G, Marafioti T, Gupta R, Indrasari SR, Herdini C, Slim MAM, Indrawati I, Sutton L, Fles R, Tan B, Yeong J, Jain A, Han S, Wang H, Loke KSH, He W, Xu R, Jin H, Cheng Z, Howard D, Hwang PH, Le QT, Tay JK, West RB, Tsao SW, Meyer T, Riechelmann H, Oppermann U, Delecluse HJ, Willems SM, Chua MLK, Busson P, Lo KW, Wollmann G, Pillay N, Vanhaesebroeck B, Lund VJ. Somatostatin receptor 2 expression in nasopharyngeal cancer is induced by Epstein Barr virus infection: impact on prognosis, imaging and therapy. Nat Commun 2021; 12:117. [PMID: 33402692 PMCID: PMC7785735 DOI: 10.1038/s41467-020-20308-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 11/17/2020] [Indexed: 12/13/2022] Open
Abstract
Nasopharyngeal cancer (NPC), endemic in Southeast Asia, lacks effective diagnostic and therapeutic strategies. Even in high-income countries the 5-year survival rate for stage IV NPC is less than 40%. Here we report high somatostatin receptor 2 (SSTR2) expression in multiple clinical cohorts comprising 402 primary, locally recurrent and metastatic NPCs. We show that SSTR2 expression is induced by the Epstein-Barr virus (EBV) latent membrane protein 1 (LMP1) via the NF-κB pathway. Using cell-based and preclinical rodent models, we demonstrate the therapeutic potential of SSTR2 targeting using a cytotoxic drug conjugate, PEN-221, which is found to be superior to FDA-approved SSTR2-binding cytostatic agents. Furthermore, we reveal significant correlation of SSTR expression with increased rates of survival and report in vivo uptake of the SSTR2-binding 68Ga-DOTA-peptide radioconjugate in PET-CT scanning in a clinical trial of NPC patients (NCT03670342). These findings reveal a key role in EBV-associated NPC for SSTR2 in infection, imaging, targeted therapy and survival.
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MESH Headings
- Animals
- Female
- Humans
- Male
- Mice
- Antineoplastic Agents/pharmacology
- Cell Line, Tumor
- Epstein-Barr Virus Infections/drug therapy
- Epstein-Barr Virus Infections/genetics
- Epstein-Barr Virus Infections/mortality
- Epstein-Barr Virus Infections/virology
- Gene Expression Regulation, Neoplastic
- Herpesvirus 4, Human/drug effects
- Herpesvirus 4, Human/growth & development
- Herpesvirus 4, Human/pathogenicity
- Host-Pathogen Interactions/genetics
- Lymphatic Metastasis
- Mice, Nude
- Molecular Targeted Therapy
- Nasopharyngeal Carcinoma/drug therapy
- Nasopharyngeal Carcinoma/genetics
- Nasopharyngeal Carcinoma/mortality
- Nasopharyngeal Carcinoma/virology
- Nasopharyngeal Neoplasms/drug therapy
- Nasopharyngeal Neoplasms/genetics
- Nasopharyngeal Neoplasms/mortality
- Nasopharyngeal Neoplasms/virology
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/virology
- NF-kappa B/genetics
- NF-kappa B/metabolism
- Octreotide/pharmacology
- Positron Emission Tomography Computed Tomography
- Receptors, Somatostatin/antagonists & inhibitors
- Receptors, Somatostatin/genetics
- Receptors, Somatostatin/metabolism
- Signal Transduction
- Survival Analysis
- Viral Matrix Proteins/antagonists & inhibitors
- Viral Matrix Proteins/genetics
- Viral Matrix Proteins/metabolism
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Matt Lechner
- UCL Cancer Institute, University College London, London, UK.
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.
- Barts Health NHS Trust, London, UK.
- Royal National Throat, Nose and Ear Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK.
| | - Volker H Schartinger
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Wen Long Nei
- Divisions of Radiation Oncology and Medical Sciences, National Cancer Centre, Singapore, Singapore
- Oncology Academic Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Marc Lucas Ooft
- King´s College Hospitals, NHS Foundation Trust, London, UK
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Liesa-Marie Schreiber
- Institute of Virology and Christian Doppler Laboratory for Viral Immunotherapy of Cancer, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Grace Tin-Yun Chung
- Department of Anatomical and Cellular Pathology and State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuk Yu Chan
- Department of Anatomical and Cellular Pathology and State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Feng Wu
- Department of Anatomical and Cellular Pathology and State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka-Fai To
- Department of Anatomical and Cellular Pathology and State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Man Tsang
- Department of Anatomical and Cellular Pathology and State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wayne Pearce
- UCL Cancer Institute, University College London, London, UK
| | | | | | - Liam Masterson
- Department of Otolaryngology, Addenbrooke's Hospital, Cambridge, UK
| | - Reshma Nibhani
- Botnar Research Centre, University of Oxford, Oxford, UK
| | - Graham Wells
- Botnar Research Centre, University of Oxford, Oxford, UK
| | - Christopher G Bell
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Julia Koller
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
- Botnar Research Centre, University of Oxford, Oxford, UK
| | - Susanne Delecluse
- German Cancer Research Centre (DKFZ) and Inserm, Unit F100/U1074, Heidelberg, Germany
| | - Yim Ling Yip
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Jacklyn Liu
- UCL Cancer Institute, University College London, London, UK
| | - Cillian T Forde
- Royal National Throat, Nose and Ear Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Martin D Forster
- UCL Cancer Institute, University College London, London, UK
- Royal National Throat, Nose and Ear Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
| | - Amrita Jay
- Department of Histopathology, University College London Hospitals NHS Trust, Euston Road, London, UK
| | - József Dudás
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Annika Krapp
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Simon Wan
- Institute of Nuclear Medicine, University College Hospital, Euston Road, London, UK
| | - Christian Uprimny
- Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Susanne Sprung
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Johannes Haybaeck
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
- Diagnostic & Research Center for Molecular Biomedicine, Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Tim R Fenton
- School of Biosciences, University of Kent, Canterbury, UK
| | - Kerry Chester
- UCL Cancer Institute, University College London, London, UK
| | - Christina Thirlwell
- UCL Cancer Institute, University College London, London, UK
- University of Exeter College of Medicine and Health, Exeter, UK
| | - Gary Royle
- UCL Cancer Institute, University College London, London, UK
| | | | - Rajeev Gupta
- UCL Cancer Institute, University College London, London, UK
| | - Sagung Rai Indrasari
- ENT Head and Neck Surgery Department, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Camelia Herdini
- ENT Head and Neck Surgery Department, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Mohd Afiq Mohd Slim
- Department of Ear, Nose and Throat, University Hospital Crosshouse, Crosshouse, Kilmarnock, UK
| | - I Indrawati
- Department of Anatomical Pathology, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | | | - Renske Fles
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Bing Tan
- ENT Head and Neck Surgery Department, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Joe Yeong
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
| | - Amit Jain
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Shuting Han
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Haitao Wang
- Divisions of Radiation Oncology and Medical Sciences, National Cancer Centre, Singapore, Singapore
| | - Kelvin S H Loke
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
| | - Wan He
- Department of Oncology, The Second Clinical Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Ruilian Xu
- Department of Oncology, The Second Clinical Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Hongtao Jin
- Department of Pathology, The Second Clinical Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Zhiqiang Cheng
- Department of Pathology, The Second Clinical Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| | - David Howard
- Royal National Throat, Nose and Ear Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK
- ENT Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Peter H Hwang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Quynh-Thu Le
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Joshua K Tay
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
- Department of Otolaryngology-Head and Neck Surgery, National University of Singapore, Singapore, Singapore
| | - Robert B West
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Sai Wah Tsao
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Tim Meyer
- UCL Cancer Institute, University College London, London, UK
| | - Herbert Riechelmann
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Udo Oppermann
- Botnar Research Centre, University of Oxford, Oxford, UK
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, 79085, Freiburg, Germany
| | | | - Stefan M Willems
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Pathology, University Medical Center Groningen, Groningen, The Netherlands
| | - Melvin L K Chua
- Divisions of Radiation Oncology and Medical Sciences, National Cancer Centre, Singapore, Singapore
- Oncology Academic Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Pierre Busson
- CNRS-UMR 9018-METSY, Gustave Roussy and Université Paris-Saclay, Villejuif, France
| | - Kwok Wai Lo
- Department of Anatomical and Cellular Pathology and State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Guido Wollmann
- Institute of Virology and Christian Doppler Laboratory for Viral Immunotherapy of Cancer, Medical University of Innsbruck, Innsbruck, Austria
| | - Nischalan Pillay
- UCL Cancer Institute, University College London, London, UK
- Department of Cellular and Molecular Pathology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | | | - Valerie J Lund
- UCL Cancer Institute, University College London, London, UK.
- Royal National Throat, Nose and Ear Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK.
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8
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Kofler B, Laimer J, Bruckmoser E, Steinbichler TB, Runge A, Schartinger VH, von Laer D, Borena W. The Role of HPV and Non-HPV Sexually Transmitted Infections in Patients with Oropharyngeal Carcinoma: A Case Control Study. Cancers (Basel) 2020; 12:cancers12051192. [PMID: 32397254 PMCID: PMC7281731 DOI: 10.3390/cancers12051192] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 04/29/2020] [Accepted: 05/05/2020] [Indexed: 01/26/2023] Open
Abstract
Background: Certain high-risk (hr) types of human papillomavirus (HPV) can cause cervical cancer in women and penile cancer in men. Hr-HPV can also cause cancers of the oropharynx and anus in both sexes. In the anal and cervical region, a contribution of co-infections with Ureaplasma spp. on the persistence of the hr-HPV infection by a profound inflammatory state is suggested. Here, we investigated if non-HPV sexually transmitted infections are associated with oropharyngeal carcinoma (OPC). Materials and Methods: In this case-control study, a brush test directly from the tumor surface of OPC patients (study group) and from the oropharynx of healthy volunteers (control group), both groups matching in age and sex, was performed. HPV subtypes were detected using a commercially available test kit. For non-HPV sexually transmitted infections (Ureaplasma spp., Chlamydia trachomatis, Mycoplasma hominis, and Mycoplasma genitalium), a multiplex nucleic acid amplification approach was performed. Results: In the study group, 96 patients (23 female/73 male), with histologically confirmed OPC and in the control group 112 patients (19 female/93 male), were included. Oropharyngeal hr-HPV-positivity was detected in 68% (65/96 patients) of the study group and 1.8% (2/112 patients) of the control group (p < 0.001). In three patients in the study group, Ureaplasma spp. was detected, whereas no patient was Ureaplasma spp. positive in the control group (p = 0.097). Chlamydia trachomatis, Mycoplasma hominis, and Mycoplasma genitalium were negative in both groups. Conclusion: Based on the current study, the prevalence of oropharyngeal Ureaplasma spp. among patients with OPC is low and does not support a role in oropharyngeal cancer. However, the detection of the pathogen only among OPC patients but not in the healthy individuals might indicate a potential role and needs further elucidation.
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Affiliation(s)
- Barbara Kofler
- Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (B.K.); (T.B.S.); (A.R.); (V.H.S.)
| | - Johannes Laimer
- University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | | | - Teresa B. Steinbichler
- Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (B.K.); (T.B.S.); (A.R.); (V.H.S.)
| | - Annette Runge
- Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (B.K.); (T.B.S.); (A.R.); (V.H.S.)
| | - Volker H. Schartinger
- Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (B.K.); (T.B.S.); (A.R.); (V.H.S.)
| | - Dorothee von Laer
- Institute of Virology, Department of Hygiene, Microbiology, Social Medicine, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, 6020 Innsbruck, Austria;
| | - Wegene Borena
- Institute of Virology, Department of Hygiene, Microbiology, Social Medicine, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, 6020 Innsbruck, Austria;
- Correspondence: ; Tel.: +43-512-9003-71737; Fax: +43-0512-9003-73701
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9
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Fischer N, Schartinger VH, Dejaco D, Schmutzhard J, Riechelmann H, Plaikner M, Henninger B. Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation. AJNR Am J Neuroradiol 2019; 40:1055-1059. [PMID: 31122917 DOI: 10.3174/ajnr.a6079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/21/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging has become an important tool for the detection of cholesteatomas of the middle ear. Various diffusion-weighted imaging sequences are available and have shown promising results. This study aimed to evaluate readout-segmented echo-planar DWI for the detection of cholesteatoma and compare the results with surgical validation. MATERIALS AND METHODS Fifty patients with chronic otitis media (24 females and 26 males; range, 12-76 years of age; mean age, 41 years) who underwent MR imaging before an operation of the middle ear (1-169 days) were included. The MR imaging protocol consisted of axial and coronal readout-segmented echo-planar DWI with b-values of 0 and 1000 s/mm2 and 3-mm slice thickness. The readout-segmented echo-planar diffusion-weighted images were fused with standard T2-weighted sequences for better anatomic assignment. The results of the MR imaging evaluation were correlated with the results from the operation. RESULTS Readout-segmented echo-planar DWI detected 22 of the 25 cases of surgically proved cholesteatoma. It has an accuracy of 92% (95% confidence interval, 80.8%-97.8%), a sensitivity of 88%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 89%. In 1 case, a positive finding for cholesteatoma with readout-segmented echo-planar DWI could not be proved by histology, and in 3 cases, histology yielded a cholesteatoma that was not detected with MR imaging. CONCLUSIONS Readout-segmented echo-planar DWI is a promising and reliable MR imaging sequence for the detection and exclusion of cholesteatoma.
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Affiliation(s)
- N Fischer
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - V H Schartinger
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - D Dejaco
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - J Schmutzhard
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - H Riechelmann
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - M Plaikner
- Radiology (M.P., B.H.), Medical University of Innsbruck, Innsbruck, Austria
| | - B Henninger
- Radiology (M.P., B.H.), Medical University of Innsbruck, Innsbruck, Austria
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10
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Steinbichler TB, Hauser U, Schartinger VH, Dudás J, Riechelmann H. [Head & Neck Merkel Cell Carcinoma]. Laryngorhinootologie 2018; 98:48-59. [PMID: 30005427 DOI: 10.1055/a-0588-9400] [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: 10/28/2022]
Abstract
Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine tumor of the skin. Even if it is quite rare, the incidence has increased about two fold during the last twenty years. Mortality is higher than in malignant melanoma. Risk factors are chronic UV exposition and immunosuppression. MCC are most common in patients over 70 years and half of them manifest in the head and neck region. They early metastasize to regional lymph nodes. Surgical therapy should include wide resection of the primary tumor and diagnostic lymph node excision. In the head and neck region this means usually ipsilateral selective neck dissection. Adjuvant radiotherapy of the primary tumor bed and associated lymph nodes of the head and neck region decreases recurrence and should be performed in every patient regardless of the T- and N-stage. In the head and neck region adjuvant radiotherapy can only be spared in selected patients with low-risk profile (wide excisional margins > 2 cm, primary tumor size > 1 cm, absent lymphovascular infiltration, no immunosuppression and pathologic negative cervical lymph nodes). Isolated radiotherapy or systemic therapies are usually applied in patients with metastasized MCC. Disease recurrence is most common in the first two years after initial diagnosis. Patients should be examined at short intervals during this time.
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11
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Dejaco D, Steinbichler T, Schartinger VH, Fischer N, Anegg M, Dudas J, Posch A, Widmann G, Riechelmann H. Prognostic value of tumor volume in patients with head and neck squamous cell carcinoma treated with primary surgery. Head Neck 2017; 40:728-739. [PMID: 29272056 DOI: 10.1002/hed.25040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/02/2017] [Accepted: 11/07/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Tumor volume in head and neck squamous cell carcinoma (HNSCC) was mainly measured in nonsurgically treated patients. We analyzed the influence of tumor volume on complete response (CR), overall survival (OS), and clear surgical margins also in primarily surgically treated patients. METHODS In contrast-enhanced CTs, the tumor volumes of patients with incident HNSCC were measured. RESULTS The tumor volumes of 259 patients were measured, of which 125 patients (48%) underwent primary surgery and 102 patients (84%) had clear margins. The tumor volume was not an independent factor for CR at the primary tumor site. Risk of death increased by 1.4% per mL of tumor volume (95% confidence interval [CI] 0.8%-2.0%; P < .001). The OS was better in patients treated with primary surgery, if the tumor volume was ≤12 mL (P < .001). Risk of involved margins increased by 4.5% per mL of tumor volume (95% CI 0.9%-8.3%; P = .003). The predicted probability of clear margins was ≥80% in tumor volumes ≤ 16 mL. CONCLUSION The tumor volume had an impact on CR, OS, and clear margins. The tumor volume may also aid in selecting HNSCC treatment.
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Affiliation(s)
- Daniel Dejaco
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Teresa Steinbichler
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Volker H Schartinger
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Natalie Fischer
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Maria Anegg
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Jozsef Dudas
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Posch
- Department of Radiation Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Riechelmann
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
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12
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Kofler B, Kerschbaumer J, Schartinger VH, Posch A, Gizewski ER, Widmann G. [Brain metastasis versus radiation necrosis after head and neck cancer : Brain lesion after head and neck cancer]. Radiologe 2017; 57:392-396. [PMID: 28204852 DOI: 10.1007/s00117-017-0219-x] [Citation(s) in RCA: 3] [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: 11/29/2022]
Affiliation(s)
- B Kofler
- Univ. HNO Klinik Innsbruck, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
| | - J Kerschbaumer
- Univ. Klinik für Neurochirurgie Innsbruck, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - V H Schartinger
- Univ. HNO Klinik Innsbruck, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - A Posch
- Universitätsklinik für Strahlentherapie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - E R Gizewski
- Universitätsklinik für Neuroradiologie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - G Widmann
- Universitätsklinik für Radiologie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
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13
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Kegele J, Hurth H, Lackner P, Enimil A, Sylverkin J, Ansong D, Nkyi C, Bonsu B, Agbenyega T, Schartinger VH, Schmutzhard E, Zorowka P, Kremsner P, Schmutzhard J. Otoacoustic emission testing in Ghanaian children with sickle-cell disease. Trop Med Int Health 2015; 20:1209-1212. [PMID: 25941122 DOI: 10.1111/tmi.12533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate hearing loss in children as a complication of sickle-cell disease. METHODS In Kumasi, Ghana, 35 children with SCD aged 6 months to 10 years underwent transient-evoked otoacoustic emissions testing (TEOAE) to investigate the function of the inner ear. Healthy Ghanaian children recruited in school and kindergarten served as controls. RESULTS One of 35 children with SCD and 13 of 115 control children failed the otoacoustic emissions testing. This difference between the control group and the children with SCD was not statistically significant. CONCLUSION Early hearing impairment does not regularly occur in sickle-cell disease, and in children, it is not a likely cause of delayed or impaired language development.
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Affiliation(s)
- Josua Kegele
- Department of Neurology, NICU, Medical University Innsbruck, Innsbruck, Austria
| | - Helene Hurth
- Department of Neurology, NICU, Medical University Innsbruck, Innsbruck, Austria
| | - Peter Lackner
- Department of Neurology, NICU, Medical University Innsbruck, Innsbruck, Austria
| | - Anthony Enimil
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justice Sylverkin
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Ansong
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Clara Nkyi
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Benedicta Bonsu
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Tsiri Agbenyega
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Volker H Schartinger
- Department of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, Austria
| | - Erich Schmutzhard
- Department of Neurology, NICU, Medical University Innsbruck, Innsbruck, Austria
| | - Patrick Zorowka
- Department of Hearing, Speech and Voice Disorders, Medical University Innsbruck, Innsbruck, Austria
| | - Peter Kremsner
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Joachim Schmutzhard
- Department of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, Austria
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14
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Url C, Schartinger VH, Riechelmann H, Glückert R, Maier H, Trumpp M, Widmann G. Radiological detection of extracapsular spread in head and neck squamous cell carcinoma (HNSCC) cervical metastases. Eur J Radiol 2013; 82:1783-7. [PMID: 23751931 DOI: 10.1016/j.ejrad.2013.04.024] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [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: 10/10/2012] [Revised: 03/11/2013] [Accepted: 04/01/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Extracapsular spread of cervical lymph nodes deteriorates the prognosis of patients with head and neck squamous cell carcinoma. Postoperative radiochemotherapy is superior to postoperative radiotherapy alone in patients with histologically proven extracapsular spread. If extracapsular spread can be detected preoperatively, patients may favor primary radiochemotherapy instead of primary surgery plus postoperative radiochemotherapy. METHODS Computed tomography (CT) scans of nodal positive head and neck squamous cell carcinoma patients treated between 2008 and 2010 with comprehensive neck dissection as part of first line surgical treatment were retrospectively scanned for extracapsular spread by two blinded radiologists. If a positive lymph node was identified by the pathologist, CT scans were assessed for extracapsular spread retrospectively. CT criteria for Extracapsular spread were apparent fat and soft tissue infiltration or infiltration of sternocleidomastoid muscle, internal jugular vein or carotid artery. Radiologic judgment was compared with histological evidence of extracapsular spread and specificity and sensitivity of CT detection was calculated. RESULTS Forty-nine patients with histologically proven positive lymph nodes (pN+) were included. Extracapsular spread was histologically proven in 17 cases; the number of all affected lymph nodes was not listed. Radiologist 1 found extracapsular spread in CT scans of 15/49 patients and radiologist 2 in 16/49 patients (Cohen's kappa=0.86; p<0.01). Sensitivity of radiologic extracapsular spread detection was 73% (95% confidential index (CI): 44.0-89.7%) and specificity 91% (75.0-98.0%). CONCLUSION Extracapsular spread depicted on computed tomography using strict criteria has high specificity.
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Affiliation(s)
- C Url
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University Innsbruck, Austria.
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15
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Schartinger VH, Dudás J, Decristoforo C, Url C, Schnabl J, Göbel G, Virgolini IJ, Riechelmann H, Rasse M, Waitz D, Putzer D. 68Ga-DOTA0-Tyr3-octreotide positron emission tomography in head and neck squamous cell carcinoma. Eur J Nucl Med Mol Imaging 2013; 40:1365-72. [DOI: 10.1007/s00259-013-2442-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 04/22/2013] [Indexed: 12/22/2022]
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