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Cai Z, Chen L, Chen S, Fang R, Chen X, Lei W. Single-cell RNA sequencing reveals pro-invasive cancer-associated fibroblasts in hypopharyngeal squamous cell carcinoma. Cell Commun Signal 2023; 21:292. [PMID: 37853464 PMCID: PMC10585865 DOI: 10.1186/s12964-023-01312-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/09/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Hypopharyngeal squamous cell carcinoma (HPSCC) has the worst prognosis among all head-and-neck cancers, and treatment options are limited. Tumor microenvironment (TME) analysis can help identify new therapeutic targets and combined treatment strategies. METHODS Six primary HPSCC tissues and two adjacent normal mucosae from six treatment-naïve patients with HPSCC were analyzed using scRNA-seq. Cell types were curated in detail, ecosystemic landscapes were mapped, and cell-cell interactions were inferred. Key results were validated with The Cancer Genome Atlas and cell biology experiments. RESULTS Malignant HPSCC epithelial cells showed significant intratumor heterogeneity. Different subtypes exhibited distinct histological features, biological behaviors, and spatial localization, all affecting treatment selection and prognosis. Extracellular matrix cancer-associated fibroblasts (mCAFs) expressing fibroblast activation protein were the dominant CAFs in HPSCC tumors. mCAFs, constituting an aggressive CAF subset, promoted tumor cell invasion, activated endothelial cells to trigger angiogenesis, and synergized with SPP1+ tumor associated macrophages to induce tumor progression, ultimately decreasing the overall survival of patients with HPSCC. Moreover, the LAMP3+ dendritic cell subset was identified in HPSCC and formed an immunosuppressive TME by recruiting Tregs and suppressing CD8+ T cell function. CONCLUSIONS mCAFs, acting as the communication center of the HPSCC TME, enhance the invasion ability of HPSCC cells, mobilizing surrounding cells to construct a tumor-favorable microenvironment. Inhibiting mCAF activation offers a new anti-HPSCC therapeutic strategy. Video Abstract.
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Affiliation(s)
- Zhimou Cai
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, Guangdong, 510080, P.R. China
| | - Lin Chen
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, Guangdong, 510080, P.R. China
| | - Siyu Chen
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, Guangdong, 510080, P.R. China
| | - Ruihua Fang
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, Guangdong, 510080, P.R. China
| | - Xiaolin Chen
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, Guangdong, 510080, P.R. China
| | - Wenbin Lei
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, Guangdong, 510080, P.R. China.
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Li Y, Gu W, Yue H, Lei G, Guo W, Wen Y, Tang H, Luo X, Tu W, Ye J, Hong R, Cai Q, Gu Q, Liu T, Miao B, Wang R, Ren J, Lei W. Real-time detection of laryngopharyngeal cancer using an artificial intelligence-assisted system with multimodal data. J Transl Med 2023; 21:698. [PMID: 37805551 PMCID: PMC10559609 DOI: 10.1186/s12967-023-04572-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/23/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Laryngopharyngeal cancer (LPC) includes laryngeal and hypopharyngeal cancer, whose early diagnosis can significantly improve the prognosis and quality of life of patients. Pathological biopsy of suspicious cancerous tissue under the guidance of laryngoscopy is the gold standard for diagnosing LPC. However, this subjective examination largely depends on the skills and experience of laryngologists, which increases the possibility of missed diagnoses and repeated unnecessary biopsies. We aimed to develop and validate a deep convolutional neural network-based Laryngopharyngeal Artificial Intelligence Diagnostic System (LPAIDS) for real-time automatically identifying LPC in both laryngoscopy white-light imaging (WLI) and narrow-band imaging (NBI) images to improve the diagnostic accuracy of LPC by reducing diagnostic variation among on-expert laryngologists. METHODS All 31,543 laryngoscopic images from 2382 patients were categorised into training, verification, and test sets to develop, validate, and internal test LPAIDS. Another 25,063 images from five other hospitals were used as external tests. Overall, 551 videos were used to evaluate the real-time performance of the system, and 200 randomly selected videos were used to compare the diagnostic performance of the LPAIDS with that of laryngologists. Two deep-learning models using either WLI (model W) or NBI (model N) images were constructed to compare with LPAIDS. RESULTS LPAIDS had a higher diagnostic performance than models W and N, with accuracies of 0·956 and 0·949 in the internal image and video tests, respectively. The robustness and stability of LPAIDS were validated in external sets with the area under the receiver operating characteristic curve values of 0·965-0·987. In the laryngologist-machine competition, LPAIDS achieved an accuracy of 0·940, which was comparable to expert laryngologists and outperformed other laryngologists with varying qualifications. CONCLUSIONS LPAIDS provided high accuracy and stability in detecting LPC in real-time, which showed great potential for using LPAIDS to improve the diagnostic accuracy of LPC by reducing diagnostic variation among on-expert laryngologists.
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Affiliation(s)
- Yun Li
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Wenxin Gu
- School of Computer Science and Engineering, Guangdong Province Key Lab of Computational Science, Sun Yat-Sen University, Guangzhou, 510006, Guangdong, China
| | - Huijun Yue
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Guoqing Lei
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Wenbin Guo
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Yihui Wen
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Haocheng Tang
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Luo
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wenjuan Tu
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jin Ye
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ruomei Hong
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Qian Cai
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Qingyu Gu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Tianrun Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Beiping Miao
- Department of Otolaryngology-Head and Neck Surgery, Shenzhen Secondary Hospital and First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Ruxin Wang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jiangtao Ren
- School of Computer Science and Engineering, Guangdong Province Key Lab of Computational Science, Sun Yat-Sen University, Guangzhou, 510006, Guangdong, China.
| | - Wenbin Lei
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
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Wang B, Lin Y, Yue HJ, Guo WB, Chen L, Lyu KX, Huang DY, Lei WB. [Comparison of pingyangmycin fibrin glue composite and pingyangmycin dexamethasone composite in the treatment of pharyngolaryngeal venous malformation]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:552-557. [PMID: 37339894 DOI: 10.3760/cma.j.cn115330-20221026-00631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Objective: To analyze and compare the efficacy and safety of pingyangmycin fibrin glue composite (PFG) and pingyangmycin dexamethasone composite (PD) in the treatment of pharyngolaryngeal venous malformation (VM). Methods: The clinical data of 98 patients with pharyngolaryngeal VM who underwent sclerotherapy with pingyangmycin composite in the First Affiliated Hospital of Sun Yat-sen University from June 2013 to November 2022 were retrospectively analyzed. According to their treatment, patients were divided into PFG group (n=34) and PD group (n=64), among those patients there were 54 males and 44 females, aged 1-77(37.06±18.86)years. The lesion size, total treatment times and adverse events were recorded before and after treatment. And the efficacy was divided into three grades: recovery, effective and invalid. According to the length of VM, all patients were divided into three subgroups, to compare the differences in efficacy and treatment times between each two groups.And finally the adverse events and their treatments were analyzed. SPSS 25.0 software was used for statistical analysis. Results: The efficacy of PFG group was 94.11%(32/34), the recovery rate was 85.29%(29/34).And the efficacy of PD group was 93.75%(60/64), the recovery rate was 64.06%(41/64). No serious adverse eventst occurred in subgroup comparison, there was no statistical difference between the two groups in efficacy and the times of treatments when the length was≤3 cm (Zefficacy=1.04, ttreatment times=2.18, P>0.05); when the length was 3-5 cm, there was no significant efficacy difference between the two groups(Zefficacy=1.17, P>0.05), but the treatment times of PFG were less (ttreatment times=4.87, P<0.01); when the length≥5 cm, efficacy of PFG was significantly better than PD (Zefficacy=2.94, P<0.01), and had fewer treatments times (ttreatment times=2.16, P<0.01). There were no serious adverse events in either group during treatment and follow-up. Conclusion: Both PFG and PD are safe and effective composite sclerotherapy agent for the treatment of laryngeal VM, but PFG has a higher cure rate and fewer treatment times for massive lesions.
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Affiliation(s)
- B Wang
- Otorhinolaryngology Hospital, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou 510080, China
| | - Y Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, the Second Affiliated Hospital of the Medical College of Shantou University,Shantou 515041, China
| | - H J Yue
- Otorhinolaryngology Hospital, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou 510080, China
| | - W B Guo
- Otorhinolaryngology Hospital, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou 510080, China
| | - L Chen
- Otorhinolaryngology Hospital, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou 510080, China
| | - K X Lyu
- Otorhinolaryngology Hospital, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou 510080, China
| | - D Y Huang
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - W B Lei
- Otorhinolaryngology Hospital, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou 510080, China
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Cai Z, Yue H, Chen L, Xv Y, Li Y, Tang B, Lin Y, Lei W. Salvage transoral laser microsurgery for early local recurrence of glottic squamous cell cancer. J Otolaryngol Head Neck Surg 2023; 52:40. [PMID: 37248502 DOI: 10.1186/s40463-023-00628-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/23/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND For recurrent laryngeal cancer, the feasibility of salvage transoral laser microsurgery (TLM) remains controversial. This study compared the efficacy of TLM and open partial laryngectomy (OPL) for treatment of early local recurrence of glottic squamous cell cancer (GSCC) and confirm the effectiveness of salvage TLM as a treatment option. METHODS This retrospective study involved 55 patients with early local recurrent GSCC treated with TLM, and the oncologic outcomes, functional outcomes, hospitalization time and complications were compared with a group of 40 recurrent GSCC patients matched for clinical variables of TLM group, treated by OPL by the same team of surgeons. RESULTS The 5-year overall survival and disease-specific survival rates were 65.8% and 91.5%, respectively, for 55 patients with rTis-rT2 stage treated by TLM and 77.1% and 94.7%, respectively, for 40 patients with rTis-rT2 stage treated by OPL (OPL group). In the TLM and OPL groups, the local control rates after 5 years were 77.5% and 79.3%, respectively, and the laryngeal preservation rates were 94.4% and 83.6%, respectively (p > 0.05). Compared with the OPL group, the complication rate (1.82%) and hospitalization duration (5.42 ± 2.26 days) were significantly lower in the TLM group (p < 0.05). Compared with the OPL group, postsurgical health-related quality of life and quality of voice were significantly better in the TLM group (p < 0.001). CONCLUSION Salvage TLM can be used as an effective treatment option for suitable patients after a full, comprehensive, and careful assessment of the characteristics of early locally recurrent glottic carcinoma.
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Affiliation(s)
- Zhimou Cai
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Huijun Yue
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Lin Chen
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Yang Xv
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Yun Li
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Bingjie Tang
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Yu Lin
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Wenbin Lei
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China.
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