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Lymph-node Epstein-Barr virus concentration in diagnosing cervical lymph-node metastasis in nasopharyngeal carcinoma.

淋巴结 eb病毒浓度诊断鼻咽癌颈部淋巴结转移。

  • 影响因子:1.65
  • DOI:10.1007/s00405-020-05937-5
  • 作者列表:"Li H","Huang C","Chen Q","Peng C","Zhang R","Shen J","Chen M","Mai H","Zou R
  • 发表时间:2020-04-02
Abstract

PURPOSE:Cervical lymph-node (CLN) metastasis commonly occurs in patients with nasopharyngeal carcinoma (NPC) metastasis. The presence of Epstein-Barr virus (EBV) genomes in neck lymph nodes may diagnose CLN. This research was designed to appraise the diagnostic value of EBV concentration for cervical lymph nodes in NPC. METHODS:Two hundred and fifty-three NPC patients with 276 CLNs were enrolled. MRI was performed to detect CLN metastasis, and plasma EBV concentration was measured by quantitative PCR before treatment. Ultrasonography (US) and US-FNA were subsequently performed in the suspicious lymph nodes. Fifteen patients (22 lymph nodes) underwent fine-needle aspiration cytology (FNAC), and the remaining 242 patients (254 lymph nodes) underwent core needle biopsy (CNB) for CLNs at the clinician's demand. The aspiration needle was rinsed with 1 ml of normal saline for EBV detection. The method of lymph-node EBV measurement was consistent with that for plasma. The MRI results and EBV concentrations in plasma and lymph nodes were recorded and analyzed. Plasma EBV concentrations ≥ 4000 copies/ml were regarded as positive. RESULTS:CLN-EBV concentrations ≥ 787.5 copies/ml were regarded as positive according to receiver-operating characteristic curve analysis. The AUC of the EBV (0.925) concentration in CLN metastasis was significantly larger than the AUC of MRI (0.714) (P < 0.001). The sensitivity and specificity were 94.09% and 48.72% for MRI in lymph-node metastasis and 95.36% (P > 0.05) and 84.62% (P < 0.01) for EBV DNA in CLN metastasis, respectively. The sensitivity and specificity of EBV in plasma were 77.2% and 71.8%, respectively. The diagnostic specificity and AUC of EBV in CLNs were higher than those of MRI and plasma EBV (P < 0.005). CONCLUSIONS:Ultrasound-guided CLN FNA to obtain EBV concentrations may provide a new method to diagnose CLN metastasis with high sensitivity and specificity.

摘要

目的: 颈淋巴结 (CLN) 转移常见于鼻咽癌 (NPC) 转移患者。颈部淋巴结中存在 Epstein-Barr 病毒 (EBV) 基因组可能诊断 CLN。本研究旨在评价 EBV 浓度对鼻咽癌颈部淋巴结的诊断价值。 方法: 入选 276 例 CLNs 的 NPC 患者 2 53 例。治疗前行 MRI 检测 CLN 转移,定量 PCR 测定血浆 EBV 浓度。随后对可疑淋巴结进行超声检查 (US) 和 US-FNA 检查。15 例 (22 枚淋巴结) 行细针穿刺细胞学检查 (FNAC),其余 242 例 (254 枚淋巴结) 行粗针穿刺活检 (CNB) 根据临床医生的要求为 CLNs。用 1毫升 ml 生理盐水冲洗抽吸针进行 EBV 检测。淋巴结 EBV 测定方法与血浆方法一致。记录并分析 MRI 结果及血浆和淋巴结中 EBV 浓度。血浆 EBV 浓度 ≥ 4000 拷贝/ml 为阳性。 结果: 根据受试者工作特征曲线分析,CLN-EBV 浓度 ≥ 787.5 拷贝/ml 为阳性。CLN 转移灶中 EBV (0.925) 浓度的 AUC 明显大于 MRI 的 AUC (0.714) (p <0.001)。MRI 对淋巴结转移的敏感性和特异性分别为 94.09% 和 48.72%,EBV DNA 对 CLN 转移的敏感性和特异性分别为 95.36% (p> 0.05) 和 84.62% (p <0.01)。血浆中 EBV 的敏感性和特异性分别为 77.2% 和 71.8%。EBV 在 CLNs 中的诊断特异性和 AUC 均高于 MRI 和血浆 EBV (p <0.005)。 结论: 超声引导下 CLN-FNA 检测 EBV 浓度可作为诊断 CLN 转移的一种新方法,具有较高的敏感性和特异性。

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影响因子:2.65
发表时间:2020-01-29
来源期刊:BMJ open
DOI:10.1136/bmjopen-2019-031602
作者列表:["Wendland EM","Kops NL","Comerlato J","Horvath JDC","Bessel M","Sperb D","Pimenta C","de Souza FMA","Mendes Pereira GF","Falcetta FS"]

METHODS:INTRODUCTION:Human papillomavirus (HPV) is the most common sexually transmitted infection and is associated with several types of cancer. The number of cases of HPV-associated head and neck squamous cell carcinomas (HNSCCs), especially oropharyngeal carcinomas, has increased significantly in recent years despite decreased tobacco smoking rates. Currently, no data concerning the risk factors and prevalence of HPV in HNSCC patients in all regions of Brazil are available, making it difficult to promote advances in this field of public health. Therefore, our goal is to determine the impact of infection by HPV, including HPVs with different genotypes, on head and neck cancer and the risk factors associated with the development of head and neck cancer in all regions of Brazil. METHODS AND ANALYSIS:This is a case-control study that will include 622 patients and 622 controls from all regions of Brazil. A questionnaire will be applied to gather information on sociodemographic, behavioural and health factors. Oral, cervical or penile/scrotal, and anal specimens and serum samples will be collected from all participants. Formalin-fixed paraffin-embedded tissue from tumour biopsies will be analysed only in the case group. Molecular and serological analyses will be performed to evaluate the presence and role of HPV in the development of head and neck cancer. ETHICS AND DISSEMINATION:This project was approved by the research ethical committee of the proposing institution (Hospital Moinhos de Vento, number 2.852.060). Ethical approval from the collaborators is currently under evaluation and is not yet complete. The results of this study will be presented at meetings with the Brazilian Ministry of Health through technical reports and to the scientific community at national and international events, with subsequent publication of scientific articles.

翻译标题与摘要 下载文献
影响因子:2.60
发表时间:2020-01-21
来源期刊:Head &amp; neck
DOI:10.1002/hed.26063
作者列表:["Soldera EB","Ortigara GB","Bonzanini LIL","Schulz RE","Danesi CC","Antoniazzi RP","Linhares Ferrazzo K"]

METHODS:BACKGROUND:Factors related to head and neck cancer and the treatment of the disease can affect quality of life. The aim of this study was to determine factors associated with the severity of impact on oral health-related quality of life (OHRQoL) in survivors of head and neck cancer using a multivariate analysis. METHODS:This cross-sectional study evaluated 90 volunteers who had completed radiotherapy at least 3 months earlier. OHRQoL was assessed using oral health impact profile (OHIP-14) and the data were analyzed using robust variance poisson regression models. RESULTS:The mean total OHIP-14 score was 23.98 ± 12.55. Patients with hyposalivation had 56% higher (worse) mean OHIP-14 total scores (CI:1.11-2.18) and patients with advanced stage tumors had 31% higher mean OHIP-14 total scores (CI:1.03-1.66) in multivariate analyses. CONCLUSION:OHRQoL of survivors of head and neck cancer experienced a negative impact following radiotherapy. The impact was associated with hyposalivation and advanced stage tumors.

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影响因子:1.62
发表时间:2020-01-22
DOI:10.4317/medoral.23335
作者列表:["Ramos-Vega V","Venegas Rojas B","Donoso Torres W"]

METHODS:BACKGROUND:To immunohistochemically evaluate the association between the presence of cancer-associated fibroblasts (CAFs) and the tumour expression of podoplanin (PDPN) in head and neck squamous cell carcinoma (HNSCC) and their association with clinicopathological variables. MATERIAL AND METHODS:A tissue microarray (TMA) with biopsy sections from patients diagnosed with HNSCC was stained with antibodies against the CAFs marker, α-smooth muscle actin (α-SMA), and PDPN. We subsequently evaluated their expression to determine the association between them and with clinicopathological variables including age, primary tumour site, TNM stage, and tumour differentiation grade. RESULTS:Positive reaction to α-SMA was observed in the tumour stroma, revealing spindle-shaped cells compatible with CAFs, which showed a high expression in 62% of cases and a significant association with laryngeal carcinomas, advanced clinical stages, and lower tumour differentiation (P ≤ 0.05). PDPN staining on tumour cells showed low expression in 72% of cases, and it was not associated with any clinicopathological variable or with the presence of CAFs. CONCLUSIONS:The presence of CAFs in the tumour stroma is related to an aggressive phenotype and could increase as the disease progresses, although based on our findings, it would have no relationship, at least directly, with the expression of PDPN.

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