pinecone/core-2020-05-10-deduplication huggingface dataset:
Thyroglobulin measurement in fine-needleaspiration biopsy of metastatic lymph nodes after rhTSH stimulation.

BACKGROUND: \ud
\ud
Thyroglobulin measurement in the washout of the needle used in fine-needle aspiration cytology (FNAC) has been proposed for the early detection of lymph node metastasis both in patients with or without serum thyroglobulin antibodies; however, up to now, there have been no reports that recombinant human thyrotropin (rhTSH) stimulation modifies thyroglobulin measurement in lymph node aspirates.\ud
\ud
METHODS: \ud
\ud
We described, after rhTSH stimulation, the switching from undetectable to detectable levels of thyroglobulin in fine-needle aspiration fluid from a suspected metastatic lymph node in 2 patients.\ud
\ud
RESULTS: \ud
\ud
We hypothesized that thyroglobulin levels in the lymph node increased after rhTSH stimulation. The excess thyroglobulin saturates all thyroglobulin antibody binding sites and becomes detectable, explaining why it was undetectable when TSH was suppressed.\ud
\ud
CONCLUSION: \ud
\ud
On the basis of our experience, we suggest submitting to thyroglobulin measurement in the washout of the needle used in FNAC all patients with detectable serum thyroglobulin antibody after rhTSH stimulation
Infrahyoid flap reconstruction of oral cavity and oropharyngeal defects in elderly patients with severe general comorbidities.

In current practice, surgeons frequently deal with elderly patients who have severe medical comorbidities.We present our series of 18 consecutive patients with severe general comorbidities that received infrahyoid flap reconstruction. The results were compared with those of 16 consecutive patients in good general medical state receiving free radial forearm flap reconstruction during the same study period. We also describe an original method for tongue base reconstruction using the infrahyoid flap.No total flap necrosis was experienced; successful separation between oral cavity/oropharyngeal contents and neck spaces was obtained in all patients with a low rate of general complications. No significant differences were found with regard to verbal intelligibility and diet scores between groups.Infrahyoid flap in high-risk cases represents a valid alternative to free radial forearm flap. We introduced a novel technical innovation for tongue base reconstruction using the infrahyoid flap with very encouraging results. © 2011 Wiley Periodicals, Inc. Head Neck, 2012
Biomarkers in nasopharyngeal carcinoma

Nasopharyngeal carcinoma (NPC) is one of the most common malignancies in certain areas of Southern China, Southeastern Asia and Northern Africa. Currently, evaluation of NPC prognosis is mainly based on the tumor-node-metastasis (TNM) staging system. However, NPC patients with the same clinical stage often present different clinical courses, suggesting that the TNM staging is insufficient to predict prognosis of this disease. Therefore, it is important to find molecular biomarkers, which can help clinicians to identify NPC patients with worse prognosis and develop therapeutic interventions in NPC patients.



This thesis presents the identification and investigation of mechanism of several novel markers in NPC. In the first paper, Caveolin-1 (Cav-1), a major structural component of caveolae, and CD147 (also known as extracellular matrix metalloproteinase inducer, EMMPRIN), a glycoprotein, were found to be overexpressed in NPC. Both Cav-1 and CD147 expression levels correlated significantly with metastasis and poor prognosis of NPC patients. Further studies revealed that Cav-1 and CD147 enhance NPC cell migration, which is associated with MMP-3 and MMP-11 (active) secretion.



The role of microRNA-155 (miR-155) is associated with oncogenesis of several human tumors. In the second paper, miR-155 was found to be upregulated in NPC cell lines and clinical samples. EBV encoded LMP1 and LMP2A could further enhance the expression of miR-155 in NPC CNE1 and TW03 cells. JMJD1A was identified as a direct target of miR-155 in NPC. Downregulation of JMJD1A was significantly correlated with N stage of the TNM classification, a lower five-year survival rate, and a lower five-year disease-free survival rate of NPC patients.
Spleen tyrosine kinase (Syk) is a nonreceptor tyrosine kinase and often aberrantly expressed in human cancers. In the third paper, high expression of Syk was detected in 24% of NPC cases. High expression of Syk, resulted partly from LMP2A expression in NPC, is associated with tumor recurrence and poor prognosis of NPC patients.



Human chromosome 3 (Chr. 3) contains clusters of tumor suppressor genes (TSGs) involved in many cancer types. In the fourth paper, using Not I Chr. 3 microarray, ten candidate TSGs were found in NPC. Among them, the CpG island in the promoter region of Wingless-type Mouse mammary tumor virus integration site family, member 7A (WNT7a) and the intron 1 region of Integrin α9 (ITGA9) were confirmed to be hypermethylated in NPC by bisulfite sequencing and methylation specific PCR. Demethylating agent 5-aza-2′-deoxycytidine (5-aza-CdR) treatment could restore the expression of WNT7a and ITGA9 in NPC cell lines. Furthermore, WNT7a and ITGA9 were downregulated in NPC clinical samples. As both proteins execute significant functions related to the tumor cell biology, the potential of WNT7a and ITGA9 as diagnosis or therapeutic targets for NPC should be considered
Orosphere assay: A method for propagation of head and neck cancer stem cells

Background  Recent evidence suggests that head and neck squamous cell carcinomas (HNSCCs) harbor a small subpopulation of highly tumorigenic cells, designated cancer stem cells. A limiting factor in cancer stem cell research is the intrinsic difficulty of expanding cells in an undifferentiated state in vitro.    Methods  Here, we describe the development of the orosphere assay, a method for the study of putative head and neck cancer stem cells. An orosphere is defined as a nonadherent colony of cells sorted from primary HNSCCs or from HNSCC cell lines and cultured in 3‐dimensional soft agar or ultralow attachment plates. Aldehyde dehydrogenase activity and CD44 expression were used here as stem cell markers.    Results  This assay allowed for the propagation of head and neck cancer cells that retained stemness and self‐renewal.    Conclusion  The orosphere assay is well suited for studies designed to understand the pathobiology of head and neck cancer stem cells. © 2012 Wiley Periodicals, Inc. Head Neck, 201
Sinonasal mucosal melanoma: Molecular profile and therapeutic implications from a series of 32 cases

BACKGROUND:\ud
Primary sinonasal mucosal melanomas are aggressive tumors with a poor clinical control by current treatments, raising the urgent need of novel strategies.\ud
METHODS:\ud
By fluorescence in situ hybridization (FISH), direct sequencing, and immunohistochemistry, we investigate the spectrum of molecular abnormalities in a cohort of 32 cases of primary sinonasal mucosal melanomas.\ud
RESULTS:\ud
We found that all primary sinonasal mucosal melanomas lack BRAF V600E mutation; in addition, they are characterized by somatic mutations of NRAS (22%) and KIT (12.5%), together with amplification of RREB1 (100%) and loss of MYB (76%). The large majority of cases showed KIT protein expression (96.9%). Among tumor suppressor genes, primary sinonasal mucosal melanomas showed loss of PTEN (48.1%) and p16/INK4a (55.2%). All tested cases showed expression of pAkt and pErk, suggesting a combined activation of PI3K/Akt and RAS-mitogen-activated protein kinase (MAPK) pathways.\ud
CONCLUSIONS:\ud
This molecular fingerprint strongly argues against the clinical efficacy of BRAF-inhibitors, but could candidate primary sinonasal mucosal melanomas to therapeutic strategies targeting RAS and KIT mutations or inhibiting PI3K-Akt-mTOR pathway
Prevalence and predictive role of p16 and epidermal growth factor receptor in surgically treated oropharyngeal and oral cavity cancer

Background  The purpose of this study was to describe the relationship of p16 and epidermal growth factor receptor (EGFR) expression with survival in surgically treated patients who had oropharyngeal or oral cavity squamous cell carcinoma (SCC).    Methods  Tissue from 36 patients with oropharyngeal SCC and 49 patients with oral cavity SCC treated between 1997 and 2001 was imbedded and immunostained using a tissue microarray.    Results  The p16 was positive in 57% and 13% of patients with oropharyngeal SCC and oral cavity SCC, respectively. EGFR was positive in 60% and 63% of patients with oropharyngeal SCC and oral cavity SCC, respectively. In patients with oropharyngeal SCC, p16 expression was associated with improved disease‐specific survival (DSS), overall survival (OS), and time to recurrence (TTR) ( p  < .01, < .01, and <.01, respectively). EGFR expression was associated with poorer DSS, OS, and TTR ( p  < .01, = .01, and < .01, respectively). For oropharyngeal SCC, when examining both p16 and EGFR expression as combined biomarkers, high p16 expression coupled with low EGFR expression was associated with improved DSS ( p  p16 = .01;  p  EGFR = .01). Patients with oral cavity SCC showed no association between biomarker and outcome.    Conclusions  For patients with oropharyngeal SCC, high p16 and low EGFR were associated with improved outcome, suggesting a predictive role in surgically treated patients. © 2012 Wiley Periodicals, Inc. Head Neck, 201
Effect of erlotinib on epidermal growth factor receptor and downstream signaling in oral cavity squamous cell carcinoma

Background  The purpose of this study was to determine if there are differences in biomarker modulation and epidermal growth factor receptor (EGFR) degradation between the tumor and the normal mucosa after treatment with an EGFR inhibitor, erlotinib, in head and neck cancer.    Methods  Patients with primary oral cavity squamous cell cancers received a course of erlotinib, 150 mg every day for 7 days before surgical resection. Tumor and normal mucosa biopsies were obtained both pre‐erlotinib and post‐erlotinib. Changes in known markers of EGFR activity (phospho, AKT, STAT3) were measured by immunoblotting, whereas changes in tissue distribution were analyzed by immunohistochemical analysis.    Results  Twelve patients were enrolled; 7 had evaluable paired tumors and normal mucosa biopsies pretreatment and posttreatment. Expression of EGFR was higher in tumors compared to the normal mucosa ( p  = .005). Erlotinib administration was associated with marked inhibition of phosphorylated epidermal growth factor receptor (pEGFR) and reduction in total EGFR protein ( p  = .004,  p  = .007) in tumors, whereas there was heterogeneity in EGFR inhibition in the normal mucosa ( p  = .10 [pEGFR], and  p  = .07 [EGFR]). Reduced levels of pSrc and pSTAT3 and enhanced p27 levels were noted in tumors after erlotinib. Cell culture studies confirmed that EGFR is degraded in tumor cells after prolonged treatment with erlotinib.    Conclusion  Our results show that EGFR inhibition by erlotinib led to a marked reduction in EGFR protein levels in patients. Differential effects of erlotinib on tumors compared to the normal mucosa suggest there may be individual patient heterogeneity. These preliminary data suggest EGFR degradation should be further analyzed as a potential biomarker in selecting patients likely to benefit from EGFR inhibitors. © 2012 Wiley Periodicals, Inc. Head Neck, 201
Metastasis at a tracheostomy site as the presenting sign of late recurrent breast cancer.

Background. Metastasis in a tracheostomy site occurs\ud
rarely, usually from head and neck primary tumors. Breast\ud
cancer relapse to a tracheostomy has not been described to\ud
date.\ud
Methods and Results. A 71-year-old women presented with symptoms typical of central airway obstruction, 10 years after mastectomy for breast cancer. Fifteen months before admission, when cancer followup was negative, she also had surgery for cerebral aneurysm and a tracheostomy. On admission, CT showed a solid mass infiltrating the\ud
tracheostomy tract and projecting into the airway. Tracheal\ud
obstruction palliation was achieved by laser resection of the\ud
endotracheal growth and stenting. Histology documented breast cancer metastasis.\ud
Conclusions. Tracheostomy site metastasis was the presenting sign of late-onset relapse of breast cancer. This case supports the concept of surgery-driven interruption of micrometastatic cancer dormancy, in that the initial recurrence developed in a tracheostomy that was surgically created several years after resection of the primary tumor
American college of radiology appropriateness criteria ®  treatment of stage I T1 glottic cancer

Background  Controversy surrounds the appropriate therapy for T1 glottic cancer. Both transoral endolaryngeal resection and radiation offer excellent local control and voice quality; some lesions are best addressed with resection and others with radiation.    Methods  The American College of Radiology (ACR) Appropriateness Criteria are evidence‐based guidelines for specific clinical conditions that are reviewed by a multidisciplinary expert panel. The guideline development includes an analysis of current literature from peer reviewed journals and the well‐established “modified Delphi” consensus methodology to rate the appropriateness of treatment. Where evidence is not definitive, expert opinion informed recommendations.    Results  The ACR Expert Panel on Radiation Oncology – Head and Neck Cancer developed consensus recommendations for treatment of T1 glottic cancer. Treatment planning is complex and decisions nuanced.    Conclusion  Best treatment for a particular cancer cannot be defined without consideration of the lesion's location, extent, depth of invasion, and quality of surgical exposure during direct laryngoscopy. © 2013 American College of Radiology. Head & Neck © 2013 Wiley Periodicals, Inc.  Head Neck   36 : 3–8, 201
Patterns of nodal metastasis and prognosis in human papillomavirus–positive oropharyngeal squamous cell carcinoma

Background  The current American Joint Committee on Cancer (AJCC) staging system may not accurately reflect survival in patients with human papillomavirus (HPV)‐positive oropharyngeal squamous cell carcinoma (SCC). The purpose of this study was to develop a system that more precisely predicts survival.    Methods  CT scans from 156 patients who underwent chemoradiation for advanced‐stage oropharyngeal SCC with >2 years follow‐up were reviewed. We modeled patterns of nodal metastasis associated with different survival rates. We defined  HPV+ N1 as a single node <6 cm, ipsilaterally, contralaterally, or bilaterally.  HPV+ N2 was defined as a single node ≥6 cm or ≥2 nodes ipsilaterally/contralaterally or ≥3 nodes bilaterally.  HPV+ N3 was defined as matted nodes.    Results  There was no significant difference in disease‐specific survival (DSS;  p  = .14) or overall survival (OS;  p  = .16) by AJCC classification. In patients grouped by  HPV+ N1,  HPV+ N2, and  HPV+ N3 nodal classification, significant differences in DSS (100%, 92%, and 55%, respectively;  p  = .0001) and OS (100%, 96%, and 55%, respectively;  p  = .0001) were found.    Conclusion  A staging system with reclassification of size, bilaterality, and matted nodes more accurately reflects survival differences in this cohort of patients. Review of the AJCC staging system with these criteria should be considered for HPV‐positive oropharyngeal SCC. © 2014 Wiley Periodicals, Inc.  Head Neck  36: 1233–1240, 201
Impact of primary tumor volume on local control after definitive radiotherapy for head and neck cancer

Background  The impact of primary tumor volume (pTV) on local control after definitive radiotherapy (RT) for head and neck squamous cell carcinoma (HNSCC) is unclear.    Methods  Pertinent literature was reviewed to address the impact of pTV on local control after definitive RT for HNSCC.    Results  Reproducibility of pTV calculations is probably influenced by interobserver variability and may be reduced by relying on experienced observers. The impact of pTV on local control after definitive RT is probably influenced by primary site. A relatively limited impact of pTV on local control after RT for oropharyngeal squamous cell carcinomas (SCCs) might be attributable to human papillomavirus (HPV) positivity.    Conclusion  pTV may be a useful parameter to select patients for treatment with definitive RT, particularly for those with laryngeal SCCs. Patients with high‐volume primary cancers, in which the probability of local control with a functional larynx is low, are likely better treated with surgery. © 2013 Wiley Periodicals, Inc.  Head Neck  36: 1363–1367, 201
Characterization of changes in total body composition for patients with head and neck cancer undergoing chemoradiotherapy using dual‐energy x‐ray absorptiometry

Background  Patients with head and neck cancer experience significant weight loss secondary to concurrent chemoradiotherapy (CCRT). Using dual‐energy X‐ray absorptiometry (DEXA) scans, we characterize total body composition changes during and after CCRT in order to develop novel clinical care models that will improve the patient's quality of life (QOL).    Methods  Sixty DEXA scans were obtained from 12 patients undergoing CCRT for locally advanced squamous cell head and neck cancer. DEXAs were performed at baseline, during treatment, completion of CCRT, and then 1 and 2 months posttreatment.    Results  Mean weight loss by treatment end was 9.5 kg (10.2%;  p  = .0002). On average, lean body mass (LBM) decreased 10.2% ( p  = .001), and fat body mass (FBM) decreased 11.1% ( p  = .001) during CCRT. LBM began to normalize after completion of treatment, whereas FBM continued to decline.    Conclusion  Substantial loss of muscle and FBM occurs in patients undergoing CCRT for head and neck cancer. To prevent long‐term disability and QOL decline after curative CCRT, clinical care interventions incorporating aggressive nutrition/exercise counseling are needed. © 2013 Wiley Periodicals, Inc.  Head Neck  36: 1356–1362, 201
Head and neck squamous cell carcinoma of unknown primary: Neck dissection and radiotherapy or definitive radiotherapy

Background  Management of head and neck carcinoma from unknown primary (HNCUP) remains controversial, with neck dissection and radiotherapy (RT) or definitive RT both commonly used. The purpose of this study was to characterize HNCUP and retrospectively compare outcomes for patients treated with neck dissection + RT versus definitive RT.    Methods  From 1994 to 2009, 41 patients with HNCUP underwent either neck dissection + RT ( n  = 22) or definitive RT ± concurrent chemotherapy ( n  = 19) at our institution. Treatment outcomes were compared using Kaplan–Meier methods and log‐rank test.    Results  There were no differences between patients treated with neck dissection + RT and definitive RT in overall survival (OS), progression‐free survival (PFS), locoregional relapse‐free survival (LRFS), freedom from locoregional failure (FFLRG), or freedom from distant failure (FFDF). Among 17 patients who underwent neck dissection + RT for whom human papillomavirus (HPV) status could be determined, HPV(+) patients trended toward improved OS ( p  = .06) and PFS ( p  = .15).    Conclusion  Neck dissection and postoperative RT resulted in similar outcomes as definitive RT. The prognostic implications of HPV(+) nodes in HNCUP are similar to those in oropharyngeal primary cancers. © 2013 Wiley Periodicals, Inc.  Head Neck  36: 1589–1595, 201
Evaluation of shoulder disability questionnaires used for the assessment of shoulder disability after neck dissection for head and neck cancer

Background  Several questionnaires have been used to evaluate shoulder disability after neck dissection. The purpose of this study was to review these measures and highlight their strengths and weaknesses.    Methods  A literature review was performed to identify measures of shoulder disability after head and neck cancer surgery. These measures were evaluated in terms of their methods of development and assessment of their psychometric properties.    Results  Seven questionnaires were identified. Several of the other questionnaires have been well developed but have not had their psychometric properties assessed in the head and neck cancer population. Each questionnaire has its strengths and weaknesses.    Conclusion  The strengths and weaknesses of the shoulder disability questionnaires should be considered when deciding which questionnaire to use. Efforts should be focused on using well‐designed questionnaires that have been assessed in this patient population rather than developing or using other questionnaires. © 2013 Wiley Periodicals, Inc.  Head Neck , 36: 1453–1458, 201
Proton Therapy for Head and Neck Adenoid Cystic Carcinoma: Initial Clinical Outcomes

Background
The purpose of this study was to report outcomes of proton therapy in head and neck adenoid cystic carcinoma.

Methods
We conducted a retrospective analysis of 26 patients treated between 2004 and 2012. Twenty patients (77%) had base of skull involvement; 19 (73%) were treated for initial disease and 7 (27%) for recurrent disease. Twenty patients were treated postoperatively, 6 after biopsy alone and 24 had positive margins or gross residual disease. Median dose delivered was 72 Gy (relative biological effectiveness [RBE]).

Results
Median follow-up was 25 months (range, 7–50 months). The 2-year overall survival was 93% for initial disease course and 57% for recurrent disease (p = .19). The 2-year local control was 95% for initial disease and 86% for recurrent disease (p = .48). The 2-year distant metastatic rate was 25%. Late toxicity of grade 0 or 1 was seen in 17 patients, grade 2 in 5, grade 3 in 2, grade 4 in 1, and grade 5 in 1.

Conclusion
Initial outcomes of proton therapy are encouraging. Longer follow-up is required
Assessment of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire for use in patients after neck dissection for head and neck cancer

BackgroundIn this cross‐sectional study, the sensibility, test‐retest reliability, and validity of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire were assessed in patients who underwent neck dissection.MethodsSensibility was assessed with a questionnaire. Test‐retest reliability was performed with completion of the DASH questionnaire 2 weeks after initial completion; validity, by evaluating differences in scores between patients undergoing different types of neck dissections and correlating DASH scores with Neck Dissection Impairment Index (NDII) scores.ResultsThe DASH questionnaire met sensibility criteria. For test‐retest reliability analysis, the intraclass coefficient was 0.91. The DASH questionnaire showed differences between patients who underwent accessory nerve‐sacrifice and nerve‐sparing neck dissection. DASH questionnaire scores strongly correlated with NDII scores (r = ‐0.86).ConclusionAlthough this study provides preliminary data on some psychometric properties of the DASH questionnaire in patients who have undergone a neck dissection, further assessment of responsiveness and other properties are required. © 2014 Wiley Periodicals, Inc. Head Neck 37: 234‐242, 201