Microneedling radiofrequency enhances poly-L-lactic acid penetration that effectively improves facial skin laxity without lipolysis.

BACKGROUND: Microneedle fractional radiofrequency (MFR) is commonly used for skin laxity treatment, and poly-L-lactic acid (PLLA) can stimulate collagen synthesis in the body. However, the synergy of their combination for skin rejuvenation has not been proven. We aimed to evaluate the combined efficacy of PLLA and MRF and the potential mechanism underlying skin laxity. METHODS: This prospective, randomized study included C57BL/6 mice treated with MFR, MFR+PLLA, and CO2 laser+PLLA and 32 patients who underwent split-face treatments with MFR or MFR+PLLA twice every 2 months. The global aesthetic improvement scale, Facial Laxity Rating scale of the whole face, ECCA grading scale of acne scars, and VISIA parameters on both treated sides were evaluated. Dermatological changes were measured by ultrasonography in the submental space, and adverse events were documented. RESULTS: PLLA was delivered by channels produced by MFR but not CO2 laser in the mice model. Thirty patients were treated with split-face MFRF+PLLA or MFRF, revealing an improvement in VISIA wrinkle percentile (0.020) compared with the age-matched controls (0.000). The thickness of the dermis increased, while the fat layer did not change significantly. No adverse effects were observed. CONCLUSIONS: PLLA can be delivered via microchannels produced by MFR. PLLA enhances the efficacy of MFR for skin laxity without lipolysis.

Effectiveness and safety of nonablative fractional laser and infrared bipolar radiofrequency for treating periorbital wrinkles.

Non-ablative fractional laser (NAFL) and radiofrequency (RF) are popular for treating periorbital wrinkles owing to short downtime and low risk of side effects. To compare the effectiveness and safety of infrared bipolar radiofrequency (IR-RF) and NAFL, including 1540 nm Er: glass and 1927 nm thulium-doped laser, to determine the better option for clinical treatment of periorbital wrinkles. Twenty-seven patients assigned to 3 groups underwent split-face treatment. Two of the three treatments were randomly selected for patients in each group: IR-RF, 1540 nm Er: glass NAFL, and 1927 nm thulium-doped NAFL. Therapeutic outcomes were subjectively and objectively evaluated six months after the last treatment. Side effects and pain evaluations were conducted. Fitzpatrick wrinkle scores revealed no statistical difference for IR-RF, whereas the NAFL-treated sides exhibited significant improvements (p < .05). VISIA analysis of skin texture showed similar results. In IR-RF-treated sides, patients over 50 years old exhibited significant improvements compared with those below 50 (p < .05). The sample size was small. More objective evaluations like photometer measurements are required. NAFL is effective and safe for improving periorbital wrinkles, but IR-RF might be more suitable for elderly patients, particularly those with low pain tolerance.

Comparison of the safety and efficacy of low fluence Q-switched 1064-nm and conventional Q-Switched 755-nm lasers in the treatment of café-au-lait macules: A prospective self-controlled trial.

BACKGROUND: Conventional high fluence Q-switched (HFQS) Alexandrite 755-nm are widely used in clinical café-au-lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q-switched (LFQS) Nd: YAG 1064-nm lasers. OBJECTIVE: To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs. METHODS: Within 3 months, 20 patients underwent prospective self-controlled split-lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow-up visit. Patient and physician preferences for laser selection were also recorded. RESULTS: The average VAS scores of areas treated with HFQS and LFQS were 2.92 ± 0.86 and 2.93 ± 1.13, respectively (p > 0.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82-2.37, p < 0.001). 11 lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67 ≤ VAS ≤ 4). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment. CONCLUSIONS: The efficacy difference between the LFQS 1064-nm laser and HFQS 755-nm laser in treating CALMs in a 3-month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation. The LFQS had obvious lesion clearance after the fourth treatment.

Can Microneedle Fractional Radiofrequency System Treatment Impair the Skin Barrier Function in Chinese Patients? A Prospective Clinical Trial.

INTRODUCTION: Facial cosmetic conditions can manifest as post-inflammatory erythema, scars, pigmentation, enlarged pores, skin laxity, and photoaging. The microneedle fractional radiofrequency system (MFRS) is a new device that combines radiofrequency and microneedles and has been widely used for skin rejuvenation. Since MFRS is an invasive technique, this study aimed to evaluate whether the skin barrier functions might be impaired by this treatment, revealed by skin sensitivity and exacerbation of melasma. METHODS: Twenty patients with Fitzpatrick grades III-IV facial conditions (skin laxity with melasma, n = 9; post-inflammatory erythema and scars, n = 5; and enlarged pores, n = 6) and treated with MFRS were enrolled. Transepidermal water loss (TEWL, using Ultrascan UC22), skin sensitivity (ten-item Sensitive Scale, SS-10), melanin index (MI), melasma area and severity index (MASI), red areas (VISIA), and thickness and density of the epidermis and dermis on ultrasonography were compared between baseline and 6 months after all treatment sessions. RESULTS: Twenty patients completed a 6-month follow-up after two MFRS treatments. During days 1-3 post-treatment, the TEWL values gradually increased to the peak and decreased to baseline levels (BD) on day 7. There was no significant difference in TEWL compared with baseline in month (M) 1, M3, and M6. There were no significant changes in the thickness and density of the epidermis. Although the thickness and density of the dermis increased, there was no significant difference compared to baseline. There was no significant difference in the MI, MASI, and SS-10 score before and after MFRS treatment. After treatment with MFRS, the red area and scarring reduced significantly (p < .01), and no significant difference was observed in other patients. CONCLUSIONS: MFRS is a safe and effective treatment for facial cosmetic conditions. The skin barrier function is not impaired by MFRS treatment, since it does not cause skin sensitivity or melasma exacerbation.

A Prospective Trial of the Microneedle Fractional Radiofrequency System Application in the Treatment of Infraorbital Dark Circles.

Background: Infraorbital dark circles (IDC) are commonly consulted in aesthetic practice. There is not yet a multifactorial approach to facilitating their treatment. Objective: To investigate the safety and efficacy of the microneedle fractional radiofrequency (MRF) system for the treatment of IDC. Methods: A prospective, split-face, evaluator-blind clinical trial was conducted to study the change in the overall appearance, color, and wrinkles in 21 female patients with mixed type IDC before and after MFR treatment. Results: Both patients and independent evaluators found significant improvement on the global aesthetic scales after the MFR treatment, especially on periorbital wrinkles (p=0.031). Trends in decreased melanin density in the IDC area were found, but no statistical differences were established. No side effects were observed. Conclusion: MFR is a safe and effective modality for improving mixed type IDC by correcting the structural factors.

Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients.

INTRODUCTION: Post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH. METHODS: This retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4-6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections. RESULTS: On the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement (p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction (p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up. CONCLUSION: IPL is an effective and safe treatment for acne-related PIE and PIH.

Prospective trial of microneedle fractional radiofrequency in the hand rejuvenation treatment.

AIM: This study aimed to evaluate the safety and efficacy of a novel therapeutic strategy, a microneedle fractional radiofrequency system, for hand rejuvenation. MATERIAL AND METHOD: Sixteen subjects were enrolled in a self-controlled evaluator-blind prospective trial. All subjects received three microneedle fractional radiofrequency treatments at 4 weeks intervals. Hand volume was evaluated through subjective (Hand Volume Rating Scale) and quantitative measurements. Patients were also assessed on the Global Aesthetic Improvement Scale using digital photographs. Patients were followed up at 1, 3, and 6 months after the last radiofrequency treatment. RESULTS: Statistically significant improvements on the Global Aesthetic Improvement Scale and Hand Rating Volume Scale were noted (p < 0.05). Compared with the control side, the treated hand showed a 44% improvement in dorsal skin surface roughness (p < 0.05). Quantitative measurements of hand volume showed a trend toward increased volume for the treated hand, but the difference was not statistically significant. CONCLUSION: We conclude that microneedle fractional radiofrequency is a safe therapeutic option for hand rejuvenation.

Targeting delivery and minimizing epidermal diffusion of tranexamic acid by hyaluronic acid-coated liposome nanogels for topical hyperpigmentation treatment.

Hyperpigmentation is a common complaint and distressing problem in dermatology, and tranexamic acid (TA) is an effective treatment agent but limited by the delivery to melanocytes in the epidermis. Herein, a novel TA naogels (named HA/TA-LP), combining the advantages of liposomes and hyaluronic acid (HA), are prepared and assessed for topical hyperpigmentation treatment with targeting delivery and minimizing epidermal diffusion. Morphological characteristics indicate numerous TA-loaded liposomes packed in HA gels. In vitro cell studies using human A375 melanoma cells show that HA/TA-LP can promote the uptake of TA by targeting delivery with resulting inhibition of tyrosinase activity and melanin production. Guinea pigs are used to construct hyperpigmentation models and investigate the topical delivery and treatment efficacy of HA/TA-LP. In vivo topical delivery studies indicate HA/TA-LP realize the effective delivery into melanocytes with an ideal balance of effective permeability and minimizing epidermal diffusion. Subsequently, hyperpigmentation treatment assessments reveal that HA/TA-LP inhibit tyrosinase activity and melanin production under the radiation of UVB. Our study identifies favorable properties of HA/TA-LP for treating hyperpigmentation, and provides an experimental basis for further clinical application.

Effect of New Frying Technology on Starchy Food Quality.

Frying is commonly used by consumers, restaurants, and industries around the globe to cook and process foods. Compared to other food processing methods, frying has several potential advantages, including reduced processing times and the creation of foods with desirable sensory attributes. Frying is often used to prepare starchy foods. After ingestion, the starch and fat in these foods are hydrolyzed by enzymes in the human digestive tract, thereby providing an important source of energy (glucose and fatty acids) for the human body. Conversely, overconsumption of fried starchy foods can promote overweight, obesity, and other chronic diseases. Moreover, frying can generate toxic reaction products that can damage people's health. Consequently, there is interest in developing alternative frying technologies that reduce the levels of nutritionally undesirable components in fried foods, such as vacuum, microwave, air, and radiant frying methods. In this review, we focus on the principles and applications of these innovative frying technologies, and highlight their potential advantages and shortcomings. Further development of these technologies should lead to the creation of healthier fried foods that can help combat the rise in diet-related chronic diseases.

A split-face randomized controlled trial of treatment with broadband light for enlarged facial pores.

BACKGROUND: Broadband light (BBL) is one of the intense pulsed light. BBL treatment for nonablative, noninvasive skin tightening and rejuvenation reportedly elicits satisfactory clinical outcomes. Up until now, self-controlled case series with objective evaluation of efficacy of facial pores in response to BBL treatment have not been reported. We aimed to assess its safety and efficacy on enlarged facial pores by objective measuring technique. OBJECTIVE: To evaluate the efficacy and safety of BBL on the appearance of facial pores. METHODS: 25 patients received five treatments with BBL at 2-week intervals. One split-face was treated by BBL, another split-face was untreated as a control. Objective measurements of the quantitative number of pores were calculated with a VISIA-CR imaging system. Skin elasticity, transepidermal water loss, skin sebum excretion, and skin surface hydration values were also evaluated by using an Elastimeter, Vapometer, Sebumscale, and Moisturemeter. RESULTS: Pretreatment, the total average number of facial pores was 835.88 and 835.68 for BBL-treated facial sides and untreated facial sides, respectively (p = .993). These values were 801.44 and 811.8, respectively, 2 months after the final treatment (p = .606). There were no long-term side effects. CONCLUSION: BBL seems to be a safe and mildly effective approach to reduce detectable pores.

Comparative Effectiveness of 755-nm Picosecond Laser, 755- and 532-nm Nanosecond Lasers for Treatment of Café-au-Lait Macules (CALMs): A Randomized, Split-Lesion Clinical Trial.

BACKGROUND AND OBJECTIVES: Many types of lasers have been used to treat café-au-lait macules (CALMs) since the introduction of the selective photothermolysis theory. However, the efficacy and safety of picosecond lasers, compared with those of nanosecond lasers, have not been researched. To compare the efficacy and safety of 755 nm picosecond laser (PS-755 nm), Q-switched (QS) Alexandrite 755 nm nanosecond laser (QS-755 nm), and QS Nd:YAG 532 nm nanosecond laser (QS-532 nm) for treating CALMs. STUDY DESIGN/MATERIALS AND METHODS: Forty-one patients received several treatments at 3-month intervals. Lesions were divided into two or three approximately equal parts, which were randomly treated with PS-755 nm, QS-755 nm, and QS-532 nm. The safety and efficacy of three lasers were determined based on blinded visual assessments and self-reports of patients three months after the comparative trial. RESULTS: Visual assessment 3 months after the comparative trial revealed that there was no statistically significant difference among the sites treated by QS-755 nm (2.84 ± 1.11), QS-532 nm (2.63 ± 1.06), and PS-755 nm (2.74 ± 1.05) lasers. Five (26.32%) of 19 patients showed lesion recurrence. Adverse effects included acneiform miliaris, hypopigmentation, and hyperpigmentation, which were resolved within 12 months. Five (26.32%) of 19 patients who showed lesion recurrence 1-5 months after laser treatment had lightened or cleared at least 50% of the lesion. 46.67% of patients were satisfied or very satisfied with the outcome of the overall treatment. CONCLUSIONS: PS-755 nm, QS-755 nm, and QS-532 nm laser treatments were equally effective in treating and improving CALMs. PS-755 nm caused fewer adverse effects. Individuals can react differently to different types of lasers. Patch tests should be conducted before the treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Erratum to "Therapeutic Effectiveness and Safety of Mesotherapy in Patients with Osteoarthritis of the Knee".

[This corrects the article DOI: 10.1155/2018/6513049.].

Therapeutic Effectiveness and Safety of Mesotherapy in Patients with Osteoarthritis of the Knee.

OBJECTIVE: To evaluate the therapeutic effectiveness and safety of mesotherapy by comparing it with the classic systematic therapy in patients with osteoarthritis (OA). METHODS: Sixty patients were included and classified into two groups based on the existence of contraindications for nonsteroidal anti-inflammatory drugs (NSAIDs). These patients were treated with oral NSAIDs (Group A) or mesotherapy (Group B). After completing the treatment, the patients were followed up for 6 months. Their clinical features, laboratory results, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. RESULTS: A total of 50 patients completed treatment and follow-up. The patients in Group B had significantly fewer gastric acid-related complaints and requested less supplementary treatment for recurrent pain (p < 0.05). The patients in both groups exhibited decreased blood viscosity after treatment (p < 0.05). WOMAC scores, specifically those for pain and stiffness, were found to be significantly improved after either type of treatment (p < 0.05). Mesotherapy also ameliorated physical function (p < 0.05). Furthermore, Group B presented with better outcomes than Group A (p < 0.05 or p < 0.01). CONCLUSION: Our results suggest that mesotherapy is an effective and safe treatment for patients with OA. Clinicians should consider mesotherapy as an alternative therapy for patients with contraindications for NSAID use.

L161982 alleviates collagen-induced arthritis in mice by increasing Treg cells and down-regulating Interleukin-17 and monocyte-chemoattractant protein-1 levels.

BACKGROUND: To investigate the effects and potential mechanism of L161982 (a kind of EP4 antagonist) on the collagen-induced arthritis (CIA) mice model. METHODS: The CIA mice model were first established by immunizing with Chicken Type II Collagen on DBA/1 mice. The CIA groups were administered once a day for 2 weeks with either 5 mg/kg L161982 by intraperitoneal injections (IP), 200 U celecoxib by intragastrical injections, or 100 µl PBS (IP). At the end of the study, total arthritis score and histopathologic examination were assessed to determine CIA severity. The plasma and tissue expressions of IL-17 and monocyte chemoattractant protein-1 (MCP-1) were detected by enzyme-linked immunosorbent assay (ELISA) and Immunohistochemical staining (IHC) respectively; The number of CD4+CD25+Foxp3+ regulatory T cells (Treg) determined as a proportion of total CD4+ cells in the lymph nodes and spleen. We also tested the proliferation of isolated Tregs and the ratio of Th17 polarization of Naïve T cells under the treatment of L161982 by BrdU assay and flow cytometry respectively. RESULTS: CIA mice treated with L161982 showed reduced arthritis scores, joint swellings, cracked cartilage surface, and less hyperplasia in the connective tissue of the articular cavity. Plasma and tissue IL-17 and MCP-1 decreased, while the proportion of Treg cells is increased both in the spleen and lymph nodes of CIA mice. Otherwise, L161982 have no direct effect on Tregs proliferation; a decreased tendency of Th17 polarization in vitro were observed in L161982-treated naïve T cells. CONCLUSION: Although less effective than Celecoxib, L161982 also resulted in a reduction of ankle joint inflammation in CIA mice. L161982 reduces the RA severity in CIA mice through inhibition of IL-17 and MCP-1, increasing Treg cells, and reducing inflammation. The mechanism of the reduction of IL-17 in plasma or tissue after administration of L161982 might be potentially derived from the suppression of CD4+ T cells differentiation into Th-17 cells.

Tumor-Specific D-Dimer Concentration Ranges and Influencing Factors: A Cross-Sectional Study.

D-dimer level in cancer patients is associated with risk of venous thromboembolism and deep venous thrombosis. Most cancer patients have "abnormal" D-dimer levels based on the current normal reference range. To investigate tumor-specific D-dimer reference range, we compared D-dimer levels for nine different tumour types with healthy controls by using simultaneous quantile regression and constructing a median, 5th percentile, and 95th percentile model of normal tumour D-dimer concentration. Associations with tumour primary site, stage, pathological type, and treatment were also explored. Additionally, 190 patients were tracked to reveal the relevance of initial D-dimer levels to cancer prognosis. D-dimer ranges (median, 5th, 95th) in various cancers (mg/L) were: liver 1.12, 0.27, 5.25; pancreatic 0.96, 0.23, 4.81; breast 0.44, 0.2, 2.17; gastric 0.65, 0.22, 5.03; colorectal 0.73, 0.22, 4.45; lung 0.7, 0.25, 4.0; gynaecological 0.61, 0.22, 3.98; oesophageal 0.23, 0.7, 3.45; and head and neck 0.22, 0.44, 2.19. All were significantly higher than that of healthy controls (0.18, 0.07, 0.57). D-dimer peaked 1-2 days postoperatively but had decreased to the normal range by 1 week. Additionally, cancer patients with high initial D-dimer were shown a tendency of poor prognosis in survival rate. In conclusion, D-dimer levels in cancer depend on patient age, tumour primary site, and tumour stage. Thrombosis prevention is necessary if D-dimer has not decreased to the tumor-specific baseline a week after surgery.

The Protective effect of the endoplasmic reticulum stress-related factors BiP/GRP78 and CHOP/Gadd153 on noise-induced hearing loss in guinea pigs.

CONTEXT: The audiological features and cochlear morphology of individuals with noise-induced hearing loss (NIHL) are well characterized. However, the molecular processes in the cochlea are not well understood. AIMS: To explore the role of the endoplasmic reticulum stress (ERS) response in the guinea pig model of cochlear damage induced by exposure to intense noise. SETTINGS AND DESIGN: A pilot case-control study. SUBJECTS AND METHODS: Forty-eight guinea pigs were divided into four equal groups. At 1, 4, or 14 days (d) post-exposure, the auditory brainstem responses (ABRs) were tested before sacrificing the subjects. The expression levels of the binding immunoglobulin protein/glucose-regulated protein 78 (BiP/GRP78) and C/EBP-homologous protein/growth arrest and DNA damage-inducible gene 153 (CHOP/Gadd153) proteins were evaluated using immunohistochemistry and Western blotting. The number of cochlear hair cells with altered nuclei was counted using confocal fluorescence microscopy. STATISTICAL ANALYSIS USED: One-way analysis of variance (ANOVA) and the least squares difference (LSD) test. RESULTS: The outer hair cells (OHCs) showed changes of apoptosis, necrosis, and loss after noise exposure. In the 1- and 4-d groups, more apoptotic cells were found than necrotic cells (P < 0.01). The level of BiP/GRP78 was significantly higher in all three experimental groups compared to the control group (P < 0.01). The level of CHOP/Gadd153 was increased at 1 d post-exposure, achieving a peak that was maintained until 4 d, after which it returned to baseline levels by 14 d post-exposure. CONCLUSIONS: ERS response was activated by inducing the expression of BiP/GRP78 to lessen the extent of the resulting cellular damage and activating the CHOP/Gadd153 pathway to eliminate the most severely damaged cells.

New Sesquiterpenenoids from Ainsliaea yunnanensis.

Investigation of the ethanol extract of the whole plant of Ainsliaea yunnanensis led to the isolation of four new dimeric sesquiterpene lactones, ainsliadimer F-I (1-4), together with seven known dimeric sesquiterpene lactones (5-11) and ten sesquiterpenes (12-21). Their structures were elucidated by spectroscopic methods. The relative stereochemistry of ainsliadimer F was further confirmed by single crystal X-ray diffraction analysis. Compounds 1-21 were tested for the inhibition of nuclear factor kappa B (NF-κB) in the 293-NF-κB-luciferase reporter cell line induced by lipopolysaccharide (LPS), and Compounds 5, 18, 20 and 21 were further tested for the production of TNF-α, IL-1ß, IL-6 and IL-10 in RAW 264.7 macrophages induced by LPS. Compounds 5, 18, 20 and 21 exhibited significant activity in anti-inflammatory activity assays.

A rare case of extremely high counts of circulating tumor cells detected in a patient with an oral squamous cell carcinoma.

BACKGROUND: Despite aggressive regimens, the clinical outcome of head and neck squamous cell carcinoma remains poor. The detection of circulating tumor cells could potentially improve the management of patients with disseminated cancer, including diagnosis, treatment strategies, and surveillance. Currently, CellSearch(®) is the most widely used and the only Food and Drug Administration-cleared system for circulating tumor cells detection in patients with metastatic breast, colorectal, or prostate cancer. In most cases of head and neck squamous cell carcinoma, only low counts of circulating tumor cells have been reported. CASE PRESENTATION: A 56-year-old white male with no particular medical history, was diagnosed with a squamous cell carcinoma of oral cavity. According to the imaging results (computed tomography and (18)F-fluorodeoxyglucose positron emission tomography / computed tomography) and panendoscopy, the TNM staging was classified as T4N2M0. A non-interruptive pelvimandibulectomy was conducted according to the multidisciplinary meeting advices and the postoperative observations were normal. The patient complained of a painful cervical edema and a trismus 6 weeks after the surgery. A relapse was found by computed tomography and the patient died two weeks later. The search for circulating tumor cells in peripheral venous blood by using the CellSearch(®) system revealed a very high count compared with published reports at three time points (pre-operative: 400; intra-operative: 150 and post-operative day 7: 1400 circulating tumor cells). Of note, all detected circulating tumor cells were epidermal growth factor receptor negative. CONCLUSION: We report here for the first time a rare case of oral squamous cell carcinoma with extremely high circulating tumor cells counts using the CellSearch(®) system. The absolute number of circulating tumor cells might predict a particular phase of cancer development as well as a poor survival, potentially contributing to a personalized healthcare.

Diagnostic and Prognostic Value of Circulating Tumor Cells in Head and Neck Squamous Cell Carcinoma: a systematic review and meta-analysis.

Several techniques have been developed to detect circulating tumor cells (CTC) in patients with head and neck squamous cell carcinoma (HNSCC), but their diagnostic and prognostic value are not yet fully established. A computerized retrieval of literatures was conducted without time restrictions using the electronic database in December 2014. Diagnostic accuracy variables were pooled and analyzed by the Meta-DiSc software. Engauge Digitizer and Stata software were used for pooled survival analysis. Twenty-two retrieved studies were eligible for systematic review, of which 9 conformed for the diagnostic test meta-analysis and 5 for the prognostic analysis. Subgroup analysis showed 24.6% pooled sensitivity and 100% pooled specificity of detections by using positive selection strategy, which moreover presented low heterogeneity. The presence of CTC was significantly associated with shorter disease free survival (DFS, HR 4.62, 95% CI 2.51-8.52). In conclusion, current evidence identifies the CTC detection assay as an extremely specific, but low sensitive test in HNSCC. Also, the presence of CTC indicates a worse DFS.

CellSearch technology applied to the detection and quantification of tumor cells in CSF of patients with lung cancer leptomeningeal metastasis.

OBJECTIVES: The diagnosis of solid cancer leptomeningeal metastasis (LM) relies on the cytology of cerebrospinal fluid (CSF) and/or imaging evidence of neuraxis, yet both lack sufficient sensitivity. The utility of the CellSearch, an FDA -approved technology, in assessing CSF tumor cell (CSFTC) was evaluated here in the diagnosis and treatment of patients with lung cancer-related LM. MATERIALS AND METHODS: In 18 patients with magnetic resonance imaging (MRI) confirmed LM due to lung cancer, 5 mL of CSF were collected in CellSave preservative tubes, which allow performing the assay within 96 h after sampling. Using a previously adapted CellSearch method, we detected, visualized and enumerated CSFTCs and compared the results with conventional cytology. In 3 patients, tumor cells were evaluated sequentially to explore the predictive role of CSFTCs enumeration in the treatment response monitoring. RESULTS: CSFTCs were disclosed in 14 of 18 MRI confirmed LM samples (median 785CSFTCs/5 mL CSF, range 1 to >20,000), yielding a sensitivity of 77.8%, compared with 44.4% for conventional cytology. CSFTC clusters were observed in 12 patients, similar to those previously described in blood as circulating tumor microemboli (CTM), and enumerated sequentially with reproducible results, which did not necessarily correlate with response to treatment. CONCLUSION: The CellSearch technology, applied to limited sample volumes and allowing delayed processing, could be of great interest in the diagnosis of LM in lung cancer patients.