Prognostic and predictive role of soluble programmed death ligand-1 in head and neck cancer

Abstract Objectives The aim of the study was to investigate clinical significance of soluble PD-L1 (sPD-L1) serum level in head and neck cancer and to evaluate its role as a possible prognostic and predictive biomarker. Methods A prospective analysis of sPD-L1 levels in 60 patients diagnosed and treated due to malignant and non-malignant lesions in the region of head and neck was performed in peripheral blood by an ELISA test. Results The range of sPD-L1 in the study group was 0.16-1.63 ng/mL, mean 0.64 ± 0.32. There were no differences in the mean sPD-L1 regarding patients' age, sex, and the localization of the lesion. Statistically significant difference was revealed in the average sPD-L1 level (p = 0.006) depending on the histopathological advancement of the lesions, 0.704 ± 0.349 and 0.512 ± 0.177 respectively in the malignant and benign group. The separate analysis of laryngeal lesions confirmed statistical difference in sPD-L1 (p = 0.002) for the malignant lesions (0.741 ± 0.353) compared with the benign (0.489 ± 0.175). The sPD-L1 level of 0.765 ng/mL or higher, revealed 35% sensitivity and 95.5% specificity for the diagnosis of head and neck malignant lesions (AUC = 0.664, 95% CI 0.529‒0.8, p-value = 0.039). The 1-year DFS was 83.3% in the group of patients with low sPD-L1 levels (< 0.765 ng/mL) and 53.8% in patients with high sPD-L1 (≥0.765 ng/mL). The 2-year OS were 68% and 69.2% respectively in both groups. The log-rank test confirmed statistically significant prognostic value of sPD-L1 level for 1-year DFS (p-value = 0.035). Conclusions sPD-L1 is a promising prognostic and early recurrence predictive biomarker for head and neck cancers, most significantly for laryngeal lesions. Level of evidence 3.

Cryosurgery in the Management of Potentially Malignant Lesions: A Report of Two Cases.

Cryosurgery is a therapeutical approach that uses freezing to obtain a tissue inflammatory or destructive response. It has been successfully used for both cutaneous and oral conditions. The characteristics of oral mucosa like humidity and smoothness makes it an ideal site for this approach. Oral submucous fibrosis is a potentially malignant disorder of the oral mucosa, with areca nut chewing being the primary causative agent. Leukoplakia is a potentially malignant lesion associated with excessive consumption of alcohol and tobacco. Although there are no specific treatment modalities to prevent recurrence, abandoning habits can decrease the chance of recurrence, as well as the transfiguration into malignant tumors of these disorders. However, with the advent of cryosurgery, oral surgeons are provided with a new modality for treating oral potentially malignant disorders. This case report highlights the pioneering effect of nitrous oxide cryosurgery in treating two cases of oral submucous fibrosis with leukoplakia and oral leukoplakia respectively showing promising results during follow-up.

Management of Oral Leukoplakia Using Diode Laser: A Pilot Study.

Aim: To evaluate the effectiveness of 810-nm diode LASER in the management of patients with oral leukoplakia. Materials and Methods: A total of 10 cases diagnosed clinically and histopathologically as leukoplakia were included in the present study. All the cases were treated using 810-nm diode LASER at a power of 5 watts and followed up for 3 months and assessed for pain and healing post-operatively. Results: All the lesions healed within duration of 3-4 weeks without scarring. Complications or recurrence has not been noticed in any of the patients except for mild pain during follow up period. Conclusion: Patient acceptance was found to be high using 810-nm diode LASER without compromising health and function. Thus usage of diode LASER may indeed be the best choice in the management of oral leukoplakia.