RESUMEN
BACKGROUND: [(18)F]fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) is widely used to evaluate tumor metabolic activity. The aim of this study was to evaluate the usefulness of FDG-PET in assessing the histopathological response to preoperative concurrent chemoradiotherapy (CRT) in patients with oral squamous cell carcinoma (OSCC). METHODS: Forty-five patients with resectable advanced OSCC who had received preoperative CRT followed by tumor ablative surgery between January 2004 and December 2011 were included in the study. All patients underwent FDG-PET before and after preoperative CRT. The maximum standardized uptake value (SUVmax) before (pre-SUV) and after preoperative CRT (post-SUV) and the SUVmax reduction rate (ΔSUV %) were used to evaluate the response to preoperative CRT. Correlations among SUVmax, histopathological response, and expression of cancer antigen Ki-67 and hypoxia-inducible factor-1α (HIF-1α) were analyzed. RESULTS: Preoperative CRT significantly reduced intratumoral FDG uptake (P < 0.001). The pre-SUV and post-SUV were significantly lower in patients with a pathological complete response (pCR) than in those with a non-pCR (pre-SUV P = 0.037; post-SUV P = 0.001). ΔSUV % was higher in patients with pCR than in those with non-pCR (P = 0.029). The pre-SUV was significantly correlated with Ki-67 and HIF-1α expression in pretreatment biopsy specimens (Ki-67 P = 0.046, R = 0.292; HIF-1α P = 0.007, R = 0.385). The expression of both Ki-67 and HIF-1α was significantly lower in patients with pCR than in those with non-pCR (Ki-67 P < 0.001; HIF-1α P < 0.001). CONCLUSIONS: Low pre-SUV and post-SUV and high ΔSUV % may predict a good histopathological response to preoperative CRT. Ki-67 and HIF-1α expression in pretreatment biopsy specimens were predictors of histopathological response to preoperative CRT.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/terapia , Neoplasias de la Boca/diagnóstico por imagen , Neoplasias de la Boca/terapia , Tomografía de Emisión de Positrones , Adulto , Anciano , Carboplatino/administración & dosificación , Carcinoma de Células Escamosas/patología , Quimioradioterapia Adyuvante , Fraccionamiento de la Dosis de Radiación , Femenino , Fluorodesoxiglucosa F18 , Fluorouracilo/administración & dosificación , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/análisis , Antígeno Ki-67/análisis , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Terapia Neoadyuvante , Cuidados Preoperatorios , RadiofármacosRESUMEN
We report a case of advanced upper gingival carcinoma with a contralateral metastatic lymph node invading the maxillary sinus (T4aN2cM0). An 83-year-old man was treated concurrently with chemoradiotherapy and S-1. S-1 (80 mg/body/day) was administered for 2 weeks followed by a 1-week rest period as one course. Radiation therapy involved a total of 60 Gy (2 Gy/day; 5 days/week). There were side effects of mild leucopenia and a grade 2 stomatitis. After the completion of 2 courses and radiation therapy, the primary tumor disappeared, and the patient achieved a pathologically complete response. The metastatic lymph node also completely disappeared. S-1 was then administered in the same regimen for 1 year. Neither local recurrence nor distant metastasis has been detected 2 years after the completion of the concurrent chemoradiotherapy with S-1.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Gingivales/tratamiento farmacológico , Ácido Oxónico/uso terapéutico , Tegafur/uso terapéutico , Anciano de 80 o más Años , Biopsia , Terapia Combinada , Combinación de Medicamentos , Neoplasias Gingivales/diagnóstico por imagen , Neoplasias Gingivales/patología , Neoplasias Gingivales/radioterapia , Humanos , Masculino , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Expression of ligands of natural killer group 2D (NKG2D) immunoreceptors, such as major histocompatibility complex class I-related chain A/B (MICA/B), has been proposed to play an important role in tumour immunosurveillance. Soluble forms of MICA/B are increased in sera of cancer patients and are postulated to impair antitumour immune response by downregulating expression of NKG2D immunoreceptors. Serum levels of soluble MICA have been shown to be of diagnostic significance in malignant diseases. AIMS: The potential of soluble MICB (sMICB) as a marker for oral squamous cell carcinoma (OSCC) was investigated. RESULTS: sMICB levels did not differ significantly from those in normal control individuals. However, the findings indicate that sMICB levels are significantly increased in stage IV OSCC and high sMICB levels are significantly associated with decreased survival rates in patients.
Asunto(s)
Biomarcadores de Tumor/sangre , Carcinoma de Células Escamosas/sangre , Antígenos de Histocompatibilidad Clase I/sangre , Neoplasias de la Boca/sangre , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Ensayo de Inmunoadsorción Enzimática , Femenino , Antígenos de Histocompatibilidad Clase I/biosíntesis , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Estadificación de NeoplasiasAsunto(s)
Trasplante Óseo/métodos , Peroné/trasplante , Mandíbula/cirugía , Modelos Anatómicos , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Peroné/irrigación sanguínea , Humanos , Imagenología Tridimensional , Osteotomía , Tomografía Computarizada por Rayos XRESUMEN
UNLABELLED: Nonsyndromic cleft lip with or without cleft palate (NSCLP) is one of the most common birth defects. Despite its frequency, the etiology remains largely unknown. Most likely, both genetic and environmental factors contribute to this malformation. A polymorphic gene family, the major histocompatibility complex class I chain-related gene A (MICA), is located about 40 kb centromeric to the HLA-B gene. In this study, we analyzed the association between MICA gene polymorphisms and NSCLP in Japanese patients. METHODS: The (GCT)n polymorphism of the MICA gene was investigated in 94 patients with NSCLP and 180 normal controls using polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. RESULTS: Our results demonstrate that there are no differences in microsatellite allele frequency between NSCLP patients and controls. However, the microsatellite allele frequency of the MICA-A6 (p = 0.045) allele was increased in male patients, as compared with controls. Further, the MICA-A5 (p = 0.359) allele was also increased in female NSCLP patients. CONCLUSION: These results suggest that the microsatellite allele frequencies of the MICA-A6 allele increased in male NSCLP patients. Although the MICA-A5 allele increased in female NSCLP patients, the increase was not statistically significant. These results suggest that the MICA gene could be one of the candidate genes for NSCLP.
Asunto(s)
Labio Leporino/genética , Fisura del Paladar/genética , Antígenos de Histocompatibilidad Clase I/genética , Adulto , Alelos , Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Electroforesis en Gel de Poliacrilamida/métodos , Femenino , Frecuencia de los Genes , Humanos , Japón , Masculino , Repeticiones de Microsatélite/genética , Reacción en Cadena de la Polimerasa/métodos , Adulto JovenRESUMEN
PURPOSE: This study analyzed the changes in mandibular movement and occlusal condition after conservative treatment for unilateral condylar fractures by use of a sensitive occlusal pressure sheet (Dental Prescale; Fujifilm, Tokyo, Japan) for the evaluation of occlusal condition. PATIENTS AND METHODS: We compared 18 patients conservatively treated for unilateral condylar fracture with 23 control subjects. Mandibular movement and occlusal condition were evaluated at 3 and 6 months after conservative treatment. RESULTS: Maximal mouth opening over 40 mm was achieved at 6 months but was not improved to the control level. Recovery of lateral excursion, protrusion, or deviation on mouth opening was also limited at 6 months. Occlusal area, which was reduced at 3 months, had significantly improved at 6 months. The asymmetry index of the occlusal area was significantly improved at 6 months compared with that at 3 months. Mean pressure in the patient group was significantly greater than that in the control group. Total occlusal force, which was reduced at 3 months, was significantly improved at 6 months. The asymmetry index of occlusal force, which was significantly greater than that in the control group, was significantly improved at 6 months. CONCLUSIONS: Mandibular movement was increased at 6 months despite the slight disturbance in lateral excursion to the nonfractured side and the presence of deviation on mouth opening. Occlusal area and occlusal force improved at 6 months, although mean pressure remained slightly higher than that in the control group.
Asunto(s)
Fuerza de la Mordida , Maloclusión/diagnóstico , Fracturas Mandibulares/terapia , Rango del Movimiento Articular/fisiología , Articulación Temporomandibular/lesiones , Estudios de Casos y Controles , Oclusión Dental , Femenino , Humanos , Registro de la Relación Maxilomandibular/instrumentación , Masculino , Maloclusión/etiología , Cóndilo Mandibular/lesiones , Cóndilo Mandibular/fisiopatología , Fracturas Mandibulares/complicaciones , Fracturas Mandibulares/fisiopatología , Recuperación de la Función , Valores de Referencia , Articulación Temporomandibular/fisiopatología , Resultado del TratamientoRESUMEN
NK and cytotoxic T cells play an important role in the elimination of virus-infected and tumor cells through NKG2D activating receptors, which can promote the lysis of target cells by binding to the major histocompatibility complex class I-related chain A (MICA) proteins. Polymorphisms in MICA may influence its binding to the NKG2D. The soluble form of MICA is released from the surface of tumor cells of epithelial origin. Whereas MICA expressed on the cell surface stimulates the immunoreceptor natural killer group 2, member D (NKG2D), the secreted form down-regulates NKG2D activity, thus allowing the tumor to escape immunosurveillance by NKG2D-expressing cells. In this study, we examined the association between MICA gene microsatellite polymorphisms and serum levels of soluble MICA in patients with oral squamous cell carcinoma (OSCC). We found that patients with OSCC were more likely to have the A5.1 allele when compared to healthy subjects and also more likely to be homozygous for this allele (p=0.041). Patients with the homozygous A5.1 genotype had higher levels of soluble MICA (p=0.031) and a lower survival rate (p=0.026).
Asunto(s)
Carcinoma de Células Escamosas/fisiopatología , Antígenos de Histocompatibilidad Clase I/genética , Antígenos de Histocompatibilidad Clase I/metabolismo , Neoplasias de la Boca/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/genética , Ensayo de Inmunoadsorción Enzimática , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/genética , Estadificación de Neoplasias , Polimorfismo Genético , SolubilidadRESUMEN
The soluble form of major histocompatibility complex class I-related chain A (MICA) is released from the surface of tumor cells of epithelial origin. Although MICA expressed on the cell surface stimulates the immunoreceptor natural killer (NK) group 2, member D (NKG2D), the secreted form downregulates NKG2D activity, thus allowing the tumor to escape immunosurveillance by NKG2D-expressing cells. In this study, we examined the association between serum levels of soluble MICA and the severity of disease in patients with oral squamous cell carcinoma (OSCC). We used enzyme-linked immunoabsorbent assay to measure serum levels of soluble MICA in OSCC patients and normal control individuals. Among patients categorized according to most disease parameters tested (tumor size, location, grade of differentiation, regional lymph node status, disease stage), soluble MICA levels in sera did not statistically differ from those in normal control individuals. Patients with stage IV disease and/or regional lymph node metastasis did, however, exhibit significantly higher serum levels of soluble MICA than control individuals (95% confidence interval (CI), 0.65-2.45, p = 0.021, and 95% CI, 0.62-4.42, p = 0.031, respectively). Overall survival rates were significantly higher for OSCC patients with low soluble MICA levels (<50 pg/ml) than for those with high soluble MICA levels (>50 pg/ml) (95% CI, 0.43-2.75, p = 0.03). Serum levels of soluble MICA may be useful in the diagnosis of advanced stage OSCC and as an indicator of regional lymph node metastasis.
Asunto(s)
Biomarcadores de Tumor , Carcinoma de Células Escamosas/inmunología , Antígenos de Histocompatibilidad Clase I/sangre , Neoplasias de la Boca/inmunología , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/sangre , Carcinoma de Células Escamosas/sangre , Carcinoma de Células Escamosas/patología , Femenino , Antígenos de Histocompatibilidad Clase I/inmunología , Humanos , Japón , Estimación de Kaplan-Meier , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/sangre , Neoplasias de la Boca/patología , Estadificación de Neoplasias , PronósticoRESUMEN
A 52-year-old female, scheduled for rectal cancer resection, had no history of central nervous system abnormality. Anesthesia was maintained with general anesthesia combined with epidural anesthesia. Her only hemodynamic change was a rise in arterial pressure to 140 mmHg just after the start of the operation. However, postoperatively she failed to be aroused and she exhibited a positive Babinski's sign, anisocoria, an absent light reflex and paresis of the left lower extremity. Cerebral vascular accident was suspected and a CT scan revealed a cerebral hematoma which was immediately removed surgically. Upon exploration, abnormal vessels were recognized and we diagnosed an acute rupture of arteriovenous malformation. She fully recovered consciousness immediately after the operation. Her postoperative course was uneventful, except for a residual paresis of the left lower extremity.
Asunto(s)
Malformaciones Arteriovenosas Intracraneales/cirugía , Complicaciones Intraoperatorias , Enfermedad Aguda , Anestesia Epidural , Anestesia General , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/cirugía , Trastornos de la Conciencia/etiología , Femenino , Hematoma/diagnóstico , Hematoma/cirugía , Humanos , Malformaciones Arteriovenosas Intracraneales/diagnóstico , Persona de Mediana Edad , Complicaciones Posoperatorias , Neoplasias del Recto/cirugíaRESUMEN
Intravenous anesthetic, propofol (2,6-diisopropylphenol), is extensively used for general anesthesia without knowing the effects on cancer. We found here that clinically relevant concentrations of propofol (1-5 microg/ml) decreased the invasion ability of human cancer cells (HeLa, HT1080, HOS and RPMI-7951). In the HeLa cells treated with propofol, formation of actin stress fibers as well as focal adhesion were inhibited, and propofol had little effect on the invasion ability of the HeLa cells with active Rho A (Val(14)-Rho A). In addition, continuous infusion of propofol inhibited pulmonary metastasis of murine osteosarcoma (LM 8) cells in mice. These results suggest that propofol inhibits the invasion ability of cancer cells by modulating Rho A and this agent might be an ideal anesthetic for cancer surgery.
Asunto(s)
Anestésicos Intravenosos/farmacología , Invasividad Neoplásica/prevención & control , Propofol/farmacología , Actinas/metabolismo , Animales , Neoplasias Óseas/patología , Adhesión Celular/efectos de los fármacos , Células HeLa/efectos de los fármacos , Células HeLa/patología , Humanos , Neoplasias Pulmonares/prevención & control , Neoplasias Pulmonares/secundario , Ratones , Osteosarcoma/patología , Osteosarcoma/prevención & control , Osteosarcoma/secundario , Células Tumorales CultivadasRESUMEN
In oral and maxillofacial surgery, epinephrine is routinely used for cancer resection and it is important to clarify the effects of this agent on cancer. We found here that the clinically relevant concentrations of epinephrine (10, 50 and 100 microg/ml) decreased the invasion ability of oral squamous carcinoma (Sa3) cells. In the Sa3 cells treated with epinephrine (10, 50 and 100 microg/ml), migration, morphological changes and formation of actin stress fibers were inhibited and intracellular cyclic adenosine monophosphate (cAMP) increased significantly. These findings suggest that epinephrine inhibits the invasion of cancer cells by modulating intracellular cAMP and that clinicians could use epinephrine effectively for the surgical resection of the cancer.