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1.
Acta Dermatovenerol Croat ; 29(2): 111-113, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34477079

RESUMO

Dear Editor, The ongoing pandemic of coronavirus disease 2019 (COVID-19) was declared by the World Health Organization on March 11, 2020, and remains a global challenge. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), transmitted primarily through respiratory droplets and aerosols. Even though the COVID-19 vaccine has become available since December 2020, the main preventive measures still include social distancing, hand washing, and the use of protective face masks. By May 22, 2021, 3,437,545 deaths caused by SARS-CoV-2 have been registered by WHO, confirming the burden of this disease (1). Consequently, the pandemic has become a challenge for health care systems, as they had to be focused on the care of patients with COVID-19. During the first lockdown from March to May 2020, it was advised to postpone clinical visits whenever this could be done without risk. This recommendation was mainly aimed at older patients and those with chronic diseases, as it has been shown that they are at greater risk for complications from COVID-19. Renal transplant recipients (RTRs) are at a greater risk for infections and different cancers due to their permanent immunosuppressive therapy. The most common malignancies in RTRs are skin cancers, particularly non-melanoma skin cancers. It has been estimated that RTRs have a 65-250 times higher risk for cutaneous squamous cell carcinoma (SCC), 10 times higher risk for basal cell carcinoma, and 2-5 times higher risk for melanoma when compared with the general population (2-4). RTRs are at a higher risk for complications from COVID-19, not only because of their immunosuppressive therapy but also because of different comorbidities, such as hypertension, cardiovascular disease, and diabetes mellitus (5). Therefore, RTRs tend to limit their medical visits and postpone clinical examinations for skin cancer screenings. Moreover, during clinical visits the patients are commonly asked to keep their protective masks on, increasing the risk of overlooking their facial skin changes. Herein we present two RTRs who developed skin cancers during the COVID-19 pandemic, and the tumors were diagnosed with a significant delay. Patient 1 A 67-year-old woman with unknown primary kidney disease received a renal allograft from a deceased donor in 2014. The immunosuppressive protocol included antithymocyte globulin induction with tacrolimus, mycophenolate mofetil, and steroid maintenance. In January 2020, she had noticed a reddish squamous lesion on her right cheek, which enlarged slowly. Since there were no other symptoms, she postponed the dermatologic examination. Additionally, she further postponed the visit to her physician during the pandemic as she wanted to avoid social contact as much as possible. One year later, at the nephrologist's examination, she was asked to take off her face mask for a skin check, and two skin tumors on her right cheek were noticed (Figure 1). One lesion was located at the angle of her mandible and presented as a hypertrophic, sharply marginated lesion with central crusting and a diameter of 2 cm. The other lesion was at the right zygomatic region and appeared as a scaly, erythematous lesion with a diameter of 7 mm. The patient was referred to a dermatologist, and a biopsy of both lesions was indicated. The pathohistological analysis revealed cutaneous SCC in situ for the mandibular lesion and actinic keratosis for the zygomatic lesion. SCC in situ has been excised, and actinic keratosis was treated by cryosurgery. Patient 2 A 66-year-old woman received a renal allograft from a deceased donor in 2010 due to chronic glomerulonephritis without biopsy. The immunosuppressive protocol included basiliximab induction with tacrolimus, mycophenolate mofetil, and steroid maintenance. In June 2020, an erosion occurred at her left infraocular area and did not heal but instead gradually enlarged. The patient suspected that the "wound" developed due to the friction from the rim of her eyeglasses. Six months later, the nephrologist noticed the erosion which was 10×5 mm in size with a slightly elevated, pearl-colored margin (Figure 2). The patient was referred to a dermatologist who indicated tumor excision due to suspected basal cell carcinoma. The pathohistological analysis confirmed the clinical diagnosis. DISCUSSION Both presented patients did not inform their family physicians about their skin changes because they avoided all non-nephrological medical visits during the pandemic. The additional reason for the diagnostic delay was the fact that they kept the masks on their faces during most examinations, with the skin lesions behind the mask consequently remaining unnoticed. The problem of diagnostic delay of skin cancers during the COVID-19 pandemic has been recognized by several studies. Canadian authors compared the number of biopsies for skin cancers during the first 15 weeks in 2020 and during the same period in 2019. They found a decrease in the number of biopsies for non-melanoma skin cancers (NMSC) and melanoma of 18% and 27%, respectively (6). A multicenter study performed in northern-central Italy showed that the number of skin cancer (NMSC and melanoma) diagnoses fell by 56.7% in weeks 11 to 20 of 2020 compared with the average number noted in the same periods of 2018 and 2019 (7). Furthermore, a single-center retrospective study in Italy demonstrated that the number of advanced skin cancers surgically treated between May 18 and November 18, 2020, was significantly higher than in the same period in 2019. These findings led the authors to conclude that the surgical excisions were postponed due to the delay in follow-ups, which resulted in increased incidence of advanced skin cancers (8). RTRs are at particular risk of severe consequences from diagnostic delay with regard to skin cancers. Namely, skin cancers in RTRs are more aggressive and are associated with a higher incidence rate of metastases and recurrences than in the general population (9). Therefore, RTRs should be advised to regularly check their skin for potential skin cancer, which includes self-examinations and dermatologic follow-ups.


Assuntos
COVID-19/epidemiologia , Diagnóstico Tardio , Transplante de Rim , Equipamento de Proteção Individual , Neoplasias Cutâneas/diagnóstico , Transplantados , Idoso , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Comorbidade , Feminino , Humanos , Hospedeiro Imunocomprometido , Melanoma/diagnóstico , Pandemias , Fatores de Risco , SARS-CoV-2
2.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(9): 926-932, 2021 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-34496544

RESUMO

Objective: To explore the changes in serum metabolic profile in patients with oral squamous cell carcinoma (OSCC) and to identify the diagnostic biomarkers in order to provide new ideas for the early diagnosis of OSCC. Methods: In total, 76 OSCC patients who were diagnosed at the Department of Oral and Maxillofacial Surgery and 70 healthy individuals who at the Department of Medical Center of The First Affiliated Hospital of Zhengzhou University from August 2019 to January 2020 were recruited in The study. According to the random number table method, all subjects were divided into a test group (n=96) and a verification group (n=50). Subjects in the test group consisted of 51 OSCC patients and 45 healthy subjects and subjects in the verification group included 25 OSCC patients and 25 healthy individuals. Serum samples and clinical data of each of the subjects were collected. The serum samples were analyzed by ultra-high-performance liquid chromatography quadrupole-Orbitrap high resolution accurate mass spectrometry. Principal component analysis, orthogonal partial least square discrimination analysis and t-test were used to profile the differential metabolites in the test group. Pathway analysis of differential metabolites was performed. In addition, binary logistic regression analysis and receiver operating characteristic analysis were used in order to establish the potential diagnostic panel. Results: Twenty-one endogenous differential metabolites were identified showing significant association with OSCC. Results of pathway analysis suggested that OSCC associated with lipid metabolism and amino acid metabolism (P<0.05). A novel diagnostic panel consisting of lysophosphatidylcholine (LysoPC) (16∶0/0∶0), LysoPC[18∶1(9z)/0∶0], taurine and D-glutamic acid was defined. The panel performed a high area under the receiver operating characteristic curve (0.998, 95%CI: 0.994-0.999, P<0.05). Conclusions: There were obvious lipid and amino acid metabolism disorders in OSCC patients. It was an effective method to establish a diagnostic model by metabolomics.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Biomarcadores , Biomarcadores Tumorais , Carcinoma de Células Escamosas/diagnóstico , Humanos , Neoplasias Bucais/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço
3.
Medicine (Baltimore) ; 100(33): e26960, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414964

RESUMO

ABSTRACT: To explore the predictive value of preoperative serum squamous cell carcinoma antigen (SCC-Ag) level for lymph node metastasis (LNM), particularly, in patients surgically treated for early-stage cervical squamous cell carcinoma.We enrolled 162 patients with cervical squamous cell carcinoma stages IB to IIA following the International Federation of Gynecology and Obstetrics (FIGO) 2009 classification. The patients had previously undergone radical surgery. Correlation of the SCC-Ag level with clinicopathological features and the predictive value of SCC-Ag for LNM were analyzed.High preoperative SCC-Ag level was correlated with FIGO stage (P = .001), tumor diameter >4 cm (P < .001), stromal infiltration (P < .001), LNM (P < .001) and lymphovascular space invasion (LVSI), (P = .045). However, it was not correlated with age, histological differentiation, parametrial involvement, and positive vaginal margin (P > .05). Univariate analysis revealed that FIGO stage (P = .015), tumor diameter (P = .044), stromal infiltration (χ2 = 10.436, P = .005), SCC-Ag ≧ 2.75 ng/mL (χ2 = 14.339, P < .001), LVSI (χ2 = 12.866, P  < .001), parametrial involvement (χ2 = 13.784, P < .001) were correlated with LNM, but not with age, histological differentiation, and positive vaginal margin. Moreover, multivariate analysis demonstrated that SCC-Ag ≧2.75 ng/mL (P = .011, OR = 3.287) and LVSI (P = .009, OR = 7.559) were independent factors affecting LNM. The area under the receiver operator characteristic curve of SCC-Ag was 0.703 (P < .001), while 2.75 ng/mL was the best cutoff value for predicting LNM. The sensitivity and specificity of diagnosis were 69.4% and 65.9%, respectively.High SCC-Ag level was revealed to be an independent risk factor for the prognosis of squamous carcinoma of the cervix before an operation. Besides, SCC-Ag (2.75 ng/mL) can be utilized as a potential marker to predict LNM in early stage cervical cancer before an operation.


Assuntos
Antígenos de Neoplasias/sangue , Carcinoma de Células Escamosas/diagnóstico , Metástase Linfática/diagnóstico , Serpinas/sangue , Neoplasias do Colo do Útero/diagnóstico , Adulto , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Neoplasias do Colo do Útero/sangue , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia
4.
Cochrane Database Syst Rev ; 7: CD010276, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34282854

RESUMO

BACKGROUND: Squamous cell carcinoma is the most common form of malignancy of the oral cavity, and is often proceeded by oral potentially malignant disorders (OPMD). Early detection of oral cavity squamous cell carcinoma (oral cancer) can improve survival rates. The current diagnostic standard of surgical biopsy with histology is painful for patients and involves a delay in order to process the tissue and render a histological diagnosis; other diagnostic tests are available that are less invasive and some are able to provide immediate results. This is an update of a Cochrane Review first published in 2015. OBJECTIVES: Primary objective: to estimate the diagnostic accuracy of index tests for the detection of oral cancer and OPMD, in people presenting with clinically evident suspicious and innocuous lesions. SECONDARY OBJECTIVE: to estimate the relative accuracy of the different index tests. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials to 20 October 2020. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA: We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting OPMD or oral cavity squamous cell carcinoma: vital staining (a dye to stain oral mucosa tissues), oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. MAIN RESULTS: This update included 63 studies (79 datasets) published between 1980 and 2020 evaluating 7942 lesions for the quantitative meta-analysis. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (22 datasets), oral cytology (24 datasets), light-based detection or oral spectroscopy (24 datasets). Nine datasets assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis. Two studies were classed as being at low risk of bias across all domains, and 33 studies were at low concern for applicability across the three domains, where patient selection, the index test, and the reference standard used were generalisable across the population attending secondary care. The summary estimates obtained from the meta-analysis were: - vital staining: sensitivity 0.86 (95% confidence interval (CI) 0.79 to 0.90) specificity 0.68 (95% CI 0.58 to 0.77), 20 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; - oral cytology: sensitivity 0.90 (95% CI 0.82 to 0.94) specificity 0.94 (95% CI 0.88 to 0.97), 20 studies, sensitivity moderate-certainty evidence, specificity moderate-certainty evidence; - light-based: sensitivity 0.87 (95% CI 0.78 to 0.93) specificity 0.50 (95% CI 0.32 to 0.68), 23 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; and - combined tests: sensitivity 0.78 (95% CI 0.45 to 0.94) specificity 0.71 (95% CI 0.53 to 0.84), 9 studies, sensitivity very low-certainty evidence, specificity very low-certainty evidence. AUTHORS' CONCLUSIONS: At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this updated review, further research into biomarkers may be warranted.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Bucais/diagnóstico , Viés , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/patologia , Corantes , Detecção Precoce de Câncer , Humanos , Luz , Neoplasias Labiais/diagnóstico , Neoplasias Labiais/patologia , Boca/patologia , Neoplasias Bucais/patologia , Saliva/química , Sensibilidade e Especificidade
5.
Artigo em Inglês | MEDLINE | ID: mdl-34299679

RESUMO

The aim of the study was to investigate the unstimulated whole saliva (UWS) tumor necrosis factor alpha (TNF-α) and cellular micronuclei in snuff dippers (Naswar) compared to healthy control subjects. The case control study was conducted over 9 months at a tertiary care center. Sixty patients were divided into two groups: Snuff dippers (SD) (Naswar) and non-snuff dippers (NSD) (control subjects). The included self-reported SD used Snuff twice daily for more than 12 months. UWS was collected and salivary TNF-α assessment was performed using enzyme-linked immunosorbent assay (ELISA). For cellular micronuclei, buccal mucosa was brushed to obtain cells in Naswar users, fixed with a dibutylphthalate polystyrene xylene (DPX) mounting to view micronuclei. Means and standard deviations were compared using the t-test and outcomes were related using Pearson correlation, considering p ≤ 0.05 as significant. The mean age of participants was 38.85 ± 11.56 years. The mean duration of snuff use was 20.43 ± 12.79 years and the common site for Naswar placement was the lower vestibule (n = 19, 63.3%). TNF-α levels among SD were 9.6 ± 3.3 pg/mL, which were significantly higher than levels in NSD, 5.2 ± 3 pg/mL (p < 0.05). The number of cellular micronuclei in SD was 30.7 ± 7.8, which was comparatively higher than in NSD, which was 9.2 ± 3.3 (p < 0.05). The duration of snuff use was positively correlated to TNF-α levels (p = 0.048) rather than the micronuclei number (p = 0.97). SD showed higher levels of TNF-α and cellular micronuclei compared with NSD (control subjects); a positive correlation was shown with the duration of snuff use. We conclude that TNF-α and micronuclei are potential salivary biomarkers for an oral biological effect in snuff (Naswar) users.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Tabaco sem Fumaça , Adulto , Carcinoma de Células Escamosas/diagnóstico , Estudos de Casos e Controles , Diagnóstico Precoce , Humanos , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço , Fator de Necrose Tumoral alfa
6.
Int J Mol Sci ; 22(13)2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34202728

RESUMO

The prognosis of patients with oral squamous carcinoma (OSCC) largely depends on the stage at diagnosis, the 5-year survival rate being approximately 30% for advanced tumors. Early diagnosis, including the detection of lesions at risk for malignant transformation, is crucial for limiting the need for extensive surgery and for improving disease-free survival. Saliva has gained popularity as a readily available source of biomarkers (including cytokines) useful for diagnosing specific oral and systemic conditions. Particularly, the close interaction between oral dysplastic/neoplastic cells and saliva makes such fluid an ideal candidate for the development of non-invasive and highly accurate diagnostic tests. The present review has been designed to answer the question: "Is there evidence to support the role of specific salivary cytokines in the diagnosis of OSCC?" We retrieved 27 observational studies satisfying the inclusion and exclusion criteria. Among the most frequent cytokines investigated as candidates for OSCC biomarkers, IL-6, IL-8, TNF-α are present at higher concentration in the saliva of OSCC patients than in healthy controls and may therefore serve as basis for the development of rapid tests for early diagnosis of oral cancer.


Assuntos
Biomarcadores , Carcinoma de Células Escamosas/metabolismo , Citocinas/metabolismo , Neoplasias Bucais/metabolismo , Saliva/metabolismo , Biomarcadores Tumorais , Carcinoma de Células Escamosas/diagnóstico , Humanos , Biópsia Líquida/métodos , Neoplasias Bucais/diagnóstico , Prognóstico
7.
J Int Med Res ; 49(7): 3000605211032807, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34311595

RESUMO

OBJECTIVE: Lung cancer (LC) is one of the most prevalent malignant tumors worldwide. As a subtype of LC, lung squamous cell carcinoma (LUSC) has a 5-year survival rate of less than 15%. In this study, we aimed to evaluate the prognostic value of a glycolysis-related gene signature in LUSC patients. METHODS: We obtained RNA-Seq data from The Cancer Genome Atlas (TCGA) database. Prognosis-related genes were screened out by Gene Set Enrichment Analysis (GSEA) and Cox proportional regression models. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) was used to verify the mRNA expression levels in relevant tissues. RESULTS: We found that sperm-associated antigen 4 (SPAG4) overexpression was an independent risk factor for overall survival (OS) in LUSC. Patients with high-risk scores had higher mortality rates than those with low-risk scores. Moreover, by using RT-qPCR, we validated that SPAG4 mRNA was overexpressed in LUSC tissue samples compared with their paired para-cancerous histological normal tissues. CONCLUSIONS: Analysis of aberrantly overexpressed SPAG4 may provide a further useful approach to complement existing methods and predict prognosis in LUSC patients.


Assuntos
Carcinoma de Células Escamosas , Proteínas de Transporte/genética , Neoplasias Pulmonares , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/genética , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/genética , Masculino , Prognóstico
8.
Artigo em Inglês | MEDLINE | ID: mdl-34172257

RESUMO

Esophageal cancer is the eight most common cancer in the world and is associated with a poor prognosis. Significant efforts are necessary to improve the detection of early squamous cell cancer such that curative endoscopic therapy can be offered. Studies have shown an overall miss rate of esophageal cancer of up to 6.4%. Human factors including fatigue and lack of attention may be a contributory factor. Computer aided detection and characterisation of early squamous cell cancer can be a second reader which potentially offsets these factors. Recent studies developing artificial intelligence systems show real promise in the detection of early squamous cell cancer and predicting depth of invasion to aid in the management of patients in the same endoscopic session. This has the potential to revolutionise this area of endoscopy.


Assuntos
Inteligência Artificial/normas , Carcinoma de Células Escamosas/diagnóstico , Aprendizado Profundo/normas , Endoscopia/métodos , Neoplasias Esofágicas/diagnóstico , Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Humanos
9.
Viruses ; 13(5)2021 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-34069114

RESUMO

The incidence of Human-papillomavirus-positive (HPV+) tonsillar and base-of-tongue squamous cell carcinoma (TSCC and BOTSCC, respectively) is increasing epidemically, but they have better prognosis than equivalent HPV-negative (HPV-) cancers, with roughly 80% vs. 50% 3-year disease-free survival, respectively. The majority of HPV+ TSCC and BOTSCC patients therefore most likely do not require the intensified chemoradiotherapy given today to head and neck cancer patients and would with de-escalated therapy avoid several severe side effects. Moreover, for those with poor prognosis, survival has not improved, so better-tailored alternatives are urgently needed. In line with refined personalized medicine, recent studies have focused on identifying predictive markers and driver cancer genes useful for better stratifying patient treatment as well as for targeted therapy. This review presents some of these endeavors and briefly describes some recent experimental progress and some clinical trials with targeted therapy.


Assuntos
Biomarcadores Tumorais , Carcinoma de Células Escamosas/etiologia , Oncogenes , Infecções por Papillomavirus/complicações , Neoplasias da Língua/etiologia , Neoplasias Tonsilares/etiologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/terapia , Transformação Celular Neoplásica/genética , Transformação Celular Viral , Expressão Gênica , Humanos , Imuno-Histoquímica , Terapia de Alvo Molecular , Mutação , Infecções por Papillomavirus/virologia , Prognóstico , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/uso terapêutico , Neoplasias da Língua/diagnóstico , Neoplasias da Língua/metabolismo , Neoplasias da Língua/terapia , Neoplasias Tonsilares/diagnóstico , Neoplasias Tonsilares/metabolismo , Neoplasias Tonsilares/terapia , Resultado do Tratamento
10.
In Vivo ; 35(4): 2337-2340, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34182515

RESUMO

BACKGROUND: Preoperative diagnosis of parotid tumor is mainly performed via imaging and cytology to avoid both facial nerve injury and tumor seeding. Synchronous resection of solitary parotid metastasis with esophagectomy for esophageal squamous cell carcinoma is rarely performed. CASE REPORT: This is a case report of a 58-year-old male patient with a left preauricular tumor, which was cytologically diagnosed as squamous cell carcinoma. Esophageal squamous cell carcinoma was pathologically diagnosed following 18F-fluorodeoxyglucose positron emission tomography with computed tomography. His diagnosis was cT2N0M0 esophageal squamous cell carcinoma with cT3N0M0 parotid carcinoma. Esophagectomy for esophageal cancer, as well as parotidectomy were performed. Pathological diagnosis of pT1bN1M1 (parotid) esophageal squamous cell carcinoma was based on exclusion diagnosis of no primary tumor from several specialists and pathological findings including immunohistochemical staining. CONCLUSION: Reporting of more cases of rare synchronous metastasectomy and esophagectomy is needed to clarify treatment strategies.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Esofagectomia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias
11.
Tidsskr Nor Laegeforen ; 141(10)2021 06 29.
Artigo em Norueguês | MEDLINE | ID: mdl-34182724

RESUMO

BACKGROUND: The development of skin cancer, especially squamous cell carcinoma, is a well-known but rare and often under-recognised complication of chronic wounds and longstanding scar tissue. These skin cancers, known as Marjolin's ulcer, are more aggressive in nature than similar cutaneous cancers of different etiology, with a higher rate of local recurrence and an increased metastatic potential. CASE PRESENTATION: Our patient suffered severe trauma to his left leg and foot in a car accident during childhood and underwent extensive reconstruction. In the years leading up to today the left foot has been lymphedematous, with recurring sinuses and ulcerations. He was now admitted due to a rapidly progressing and debilitating wound. During the first consultation the clinical findings led to suspicion of malignancy and osteomyelitis. The histopathologic examination from our biopsies could not rule out the presence of a highly differentiated squamous cell carcinoma. MRI and bone biopsy revealed osteomyelitis. INTERPRETATION: With few exceptions, the treatment of malignancy in chronic wounds and longstanding scar tissue is surgical. Early diagnostics, including biopsies, and intervention are instrumental to a favourable outcome. We present this case report alongside current literature in order to raise awareness on the topic.


Assuntos
Carcinoma de Células Escamosas , Pé Diabético , Neoplasias Cutâneas , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirurgia , Cicatriz , Humanos , Masculino , Recidiva Local de Neoplasia , Neoplasias Cutâneas/diagnóstico
12.
Int J Mol Sci ; 22(9)2021 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-34065085

RESUMO

The role and prognostic value of tetraspanins (TSPANs) in vulvar squamous cell carcinoma (VSCC) remain poorly understood. We sought to primarily determine, at both the molecular and tissue level, the expression profile of the TSPANs CD9, CD63, CD81, and CD82 in archived VSCC samples (n = 117) and further investigate their clinical relevance as prognostic markers. Our studies led us to identify CD63 as the most highly expressed TSPAN, at the gene and protein levels. Multicomparison studies also revealed that the expression of CD9 was associated with tumor size, whereas CD63 upregulation was associated with histological diagnosis and vascular invasion. Moreover, low expression of CD81 and CD82 was associated with worse prognosis. To determine the role of TSPANs in VSCC at the cellular level, we assessed the mRNA levels of CD63 and CD82 in established metastatic (SW962) and non-metastatic (SW954) VSCC human cell lines. CD82 was found to be downregulated in SW962 cells, thus supporting its metastasis suppressor role. However, CD63 was significantly upregulated in both cell lines. Silencing of CD63 by siRNA led to a significant decrease in proliferation of both SW954 and SW962. Furthermore, in SW962 particularly, CD63-siRNA also remarkably inhibited cell migration. Altogether, our data suggest that the differential expression of TSPANs represents an important feature for prognosis of VSCC patients and indicates that CD63 and CD82 are likely potential therapeutic targets in VSCC.


Assuntos
Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/mortalidade , Regulação Neoplásica da Expressão Gênica , Tetraspaninas/genética , Transcriptoma , Neoplasias Vulvares/genética , Neoplasias Vulvares/mortalidade , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico , Suscetibilidade a Doenças , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Modelos Biológicos , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , Fatores de Risco , Tetraspaninas/metabolismo , Neoplasias Vulvares/patologia
13.
Medicine (Baltimore) ; 100(22): e26232, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087906

RESUMO

RATIONALE: Metastasis of neoplasms to the eye is quite uncommon. In this case report, we describe a patient where primary esophageal cancer was diagnosed by fine needle aspiration biopsy (FNAB) of an iris tumor. PATIENT CONCERNS: A 70-year-old male complained of redness and discomfort in the right eye. DIAGNOSIS AND INTERVENTIONS: The patient's right eye was diagnosed as idiopathic uveitis, and a topical steroid was administered. As vitreous opacities were observed even after topical therapy, oral prednisolone was administered. On slit-lamp examination of the right eye, an iris mass with neovascularization was seen in the anterior chamber. A metastatic tumor was suspected, and FNAB was performed. Histology revealed squamous cell carcinoma. Systemic workup revealed esophageal cancer with several metastases. Best-corrected visual acuity decreased to 20/400, and intraocular pressure was 40 mmHg in the right eye. Two iris tumors with neovascularization were present extending into the anterior chamber with posterior iris synechiae and 360 degree peripheral anterior synechiae. Intraocular pressure in the right eye was medically managed with hypotensive eye drops and oral acetazolamide. Iris metastases were treated with 40 Gray of radiation therapy and concurrent chemotherapy. OUTCOMES: The tumor regressed, but intraocular pressure was refractory to treatment because of 360 degree goniosynechial closure. The right eye lost light perception six months after treatment commenced, and the patient died 9 months after the onset of therapy due to multiple systemic metastases. LESSONS: This is a rare case of masquerade syndrome without systemic symptoms in which FNAB of an iris tumor led to a diagnosis of metastatic esophageal squamous cell carcinoma. Although the patient lost his sight due to uncontrollable ocular hypertension, systemic chemotherapy, and radiation therapy were initially effective in the treatment of the metastatic iris tumor. As the prognosis of patients with metastatic iris tumors is poor, it is important for ophthalmologists to consider such diagnoses and conduct systemic investigations when necessary.


Assuntos
Biópsia por Agulha Fina/métodos , Neoplasias Esofágicas/patologia , Neoplasias da Íris/secundário , Iris/patologia , Hipertensão Ocular/tratamento farmacológico , Acetazolamida/administração & dosagem , Acetazolamida/uso terapêutico , Administração Oral , Idoso , Câmara Anterior/patologia , Inibidores da Anidrase Carbônica/administração & dosagem , Inibidores da Anidrase Carbônica/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico , Quimiorradioterapia/métodos , Evolução Fatal , Humanos , Pressão Intraocular/efeitos dos fármacos , Neoplasias da Íris/diagnóstico , Neoplasias da Íris/terapia , Masculino , Metástase Neoplásica/patologia , Neovascularização Patológica/patologia , Acuidade Visual
14.
BMJ Case Rep ; 14(6)2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34130973

RESUMO

A 47- year-old woman developed a rapidly enlarging vulvar mass. Although the clinical appearance suggested malignancy, its lack of atypia and invasion on initial superficial biopsy delayed the pathological diagnosis. It was not until a large incisional biopsy was performed that showed the diagnosis of verrucous squamous cell carcinoma (VSCC) involving pre-existing sinuses of hidradenitis suppurativa (HS). VSCC arising in HS is very rare and often leads to death in published cases. This case demonstrates the challenge in pathological diagnosis of this condition which impacted time to treatment.


Assuntos
Carcinoma de Células Escamosas , Carcinoma Verrucoso , Hidradenite Supurativa , Doenças da Vulva , Neoplasias Vulvares , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirurgia , Feminino , Hidradenite Supurativa/diagnóstico , Humanos , Pessoa de Meia-Idade , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/cirurgia
15.
BMJ Case Rep ; 14(5)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-33975847

RESUMO

Dyskeratosis congenita is a rare disease caused by telomerase dysfunction classically characterised by the triad: skin pigmentation, nail dystrophy and mucosal leukoplakia. Few cases are described in literature regarding patients with head and neck squamous cell carcinoma affected by dyskeratosis congenita, and the therapeutic decisions are not yet well defined. A review of the literature of the last 20 years (2001-2021) was performed, and it was analysed the case of a 38-year-old male patient affected by dyskeratosis congenita diagnosed with a squamous cell carcinoma of the inferior alveolar ridge, treated with surgery. The absence of complications and the good postoperative recovery of the patient comfort in saying that resection and reconstructive surgery can be safely performed. The occurrence of disseminated disease 6 months after the treatment warns about the extreme aggressiveness of the pathology, its often systemic nature and the necessity of a multidisciplinary approach as well as further studies.


Assuntos
Carcinoma de Células Escamosas , Disceratose Congênita , Neoplasias de Cabeça e Pescoço , Adulto , Processo Alveolar , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirurgia , Disceratose Congênita/complicações , Disceratose Congênita/diagnóstico , Humanos , Leucoplasia , Masculino
17.
Artif Intell Med ; 115: 102060, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34001326

RESUMO

BACKGROUND: Oral cancer can show heterogenous patterns of behavior. For proper and effective management of oral cancer, early diagnosis and accurate prediction of prognosis are important. To achieve this, artificial intelligence (AI) or its subfield, machine learning, has been touted for its potential to revolutionize cancer management through improved diagnostic precision and prediction of outcomes. Yet, to date, it has made only few contributions to actual medical practice or patient care. OBJECTIVES: This study provides a systematic review of diagnostic and prognostic application of machine learning in oral squamous cell carcinoma (OSCC) and also highlights some of the limitations and concerns of clinicians towards the implementation of machine learning-based models for daily clinical practice. DATA SOURCES: We searched OvidMedline, PubMed, Scopus, Web of Science, and Institute of Electrical and Electronics Engineers (IEEE) databases from inception until February 2020 for articles that used machine learning for diagnostic or prognostic purposes of OSCC. ELIGIBILITY CRITERIA: Only original studies that examined the application of machine learning models for prognostic and/or diagnostic purposes were considered. DATA EXTRACTION: Independent extraction of articles was done by two researchers (A.R. & O.Y) using predefine study selection criteria. We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) in the searching and screening processes. We also used Prediction model Risk of Bias Assessment Tool (PROBAST) for assessing the risk of bias (ROB) and quality of included studies. RESULTS: A total of 41 studies were published to have used machine learning to aid in the diagnosis/or prognosis of OSCC. The majority of these studies used the support vector machine (SVM) and artificial neural network (ANN) algorithms as machine learning techniques. Their specificity ranged from 0.57 to 1.00, sensitivity from 0.70 to 1.00, and accuracy from 63.4 % to 100.0 % in these studies. The main limitations and concerns can be grouped as either the challenges inherent to the science of machine learning or relating to the clinical implementations. CONCLUSION: Machine learning models have been reported to show promising performances for diagnostic and prognostic analyses in studies of oral cancer. These models should be developed to further enhance explainability, interpretability, and externally validated for generalizability in order to be safely integrated into daily clinical practices. Also, regulatory frameworks for the adoption of these models in clinical practices are necessary.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Inteligência Artificial , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Humanos , Aprendizado de Máquina , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço
18.
Turk Neurosurg ; 31(4): 574-581, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33978215

RESUMO

AIM: To analyze the clinical and surgical outcomes following gross total resection (GTR) and planned subtotal resection (STR) of giant intracranial epidermoid tumors. MATERIAL AND METHODS: In this retrospective cohort study, all patients who were diagnosed with and operated for giant intracranial epidermoid tumors between January 2007 and May 2016 were included. The demographics, clinical outcomes, and surgical outcomes of these patients were analyzed. RESULTS: Forty-eight patients were enrolled in this study, and multicompartmental epidermoid tumors were observed in 23% of the patients. The mean size of the tumors was 6.2 cm (range, 4.0?9.0 cm). GTR and near-total resection (NTR) were performed in 34 (71%) patients. Fourteen patients (29%) underwent STR. Most patients (89%) had Glasgow Outcome Scale (GOS) of 5, whereas 8% had GOS of 4. The GTR/NTR group (23.5%) had more permanent complications than the STR group (7.1%). The mean follow-up period was 5.2 years (range, eight months to nine years). In the STR group, four patients (29%) showed an increase in the residual tumor, and only one patient (7%) was symptomatic and required reoperation. CONCLUSION: STR of giant intracranial epidermoid tumors is a safe surgical strategy with good surgical outcome. The requirement for reoperation is usually late and seldom required but can be done safely. The average time to recurrence was more than seven years.


Assuntos
Neoplasias Encefálicas/cirurgia , Carcinoma de Células Escamosas/cirurgia , Adolescente , Adulto , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/epidemiologia , Neoplasias Encefálicas/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Estudos de Coortes , Feminino , Humanos , Índia/epidemiologia , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Neoplasia Residual , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/métodos , Procedimentos Neurocirúrgicos/estatística & dados numéricos , Prognóstico , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Carga Tumoral , Adulto Jovem
19.
J Equine Vet Sci ; 101: 103426, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33993933

RESUMO

Skin lesions are among the leading diseases in equids, and the urogenital region is considered the third most frequently affected body location with tumors and tumor-like skin lesions in horses. Tumor-like skin lesions or multiple tumors of different types in the equine prepuce and penis are a challenging clinical presentation leading to misdiagnosis and subsequent ineffective treatment. An 18-year-old 395-kg male mixed-breed gelding was referred for evaluation of preputial enlargement. Clinical examination revealed a 2.5 × 2.0 × 0.8 cm proliferative ulcerated lesion on the penile mucosa, five ulcerated and circumscribed hardened wounds on the preputial skin fold from 2.0 to 6.0 cm in diameter, and multiple variable-sized raised exophytic lesions ranging from 2.0 mm to 2.3 cm cauliflower-like lesions throughout the prepuce and penis. Pathological and immunohistochemical findings confirmed the definitive diagnosis of three distinct proliferative lesions: squamous cell carcinoma, squamous viral papilloma and cutaneous habronemiasis. Additionally, we present features of concurrent habronemiasis and squamous cell carcinoma and highlight the importance of proper diagnostic approach in the prognosis and correct treatment selection.


Assuntos
Carcinoma de Células Escamosas , Doenças dos Cavalos , Papiloma , Neoplasias Penianas , Animais , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/veterinária , Cavalos , Masculino , Papiloma/veterinária , Neoplasias Penianas/diagnóstico , Neoplasias Penianas/veterinária , Pênis/cirurgia
20.
J Int Med Res ; 49(5): 3000605211016206, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34044599

RESUMO

OBJECTIVE: To identify biomarkers related to esophageal squamous cell carcinoma (ESCC) prognosis by analyzing genetic variations and the infiltration levels of tumor-infiltrating lymphocytes (TILs) in patients. METHODS: The clinical features of 61 patients with ESCC were collected. DNA panel sequencing was performed to screen differentially expressed genes (DEGs). Transcriptome sequencing was performed to identify gene expression profiles, and subsequent enrichment analysis of DEGs was conducted using Metascape. RESULTS: We identified 488 DEGs between patients with ESCC with distinct prognoses that were mainly enriched in the human immune response, fibrinogen complex, and protein activation cascade pathways. Among patients with ESCC treated with postoperative chemotherapy, those with a high infiltration level of myeloid-derived suppressor cells (MDSCs) had longer overall survival (OS), and OS was positively correlated with the infiltration level of T helper type 2 (Th2) cells among patients treated without chemotherapy after surgery. Additionally, in the case of MDSCs >0.7059 or Th2 cells <0.6290, patients receiving postoperative chemotherapy had a longer OS than those treated without chemotherapy following surgery. CONCLUSION: The level of MDSCs or Th2 cells can be used as a biomarker for assessing the prognosis of patients with ESCC treated with or without postoperative chemotherapy, respectively.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/genética , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/genética , Carcinoma de Células Escamosas do Esôfago/tratamento farmacológico , Carcinoma de Células Escamosas do Esôfago/genética , Regulação Neoplásica da Expressão Gênica , Humanos , Linfócitos do Interstício Tumoral , Prognóstico
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