laryngeal neoplasms

喉肿瘤
  • 文章类型: Systematic Review
    背景:窄带成像是一种先进的内窥镜技术,用于检测喉组织表面的变化,采用比较方法与白光内窥镜检查,以促进组织病理学检查。目的:本研究旨在通过与组织病理学检查的比较分析,评估NBI(窄带成像)在识别喉部恶性病变中的实用性和优势。方法:我们进行了系统的文献综述,利用PubMed等数据库,CNKI数据库,和Embase为我们的研究。结果:我们通过回顾文章的标题和摘要来分析文章,根据确定的标准选择我们认为相关的;在最后阶段,我们根据具体的资格标准审查了相关研究.结论:窄带成像是一种先进的内镜技术,可证明其作为诊断喉恶性病变并将其与癌前病变进行比较的工具的有效性。欧洲喉科学会已经实施了用于喉部病变的标准化分类系统,以增强数据相关性和组织。
    Background: Narrow-band imaging is an advanced endoscopic technology used to detect changes on the laryngeal tissue surface, employing a comparative approach alongside white-light endoscopy to facilitate histopathological examination. Objective: This study aimed to assess the utility and advantages of NBI (narrow-band imaging) in identifying malignant laryngeal lesions through a comparative analysis with histopathological examination. Methods: We conducted a systematic literature review, utilizing databases such as PubMed, the CNKI database, and Embase for our research. Results: We analyzed the articles by reviewing their titles and abstracts, selecting those we considered relevant based on determined criteria; in the final phase, we examined the relevant studies according to the specific eligibility criteria. Conclusions: Narrow-band imaging is an advanced endoscopic technology that demonstrates its efficacy as a tool for diagnosing malignant laryngeal lesions and comparing them to premalignant lesions. The European Society of Laryngology has implemented a standardized classification system for laryngeal lesions to enhance data correlation and organization.
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  • 文章类型: Journal Article
    炎症在癌症的发展过程中起着重要作用。近年来,评估炎症生物标志物预测生存能力的研究数量有所增加。本研究旨在全面评估炎性生物标志物在喉癌患者接受确定性放疗中的预测作用。回顾性检查了在我们中心接受喉癌明确放疗的101例患者。患者放疗前取血样获取C反应蛋白(CRP)等生物标志物,中性粒细胞-淋巴细胞比率(NLR),血小板-淋巴细胞比率(PLR),单核细胞-淋巴细胞比率(MLR),全身免疫炎症指数(SII),泛免疫炎症值(PIV),血嗜酸性粒细胞炎症指数(HEI),白蛋白,和乳酸脱氢酶(LDH)。该研究检查了无进展生存期(PFS)参数的预测价值,无局部复发生存率(LRFS),使用单变量和多变量Cox回归分析和总生存期(OS)。在单变量分析中,预测PFS的生物标志物是SII,PIV,CRP,和东部肿瘤协作组绩效状态(ECOGPS)。根据多变量分析,只有CRP被发现是PFS的显著预测因子.在单变量分析中,发现以下生物标志物可以预测OS:NLR,PLR,MLR,SII,PIV,CRP,HEI,舞台,和ECOGPS。在多变量分析中,发现NLR和ECOGPS是OS的预测因子。在MLR中发现了显著差异,PIV,和基于淋巴转移的CRP值。当前的研究是第一个全面检查喉癌与几种炎症生物标志物之间关系的研究。这些生物标志物中的许多已被证明可以预测正在接受明确放射治疗的喉癌患者的PFS和OS。已显示,除PFS和OS外,PIV和CRP还可以预测淋巴转移的存在。
    Inflammation plays an important role in the process of cancer development. The number of studies evaluating the ability of inflammatory biomarkers to predict survival has increased in recent years. This study aimed to comprehensively evaluate the predictive role of inflammatory biomarkers in patients with larynx cancer undergoing definitive radiotherapy. A total of 101 patients who underwent definitive radiotherapy for larynx cancer at our center were retrospectively examined. Blood samples were taken from the patients before radiotherapy to obtain biomarkers such as C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), pan-immune inflammatory value (PIV), hemo-eosinophil inflammation index (HEI), albumin, and Lactate dehydrogenase (LDH). The study examined the predictive value of parameters for progression-free survival (PFS), local recurrence-free survival (LRFS), and overall survival (OS) using both univariate and multivariate Cox regression analysis. In the univariate analysis, the biomarkers that predicted PFS were SII, PIV, CRP, and Eastern Cooperative Oncology Group Performance Status (ECOG PS). According to the multivariate analysis, only CRP was found to be a significant predictor of PFS. In the univariate analysis, the following biomarkers were found to predict OS: NLR, PLR, MLR, SII, PIV, CRP, HEI, stage, and ECOG PS. In the multivariate analysis, NLR and ECOG PS were found to be predictors of OS. A significant difference was found in MLR, PIV, and CRP values based on the presence of lymphatic metastasis. The current study is the first to comprehensively examine the relationship between larynx cancer and several inflammatory biomarkers. Many of these biomarkers have been shown to predict both PFS and OS in patients with larynx cancer undergoing definitive radiotherapy. It has been shown that PIV and CRP may predict the presence of lymphatic metastases in addition to PFS and OS.
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  • 文章类型: Journal Article
    喉癌表现出显著的全球健康负担,后期检测有助于降低死亡率。喉部区域图像上的喉癌诊断是计算机视觉(CV)和医学图像诊断在医学领域的关键应用。它包括检测和分析喉部的异常或癌组织,声乐和呼吸系统的一个组成部分。计算机辅助系统通过深度学习(DL)和机器学习(ML)模型利用人工智能(AI),包括卷积神经网络(CNN),用于自动疾病诊断和检测。执行各种DL和ML方法以将提取特征分类为健康组织和癌组织。本文介绍了在生物医学喉部区域图像上使用蒲公英优化算法和集成学习(LCD-DOAEL)方法的自动喉癌诊断。LCD-DOAEL方法旨在研究喉癌存在的咽喉区域的图像。在LCD-DOAEL方法中,高斯滤波(GF)方法用于消除生物医学图像中的噪声。此外,复杂和内在的特征模式可以通过MobileNetv2模型来提取。同时,DOA模型进行MobileNetV2架构的超参数选择。最后,三个分类器的集合,如双向长短期记忆(BiLSTM),正则化极限学习机(ELM),和反向传播神经网络(BPNN)模型,用于分类过程。在生物医学图像数据集上进行了一组全面的模拟,以突出LCD-DOAEL技术的有效性能。LCD-DOAEL方法的比较分析显示出优于其他现有技术的97.54%的准确性结果。
    Laryngeal cancer exhibits a notable global health burden, with later-stage detection contributing to a low mortality rate. Laryngeal cancer diagnosis on throat region images is a pivotal application of computer vision (CV) and medical image diagnoses in the medical sector. It includes detecting and analysing abnormal or cancerous tissue from the larynx, an integral part of the vocal and respiratory systems. The computer-aided system makes use of artificial intelligence (AI) through deep learning (DL) and machine learning (ML) models, including convolution neural networks (CNN), for automated disease diagnoses and detection. Various DL and ML approaches are executed to categorize the extraction feature as healthy and cancerous tissues. This article introduces an automated Laryngeal Cancer Diagnosis using the Dandelion Optimizer Algorithm with Ensemble Learning (LCD-DOAEL) method on Biomedical Throat Region Image. The LCD-DOAEL method aims to investigate the images of the throat region for the presence of laryngeal cancer. In the LCD-DOAEL method, the Gaussian filtering (GF) approach is applied to eliminate the noise in the biomedical images. Besides, the complex and intrinsic feature patterns can be extracted by the MobileNetv2 model. Meanwhile, the DOA model carries out the hyperparameter selection of MobileNetV2 architecture. Finally, the ensemble of three classifiers such as bidirectional long short-term memory (BiLSTM), regularized extreme learning machine (ELM), and backpropagation neural network (BPNN) models, are utilized for the classification process. A comprehensive set of simulations is conducted on the biomedical image dataset to highlight the efficient performance of the LCD-DOAEL technique. The comparison analysis of the LCD-DOAEL method exhibited a superior accuracy outcome of 97.54% over other existing techniques.
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  • 文章类型: Journal Article
    背景:最初在唾液腺多形性腺瘤中描述了富含酪氨酸或酪氨酸样晶体(TC)。TC在非肿瘤组织中的存在是罕见的,据报道,它只存在于喉部。这项研究旨在表征全喉切除术标本中TC的频率和解剖定位。
    方法:回顾连续的喉切除术标本,其中盒式总结记录了左右声带和前连合的矢状面旁切片采样。收集的数据包括患者人口统计学,潜在的诊断,放射治疗史,存在,和TC的位置。
    结果:在86个喉切除标本中,16(19%)含有两性至嗜酸性的TC。该研究队列包括11名男性和5名女性,年龄37至85岁(平均62岁,中位数63岁)。晚期未经治疗的鳞状细胞癌(SCCa)进行喉切除术(7/16,43.75%),治疗后复发SCCa(7/16,43.75%),以前未经治疗的喉大细胞神经内分泌癌(1/16,6.25%),放化疗后喉无功能(1/16,6.25%)。根据宏观卡带总结,主要在前连合部分发现TC。(13/16,81.25%),在包含左侧(2/16,12.5%)或右侧(1/16,6.25%)声带的切片中,病例较少。微观上,TC位于黄斑前黄和/或邻近的声带韧带(12/16,75%)和前连合肌腱(4/16,25%)。
    结论:据报道,TC主要与肿瘤混合,然而,这项研究证实,TC也可以发生在喉部的非肿瘤组织中。TC的存在与先前的放射治疗之间没有明确的关系。黄斑黄花的特殊结缔组织中的TC和与肿瘤不同的真索肌腱插入可能响应于机械应力的改变而形成,尽管正常喉部显微解剖结构范围内的年龄相关变化仍有可能。
    BACKGROUND: Tyrosine-rich or tyrosine-like crystalloids (TC) were initially described in salivary gland pleomorphic adenoma. The presence of TC in non-neoplastic tissues is rare, and it has been reported exclusively in the larynx. This study aims to characterize the frequency and anatomical localization of TC in total laryngectomy specimens.
    METHODS: Review of consecutive laryngectomy specimens in which the cassette summary documented parasagittal section sampling of the right and left vocal folds and the anterior commissure. Data collected included patient demographics, underlying diagnoses, history of radiation therapy, presence, and location of TC.
    RESULTS: Of 86 laryngectomy specimens, 16 (19%) contained amphophilic to eosinophilic TC. The study cohort included 11 males and 5 females, aged 37 to 85 years (mean 62, median 63). Laryngectomy surgery was performed for advanced untreated squamous cell carcinoma (SCCa) (7/16, 43.75%), recurrent post-treatment SCCa (7/16, 43.75%), previously untreated laryngeal large cell neuroendocrine carcinoma (1/16, 6.25%), and non-functional larynx post-chemoradiation (1/16, 6.25%). According to the macroscopic cassette summary, TC were predominantly found in the anterior commissure Sect. (13/16, 81.25%), with fewer cases in sections containing the left (2/16, 12.5%) or the right (1/16, 6.25%) vocal folds. Microscopically, TC localized to the anterior macula flava and/or adjacent vocal ligament (12/16, 75%) and the anterior commissure tendon (4/16, 25%).
    CONCLUSIONS: TCs are predominantly reported as admixed with a neoplasm, however this study confirms that TC can also occur in non-neoplastic tissues of the larynx. There was no clear relationship between the presence of TC and prior radiation therapy. TC in the specialized connective tissues of the macula flava and true cord tendinous insertions distinct from tumor may form in response to alterations in mechanical stress, though an age-related change within the spectrum of normal laryngeal microanatomy also remains a possibility.
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  • 文章类型: Case Reports
    髓外浆细胞瘤是一种罕见的局部浆细胞肿瘤,通常在骨髓外的软组织中发现。主要发生在头颈部,特别是在鼻窦和鼻咽区域,由于其不常见的性质,它提出了诊断挑战。在这里,我们报告了一名38岁女性唐氏综合征患者,2年主诉间歇性发声障碍,声音嘶哑,和进行性呼吸窘迫,包括呼吸困难,疲劳,和双相喘鸣。通过柔性喉镜检查发现白色病变,提示直接显微喉部手术切除1x1厘米的肿块。组织学发现证实诊断为孤立的髓外浆细胞瘤。值得注意的是,这是第一例记录的唐氏综合征患者的喉孤立性髓外浆细胞瘤。该病例强调了考虑唐氏综合征患者喉部肿瘤发展的重要性,强调有必要制定量身定制的管理策略,以有效解决此类事件。提高对这种关联的认识可以帮助该人群中肿瘤的早期发现和适当治疗。
    Extramedullary plasmacytoma is a rare localized plasma cell neoplasm typically found in soft tissues outside the bone marrow. Predominantly occurring in the head and neck region, particularly in the sinonasal and nasopharyngeal areas, it presents a diagnostic challenge due to its uncommon nature. Herein, we report a 38-year-old female patient with Down\'s syndrome with a 2-year complaint of intermittent dysphonia, hoarseness, and progressive respiratory distress, including dyspnea, fatigue, and biphasic stridor. Examination via flexible laryngoscopy revealed a white lesion, prompting direct microscopic laryngeal surgery to excise a 1x1 cm mass. Histological findings confirmed the diagnosis as solitary extramedullary plasmacytoma. Notably, this represented the first documented case of laryngeal solitary extramedullary plasmacytoma in a patient with Down\'s syndrome. This case underscores the importance of considering tumor development in the larynx among individuals with Down\'s syndrome, highlighting the necessity for tailored management strategies to address such occurrences effectively. Increasing awareness of this association can aid in early detection and appropriate treatment of tumors in this population.
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  • 文章类型: Journal Article
    早期筛查多发肿瘤的护理和体检有助于早期发现肿瘤,从而提高治愈率。研究其分子机制迫在眉睫。通过登录基因表达综合数据库,我们发现喉癌数据集GSE127165,膀胱癌数据集GSE65635,口腔癌数据集GSE146483,获得差异表达基因,随后,加权基因共表达网络分析,蛋白质-蛋白质相互作用网络,功能富集分析,免疫浸润分析,生存分析,进行了比较毒物基因组学数据库分析。绘制基因表达的热图。使用targetScan搜索有关核心DEG的miRNA信息。获得了53个差异表达基因。在GOKEGG分析中,它们聚集在细胞周期过程中,主轴杆,和蛋白质丝氨酸/苏氨酸/酪氨酸激酶活性细胞周期,癌症中的转录失调,RIG-I样受体信号通路,P53信号通路。蛋白质相互作用分析筛选出5个基因(NEK2、BUB1、HMMR、TTK,CCNB2)。细胞周期蛋白B2(CCNB2)和不被苯并咪唑1(BUB1)抑制的出芽在喉癌中高表达,膀胱癌,口腔癌。比较毒物基因组学数据库分析发现,核心基因(CCNB2、BUB1)与肿瘤、坏死,和炎症。CCNB2基因相关miRNA为hsa-miR-670-3p;BUB1基因相关miRNA为hsa-miR-5688、hsa-miR-495-3p。CCNB2和BUB1在喉癌中高表达,膀胱癌,口腔癌,这表明了它们作为精确治疗这些癌症的分子靶点的潜力。
    Nursing and physical examination early screening of multiple tumors is helpful to find tumors early, so as to improve the cure rate. Studying its molecular mechanisms is urgent. By logging into gene expression omnibus database, we found laryngeal cancer dataset GSE127165, bladder cancer dataset GSE65635, oral cancer dataset GSE146483, obtain differentially expressed genes, subsequently, weighted gene co-expression network analysis, protein-protein interaction networks, functional enrichment analysis, immune infiltration analysis, survival analysis, comparative toxicogenomics database analysis were conducted. Draw a heatmap of gene expression. Use targetScan to search for miRNA information about core DEG. Got 53 differentially expressed genes. In GOKEGG analysis, they were clustered in cell cycle processes, spindle poles, and protein serine/threonine/tyrosine kinase activity cell cycle, transcriptional dysregulation in cancer, RIG-I-like receptor signaling pathway, P53 signaling pathway. Protein-protein interaction analysis screened out 5 genes (NEK2, BUB1, HMMR, TTK, CCNB2). Cyclin B2 (CCNB2) and budding uninhibited by benzimidazole 1 (BUB1) were highly expressed in laryngeal cancer, bladder cancer, oral cancer. Comparative toxicogenomics database analysis found that core genes (CCNB2, BUB1) are associated with tumors, necrosis, and inflammation. Related miRNA of CCNB2 gene is hsa-miR-670-3p; related miRNAs of BUB1 gene are hsa-miR-5688, hsa-miR-495-3p. CCNB2 and BUB1 exhibit high expression in laryngeal cancer, bladder cancer, and oral cancer, suggesting their potential as molecular targets for precision therapy in these cancers.
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  • 文章类型: Journal Article
    在早期喉癌的治疗中,手术(经口喉部手术(TOLS),开放部分喉手术(OPLS)和放射治疗(RT)。
    比较TOLS或RT治疗的早期喉鳞状细胞癌(LSCC)患者的肿瘤学结果。
    回顾性研究。
    三级培训和研究医院。
    参与者被分为接受TOLS和RT治疗的患者。两组在局部复发方面进行比较,区域性复发,远处转移,3年和5年总生存期(OS),无病生存率(DFS),疾病特异性生存率(DSS)和无喉切除术生存率(LFS)。
    TOLS和RT治疗对局部控制的影响,区域控制,操作系统,DFS,早期喉癌的DDS和LFS。
    261。
    平均随访时间为48(26)个月。有186例患者接受了TOLS治疗,75例患者接受了RT治疗。性别,香烟/酒精消费,肿瘤定位,前连合受累,肿瘤等级,两组的复发率和复发部位相似.5年总体来说,疾病特异性,无病和无喉切除术生存率为85.9%,88%,79.4%,TOLS组的96.3%和74.3%,76.7%,72.3%,RT组为85.2%(分别为P=.034、.065、.269、.060)。
    与RT相比,TOLS在OS和DFS上的肿瘤学结果相同且良好。前连合受累是两组DFS的统计学显著独立预后危险因素。TOLS组的5年OS率更高(P=.034)。
    回顾性,但就我们所知,这是土耳其首例患者量大,随访时间长的研究.
    UNASSIGNED: In the treatment of early stage laryngeal cancers, surgery (transoral laryngeal surgery (TOLS), open partial laryngeal surgery (OPLS) and radiotherapy (RT) are used.
    UNASSIGNED: Compare the oncological results of patients with early stage laryngeal squamous cell carcinoma (LSCC) treated with TOLS or RT.
    UNASSIGNED: Retrospective.
    UNASSIGNED: Tertiary training and research hospital.
    UNASSIGNED: The participants were divided into patients who underwent TOLS and RT treatment. The groups were compared with each other in terms of local recurrence, regional recurrence, distant metastasis, 3 and 5-year overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS) and laryngectomy-free survival rates (LFS).
    UNASSIGNED: The effects of TOLS and RT treatment on local control, regional control, OS, DFS, DDS and LFS in early stage laryngeal cancers.
    UNASSIGNED: 261.
    UNASSIGNED: The mean follow-up time was 48 (26) months. There were 186 patients who underwent TOLS and 75 patients who underwent RT treatment. Gender, cigarette/alcohol consumption, tumor localization, anterior commissure involvement, tumor grades, recurrence rates and recurrence localizations of the groups were similar. The 5-year overall, disease specific, disease free and laryngectomy-free survival rates were 85.9%, 88%, 79.4%, 96.3% in the TOLS group and 74.3%, 76.7%, 72.3%, 85.2% in the RT group (P=.034, .065, .269, .060, respectively).
    UNASSIGNED: TOLS had equal and good oncological outcomes on OS and DFS compared to RT. Anterior commissure involvement was statistically significant independent prognostic risk factor for DFS in both groups. The 5-year OS rate was greater in the TOLS groups (P=.034).
    UNASSIGNED: Retrospective, but to the best our knowledge, this is the first study in Turkey with a high patient volume and a long follow-up time.
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  • 文章类型: Journal Article
    目的:分析经口微创手术(TMIS)治疗声门上喉癌(SGLC)的肿瘤和功能结果,并探讨独立的预后因素。
    方法:纳入接受TMIS治疗的70例SGLC患者。总生存期(OS),无复发生存率(RFS),并对术后功能进行分析。
    结果:62例患者为早期阶段(Tis,T1和T2)和8例患者为T3。11例患者接受术前诱导化疗(IC)。60例患者接受经口激光显微手术(TLM),10例患者接受经口机器人手术(TORS).58名患者通过水吞咽测试获得1级评分,49例患者分0级,粗糙度,呼吸,虚弱,应变。1年、3年和5年OS均为95.450%,84.877%,和78.026%,RFS为89.167%,78.052%,和75.451%。Kaplan-Meier生存分析显示N分期和临床分期与OS相关,吸烟,临床分期,手术切缘,Ki-67指数与RFS相关。术前IC或直接手术无显著差异,TLM,或TORS。Cox分析显示,吸烟和手术切缘是RFS的独立预后因素。
    结论:阳性边缘,Ki-67指数≥40%和P53(+)和Ki-67指数≥40%是SGLC患者复发的较差因素。吸烟和手术切缘是影响复发的独立预后因素。
    OBJECTIVE: To analyze oncological and functional results of transoral minimally invasive surgery (TMIS) for supraglottic laryngeal carcinoma (SGLC), and investigate independent prognostic factors.
    METHODS: Seventy SGLC patients treated with TMIS were included. The overall survival (OS), recurrence-free survival (RFS), and postoperative functions were analyzed.
    RESULTS: Sixty-two patients were early-stage (Tis, T1, and T2) and eight patients were T3. Eleven patients received preoperative induction chemotherapy (IC). Sixty patients received transoral laser microsurgery (TLM), and 10 patients received transoral robotic surgery (TORS). Fifty-eight patients were scored Grade-1 by water swallow test, and 49 patients were scored Grade 0 by grade, roughness, breathiness, asthenia, strain. The 1, 3, and 5 year OS of all were 95.450%, 84.877%, and 78.026%, and RFS were 89.167%, 78.052%, and 75.451% respectively. Kaplan-Meier survival analysis showed N stage and clinical stage were associated with OS, smoking, clinical stage, surgical margins, and Ki-67 index were associated with RFS. There were no significant differences in preoperative IC or direct surgery, TLM, or TORS. Cox analyses showed smoking and surgical margins were independent prognosis factors for RFS.
    CONCLUSIONS: The positive margin, Ki-67 index ≥40% and P53(+)&Ki-67 index ≥40% are worse factors affecting recurrence for SGLC patients. Both smoking and surgical margins are independent prognostic factors affecting recurrence.
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  • 文章类型: Journal Article
    背景:HHLA2(人类内源性逆转录病毒-H长末端重复序列相关蛋白2)代表了最近确定的B7免疫检查点家族成员,其特征是在正常组织中表达有限,但在各种癌症类型中明显过表达。然而,精确的功能和与免疫细胞的相互作用仍然知之甚少,尤其是喉鳞状细胞癌(LSCC)。这项研究试图阐明HHLA2在人类LSCC组织的肿瘤微环境中的生物学意义,并描述HHLA2在LSCC发病机理中的临床相关性和功能作用。
    方法:通过对来自LSCC患者(n=72)的组织微阵列进行的多重免疫组织化学分析,进行分析以评估HHLA2的表达水平,CD68HLA-DRCD163-(M1巨噬细胞)的密度和空间模式,CTLA-4+CD4+FoxP3+(CTLA-4+Treg细胞),CTLA-4+CD4+FoxP3-(CTLA-4+Tcon细胞),耗尽的CD8+T细胞,和LSCC组织中终末耗尽的CD8+T细胞。进行生存分析以评估HHLA2和这些免疫检查点或免疫细胞群的预后意义。采用COX回归分析确定独立的预后因素。
    结果:Kaplan-Meier(K-M)存活曲线揭示了LSCC中HHLA2表达与总生存期(OS)之间的显著关联。HHLA2水平升高与患者生存率降低有关。表明其作为预后标志物的潜力(HR:3.230,95CI0.9205-11.34,P=0.0067)。值得注意的是,CD68+细胞(总巨噬细胞)的浸润增加,STING+CD68+HLA-DR+CD163-(STING+M1巨噬细胞),CTLA-4+CD4+FoxP3+,CTLA-4+CD4+FoxP3-,PD-1+LAG-3+CD8+T细胞,PD-1+LAG-3+TIM-3+CD8+T细胞与较差的生存结局密切相关(P<0.05)。在这些免疫细胞群的水平之间观察到明显的趋势,STING+CD68+(STING+总巨噬细胞),CD68+HLA-DR+CD163-,STING+CD68+CD163+HLA-DR-(STING+M2巨噬细胞),PD-1+LAG-3-CD8+T细胞,PD-1+TIM-3+CD8+T细胞,PD-1+LAG-3+TIM-3-CD8+T细胞与预后的关系。重要的是,多因素COX分析确定HHLA2是LSCC患者OS的独立预测因子(HR=3.86,95%CI1.08-13.80,P=0.038)。这强调了HHLA2作为预测LSCC患者预后的关键标志物的潜力。
    结论:HHLA2作为评估LSCC患者OS的一个有害的预后生物标志物出现。相对于其他免疫检查点,HHLA2对LSCC患者的预后表现出更高的预测功效。
    BACKGROUND: HHLA2 (human endogenous retrovirus-H long terminal repeat-associating protein 2) represents a recently identified member of the B7 immune checkpoint family, characterized by limited expression in normal tissues but notable overexpression in various cancer types. Nevertheless, the precise function and interaction with immune cells remain poorly understood, particularly in laryngeal squamous cell carcinoma (LSCC). This investigation endeavored to elucidate the biological significance of HHLA2 within the tumor microenvironment of human LSCC tissues and delineate the clinical relevance and functional roles of HHLA2 in LSCC pathogenesis.
    METHODS: Through multiplexed immunohistochemistry analyses conducted on tissue microarrays sourced from LSCC patients (n = 72), the analysis was executed to assess the expression levels of HHLA2, density and spatial patterns of CD68+HLA-DR+CD163- (M1 macrophages), CTLA-4+CD4+FoxP3+ (CTLA-4+Treg cells), CTLA-4+CD4+FoxP3- (CTLA-4+Tcon cells), exhausted CD8+T cells, and terminally exhausted CD8+T cells in LSCC tissues. Survival analysis was conducted to evaluate the prognostic significance of HHLA2 and these immune checkpoints or immune cell populations, employing COX regression analysis to identify independent prognostic factors.
    RESULTS: Kaplan-Meier (K-M) survival curves revealed a significant association between HHLA2 expression and overall survival (OS) in LSCC. Elevated levels of HHLA2 were linked to reduced patient survival, indicating its potential as a prognostic marker (HR: 3.230, 95%CI 0.9205-11.34, P = 0.0067). Notably, increased infiltration of CD68+ cells (total macrophages), STING+CD68+HLA-DR+CD163- (STING+M1 macrophages), CTLA-4+CD4+FoxP3+, CTLA-4+CD4+FoxP3-, PD-1+LAG-3+CD8+T cells, and PD-1+LAG-3+TIM-3+CD8+T cells strongly linked to poorer survival outcomes (P < 0.05). A discernible trend was observed between the levels of these immune cell populations, STING+CD68+ (STING+ total macrophages), CD68+HLA-DR+CD163-, STING+CD68+CD163+HLA-DR- (STING+M2 macrophages), PD-1+LAG-3-CD8+T cells, PD-1+TIM-3+CD8+T cells, and PD-1+LAG-3+TIM-3-CD8+T cells and prognosis. Importantly, multivariate COX analysis identified HHLA2 as an independent predictive factor for OS in LSCC patients (HR = 3.86, 95% CI 1.08-13.80, P = 0.038). This underscored the potential of HHLA2 as a critical marker for predicting patient outcomes in LSCC.
    CONCLUSIONS: HHLA2 emerged as a detrimental prognostic biomarker for assessing OS in LSCC patients. Relative to other immune checkpoints, HHLA2 exhibited heightened predictive efficacy for the prognosis of LSCC patients.
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  • 文章类型: Journal Article
    目的:治疗方法的变化,特征是从喉切除术转向关注器官保存方法可能导致生存率降低。我们的目标是确定北欧国家50年期间喉癌(LC)生存趋势的差异,并讨论治疗方案变化等因素的潜在影响。
    方法:1972年至2021年的五年相对生存(RS)数据来自NORDCAN数据库2.0,其中包括33,692例LC病例,其中85%被诊断为男性。在NORDCAN数据库中,年龄标准化RS是使用PoharPerme估计器和单个国际癌症生存标准权重计算的。Joinpoint回归模型用于评估RS多年来趋势的潜在变化。
    结果:尽管丹麦和挪威在1972年至2021年的5年RS中表现出增长趋势,但在芬兰和瑞典,男性的5年RS保持不变,没有任何明显的趋势。在1992-1996年至2017-2021年的30年间,丹麦的RS分别提高了9、4、13和2个百分点。芬兰,挪威,瑞典,分别。在瑞典的女性中,观察到线性负趋势,值得注意的是,从最早到最近一段时间,5年期RS下降了16个百分点。
    结论:生存趋势差异的根本原因尚不清楚。除了治疗方案的差异,其他几个因素也会影响RS,这使得RS趋势的解释具有挑战性。
    OBJECTIVE: Changes in treatment approaches, characterised by the shift from laryngectomy to a focus on organ-preserving methods may have potentially resulted in lower survival. We aim to identify differences in survival trends for laryngeal cancer (LC) in the Nordic countries over a period of 50 years, and discuss the potential impact of factors such as changes in treatment protocols.
    METHODS: Five-year relative survival (RS) data from 1972 to 2021 were obtained from the NORDCAN database 2.0 which included 33,692 LC cases, of which 85% were diagnosed among men. In the NORDCAN database, the age-standardised RS is calculated using the Pohar Perme estimator with individual International Cancer Survival Standards weights. Joinpoint regression models were used to assess potential shifts in trend over the years in RS.
    RESULTS: While Denmark and Norway demonstrated an increasing trend in 5-year RS from 1972 to 2021, in Finland and Sweden, the 5-year RS among men remained static, without any discernible significant trend. Over the 30-year period from 1992-1996 to 2017-2021, RS improved by 9, 4, 13, and 2 percentage points in Denmark, Finland, Norway, and Sweden, respectively. Among women in Sweden, a linear negative trend was observed, noticeable as a 16 percentage-point decline in 5-year RS from the earliest to the latest period.
    CONCLUSIONS: The underlying causes for the differences in survival trends remain unclear. Besides differences in treatment protocols, several other factors can affect RS making the interpretation of RS trends challenging.
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