Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed t...Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed tomography(CT), magnetic resonance imaging(MRI) and ^(18)F-2-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography(^(18)F-FDG PET/CT) are widely used to determine the presence and extent of tumors and metastatic disease, both before and after treatment. Advances in PET/CT imaging have allowed it to emerge as a superior imaging modality compared to both CT and MRI, especially in detection of carcinoma of unknown primary, cervical lymph node metastasis, distant metastasis, residual/recurrent cancer and second primary tumors, often leading to alteration in management. PET/CT biomarker may further provide an overall assessment of tumor aggressiveness with prognostic implications. As new developments emerged leading to better understanding and use of PET/CT in head and neck oncology, the aim of this article is to review the roles of PET/CT in both pre- and post-treatment management of HNSCC and PET-derived parameters as prognostic indicators.展开更多
目的探讨分析M2型巨噬细胞在头颈部鳞状细胞癌(squamous cell carcinoma of head and neck,HNSCC)多原发癌患者中的浸润特点及其临床意义,总结及发掘M2型巨噬细胞在多原发癌患者鉴别诊断及预后评价中的作用。方法获取癌症基因组图谱(The...目的探讨分析M2型巨噬细胞在头颈部鳞状细胞癌(squamous cell carcinoma of head and neck,HNSCC)多原发癌患者中的浸润特点及其临床意义,总结及发掘M2型巨噬细胞在多原发癌患者鉴别诊断及预后评价中的作用。方法获取癌症基因组图谱(The Cancer Genome Atlas,TCGA)数据库中502例HNSCC患者的癌组织与44例癌旁组织样本RNA表达谱数据,使用R包及R软件v4.0.3进行统计分析。回顾性筛选1998年7月至2016年2月期间就诊于北京大学口腔医学院·口腔医院口腔颌面外科,经随访并确诊为HNSCC多原发癌的患者44例,其中男性17例,女性27例。筛选2013年8月至2015年12月期间经随访为单发的牙龈癌患者41例,其中男性28例,女性13例。石蜡切片免疫组织化学染色全景切片分析CD163表达阳性细胞数及表达特点,CD163阳性细胞数≤15为CD163低表达组,CD163阳性细胞数>15为CD163高表达。采用χ2检验及Spearman相关性分析比较单发牙龈癌患者与HNSCC多原发癌患者CD163阳性计数和(或)浸润深度与发病次数间差异及关联。多原发癌及单发牙龈癌患者的临床特征用SPSS 25.0进行描述性统计分析。结果分析TCGA数据库RNAseq数据结果提示,巨噬细胞浸润在HNSCC组织中较癌旁组织增加(P<0.001)。多原发癌患者原发肿瘤的CD163阳性细胞数[90.9%(40/44)]显著高于单发牙龈癌患者[61.0%(25/41)](P=0.001),且CD163阳性细胞计数与发病次数呈正相关(r=0.368,P=0.001)。CD163原发肿瘤阳性细胞数与浸润深度比值与发病次数也呈正相关(r=0.331,P=0.03)。44例多原发癌患者以女性、无烟酒嗜好、无系统病史、Tis~T2期以及N0期HNSCC为主,多原发次数自第2至第8次不等。同时癌发病比例随多原发次数增加而增大。原发癌发病部位以舌、牙龈、颊为主,随着多原发次数增加,发病部位牙龈、颊及腭部占比增高。结论M2型巨噬细胞数和(或)结合浸润深度与多原发癌发生次数相关,可能成为临床鉴别单发与多原发癌患者的指标。对发生于头颈部(舌、牙龈、颊部为主)的女性、无烟酒嗜好、无系统病史的早期HNSCC患者,应加强随访。展开更多
文摘Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed tomography(CT), magnetic resonance imaging(MRI) and ^(18)F-2-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography(^(18)F-FDG PET/CT) are widely used to determine the presence and extent of tumors and metastatic disease, both before and after treatment. Advances in PET/CT imaging have allowed it to emerge as a superior imaging modality compared to both CT and MRI, especially in detection of carcinoma of unknown primary, cervical lymph node metastasis, distant metastasis, residual/recurrent cancer and second primary tumors, often leading to alteration in management. PET/CT biomarker may further provide an overall assessment of tumor aggressiveness with prognostic implications. As new developments emerged leading to better understanding and use of PET/CT in head and neck oncology, the aim of this article is to review the roles of PET/CT in both pre- and post-treatment management of HNSCC and PET-derived parameters as prognostic indicators.
基金国家自然科学基金，首都临床特色应用研究，吴阶平医学基金会临床科研专项资助基金(2013-428-2084)National Natural Science Foundation of China，Beijing Municipal Science and Technology Commission，Jieping Medical Special Foundation for clinical research
文摘目的 总结分析头颈部多原发癌（multiple primary carcinoma,MPC）的临床特点.方法 回顾性分析2008年1月-2015年11月解放军总医院耳鼻咽喉头颈外科的71例MPC患者,包括20例同时性MPC患者,51例异时性MPC患者.其中63.4％ （45/71）为头颈部区域癌化（field cancerization of head neck,FCHN）,36.6％ （26/71）为头颈部非区域癌化（non-field-cancerization of head neck,NFCHN）.对间隔时间为0的同时性MPC患者,FCHN患者选择放化疗综合治疗,NFCHN患者首先治疗病变较重的部位;对其他类型的MPC患者,根据国际指南或国内专家共识,治疗首发部位及后续发生部位的肿瘤.结果 平均随访63.4个月,3年和5年总生存率（overall survival,OS）分别为84.6％和75.7％;其中同时性MPC的3年和5年OS分别为56.4％和37.6％,异时性MPC的3年和5年OS分别为92.2％和84.2％.两组间比较,异时性MPC的OS明显高于同时性MPC（P=0.0001）;FCHN患者3年和5年OS分别为85.7％和77.9％,NFCHN患者3年和5年OS分别为82.9％和72.8％.两组间比较差异无统计学意义（P=0.62）.结论 通过正确的诊断和有效的根治性治疗,部分MPC患者得到长期存活,其中异时性MPC患者得到更好的预后.
文摘目的探讨分析M2型巨噬细胞在头颈部鳞状细胞癌(squamous cell carcinoma of head and neck,HNSCC)多原发癌患者中的浸润特点及其临床意义,总结及发掘M2型巨噬细胞在多原发癌患者鉴别诊断及预后评价中的作用。方法获取癌症基因组图谱(The Cancer Genome Atlas,TCGA)数据库中502例HNSCC患者的癌组织与44例癌旁组织样本RNA表达谱数据,使用R包及R软件v4.0.3进行统计分析。回顾性筛选1998年7月至2016年2月期间就诊于北京大学口腔医学院·口腔医院口腔颌面外科,经随访并确诊为HNSCC多原发癌的患者44例,其中男性17例,女性27例。筛选2013年8月至2015年12月期间经随访为单发的牙龈癌患者41例,其中男性28例,女性13例。石蜡切片免疫组织化学染色全景切片分析CD163表达阳性细胞数及表达特点,CD163阳性细胞数≤15为CD163低表达组,CD163阳性细胞数>15为CD163高表达。采用χ2检验及Spearman相关性分析比较单发牙龈癌患者与HNSCC多原发癌患者CD163阳性计数和(或)浸润深度与发病次数间差异及关联。多原发癌及单发牙龈癌患者的临床特征用SPSS 25.0进行描述性统计分析。结果分析TCGA数据库RNAseq数据结果提示,巨噬细胞浸润在HNSCC组织中较癌旁组织增加(P<0.001)。多原发癌患者原发肿瘤的CD163阳性细胞数[90.9%(40/44)]显著高于单发牙龈癌患者[61.0%(25/41)](P=0.001),且CD163阳性细胞计数与发病次数呈正相关(r=0.368,P=0.001)。CD163原发肿瘤阳性细胞数与浸润深度比值与发病次数也呈正相关(r=0.331,P=0.03)。44例多原发癌患者以女性、无烟酒嗜好、无系统病史、Tis~T2期以及N0期HNSCC为主,多原发次数自第2至第8次不等。同时癌发病比例随多原发次数增加而增大。原发癌发病部位以舌、牙龈、颊为主,随着多原发次数增加,发病部位牙龈、颊及腭部占比增高。结论M2型巨噬细胞数和(或)结合浸润深度与多原发癌发生次数相关,可能成为临床鉴别单发与多原发癌患者的指标。对发生于头颈部(舌、牙龈、颊部为主)的女性、无烟酒嗜好、无系统病史的早期HNSCC患者,应加强随访。
