Incidence,trends, and survival of oropharyngeal squamous cell cancer in Aotearoa New Zealand, 2006–2020

BackgroundAn increasing trend of oropharyngeal cancer (OPC) has been reported in several countries with different demographic characteristics, and often attributed to increases in human papillomavirus (HPV) infection. The survival of patients with OPC has steadily improved, especially for those with positive HPV status. This study assessed the incidence, trends, and survival of OPC in Aotearoa New Zealand (NZ) by age at diagnosis, sex and ethnicity.MethodsThe study included all 2109 patients resident in NZ with a primary diagnosis of oropharyngeal squamous cell carcinoma from 2006 to 2020, identified from the National Cancer Registry. We assessed age-standardised incidence rate (ASR), annual percent change (APC) and overall and relative survival rates.ResultsThe average annual incidence of OPC was 2.2 per 100,000 population. There was a steady increase of 4.9% per year over 15 years. Although the incidence rates were higher in males over the study period, the overall rate of increase was similar in males (4.9%) and in females (4.3%). The incidence was highest in the 50–69-year group (8.8/100,000 population). This age group had an incidence that increased by 7.5% per year to 2018, and then declined. The main increase in rates was seen between the birth cohort of 1946–50 and that of 1956–60. The increase in incidence was seen in Māori and Pākehā/European populations, but no increase was seen in Pacific or Asian populations. The 5-year overall relative survival rate improved from 69% in 2006‐13 to 78% in 2014–20. Survival rates were lower in older patients, females, and Māori patients.ConclusionThis study confirmed a substantial increase in OPC incidence in NZ, with some evidence to suggest a recent slowing in this increase. Māori and Pākehā/European had the highest incidence, while Pacific and Asian populations showed the lowest rates and no increase over the study period. Survival rates have improved over time, but remained lower in some demographic groups.     

Cholecystokinin and bombesin effects on rewarded and nonrewarded operants

Rats were food-rationed (15 g/day) and trained to bar-press for food. In Experiment 1, the animals were injected with cholecystokinin octapeptide (CCK, 2 μg/kg), bombesin (BBS, 12 μg/kg), normal saline, or prefed with 20 Noyes 45 mg pellets. The animals were then tested for one hour for bar-pressing responses with food reward. In Experiment 2, the animals were similarly trained, treated, and tested for bar-pressing responses without food reward. The results showed that BBS and prefeeding decreased bar-pressing, rewarded or non-rewarded, but the CCK effect was greatly decreased when food was withheld. It appeared that the CCK effect was more dependent upon the presence of food than the BBS or prefeeding effects. The results were discussed in terms of involvement of the food and reward-related oropharyngeal stimuli for the CCK effect and the drive-related stimuli for the BBS and prefeeding effects.     

Current Status of Human Papillomavirus-Related Head and Neck Cancer: From Viral Genome to Patient Care

Virologica Sinica - Human papillomavirus (HPV) infection identified as a definitive human carcinogen is increasingly being recognized for its role in carcinogenesis of human cancers. Up to...     

Evolution of 1, 3, 5-trisubstituted bipyrazole scaffold based platinum(II) complexes as a biological active agent

Abstract

Square planar mononuclear platinum(II) complexes having general formula [Pt(Lⁿ)Cl₂], (where, Lⁿ?=?L^1–4) were synthesized with neutral bidentate heterocyclic 1,3,5-trisubstituted bipyrazole based ligands. The synthesized compounds were characterized by physicochemical method such as TGA, molar conductance, micro-elemental analysis and magnetic moment, and spectroscopic method such as, FT-IR, UV–vis, ¹H NMR, ¹³C NMR and mass spectrometry. Biological applications of the compounds were carried out using in vitro brine shrimp lethality bioassay, in vitro antimicrobial study against five different pathogens, and cellular level cytotoxicity against Schizosaccharomyces pombe (S. Pombe) cells. Pt(II) complexes were tested for DNA interaction activities using electronic absorption titration, viscosity measurements study, fluorescence quenching technique and molecular docking assay. Binding constants (K_b) of ligands and complexes were observed in the range of 0.23–1.07?×?10⁵?M^?1 and 0.51–3.13?×?10⁵?M^?1, respectively. Pt(II) complexes (I–IV) display an excellent binding tendency to biomolecule (DNA) and possess comparatively high binding constant (K_b) values than the ligands. The DNA binding study indicate partial intercalative mode of binding in complex-DNA. The gel electrophoresis activity was carried out to examine DNA nuclease property of pUC19 plasmid DNA.     

沙美特罗/氟替卡松吸入治疗对COPD患者临床疗效及 口咽部菌群和免疫功能的影响

目的研究沙美特罗/氟替卡松吸入治疗对慢性阻塞性肺病(COPD)患者临床疗效及口咽部菌群和免疫功能的影响。方法选取我院2015年1月至2017年12月确诊的COPD II-III级患者92例。按照随机数字表将研究对象随机分为研究组和对照组,每组46例。所有研究对象给予持续低通量吸氧、抗感染、祛痰止咳、解痉平喘等对症支持治疗,并服用盐酸氨溴索治疗。研究组在常规治疗基础上加用沙美特罗/氟替卡松干粉剂。观察患者临床疗效,记录患者肺功能指标并测定CD_4~+细胞、CD_8~+细胞、CD_4~+/CD_8~+、IgA、IgM和IgG水平。采集患者的咽拭子进行培养,计算菌落比例并鉴定种属。结果治疗后,研究组总有效率为93.48%,明显高于对照组的80.43%,差异有统计学意义(P0.05)。肺功能指标显示治疗后两组患者肺功能均有所上升,研究组肺功能指标水平上升幅度大于对照组(P0.05)。治疗后研究组患者CD_4~+细胞和CD_4~+/CD_8~+水平高于对照组,而CD_8~+细胞水平低于照组,差异均有统计学意义(P0.05)。两组患者治疗前后免疫球蛋白水平差异无统计学意义(P0.05)。治疗后研究组患者发现9种细菌,对照组发现6种,各菌株的构成比具有一定差异。结论沙美特罗/氟替卡松对COPD患者临床疗效显著,能有效提升肺功能,改善患者免疫功能,对口咽部菌群的影响较小,提示该吸入治疗方法值得临床应用推广。     

Influence of bite force and tongue pressure on oro-pharyngeal residue in the elderly

Objective: To investigate the influence of maximal bite force, maximal tongue pressure, number of mastications and swallowing on the oro‐pharyngeal residue in the elderly. Background: Oro‐pharyngeal residue in the elderly is an indication of dysphagia. Pharyngeal residue is especially critical as it may cause aspiration pneumonia, which is one of the major causes of death in elderly. Materials and methods: Videofluorographic recordings were performed on 14 elderly volunteers (six males, eight females, age range 65–93 years) without any history or symptoms of dysphagia. The subjects were instructed to consume 9 g of barium containing bread in two manners; free mastication and swallow (FMS: masticate and swallow freely), and limited mastication and swallow (LMS: swallow once after 30 chewing actions). The amount of oral and pharyngeal residue was evaluated using a 4‐point rating scale. Maximal occlusal force was measured by a pressure sensitive sheet, and maximal tongue pressure using a handy probe. Multiple regression analysis was performed to examine the influence of these items on the amount of oral and pharyngeal residue in FMS and LMS. Results: In FMS, age was found to be a factor which increased oral residue (p = 0.053), and the number of swallowing (p = 0.017) and the state of the prosthesis (p = 0.030) reduced the pharyngeal residue. In LMS, tongue pressure was a factor which reduced oral residue (p = 0.015) and increased pharyngeal residue (p = 0.008). Conclusion: It is suggested that in the elderly tongue pressure contributed to propulsion of the food bolus from oral cavity into the pharynx, and multiple swallowing contributed to the reduction in the amount of pharyngeal residue.     

Plasma levels of amino acids in elderly long term care residents with oropharyngeal dysphagia: Comparison of hand-oral with tube-enteral-fed patients

Summary. Background: Dysphagia and eating difficulties are highly prevalent in long term care patients. Evaluation of their nutritional status is complicated by comorbidity, frailty and individual patterns of feeding. In previous studies we found vitamin deficiencies (folic acid B6 and B12) in orally fed elderly in early stages of oropharyngeal dysphagia despite satisfactory nutritional parameters (BMI, albumin and hemoglobin). The aim of this study is to evaluate the plasma amino acids levels in these hand-oral fed elderly patients with dysphagia. Methods: Plasma amino acids were measured in 15 orally fed elderly patients in early functional outcome swallowing scale (FOSS), stage 2, and compared with those of 15 matched nasogastric-tube-fed counterparts. Results: The plasma levels of all measured amino acids, ratio of essential to nonessential, levels of conditionally essential and the immune-enhancing amino acids were similar in both groups and within the normal range of our laboratory. The traditional nutritional parameters were also similar in both groups and within the normal range. Conclusions: Plasma levels of amino acids in elderly patients in early stage of FOSS are satisfactory, supporting the view that their protein intake is adequate. Further studies should concentrate on patients in advanced stages of FOSS.     

Change in dysphagia and laryngeal function after radical radiotherapy in laryngo pharyngeal malignancies — a prospective observational study

BackgroundIntensity modulated radiotherapy (IMRT) has the perceived advantage of function preservation by reduction of toxicities in the treatment of laryngo-pharyngeal malignancies. The aim of the study was to assess changes in dysphagia from baseline (i.e. prior to start of treatment) at three and six months post treatment in patients with laryngo-pharyngeal malignancies treated with radical radiotherapy ± chemotherapy. Functional assessment of other structures involved in swallowing was also studied.Materials and methods40 patients were sampled consecutively. 33 were available for final analysis. Dysphagia, laryngeal edema, xerostomia and voice of patients were assessed at baseline and at three and six months after treatment. Radiation was delivered with simultaneous integrated boost (SIB) using volumetric modulated radiation therapy (VMAT). Concurrent chemotherapy was three weekly cisplatin 100 mg/m².ResultsProportion of patients with dysphagia rose significantly from 45.5% before the start of treatment to 57.6% at three months and 60.6% at six months post treatment (p = 0.019). 67% patients received chemotherapy and addition of chemotherapy had a significant correlation with dysphagia (p = 0.05, r = −0.336). Severity of dysphagia at three and six months correlated significantly with the mean dose received by the superior constrictors (p = 0.003, r = 0.508 and p = 0.024, r = 0.391) and oral cavity (p = 0.001, r = 0.558 and p = 0.003, r = 0.501). There was a significant worsening in laryngeal edema at three and six months post treatment (p < 0.01) when compared to the pre-treatment examination findings with 60.6% of patients having grade two edema at six months. Significant fall in the mean spoken fundamental frequency from baseline was seen at 6 months (p = 0.04), mean fall was 21.3 Hz (95% CI: 1.5–41 Hz) with significant increase in roughness of voice post treatment (p = 0.01).ConclusionThere was progressive worsening in dysphagia, laryngeal edema and voice in laryngo-pharyngeal malignancies post radical radiotherapy ± chemotherapy.     

HPV-DNA、p16和EGFR在口咽癌诊断中的临床价值分析

摘要 目的：探讨人乳头状瘤病毒感染状态（HPV-DNA）、p16基因和表皮生长因子受体（EGFR）在口咽癌诊断中的临床价值。方法：选取我院2015年5月到2021年10月共收治的口咽癌60患者作为研究对象,进行回顾性分析,分析HPV-DNA、p16和EGFR在口咽癌患者的表达情况,分析HPV-DNA、p16和EGFR与肿瘤病理的关系,之后对所有患者进行随访,应用Cox比例风险回归模型分析患者的生存情况与HPV-DNA、p16和EGFR的关系。结果：HPV-DNA、p16和EGFR在口咽癌患者中的阳性表达对比无明显差异（P＜0.05）;HPV-DNA阳性患者与阴性患者性别、年龄对比无明显差异（P＞0.05）,肿瘤分期与淋巴结受累情况对比差异显著（P＜0.05）;p16阳性患者与阴性患者性别、年龄、肿瘤分期对比无差异（P＞0.05）,淋巴结受累情况对比差异显著（P＜0.05）;EGFR阳性患者与阴性患者性别、年龄对比无明显差异（P＞0.05）,肿瘤分期与淋巴结受累情况对比差异显著（P＜0.05）;在患者生存分析之中,有20例患者因为随访数据不全被剔除,其中无病生存率之中,P16/EGFR、p16对比差异显著（P＜0.05）,总生存率中淋巴结转移、P16/EGFR对比差异显著（P＜0.05）;口咽癌中HPV-DNA水平与p16水平呈现负相关关系,与EGFR呈现正相关关系,p16与EGFR呈现负相关关系（P＜0.05）。结论：p16的表达是口咽癌最可靠的预后标志物,而且可能是HPV阳性口咽癌的替代标记物。HPV1/p161肿瘤倾向于减少EGFR的表达,但使用两种免疫组织学标记物对预后有显著影响。