MiRNome analysis identifying miR-205 and miR-449a as biomarkers of disease progression in intestinal-type sinonasal adenocarcinoma.

BACKGROUND: Patients with intestinal-type sinonasal adenocarcinoma (ITAC) have an unfavorable prognosis, and new diagnostic and therapeutic approaches are needed to improve clinical management. METHODS: Next-generation sequencing-based miRNome analysis was performed on 43 ITAC patients who underwent surgical resection, and microRNA (miRNA) data were obtained from 35 cases. Four miRNAs were identified, and their expression levels were detected by reverse-transcription quantitative polymerase chain reaction and related to the relevant patient outcome. Overall survival and disease-free survival rates were evaluated through the Kaplan-Meier method and log-rank test, and multivariate analysis was performed by means of Cox proportional hazard analysis. RESULTS: High levels of miR-205 and miR-34c/miR-449 cluster expression were associated with an increased recurrence risk and, therefore, a worse prognosis. Multivariate analysis confirmed that miR-205 and miR-449 were significant prognostic predictors. CONCLUSIONS: A high expression of miR-205 and miR-449 is independent predictors of poor survival for ITAC patients.

Expression Levels and Clinical Significance of miR-21-5p, miR-let-7a, and miR-34c-5p in Laryngeal Squamous Cell Carcinoma.

OBJECTIVE: Altered microRNAs (miRNAs) expression has been found in many cancer types, including laryngeal squamous cell carcinoma (LSCC). The aim of this study was to determine the role and clinical value of three LSCC-related miRs, such as miR-21-5p, miR-let-7a, and miR-34c-5p in a homogeneous cohort of patients with primary LSCC treated by primary surgery. METHODS: Expression levels of miR-21-5p, miR-let-7a, and miR-34c-5p were detected in 43 pairs of LSCC and adjacent normal tissues by reverse-transcription quantitative PCR. Overall survival and disease-free survival were evaluated using the Kaplan-Meier method, and multivariate analysis was performed using the Cox proportional hazard analysis. RESULTS: miR-21-5p is significantly upregulated, while miR-let-7a is significantly downregulated in LSCC tumor tissues compared with the corresponding adjacent normal tissues. The downregulation of miR-34c-5p expression significantly correlated with a shorter disease-free survival and, in the multivariate analysis, low miR-34c-5p expression was associated with an increased risk of recurrence. CONCLUSIONS: miR-21-5p, miR-let-7a, and miR-34c-5p seem to play a critical role in LSCC carcinogenesis and might have a diagnostic and prognostic clinical value. The miR-let-7a levels could have a predictive role for lymph node metastases and miR-34c-5p might be a promising biomarker of patient outcome.

Electrochemotherapy and its controversial results in patients with head and neck cancer.

BACKGROUND: Electrochemotherapy (ECT) is proposed as an innovative treatment for cutaneous and subcutaneous primary and secondary malignancies. Its actual application is limited to palliative treatment but recent experience predisposes for its utilization as neoadjuvant and first-line treatment. We explored the clinical application of ECT in a population of patients with head and neck cancer and we critically analyzed our results. PATIENTS AND METHODS: Nine patients (four females; mean age=62.7 years) with recurrent or persistent squamous cell cancer in the head and neck area were treated with electrochemotherapy (ECT), with the aim of controlling local neoplastic growth and diminish local symptoms (pain, bleeding). RESULTS: Our results in terms of local control and impact on quality of life were evaluated: among 14 lesions assessable for the study, 6/14 lesions exhibited a partial response, 4/14 a complete response, and in four cases we observed progression of the disease. CONCLUSION: Our personal experience in a heterogeneous, small group of patients with head and neck cancer gave controversial results, with disputable advantages in terms of quality of life improvement. We believe that the critical aspects of ECT in patients with head and neck cancer need to be further analyzed in order to better focus on the role of ECT for head and neck cancer.

Patient-related and ENT-related predictive factors based on the pain experienced during flexible nasendoscopy.

OBJECTIVES/HYPOTHESIS: The objective was to explore the role of specific patient-related and operator-related factors in pain perception during flexible laryngoscopy, which is one of the most common ENT procedures. STUDY DESIGN: Monocentric, randomized, individual prospective study. METHODS: A total of 532 patients (145 men and 387 women), without any relevant ENT diseases, underwent laryngoscopy performed by otolaryngologists with various degrees of experience. Patient discomfort was reported using visual analog scores, and willingness to repeat the experience was also recorded. RESULTS: Statistical analysis showed that greater pain was significantly associated with female patients and female otolaryngologists, whereas the pain was less severe in the cases of experienced laryngologists and older patients. Pain plays an important role in determining the willingness to repeat the examination; in fact, patients who experienced lower levels of pain during laryngoscopy were more prone to repeat the experience. CONCLUSION: This article explores the importance of the extrinsic factors that are related to the patient and the otolaryngologist in determining the level of pain associated with laryngoscopy. Our study indicated that laryngoscopy is generally a well-tolerated procedure, causing little overall discomfort, but that a subgroup of patients may experience more pain than others, which may affect the patient's perspective toward undergoing a similar future experience. Our analysis may be helpful for clinicians in understanding pain perception during a routine procedure, enabling them to focus more on that subgroup of patients who are more prone to pain. LEVEL OF EVIDENCE: 1b.