Characterization of High-risk Oncogenic Human Papillomavirus Genotypes in Histologically Confirmed Ear, Nose and Throat (Ent) Cancers in Burkina Faso.

BACKGROUND: High-risk human papillomavirus (HPV-HR) infections are responsible for 99.99% of cervico-uterine cancers and 50% of carcinomas of the oropharynx. OBJECTIVE: To characterize high-risk HPV genotypes (HPV-HR) in histologically confirmed ear, nose and throat (ENT) cancers in Ouagadougou. METHODS: One hundred and twenty-eight archived tissues from the ENT sphere, obtained over the last ten years (2007 to 2017) and histologically diagnosed in anatomy and pathology-cytology laboratories in Ouagadougou were included. These tissues were dewaxed with xylene; HPV DNA extraction was performed and HPV-HR were researched by real-time multiplex PCR. RESULTS: Among the fourteen HPV-HR genotypes tested for, seven were identified. The prevalence of HPV-HR infection was 15.6%. The most common genotypes were: HPV56 (45%) and HPV33 (20%). Squamous cell carcinomas accounted for 75% of cases, followed by lymphomas for 10%. The age range was between 5 and 80 years. CONCLUSION: The results show the involvement of a diversity of HPV-HR genotypes and a high frequency of HPV56 and HPV33 in ENT cancers in Ouagadougou, Burkina Faso. The appropriate HPV vaccination will considerably reduce the number of these cancers.
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[Pediatric radiology in oto-rhino-laryngology]. / Pädiatrische Radiologie in der Hals-Nasen-Ohren-Heilkunde.

Head and neck diseases in children and adolescents pose special diagnostic and differential diagnostic challenges to ENT surgeons as well as to radiologists. Both disciplines have to adapt the latest radiological and interventional technologies to the needs of the paediatric patient in order to enable a minimally invasive but successful diagnostic procedure. High quality sonography by an experienced examiner often is the only imaging technique that is required in children and adolescents. Radiographs are rarely indicated in paediatric head and neck diseases. MRI, compared to computed tomography, has the advantage of the lack of radiation exposure. Additionally, because of current advances in high resolution techniques to delineate very small details or in visualization of different tissue characteristics it has become an integral part of the pre-and post-operative imaging. However, children should not be denied an adequate diagnostic procedure even if it includes a sedation, an intervention or an exposure to radiation. The responsible use of the diagnostic options under consideration of the therapeutic consequences is essential. It is most likely to be successful in a close interdisciplinary cooperation of paediatric ENT specialists and radiologists as well as paediatric anaesthesiologists in selected cases. Although benign diseases predominate in children and adolescents, the possibility of a malignancy has to be considered in case of atypical clinical and radiological findings. In many of these young patients the outcome and the probability of survival are directly connected to the initial diagnostic and therapeutic strategies, which should therefore be in accordance with the current guidelines in oncological therapy studies. Our collection of clinical cases consists of representative examples of useful diagnostic approaches in common and age specific diagnoses as well as in rare diseases and malformations. It shows the significance of a special knowledge in embryology and normal postnatal development for the differentiation of normal variants from pathological findings. Only in considering the results of imaging studies in their clinical context, we may succeed in detecting a syndrome behind a single malformation or in adequately caring for a patient with a chronic disease such as cystic fibrosis.

Patterns of cancer occurrence in different regions of West Bengal--a hospital based study.

The incidence of cancer has been rising steadily in the third world countries including India. The patterns of cancer incidence reflect the racial, cultural and pharmacogenomic diversity within populations and nowhere is this diversity more striking than in the Indian subcontinent. This article shows the diversity in patterns of incidence of major cancers across three medical college hospitals in the state of West Bengal in India. All the data were collected from the period between 2001 and 2005. The results show a striking variation of incidence of major cancers in the urban, semi-urban and rural parts of the same state. Indeed the differences of the patterns are explainable by the cultural and socioeconomic differences within the populations from which the study samples are drawn. This constitutes the largest single hospital based data collected from this part of the world till date and will help in re-evaluation of cancer control programmes promulgated by the health authorities of the region.

Integration of a smoking cessation program in the treatment protocol for patients with head and neck and lung cancer.

Smoking is the main causative factor for development of head and neck and lung cancer. In addition, other malignancies such as bladder, stomach, colorectal, kidney and pancreatic cancer have a causative relation with smoking. Continued smoking after having been diagnosed with cancer has many negative consequences: effectiveness of radiotherapy is diminished, survival time is shortened and risks of recurrence, second primary malignancies and treatment complications are increased. In view of the significant health consequences of continued smoking, therefore, additional support for patients to stop smoking seems a logical extension of the present treatment protocols for smoking-related cancers. For prospectively examining the effect of nursing-delivered smoking cessation programme for patients with head and neck or lung cancer, 145 patients with head and neck or lung cancer enrolled into this programme over a 2-year period. Information on smoking behaviour, using a structured, programme specific questionnaire, was collected at baseline, and after 6 and 12 months. At 6 months, 58 patients (40%) had stopped smoking and at 12 months, 48 patients (33%) still had refrained from smoking. There were no differences in smoking cessation results between patients with head and neck and lung cancer. The only significant factor predicting success was whether the patient had made earlier attempts to quit smoking. A nurse-managed smoking cessation programme for patients with head and neck or lung cancer shows favourable long-term success rates. It seems logical, therefore, to integrate such a programme in treatment protocols for smoking-related cancers.

[Diversity of incidence trend patterns: implications for carcinogenesis?]. / Diversité des modèles d'évolution des incidences: implication en cancérogenèse?

OBJECTIVE: Cancers of the ENT, oesophagus and lungs are caused mainly by alcohol and/or tobacco consumption but have potentially heterogeneous latencies and dose-incidence relationships. The incidence of cancers having the same risk factors may vary in a similar way over time and space. The aim of the study was to identify groups of cancers with similar spatio-temporal incidence trends. METHODS: Fifty thousand nine hundred and eighty cases of ten cancer types were collected between 1982 and 2002 in six French departments. The incidence levels and trends were assessed using an age-cohort random-effect model that took into account heterogeneity of incidence levels and trends between departments. RESULTS: Three groups of cancer sites/types with similar spatio-temporal incidence trends were identified: (1) oral cavity, oropharynx, hypopharynx, larynx, oesophagus, and lung squamous cell carcinomas in which the incidence decreased similarly in time and space; (2) other types of lung cancer and lung adenocarcinomas whose incidence increased similarly; and (3) lung large- and small-cell carcinomas whose incidence trends were heterogeneous. CONCLUSION: Using the tools of descriptive epidemiology different cancer groups with different temporal and spatial incidence trends were identified. This diversity suggests different latencies and different sensitivities of those groups to the main risk factors, alcohol and tobacco.

Causes and predisposing factors of de novo tumors in our series of liver transplant recipients.

INTRODUCTION: Liver transplant recipients suffer a high risk of developing cancer, mainly as a consequence of immunosuppressant treatment, although a variety of other factors are involved. Our purposes were to evaluate the frequency of de novo tumours and to determine predisposing factors. MATERIAL AND METHODS: We analyzed all of the transplantations performed during 1990, with a total of almost 700 cases. We analyzed the frequency of de novo tumors, their location, time since transplantation, survival, and recurrence rates and factors that may influence their appearance. RESULTS: The series included 64 cases in 50 patients with a frequency of 7%. Skin tumors were the most frequent (39.06%), followed by those in the otolaryngologic (ear, nose, and throat) region (15.62%) and the lung (14.06%). The average time to progression between the transplantation and diagnosis was less than 4 years (47.74 months). The recurrence rate was 16%. The factors with the greatest influence on their appearance were age and gender of the recipient, alcohol consumption, and Child-Pugh score. Plasma transfusion was statistically, although not clinically, significant. DISCUSSION: Our frequency of de novo tumors was consistent with that described in the literature. Despite some factors that influence their appearance, the main predisposing factor was immunosuppression and its duration.

[Assurance-associated aspects of head and neck carcinomas: disposition, exposition, prognosis]. / Versicherungsrelevante Aspekte bei Karzinomen der Kopf-hals-Region: Disposition, Exposition, Prognose.

After a brief introduction into the basics of head and neck oncology, the current review focusses on potential predictive markers and predisposing factors for these kinds of cancers. Furthermore, prognosis and degree of disability of cancer patients are commented on. With a survival rate of approximately 50%, the prognosis of head and neck carcinomas seems rather good, but it is in fact unsatisfactory. Since the treatment of advanced head and neck cancers is often accompanied by profound functional (articulation, phonation, respiration, and deglutition) and aesthetic impairment, it repeatedly leads to a high degree of disability and occupational invalidity. Furthermore, special limitations of head and neck cancer patients are discussed as well as the consequences they may have on the qualification for certain jobs.

[Occupational head and neck cancer. Part I: Registered occupational diseases]. / Berufliche Krebserkrankungen im HNO-Fachgebiet. Teil I: "Listen-Berufskrankheiten".

Head and neck cancer can be caused by the occupational contact with cancerogenic substances, which contribute to the formation of cancer. The knowledge about those cancer entities which are frequently found under similar circumstances and working conditions, helps for getting compensation and alternatively for a realistic view when other influences--particularly lifestyle factors like smoking, alcohol and nutrition--have mainly contributed for the origin of the cancer disease. Our knowledge increases and therefore it is helpful from time to time to keep up to the state-of-art of cancer genesis. This article has two parts: part I deals with occupational cancer diseases, which are listed in a decree of the German government and part II deals with the cancer diseases, which could likely be caused by occupational factors according to latest scientific findings and are not yet listed.

Occupational exposure to eight organic dusts and respiratory cancer among Finns.

BACKGROUND: There is inconclusive evidence concerning cancer risks of organic dusts. AIM: The carcinogenic exposures are mainly inhalatory and the authors therefore studied associations between occupational exposure to eight different organic dusts and respiratory cancers in Finland. METHODS: The authors followed up a cohort of all economically active Finns born between 1906 and 1945 for 30 million person-years during 1971-95. Incident cases of nasal, laryngeal, and lung cancer and mesotheliomas were identified through a record linkage with the Finnish Cancer Registry. Occupations from the population census in 1970 were converted to exposures to eight organic dusts with a job-exposure matrix (FINJEM). Cumulative exposure (CE) was calculated as a product of prevalence, level, and estimated duration of exposure. Standardised incidence ratios (SIR) and 95% confidence intervals (CI) adjusted for age, period, and social class were calculated for each organic dust using the economically active population as the reference. RESULTS: A total of 20 426 incident cases of respiratory cancer were observed. Slightly increased risk was observed among men exposed to wood dust for nasal cancer (SIR 1.42, 95% CI 0.79 to 2.44). For laryngeal cancer, men exposed to plant dust (mainly grain millers) had a raised SIR in the high exposure class (SIR 3.55, 95% CI 1.30 to 7.72). Men exposed to wood dust had a raised SIR for lung cancer, but only in the low exposure class (SIR 1.11, 95% CI 1.04 to 1.18). Women exposed to wood dust showed an increased SIR for mesotheliomas in the low exposure class (SIR 4.57, 95% CI 1.25 to 11.7) and some excess in the medium exposure category. CONCLUSIONS: Exposure to organic dusts is unlikely to be a major risk factor of respiratory cancer. Even exposure to wood dust which is a major exposure in Finland seems to have minor effect for nasal cancer. The authors found suggestive evidence that exposure to grain dust may increase the risk of laryngeal cancer, and some support to the hypothesis that exposure to textile dust, and to plant and animal dust (agricultural dusts) may decrease the risk of lung cancer.

[Sonographical differential diagnosis of cervical lumps]. / Knoten am Hals--Sonographische Differentialdiagnostik.

A brief synopsis for a practical approach in the clinical and sonographical evaluation of cervical lumps except for lymph node diseases is presented.

[Alcohol related diseases of the head and neck]. / Alkoholinduzierte Erkrankungen im Kopf-Hals-Bereich.

Chronic consumption of alcohol is an accepted social custom worldwide. In the upper aerodigestive tract, local morphologic, metabolic and functional alterations can be present due such consumption. Gastroesophageal reflux or alterations in sleep structure are typical examples of functional disorders. While alcohol was initially described as a risk enhancer only in smokers, a number of epidemiological studies have now shown that chronic alcohol consumption increases the risk of head and neck cancer independently of exposure to tobacco smoke. In addition, alcohol leads to an accumulation of pathologic microbes within the mucosa, leading to chronic infection. Susceptibility to carcinogens and cell proliferation in the mucosa are increased, resulting in genetic changes with the development of dysplasia, leucoplakia and carcinoma. Chronic alcohol consumption is correlated with an increased risk of cancer and increased mortality in a dose-dependent relationship. A number of biologically plausible mechanisms exist by which alcohol may cause cancer.

Dietary antioxidant intake in patients at risk for second primary cancer.

OBJECTIVES: To analyze dietary antioxidant intake for head and neck cancer patients at risk for development of second primary cancers. STUDY DESIGN: Prospective observational study. METHODS: Twenty-four patients underwent three random, unscheduled, 24-hour dietary recalls over a 15-day period within 6 to 60 months after successful treatment for stage I or II oral cavity squamous cell carcinoma. RESULTS: The study sample had a lower mean daily dietary intake of fruits and vegetables and antioxidant nutrients, including vitamins A, C, E, and total carotenes than age- and sex-matched historic control subjects (all P <.05 except vitamin A). A positive linear correlation was noted between daily servings of F&V and dietary intake of vitamins A, C, E, and total carotenoids (all P <.05 except vitamin A). Compared to current recommendations, the study sample had lower mean daily dietary intake of vitamins A, C, and E (P =.81,.06, and <.01) and servings of fruits and vegetables (P <.01). When vitamin supplements were included in the analysis, mean daily intake exceeded recommended dietary allowance (RDA) for vitamins A, C, and E (all P <.05). CONCLUSION: This study suggests that patients treated for early-stage oral cavity carcinoma, at risk for second primary cancers, have a statistically significant deficiency in dietary (food) sources of antioxidant nutrients when compared with both historic control subjects and current recommendations. Vitamin supplementation significantly exceeded current RDAs. Because increased fruit and vegetable intake, but not vitamin supplementation exceeding RDA, is associated with reduced cancer risk, physicians may consider recommending at least five daily servings of fruits and vegetables as an alternative to vitamin supplementation.

Carcinoma sebáceo nasal. A propósito de un caso / Nasal sebaceus carcinoma. About a case

Se presenta un caso clínico de un carcinoma sebáceo extra-ocular, en un varón de 71 años de edad con una tumoración en ala nasal derecha (AU)