Diagnosis Of Laryngeal Squamous Cell Carcinoma Research Articles

Evaluation of UCA1/miR-138/CDK6 Network in the Patients with Laryngeal Squamous Cell Carcinoma

Objective: Noncoding RNAs (ncRNAs) have the potential to be diagnostic and therapeutic targets, in many cancer types. miRNA ‐ mRNA ceRNA (competing endogenous RNA) network in cancer has been an interesting topic that has been studied in recent years. We aimed to investigate the relationship of UCA1/miR-138/CDK6 network with laryngeal squamous cell carcinoma (LSCC). Material and Methods: We studied with the cancerous tissue and as the control; neighboring normal tissue samples of the patients with diagnosis of LSCC. UCA1, miR-138 and CDK6 expression analysis was made by quantitative real-time PCR (qRT-PCR) method after RNA isolation of the samples. Results: Expressions of cancerous tissue samples and normal adjacent tissue samples as controls were compared. CDK6 and UCA1 levels were increased and miR-138 levels were found to be decreased in cancer tissues but not statistically significant. Conclusions: To the best of our knowledge there is no study to provide an expression profile of the UCA1/CDK6/miR-138 network for LSCC patients. Although we could not obtain statistically significant results, our results were similar with the UCA1, miR‐138, and CDK6 axis literature. Further studies with larger patient samples and LSCC cell lines may confirm the function of this axis, which might be a diagnostic and therapeutic target for LSCC.

Integrative Analysis Reveals STC2 as a Prognostic Biomarker of Laryngeal Squamous Cell Carcinoma.

Stanniocalcin 2 (STC2) is involved in many tumour types, but it remains unclear what its biological function is in laryngeal squamous cell carcinoma (LSCC). Therefore, we investigated STC2's expression, potential function, and prognostic significance of in LSCC. The expression and prognosis of STC2 in LSCC were described using the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. In the TCGA database, the relationship between STC2 and immune infiltration, expression of immune cell chemokine and receptor genes, immune cell molecular marker genes, and epithelial‒mesenchymal transition (EMT) marker genes were analysed. The biological processes involved in STC2 and its expression-related genes were analysed comprehensively using bioinformatics. The single-gene ceRNA network of STC2 was constructed in the TCGA database. Finally, LSCC patients' tumour tissue STC2 expression was verified. STC2 silencing with the RNAi technique was used for the determination of cellular functions in a laryngeal cancer cell line. STC2 expression was higher in most tumours, including LSCC, than in normal tissues and was associated with poor prognosis. The relative proportions of naïve B, plasma, follicular helper T, and macrophage M0 cells in LSCC and normal samples differed significantly. STC2 expression correlated significantly positively with that of TGFB1 (biomarker of Tregs) and significantly negatively with that of D79A and CD19 (biomarkers of B cells). Furthermore, STC2 affected chemokine and receptor gene expression in immune cells. STC2 expression correlated with EMT marker gene expression in LSCC. STC2 was enriched in the PI3K/AKT signalling pathway, extracellular matrix (ECM) organisation, ECM-receptor interaction, and other tumour-related signalling pathways. STC2 was highly expressed in our clinical samples. N-cadherin and vimentin expression were decreased in the TU686 cell line after successful silencing of STC2, indicating that high STC2 expression may prompt LSCC cells to adopt a mesenchymal cell phenotype. STC2 silencing substantially reduced proliferation and migration in the TU686 cell line. STC2 may be a promising predictive biomarker for tumours, providing new approaches for LSCC diagnosis and treatment monitoring.

The prognostic role of coagulation markers in the progression and metastasis of laryngeal squamous cell carcinoma

BackgroundThe application of coagulation-related markers in laryngeal squamous cell carcinoma(LSCC) remains unclear. This study explored the prognostic role of coagulation markers in the progression and metastasis of LSCC.MethodsCoagulation markers of patients with LSCC receiving surgery in the Second Affiliated Hospital of Fujian Medical University in China, from January 2013 to May 2022 were retrospectively analyzed and compared with those of contemporary patients with benign laryngeal diseases. The relationship between clinicopathological features of LSCC and coagulation markers was analyzed with the chi-square and rank sum tests. The ROC curve analysis was utilized to evaluate the diagnostic efficacy of seven coagulation markers for LSCC and its different clinicopathological features, and to find the optimal cutoff value of each coagulation marker.Results303 patients with LSCC and 533 patients with benign laryngeal diseases were included in the present analysis. Compared to the control group, prothrombin time (PT) (p < 0.001), activated partial thromboplastin time (APTT) (p = 0.001), and Fib (p < 0.001) in patients with LSCC were significantly higher, while mean platelet volume (MPV) (p < 0.001) was significantly shorter. Significant increases were detected in PT (Z = 14.342, p = 0.002), Fib (Z = 25.985, p < 0.001), platelet count (PC) (Z = 12.768, p = 0.005), PCT (Z = 9.178, p = 0.027), MPV (F = 2.948, p = 0.033) in T4 stage. Fib had the highest prognostic value among the seven coagulation markers in different T stages (AUC = 0.676, p < 0.001), N stages (AUC = 0.717, p < 0.001), tumor stage (AUC = 0.665, p < 0.001), differentiation degree (AUC = 0.579, p = 0.022), and neurovascular invasion (AUC = 0.651, p = 0.007). Fib (Z = 25.832, p < 0.001), PC (Z = 23.842, p < 0.001), and PCT (Z = 20.15, p < 0.001) in N1 and N3 stages were significantly higher than in N0 stage. PT (Z = 12.174, p = 0.007), Fib (Z = 23.873, p < 0.001), PC (Z = 17.785, p < 0.001), and PCT (Z = 14.693, p = 0.002) were significantly higher in stage IV than in stage I and II. APTT (Z=-1.983, p = 0.047), Fib (Z=-2.68, p = 0.007), PC (Z=-2.723, p = 0.006), and PCT (Z=-2.592, p = 0.01) increased significantly when the tumor invaded neurovascular tissue.ConclusionsCoagulation markers have the potential to act as biomarkers for predicting pathological features of LSCC. The high level of Fib was helpful for the diagnosis of LSCC and the detection of advanced LSCC.Trial registrationNot applicable.

Oral-microbiome-derived signatures enable non-invasive diagnosis of laryngeal cancers

BackgroundRecent studies have uncovered that the microbiota in patients with head and neck cancers is significantly altered and may drive cancer development. However, there is limited data to explore the unique microbiota of laryngeal squamous cell carcinoma (LSCC), and little is known regarding whether the oral microbiota can be utilized as an early diagnostic biomarker.MethodsUsing 16S rRNA gene sequencing, we characterized the microbiome of oral rinse and tissue samples from 77 patients with LSCC and 76 control patients with vocal polyps, and then performed bioinformatic analyses to identify taxonomic groups associated with clinicopathologic features.ResultsMultiple bacterial genera exhibited significant differences in relative abundance when stratifying by histologic and tissue type. By exploiting the distinct microbial abundance and identifying the tumor-associated microbiota taxa between patients of LSCC and vocal polyps, we developed a predictive classifier by using rinse microbiota as key features for the diagnosis of LSCC with 85.7% accuracy.ConclusionThis is the first evidence of taxonomical features based on the oral rinse microbiome that could diagnose LSCC. Our results revealed the oral rinse microbiome is an understudied source of clinical variation and represents a potential non-evasive biomarker of LSCC.

A deep convolutional neural network-based method for laryngeal squamous cell carcinoma diagnosis.

BackgroundLaryngeal squamous cell carcinoma (LSCC) is one of the most common tumors of the respiratory tract. Currently, the diagnosis of LSCC is mainly based on a laryngoscopy analysis and pathological findings. Deep-learning algorithms have been shown to provide accurate clinical diagnoses.MethodsWe developed a deep convolutional neural network (CNN) model, and evaluated its application to narrow-band imaging (NBI) endoscopy and pathological diagnoses of LSCC at several hospitals. A total of 4,591 patients’ laryngeal NBI scans (1,927 benign and 2,664 LSCC) were used to test and validate the model. Additionally, 3,458 pathological images (752 benign and 2,706 LSCC) of 1,228 patients’ hematoxylin and eosin staining slides (318 benign and 910 LSCC) were used for the pathological diagnosis training and validation. The images were randomly divided into training, validation and testing images at the ratio of 70:15:15. An independent test cohort of LSCC NBI scans and pathological images from other institutions were also used.ResultsIn the NBI group, the areas under the curve of the validation, test, and independent test data sets were 0.966, 0.964, and 0.873, respectively, and those of the pathology group were 0.994, 0.981, and 0.982, respectively. Our method was highly accurate at diagnosing LSCC.ConclusionsIn this study, the CNN model performed well in the NBI and pathological diagnosis of LSCC. More accurate and faster diagnoses could be achieved with the assistance of this algorithm.

Diagnostic and Prognostic Value of Fibrinogen, Fibrinogen Degradation Products, and Lymphocyte/Monocyte Ratio in Patients With Laryngeal Squamous Cell Carcinoma.

Laryngeal squamous cell carcinoma (LSCC) is a common squamous cell carcinoma of the head and neck with no reliable diagnostic biomarkers. However, recent studies have shown that inflammation plays an essential role in tumor development, and several inflammation-based biomarkers have been shown to have prognostic value. This study aimed to investigate the auxiliary value of fibrinogen (FIB), fibrinogen degradation products (FDP), and lymphocyte/monocyte ratio (LMR) in LSCC diagnosis and prognosis. Clinical data from 218 patients recently diagnosed with LSCC and 207 diagnosed with benign laryngeal lesions (BLLs) were retrospectively reviewed. Potential diagnostic biomarkers were evaluated using univariate and multivariate analyses; receiver operating characteristic (ROC) curve analysis was used to identify cut-off values and diagnostic efficiency. Least absolute shrinkage and selection operator (LASSO) Logistic regression analysis was used to screen for independent risk factors to construct a diagnostic nomogram. The chi-squared test and Kaplan-Meier method were performed to investigate the correlation of clinicopathological characteristics and 3-year overall survival (OS) with FIB, FDP, and LMR in patients with LSCC. FIB, FDP, and LMR levels were significantly different between the LSCC and BLL groups (P < .001), and all were independent risk factors for LSCC. The area under the ROC curve of the diagnostic nomogram was .894. Additionally, FIB, FDP, and LMR were correlated with some invasive clinicopathological features, and LMR ≥4.29 was associated with reduced OS (P = .038). FIB, FDP, and LMR demonstrated potential as biomarkers for the diagnosis and prognosis of LSCC; however, further studies are needed to confirm their efficacy.

MiR-1207-5p suppresses laryngeal squamous cell carcinoma progression by downregulating SKA3 and inhibiting epithelial-mesenchymal transition

Laryngeal squamous cell carcinoma (LSCC) is the second most common head and neck cancer. Previously, we discovered that miR-1207-5p was downregulated in LSCC. In this study, the clinical significance, function, and mechanism of miR-1207-5p in LSCC were investigated. Downregulation of miR-1207-5p was found to be strongly linked to the malignant progression of LSCC. Functional studies revealed that miR-1207-5p upregulation suppressed LSCC cell proliferation, invasion, migration, and xenograft tumor growth. Bioinformatics analysis revealed that miR-1207-5p target genes were involved in cell cycle regulation, proliferation, adhesion, and the phosphatidylinositol 3-kinase (PI3K)/Akt pathway. Mechanistic studies revealed that miR-1207-5p interacts directly with the 3′ untranslated region of spindle and kinetochore associated complex subunit 3 (SKA3) and downregulates SKA3 expression. Furthermore, SKA3 was found to be overexpressed in LSCC, and its high expression was associated with tumor progression and a poor prognosis. Rescue experiments demonstrated that miR-1207-5p inhibited the malignant phenotypes of LSCC via SKA3. Furthermore, miR-1207-5p upregulation or knockdown of SKA3 inhibited the epithelial-mesenchymal transition (EMT). Collectively, miR-1207-5p inhibited LSCC malignant progression by downregulating SKA3 and preventing EMT. These findings provide new insights into the mechanism of LSCC progression, as well as new potential biomarkers and therapeutic targets for LSCC diagnosis and treatment.

Application of deep convolutional neural networks in the diagnosis of laryngeal squamous cell carcinoma based on narrow band imaging endoscopy

Objective: To explore the possibility of using artificial intelligence (AI) technology based on convolutional neural network (CNN) to assist the clinical diagnosis of laryngeal squamous cell carcinoma (LSCC) through deep learning algorithm. Methods: A deep CNN was developed and applied in narrow band imaging (NBI) endoscopy of 4 799 patients with laryngeal lesions, including 3 168 males and 1 631 females, aged from 21 to 87 years, from 2015 to 2017 in Beijing Tongren Hospital, Capital Medical University. A simple randomization method was used to select the laryngeal NBI images of 2 427 patients (1 388 benign lesions and 1 039 LSCC lesions) for the training and correction the CNN model. The remaining laryngeal NBI images of 2 372 patients (including 1 276 benign lesions and 1 096 LSCC lesions) were used as validation data set to compare performance between CNN and otolaryngologists. SPSS 21.0 software was used for Chi-square test to calculate the accuracy, sensitivity and specificity of AI and otolaryngologists. The area under the curve (AUC) of receiver operating curve (ROC) was used to evaluate the diagnostic ability of the algorithm for NBI images. Results: The accuracy, sensitivity and specificity for NBI predictions were respectively 90.91% (AUC=0.96), 90.12% and 91.53%, which were equivalent to those for otolaryngologists' predictions (accuracy, sensitivity and specificity were (91.93±3.20)%, (91.33±3.25)% and (93.02±2.59)%, t values were 0.64, 0.75 and 1.17, and P values were 0.32, 0.28 and 0.21, respectively). The diagnostic efficiency of CNN was significantly higher than that of otolaryngologists (0.01 vs. 5.50, t =9.15, P<0.001). Conclusion: AI based on deep CNN is effective for using in the laryngeal NBI image diagnosis, showing a good application prospect in the diagnosis of LSCC.

Identification of MMP1 and MMP2 by RNA-seq analysis in laryngeal squamous cell carcinoma.

Laryngeal squamous cell carcinoma (LSCC) is the most common histologic subtype of laryngeal cancer characterized by a poor prognosis. Determining gene expression changes in LSCC should improve our understanding of putative risk factors and provide potential targets for therapy. To assess differential gene expression between LSCC tissue and paired normal laryngeal tissue, and to provide gene targets for future studies of this type of laryngeal cancer. Three paired-sample groups (tumor and normal tissue) from patients with laryngeal squamous cell carcinoma were analyzed by RNA sequencing (RNA-seq). The six cDNA libraries generated raw reads ranging from 15,195,586 to 21,443,488 counts. Changes in gene expression levels were determined in 40,205 of these counts, with 18,466 deferentially expressed genes in all three groups. Compared to normal tissue, the expression levels of MMP1 and MMP2 increased significantly in tumor tissue of patients with laryngeal squamous cell carcinoma. Whole transcriptome sequencing revealed that MMP1 and MMP2 are highly expressed in LSCC. These genes may be useful both as biomarkers for LSCC diagnosis and as targets for therapy, as well as for increasing our understanding of LSCC tumorigenesis.

Serum Exosomal miR-941 as a promising Oncogenic Biomarker for Laryngeal Squamous Cell Carcinoma.

At present, no blood-based biomarkers have been used in clinical practice for laryngeal squamous cell carcinoma (LSCC). Increasing evidence suggests that circulating exosomal microRNAs (miRNAs) may serve as potential diagnostic biomarkers for various cancers. This study aims to identify and evaluate serum exosomal miRNAs for LSCC diagnosis. The ExoQuick solution (EQ), which provides a high-yield and is a highly efficient exosome isolation method, was selected to isolate serum exosomes in the current study. In LSCC samples, exosome concentrations were higher than in healthy control (HC) samples. RNA-seq analysis identified a total of 1608 miRNAs, with 34 upregulated and 41 downregulated in LSCC samples relative to HC samples. Furthermore, qRT-PCR showed that miR-941 is significantly upregulated in LSCC serum exosomes, with this same trend seen in LSCC tissues and cells. Moreover, when examining miR-941 in cell lines, miR-941 overexpression promoted proliferation and invasion, while miR-941 knockdown inhibited cell proliferation and invasion. ROC curve analysis showed that miR-941 has an area under the curve (AUC) of 0.797 (95% CI = 0.676-0.918) for distinguishing LSCC patients from HCs. In conclusion, serum exosomal miR-941 may serve as a promising oncogenic biomarker for diagnosing LSCC, and has the potential as a therapeutic target.

Evaluation of the Expression of Matrix Metalloproteinase-1 of Laryngeal Squamous Cell Carcinoma by Ultrasound Molecular Imaging.

Purpose: The aims of this study were to evaluate the expression of matrix metalloproteinase-1 (MMP-1) on laryngeal squamous cell carcinoma (LSCC) and improve the early diagnosis rate via ultrasound molecular imaging (USMI). Methods: The microsized MMP-1-targeted microbubbles (MBMMP-1) and the control MBs (MBIgG) based on perfluorocarbon-filled lipid-shelled MBs were constructed and characterized. The in vitro binding experiment was performed with human epidermoid laryngeal cancer cells (HEp-2) and tested the binding efficiency of MBMMP-1 and MBIgG. In the in vivo study, the LSCC model was established in 10 mice. The MBMMP-1 and MBIgG were randomly injected into tumor-bearing mice via the tail vein at Day 7, Day 12, and Day 17 to dynamically evaluate the differential targeted enhancement (dTE) signals via USMI. Subsequent immunofluorescence analysis was used for confirmation of MMP-1 expression. Result: The effective adhesion rate of MBMMP-1 and MBIgG to HEp-2 was 298.42 ± 16.57 versus 12.38 ± 3.26 bubbles/per field in vitro experiment, which shows a significant difference (P < 0.01). The in vivo ultrasound molecular imaging (USMI) results demonstrated that dTE signal intensity from MBMMP-1 was significantly higher than that from the MBIgG at Day 7, Day 12, and Day 17 (Day 7, 41.21 ± 15.00 versus 2.25 ± 0.6 a.u., P < 0.05; Day 12, 124.64 ± 5.19 versus 11.13 ± 1.13 a.u., P < 0. 05; Day 17, 332.01 ± 64.88 versus 42.99 ± 11.9 a.u., P < 0.01). Moreover, immunofluorescence analysis further confirmed the expression of MMP-1 in LSCC with a gradual increase with the tumor growth. Conclusion: MBMMP-1 could be a potential probe that can be used in the early diagnosis of LSCC by USMI.

The identification of induction chemo-sensitivity genes of laryngeal squamous cell carcinoma and their clinical utilization.

To identify potential molecular markers for induction chemotherapy of Laryngeal squamous cell carcinoma (LSCC). Differently expressed genes between chemo-sensitive group (seven cases) and chemo-insensitive (five cases) group after induction chemotherapy by TPF were identified by microarrays. Bayes network and Random forest analyseswere employed to identify core genes for induction chemotherapy. The diagnostic value of these core genes was also evaluated by ROC analysis. Six genes (SPP1, FOLR3, KYNU, LOC653219, ADH7 and XAGE1A) are highly expressed, while seven gene (CADM1, NDUFA4L2, CCND2, RARRES3, ERAP2, LYD6 and CNTNAP2) present significantly low expression. Among these genes, genes CADM1, FOLR3, KYNU, and CNTNAP2 are core candidates for LSCC chemo-sensitivity. And that the low expression of CADM1 may result in chemo-sensitivity, which leads to high expression of gene FOLR3 and KYNU, and low expression of gene CNTNAP2. Besides, ROC analysis shows that these four genes exhibit effective diagnostic value for induction chemo-sensitivity. CADM1 may be a potential molecular marker for LSCC induction chemotherapy, while CADM1, FOLR3, KYNU, and CNTNAP2 may provide essential guidance for LSCC diagnosis and follow-up treatment strategies.

Anti-tumor effect of HOTAIR-miR-613-SNAI2 axis through suppressing EMT and drug resistance in laryngeal squamous cell carcinoma.

Laryngeal squamous cell carcinoma (LSCC) is the main pathological type of laryngeal cancer, which attacks the head and neck. Our present study aims to investigate the effect of long non-coding RNA (LncRNA) HOX transcript antisense RNA (HOTAIR) on epithelial mesenchymal transition (EMT) and drug resistance in LSCC. Firstly, the level of HOTAIR was found to be overexpressed in LSCC tissues compared with normal healthy tissues. Then, increased EMT and drug resistance were suppressed by specific HOTAIR shRNA effectively in LSCC cell lines. Besides, miR-613 was predicted to be a target of HOTAIR through bioinformatics analysis. Meanwhile, we found that a down-regulated level of miR-613 could be increased by HOTAIR shRNA and suppressed by LncRNA HOTAIR transfection in LSCC cells. The targeting relationship between miR-613 and HOTAIR was further demonstrated by a luciferase report assay. What is more, the inhibiting effect of HOTAIR shRNA on EMT and drug resistance was obviously abolished by the miR-613 inhibitor. Moreover, SNAI2, a critical regulator of EMT, was predicted as a target of miR-613 through bioinformatics analysis and luciferase report assays. As expected, the level of SNAI2 could be suppressed by HOTAIR shRNA and increased by the miR-613 inhibitor. Additionally, we discovered that SANI2 shRNA had similar inhibiting effect on EMT and drug resistance with HOTAIR shRNA in LSCC cells. Finally, the in vivo experiment further demonstrated that HOTAIR shRNA restricted tumor growth, EMT and drug resistance. Additionally, HOTAIR shRNA transfection could also increase the level of miR-613 and decrease the level of SNAI2 in vivo. Taken together, our research for the first time revealed the effect of the HOTAIR–miR-613-SNAI2 axis on EMT and drug resistance in LSCC, providing new targets for LSCC diagnosis and treatment.

MiR-148a and miR-375 may serve as predictive biomarkers for early diagnosis of laryngeal carcinoma.

The role of microRNAs (miRs) as possible biomarkers and therapy targets has been extensively investigated in a number of types of cancer. However, the aberrant expression of miRs in laryngeal squamous cell carcinoma (LSCC), particularly during the progression of the disease, is poorly understood. In the present study, the role of miRs as possible novel early pre-diagnostic biomarkers of LSCC was investigated. TaqMan probe stem-loop quantitative polymerase chain reaction was utilized to accurately measure the amount of miR-148a and miR-375 in clinical samples of mild dysplasia, moderate dysplasia, severe dysplasia, cancer in situ, laryngeal cancer and normal epithelial controls. The application of miR-148a and miR-375 as potential predictive biomarkers for early diagnosis of LSCC was analyzed. The results of the present study suggested that miR-148a and miR-375 were significantly upregulated in LSCC tissues, and increased expression of miR-375 was associated with a more aggressive phenotype of LSCC. Additional investigation revealed that miR-148a and miR-375 increased during different dysplasia stages of LSCC carcinogenesis, and high-level expression of miR-148a or miR-375 in patients with laryngeal dysplasia may predict subsequent malignant transformation. miR-148a and miR-375 were significantly upregulated during LSCC carcinogenesis and may serve as possible predictive biomarkers for early diagnosis of LSCC.

Abstract 4001: Array profiling identified upregulated miRNAs and target genes and pathways in laryngeal squamous cell carcinoma

Abstract Background: Laryngeal squamous cell carcinoma (LSCC) is prevalent in the Chinese population, where smoking is a major carcinogen. MicroRNAs (miRNAs) and their gene targets potentially contribute to the multistep regulatory processes of LSCC development. Objective: The purpose of this study is to investigate and validate aberrant expressed miRNAs in LSCC, and analyze the putative target genes of the screened miRNAs. Methods: Six pairs of primary Stage II-IV LSCC and adjacent non-neoplastic tissues were surgically removed for miRNA array analysis using the Affymetrix GeneChip miRNA Array 3.0, containing probes for 5683 miRNAs, and the significantly altered miRNAs were validated by the qRT-PCR in an independent cohort of 36 LSCC patients. MiRNA gene targets were predicted using TargetScan, PITA and microRNAorg in GeneSpring 12.5 software. The functional categories and pathways of the target genes were analyzed by GO category and KEGG pathway database. Results: MiRNAs arrays identified seven up-regulated miRNAs, including hsa-miR-224, hsa-miR-183, hsa-miR-23a, hsa-miR-675, hsa-miR-27a, hsa-miR-503 and hsa-miR-4800-3p in LSCC by the SAM method, and qRT-PCR was performed to validate the screened miRNAs. 72 putative target genes were identified by GeneSpring 12.5 software. These putative target genes are involved in biological processes, such as metabolic, biological regulation, membrane, protein binding, ion binding by GO category analysis, and are the molecular components in MAPK signaling, adherence, and junction pathways by KEGG pathway database analysis. Conclusions: Seven upregulated miRNAs were identified in LSCC tissues by microarrays, and validated by qRT-PCR. The putative target genes were also identified. These up-regulated miRNAs could serve as potential biomarkers for LSCC diagnosis and therapy. Citation Format: Meng Lian, Xiaoqin Liu, Demin Han, Jugao Fang, Zhong Chen. Array profiling identified upregulated miRNAs and target genes and pathways in laryngeal squamous cell carcinoma. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4001. doi:10.1158/1538-7445.AM2015-4001

New Insights into Laryngeal Squamous Cell Carcinoma: Cancer Stem-Like Cells

The Cancer Stem-Like Cells (CSLCs) are cells with tumorigenic potential, which are involved in initiation, progression and spread of the tumor. Recent evidences in the last decade have suggested the existence of CSLCs in distinct types of tumors such as lung, brain, breast, prostate, colon, head and neck, ovarian and larynx cancers. They are identified by their tissue specific stem cell-like properties including self-renewal and having potential to differentiate. Laryngeal squamous cell carcinoma (LSCC), originating from laryngeal epithelial tissue, is one of the most commonly diagnosed malignancies among the head and neck tumors worldwide. LSCC is frequently diagnosed among middle-aged people and its incidence has been reported to increase each year. Therapeutic options mostly cannot give positive clinical response especially for the advanced LSCC cases. LSCC is still one of the important causes of cancer deaths, particularly in men, worldwide, although the technologies in detection and diagnosis of LSCC have been significantly improved recently. In this review, we have summarized the most current literature to understand the functions and roles of CSLCs in human LSCC. We believe that this review will contribute to knowledge of scientist not only working in LSCC field, but also studying the CSLCs in other cancers and diseases, and will help elucidating the roles of CSLCs implicated in LSCC initiation, development, progression, and chemo-radioresistance.

Clinical value of serum HMGB1 in diagnosis and prognosis of laryngeal squamous cell carcinoma.

Laryngeal squamous cell carcinoma (LSCC) is one of the most common malignancies in the head and neck region. Recently, aberrantly expressed high-mobility group box 1 (HMGB1) has received a great deal of attention as a potential biomarker for cancer diagnosis and prognosis. Therefore, the aim of this study was to estimate HMGB1 levels in serum in LSCC patients and healthy controls and evaluated the potential of serum HMGB1 as a noninvasive biomarker for diagnosis and prognosis in LSCC. Serum HMGB1 levels were analyzed in 71 LSCC patients and 50 healthy controls. The serum HMGB1 level was significantly higher in LSCC patients compared with the healthy controls (4.81 ± 2.33 vs. 3.21 ± 1.08 ng/mL, P < 0.001). High serum HMGB1 was significantly associated with T classification (P = 0.005), N classification (P = 0.002), and clinical stage (P = 0.001). The area under ROC curve was 0.716, and the sensitivity and specificity were 42.3 and 92.0%, respectively. The Kaplan-Meier plots showed that patients with high serum HMGB1 had a poorer overall survival than those with low serum HMGB1 (P = 0.036). Serum HMGB1 levels are significantly associated with the progression of LSCC. In this population, HMGB1 has a poor sensitivity, but a high specificity for the diagnosis of LSCC. Serum HMGB1 level has potential as a biomarker for the prognosis in LSCC patients.

MiR-21, miR-106b and miR-375 as novel potential biomarkers for laryngeal squamous cell carcinoma.

MicroRNAs (miRNAs), the endogenous noncoding RNAs, are involved in carcinogenesis. Laryngeal squamous cell carcinoma (LSCC) is the common cancer in head and neck. Whether miRNAs can be used in the diagnosis of LSCC is largely unknown. The purpose of this study was to identify whether miRNAs could be use as potential biomarkers for LSCC diagnosis. The expression levels of miR-21, miR-106b and miR-375, in LSCC tissues and paired nontumor tissues were first quantitatively analyzed by reverse transcription-polymerase chain reaction. Then, the relationships between their expression levels and clinicopathological parameters of patients with LSCC were further determined. We found that these miRNAs' expression levels were significantly different between LSCC tissues and adjacent normal tissues. Two miRNAs, miR-21 and miR-106b were found up-regulated in cancer tissues (P=0.0012 and P<0.001, respectively), while miR-375 down-regulated (P<0.001). Moreover, miR-21 and miR-106b levels were found significantly increased in poorly (G3)/moderately differentiated (G2) cancer tissues comparing with well differentiated (G1) and dysplasia (D) tissues (P<0.001, respectively). Their levels were also positively associated with lymph node metastasis (P<0.05) and TNM stages (P<0.01). However, miR-375 expression level was only found negatively associated with TNM stages. Our preliminary data suggest that three miRNAs, miR-21, miR-106b and miR- 375 might become novel tumor markers for LSCC diagnosis.

Combined detection of serum exosomal miR-21 and HOTAIR as diagnostic and prognostic biomarkers for laryngeal squamous cell carcinoma.

Serum exosomes containing noncoding RNA (ncRNA) play an important role in both physiological and pathological conditions. However, biological function of exosomal ncRNA remains unclear. The aim of the study was to investigate the prognostic and diagnostic values of exosomal ncRNA by comparing the amounts of exosomal miR-21 and HOTAIR in serum of laryngeal squamous cell carcinoma (LSCC) patients with those of polyps of vocal cords, and by determinating whether combined detection of the two molecules could provide useful information in the diagnosis of LSCC. Exosomes were isolated from the serum samples of 52 LSCC patients and those of 49 patients with polyps of vocal cords. TEM and Western blot were applied for the confirmation of isolated exosomes by observing the ultra structure and testing CD63 marker protein, respectively. RT-PCR was performed to detect the expression of miR-21 and HOTAIR in the exosomes. The receiver-operating characteristic (ROC) curve was generated to examine the prognostic value of the two molecules. The expression of exosomal miR-21 and HOTAIR was significantly higher in patients with LSCC than those with vocal cord polyps. There were significant differences of serum exosomal miR-21 and HOTAIR expressions between the advanced T classifications (T3/T4) or clinical stages (III/IV) and the early stages. The patients with lymph node metastasis had higher serum exosomal miR-21 and HOTAIR expressions than those without. There were no differences between patient sex, tumor locations and differentiations. The area under the ROC curve of combined examination of exosomal HOTAIR and miR-21 for diagnosing LSCC was 87.6 %, which was significantly higher than 80.1 % of miR-21 (p = 0.0359) or 72.7 % of HOTAIR (p = 0.0012), showing 94.2 and 73.5 % of sensitivity and specificity, respectively, in differentiating the malignant from benign laryngeal disease. Serum exosomal miR-21 and HOTAIR were significantly correlated with clinical parameters of LSCC, and combined evaluation of their serum expressions may be a valuable biomarker to screen LSCC and might be a promising predicting tool for LSCC patient.

Low mRNA expression levels of kallikrein-related peptidase 4 (KLK4) predict short-term relapse in patients with laryngeal squamous cell carcinoma

Several members of the family of tissue kallikrein and kallikrein-related peptidases have been suggested as promising tumor biomarkers with important prognostic significance. However, only one (KLK11) has already been studied in laryngeal squamous cell carcinoma (LSCC) as a potential biomarker for LSCC diagnosis and/or prognosis. Our study investigated the prognostic value of kallikrein-related peptidase-4 (KLK4) mRNA expression as a molecular tissue biomarker in LSCC. For this purpose, KLK4 mRNA expression analysis was performed in 116 cancerous and 74 paired non-cancerous laryngeal tissue specimens obtained from patients that had undergone surgical treatment for primary LSCC. A remarkable downregulation of KLK4 mRNA expression was discovered in laryngeal tumors, compared to non-cancerous laryngeal tissue specimens. KLK4 mRNA expression was also shown to distinguish LSCC from non-cancerous laryngeal tissues. Furthermore, low KLK4 mRNA expression was shown to predict poor disease-free survival, independently of the histological grade and size of the malignant tumor as well as patient TNM stage. According to Kaplan-Meier survival analysis, low KLK4 mRNA expression predicts short-term relapse even among patients with well-differentiated tumors or those at an early TNM stage. Thus, KLK4 mRNA positivity could be regarded as a novel independent indicator of favorable prognosis for the disease-free survival of LSCC patients.