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      Clinicopathological Features of Patients Nominated for Head and Neck Biopsies: A One-Year Series

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          Abstract

          Background

          Head and neck lesions, which are predominantly benign, were widely reported. Some of these tumors are potentially neoplastic and others are non-neoplastic. Therefore, this study aimed to assess the clinicopathological features of patients nominated for head and neck biopsies.

          Methodology

          In this study, data regarding head and neck biopsies were retrieved from the Department of Pathology at King Khalid Hospital, Hai'l, Northern Saudi Arabia. Data referring to head and neck biopsies of patients who were diagnosed during the period from January 2018 to December 2018 were included.

          Results

          The initial clinical presentations were stated for 50/64 (78.1%) head and neck lesions, 12/64 (18.8%) head and neck cysts, 1/64 (1.6%) keloid, and 1/64 (1.6%) ischemia. With regard to the biopsy's site, most were taken from the nose followed by oral cavity, scalp, ear, face, and eye, constituting 19/64 (29.7%), 15/64 (23.4%), 9/64 (14.1%), 5/65 (7.8%), 4/64 (6.2%), and 3/64 (4.7%), respectively.

          Conclusion

          Head and neck benign lesions, predominantly inflammatory lesions, are common in Northern Saudi Arabia. Accurate identification of these lesions is important during histopathological diagnosis, as some have pathological features that mimic some potentially neoplastic lesions.

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          Most cited references21

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          Epidemiology and Demographics of the Head and Neck Cancer Population

          Head and neck malignancies comprise a heterogeneous group of malignancies that cause significant morbidity to those affected. These malignancies are associated with specific risk factors and exposures, some of which impact prognosis. The most common risk factors for developing head and neck cancers are tobacco and alcohol use. Marijuana and e-cigarettes, occupational exposures, and use of topical substances have also been linked to head and neck cancers. Human papilloma virus has been associated with oropharyngeal cancer. Such measures as oral hygiene, screening, smoking cessation, and vaccination are measures taken to decrease the incidence and morbidity of head and neck cancers.
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            Epidemiological Trends of Head and Neck Cancer in the United States: A SEER Population Study

            Purpose This study represents the most recent epidemiologic trends of head and neck cancer (HNC) in the United States. It provides an important discussion on oropharyngeal cancer and cancers related to the human papillomavirus. The objective was to identify trends in HNC (2002 to 2012) within the United States. Materials and Methods This study is a retrospective analysis of the US National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) submission. Using the November 2014 submission of the SEER database and SEER-18 data files, data from 2002 to 2012 were analyzed to determine the most recent epidemiologic trends. HNCs of all subtypes were analyzed together. Laryngeal cancers were further analyzed separately. Oropharyngeal cancers of the base of tongue and tonsil were analyzed independently to attempt to trend HPV-related cancers. Results From 2002 to 2012, there were 149,301 cases of HNC recorded in the SEER database. The HNC rate decreased by 0.22% per year ( P = .0549) and the rate of laryngeal cancer decreased by 1.9% per year ( P < .0001). The rate of oropharyngeal (HPV-related) cancer increased by 2.5% per year ( P < .0001). HNC rates increased significantly in Kentucky and Connecticut and decreased in California ( P < .05). HPV-related cancers increased significantly in all states except Georgia, Hawaii, and Michigan ( P < .05). Laryngeal cancer rates decreased in California, Georgia, New Jersey, and New Mexico ( P < .05). Conclusions The overall incidence of HNC is decreasing in the United States. There is an increasing incidence of HPV-related cancers of the oropharynx. Meaningful differences in cancer incidence and rate of change exist between men and women. Furthermore, younger groups have a greater decrease of overall HNC, with an overall increase in HPV-related cancer in patients older than 50 years.
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              Head and Neck Cancers Promote an Inflammatory Transcriptome through Coactivation of Classic and Alternative NF-κB Pathways

              Head and neck squamous cell carcinomas (HNSCC) promote inflammation in the tumor microenvironment through aberrant NF-κB activation, but the genomic alterations and pathway networks that modulate NF-κB signaling have not been fully dissected. Here, we analyzed genome and transcriptome alterations of 279 HNSCC specimens from The Cancer Genome Atlas (TCGA) cohort and identified 61 genes involved in NF-κB and inflammatory pathways. The top 30 altered genes were distributed across 96% of HNSCC samples, and their expression was often correlated with genomic copy number alterations (CNA). Ten of the amplified genes were associated with human papilloma virus (HPV) status. We sequenced 15 HPV(−) and 11 HPV(+) human HNSCC cell lines, and three oral mucosa keratinocyte lines, and supervised clustering revealed that 28/61 genes exhibit altered expression patterns concordant with HNSCC tissues, and distinct signatures related to their HPV status. RNAi screening using an NF-κB reporter line identified 16 genes that are induced by TNF-α or Lymphotoxin β (LTβ) and implicated in the classical and/or alternative NF-κB pathways. Knockdown of TNFR , LTΒR , or selected downstream signaling components established cross-talk between the classical and alternative NF-κB pathways. TNF-α and LTβ induced differential gene expression involving the NF-κB, IFN-γ and STAT pathways, inflammatory cytokines, and metastasis related genes. Improved survival was observed in HNSCC patients with elevated gene expression in T cell activation, immune checkpoints, and IFN-γ and STAT pathways. These gene signatures of NF-κB activation, which modulate inflammation and responses to the immune therapy, could serve as potential biomarkers in future clinical trials.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                3 March 2021
                March 2021
                : 13
                : 3
                : e13666
                Affiliations
                [1 ] Department of Clinical Laboratory, College of Applied Medical Science, University of Hail, Hail, SAU
                [2 ] Department of Clinical Laboratory, College of Applied Medical Science, Shaqra University, Shaqra, SAU
                [3 ] Department of Pathology, College of Medicine, University of Hail, Hail, SAU
                [4 ] Department of Pathology, King Salman Hospital, Hail, SAU
                [5 ] Department of Pathology, King Khalid Hospital, Hail, SAU
                [6 ] Department of Histopathology and Cytology, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, SDN
                [7 ] Department of Pathology, University of Hail, Hail, SAU
                Author notes
                Fawaz D. Alshammari fawazabof@ 123456gmail.com
                Article
                10.7759/cureus.13666
                8017897
                4998387b-2bcb-41df-ad8d-6b46be79fc85
                Copyright © 2021, Alshammari et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 2 March 2021
                Categories
                Pathology
                Oncology

                head and neck,benign,saudi arabia,lesions
                head and neck, benign, saudi arabia, lesions

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