Preoperative discrimination between early (N0/N1) and advanced (N2/N3) nodal stages is critical for treatment planning in tongue squamous cell carcinoma (TSCC) due to its well-established impact on prognosis. Nevertheless, conventional imaging techniques show limited accuracy in staging precision. To address this gap, we developed and validated a Deep Learning Radiomics (DLR) model utilizing multimodal MRI, with the goal of enhancing preoperative staging reliability and supporting clinical decision-making in oral oncology. A total of 579 patients with TSCC from two independent centers were enrolled. Patients from Center 1 were randomly split into training (n = 357) and internal test (n = 153) sets, while patients from Center 2 formed an external test set (n = 69). Handcrafted radiomic features were extracted from primary tumor volumes on contrast-enhanced T1-weighted and T2-weighted images. Concurrently, deep learning features were extracted from the maximum cross-sectional region of interest using three convolutional neural networks (ResNet34, ResNet101, DenseNet121). These features were integrated to build the DLR models. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC), with comparisons made using DeLong’s test. Calibration and decision curve analysis were also employed. ResNet34 DLR model achieved optimal performance, with AUC values of 0.811 (95

6067 Background: Clinical research on Head and Neck Squamous Cell Carcinoma (HNSCC) often considers the disease as a whole. However, the therapeutic outcomes may vary significantly across different subanatomical sites, as well as between locally advanced (LA) and recurrent resectable (RR) HNSCC. Therefore, we stratified HNSCC according to specific anatomical sites and initial diagnosed versus recurrent tumors, and analyzed the efficacy of neoadjuvant PD-1 inhibitor + chemotherapy. Methods: Retrospectively analyzed patients with LA and RR HNSCC admitted to Hunan Cancer Hospital from October 2021 to December 2024, who received neoadjuvant PD-1 inhibitor and chemotherapy. Post-treatment efficacy was evaluated using imaging, endoscopy, or pathology. Differences in efficacy outcomes between different subanatomical sites and between LA and RR tumors were classified and statistically analyzed. Results: 1) A total of 482 patients were included: 434 with LA HNSCC(90.04%) and 48 with RR HNSCC (9.96%), 453 males (93.98%) and 29 females (6.02%). Patient ages ranged from 17 to 77 years, with a mean age of 52.43 ± 9.83 years. 2). The top three types of LAHNSCC that underwent neoadjuvant therapy were: tongue (N=157, 36.180%), buccal oris (N=105, 24.19%),and hypopharynx (N=92, 21.20%). 3)The objective response rates (ORR) following neoadjuvant therapy were as follows: 90.32% for oropharyngx, 83.33% for gingiva, 80.25% for tongue, 79.35% for hypopharynx, 68.57% for buccal oris, and 56.25% for RR HNSCC. The highest pathological deep response rates (pCR+MPR) was observed in tongue (34.40%), followed by oropharynx (29.04%), gingiva (26.67%), and only 33% for RR HNSCC. Conclusions: There are significant variations in the sensitivity of HNSCC to neoadjuvant immunotherapy + chemotherapy across different subanatomical sites. Oropharynx exhibits the highest response to this regimen, whereas RR cases demonstrate relatively poor responsiveness. In terms of pathological deep response, tongue, oropharynx, and gingiva show favorable response rates, while RR cases exhibit significantly lower response rates. Disease status Tongue Buccal oris Hypopharynx Oropharynx Gingiva Others Recurrent Resectable HNSCC Number 157 105 92 31 30 19 48 CR 31(19.75%) 12(11.43%) 13(14.13%) 8(25.81%) 3(10.00%) 7(36.84%) 4(8.33%) MPR 23(14.65%) 13(12.38%) 7(7.61%) 1(3.23%) 5(16.67%) 0(0.00%) 0(0.00%) PR 72(45.86%) 47(44.76%) 53(57.61%) 19(61.29%) 17(56.67%) 10(52.63%) 23(47.92%) SD 20(12.74%) 18(17.14%) 11(11.96%) 2(6.45%) 1(3.33%) 0(0.00%) 16(33.33%) PD 8(5.10%) 11(10.48%) 7(7.61%) 0(0.00%) 3(10.00%) 0(0.00%) 10(10.42%) NA 3(1.91%) 4(3.81%) 1(1.09%) 1(3.23%) 1(3.331%) 2(10.53%) 0(0.00%) ORR 126(80.25%) 72(68.57%) 73(79.35%) 28(90.32%) 25(83.33%) 17(89.47%) 27(56.25%)

Objective:This study retrospectively analyzes two mandibular resection techniques for T3-stage lower gingival carcinoma, aiming to compare their impact on patient prognosis. Methods:Retrospective cohort study. Data from 78 cases of T3-stage lower gingival carcinoma involving the mandible were reviewed in our Department of Head and Neck Surgery. These cases included patients who underwent either marginal mandibulectomy or segmental mandibulectomy. A cohort analysis was performed to evaluate the clinical outcomes and identify factors influencing prognosis in T3-stage lower gingival carcinoma. Results:Thirty-eight patients underwent marginal mandibulectomy, while 40 underwent segmental mandibulectomy. The 3-year overall survival (OS) rate in the marginal mandibulectomy group was 70.8%, with a 5-year OS rate of 52.1%. In the segmental mandibulectomy group, the 3-year OS was 68.1%, and the 5-year OS rate was 52.7%, with no statistically significant difference between the two groups (p > 0.05). The 3-year disease-free survival (DFS) rate was 67.4% in the marginal mandibulectomy group and 50.7% at 5 years, compared to 62.2% and 57.4%, respectively, in the segmental resection group, again showing no statistically significant difference in DFS between the two groups (p > 0.05). However, patients in the marginal resection group demonstrated superior postoperative mandibular functional preservation. Multivariate Cox regression analysis identified advanced age, lymph node metastasis, poor pathological differentiation, and lack of adjuvant radiotherapy as independent risk factors for poor prognosis. Conclusion:The marginal mandibulectomy has been proven to be an oncologically safe method with satisfactory mandibular functional outcomes in selected cases of T3-stage lower gingival carcinoma.

6074 Background: The incidence rate of HNSCC in Hunan China are notably higher than in other regions, likely due to the high prevalence of betel nut chewing. Therefore, we conducted a study to examine the PD-L1 expression in newly diagnosed locally advanced (stage III-IVB) HNSCC patients. Methods: 1. We conducted a retrospective analysis of the PD-L1 expression (represented as CPS) in pre-treatment biopsy tissues from locally advanced HNSCC. 2. 57 patients received neoadjuvant treatment consisting of nab-paclitaxel+ cisplatin+ pembrolizumab. The efficacy of the treatment was evaluated using pathology assessments. Results: 1. A total of 373 patients were included. The top five primary sites of the tumors were the tongue(32.17%), Buccal oris (20.91%), oropharynx (10.19%), hypopharynx(9.92%), and gingiva(7.77%). The proportion of patients with PD-L1 CPS≥20 (55.23%) was significantly higher than the 43.20% reported in the KEYNOTE-048 study. Furthermore, the subgroup was even higher in the buccal oris (70.51%) and gingiva (72.41%). 2. A total of 57 patients were tested for PD-L1 CPS and received neoadjuvant treatment.After surgery, 22/57 (38.60%) achieved pathological complete response (pCR) or major pathological response (MPR), 29/57 (50.88%) achieved partial pathological response (pPR), resulting in an overall response rate (ORR) of 89.47%. In the PD-L1 CPS ≥20 group, the ORR was as high as 91.89% (34/37). 3. Among the 57 patients, 36 patients had lymph node metastasis. After treatment, 15/36 patients (41.67%) achieved pCR/MPR in lymph nodes, 7/36 patients (19.44%) achieved pPR, resulting in an ORR was 61.11% (22/36). Conclusions: 1. The oral cavity is the most common primary in HNSCC in Hunan,China. In the locally advanced , the proportion of PD-L1 CPS ≥20 is higher than reported in other studies. 2. Regardless of PD-L1 expression, neoadjuvant treatment with nab-paclitaxel+ cisplatin+ pembrolizumab has shown a high rate of local disease control in newly diagnosed HNSCC patients. Additionally, the use of neoadjuvant therapy has improved the delineation of surgical safety margins, leading to 100% R0 resections in all 57 patients. 3. The response of the primary lesion in patients treated with neoadjuvant therapy is better than that of the lymph node. Patients with a well-responding primary lesion but multiple lymph node metastases should be closely monitored for the possibility of short-term systemic metastasis. [Table: see text]

Objective: To investigate the feasibility, safety and effectiveness of colonic interposition with vascular anastomosis in reconstructing the entire esophagus and hypopharynx after resection of hypopharyngeal cancer with esophageal cancer. Methods: We conducted a retrospective analysis of 4 male patients with simultaneous multiple primary cancers of the hypopharynx and esophagus, aged 47 to 58, treated in the Department of Head and Neck Surgery at the Hunan Cancer Hospital from February to August 2019. All cases underwent total hypopharyngectomy and total esophagectomy, of whom, three cases presented with total laryngectomy and one case with larynx preservation. Colonic interposition was performed using the left colic artery as a pedicle, with an average colonic length of 48.5 cm. The colon was elevated through the esophageal bed to the neck, and the branch of the colonic mesenteric artery was anastomosed to one of the neck arteries, including the inferior thyroid artery in one case, the transverse cervical artery in two cases, and the superior thyroid artery in one case, and all venous anastomoses were performed with the internal jugular veins. Results: The postoperative neck and abdominal wounds healed well without anastomotic leakage, and all patients were able to resume a regular oral diet within 21-30 days postoperatively. During the follow-up of 48-52 months, two cases died due to tumor recurrence, while the remaining two cases were disease-free survivals. Conclusion: Colonic interposition with vascular anastomosis is a safe and reliable reconstruction method suitable for repairing long-segment upper digestive tract defects after resection of hypopharyngeal cancer with esophageal cancer.

Background Dosage-optimized multimodal radiotherapies that are safe for head and neck cancer patients are desirable. In this study, we investigated tissue tolerance to varying doses of external beam radiotherapy (EBRT) combined with low-dose rate brachytherapy in the neck of a rabbit model. Methods Twenty rabbits were used in the four test groups (five each) with iodine-125 seeds implanted in the neck treated with EBRT in four doses at 50, 40, 30 and 20 Gy each. Twelve rabbits for three control groups (four each). Three months after implantation, all rabbits were euthanized, and target tissues were collected. Analyses included seed implantation assessment, histopathological evaluation, immunohistochemistry staining, terminal deoxynucleotidyl transferase dUTP nick end labeling assay, electron microscopy and statistics with the SPSS software. Results Five rabbits died in the four test groups, and three rabbits died in the three control groups (one per group), which showed no significant difference by survival analysis. The calculated minimum peripheral dose was 17.6 Gy, the maximum dose near the seed was 1812.5 Gy, the D90 was 34.5 Gy and the mean dose was 124.5 Gy. In all groups that received radiation, apoptosis occurred primarily in the esophageal mucosa and corresponded to the dose of radiation; a higher dose caused a greater apoptosis, with significant difference between groups (P < 0.05). Electron microscopy of carotid arteries revealed that endothelial cells were swollen and some were shed from basement membrane, but no other noticeable tissue damages. Conclusions Limited EBRT at maximal dose (50 Gy) combined with the brachytherapy interstitially applied to the neck was tolerated well in the rabbit model.

6063 Background: We hypothesized that concurrent chemoradiotherapy (CCRT) plus concurrent and adjuvant camrelizumab as first-line treatmentwas associated with improved survival compared with concurrent chemoradiotherapy alone for nonoperative locoregionally advanced head and neck squamous cell carcinoma (HNSCC). The purpose of this comparative study was to compare the efficacy and toxicity of CCRT plus concurrent and adjuvant camrelizumab versus CCRT alone in nonoperative locoregionally advanced HNSCC. Methods: One hundred and eighty patients with nonoperative locoregionally advanced HNSCC (cancer of the oral cavity, oropharyngeal cancer, hypopharyngeal cancer and laryngeal cancer) received either CCRT plus concurrent and adjuvant camrelizumab (camrelizumab + CCRT group, n = 90) or CCRT alone (CCRT alone group, n = 90). Patients in both groups received curative cisplatin-based concurrent chemoradiotherapy. The radiation dose was 70 Gy (2.0 Gy/fraction). In camrelizumab + CCRT group, concurrent camrelizumab (200mg/day on days 1, 22, 43) was added to CCRT, followed by adjuvant camrelizumab (200mg, every 3 weeks for 6 months or until disease progression, unacceptable adverse events or withdrawal of consent). Results: Compared with CCRT alone, the addition of concurrent and adjuvant camrelizumab significantly improved complete response (CR) rates (92.2% vs. 80.0%; P = 0.018), 3-year disease free survival (DFS, 72.2% vs. 56.7%; P = 0.029), locoregional recurrence-free survival (LRRFS, 76.7% vs. 61.1%; P = 0.024), and overall survival (OS, 78.9% vs. 63.3%; P = 0.033). Reactive cutaneous capillary endothelial proliferation was higher in the camrelizumab + CCRT group (6.7% vs. 0.0%; P = 0.013). No statistically significant differences in other acute (mucositis, leukopenia, thrombocytopenia, anemia, etc.) and late toxic effects (mucosal necrosis, trismus, cranial nerve palsy, etc.) were observed between the two groups. The addition of camrelizumab (CCRT plus camrelizumab vs. CCRT alone) was a significant independent prognostic factor for 3-year DFS, LRRFS and OS (P = 0.038, P = 0.032, and P = 0.048, respectively). Conclusions: Concurrent chemoradiotherapy plus concurrent and adjuvant camrelizumab as first-line treatment is associated with a considerable survival benefit, with acceptable adverse events, as compared with concurrent chemoradiotherapy alone, among patients with nonoperative locoregionally advanced head and neck squamous cell carcinoma. Our ongoing prospective clinical trial (registered with chictr.org.cn, number ChiCTR2200056298) will further investigate the efficacy of camrelizumab in combination with chemoradiotherapy for HNSCC.

Objective:To investigate the role of pre-treatment magnetic resonance imaging (MRI) radiomics for the preoperative prediction of lymph node (LN) metastasis in patients with hypopharyngeal squamous cell carcinoma (HPSCC).Methods:A total of 155 patients with HPSCC were eligibly enrolled from single institution. Radiomics features were extracted from contrast-enhanced axial T-1 weighted (CE-T1WI) sequence. The most relevant features of LN metastasis were selected by the least absolute shrinkage and selection operator (LASSO) method. Univariate and multivariate logistic regression analysis was adopted to determine the independent clinical risk factors. Three models were constructed to predict the LN metastasis status: one using radiomics only, one using clinical factors only, and the other one combined radiomics and clinical factors. Receiver operating characteristic (ROC) curves and calibration curve were used to evaluate the discrimination and the accuracy of the models, respectively. The performances were tested by an internal validation cohort (n=47). The clinical utility of the models was assessed by decision curve analysis.Results:The nomogram consisted of radiomics scores and the MRI-reported LN status showed satisfactory discrimination in the training and validation cohorts with AUCs of 0.906 (95% CI, 0.840 to 0.972) and 0.853 (95% CI, 0.739 to 0.966), respectively. The nomogram, i.e., the combined model, outperformed the radiomics and MRI-reported LN status in both discrimination and clinical usefulness.Conclusions:The MRI-based radiomics nomogram holds promise for individual and non-invasive prediction of LN metastasis in patients with HPSCC.

Objective:To explore the value of nasal endoscopy assisting combined with transoral approach in resection of the carcinoma of the palate with the nasal cavity and sinuses invaded. Methods:A retrospective analysis of 21 patients with a primary malignant tumors of the palate was performed. Preoperative nasal endoscopy and CT and MRI scan showed that the primary tumors invading the nasal cavity and sinuses in all patients or skull base with varying degrees. All patients were treated by nasal endoscopic assisting combined with transoral approach. Postoprational adjuvant radiotherapy or concurrent chemoradiotherapy was performed according to pathological types and clinical stage. Postoperative complications, all-tumor resection rate, local control rate and 5-year survival rate were analyzed statistically. Results:The combined approach was successfully performed in all patients. En bloc resection was carried out in 18 patients by this combined approach and surgical margins were free of carcinoma. The median follow-up period was 60 months. All patients had good nasal ventilation function and no epiphora in postoperation, and the overall local control rate of primary site was 85.7%, overall 5-year survival rate was 76.2%. Conclusion:Nasal endoscopy assisting combined with transoral approach is an effective method for the resection of palate malignant tumors invading the nasal cavity and sinuses. It is convenient for en bloc resection and local control of primary lesions. It is beneficial to preserve the function of nasal cavity and sinuses, which is in line with the principle of functional surgery.

Objectives To evaluate the effectiveness of machine learning models based on morphological magnetic resonance imaging (MRI) radiomics in the classification of parotid tumors. Methods In total, 298 patients with parotid tumors were randomly assigned to a training and test set at a ratio of 7:3. Radiomics features were extracted from the morphological MRI images and screened using the Select K Best and LASSO algorithm. Three-step machine learning models with XGBoost, SVM, and DT algorithms were developed to classify the parotid neoplasms into four subtypes. The ROC curve was used to measure the performance in each step. Diagnostic confusion matrices of these models were calculated for the test cohort and compared with those of the radiologists. Results Six, twelve, and eight optimal features were selected in each step of the three-step process, respectively. XGBoost produced the highest area under the curve (AUC) for all three steps in the training cohort (0.857, 0.882, and 0.908, respectively), and for the first step in the test cohort (0.826), but produced slightly lower AUCs than SVM in the latter two steps in the test cohort (0.817 vs. 0.833, and 0.789 vs. 0.821, respectively). The total accuracies of XGBoost and SVM in the confusion matrices (70.8% and 59.6%) outperformed those of DT and the radiologist (46.1% and 49.2%). Conclusion This study demonstrated that machine learning models based on morphological MRI radiomics might be an assistive tool for parotid tumor classification, especially for preliminary screening in absence of more advanced scanning sequences, such as DWI. Key Points • Machine learning algorithms combined with morphological MRI radiomics could be useful in the preliminary classification of parotid tumors. • XGBoost algorithm performed better than SVM and DT in subtype differentiation of parotid tumors, while DT seemed to have a poor validation performance. • Using morphological MRI only, the XGBoost and SVM algorithms outperformed radiologists in the four-type classification task for parotid tumors, thus making these models a useful assistant diagnostic tool in clinical practice.

目的 探讨局部晚期口鼻相关恶性肿瘤的修复重建及术后并发症处理的应用价值.方法 回顾性分析原发于鼻腔鼻窦,硬腭及上颌牙槽的局部晚期口鼻恶性肿瘤33例,继发口腔癌术后复发病例侵犯口鼻恶性肿瘤3例,病理类型主要为鳞癌和小涎腺恶性肿瘤.术前CT和MRI检查,所有病例肿瘤均不同程度破坏鼻腔鼻窦,上腭,眶周,颅底区域,根据病情采用不同手术入路完整切除病灶后,采用游离股前外侧皮瓣,游离腓骨肌皮瓣及钛网等修复方法重建缺损并随访疗效及并发症.结果 所有病例均成功切除肿瘤,一期重建均成功,皮瓣成活,外形恢复可,无明显口鼻瘘,脑脊液瘘,眶底及面部塌陷.术后中位随访期12个月,出现咽鼓管闭塞中耳积液8例,鼻泪管溢泪5例,吞咽障碍6例.结论 手术切除是口鼻相关恶性肿瘤的一种有效治疗方法,一期修复重建及积极处理并发症对改善患者外形及生活质量具有重要意义,对术后的综合治疗提供了便利.

OBJECTIVE:To explore whether radiomics features extracted from pre-treatment magnetic resonance imaging (MRI) can predict the overall survival (OS) in patients with hypopharyngeal squamous cell carcinoma.METHODS:A total of 190 patients with hypopharyngeal squamous cell carcinoma were eligibly enrolled from two institutions. Radiomics features were extracted from contrast-enhanced axial T1-weighted (CE-T1WI) sequence. The least absolute shrinkage selection operator (LASSO) algorithm was applied to establish a radiomics score correlated with OS. Multivariate logistic regression analysis was applied to determine the independent risk factors, which was combined with radiomics score to build the final radiomics nomogram.RESULTS:A radiomics score with 6 CE-T1WI features for OS prediction was constructed and validated; its integration with specific clinicopathologic factors (N stage) showed a better prediction performance in the training, internal validation, and external validation cohorts (C-index 0.78, 0.75, and 0.75). Calibration curves determined a good agreement between the predicted and actual overall survival.CONCLUSIONS:The radiomics-clinical nomogram and radiomics score might be non-invasive and reliable methods for the risk stratification in patients with hypopharyngeal squamous cell carcinoma.KEY POINTS:• An MRI-based radiomics model was constructed to evaluate of OS in patients with hypopharyngeal squamous cell carcinoma. • A radiomics-clinical nomogram that combined radiomics features and clinical characteristics was established. • Multi-cohort study validated the predictive performance of the radiomics-clinical nomogram to stratify patients with high risk in clinical practice.

目的 评估放射治疗应用于口颊癌术后腮腺瘘的疗效以及不良反应.方法 回顾性分析2010年1月-2020年1月湖南省肿瘤医院头颈外科收治的因口颊癌术后出现腮腺瘘且接受放射治疗的患者37例,所有患者均采用6-MeV电子线照射,每次2 Gy,每天1次,每周5次,照射总剂量为8～18 Gy(平均剂量9.7 Gy),照射野包括整个腮腺区域.结果 37例接受放射治疗的腮腺瘘患者均治愈,治愈率达100％.后期随访3个月,无1例再次出现腮腺瘘.仅有1例患者出现轻微口干以及味觉改变,未观察到其他相关不良反应.结论 放疗用于口颊癌术后腮腺瘘的治疗,其起效快、效果显著、无明显的并发症,值得在临床推广应用.

Objective:To explore the classification and reconstruction strategy of defects in lateral face region after operation of malignant tumors.Methods:Eighteen cases with the reconstruction of complicated defects after resection of tumors in the region of lateral face from January 2015 to January 2018 in Hunan Cancer Hospital were retrospectively reviewed. There were 14 males and 4 females, aged from 32 to 68 years. According to the presence or absence of bony scaffold, complicated defects were divided into two main categories: soft tissue perforating defects and soft tissue defects combined with bony scaffold defects. All soft tissue perforating defects in 5 cases were repaired with free anterolateral femoral flaps. Among 13 cases with soft tissue plus bony scaffold defects, 3 were repaired with free fibular flaps, 6 with free fibular flaps combined with free anterolateral femoral flaps, and 4 with chimeric deep circumflex iliac artery perforator flaps combined with anterolateral femoral flaps.Results:All flaps survived well. Two patients complicated with fistula in floor of mouth, but the wound healed after dressing change. Transoral feeding was resumed within 2 weeks after surgery in all patients. One year follow-up evaluation showed that 14 cases had symmetrical face and 10 cases had mouth opening more than 3 transverse fingers. After 36-50 months of follow-up, 6 patients died, with an overall 3-year survival rate of 66.7%.Conclusion:The classification of defects with or without bony stent loss is conducive to the overall repair design, the recovery of facial contour stent, the effective fill of dead space and the maintain of residual occlusal relationship. Good reconstruction results require a multi flap combination of osteocutaneous and soft tissue flaps.

BACKGROUND Head and neck squamous cell carcinoma (HNSCC) is the seventh most common type of cancer around the world. The aim of this study was to seek the long non-coding RNAs (lncRNAs) acting as diagnostic and prognostic biomarker of HNSCC. METHODS Base on TCGA dataset, the differentially expressed mRNAs (DEmRNAs) and lncRNAs (DElncRNAs) were identified between HNSCC and normal tissue. The machine learning and survival analysis were performed to estimate the potential diagnostic and prognostic value of lncRNAs for HNSCC. We also build the co-expression network and functional annotation. The expression of selected candidate mRNAs and lncRNAs were validated by Quantitative real time polymerase chain reaction (qRT-PCR). RESULTS A total of 3363 DEmRNAs (1822 down-regulated and 1541 up-regulated mRNAs) and 32 DElncRNAs (13 down-regulated and 19 up-regulated lncRNAs) between HNSCC and normal tissue were obtained. A total of 13 lncRNAs (IL12A.AS1, RP11.159F24.6, RP11.863P13.3, LINC00941, FOXCUT, RNF144A.AS1, RP11.218E20.3, HCG22, HAGLROS, LINC01615, RP11.351J23.1, AC024592.9 and MIR9.3HG) were defined as optimal diagnostic lncRNAs biomarkers for HNSCC. The area under curve (AUC) of the support vector machine (SVM) model, decision tree model and random forests model and were 0.983, 0.842 and 0.983, and the specificity and sensitivity of the three model were 95.5% and 96.2%, 77.3% and 97.6% and 93.2% and 97.8%, respectively. Among them, AC024592.9, LINC00941, LINC01615 and MIR9-3HG was not only an optimal diagnostic lncRNAs biomarkers, but also related to survival time. The focal adhesion, ECM-receptor interaction, pathways in cancer and cytokine-cytokine receptor interaction were four significantly enriched pathways in DEmRNAs co-expressed with the identified optimal diagnostic lncRNAs. But for most of the selected DEmRNAs and DElncRNAs, the expression was consistent with our integrated analysis results, including LINC00941, LINC01615, FOXCUT, TGA6 and MMP13. CONCLUSION AC024592.9, LINC00941, LINC01615 and MIR9-3HG was not only an optimal diagnostic lncRNAs biomarkers, but also were a prognostic lncRNAs biomarkers.

Squamous cell carcinoma (SCC) is an aggressive malignancy that can originate from various organs. TP63 is a master regulator that plays an essential role in epidermal differentiation. It is also a lineage-dependent oncogene in SCC. ΔNp63α is the prominent isoform of TP63 expressed in epidermal cells and SCC, and overexpression promotes SCC development through a variety of mechanisms. Recently, ΔNp63α was highlighted to act as an epidermal-specific pioneer factor that binds closed chromatin and enhances chromatin accessibility at epidermal enhancers. ΔNp63α coordinates chromatin-remodeling enzymes to orchestrate the tissue-specific enhancer landscape and three-dimensional high-order architecture of chromatin. Moreover, ΔNp63α establishes squamous-like enhancer landscapes to drive oncogenic target expression during SCC development. Importantly, ΔNp63α acts as an upstream regulator of super enhancers to activate a number of oncogenic transcripts linked to poor prognosis in SCC. Mechanistically, ΔNp63α activates genes transcription through physically interacting with a number of epigenetic modulators to establish enhancers and enhance chromatin accessibility. In contrast, ΔNp63α also represses gene transcription via interacting with repressive epigenetic regulators. ΔNp63α expression is regulated at multiple levels, including transcriptional, post-transcriptional, and post-translational levels. In this review, we summarize recent advances of p63 in epigenomic and transcriptional control, as well as the mechanistic regulation of p63.

Head and neck squamous cell carcinoma (HNSCC) constitute approximately 4% of all cancers worldwide. In this study, we analyzed the expression profile of the long noncoding RNA (lncRNA) of 502 HNSCC patients from The Cancer Genome Atlas database. Among the differentially expressed lncRNAs between HNSCC and normal samples, LNCAROD is overexpressed in HNSCC and associated with advanced T stage and shortened overall survival. The N6‐methyladenosine (m6A) modification mediated by METTL3 and METTL14 enhanced the stability of LNCAROD in HNSCC cells. Depletion of LNCAROD attenuated cell proliferation, mobility in vitro, and tumorigenicity in vivo, whereas overexpression of LNCAROD exerted opposite effects. LNCAROD is mainly distributed in nucleus and binds with YBX1 and HSPA1A proteins. Silencing either YBX1 or HSPA1A did not affect the level of LNCAROD. However, loss of LNCAROD led to shortened half‐life of YBX1 protein. Mechanistically, LNCAROD protected YBX1 from proteasomal degradation by facilitating YBX1‐HSPA1A protein–protein interaction. Depletion of HSPA1A in LNCAROD‐overexpressing cells resulted in accelerated proteasomal degradation of YBX1 protein. Moreover, re‐expression of Flag‐YBX1 in LNCAROD‐silenced cells rescued malignant behavior of HNSCC cells. Our study indicates that LNCAROD is an oncogenic lncRNA and dysregulation of m6A modification might account for aberrant expression of LNCAROD in HNSCC. LNCAROD acts as a scaffold for the interaction between YBX1 and HSPA1A, preventing proteasomal degradation of YBX1 in HNSCC cells.

目的:评估改良手术切口联合自体组织在腮腺肿瘤切除术后的效果.方法:回顾性分析65例行改良手术切口切除腮腺肿瘤的患者资料,其中39例行胸锁乳突肌瓣填充术腔,26例游离脂肪填充术腔,术后随访24～96个月.评价术区情况和味觉出汗综合征的发生.结果:4例发生味觉出汗综合征.术区外形饱满,两侧颜面部对称性好,手术疤痕隐蔽.结论:改良的手术切口联合自体组织一期填充术腔,可改善腮腺肿瘤手术后术区凹陷畸形,降低味觉出汗综合征的发生.

Invasion and metastasis represent the primary causes of therapeutic failure in patients diagnosed with squamous cell carcinoma of the head and neck (SCCHN). Therefore, disease prediction and inhibition of invasion and metastasis are critical for enhancing the survival of patients with SCCHN. Our previous study revealed that increased expression of miR-93-5p is associated with poor prognosis in SCCHN; however, the mechanism underlying the oncogenic functions of miR-93-5p in SCCHN migration and invasion remains unclear. Using qPCR analyses, transwell assays, and scratch tests, we demonstrated that expression of ectopic miR-93-5p induced the migration and invasion of SCCHN, and this was accompanied by corresponding alterations in biomarkers and transcription factors specific for epithelial-mesenchymal transition (EMT). Luciferase reporter assays were used to demonstrate that miR-93-5p directly targeted the 3' UTR of RGMB, and we further found that the tumor-promoting functions of miR-93-5p were partly mediated by targeting RGMB, whose downregulation also promoted the migration and invasion of SCCHN. Overall, our results indicate that miR-93-5p acts as an oncogene in the regulation of migration and invasion by suppressing RGMB in SCCHN. These findings provide novel evidence that miR-93-5p may serve as a valuable predictive biomarker and potential intervention target in patients with SCCHN.

居泉沙雷菌（serratia fonticola）属沙雷菌属，近年其少见的人体感染与部分多重耐药已引起临床重视。恶性肿瘤合并居泉沙雷菌的报道罕见。2019年4月我院收治1例巨大腮腺恶性肿瘤合并居泉沙雷菌感染的病例。入院后根据药敏结果，选用哌拉西林钠舒巴坦钠静脉滴注，单次剂量3 g，每8小时1次抗感染治疗；联合局部伤口换药，每天2次。局部感染控制后手术治疗，患者术后恢复良好出院。术后2个月于当地医院行三维适型放射治疗，左侧术区+双侧颈部Ⅰ~Ⅴ区共放疗50 Gy。术后6个月复查，头颈部及全身无肿瘤复发。