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Weston, Andrew, Marie Hughes, Gillian Corbett, Neil Graham i Franz Strydom. "Incidence of Non-Melanoma Skin Cancers in Patients with Chronic Lymphocytic Leukaemia: A Retrospective Study in a Bay of Plenty, New Zealand Population". Blood 138, Supplement 1 (5.11.2021): 4692. http://dx.doi.org/10.1182/blood-2021-147766.
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Abstract Background/Aims: Chronic lymphocytic leukaemia (CLL) incurs an increased risk of developing second primary malignancies (SPMs). The pathogenesis underpinning this increased SPM risk is attributable to synergism between genetic aberrations, chronic immune suppression / dysfunction and CLL treatments. Specifically, CLL associated skin cancer is a well-documented phenomenon, with common malignancies such as squamous (SCC) and basal cell (BCC) carcinomas occurring at higher frequencies in CLL patients and are often of a more aggressive phenotype. The incidence of non-melanoma skin cancers (NMSCs) among New Zealand CLL patients is unknown, as NMSCs are not required to be reported to the New Zealand Cancer Registry. Accordingly, this study aimed to analyse the incidence of NMSC in CLL patients from the Bay of Plenty region of New Zealand. Methods: We conducted a retrospective analysis of 213 CLL patients, who were referred to Bay of Plenty District Health Board (BOPDHB) between 2015 and 2020, for the occurrence of SPMs. Clinical notes were reviewed for the demographics of sex, age at time of CLL diagnosis, CLL treatments received and occurrence and type of NMSCs. A control group of 76 patients referred to BOPDHB haematology, for anaemia or thrombocytopenia, of which the cause subsequently remained unknown and was not associated with lymphoproliferative disease, was reviewed for primary malignancy (PM), occurrence and type. NMSC incidence was also compared to a local data, on overall NMSC incidence in the general Bay of Plenty population, in 2015. Results: The predominant SPM types occurring in this CLL patient group were NMSCs. A total of 249 and 170 histological diagnoses of SCC and BCC were made in our group of CLL patients, respectively. Of the 213 CLL patients, 48.8% had a diagnosis of at least one NMSC, with median time between CLL and NMSC diagnosis of 5 years (range, -6 to 19 years). CLL patients that were diagnosed with NMSC developed a mean number of 3.93 ± 2.94 separate lesions, compared to 2.6 ± 1.7 lesions in our control population. Note: comparison of NMSC incidence data between CLL group and Bay of Plenty population Conclusion: Patients with CLL are at increased risk of developing multiple NMSC lesions. Therefore, we believe CLL patients should be assessed by dermatologists or general practitioners for whole-body skin examination, 6 monthly following their CLL diagnosis. This strategy promotes early diagnosis, and patient education on importance of sun protection strategies to reduce NMSC risk. This is essential to the ongoing care of CLL patients in a NZ context, given the increased incidence of NMSC associated with CLL, in combination with the high levels of UV exposure and skin damage among the NZ general population. This study also highlights how NMSC disease burden is likely to be significantly underestimated due to a lack of data collection on these malignancies by the New Zealand Cancer Registry. Disclosures No relevant conflicts of interest to declare.
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Bislimi Berisha, Reihane, Djordje Dzokic i Shkendije Dobruna. "Evaluation of Pre-operative Dermoscopy in Early Diagnosis of Non-melanocytic Skin Cancer". Open Access Macedonian Journal of Medical Sciences 9, B (2.12.2021): 1660–63. http://dx.doi.org/10.3889/oamjms.2021.7539.
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BACKGROUND: Dermatoscopy is an integral part of every clinical examination of skin tumors. Dermoscopy has markedly enhances the early diagnosis of non-melanocytic skin cancer (NMSC) compared to naked-eye inspection. Besides its value in the noninvasive diagnosis tool of skin cancer, dermoscopy has also gained increased interest in the response assessment and management of NMSC including basal cell carcinoma, Bowen’s disease, squamous cell carcinoma and merkel cell carcinoma. NMSCs are usually considered a curable disease, however they currently present a growing global healthcare problem due to the increasing incidence, hence this is the reason for my work. AIM: The main aim of the study is to prove the value of dermoscopy in the precision of pre-operative diagnosis of NMSC confirmed by postoperative histopathology (PH) findings. Additional goals are to declare dermoscopy subtypes of NMSC in according to the age, sex, localization, UV radiation, anatomical region, and phototype of skin. METHODS: We used two types of dermoscopy, non-polarized, and polarized dermoscopy. Non-polarized dermoscopy uses magnifying lenses and LED illumination light. This method requires contact with pre-liquid (gel, oil, and alcohol) skin to reduce reflection. Non-polarized dermoscopy allows visualization of structures located in the epidermis and dermoepidermal junction, but not below it. Polarized dermoscopy in addition to the magnifying and light lenses, it uses two polarizing filters to enable cross-polarization. This type of method does not require liquid medium on the skin surface and does not require skin contact. Polarized dermoscopy allows visualization of structures located deeper and below the dermoepidermal junction and the superficial dermis. RESULTS: This paper provides an update on NMSC with special emphasis of dermoscopy in the precision of preoperative diagnosis of NMSC confirmed by postoperative histopathology findings. CONCLUSION: Our first experiences with pre-operative dermoscopy in 11 patients indicate its value in the diagnosis of NMCS. Our further studies in multiple patients should determine its accuracy in pre-operative diagnosis confirmed by post-operative PH findings.
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Antonijevic, Aleksandar, Natasa Rancic, Mirko Ilic, Biljana Kocic, Jasmina Stevanovic i Marija Milic. "Trends in incidence of non-melanoma and melanoma skin cancers in central Serbia". Srpski arhiv za celokupno lekarstvo 146, nr 7-8 (2018): 391–95. http://dx.doi.org/10.2298/sarh161121002a.
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Introduction/Objective. The incidence of both melanoma and non-melanoma skin cancers (NMSC) has been increasing over the past decades worldwide. NMSC is the most common cancer in white population and melanoma is one of the deadliest cancers today. The objective of the paper was to determine trends in age-standardized incidence rates of NMSC and melanoma in central Serbia from 1999 to 2013. Method. A descriptive epidemiological study was done. Data about incidence for NMSC and melanoma were obtained from the Serbian Cancer Registry and data about population originating from 1991, 2001, and 2011 censuses. Crude incidence rates were calculated per 100,000 inhabitants. Direct method of standardization was performed with the world population as the standard. Trend lines were estimated using linear regression. Results. During a 15-year period, the total number of new NMSC cases was 41,719 [21,690 (52%) in men and 20,029 (48%) in women]. There were 5,781 new cases of melanoma [2,969 (51.4%) in men and 2,812 (48.6%) in women]. A significantly increasing incidence trend for NMSC both in men (y = 0.617x + 24.29, R2 = 0.500) and women (y = 0.672x + 0.670, R2 = 0.670) was determined. In the same period, a statistically significant increase of incidence trend for melanoma was determined in men (y = 0.111x + 3.708, R2 = 0.384) and in women (y = 0.098x + 3.375, R2 = 0.409). NMSC was registered in persons of all ages. NMSC incidence increased rapidly in persons older than 50 years. Melanoma predominates in children and adolescents and is registered more frequently than NMSC in persons bellow 60 years of age. Conclusion. Our findings showed significantly increasing trend of age-standardized incidence rates for both NMCC and melanoma. In the observed period, there were 7.2 times more new cases of NMSC than melanoma in the population of central Serbia. There were more registered new cases of NMSC and melanoma in men than in women. Screening of skin cancers and earlier diagnosis may improve treatment and prognosis.
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Hu, Dailun, Philip K. Nicholls, Changfu Yin, Khama Kelman, Qionglan Yuan, Wayne K. Greene, Zhongli Shi i Bin Ma. "Immunofluorescent Localization of Non-myelinating Schwann Cells and Their Interactions With Immune Cells in Mouse Thymus". Journal of Histochemistry & Cytochemistry 66, nr 11 (18.05.2018): 775–85. http://dx.doi.org/10.1369/0022155418778543.
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The thymus is innervated by sympathetic/parasympathetic nerve fibers from the peripheral nervous system (PNS), suggesting a neural regulation of thymic function including T-cell development. Despite some published studies, data on the innervation and nerve-immune interaction inside the thymus remain limited. In the present study, we used immunofluorescent staining of glial fibrillary acidic protein (GFAP) coupled with confocal microscopy/three-dimensional (3D) reconstruction to reveal the distribution of non-myelinating Schwann cells (NMSC) and their interactions with immune cells inside mouse thymus. Our results demonstrate (1) the presence of an extensive network of NMSC processes in all compartments of the thymus including the capsule, subcapsular region, cortex, cortico-medullary junction, and medulla; (2) close associations/interactions of NMSC processes with blood vessels, indicating the neural control of blood flow inside the thymus; (3) the close “synapse-like” association of NMSC processes with various subsets of dendritic cells (DC; e.g., B220+ DCs, CD4+ DCs, and CD8+ DCs), and lymphocytes (B cells, CD4+/CD8+ thymocytes). Our novel findings concerning the distribution of NMSCs and the associations of NMSCs and immune cells inside mouse thymus should help us understand the anatomical basis and the mechanisms through which the PNS affects T-cell development and thymic endocrine function in health and disease.
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Ghahartars, Mehdi, Shiva Najafzadeh, Shabnam Abtahi, Mohammad Javad Fattahi i Abbas Ghaderi. "Investigation of Interleukin-27 in the Sera of Nonmelanoma Skin Cancer Patients". Dermatology Research and Practice 2018 (19.11.2018): 1–5. http://dx.doi.org/10.1155/2018/8321302.
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IL-27 has been shown to have both tumor promoting and suppressing functions. IL-27, with its diverse influences on immune responses, has not been studied extensively in nonmelanoma skin cancers (NMSC), including Squamous and Basal Cell Carcinomas (SCC and BCC), and its roles in tumor initiation, progression, and its probable use in NMSC treatment have yet to be unveiled. A cross-sectional analytical study was designed to investigate the serum levels of IL-27 in NMSC patients in comparison to normal individuals. Levels of IL-27 in the sera of 60 NMSC patients along with 28 healthy controls were measured by means of quantitative enzyme-linked immunosorbent assay (ELISA). In this study we observed that IL-27 serum levels were significantly higher in NMSC patients in comparison to healthy individuals (0.0134versus0.0008 ng/ml; P<0.001). Furthermore, when subcategorized based on pathological diagnosis, both BCC and SCC patients had higher levels of IL-27 in their sera compared to controls (P=0.002 and P=0.033; respectively). However, these levels were not different among SCC and BCC patients. According to our results, it seems that IL-27 is involved in antitumor immune responses in NMSCs. On the other hand, these observations might be indicative of this cytokine involvement in NMSC tumorigenesis and progression. Therefore, administration of this cytokine for therapeutic purposes in patients with such conditions should be erred on the side of caution.
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Møllersen, Kajsa, Herbert Kirchesch, Maciel Zortea, Thomas R. Schopf, Kristian Hindberg i Fred Godtliebsen. "Computer-Aided Decision Support for Melanoma Detection Applied on Melanocytic and Nonmelanocytic Skin Lesions: A Comparison of Two Systems Based on Automatic Analysis of Dermoscopic Images". BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/579282.
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Commercially available clinical decision support systems (CDSSs) for skin cancer have been designed for the detection of melanoma only. Correct use of the systems requires expert knowledge, hampering their utility for nonexperts. Furthermore, there are no systems to detect other common skin cancer types, that is, nonmelanoma skin cancer (NMSC). As early diagnosis of skin cancer is essential, there is a need for a CDSS that is applicable to all types of skin lesions and is suitable for nonexperts. Nevus Doctor (ND) is a CDSS being developed by the authors. We here investigate ND’s ability to detect both melanoma and NMSC and the opportunities for improvement. An independent test set of dermoscopic images of 870 skin lesions, including 44 melanomas and 101 NMSCs, were analysed by ND. Its sensitivity to melanoma and NMSC was compared to that of Mole Expert (ME), a commercially available CDSS, using the same set of lesions. ND and ME had similar sensitivity to melanoma. For ND at 95% melanoma sensitivity, the NMSC sensitivity was 100%, and the specificity was 12%. The melanomas misclassified by ND at 95% sensitivity were correctly classified by ME, and vice versa. ND is able to detect NMSC without sacrificing melanoma sensitivity.
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Mistry, Nisha, Zenaida Abanto, Chris Bajdik i Jason K. Rivers. "Demographic and Tumor Characteristics of Patients Diagnosed with Nonmelanoma Skin Cancer: 13-Year Retrospective Study". Journal of Cutaneous Medicine and Surgery 16, nr 1 (styczeń 2012): 32–38. http://dx.doi.org/10.1177/120347541201600107.
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Background: The incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) is increasing worldwide; however, this varies by region. To date, there are limited data about trends of nonmelanoma skin cancer (NMSC) in Canada. Objective: To determine the demographic and tumor characteristic changes in patients diagnosed with BCC and SCC from 1993 to 2005 in a dermatology practice in Vancouver, British Columbia. Method: A retrospective chart review was conducted on patients with biopsy-confirmed NMSC between 1993 and 2005. Demographic and tumor characteristics were documented for the first two incident BCCs and SCCs per patient, and a descriptive data analysis was undertaken. Results: A total of 1,177 NMSCs were identified from 885 patient charts. The number of BCCs increased from 1993 to 2003 and then decreased until 2005. BCCs and SCCs were generally diagnosed in older people (60+ years); however, an important group of younger patients (20–39 years) was also diagnosed with BCCs. BCCs and SCCs were most commonly seen on the head and neck, but the leg was a common location for SCC in women. Conclusion: NMSC is prevalent in British Columbia. These results highlight the fact that NMSC can affect individuals younger than 40 years old. Prevention strategies are warranted to reduce the burden of NMSC in British Columbia.
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Dacosta Byfield, Stacey, Diana Chen, Yeun Mi Yim i Carolina Reyes. "Age distribution of patients with advanced non-melanoma skin cancer in the United States". Archives of Dermatological Research 305, nr 9 (21.04.2013): 845–50. http://dx.doi.org/10.1007/s00403-013-1357-2.
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Abstract The epidemiology of non-melanoma skin cancer (NMSC) is not well understood due to exclusion from most US cancer registries. Patients with at least two claims with a NMSC diagnosis (ICD-9-CM 173.xx) at least 60 days apart, or at least one claim for a NMSC-specific treatment from 1/2010 to 12/2010, were identified from a large US commercial insurance claims database and grouped into one of three cohorts: metastatic (MET), locally advanced (LA), or “all other”. MET patients had at least two claims with a metastasis code at least 30 days apart. LA patients had at least two visits to a medical oncologist, one diagnostic imaging service, two radiation therapy services, or one visit to two or more physician specialties. Remaining patients were “all other”. Incidence and prevalence of NMSC were calculated from among the total number of persons continuously enrolled in the plan during the study period and standardized to the 2010 US population. From among 6,610,256 patients, there were 47,451 incident cases of NMSC (MET n = 16, LA n = 387, all other n = 47,048). The age-adjusted incidence rate of 693 per 100,000 persons (2010 population) approximates to 2,139,535 total NMSC cases in the US (0.7 % of population). 671 prevalent cases had advanced disease (MET n = 43, LA n = 628); an age-adjusted rate of 0.6 and 10 per 100,000 US persons equivalent to 1,993 and 29,841 MET and LA cases, respectively. Although NMSCs rarely progress, the number of patients with advanced disease is significant. Further studies to determine proportions of advanced NMSC by subtype are needed.
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Perkins, Joanna L., Yan Liu, Pauline A. Mitby, Joseph P. Neglia, Sue Hammond, Marilyn Stovall, Anna T. Meadows i in. "Nonmelanoma Skin Cancer in Survivors of Childhood and Adolescent Cancer: A Report From the Childhood Cancer Survivor Study". Journal of Clinical Oncology 23, nr 16 (1.06.2005): 3733–41. http://dx.doi.org/10.1200/jco.2005.06.237.
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Purpose Nonmelanoma skin cancer (NMSC) has become the most common type of cancer in many populations throughout the world. Ultraviolet and ionizing radiation are known risk factors. Because NMSCs are rarely lethal and most cancer registries do not routinely report data regarding these cancers, they have received little attention in studies evaluating long-term effects of cancer therapy. This article reports on the occurrence of secondary NMSC as a long-term effect of cancer therapy in survivors of childhood cancer. Patients and Methods The Childhood Cancer Survivor Study (CCSS) is a cohort study of 5-year survivors of childhood and adolescent cancer from 25 participating institutions in North America. NMSC patients were defined by a history of basal cell or squamous cell carcinoma of the skin after primary malignancy treatment. Demographic and treatment data were collected and analyzed. Results Among the 13,132 eligible CCSS participants, 213 have reported NMSC; 99 patients (46%) have had multiple occurrences. Median age of occurrence was 31 years (range, 7 to 46 years). Location of NMSC included head and neck (43%), back (24%), chest (22%), abdomen and pelvis (5%), extremity (3%), and unknown (4%). Ninety percent of patients had previously received radiation therapy (RT); 90% of tumors occurred within the RT field. RT was associated with a 6.3-fold increase in risk (95% CI, 3.5- to 11.3-fold). Conclusion Long-term survivors of childhood and adolescent cancer who were treated with RT are at highest risk for developing NMSC. Educational efforts need to be directed to this population to facilitate early diagnosis of NMSC and reduction in sun exposure.
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Borik-Heil, Liliane, Georg Endler, Walther Parson, Andreas Zuckermann, Lisa Schnaller, Keziban Uyanik-Ünal, Peter Jaksch i in. "Cumulative UV Exposure or a Modified SCINEXA™-Skin Aging Score Do Not Play a Substantial Role in Predicting the Risk of Developing Keratinocyte Cancers after Solid Organ Transplantation—A Case Control Study". Cancers 15, nr 3 (30.01.2023): 864. http://dx.doi.org/10.3390/cancers15030864.
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The risk of keratinocyte cancer is determined by intrinsic and extrinsic factors, which also influence skin aging. Few studies have linked skin aging and UV exposure with the incidence of non-melanoma skin cancer (NMSC). We evaluated signs of actinic skin damage and aging, individual UV burden, and melanocortin-1 receptor (MC1R) variants. A total of 194 organ transplant recipients (OTR) who suffered from NMSC were compared to 194 tumor-free controls matched for gender, age, type of transplanted organ, post-transplantation (TX) period, and immunosuppressive therapy. Compared with the cases, the controls scored higher in all skin aging scores and there were no differences in UV burden except for intentional whole-body UV exposure for specific UV scenarios and periods of life in favor of cases. The number of NMSCs correlated with all types of skin aging scores, the extent of intentional sun exposure, older age, longer post-TX period, shorter interval from TX to first NMSC, and specific MC1R risk groups. Multivariable models revealed a 7.5-fold risk of developing NMSC in individuals with actinic keratosis; 4.1- or 3.6-fold in those with green or blue eyes, respectively; and a 1.9-fold increased risk in the MC1R medium- + high-risk group. In the absence of skin aging contributing to NMSC development, certain MC1R risk types may identify OTR at risk for high tumor burden.
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Ilic, Danijela, Goran Videnovic, Ruzica Kozomara, Sonja Radakovic, Zoran Vlahovic, Vladimir Matvijenko i Snezana Zivkovic. "Non-melanoma skin cancer in Serbia (1999-2015) -the need for national prevention and control strategy". Vojnosanitetski pregled 77, nr 11 (2020): 1154–60. http://dx.doi.org/10.2298/vsp181112201i.
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Background/Aim. Non-melanoma skin cancers (NMSC) are ones of the most rapidly increasing cancers worldwide. Although NMSCs have a relatively low mortality rate, they are an important public health concern and the most costly cancers in many countries. The two main objectives in this study were: first, to analyze the trend of age-standardized incidence rate of NMSCs in Serbia and second, to assess the need for national prevention and control strategy based on analyzed trend. Methods. From the Serbian Cancer Registry, we extracted all cases of NMSCs registered in central Serbia from January 1, 1999 to December 31, 2015. Joinpoint regression analysis was used to define trends and annual percentage change (APC). Results. NMSCs significantly increased for both genders with APC of +2.32% (p < 0.001). Significantly increasing trend of incidence rates was higher in women (APC, +2.63%; p < 0.0001) than in men (APC, +2.01%; p < 0.001). Conclusion. Our results show a continuously increasing incidence rate of NMCS in Serbia. Without the national preventive strategy, current sporadic activities are highly unlikely to result in reducing the growing trends
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Yang, Shi-Han, Can-Tong Liu, Chao-Qun Hong, Ze-Yuan Huang, Huan-Zhu Wang, Lai-Feng Wei, Yi-Wei Lin, Hai-Peng Guo, Yu-Hui Peng i Yi-Wei Xu. "Autoantibodies against p53, MMP-7, and Hsp70 as Potential Biomarkers for Detection of Nonmelanoma Skin Cancers". Disease Markers 2021 (10.07.2021): 1–10. http://dx.doi.org/10.1155/2021/5592693.
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Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are two predominant histological types of nonmelanoma skin cancer (NMSC), lacking effective early diagnostic markers. In this study, we assessed the diagnostic value of autoantibodies against p53, MMP-7, and Hsp70 in skin SCC and BCC. ELISA was performed to detect levels of autoantibodies in sera from 101 NMSC patients and 102 normal controls, who were recruited from the Cancer Hospital of Shantou University Medical College. A receiver operator characteristic curve was used to evaluate the diagnostic value. The serum levels of autoantibodies against p53, MMP-7, and Hsp70 were higher in NMSCs than those in the normal controls (all P < 0.01 ). The AUC of the three-autoantibody panel was 0.841 (95% CI: 0.788-0.894) with the sensitivity and specificity of 60.40% and 91.20% when differentiating NMSCs from normal controls. Furthermore, measurement of this panel could differentiate early-stage skin cancer patients from normal controls (AUC: 0.851; 95% CI: 0.793-0.908). Data from Oncomine showed that the level of p53 mRNA was elevated in BCC ( P < 0.05 ), and the Hsp70 mRNA was upregulated in SCC ( P < 0.001 ). This serum three-autoantibody panel might function in assisting the early diagnosis of NMSC.
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Ramchatesingh, Brandon, Amelia Martínez Villarreal, Domenico Arcuri, François Lagacé, Samy Abu Setah, Fadi Touma, Faris Al-Badarin i Ivan V. Litvinov. "The Use of Retinoids for the Prevention and Treatment of Skin Cancers: An Updated Review". International Journal of Molecular Sciences 23, nr 20 (20.10.2022): 12622. http://dx.doi.org/10.3390/ijms232012622.
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Retinoids are natural and synthetic vitamin A derivatives that are effective for the prevention and the treatment of non-melanoma skin cancers (NMSC). NMSCs constitute a heterogenous group of non-melanocyte-derived skin cancers that impose substantial burdens on patients and healthcare systems. They include entities such as basal cell carcinoma and cutaneous squamous cell carcinoma (collectively called keratinocyte carcinomas), cutaneous lymphomas and Kaposi’s sarcoma among others. The retinoid signaling pathway plays influential roles in skin physiology and pathology. These compounds regulate diverse biological processes within the skin, including proliferation, differentiation, angiogenesis and immune regulation. Collectively, retinoids can suppress skin carcinogenesis. Both topical and systemic retinoids have been investigated in clinical trials as NMSC prophylactics and treatments. Desirable efficacy and tolerability in clinical trials have prompted health regulatory bodies to approve the use of retinoids for NMSC management. Acceptable off-label uses of these compounds as drugs for skin cancers are also described. This review is a comprehensive outline on the biochemistry of retinoids, their activities in the skin, their effects on cancer cells and their adoption in clinical practice.
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Lengyel, Zsuzsanna, Csongor Németh, Klára Németh, Zsolt Kádár i Rolland Gyulai. "Breakthroughs in the treatment of advanced and metastatic non-melanoma skin cancers (basal cell and cutaneous squamous cell carcinomas)". Bőrgyógyászati és Venerológiai Szemle 98, nr 5 (11.11.2022): 248–54. http://dx.doi.org/10.7188/bvsz.2022.98.5.2.
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Non-melanoma skin cancers (NMSCs) are the most common malignant tumors worldwide and their incidence shows a continuous increase. Basal cell-, and squamous cell carcinoma account for approximately 99% of the NMSC cases. The majority of NMSCs are curable, however, there are locally advanced or distant metastatic cases where our therapeutic options have been limited until nowadays. In this article, the authors briefly summarize the registered systemic therapies used in the treatment of advanced NMSCs, as well as provide an outlook on possible future therapies.
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Brokmeier, Luisa Leonie, Katharina Diehl, Bianca Annika Spähn, Charlotte Jansen, Tobias Konkel, Wolfgang Uter i Tatiana Görig. "“Well, to Be Honest, I Don’t Have an Idea of What It Might Be”—A Qualitative Study on Knowledge and Awareness Regarding Nonmelanoma Skin Cancer". Current Oncology 30, nr 2 (15.02.2023): 2290–99. http://dx.doi.org/10.3390/curroncol30020177.
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Nonmelanoma skin cancer (NMSC) is the most common cancer type in Western industrialized countries. However, research into the knowledge and awareness in the general population regarding NMSC is still scarce. This qualitative study aims to fill this research gap. Face-to-face, semi-structured interviews with 20 individuals aged 55–85 years were conducted between February and October 2020. Transcribed interviews were analyzed using qualitative content analysis. The term “white skin cancer”—the German colloquial term of NMSC—was well-known, but the incidence was underestimated. None of the participants could give a precise definition of NMSC, and various alterations in the skin were, partially wrongly, stated as potential signs for NMSC. As risk factors for NMSC, solar radiation, and fair skin type were mentioned most often. The perceived individual risk of developing NMSC and risk compared to individuals of the same age and gender were low in our sample. Own knowledge about NMSC was mostly perceived to be insufficient, and the majority of the sample would like to receive more information on NMSC. Our results emphasize a need to inform about the signs and risks of NMSC not only in the studied older age group but also in younger people.
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Sands, B. E., R. D. Cohen, C. Ha, W. Reinisch, L. Salese, R. Mundayat, N. Lawendy i J. Panés. "P260 An analysis of non-melanoma skin cancer rates in the tofacitinib Ulcerative Colitis clinical programme". Journal of Crohn's and Colitis 15, Supplement_1 (1.05.2021): S294—S296. http://dx.doi.org/10.1093/ecco-jcc/jjab076.386.
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Abstract Background Tofacitinib is an oral, small molecule JAK inhibitor for the treatment of ulcerative colitis (UC). We present an updated analysis of non-melanoma skin cancer (NMSC) events in the tofacitinib UC clinical programme, including final data from the open-label, long-term extension (OLE) study (as of 24 Aug 2020). Methods NMSC events were evaluated from 3 randomised, placebo (PBO)-controlled studies (2 Phase [P]3 induction studies [NCT01465763; NCT01458951]; 1 P3 maintenance study [NCT01458574]) and an OLE study (NCT01470612), as 3 cohorts: Induction (P3 induction studies [patients (pts) receiving tofacitinib 10 mg twice daily (BID) or PBO]); Maintenance (P3 maintenance study [pts receiving tofacitinib 5 or 10 mg BID or PBO]); Overall (pts receiving tofacitinib 5 or 10 mg BID in P3 or OLE studies). Analysis was by predominant dose (PD) 5 or 10 mg BID, based on average daily dose <15 or ≥15 mg, respectively (82% of pts received PD 10 mg BID). An independent adjudication committee reviewed potential NMSC. Proportions and incidence rates (IRs; unique pts with events per 100 pt-years of exposure) were evaluated for NMSC. A Cox proportional hazards model was used for risk factor analysis. Results 1124 pts were evaluated for NMSC (2809.4 pt-years of tofacitinib exposure; up to 7.8 years of treatment; median duration 685.5 days). NMSC events in Induction and Maintenance were previously reported (Table 1).1 In Overall, NMSC occurred in 21 pts (IR 0.73 [95% confidence interval (CI) 0.45, 1.12]): PD tofacitinib 5 mg BID n=5, IR 0.63 (0.21, 1.48); PD tofacitinib 10 mg BID n=16, IR 0.77 (0.44, 1.25) (Table 1); 2 new cases since May 2019.1 Eleven pts had squamous cell carcinoma and 15 pts had basal cell carcinoma; 5 pts had both. No NMSC was metastatic or led to discontinuation. IRs by time interval and subgroup are reported (Table 2). Prior NMSC (hazard ratio [HR] 12.08 [95% CI 4.20, 34.76]) and age (per 10-year increase, HR 2.01 [1.38, 2.93]) were significant risk factors for NMSC in the multivariable analysis. Prior immunosuppressant use was not a significant risk factor in either the multivariable or univariate analyses. Conclusion In this analysis, NMSC IRs for tofacitinib were similar to those in pts with UC treated with biologics2 and those previously reported in the tofacitinib UC clinical programme.1 NMSC events were more likely to occur in pts with recognised NMSC risk factors: prior NMSC and increasing age.3 Dose dependency of NMSC IR could not be concluded here, as dose changes were permitted. NMSC IRs remained stable over time, up to 7.8 years of exposure. References
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Perera, Eshini, i Rodney Sinclair. "An estimation of the prevalence of nonmelanoma skin cancer in the U.S." F1000Research 2 (9.04.2013): 107. http://dx.doi.org/10.12688/f1000research.2-107.v1.
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Nonmelanoma skin cancer (NMSC) is the most commonly diagnosed cancer in Australia and has a significant impact on the cost of and use of healthcare resources. Current estimates of NMSC in the USA are 3.5 million cases in 2010 compared to 1.63 million cases of all other cancers combined. However, we believe that this figure significantly underestimates the prevalence of NMSC in the USA. We calculated that melanoma is diagnosed 5.7 times more in the USA than in Australia. In Australia, in 2010, there were 767,000 NMSC diagnoses. If the ratio of melanoma: NMSC is constant in both Australia and the USA, then there should be 5.7 times the number of NMSC in the USA or 4.3 million cases. The assumptions that underlie this calculation are discussed.
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Townsend, C., R. Khanna i A. S. Wilson. "P400 Understanding the impact of TNF-α antagonists on the severity of non-melanoma skin cancer in inflammatory bowel disease and the consequences for therapy". Journal of Crohn's and Colitis 14, Supplement_1 (styczeń 2020): S370—S371. http://dx.doi.org/10.1093/ecco-jcc/jjz203.529.
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Abstract Background Non-melanoma skin cancer (NMSC) accounts for at least 40% of all new cancer diagnoses in Canada annually and presents a significant cost to the health care system due to the volume of cases. The incidence of NMSC in patients with inflammatory bowel disease (IBD) is higher when compared with the general population. Generally, in a non-IBD population, the risk of further NMSC progression is low; however, little data exists that highlights differences in the clinical course of patients diagnosed with NMSC who have IBD and are TNF-α antagonist exposed. It is unclear if TNF-α antagonist therapy should be discontinued in this patient population. Our goal is to determine whether TNF-α antagonist exposure in IBD is associated with a high-risk NMSC presentation at diagnosis, as defined by the National Comprehensive Cancer Network (NCCN) stratification. Our secondary objectives include the presence of positive margins following resection, presence of metastatic disease on initial presentation, the requirement of additional therapy to treat NMSC, number of patients who had TNF-α antagonist therapy discontinued following the diagnosis of NMSC and number of individuals with recurrent NMSC. Methods Four hundred and twenty-four IBD patients seen at London Health Sciences Centre were reviewed. We have identified 22 patients who were diagnosed with NMSC. Twelve patients had a pre-NMSC TNF-α antagonist exposure while 10 patients who developed an NMSC and had no TNF-α antagonist exposure prior to NMSC diagnosis. Results Preliminary results of the primary outcome demonstrate that 50% (6/12) of patients who have been exposed to TNF antagonist therapy presented with a high-risk NMSC lesion at diagnosis compared with 40% (4/10) who were not exposed (OR 5.16, 95% CI 0.47–57.00; p = 0.181). Preliminary results of the secondary outcomes suggest that 25% (3/12) of patients exposed to TNF-α antagonist had positive margins compared with 0% (0/10) of patients who were not exposed. No patients in either group presented with metastatic disease. Twenty-five per cent (3/12) of patients in the exposed group received more advanced treatment compared with 0% (0/10) in the non-exposed group. Eight per cent (1/12) of patients in the TNF-α antagonist group had their IBD therapy changed from a TNF-α antagonist to an alternative biologic class, and 17% of patients (2/12) in the TNF-α antagonist group had recurrent NMSC lesions. Conclusion In conclusion, preliminary results suggest that TNF-α antagonist exposure may be associated with higher risk NMSC lesion at presentation. Further expansion of the sample size is required to explore these hypotheses further.
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Townsend, C. M., R. Khanna i A. Wilson. "A231 UNDERSTANDING THE IMPACT OF TNF-ALPHA ANTAGONISTS ON THE SEVERITY OF NON-MELANOMA SKIN CANCER IN INFLAMMATORY BOWEL DISEASE AND THE CONSEQUENCES FOR THERAPY". Journal of the Canadian Association of Gastroenterology 3, Supplement_1 (luty 2020): 107–8. http://dx.doi.org/10.1093/jcag/gwz047.230.
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Abstract Background Non-melanoma skin cancer (NMSC) accounts for at least 40% of all new cancer diagnoses in Canada annually and presents a significant cost to the health care system due to the volume of cases. The incidence of NMSC in patients with Inflammatory Bowel Disease (IBD) is higher when compared to the general population. Generally, in a non-IBD population, the risk of further NMSC progression is low, however, little data exists that highlights differences in clinical course of patients diagnosed with NMSC who have IBD and are TNF-α antagonist exposed. It is unclear if TNF-α antagonist therapy should be discontinued in this patient population. Aims Our goal is to determine whether TNF-α antagonist exposure in IBD is associated with a high risk NMSC presentation at diagnosis, as defined by the National Comprehensive Cancer Network (NCCN) stratification. Our secondary objectives include presence of positive margins following resection, presence of metastatic disease on initial presentation, requirement of additional therapy to treat NMSC, number of patients who had TNF-α antagonist therapy discontinued following diagnosis of NMSC and number of individuals with recurrent NMSC. Methods Four hundred and twenty-four IBD patients seen at London Health Sciences Centre were reviewed. We have identified 22 patients who were diagnosed with NMSC. Twelve patients had a pre-NMSC TNF-α antagonist exposure while 10 patients who developed an NMSC and had no TNF-α antagonist exposure prior to NMSC diagnosis. Results Preliminary results of the primary outcome demonstrate that fifty-percent (6/12) of patients who have been exposed to TNF antagonist therapy presented with a high risk NMSC lesion at diagnosis compared to 40% (4/10) who were not exposed (OR 5.16, 95%CI 0.47–57.00; p = 0.181). Preliminary results of the secondary outcomes suggest that 25% (3/12) of patients exposed to TNF-α antagonist had positive margins compared with 0% (0/10) of patients who were not exposed. No patients in either group presented with metastatic disease. Twenty-five percent (3/12) of patients in the exposed group received more advanced treatment compared with 0% (0/10) in the non-exposed group. Eight percent (1/12) of patients in the TNF-α antagonist group had their IBD therapy changed from a TNF-α antagonist to an alternative biologic class, and 17% of patients (2/12) in the TNF-α antagonist group had recurrent NMSC lesions. Conclusions In conclusion, preliminary results suggest that TNF-α antagonist exposure may be associated with higher risk NMSC lesion at presentation. Further expansion of the sample size is required to explore these hypotheses further. Funding Agencies None
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Wiznia, Lauren, Leah M. Ferrucci, Susan T. Mayne i Anees B. Chagpar. "Do nonmelanoma skin cancer survivors use tanning beds more often than the general public?" Journal of Clinical Oncology 31, nr 15_suppl (20.05.2013): e20017-e20017. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20017.
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e20017 Background: Tanning bed use increases the incidence of nonmelanoma skin cancer (NMSC), however utilization of indoor tanning after diagnosis in this population is not well-studied. We sought to determine if tanning bed use among NMSC survivors differed from the general population. Methods: The National Health Interview Survey is an annual population-based survey that is representative of the civilian US population. We utilized the 2010 cancer supplement to evaluate self-reported tanning bed use in the previous 12 months in self-reported NMSC survivors compared to individuals without a history of skin cancer. Results: In 2010, 24,941 people were surveyed, 1.85% of whom had a self-reported history of NMSC. On univariate analysis, NMSC survivors were significantly less likely to use tanning beds in the previous 12 months (2.16 vs. 5.61%, p < 0.001). On multivariate analysis, however, NMSC survivors were equally likely to use tanning beds as those who had never had skin cancer (see Table). Conclusions: When controlling for other sociodemographic factors, NMSC survivors were no less likely to use tanning beds than the general population. These findings suggest a need to better educate NMSC survivors about the increased risk of future skin cancers with ongoing tanning bed use. [Table: see text]
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Nowotarski, Shannon L., David J. Feith i Lisa M. Shantz. "Skin Carcinogenesis Studies Using Mouse Models with Altered Polyamines". Cancer Growth and Metastasis 8s1 (styczeń 2015): CGM.S21219. http://dx.doi.org/10.4137/cgm.s21219.
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Nonmelanoma skin cancer (NMSC) is a major health concern worldwide. With increasing numbers in high-risk groups such as organ transplant recipients and patients taking photosensitizing medications, the incidence of NMSC continues to rise. Mouse models of NMSC allow us to better understand the molecular signaling cascades involved in skin tumor development in order to identify novel therapeutic strategies. Here we review the models designed to determine the role of the polyamines in NMSC development and maintenance. Elevated polyamines are absolutely required for tumor growth, and dysregulation of their biosynthetic and catabolic enzymes has been observed in NMSC. Studies using mice with genetic alterations in epidermal polyamines suggest that they play key roles in tumor promotion and epithelial cell survival pathways, and recent clinical trials indicate that pharmacological inhibitors of polyamine metabolism show promise in individuals at high risk for NMSC.
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Eftimie, Lucian G., Daniel O. Costache, Constantin D. Uscatu, Remus R. Glogojeanu i Raluca S. Costache. "Non‑melanoma skin cancer (NMSC): Extramammary Paget ’s disease". Romanian Journal of Military Medicine 123, nr 3 (1.08.2020): 184–89. http://dx.doi.org/10.55453/rjmm.2020.123.3.6.
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Non ‑melanoma skin cancer (NMSC) comprises squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and severalrare skin tumors (i.e., Extramammary Paget’s disease), being the most common malignancy-affecting people worldwide. Itrepresents the majority of skin cancers and a significant percentage of all malignancies. Despite increasing public awarenessand scientific interest, the incidence of NMSC is constantly increasing. Even though most NMSC`s are associated with lessaggressive behavior, they can still be invasive locally and cause extensive damage to neighboring structures, inducingsignificant morbidity. In addition, different types and subtypes of NMSC tend to have frequent recurrences and may have significantmetastatic potential. As a direct consequence, NMSC has become an important issue for healthcare systems with a significantsocio ‑economic impact.
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Thomas, Valencia D., Michael K. Wong i Andrew J. Bishop. "Management of Patients With Aggressive Nonmelanoma Skin Cancers". Journal of the National Comprehensive Cancer Network 20, nr 5.5 (maj 2022): 1–5. http://dx.doi.org/10.6004/jnccn.2022.5021.
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Nonmelanoma skin cancers (NMSCs), which encompass a variety of cutaneous malignancies, are frequently managed with surgery, radiation therapy, cytotoxic chemotherapy, systemic immunotherapy, and active surveillance. In this tumor board–style forum, a panel of experts used several case studies as a basis to review these approaches and to describe existing clinical challenges. The current NCCN Guidelines for NMSC, which reflect the most up-to-date, evidence-based data relating to the evaluation and management of NMSCs, also provide key considerations and recommendations for the treatment of this patient population.
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Schaar, Dana, Filip Pirsl, Seth M. Steinberg, Laura Parsons-Wandell, Michael Emanuel, Shaneil Flucker, Jeannette Nashed i in. "Factors Associated with Subsequent Cancers in Patients with Moderate or Severe Chronic Graft-Versus-Host Disease after Transplant for Hematologic Malignancy". Blood 134, Supplement_1 (13.11.2019): 4558. http://dx.doi.org/10.1182/blood-2019-124020.
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Among patients who survive over two years post-allo-HSCT, cGVHD and subsequent cancers represent a significant source of morbidity and mortality. Long-term treatment with immunosuppressive agents and cGVHD-related immune dysregulation may promote the development of subsequent cancers. The burden of subsequent cancers has not yet been described in patients with the most severe manifestations of cGVHD, who likely represent a high-risk population. 439 patients were enrolled on the prospective NIH Chronic GVHD Natural History Study from 2004 to 2019, underwent one-week evaluation by subspecialists, and were scored in accordance with 2005 NIH criteria. Follow-up data were collected by annual survey in which patients self-reported cancer diagnoses and provided consent for confirmatory medical records. Cumulative incidence was estimated for non-melanoma skin cancer (NMSC) competing with death, relapse, or cancer other than NMSC and for cancer other than NMSC competing with death or relapse using the method of Gooley. Potential predictors of subsequent cancers including demographics, transplant characteristics, and cGVHD-related factors were assessed using Gray's test in univariable analysis and Cox proportional hazards models in multivariable analysis. Patients must have been free of post-transplant relapse, NMSC (for NMSC analyses only), and cancer other than NMSC at evaluation to be included in analysis. 22 NMSC and 19 cancers other than NMSC were observed among 205 eligible patients, with cumulative incidences at 60 months of 11.2% (95% CI: 6.9-16.7) and 7.3% (95% CI 4.1-11.8), respectively. The most common cancers other than NMSC were oral squamous cell carcinoma and melanoma (n=6 each). Factors associated with NMSC in univariable analysis were older age at transplant, older age at evaluation, having received sirolimus for cGVHD, having received extracorporeal photopheresis or psoralen-ultraviolet therapy for cGVHD as well as higher CRP, higher NK cell count, and greater BMI at evaluation. Only older age at transplant (HR=2.12; 95% CI: 1.35-3.31) and higher CRP (HR=9.61; 95% CI: 1.29-71.73) remained associated in the multivariable model. Factors associated with subsequent cancers other than NMSC in univariable analysis were T-cell depletion, lymphoid malignant indication for transplant, and increasing severity of oral cGVHD by NIH score. Only lymphoid malignant indication for transplant (HR=2.58; 95% CI: 1.31-5.07) remained significant in multivariable analysis. The association of CRP with NMSC may represent an effect of cGVHD-related inflammation, with CRP previously associated with cGVHD severity. Interestingly, sirolimus was associated with increased risk of NMSC despite its purported antineoplastic effects. One study has previously reported increased risk of NMSC in allo-HSCT recipients treated with sirolimus, however, numerous studies have reported that sirolimus reduces risk of NMSC in solid organ recipients. In this study population, sirolimus was often prescribed later in patients already with refractory cGVHD and adjustment for measures of disease severity attenuated this association in multivariable modeling. The association of lymphoid indication with cancers other than NMSC may be attributable to age as patients with lymphoid malignancies were older at transplant than those with other indications. Additionally, differences in pre-transplant therapies for lymphoid vs. other indications may also contribute to this observation. Post-transplant patients with cGVHD are at high risk of developing subsequent cancers, with higher incidence of NMSC than other cancers. This study identifies potential risk groups for subsequent cancers, highlights patients who may benefit from increased surveillance, and reiterates the need for effective cGVHD therapy to mitigate risks associated with long-term immunosuppression and immune dysfunction. Disclosures Cowen: UpToDate: Other: Royalties; Elsevier: Other: Royalties.
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Nikolouzakis, Taxiarchis Konstantinos, Luca Falzone, Konstantinos Lasithiotakis, Sabine Krüger-Krasagakis, Alexandra Kalogeraki, Maria Sifaki, Demetrios A. Spandidos, Emmanuel Chrysos, Aristidis Tsatsakis i John Tsiaoussis. "Current and Future Trends in Molecular Biomarkers for Diagnostic, Prognostic, and Predictive Purposes in Non-Melanoma Skin Cancer". Journal of Clinical Medicine 9, nr 9 (4.09.2020): 2868. http://dx.doi.org/10.3390/jcm9092868.
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Skin cancer represents the most common type of cancer among Caucasians and presents in two main forms: melanoma and non-melanoma skin cancer (NMSC). NMSC is an umbrella term, under which basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and Merkel cell carcinoma (MCC) are found along with the pre-neoplastic lesions, Bowen disease (BD) and actinic keratosis (AK). Due to the mild nature of the majority of NMSC cases, research regarding their biology has attracted much less attention. Nonetheless, NMSC can bear unfavorable characteristics for the patient, such as invasiveness, local recurrence and distant metastases. In addition, late diagnosis is relatively common for a number of cases of NMSC due to the inability to recognize such cases. Recognizing the need for clinically and economically efficient modes of diagnosis, staging, and prognosis, the present review discusses the main etiological and pathological features of NMSC as well as the new and promising molecular biomarkers available including telomere length (TL), telomerase activity (TA), CpG island methylation (CIM), histone methylation and acetylation, microRNAs (miRNAs), and micronuclei frequency (MNf). The evaluation of all these aspects is important for the correct management of NMSC; therefore, the current review aims to assist future studies interested in exploring the diagnostic and prognostic potential of molecular biomarkers for these entities.
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Ndiaye, Mary A., Debra R. Garvey, Gagan Chhabra, Chandra K. Singh i Nihal Ahmad. "Abstract 3979: CRISPR/Cas9-mediated knockout of PLK4 results in antiproliferative response in human epidermoid carcinoma cells in vitro and in implanted xenografts". Cancer Research 82, nr 12_Supplement (15.06.2022): 3979. http://dx.doi.org/10.1158/1538-7445.am2022-3979.
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Abstract Non-melanoma skin cancers (NMSCs) constitute the largest number of cancers diagnosed in the United States, with an estimated 1 in 5 people affected by the age of 70. The most notable NMSCs are squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs), which are considered keratinocyte cancers due to their origin. Although the majority of NMSCs can be removed with surgery or curettage, these options are not always available if the tumor occurs in an inoperable location or becomes metastatic. While non-surgical treatment modalities are also currently available, they have not been fully effective in NMSC management. Therefore, novel mechanistic-based therapeutic strategies are needed. The polo-like kinases (PLKs) are a family of serine/threonine kinases that have been found to play multiple roles in regulating the cell cycle. PLK4 is a structurally unique member of this family, which has been shown to be essential for precise centriole duplication. However, PLK4 has been shown to be dysregulated in certain cancers. Though the role of PLK4 in NMSC is not fully understood, we previously showed that PLK4 was significantly overexpressed in NMSC cell lines at both mRNA and protein levels as compared to normal keratinocytes, and its small molecule inhibition resulted in anti-proliferative responses in NMSC cell lines (Cancer Res 2018; 78 [13 Suppl]: Abstract nr 547). Here, we further validated our previous observation by determining the effects of CRISPR/Cas9-mediated knockout (KO) of PLK4 in the A431 human SCC line, both in vitro and in vivo. Our data demonstrated significantly reduced cell growth of multiple A431 PLK4 KO clones compared to wild-type (WT) cells, as measured by RealTime-Glo MT cell viability and trypan blue exclusion assays. In addition, we found significant reduction in clonogenic survival of A431 PLK4 KO cells, as measured by colony formation assays. Using a Human Cancer Pathway Finder RT2 Profiler PCR array, we identified 18 of the 84 genes tested to be greater than 1.6-fold differentially regulated after PLK4 KO in these cells. Employing Ingenuity Pathway Analysis (IPA) software, we identified that the regulation of the epithelial-mesenchymal transition by growth factors was one of the top canonical pathways modulated by PLK4 KO. To determine the in vivo relevance of our in vitro data, we compared the tumorigenicity of the A431 WT and PLK4 KO cells in nu/nu mice. The mice (n=7 per group) were injected subcutaneously with 5 x 105 A431 WT or PLK4 KO cells and tumors were allowed to grow for further analyses. We found a significant reduction in tumor volume in A431 PLK4 KO xenografts as compared to A431 PLK4 WT xenografts. Taken together, these findings support our previous results that suggest PLK4 has pro-proliferative roles in NMSC and should be further studied as a potential novel target for skin cancer management. Citation Format: Mary A. Ndiaye, Debra R. Garvey, Gagan Chhabra, Chandra K. Singh, Nihal Ahmad. CRISPR/Cas9-mediated knockout of PLK4 results in antiproliferative response in human epidermoid carcinoma cells in vitro and in implanted xenografts [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3979.
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Scola, Letizia, Maria Rita Bongiorno, Giusi Irma Forte, Anna Aiello, Giulia Accardi, Chiara Scrimali, Rossella Spina, Domenico Lio i Giuseppina Candore. "TGF-β/VEGF-A Genetic Variants Interplay in Genetic Susceptibility to Non-Melanocytic Skin Cancer". Genes 13, nr 7 (13.07.2022): 1235. http://dx.doi.org/10.3390/genes13071235.
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Differential genetically determined expression of transforming growth factor-β (TGF-β pathway and of vascular endothelial growth factor-A (VEGF-A) might modulate the molecular “milieu” involved in the etio-pathogenesis of non-melanoma skin cancer (NMSC). We have evaluated the frequency of some functionally relevant SNPs of TGF-β and VEGF-A genes in 70 NMSC patients and 161 healthy controls, typed for TGF-β1 rs1800471, TGF-β2 rs900, TGF-βR1 rs334348 and rs334349, TGF-βR2 rs4522809 and VEGF-A rs3025039 SNPs. TGF-βR2 rs1800629G allele and related genotypes were found to be associated with a possible protective role against NMSC, whereas VEGF-A rs3025039T was associated with an increased risk. To evaluate the effect of genotype combinations on NMSC susceptibility, we determined the frequencies of 31 pseudo-haplotypes due to non-random linkage among alleles of loci not lying on the same chromosome. Two pseudo-haplotypes that imply a minor allele of TGF-βR2 or minor allele of VEGF-A SNPs combined with major alleles of the other SNPs were, respectively, associated with a protective effect, and susceptibility to NMSC. In addition, a pseudo-haplotype involving minor alleles of TGF-β2 rs900, TGF-βR1 rs334348 and rs4522809 SNPs might be a susceptibility marker for NMSC. In conclusion, our data suggest that a complex interplay among the genetic polymorphisms of TGF-β, TGF-β receptors and VEGF-A genes might influence the net effect of genetic background of the patients on NMSC development. This might be relevant in the risk evaluation, diagnosis and treatment of NMSC.
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Kuklinski, Lawrence F., Shufeng Li, Margaret R. Karagas, Bernice Y. Kwong i Wen-Kai Weng. "Risk of Non-Melanoma Skin Cancer Following Hematopoietic Cell Transplantation and Voriconazole-Associated Risk". Blood 128, nr 22 (2.12.2016): 2249. http://dx.doi.org/10.1182/blood.v128.22.2249.2249.
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Abstract Introduction: Recipients of hematopoietic cell transplant (HCT) are at increased risk for secondary malignancy, most commonly non-melanoma skin cancer (NMSC) including cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) (Leisenring et al J Clin Oncol 2006).While both SCC and BCC are generally associated with low mortality, HCT recipients are more likely to develop clinically aggressive forms of disease associated with poorer prognosis and requiringchemoradiotherapy(Lott et al Transplantation 2010). Voriconazolehas been available since 2002 for the treatment of serious fungal infections, and has contributed to improved clinical outcomes in patients who undergo HCT. However,voriconazoleis associated with several known cutaneous toxicities including photosensitivity, and along with its metabolite,voriconazoleN-oxide, sensitizes keratinocytes to UVA light and may cause DNA damage and inhibition of repair mechanisms (Onaet alBr J Dermatol 2015). While the association betweenvoriconazoleuse and NMSC has been established in the solid organ transplant population (Singer et al J Heart Lung Transplant 2012), less is known about HCT patients. Therefore, we sought to determine the post-HCT risk of NMSC related tovoriconazoleuse. Methods: We performed a retrospective cohort study by exposure tovoriconazolefor allogeneic (n = 1370) and autologous (n = 1538) HCT recipients at Stanford University Medical Center between January 2003 and March 2015. Post-HCT incidence rates (IR) and hazard ratios (HR) were calculated based on first diagnosed NMSC after HCT. Multivariate analysis includedvoriconazoleexposure and known risk factors for NMSC including history of chronic graft-versus-host disease, age at transplant, sex, race, and history of NMSC. Results: The 10-year IR for NMSC in the overall HCT population was 14.1 (95% CI = 11.7 - 16.8) and time to incident NMSC ranged from 0.1 to 10.9 years post-transplant. Among allogeneic HCT recipients, 90 patients developed NMSC with a 10-year IR of 25.6 (95% CI = 20.6 - 31.5) (Table 1). The median time from HCT to first diagnosis of NMSC was 1.9 years (range 0.1 - 9.9 years). The 10-year IR for SCC was 19.7 (95% CI = 15.3 - 24.9) and 6.8 (95% CI = 4.4 - 10.2) for BCC (Table 1). NMSC occurred more often on the head and neck in the exposed cohort compared to the unexposed cohort (p = 0.020). In multivariate analyses, among allogeneic HCT recipients,voriconazoleuse was associated with an increased overall risk for NMSC (HR = 1.86, 95% CI = 1.18 - 2.92, p = 0.008) (Table 2). The association withvoriconazoleexposure was largely for SCC (HR = 2.12, 95% CI = 1.26 - 3.57, p = 0.005). Exposure tovoriconazoledid not appear to affect the risk for BCC (HR = 1.03, 95% CI = 0.43 - 2.46, p = 0.954). Among autologous HCT recipients, 34 developed NMSC with a 10-year IR of 6.3 (95% CI = 4.4 - 8.9) and a median time from HCT to diagnosis of 1.6 years (range 0.2 -10.9 years) (Table 1). The 10-year IRs among autologous HCT recipients for SCC and BCC respectively were 3.6 (95% CI = 2.2 - 5.9) and 2.1 (95% CI = 1.1 - 3.8) (Table 1). In the multivariate analysis, we found no relationship betweenvoriconazoleuse and risk for NMSC (HR = 0.93, 95% CI = 0.33 - 2.64, p = 0.887) (Table 3). Conclusion: There is a high rate of incident NMSC in the post-HCT setting with a wide range of times to diagnoses, and voriconazoleuse represents a novel factor that may contribute to increased risk for SCC in the allogeneic HCT population. Our data indicate that any history of exposure to voriconazolemay increase the risk of SCC, but not BCC, in allogeneic but not autologous HCT recipients. While other factors have greater impacts on HCT recipientsÕ risk of NMSC, the widely accepted use of voriconzaoleas either a prophylactic or therapeutic anti-fungal agent in HCT recipients makes it an important consideration in overall risk assessment.Regardless ofvoriconazole exposure, NMSC is prevalent in the post-HCT setting and there is a critical need for patient education and regular, vigilant surveillance by an experienced dermatologist to screen for and treat early skin cancer or precursor lesions. Disclosures No relevant conflicts of interest to declare.
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Skroza, Nevena, Ilaria Proietti, Anna Marchesiello, Salvatore Volpe, Veronica Balduzzi, Nicoletta Bernardini, Patrizia Maddalena i in. "Do Diet and Lifestyles Play a Role in the Pathogenesis of NMSCs?" Nutrients 12, nr 11 (11.11.2020): 3459. http://dx.doi.org/10.3390/nu12113459.
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Background and Aims: Literature highlights the role of risk factors like age, body mass index (BMI), tobacco smoking, alcohol intake and diet in the pathogenesis of several cancer types but little is known for non-melanoma skin cancers (NMSC). The aim of this epidemiological study was to evaluate the correlation between modifiable risk factors (BMI, metabolic panel, diet, lifestyle, medical history) and not modifiable risk factors (gender, age) and NMSC development. Methods: From February 2018 to September 2019, 162 patients affected by NMSC were compared to a group of 167 controls. A univariate and multivariate analysis was conducted to elaborate the data collected through face-to-face interviews. Results: While our evidence did not always reach statistical significance, NMSC study group patients exhibited high rates of analyzed risk factors (male gender aging over 55 years, high BMI, reduced physical activity) compared to the control group. Conclusions: Our study indicates that practicing more than 30 min of physical activity daily could be a protective factor against the NMSC onset. Other risk factors were not correlated with NMSC, but more evidence is needed to establish a possible link.
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Ungaro, R. C., M. A. Ciorba, G. Rogler, A. I. Sharara, N. Sunna, S. B. Connelly, R. Mundayat, N. Lawendy i J. Panés. "P334 Tofacitinib for the treatment of Ulcerative Colitis: Analysis of malignancy rates from the Ulcerative Colitis clinical programme". Journal of Crohn's and Colitis 15, Supplement_1 (1.05.2021): S357—S359. http://dx.doi.org/10.1093/ecco-jcc/jjab076.458.
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Abstract Background Tofacitinib is an oral, small molecule JAK inhibitor for the treatment of ulcerative colitis (UC). We present an updated analysis of adjudicated malignancies in the tofacitinib UC clinical programme, including final data from the open-label, long-term extension (OLE) study (as of 24 Aug 2020). Methods Malignancies were evaluated from 3 randomised, placebo-controlled studies (2 Phase [P]3 induction studies [NCT01465763; NCT01458951]; 1 P3 maintenance study [NCT01458574]) and an OLE study (NCT01470612). Three cohorts were analysed: Induction (P3 induction studies), Maintenance (P3 maintenance study) and Overall (patients receiving tofacitinib 5 or 10 mg twice daily [BID] in P3 or OLE studies; data from the previous data cut [May 2019] are also reported for comparison). Analysis was by predominant dose (PD) 5 or 10 mg BID, based on average daily dose <15 mg or ≥15 mg, respectively (82.1% of patients received PD 10 mg BID). An independent adjudication committee reviewed potential malignancies. Proportions and incidence rates (IRs; unique patients with events per 100 patient-years of exposure) were evaluated for malignancies (excluding non-melanoma skin cancer [NMSC]) and NMSC. Results 1124 patients were evaluated for malignancies (2809.4 patient-years of tofacitinib exposure; up to 7.8 years of treatment; median duration of 685.5 days). No malignancies (excluding NMSC) occurred in Induction Cohort patients. Malignancies (excluding NMSC) occurred in 1 Maintenance Cohort patient (who was receiving placebo) and in 25 Overall Cohort patients (IR 0.86 [95% confidence interval (CI) 0.56, 1.27]: PD tofacitinib 5 mg BID n=5, IR 0.63 [95% CI 0.20, 1.47]; PD tofacitinib 10 mg BID n=20, IR 0.95 [95% CI 0.58, 1.46]); 5 new cases since May 2019 (Table).1 NMSC events in the Induction and Maintenance Cohorts were previously reported (Table).1 NMSC events occurred in 21 Overall Cohort patients (IR 0.73 [95% CI 0.45, 1.12]): PD tofacitinib 5 mg BID n=5, IR 0.63 (95% CI 0.21, 1.48); PD tofacitinib 10 mg BID n=16, IR 0.77 (95% CI 0.44, 1.25); 2 new cases since May 2019 (Table).1 Conclusion There was no apparent clustering of types of malignancy, excluding NMSC. Malignancies (excluding NMSC) and NMSC IRs remained stable over time, being comparable to those previously reported in the tofacitinib UC clinical programme.1 In this analysis, malignancies (excluding NMSC) and NMSC IRs were similar to those in patients with UC treated with tumour necrosis factor inhibitors, as reported from claims data (IRs of 0.63 and 1.69, respectively).2 References
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Sendín-Martin, Mercedes, Juan Carlos Hernández-Rodríguez, Antonio-José Durán-Romero, Juan Ortiz-Álvarez, Julian Conejo-Mir i José-Juan Pereyra-Rodríguez. "Non-Melanoma Skin Cancer Mortality in Spain: A Predictive Model up to 2044". Journal of Clinical Medicine 10, nr 24 (8.12.2021): 5750. http://dx.doi.org/10.3390/jcm10245750.
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Non-melanoma skin cancers (NMSC) are the most common malignancies worldwide and are, worryingly, increasing in incidence. However, data in the literature on NMSC specific mortality are scarce, because these tumors are excluded from most mortality registries. The main objective of this study is to analyze NMSC’s mortality rates and use them to generate a predictive model for the coming years in Spain. Data on mid-year population and death certificates for the period 1979–2019 were obtained from the Spanish National Statistics Institute. The Nordpred program (Cancer Registry of Norway, Oslo, Norway) within statistical program R was used to calculate mortality adjusted rates, as well as the mortality projection with an age-period-cohort model. This is the first study to report a prediction about NMSC mortality in the next years. According to our findings, the number of NMSC deaths in older people will grow in both sexes, especially in those older than >85 years old (y.o.). The age-specific mortality rates of NMSC will tend to stabilize or gradually decrease, with the exception of women between 75–79 y.o., who will present a slight increase at the end of the period. Early prevention and screening of NMSC specifically oriented to this population might change this tendency.
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Caini, Saverio, Patrizia Gnagnarella, Ignazio Stanganelli, Federica Bellerba, Emilia Cocorocchio, Paola Queirolo, Benedetta Bendinelli, Calogero Saieva, Sara Raimondi i Sara Gandini. "Vitamin D and the Risk of Non-Melanoma Skin Cancer: A Systematic Literature Review and Meta-Analysis on Behalf of the Italian Melanoma Intergroup". Cancers 13, nr 19 (26.09.2021): 4815. http://dx.doi.org/10.3390/cancers13194815.
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We aimed to provide a comprehensive overview of the link between vitamin D and non-melanoma skin cancer (NMSC). For this purpose, we conducted a systematic literature review (updated to 3 February 2021) and meta-analysis of the studies reporting on the association between vitamin D intake (from diet and supplements) and blood concentration, polymorphisms of the vitamin D receptor (VDR) and vitamin D binding protein (VDBP) genes, and the risk of NMSC. Random effects meta-analysis models were fitted to merge study-specific risk estimates into summary relative risk (SRR) and corresponding 95% confidence intervals (CI). Twenty-four studies altogether were included. There was a suggestive association between increasing serum/plasma vitamin D concentration and NMSC risk (SRR for highest vs. lowest concentration 1.67, 95%CI 0.61–4.56), although with large heterogeneity across studies (I2 = 91%). NMSC risk was associated with highest vitamin D intake in observational studies but not in clinical trials. Finally, there was no significant association between any polymorphism of the VDR and VDBP genes and NMSC risk. In conclusion, no strong relationship between vitamin D metabolism and NMSC risk appears to exist according to our systematic review and meta-analysis, although some findings are worthy of further investigation.
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Almendra Freitas, Betânia de Jesus e. Silva de, Gustavo Rafaini Lloret, Marília Berlofa Visacri, Bruna Taliani Tuan, Lais Sampaio Amaral, Daniele Baldini, Vanessa Marcílio de Sousa i in. "High 15-F2t-Isoprostane Levels in Patients with a Previous History of Nonmelanoma Skin Cancer: The Effects of Supplementary Antioxidant Therapy". BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/963569.
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Background. Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC), previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group.Materials and Methods. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with history of NMSC previously treated with surgery. In Phase II, the 60 patients with history of NMSC were randomized into two subgroups, one receiving placebo (n=34) and the other (n=26) receiving vitamin C, vitamin E, and zinc supplementation for 8 weeks, followed by reevaluation of biomarkers.Results. In Phase I, patients with history of NMSC showed increased plasma concentrations of all biomarkers, but only 15-F2t-isoprostane was significantly higher than in the healthy subjects. Risk of NMSC increased by 4% for each additional 1 pg/mL increase in 15-F2t-isoprostane. In Phase II, supplementation did not significantly reduce levels of oxidative stress biomarkers.Conclusion. Patients with history of NMSC had significantly high 15-F2t-isoprostane plasma levels; supplementation did not result in significant reduction of oxidative stress biomarkers. This trial was registered with ClinicalTrials.gov (IDNCT02248584).
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Sakaki, Junichi R., Melissa M. Melough, Mary B. Roberts, Charles B. Eaton, Aladdin H. Shadyab, Abrar A. Qureshi, Ock K. Chun i Eunyoung Cho. "Citrus Consumption and the Risk of Non-Melanoma Skin Cancer in the Women’s Health Initiative". Cancers 13, nr 9 (30.04.2021): 2173. http://dx.doi.org/10.3390/cancers13092173.
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Evidence from animal studies suggests that furocoumarins, compounds present in citrus products, can increase the risk of non-melanoma skin cancer (NMSC) when combined with ultraviolet radiation. The objective of this study was to determine the relationship between citrus intake and NMSC risk among postmenopausal women from the Women’s Health Initiative (WHI) Observational Study, who were aged 50–79 years at enrollment (1993–1998). The consumption of citrus fruit, citrus juice, and non-citrus fruit and juice were measured at the baseline of the study using a food frequency questionnaire (FFQ). NMSC cases (basal or squamous cell carcinomas) were self-reported during annual follow-up surveys. The outcome data used for this analysis were collected through March 2020. The relative risk (RR) for incident NMSC by citrus consumption was calculated. Among 49,007 non-Hispanic white participants, there were 8642 cases of incident NMSC. Using less than one serving of citrus juice per week as reference, the RRs and 95% confidence intervals (CI) for incident NMSC by citrus juice intake were 1.03 (0.95, 1.10) for one serving/week, 1.06 (1.00, 1.12) for two to four servings/week, 0.98 (0.90, 1.07) for five to six servings/week, and 1.08 (1.02, 1.13) for one or more serving/day (p-trend = 0.007). Subgroup analyses did not reveal meaningful associations by sun exposure variables. In conclusion, there were indications of a slightly higher risk of incident NMSC among citrus juice consumers; however, further longitudinal and mechanistic studies are needed to confirm the key risk factors.
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Tang, Jean Y., Teresa Fu, Erin LeBlanc, JoAnn E. Manson, David Feldman, Eleni Linos, Mara Z. Vitolins, Nathalie C. Zeitouni, Joseph Larson i Marcia L. Stefanick. "Calcium Plus Vitamin D Supplementation and the Risk of Nonmelanoma and Melanoma Skin Cancer: Post Hoc Analyses of the Women's Health Initiative Randomized Controlled Trial". Journal of Clinical Oncology 29, nr 22 (1.08.2011): 3078–84. http://dx.doi.org/10.1200/jco.2011.34.5967.
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Purpose In light of inverse relationships reported in observational studies of vitamin D intake and serum 25-hydroxyvitamin D levels with risk of nonmelanoma skin cancer (NMSC) and melanoma, we evaluated the effects of vitamin D combined with calcium supplementation on skin cancer in a randomized placebo-controlled trial. Methods Postmenopausal women age 50 to 79 years (N = 36,282) enrolled onto the Women's Health Initiative (WHI) calcium/vitamin D clinical trial were randomly assigned to receive 1,000 mg of elemental calcium plus 400 IU of vitamin D3 (CaD) daily or placebo for a mean follow-up period of 7.0 years. NMSC and melanoma skin cancers were ascertained by annual self-report; melanoma skin cancers underwent physician adjudication. Results Neither incident NMSC nor melanoma rates differed between treatment (hazard ratio [HR], 1.02; 95% CI, 0.95 to 1.07) and placebo groups (HR, 0.86; 95% CI, 0.64 to 1.16). In subgroup analyses, women with history of NMSC assigned to CaD had a reduced risk of melanoma versus those receiving placebo (HR, 0.43; 95% CI, 0.21 to 0.90; Pinteraction = .038), which was not observed in women without history of NMSC. Conclusion Vitamin D supplementation at a relatively low dose plus calcium did not reduce the overall incidence of NMSC or melanoma. However, in women with history of NMSC, CaD supplementation reduced melanoma risk, suggesting a potential role for calcium and vitamin D supplements in this high-risk group. Results from this post hoc subgroup analysis should be interpreted with caution but warrant additional investigation.
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Xerfan, Ellen, Gabriela Leandro, Gabriel Pires, Monica Andersen, Sergio Tufik, Anamaria Facina i Jane Tomimori. "0582 Effects of non-melanoma skin cancer on sleep and quality of life among renal transplant recipients". Sleep 45, Supplement_1 (25.05.2022): A256. http://dx.doi.org/10.1093/sleep/zsac079.579.
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Abstract Introduction Non-melanoma skin cancer (NMSC) is highly prevalent in renal transplant recipients (RTR), due to the immunosuppressive effects of anti-rejection therapy after transplantation. Sleep disturbances can impair the immune system and enhance the repercussions of oxidative stress, which may play an important role in the carcinogenesis pathways. This survey aimed to compare data on quality of life and sleep in RTR with and without NMSC in a dermatology service. Methods The study comprised 126 individuals, distributed in the following groups: RTR with NMSC (n=42), RTR without NMSC (n=43) and healthy controls (n=41). Participants answered a set of questionnaires, including the WHOQOL-bref, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Berlin Respiratory Disorder questionnaire (BRD). Results The proportion of men were significantly higher among RTR (p=0.034). No statistically significant differences were observed regarding age, body mass index (BMI) and socioeconomic class. Transplantation living donors were statistically more frequent among RTR with NMSC (67% against 37% in the RTR without NMSC group; p=0.005). Among patients of the RTR with NMSC group, 9% had only basal cell carcinoma, 42% had only squamous cell carcinoma and 49% had both types of NMSC. There were no statistically significant differences on the final scores of the sleep questionnaires, except in 3 domains of the PSQI: sleep quality (p<0.001), sleep latency (p=0.01) and daytime dysfunction (p=0.02). Worse sleep quality was seen in the RTR with NMSC and controls, while worse sleep latency and more daytime consequences were found in both RTR clusters. All groups were predominantly composed of subjects with morning-type chronotype, low sleep quality and increased daytime sleepiness. In the WHOQOL, the physical domain was significantly impaired in the RTR groups (p<0.001). Conclusion Although all groups were mainly composed of individuals with excessive daytime sleepiness and low sleep quality, there were no differences regarding quality of life and sleep between RTR and controls. Further long-term examination of kidney transplant recipients and their sleep pattern are warranted, as poor sleep may have a link with immunosuppression and organism imbalance, as well as on quality of life of these individuals. Support (If Any) AFIP, CAPES, CNPq, and FAPESP.
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Karagas, M. R., S. K. Spencer, Martin A. Weinstock, J. Kuypers, M. Koff i E. R. Greenberg. "Rarity of Human Papillomavirus in Nonmelanoma Skin Cancer among Immunocompetent Patients". Journal of Cutaneous Medicine and Surgery 2, nr 1 (lipiec 1997): 16–19. http://dx.doi.org/10.1177/120347549700200104.
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Background: The role of human papillomavirus (HPV) in nonmelanoma skin cancer (NMSC) among immunocompentent individuals is not well understood. Objective: We tested for the presence of HPV DNA in NMSC of immunocompetent patients from New England. Methods: Biopsies taken from 59 patients were reviewed histopathologically. A segment of the biopsy and scrapings from a site remote from the skin lesion were analyzed for HPV using a standardized polymerase chain reaction (PCR) DNA amplification assay. Results: Of 55 evaluable samples, 21 were histologically confirmed squamous cell carcinomas (SCC), 25 were basal cell carcinomas (BCC), and nine had other diagnoses. Two samples were HPV-positive (3.6%): a basal cell carcinoma of the forehead and a squamous cell carcinoma of the thumbnail bed. Type analysis of these samples revealed HPV 16 from both lesions. Conclusion: The HPV DNA is not commonly detected in NMSCs of immunocompetent patients using standard laboratory techniques. It is possible, however, that a wider range of HPV types could be detected using more sensitive assays; this warrants further investigation.
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Wollina, Uwe, Georgi Tchernev i Torello Lotti. "Chimeric Monoclonal Antibody Cetuximab Targeting Epidermal Growth Factor-Receptor in Advanced Non-Melanoma Skin Cancer". Open Access Macedonian Journal of Medical Sciences 6, nr 1 (31.12.2017): 152–55. http://dx.doi.org/10.3889/oamjms.2018.022.
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BACKGROUND: Non-melanoma skin cancer (NMSC) is the most common malignancy in humans. Targeted therapy with monoclonal antibody cetuximab is an option in case of advanced tumor or metastasis.AIM: We present and update of the use of cetuximab in NMSC searching PUBMED 2011-2017.METHODS: The monoclonal antibody cetuximab against epidermal growth factor receptor (EGFR) has been investigated for its use in NMSC during the years 2011 to 2017 by a PUBMED research using the following items: “Non-melanoma skin cancer AND cetuximab,” “cutaneous squamous cell carcinoma AND cetuximab,” and “basal cell carcinoma AND cetuximab”, and “cetuximab AND skin toxicity”. Available data were analyzed including case reports.RESULTS: Current evidence of cetuximab efficacy in NMSC was mainly obtained in cutaneous SCC and to a lesser extend in BCC. Response rates vary for neoadjuvant, adjuvant, mono- and combined therapy with cetuximab. Management of cutaneous toxicities is necessary. Guidelines are available.CONCLUSIONS: Cetuximab is an option for recurrent or advanced NMSC of the skin. It seems to be justified particularly in very high-risk tumors. There is a need for phase III trials.
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Czarnecki, D., Tina Sutton, C. Czarnecki i G. Culjak. "A 10-Year Prospective Study of Patients with Skin Cancer". Journal of Cutaneous Medicine and Surgery 6, nr 5 (wrzesień 2002): 427–29. http://dx.doi.org/10.1177/120347540200600503.
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Background and Objective: To determine the incidence of new skin cancer formation in people who have had a nonmelanoma skin cancer (NMSC) removed. Methods: A prospective study of Australian outpatients with histologically confirmed nonmelanoma skin cancer (NMSC). Results: Four hundred eighty-one patients were entered in the study and 300 were followed for at least 10 years. Another skin cancer developed in 67.8% and multiple skin cancers (three or more) in 51.8%. A logistical regression analysis found that the main risk factors for new skin cancer formation were male sex and if the patient had multiple skin cancers. A squamous cell carcinoma (SCC) developed in 36% during the study and a melanoma in 4.7% of men and 2.1% of women. Men who had a NMSC were 8 times more likely than the general population to develop a melanoma while women with NMSC were 4 times more likely. Three patients died of metastatic SCC and one of metastatic melanoma during the followup period. A multivariate analysis showed that multiple skin cancer formation was the main risk factor for SCC or melanoma formation. Conclusion: Patients with NMSC require careful followup as they have an increased risk of new cancer formation. Those with multiple skin cancer merit particularly careful followup as all develop another NMSC within 10 years and have a significantly increased risk of developing SCC or melanoma.
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Gräger, Nikolai, Mareike Leffler, Jens Gottlieb, Jan Fuge, Gregor Warnecke, Ralf Gutzmer i Imke Satzger. "Risk Factors for Developing Nonmelanoma Skin Cancer after Lung Transplantation". Journal of Skin Cancer 2019 (10.03.2019): 1–11. http://dx.doi.org/10.1155/2019/7089482.
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Background. Nonmelanoma skin cancer (NSMC) is the most common malignancy after organ transplantation. Lung transplant recipients (LTRs) are particularly prone to develop NMSC as compared to renal or hepatic transplant recipients due to higher dosages of immunosuppression needed. Everolimus, an immunosuppressant used in organ transplant recipients, is thought to inherit a lower risk for NMSC than calcineurin inhibitors, especially in renal transplant recipients. It is currently unknown whether this also applies to LTRs. Objectives. To determine risk factors for NMSC and precancerous lesions after lung transplantation (LTx) and to characterize the effect of everolimus-based regimens regarding this risk. Materials and Methods. 90 LTRs and former participants of the interventional trial “Immunosuppressive Therapy with Everolimus after Lung Transplantation”, who were randomized to receive either an everolimus- or mycophenolate mofetil- (MMF-) based regimen, were enrolled and screened in this retrospective, single-center cohort study. Results. After a median follow-up of 101 months, we observed a prevalence of 38% for NMSC or precancerous lesions. 33% of the patients continuously receiving everolimus from LTx to dermatologic examination compared to 39% of all other patients, predominantly receiving an MMF-based regimen, were diagnosed with at least one NMSC or precancerous lesion (P=.66). Independent risk factors for NMSC or precancerous lesions after LTx were male sex and duration of voriconazole therapy. Conclusion. NMSC or precancerous lesions were very common after LTx, and risk factors were similar to previous reports on LTRs. Everolimus did not decrease this risk under the given circumstances of this study. Patients should be counseled regarding their risk, perform vigorous sunscreen, and undergo regular dermatological controls, regardless of their immunosuppressive regimen.
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Lichtenstein, G. R., B. Bressler, S. Vermeire, C. Francisconi, N. Lawendy, H. Shi, L. Salese, D. Judd i E. V. Loftus. "P539 Assessment of age as a risk factor for adverse events in patients from the tofacitinib ulcerative colitis clinical programme". Journal of Crohn's and Colitis 14, Supplement_1 (styczeń 2020): S460—S461. http://dx.doi.org/10.1093/ecco-jcc/jjz203.667.
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Abstract Background Tofacitinib is an oral, small-molecule JAK inhibitor for the treatment of UC. Safety and efficacy of tofacitinib were demonstrated in Phase (P)2/3 induction studies, a 52-week, P3 maintenance study, and are being further investigated in an ongoing, open-label, long-term extension (OLE) study.1,2 Here, we provide an updated analysis of age as a risk factor for adverse events (AEs) in the tofacitinib UC clinical programme.3 Methods Proportions of AEs and serious AEs (SAEs), and incidence rates (IRs; unique patients with events per 100 patient-years) for AEs of special interest (AESIs), were determined for two cohorts: the Maintenance Cohort (patients who received placebo or tofacitinib 5 or 10 mg twice daily [BID] in the maintenance study) and the Overall Cohort (all tofacitinib 5 or 10 mg BID-treated patients in the P2/P3/OLE studies; as of May 2019), stratified by age. Multivariable Cox proportional hazards regression analyses were performed to assess whether older age was associated with increased risk of AESIs in the Overall Cohort. Results In the Maintenance Cohort, IRs of AEs and SAEs were generally similar between treatment groups, with no age-related trend in the proportions of AEs in tofacitinib-treated patients. AESIs were infrequent in both treatment groups; however, herpes zoster (HZ; non-serious and serious) IRs were numerically higher in the ≥40 to <50 and ≥50 years age groups for patients treated with tofacitinib 10 mg BID vs. placebo and tofacitinib 10 vs. 5 mg BID. In the Overall Cohort, IR of serious infections was generally similar between age groups, while IRs of opportunistic infections (OIs) and HZ (non-serious and serious), malignancy (excl. non-melanoma skin cancer [NMSC]), NMSC and major adverse cardiovascular events increased with increasing age. The IRs of HZ and NMSC were significantly greater in patients ≥50 years compared with patients <30 years, and in patients ≥30 to <40 years for NMSC. In multivariate analyses, older age was identified as a significant predictor of malignancy (excl. NMSC), NMSC and HZ. Conclusion In the Overall Cohort, there was a trend for an increase in the rates of OIs, HZ, malignancy (excl. NMSC) and NMSC with increasing age. In multivariate analyses, older age was associated with increased risk of malignancy (excl. NMSC), NMSC and HZ. The results of this analysis are generally consistent with previous studies suggesting older age may be associated with an increased risk of certain AESIs in patients with UC, and in some instances in the general population.4 References
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Paurević, Spomenka, Darko Lukić, Jozo Grgić, Nenad Babić, Duško Ivić i Predrag Lazić. "The importance of early suspicion of non-melanocytic malignant skin cancer (NMSC) in primary and secondary health care". Medicinska istrazivanja 50, nr 2 (2016): 35–39. http://dx.doi.org/10.5937/medist1601035p.
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The prospective study, which took place from February 2011 to March 2014, included respondents who were sent for computerized dermoscopy because of non-melanocytic skin tumours. Respondents were divided into 2 groups. The first one, group A (45 respondents), consisted of respondents who had expressed concern about the observed changes in the skin and the desire for examination. The second one, group B (50 respondents) were respondents that did not come for examination due to changes on the skin, but for other reasons, so they had indirectly detected suspicious skin lesions. The aim of this study is to analyse the importance of early suspicion of non-melanocytic malignant skin tumours by specialists in primary and secondary health care. Parameters for comparison were respondents' subjective attitude of non-pigment skin lesions and dermoscopy and/or PH findings. It has been shown that changes in the skin that bleed are sometimes highly suspect of NMSC because group A had 5 such cases and NMSC was detected in 4 cases, and group B had 7 respondents with haemorrhage and there were 4 with NMSC. In group B, out of 12 respondents who said that they had found suspicious skin lesions caused by trauma, there were 8 NMSC, while in group A there were 3 cases, which is a statistically significant difference. In group B, out of 16 respondents who claimed that they had had suspicious skin changes dormant for years, NMSC has been proven in 3 cases, and in group A there was not NMSC which is also a statistically significant difference. It was confirmed that the claims of the respondents are unreliable and that all patients should be addressed to computer dermoscopy, in patients with visible changes that arise even a slightest suspicion of NMSC.
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LE BLAY, PIERRE, GAEL MOUTERDE, THOMAS BARNETCHE, JACQUES MOREL i BERNARD COMBE. "Short-term Risk of Total Malignancy and Nonmelanoma Skin Cancers with Certolizumab and Golimumab in Patients with Rheumatoid Arthritis: Metaanalysis of Randomized Controlled Trials". Journal of Rheumatology 39, nr 4 (1.03.2012): 712–15. http://dx.doi.org/10.3899/jrheum.110982.
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Objective.To assess the risk of total malignancy and nonmelanoma skin cancers (NMSC) in patients with rheumatoid arthritis (RA) receiving certolizumab and golimumab through a metaanalysis of data from randomized control trials (RCT).Methods.We systematically reviewed the literature up to May 2011 in Medline databases, as well as abstracts from the 2009 and 2010 annual meetings of the European League Against Rheumatism and the American College of Rheumatology. Mantel-Haenszel method was used to determine a common odds ratio (OR). Statistical heterogeneity was assessed by chi-square Q test. We selected only RCT including more than 30 RA subjects randomly assigned to an anti-tumor necrosis factor (TNF) or a nonbiological disease-modifying antirheumatic drug (DMARD) control group.Results.The literature search identified 793 articles; 6 (2 with certolizumab and 4 with golimumab) were selected for metaanalysis. A total of 2710 patients received at least 1 dose of certolizumab or golimumab. For anti-TNF-treated patients, 18 cancers (excluding NMSC) and 9 NMSC were observed versus 4 cases of total malignancy and 3 NMSC in control groups. Metaanalysis revealed a pooled OR of 1.06 (95% CI 0.39–2.85) for risk of total malignancy and 0.69 (95% CI 0.23–2.11) for risk of NMSC with certolizumab and golimumab versus DMARD. Heterogeneity was not significant.Conclusion.Metaanalysis of RCT of golimumab and certolizumab did not find an increased risk of total malignancy and NMSC. These results must be confirmed with longterm extension studies and registry studies, and careful monitoring remains mandatory.
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Ascierto, Paolo A., i Dirk Schadendorf. "Update in the treatment of non-melanoma skin cancers: the use of PD-1 inhibitors in basal cell carcinoma and cutaneous squamous-cell carcinoma". Journal for ImmunoTherapy of Cancer 10, nr 12 (grudzień 2022): e005082. http://dx.doi.org/10.1136/jitc-2022-005082.
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Non-melanoma skin cancer (NMSC) includes a wide range of cutaneous tumors, the most frequent of which are basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (CSCC). Although NMSC is usually cured by surgical resection, in rare cases it can progress to locally advanced and metastatic disease. Risk factors for advanced disease include comorbidities, neglect, and immunosuppression. Advanced NMSC may require systemic treatment if surgery and radiation are not feasible. Chemotherapy, epidermal growth factor receptor (EGFR) inhibitors in CSCC, and hedgehog inhibitors in BCC have been used but are generally of limited benefit, with responses often short-lived and toxicity issues. Given the high mutational burden of NMSC, the use of immunotherapy has been investigated and two anti-PD-1 antibodies, cemiplimab and pembrolizumab, are approved for the treatment of advanced CSCC not curable by surgery or radiation. Both have shown durable responses with good tolerability in patients in phase II trials and anti-PD-1 therapy is now the standard of care for locally advanced and metastatic CSCC. PD-1 blockade is also approved as second-line therapy in advanced BCC, with frequent and durable responses after failure on hedgehog inhibitor therapy. PD-1 checkpoint inhibition is being assessed for NMSC in combination with other modalities, including oncolytic viruses and EGFR inhibitors. Adjuvant and neoadjuvant use of cemiplimab and pembrolizumab is also being investigated with several ongoing trials. Further clinical trials of immunotherapy must be prioritized in NMSC for further improvement in outcomes.
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Hartman, Rebecca I., Yun Xue, Ryan Karmouta, Elizabeth Tkachenko, Sara J. Li, David G. Li, Cara Joyce i Arash Mostaghimi. "Development and Validation of a Simple Model to Predict the Risk of Nonmelanoma Skin Cancer on Screening Total Body Skin Examination". Dermatology Research and Practice 2022 (16.08.2022): 1–5. http://dx.doi.org/10.1155/2022/2313896.
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Objective. There is insufficient evidence to generate skin cancer screening guidelines at the population level, resulting in arbitrary variation in patient selection for screening skin examinations. This study was aimed at developing an easy-to-use predictive model of nonmelanoma skin cancer (NMSC) risk on screening total body skin examination (TBSE). Methods. This epidemiologic assessment utilized data from a prospective, multicenter international study from primarily academic outpatient dermatology clinics. Potential predictors of NMSC on screening TBSE were identified and used to generate a multivariable model that was converted into a point-based scoring system. The performance characteristics of the model were validated in a second data set from two healthcare institutions in the United States. Results. 8,501 patients were included. Statistically significant predictors of NMSC on screening TBSE included age, skin phototype, and history of NMSC. A multivariable model and point-based scoring system using these predictors exhibited high discrimination (AUC = 0.82). Conclusion. A simple three-variable model, abbreviated as CAP (cancer history, age, phototype) can accurately predict the risk of NMSC on screening TBSE by dermatology. This tool may be used in clinical decision making to enhance the yield of screening TBSE.
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Porceddu, Sandro V. "Prognostic Factors and the Role of Adjuvant Radiation Therapy in Non-Melanoma Skin Cancer of the Head and Neck". American Society of Clinical Oncology Educational Book, nr 35 (maj 2015): e513-e518. http://dx.doi.org/10.14694/edbook_am.2015.35.e513.
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Non-melanoma skin cancer (NMSC) is the most common cancer worldwide. Among the two types of NMSC, basal cell carcinoma (BCC) accounts for approximately 75% to 80% of cases and cutaneous squamous cell carcinoma (cSCC) accounts for 20% to 25% of cases. The majority of lesions are low risk and treated with simple surgical excision, which provides histopathologic information and is associated with high cure rates and acceptable cosmetic and functional outcomes. cSCCs are generally more aggressive than BCCs. NMSC commonly occurs in the sun-exposed head and neck region (80% to 90%). Approximately 5% of patients with NMSC (mainly cSCC) will have clinicopathologic features that predict for an increased risk for local and regional recurrence and, rarely, distant relapse. These features include locally advanced primary disease (stage T3-T4), regional nodal involvement, clinical perineural invasion, recurrent disease following treatment, and immunosuppression. Patients who have these features may warrant review by a multidisciplinary tumor board and might require combined modality treatment involving surgery and adjuvant radiation therapy (RT). This article focuses on our current understanding of the prognostic factors and role of adjuvant RT in high-risk NMSC of the head and neck.
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Ohtsuka, Hisashi. "Statistical Survey of Deaths from Nonmelanoma Skin Cancer in Japan during 54 Years". Journal of Skin Cancer 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/293926.
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The author analyzed the annual trends in the number of deaths from nonmelanoma skin cancer (NMSC) from 1955 to 2008 in Japan on the basis of the data from the Vital Statistics of Japan. The general trends in the number of deaths from NMSC were downward between 1979 to 1994, but upward after 1995. The general trends in age-standardized death rates were roughly downward, although the death rates plateaued after 1995. The recent annual increased ratio of deaths from NMSC was 3.8% (95% confidence interval: 2.7 ∼ 4.9%). The number and proportion of deaths from NMSC among the elderly were increasing in Japan. For females, more than 50% of the deaths occurred recently at or after 85 years of age, whereas, for males, this proportion was at or after 75 years of age, nearly reaching at or after 80 years of age.
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Faur, Cosmin Ioan, Mădălina Anca Moldovan, Mădălina Văleanu, Horațiu Rotar, Laura Filip i Rareș Călin Roman. "The Prevalence and Treatment Costs of Non-Melanoma Skin Cancer in Cluj-Napoca Maxillofacial Center". Medicina 59, nr 2 (23.01.2023): 220. http://dx.doi.org/10.3390/medicina59020220.
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Background and Objectives: An increasing incidence of non-melanoma skin cancer (NMSC) is noted, as well as an increasing cost of the treatment, with NMSC becoming a public health problem. We aimed to investigate the prevalence and treatment costs of surgically treated NMSC from the Oral and Maxillofacial Surgery Department of Cluj-Napoca County Hospital. Materials and Methods: We retrospectively analyzed the clinical data and the charge data of hospitalization from the informatic system of Cluj-Napoca County Hospital. All patients benefited from standard surgical excision with the reconstruction of the post-excisional defect. A statistical analysis of the costs related to the patients’ features, period and conditions of hospitalization, materials, medication, and paraclinical investigations was performed. Results: Between 2015 and 2019, 133 patients with NMSC were addressed to our department, with basal cell carcinoma (BCC) being four-fold higher than squamous cell carcinoma (SCC). Most NMSC cases were diagnosed in stage I or II, and they benefited from local reconstruction. The treatment costs progressively increased in the last five years, reaching a total cost of EUR ~13.000 in 2019. The treatment cost per episode was higher for SCC compared to BCC, while the total cost of treatment in 5 years was higher for BCC. Low income, immunosuppression, comorbidities, flap reconstruction option, long-lasting surgery, and prolonged hospitalization were associated with an increased cost of the treatment. Conclusion: The prevalence and treatment cost of surgically treated NMSC of the head and neck region increased in the last five years, with high-cost drivers being related to patients and treatment options.
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Brand, Rhonda, J. Mark Stottlemyer, Melissa Paglia i Louis Falo. "Alcohol consumption increases ultraviolet radiation induced immune dysfunction. (HUM2P.341)". Journal of Immunology 192, nr 1_Supplement (1.05.2014): 53.14. http://dx.doi.org/10.4049/jimmunol.192.supp.53.14.
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Abstract Alcohol ingestion and sun exposure often occur simultaneously. Excessive ultraviolet radiation (UVR) is associated with increased incidence of nonmelanoma skin cancers (NMSCs). More recently, epidemiologic studies have revealed an independent correlation between alcohol use and increased incidence of NMSC. Although multiple factors have been proposed to explain these interactions, the underlying mechanisms responsible for this association have not been determined. Impaired tumor surveillance contributes to the development of skin cancer, and UVR can suppress immune function. Furthermore, the metabolism of alcohol can also suppress immune function. We therefore sought to determine whether UVR mediated immune dysfunction is affected by alcohol consumption. Specifically, we evaluated UVR induced immune suppression in the presence or absence of alcohol ingestion by combining standard mouse models of alcohol consumption and UVR induced immune suppression. In this controlled system, our results demonstrate that mice exposed to both ETOH and UV suffer greater immune suppression than those exposed to either alone. These results suggest that combining alcohol and UV exposure increases immune suppression, and support additional efforts to investigate the interactions between UVR and alcohol relevant to immunosuppression and the development of NMSC.
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Verdelli, Alice, Marzia Caproni, Alessio Coi, Alberto Corrà, Donatella Degl’Innocenti, Marzia Vasarri, Lavinia Quintarelli, Valter Volpi, Emanuele Maria Cipollini i Emanuela Barletta. "Neutrophil Gelatinase-Associated Lipocalin as Potential Predictive Biomarker of Melanoma and Non-Melanoma Skin Cancers in Psoriatic Patients: A Pilot Study". International Journal of Molecular Sciences 23, nr 20 (14.10.2022): 12291. http://dx.doi.org/10.3390/ijms232012291.
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Background: Studies have demonstrated a higher risk of nonmelanoma skin cancers (NMSC) and a modestly increased melanoma risk in patients with psoriasis. To date, no biomarkers predictive of evolution have been identified yet. Methods: The aim of this prospective case-control study was to investigate the potential role of neutrophil gelatinase-associated lipocalin (NGAL) as a predictive biomarker of skin cancers in psoriatic patients. Patients with a diagnosis of psoriasis were enrolled, as well as healthy subjects and patients with skin cancers as controls. Plasma protein expression of NGAL, metalloproteinases (MMP)-2, and MMP-9 was performed by an enzyme-linked immunosorbent assay (ELISA). In all the patients who developed skin cancer at follow-up, NGAL, MMP-2, and MMP-9 serum levels were dosed again. Results: Plasma NGAL levels were significantly higher in psoriatic patients with NMSC than without (182.3 ± 36.6 ng/mL vs. 139.9 ± 39.3 ng/mL) (p < 0.001). Plasma NGAL levels were significantly higher (p < 0.00001) in patients with psoriasis and NMSC than in patients with skin tumors without psoriasis (182.3 vs. 122.9). Patients with psoriasis who developed NMSC at follow-up showed increased plasma MMP-9 levels. Conclusion: NGAL seems to play a role in the pathogenesis of NMSC but not melanoma in patients with psoriasis.