[show abstract][hide abstract] ABSTRACT: Hypermethylation of tumor suppressor gene promoters has been found in head and neck squamous carcinoma (HNSCC) and other solid tumors. We evaluated these alterations in pretreatment salivary rinses from HNSCC patients by using real-time quantitative methylation-specific PCR (Q-MSP).
Pretreatment saliva DNA samples from HNSCC patients were evaluated for patterns of hypermethylation by using Q-MSP. Target tumor suppressor gene promoter regions were selected based on a previous study describing a screening panel for HNSCC in a high-risk population subjects. The selected genes were: DAPK, DCC, MINT-31, TIMP-3, p16, MGMT, CCNA1.
We analyzed the panel in a cohort of 61 HNSCC patients. Thirty-three of the analyzed patients (54.1%) showed methylation of at least one of the selected genes in the saliva DNA. Pretreatment methylated saliva DNA was not significantly associated with tumor site (P = 0.209) nor clinical stage (P = 0.299). However, local disease control and overall survival were significantly lower in patients presenting hypermethylation in saliva rinses (P = 0.010 and P = 0.015, respectively). Multivariate analysis confirmed that this hypermethylation pattern remained as an independent prognostic factor for local recurrence (HR = 12.2; 95% CI = 1.8-80.6; P = 0.010) and overall survival (HR = 2.8; 95% CI = 1.2-6.5; P = 0.016).
We were able to confirm an elevated rate of promoter hypermethylation in HNSCC saliva of patients by using a panel of gene promoters previously described as methylated specifically in HNSCC. Detection of hypermethylation in pretreatment saliva DNA seems to be predictive of local recurrence and overall survival. This finding has potential to influence treatment and surveillance of HNSCC patients.
Clinical Cancer Research 05/2011; 17(14):4782-9. · 7.84 Impact Factor
[show abstract][hide abstract] ABSTRACT: A cohort of patients with small primary (T1-T2) squamous cell carcinoma of the oropharynx and advanced cervical nodal metastasis were treated with initial neck dissection(s) followed by definitive radiation therapy with or without chemotherapy. Our rationale for this algorithm and our results are examined.
Retrospective chart review.
Pathology records and medical records from 1996 to 2003 from the Johns Hopkins Hospital were examined for patients meeting the inclusion criteria.
Sixteen patients meeting the inclusion criteria were identified. Follow-up periods ranged from 6 to 75 months. Mean and median follow-up periods were 38 and 33 months, respectively. One (6.25%) patient developed a metastasis and was alive with disease at last follow-up. Fifteen (93.75%) patients were alive without evidence of disease at last follow-up. Overall survival was 100%. Disease free survival was 93.75%.
Initial neck dissection followed by primary radiation therapy to the primary site and neck with or without chemotherapy is an effective therapy for small primary oropharynx cancers with N2 or greater cervical metastases.
The Laryngoscope 08/2005; 115(7):1196-200. · 1.98 Impact Factor
[show abstract][hide abstract] ABSTRACT: A high frequency of death-associated protein kinase (DAPK) promoter hypermethylation has been noted in B-cell malignancies, head and neck cancers, and other solid tumors, and it has been used as a tumor marker in molecular detection strategies. Low levels of DAPK promoter hypermethylation, ranging from 0.003 to 1.181%, were detected in peripheral blood cells from 75 of 143 (52%) normal subjects by quantitative methylation-specific PCR (Q-MSP). In 10 of 10 selected patients, MSP amplification of a portion of the DAPK promoter followed by PCR product sequencing confirmed dense hypermethylation of the CpG island in their peripheral blood cells. Q-MSP analysis of fluorescence-activated cell-sorted peripheral blood cells from three of these patients demonstrated that a significantly greater proportion of B cells (1.074-6.026%) were DAPK hypermethylated than were T cells, monocytes, or neutrophils, which were <0.06% hypermethylated. Further analysis after sorting of one subject's B cells into IgM+, IgM-, IgG+, and IgG- subpopulations demonstrated that DAPK hypermethylation was predominantly present in the IgM- compared with IgM+ B cells (3.338% versus 0.436%). DAPK promoter hypermethylation was found in IgM- B cells in normal individuals. The same hypermethylation identified in B-cell malignancies may reflect a clonal outgrowth of B cells arising from this compartment and may indicate a susceptibility to neoplastic transformation in a subset of B cells. Normal circulating lymphocytes with DAPK promoter hypermethylation may act as confounding factors in tumor detection based on DAPK hypermethylation.
Cancer Research 11/2003; 63(22):7694-8. · 8.65 Impact Factor