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Frontiers in Genetics 2022Carcinomas of the oral cavity and oropharynx belong among the ten most common malignancies in the human population. The prognosis of head and neck squamous cell... (Review)
Review
Carcinomas of the oral cavity and oropharynx belong among the ten most common malignancies in the human population. The prognosis of head and neck squamous cell carcinoma (HNSCC) is determined by the degree of invasiveness of the primary tumor and by the extent of metastatic spread into regional and distant lymph nodes. Moreover, the level of the perineural invasion itself associates with tumor localization, invasion's extent, and the presence of nodal metastases. Here, we summarize the current knowledge about different aspects of epigenetic changes, which can be associated with HNSCC while focusing on perineural invasion (PNI). We review epigenetic modifications of the genes involved in the PNI process in HNSCC from the omics perspective and specific epigenetic modifications in OSCC or other neurotropic cancers associated with perineural invasion. Moreover, we summarize DNA methylation status of tumor-suppressor genes, methylation and demethylation enzymes and histone post-translational modifications associated with PNI. The influence of other epigenetic factors on the HNSCC incidence and perineural invasion such as tobacco, alcohol and oral microbiome is overviewed and HPV infection is discussed as an epigenetic factor associated with OSCC and related perineural invasion. Understanding epigenetic regulations of axon growth that lead to tumorous spread or uncovering the molecular control of axon interaction with cancer tissue can help to discover new therapeutic targets for these tumors.
PubMed: 35571032
DOI: 10.3389/fgene.2022.848557 -
Neuroimaging Clinics of North America Nov 2021Perineural extension is an increasingly recognized pathway of extension of cutaneous, mucosal, and salivary gland neoplasms associated with a severe adverse prognosis.... (Review)
Review
Perineural extension is an increasingly recognized pathway of extension of cutaneous, mucosal, and salivary gland neoplasms associated with a severe adverse prognosis. Imaging identification is feasible by MR imaging 3-dimensional contrast-enhanced submillimetric sequences. The trigeminal nerve branches and facial nerve are the most commonly involved. PET with computed tomography may aid in the identification of the primary tumor location or recognition of recurrence, but only in conjunction with MR imaging does it achieve similar detection rates for perineural extension. Computed tomography scanning is an adjunct to MR imaging to increase specificity and for surgical treatment planning.
Topics: Cranial Nerve Neoplasms; Head and Neck Neoplasms; Humans; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Skull Base Neoplasms
PubMed: 34689928
DOI: 10.1016/j.nic.2021.05.007 -
Cancers Aug 2022Perineural invasion (PNI) is a common indication of tumor metastasis that can be detected in multiple malignancies, including prostate cancer. In the development of PNI,... (Review)
Review
Perineural invasion (PNI) is a common indication of tumor metastasis that can be detected in multiple malignancies, including prostate cancer. In the development of PNI, tumor cells closely interact with the nerve components in the tumor microenvironment and create the perineural niche, which provides a supportive surrounding for their survival and invasion and benefits the nerve cells. Various transcription factors, cytokines, chemokines, and their related signaling pathways have been reported to be important in the progress of PNI. Nevertheless, the current understanding of the molecular mechanism of PNI is still very limited. Clinically, PNI is commonly associated with adverse clinicopathological parameters and poor outcomes for prostate cancer patients. However, whether PNI could act as an independent prognostic predictor remains controversial among studies due to inconsistent research aim and endpoint, sample type, statistical methods, and, most importantly, the definition and inclusion criteria. In this review, we provide a summary and comparison of the prognostic significance of PNI in prostate cancer based on existing literature and propose that a more standardized description of PNI would be helpful for a better understanding of its clinical relevance.
PubMed: 36077602
DOI: 10.3390/cancers14174065 -
Journal of Neurological Surgery. Part... Apr 2016Perineural invasion (PNI) is the neoplastic invasion of nerves. PNI is widely recognized as an important adverse pathological feature of many malignancies, including... (Review)
Review
Perineural invasion (PNI) is the neoplastic invasion of nerves. PNI is widely recognized as an important adverse pathological feature of many malignancies, including pancreatic, prostate, and head and neck cancers and is associated with a poor prognosis. Despite widespread acknowledgment of the clinical significance of PNI, the mechanisms underlying its pathogenesis remain largely unknown. Recent theories of PNI pathogenesis have placed a significant emphasis on the active role of the nerve microenvironment, with PNI resulting from well-orchestrated reciprocal interactions between cancer and host. Elucidating the mechanisms involved in PNI may translate into targeted therapies for this ominous process.
PubMed: 27123385
DOI: 10.1055/s-0036-1571835 -
Regional Anesthesia and Pain Medicine 2017Dexamethasone is a useful adjuvant in regional anesthesia that is used to prolong the duration of analgesia for peripheral nerve blocks. Recent randomized controlled... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND AND OBJECTIVES
Dexamethasone is a useful adjuvant in regional anesthesia that is used to prolong the duration of analgesia for peripheral nerve blocks. Recent randomized controlled trials (RCTs) have demonstrated conflicting results as to whether perineural versus intravenous (IV) administration is superior in this regard, and the perineural use of dexamethasone remains off-label. Therefore, we sought to perform a systematic review and meta-analysis of RCTs.
METHODS
In accordance with PRISMA guidelines, we performed a random-effects meta-analysis of RCTs comparing perineural versus IV dexamethasone with duration of analgesia as the primary outcome.
RESULTS
Eleven RCTs met the inclusion criteria with a total of 1076 subjects. Perineural dexamethasone prolonged the duration of analgesia by 3.77 hours (95% confidence interval [CI], 1.87-5.68 hours; P < 0.001) compared to IV dexamethasone, with high statistical heterogeneity. For secondary outcomes, perineural dexamethasone prolonged the duration of both motor (3.47 hours [95% CI, 1.49-5.45]; P < 0.001) and sensory (2.28 hours [95% CI, 0.38-4.17]; P = 0.019) block compared to IV administration. Furthermore, perineural dexamethasone patients consumed slightly less oral opioids at 24 hours than IV dexamethasone patients (7.1 mg of oral morphine equivalents [95% CI, 0.74-13.5 mg]; P = 0.029), and there were no statistically significant differences in the other secondary outcomes. Notably, no increase in adverse events was detected.
CONCLUSIONS
Perineural dexamethasone prolongs the duration of analgesia across the RCTs included in our meta-analysis. The magnitude of effect of 3.77 hours raises the question as to whether perineural dexamethasone should be administered routinely over its IV counterpart-or reserved for selected patients where such prolongation would be clinically important.
Topics: Administration, Intravenous; Anti-Inflammatory Agents; Autonomic Nerve Block; Dexamethasone; Humans; Randomized Controlled Trials as Topic
PubMed: 28252523
DOI: 10.1097/AAP.0000000000000571 -
Oral Oncology Jan 2015Perineural growth is a unique route of tumor metastasis that is associated with poor prognosis in several solid malignancies. It is diagnosed by the presence of tumor... (Review)
Review
Perineural growth is a unique route of tumor metastasis that is associated with poor prognosis in several solid malignancies. It is diagnosed by the presence of tumor cells inside the neural space seen on histological or imaging evaluations. Little is known about molecular mechanisms involved in the growth and spread of tumor cells in neural spaces. The poor prognosis associated with perineural growth and lack of targeted approaches necessitates the study of molecular factors involved in communication between tumor and neural cells. Perineural growth rates, shown to be as high as 63% in head and neck squamous cell carcinoma (HNSCC), correlate with increased local recurrence and decreased disease-free survival. Here we describe the literature on perineural growth in HNSCC. In addition, we discuss factors implicated in perineural growth of cancer. These factors include brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin-3 and -4, glial cell-line derived neurotrophic factor (GDNF), the neural cell adhesion molecule (NCAM), substance P (SP), and chemokines. We also explore the literature on membrane receptors, including the Trk family and the low-affinity nerve growth factor receptor. This review highlights areas for further study of the mechanisms of perineural invasion which may facilitate the identification of therapeutic targets in HNSCC.
Topics: Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Neoplasm Metastasis
PubMed: 25456006
DOI: 10.1016/j.oraloncology.2014.10.004 -
Dermatologic Surgery : Official... Jun 2001Perineural invasion is an important mode of tumor spread and is associated with increased aggressiveness and a propensity for recurrence among cutaneous malignancies. (Review)
Review
BACKGROUND
Perineural invasion is an important mode of tumor spread and is associated with increased aggressiveness and a propensity for recurrence among cutaneous malignancies.
OBJECTIVE
To review the pathogenesis, diagnosis, and treatment of cutaneous tumors exhibiting perineural invasion.
METHODS
This article is based on a review of the medical literature concerning tumors with perineural involvement.
RESULTS
This article describes the clinical signs and histologic features of cutaneous malignancies exhibiting perineural involvement.
CONCLUSION
Appropriate patient care mandates consideration of perineural invasion in the evaluation of cutaneous tumors. As the majority of patients present without symptoms of neural involvement, physicians must be vigilant in the search for this type of tumor spread.
Topics: Humans; Neoplasm Invasiveness; Peripheral Nervous System Neoplasms; Skin Neoplasms
PubMed: 11442588
DOI: 10.1046/j.1524-4725.2001.00330.x -
Journal of Neurological Surgery. Part... Apr 2016Head and neck malignancies with orbital involvement present difficult decisions to the treating physician. When the spread is perineural, the challenges are greater due... (Review)
Review
Head and neck malignancies with orbital involvement present difficult decisions to the treating physician. When the spread is perineural, the challenges are greater due to the incipient nature of the spread and the fact that the orbit can also be involved by centrifugal spread from the non-ophthalmic branches of the trigeminal nerve. The disease is often misdiagnosed and the subsequent delay in treatment results in worse outcomes. This article discusses the evaluation of the eye and the many facets of orbital involvement by perineural spread of malignancy including the treatment of complications.
PubMed: 27123389
DOI: 10.1055/s-0036-1582239 -
Radiologic Clinics of North America Jan 2017Perineural spread (PNS) of tumor is a recognized pattern of metastasis occurring in the head and neck. Imaging plays a critical role in identifying PNS for adequate... (Review)
Review
Perineural spread (PNS) of tumor is a recognized pattern of metastasis occurring in the head and neck. Imaging plays a critical role in identifying PNS for adequate staging and treatment planning. Understanding the major branches and pathways of cranial nerves V and VII, key anatomic landmarks, interconnections between these nerves, and pearls and pitfalls of PNS imaging can aid in early detection, appropriate therapy, and the best possible chance for cure.
Topics: Cranial Nerve Neoplasms; Diagnosis, Differential; Facial Nerve; Facial Nerve Diseases; Head and Neck Neoplasms; Humans; Magnetic Resonance Imaging; Neoplasm Invasiveness; Neuroimaging; Skull Base; Trigeminal Nerve; Trigeminal Nerve Diseases
PubMed: 27890182
DOI: 10.1016/j.rcl.2016.08.006 -
International Journal of Dermatology Jun 2022Squamous and basal cell carcinomas with perineural invasion are typically difficult to treat because of their propensity to metastasize, their aggressive nature, and the... (Review)
Review
Squamous and basal cell carcinomas with perineural invasion are typically difficult to treat because of their propensity to metastasize, their aggressive nature, and the concept of skip lesions. Perineural invasion is an under-recognized and underdiagnosed condition even though the literature points to its high rate of incidence in squamous cell carcinoma and a nonnegligible incidence rate in basal cell carcinoma. Perineural invasion has been linked to higher recurrence rates and poorer prognosis. This review has been written to aid clinicians in identifying and managing the condition as early as possible by describing the clinical and microscopic manifestations of perineural invasion.
Topics: Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Humans; Neoplasm Invasiveness; Skin Neoplasms
PubMed: 34370865
DOI: 10.1111/ijd.15817