Head and neck cancer

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Head and neck cancer

• Faina Linkov, PhD
• Research Assistant Professor of Medicine
• University of Pittsburgh Cancer Institute

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What is head and neck cancer?

• Head and Neck Cancer is a group of cancers that
  includes tumors in several areas above the collar
  bone.

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Head and Neck Cancer has three major
subdivisions

• Oral Cancer
• Laryngeal Cancer
• Nasopharyngeal Cancer.

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Head and Neck Cancer

• Squamous cell carcinoma of the head and neck
  (SCCHN) occurs in 50,000 new cases annually in
  the US, resulting in over 13,000 deaths each year

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Risk Factors for Head and Neck Cancer

• Tobacco Products
• Smoking Tobacco
• Cigarettes
• Cigars
• Pipes
• Chewing Tobacco
• Snuff
• Ethanol Products

• Chemicals
• Asbestos
• Chromium
• Nickel
• Arsenic
• Formaldehyde
• Other Factors
• Ionizing Radiation
• Plummer-Vinson Syndrome
• Epstein-Barr Virus
• Human Papilloma Virus

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Possible Occupational Risks for Head and Neck
Cancer

• Woodworking
• Leather manufacturing
• Nickel refining
• Textile industry
• Radium dial painting

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Warning Signs of Head and Neck Cancer

• Hoarseness
• Erythroplasia
• Referred otalgia
• Persistent sore throat
• Epistaxis
• Nasal obstruction

• Serous otitis media
• Neck mass
• Non-healing ulcer
• Dysphagia
• Submucosal mass

Not all cancers present with symptoms at early
stages!
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Factors Delaying the Diagnosis of Head and Neck
Cancers

• Patient procrastination in seeking medical
  attention
• Physician delay in diagnosis
• Patient remains asymptomatic for a prolonged
  period

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Five-Year Survival Rate for Oral Cavity and
Pharynx Cancer
Stage at Diagnosis
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Research in Head and Neck Cancer Biomarkers at
UPCI

• Concentrations of 60 cytokines, growth factors,
  and tumor antigens were measured in the sera of
  116 SCCHN patients prior to treatment (active
  disease group), 103 patients who were
  successfully treated (no evidence of disease,
  NED, group), and 117 smoker controls without
  evidence of cancer.

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Luminex xMAP Technology

• Bead-based assay
• 1-100 analytes/well
• Small sample volume
• gt1000 sample/day
• Reproducible results
• Cost effective

flow-based LUMINEX array reader
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Biomarkers utilized in this study
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Projection Pursuit Technique
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Head and Neck Cancer (ROC curve) Classification
of head and neck cancer (n116) vs. no evidence
of disease group (n103), and healthy smokers
control utilizing the 25-marker panel.
Cross-validation test, 55/45 random split, 100
runs.
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Sensitivity refers to the fraction of patients
with the disease correctly identified as positive
by the test. Specificity refers to the
fraction of patients without the disease
correctly identified as negative by the test.
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The multi-marker panel offering the highest
diagnostic power was comprised of 25 biomarkers,
includingEGF, EGFR, IL-8, tPAI-1, AFP, MMP-2,
MMP-3, IFN-?, IFN-?, IP-10, RANTES, MIP-1?, IL-7,
IL-17, IL-1R?, IL-2R, G-CSF, mesothelin, IGFBP-1,
E-selectin, cytokeratin (CK)19, V-CAM, and
CA-125.
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Head and Neck Cancer

• Link to chronic infection
• HPV
• Epstein Barr virus

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Human Papillomavirus (HPV)

• DNA virus
• Preferentially infect squamous epithelial cells
• gt100 genotypes
• 40 genital HPV types

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Epidemiology of HPV

• The most common STD worldwide
• 80 sexually active adults in the US infected
  with at least one HPV type by age 501
• Peak prevalence during adolescence and young
  adulthood
• Prevalence declines with age
• HPV 16 is the most common HR type
• 1. Centers for Disease Control and Prevention.
  Rockville, Md CDC National Prevention
  Information Network 2004

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Lifestyle Factors
Genes load the gun.Lifestyle pulls the trigger
Dr. Elliot Joslin
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Acknowledgement Luminex Core Facility

• Anna Lokshin, PhD
• Alex Lisovich, PhD
• Zoya Yurkovetsky, PhD
• Adele Marrangoni, BS
• Lyudmila Velikokhatnaya, MS
• Matt Winnans, BS
• Bryan Nolen, MS