Perineal scanning using linear array ultrasound was used as an alternative to radiologic urethrocystography in the investigation of female urinary incontinence. The posterior urethro-vesical angle (beta) and the angle of inclination (alpha) of 30 patients (age: 48 +/- 10.2 years) with genuine stress incontinence were measured by both procedures. In all cases the radiologic and ultrasound findings correlated well. Perineal scan provides similar information to that obtained by the radiographic procedure without exposure to X-rays. In contrast to urethrocystography perineal scan is fast, inexpensive, readily accessible and more acceptable to the patient.
The recent Food and Drug Administration's approval of monoclonal antibodies targeting immune checkpoint receptors (ICRs) for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) offers exciting promise to improve patient outcome and reduce morbidities. A favorable response to ICR blockade relies on an extensive collection of preexisting tumor-specific T cells in the tumor microenvironment (TME). ICR blockade reinvigorates exhausted CD8 T cells and enhances immune killing. However, resistance to ICR blockade is observed in about 85% of patients with HNSCC, therefore highlighting the importance of characterizing the mechanisms underlying HNSCC immune escape and exploring combinatorial strategies to sensitize hypoimmunogenic cold HNSCC to ICR inhibition. Cancer vaccines are designed to bypass the cold TME and directly deliver cancer antigens to antigen-presenting cells (APCs); these vaccines epitomize a priming strategy to synergize with ICR inhibitors. Cancer cells are ineffective antigen presenters, and poor APC infiltration as well as the M2-like polarization in the TME further dampens antigen uptake and processing, both of which render ineffective innate and adaptive immune detection. Cancer vaccines directly activate APC and expand the tumor-specific T-cell repertoire. In addition, cancer vaccines often contain an adjuvant, which further improves APC function, promotes epitope spreading, and augments host intrinsic antitumor immunity. Thus, the vaccine-induced immune priming generates a pool of effectors whose function can be enhanced by ICR inhibitors. In this review, we summarize the major HNSCC immune evasion strategies, the ongoing effort toward improving HNSCC vaccines, and the current challenges limiting the efficacy of cancer vaccines.
Approximately one-third of advanced squamous cell carcinoma of the head and neck (HNSCC) recur within two years of treatment. Due to ease of collection, saliva is of interest to monitor changes that correlate with treatment. Previously this was a challenge due to xerostomia following conventional radiation. The emergence of gland-sparing radiation has made it possible to collect saliva post-treatment. Objective This study investigated changes in cytokines in saliva pre- to post-treatment to provide foundational knowledge for future studies exploring the use of saliva to monitor treatment response. Study Design Pre- and post-treatment saliva was evaluated for eight cytokines by multiplex assay and ELISA. Results In oropharyngeal HNSCC, secretion of EGF, GROα, IL-1α, IL-1β, IL-6, IL-8, TNFα, and VEGF increased significantly post-treatment. In additional patients, significant increases of GROα and IL-6 were validated but EGF showed no change. Conclusions The uniqueness of this study is the comparison of salivary cytokines from HNSCC patients pre- and post-treatment.
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