Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, University of Patras, Patras, 26504, Greece.
2nd Otolaryngology Department, School of Medicine, National & Kapodistrian University of Athens, 'Attikon' University Hospital, Rimini 1, Athens, 12462, Greece.
Mol Biol Rep. 2024 Apr 29;51(1):597. doi: 10.1007/s11033-024-09476-8.
The incidence of head and neck cancer (HNC), constituting approximately one in ten cancer cases worldwide, affects approximately 644,000 individuals annually. Managing this complex disease involves various treatment modalities such as systemic therapy, radiation, and surgery, particularly for patients with locally advanced disease. HNC treatment necessitates a multidisciplinary approach due to alterations in patients' genomes affecting their functionality. Predominantly, squamous cell carcinomas (SCCs), the majority of HNCs, arise from the upper aerodigestive tract epithelium. The epidemiology, staging, diagnosis, and management techniques of head and neck squamous cell carcinoma (HNSCC), encompassing clinical, image-based, histopathological and molecular profiling, have been extensively reviewed. Lymph node metastasis (LNM) is a well-known predictive factor for HNSCC that initiates metastasis and significantly impacts HNSCC prognosis. Distant metastasis (DM) in HNSCC has been correlated to aberrant expression of cancer cell-derived cytokines and growth factors triggering abnormal activation of several signaling pathways that boost cancer cell aggressiveness. Recent advances in genetic profiling, understanding tumor microenvironment, oligometastatic disease, and immunotherapy have revolutionized treatment strategies and disease control. Future research may leverage genomics and proteomics to identify biomarkers aiding individualized HNSCC treatment. Understanding the molecular basis, genetic landscape, atypical signaling pathways, and tumor microenvironment have enhanced the comprehension of HNSCC molecular etiology. This critical review sheds light on regional and distant metastases in HNSCC, presenting major clinical and laboratory features, predictive biomarkers, and available therapeutic approaches.
头颈部癌症（HNC）的发病率约占全球癌症病例的十分之一，每年影响约 644,000 人。管理这种复杂的疾病需要多种治疗方式，如系统治疗、放疗和手术，特别是对于局部晚期疾病的患者。由于影响患者功能的基因组改变，HNC 治疗需要多学科方法。主要的鳞状细胞癌（SCC）是大多数 HNC 的来源，源自上呼吸道和消化道上皮。头颈部鳞状细胞癌（HNSCC）的流行病学、分期、诊断和管理技术，包括临床、基于图像、组织病理学和分子分析，已经得到了广泛的综述。淋巴结转移（LNM）是 HNSCC 的一个众所周知的预测因素，它启动转移并显著影响 HNSCC 的预后。HNSCC 的远处转移（DM）与癌细胞衍生的细胞因子和生长因子的异常表达有关，这些因子触发了几个信号通路的异常激活，从而增强了癌细胞的侵袭性。遗传分析、肿瘤微环境、寡转移疾病和免疫治疗的最新进展彻底改变了治疗策略和疾病控制。未来的研究可能会利用基因组学和蛋白质组学来识别有助于个体化 HNSCC 治疗的生物标志物。了解分子基础、遗传景观、非典型信号通路和肿瘤微环境增强了对 HNSCC 分子病因的理解。这篇重要的综述阐明了 HNSCC 的局部和远处转移，介绍了主要的临床和实验室特征、预测生物标志物和可用的治疗方法。
