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Cell-mediated mucositis of the oral cavity: narrative review on etiology, clinico-pathological aspects and malignant transformation. 细胞介导的口腔粘膜炎:病因、临床病理和恶性转化的叙述综述。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1093
Giulia Querzoli, Andrea Gabusi, Davide Bartolomeo Gissi, Sara Bassani, Roberto Rossi, Achille Tarsitano, Lucio Montebugnoli, Maria Pia Foschini
{"title":"Cell-mediated mucositis of the oral cavity: narrative review on etiology, clinico-pathological aspects and malignant transformation.","authors":"Giulia Querzoli, Andrea Gabusi, Davide Bartolomeo Gissi, Sara Bassani, Roberto Rossi, Achille Tarsitano, Lucio Montebugnoli, Maria Pia Foschini","doi":"10.32074/1591-951X-1093","DOIUrl":"10.32074/1591-951X-1093","url":null,"abstract":"<p><p>Cell-mediated mucositis is the expression of a type IV hypersensitivity, in which cytotoxic CD8+ T lymphocytes attack the keratinocytes of the basal layer responsible for activating the immune response. There is sufficient evidence for an increased risk of oral cancer in patients with a diagnosis cell mediated mucositis. This review aims to examine the etiology, clinical-histological features, management and malignant transformation of a group of cell-mediated mucositis, including oral lichen planus, oral lichenoid lesions, Graft versus host disease, oral lesion of lupus erythematous.</p><p><p>The authors conducted a literature review, selecting relevant studies based on their novelty, applicability, and impact. The text highlights the varying rates of malignant transformation associated with different oral conditions. For oral lichen planus, the risk of transformation ranges from 0.44% to 2.28%, while for oral lichenoid lesions (OLLs), the rate is slightly higher, between 1.20% and 3.80%. Conditions like graft-versus-host disease are linked to a malignant transformation rate of 3.47%, and oral lesions associated with lupus erythematosus carry a similar risk at 3.3%, often involving squamous cell carcinoma of the lips. In cases of oral epithelial dysplasia, the risk increases significantly with severity, reaching 24.1% for severe dysplasia. The condition with the highest malignant potential is proliferative verrucous leukoplakia, with a transformation rate estimated at 49.5%. These findings underscore the importance of accurate diagnosis, vigilant monitoring, and the development of new therapeutic strategies. Recent advancements in treatments, such as nivolumab and imiquimod, show promise in early trials. These approaches aim to move beyond passive observation, shifting towards personalized medical interventions to reduce the risk of malignant transformation in high-risk patients.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"84-100"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eosinophilic vacuolated tumor of the kidney can have distant metastasis: a histo-molecular case study. 肾嗜酸性空泡性肿瘤可有远处转移:一个组织分子病例研究。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1122
Yang Liu, Luting Zhou, Xianwei Yang, Jing Xie, Fei Yuan, Haimin Xu, Chaofu Wang, Xiaoqun Yang
{"title":"Eosinophilic vacuolated tumor of the kidney can have distant metastasis: a histo-molecular case study.","authors":"Yang Liu, Luting Zhou, Xianwei Yang, Jing Xie, Fei Yuan, Haimin Xu, Chaofu Wang, Xiaoqun Yang","doi":"10.32074/1591-951X-1122","DOIUrl":"10.32074/1591-951X-1122","url":null,"abstract":"<p><p>Eosinophilic vacuolated tumor (EVT) is an emerging renal entity and further studies are required to characterize this neoplasm. EVT is considered generally indolent because metastasis or death from the disease has never been reported. Herein, we report the first case of EVT with mediastinal lymph node metastasis to validate its at least borderline behavior. Based on the morphological features, we additionally used a large panel of immunohistochemical antibodies and next-generation sequencing (NGS) to confirm the diagnosis of EVT and exclude other renal entities. This case report highlights the notion that EVT can exhibit mediastinal lymph node metastasis and patients with EVT need to be closely followed.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"162-164"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Head and neck synovial sarcoma in a woman with previous lymphoma and papillary thyroid carcinoma. 头颈部滑膜肉瘤1例既往有淋巴瘤和甲状腺乳头状癌。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1034
Mariano Lombardi, Daniela Lepanto, Eleonora Pisa, Valeria Midolo De Luca, Renato Lobrano, Simona Pessina, Chiara Zanetti, Marta Tagliabue, Elvio De Fiori, Fausto Maffini
{"title":"Head and neck synovial sarcoma in a woman with previous lymphoma and papillary thyroid carcinoma.","authors":"Mariano Lombardi, Daniela Lepanto, Eleonora Pisa, Valeria Midolo De Luca, Renato Lobrano, Simona Pessina, Chiara Zanetti, Marta Tagliabue, Elvio De Fiori, Fausto Maffini","doi":"10.32074/1591-951X-1034","DOIUrl":"10.32074/1591-951X-1034","url":null,"abstract":"<p><p>Synovial sarcoma is a rare malignant mesenchymal neoplasm that rarely arises in the head and neck and thyroid lodge. Researchers have documented only few cases in the literature. We present the case of a young woman diagnosed with synovial sarcoma that originated in the thyroid region one year after a total thyroidectomy for a primary papillary carcinoma and eight years after chemo-radiotherapy for a lymphoma.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"131-135"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Head and neck hematolymphoid proliferations: what is new? 头颈部淋巴细胞增生:有什么新发现?
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1207
Silvia Varricchio, Rosaria Cappiello, Francesca Magnoli, Daniela Russo, Giovanna Motta, Clara Bertuzzi, Elena Sabattini, Gennaro Ilardi, Mariarosaria Cervasio, Claudia Giordano, Alessandro Severino, Marco Picardi, Massimo Mascolo
{"title":"Head and neck hematolymphoid proliferations: what is new?","authors":"Silvia Varricchio, Rosaria Cappiello, Francesca Magnoli, Daniela Russo, Giovanna Motta, Clara Bertuzzi, Elena Sabattini, Gennaro Ilardi, Mariarosaria Cervasio, Claudia Giordano, Alessandro Severino, Marco Picardi, Massimo Mascolo","doi":"10.32074/1591-951X-1207","DOIUrl":"10.32074/1591-951X-1207","url":null,"abstract":"<p><p>In 2024, the World Health Organization published its 5th edition of tumor classification, which comprises several updates and modifications in the \"blue book\" focused on head and neck tumors. These changes feature a systematized and expanded discussion on haematolymphoid proliferations using a multi-parameter approach that comprises clinical features, morphology, immunophenotype, and genetic data, with the latter becoming an essential characteristic for classification. Moreover, for the first time, the World Health Organization has included non-neoplastic diseases, such as reactive lymphoid proliferations, alongside several recognized independent disorders, including Epstein-Barr Virus positive mucocutaneous ulcers and IgG4-related diseases. Also, various neoplastic diseases, such as paediatric-type follicular lymphoma and large B-cell lymphoma with IRF4 rearrangement, are recognized as independent entities. Finally, the focus has expanded to include different types of histiocytic neoplasms. This review examines and illustrates the main changes and updates on hematolymphoid proliferation and neoplasia in the Head and Neck chapter of the 5th Edition of the Head and Neck WHO classification.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"101-110"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
One protocol to rule them all: a pilot study to identify the best fixation and decalcification approach for bone marrow biopsy immunohistochemistry. 一个方案来统治他们所有:一个试点研究,以确定最佳固定和脱钙方法骨髓活检免疫组织化学。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1065
Michele Paudice, Alessandro Gambella, Simona Pigozzi, Michela Campora, Francesca Pitto, Silvia Bozzano, Luca Mastracci, Federica Grillo
{"title":"One protocol to rule them all: a pilot study to identify the best fixation and decalcification approach for bone marrow biopsy immunohistochemistry.","authors":"Michele Paudice, Alessandro Gambella, Simona Pigozzi, Michela Campora, Francesca Pitto, Silvia Bozzano, Luca Mastracci, Federica Grillo","doi":"10.32074/1591-951X-1065","DOIUrl":"10.32074/1591-951X-1065","url":null,"abstract":"<p><strong>Objective: </strong>Standardization of the pre-analytical phases of bone marrow trephine biopsy (BM) has yet to be achieved. In particular, several fixative and decalcifying reagents with specific benefits and drawbacks are described, but only a few direct comparisons are available. This study aims to test the most used fixation and decalcification protocols and evaluate their effect on tissue antigenicity via immunohistochemistry (IHC).</p><p><strong>Methods: </strong>To avoid damaging and exhausting diagnostic BMs, we used \"surrogate\" BMs obtained from dedicated grossing of a non-pathologic spleen. Eleven fixation and decalcification protocols were tested, and their performances were evaluated via IHC protein expression of 25 biomarkers.</p><p><strong>Results: </strong>The IHC yield varied based on the fixative and decalcifying reagents, but the overall quality is mainly related to the fixative rather than the decalcifying phases. The protocol with the lowest number of inadequate IHC stains (5 out of 25) combined commercially available B5-based fixative and EDTA-based decalcifying reagents. The worst metrics (8 inadequate IHC stains out of 25) were obtained with a protocol based on \"in-house\" B5-based and EDTA-based reagents.</p><p><strong>Conclusions: </strong>We compared different protocols and found the best combination of fixative and decalcifying reagents for accurate IHC staining. These findings can improve bone marrow sample handling and standardization in pathology laboratories.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"145-152"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cholesterol granuloma. Another brick in the wall of mediastinal lesions. 胆固醇肉芽肿。纵隔病变壁上的另一块砖。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1054ER
Michela Campora, Giampiero Negri, Virgilio Longari, Maurilio Ponzoni
{"title":"Cholesterol granuloma. Another brick in the wall of mediastinal lesions.","authors":"Michela Campora, Giampiero Negri, Virgilio Longari, Maurilio Ponzoni","doi":"10.32074/1591-951X-1054ER","DOIUrl":"10.32074/1591-951X-1054ER","url":null,"abstract":"","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"173-177"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biopsy in chronic liver disease: proposal for a shared path between clinicians and pathologists. 慢性肝病的活检:临床医生和病理学家共享路径的建议。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1063
Andrea Baiocchini, Maria Conti, Daniela Fanni, Francesca Romana Ponziani, Giuliano Alagna, Clara Balsano, Simone Carotti, Antonio Cossu, Guido Delle Monache, Shirin Demma, Maria Cristina Giustiniani, Vito Gomes, Cristina Manieli, Alessandra Moretti, Teresa Musarra, Valeria Pace Palitti, Giuseppe Perrone, Chiara Taffon, Francesca Terracciani, Umberto Vespasiani-Gentilucci, Teresa Zolfino, Giulia d'Amati
{"title":"Biopsy in chronic liver disease: proposal for a shared path between clinicians and pathologists.","authors":"Andrea Baiocchini, Maria Conti, Daniela Fanni, Francesca Romana Ponziani, Giuliano Alagna, Clara Balsano, Simone Carotti, Antonio Cossu, Guido Delle Monache, Shirin Demma, Maria Cristina Giustiniani, Vito Gomes, Cristina Manieli, Alessandra Moretti, Teresa Musarra, Valeria Pace Palitti, Giuseppe Perrone, Chiara Taffon, Francesca Terracciani, Umberto Vespasiani-Gentilucci, Teresa Zolfino, Giulia d'Amati","doi":"10.32074/1591-951X-1063","DOIUrl":"10.32074/1591-951X-1063","url":null,"abstract":"<p><strong>Introduction: </strong>Liver biopsy is fundamental for characterizing chronic liver disease. Effective communication between specialists during the diagnostic process is crucial. This project aims to outline a diagnostic path shared by clinicians and pathologists, and to propose practical solutions at different stages of the diagnostic work-up, from clinical suspicion to the histology report in patients with chronic liver diseases.</p><p><strong>Methods: </strong>A panel of experts, within the methodological framework of lean management, joined two rounds of discussion sharing their professional experiences. They reached an agreement on the essential phases and actions of the diagnostic process, and built a shared diagnostic workflow.</p><p><strong>Results: </strong>The panel agreed on the importance of a standardized form to be filled with all relevant clinical and laboratory data to ensure the flow of information between the clinician and the pathologist. Further decisions were reached on the following practical issues: the advantage of performing liver biopsies in dedicated centers, the need for homogeneous procedures, and the minimum quality standards in all phases, including reporting. Finally, the panel agreed on the usefulness of digital pathology to exchange observations and opinions and to create a territorial network to discuss challenging cases.</p><p><strong>Conclusion: </strong>Sharing a diagnostic path between the pathologist and the clinician can be a powerful tool to improve both the timing and accuracy of the histology report.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"136-144"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
KRAS/NRAS variants and copy number alterations prognostically stratify patients with sinonasal melanoma. KRAS/NRAS变异和拷贝数改变对鼻窦黑色素瘤患者的预后分层有影响。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1088
Laura Libera, Nora Sahnane, Mario Turri-Zanoni, Fabiana Pettenon, Deborah Marchiori, Paolo Battaglia, Alberto Daniele Arosio, Daniela Furlan, Maurizio Bignami, Paolo Castelnuovo, Fausto Sessa, Carla Facco, Michele Cerati, Stefano La Rosa
{"title":"<i>KRAS/NRAS</i> variants and copy number alterations prognostically stratify patients with sinonasal melanoma.","authors":"Laura Libera, Nora Sahnane, Mario Turri-Zanoni, Fabiana Pettenon, Deborah Marchiori, Paolo Battaglia, Alberto Daniele Arosio, Daniela Furlan, Maurizio Bignami, Paolo Castelnuovo, Fausto Sessa, Carla Facco, Michele Cerati, Stefano La Rosa","doi":"10.32074/1591-951X-1088","DOIUrl":"10.32074/1591-951X-1088","url":null,"abstract":"<p><p>Sino-nasal mucosal melanoma (SN-MM) is an aggressive and rare form of melanoma arising from mucosal melanocytes with pathogenesis unrelated to sun exposure. Conversely to cutaneous melanoma (CM), the molecular bases underling SN-MM development and progression are unclear, and no molecular predictive markers have been identified yet. To better define the molecular landscape of SN-MM, a retrospective series of 37 SN-MMs from 31 patients was analysed for both somatic mutations and cytogenetic alterations. The somatic mutation analysis identified the presence of a driver gene pathogenic variant in 54% of cases. In detail, mutually exclusive <i>NRAS</i> mutations were found in 42% of cases, <i>KRAS</i> mutations in 6%, and <i>KIT</i> mutations in 6% of cases. Remarkably, no <i>BRAF</i> mutations were detected. Patients with <i>NRAS</i>-mutated/<i>KRAS</i>-wild type (wt) melanomas showed better outcome than patients with <i>NRAS</i>-wt/<i>KRAS</i>-mutated melanomas, which were associated with multiple recurrences at local or regional sites. On the other hand, focusing on genomic alterations, copy number variants (loss of 1p36, loss of 3p/3q) were identified in 19% of SN-MMs, which showed poor overall survival and short disease-free survival with early metastatic dissemination. This work describes a new integrated characterization of both single nucleotide variants and, for the first time, genomic alteration in SN-MM, providing a new insight into molecular bases of these neoplasms and prompting further efforts for personalized clinical protocols according to tumour aggressiveness.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"121-130"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When to think of Sarcina sp. in histopathologic examination of gastrointestinal tract: insights from a one-year-old with esophagitis and gastric outlet obstruction. 在胃肠道的组织病理学检查中,什么时候应该想到Sarcina sp:来自1岁食管炎和胃出口梗阻的见解。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1114
Farzaneh Afshari, Maryam Khalesi, Nema Mohammadian Roshan, Amir Hossein Jafarian
{"title":"When to think of Sarcina sp. in histopathologic examination of gastrointestinal tract: insights from a one-year-old with esophagitis and gastric outlet obstruction.","authors":"Farzaneh Afshari, Maryam Khalesi, Nema Mohammadian Roshan, Amir Hossein Jafarian","doi":"10.32074/1591-951X-1114","DOIUrl":"10.32074/1591-951X-1114","url":null,"abstract":"","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"171-172"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immunotherapy in recurrent/metastatic head and neck squamous cell carcinoma: PD-L1 and beyond. 复发/转移性头颈部鳞状细胞癌的免疫治疗:PD-L1及以上。
IF 4.4
PATHOLOGICA Pub Date : 2025-04-01 DOI: 10.32074/1591-951X-1092
Andrea Ascione, Andrea Botticelli, Martina Leopizzi, Edoardo Cerbelli, Alessio Cirillo, Diana Bellavia, Carlo Della Rocca, Giulia d'Amati, Bruna Cerbelli
{"title":"Immunotherapy in recurrent/metastatic head and neck squamous cell carcinoma: PD-L1 and beyond.","authors":"Andrea Ascione, Andrea Botticelli, Martina Leopizzi, Edoardo Cerbelli, Alessio Cirillo, Diana Bellavia, Carlo Della Rocca, Giulia d'Amati, Bruna Cerbelli","doi":"10.32074/1591-951X-1092","DOIUrl":"10.32074/1591-951X-1092","url":null,"abstract":"<p><p>Head and neck squamous cell carcinoma (HNSCC) is a prominent global health concern because of its high incidence, aggressive clinical behavior, and scarce therapeutic options. The management of these neoplasms in the recurrent/metastatic setting has been revolutionized following the results of key clinical trials, leading to the advent of immunotherapeutic agents targeting the PD-1/PD-L1 axis. Despite the exciting results obtained with the new drugs, immunotherapy is helpful only in a sizable minority of patients, and there is a pressing need to identify reliable predictive biomarkers for patient selection. The immunohistochemical assessment of PD-L1 expression was initially identified as a powerful and easily accessible predictive tool, and gained its place as the current standard for patient selection, but it has clear limitations. The imperfect predictive power of PD-L1 has resulted in a strong effort to discover additional clinical, pathological and molecular biomarkers such as tumor HPV status, mutational burden, microsatellite instability, and much more. In addition, the tumor microenvironment has been extensively studied searching for promising new biomarkers as potential avenues for refining patient selection and improvement of treatment outcomes. As we gain deeper understanding of the complex interplay between tumor biology, immune system, and tumor microenvironment, we are rapidly realizing that the perfect biomarker, the magic bullet, probably doesn't exist. On the other hand, with the introduction of new drugs on the horizon, integration of multiple variables in the context of combined predictive scores is shaping up to be our best weapon in this strife to treat each patient with the best possible drug.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"73-83"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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