Black Americans (BAs) with head and neck cancer (HNC) have worse survival outcomes compared to the White patients. While HNC disparities in patient outcomes for BAs have been well recognized, the specific drivers of the inferior outcomes remain poorly understood. Here, we investigated the biologic features of patient tumor specimens obtained during the surgical treatment of oral cancers and performed a follow-up study of the patients’ post-surgery recurrences and metastases with the aim to explore whether tumor biologic features could be associated with the poorer outcomes among BA patients compared with White American (WA) patients. We examined the tumor stemness traits and stromal properties as well as the post-surgery recurrence and metastasis of oral cancers among BA and WA patients. It was found that high levels of tumor self-renewal, invasion, tumorigenesis, metastasis, and tumor-promoting stromal characteristics were linked to post-surgery recurrence and metastasis. There were more BA than WA patients demonstrating high stemness traits and strong tumor-promoting stromal features in association with post-surgery tumor recurrences and metastases, although the investigated cases displayed clinically comparable TNM stages and histological grades. These findings demonstrated that the differences in tumor stemness and stromal property among cancers with comparable clinical diagnoses contribute to the outcome disparity in HNCs. More research is needed to understand the genetic and molecular basis of the biologic characteristics underlying the inferior outcomes among BA patients, so that targeting strategies can be developed to reduce HNC disparity.
与白人患者相比，患有头颈癌的非裔美国人预后更差。尽管非裔美国人在头颈癌患者预后方面的差异已得到广泛认识，但导致其预后较差的具体驱动因素仍不清楚。本研究通过分析口腔癌手术切除标本的生物学特征，并对患者术后复发及转移情况进行随访，旨在探讨肿瘤生物学特征是否与非裔美国人较白人患者更差的预后相关。我们比较了非裔美国人与白人患者口腔癌的肿瘤干细胞特性、间质特征以及术后复发转移情况。研究发现，高水平的肿瘤自我更新能力、侵袭性、致瘤性、转移潜能及促肿瘤间质特征与术后复发转移密切相关。尽管所研究病例在临床TNM分期和组织学分级上具有可比性，但非裔美国人患者中表现出高干细胞特性及强促肿瘤间质特征并伴有术后复发转移的比例高于白人患者。这些发现表明，在临床诊断相似的癌症中，肿瘤干细胞特性及间质特征的差异是导致头颈癌预后差异的重要因素。需要进一步研究以理解非裔美国人患者不良预后背后生物学特征的遗传与分子基础，从而制定针对性策略以减少头颈癌的预后差异。
肿瘤(癌症)患者之家