Baseline growth kinetics of pulmonary metastases in head and neck adenoid cystic carcinoma: analysis of correlated clinical and molecular factors
- 1Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- 2Department of Otorhinolaryngology, Beijing University Of Chinese Medicine Third Affiliated Hospital, Beijing, China
- 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
Abstract
Objective: To establish baseline growth rates of lung nodules in untreated head and neck adenoid cystic carcinoma(ACC) patients and analyze associated clinical and molecular factors influencing these rates.
Methods: CT was used to calculate the diameter of 74 pulmonary metastatic nodules in 37 patients under natural state. The diameter growth rate of lung metastatic nodules was fitted with a linear regression equation, and the differences in the progression rate of lung metastasis among patients were compared. Additionally, clinical features such as location, pathological subtypes, and staging were also collected to compare their correlation with the growth rate of lung metastatic nodules. Subsequently, single-cell sequencing data from three lung metastatic nodules of differing diameters within the same case were analyzed.
Results: We defined three different states based on the progression of lung metastases: rapid progression was defined as a monthly diameter increase of more than 1 mm in 16.2% (6/37) of the patients; slow progression was defined as a monthly diameter increase between 0.3-1 mm in 56.8% (21/37) of the patients; and stable state was defined as a monthly diameter increase of less than 0.3 mm in 27.0% (10/37) of the patients. In addition, factors such as low expression of TP63, a higher pathological grade (Grade III), and a nodule diameter greater than 10mm at initial diagnosis of lung metastasis were identified as significant predictors for a faster diameter growth rate (P<0.05). Subsequently, through single-cell sequencing analysis, it was found that rapidly progressing nodules exhibited upregulation of signals related to hypoxia, vascular genesis, and a weakening of immune response-related signals.
Conclusion: The findings of this study suggest that baseline characteristics based on the growth rate of pulmonary metastatic nodules may be used to help stratify the progression rate of lung metastasis. In particular, based on our observations, for patients with pulmonary metastatic lesions presenting with a nodule diameter > 10 mm, pathological grade III, and low TP63 expression at initial diagnosis, clinicians might consider adopting closer follow-up monitoring or potentially initiating intervention measures earlier. Additionally, for rapidly growing pulmonary metastatic nodules, it may be worth considering targeted therapy against hypoxic/anti-angiogenic pathways or combination with immunotherapy aimed at restoring or enhancing local immune responses.
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BibTeX
@article{liu2026baseline,
title = {{Baseline growth kinetics of pulmonary metastases in head and neck adenoid cystic carcinoma: analysis of correlated clinical and molecular factors}},
author = {Hong-fei Liu and Ling-yan Jiang and Ting-yao Ma and Yue Zhao and Tian-yi Li and Xue-lian Wang and Shu-jing Zhang and Guo-liang Yang and Jing Zhou and Zhong-yu Yan and Xiao-hong Chen},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1811232},
url = {https://doi.org/10.3389/fonc.2026.1811232},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Baseline growth kinetics of pulmonary metastases in head and neck adenoid cystic carcinoma: analysis of correlated clinical and molecular factors
AU - Hong-fei Liu
AU - Ling-yan Jiang
AU - Ting-yao Ma
AU - Yue Zhao
AU - Tian-yi Li
AU - Xue-lian Wang
AU - Shu-jing Zhang
AU - Guo-liang Yang
AU - Jing Zhou
AU - Zhong-yu Yan
AU - Xiao-hong Chen
PY - 2026
DA - 2026/10/12
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1811232
UR - https://doi.org/10.3389/fonc.2026.1811232
AB - Objective: To establish baseline growth rates of lung nodules in untreated head and neck adenoid cystic carcinoma(ACC) patients and analyze associated clinical and molecular factors influencing these rates. Methods: CT was used to calculate the diameter of 74 pulmonary metastatic nodules in 37 patients under natural state. The diameter growth rate of lung metastatic nodules was fitted with a linear regression equation, and the differences in the progression rate of lung metastasis among patients were compared. Additionally, clinical features such as location, pathological subtypes, and staging were also collected to compare their correlation with the growth rate of lung metastatic nodules. Subsequently, single-cell sequencing data from three lung metastatic nodules of differing diameters within the same case were analyzed. Results: We defined three different states based on the progression of lung metastases: rapid progression was defined as a monthly diameter increase of more than 1 mm in 16.2% (6/37) of the patients; slow progression was defined as a monthly diameter increase between 0.3-1 mm in 56.8% (21/37) of the patients; and stable state was defined as a monthly diameter increase of less than 0.3 mm in 27.0% (10/37) of the patients. In addition, factors such as low expression of TP63, a higher pathological grade (Grade III), and a nodule diameter greater than 10mm at initial diagnosis of lung metastasis were identified as significant predictors for a faster diameter growth rate (P<0.05). Subsequently, through single-cell sequencing analysis, it was found that rapidly progressing nodules exhibited upregulation of signals related to hypoxia, vascular genesis, and a weakening of immune response-related signals. Conclusion: The findings of this study suggest that baseline characteristics based on the growth rate of pulmonary metastatic nodules may be used to help stratify the progression rate of lung metastasis. In particular, based on our observations, for patients with pulmonary metastatic lesions presenting with a nodule diameter > 10 mm, pathological grade III, and low TP63 expression at initial diagnosis, clinicians might consider adopting closer follow-up monitoring or potentially initiating intervention measures earlier. Additionally, for rapidly growing pulmonary metastatic nodules, it may be worth considering targeted therapy against hypoxic/anti-angiogenic pathways or combination with immunotherapy aimed at restoring or enhancing local immune responses.
SN - 2234-943X
ER -