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Background No clear association between hepatitis B virus ( HBV) infection and atopic dermatitis ( AD) has been established. Some studies have reported that subjects with HBV had an increased risk of atopy; other studies reported an inverse association between HBV seropositivity and allergic diseases. Objective We evaluated the association between AD and hepatitis B antigen ( HBsAg) positivity using Korean National Health and Nutrition Examination Survey data. Methods In total, 14 776 participants aged >19 years were included in the analysis. Multiple logistic regression analyses were used to evaluate the odds ratio of HBsAg positivity in association with AD and asthma. Results The prevalence of HBsAg positivity was lower in individuals with AD than in those without AD (mean [ SE], 0.7% [0.4] vs. 3.7% [0.2]; P < 0.001). However, HBsAg positivity was not significantly associated with asthma (3.7% [0.2] vs. 2.8% [0.8]; P < 0.001). HBsAg positivity decreased the risk of AD significantly ( OR = 0.223; 95% CI = 0.069-0.72). Conclusions This study demonstrates an inverse association between AD and HBsAg positivity using a nationwide, population-based, cross-sectional health examination and survey. [ABSTRACT FROM AUTHOR]

Primary Parotid Carcinomas (PPC) comprise a wide array of histologies, each with varying propensity for local invasion and cervical nodal involvement. Upfront surgical excision of the primary tumor constitutes the standard of care for PPC, but there exists little consensus regarding management of the clinically negative neck (cN0). We conducted a clinicopathologic correlative analysis of the National Cancer Database (NCDB) to identify predictors of occult nodal involvement in PPC to guide elective neck management. The NCDB was queried for adults diagnosed from 2010-2020 with cN0M0 PPC who underwent adequate surgical resection (defined as subtotal to radical parotidectomy with >/=18 nodes examined) without pre-surgical treatment. Pathologic T-classification, tumor size, histology, grade, lymphovascular space invasion (LVSI), gender, and age at diagnosis were specified a priori as variables of interest. The primary outcome, occult nodal positivity (i.e. cN0 but pN+), was assessed by univariable (UVA) and multivariable (MVA) logistic regression, depicted as odds ratios (OR) and corresponding 95% confidence intervals (95%CI) with a prespecified threshold for statistical significance of p< 0.05. Recursive partitioning analysis (RPA) was then performed to hierarchically categorize patients according to occult nodal disease risk. From an initial 51,663 patients with PPC 1,899 met inclusion criteria and were included for analysis, of whom 1,047 (55.1%) had occult nodal involvement. By UVA, the incidence of occult nodal positivity was significantly higher with male sex; age 51 and older; high grade; pT2 status or greater; histology of adenocarcinoma, salivary duct carcinoma, or carcinoma ex-PA; tumor size >2cm; and LVSI. On MVA, tumor size, age, and gender were no longer significantly associated with occult nodal involvement; however, LVSI (OR 8.3, 95%CI 6.3-10.8), carcinoma ex-pleomorphic adenoma (OR 3.6, 95%CI 1.7-7.7), adenocarcinoma (OR 3.5, 95%CI 2.2-5.5), salivary duct carcinoma (OR 3.62, 95%CI 2.2-6.1), pT3 (OR 1.9, 95%CI 1.1-3.3), pT4 (OR 3.1, 95%CI 1.8-5.4), and high grade (OR 2.7, 95%CI 2.0-3.5) remained significant. On RPA evaluating LVSI, histology, pT, and grade, LVSI was the strongest predictor of occult nodal involvement (87% if LVSI+ vs 32% if LVSI–). LVSI appears to supersede tumor histology, grade, size, and pT status as the strongest risk factor for occult nodal involvement in PPC. To our knowledge, this is the largest series to evaluate this pathologic feature. Further research into this heretofore underappreciated risk factor and its implications for management of the cN0 neck is warranted. [ABSTRACT FROM AUTHOR]

Primary Parotid Carcinomas (PPC) comprise a wide array of histologies, each with varying propensity for local invasion and cervical nodal involvement. Upfront surgical excision of the primary tumor constitutes the standard of care for PPC, but there exists little consensus regarding management of the clinically negative neck (cN0). We conducted a clinicopathologic correlative analysis of the National Cancer Database (NCDB) to identify predictors of occult nodal involvement in PPC to guide elective neck management. The NCDB was queried for adults with a first malignant diagnosis of cN0M0 cancer of the parotid who underwent adequate surgical resection (defined as subtotal to radical parotidectomy with ³18 nodes examined) without pre-surgical treatment. Pathologic T-classification, tumor size, histology, grade, lymphovascular space invasion (LVSI), gender, and age at diagnosis were specified a priori as variables of interest. The primary outcome, occult nodal positivity (i.e. cN0 but pN+), was assessed by univariable (UVA) and multivariable (MVA) logistic regression analysis, depicted as odds ratios (OR) and corresponding 95% confidence intervals (95% CI) with a prespecified threshold for statistical significance of p £0.05. Recursive partitioning analysis (RPA) was subsequently performed to categorize patients according to their calculated risk of occult nodal disease. From an initial cohort of 41,445 patients with PPC 978 met inclusion criteria and were included for analysis, of whom 331 (33.8%) had occult nodal involvement. By UVA, the incidence of occult nodal positivity was significantly higher in male patients, those aged 72 and older, patients with high grade disease, pT4 classification, adenocarcinoma histology, a >4cm tumor, and those with positive LVSI. On MVA, tumor size, age, and gender were no longer significantly associated with occult nodal involvement; however, LVSI (OR 6.1, 95% CI 4.3-8.8), carcinoma ex-pleomorphic adenoma (OR 5.6, 95% CI 2.1-14.8), adenocarcinoma (OR 5.1, 95% CI 2.6-9.9), salivary duct (OR 4.0, 95% CI 1.8-8.6), or mucoepidermoid (OR 2.3, 95% CI 1.2-4.3) histology, pT3 (OR 2.0, 95% CI 1.1-3.7) or pT4 (OR 3.9, 95% CI 2.1-7.3) status, and high grade (OR 2.0, 95% CI 1.4-3.0) remained significant. LVSI, histology, pT status, and grade were further evaluated with RPA, which identified LVSI as the strongest predictor of occult nodal involvement (57.1% vs 42.9%, p <0.01). LVSI appears to supersede tumor histology, grade, size, and pT status as the strongest risk factor for occult nodal involvement in PPC. To our knowledge, this is the largest series to evaluate this pathologic feature. Further research into this heretofore underappreciated risk factor and its implications for management of the cN0 neck is warranted. [ABSTRACT FROM AUTHOR]