Role of vasculogenic mimicry and endothelium-dependent vessel in metastasis of laryngeal cancer / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the contribution of vasculogenic mimicry (VM) and endothelium-dependent vessel (EDV) to invasion and metastasis of laryngeal squamous cell carcinoma (LSCC).</p><p><b>METHODS</b>A total of 203 cases with LSCC was reviewed and followed up. VM and EDV in LSCC tissues were assessed by double staining with anti-CD31 immunohistochemistry and periodic acid-schiff. Kruskal-Wallis test and one-way ANOVA were used to analyze the relationship between VM, EDV and clinical pathology parameters of LSCC. Kaplan-Meier analysis was used to evaluate overall survival (OS) of patients with LSCC.</p><p><b>RESULTS</b>VM related to pTNM stage, lymph node metastasis and pathology grade of LSCC, while EDV related to primary sites, pTNM stage, T stage and distant metastasis of LSCC. Univariate analysis showed VM (P = 0.014), pTNM stage (P = 0.009), T stage (P = 0.013), nodal status (P = 0.013), histopathology grade (P = 0.038), tumor size (P = 0.028), and radiotherapy (P < 0.0001) related to OS. VM (P = 0.011), primary sites (P = 0.049), tumor size (P = 0.001) and radiotherapy (P < 0.0001) related to disease free survival. Multivariate analysis indicated that VM was an adverse predictor for both OS and disease free survival.</p><p><b>CONCLUSIONS</b>Both VM and EDV existed in LSCC. VM contributed to progression of LSCC through promoting lymph node metastasis. VM is an independent predictor for the prognosis of LSCC.</p>

Vasculogenic mimicry is a key prognostic factor for laryngeal squamous cell carcinoma: a new pattern of blood supply / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recurrence and local lymph node metastasis affected the prognosis of patients with laryngeal cancer. The aim of this study was to analyze clinical and pathological significance of vasculogenic mimicry (VM) in laryngeal squamous cell carcinoma (LSCC) and evaluate its contribution to prognosis.</p><p><b>METHODS</b>Data of 168 cases of LSCC were reviewed retrospectively to reveal clinical pathology and prognostic significance of VM. CD31 and periodic acid-Schiff double staining was used to identify VM.</p><p><b>RESULTS</b>VM in LSCC contributed to lymph node metastasis (P = 0.003) and clinical progression. VM correlated to histopathology grade (P = 0.001) of LSCC. VM was an adverse prognostic factor for both disease-specific survival (P = 0.039) and metastasis-free survival (P = 0.042) by univariate survival analyses. And it was an independent prognostic factor for only disease-specific survival (P = 0.003) by multivariate survival analyses.</p><p><b>CONCLUSIONS</b>VM existed in LSCC. LSCC with VM has more potential to invasion and metastasis.</p>

Subjective visual horizontal in peripheral unilateral vestibular dysfunction / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the characteristics of subjective visual horizontal (SVH) and evaluate its clinical value for vestibular function in peripheral unilateral vestibular hypofunction (UVH).</p><p><b>METHODS</b>Eighty-five patients with UVH (study group) and 39 normal persons (control group) accepted vestibular function tests, including SVH, subjective visual vertical (SVV) and caloric test by video-nystagmography. The parameters of the angle of SVH and SVV, directional preponderance (DP) and unilateral weakness (UW) of caloric test were observed. The correlation between SVH/SVV, DP, UW and the course of disease were investigated respectively. SPSS 16.0 software was used to analyze the data.</p><p><b>RESULTS</b>Reference range of SVH and SVV was from -2° to 2° in the control group. Among the 85 patients, 46 cases (54.1%) and 43 cases (50.6%) had the abnormal values of SVH and SVV respectively, with no statistical significance (χ(2) = 12.5, P = 0.481) by chi square test. Fifty-five cases (64.7%) with abnormal DP had no statistical significance when compared with SVH and SVV respectively (χ(2) values were 0.19 and 2.86, respectively, P value were 0.164, 0.067, respectively). In UVH, there were positive correlation between SVH, SVV and DP (r value was 0.939, 0.648, 0.658, all P < 0.05) respectively, but no correlation between UW and SVH or SVV (r value was 0.048, 0.085, all P > 0.05). According to the permutation and combination of the four parameters, positive or negative, three main groups could be defined [SVH(+)DP(+)UW(+), SVH(-)DP(+)UW(+), SVH(-)DP(-)UW(+); SVV(+)DP(+)UW(+), SVV(-)DP(+)UW(+), SVV(-)DP(-)UW(+)]. The course of disease in the three main groups was positively skewed distribution, with median of 5.0, 10.0, 15.0 d and 5.0, 9.5, 14.5 d respectively. By Kruskal-Wallis Test, χ(2) value were 8.80 and 6.26, respectively(P value were 0.012, 0.040, respectively), with statistical significance between the above three main groups.</p><p><b>CONCLUSIONS</b>The SVH value can evaluate the function of the otolithic. The angle of SVH and SVV are changing in the course of disease, SVH and SVV can be used as a guidance of the vestibular compensation evaluation.</p>

Analysis of directional preponderance of caloric test in evaluation of vestibular dynamic compensation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the value of directional preponderance (DP) in vestibular dynamic compensation evaluation.</p><p><b>METHODS</b>One hundred fifty-five patients with sudden deafness accompanied vertigo were asked to accept routine vestibular tests including the spontaneous nystagmus (SN) and caloric test with video-nystagmography. DP, SN and unilateral weakness (UW) were selected as the observation parameters. Then the correlation analysis between DP, SN, UW and course of disease were investigated respectively. The change characteristic of the three parameters was also analyzed in the course of vestibular compensation.</p><p><b>RESULTS</b>Of the 155 patients, there were negative correlations between SN, DP and course of disease (r(s) = -0.386, r(s) = -0.424, P < 0.05), positive correlation between SN and DP (r(s) = 0.543, P < 0.05), but no correlation between UW and course of disease (r(s) = 0.004, P > 0.05), and also positive correlation (r(s) = 0.274, P < 0.05) between DP and UW. According to three parameters were positive or negative, three main groups (DP+UW+SN+, DP+UW+SN- and DP-UW+SN-) in DP, UW, SN. The course of disease in three main groups was positively skewed distribution. Median was 6 days, 10 days and 20 days respectively. Through Kruskal-Wallis Test, chi(2) = 24.63, P < 0.05, there was statistical significance among the above three main groups.</p><p><b>CONCLUSIONS</b>DP keeps on changing in the acute stage, static and dynamic compensation stage of peripheral vestibular disease. This indicates that DP can be considered as an objective evaluation index of vestibular dynamic compensation and as a guidance of the vestibular rehabilitation evaluation.</p>

Clinical research of vestibular autorotation test for patients with vertebrobasilar insufficiency / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the diagnostic values of vestibular autorotation test (VAT) for patients with vertebrobasilar insufficiency (VBI).</p><p><b>METHODS</b>VAT and videonystagmography ( VNG) were performed on 73 patients with VBI and 48 patients with peripheral vestibular lesions (contrast group). Parameters analyzed included Gain, phase and asymmetry of VAT, as well as the canal paresis (CP) of caloric test and results of optokinetic-pursuit tests in VNG. Positive result of the test could be defined if anyone of the parameters was abnormal.</p><p><b>RESULTS</b>For VAT test, Gain was enhanced in VBI group and was reduced in contrast group. In VBI group and contrast group, Gain enhanced showed in 47 (64.4%) cases and 5 (10.4%) cases, respectively (chi2 = 31.19, P < 0.01). Simultaneity, Gain reduced in 11 cases (15.5%) and 22 cases (45.8%), respectively (chi2 = 13.82, P < 0.01). But there was no statistics significant for results of the parameters of phase, asymmetry and integration between two groups. For VNG test, results with optokinetic-pursuit tests were more abnormal in VBI group than that in contrast group, which showed central lesions characteristics. Forty-four cases (60.3%) in VBI group and 10 cases (20.8%) in control group showed central lesions results with optokinetic-pursuit tests and visual fixation test (chi2 = 15.89, P < 0.01). Unilateral or bilateral CP showed in 33 cases (68.6%) in control group and 51 cases (69.9%) in VBI group with caloric test.</p><p><b>CONCLUSIONS</b>Gain of VAT is mostly enhanced in VBI group, and Gain as a main characteristic is reduced in patients with peripheral vestibular lesions. The Gain parameter is availability for assessing characteristics of vestibular lesions. Phase and asymmetry can be used to assess the vestibular function but can not indicate the characteristics of vestibular lesions.</p>