Clinical analysis of 14 cases of head and neck carcinosarcoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the clinicopathological characteristics, treatment and prognosis of head and neck carcinosarcoma. Methods: The clinical data of 14 patients with head and neck carcinosarcoma treated in the First Affiliated Hospital of Zhengzhou University from January 2010 to May 2020 were retrospectively analyzed, including 11 males and 3 females, with age range from 30 to 72 years old. Clinicopathological characteristics, treatments and follow-up results of patients were evaluated. Kaplan-Meier method was used to estimate the cumulative survival rate. Results: Histopathological examination showed the co-existence of malignant epithelial and mesenchymal components in all cases. Immunohistochemical staining of 13 cases showed cytokeratin and epithelial membrane antigens were positively expressed in the epithelial areas, whereas vimentin was positive in the malignant mesenchymal tissue area. Among 14 cases, 5 cases were treated with surgery, 3 cases with surgery and radiotherapy, and 6 cases with surgery, radiotherapy and chemotherapy. The follow-up time was 2-81 months, with a median follow-up time of 22.5 months. Except for one patient who was lost to follow-up in 21 months after treatment, among the remaining 13 patients, 4 patients had recurrence, 8 patients died, and 5 patients had a tumor-free survival. The Kaplan-Meier analysis showed that the 1, 3, and 5-year cumulative survival rates of 14 patients with head and neck carcinosarcoma were 64.3%, 57.1%, and 42.9%, respectively. Conclusions: Carcinosarcoma of the head and neck is rare in clinic, histopathological and immunohistochemical examinations are important basis for diagnosis, and surgery is a preferred treatment. Carcinosarcoma of the head and neck has a poor prognosis, and patients should be followed up for a long time.

Detection of early gastric cancer and analysis of its endoscopic characteristics (43 cases) / 中国内镜杂志

Objective To investigate and analyze the detection of early gastric cancer (ECG) and explore the endoscopic and pathological characteristics. Methods Clinical data of patients underwent gastroscopy in 2016 were retrospectively collected for the screening and statistics of the detection rate of ECG (detected in examination and confirmed by pathology). In addition, the clinical data of 43 detected patients with ECG (47 lesions) were retrospectively summarized. Endoscopic characteristics under a white light endoscope and a magnifying endoscope with narrow band imaging (NBI) as well as pathological characteristics of ECG were compared. Results The overall detection rate of ECG was 0.23% (43/18,534), accounting for 24.71% (43/174) in the total detected cases of gastric cancer. This study revealed that ECG was the most commonly detected in the gastric antrum (36.17%, 17/47), lesion size >1.0 cm was the most common (68.09%, 32/47), and 0-IIc type were the most common under the endoscope, accounting for 55.32% (26/47). Under the white light endoscope, 35 (74.47%, 35/47) lesions showed mucosal redness, 43 (91.49%, 43/47) lesions presented clear boundaries, 42 (89.36%, 42/47) lesions exhibited irregular surface, 39 (82.98%, 39/47) lesions demonstrated mucosal atrophy and (or) intestinal metaplasia, 17 (36.17%, 17/47) lesions presented edge burrs, 8 (17.02%, 8/47) lesions showed WOS, 13 (27.66%, 13/47) lesions had superficial ulcers, and 21 (44.68%, 21/47) lesions demonstrated spontaneous bleeding. Magnifying endoscopy with NBI was conducted in 30 lesions, revealing clear boundaries in 86.67% (26/30) lesions, irregular or disappeared submucosal microvasculature in 96.67% (29/30) lesions, and irregular or disappeared epithelial microstructure and pit pattern in 90.00% (27/30) lesions. Differentiated pathological type was dominant (89.36%, 42/47). Conclusion ECG mainly occurs in the gastric antrum and 0-IIc type are dominant. Careful observation of the changes and characteristics of the local tone of gastric mucosa under a white light endoscope as well as the changes in lesion boundaries, submucosal microvasculature, epithelial microstructure and pit pattern under a magnifying endoscope with NBI is helpful to improve the diagnosis rate of ECG.

Effect of HDAC6 down-regulation on the growth of xenografted human laryngeal carcinoma cell line Hep-2 in nude mice and underlying mechanism / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the effect of histone deacetylation 6 (HDAC6) siRNA on the growth of xenografted human laryngeal squamous cell carcinoma cell line Hep-2 in nude mice and underlying mechanism.</p><p><b>METHODS</b>Laryngeal squamous cell carcinoma cell line Hep-2 cells were subcutaneously injected to the back of nude mice and transplanted tumor model was established after one week. Nude mice was divided into three groups including blank control group, empty vector group and HDAC6 siRNA group, and the tumor growth was observed. Ki-67 proliferation index was detected by immunohistochemistry. Western blot, in situ hybridization and immunohistochemistry were used to detect the mRNA and protein expressions of HDAC6 in xenograft. The expressions of Bcl-2 and Bax proteins were examined by Western blotting. Cell apoptosis was detected by TUNEL.</p><p><b>RESULTS</b>The mean volume of xenograft transfected with HDAC6 siRNA was less than that of xenograft transfected with empty vector or that of xenograft with blank control treatment (P < 0.05). HDAC6 siRNA effectively down-regulated the expressions of HDAC6 mRNA and the expressions of HDAC6 and Bcl-2 proteins, but up-regulated the expression of Bcl-2 protein in xenografts, with significant differences (all P < 0.05). The proliferation index of Ki-67 in HDAC6 siRNA transfection group was significantly lower than that in blank control group or empty vector group (P < 0.05). TUNEL assay demonstrated that HDAC6 evidently evoked cell apoptosis (P < 0.05).</p><p><b>CONCLUSION</b>HDAC6 siRNA could effectively inhibited the growth of xenografted human laryngeal carcinoma cell line Hep-2 in nude mice, down-regulate the expressions of HDAC6 and bcl-2, and up-regulate the expression of bax.</p>

Down-regulation of histone deacetylase 2 induces cell apoptosis and inhibits cell proliferation and migration of laryngeal squamous cell carcinoma cells / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the effects of histone deacetylase 2 (HDAC2) expression on cell proliferation, apoptosis and migration of laryngeal squamous cell carcinoma (LSCC) Hep-2 cells.</p><p><b>METHODS</b>HDAC2 siRNA and control siRNA were transfected into LSCC Hep-2 cells by lipofectamine 2000, and cells were divided into three experimental groups: untreated group, control siRNA group and HDAC2 siRNA transfection group. Western blotting was utilized to detect the expression of HDAC2 protein in Hep-2 cells. Cell proliferation and apoptosis were investigated by CCK-8 kit and flow cytometry, respectively. Boyden chamber was used to study cell migration. Expressions of cell apoptosis and cell migration related proteins were detected by Western blotting.</p><p><b>RESULTS</b>HDAC2 siRNA significantly down-regulated the expression of HDAC2 protein in LSCC Hep-2 cells. Down-regulation of HDAC2 expression coincided with an inhibition of cell proliferation and migration along with an induced cell apoptosis of Hep-2 cells. Moreover, down-regulation of HDAC2 expression significantly increased the expressions of caspase-3 and caspase-9 proteins but decreased the expressions of matrix metalloproteinases (MMP)-2 and MMP-9 proteins.</p><p><b>CONCLUSIONS</b>HDAC2 may play a pivotal role in the initiation and development of LSCC. Down-regulation of HDAC2 expression mediates cell apoptosis. Cell migration inhibition may be tightly associated with overexpression of caspase-3 and caspase-9 along with down-regulation of MMP-2 and MMP-9 expressions.</p>

Diagnosis and management of congenital pyriform sinus fistula / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the clinical presentation and management principles of congenital pyriform sinus fistula.</p><p><b>METHODS</b>Seven sequential cases of congenital pyriform sinus fistula (CPSF) treated between January 2007 and January 2011 were reported. The clinical presentation were recurrent left lower neck abscess or acute suppurative thyroiditis. All of these patients had past histories of misdiagnosis ranged from 3 years to 11 years. All the patients had undergone incision and drainage several times. In acute infection period, these patients received incision and drainage, after inflammation subsided, were treated with definitive surgery.</p><p><b>RESULTS</b>After barium swallow study and CT examination in the quiescent stage of infection, 5 patients could be seen fistula in the pyriform, all the patients were found scar tissue near the left thyroid lobe, 4 patients received direct laryngoscope examination and 3 of them could be found inner orifice near the apex of pyriform sinus, fistula and the involved lobe of thyroid were successfully excised without permanent recurrent laryngeal nerve injury or hypothyroidism. All the patients had an uneventful recovery and remained symptom free from 5 months to 40 months.</p><p><b>CONCLUSIONS</b>The clinical history of recurrent low neck inflammatory episodes in patients, especially on the left side, should raise the suspicion of CPSF, investigation using barium swallow in combination with CT scanning is useful. CPSF can be treated by excising the fistula and involved lobe of thyroid.</p>

Inhibitory effects of small interfering RNA targeting c-myc in combination with 5-fluorouracil on the growth in vitro and in vivo / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the effects of small interfere RNA (siRNA) targeting the c-myc in combination with 5-fluorouracil (5-Fu) on the growth of Hep-2 cells in vitro and in vivo.</p><p><b>METHODS</b>Hep-2 cells transfected with or without c-myc siRNA were treated with 5-Fu for 48 h. C-myc protein levels in Hep-2 cells were detected using the Western blot. The cell cycle was analyzed by flow cytometry. Hep-2 cells were subcutaneously inoculated into the back of BALB/c nude mice to establish the implanted laryngeal squamous carcinoma model. PBS, c-myc siRNA, and 5-Fu, alone or in combinations were administered i.p. The mice were sacrificed after the treatments and the tumor masses were removed to determine the tumor volume and weight. The inhibitory rate was calculated. Expression of c-myc in tumor tissue was detected by immunocytochemistry and cell apoptosis was analyzed by terminal transferase dUTP nick end labeling (TUNEL).</p><p><b>RESULTS</b>The protein levels of c-myc decreased after transfected with c-myc siRNA. C-myc siRNA-transfected cells showed an increase in the percentage of cells in the GO-G1 phase and a decrease in the percentage of cells in the S phase. When combined with 5-Fu, the results were improved. The tumor growth was faster in the control group and was significantly slower in the c-myc siRNA plus 5-Fu group than that in the c-myc siRNA group or 5-Fu group (P < 0.05). The tumor weight in the c-myc siRNA plus 5-Fu group was significantly smaller than that in the c-myc siRNA or 5-Fu group (P < 0.05). Immunohistochemistry showed that c-myc siRNA inhibited the expression of c-myc in tumor tissues in the c-myc siRNA group and c-myc siRNA plus 5-Fu group (P < 0.05). The number of apoptotic cells in the c-myc siRNA plus 5-Fu group was higher than those in the c-myc siRNA groups (P < 0.05).</p><p><b>CONCLUSIONS</b>C-myc siRNA inhibits the expression of c-myc in Hep-2 cells and in the tumor tissues of nude mice. C-myc siRNA combined with 5-Fu inhibits the growth of implanted laryngeal squamous carcinoma and promotes cell apoptosis. C-myc could become a novel target for the treatment of laryngeal squamous carcinoma.</p>