Significance of p53 Mutation and Expression of Rb, MIB1 in Laryngeal Squamous Cell Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Treatment results of laryngeal carcinoma may depend on the microscopic environment of the primary lesion. If there is an abundance of lymphatic channels, the laryngeal lesion is more likely to develop frequent cervical metastases, leading to treatment failure. Prognosis of the laryngeal carcinoma is usually determined by clinical staging. However, it does not account for the oncobiological characteristics and microscopic environments. The importance of biological markers including p53, Rb and MIB1 as a prognostic factor has yet to be determined. To determine the relationship between the prognosis and biological characteristics of p53, Rb, and MIB1 in laryngeal cancers. MATERIALS AND METHODS: Thirty seven laryngeal carcinoma specimens were studied for p53 gene mutation by PCR-SSCP and expression pattern of Rb and MIB1 proteins by immunohistochemistry. RESULTS: p53 gene mutation was found in 32.4% with nine cases in exon 5, two cases in exon 7, and two cases in exon 8, respectively. Higher incidence of p53 gene mutation was found in supraglottic cancer (p>0.05). Negative expression rate for Rb was 29.7% and positive MIB1 expression rate was 32.4%. There was no significant correlation between the treatment success and p53 gene mutation, expression pattern of Rb and MIB1 gene. CONCLUSION: p53 gene mutation and expression pattern of both Rb and MIB1 showed little value as a prognostic factor. However, in cases where p53 and Rb tumor suppressor gene mutation were found in combination, the prognosis was poor. In this regard, such marker might be used as one of the important biological prognostic factors.

Surgical Management of Substernal Goiter / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Substernal goiter, defined as any thyroid enlargement that has greater mass inferior to the thoracic inlet, is a relatively rare disease with a potential for malignancy and the risk of postoperative airway obstruction secondary to tracheomalacia. We investigated clinical characteristics of substernal goiters and analyzed the results of the treatment to establish modalities of the surgical management. MATERIALS AND METHODS: We examined, retrospectively, ten cases of substernal goiters and reviewed their clinical features, radiological findings, histopathologic findings, operative findings and postoperative complications. RESULTS: We found tracheal deviations in six patients, tracheomalacia in three patients and calcification in two patients. We performed partial thyroidectomy for 9 cases and total thyroidectomy and superior mediastinal dissection were done for a case which revealed to be follicular carcinoma. The main histopathologic findings were multinodular goiter in five cases, followed by follicular adenoma, and follicular carcinoma in one case. Endotracheal intubation was removed after 24 hours postoperatively for six cases who showed severe tracheal compression and tracheal deviation and the tracheopexy (tracheal suspension) to the sternum was performed for one case among them. CONCLUSION: Because of the possibilities of malignancy and the acute airway obstruction, the surgical treatment and careful postoperative airway management should be emphasized for substernal goiter.