Construction and confirmation of a recombinant adenovirus vector of survivin / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To construct a recombinant adenovirus of survivin vector and provid valuable reference for gene therapy of laryngeal cancer.</p><p><b>METHODS</b>The survivin gene was cloned by PCR. After confirmation by enzyme restriction analysis and sequencing, the gene and the adenovirus vector were recombined together to construct the recombinant adenovirus vector. The recombinant adenovirus vector was confirmed via both sequencing and digestion restriction analysis, and then linearized and transfected into the HEK 293 cell line to generate recombinant adenovirus.</p><p><b>RESULTS</b>The sequence analysis demonstrated that the survivin gene sequence was the same as published in the literature, suggesting that a recombinant adenovirus vector has been successfully constructed.</p><p><b>CONCLUSIONS</b>A survivin recombinant adenovirus has been successfully constructed.</p>

Neck dissection of Levels II and III for the treatment of supraglottic laryngeal cancer with clinically negative neck / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility of routine inclusion of levels II and III in neck dissection to treat the occult neck metastasis as elective treatment for supraglottic cancer with clinically node negative (cN0).</p><p><b>METHODS</b>The results of 52 cN0 patients with supraglottic cancer treated in Tumor Hospital, Harbin Medical University from October 2002 to March 2006 were reviewed retrospectively.</p><p><b>RESULTS</b>Of the 52 patients with supraglottic cancer and cN0 neck, 32 cases received ipsilateral SND (levels II and III) and 20 cases with bilateral SND (levels II and III). Fifteen (28.9%) of 52 patients were found to have occult regional metastasis on pathological examination. Three patients without metastasis in dissected side at pathologic examination showed metastasis in the contralateral undissected neck later on therefore the total occult metastasis rate was 34.6% (18 of 52). The unilateral and bilateral neck occult metastases were determined in 15 cases (28.9%) and 3 cases (5.8%) respectively. A total of 1190 lymph nodes were harvested in 72 specimens, with 30 positive nodes. The distributions of the 30 positive nodes were as follows: level IIA 83.3% (25 nodes), level III 16.7% (5 nodes). Three-year regional recurrence rate was 5.8%. The 3-year survival rate was 84.6% according to Kaplan-Meier in all cN0 patients (n = 52). Patients with positive neck metastasis and patients with extracapsular spread had higher regional recurrence rates (P = 0.021 and 0.002, respectively).</p><p><b>CONCLUSIONS</b>The results support the use of SND (levels II and III) in cN0 supraglottic cancer. This procedure will reduce both operating time and morbidity, without compromising the oncologic result.</p>

Supraglottic horizontal partial laryngectomies in 163 cases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of supraglottic horizontal partial laryngectomy.</p><p><b>METHODS</b>One hundred and sixty-three patients with supraglottic laryngeal carcinoma were treated surgically by supraglottic horizontal partial laryngectomy from 1978 to 1998. There were 64 males and 99 females. Five cases were staged I, 95 staged II, 48 staged III and 15 staged IV. The surgical techniques were improved: The hyoid was removed conventionally; The outer perichondrium of thyroid cartilage was turned into the laryngeal cavity and sutured with the mucosa of laryngeal ventricle and the base of tongue was sutured to the reserved thyroid cartilage. Survival was evaluated using the Kaplan-Meier method. The differences between stages were tested by Los-Rank method.</p><p><b>RESULTS</b>The 5-year survival rate were 100.0%, 77.9%, 54.2% and 33.3% for patients staged I to IV respectively, and were statistically significant (P = 0.0006) between different clinical stages. The 5-year survival rate were 73.1% and 45.5% in patients with cN0 and cN + respectively, and were statistically significant (P = 0.0132). The speech and swallowing functions were good after operation. The decannulation rate was 91.4%. The main causes of death were cervical lymph node metastasis in 40% (20/50) and laryngeal recurrence in 18% (9/50). The occult metastasis rate was 23.1% (30/130) and cervical metastasis rates of patients with cN1-3 75.8% (25/33), with a total metastasis rate was 33.7 (55/163).</p><p><b>CONCLUSIONS</b>Supraglottic horizontal partial laryngectomy is very effective in eradicating disease and in preserving laryngeal function on condition that the indications were selected correctly. The selective lateral neck dissection was recommended for supraglottic carcinoma.</p>