Research on the relationship between mucoepidermoid carcinoma and human papillomavirus infection / 中国耳鼻咽喉头颈外科

OBJECTIVE To find out the relationship between mucoepidermoid carcinoma and Human papillomavirus (HPV) infection.METHODS Nested polymerase chain reaction (Nested PCR) was adapted to detect HPV DNA from 51 tissues of mucoepidermoid carcinoma using consensus primers, 9 tissues of chronic parotitis were as control.RESULTS HPV DNA was detected in 37 of total 51 mucoepidermoid carcinoma tissues, the detection rate was up to 72.5%, comparatively, it was 22.2% (2 of 9) in chronic parotitis tissues. The HPV DNA detection rate of mucoepidermoid carcinoma tissues was statistically higher than that of chronic parotitis tissues (χ2=8.517, P=0.004).CONCLUSION The results suggested that the HPV infection may cause mucoepidermoid carcinoma.

Morphological Alteration and the Protein Expression of Caspase -3 in Denervated Posterior Cricoarytenoid Muscles / 听力学及言语疾病杂志

Objective To investigate the morphological alteration and the protein expression of caspase -3 in long -term denervated posterior cricoarytenoid muscles (PCAMs)in order to find the appropriate time point of rein‐neration in long -term denervated PCAMs .Methods A total of 45 patients with vocal paralysis were recruited and devided into 3 groups ,the 3~6 months denervation group ,the 6~12 months denervation group ,the 1~2 year denervation group .12 adults served as control group .The morphological alteration was evaluated using HE staining and the change in expression of caspase -3 ,an apoptosis related factor ,were observed using immunehistochemistry stain and western blot .Results With elongation of denervation time ,there were increased denaturation in the mus‐cle fibers .The nucleus moved inside and some of them concentrated .Caspase-3 showed weak staining in innerva‐ted ,however ,by 3-6 months of muscle denervation there was a significant accumulation of caspase -3 protein in myofibers ,6~12 months and 1~2 years of denervation ,expression of caspase -3 protein in myofibers was de‐creased significantly .In western blot ,the change in protein expression of caspase -3 was observed an 21-fold (P< 0 .01) increase from 3~6 months denervated muscles to innervated muscles ,11-fold (P< 0 .01) increase from 6~12 months denervated muscles to innervated muscles ,3~fold (P< 0 .01) increase from 1~2 year denervated muscles to innervated muscles .Conclusion The morphological alterations and changes in expression of caspase -3 indicated there was a high amplitude of apoptosis in denervated posterior cricoarytenoid muscles within 1 year .

The correlation of human papillomavirus and EB virus infection in nasopharyngeal carcinoma in Fujian / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the prevalence of human papillomavirus in nasopharyngeal carcinomas of Fujian province in China.@*METHOD@#Samples from 70 patients with NPC and 25 controls. All samples were detected HPV DNA by polymerase chain reaction (PCR) suing GP5+/6+ and MY09/11 primers and genotyped by surface plasmon resonance (SPR) and HPV 16/18 E6 and LMP-1 using immunohistochemistry and EBER using in situ hybridization.@*RESULT@#Only 2 cases of 70 patients were showed evidence of HPV DNA by PCR, the 2 HPV positive cases subtype HPV-70 and HPV-18 were genotyped by SPR, both the 2 HPV positive cases are non-keratinizing carcinomas (the HPV-70 positive one is differentiated and the HPV-18 positive one is undifferentiated), both the 2 HPV positive cases do not show any evidence of EBV. Data showed that 57 of 70 NPC detected EBER positive, but only 25 out of 70 NPC samples were detected LMP-1 positive.@*CONCLUSION@#Our study showed a low prevalence of human papillomavirus in NPC patients of Fujian province in Southern China, there is no evidence about HPV and EBV co-infection.

Risk factors analysis of local failure following radiotherapy and chemotherapy to nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyse the risk factors involved in local failure following radiotherapy and chemotherapy to nasopharyngeal carcinoma.@*METHOD@#A retrospective analysis was carried out to review the histopathological data from 308 NPC patients who recieved medical treatment between 2004 and 2006. The incidence and the risk factor for local treatment failure were evaluated in a model that included the following factors: sex, age, T and N staging, histological grade of primary tumor, presence of cervical lymph node metastasis, size and laterals of positive neck nodes, levels involved, ways of radiation and condition of concurrent chemotherapy. Univariate chi2 test and multivariate stepwise logistic regression model were used for the analysis. Statistical analysis of survival of patients with local residues and recurrence was performed using Kaplan-Meier method.@*RESULT@#Ninty-three cases (30.2%) presented local residues and recurrence in 308 patients of nasopharyngeal carcinomas. In the univariate analysis, it was confirmed that the following variables correlated to local failure, i. e., T staging (P < 0.01), N staging (P < 0.01), presence of cervical lymph node metastasis (P < 0.05), size and laterals of positive neck nodes (P < 0.05, respectively). In the multivariate analysis, the most ignificant risk factors for local failure were the T staging only. Kaplan-Meier analysis showed that overall survival rates of 71 NPC patients with local residues and recurrence who received re-treatment were 77.2% at 1 year, 40.4% at 3 years, 22.4% at 5 years, respectively.@*CONCLUSION@#T staging is the key risk factors in determining the development of local failure following radiotherapy or chemotherapy in NPC patients. Patients with primary tumor infiltrating bone have the higher risk of developing local residues and recurrence. Retreatment to the patients suffering from local failure can imrove survival rates.

Cancer stem cells promotes resistance of laryngeal squamous cancer to irradiation mediated by hypoxia / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study whether cancer stem cells promotes resistance of laryngeal squamous cancer to irradiation mediated by hypoxia.@*METHOD@#Hep-2 cells were respectively cultured in hypoxia and normoxia environment, and the express of HIF-la was detected by western blot. Then they were radiated with different doses of gamma-rays. After that we detected growth inhibition ratio with MTT assay, cell circle and ratio of CD133+ cells with Flow cytometry at different times.@*RESULT@#MTT assay showed that inhibition ratio of the hypoxia group was lower than that of the normoxia group after different doses of gamma-rays at each time point, and the difference was significant 24 h after 10 Gy irradiation (P < 0.05). The results of Flow cytometry demonstrated that cells of the two groups were arrested at G1 phase, and cells ratio in G1 phase of the hypoxia group was higher than that of he normoxia group after 10 Gy irradiation. The ratio of CD133-positive cells was higher in the hypoxia group than in the normoxia group after radiation, and difference was significant 24 h after 10 Gy irradiation (P < 0.05). In each group, the ratio of CD133-positive cells became higher after radiation than that before radiation (P < 0. 05).@*CONCLUSION@#We can conclude that cancer stem cells play an important role in radioresistance mediated by hypoxia.

Prognostic analysis of 45 cases of nasal natural killer/T-cell lymphoma / 中国综合临床

Objective To analyze the clinical characteristics, short-term and long-term outcome, overall survival and prognosis of nasal-type,natural killer T-cell lymphoma(NK/TCL) patients. Methods Clinical data of 45 patients with nasal NK/T cell lymphoma from Jan 2001 to Dec 2008 were analyzed retrospectively. Results The complete remission rate was 53.3% (24/45)and the partial remission rate was 17. 8% (8/45), the overall response rate was 71.1% (32/45). At a median follow-up of 15 months, the 1-year,3-year and 5-year survival rates were 68. 3% ,57. 1% ,and 43. 7% respectively. Multivariate analysis showed that B symptoms was independent prognostic factors of NK/TCL( P = 0. 001 ). Conclusions NK/TCL showed specific characteristics, and the long-term survival rate is still poor. Investigation of optional treatment is needed.

Repair of the surgical defect for stomal recurrence after total laryngectomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the indication and effect of primary repair of the defects for stomal recurrence after total laryngectomy. METHODS A total of 18 cases with stomal recurrence after total laryngectomy were performed operation.The defect of hypopharynx and cervical oesophagus was repaired with free forearm flap (n=5),free jejunual interposition(n=3),pectoralis major myocutaneous flap (n=1)and pharyngogastric anastomosis(n=2).The defect of skin was repaired with pectoralis major myocutaneous flap.RESULTS All pectoralis major myocutaneous flaps were viable. Pharyngeal fistula occurred in 4 cases,one of whom had been performed free jejunual interposition,2 had been performed free forearm flap,and one with fistula bleeding had been performed pharyngogastric anastomosis.All cases could swallow after operation. During follow-up for 6 to 74 months,swallow obstruction occurred in 3 cases.CONCLUSION The methods of repair for surgical defect of stomal recurrence after total laryngectomy should depend on the bound of stomal recurrence and therapeutic procedure of primary tumor.

Transcervico-mandibulo-palatal approach in salvage surgery of nasopharyngeal carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the surgical approach for recurrent or residual nasopharyngeal carcinoma after radiotherapy failure. METHODS The clinical data of 12 patients with recurrent or residualnasopharyngeal carcinoma after radiotherapy failure for salvage surgery were retrospectively analyzed. The 12 patients were underwent salvage surgery via transcervico-mandibulo-palatal approach. The residual and recurrent tumors were found in 2 and 10 patients (included 2 recurrent patients after re- radiation) after radiotherapy respectively. RESULTS The paranasopharyngeal region defects were repaired with submandibular gland flaps in 10 patients and with free inferior turbinate mucosal graft in 2 patients. All of the 12 patients were followed up for more than 2 years. Seven patients survived with no evidence of disease and one patient survived with tumor. Three patients died of local recurrence and one died of distant metastasis. The 2-year survival rate was 75 %. CONCLUSION Resection of the local recurrent nasopharyngeal carcinoma via transcervico- mandibulo-palatal approach provides wide field exposure of the central skull base. The tumors located in paranasopharyngeal region can be resected en bloc and the internal carotid artery can be identified by palpation under direct vision. The surgical defects can be repaired with submandibular gland flap. The transcervico-mandibulo-palatal approach is the suitable procedure for local recurrent nasopharyngeal carcinoma with less mortality and complications.

Role of preoperative ultrsonography in evaluating cervical metastasis in patients with differentiated thyroid carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the role ofpreoperative ultrasonograpy in detecting cervical lymph node metastasis. METHODS Medical records between February 1998 and February 2002,consisting of 51 cases (58 sides) of well-differentiated thyroid carcinoma with cervical lymph nodes metastasis, were reviewed. Patients were divided into 2 groups: group 1,34 cervical sides with palpable cervical lymph nodes preoperatively and group 2,24 cervical sides with impalpable nodes but positive for nodal metastasis ultrasonically. All patients underwent modified neck dissection. The preoperative ultrsonographic results and preoperative pathologic findings were compared. RESULTS Of the 58 sides with positive preoperative ultrsonographic results, 53 sides had been demonstrated to have cervical lymph nodes metastasis pathologically. The sensitivity of ultraonography was 91.4 %(53/58). Four patients had developed lateral cervical recurrence during the course of the follow-up, yielding a recurrence rate of 7.5 %. Ultrasonography detected cervical lymph node believed to be uninvolved by physical examination in 39.6 % of patients. The most frequent involvement site was middle neck according to ultrasonography [71.7 %(38/53)] and level Ⅲ according to pathological findings [67.9 %(36/53)]. CONCLUSION Preoperative ultrasonograpy is a basis for detecting cervical lymph nodes metastasis in thyroid cancer patients. It can detect metastatic cervical lymph nodes and their localizations. All thyroid cancer patients should undergo preoperative ultrasonography.