Analysis of the human papillomavirus in laryngeal squamous cell carcinoma patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyze the infection of human papillomavirus in laryngeal squamous cell carcinoma patients.</p><p><b>METHODS</b>The pathological samples of 64 clinical diagnosed laryngeal squamous cell carcinoma patients were collected. Lunimex and PCR techniques were used to detect the HPV gene infection and immunohistochemistry method was used to analyze the HPV protein expression in the samples.</p><p><b>RESULTS</b>In the 64 cases, 7 were positive for HPV infection by Luminex and PCR tests. 18 were positive for HPV16/18 E6 protein expression. The total positive rate was about 39. 1%.</p><p><b>CONCLUSION</b>The high HPV infection rate in laryngeal squamous cell carcinoma patients in the study indicated indirectly that the importance of the HPV infection in pathogenesis of the laryngeal squamous cell carcinoma.</p>

The analysis of human papillomavirus infection in lip squamous cell carcinoma patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyze the infection of human papillomavirus in lip squamous cell carcinoma patients.</p><p><b>METHODS</b>The pathological samples of 9 clinical diagnosed lip cancer patients were collected. Lunimex and PCR techniques were used to detect the HPV gene infection and immunohistochemistry method was used to analyze the HPV protein expression in the samples.</p><p><b>RESULTS</b>In the 9 cases, 1 was positive for HPV16 gene and 7 were positive for HPV16/18 E6 protein expression. The total positive rate was about 8/9.</p><p><b>CONCLUSION</b>The high HPV infection rate in lip cancer patients in the study indicated indirectly that the importance of the direct contact to the infection of HPV what was the basis for pathogenesis of the lip squamous cell carcinoma.</p>

Evaluation of the function of autotransplanted parathyroid tissues / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the function autotransplanted parathyroid tissues in thyroid surgery.</p><p><b>METHODS</b>The control group comprised 120 volunteers with normal parathyroid glands in whom serum parathyroid hormone (PTH) levels in blood samples taken from the bilateral elbow head veins. The experimental group comprised 34 patients in whom the parathyroid glands, which were mistakenly cut or could not be preserved during thyroid surgery because of ischemia, were fragmented and autografted into the brachioradialis muscle of the nondominant forearm. On the day of surgery and at 3 days, 7 days, and 2 months postoperatively, contrast imaging and detection of serum PTH levels were performed to evaluate the function of the transplanted parathyroid tissues.</p><p><b>RESULTS</b>In the control group, the mean value of the difference between the bilateral brachiocephalic vein PTH levels was (1.19 ± 0.98) ng/L (maximum 4.52 ng/L). In this study, twice the maximum value (9.04 ng/L) was taken as the effective standard. Based on the 9.04 ng/L effective value, the effective number was 26 patients and the effective rate was 76.5% at 2 months postoperatively in the 34 patients of the experimental group.</p><p><b>CONCLUSIONS</b>The autotransplanted parathyroid tissues showed their functions in most patients, therefore, parathyroid gland autotransplantation is an effective method of preserving function of parathyroid glands that are free or severely ischemic in thyroid surgery.</p>

Salvage central neck dissection for papillary thyroid cancer / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the salvage central neck dissection (CND) for papillary thyroid cancer in the patients with suspicious residual positive lymph nodes in the central compartment.</p><p><b>METHODS</b>A total of 85 cases undergoing salvage CND between January 2006 to January 2009 was reviewed.</p><p><b>RESULTS</b>Fifty-nine (69.4%) of the 85 patients showed residual positive lymph nodes in the central compartments. The number of dissected lymph nodes for each dissection ranged 2 - 13 nodes, with an average of 5.7 nodes. A total of 159 positive lymph nodes were found in the 59 cases, with an average of 2.7 positive nodes in each case. Four of 6 patients who underwent initial CND in other hospitals were found with residual positive nodes in the central apartments. The incidence of postoperative complications for the salvage CND was 10.6% (9/85), of them 5 cases with hoarseness, 2 cases with transient hypoparathyroidism, 1 case with postoperative bleeding, and 1 case with subplatysmal effusion. The median of follow-up after salvage CND was 44 months (3 - 5 years), showing contralateral central recurrence in 1 case, lateral neck recurrence in 4 cases, lung metastasis in 1 case, and no death case.</p><p><b>CONCLUSIONS</b>Salvage CND should be done for those patients without undergoing initial CND but with positive nodes found after thyroidectomy or the high risks (T3, T4, extra thyroid extension, residual in primary site, and vascular or lymphatic vessel invasion); and also for those patients with initial CND but insufficient extent.</p>

Selective neck dissection in clinical node positive low risk papillary thyroid cancer patients / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the improvement of modified radical neck dissection in clinical node positive (cN(+)) low risk papillary thyroid cancer patients.</p><p><b>METHODS</b>Seventy-one cases of papillary thyroid cancer with cN(+) underwent selective neck dissection (IIa, III, IV) from 2007 to 2010 were reviewed, including 10 men and 61 women. All patients were at stage I, including 15 T1, 46 T2, 10 T3. Twenty-six patients were found Positive nodes were found by palpation in 26 cases and by ultrasonagraphy in 45 cases.</p><p><b>RESULTS</b>Cervical lymph node metastasis were confirmed pathologically in 63 cases, with metastatic rate of 88.7%; 100% in cN(+) cases by palpation and 82.2% in cN(+) cases by ultrasonagraphy, respectively. Metastatic nodes existed in one level in 13 cases, two levels in 31 cases, and three levels in 19 cases. Recurrence occurred to 4 patients during follow up, with a recurrent rate of 5.6%, and 2 cases of them were found recurrence in the anterior part of Vb, 2 cases in the carotid sheath.</p><p><b>CONCLUSION</b>Selective neck dissection (IIa, III, IV) is acceptable for cN(+) low risk papillary thyroid cancer patients, which can decrease complications in neck and shoulder greatly.</p>

Use of en bloc principle in re-operation of thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The study is to explore the extent, main-point and use of en bloc principle in re-operation of thyroid carcinoma.</p><p><b>METHODS</b>Clinical data of 75 patients received re-operation from 2002 to 2006 because of nonstandard operation were reviewed, including 10 men, 65 women, age ranging from 21-56. Ipsilateral completing lobectomy, isthmectomy, ipsilateral anterior cervical muscle, and level VI dissection were done in all the patients by en bloc principle.</p><p><b>RESULTS</b>Residual tumor was found in 39 cases. There were, 10 in primary site, 8 in VI level, and 21 in both. Therefore tumor residual rate was 52.0%. The total metastatic lymph nodes in VI level were 63. Among the eight patients with recurrent laryngeal nerves paralyses which were hurt in the first operation, 4 were found been cut completely, 4 were ligated. The ligated locations were all near the place which the nerve enter the larynx. The ligated nerves were released, and the patients voice was improved greatly.</p><p><b>CONCLUSIONS</b>Ipsilateral completing lobectomy, isthmectomy, ipsilateral anterior cervical muscle and VI level dissection is adequate for thyroid carcinoma patients who received nonstandard operation. The principle of en bloc resection can be used in the reoperation of thyroid carcinoma.</p>

Parotidectomy of deep-lobe tumors / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate advantages of the superficial lobe preservation in the parotidectomy of deep-lobe tumors, which include much lower incidence in postparotidectomy depression, variable aesthetic deformities, facial nerve injury and Frey's syndrome.</p><p><b>METHODS</b>This retrospective review included 114 patients with benign parotid gland tumors hospitalized from 2001 to 2004, among which 13 patients with deep-lobe parotid tumors and 101 patients in the superficial lobe of parotid gland. Seven in the 13 patients with deep-lobe tumors were operated with the method of the superficial lobe preservation.</p><p><b>RESULTS</b>During median 3 years and 3 months following-up, no any cases with either tumor recurrence, permanent facial nerve injury, postparotidectomy depression, or Frey's syndrome was found in the 7 operated patients. Only 1 case with the facial nerve marginal mandibular branch palsy occurred, but completely recovered over a 3-month period of time.</p><p><b>CONCLUSIONS</b>Preservation of the superficial lobe for deep-lobe tumors parotidectomy could decrease the incidence of parotidectomy complications without any influence in the treatment effect. Additionally, the parotid function preservation and cosmetic appearance after operation also satisfy both the patients and surgeons.</p>