Clinical analysis of 10 cases with extramedullary plasmacytoma of the head and neck / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the clinical characteristics, treatment methods and outcomes of extramedullary plasmacytoma of the head and neck. Methods: A retrospective analysis was conducted on 10 cases with extramedullary plasmacytoma of the head and neck who were admitted to Henan Tumor Hospital from January 2005 to January 2020. Among the 10 patients, 6 were male and 4 were female. The average age at diagnosis was 56.3 years old (34-74 years old). Among them, 3 cases were located in the nasal cavity, 2 cases in the nasopharynx, 1 case in the sinuses, 2 cases in the larynx, 1 case in the oropharynx, and 1 case in the cervical lymph nodes. Treatments were administered according to tumor size and resection extent. Complete surgical excision (negative margins) was preferred, followed by adjuvant radiotherapy or radiotherapy alone. The clinical characteristics, diagnosis, treatment and prognosis of EMP were analyzed. Results: The patients' symptoms were not specific, frequently with local obstruction symptom and localized masses. All patients were confirmed pathologically as suffering from monoclonal plasmacytoma, with negative bone marrow biopsy and negative skeletal survey. Five patients received surgery, 3 received radiotherapy, and 2 received surgery with additional radiation. The follow-up time was 16-125 months, with a median of 92 months. Two patients developed into multiple myeloma. One patient who received radiotherapy after surgery relapsed after 7 years of follow-up and again received surgical treatment, with no evidence of second recurrence. The remaining patients had no recurrence or progression. Conclusion: Extramedullary plasmacytoma of the head and neck has a good prognosis. Surgical treatment can be considered for completely resectable lesions.

Mitochondrial DNA mutations in gastric endothelial cells induced by extract of helicobacter pylori in vitro / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the helicobacter pylori (HP) infection and the genetic instability of mitochondrial DNA (mtDNA) in human gastric adenocarcinoma epithelial cells (AGS).</p><p><b>METHODS</b>After treated with extracts of HP11638 (CagA+, VacA+) or Hp11638 mutant strain (CagA+, VacA-), AGS cells were collected, and mitochondrial DNA was extracted and Cox-I, Cox-II, Cox-III, ATPase6, ATPase8 and Cytb genes and the D-Loop region were amplified by PCR and then sequenced.</p><p><b>RESULTS</b>The mutation rates of the mtDNA in AGS cells were correlated with the extracts of the two HP strains in a concentration- and time-dependent manner. But the mtDNA mutation rate in AGS cells treated with the HP11638 extract was higher than that treated with the Hp11638 mutant extract. Total of 616 mutations in D-Loop region were detected, including 489 point mutations, 81 insertions and 46 deletions. Among them, 70.9% (437/616) belonged to GC to AT and AT to GC transition. Seventeen out of 20 (85%) AGS cells treated with extract of HP had mutations in 303PolyC, 16184PolyC and 514CA regions of mtDNA D-Loop. No mutation was detected in Cox-I, Cox-II, Cox-III, ATPase6 and ATPase8 genes, three point mutations were found in the Cytb gene.</p><p><b>CONCLUSION</b>HP can cause the accumulation of mutations in mtDNA, in particular, in the D-Loop region, and the VacA participated in the process.</p>

Experience of surgical treatment for cervical esophageal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of surgical treatment for cervical esophageal carcinoma.</p><p><b>METHODS</b>Clinical and follow-up data of 82 patients with cervical esophageal carcinoma undergone surgical treatment in Henan Provincial Cancer Hospital from Dec. 1993 to Dec. 2005 were analyzed retrospectively. The difference of the therapeutic regimen and 5-year survival rate of these patients were evaluated.</p><p><b>RESULTS</b>Before 1997, patients mainly underwent surgical therapy solely (27 cases). After 1997, 50 cases received surgical therapy following neoadjuvant radiotherapy (multimodality group), except 5 early-stage cases received surgical therapy solely. Seventy-three patients underwent esophagectomy without thoracotomy, including 21 cases of invert-stripping of the esophagus, and 52 cases of blunt denudation of esophagus. Nine patients underwent transthoracic esophagectomy. Concurrent monolateral or bilateral cervical lymph node dissection accounted for 14 cases and combined organ resection 12 cases. No serious hemorrhage and tracheal or bronchial tearing occurred. No hospital death occurred. Postoperative complications were found in 14 patients, and the incidence of complication was 19.5%. In sole surgery group, upper incised margins of 5 patients were confirmed to be positive. The laryngeal function of 26 patients in sole surgery group was preserved, while 47 patients in multimodality group preserved. Lymph node metastasis occurred in 14 cases, including 13 cases cervical lymph node metastasis (monolateral 9, bilateral 4) and 1 case of upper mediastinal lymph node metastasis. During follow-up, 3 patients were lost. The total 5-year survival rate was 43%. The patients in multimodality group had higher 5-year survival rate as compared to those in sole surgery group. (50.2% vs 33.9%,chi(2 )=7.17,P=0.007). The 5-year survival rates of patients with transthoracic esophagectomy, esophagectomy plus concurrent monolateral or bilateral cervical lymph nodes dissection or combined organ resection were 36.5%, 45.8% and 33.3% respectively. All the 5-year survival rates of these subgroups were lower as compared to multimodality group.</p><p><b>CONCLUSIONS</b>For patients with early stage cervical esophageal carcinoma and with proximal end of residual normal esophagus longer than 2 cm, the optimal therapy should be surgery. For most of the patients, surgery combined with neoadjuvant radiotherapy is the ideal therapeutic strategy, which can lower the risk of positive revised margin, improve the possibility of preserving the laryngeal function and result in the improvement of 5-year survival rate. Esophagectomy without thoracotomy should be preferred. Combined organ resection or bilateral lymph node dissection should be chosen carefully because these operating procedures may lead to severe injury and function lose.</p>

Childhood and adolescent thyroid carcinoma: a clinical analysis of 86 cases / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinico-pathologic characteristics, treatment and prognosis of thyroid carcinoma in childhood and adolescents.</p><p><b>METHODS</b>From 1984 to 1997, 86 cases with thyroid carcinoma in childhood and adolescent treated were summarized.</p><p><b>RESULTS</b>All cases underwent operation with adjuvant therapy. Pathologically, papillary carcinoma was diagnosed in 73 (84.9%), follicular carcinoma in 6 (7%), papillary-follicular carcinoma in 4 (4.7%) and medullary carcinoma in 3 (3.5%). Cervical lymph node metastasis was found in 59 cases (68.6%), 16 of which with both thyroid carcinoma and bilateral cervical lymph node metastasis (27.1%). Lung metastasis was found in 11 cases. Recurrence occurred in 6 cases after operation. Compared with the thyroid carcinoma in adult patients, cervical lymph node metastasis, bilateral involvement of the thyroid gland with bilateral cervical nodes and lung metastasis rate were more commonly seen in childhood and adolescence. All but 2 patients had been followed up for more than 5 years, 41 patients for more than 10 years. The 5-year and 10-year survival rate was 95.3% (82/86) and 87.8% (36/41), respectively.</p><p><b>CONCLUSION</b>The clinical manifestations of childhood and adolescent thyroid cancer are generally not pathognostic which may lead to misdiagnosis. Surgery is the main method in the comprehensive treatment with a good prognosis. The therapy with (131)I after operation was beneficial for some patients accompanied with lung metastasis.</p>