Mutation and abnormal expression of FHIT gene in hypopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the mutation and abnormal expression of the FHIT gene in human hypopharyngeal carcinoma.@*METHOD@#Matched normal and cancerous tissues from 24 patients with hypopharyngeal squamous cell carcinoma were obtained immediately after surgery. Total RNA was extracted, the FHIT gene was detected by nested RT-PCR and DNA sequencing technology.@*RESULT@#Normal sized FHIT transcript was detected in 23 of the 24 cases of normal matched tissues. Aberrant FHIT transcripts were found in 9/24 (37.5%) cases in hypopharyngeal carcinoma. Aberrant FHIT transcripts rate of well-differentiated, moderately differentiated and poorly differentiated squamous cell carcinoma, was 28.6% (2/7), 50.0% (4/8) and 33.3% (3/9), respectively. There the carcinoma with FHIT aberrant transcripts was neither corresponding to histological grade (P>0.05) nor to lymphatic metastasis. The sequence analyses of the two aberrant cDNAs revealed absence of exon 8 and exon 7-9. All initial deletion were in conjunction of exons.@*CONCLUSION@#High deletion rate of the FHIT gene in Chinese hypopharyngeal squamous cell carcinoma suggested the FHIT gene, a candidate tumor suppressor gene at 3p14.2, plays an important role in the tumor carcinogenesis, development and progression of the tumor, and thus may become a new prognostic marker in hypopharyngeal carcinoma.

Reconstruction of oropharyngeal defects after resection of tonsillar cancer / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the methods and curative effects of reconstruction of oropharyngeal defects after resection of tonsillar cancer. METHODS Nineteen patients with tonsillar cancer underwent operation. The choice of surgical procedure was decided on the size of the lesions. The tumor was resected through the hyoid approach and mandibular swing approach. Surgical defects were repaired immediately with tongue flap, temporalis myofascial flap, pectoralis major myocutaneous flap. RESULTS The functions of respiration, chewing, deglutition, and speech were restored satisfied in all patients. Partial necrosis of the pectoralis major myocutaneous flap occurred in one patient, and mild difficulty of open mouth in 3 patients after repaired with temporalis myofascial flap. CONCLUSION Choosing what is optimum from multiple feasible surgical methods is prerequisite for better oropharyngeal function and quality of life in patients with tonsillar cancer.

Preservation of laryngeal function in surgery for medial wall pyriform sinus cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the feasibility, surgical technique and results of laryngeal function preservation in surgical treatment for medial wall pyriform sinus cancer.</p><p><b>METHODS</b>From 1992 to 1999, 31 patients with medial wall pyriform sinus cancer including stage I 1, II 4, III 14 and IV 12 lesions were treated. Partial resection of pyriform sinus and partial laryngectomy were performed, then, the remains of epiglottis and uni-pedicled sternohyoid myofascial flap were used to restore the defects of larynx. At last, the remaining hypopharyngeal mucosa was sutured to cover the wound of hypopharynx and for artificial rebuild-up. All patients received postoperative radiotherapy.</p><p><b>RESULTS</b>The 3- and 5-year survival rates were 62.1% and 43.6% respectively, with 77.4% patients having laryngeal functions (voice, respiration and deglutition) completely restored and 32.6% partially restored (voice and deglutition).</p><p><b>CONCLUSION</b>Conservative surgery so introduced is feasible for selected medial wall pyriform sinus cancer patients with the lesion completely resected.</p>

Surgical management of supraglottic laryngeal carcinoma in 182 patients with special emphasis on functional preservation / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the surgical methods and evaluate the long-term result of laryngectomy in patients with supraglottic laryngeal cancer.</p><p><b>METHODS</b>182 patients with supraglottic laryngeal carcinoma underwent operation from 1979 to 1999, with stage I 11, stage II 45, stage III 49 and stage IV 77 lesions. The choice of surgical procedure was decided with the disease condition of the larynx. The surgical procedures proposed by TD Wang were adhered to as: minor partial laryngectomy 36, major partial laryngectomy 85, subtotal partial laryngectomy with laryngoplasty 22 and total laryngectomy 39.</p><p><b>RESULTS</b>The ultimate rate of larynx preservation was 78.6% (143/182) with 69.8% (88/126) in stage III and IV diseases. The decannulation rate was 81.8% in cases with preservation of laryngeal function. The overall 3- and 5-year survival rates were 82.9% and 67.3%, with 76.88% and 57.4% in the advanced (stage III and IV) cases who survived with preserved laryngeal function. They were 82.5% and 67.0% in similar advanced cases who were treated by total laryngectomy. The difference in the survival rates between these two groups was not statistically significant.</p><p><b>CONCLUSION</b>It is suggested that preservation of the laryngeal function be possible for advanced supraglottic laryngeal carcinoma without compromising the remote survival rate. To improve the rate of larynx preservation, one should follow the surgical methods suggested.</p>

Relationship between polymorphism of N-acetyltransferase 2 and genetic susceptibility to laryngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the relationship between polymorphism of N-acetyltransferase (NAT2) gene and genetic susceptibility to laryngeal carcinoma.</p><p><b>METHODS</b>A case-control study on 62 laryngeal carcinoma patients and 56 controls was conducted. NAT2 alleles were differentiated by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) methods using originally created PCR primers and genomic DNA extracted from peripheral white blood cells. Genetic risk for NAT2 genotype was analyzed by smoking index (SI, cigarettes smoked per day x years of smoking).</p><p><b>RESULTS</b>The frequency of NAT2 slow genotype was 80.6% in patients with laryngeal carcinoma and 60.7% in the controls, the difference of which was statistically significant (chi(2) = 5.70, P = 0.017). The odds ratios were 2.70 (95% CI 1.19 approximately 6.11). Among the individuals with NAT2 slow genotype at high level of cigarette smoking, there was a significantly higher risk of 5.64 (95% CI 1.77 approximately 17.92), while those at low level were considered the reference group (OR 1.38, 95% CI 0.42 approximately 4.52).</p><p><b>CONCLUSION</b>NAT2 slow genotype increases the risk of susceptibility to laryngeal carcinoma. The combined effect of NAT2 slow genotype and exposure to smoking is observed during the development of laryngeal cancer.</p>

Clinical studies on sternocleidomastoid myoperiosteal flap for cervical tracheal reconstruction / 临床耳鼻咽喉头颈外科杂志

Objective:To introduce the experience of repairing the defect of cervical trachea wall by using the sternocleidomastoid myoperiosteal flap after the anterior or posterior wall of cervical trachea was invaded by cervical neoplasm. Method:Between 1989 to 1998 the sternocleidomastoid myoperiosteal flap was applied in 12 patients with different diseases, among which 3 cases were thyroid carcinoma, 5 cases were laryngeal carcinoma, 4 cases were cervical esophageal carcinoma. Result:The operation was successful. 12 patients were decannuated and had normal exercise tolerance. The time from reconstruction to decannulation was ranging from 20 days to 6 months. Conclusion: The sternocleidomastoid myoperiosteal flap is an ideal transplant for cervical tracheal reconstruction.

Measurement of microvessel density in laryngeal carcinoma and its clinical significance / 临床耳鼻咽喉头颈外科杂志

Objective:To determine the microvessel density (MVD) in laryngeal carcinoma and its clinical significance.Method:Thirty-eight tumor specimens were selected from laryngeal cancer patients from January,1994 to March,1996.Histological sections of the tumors were stained immunohistochemically for factor Ⅷ.Using light microscopy,we counted microvessels per 400×field in the most active areas of tumor angiogenesis.Result:①The tumor blood vessels,composed of only one layer of endothelium were mainly distrbuted heterogenously in the interstitial tissue of laryngeal carcinoma with irregular lumen,poorly developed structure.②The MVD in the cancer tissues were statistically higher than that in peritumoral tissues (P＜0.01).③The MVD in the cancer tissues in group of patients with metastasis to cervical lymphonodes were statistically higher than in group without metastasis (P＜0.01),the MVD in the cancer tissues in group of advanced cases (Ⅲ,Ⅳ stages) were statistically higher than that in group of early cases (Ⅰ,Ⅱ stages,P＜0.01).④There was no statistically difference in MVD in the cancer tissue between supraglottic and glottic laryngeal carcinoma patients (P＞0.05).⑤There was no statistically difference in MVD in the cancer tissue among the G1,G2 and G3 group (P＞0.05).Conclusion:The laryngeal cancer blood vessels have some characteristics that don′t appear in normal vessels.It is suggested that tumor angiogenesis can promote tumor growth and metastasis and MVD may be a new prognostic indicator of laryngeal carcinoma.

Prognostic significance of CD57+ cell level and pTNM staying system in patients with laryngeal cancer / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the prognostic value of the pTNM clinical staying system,as well as the CD57+ cells level in peripheral blood samples of the patients with laryngeal carcinoma.Method:The CD57+ cells level of peripheral blood was determined with SAP method in 34 patients with laryngeal carinoma and 16 normal subjects.The pTNM clinical stage was T1-2in 13,T3-4 in 21;pN+ in 10, pN0 in 24;supraglottis in 8,glottis in 23;hypoglottis in 3;pathologic differentiation G1 in 11,G2,3 in 23.Result:The CD57+ cells level significantly increased (pN+ vs.pNO).In the 12nd month actual survival were significantly different (T1,2 vs.T3,4,pN0 vs.pN+,G1 vs G2、3,supraglottis vs.glottis and hypoglottis,CD57+≥15% vs.CD57+＜15%).In the 24th month and 36th month actual survival were significantly different (pN0 vs.pN+,G1 vs G2、3,supraglotisvs.glottis and hypoglottis,CD57+≥15% vs.CD57+＜15%).In the 48th month actual survival were significantly different only (pN0 vs.pN+,supraglottis vs.glottis and hypo glottis,CD57+≥15% vs.CD57+＜15%).Conclusion:These results suggested that the assessment of pTNM system and the CD57+ cells level have significance for prognosis of patients with laryngeal carcinoma.