Meta-analysis of comparison for efficacies between surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced hypopharyngeal cancer / 中华耳鼻咽喉头颈外科杂志

Objective@#Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT).@*Methods@#We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software.@*Results@#A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01).@*Conclusions@#SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.

Concept and clinical application of surgical margin principle on head and neck cancers / 中华耳鼻咽喉头颈外科杂志

Surgical margin principle is one of the central surgical principles for head and neck cancers. Negative surgical margin is the primary purpose of surgery for head and neck cancers. This paper is based on the current clinical application of surgical margins of head and neck cancers, and it is proposed that surgical margins of head and neck cancers may be classified into three types: surface margin, deep margin, and tissue interface margin in consideration of surgical exposure of tumors. The classification of surgical margins can make the clinical application and the research of surgical margins of head and neck cancers more systematic and clear.

Postoperative reconstruction of facial squamous cell carcinoma by cervicothoracic flap and temporal flap: a case report / 临床耳鼻咽喉头颈外科杂志

To report one case of postoperative reconstruction of facial squamous cell carcinoma by cervicotho-racic flap and temporal flap in our hospital. Clinical symptoms of the patient are facial mass and tumor ulceration.The patient had chronic bronchitis. On admission, the right side of the patient face was found to have a mass of about 6. 5 cm X 5. 0 cm, and the middle is about 2. 5 cm X 2. 5 cm X 1. 0cm ulcer, the neck has no swollen lymphnodes by palpation. After imaging and pathological examination,the patient was diagnosed as right facial squamouscell carcinoma and chronic bronchitis.

Effect of CD14 promoter variants on the susceptibility to laryngeal cancer / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of -260C>T and -651C>T genetic variants in the promoter region of CD14 on the susceptibility to laryngeal cancer.</p><p><b>METHODS</b>A total of 163 patients with laryngeal cancer and 326 healthy subjects as controls were included. Genotypes of CD14 -260C>T (rs2569190) and -651C>T (rs5744455) variants were determined by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP). Odd ratios (OR) and 95% confidence intervals (95%CI) were calculated with logistic regression analysis.</p><p><b>RESULTS</b>Compared with CD14 -651CC genotype carriers, -651TT genotype carriers had the increased risk of laryngeal cancer with the OR (95%CI) of 5.79 (2.38-14.11). When the -651TT genotype carriers were stratified by smoking status, the OR (95%CI) for laryngeal cancer was 8.64 (1.88-39.77) in nonsmokers and 4.74 (1.69-13.25) in smokers; the OR (95%CI) was 5.40 (1.10-26.45) in the light smokers and 4.30 (1.10-16.75) in the hevey smokers. When the -651TT genotype carriers were stratified by drinking status, the OR (95%CI) for laryngeal cancer was 6.48 (2.81-14.95) in nondrinkers and 2.01 (0.65-6.26) in drinkers. There was no significant difference in CD14 -260C>T genotype distribution between patients and controls.</p><p><b>CONCLUSION</b>Polymorphisms of -651C>T in CD14 promoter contribute to the susceptibility to laryngeal cancer in Chinese population.</p>

Anterolateral thigh flap, a better flap for reconstruction of hypopharyngeal and cervical esophageal defects / 临床耳鼻咽喉头颈外科杂志

Because of minimal donor site morbidity, adequate tissue, excellent clinical and functional results, the anterolateral thigh flap has become one of the most important tissue flaps which are used to repair the defects of head and neck. Generally, anterolateral thigh flap is mainly used to repair the maxillofacial defects in head and neck surgery. However, the anterolateral thigh flap is a better tissue flap for reconstruction of hypopharyngeal and cervical esophageal defects.

Surgical treatment for primary papillary thyroid cancer: a Meta-analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess and compare the two procedures, total thyroidectomy (TT) and partial thyroidectomy (PT), for papillary thyroid cancer in terms of associated injuries, postoperative complication, recurrence rate and survival, so as to provide a reference and basis for surgical procedure option of this disease.@*METHOD@#Strictly specified into the exclusion criteria, the combination of computer retrieval and manual retrieval and retrieval systems such as CNKI, Wang Fan, PubMed, central, CBM database. Total thyroidectomy and partial thyroidectomy for the treatment of patients with thyroid papillary cancer related literature were compared, with the retrieval time until December 31, 2013.@*RESULT@#According to the retrieval strategy 4630 literatures were found, and 20 witch matched the exclusion criteria were left, all were retrospective study. TT and PT group of recurrent laryngeal nerve injury rate are 5.9%, 2.0% respectively [OR = 0.39, 95% CI (0.17 - 0.90), P < 0.05], TT and PT group of parathyroid injury rate are respectively 4.9%, 0.8% respectively [OR = 0.23, 95% CI (0.08 - 0.68), P < 0.01]. The TT group of 10 years survival rate is 95.24% - 100%, and the PT group is 96.8% - 99.2% [OR = 0.03, 95% CI (0 - 0.34), P < 0.01]. Unstaged, unstaged TT group' postoperative recurrence rate is 4.7%, while PT group is 12.6% [OR = 3.21, 95% CI (1.57 - 6.57), P < 0. 01]. Postoperative recurrence of stage I TT group and PT group are 4.9%, 7.8% respectively [OR = 3.82, 95% CI (1. 07-13.66) P < 0.05]; The rate of stage II TT group is 0.5%, while the rate of PT group is 15.9% [OR = 17.23, 95% CI (4.03 - 73.73), P < 0.01].@*CONCLUSION@#Different methods of primary thyroid papillary carcinoma surgical treatment can all obtaina good survival, but the rate of laryngeal recurrent nerve injury and parathyroid injury caused by partal throidectomy is relatively lower. As a result, partial thyroidectomy can be a good choice for early stage thyroid papillary carcinoma.

The expression and clinical significance of Bax and PHF20 in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of Bax and PHF20 in laryngeal squamous cell carcinoma (LSCC)and to discuss their relevance and the roles in carcinogenesis and development in LSCC.@*METHOD@#The expressions of Bax and PHF20 in the LSCC tissues and normal mucosa tissues adjacent to carcinoma were detected by SP immunohistochemistry assay. The relationship between the expressions of Bax and PHF20 and the clinicopathological characteristics including clinical stage, pathological type, histological grade and lymph node metastasis in LSCC were analyzed according to the clinical data.@*RESULT@#(1) The expressions of Bax and PHF20 were both significantly lower in the LSCC tissue than that in the normal laryngeal tissue (P 0.05). In histological differentiation grouping, the quantity and positive rate of Bax and PHF20 expressions decreased significantly in poorly differentiated LSCC compared with the well and moderately differentiated LSCCs (P < 0.01, P < 0.05, respectively). In T stage grouping, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in T1 + T2 compared with T3 +T4 (both P < 0.01). In addition, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in LSCC with lymph node metastasis compared to that without lymph node metastasis (both P < 0.01).@*CONCLUSION@#The lack of Bax and PHF20 might contribute to the carcinogenesis and development in LSCC. The positive expression of Bax and PHF20 maybe relative to T term degree, differentiation degree and lymphamatic metastasis of LSCC.

Relationship between vasculogenic mimicry and clinic pathological features in laryngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the presence of vasculogenic mimicry in laryngeal squamous cell carcino- ma and explore its clinical significance.@*METHOD@#The presence of vasculogenic mimicry and expression of endotheli- um-dependent vessel in 138 laryngeal squamous cell carcinomas cases were detected by the immunohistochemistry and tissue microarray. Metlab software was used to evaluate the relationship among vasculogenic mimicry, mi- crovessel density and clinic pathological parameters in laryngeal carcinoma.@*RESULT@#We found vasculogenic mimicry in 32 (26.23%) of 122 laryngeal carcinoma samples. The mean of microvessel density is 12.61 per high-power field. The vasculogenic mimicry and expression of endothelium-dependent vessel were not significantly related to patient age or gender, tumor location, pathology grade, T stage or N stage (P > 0.05). However, the vasculo- genic mimicry and the mean of microvessel density were a little higher in patients older than 60, with poorly differ- entiated and patients with N₁₋₃ stage. Vasculogenic mimicry was positively correlatedwith microvessel density (r = 0.1927, P < 0.05).@*CONCLUSION@#Vasculogenic mimicry can occur in laryngeal carcinoma. Moreover, vasculogenic mimicry may be associated with recurrence and metastasis in laryngeal carcinoma.

Expression and significance of PTEN and HIF-1α proteins in sinonasal inverted papilloma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and clinical significance of phosphatase and tensin homology deleted on chromosome ten (PTEN) and hypoxia-inducible factor 1 alpha (HIF-1α) in sinonasal inverted papilloma (SNIP) of different pathological grades.</p><p><b>METHODS</b>Fifty-five paraffin samples from patients with SNIP and a control group of 10 paraffin samples of patients with normal nasal cavity mucosa (NM) who underwent inferior turbinectomy were consisted in this study. Among the 55 cases of SNIP, 30 cases were without dysplasia subtypes, 11 cases were with dysplasia subtypes, and 14 cases with canceration to squamous cell carcinoma (SCC) subtypes. PTEN and HIF-1α expression in SNIP was detected by immunohistochemistry. The differences between NM and SNIP, and among the three subtypes were analyzed, and the relationship between PTEN, HIF-1α expression and SNIP recurrence and the correlation between PTEN expression and HIF-1α expression were also analyzed. SPSS 16.0 software was used to analyze the data.</p><p><b>RESULTS</b>The positive expression rate of PTEN in NM and SNIP was 100% and 65.5%, the difference was significant (U = 147, P = 0.014), while HIF-1α was 0 and 30.9%, the difference was significant (U = 190, P = 0.045). The positive expression rate of PTEN in SNIP without dysplasia, SNIP with dysplasia and NSCC was 83.3%, 63.6%, 28.6%, respectively, the difference was significant (H = 12.644, P = 0.002); while HIF-1α was 16.7%, 45.5%, 50.0%, respectively, the difference was significant (H = 8.292, P = 0.016). A total of 22 SNIP patients recurred. PTEN had lower expression in recurrent SNIP (45.5%) than that in non-recurrent SNIP (82.8%), and the difference was significant(χ² = 7.834, P = 0.005). However, the expression of HIF-1α had no significant difference between recurrent SNIP and the SNIP which had no recurrence (χ² = 0.901, P = 0.343). The expression of PTEN protein was negatively correlated with that of HIF-1α protein (r = -0.503, P = 0.001).</p><p><b>CONCLUSIONS</b>PTEN expression decreased graduately with the severity of malignancy of SNIP, but HIF-1α increased. The expression of HIF-1α was induced by hypoxia, which may negatively effect the expression of PTEN, and both HIF-1α and PTEN may play critical roles in the progress of SNIP. PTEN is one of the factors responsible for the postoperative recurrence of SNIP.</p>

Expression of cancer stem cell marker USP22 in laryngeal squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of cancer stem cell marker USP22 in laryngeal squamous cell carcinoma (LSCC) and clinical implications.</p><p><b>METHODS</b>The expression of USP22 was detected by immunohistochemistry in LSCC tissues of 64 cases and squamous epithelium tissues beside carcinoma of 26 cases (control). The correlation of USP22 expression with various clinicopathologic factors was evaluated with the single factor analysis.</p><p><b>RESULTS</b>The expression levels of USP22 in LSCC and control were 57.8% and 19.2% (P < 0.05). Clinicopathological analysis showed that USP22 expression level had a relationship with clinical stage, T stage, and lymph node metastasis (P < 0.05), but not with gender, age, smoking and differentiation (P > 0.05). Survival analysis showed that patients with high USP22 expression had significantly poorer outcome compared with patients with low USP22 expression. The survival was related to clinical stage, T stage, and lymph node metastasis, but not with age, sex, and smoking (P > 0.05).</p><p><b>CONCLUSIONS</b>The expression of USP22 is significantly increased in LSCC, which correlates with the malignant degree, invasion, metastasis and prognosis of LSCC. USP22 may be served as a new candidate molecular marker and therapeutic target of LSCC.</p>

Expression and clinical significance of NY-ESO-1 protein in human laryngeal squamous carcinoma / 肿瘤研究与临床

Objective To detect the expression of Cancer-Testis antigen NY-ESO-1 in human laryngeal squamous carcinoma (LSC) and to explore its significance in immunotherapeutic application. Methods The expressions of NY-ESO-1 protein in the LSC and in the pathologically positive lymph nodes were detected by PV-9000 Immunohistochemistry. Western blotting was also employed to measure the expressions of NY-ESO-1 in the tumor core region(TC), the tissues at the sites of 0.5cm, 1.0cm away from LSC periphery and the distant normal larynx tissues. Results NY-ESO-1 protein expression was positive in 30 out of 69 (43.48 %) cases of LSC. The expression level of NY-ESO-1 protein were found to significantly decrease by tums in TC and corresponding adjacent tissues (P ＜0.01). None of the nine normal larynx tissues expressed NY-ESO-1 protein.It did not display an obvious correlation between the expression of NY-ESO-1 with T staging, pathological grading and lymph node metastasis (P ＞0.05). Its positive expression was found in pathologically positive cervical lymph nodes, which were significantly lower than that in the primary site (P ＜0.05). Conclusion NY-ESO-1 protein express at high level in human laryngeal squamous carcinoma, and they may play a role in genesis and development of tumors, which suggests that NY-ESO-1 gene might be used as target antigens for immunotherapy of LSC and the further research is necessary.

Clinical significance of lymph vessel density marked by D2-40 in laryngeal squamous cell carcinomas / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the relationship between lymphatic vessel density and clinicopathological features of laryngeal squamous cell carcinoma.@*METHOD@#The lymph vessels, 40 specimens of LSCC and normal mucosa, were quantitated by SABC immunohistochemistry staining with lymphatic endothelial marker oncofetal antigen M2A Monoclonal antibody (D2-40).@*RESULT@#The density of peritumoral D2-40(+) vessels in the LSCC group was higher than that of normal mucosa one (P0.05).@*CONCLUSION@#Tumor lymph vessel mainly means peritumoral lymph vessel. The density of peritumoral lymph vessel marked with D2-40 in laryngeal carcinoma tissues was significantly correlated with progression and invasion of tumor.

Expression and clinical significance of LYVE-1 and VEGF-C in patients with laryngeal squamous cell carcinoma / 肿瘤研究与临床

Objective To elucidate the relationship between LYVE-1 and VEGF-C and their expression in laryngeal squamous cell carcinoma(LSCC),and provide theoretic evidence for the judgement of metastasis and prognosis of LSCC,also for the treatment.Methods An immunohistocbemical analysis was performed to 50 specimens of LSCC with lymphatic endothelial marker LYVE-1.Quantitation of lymphangiogenesis growth factor VEGF-C by RT- PCR was performed to 30 specimens of LSCC.Finally the correlation between LVD and VEGF-C mRNA was analyzed with statistics methods.Results LYVE-1 (+) was observed in all LSCC.The median copy number of VEGF-c mRNA was 4-5-fold higher in LSCC than in adjacent normal tissue.There was correlation between tumor VEGF-C mRNA copy number and intratumoral LVD.Conclusion Lymphatic vessels existed in LSCC.There was correlation between high levels of LVD in LSCC than in normal tissue.The high level of VEGF-C may accelerate the lymphatic metastasis by promoting the proliferation of lymphatic vessel.

Effect of CDK2 on proliferation in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the role of CDK2 in the development of DNA heteroploid in laryngeal squamous cell carcinoma (LSCC).@*METHOD@#Fifty specimens of LSCC, twelve specimens of atypical hyperplasia and thirty specimens of vocal cord polyp were obtain during operation. Centrosome were detected by anti tubulin antibodies. Immunohistochemical method was used to analyze the protein expression of CDK2 and gamma-tubulin.@*RESULT@#The positive rate of CDK2 and gamma-tubulin in LSCC were 68.0% (34/50) and 78.0% (10/15), all of them were significant higher than those in the vocal cord polyp (P<0.05). Expression of CDK2 in LSCC was positively association with expression of gamma-tubulin.@*CONCLUSION@#This experiment indicated that overexpression of CDK2 was strongly correlated with abnormal proliferation in LSCC, and it may be a valuable marker for the diagnosis and therapy of LSCC.

Partial horizontal laryngectomy and epiglottiplasty / 华中科技大学学报（医学）（英德文版）

In order to evaluate the availability of the lateral horizontal laryngectomy and anaplasty of epiglottis to treat some patients with specific supraglottic carcinomas and hypopharyngeal carcinomas, 17 cases of laryngeal and hypopharyngeal carcinomas were retrospectively analyzed, whose tumors were located at the lateral margin of epiglottis, aryepiglottic fold, medial wall of piriform fossa and were treated by the lateral horizontal laryngectomy and anaplasty of epiglottis. The results showed that all cases took food by mouth in postoperative 9-14 days and subjected to decannulation in postoperative 9-15 days. Three cases had postoperative hoarse voice. The free-disease survival rate of 3 years was 71.4% in 14 cases followed up after the first surgical therapy, and the overall free-disease survival rate of 3 years was 85.7% after the second surgical therapy. It was concluded that the manipulations of the lateral horizontal laryngectomy and epiglottiplasty were simple. It could alleviate the postoperative symptoms of aspiration and bucking remarkably and shorten their postoperative recovery time, yet does not lower the survival rate of patients if laryngocarcinoma or hypopharyngeal carcinoma cases were properly selected.

Relationship between external appearance of laryngeal carcinoma and submucosal infiltrating extent / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the submucosal infiltrating extent of laryngeal carcinoma tissue by different location,different T staging and external appearance and to analyze the impact of laryngeal carcinoma submucosal infiltrating extent on surgical margin.METHODS Forty-three laryngeal en bloc specimens coming from 43 cases with laryngeal carcinoma were vertically cut-down along tumor long axis,and were slivered into sections by which laryngeal carcinoma submucosal infiltrating distance was measured under microscope.Laryngeal carcinoma latent submucosal infiltrating extent was compared among different location,different T staging and external appearance.RESULTS Basing on tumor external appearance and infiltrating extent,laryngeal carcinoma was classified into three types:exogenic type,ulcerating infiltrating type and mixed infiltrating type.Of 43 specimens,the three types were 10,8 and 25 cases respectively.There was a significant difference in submucosal infiltrating extent between T1～T2 and T3～T4 laryngeal carcinoma.There was also significant difference in submucosal infiltrating extent between exogenic type and ulcerating infiltrating type or mixed infiltrating type.CONCLUSION The submucosal infiltrating extent of laryngeal carcinoma tissue plays an important role in the surgical margin. As laryngeal carcinoma T stage developing,tumor submucosal infiltrating extent is becoming more extensive.Laryngeal carcinoma submucosal infiltrating extents in ulcerating infiltrating and mixed infiltrating type are more extensive than that in exogenic type.The partial laryngectomy should be prudent to be performed in cases with local advanced ulcerating infiltrating and mixed infiltrating laryngeal carcinoma.

Partial Horizontal Laryngectomy and Epiglottiplasty / 华中科技大学学报（医学）（英德文版）

In order to evaluate the availability of the lateral horizontal laryngectomy and anaplasty of epiglottis to treat somepatients with specific supraglottic carcinomas and hypopharyngeal carcinomas, 17 cases of laryngeal and hypopharyngeal carcinomas were retrospectively analyzed, whose tumors were located at the lateral margin of epiglottis, aryepiglottic fold, medial wall of piriformfossa and were treated by the lateral horizontal laryngectomy and anaplasty of epiglottis. The results showed that all cases took food by mouth in postoperative 9-14 days and subjected to decannulation in postoperative 9-15 days. Three cases had postoperative hoarse voice. The free-disease survival rate of 3 years was 71.4 % in 14 cases followed up after the first surgical therapy, and the overall free-disease survival rate of 3 years was 85.7 % after the second surgical therapy. It was concluded that the manipulations of the lateral horizontal laryngectomy and epiglottiplasty were simple. It could alleviate the postoperative symptoms of aspiration and bucking remarkably and shorten their postoperative recovery time, yet does not lower the survival rate of patients if laryngocarcinoma or hypopharyngeal carcinoma cases were properly selected.