The combination of ultrasound and CT evaluate lymph node metastasis of thyroid papillary carcinoma in different compartments / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the role of the combination of ultrasound and enhanced CT in analyzing lymph node metastasis in thyroid papillary carcinoma (PTC) patients by compartment.@*METHOD@#Clinical data of 115 cases (141 sides) with PTC were collected. All had undergone ultrasound in neck and enhanced CT both in neck and in mediastinum before surgery. They were divided into ultrasound group. CT group, and the combination of ultrasound and enhanced CT group to evaluate lymph node metastasis.@*RESULT@#For the central compartment, the accuracy of ultrasound was 61.0%. CT was 48.9%, and the combination of ultrasound and CT was 62.4%. For the lateral compartment, ultrasound was 87.9%, CT was 78.7%, the combination of ultrasound and CT was 85.8%. Ultrasound had higher accuracy than CT in the central (P 0.05). There was no significant difference in accuracy between ultrasound and the combination of ultrasound and CT neither in central (P > 0.05) nor in lateral (P > 0.05) compartment. Six cases of lymph node metastasis in mediastinum and 1 case in parapharyngeal space detected by CT were pathologically proven. CT found that five patients with pulmonary metastasis.@*CONCLUSION@#The combination of ultrasound and CT or single ultrasound has higher accuracy in preoperative evaluation than single CT for lymph node metastasis in PTC. CT can assess some compartments such as mediastinum which can't be detected by ultrasound, and at the same time to evaluate lung metastasis. To evaluate lymph node metastasis in PTC, the combination of ultrasound and CT is more accurate and considerate than single method.

The role of medical imaging plus carbon nanoparticles to manage the cervical lymph nodes in patients with thyroid carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The purpose of this study was to discuss the role of the combination of carbon nanoparticles and medical imaging to manage the cervical lymph nodes in patients with thyroid carcinoma.@*METHOD@#Eighty one patients with thyroid carcinoma that primary treated were divided into two groups: trial group and control group. Carbon nanoparticles were injected into the thyroid gland of trial group patients. Central compartment (level VI) dissection, levels IIl and IV dissection, lateral node (levels II-V) dissection were performed respectively in all the patients on the basis of medical imaging and pathology. Total lymph nodes, metastasis lymph nodes, black stained lymph nodes and black stained metastasis lymph nodes of trial group were counted respectively in different dissection specimens. Total lymph nodes and metastasis lymph nodes of control group were counted respectively in different dissection specimens. Parathyroid glands of thyroid or central compartment dissection specimens were counted in two groups.@*RESULT@#In trial group, rate of staining lymph node was 80.0% in central neck dissection tissue, 54.9% in levels III and IV dissection specimen, 39.1% in lateral node dissection specimen. In central compartment dissection tissue, lymph nodes on average in control group were less than in trial group (3.03 ± 2.07 vs. 4.72 ± 2.97) (P 0.05). There was no statistic difference between control group and trial group for the metastasis lymph nodes in difference dissection specimens. Parathyroid gland was found in 3 thyroid or central compartment dissection specimens among trial group, which was found in 9 specimens among control group, the difference had statistical significance (P < 0.05).@*CONCLUSION@#During levels III and IV dissection in cN0 patients or central compartment dissection, lymph nodes can be signed well by carbon nanoparticles, which can improve the lymph node detection rate, but can not increase the lymph node detection rate in cN+ patients. Parathyroid gland can be preserved by carbon nanoparticles during the thyroid gland resection and central neck dissection.

Expression and methylation status of IGFBP-rP1 gene in laryngocarcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the relationship between the promoter methylation and protein expression of insulin-like growth factor binding protein-related protein 1(IGFBP-rP1) in laryngeal squamous cell carcinoma (LSCC).@*METHOD@#Methylation specific PCR (MSP) approach and immunohistochemistry methods were used to examine the methylation status and protein expression of IGFBP-rP1 in 45 samples of laryngeal carcinoma and 18 samples of tissues beside cancer.@*RESULT@#For the promoter site, methylation frequency of IGFBP-rP1 in tumor specimens (33.3%, 15/45) was significantly higher than that in corresponding normal tissues (5.6%, 1/18) (P < 0.05). The protein expression of IGFBP-rP1 in tumor tissues was significantly higher than that in corresponding normal tissues (P < 0.05) and was inversely correlated with its methylation status of promoter.@*CONCLUSION@#Epigenetic silencing of IGFBP-rP1 gene expression by promoter hypermethylation may play an important role in LSCC.

Expression of matrix metalloproteinase-1, E26 transformation-specific-1 in laryngeal carcinoma tissue and the clinical significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of matrix metalloproteinase-1 (MMP-1), E26 transformation-specific-1 (Ets-1) in laryngeal carcinoma and to discuss their relevance and the roles in carcinogenesis and development of laryngeal carcinoma.@*METHOD@#Immunohistochemical technique was used to detect the expression of MMP-1 and Ets-1 protein in 34 tissues of laryngeal carcinoma and 34 para-carcinoma tissues, 15 cases of vocal cord polyps, and the use of the pathological image analysis software, we analysis the results of immunohistochemical semi-quantitatively.@*RESULT@#(1) The expression of MMP-1 and Ets-1 protein in laryngeal carcinoma tissues is obviously higher than that in para-carcinoma and in vocal cord polyps respectively (P 0.05). (2) The expression of MMP-1, Ets-1 protein isn't related to patients' age and sex, tumor size,clinical classification (P > 0.05), but related to pathological grade, clinical stage and lymph nodes metastasis (P < 0.05). (3) There is a positive correlation between the expression of MMP-1 and Ets-1 in laryngeal carcinoma.@*CONCLUSION@#Overexpression of MMP-1 and Ets-1 was observed in laryngeal carcinoma. The high expression of MMP-1 and Ets-1 may contribute to the carcinogenesis and development of laryngeal carcinoma,which is a important value to judge the malignant degree and progress of laryngeal carcinoma.

Discussion about cervical incision of goiter in mediastinum posterior and its indications / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the feasibility of cervical approach for goiter in posterior mediastinum.@*METHOD@#According to the mechanism that goiter filed into posterior mediastinum and the dissection of thyroid gland and mediastinum, we designed the following surgery principles (1) From top to bottom. (2) Find out recurrent nerve at the place where it enters larynx, then dissect recurrent nerve as long as possible and protect it carefully, meanwhile, search thyroid vessels along recurrent nerve. (3) To avoid and uncontrollable serious hemorrhage in the operation, all normal and aberrant blood vessels must be ligated cautiously, and avoid pulling great vessels in the thoracic part. (4) Separating tumor of hemorrhage under surgical capsule. Bluntly, it can avoid damage important structure in most occasions. (5) If the tumor of hemorrhage was difficult to be separated from the surrounding structure, ask thoracic surgeon for cooperation.@*RESULT@#Two operations case were operated under the above guideline successfully, and the operations were performed with satisfactory effect, minimal invasion, rapid recovery and low medical cost.@*CONCLUSION@#Cervical approach for goiter in mediastinum posterior is an ideal method of surgery, but it has following operative indication. (1) imaging date indicate that tumor of posterior septum is not connected to the surrounding structure. (2) It is not accompanied with superior vena cava syndrome. (3) The size of large thyroid tumor of posterior septum could be decreased by taking out the center part of tumor, and it is suitable for liquidized center tissue especially, then take out the tumor from neck. If it is hard to be taken out, you can ask thoracic surgeon for help.

Expression of DcR3 protein and its significance in laryngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of DcR3 in laryngeal carcinoma and analyze the relation between DcR3 and clinical factors.@*METHOD@#The expression of DcR3 protein in 41 laryngeal carcinoma tissues and 41 para-carcinoma tissues (to cutting margin > 0.5 cm) were measured by Flow Cytometer(Epics-XL II), 15 normal laryngeal mucosa tissues were served as controls.@*RESULT@#(1) The quantitative and qualitative expression of DcR3 protein in laryngeal carcinoma tissues was obviously higher than those in para-carcinoma and normal laryngeal mucosa tissues, respectively (P < 0.05). There was no significant difference for the DcR3 protein expression between para-carcinoma and normal laryngeal mucosa tissues. (2) In laryngeal carcinoma, the expression of DcR3 protein was not significantly related to clinical classification, tumor size, smoking history, patients' age and sex but related to metastasis, pathological grade and clinical stage.@*CONCLUSION@#The high level of DcR3 expression may contribute to the carcinogenesis and development of laryngeal carcinoma. So it can be an important index for judging the differentiation, infiltration, metastasis and staging of laryngeal carcinoma.