Clinical characteristics and efficacy of second primary malignancies in hypopharyngeal carcinoma: an analysis of 216 real-world cases / 中华放射肿瘤学杂志

Objective:To evaluate the incidence, clinical characteristics and prognosis of second primary malignancies (SPMs) among patients with hypopharyngeal carcinoma (HPC) in real-world analysis.Methods:A total of 594 HPC patients admitted to Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from 2010 to 2018 were retrospectively analyzed.The incidence and clinical characteristics of HPC patients complicated with SPMs were analyzed. Clinical efficacy was compared among different groups.Results:With a median follow-up time of 66.9 months, SPMs were present in 36.4% (216/594) of HPC patients: 22.2% (132/594) were synchronous and 14.1% (84/594) were metachronous. The upper aerodigestive tract was the most common involved region. Compared with patients without SPMs, patients with synchronous and metachronous carcinoma in situ had similar 5-year overall survival (OS) of 42.2% vs. 44.5% ( P=0.958) and 62.2% vs. 44.5% ( P=0.240), respectively. Patients with synchronous invasive SPMs had a worse 5-year OS of 27.2% vs. 44.5% in their counterparts without SPMs ( P=0.001). Patients with metachronous invasive SPMs had similar 5-year OS of 50.2% vs. 44.5% in their counterparts without SPMs ( P=0.587). SPMs accounted for 42.5% of total death in metachronous invasive SPMs group. Conclusions:Patients with HPC have a high probability of developing SPMs. Moreover, the incidence of complicated with esophageal/gastric carcinoma in situ or metachronous SPMs exerts no effect on prognosis, while the occurrence of synchronous SPMs significantly affectes the prognosis of patients. However, the incidence of SPMs is still one of the main death causes in metachronous invasive SPMs group.

Risk factors and survival analysis for synchronous esophageal carcinoma in patients with hypopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the risk factors and survival status of hypopharyngeal carcinoma with synchronous second primary carcinoma of the esophagus.@*Methods@#One hundred and sixty patients with newly diagnosed hypopharyngeal carcinoma from January 2009 to December 2012 were retrospectively reviewed. The clinical data, tumor-related information and follow-up results were collected and analyzed.@*Results@#Forty-three synchronous esophageal carcinomas (27%) were detected in 160 patients with hypopharyngeal carcinoma, and most patients (72%) were at an early stage. On univariate analysis, the median age of less than 55 years old (χ2=4.525, P=0.033), excessive alcohol consumption (χ2=6.942, P=0.008) and invasion site more than 3 anatomical regions (χ2=21.503, P=0.000) had a significant correlation with the occurrence of synchronous esophageal carcinomas. Multivariate analysis showed that excessive alcohol consumption (OR=4.787, P=0.029) and invasion site more than 3 anatomical regions (OR=14.391, P=0.000) were independent risk factors. The median survival time was 26 months in 43 patients with synchronous esophageal carcinomas, which was significantly lower than that (58 months) in patients without secondary primary esophageal carcinomas (χ2=11.981, P=0.001).@*Conclusions@#There is a high incidence of synchronous esophageal carcinoma in hypopharyngeal carcinoma patients, affecting the prognosis of hypopharyngeal carcinoma. Surveillance for esophageal carcinomas in patients with hypopharyngeal carcinoma, especially in excessive alcohol drinkers, is warranted.

Clinical evaluation of end-to-end neurorrhaphy for unilateral recurrent laryngeal nerve transaction injury / 中华普通外科杂志

Objective To investigate the necessity of primary neurorrhaphy (direct end-to-end anastomosis) when the recurrent laryngeal nerve(RLN) is severed during thyroid surgery.Methods 15 patients who suffered from iaotmgenic unilateral complete RLN injury or whose unilateral RLN had to be sacrificed because of disease invasion had a primary repair of RLN by direct end-to-end anastomosis.In control group,26 patients who did not have a nerve repair were enrolled into this study.Subjective evaluation of aspiration and voice quality were based on patient reports and hearer reports for all patients.9 patients with neurorrhaphy and 12 patients without nerve repair were followed with videolaryngoscopic examination.Results 14 patients undergoing neurorrhaphy restored normal voice at 2-5 months postoperatively.Although there were no significant functional motion of the vocal fold,slight adductory movement of the affected arytenoid was found with good tension vocal cords and symmetric arytenoids of the glottis during phonation.Only 2 patients without nerve repair had nearly restored normal voice.The patients with hoarseness had stiff arytenoids and atrophic folds resulting in glottal gap.Conclusions Neurorrhaphy is a simple and effective method to restore the normal aspiration and voice quality of patients with unilateral complete recurrent laryngeal nerve injuries.

Expression of annexin A1 and PCNA in pancreatic cancer and their correlation / 中华胰腺病杂志

Objective To investigate the expressions of the annexin A1 ( ANXA1 ) in pancreatic cancer and the correlations with proliferating cell nuclear antigen (PCNA). Methods Tissue microarray instrument was used to construct the chip. There were 39 samples of normal pancreas tissue, 42 samples of pancreatic cancer, 7 samples of islet cell tumor and 8 samples of ampullary carcinoma. The expressions of ANXA1 and PCNA protein were examined by immunohistochemistry and their correlation was analyzed. Results The off-chip rate of tissue chips after immunohistochemistry was 11.7% ～ 13.3%, which could satisfy the needs for experiment. Immunohistochemical results of pancreatic cancer tissue microarray showed that the positive rate of ANXA1 expression in pancreatic cancer was 71.4% (30/42), which was significantly higher when compared with that of normal pancreas tissue ( 18.4%, 7/38; P < 0. 01 ). The positive rate of PCNA expression in pancreatic cancer was 73.8% (31/42), which was significantly higher than that of normal pancreas tissue (22.2%, 8/36; P < 0.01 ). The expression of ANXA1 had a significant correlation with PCNA in pancreatic cancer ( P < 0.01 ). Conclusions The expression of ANXA1 protein was significantly increased in pancreatic cancer. The expression of ANXA1 was significantly correlated with the expression of PCNA.

Endoscopic ultrasonography combined with miniprobe endoscopic ultrasonography in preoperative tumor staging of early esophageal cancer / 中华消化内镜杂志

Objective To assess the clinical value of endoscopic uhrasonography(EUS)combined with the mini-probe endoscopic uhrasonography(MPUS)in determing tumor invasion depth and lymph node metastases of early superficial esophageal cancer.Methods One hundred and twenty-four superficial esophageal cancer lesions of 121 patients were staged by EUS combined with MPUS,and the results were finally compared with pathological findings of surgical specimens or samples obtained by mucosal resection.Results The diagnostic accuracy of EUS in T staging of superficial esophageal cancer was 82.3%(102/124).The total ratio of lymph node metastases was 5.0%(6/121),with no node metastases in carcinoma in situ,1.3%(1/28)in mucosal carcinoma,11.6%(5/43)in submucosal carcinoma.Conclusion EUS combined with MPUS is accurate in staging of the superficial carcinoma,which can help the choice of therapeutic strategies.

Comparative proteomic study of pancreatic cancer using antibody microarray / 中华胰腺病杂志

Objective By proteomic analysis of differentially expressed protein profiling in pancreatic cancer using antibody microarray, new tumor marker of pancreatic cancer was supposed to be discovered. Methods The antibody microarray containing 378 monoclonal antibodies was applied to detect the differentially expressed proteins of 7 sets of pancreatic ductal adenocareinoma pooled samples and their paired normal pancreas tissues pooled samples. Results 11 up-regulated proteins (UbcH6, GABA b R2, Plakophilin 2a, Inhibitor 2, Nestin, ShcC, PRK2, Neurogenin 3, STAT 3, NHE-3 and SRP54) and 9 down- regulated proteins (DCC, HPV-16 L1, RACKI, Gelsolin, Rabaptin-5, DBP2, IKKa/I, c-Cbl, FXR2) were found in pancreatic cancer. Conclusions Antibody microarray was an effective comparative proteomic technology. These dys-regulated proteins facilitated to elucidate the mechanisms of pancreatic cancer and to identify new diagnostic markers and therapeutic targets.

Endoscopic characteristics and etiological examinations of viral esophagitis: a report of 16 cases / 中华消化内镜杂志

Objective To evaluate the endoscopic and pathologic characteristics and etiological ex-amination of viral esophagitis. Methods The data of 16 patients with viral esophagitis, including endoscop-ic, pathological and immunohistochemical findings were retrospectively studied. Results Endoscopic find-ings of viral esophagitis were characterized by single or multiple round and oval ulcers, located at the upper and middle esophagus. The surface of the ulcer was clean, and the boundary was distinct. Pathologic findings included degeneration and necrosis in squamons epithelium, accompanied by ulcer, infiltration of neutrophils and lymphocytes, hyperplasia of capillaries and basal cells and formation of granulation tissues, Immunocyto-chemical examination showed HSV-1 was positive in biopses, while CMV, EBV, HHV8 were negetive. Con-dusion Viral esophagtitis exhibited distinctive endosoopic and pathological features, and etiology can be confirmed by immunohistochemical examinations.

Degradation of gelsolin in pancreatic cancer cell lines by ubiquitin-proteasome pathway / 基础医学与临床

Objective To explore the role of ubiquitin-proteasome pathway for the gelsolin protein degradation in pancreatic cancer.Methods Pancreatic cancer cell lines BxPC-3 and PANC-1 were first treated with specific 26s proteasome inhibitor lactacystin.Immunoblots of cell lysates were probed for gelsolin expression.To determine whether gelsolin was conjugated to ubiquitin,proteins extracted from the cells with or without lactacystin were immunoprecipitated with anti-gelsolin antibody,followed by Western blot analysis.Results The expression of gelsolin protein increased obviously after treatment with lactacystin in BxPC-3 cells for 12 h.Using anti-gelsolin antibody to immunoprecipitate gelsolin protein and followed by Western blot using anti-ubiquitin monoclonal antibody,it was found that inhibition of proteasome pathway by lactacystin resulted in accumulation of ubiquitylated forms of gelsolin protein.In PANC-1 cell line,there was no significant changes of gelsolin after treatment with lactacystin.Conclusion Ubiquitin-proteasome dependent degradation may be an important regulatory mechanism for gelsolin down-regulation in pancreatic cancer cells.

The application of narrow band imaging endoscopy in the early diagnosis of hypopharyngeal carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the characteristics of hypopharyngeal carcinoma detected by narrow band imaging(NBI)endoscopy and evaluate the value of NBI in the early diagnosis of hypopharyngeal carcinoma. METHODS Between December 2008 and July 2009,a total of 46 consecutive patients with hypopharyngeal squamous cell carcinoma were enrolled in this study. High performance endoscopic system equipped with the white light mode and NBI mode was introduced in the examination of pharynx and larynx. The quality of visualization of morphologies of epithelial capillary and demarcation line of each lesion under NBI view was evaluated in comparison with conventional white light endoscopy. RESULTS Among the 46 patients,a total of 86 lesions were detected. The notable characteristic of hypopharyngeal squamous cell carcinoma is the well demarcated brownish area and scattered brown dots. The NBI laryngoscope could provide better visualization of morphologies of epithelial capillary and demarcation line in superficial carcinoma of hypopharynx than the white light mode(P