Arsenic trioxide induced the apoptosis of laryngeal cancer via down-regulation of survivin mRNA.

OBJECTIVE: Arsenic trioxide (As(2)O(3)) is used clinically to treat acute promyelocytic leukemia and has activity in vitro against several solid tumor cell lines, where induction of differentiation and apoptosis are the prime effects. As a novel anticancer agent for treatment of solid cancers, As(2)O(3) is promising and the mechanism has been not still fully understood. Laryngeal squamous cell carcinoma (LSCC) is one common tumor in head and neck cancers. The objective of this study was to investigate the effects of As(2)O(3) on LSCC cell line HEP-2, and their possible involvement in As(2)O(3)-induced apoptosis. METHODS: The cell viability was analyzed by MTT assay method and the morphological changes were observed by an inverted microscope and acridine orange (AO) staining. The caspase-3 activity was measured by a fluorophotometer. The expression of survivin mRNA was evaluated by RT-PCR. RESULTS: In this study, we demonstrated an apoptotic effect of As(2)O(3) in LSCC cell line Hep-2. In Hep-2 cells, As(2)O(3) decreased the cell viability, inhibited the growth and proliferation, induced apoptosis and increased the activity of caspase-3 in a dose-dependent manner. And the expression of survivin mRNA was also decreased in a dose-dependent manner. CONCLUSION: We concluded that As(2)O(3) induced the apoptosis of Hep-2 cells via down-regulating the expression of survivin mRNA.

[The value of 99mTc-DX105 cervical lymphatic imaging in detecting cervical lymph node metastasis of laryngeal and hypopharyngeal carcinoma].

OBJECTIVE: To study the value of single photon emission-computed tomography (SPECT) lymphatic imaging by percutaneous injection of 99mTc-DX105 in detecting cervical lymph node metastasis of laryngeal and hypopharyngeal carcinoma. METHOD: One-three days before the operation, 185MBq 99mTc-DX105 was injected via bilateral mastoids portion percutaneously in each of 30 patients with laryngeal and hypopharyngeal carcinoma, and thus SPECT lymphatic imaging was conducted. Then, the diagnostic result was compared with those of pathological examination of neck dissection specimens. RESULT: In SPECT lymphatic imaging of 53 sides neck of 30 patients, 24 sides cervical lymph node were positive, and 3 sides were false positive; 29 sides cervical lymph node were negative, and 1 side was false negative, Sensitivity, specificity and accuracy of SPECT lymphatic imaging were 95.5% (21/22), 90.3% (28/31) and 92.5% (49/53) respectively. Among the 8 sides cervical lymph node metastasis which were false negative by clinical palpation, 7 sides were positive by SPECT lymphatic imaging. CONCLUSION: It is suggested that SPECT lymphatic imaging by percutaneous injection of 99mTc-DX105 in detecting cervical lymph node metastasis of laryngeal and hypopharyngeal carcinoma is pretty valuable for guiding clinical neck node dissection.

[Expression and significance of TERT and c-Myc oncogene protein product on cholesteatoma epithelium].

OBJECTIVE: To detect the expression and localization of human telomerase catalytic subunit (hTERT) and c-Myc oncogene protein product in human middle ear cholesteatoma, and to evaluate their roles in the proliferation of cholesteatoma epithelium. METHOD: The specimens from the middle ear cholesteatoma tissue of 32 cases and external ear skin of 14 cases were examined by immunohistochemical SP method and computer image analysis system for TERT and c-Myc oncogene protein product. RESULT: All 32 samples of cholesteatoma showed a stronger expression of TERT and c-Myc oncogene protein product than that of the external ear skin. The indexes, such as mean positive cell rate and mean obsorbency of cholesteatoma epithelium are much higher than that of the normal external ear shin remarkably( P < 0.05). Accompanied with numerous inflammatory cells(lymphocytes, plasmocytes, neutrophils and macrophages) subcutaneously, the high expression of TERT and c-Myc oncogene protein product were correlated with each other( P < 0. 05). CONCLUSION: Excessive proliferation and keratinization of cholesteatoma are presented by the expression of TERT and c-Myc oncogene protein product in different ways, both of which play a cooperative role in the development of cholesteatoma. Subcutaneous inflammatory response may contribute to the excessive proliferation of keratose cells.

[Long-term results analysis of mastoidectomy for chronic otitis media].

OBJECTIVE: To study the operative indications of chronic otitis media and their long-term results. METHOD: One hundred and forty-five cases of mastoidectomy were followed for 5 years between 1995-1998. We discussed the results of recurrence and hearing level of radical mastoidectomy, canal wall up mastoidectomy (CWUM) and canal wall down mastoidectomy with mastoid obliteration (CWDM). Advantages and disadvantages were analyzed by the rate of visiting. RESULT: RM is almost invariable in hearing. There is no significant difference between CWDM [improved (10.84+/-4.63) dB HL] and CWUM [improved (10.39+/-3.93) dB HL]. The recurrence rate of RM was 11.63%, CWDM was 12.68%, but the CWUM was 22.58%. Rate of re-visiting of RM is obviously higher that of CWUM and CWDM. CONCLUSION: RM, CWUM and CWDM have all advantages, but the indication must be selected carefully. The effect of CWDM is better than that of RM and CWUM for the long-term results in these cases.

[The role of high-resolution CT in the preoperative assessment of chronic otitis media].

OBJECTIVE: To assess the high-resolution CT scan in depicting the middle ear structures. METHOD: The surgical findings of 51 ears operated on were retrospectively compared with the CT findings. The followings were analysed: diagnostic features of chronic otitis media (COM) on CT status of the middle ear structures (ossicles, facial nerve canal, semicircular canals and tegmen tympani), and anatomical variations. RESULT: The radio-surgical agreement was excellent for the malleus (kappa statistics, k = 0.840) and tegmen (0.788), good for the incus (0.700) and semicircular canals (0.56), but poor for the stapes (0.366) and facial nerve dehiscence (0.310). Potential surgical hazards detected by the scans included: Low lying dura, high jugular bulb, anterior lying sigmoid sinus, facial nerve dehiscence and other situations brought about by the destructive nature of the lesion. CONCLUSION: There is a good radio-surgical correlation in COM for most middle ear structures except for the integrity of the facial canal and stapes. The scan alerts the surgeon the potential surgical dangers and complications of disease. High-resolution CT scan should be a routine examination prior to middle ear and mastoid surgery.

[Application of chlorophyll in the cervical lymph nodes dissection of laryngeal and hypopharyngeal carcinomas].

OBJECTIVE: To investigate the patterns of cervical lymph node metastases from the carcinomas of larynx and hypopharynx. METHOD: Chlorophyll solution was injected submucosally into some portions of the larynx and hypopharynx preoperately as a stain of lymphatic system to help conduct modified neck dissections in 50 patiants with laryngeal or hypopharyngeal carcinomas. Searial sections were performed. RESULT: The cervical lymph nodes were stained into deep green with a color contrast to the ambient structures, which facilitated the operation of neck dissections and the distinction of lymph nodes. Pathologically positive lymph nodes found in 48% of all the cases. The metastases to level I and V were always associated with other levels. By statistical analysis, there was a higher metastaic rate in level II, III, and V (P < 0.01). Overal 1 occult metastases were recorded in 23.5% of No (clinically negative neck)cases. The involvement were located only at level II or III. CONCLUSION: For cN+ (clinically positive neck) patiants, upper and middle jugular vein nodes should be dissected necessarilly,and then appropriate selective neck dissections might be considerd according to the intraoperative findings. For the cN(o) cases with supraglottic or hypopharyngeal carcinomas, it is suggested ipsilateral or bilateral upper and middle jugular vein nodes be dissected according to the clinical status. Chlorophyll as a kind of safe and distinctive stain of lymphatic system can be injected preoperatively routinely.