CO2 transoral laser microsurgery for early glottic carcinoma with anterior commissure involvement.

OBJECTIVE: Anterior commissure (AC) involvement is an unfavorable factor for transoral laser microsurgery (TLM) treatment of early glottic carcinoma (EGC). This study aimed to evaluate the therapeutic efficacy of TLM treatment for EGC with AC involvement. METHODS: From 2008 to 2017, 177 patients with T1-T2 EGC with AC involvement were retrospectively included and divided into the TLM group (n=115) receiving CO2 laser TLM and the control group undergoing open surgery (n=62). The survival outcomes, postoperative complications, laryngeal preservation rate, recurrence and the phonological results were compared between groups. RESULT: The TLM group had significantly reduced hospital stay, hospitalization costs, and intraoperative blood loss as compared with the control group. The tracheotomy rate was significantly higher in the control group (96.8% vs. 0%). The 5-year overall survival (OS) was 89.6% and 85.5% in the TLM group and control group, respectively. Log-rank test showed no difference in survival rate between the two groups. There was no significant difference in laryngeal preservation rate and overall recurrence rate between groups. In postoperative vocal function evaluation, there were significant differences in the overall grade (G), the roughness (R), the breathiness (B), Voice Handicap Index-10 (VHI-10), Jitter, Shimmer, noise/harmonic ratio (NHR), maximum phonation time (MPT), phonation threshold pressure (PTP) between the two groups. CONCLUSION: For EGC with AC involvement, TLM has similar survival outcomes with the open surgery, but has better postoperative voice outcomes. Meanwhile, TLM can effectively reduce intraoperative blood loss, hospitalization time, hospitalization costs and postoperative complications.

Antitumor activity of 7RH, a discoidin domain receptor 1 inhibitor, alone or in combination with dasatinib exhibits antitumor effects in nasopharyngeal carcinoma cells.

Dysregulation of the discoidin domain receptors (DDRs) has been implicated in the development of numerous types of tumors, including head and neck cancer, and nasopharyngeal, breast, ovarian and esophageal carcinomas. Furthermore, agents that inhibit DDR1 activity are hypothesized to be useful for the treatment of nasopharyngeal carcinoma (NPC). The aim of the present study was to evaluate the effect of the DDR1 inhibitory (3-(2-(pyrazolo(1,5-a)pyrimidin-6-yl)-ethynyl)benzamide compound, 7RH, in NPC cells both in vitro and in vivo, and its effect when used in combination with dasatinib, a SRC family kinase (SFK) inhibitor. The effects of 7RH alone or in combination with dasatinib on cell viability were assessed using MTT assays and apoptosis was detected by flow cytometry. In addition, western blotting was performed to analyze the relative protein expression levels of cell cycle-associated genes in human NPC cell lines (CNE1, CNE2, HONE1 and SUNE1). Cell migration was also assessed using cell adhesion assays. Furthermore, tumor xenografts of CNE2 NPC cells were established in nude mice and the growth inhibitory effects of 7RH treatment alone or in combination with dasatinib were evaluated. Finally, knockdown of DDR1 protein expression was achieved by transfection of CNE2 cells with DDR1-specific small interfering RNA. Treatment with 7RH effectively suppressed the proliferation and induced the apoptosis of NPC cells. In addition, the Janus kinase 1 (JAK1)/signal transducer and activator of transcription (STAT3) signaling pathway was downregulated by 7RH, whereas the activities of the Ras/Raf/mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) and phosphoinositide 3-kinase (PI3K)/AKT signaling pathways were upregulated in response to 7RH treatment. Furthermore, the expression levels of phosphorylated SRC were increased in NPC cells treated with 7RH; thus indicating that SRC exhibits a vital function in the resistance of NPC cells to 7RH via activation of the PI3K/AKT signaling pathway. The results of the present study indicate that DDR1 and SFK inhibition may present a potential therapeutic strategy for patients with NPC.

[Repair surgical defect of squamous cell carcinoma of tongue base with advanced patients].

OBJECTIVE: To repair the postoperative tissue detect of the base of tongue cancer in advanced patients. METHOD: There were 30 patients of medium-high differentiation squamous cell carcinoma(SCC) included in this study. According to the TNM staging of AJCC 2002, there were 4 cases of T2N1M0, 7 of T3N1M0, 10 of T3N2M0, 4 of T4N1M0 and 5 of T4N2M0. Surgical approach of the primary lesion: 12 with transhyoidpharyngotomy approach and 18 with mandibulotomy approach. All cases accepted radiotherapy 4-6 weeks after surgery. RESULT: Twenty-five cases were reconstructed with pedicle pectoralis major myocutaneous flaps, and all them survived. Among them, 1 flap was partial split with surrounding tissue spontaneously, and another flap had partial tissue necrosis, however, both flaps grew well with dressing and other local treatment. Other 5 cases were reconstructed with free anterolateral myocutaneous flaps. Among them, 1 flap had partial tissue necrosis, but had a secondary healing after removing necrotic tissue via mouth approach. All 18 patients of larynx-preservation had tracheal tube pulled out. The 3-year survival rate was 68% and the local control rate was 87%. CONCLUSION: Pedicle pectoralis major myocutaneous flaps and free anterolateral myocutaneous flaps were alternative donor area for repairing postoperative tissue defect of the base of tongue; The former was preferred, and the latter was concealed so as to be a kind of effective method, which need adept technique of microsurgery.

[The correlation between stanniocalcin 2 expression and prognosis in laryngeal squamous cell cancer].

OBJECTIVE: In this study, we have detected the expression of STC2 protein in laryngeal cancer and The safe incisal margin by immunohistochemical staining, to evaluate its correlation with clinical features and the prognosis value in laryngeal squamous cell cancer. METHOD: Eighty-one paraffin-embedd specimens of patients who underwent surgery for laryngeal cancer were collected. Clinical data, including date of birth, gender, tumor subsite, tumor stage, RT, and survival status have been recorded. The samples including laryngeal cancer tissues and the safe incisal margin were analyzed for the expression of STC2 protein by immunohistochemical staining. We analyzed the correlations with STC2 expression level and clinical data with software SPSS 18. 0. RESULT: (1)fifty-six cases in 81 cases (69. 1 %) are positive. In 30 cases of the safe incisal margin tissues, STC2 is not expressed, which shows statistically significant differences between the two groups (P<0. 05). (2)Overexpression of STC2 in laryngeal cancer were correlated with the tumor clinical stage and N stage, T stage, tumor site location and histological grade (P<0. 05), but not with genderor age (P> 0. 05). (3)The result showed that the 3-year survival rate is 74. 1%, according to the survival analysis by STC2, STC2 positive group has poorer outcome versus the negative group. (4)The clinical stage displayed the independent value in predicting the tumor prognosis of laryngeal cancer (P<0. 05), not the expression level of STC2. CONCLUSION: Overexpression of STC2 in laryngeal cancer patients is correlated with poor outcome, which means STC2 positive group has poorer prognosis than the STC2 negative group.

SOX1 down-regulates ß-catenin and reverses malignant phenotype in nasopharyngeal carcinoma.

BACKGROUND: Aberrant activation of the Wnt/ß-catenin signaling pathway is an important factor in the development of nasopharyngeal carcinoma (NPC). Previous studies have demonstrated that the developmental gene sex-determining region Y (SRY)-box 1 (SOX1) inhibits cervical and liver tumorigenesis by interfering with the Wnt/ß-catenin signaling pathway. However, the role of SOX1 in NPC remains unclear. This study investigates the function of SOX1 in NPC pathogenesis. RESULTS: Down-regulation of SOX1 was detected in NPC cell lines and tissues. Besides, quantitative methylation-specific polymerase chain reaction revealed that SOX1 promoter was hypermethylated in NPC cell lines. Ectopic expression of SOX1 in NPC cells suppressed colony formation, proliferation and migration in vitro and impaired tumor growth in nude mice. Restoration of SOX1 expression significantly reduced epithelial-mesenchymal transition, enhanced cell differentiation and induced cellular senescence. Conversely, transient knockdown of SOX1 by siRNA in these cells partially restored cell proliferation and colony formation. Notably, SOX1 was found to physically interact with ß-catenin and reduce its expression independent of proteasomal activity, leading to inhibition of Wnt/ß-catenin signaling and decreased expression of downstream target genes. CONCLUSIONS: SOX1 decreases the expression of ß-catenin in a proteasome-independent manner and reverses the malignant phenotype in NPC cells.

The vocal aerodynamic change in female patients with muscular tension dysphonia after voice training.

OBJECTIVE: To investigate the changes of vocal aerodynamics indicators after voice training in female patients with muscular tension dysphonia (MTD). METHODS: Twenty-one female MTD patients (before voice training and 12 weeks after voice training) and 20 female volunteers with normal voices (the control group) received vocal aerodynamic analysis. Parameters included subglottal pressure (SGP), aerodynamic power (AP), mean expiratory airflow (MEA), and maximum phonation time (MPT) were recorded and analyzed by phonatory aerodynamic system. RESULTS: Before voice training, the median SGP and mean AP were higher than control group, whereas median MPT was shorter, and these differences were statistically significant. After 12 weeks of voice training, the median SGP and mean AP were decreased and the median MPT was increased compared with the measurements obtained before training, and these differences were statistically significant. The differences of median SGP, mean AP, mean MEA, and median MPT between MTD after 12 weeks of training and control group were not statistically significant. CONCLUSION: Voice training is an effective treatment for MTD patients. Aerodynamic analysis can effectively evaluate the vocal functional status of MTD patients before and after training, which is beneficial for the treatment efficacy evaluation.

The diagnostic value of narrow-band imaging for the detection of nasopharyngeal carcinoma.

OBJECTIVES: To evaluate the diagnostic value of narrow-band imaging (NBI) for the detection of nasopharyngeal carcinoma (NPC). STUDY DESIGN: Prospective study. SETTING: Tertiary medical center. SUBJECTS AND METHODS: Between December 2009 and June 2010, a total of 1,854 patients were examined by means of an electronic nasopharyngolaryngoscope equipped with conventional white light (WL) and an NBI system. The sensitivity, specificity and positive/negative predictive values for detecting NPC were calculated and compared. RESULTS: Of these patients, 62 cases (3.34%) were pathologically confirmed as NPC. The sensitivity, specificity, positive predictive value and negative predictive value for detecting NPC significantly increased from 90.3, 75.4, 11.3 and 99.6% with WL up to 100, 99.2, 81.6 and 100% with NBI, respectively. CONCLUSION: Our findings suggested that NBI endoscopy might serve as an ideal tool in the detection of NPC.

[Mechanism of radiosensitization of 3-methyladenine in human hypopharynx cancer cells].

OBJECTIVE: To investigate the radiosensitizing effect and its mechanism of 3-MA in human hypopharynx cancer cells. METHODS: 5 mmol/L of 3-MA combined with 2 Gy or 4 Gy of X-ray was utilized to deal with Fadu cells, and the cell livability (cloning efficiency) and DNA lesion severity (tail moment) of each groups was examined by clonogenic survival assay and comet assay, then differences were compared between groups by independent-sample T test. Fadu cells were then treated with different dose of 3-MA (1, 2, 5, 10 mmol/L), the alteration of cell cycle distribution was detected by flow cytometer, and differences among groups were analyzed through one-way analysis of variance. The expression of p62 and cyclinB1 in each group was examined by western blot. RESULTS: The livability and DNA lesion severity of cells treated with 3-MA alone showed no notable variation. Compared with non-3-MA groups, the cloning efficiency of cells treated with 3-MA decreased much more after irradiated with 2 Gy or 4 Gy of X-ray (t = 13.41 or 13.98, P < 0.001), and the cells showed a more serious DNA lesion (t = 7.07 or 6.91, P < 0.001). The G2/M percentages of cells in the control group and groups treated with 1, 2, 5, 10 mmol/L of 3-MA were 17.10 ± 1.20, 23.30 ± 2.3, 39.90 ± 3.12, 58.47 ± 1.65, 76.13 ± 3.51 and differences among groups were statistically significant (F = 278.4, P < 0.05). The expression of p62 in cells treated with 3-MA showed a dose-dependent increase, while cyclinB1 showed a dose-dependent decrease. CONCLUSIONS: The autophagy inhibitor 3-MA could enhance radiosensitivity of human hypopharynx cancer cells by inducing G2/M arrest and enhancing irradiation-induced DNA damage.

[Application of narrow band imaging endoscopy in the diagnosis of nasopharyngeal lesions].

OBJECTIVE: To evaluate the value of narrow band imaging (NBI) endoscopy in the diagnosis of nasopharyngeal lesions. METHODS: Between December 2009 and April 2010, a total of 124 patients with nasopharyngeal lesions were examined with electronic nasopharyngolaryngoscope equipped with the white light mode and NBI mode. The biopsies of nasopharyngeal lesions were done in all patients. The characteristics of morphologies of mucosa and mucosal superficial vessels of each lesion under NBI mode were evaluated. RESULTS: Of all cases, there were 1 of papilloma, 87 of lymphoid follicular hyperplasia and chronic inflammation, 11 of nasopharyngeal cysts, and 25 of nasopharyngeal carcinoma. According to the pathological results, the morphologies of nasopharyngeal lesions under NBI mode were quite different. The color depth of the mucosa could be divided into four types: light red (+), dark red (++), prunosus (+++), and blue or blue black (++++). Under NBI, the color depths were (+) in papilloma, (++) in nasopharyngeal cysts, and (+++) in lymphoid follicular hyperplasia and chronic inflammation, without abnormal vessels. The color depths were (+++)-(++++) in nasopharyngeal cancer, with abnormal vessels. CONCLUSION: NBI has a potential ability to predict pathological results of nasopharyngeal lesions.

[Evaluation the curative effect of supracricoid partial laryngectomy for laryngeal cancer].

OBJECTIVE: To analyze the oncological outcomes, functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL). Provide clinical experience for application of SCPL. METHOD: A retrospective analysis of the 115 cases with laryngeal carcinoma accepted SCPL in our department from Jan 1996 to Dec 2004. Use the Kaplan-Meier method to analyze the patients'survival rate. Evaluate the value of reserve larynx function. RESULT: The 5-years survival rates and the decannulation rate was 80.8%, 99.1% respectively; and the average decannulation time was 22.25 days. The mean time of removal of gastric tube was 9.57 days. The function of CHEP was superior to CHP. The vocal function of 115 cases were all achieved in general communication. CONCLUSION: SCPL get better oncological and functional outcomes and allows the preservation of the basic function of the larynx. It's a safe, effective technique and deserved to generalization.

Inhibitor of differentiation 1 contributes to head and neck squamous cell carcinoma survival via the NF-kappaB/survivin and phosphoinositide 3-kinase/Akt signaling pathways.

PURPOSE: A key issue in cancer is apoptosis resistance. However, little is known about the transcription factors that contribute to cellular survival of head and neck squamous cell carcinoma (HNSCC). EXPERIMENTAL DESIGN: Three batches (54, 64, and 38) of HNSCC specimens were used for cellular and molecular analyses to determine the major molecular signaling pathways for cellular survival in HNSCC. Animal models (cell culture and xenografts) were used to verify the importance of apoptosis resistance in HNSCC. RESULTS: Inhibitor of differentiation (Id) family member, Id1, was significantly upregulated in clinical HNSCC specimens and acted to protect keratinocytes from apoptosis. Transfection of HNSCC cells with Id1 in vitro induced the phosphorylation of Akt (p-Akt) via phosphoinositide 3-kinase and increased the expression of survivin via NF-kappaB. Blockage of both pathways by specific inhibitors (LY294002 and IkappaBalphaM, respectively) abrogated Id1-induced cell survival of keratinocytes. In vivo studies showed that increased expression of Id1 allowed nontumorigenic keratinocytes (Rhek-1A) to become tumorigenic in nude mice by increased expression of survival genes such as p-Akt and survivin. More importantly, short interfering RNA for Id1 significantly reduced HNSCC tumor volume of HNSCC in xenograft studies. Analysis of clinical data verified the importance of the Id1 downstream molecule, survivin, in the prognosis of HNSCC patients. CONCLUSIONS: The above data, taken together, suggest that Id1 and its downstream effectors are potential targets for treatment of HNSCC because of their contribution to apoptosis resistance.

[Evaluation of effectiveness of advanced tonsillar carcinoma by different treatment].

OBJECTIVE: To evaluate the treatment of advanced tonsillar carcinoma by radiotherapy plus salvage surgery (R+S) or surgery coupling with postoperative radiotherapy (S+R). METHOD: Clinical data of 48 patients with advanced tonsillar carcinoma who were treated in The 2nd Affiliated Hospital of Sun Yat-sen University from June 1996 to June 2004 was retrospectively analyzed. The patients were divided into R+S group (group A, 21 cases) and S+R group (group B, 27 cases). Treatment outcomes were compared between these two groups. The QOL (quality of life) scale of Washington University (UW-QOL) was used to investigate the patient's quality of life. RESULT: The 5-year survival rates were 42.9% in group A and 45.8% in group B, there was no significant statistical difference between the two groups (P < 0.05). Both the two treatment modalities could reduce the QOL in some degree. The average QOL score of 46 patients was 661.00 +/- 98.52 , group A was 696.09 + 90.70, while group B was 631.52 +/- 96.74, there was a significant statistical difference between the two groups (P < 0.05). CONCLUSION: The two treatment modalities reached similar survivals. However, compared with the S+R, some patients who accepted treatment of R+S could avoid composite resection, reduce functional lesion and improve the QOL.

[Resection of nasopharyngeal angiofibroma using by midfacial degloving approach and modified maxillectomy].

OBJECTIVE: To explore the feasibility of treatment on angiofibroma patients with stage III, IV by midfacial degloving approach and modified maxillectomy. METHOD: From Feb. 2001 to Aug. 2004, midfacial degloving approach and modified maxillectomy was used for treating 7 angiofibroma patients with stage III, IV. Using Fisch stage: Five cases were in stage III, 2 cases were stage IV; 2 cases with stage III accepted midfacial degloving approach and modified maxillectomy. Five cases accepted midfacial degloving approach and Le fort I approach (stage III, 3 cases; stage IV, 2 cases). One patient accepted the combined therapy of facial approach and cranium approach. 6 cases accept the embolization of the artery which feed the tumor (2 cases in stage IV, 4 cases in stage III). RESULT: The blood loss was (600 +/- 324) ml in operation, the blood loss in operation of patients with selective preoperative embolization was (483 +/- 165) ml. The blood loss of one case with no selective preoperative embolization was 1300 ml. The operating time was 129 +/- 22 min. The pathology of 7 cases was nasopharyngeal angiofibroma. For 30 to 72 months follow-up, No tumor recurrence were observed, one case in stage III accepted the selective preoperative embolization got the tumor recurrence 1 year after the surgery. After the second surgery, no tumor recurrence were seen till now. CONCLUSION: For the patients in stage III, IV, midfacial degloving approach and modified maxillectomy is not only good for radical excision, curtating the operating time and blood loss, but also good for the cosmetic outlook and functional recovery. The selective preoperative embolization has a good significance on reducing the operating blood loss and tumor recurrence rate.

[Repair of pharynx with acellular dermal matrix].

OBJECTIVE: To evaluate the clinical use of acellular dermal matrix (ADM) in the repair of pharynx. METHOD: From June 2003 to December 2004, 18 cases of laryngopharyngeal carcinoma or oropharyngeal carcinoma accepted treatment of surgery. Four of them had the tumor in the place of posterior wall of laryngopharynx or oropharynx. In the operation, the tumor was resected and the function of larynx was reserved, reconstruction of the posterior wall of laryngopharynx or oropharynx was made with ADM. Three of them had normal function of vocal cords and the tumor was in the place of posterior wall of pharynx and lateral wall of piriform fossa. These patients accepted resection of the tumor and the larynx was reserved. ADM was sutured to the prevertebral fascia to repair the pharynx, reinforcement was made with sternocleidomastoid muscle then. The other 11 patients had the tumor in the pharynx and cervico-esophagus and the vocal cords were fixed. These cases accepted total resection of the larynx and laryngopharynx. ADM was sutured to the prevertebral fascia to repair the posterior wall of laryngopharynx, musculo-cutaneous flap of pectoralis major muscle was made to repair the anterior and lateral walls. All these 18 patients accepted radiotherapy after the operation, the dosage was 60-70 Gy. RESULTS: Among all these 18 cases, no rejection of ADM or formation of pharynx fistula happened after the operation. The allograft became normal mucosa finally. Two patients had subcutaneous infection. After the treatment of dressing change and antibiotics, the wound healing was satisfying. All the 18 patients had resumption of oral diet finally but 3 of them had light mis-swallowing. Seven patients whose larynx were reserved had the trachea cannula pulled out The follow-up periods after the operation lasted 12 months to 30 months. The middle follow-up period was 19. 38 months. Neither rejection nor scar formation of the allograft happened. The follow-up of 11 patients lasted more than 18 months, 3 of them had relapse of tumor. After the second operation 1 patient was still alive and 2 patients died of distant metastasis. CONCLUSION: ADM can be easily obtained. Its histocompatibility were perfect The operative procedure were easy to perform. The complications of donor part can be totally avoided. The combined use of ADM and musculo-cutaneous flap of pectoralis major muscle or other neck tissue was safe and effective in the reconstruction of pharynx.

[Analysis of surgical treatment of nasopharyngeal angiofibroma].

OBJECTIVE: To study the individual surgical treatment of nasopharyngeal angiofibroma. METHODS: Between Feb. 1989 and Oct. 2004, different kinds of surgical approaches in 51 patients with angiofibromas were retrospectively analysed. Using Fisch stage: thirty three cases were in stage I and II, 22 cases via palatal approach, 11 cases via endoscopic surgery;18 cases were in stage IIN and IV, 9 cases via lateral rhinotomy approach, 4 cases via midfacial degloving approach + Lefort I approach or modified maxillotomy, 5 cases via craniofacial approach. Twenty three cases accepted the embolization of the artery which feed the tumor, 7 cases in stage IV, 8 cases in stage IlI, 5 cases in stage II, 3 cases in stage I. RESULTS: The average of blood loss was 1010 ml in operation but it became 200 - 870 ml (the average of blood loss was 485 ml) when had a selective preoperative embolization. The blood loss of none selective preoperative embolization was 500 - 3500 ml (the average of blood loss was 1600 ml), t = 7. 48, P < 0.05, the average of blood loss of selective preoperative embolization is less than the average of blood loss of none selective preoperative embolization. After 9 to 48 months of operation (the average time was 26.4 months), 8 cases recurred one time and 2 cases recurred two times. CONCLUSIONS: The preoperative embolization could reduce the amount of bleeding during operation. In patients who are in stage I and II, searching endoscopic surgery could avoid the effect on craniofacial development which traditional surgical procedure did. For patient who are in stage III and IV, midfacial degloving approach and Lefort I approach or modified maxillotomy are not only good for exclusive resection of the tumor but also have less effect on articulation and beautiful cosmetic outlook.

[Animal experiment and clinical application of minimally invasive thyroid surgery].

OBJECTIVE: To investigate and evaluate the possibility of minimally invasive thyroid surgery. METHOD: The technique of video-assisted endoscopic resection of thyroid lobe and isthinums was developed in six adult mongrel dogs and two patients,using laparoscope and its equipments. RESULT: Under the video-assisted laparoscope, resection of thyroid lobe and isthmus was successfully completed in the dogs and the patients, no complication happened. CONCLUSION: The technique of minimally invasive thyroid surgery is possible and safe. In this technique, there is diminished tissue damage, highly accuracy of operation, as well as improved cosmesis.

[Endoscopic thyroid gland surgery without carbon dioxide neck insufflation].

OBJECTIVE: To evaluate endoscopic thyroid gland surgery without carbon dioxide neck insufflation. METHODS: Sixteen patients with thyroid gland benign tumor, aged from 23-62 years, were selected and treated with endoscopic surgery. Eight cases received whole thyroid lobectomy and the other eight cases received partial thyroid lobectomy, the procedure was through a wall method or a single 2.0-3.0 cm horizontal skin incision. Among the 16 cases, 6 were thyroid adenoma and 10 were nodular goiter. RESULTS: All patients received endoscopic surgery, 2 cases with sub-clavicle approach and 14 cases with a single 2.0-3.0 cm horizontal skin incision approach. The recurrent laryngeal nerve and parathyroid glands were easily identified and preserved during operation, the operating time lasted from 1.1 hours to 4.0 hours, no complication occurred, the postoperative cosmetic outcome was excellent. CONCLUSIONS: The results indicated that gasless technique is feasible and safe, so it suggested that the video-assisted thyroid surgery without carbon dioxide neck insufflation could be an alternative for thyroid gland surgery.

[Relationship between expression of survivin and prognosis in human laryngeal squamous cell carcinoma].

BACKGROUND & OBJECTIVE: A novel inhibitor of apoptosis Survivin has recently been found in many common human cancers but not in normal tissues. Its potential distribution in human laryngeal squamous cell carcinoma (HLSCC) and its implication for inhibition of apoptosis were not yet very clear. This study was designed to investigate the expression of survivin and the probabilities of using it as a new indicator of the prognosis of HLSCC. METHODS: HLSCC samples from 71 patients treated in Department of Otorhinolaryngology, Second Affiliated Hospital of Sun Yat-sen University between 1995 and 1998 were analyzed for survivin expression by immunohistochemistry method. The patients were followed-up for long term and the relationship between survivin expression and clinical data including age, gender, classification, clinical type, pathological type, lymph node metastasis, distant metastasis, and prognosis were analyzed using software SPSS11.0. RESULTS: The expression rate was 50.7% (36/71) in all 71 cases. The expression rate was 81.8% (9/11) in the cases with lymph nodes metastasis, which was higher than that in the cases without lymph nodes metastasis (45%, 27/60), with significant difference (P=0.025). Univariate analysis revealed that classification,type and survivin expression were significantly related to the prognosis of HLSCC. P value were 0.0001, 0.009, and 0.0008, respectively. Multivariate analysis demonstrated that the patients with positive survivin had significant shorter survival (63.5 months) than those with negative survivin (84.0 months) (P=0.006) except the effect of classification and type on the prognosis of HLSCC. CONCLUSION: Survivin expressed in HLSCC especially in the cases with lymph nodes metastasis. Its expression may related to the prognosis of HLSCC.

[The pterygoid hamulus syndrome with the main discomfort of pharynx].

OBJECTIVE: To explore the clinical features, diagnosis and therapy of pterygoid hamulus syndrome. METHOD: Nine cases of pterygoid hamulus syndrome were retrospectively analysed in history, signs and therapy. RESULT: The pharyngeal pain and foreign body sensation were disappear or straighten up after treatment. The rates of efficacy and cure were 100.0% and 66.7%. CONCLUSION: The clinic manifestation of pterygoid hamulus syndrome is not typical. Signs, local close therapy, X ray and CT may be suitable technique for the diagnosis. Surgical resection is a simple, safe and effective method for treatment of pterygoid hamulus syndrome.