Microinvasive Nd:YAG laser therapy of early glottic carcinoma and its effect on soluble interleukin-2 receptor, interleukin-2, and natural killer cells.

OBJECTIVE: To investigate the effectiveness of microinvasive Nd:YAG laser therapy in human glottic Tis and T1 carcinomas, as well as its effect on the cellular immune function of the tumor-bearing hosts. STUDY DESIGN: We treated 34 patients with microinvasive Nd:YAG laser therapy and evaluated its effect on the cellular immune function of the host. METHODS: Thirty-four patients with glottic Tis or T1 squamous cell carcinoma were treated with fiberoptic laryngoscopic Nd:YAG laser surgery. Both before and after therapy, serum levels of soluble interleukin-2 receptor (SIL-2R) and interleukin-2 (IL-2), as well as natural killer (NK) cell activity, were determined by means of double-antibody sandwich technique, tritiated thymidine-deoxyribonucleoside incorporation, and iodine 125-uridine-deoxyribonucleoside release technique, respectively. RESULTS: All 34 patients tolerated the procedure well. A 3- to 7-year follow-up in a subgroup of 27 patients resulted in an estimated cure rate of 85.2% (23 of 27 patients). In all 27 patients with a regular follow-up, a subjective improvement of phonation was noted after therapy to various degrees. In 74% (20 of 27 patients), voice and speech subjectively recovered to almost normal levels. The post-therapy serum levels of SIL-2R were significantly declined (P <.001), whereas those of IL-2 and the NK activity were significantly elevated (P <.001) as compared with those detected before therapy. CONCLUSIONS: Therapy with fiberoptic laryngoscopic Nd:YAG laser surgery is simple, safe, effective and only minimally invasive for patients with glottic Tis or T1 carcinoma. At the same time, it has an immunoenhancing effect on its host.

Active ion secretion and permeability of rabbit maxillary sinus epithelium, impact of staphylococcal enterotoxin B.

The aim of this study was to investigate the impact of staphylococcal enterotoxin B (SEB), a model superantigen, on the physiologic functions of rabbit maxillary sinus epithelium. Rabbit sinus mucosae were separated under a surgical microscope and mounted in Ussing chambers to record short-circuit current, conductance, and permeability to horseradish peroxidase. The results showed that SEB evoked increases in sinus epithelial cell baseline short-circuit current, conductance, and permeability to horseradish peroxidase. When tumor necrosis factor-alpha (TNF-alpha) was added to the Ussing chambers, we got results similar to those obtained by SEB stimulation in vitro; the effects of SEB on sinus epithelial cells could be blocked by pretreatment with anti-TNF-alpha antibody. These results demonstrate that SEB is able to alter the function of sinus epithelial cells and to affect the capability of the epithelial defensive barrier, which may be mediated by TNF-alpha.

[MDM2 gene expression in nasopharyngeal carcinoma and its relationship with p53 protein expression and EB virus latent infection].

OBJECTIVE: To define the expression levels of MDM2 gene in nasopharyngeal carcinoma (NPC) and its relationship with p53 protein expression and EB virus latent infection. METHOD: MDM2 gene expression at mRNA and protein levels, p53 protein and EB virus DNA were detected by nonradioactive in situ hybridization (ISH), immunohistochemistry(IHC) and polymerase chain reaction (PCR) separately in 46 cases of NPC tissues and 12 cases of chronic inflammation of nasopharyngeal epithelium (CINE). RESULT: Fourteen cases of NPC showed MDM2 mRNA and protein overexpression, 38 cases were p53 protein positive, and 43 cases were EBV-DNA positive. Neither MDM2 nor p53 protein was expressed in any case of CINE. MDM2 expression was significantly related to p53 protein expression (P < 0.05), but not to EB virus latent infection in NPC. CONCLUSION: MDM2 gene may play an important role in the pathogenesis of NPC through interacting with p53 protein.

Effect of photodynamic therapy on selected laboratory values of patients with nasopharyngeal carcinoma.

We determined pre- and post-photodynamic therapy (PDT) serum levels of soluble interleukin-2 receptor (SIL-2R) and interleukin-2 (IL-2), as well as activity of natural killer (NK) cells, among 24 patients with either persistent or recurrent nasopharyngeal carcinoma (NPC), using a double-antibody sandwich technique, tritiated thymidine-deoxyribonucleoside incorporation, and iodine 125-uridine-deoxyribonucleoside release techniques, respectively. The results showed that the post-PDT serum level of SIL-2R had significantly declined (p < .0005), while that of IL-2 and the NK cell activity had significantly increased (p < .0005), compared with pre-PDT values, suggesting an immunoenhancing effect of PDT on NPC patients.

An immunocytochemical study on the distribution of calcitonin gene-related peptidergic nerve fibers in rat nasal mucosa.

The distribution of calcitonin gene-related peptidergic (CGRP) nerve endings in rat nasal mucosa was investigated with immunocytochemical technique (ABC method). The results showed that CGRP endings had a robust localization along the walls of arterioles, venules and around the acini of glands, with the endings near the wall of arterioles being most strongly stained. The typical morphology of CGRP endings could be recognized as multistage-branched terminals with rosary varicosities. CGRP immunoreactive neurons were also found in the trigeminal ganglion (TG). Supported by morphological evidence, we suggest that CGRP endings in rat nasal mucosa are the peripheral fibers originating from the ganglion cells in TG. These fibers may be involved in the perception of mucosal stimuli and the propagation of nerve impulse to the central terminals and will thus release CGRP in the brain stem. There is also possibility that CGRP may be peripherally released following local stimulation in the nasal mucosa and exert influences on the mucosal functions.

Changes of nuclear DNA content in different types of nasopharyngeal epithelium.

The unclear DNA content was measured with flow cytometry (FCM) in 167 specimens of normal nasopharyngeal epithelium (NE), adjacent tissue to carcinoma (ATC) and nasopharyngeal carcinoma (NPC). All 20 patients with NE showed diploid, whereas 38 (38%) of 101 patients with NPC, 7 (58%) of 12 patients with recurrent NPC, 6 (30%) of 20 patients with ATC and 2 (33%) of 6 patients with NE, positive to EBVCA-IgA test, showed nondiploid. In addition, cellular proliferation index (PI) of diploid NPC and diploid ATC, though differed nonsignificantly, was significantly increased as compared with that of NE (P < 0.01). The rate of cervical metastasis in nondiploid NPC was significantly higher than that in diploid NPC (P < 0.025).

[AgNORs staining of exfoliated cells in the nasopharynx for diagnosis of nasopharyngeal cancer].

AgNORs were investigated in exfoliated cell smears from nasopharynx and in sections of biopsied tissues of NPC patients. It showed increased tendency of AgNOR activity that was significantly higher in carcinomas than in benign tumors, chronic nasopharyngitis, and normal nasopharyngeal tissues. This suggests that AgNOR technique of exfoliated cells might be useful for NPC diagnosis, follow-up of NPC patients, and identification of precancerous lesions of the nasopharynx.

[Transcranial resection of tumors involving nose, paranasal sinuses and anterior skull base].

Two cases of low-grade malignancies involving extensively the nose, paranasal sinuses, and anterior skull base were treated with transcranial resection and simultaneous repair of the dura as well as reconstruction of the skull base. The results appeared satisfactory. The advantages include: (1) much better cosmetic effect than the combined craniofacial resection. (2) almost equally full surgical exposure. (3) reliable repair and reconstruction of the anterior skull base with elimination of severe intracranial complications.

Oculomotor neuropathy syndrome. A diagnostic challenge in nasopharyngeal carcinoma.

Of 22 patients with different kinds of oculomotor neuropathy syndrome (ONS), 18 were initially suspected of suffering from nasopharyngeal carcinoma (NPC). However, in a series of evaluations, their diagnoses eventually proved to be other diseases such as cranial neuritis, aneurysm of intracranial internal carotid artery, chordoma, etc. The remaining four patients initially diagnosed as having aneurysm of skull base or pituitary lesion were actually NPC sufferers. Therefore, one should be very careful in differentiating NPC from many other diseases contributing to the similar manifestation of ONS.

Photoradiation therapy of animal tumors and nasopharyngeal carcinoma.

Both animal tumors and human nasopharyngeal carcinoma were submitted to a photoradiation therapy (PRT) trial in order to determine the efficacy and side effects of PRT, as well as to elucidate its mechanism of cytotoxicity. In animal tumors, the inhibition rate was 70%, and of 20 patients, eight achieved complete remission, and ten, significant remission, with an overall response rate of 90%. The blood picture and the values of serum IgG, IgM, IgA, and C3 all remained stable post-PRT. Only three patients developed mild generalized skin photosensitive reactions, and these did not affect subsequent treatment. There was no immunosuppressive effect as evidenced by a tritium-labeled thymidine-incorporated lymphocytoblast transformation assay performed both before and after PRT. Ultrastructural studies at different time intervals after PRT highly suggested that the mitochondria and rough endoplasmic reticulum were among the first organelles to be damaged.