[Clinical report of 81 cases of multiple primary cancers in laryngeal carcinoma].

OBJECTIVE: To explore the clinical characteristics and the survival status of the patients with laryngeal squamous cell carcinoma in the multiple primary cancers (MPC). METHODS: Follow-up and clinical data were analyzed retrospectively in 81 laryngeal squamous cell cancer patients with MPC among 1101 patients with laryngeal carcinoma. Survival analysis and every influencing factor on survival rate were performed by Kaplan-Meier method. RESULTS: The occurrence rate of MPC in the patients with laryngeal squamous cell cancer was 7.4% (81/1101) in this report. Oral cavity carcinoma and nasopharyngeal carcinoma were the most common MPC in 29 cases (35.8%) in head and neck regions. MPC in head and neck regions were more often seen among patients who had treated with radiotherapy (chi2 = 5.7, P = 0.017). Lung carcinoma (25.9%, 21/81) and esophageal carcinoma (22.2%, 18/81) were the most common MPC in remote organs in 52 cases (64.2%). Thirty seven MPC cases (45.7%) were occurred in aerodigestive tract and 32 cases(39.5%) in respiratory tract in this series. Fourteen cases (17.3%) were synchronous MPC, the median time interval was 2 months. Other 67 cases (82.7%) were metachronous MPC, the median time interval was 28 months. The squamous cell carcinoma (66.7%) was the most common pathologic type among all MPC in 81 cases, which was more often seen among patients who had smoked and drunk (P = 0.007). The MPC of esophageal carcinoma and oropharyngeal carcinoma were more often seen among patients of supraglottic index cancer presentation (P = 0.04). The MPC of oral cavity cancers and nasopharyngeal carcinoma and lung carcinoma were more often seen among patients of glottic index cancer presentation (P = 0.006). The total three-and five-year survival rates were 45.2% and 29.7% respectively of all MPC patients, the five-year survival rate for patients (53 cases) who received actively different therapies for their MPC was 45.5%, obviously higher than that of untreated patients (28 cases) whose three-year survival rate was zero (P = 0.000). CONCLUSIONS: Lung carcinoma and esophageal carcinoma were the most common multiple primary cancers among MPC of the laryngeal cancer. MPC of the laryngeal cancer in head and neck regions were more often seen among patients who had treated with radiotherapy. The pathologic type of squamous carcinomas of MPC was more often seen among patients who had smoked and drunk. MPC affected the prognosis of patients in laryngeal cancer largely. Treating effectively and in time could help to improve the survival rate of patients with MPC in laryngeal squamous cell carcinomas.

[Treatment and prognosis of anaplastic thyroid carcinoma].

OBJECTIVE: To investigate the treatment model and the factors that influence survival of the patients with anaplastic thyroid carcinoma (ATC). METHODS: The clinical data of all patients with ATC in our hospital from May. 1970 to May. 2005 were analyzed retrospectively with regard to mortality and survival rate (Kaplan-Meier). Multivariate analysis was performed by the Cox proportional hazard model. RESULTS: Fifty cases together were analyzed. The overall 1-year, 3-year, 5-year survival rate were 39.4%, 29.6% and 20.7% respectively. The median survival time was 6 months. Univariate analysis showed the patients with their age < 55 years old, without distant metastasis, white blood cell count < 10.0 x 10(9)/L at presentation, without receiving chemotherapy, receiving radiotherapy with the dose no less than 40 Gy, receiving multiple modality therapy had a better prognosis. White blood cell count at presentation, the model of therapy were the risk factors independently influencing prognosis by multivariate analysis. CONCLUSIONS: White blood cell count at presentation, receiving surgery and postoperative radiotherapy or not were the risk factors independently influencing prognosis. The prognosis of anaplastic thyroid carcinoma was worse; the patients with ATC maybe get a better prognosis by receiving surgery and postoperative radiotherapy.

[Expression of p73 and PTEN in laryngeal squamous cell carcinoma and their clinical significance].

BACKGROUND & OBJECTIVE: There are few ideal predictors used to evaluate the prognosis of laryngeal squamous cell carcinoma (LSCC). This study was designed to investigate the expression of p73 and PTEN (phosphates and tension homolog deleted on chromosome ten) and their association with clinical, histologic characteristics and prognosis in LSCC. METHODS: p73 protein and PTEN protein were examined by using immunochistochemical SABC staining method in 65 cases of LSCC and in 23 cases of para-tumor tissues. RESULTS: p73 protein and PTEN protein in LSCC showed positive expression of about 58.5% (38/65) and 49.2% (32/65), compared to para-tumor tissues of about 17.4% (4/23) and 95.7% (22/23) with statistical significance (P< 0.05). p73 protein positive expression showed stronger in stage III-IV of LSCC than that in stage I-II (P< 0.05); it more often appeared in recurrent cases than in primary cases (P< 0.05). And p73 protein positive expression with distant metastasis was stronger than that in LSCC without distant metastasis (P< 0.05). PTEN protein positive expression was stronger in stage I-II of LSCC than that in stage III-IV (P< 0.05); PTEN protein positive expression appears less frequently in poor differentiation of LSCC, compared to well/moderate differentiation (P< 0.05); PTEN positive expression in cases with cervical lymph node metastasis and distant metastasis was lower than that in those without metastasis (P< 0.05). PTEN expression showed significantly stronger in the patients whose survival time over 5 years (66.7%) than in the patients whose survival time was less than 5 years (27.3%) (P< 0.05). CONCLUSION: PTEN positive expression may be useful for predicting the prognosis of LSCC.