[Clinical analysis on 18 cases of adenoid cystic carcinoma of nasal cavity and sinuses].

OBJECTIVE: To explore the clinical characteristics and treatment effect of adenoid cystic carcinoma in nasal cavity and sinuses. METHOD: Sixteen of all 18 cases of adenoid cystic carcinoma of nasal cavity and sinuses were performed operation and radiotherapy. Other 2 cases were performed radiotherapy. RESULT: Eighteen cases of patients were followed up for 5 years. Eight patients with early stage had no death. Five in 10 cases of advanced patients died, one case was out of following-up. In 11 of high differentiation group, 1 case died. In 7 of lower differentiation group, 4 cases died, 1 case lost. CONCLUSION: Adenoid cystic carcinomas of nasal cavity and sinuses are distinct clinicopathological category and the clinical symptoms are noncharacteristic. Paying attention to the differential diagnosis and promoting related knowledge can help to avoid misdiagnosis. The prognosis is related to pathological category and clinical stage. High stage and high invasion of adenoid cystic carcinoma lead to poor prognosis.

[Effects of celecoxib combined with radiotherapy on apoptosis of CNE-2Z cell lines].

OBJECTIVE: To investigate the effects of celecoxib combined with radiotherapy on apoptosis of CNE-2Z cell lines and the potential mechanisms. METHODS: Four groups were used, a control, celecoxib (25 micromol/L celecoxib), irradiation (8 Gy X ray) and celecoxib plus irradiation. The radiosensitising effect was detected by clone formation experiment. Flow cytometry was used to detect the apoptosis rate of cells. The expressions of Bcl-2 and Bax were assessed by immunocytochemistry. Western blot was used to examine the expression of Caspase-3. RESULTS: Celecoxib enhanced the radiosensitivity of CNE-2Z cells. In experimental group, the mean surviving fraction and the mean lethal dose of CNE-2Z cells were 0.50 and 2.36 respectively. Compared with the irradiated group, there was significant differences between the two groups (P < 0.01). Celecoxib combined with radiotherapy up-regulation the expression of Bax. The score of the expression of Bax in the control group and the experimental group were 1.221 +/- 0.116 and 2.758 +/- 0.256 respectively. Celecoxib combined with radiotherapy could inhibit the expression of the protein of Bcl-2. The score of the expression of Bcl-2 in the control group and the experimental group were 2.559 +/- 0.144 and 1.253 +/- 0.114 respectively, with significant differences (P < 0.01). Celecoxib combined with radiotherapy could increase the apoptosis rate of tumor cells with significant differences (F = 7.63, P < 0.01). Western blot showed that the expression of Caspase-3 was strengthened. CONCLUSION: Celecoxib combined with radiotherapy could induce apoptosis and enhance the radiosensitivity of human nasopharyngeal carcinoma CNE-2Z cell lines.

[Clinical significance of MRP8 and cypA expression in laryngeal squamous cell carcinoma tissues].

OBJECTIVE: To study differential expression of MRP8, CypA protein in the patients of laryngeal squamous cell carcinoma (LSCC) and the relationship in the development of LSCC. METHOD: Immunohistochemistry was used to detect the expression of MRP8,CypA protein in LSCC tissues of 41 cases and matched paraneoplastic normal tissues of 41 cases,with results compared to the clinical data to determine significance. RESULT: The expression of MRP8, CypA protein in carcinoma and normal tissues and composition of different positive grades were in statistical significance (P < 0.01). The expression levels of MRP8 were no significant correlations were identified against any parameter (age,sex and cervical lymphatic metastasis) examined (P > 0.05), but related to pathological stage (P < 0.05). CONCLUSION: MRP8 protein is on intimate terms with different pathological differentiation stage of LSCC. MRP8, CypA protein may play an important role in the development and progression of LSCC.

[Clinical analysis on 14 cases with malignant melanoma in nasal cavity and sinus].

OBJECTIVE: To investigate the effect of treatment on malignant melanoma in nasal cavity and paranasal sinus. METHOD: Fourteen patients with malignant melanoma in nasal cavity and paranasal sinus were retrospectively analyzed from 1995 to 2002, including clinical presentation, diagnosis, treatment and follow-up data. RESULT: Thirteen patients were followed up, the survival rates of 3 and 5 years were 42.9% and 21.4% respectively. CONCLUSION: Sinonasal malignant melanoma has an aggressive behavior and easy recurrence. Early diagnosis, radical operation and postoperative radiotherapy could improve the survival rate.

[Effect of adenoidectomy on pediatric chronic rhinosinusitis].

OBJECTIVE: To explore the effect of adenoidectomy on pediatric chronic rhinosinusitis. METHOD: A total of 51 pediatric patients with chronic rhinosinusitis were included in this study. There were 17 cases underwent adenoidectomy, 12 cases underwent endoscopic sinus surgery,and 22 cases underwent both adenoidectomy and endoscopic sinus surgery. RESULT: There was significant differences in the efficiencies between endoscopic sinus surgery group and both adenoidectomy and endoscopic sinus surgery group. CONCLUSION: Adenoidectomy is effective treatment for sinusitis in children.

[Identification of tumor-associated proteins in laryngeal squamous cell carcinoma by proteomics].

OBJECTIVE: To establish two-dimensional electrophoresis profiles from human laryngeal squamous cell carcinoma tissue and paired normal tumor-adjacent mucosa epithelia tissue, and to identify differential expression proteins. METHODS: The total proteins of human laryngeal squamous carcinoma tissue and paired normal tumor-adjacent mucosa epithelia tissue were separated by immobilized pH gradient-based two-dimensional gel electrophoresis (2-DE). The differential expression proteins were analyzed using image analysis software, then identified using mass spectrometry and database searching. RESULTS: Well-resolved, reproducible 2-DE patterns of laryngeal squamous cell carcinoma and adjacent normal mucosa epithelial were obtained. Differential protein spots were defined as spots in 2-DE gels. Thirteen proteins were preliminarily identified, naming which 10 proteins were upregulated in laryngeal cancer tissue. Such as cofilin-1, nuclear body protein SP140, GRP94, HSP 90, GSTP1-1, superoxide dismutase [Mn], cyclophilin A, proteasome activator complex subunit 2, apolipoprotein A-I precursor, CaM-like protein and so on. There were 3 proteins downregulated in laryngeal cancer tissue, which were fatty acid-binding protein, calgranulin A and calgranulin B. CONCLUSIONS: Thirteen proteins which are associated with the tumorigenesis of the laryngeal squamous cell carcinoma were characterized. These extensive protein variations indicate that multiple protein molecules should be simultaneously targeted as an effective strategy to counter the disease. It is better for understanding of the oncogenesis and pathogenesis in a global way, which in turn is a basis-for the rational designs of diagnostic and therapeutic methods.

[Nasopharyngeal carcinoma and cervical masses].

OBJECTIVE: To study the clinical characteristic of cervical metastatic lymph nodes in patients with nasopharyngeal carcinoma (NPC) and the relation between NPC and cervical masses. METHOD: The clinical material of 246 cases with NPC was analyzed retrospectively. RESULT: One hundred and eighty-three of 246 cases suffered from cervical masses and 101 cases began with them. In all cases, 134 cases had cervical masses on the same lateral of lesion, 44 cases on both sides, and others on the opposite sides. In 172 cases, the masses were found to be the involved superior deep cervical lymph nodes. There was no remarkable difference between the NPC with cervical masses and without cervical masses in EBV VCA-IgA and EA-IgA titers. Large masses were relative to metastases. CONCLUSION: Superior deep cervical lymph nodes were involved in most of the patients with NPC, usually on the same lateral of lesion. The EBV titers were not relative to cervical masses. Distant metastases were more likely to be detected in patients with large masses.

[Surgical management of carcinoma of the hypopharynx and cervical esophagus].

OBJECTIVE: To report our experience in reconstructing hypopharynx and cervical esophagus with four kinds of operations. METHOD: Twenty one patients underwent reconstruction of the hypopharyngeal and cervical esophagus defect using contralateral hemilaryngeal mucosa flap, pectoralis major myocutaneous flap, forearm free flap and jejunal free flap. RESULT: All of cases were successful. Postoperative pharyngocutaneous fistulas occurred in two patients, which resolved spontaneously. All of patients can swallow ordinary food and had no benign strictures after operation. CONCLUSION: Every operation style has advantage and disadvantage. We had to select the operation of choice depending upon the location and size of the carcinoma, perioperative complication.

[Hypopharynx reconstruction of defects after operation on advanced pyriform sinus cancer with remaining laryngeal mucosa flap and pectoralis major myocutaneous flap].

OBJECTIVE: To explore the outcome of hypopharynx reconstruction by using remaining laryngeal mucosa flap and pectoralis major myocutaneous flap in advanced pyriform sinus cancer. METHODS: Twelve patients with pyriform sinus cancers underwent hemilaryngectomy and partial pharyngectomy, two patients underwent cervical esophagectomy at the same time. The defects were reconstructed by remaining laryngeal mucosa flap. Four cases were involved in the bilateral larynx, received total laryngectomy and were repaired by pectoralis major myocutaneous flap. RESULTS: There was no operative fatal case and all flaps survived. Only one suffered from postoperative pharyngocutaneous fistulas, whose defect was reconstructed by remaining laryngeal mucosa flap and had radiotherapy. All patients could swallow ordinary food and had no benign esophagostenosis and pharyngostenosis after operation. Out of 16 patients, 1 case died of general metastasis; 3 cases died of local tumor relapse, tumor relapse of cervical lymphonode and lung metastasis respectively within 1 year after operation; the other 12 cases survived over 2 years. CONCLUSION: The advantage of hypopharynx reconstruction with remaining laryngeal mucosa flap is simple and convenient with less trauma and complication. The reconstruction should be completed by using the pectoralis major myocutaneous flap when the bilateral larynx are involved in.

[A study on the application of Nickle-Titanium alloys stent for prevention and treatment tracheostomal stenosis after total laryngectomy].

OBJECTIVE: To evaluate the effect of Nickle-Titanium alloys annular stent to prevent and treatment tracheostomal stenosis after total laryngectomy. METHOD: The stent was used following total laryngectomy and after total laryngectomy. RESULT: Long stent was implanted in 2 cases following total laryngectomy and in 1 cases after total laryngectomy, Which resulted in widening stenosis and relieving obstruction of airway. The tracheostomal diameter is 2 cm afterwards, but the patients have crusts, granuloma and stretch feeling in tracheostoma. Tracheostomaplasty was performed using short stent in 18 cases during laryngectomy. All the cases have no tracheostomal stenosis following over 6 months. The tracheostoma is smooth, enough larger and stable. CONCLUSION: Nickle-Titanium alloys annular short stent is fixed outside the wall of trachea, its complication is less. It may prevent from tracheostomal stenosis. Nickle-Titanium alloys annular long stent is a better method to resolve dyspnea.

[Experimental and clinical study on the chemosensitivity assay in vitro for head and neck tumor by AgNOR methods].

OBJECTIVE: To evaluate in vitro chemosensitivity of head and neck tumor to eight kinds of antineoplastic drugs by AgNOR technique. METHOD: Fifty-nine cases' fresh specimens were obtained from head and neck tumors. We severed tumor tissue with simple mechanical separation method. After the acting of drugs, cell smear and argyophilie staining, mean Inhibiting rate was calculated. 12 cases were treated with chemotherapy at the same time. RESULT: 54 cases' specimens succeeded in the experiments, the rate of success was 91.5%. The changes of mean Inhibiting rate were from 0 to 63.0%. The chemosensitivity to DDP was the highest in eight kinds of antineoplastic drugs. VCR, 5-Fu, PYM were higher sensitive drugs respectively. The sensitivity to drugs in NPC was significantly higher than laryngeal cancer. The coincidence between the experiment and clinic was 75.0%. CONCLUSION: AgNOR method is simple and convenient. In addition, it has clear correlation with the results of therapy. The method is useful for chemotherapy.

[Analysis on clinical and immunohistochemical characteristics of primary extranodular non-Hodgkin's lymphoma in otolaryngol head and neck].

OBJECTIVE: To study the characteristic of clinical manifestation and cell immunophenotype in cases with primary extra-nodular non-Hodgkin's lymphoma (PE-NHL) in otolaryngol head and neck for early diagnosis and treatment. METHOD: Clinical manifestation of one hundred and fifty five patients with PE-NHL in otolaryngol head and neck from 1991 to 2000 were analyzed and restudied by pathological sections with immunohistochemical technology. RESULT: The age of twenty six to fifty years old was the most common age range in the group of patients with PE-NHL. Waldeyer's ring was the most commonly involved site (92 cases), the rest were in sinonasal (57 cases), in laryngopharynx (2 cases) and in larynx (4 cases). There were no characteristic symptoms of primary lesion located. The lump or fester signs were mostly observed on primary position. Cell immunophenotype result displayed 46.4% of the PE-NHL originating from T cells, while 53.6% originating from B cell. Most of waldeyer's PE-NHL originating from B cell, while most of sinonasal PE-NHL originating from T cell. CONCLUSION: The clinical behavior in patients with the PE-NHL is complicated and lacks characterisic symptoms, so the diagnosis is difficult. Doctor should be alert and the repeated exact biopsy may be needed. The diagnosis can be definite by pothological and immunohistochemical approaches with clinical manifestation.