[Reoperation treatment of persistent postoperative secondary hyperparathyroidism].

Objective:To evaluate the clinical effect of reoperation in persistent hyperparathyroidism （PHPT） patients after operation of parathyroidectomy combined with autotransplantation（PTX+AT） on secondary hyperparathyroidism （SHPT） . Methods:18 PHPT patients who treated with reoperation after PTX+AT were enrolled in this study during the period from Aug 2012 to Dec 2021 in the Department of Otolaryngology Head and Neck Surgery of Peking University Civil Aviation School of Clinical Medicine, Civil Aviation General Hospital. The remaining parathyroid glands were located by preoperative colour Doppler ultrasonography, radionuclide imaging, enhanced CT and MR imaging in the neck region . Based on the imaging findings, the remaining parathyroid glands were removed in situ, and the missed ectopic or extra parathyroid glands were resected with an extended surgical scope according to the parathyroid dissection method. The surgical effect was evaluated by the changes of clinical symptoms, the dynamic change of serum intact paramyroidhomone（i-PTH） between preoperative and postoperative periods and the surgical complications. Results:All the 18 patients accepted successful operation. 30 parathyroid glands were resected confirmed by postoperative pathology, including 16 in situ and 14 ectopic glands（5 in superior mediastinum, 4 in thymus, 2 in posterior mediastinum ,2 in thyroid glands, 1 in carotid sheath）.Osteoarthropathy and skin itching were significantly relieved or even disappeared at 6 h after surgery. The levels of serum i-PTH, calcium and phosphorus reached the standards and muscle weakness was significantly improved 1 week after surgery. 16 patients presented hypocalcemia and returned to normal after supplement of calcium. Hoarseness due to temporary injury of laryngeal nerve was found in 6 cases. No serious complications or death occurred after the operation.There was no recurrence after 1 year follow-up. Conclusion:Reoperation is the first choice for SHPT patients complicated with persistent hyperparathyroidism. Multiple imaging examinations are used to locate the residual parathyroid, especially the ectopic gland. Expanded surgical scope is applied to resect all the residual parathyroid glands（ectopic, in situ and concealed parathyroid） according to the concept of dissection parathyroidectomy. The surgery is effective and safe. Patients'quality of life and long-term survival rate is improved.

Multi-Scale Spatial Attention-Guided Monocular Depth Estimation With Semantic Enhancement.

Depth estimation from single monocular image is a vital but challenging task in 3D vision and scene understanding. Previous unsupervised methods have yielded impressive results, but the predicted depth maps still have several disadvantages such as missing small objects and object edge blurring. To address these problems, a multi-scale spatial attention guided monocular depth estimation method with semantic enhancement is proposed. Specifically, we first construct a multi-scale spatial attention-guided block based on atrous spatial pyramid pooling and spatial attention. Then, the correlation between the left and right views is fully explored by mutual information to obtain a more robust feature representation. Finally, we design a double-path prediction network to simultaneously generate depth maps and semantic labels. The proposed multi-scale spatial attention-guided block can focus more on the objects, especially on small objects. Moreover, the additional semantic information also enables the objects edge in the predicted depth maps more sharper. We conduct comprehensive evaluations on public benchmark datasets, such as KITTI and Make3D. The experiment results well demonstrate the effectiveness of the proposed method and achieve better performance than other self-supervised methods.

Giant Malignant Peripheral Nerve Sheath Tumor of the Head and Neck: A Case Report and Literature Review.

Malignant peripheral nerve sheath tumor (MPNST) is a malignant soft tissue sarcoma with high mortality, low morbidity, and poor prognosis. The MPNST occurs mostly in the limbs and torso, and rarely in the head and neck. However, MPNST is insensitive to radiotherapy and chemotherapy, and complete surgical resection with negative margin is the most important and effective strategy. We present a case of MPNST in the head and neck. The tumor invades the left temporal bone, petrous bone, and mastoid bone, and compression changes in the focal cerebellum and sigmoid sinus. The patient underwent the left temporal region tumor resection + surgical reconstruction with temporalis muscle flap and pectoralis major myocutaneous flap. Adjuvant radiotherapy (55 Gy) was given after surgery, and there were no local recurrence and distant metastasis after 31-month follow-up.

Corrigendum to "Special Staining of the Liquid-Based Cytopathology Test in Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis with Nonneutropenic Patients".

[This corrects the article DOI: 10.1155/2020/8243473.].

Special Staining of the Liquid-Based Cytopathology Test in Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis with Nonneutropenic Patients.

In recent years, various biomarkers have been gradually applied on bronchoalveolar lavage (BAL) fluid for the diagnosis of invasive pulmonary aspergillosis (IPA). The objective of this study is to assess the value of the liquid-based cytopathology test (LCT) for improving the identification of IPA in BAL fluid from possible IPA patients, following special staining with periodic acid-Schiff staining (PAS) or Grocott's methenamine silver (GMS). A total of 47 consecutive possible IPA patients who underwent bronchoscopy with BAL fluid from January 2017 to December 2018 were included. 45 people had a pair of BAL fluid specimens and 2 patients had two BAL fluid specimens. The 49 pairs of BAL fluid specimens were processed for culture, tuberculosis acid fast staining smear, direct microbial smear, and LCT with special staining (PAS and GMS), respectively. Then, we compared the sensitivity and specificity of PAS and GMS in BAL fluid in high-risk patients. Among 47 possible IPA patients, 25 patients had proven/probable IPA, and 11 patients had other invasive fungal diseases. The sensitivity of GMS was higher than that of PAS (92.11% versus 81.58%; P = 0.175). The specificity of GMS was 81.82%, which was higher than that of PAS (81.82% versus 72.73%; P = 0.611). The negative predictive value (NPV) for PAS and GMS were 53.33% and 75.00%, respectively. The positive predictive value (PPV) for PAS and GMS were 91.18% and 94.59%, respectively. This study showed that special staining of LCT in BAL fluid may be a novel method for the diagnosis of IPA, and the GMS of LCT had higher sensitivity and specificity, which was superior to PAS.

[Postoperative anxiety and its relationship with life quality in patients with Ménière's diseases].

OBJECTIVE: To investigate the postoperative anxiety and its relationship with life quality in patients with Ménière's diseases.
 Methods: A total of 68 patients with Ménière's disease, who received the treatment of endolymphatic sac decompression from 2010 to 2016, were enrolled. They finished two scales (the self-rating anxiety scale and the quality of life questionnaire for endolymphatic sac decompression of Ménière's disease) by snail mail. The patients were divided into different groups based on their preoperative course, postoperative follow-up time, clinic stage and quality of life after endolymphatic sac decompression surgery, and their anxiety was analyzed. In addition, 109 gender and age-matched patients with other diseases of otorhinolaryngology served as the control group, and their anxiety was also analyzed.
 Results: There was no statistical difference in the postoperative anxiety among the patients with preoperative course for less than 1 year, 1 to 5 years or more than 5 years (all P>0.05). There was no statistical difference in the patients with different duration of follow-up (P>0.05). There was no statistical difference in the patients with the different clinic stages (all P>0.05). There was no statistical difference in the patients with the improved life or non-improved life after surgery (P>0.05). The degree of the anxiety in the Ménière's group was more severe than that in the control group (P<0.01).
 Conclusion: It needs to keep in mind that a certain degree of postoperative anxiety still keeps in patients with Ménière's disease.

Application of LC-MS-Based Global Metabolomic Profiling Methods to Human Mental Fatigue.

Mental fatigue is characterized by a reduced capacity for work and a loss of capacity to respond to stimulation and is usually accompanied by a feeling of tiredness and drowsiness. Mental fatigue at work is a serious problem and can raise safety concerns especially in the transportation system. It is believed that mental fatigue is a direct or contributing cause of road and air related accidents and incidents. Psychological studies indicate that fatigue results in reduced work efficiency, alertness, and impaired mental performance. However, its underlying biochemical mechanisms are poorly understood. We hypothesized that the human body is an integrated system, and mental fatigue results in changes not only in psychology but also in biochemistry of the human body. These biochemical changes are detectable in metabolites. We employed global metabolomic profiling methods to screen biochemical changes that occur with mental fatigue in air traffic controllers (ATCs) in civil aviation. A total of 45, all male, ATCs (two batches) were recruited as two mental fatigue groups and 23 executive staff acted as a control group for this study. The volunteers' urine samples were collected before and after their work. The samples were analyzed with liquid chromatography/mass spectrometry equipped with a polar, a weak polar, and a nonpolar column, respectively. Three candidate biomarkers were selected on the basis of statistical significance, coefficient of variance, and compared with data of the three groups. The results suggest that urine metabolites may provide a complete new clue from biochemistry to understand, monitor, and manage human mental fatigue.

[Maxillary sinus carcinoma combined with maxillary sinus fungal sinusitis: one case report].

A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.

[Primary investigation of central auditory function in patients with temporal lobe epilepsy].

OBJECTIVE: To investigate the function of central auditory, Speech-perception-in-noise test (SPIN test) was used to assess that whether temporal lobe epilepsy patients have central auditory processing disorders. METHODS: Four audiological test were performed in 9 patients with temporal lobe epilepsy and 19 age-matched normal hearing persons as controls, which include pure tone audiometry, acoustic immittance measurement, ABR (auditory brainstem response) and SPIN test. All the temporal lobe epilepsy patients were performed by CT or MRI and diagnosed by the neurologists prior to the test. The testing materials of speech and noise in SPIN test was recorded in independent tracks and the S/N was identified by -25 dB by pre-experiment. In the test, every words were read twice and both the results were recorded. RESULTS: In the ABR test, only wave V latency showed longer values in the left ear, other waves like I, III and inter-peak intervals had'nt shown significant statistical differences in both ears of temporal lobe epilepsy patients. However, in the SPIN test, there's no significant statistical differences in both left and right ears of the controls by the first-time hearing (P = 0.107), and the differences showed by the second-time hearing (P = 0.048); but in the comparison of both ears in temporal lobe epilepsy patients, both time of hearing showed no significant statistical differences with P = 0.174 and P = 0.163. In additional, the SPIN recognition score of the temporal lobe epilepsy patients, whether in the fist or second time hearing, whether in the monaural or binaural models, presented significant statistical differences compared to the controls (P = 0.000). CONCLUSIONS: There was no statistically significant difference in pure tone audiometry and ABR test for all the groups. But the speech recognition score obtained from SPIN test of tempol lobe epilepsy patients is lower than the normal persons, which has statistically significant difference. (P < 0.001) Then we can come to the conclusion that Temporal lobe epilepsy patients had central auditory dysfunctions and SPIN test is a sensitive way to assess this abnormal.

[Application of flow cytometry in diagnosis of T-cell rich diffuse large B-cell lymphoma].

OBJECTIVE: To investigate the application of flow cytometry in diagnosis of T-cell rich diffuse large B-cell lymphoma. METHODS: Histopathologic features, immunohistochemical findings and flow cytometry results of three cases of T-cell rich diffuse large B-cell lymphoma were reviewed retrospectively. RESULTS: In CD45-side scatter (SSC) dot plot of the first patient, two different CD45-positive lymphoid cell populations were identified. The bright population consisted of both T and B cells, with a T-cell predominance. The dim population consisted mainly of B cells which showed lambda light chain restriction. In the second patient, CD45-positive cells were subdivided into two groups according to CD45-SSC dot plot. The small population consisted of both T and B cells, with a T-cell predominance. The large population consisted mainly of B cells which showed kappa light chain restriction. In the third patient, CD19-positive cells were subdivided into two groups according to the expression of CD20 in CD19-CD20 dot plot. The CD20-positive population expressed both kappa and lambda light chains, while the CD20-negative population demonstrated kappa light chain restriction. CONCLUSIONS: Neoplastic B cells can be distinguished from reactive lymphoid cells in T-cell rich diffuse large B-cell lymphoma by flow cytometry, according to a number of parameters which include intensity of antigen expression, loss of antigens, expression of non-B-cell lineage antigens, patterns of forward scatter (FSC) and/or SSC, and expression of immature B-cell antigens.

[Treatment and prognosis of tracheal invasion by papillary thyroid carcinoma].

OBJECTIVE: To explore the treatment and prognosis on patients with tracheal invasion by papillary thyroid carcinoma (PTC). METHODS: Forty-five patients treated for PTC with tracheal invasion between 1980 and 1995 were retrospectively analyzed. The different kinds of surgical modalities were performed according to the extent and degree of tracheal invasion by PTC. Neck dissect was performed in 39 patients. External beam radiotherapy was used postoperatively in patients with gross residual tumor or microscopic residual tumor in pathologic margins after resection. Survival was evaluated using the Kaplan-Meier method. RESULTS: (1) Twenty-eight patients with limited tracheal invasion were treated with shave excision, the 5- and 10-year survival rates were 85.0% and 62.6%, respectively. After a shave excision, the differences of 5- and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05). (2) Ten patients were radical excision for intraluminal involvement extending through the tracheal cartilage, including circumferential sleeve resection (4 cases), tracheal window resection (5 cases) and total laryngectomy (1 case), the survival rate was 80.0% for five years and 58.3% for ten years. After a radical excision, the differences of 5- and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05). (3) For 7 patients performing the palliative operation, the 5-and 10-year survival rates were 42.9% and 28.6%, respectively. For 4 patients received postoperative radiotherapy, the 5-and 10-year survival rates were 50.0% and 50.0%, respectively. Three patients didn't received postoperative radiotherapy, the 5-year survival rate was 33.3%, no patient survived for ten years. In these patients of incomplete resection, the differences of 5-and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05). CONCLUSIONS: PTC with limited involvement of the trachea could be treated successfully by shaving tumor off the tracheal cartilage. Intraluminal involvement extending through the tracheal cartilage could be resected radically in patients with PTC. Postoperative radiotherapy could improve the survival of the patients with PTC with tracheal invasion who have been performed incomplete resection.

[Specialization in thyroid surgery].

OBJECTIVE: To evaluate the results of surgically treated patients with benign thyroid disorders from Department of Otolaryngology- Head and Neck Surgery. METHODS: The clinical data of 496 patients operated for benign thyroid disorders were retrospectively analyzed in this department from January 2001 to April 2004. The incidence of complications, particularly postoperative permanent recurrent laryngeal nerve palsy and hypocalcemia, duration of surgery, incision length on the neck, hospitalization days and postoperative recurrence were evaluated. RESULTS: Unilateral total thyroidectomy with contralateral partial lobectomy was performed in 314 cases, unilateral total thyroidectomy with isthmectomy in 76, bilateral subtotal thyroidectomy with the remnant left at the upper pole in 29, isthmectomy in 3, total thyroidectomy in 46. The operations on 28 patients with substernal goiter have been successfully performed via cervical collar incision. Of these patients, the incidences of unilateral recurrent laryngeal nerve paralysis and temporary postoperative hypocalcemia were 0.2% (1/496) and 1.8% (9/496), respectively. There were no bilateral vocal cord paralyses and permanent hypocalcaemia. Postoperative hemorrhage requiring reoperation occurred in 3 cases (0.6%). No patients had incision infection. The mean duration of surgery was 66 min. The mean incision length on the neck was 5.2 cm. The incidence of postoperative recurrence was 0.2% (1/496). The mean hospitalization day was 6.3 d. CONCLUSIONS: Otolaryngologists who had received stringent training of head and neck surgery seem to have the advantage to avoid injury of recurrent nerve in the thyroid surgery.

Detailed deletion mapping of loss of heterozygosity on 9p13-23 in laryngeal squamous cell carcinoma by microsatellite analysis.

BACKGROUND: This study was designed to investigate the hot spots of microsatellite loss of heterozygosity (LOH) on 9p13-23 in laryngeal squamous cell carcinoma and to find out the correlation between the incidence of microsatellite LOH and the clinicopathological parameters. METHODS: Tumor tissues were obtained from paraffin embedded sections with microdissection. Genomic DNA was extracted from tumor tissues and peripheral blood lymphocytes with the phenol-chloroform. Polymerase chain reaction (PCR) amplification and denaturing gel electrophoresis were carried out in a set of 42 squamous cell carcinoma (SCC) of larynx and corresponding peripheral blood lymphocytes using 13 highly polymorphic microsatellite markers on 9p13-23. The correlation was analyzed between microsatellite LOH at the high frequency on 9p13-23 and clinicopathological parameters in the patients with squamous cell carcinoma of larynx. RESULTS: Of the 42 laryngeal cancers, 41 (97.6%) showed LOH in at least one of the microsatellite markers tested on 9p13-23. The most frequently deleted marker was D9S162 in 17 of the 19 (89.5%) informative samples. The marker D9S171, which is located on 9p21, had LOH detected in 12 of the 15 informative cases (80.0%). LOH at the D9S1748 marker (closest to the p16 gene locus) was detected in 18 of the 36 informative cases (50.0%). Allelic deletion mapping revealed two minimal regions of LOH encompassing markers D9S161-D9S171 on 9p21 and IFNA-D9S162 on 9p22-23. Multiple LOH (> or = 4) on 9p21-23 was found more frequently in the patients under 60 years, with supraglottic SCC or cervical lymph node metastasis than those over 60 years, with glottic SCC or without cervical lymph node metastasis (P < 0.01 or 0.01, 0.05, respectively). On the contrary, there was no correlation between T stages or pathologic classification and the frequency of LOH on 9p21-23 in 42 SCC of Larynx. CONCLUSIONS: These findings imply the presence of at least two putative tumor suppressor genes on 9p13-23 in laryngeal SCC. Multiple genetic alterations are probably implicated in supraglottic SCC with cervical lymph node metastasis in younger patients.

[Application of flow cytometry in the differential diagnosis of lymphoma/leukemia with aberrant antigen expression].

OBJECTIVE: To investigate the application of flow cytometry in the differential diagnosis of lymphoma/leukemia with aberrant antigen expression. METHODS: The results of flow cytometry of 30 lymphoma/leukemia cases with aberrant antigen expression, of which 3 cases being lymphomas, 8 B-cell leukemia, 1 T-cell leukemia, 17 acute non-lymphoid leukemia and 1 acute non-lymphoid leukemia involving lymph nodes were analyzed. Immunohistochemistry (EnVision) for CD79a, CD3 and MPO was performed on all cases. RESULTS: Eleven cases of B-cell lymphoma/leukemia were cytoplasmic CD79a (cCD79a)-positive, cytoplasmic CD3 (cCD3epsilon) and cytoplasmic MPO (cMPO)-negative. Five of these cases were positive for CD5 and 2 for CD5, 1 or 2 for myeloid marker(s). The T-cell leukemia cases were cCD3epsilon-positive, cCD79a and cMPO-negative, they also co-expressed CD13 and CD33. The mantle cell lymphoma cases were positive for CD3, CD13 and CD33. Of the 8 B-cell leukemia cases, 4 were positive for CD5, 3 for CD13 and 1 for CD13 and CD33. The 18 acute non-lymphoid leukemia cases (including 1 acute non-lymphoid leukemia case involving lymph nodes) were cMPO-positive and cCD79a and cCD3epsilon-negative. Eight of the 18 expressed T-cell markers (including 1 case of acute non-lymphoid leukemia involving lymph nodes), 8 expressed B-cell markers, 2 expressed both T and B-cell markers. CONCLUSIONS: Flow cytometry can demonstrate aberrant antigen expression in lymphoma/leukemia cells and is helpful in delineating their cell origin. The technique is thus useful in the differential diagnosis of lymphoma/leukemia.

[The management and prognosis of laryngotracheal invasion by well-differentiated thyroid carcinoma].

OBJECTIVE: To explore the treatment and prognosis on patients with laryngotracheal invasion by well-differentiated thyroid carcinoma (DTC). METHODS: Eighty-six patients treated for DTC with laryngotracheal invasion between 1976 and 1996, from Beijing Chaoyang Hospital and Cancer Hospital, Chinese Academy of Medical Sciences, were retrospectively analyzed. The different kinds of surgical modalities were performed according to the extent of laryngotracheal invasion by DTC, including shave excision (39 cases), tracheal window resection (11 cases), circumferential sleeve resection (8 cases), total laryngectomy (2 cases) and incomplete tumor resection (26 cases). Some patients received postoperative radiotherapy. Survival was evaluated using the Kaplan-Meier method. RESULTS: (1) Thirty-nine patients with laryngotracheal invasion were treated with shave excision, the 5- and 10-year survival rates were 92.3% (36/39) and 75.9% (22/29), respectively. Nine patients received postoperative radiotherapy, 30 patients didn't received postoperative radiotherapy. After a shave excision, the differences of 5- and 10-year survival rates between the irradiated and nonirradiated patients were not statistically significant (P >0.05). (2) Twenty-one patients underwent radial excision for intraluminal involvement extending through the laryngotracheal cartilage, including circumferential sleeve resection, tracheal window resection and total laryngectomy, the survival rate was 85.7% (18/21) for five years and 53.9% (7/13) for ten years. Eleven patients received postoperative radiotherapy, 10 patients didn't received postoperative radiotherapy. After a radial excision, the differences of 5- and 10-year survival rates between underwent irradiated and nonirradiated patients were not statistically significant (P >0.05). (3) For the 26 patients receiving the incomplete resection, the 5- and 10-year survival rates were 50.0% (13/26) and 19.2% (5/26), respectively. For 9 patients receiving postoperative radiotherapy, the 5- and 10-year survival rates were 77.8% (7/9) and 55.6% (5/9), respectively. 17 patients did not received postoperative radiotherapy, the 5-year survival rate was 35.5% (6/17). No patient survived for ten years. CONCLUSION: Tumors with minimal invasion could be treated successfully by shaving tumor from the aerodigestive tract. Intraluminal involvement extending through the laryngotracheal cartilage should be resected completely to prevent complications, such as airway hemorrhage or suffocation, and markedly improve the survival for patients with invasive DTC.

[Detailed mapping and clinical significance of loss of heterozygosity on 9p13-23 in laryngeal squamous cell carcinoma by microsatellite analysis].

BACKGROUND & OBJECTIVE: Microsatellites are the repeated DNA sequences scattered widely within the biological genomes and closely linked with many important genes. In carcinogenesis, microsatellites often display loss of heterozygosity(LOH) as tumor suppressor genes. Some microsatellite loci often exist in the hot spots of LOH at high frequency in some specific maligances. The tumor suppressor genes, which are associated with the development and progression of the tumor, possibly harbor in the vicinity of these hot spots. Therefore, the study of LOH by microsatellite analysis is an important way to detect the putative tumor suppressor genes. This study was designed to refine the hot spots of LOH on 9p13-23 in laryngeal squamous cell carcinoma and compare the correlation between the incidence of microsatellite LOH and the clinicopathological parameters. METHODS: Tumor tissues were obtained from paraffin embedded sections with microdissection. Genomic DNA was extracted from tumor tissues and peripheral blood lymphocytes with the phenol-chloroform. Polymerase chain reaction(PCR) amplification and denaturing gel electrophoresis were performed on a set of 42 laryngeal squamous cell carcinoma and corresponding peripheral blood lymphocytes using 13 highly polymorphic microsatellite markers on 9p13-23. The correlation was analyzed between microsatellite LOH at the high frequency on 9p13-23 and clinicopathological characteristics in the patients with squamous cell carcinoma of larynx. RESULTS: (1)Of the 42 laryngeal cancers, 41(97.6%) showed LOH in at least one of the microsatellite markers tested on 9p13-23. The most frequently deleted marker was D9S162 in 17 of the 19 (89.5%) informative samples. The marker D9S171, which is located on 9p21, had LOH detected in 12 of the 15 informative cases (80.0%). LOH at the D9S1748 marker (closest to the p16 gene locus) was detected in 18 of the 36 informative cases (50.0%). (2)Allelic deletion mapping revealed two minimal regions of LOH encompassing markers D9S161-D9S171 on 9p21 and IFNA-D9S162 on 9p22-23. (3) Multiple LOH (>or= 4) on 9p21-23 was found more frequently in the patients under 60 years, with supraglottic squamous cell carcinoma or cervical lymph node metastasis than those over 60 years, with glottic squamous cell carcinoma or without cervical lymph node metastasis (P< 0.01,P< 0.01,P< 0.05, respectively). On the contrary, there was no correlation between T stages or pathologic classification and the frequency of LOH on 9p21-23 in 42 squamous cell carcinoma of larynx. CONCLUSION: These findings imply the presence of at least two putative tumor suppressor genes on 9p13-23 in laryngeal squamous cell carcinoma. Multiple genetic alterations are probably implicated in supraglottic squamous cell carcinoma with cervical lymph node metastasis in younger patients.