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microRNAs, a family of small non-coding RNAs, involve in the pathogenesis of several types of cancers, including laryngeal squamous cell carcinoma (LSCC). MiR-370 is frequently aberrant expressed in various types of human cancer including LSCC. However, the role for miR-370 in LSCC remains elusive. Here, we demonstrate that miR-370 was down-regulated in human LSCC tissues. Furthermore, there was an inverse relationship between Forkhead Box ml (FoxM1), which was up-regulated and miR-370 expression in LSCC tissues. FoxM1 was subsequently predicted by bioinformatics and verified to be a target of miR-370 by Luciferase reporter assay. Restored expression of miR-370 in Hep2 cells significantly inhibited cell proliferation. In conclusion, our results suggest that miR-370 may function as a tumor suppressor in LSCC through downregulation of FoxM1, suggesting that miR-370 could serve as a novel potential maker for LSCC therapy.

Myeloid cell leukemia-1 (Mcl-1) plays an important role in survival, chemo- and radioresistance of head and neck squamous cell carcinoma (HNSCC). Cyclin-dependent kinase 9/cyclin T (CDK9) promotes excessive production of multiple pro-survival proteins including Mcl-1, leading to impaired apoptosis of cancer cells. As such, CDK9 is an emerging therapeutic target in cancer therapy. We herein report the first study of targeting CDK9 as a treatment strategy for hypopharyngeal squamous cell carcinoma (HSCC), an aggressive malignancy associated with one of the worst prognoses within HNSCC. We showed that mRNA levels of Mcl-1 were significantly higher in HSCC tumor tissues than in the adjacent non-tumor mucosae. In addition, the levels of Mcl-1 mRNA correlated with the tumor size and clinical stage of HSCC patients. CDKI-73, a potent CDK9 inhibitor, was capable of downregulating the expression of Mcl-1 in the HSCC cells by suppression of the CDK9 mediated phosphorylation of RNA polymerase II. CDKI-73 effectively induced apoptosis as a single agent and synergized anti-tumor activity of cisplatin in HSCC cells. Taken together, our study presents compelling evidence for developing CDK9 inhibitors, such as CDKI-73, as new therapeutic strategy for HSCC. Refereed/Peer-reviewed

Aim of the investigation was to develop folate-functionalized lipid nanoemulsion (LNE) comprising chemo-radiotherapeutics for targeted delivery to nasopharyngeal carcinoma (NPC). Soy lecithin nanoemulsion of doxorubicin (Dox) and yittrium-90 (90Y) was prepared by nanoprecipitation using ultrasonic homogenization technique followed by folic acid conjugation. Nanoemulsion (Dox-LNE) was characterized as positively charged (zeta potential), spherical shape (transmission electron microscopy) nano-droplets of uniform size distribution (polydispersity index). No significant variation in parameters such as particle size, zeta potential, and polydispersity index was observed when the stability of Dox-LNE was assessed during long-term storage at room temperature and at 8000 rpm, 121°C temperature, and 5000 time dilution in water. In vitro release of Dox from Dox-LNE was observed to be controlled for at least 48 h. Folate decoration over Dox-LNE surface (FD-Dox-LNE) and incorporation of 90Y in FD-Dox-LNE (FD-Dox + 90Y-LNE) changed droplet size up to 50 nm; however, surface charge of Dox-LNE did not change significantly. FD-Dox + 90Y-LNE inhibited growth of cancerous cell line like CNE1 (folate receptor rich) in vitro and alleviated tumor volume in NPC-induced nude mice significantly as compared to Dox + 90Y-LNE. Massive necrosis and hemorrhage of CNE1 cells were observed by FD-Dox + 90Y-LNE (89.9%); however, inhibition of growth of nasal epithelial cells (RPMI 2650; folate deficient) by FD-Dox + 90Y-LNE and Dox + 90Y-LNE was observed to be 21.5 and 43.65%, respectively. The investigation highlights the vast utility of folate-decorated lipid emulsion in delivering chemo-radiotherapeutics to the specific NPC site. FD-Dox + 90Y-LNE might offer a cost-effective, safe, efficacious, and clinically pertinent option to the available therapeutics.

Background Although epithelial stem/progenitor cells have been isolated from many parts of the human airway epithelium such as lung and trachea, there is limited information in regard to stem cells in nasal epithelium. The aim of this study was to determine if (1) human nasal epithelial stem/progenitor cells (hNESPCs) can be isolated and propagated in vitro and (2) allogeneic adult primary human fibroblasts can serve as a feeder layer for hNESPCs expansion under serum-free conditions. Methods Primary cells taken from inferior turbinate biopsy specimens (n = 3) were enzymically dissociated and plated on either allogeneic human fibroblasts or murine NIH 3T3 fibroblasts, in a chemical-defined medium supplemented with growth factors. Self-renewal, proliferation, and differentiation potential were compared. Results The optimized media were capable of supporting the undifferentiated growth and expansion of hNESPCs on both feeder cells. The doubling time and cloning efficiency of hNESPCs cultured on a human feeder layer were comparable with that cultured on 3T3 feeders. Significantly, the hNESPCs on both feeder layers could be cultured for four passages, and they can differentiate into ciliated columnar cells and goblet cells at the air–liquid interface, resembling the in vivo mucociliary airway epithelium. Conclusion Our results showed the feasibility of expanding hNESPCs for clinical purpose by using human feeder layer, avoiding components of animal source, while preserving their self-renewal and differentiation potential. This study represents an early step toward a better understanding of hNESPCs, and serum -free media plus human feeder potentially would be an ideal method for making clinical grade hNESPCs on a large scale.

Xeroderma pigmentosum group A (XPA) participates in modulating recognition of DNA damage during the DNA nucleotide excision repair process. The XPA A23G polymorphism has been investigated in case-control studies to evaluate the cancer risk attributed to the variant, but the results were conflicting. To clarify the effect of XPA A23G polymorphism in cancer risk, we conducted a meta-analysis that included 30 published case-control studies. Overall, no significant association of XPA A23G variant with cancer susceptibility was observed for any genetic model. However, significant association was observed for colorectal cancer (GG vs. AA: OR = 1.68, 95% CI = 1.15-2.44; dominant genetic model GG + AG vs. AA: OR = 1.54, 95% CI = 1.08-1.17), for breast cancer an increased but non-significant risk was found (GG vs. AA: OR = 1.27, 95% CI = 0.98-1.66; dominant genetic model GG + AG vs. AA: OR = 1.27, 95% CI = 0.99-1.63), and for head and neck cancer an increased risk was observed in recessive model (OR = 1.19, 95% CI = 1.02-1.38), whereas for lung cancer a significant reduced risk was observed (GG vs. AA: OR = 0.77, 95% CI = 0.66–0.90; dominant genetic model GG + AG vs. AA: OR = 0.76, 95% CI = 0.66-0.87), it’s noting that in Asian population the inverse association was more apparent. In addition, in Asian population for esophageal cancer a significant decreased risk was also found in dominant genetic model (OR = 0.55; 95% CI = 0.43-0.70) and for head and neck cancer an increased risk was observed in dominant genetic model (OR = 1.51, 95% CI = 1.03-2.23). The meta-analysis suggested that the XPA A23G G allele is a low-penetrant risk factor for cancer development.

Signal transducers and activators of transcription (STAT) are important in the development of laryngeal carcinomas and are potential novel molecular targets for therapy to improve survival of patients with this cancer. This study was designed to investigate the influence of the janus activated kinase (JAK)/STAT inhibitor AG490 on proliferation and apoptosis of Hep-2 human laryngeal cancer cells and whether there was any inhibition by AG490 of the JAK/STAT3 signalling pathway. AG490 inhibited cell proliferation in dose-and time-dependent manners and induced apoptosis in Hep-2 cells, with the number of apoptotic cells increasing with time. AG490 inhibited G1 to S cell cycle transition and induced G1 cell cycle arrest as well as significantly down-regulating STAT3, phosphorylated STAT3 and survivin in Hep-2 cells. This study showed that AG490 significantly inhibited proliferation and induced apoptosis of laryngeal carcinoma cells through down-regulation of STAT3 and survivin, suggesting a potential target for laryngeal carcinoma treatment.

Objective: There are controversies on management of carotid artery invasion in advanced head and neck cancer. En bloc resection has been considered a curative modality. In this study, we evaluated the feasibility of using expanded polytetrafluoroethylene (ePTFE) in reconstructing the common carotid artery in patients with carotid artery invasion requiring resection. Method: A retrospective study including 13 patients managed from 2002 to 2005. All patients underwent en bloc resection of the tumor and internal carotid artery then reconstructed with ePTFE. Results: All patients had en bloc resection of the tumor together with internal carotid artery and reconstruction with ePTFE. Some patients required wound coverage with myocutaneous flaps in eight patients and local flaps in five patients. Intraoperative shunting was used in all patients. Intraoperative heparin infusion and postoperative low dose aspirin were used to prevent thrombosis. One patient developed graft blowout and he was treated with ligation without hemiplegia. One patient had minor stroke. The follow-up period was 18.4 ± 8.6 months. No patient suffered from neurological deficit or graft occlusion. Disease survival was 61.5% in 1 year and 38.5% in 2 years. Overall survival was 18.3 months. Conclusion: En bloc resection and tumor together with carotid artery and ePTFE reconstruction is shown to be a feasible modality in treatment of advanced head and neck cancer with carotid artery invasion.

The aim of this study was to determine the expression of cellular FLICE-like inhibitory protein (cFLIP) in head and neck squamous cell carcinoma (HNSCC) and revealed its possible correlation to Fas protein and tumour clinical parameters.The expression of cFLIP was analysed in 58 HNSCC samples and 30 morphologically normal tissues adjacent to the carcinomas using immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR) and western blot analysis. Furthermore, its possible correlation to the expression of Fas protein and tumour clinicopathologic parameters were discussed.Cellular FLICE-like inhibitory protein was demonstrated to be up regulated in most HNSCC than in normal tissues by immunohistochemistry (p0.01). Although the mRNA levels of both isoforms of cFLIP, long form (cFLIP(L)) and short form (cFLIP(S)), in HNSCC were higher than those in normal tissues (p0.01), only cFLIP(L) protein could be detected by western blot. Furthermore, the expression of cFLIP(L) protein was significantly associated with tumour clinical stage (p0.01) and lymph node metastasis (p=0.01). Since all of the tumours with Fas immunostaining also express cFLIP protein, there was no significant correlation between them (p0.05).Overexpression of cFLIP(L) is a frequent event in HNSCC and HNSCC cells in vivo may need it to evade apoptosis mediated by Fas or other receptors, which might contribute to tumour development and progression.

Brain-derived neurotrophic factor (BDNF) is critical for sensory neuron survival and is necessary for vesicular glutamate transporter 3 (VGLUT3) expression. Whether the transcription factors Etv4 and Etv5 are involved in these BDNF-induced effects remains unclear. In the present study, primary cultured dorsal root ganglion (DRG) neurons were used to test the link between BDNF and transcription factors Etv4 and Etv5 on VGLUT3 expression and neurite outgrowth. BDNF promoted the mRNA and protein expression of Etv4 and Etv5 in DRG neurons. These effects were blocked by extracellular signal-regulated protein kinase 1/2 (ERK1/2) inhibitor PD98059 but not phosphatidylinositol 3-kinase (PI3K) inhibitor LY294002 or phospholipase C-γ (PLC-γ) inhibitor U73122. Etv4 siRNA and Etv5 siRNA effectively blocked the VGLUT3 expression and neurite elongation induced by BNDF. The overexpression of Etv4 or Etv5 potentiated the effects of BNDF-induced neurite elongation and growth-associated protein 43 (GAP-43), medium neurofilament (NF-M), and light neurofilament (NF-L) expression while these effects could be inhibited by Etv4 and Etv5 siRNA. These data imply that Etv4 and Etv5 are essential transcription factors in modulating BDNF/TrkB signaling-mediated VGLUT3 expression and neurite outgrowth. BDNF, through the ERK1/2 signaling pathway, activates Etv4 and Etv5 to initiate GAP-43 expression, promote neurofilament (NF) protein expression, induce neurite outgrowth, and mediate VGLUT3 expression for neuronal function improvement. The biological effects initiated by BDNF/TrkB signaling linked to E26 transformation-specific (ETS) transcription factors are important to elucidate neuronal differentiation, axonal regeneration, and repair in various pathological states.

To analyze the clinical characters, surgical treatments and prognosis of differentiated thyroid carcinoma (DTC) with laryngeal or tracheal invasion.Forty-six cases including 33 papillary and 13 follicular were retrospectively reviewed. Thirty-four cases with tracheal invasion received conservative resection (17), window resection (11) and sleeve resection (6). One case with subglottic invasion was performed subglottic partial laryngectomy. Eleven cases with trachea-laryngeal invasion received total laryngectomy(4), 3 shave technique and 4 preservative laryngectomy.Complications included infections and hypocalcaemia, 15 patients got permanent fistula. 5-year survival rate in cases of tracheal shave resection was 88.2%, while 63.6% in those of window resection and 83.3% in those of sleeve resection. Survival rate within 5 years of patients received preservative laryngectomy was 62. 5%. Conclusion: With meticulous preoperative examination and positive surgical treatment, both survival rate and quality of life could be improved in patients of DTC with laryngeal or tracheal invasion.

The present study was undertaken to investigate the mechanisms of peroxisome proliferator activated receptor-gamma (PPAR-gamma) ligand-induced apoptosis on human myeloid leukemia K562 and HL-60 cell lines. The results revealed that both 15-deoxy-delta(12,14)-prostaglandin J2 (15d-PGJ2) and troglitazone (TGZ) have significant anti-proliferation- and apoptosis-inducing effects on these two kinds of leukemia cells. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly using Wright's and Hoechst 33258 staining. Reverse transcription-PCR and western blot analyses demonstrated that both survivin and bcl-2 expression were downregulated markedly, while bax expression was upregulated concurrently when apoptosis occurred. We therefore conclude that 15d-PGJ2 and TGZ have significant apoptosis effects on K562 and HL-60 cells in vitro, and that upregulation of bax as well as downregulation of survivin and bcl-2 expression may be the important apoptosis-inducing mechanisms. The results suggest that PPAR-gamma ligands may serve as potential therapeutic agents for both acute and chronic myeloid leukemia.

OBJECTIVE To explore the surgical methods and evaluate the long-term results of laryngectomy in patients with supraglottic laryngeal cancer. METHODS A total of 182 patients with supraglottic laryngeal carcinoma underwent an operation from 1979 to 1999. These cases comprised 11 in stage Ⅰ , 45 in stage Ⅱ , 49 in stage Ⅲ and 77 in stage Ⅳ. The choice of surgical procedure was decided based on the condition of the diseasedl arynx. The surgical procedures proposed by TD Wang were adhered to as follows: minor partial laryngectomy 36, major partial laryngectomy 85,subtotal partial laryngectomy with laryngoplasty 22 and total larygectomy 39. RESULTS The final rate of larynx preservation was 78.6% (143/182) and 69.8% (88/126) in patients with stage III and IV diseases. The extubation rate was 81.8% in cases with preservation of laryngeal function. The overall 3-and 5-year survival rates were 82.9% and 67.3%, with 76.88% and 57.4% in the advanced (stage III and IV) cases who survived with preserved laryngeal function, and 82.5% and 67.0% in similar advanced cases who were treated by total laryngectomy. The difference in the survival rates between these 2 groups was not statistically significant. CONCLUSION It is suggested that preservation of the laryngeal function is possible for advanced supraglottic laryngeal carcinoma without compromising the long-term survival rate. To improve the rate of larynx preservation, one should follow the surgical methods suggested.

Oridonin, an extract from the Chinese herb Rabdosia rubescens, is currently one of the most important traditional Chinese herbal medicines. We investigated the anti-proliferative effect of oridonin on the lung cancer cell line SPC-A-1 and its mechanism of action. Growth inhibition was measured using a microculture tetrazolium assay and apoptosis was measured by several standard methods. Western blot analysis measured the expression of bcl-2 and bax proteins. Oridonin (> 28 μmol/l) inhibited the growth of SPC-A-1 cells and induced apoptosis. Marked morphological changes indicative of apoptosis were observed, especially in cells treated with oridonin for 48–60 h. Western blot analysis revealed downregulation of bcl-2 and upregulation of bax proteins following treatment with oridonin for 48 h. We conclude that oridonin demonstrated anti-proliferative and apoptosis-inducing effects on SPC-A-1 cells in vitro, and that changes in bcl-2 and bax protein levels may play an important role in its mechanism of action.

Claudin-l and cyclin B1 are abnormally expressed in certain malignancies, but their expression in hypopharyngeal squamous cell carcinoma (HSCC) has not been reported thus far. Studying the expression levels of claudin-1 and cylin B1 in HSCC tissues and their association with clinical stage, pathological grade and prognosis in patients with HSCC may provide a theoretical basis and guide future research on HSCC targeted therapy. The protein expression levels of the above two biomarkers was immunohistochemically detected in 97 HSCC cases and 90 matched adjacent tissue samples. The correlation between the expression levels of claudin-1 and cylin B1 and the patients' clinical parameters was analyzed via Pearson's χ2 test, while survival analysis was performed using a log-rank test. The results of the current study revealed that claudin-1 and cyclin B1 were highly expressed in HSCC tissues, and the expression of claudin-1 was associated with tumor differentiation degree and lymph node metastasis, while cyclin B1 expression was associated with tumor differentiation degree. Furthermore, Kaplan-Meier analysis revealed that claudin-1 expression correlated with survival (P=0.003), and the expression levels of claudin-1 and cyclin B1 were observed to be positively correlated, in patients with HSCC. Cyclin B1 and claudin-1 exhibited an elevated expression in HSCC specimens, thus suggesting their use as tumor markers. Therefore, the joint detection of claudin-1 and cyclin B1 may aid to guide cancer therapy and to determine prognosis in HSCC. Furthermore, claudin-1 may be used as an HSCC-monitoring index, and may serve as a therapeutic target.

These findings indicate that in hypopharyngeal squamous cell carcinoma (HSCC), hypermethylation and down-regulation of death-associated protein kinase-1 (DAPk1) are common events, which are associated with a poor prognosis.This study aimed to investigate the methylation and expression of DAPk1, a tumor suppressor gene, in HSCC, and explore its clinical significance.The tumor and adjacent non-tumor tissues were collected from 53 patients with HSCC. The methylation status of DAPk1 was detected by methylation-specific polymerase chain reaction (MSP), and expression of DAPk1 was determined with real-time reverse transcriptase polymerase chain reaction (RT-PCR), immunohistochemistry, and Western blot at mRNA or protein levels. Correlations between the findings and patients' clinicopathological parameters were further evaluated.The methylation ratio of DAPk1 in tumor tissues (60.38%) was significantly higher than that in the adjacent non-tumor tissues (26.42%) (p = 0.001), while DAPk1 expression in the tumors was down-regulated markedly (real-time RT-PCR, p = 0.002; immunohistochemistry, p = 0.006; Western blot, p0.001). DAPk1 methylation was negatively correlated with its mRNA expression (p = 0.002, r = -0.521). Both hypermethylation and down-regulation of DAPk1 were closely related to lymph node metastasis (p = 0.001 and 0.001, respectively), advanced TNM stage (p = 0.009 and 0.019, respectively), and low survival rates (p = 0.031 and 0.045, respectively).

To evaluate the effect of endoscopic surgery for maxillary sinus inverted papilloma.From 2000 to 2011, 50 patients with maxillary sinus inverted papilloma were treated with intranasal endoscopic surgery or combined approach. Among them, 39 cases were primary and 11 cases were recurrent, which included 17 patients with Krouse stage IIand 33 cases with Krouse stage III. Different surgical approaches were selected according to the range and positions of the lesions. One case with severe atypical hyperplasia received postoperative radiotherapy.All cases were followed up for 3-14 years, 7 cases recurred. All occurrence within 2 years after operation. Malignant change and death was found in 1 case. After operation, epiphora occurred in 2 cases, maxillary sinus labiogingival groove fistula occurred in 2 cases, facial numbness occurred in 4 cases and incision hemorrhage occurred in 1 case. All the complications were cured after appropriate treatment.Naso-endoscopic surgery or combined approach is a safe, effective and microinvasive treatment for patients with maxillary sinus inverted papilloma. Accurate selection of suitable approach according to the range and positions of the lesions and correct management of the base of the tumor are critical to the success of the operation.

Hypopharyngeal squamous cell carcinoma (HSCC) has the worst prognosis among head and neck cancers. Cisplatin (DDP)-based chemotherapy is an important part of multimodal treatments. However, resistance to DDP severely impairs the effectiveness of chemotherapy for HSCC. Chloroquine (CQ) has been reported to enhance the effectiveness of chemotherapy and radiotherapy in liver, pancreas, breast, prostate and colon tumors, but it is unclear whether CQ could increase the efficacy of DDP for treating HSCC. We inoculated BALB/c nude mice with a subcutaneous injection of human hypopharyngeal FaDu cells to generate our animal model. Mice were randomly divided into 4 groups and treated with vehicle control, CQ (60 mg/kg/day), DDP (5 mg/kg/6 days), or a combination of DDP and CQ. Tumor growth and survival of the mice were monitored. We found that CQ inhibited autophagy and increased DDP-induced apoptosis in the xenograft mouse model. CQ enhanced the efficacy of DDP, resulting in decreased tumor growth and prolonged survival of the mice. To test whether blocking autophagy enhanced the efficacy of DDP, FaDu cells were infected with lentiviral shRNA to Beclin-1 and inoculated into the flanks of nude mice. Inhibition of autophagy markedly enhanced the DDP-induced antitumor effect. Our study suggests that the addition of CQ to DDP-based chemotherapy could be a potential therapeutic strategy for treating HSCC, and the inhibition of autophagy may contribute to chemotherapy sensitization in HSCC.

The technique of endoscopy-assisted transoral approach (EATA) has improved greatly, which should provide a better alternative for parapharyngeal space (PPS) tumors. Here, we compared curative effects between the resection of parapharyngeal space (PPS) tumors by EATA and external approaches (EAs), including the transcervical, transparotid, and transmandibular approaches. Based on the tumors’ position and the relationship with adjacent structures, we selected 20 patients with parapharyngeal space tumor hospitalized in the Second People’s Hospital in Shenzhen from January 2008 to December 2013, which were divided into the observation group and the control group with patients’ informed consents. In the observation group, the tumors were removed solely by transoral approach under the guidance of endoscopes (EATA), while in the control group, the tumors were resected completely using an external approach (EA). We compared the total removal rate, the operation time, blood loss, postoperative pain, hospitalized time, complication rate, scar, and recurrence between the two groups. All the tumors were completely removed and patients were followed up for 6 months–5 years with no recurrence in either group. There was no significant difference regarding total removal rate, operation time, complication rate, and recurrence rate between the two groups (P > 0.05). However, significant differences were observed in blood loss, hospitalized time, and postoperative pain between the two groups (P

To summarize and analyze the clinical features, diagnosis methods, surgical approaches and treatment outcomes of patients with primary parapharyngeal space tumors.A retrospective review of 91 cases with primary parapharyngeal space tumors treated from January 1999 to December 2011 was performed. All patients underwent preoperative enhanced CT scan and postoperative histopathologic examination. Intraoperative frozen section biopsies were performed in 36 of 91 cases. The surgical approaches included trans-cervical approach in 73 cases, trans-parotid approach in 5 cases, trans-oral approach in 5 cases, and mandibulotomy in 8 cases.The postoperative pathological diagnoses consisted of 29 variants, including 20 for benign tumors and 9 for malignant tumors. Of the 80 cases with benign tumors, 6 cases were lost to follow-up and 74 cases were followed up for 31-84 months with no recurrence. Eleven cases with malignant tumor were followed up for 8-51 months (median 29 months), of them 7 cases died and 1 case was lost to follow-up. The post-operative complications included Horner syndrome in 3 cases, hoarseness in 2 cases, hypoglossal nerve palsy in 1 case, accessory nerve palsy in 1 case, upper airway obstruction in 1 case, and internal carotid artery cavernous sinus fistula in 1 case.Parapharyngeal space tumors are rare, with atypical clinical manifestation, and have pathological types of diversification. CT or MRI is helpful to evaluate the tumor size, location and possible sources, and to make operation scheme. Surgery is the first choice for parapharyngeal space tumors. Trans-cervical approach can be applied to most tumors. Parapharyngeal benign tumors have good prognosis, but malignant tumors have poor prognosis.

BACKGROUND The question of whether "recurrent" laryngeal carcinoma is truly a new tumour with a clonal origin that differs from that of the primary tumour has remained unanswered. The objective of this study was to determine whether recurrent tumours have the same genetic basis as primary tumours, as the answer to this question is important for the development of treatment strategies. MATERIALS AND METHODS Matched samples consisting of primary tumour, recurrent tumour and normal tissue were obtained from the same patient. A total of 37 patients with laryngeal cancer were examined for loss of heterozygosity (LOH) on the 3p, 5p, 7q, 8p, 9p, 13p, 17p and 18q chromosomal arms using PCR to amplify microsatellite markers. All patients were routinely followed up and 5-year survival rates were calculated using directly calculating method and Kaplan-Meier's method. RESULTS A total of 28 out of 37 (75.6%) patients showed LOH at a minimum of one locus, and 19 out of 37 (51.3%) patients showed LOH at two loci. Primary and recurrent tumours in each patient showed identical allelic loss patterns and incidence rates. Patients without LOH had a longer average time to recurrence than patients with LOH (P

Extracellular acidic pH-activated chloride channels (ICl,acid) have been found in a variety of mammalian cells. In the present study, the expression and regulation of ICl,acid were investigated in THP-1 cells. Patch clamp recordings demonstrated that an extracellular acidic solution induced an outward rectified current, which could be blocked by the Cl− channel blocker. The currents exhibited time-dependent facilitation and inactivation. The relative anion permeability of this current followed the sequence Cl− > Br− > I− > gluconate. NADPH oxidase inhibitors did not decrease pH 4.4-induced currents. However, reactive oxygen species (ROS) scavengers and mitochondrial inhibitors inhibited pH 4.4-induced currents. Fluorescence imaging of intracellular ROS and mitochondrial activity confirmed these findings. We conclude that ICl,acid occurs in human THP-1 cells and that ICl,acid may be regulated by intracellular ROS mainly originating from mitochondria.

To investigate the clinical pathological features of aspirated tracheobronchial foreign body (FB) cases in children under the age of 3 years and to improve the level of diagnosis and treatment.A retrospective study was conducted examining 316 children under the age of 3 years who had been treated for tracheobronchial FB in Shenzhen children's hospital between January 2004 and December 2008. We analyzed the patients for gender, age, FB localization, treatment history, the history of foreign body aspiration (FBA), the type of foreign body and the cause of death. In addition, each patient was analyzed for FB-related complication, the results of bronchoscopic removal and the presence of foreign bodies in the airways.Fifty-two infants under the age of one year (median age=10m, group A), 199 children between the ages of 1 and 2 years (median age=17 m, group B) and 65 children between the ages of 2 and 3 years (median age=30m, group C) were included in this study. There were 38 (73.1%) patients with a confirmed history of FBA in group A, a higher percentage than that observed in group B (55.8%) or group C (53.8%) (P0.05). Earthnuts were the most common cause of FB (171 cases, 54.1%). Melon seeds (including sunflower seeds, watermelon seeds and pumpkin seeds) were the second most common cause of FB (62 cases, 19.6%). Animal sources (including 16 pig bones, 8 fish bones, 7 chicken bones and 4 other animal-based foods) comprised 11.1% (35 cases) of FB cases and were the third most common cause of FB. The percentage of animal-based FBs observed in group A was higher than in groups B and C (P0.01). Five inorganic FBs (a pushpin, a rubber band, a screw, a small stone and a plastic toy) were also observed and were the least common type of FB. There were no significant differences in the distribution of FBs between the left (41.8%) and right (40.5%) bronchia. There is no difference in the distribution of FBs among the three groups either. The data show that the youngest cohort of patients (0-1 years) is the most likely to be sent to the hospital to receive treatment within 24h of aspiration (50%) (P0.01). Five patients (1.58%) died as the result of FBA.FBAs of animal-derived FBs (especially animal bones) are very common in infants in southern China. Children between the ages of 1 and 2 years are most likely to suffer from FBA. FBA in children under the age of 3 years carries significant hazards, including morbidity and mortality. Asphyxia and/or cardiopulmonary arrest is prone to occur shortly after FBA in infants, but these events can occur days later in older children after FBA because of delays in the diagnosis and/or treatment of this condition.

To study the expressions of DSCR1 gene in laryngopharynx cancer and peri-cancerous tissues, to understand the relationship between its expression and tumor clinical features, to discussed the influence of DSCR1 gene on the biological behaviours of laryngopharynx squamous cell carcinoma.Immunohistochemical p-V9000 method,used rabbit DSCR1 antibody DCT3, detected the expressions of DSCR1 gene protein in laryngopharynx cancer and peri-cancerous tissues, between them and clinical data were statistically analyzed.Positive rates of DSCR1 gene expression in the tumor tissues was 94.9%, normal tissues was 35.9%, there was a statistically significant (t = 23.69, P0.01); There was significant difference of DSCR1 gene expressions in different pathological degree and TNM staging (P0.05). There was no significant difference in different age, gender, site, growth mode, lymph node metastasis and smoking history.DSCR1 gene has an important role in the occurrence and development process of laryngopharynx squamous cell carcinoma, and can influence the biological behavior of tumors.

To the Editor: Ossifying fibroma is a benign but rare fibro-osseous tumor in the craniofacial region. Complete resection is the only way to treat it. Here, we reported one case of maxillary juvenile ossifying fibroma operated with intranasal endoscopic prelacrimal recess approach in which nasolacrimal duct (NLD) and inferior turbinate (IT) were spared. A 9-year-old girl presented left facial asymmetry for 2 months and was hospitalized in the Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital in June 2013. A paranasal sinus computed tomography (CT) scan showed a lesion in left maxillary sinus (MS). No nasal obstruction, rhinorrhea, decreased vision, proptosis or epistaxis was ever complained. No abnormal finding was noted in and out of her nose during the physical examination and nasal endoscopy. Imaging study revealed that the left MS expanded to 2.4 cm × 2.8 cm × 3.0 cm. Soft tissue density was present inside the sinus surrounded with a clear boundary and intact bone wall [Figure ​[Figure1a1a and ​and1b].1b]. Tumor resection was performed with intranasal endoscopic prelacrimal recess approach under general anesthesia. First, we chiseled off the anterior bony portion of the medial wall of the MS to expose the NLD posteriorly and mucosa of MS interiorly. The sinus was filled with a solid, encapsulated and sand like mass, about 2.4 cm × 2.8 cm × 3.0 cm in size. Surrounding bone walls appeared as stalactite, and the surface was rough. Second, the tumor was removed completely. On the 2nd day after operation, the nasal packing was taken away, and the postoperative CT scan was carried out at the same time [Figure ​[Figure1c1c and ​and1d].1d]. Pathological finding was ossifying fibroma [Figure 2]. During the 6 months follow-up, there was no recurrence or complications. Figure 1 Preoperative paranasal sinus computed tomography (CT) in coronal position (a) and horizontal position (b) showed ossifying fibroma in left maxillary sinus (triangles). Postoperative paranasal sinus CT in coronal position (c) and horizontal position (d) ... Figure 2 Pathological finding showed ossifying fibroma (HE, original magnification ×200). For ossifying fibroma, early surgery is necessary to achieve a complete tumor resection. There are many procedures available depending on the involvements of lesion,[1,2] such as midfacial desgloving approach, Denker or modified Dener operation, Caldwell-Luc operation, medial maxillectomy, etc.[3] In all the above procedures, IT and/or NLD is to be sacrificed, and dry nose, epiphora or facial numbness may occur after operation. To improve the quality of life, Zhou et al.[4] introduced intranasal endoscopic prelacrimal recess approach to treating such disease. Without ablation of IT and NLD, the function of the nasal cavity and lacrimal aperture are preserved. Meanwhile, hospital stay can be shortened. This was first reported to use this approach to remove ossifying fibroma in MS. The surgery went smoothly and follow-up results showed no postoperative complications. In short, juvenile ossifying fibroma of MS may be the potential indications for prelacrima recess approach.

To investigate the effects of caveolin-1 (CAV1) on the growth of hypopharyngeal squamous cell carcinoma (HSCC) FaDu cells in vitro and in vivo.A CAV1-RNAi-lentivirus construct was transfected into FaDu cells and expression of caveolin-1 was tested by RT-PCR and western blotting analysis. Cell apoptosis was analyzed by transferase-medisated dUTP nick-end labeling (TUNEL) assay. Tumor inhibition effects were investigated by injecting rCAV1-RNAi-lentivirus construct into tumors created with FaDu cells in the HSCC mouse model, with the empty-vector lentivirus as a control. CAV1 expression in xenografts was tested by RT-PCR and immunohistochemistry.RT-PCR and western blot analysis demonstrated successful construction of the CAV1-RNAi-lentivirus construct producing small hairpin RNA. The average weights and volumes of tumor in mice treated with CAV1-RNAi-lentivirus were lower than in mice with control treatment (P0.05). RT-PCR revealed weak positive expression of CAV1 in CAV1-construct-treated xenografts and immunohistochemistry confirmed lower CAV1 expression than in controls.(P0.05). In addition, downregulation of CAV1 increased cell apoptosis in vitro.The growth of HSCCs could be inhibited by recombinant CAV1-RNAi-lentivirus in vitro and in vivo.

The tumor's grade, rather than the tumor's location, was related to the opportunity of preserving laryngeal functions in patients with pyriform sinus cancer. The survival rate decreased significantly with the increase of tumor grade or node grade. Preservation of laryngeal functions is a safe and promising method without compromising the survival rate of patients with pyriform sinus cancer.Surgical resection of pyriform sinus carcinoma has a profound influence on the preservation of laryngeal functions. The purpose of this study was to assess the safety and efficacy of the surgical treatment of pyriform sinus carcinoma in the preservation of laryngeal functions without compromising the survival rate.Two hundred and thirty patients with pyriform sinus cancer had been operated from March 1978 to December 2002. Of them, 158 cases had been operated with the preservation of laryngeal functions and 72 cases had been undergone total laryngectomy. In addition, 216 cases had received adjuvant postoperative radiotherapy. All cases were followed up for 6-12 months (mean 51 ± 26) after surgery. The survival rate was calculated on the basis of Kaplan-Meier analysis, and the factors that influenced the survival rate of patients with and without preservation of laryngeal functions were analyzed with the log-rank test.Laryngeal functions were preserved completely (speech, respiration, and deglutition) in 70.9% (112/158) cases, and partially (speech and deglutition) in 29.1% (46/158) cases. The 3- and 5-year survival rates were 75.4% and 59.0%, respectively, for the group with laryngeal function preservation, and 58.6% and 41.5%, respectively, for the group without preservation. There was no statistically significant difference in the survival rate between the two groups within the follow-up period (p0.05). Increase in the tumor grade resulted in a proportional decrease of patients with preservation of laryngeal function (p0.05). Increase in the tumor grade (p0.05) or node grade (p0.05) also led to significant decrease in the survival rate. The location of the primary lesions (the lateral wall or medial wall of the pyriform sinus) showed no significant influence on either the opportunity for preserving laryngeal functions (p0.05) or survival rate of patients (p0.05).

To analyze the mutation and abnormal expression of the FHIT gene in human hypopharyngeal carcinoma.Matched normal and cancerous tissues from 24 patients with hypopharyngeal squamous cell carcinoma were obtained immediately after surgery. Total RNA was extracted, the FHIT gene was detected by nested RT-PCR and DNA sequencing technology.Normal sized FHIT transcript was detected in 23 of the 24 cases of normal matched tissues. Aberrant FHIT transcripts were found in 9/24 (37.5%) cases in hypopharyngeal carcinoma. Aberrant FHIT transcripts rate of well-differentiated, moderately differentiated and poorly differentiated squamous cell carcinoma, was 28.6% (2/7), 50.0% (4/8) and 33.3% (3/9), respectively. There the carcinoma with FHIT aberrant transcripts was neither corresponding to histological grade (P0.05) nor to lymphatic metastasis. The sequence analyses of the two aberrant cDNAs revealed absence of exon 8 and exon 7-9. All initial deletion were in conjunction of exons.High deletion rate of the FHIT gene in Chinese hypopharyngeal squamous cell carcinoma suggested the FHIT gene, a candidate tumor suppressor gene at 3p14.2, plays an important role in the tumor carcinogenesis, development and progression of the tumor, and thus may become a new prognostic marker in hypopharyngeal carcinoma.

To investigate the expression and significance of vascular cell adhesion molecule-1 (VCAM-1) and P-selectin in hypopharyngeal carcinoma, and explore the relationship of VCAM-1, P-selectin and microvessel density (MVD).Expression of VCAM-1 and P-selectin were detected by immunohistochemistry staining in 40 specimens of hypopharyngeal carcinoma and 10 specimens of normal mucosa of oral pharynx. MVD was assessed based on the expression of CD34.VCAM-1 and P-selectin were detected in 26 out of 40 (65%) and 29 out of 40 (72.5%) respectively in hypopharyngeal carcinoma, but none that in normal mucosa (P0.01). MVD in hypopharyngeal carcinoma was higher than that in normal mucosa and it was related to lymph node metastasis. MVD level was significantly higher in VCAM-1 and P-selectin-positive specimens than in negative ones (P0.01), which also positively correlated with the expression of VCAM-1 and P-selectin (P0.01). The expression of P-selectin positively correlated with VCAM-1 in hypopharyngeal carcinoma specimens with lymph node metastasis.The higher expression of VCAM-1 and P-selectin play key roles in the invasion and metastasis of hypopharyngeal carcinoma and were correlated with vascularization.

To study the expressions of Cyclin D1 and p16 proteins in hypopharyngeal squamous cell carcinoma and their clinical significance.Immunohistochemical technology (P-V) was applied to detect the expression of Cyclin D1 and p16 in 36 cases of hypopharyngeal squamous cell carcinoma and 10 cases of normal epithelium.(1) The expression of cyclin D1 in the tumorous cell was significantly higher than that in normal epithelium (P0.05). The expression of p16 in the tumorous cell was significantly lower than that in normal epithelium (P0.05); (2) The positive rate of Cyclin D1 was significantly correlated with clinical stage and cervical lymph node metastases (P0.05). The positive rate of p16 was correlated with cervical lymph node metastases (P0.05). The positive rates of Cyclin D1 and p16 were not correlated with the gender, age, tumor size, primary lesion and cell differentiation (P0.05); (3) There was correlation between the expression of Cyclin D1 and the expression of p16 (r(s) = -0.420, P0.05).The over-expression of Cyclin D1 and the under-expression of p16 may play a significant role in the occurrence incidence and development of hypopharyngeal squamous cell carcinoma, and may be important indicators for cervical lymph node metastases.

To explore the feasibility,surgical techniques and the clinical curative effect of preservation of laryngeal function in surgical treatment of T3 supraglottic laryngeal carcinoma (SLC).A retrospective review of 70 cases with T3 SLC that we treated from 1994 to 2003 were accomplished. All of the cases were treated with partial laryngectomy. Among them, 42 cases underwent supraglottic horizontal partial laryngectomy, 19 supraglottic horizontovertical laryngectomy, 8 supracricoid partial laryngectomy and 1 near total laryngectomy. All patients were received postoperation radiotherapy with the dosage for 50-60 Gy.The 3 year and 5 year-survival rates were 79.2% and 68.4%, respectively. Out of the 70 cases, 60 cases were decannulated with a decannulation rate of 85.7%. The normal diet was resumed in all patients, no buckling and dysphagia obviously. All patients had their successful phonation, no one failure for laryngotracheal atresia.It is feasibility to preservative laryngeal function in surgical treatment of T3 SLC, if surgeons master indications correctly, use many kinds restorative procedure expertly and improve surgical skill.

To investigate the effect and clinical value of multiple plane operations in treating severe OSAHS.The clinical data of 28 patients with severe OSAHS were retrospectively analyzed. All the patients were performed two planes of operations or more as below: submucous nasal septum resection, nasal sinus endoscopy, adenoidectomy, uvulopalatopharyngoplasty (UPPP), tongue base incision, hyoid suspension, tongue base Coblation etc. Operations were finished in the same term or by stages. All patients underwent polysomnography(PSG) examination before operation, and 6-month and 1-year after surgical treatment separately.No severe complication occurred, the 6-month, 1-year responders are 100% and 89.29% respectively. Both AHI and LSaO2 changed obviously (P0.01).Most OSAHS have multi-level obstructions in upper airway caliber, such as nasal, nasopharyngeal, velo-pharyngeal and tongue-pharyngeal obstruction. Multiple plane operations which based on idiographic obstruction sites can improve curative effect. Operation project should be established according to the conditions of upper airway and patients' intention.

To investigate the expression of fragile histidine triad gene protein (Fhit) and the possible relationship between Fhit and biological behaviors of hypopharyngeal carcinoma.The expression of Fhit protein in 66 cases with hypopharyngeal carcinoma were detected by rabbit antibody to human FHIT gene protein with SP immunohistochemical method. The relationship between historical grade and lymphatic metastasis were analysed.(1) The positive expression rate of Fhit was 42.42% (28/66) in hypopharyngeal carcinoma, and 83.33% (55/66) in normal hypopharyngeal tissue, respectively. There was a significant difference in the expression of Fhit between the cancer tissue and normal tissue (P0.01). (2) The positive expression of Fhit in well, moderate, poor differentiated hypopharyngeal carcinoma were 65.38% (17/26), 38.10% (8/21) and 26.32% (5/19), respectively. There are significant statistic difference among them each other (P0.01). (3) The positive expression of Fhit was 75.00% (12/16) in the group without lymph node metastasis, and 36.00% (18/50) with lymph node metastasis.The expression of Fhit in hypopharyngeal squamous cell carcinoma lower than normal tissue. The expression of Fhit significantly associated with historical grade and lymphatic metastasis in hypopharyngeal squamous cell carcinoma. It suggested that the expression of Fhit decreased may plays an important role in the development and progression of the tumor, and thus may become a new prognostic marker in hypopharyngeal carcinoma.

To evaluate the clinical application of multi slice CT(MSCT) in hypopharyngeal carcinoma and serve otolaryngologist to institute proper operation.Forty-five patients with hypopharyngeal carcinoma scanned by MSCT were studied and confirmed by operation and pathologic examination. The operation material were retrospectively analyzed. All the cases were used for the enhancement scanning, whose scope was from hard palate to cervical segments of esophagus.Of 45 cases, 34 cases derived from piriform fossa, 7 cases were from the postcricoid region and 4 cases were in the posterior wall of hypopharynx. The tumor showed isodense or mixed density and slightly enhancement, piriform fossa became narrow or disappeared, retropharyngeal soft tissue thickened, laryngeal cartilage and esophageal ostium were invaded and lymph nodes of neck became metastasis. The tumor pushed the annular and arytenoids cartilage displacement anteriorly; the thyroid arytenoidal gap and cricothyroid joint were widened. The operation plan that was made according as MSCT was almost agreed with actual operation. The consistent rate is 91.1% (41/45).MSCT examination can accurately diagnose and exhibit the extension of the tumors and detect metastasis to lymph nodes, and provide reliable basis for surgery therapy.

To explore the feasibility and the related surgical techniques of laryngeal function preservation in surgical treatment of posterior hypopharyngeal wall cancer.Thirty-five cases with posterior hypopharyngeal wall cancer were treated surgically. The methods of removing tumor and repairing surgical defects were depended on the extension of lesions. The laryngeal and pharyngeal function were rebuild by normal tissue preserved with lesions entirely removed. Twenty-seven cases were surgically treated with laryngeal functions preserved and eight cases total laryngectomy. The most of the cases received postoperative radiotherapy.The overall 3 and 5-year survival rates were 45.7% and 28.6%, respectively. 45.7% patients having laryngeal functions (voice, respiration and deglutition) completely restored and 31.4% partially restored(voice and deglutition). Among the died patients, nine cases died from cervical lymph node metastasis, ten cases died from local recurrence, twa cases died from lung metastasis, one cases died from cervical massive haemorrhage, twa cases died from hear disease and one died from ambiguous reason.The preservative surgery is feasible for the selected posterior hypopharyngeal wall cancer cases. Choosing and following what is optimum from multiple feasible surgical methods is a prerequisite for improving the quality of life of the cases.

To study the effect of sodium phenylbutyrate when it combined with agents used in induction chemotherapy on laryngeal carcinoma cells Hep-2 in vitro.MTT were used to examine the growth inhibition of Hep-2 cells treated by the combination of PB with 5-FU or CDDP in vitro.When 5-FU or CDDP combined with PB respectively, there was significantly difference between every two dose groups of the two agents or every dose group and control group ( P0.05). When the dosage of 5-FU or CDDP was definition,there was significantly difference between every two dose groups of PB ( P0.05).PB could enhance the cytotoxic effects of agents used in induction chemotherapy on laryngeal carcinoma cells Hep-2 in vitro, which showed the possibility in reinforcement the treatment effect and reduction the occurrence of the complication and toxic reaction of induction chemotherapy on laryngeal carcinoma.

To explore the relationship between the expression of MDM2 and p27 in hypopharyngeal carcinoma and clinicopathological parameters and their clinical significance.The expression of MDM2 and p27 in 59 hypopharyngeal carcinoma were detected by S-P immunohistochemical technique.The high-expression rates of MDM2 and p27 were 66.1% and 33.9%, respectively, and the low-expression rates of them were 33.9% and 66.1%, respectively. The expression of MDM2 was unrelated to p27 (P0.05). The lymph node metastasis in high-expression group of MDM2 was significantly higher than that in low-expression group (P0.01). The expression rate of p27 was significantly different among the four T groups and degree of differentiation, respectively (P0.05). The survival rate was significantly higher in high-expression rate group of MDM2 than that in low-expression rate group (P0.01), while the survival rate was significantly lower in high-expression rate group of p27 than that in low-expression rate group (P0.05).The expression of MDM2 and p27 may be involved in carcinogenesis and progression in hypopharyngeal carcinoma. Combined detecting of MDM2 and p27 may predict its prognosis better in hypopharyngeal carcinoma.

To improve the curative effects of laryngotracheal stenosis.Seventy patients treated for laryngotracheal stenosis on the different pathologic condition of the larynx and trachea were retrospectively reviewed. Different operative reconstruction methods were used accordingly.Among 70 patients, 65 (92.9) patients succeed in decannulation. The average course of usage of stent was 14.8 days, the average course from operation to decannulation was 82.0 days.The choice of surgical procedure must be decided on the pathologic conditions of the larynx and trachea. Eliminating the defect of the mucosa and reconstructing a wide enough airway was the key to improve the curative effect.

To explore the surgery way for T1, T2 glottic carcinoma.Small partial laryngectomy were performed to 112 patients with T1, T2 (T1 N0 M0, T2 N0 M0) glottic carcinoma. The surgery method, effect and treatment advantage was summarized and compared with laser therapy and radiotherapy, the dynamic follow-up of arytaenoidea cartilage movement, glottidis rimae conformation and voice change was analyzed. The preoperative and postoperative voice quality was compared with the software of Dr. speech system for windows.All incisions were healed one stage in 6 or 7 days, the mean time in hospital is 9.76 days; all patients took food with mouth after 2 or 3 days, all trachea cannula was removed successfully during in hospital, the mean time with cannula is 7.32 days and the rate of removing cannula 100%. Arytaenoidea cartilago movement of 47 cases 1 week after surgery weakened and gradually improved, glottidis rimae conformation is close to be normal after 2 months. There is no significant difference of Shimmer and NNE between preoperative and postoperative 1 week (P0.05), but there is a significant difference between preoperative and postoperative 2 months, half a year, and also is between postoperative 1 week and 2 months, half a year (P0.01). All 76 cases survive during 3 years' follow-up, 35 of 36 cases in 5 years' follow-up survive (1 case died without definite cause), and there is 2 cases for recurrence.Small partial laryngectomy can provide large operative view, resect the tumor completely, make diet and speech recover in shorter time and improve the voice quality, so the surgery is available.

To study effective treatment of stomal recurrence.Thirty-one patients with stomal recurrence underwent surgical management. Twelve of them considered to have the probability of metastasis to regional lymphnodes underwent modified radical neck dissection. Twenty-five cases(I and II type) received complete tumor excision, but for III and IV type, only 50% (3/6) of the patients gained complete tumor excision. The surgical defects were repaired by pectoralis major myocutaneous flap in all the patients.In 13 cases of type I, 7 cases had followed up for 3 years, 4 cases died, while in 12 cases of type II, 8 cases had followed up for 3 years, 5 cases died. Survival remains poor for III or IV type. Most of them died within 3 years after operation. The complication rate of pharyngeal fistula and pneumatothorax was 12.9% and 9.7%, respectively.The overall prognosis of stomal recurrence is dismal. A proper surgical treatment in some cases will prolong the lifetime and improve their quality of life.

To explore the methods of surgery and evaluate the long-term results of preservative surgery for T3 glottic cancer.Seventy-five cases with T3 glottic cancer were treated surgically from 1989 to 1999. The lesions were removed entirely, the epiglottis, bi-pedicled myoperichondral flap, platysma myocutaneous flap, sternohyoid myofascial flap, platysma myofascial flap, thyroid perichondral flap were utilized to restore the defects of larynx and reconstruct the laryngeal functions.The 3- and 5-year survival rates were 83.2% and 73.6% in all cases, 82.7% had all laryngeal functions (voice, respiration and deglutition) restored and 17.3% partially restored(voice and deglutition).Preservative surgery can be carried out for T3 glottic cancer with the lesions entirely removed. Choosing and following what is optimum from multiple feasible surgical methods is a prerequisite for better laryngeal functions.

To observe the appliance value of uni-pedicled sternohyoid myofascial flap in laryngeal function reconstruction after partial laryngectomy.Forty patients who underwent partial laryngectomy from 1981 to 1999 were summarized(male 36 cases, female 4 cases). Among them 19 were supraglottic carcinomas (T2N0 6, T2N2 1, T3N0 2, T3N1 1, T3N2 2, T4N0 4, T4N1 1, T4N2 2), 19 cases were glottic carcinomas(T2N0 6, T3N0 11, T3N2 2), 2 cases were subglottic carcinomas(T2N0 1, T3N0 1). The choice of surgical procedure was decided on the pathologic conditions of the larynx, the laryngeal function was reconstructed using uni-pedicled sternohyoid myofascial flap.Thirty-three cases were decannulated and recovered with laryngeal functions. The decannulation rate was 82.50%. All the patients rehabilitated deglutition in 10 to 20 days after surgery. None presented complication of aspiration. The 3-year survival rate was 86.58% and 5-year survival rate was 72.49%.The uni-pedicled sternohyoid myofascial flaps are appropriate for reconstruction of surgical defect in laryngeal carcinomas.

To investigate clinical prognosis and the one-stage methods of reconstruction for advanced thyroid carcinoma while larynx and cervical trachea involved.One-stage resection and laryngotracheal reconstruction were performed in 18 advanced thyroid carcinomas. Among them, total laryngectomy were performed in 3 cases and partial laryngectomy in the other 4 larynx-involved cases. Cervical trachea involvement were found in all 18 cases. Besides 8 shave-off of tumor, area of trachea invaded by carcinoma were removed in other 10 cases. The methods applied for the tracheal reconstruction were 1 simple suture, 3 tracheal anastomosis, 2 pedicled sternocleidomastoid myoperiosteous flap, 3 insular myocutaneous pectoralis major flap and 1 cervical flap.One patient died of cancer reoccurrence while in the hospitalization. Except for 3 cases with total laryngectomy, larynx preservation were done in 14 cases and tracheal cannula were pulled out in 8, blocked in 2 and kept carrying in 4 cases.One stage reconstruction of larynx and cervical trachea involved by advanced thyroid carcinoma is feasible and practical. Curative rate, survival time and life quality all can be improved.

To explore new methods of preservative surgery for T4 glottic cancer and to evaluate their long term results.22 cases with T4 glottic cancer were treated surgically from 1982 to 1998. The lesions and involved cartilage and extrinsic laryngeal tissues were removed entirely, the sternohyoid myofascial flap, platysma myocutaneous flap, platysma myofascial flap, thyroid perichondral flap and hypopharyngeal mucosa flap were utilized to restore the defects of larynx, while the epiglottis or lamina of cricoid cartilage were reserved for laryngeal function restruction.The 3- and 5-year survival rates were 86.4% and 75.0% in all cases. 68.2% had laryngeal functions(voice, respiration and deglutition) restored and 31.8% partially restored(voice and deglutition).Despite the fact that the T4 glottic cancer usually involved with cartilage and extrinsic laryngeal tissues, preservative surgery can be carried out for the carefully selected cases with the lesions entirely removed.

To assess the possible relation between the MspI polymorphism of Cytochrome P4501A1(CYP1A1) gene and the susceptibility to laryngeal cancer.The genotypes of CYP1A1 MspI site were detected using the methods of polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) in 62 cases of laryngeal squamous carcinoma and 56 healthy controls. Genetic risk of CYP1A1 genotypes was analyzed by smoking index (SI, cigarettes smoked per day x years of smoking).Three genotypes of CYP1A1 MspI were classified into the predominant homozygotes (A), heterozygotes (B) and the rare homozygotes (C). The frequency of heterozygote B (58.1%) and genotype C (14.5%) in the patients with laryngeal cancer were higher than that of the controls (39.3%, 7.1%, P0.05), while their odds ratios were 2.89 (95% confidence interval, CI: 1.31-6.37) and 3.97 (95% CI: 1.10-14.28), respectively. The odds ratios of genotype C was 9 (95% CI: 1.60-50.74) in the high dose cigarette smoking group, but was 4.5 (95% CI: 0.64-31.61) in the low dose cigarette smoking group.With the carcinogenesis and development of laryngeal cancer, the polymorphism of CYP1A1 gene and smoking exposure together may play an important role. The individuals with genotype C are at especially high risk of laryngeal cancer, which grows with increasing cigarette consumption.

To assess the quality of life and relevant factors following laryngectomy.Quality of life was evaluated in 42 laryngeal cancer and hypopharyngeal cancer patients following laryngectomy and in 38 controls. The assessment included General Quality of Life Inventory, University of Washington Quality of Life Head and Neck Questionnaire and a study specific questionnaire.The laryngectomized patients reported significant lower scores of quality of life than the controls in many aspects of physical health, psychological health and social function dimensions. For patients, the most important dimension affecting quality of life was psychological condition, and the others were physical function, social function, and economic condition in turn; while for the controls, they were of opposite order. The significant factors affecting quality of life in patients following total laryngectomy were their concern about prognosis, disfigurement, decannulation, employment, speech and breathing conditions. The most important factor affecting psychological condition was physical function, while psychological condition was the most important factor affecting social function. Items ranked in the top five included those related to physical function, economic condition, psychological condition, social situation and social communication.More attention should be paid to research about quality of life. The quality of life of patients undergone laryngectomy is affected by many factors. Through the integration of psychological, clinical and social interventions, the quality of life of patients may have an overall improvement.

To study the feasibility, surgical technique and results of laryngeal function preservation in surgical treatment for medial wall pyriform sinus cancer.From 1992 to 1999, 31 patients with medial wall pyriform sinus cancer including stage I 1, II 4, III 14 and IV 12 lesions were treated. Partial resection of pyriform sinus and partial laryngectomy were performed, then, the remains of epiglottis and uni-pedicled sternohyoid myofascial flap were used to restore the defects of larynx. At last, the remaining hypopharyngeal mucosa was sutured to cover the wound of hypopharynx and for artificial rebuild-up. All patients received postoperative radiotherapy.The 3- and 5-year survival rates were 62.1% and 43.6% respectively, with 77.4% patients having laryngeal functions (voice, respiration and deglutition) completely restored and 32.6% partially restored (voice and deglutition).Conservative surgery so introduced is feasible for selected medial wall pyriform sinus cancer patients with the lesion completely resected.

To observe the application value of epiglottis in laryngeal reconstruction after partial laryngectomy.The data of 168 patients, 25 with supraglottic carcinoma (T1N0 2, T2N0 10, T2N1 1, T2N2 1, T3N0 7, T3N2 1, T4N0 2, and T4N2 1), 140 with glottic carcinoma (T1N0 36, T1N1 1, T2N0 52, T2N1 1, T2N2 1, T3N0 40, T3N2 2, T4N0 6, and T4N2 1), and 3 with subglottic carcinoma (T3N0 1, and T4N0 2), who underwent partial laryngectomy from 1982 to 1999 were summarized. The choice of surgical procedure was decided on the pathology of the larynx. Epiglottis was used in larynx reconstruction.Out of the 168 cases, 135 cases were decannulated with a decannulation rate of 80.36%, regained deglutation, recovered all laryngeal functions, and resumed normal diet. None presented complication of accidental aspiration. The 3-year and 5-year survival rates were 89.48% and 74.14% respectively.Epiglottis has many advantages in laryngeal reconstruction.

To explore the surgical methods for laryngeal cancer and long-term effects of larygectomy.625 cases of laryngeal cancer at different stages, including 182 cases of supraglottic cancer, 429 cases of glottic cancer, and 14 cases of subglottic cancer, underwent operation of different kinds from 1979 to 1999. Radiotherapy was given to those with poorly differentiated squamous carcinoma or with metastasis of cervical lymph nodes postoperatively. The effects of operation, especially that on the preservation of laryngeal function was analyzed.Partial laryngectomy was performed on 521 of the 625 cases (83.4%) and 203 of the 305 cases at stages III and IV (66.6%). The decannulation rate was 84.07% in the cases undergoing partial laryngectomy. The nasal feeding tube was removed and peroral feeding was recovered in all patients. All cases undergoing partial laryngectomy succeeded in phonation. The overall 3-year survival rate was 89.63% and the overall 5-year survival rate was 77.36%. For the cases with laryngeal cancer at stages III and IV, the 3-year survival rate among those undergoing partial laryngectomy was 84.9%, not significantly different from that among those cases undergoing total laryngectomy (87.7%, P0.05); the 5-year survival rate was 66.6% among those undergoing partial laryngectomy and was 69.7% among those undergoing totals laryngectomy (P0.05).The rate of partial laryngectomy is rather high in this group. It is possible to preserve the laryngeal function without compromising the remote survival rate. The prerequisite for the preservation of laryngeal function is to master and choose the proper renovation methods.