Author Correction: Evaluation of narrow band imaging in the assessment of laryngeal granuloma.

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Evaluation of narrow band imaging in the assessment of laryngeal granuloma.

Laryngeal granulomas belong to common complications following trans-oral laser microsurgery (TLM). The aim of this study was to evaluate NBI in the differentiation between granuloma-like lesions and local tumor recurrence. 154 consecutive patients after TLM due to early laryngeal cancer were enrolled. In the group, a monthly follow-up including NBI endoscopy was performed. Moderate and severe dysplasia, carcinoma in situ and invasive cancer were defined as positive histology, laryngeal granuloma and other benign laryngeal lesions as negative histology and premalignant lesions as suspicious histology. In 47/154 (31%) cases, granuloma-like lesion (GLL) was found. Patients with GLL were divided into two groups based on the NBI classification. In all patients, the microvascular pattern in NBI was compared with the final histology. In group A, with suspicious, perpendicular vessels, 13/13 (100%) samples were positive. In group B, with normal vascular pattern 3/34 (9%) samples were positive and 31/34 (91%) samples were negative. There was a significant correlation between the positive NBI vascular pattern and the final histology (p = 0.00001). Sensitivity, specificity, accuracy of NBI were as follows: 81%, 100%, 94%, respectively.Based on our results, NBI can reliably differentiate between postoperative laryngeal granuloma and local tumor recurrence. In such a manner, this method is very helpful in the follow-up of tumor patients.

Polymorphisms of the DNA base excision repair gene MUTYH in head and neck cancer.

BACKGROUND: Head and neck squamous cell carcinomas (HNSCC) comprise about 6% of all malignant neoplasms. The major risk factors of -HNSCC are smoking and alcohol consumption. Genetic polymorphisms of DNA repair enzymes may lead to genetic instability and carcinogenesis. MUTYH gene encodes a DNA glycosylase that can initiate the base excision repair (BER) pathway and prevent G:C > T:A transversion by excising adenine mispaired with 8-hydroxyguanine produced by reactive oxygen species (ROS). AIM: to perform a case-control study to test the association between polymorphism in the MUTYH gene: Tyr165Cys and head and neck cancer risk progression. METHODS: Genotypes were determined in DNA from peripheral blood lymphocytes of 193 patients (among them 97 subjects with precancerous hyperplastic laryngeal lesions and 96 subjects with head and neck cancer) and 140 age, sex and ethnic-matched cancer-free controls by tetra-primer amplification refractory mutation system PCR (T-ARMS-PCR). RESULTS: We found an association between head and neck cancer risk and the Tyr165Tyr variant of the MUTYH gene (OR 2.18; 95% CI 1.19-3.97). For Tyr165Tyr genotype we also observed positive correlation with cancer progression assessed by tumor size (OR 4.56; 95% CI 1.60-12.95). We did not observe any correlation between Tyr165Cys polymorphism of MUTYH gene and precancerous hyperplastic laryngeal lesions risk. CONCLUSION: The Tyr165Tyr polymorphic variant of the MUTYH gene may be associated with head and neck cancer in Polish population.

[Angiofibroma of the nasal cavity and anterior ethmoid cells--problems in differential diagnosis]. / Angiofibroma jamy nosa i komórek sitowych przednich u kobiety--problemy diagnostyki róznicowej.

BACKGROUND: Nasal angiofibromas are commonly called juvenile nasal angiofibromas (JNA) because of the almost exclusive occurrence in adolescent males. It is a relatively rare benign fibrovascular tumor originating in the posterior lateral wall of the nasopharynx with only a very few cases diagnosed in females. CASE REPORT: Authors present a case of a 26 y.o. woman with JNA in left nasal cavity with extension to the anterior left ethmoid cells diagnosed and surgically treated at the ENT Department, Medical University of Lodz. Patient presented in past medical history: lymphoma malignum--abdominal location--surgical treatment and chemotherapy (1986) with no clinical signs of recurrence. Diagnosis based on histopathologic examination with immunochemical staining (vimentin, actin, desmin, S-100 protein). CT of paranasal sinuses in frontal and axial plains--left nasal cavity filled with a solid pathologic tissue. In the left anterior ethmoid cells extension of the tumor could be seen. Surgical treatment--tumor has been surgically resected with no complications. In a 12 month follow up patient shows no signs of recurrence. CONCLUSION: Although angiofibroma in females is an extremely rare tumor of a sinonasal tract it should be taken into consideration in the differential diagnosis of all nasal cavity tumors (especially solitary fibrous tumor). It is not possible to make differential diagnosis on physical examination. The only way to confirm the diagnosis is histopathologic examination with immunochemical staining.

[Significance of angiogenesis in laryngeal cancer]. / Wartosc oceny angiogenezy w raku krtani.

Angiogenesis as multistage process, which is required for forming of new vessels and is essential for the growth of solid tumors and making metastasis. Sixty patients with laryngeal cancer were analyzed. They were treated in ENT Department of Medical University in Lodz and follow-up period was not shorter than 5 years. Intensity of neovascularisation was examined by means of immunohistochemical techniques carried out on paraffin sections using selected antibody against antigens of vessel cells. The value of the prognostic factors of angiogenesis intensity were evaluated against: dissected nodal metastasis, tumor recurrences and metastasis observed in prospective follow-up and after cancer treatment live time. Morphological properities of tumor or hospital treatment of the patients with laryngeal cancer were analyzed as well. Taking into consideration the results, we can make the conclusion that investigation of angiogenesis can be forthcoming prognostic factor for the laryngeal cancer.

[Assessment of cell proliferation antigen Ki-67, protein p53 related to apoptosis and angiogenesis in laryngeal cancer]. / Ocena ekspresji antygenu proliferacji komórkowej Ki-67, bialka zwiazanego z apoptoza p-53 i intensywnosci angiogenezy w raku krtani.

Kinetics (growth fraction of tumour cell populations), death process of cancer cells (apoptosis and necrosis) and neovascularisation in tumour (angiogenesis) have influence on the growth of cancer. Sixty patients with laryngeal cancer treated in ENT Department of Medical Academy of Lodz were analysed. Proliferation activity of cancer cells was examined by means of selection appropriate antigen (Ki-67) characteristic for cell cycle utilising immunohistochemical techniques carried out on laryngeal cancer paraffin samples. Expression of selected protein connected with apoptosis (p-53) and intensity of angiogenesis were examine using selected antibody (anti-CD34) aimed against epithelial antigens. Above-mentioned markers were correlated with: stage of cancer progression, recurrences and metastasis of laryngeal cancer and follow-up of the patients. The morphological properties were examined as well. The researches on apoptosis, angiogenesis and proliferation of cancer cells can be used as prognostic factors for the patients with laryngeal cancer.

[Programmed cell death research in laryngeal cancer]. / Badania nad programowana smiercia komórki w raku krtani.

Apoptosis--the programmed sell death is the process of characteristic events on morphological, biochemical and molecular level which lead consequently to cell death. This process require activation of some genes i.e. p-53, mdm2 and inhibiting others i.e. bcl-2. Sixty patients with laryngeal cancer treated in ENT Department of Medical Academy of Lodz were analysed. Expression of the p-53 and bcl-2 genes' products was examined by means immunohistochemical techniques carried out on laryngeal cancer paraffin samples. Above-mentioned markers were correlated with: stage of cancer progression, recurrences and metastasis of laryngeal cancer and follow-up of the patients. Initial results indicate the possible utilisation of apoptosis as prognostic factors for the patients with laryngeal cancer.

[Results of surgical treatment in patients with laryngeal carcinoma after failed radiotherapy]. / Wyniki chirurgicznego leczenia chorych z rakiem krtani po radioterapii.

Fifty-eight patients with laryngeal cancer from ENT Department in Lodz operated because of neoplastic recurrences after radio-therapy or associated therapy (surgery + radio-therapy) were analyzed. Postradiation oedema of the larynx was the most common cause of failure and delay in making diagnosis of neoplastic recurrences after primary treatment. The most common pooperative complication were cutaneous-pharyngeal and cutaneous-oesophageal fistules (24 patients--41%). In 41 patients (70.1%) long healing after operation was observed. In 8 patients (13%) recurrences in oesophagus, in pooperative scar and in stomal region were observed. Five year follow-up was observed in 54% and 3 year follow-up in 39%.

[Incidence of pharyngocutaneous fistulas after laryngectomy depending on the method of nutritive drain insertion]. / Wystepowanie przetok gardlowo-skórnych po laryngektomii w zaleznosci od sposobu zakladania drenu do odzywiania.

In the article incidence of pharyngocutaneous fistulas after total laryngectomy was estimated depending on the method of nutritive drain insertion. The study was performed in 464 patients (64% of all laryngectomized) treated surgically in ENT Department of Medical University in Lodz from 1988 to 1997. It was stated that fistulas developed in 114 cases (24.6%). There were compared two groups of patients following laryngectomy: group I was consisted of 279 patients with nasogastric tube and group II numbered 163 subjects with using a different method of nutritive drain insertion by the upper pole of neck wound during laryngectomy. It was found that pharyngocutaneous fistulas developed statistically lower in group with drain inserted by the neck wound than in group with nasogastric tube (17.8% vs 27.9% p < 0.05). Moreover patients in the second group could not suffered from the unpleasant pain in the nose, and easier accepted this manner of nutrition. Satisfactory surgical aspects for the patients and their environment confirm usefulness of different method of insertion of the nutritive drain by the neck wound.

[Evaluation of CD44 adhesion molecule, nm23 gene product expression and intensity of angiogenesis in patients with laryngeal cancer]. / Ocena ekspresji czasteczki adhezyjnej CD44, produktu genu nm23 i intensywnosci angiogenezy u chorych z rakiem krtani.

One of the most important factor in prognosis of the patients with laryngeal cancer is presence of the metastases in lymph nodes of the neck. The main purpose of the paper was the evaluation of CD34 and FVIII antigens as angiogenesis markers, and nm23 protein and CD44 antigen expression as metastasis potential markers and description of their role in the tumour progression and making metastasis in the patients with laryngeal cancer. Paraffin-embedded tissue sections from 89 patients with laryngeal cancer were stained with a monoclonal antibody raised against CD34 and FVIII antigens, against nm 23 protein and against CD44 antigen. Measuring the density of the microvasculature in tumour was investigated. We found significant dependence between intensity of angiogenesis (IA) and pT, nodal metastasis, histological grading and survival. There were also significant correlation between nm23 protein expression and nodal metastasis, and between CD44 antigen expression and pT, nm23 protein expression and FVIII antigen expression. Evaluation of mentioned markers allowed to asses the aggressiveness of tumour cells and anticipate neck metastasis in the patients with laryngeal cancer.

[Expression of selected markers for apoptosis, proliferation and metastasis in evaluation of laryngeal cancer invasiveness dynamics]. / Ekspresja wybranych wskazników apoptozy, proliferacji i przerzutowosci w ocenie dynamiki rozrostu raka krtani.

Evaluation of the biology of laryngeal cancer cell is connected either with many process inside the cell or reactions between cancer cell itself and extracellular matrix. The main purpose in this paper was the evaluation of p53 protein, bcl-2 protein, Ki-67 antigen and CD44 adhesive molecule expressions in comparison to clinical and histopathological features in patients with laryngeal cancer. Paraffin-embedded tissue sections from 89 patients with laryngeal cancer were stained with a monoclonal antibody raised against p53 and bcl-2 proteins, Ki-67 and CD44 antigens using a peroxidase-labelled streptavidin-biotin kit. There were statistically significant relationships between p-53 protein over-expression and pT, histological grading, survival and Ki-67 and CD44 antigens expressions. There were no correlation between bcl-2 protein expression and clinical and histopathological features. We observed statistically significant correlation between Ki-67 expression and pT, histological grading, recurrences and survival. Expression of CD44 statistically significant correlated only with tumour size. We conclude that comparison of data covering mentioned tumour markers expression gives valuable evaluation of biological activity of cancer cells and may allow to create the immunological panel of tumour markers which simplify the prognosis about nodal metastases, recurrences and survival in patients with laryngeal cancer.

[Complications and failure after partial laryngectomy]. / Powiklania i niepowodzenia po operacjach czesciowych krtani.

The frequency and type of failures and complications after 259 partial laryngectomies in patients treated for cancer of larynx in Otolaryngology Department of Medical University of Lodz from 1980 to 1996 were evaluated. Among the failures a local and nodal recurrence, a distant metastasis and a second primary malignant tumor were taken into consideration. Furthermore, among the complications disfunction of breathing, swallowing, voice emission and abnormal healing were analyzed. The most often failure was local recurrence which had been observed in 36 patients (13.9%) and the most often complication was a granulation in larynx which had been observed in 45 patients (17.4%).

[Distant results of putting the feeding tube through wound after laryngectomy]. / Odlegle wyniki u chorych po laryngektomii odzywianych drenem zakladanym przez rane.

Authors present their own postoperative results in nourishing the patients after laryngectomy. Their several years' observations, based on the group of 318 patients, were connected with the risk of the postoperative complications. In proposed way of nourishing (introduced by B. Latkowski) the point is in putting the nutritive drain not through the nose, but directly through the cutting during laryngectomy. The main aim of the research was presenting good points of this method and existence of no complications with the most dangerous--fistulas.