The Systemic Immune-Inflammation Index and Albumin as Prognostic Predictors in Laryngeal Carcinoma.

BACKGROUND: Systemic inflammation via host-tumor interactions is currently recognized as the seventh cancer hallmark. The purpose of this study was to detect whether pretreatment peripheral indexes were associated with aggressive behavior and prognosis of laryngeal carcinoma patients. METHODS: The pretreatment peripheral indexes such as albumin and systematic immune-inflammation index (SII) in 338 patients with laryngeal carcinoma were retrospectively recorded, the relationships between them and clinicopathological features and prognosis were analyzed. RESULTS: A high SII value was significantly positively associated with age (P = 0.01), N stage (P = 0.022) and tumor differentiation (P = 0.001). A low albumin value was significantly negatively associated with age (P = 0.01), tumor location (P = 0.001) and T stage (P = 0.015), N stage (P = 0.001) and tumor differentiation (P = 0.001). Univariate and multivariate survival analysis showed that a high SII (HR: 2.415, 95% CI 1.400-4.184; P = 0.002), a low blood albumin content (HR: 3.194, 95% CI 2.030-5.025; P = 0.001) independently predicted poor overall survival (OS). However, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and platelet distribution width (RDW) were not independent prognostic factors. CONCLUSION: Pretreatment peripheral indexes SII and albumin could function as inexpensive indicators of aggressive behavior and be feasible and promising predictive biomarkers for prognosis in laryngeal carcinoma patients. Quantification of pretreatment SII and albumin may help physicians to design more effective management and follow-up strategies in laryngeal carcinoma patients.

LAMC2 acts as a novel therapeutic target of cetuximab in laryngeal cancer.

This study was set out to determine the function of LAMC2 in laryngeal cancer (LC). Initially, we identified the expression of LAMC2 in LC cells and tissues using TCGA datasets, GEO datasets (GSE143224), qRT-PCR, and western blot. Besides, we analyzed the correlations between LAMC2 and clinicopathologic features in LC patients. The CCK-8 assays were performed to detect cell viability and the half-maximal inhibitory concentration of cetuximab (IC50) in LC cells. We explored the correlations between LAMC2 and EGFR and further explored the regulation mechanism of cetuximab in LC. This study identified a high expression of LAMC2 in LC cells and tissues. The expression levels of LAMC2 were associated with TNM classification, lymph node (LN) metastasis, differentiation, and overall survival (OS). LAMC2 significantly promoted cell proliferation and cell viability. Besides, cetuximab significantly inhibited LAMC2 expression levels. LAMC2 significantly reversed the effect of cetuximab suppressing cell proliferation in LC cells. In conclusion, LAMC2 may act as a novel anti-cancer target in LC.

Aminopeptidase N5 (APN5) as a Putative Functional Receptor of Cry1Ac Toxin in the Larvae of Athetis lepigone.

Athetis lepigone was a new lepidopteran pest and caused severe damage to maize crops in China. We have detected that Cry1Ac protoxin and toxin were highly active against the larvae of A. lepigone. However, there is no report about the mode of action of Bt Cry1Ac toxin against this pest until now. A 110 kDa APN5 protein from BBMV of A. lepigone was identified as the binding receptor of Cry1Ac toxin using Ligand blotting. The Cry1Ac receptor APN5 was cloned from A. lepigone larval midgut mRNA and named as AlAPN5 (GenBank accession no.: KU950745). AlAPN5 had a GATEN motif and been classified to Class 5 APNs. 79.2% reduction in mortality was observed when A. lepigone larvae were injected with siRNA of the AlAPN5 gene and treated with Cry1Ac toxin. These data demonstrate that AlAPN5 is a putative functional receptor and maybe the only receptor of Cry1Ac in A. lepigone.

Laryngo-tracheobronchial amyloidosis: a case report and review of literature.

AMYLOIDOSIS is a benign process which can have systemic involvement. Though larynx is the common site of localized amyloidosis in the head and neck region,1 it was seldom reported with heterochronous implication of bilateral ventricles. Here we report a case of laryngeal amyloidosis heterochronously localized at bilateral ventricles with tracheobronchial involvement. Combined with our experience we reviewed the literature, and discuss the pertinent managements of this condition.

Anticancer mechanism of apigenin and the implications of GLUT-1 expression in head and neck cancers.

Apigenin, a natural phytoestrogen flavonoid, has potential biological effects, including antioxidative, anti-inflammatory and anticancer activities. The mechanisms of anticancer activities of apigenin are unknown. Some studies have found that apigenin inhibits GLUT-1 mRNA and protein expression in cancer cells. Thus, we hypothesized that apigenin exerts similar effects on head and neck cancers through its inhibition of GLUT-1 expression. In this article, we review the anticancer mechanism of apigenin and the implications of GLUT-1 expression in head and neck cancers. In addition, we describe the current state of knowledge about the relationship between apigenin and GLUT-1 expression in head and neck cancers.

Effect of antisense oligodeoxynucleotides glucose transporter-1 on enhancement of radiosensitivity of laryngeal carcinoma.

PURPOSE: Laryngeal carcinomas always resist to radiotherapy. Hypoxia is an important factor in radioresistance of laryngeal carcinoma. Glucose transporter-1 (GLUT-1) is considered to be a possible intrinsic marker of hypoxia in malignant tumors. We speculated that the inhibition of GLUT-1 expression might improve the radiosensitivity of laryngeal carcinoma. METHODS: We assessed the effect of GLUT-1 expression on radioresistance of laryngeal carcinoma and the effect of GLUT-1 expressions by antisense oligodeoxynucleotides (AS-ODNs) on the radiosensitivity of laryngeal carcinoma in vitro and in vivo. RESULTS: After transfection of GLUT-1 AS-ODNs: MTS assay showed the survival rates of radiation groups were reduced with the prolongation of culture time (p<0.05); Cell survival rates were significantly reduced along with the increasing of radiation dose (p<0.05). There was significant difference in the expression of GLUT-1mRNA and protein in the same X-ray dose between before and after X-ray radiation (p<0.05). In vivo, the expressions of GLUT-1 mRNA and protein after 8Gy radiation plus transfection of GLUT-1 AS-ODNs were significant decreased compared to 8Gy radiation alone (p<0.001). CONCLUSION: Radioresistance of laryngeal carcinoma may be associated with increased expression of GLUT-1 mRNA and protein. GLUT-1 AS-ODNs may enhance the radiosensitivity of laryngeal carcinoma mainly by inhibiting the expression of GLUT-1.

Expression of hypoxia-related markers in inflammatory myofibroblastic tumors of the head and neck.

BACKGROUND: The etiology of inflammatory myofibroblastic tumors (IMTs) is controversial and the prognosis is unpredictable. Previous studies have not investigated the expression of hypoxia-related markers in IMTs. METHODS: Between 2002 and 2012, 12 consecutive patients with histologically proven IMTs were enrolled in the study. Immunohistochemistry was used to detect GLUT-1, HIF-1α, PI3K, and p-Akt expression in paraffin-embedded tumor specimens. Associations among GLUT-1, HIF-1α, PI3K, and p-Akt protein expression and clinical parameters were investigated. RESULTS: The mean duration of follow-up was 52.1 months (range, 11 to 132 months). Six patients had local recurrence. GLUT-1, HIF-1α, PI3K, and p-Akt expression were detected in 41.7%, 50.0%, 33.3%, and 41.7% of patients, respectively. Fisher's exact test revealed significant correlations between recurrence of IMT and PI3K expression (P = 0.01) and p-Akt expression (P = 0.015). Univariate analyses revealed significant correlations between survival and GLUT-1 expression (P = 0.028), PI3K expression (P = 0.006), and p-Akt expression (P = 0.028). Multivariate analysis did not show a significant relationship between survival and GLUT-1, HIF-1α, PI3K, or p-Akt. Spearman rank correlation analysis showed significant correlations between HIF-1α and PI3K expression (r = 0.707, P = 0.01) and between p-Akt and PI3K expression (r = 0.837, P = 0.001). CONCLUSIONS: Although our results are inconclusive owing to the small sample size, they suggest that PI3K and p-Akt expression may play a role in the recurrence of IMTs of the head and neck.

The effects of temperature on the development of the moth Athetis lepigone, and a prediction of field occurrence.

Athetis lepigone (Möschler) (Lepidoptera: Noctuidae) is an important insect pest of corn crops in China. To determine the effect of temperature on A. lepigone growth, and to provide a forecasting model for this pest, the development and fecundity of A. lepigone under five different temperatures (18, 21, 24, 27, 30 °C) was investigated, and an experimental population life table was constructed based on the obtained results. The results showed that the duration of development of A. lepigone decreased as the temperature increased from 18 to 30 °C. Approximately 95% of mature larvae stopped pupating at 18 °C, and about 70% of mature larvae stopped pupating at 21 °C. When the growth chamber temperature was above 24 °C, no growth arrest was observed. The results indicated that the optimum growth temperature of A. lepigone was about 26.47 °C. In this study, the highest survival rate, fecundity per female, and population index trend were observed when the temperature was set at 27 °C. The percentages of larvae that could spin cocoons after the 5th or 6th instar differed at the different temperatures. The developmental threshold temperatures for A. lepigone eggs, larvae, pre-pupae, pupae, preoviposition females, and the whole generation (i.e., egg to oviposition) were 11.03, 9.04, 15.08, 11.79, 11.63, and 10.84 °C, respectively, and their effective accumulative temperatures were 63.51, 339.42, 30.04, 118.41, 35.06 and 574.08 degree-days, respectively. Based on the effective accumulative temperature law, this pest insect can have four generations in most of the Huang-Huai region of China, and two to three generations annually in some cold regions. Athetis lepigone may have four generations in the mid-southern part of Hebei Province. This prediction matches the field survey results.

A study on the local corrosion behavior and mechanism of electroless Ni-P coatings under flow by using a wire beam electrode.

The local corrosion behavior and mechanism of Ni-P coatings in a 3.5 wt% sodium chloride solution with different flow speeds (0 m s-1, 0.5 m s-1, 1 m s-1) were investigated through a wire beam electrode (WBE) with morphological, elemental and electrochemical analyses as well as numerical simulations. It was found that the microstructure of the Ni-P coating was in the shape of broccoli and possessed satisfactory compactness and uniformity. The numerical simulations showed that the speed increased and the static pressure decreased at the local area. Combined with WBE, it was found that the average corrosion potential decreased at that area. The results indicated that the corrosion tendency and corrosion rate of the Ni-P coating were larger at higher speeds, and the corrosion resistance could be improved by the electroless Ni-P coating. WBE was helpful in revealing the local electrochemical information of the Ni-P coating.

Transnasal endoscopic repair of acquired posterior choanal stenosis and atresia.

BACKGROUND: There are congenital and acquired choanal atresias and many approaches have been used for their repair. We assessed the clinical effect of power instrument, endoscopic repair of acquired choanal stenosis and atresia. METHODS: Nineteen patients, aged from 32 to 61 years, with acquired choanal stenosis and atresia (from trauma in 5 cases and from radiotherapy after nasopharyngeal carcinoma in 14; 6 bilateral and 13 unilateral cases), underwent transnasal endoscopic repair of choanal stenosis and atresia. No patient had stenting. Antibiotic and local glucocorticoid were administered postoperatively. RESULTS: Eighteen patients remained free of symptoms for 12 - 40 months after the surgery, and the diameter of the neochoana was more than 1 cm after the procedure. One patient required revision surgery and recovered completely with no restenosis at 12 months after the second surgery. There were no postoperative complications. Histology of the resected tissue revealed respiratory epithelial-lined stromal tissue with chronic inflammation, edema and fibrosis, but no tumor cells. CONCLUSIONS: Transnasal endoscopic approach is a useful procedure for the repair of acquired choanal stenosis and atresia: it is highly successful, safe and effective with swift recovery and short time of hospitalization. It is very important in postoperative care to remove any granulation or polyps at the site of the neochoana at that time.

Basal cell adenoma in the parapharyngeal space resected via trans-oral approach aided by endoscopy: Case series and a review of the literature.

RATIONALE: Basal cell adenoma (BCA) is a rare benign salivary gland tumor. It is difficult to be completely resected when arising in parapharyngeal space. A contemporary trend is to develop minimally invasive approaches on the premises of safety and complete resection. PATIENT CONCERNS: Three patients were referred to our ENT Outpatient Department with the chief complaint of an uncomfortable throat. CT or MRI revealed a unilateral mass in the parapharyngeal space, round or oval in shape, with well-defined borders. DIAGNOSES: CT and MRI provided useful information for the preoperative evaluation. The appearance of large-scale cystic components may be an important clue for the diagnosis of BCA. PET/CT images were also available in one case. The final diagnoses were all basal cell adenomas (tubular type) in parapharyngeal space according to the regular histopathological examination after surgery. INTERVENTIONS: All three cases were completely resected by a trans-oral approach. The average operative time and estimated blood loss were 86 (range, 61-106) min and 116.7 (range, 50-200) mL, respectively. Endoscopy was used in the largest case to further assess the residual cavity after the complete resection and hemostasis. OUTCOMES: Postoperative recovery courses were quick and uneventful, with no neurovascular complication. Patients were discharged on the 3-5 day after surgery on an oral diet. One patient reported symptoms of velopharyngeal incompetence, manifested as mild slurred speech and nighttime salivation, for up to 3 months, which recovered spontaneously thereafter. There was no evidence of recurrence in the follow-up period. LESSONS: In our experience, the trans-oral approach appeared to be effective, safe, and less invasive for extirpation of selected basal cell adenomas in the parapharyngeal space. An assistance of endoscopy facilitates the surgery.

Transnasal endoscopic resection of vascular leiomyomas of the nasal septum.

OBJECTIVE: Our experience with endoscopic surgery for vascular leiomyomas of the nasal septum was reviewed. PATIENTS AND METHODS: All patients with vascular leiomyomas of the nasal septum who were treated with endoscopic surgery from May 1995 to June 2007 were reviewed retrospectively. RESULTS: Twelve patients had vascular leiomyomas of the nasal septum removed successfully; there were no recurrences or endocrine complications during the 15-62-month follow-up postoperatively. CONCLUSION: The endoscope technique offers simple, rapid access to the nasal septum, and excellent visualization; it is a safe, minimally invasive, efficient procedure for removing benign nasal septum tumors that leaves no scar on the face.

Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids: Case Report and Review of the Literature.

The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No optimal treatment for such metastases has yet been defined.

Primary small cell cancer of cervical trachea: a case report and literature review.

UNLABELLED: Primary small cell carcinoma of trachea is even more uncommon and only a few cases have been reported. Our search revealed only 90 cases in the English-language literatures. CASE REPORT: we report a case of cervical tracheal small cell cancer. A 67-year-old male presented with over 2-month history of cough and dyspnea. CT and MRI revealed a 1.0 cm × 2.5 cm intraluminal, irregular soft tissue mass in the upper trachea, approximately 2.5 cm below the glottis. A bronchoscopic examination disclosed a large tumor in the cervical trachea and the lesion occupied more than 60% of the tracheal lumen. Cytological examination suggested some poorly differentiated carcinoma cells. The patient received concurrent chemoradiotherapy and did not perform surgery. One week after CCR, the patient occurred difficulty in breath and tracheal stent was implanted. The symptom was improved markedly. Four days after implant of tracheal stent, the patient presented irritable cough and hemoptysis. The amount of bleeding was about 300 ml. The hemorrhage stopped by treatment of vasoconstrictor and fresh plasma. However, two days later, hemoptysis was continuing even if treatment of vasoconstrictor and fresh plasma. The patient and relatives waived the further therapies. The patient died of massive hemoptysis one week out of hospital. CONCLUSIONS: The tracheal small cell cancer is rare. The optimal treatment is unclear. In general, the strategy is introduced concurrent chemoradiotherapy following as small cell lung cancer. In cervical trachea, we suggest that surgical resection should be performed followed by postoperative adjuvant therapy.

Prognostic factors of laryngeal solitary extramedullary plasmacytoma: a case report and review of literature.

A paucity of data exists concerning the presentation, natural course and outcome of extramedullary plasmcytoma (EMP). It is difficult to determine the optimal treatment strategy and prognostic factors for EMP. We present an additional case of laryngeal EMP and systemic review relevant reports in the English and Chinese literature. We found, to our knowledge, 147 cases in larynx in the English-language literature and Chinese-literature. The most common treatment modality was radiotherapy alone. The mean survival duration was ~184 months, and the 5- and 10- year survival rates were 76.1% and 67.4%, respectively. The univariate analysis suggested that progression to multiple myeloma and amyloid deposits may be poor prognostic factors. The multivariate analysis suggested that only progression to multiple myeloma may be a poor prognostic factor. Laryngeal EMP is uncommon. Progression to multiple myeloma may be a poor prognostic factor.

Obstructive sleep apnea syndrome caused by uncommon tumors of the upper aerodigestive tract.

Obstructive sleep apnea syndrome (OSAS) is always caused by anatomic abnormalities, including nasal cavity, pharynx, and neuromuscular dysfunctions, leading to airway narrowing. OSAS associated with a mass in the aerodigestive tract is rare. In the present study, we report OSAS caused by 9 cases of preoperative uncommon tumors in the aerodigestive tract. Two tumors in the parapharyngeal space were pleomorphic adenoma, one oropharyngeal tumor was mucoepidermoid carcinoma, one tumor in the right tonsil was schwannoma, and five tumors were non-Hodgkin's lymphoma (NHL). Of the five NHL cases, one in the nasopharynx was diffuse large B-cell lymphoma, two were mantle cell lymphoma, one was chronic lymphocytic leukemia/small lymphocytic lymphoma, and one was NHL. Tumors in the aerodigestive tract should be considered in the differential diagnosis of OSAS upon exacerbation of snoring or sudden gasping. Further examinations should be performed, including a routine workup (computed tomography (CT) and magnetic resonance imaging) and positron emission tomography/CT.

Spindle cell rhabdomyosarcoma in the hypopharynx of an adult.

We herein present the first-reported case in the English-language literature of a spindle cell rhabdomyosarcoma in the hypopharynx of an adult. A 58-year-old male presented with a progressive, 7-month history of discomfort during swallowing, accompanied by hoarseness for 1 month. Computed tomography and magnetic resonance imaging revealed a tumor in the left pyriform sinus; frozen section evaluation suggested that it was rhabdomyosarcoma. The tumor was removed completely via left lateral cervical incision. Section margins were negative, and laryngeal function was preserved. The postoperative pathological results indicated spindle cell rhabdomyosarcoma. The patient received postoperative radiotherapy (6,000 cGy in 200 cGy fractions, delivered over 30 days). However, he was also required to undergo urgent tracheostomy due to severe laryngeal obstruction, precipitated by laryngeal edema, 3 months subsequent to radiotherapy. The patient was free of disease 25 months postoperatively but is still unable to close his tracheostomy.

Metastatic squamous cell carcinoma of the gingiva appearing as a solitary branchial cyst carcinoma: diagnostic role of PET/CT.

We herein present a case of a left cervical cystic mass, for which the initial pathological diagnosis was branchial cleft cyst carcinoma (following complete mass excision). Thorough postoperative examinations, including with FDG positron emission tomography/computed tomography (PET/CT), revealed a primary tumor in the retromolar region of the left mandible. A 52-year-old female presented with a 2-month history of a painless, progressively enlarged left-sided neck mass. Fine-needle aspiration biopsy suggested a branchial cleft cyst. Physical examination revealed a 3 × 3-cm smooth, tender mass in the upper-left neck and anterior border of the sternocleidomastoid muscle. Examination using nasendoscopy and a strobolaryngoscope revealed no abnormalities of the nasal cavity, nasopharynx, oropharynx, hypopharynx or larynx. MRI of the neck revealed a solitary, round, cystic mass under the left parotid gland. The mass was excised completely. Pathologic results indicated a branchial cleft cyst carcinoma. According to the diagnostic criteria for a branchial cleft cystic carcinoma, PET/CT was performed to detect the occult primary site. PET/CT revealed high FDG uptake in the tooth root of the left mandible. Frozen sections of the mass were indicative of moderate, differentiated squamous cell carcinoma. The carcinoma in the retromolar region of the left mandible was locally excised under general anesthesia. A partial left maxillectomy, partial mandibulectomy, and left radical neck dissection were performed. The patient received postoperative concurrent chemoradiotherapy, and was disease-free at the 8-month follow-up. True branchial cleft cyst carcinoma is rare: once diagnosed, it should be distinguished from metastatic cystic cervical lymph and occult primary carcinoma. FDG PET/CT is useful in the identification of occult primary tumor.