Imaging and clinical features of nasopharyngeal adenoid cystic carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the spreading patterns nasopharyngeal carcinoma and nasopharyngeal adenoid cystic carcinoma.</p><p><b>METHODS</b>Eighteen pathologically confirmed consecutive cases of adenoid cystic carcinomas (ACC) and 182 cases of untreated nasopharyngeal carcinomas (NPC) were reviewed.</p><p><b>RESULTS</b>Compared with NPC, ACC had higher rates of T4 disease (14.3% vs 38.9%,χ(2) = 7.197, P = 0.007) and paralyzed cranial nerve (6.0% vs 38.9%,χ(2) = 37.936, P < 0.001) . There was no significant difference in skull base invasion rates between 2 groups (53.3% vs 66.7%,χ(2) = 1.181, P = 0.277) . ACC had higher rates of MRI-detected cranial nerve canal invasion (32.4% vs 55.6%,χ(2) = 3.881, P = 0.049) and cavernous sinus invasion (13.7% vs 33.3%,χ(2) = 7.710, P = 0.028) than NPC. Lymph node metastasis occurred in 64.8% of ACC, and 11.1% of NPC (χ(2) = 19.699, P < 0.001) .</p><p><b>CONCLUSION</b>ACC has a higher rate of cranial nerve invasion and NPC has a higher rate of lymphatic metastasis.</p>

Prognostic value of soluble MICA levels in the serum of patients with advanced hepatocellular carcinoma / 癌症

Serum levels of soluble MHC class I-related chain A (sMICA) are related with the prognosis of various types of cancer; however, few studies on the prognostic value of sMICA in hepatocellular carcinoma (HCC) have been reported. In this study, we retrospectively investigated the relationship between sMICA levels and clinical features of advanced HCC, and we assessed the prognostic value of sMICA in advanced HCC. Furthermore, the relationship of serum sMICA levels and natural killer group 2, member D (NKG2D) expression on natural killer (NK) cells was also evaluated. We detected sMICA levels in the serum of 60 advanced HCC patients using enzyme-linked immunosorbent assay (ELISA) and measured expression levels of NKG2D on NK cells using flow cytometry. We found that serum sMICA levels in HCC patients were in the range of 0.10-6.21 ng/mL. Chi-square analyses showed that sMICA level was significantly related with only tumor size. Survival analysis showed that a high sMICA level was significantly related with poor prognosis among HCC patients. Multivariate analyses indicated that sMICA was an independent prognostic factor. In addition, the levels of CD56+NKG2D+ NK cells were within the range of 11.2%-55.4%, and correlation analyses indicated that sMICA level was negatively correlated with the level of NKG2D+ NK cells. Our results suggest that serum sMICA levels may be an independent prognostic factor for advanced HCC.

Analysis of cervical and retropharyngeal lymph node metastases in the patients with hypopharyngeal carcinoma with computed tomography and magnetic resonance imaging / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Hypopharyngeal carcinoma has a high risk for early regional lymphatic dissemination. However, reports about regional lymph node metastases, especially retropharyngeal lymph node metastases, are rare. This research explored the spread of hypopharyngeal carcinoma, especially metastases of the retropharyngeal lymph nodes by studying computed tomography (CT) and magnetic resonance imaging (MRI) images.</p><p><b>METHODS</b>The CT/MRI images of 88 patients with pathologically confirmed hypopharyngeal carcinomas that were performed at our hospital between August 2000 and March 2009 were analyzed retrospectively. The interrelations among local stage and lymph nodes in various regions were analyzed by Chi2 test and multivariate logistical regression.</p><p><b>RESULTS</b>The rate of regional lymph node metastasis for all patients was 73.9%, and the highest rates of positive lymph nodes were at levels IIa (61.4%), IIb (44.3%), and III (37.5%). Metastases to levels I, IV, V, and VI were rare, as were retropharyngeal lymph-node metastases, which were always combined with metastases at levels II and III. Univariate analysis showed that level-IV metastases correlated to metastases at levels Ib and III; retropharyngeal lymph node metastases were correlated to level IIb and bilateral cervical lymph node metastases. Multivariate analysis showed that level-VI metastases correlated to level IV and that retropharyngeal lymph-node metastases correlated to bilateral cervical lymph node metastases.</p><p><b>CONCLUSIONS</b>Regional lymph node metastases in patients with hypopharyngeal carcinoma follow some regulations, and skip metastasis is rare. The highest rates of positive lymph nodes are at levels II and III. Bilateral lymph node metastases may be a risk factor for retropharyngeal lymph node metastases.</p>