Value of postoperative radiation therapy for regional control after dissection in head and neck squamous cell carcinoma cases.

OBJECTIVE: We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) and thus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cell carcinomas (HNSCCs) with differing cervical lymph node status. METHODS: A retrospective study was performed in 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR and to define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT). RESULTS: Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmed to be the only independent risk factor for RR. There were no significant risk factors associated with RR in the ECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence of RR. CONCLUSIONS: ECS remains a determined risk factor for RR after neck dissection and PORT in patients with N+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensive postoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to prevent regional failure in HNSCC patients with ECS.

[Effect of interferon alpha on liver fibrosis in patients with chronic hepatitis B].

OBJECTIVE: To observe the histological changes in the fibrotic and inflammatory tissues in response to interferon alpha treatment in patients with chronic viral hepatitis B. METHODS: Sixteen patients with chronic viral hepatitis B in S3-S4 stages established by pathological examination were treated with interferon alpha for 6-9 months, and the degree of liver fibrosis and inflammation were examined 3 times during the treatment. The expression of Fas, transforming growth factor beta1 (TGFbeta1) and HBcAg in the liver tissues were detected by immunohistochemistry, and DNA fragmentation was examined by TUNEL assay. The levels of the serum markers for liver fibrosis and liver function were also measured. RESULTS: Patients with liver fibrosis in S3-S4 stages had high pathological expression of Fas and TGFbeta1 with severe DNA damage in the liver tissues. After 3 months of interferon therapy, the expression of Fas and TGFbeta1 were lowered (P<0.05), and further treatment till 3-9 months resulted in gradual decrease in the degree of hepatic fibrosis and cell apoptosis (P<0.05), with improved serum liver fibrosis indices and liver function. CONCLUSION: Interferon alpha may alleviate liver fibrosis and suppress cell apoptosis in patients in S3-S4 stages after a 6- to 9-month continuous treatment.

[Comparison of composite grafting of autoskin with acellular dermal matrix from different sources].

OBJECTIVE: To compare the composite grafts of acellular dermal matrix (ADM) from different sources with autoskin. METHODS: Six local white mini pigs were employed for the experiment. The pigs were randomly divided into four groups according to different skin grafts, i.e. A (human ADM with razor thin autoskin), B (porcine ADM with razor thin autoskin), C (razor thin autoskin only), and D (split thickness autoskin) as control. The survival rate, the contraction degree of the grafts, and the histological changes in grafting area were observed at 2, 4, 8, 12 and 24 hours after the operation. RESULTS: The grafted area in both A and B groups appeared smooth and elastic with satisfactory graft survival. The in growth of the host reparative cells such as fibroblast and vascular endothelium could be induced by composite grafts of different ADMs with skin grafting. The contraction areas in A and B groups seemed bigger than those in C and D groups. The tissue structure of grafting areas was similar to that of split thickness skin grafting area at 24 post-operation weeks. CONCLUSION: Combination of the homogenous and heterogeneous ADMs with autografts exhibited similar biological function during the observation period (24 weeks after operation). Xenogenous ADMs might have broader clinical applications.