[Treatment of advanced maxillary sinus squamous carcinoma: an analysis of 92 cases].

BACKGROUND & OBJECTIVE: There is no satisfactory treatment for advanced maxillary sinus squamous carcinoma. The treatment strategy is controversial. This study aimed to explore a rational treatment for advanced maxillary sinus squamous carcinoma. METHODS: Clinical data of 92 patients with stage T3-T4 maxillary sinus squamous cell carcinoma, treated in Cancer Center of Sun Yat-sen University from Jan.1978 to Dec.2001, were reviewed. Of the 92 patients, 21 received radiotherapy alone, 8 received surgery alone, 63 received multimodality therapy (51 received surgery combined with radiotherapy, and 12 received chemoradiotherapy). RESULTS: The 3-and 5-year survival rates were significantly lower in radiotherapy group and surgery group than in multimodality therapy group (19.0% and 25.0% vs. 46.0%, P<0.05; 9.5% and 12.5% vs. 33.3%, P<0.05). In multimodality therapy group, the 3-and 5-year survival rates were 33.3% and 23.8% for the patients who received radiotherapy followed by surgery, 52.9% and 47.1% for the patients who received surgery follow by radiotherapy, 53.8% and 30.8% for the patients who received pre-and postoperative radiotherapy, and 50.0% and 33.3% for the patients who received chemoradiotherapy. There were no significant differences in survival rate between these four subgroups (P>0.05). CONCLUSIONS: The efficacy of multimodality therapy is better than that of single therapy strategy for advanced maxillary sinus squamous carcinoma. The best treatment pattern for advanced maxillary sinus squamous carcinoma needs further research.

[Treatment and prognosis of gingival carcinoma: a report of 116 cases].

BACKGROUND & OBJECTIVE: The treatment and prognosis of gingival carcinoma, a common oral carcinoma, have seldom been reported. This study was to explore appropriate therapies and analyze prognostic factors of gingival carcinoma. METHODS: Clinical data of 116 gingival carcinoma patients, treated at Cancer Center of Sun Yat-sen University from 1992 to 2003, were analyzed. Survival analyses were performed for patients who received surgery, radiotherapy, or surgery combined with chemotherapy or/and radiotherapy. The patients had been followed up for more than 3 years. RESULTS: One hundred patients received radical therapy. The overall 3-and 5-year survival rates were 52.7% and 41.8%. The 5-year survival rates were 50.3% in surgery alone group and 49.0% in combined treatment group, without significant difference. The 5-year survival rate of radiotherapy alone group was only 20.0%. For advanced gingival carcinoma, the recurrence rate was much lower in combined treatment group than in surgery alone group. Clinical stage and surgical margin status were predictors of survival. CONCLUSIONS: Surgery alone is appropriate for gingival carcinoma patients at an early stage; surgery combined with chemotherapy or/and radiotherapy is an adequate treatment for patients at advanced stages. Clinical stage and surgical margin status are important prognostic factors.

[Sentinel lymph node radiolocalization in squamous cell carcinoma of the oral tongue].

BACKGROUND & OBJECTIVE: At present, there is no clinical examination that can accurately assess the lymph node metastasis status of oral tongue carcinoma with clinically negative neck lymph node (cN0) before operation. Therefore, the treatment of cN0 neck is still controversial. Sentinel lymph node (SLN) biopsy may be the evidence for individual treatment of cN0 neck. This study was to explore the feasibility of SLN radiolocalization, and to investigate the clinical value of SLN detection in squamous cell carcinoma of the oral tongue. METHODS: Twenty-one oral tongue squamous cell carcinoma patients with cN0 necks were recruited, among which 1 had received primary dissection before. 99mTc-SC, as the tracer, was injected into the submucosa around primary tumor before operation. Lymphoscintigraphy was performed immediately in 5 cases. The gamma probe was used to identify SLNs for all cases before and during operation. All patients received supraomohyoid neck lymph node dissection. The pathologic results were considered as golden standard to evaluate the effectiveness of SLN radiolocalization. SLNs that had been reported as negative by routine pathologic examination were examined by immunohistochemistry. RESULTS: The detection rate of SLNs was 100%. Among the 21 patients, the pathologic results of SLNs for 21 patients accorded with the pathologic results of neck lymph node dissection; the accuracy rate was 95%. In 1 patient, the pathologic result of SLNs was negative, but that of neck lymph node dissection was positive. Micrometastases were found in 3 of 41 detected lymph nodes by immunohistochemstry. CONCLUSIONS: SLN radiolocalization in squamous cell carcinoma of the oral tongue is feasible. SLN biopsy can well predict the cervical lymph node metastasis status of oral tongue carcinoma, but further investigation is necessary to determine its clinical value.

[Prognostic analysis of 116 patients with mucoepidermoid carcinoma of the parotid gland].

BACKGROUND & OBJECTIVE: Mucoepidermoid carcinoma is the most common malignant tumor of the salivary, but mucoepidermoid carcinoma of the parotid gland has seldom been reported. This study was to summarize the clinicopathologic prognostic factors of mucoepidermoid carcinoma of the parotid gland. METHODS: Clinical data of 116 patients with mucoepidermoid carcinoma of the parotid gland, treated in Cancer Center of Sun Yat-sen University from May 1980 to Dec. 2000, were analyzed with Cox univariate and multivariate models. RESULTS: The overall 5-, 10-, and 15-year survival rates of the 116 patients were 75.64%, 64.55%, and 60.39%, respectively. Univariate survival analysis showed that 12 factors were prognostic factors of mucoepidermoid carcinoma of the parotid gland, such as age, alcohol drinking, T stage, and so on. Multivariate analysis showed that T stage (P = 0.006, OR > 1), pathologic grade (P < 0.001, OR > 1), and distant metastasis (P < 0.001, OR > 1) were independent prognostic factors of mucoepidermoid carcinoma of the parotid gland. CONCLUSION: T stage, pathologic grade and distant metastasis are independent prognostic factors of mucoepidermoid carcinoma of the parotid gland.

[Roles of single photo emission computed tomography-CT in detecting residual tumor from patients with thyroid carcinoma].

OBJECTIVE: As newly, functional, diagnostic measure-18F-deoxyglucose single photo emission computed tomography (18F-FDG SPECT-CT) has well sensitivity and specialty , it was proved availability in differentiating benign and malignant tumor. In this study, it was compared the efficiency of detecting residual tumor of thyroid cancer between 18F-FDG SPECT-CT and CT-TWIN. METHODS: During May 2004 to August 2004, 56 patients with thyroid disease were divided into two groups, one group was 32 cases suffered thyroid tumor, another was 24 cases suffered improper operation. All cases must take 18F-FDG SPECT-CT and CT-TWIN. RESULTS: Forty eight cases had been performed operation, and 8 cases waited and watched because they didn't be found residual tumor by 18F-FDG SPECT-CT and CT-TWIN. The results in detecting thyroid tumor showed that the same rate of diagnostic correction of SPECT-CT was 87.5% (28/32), and the Youden index of SPECT-CT was 0.667, higher than that of CT which was 87.5% (28/32) and 0.633 respectively. When the results two methods were accordant, the rate of diagnostic correction was 100% (24/24), and Youden index was 1, and the result had statistic signification. The rate of diagnostic correction of SPECT-CT in detecting residual tumor was 84.6%, and its Youden index was 0.675. The rate of diagnostic correction of CT in detecting residual tumor was 75.0%, and its Youden index was 0.492; and the result had statistics signification by being compared two different measures. CONCLUSIONS: SPECT-CT and CT all had higher diagnostic efficacy, and they could promote the diagnostic efficacy when they have the same diagnosis in detecting thyroid tumor. The rate of detecting residual tumor of SPECT-CT was 81.3%, compared with that of CT the diagnostic efficacy has greater raise.

[Significance of level VI neck dissection in surgical operation for thyroid cancer].

BACKGROUND & OBJECTIVE: Patients with thyroid cancer often come along with level VI lymph nodal metastasis. Neck dissection, which includes level VI, is routinely performed on cN1 patients, but whether cN0 patients need routine level VI neck dissection is uncertain. This study was to explore the rule of level VI lymph nodal metastasis in thyroid cancer and the significance of level VI neck dissection in surgical operation for thyroid cancer. METHODS: Clinical data of 130 patients with thyroid cancer, who received level VI neck dissection from Jan. 1988 to Jan. 2000, were analyzed retrospectively. RESULTS: Of the 130 patients, 97 had level VI lymph node metastasis, 14 (10.8%) had post-operative complications, including 4 cases of recurrent laryngeal nerve injury. Multivariate survival analysis indicated that level VI lymph nodal metastasis was correlated to the survival of thyroid cancer patients. CONCLUSIONS: Routine level VI neck dissection may be helpful to improve the survival of thyroid cancer patients. Meanwhile, complication could be decreased by improving surgical skills.

[Prognostic analysis of adenoid cystic carcinoma of major salivary glands of 64 cases].

BACKGROUND & OBJECTIVE: Adenoid cystic carcinoma of salivary glands is a kind of highly malignant tumor, and researches on the tumors originated from major salivary glands are rare. This study was to investigate prognostic factors of adenoid cystic carcinoma of major salivary glands. METHODS: Clinical records of 64 patients with adenoid cystic carcinoma of major salivary glands followed up for more than 7 years were reviewed. Cumulative survival rate was analyzed by the Kaplan-Meier method. The log-rank test was applied to compare survival rates, and the comparison of the percentage of subjects between two groups was conducted with Chi2 test. RESULTS: The overall death rate was 57.8%; the cause-specific death rate was 46.9%; the 5-and 10-year cumulative survival rates were 65.63% and 54.52%, respectively; the relapse rate was 34.4%; and the metastasis rate was 45%. Univariate analysis revealed that the factors impacting the prognosis were age, presence or absence of nerve invasion, histological subtypes, clinical stage, positive or negative surgical margin. Patients aged > or = 50, presence of nerve invasion, solid/tubular subtype, advanced clinical stage (stages III and IV), and positive surgical margin had poorer prognosis than those aged < 50, absence of nerve invasion, cribriform subtype, early clinical stage (stages I and II), and negative surgical margin. Multivariate analysis showed that the presence of nerve invasion, solid histological subtype, advanced clinical stage (stages III and IV), and positive surgical margin were independently associated to poor prognosis. CONCLUSION: Presence or absence of nerve invasion, histological subtype, clinical stage, and positive or negative surgical margin are the independent factors affecting the prognosis of patients with adenoid cystic carcinoma of salivary glands.

[Clinical analysis of salivary malignant pleomorphic adenoma--a report of 95 cases].

BACKGROUND & OBJECTIVE: Malignant pleomorphic adenoma is rare with extensive location, which makes it difficult to evaluate the efficacy of the treatments. This study was to summarize the clinical features of salivary malignant pleomorphic adenoma, and thus to explore the treatment principle and efficacy of the treatment. METHODS: Clinical data of 95 salivary malignant pleomorphic adenoma patients, treated in Cancer Center, Sun Yat-sen University from May 1970 to Oct. 2000, were analyzed retrospectively. The overall cumulative survival rate was estimated using life table method by SPSS10.0 software. Survival curves were compared with Gehan method. RESULTS: The 5-, 10-, and 15-year overall survival rates of the 95 patients were (64.9+/-4.9)%, (56.3+/-5.4)%, and (47.8+/-6.1)%, respectively. The 5-and 10-year disease-specific survival rates for the patients received surgery (51 cases), surgery plus radiotherapy (35 cases) were 76.1%, 63.7% and 69.9%, 50.8%, respectively, but the 5-and 10-year disease-specific survival rates for the patients received radiotherapy only, chemotherapy only and radiochemotherapy (4 cases) were all 0. CONCLUSIONS: Surgery or surgery-dominated multi-modality are the principal treatment modalities for salivary malignant pleomorphic adenoma. The efficacy of surgery and surgery plus radiotherapy is better than non-surgery treatments.

[Pathological character and treatment of epithelial-myoepithelial carcinoma of salivary gland].

OBJECTIVE: To review and evaluate pathologic features and treatment of epithelial-myoepithelial. METHODS: Retrospectively reviewed 14 cases' pathological and clinical materials of epithelial-myoepithelial carcinoma of salivary gland. Eight cases origine from parotid gland, 2 cases from hard palate, 3 cases from submandibular gland and 1 case from nasal cavity. Three cases were performed induction chemotherapy preoperation. One case had palliative radiotherapy. Thirteen cases were performed radical surgery and 6 cases had radiotherapy postoperation. RESULTS: Tumor arisen mostly from parotid gland and neck lymph node metastasis rate was 14.28% (2/14). The survival rate was calculated with Kaplan-Meier method. The overall 3-, 5- and 10-year survival rate were 67.20%, 45.49% and 17.06%. Its histological characteristics were inner layer composed by adenoid cells and outer layer composed by myoepithelial cells. Immunohistochemical exam show cytokeratin, S-100 and actin reaction positive. CONCLUSIONS: Epithelial-myoepithelial carcinoma easily develops recurrence. It is sensitivity to radiotherapy and chemotherapy to some extent. It is suitable to adopt surgical treatment as primary modality combined with other therapies.

[Value of elective neck dissection in patients with clinically stage I squamous cell carcinoma of the tongue].

OBJECTIVE: To determine the value of elective neck dissection in patients with clinically stage I (cT1N0M0) squamous cell carcinoma of the tongue. METHODS: This was a retrospective study of patients with surgical treatment between November 1984 and November 1999. A total of 130 patients were included in the study, all of whom received operation of the primary site, meanwhile, 99 of whom underwent elective neck dissection simultaneously including level I -III or level I -IV neck dissection in 20 patients and level I - V neck dissection in 79 patients. Results Among all these patients, the rate of occult metastasis to the neck were 12. 0%. Local failure rate in patients with only local treatment, level I II, II, III/IV neck dissection and level I - V neck dissection were 25. 8%, 15. 0% and 7. 6% respectively. There were significant difference in regional failure between patients with only local treatment and patients with elective neck dissection (P < 0.05). Also, no significant differences were noted in the survival rate between patients with only local treatment, elective neck dissection (level I -III or level I -IV) and level I -V neck dissection (P > 0.05). CONCLUSIONS: Elective neck dissection significantly reduced regional control failure but was not able to reduce distant metastasis or increase the overall survival. A prospective randomized study is worthwhile to further evaluate the benefit of elective neck dissection in the treatment of clinically stage I squamous cell carcinoma of the tongue.

[Differentiated thyroid carcinoma in young people].

OBJECTIVE: To investigate the factors that influence survival of the patients with differentiated thyroid carcinoma in young people and evaluate the efficiency of unilateral lobectomy plus isthmectomy with therapeutic cervical lymph node dissection and postoperative TSH (thyroid stimulating hormone) suppressive therapy. METHODS: One hundred and thirty-one patients under 30 years old with differentiated thyroid carcinoma treated in this hospital (14 cases no more than and 117 cases more than 16 years) from Jan. 1st, 1985 to Dec. 31st, 1997 were retrospectively reviewed. One hundred and twenty-eight patients were received only surgery and TSH suppressive therapy, and 3 patients received chemotherapy or radiotherapy because of the progressive metastasis in necks or mediastina. A multivariate analysis was performed in these patients by the Cox proportional hazard model. RESULTS: The mean follow-time (x +/- s) of all patients were (140.86 +/- 43.76) months, with range from 20 to 229 months; Ninety-eight patients followed more than 10 years. Ten patients died of thyroid cancer. The overall 10-year survival rate was 97.18%. The 10-year survival rate for patients < or = 16 years of age and > 16 years were 75.97% and 96.57% respectively (P = 0. 0006). The 10-year survival rate for women and men were 94.91% and 93.69% respectively (P = 0.5261). The 10-year survival rates of patients with papillary thyroid carcinoma and follicular thyroid carcinoma were 93.77% and 96. 55% respectively (P = 0.8137). For patients with tumor size of < or = 1 cm, 1-4 cm and >4 cm the survival rate was 100.0%, 96.40%, and 80.67% respectively (P = 0. 0589). The 10-year survival rates of patients with or without lymph node metastasis were 88.37% and 100. 0% respectively (P = 0.0313). For patients of with or without distant metastasis, The survival rate was 96.64% or 60.00% (P = 0.0000). The 10-year survival rates with or without recurrence were 86. 67% and 95.48% respectively (P = 0. 5681). Using multivariate analysis, risk factors that independently influence survival were distant metastasis, tumor size and age. CONCLUSIONS: The distant metastasis, tumor size and age at diagnosis were the independent factors influencing survival significantly. The status of lymph node metastasis may have certain effect on the prognosis. Unilateral lobectomy plus isthmectomy with a therapeutic cervical lymph node dissection followed by postoperative TSH suppressive therapy is a favourable model to children and young adults with DTC without distant metastasis, but to the patients with distant metastasis, their prognosis of this therapy model is disappointing.

[Expression of S100-labeled dendritic cells in glottic squamous cell carcinoma and its correlation to prognosis].

BACKGROUND & OBJECTIVE: Dendritic cells (DCs) are the most important antigen-presenting cells, and can synthesize and secrete S100 protein. This study was designed to investigate the expression of S100-labeled DCs in glottic squamous cell carcinoma, and analyze its correlation to the prognosis. METHODS: The expression of S100-labeled DCs in peritumoral tissues of 111 specimens of gllotic squamous cell carcinoma was detected by immunohistochemistry; 17 specimens of normal tissues were used as control. The correlation of S100-labeled DCs expression to prognosis of the 111 patients was evaluated. RESULTS: The positive rates of S100-labeled DCs were 51.35% (57/111) in peritumoral tissues of gllotic squamous cell carcinoma, and 0 in normal tissues. The 5-year survival rate was significantly higher in S100-positive group than in S100-negative group (72.31% vs. 53.91%, P=0.030). CONCLUSIONS: The glottic squamous cell carcinoma patients with obvious infiltration of S100-labeled DCs may achieve good prognosis.

[Expression and clinical significance of CD1a+ dendritic cells in glottic squamous cell carcinoma].

BACKGROUND & OBJECTIVE: Dendritic cells (DCs) are the most important antigen-presenting cells. CD1a, a marker of immature DCs, plays a role in tumorigenesis. This study was designed to explore the correlation of CD1a(+) DCs to pathologic degree, T stage, local recurrence, and prognosis of glottic squamous cell carcinoma. METHODS: Clinical and follow-up data of 111 patients with glottic squamous cell carcinoma were analyzed retrospectively. The expression of CD1a(+) DCs in the 111 specimens of glottic squamous cell carcinoma and 17 specimens of non-tumor tissue was detected by immunohistochemistry. Correlations of CD1a(+) DCs to pathologic degree, T stage, local recurrence, and prognosis of glottic squamous cell carcinoma were analyzed. RESULTS: Positive rates of CD1a(+) DCs were 59.46% in glottic squamous cell carcinoma tissues, and 0 in non-tumor tissues; it was significantly higher in well-differentiated group than in moderately-and poorly-differentiated group [71.43% (55/77) vs. 28.57% (11/34), P<0.05], higher in T1-T2 group than in T3-T4 group [67.16% (45/67) vs. 47.73% (21/44), P<0.05], and higher in non-recurrence group than in local recurrence group [65.06% (54/83) vs. 42.86% (12/28), P<0.05]. CONCLUSIONS: The lower pathologic degree and higher T stage of glottic squamous cell carcinoma, the lower expression of CD1a(+) DCs. The positive rate of CD1a(+) DCs is low in recurrent glottic tumor. High expression of CD1a(+) DCs may indicate better prognosis of glottic squamous cell carcinoma.

[Extramedullary plasmacytoma in the head and neck: a report of 10 cases and literature review].

BACKGROUND & OBJECTIVE: Extramedullary plasmacytoma (EMP), a rare tumor, often appears in the head and neck region. About 80% of EMPs occur in the submucosa of the upper aerodigestive tract. On both clinical presentation and pathologic examination, these tumors may be confused with some common tumors in the head and neck. This study was to evaluate clinical feature, diagnosis, and treatment of EMP in the head and neck. METHODS: Clinical data of 10 consecutive patients with pathologically confirmed EMP in the head and neck, treated in our hospital from Jan. 1977 to Dec. 2003, were reviewed. Of the 10 patients, 2 underwent surgery alone, 2 underwent surgery plus adjuvant radiotherapy,4 received radical radiotherapy, 1 received radical radiotherapy plus adjuvant chemotherapy, and 1 gave up treatment. RESULTS: The patients mainly manifested as local masses and relevant symptoms. Of the 3 patients received immunohistochemical staining to detect IgG, 1 was lambda type, and 2 were kappa type. Six patients received Bence-Jones protein detection, and 4 patients received serum myeloma protein detection; all of them showed negative results. Bone marrow biopsy was made in 4 patients, skeletal survey was made in 4 patients; all results were normal. By the end of follow-up (Mar. 2003), 6 patients were still alive (5 patients survived for more than 1 year, 3 of the 5 patients survived disease-freely for more than 15 years); 1 died of local recurrence 2 years after diagnosis; 1 died of multiple myeloma; 1 died of heart disease before treatment; 1 lost follow-up. CONCLUSIONS: The diagnosis of EMP mainly depends on clinical manifestation and pathologic results. Radiotherapy and surgery are the main treatments for EMP in the head and neck.

[Surgical management for occult cervical metastasis of oral tongue squamous cell carcinoma].

BACKGROUND & OBJECTIVE: In oral tongue squamous cell carcinoma (SCC), the management for clinically negative (cN0) neck remains controversial. This study was to explore rational neck management for cN0 cases. METHODS: Clinical data of 187 patients with oral tongue SCC of cN0, who received surgery alone, were retrospectively reviewed. Rules of occult nodal metastasis, factors that impact cervical node metastasis, and prognostic factors were analyzed. Neck recurrences of different treatment groups were compared. RESULT: Incidence of occult nodal metastasis in all patients was 23.0% (43/187). The most common site of occult nodal metastases was ipsilateral level II. About 83.0% of occult nodal metastases were found in ipsilateral levels I, II, and III. Pathologic grade was an independent influencing factor for occult neck metastases. Occult neck metastasis was an independent prognostic factor for oral tongue SCC. Supraomohyoid neck dissection (SOHND) was an effective therapeutic method for oral tongue SCC of cN0; the neck recurrence rate after SOHND was only 6.7%. CONCLUSIONS: SOHND is the effective and safe treatment for oral tongue SCC.

[Neck management in oral tongue squamous cell carcinoma of stage I: a report of 95 cases].

BACKGROUND & OBJECTIVE: Cervical lymph node metastasis and recurrence are the most common causes of treatment failure to patients with oral tongue carcinoma. The neck management for oral tongue carcinoma of early stages remains controversial. This study was to evaluate the effectiveness of elective neck dissection (END) in treating oral tongue squamous cell carcinoma (SCC) of stage I. METHODS: A retrospective analysis of 95 patients with oral tongue SCC of stage I, undergone surgical treatment from 1988 through 1997, was performed to determine the impact of END on patients' outcomes,such as regional recurrence,and overall survival. Of the 95 patients, 24 (observation group) did not undergo END, while the rest 71 (END group) underwent END. RESULTS: In observation group, the regional recurrence rate was 25.0% (6/24), and the recurrence-related mortality was 20.8% (5/24). END significantly reduced both the regional recurrence rate and the recurrence-related mortality to 7.0% (5/71) and 4.2% (3/71) respectively (Chi(2) test, P < 0.05). The overall survival rate of END group was also significantly higher than that of observation group (log-rank test, P < 0.05). CONCLUSION: END may improve the neck control rate of oral tongue SCC of stage I, reduce the recurrence-related mortality, and increase the overall survival rate of patients.

[Expression and clinical significance of galectin-3 in well-differentiated thyroid carcinoma].

BACKGROUND & OBJECTIVE: The most challenging problem in diagnosing thyroid nodules is to distinguish benign disease from malignant disease. Although fine-needle aspiration cytology (FNAC) is an important diagnostic procedure, its inherent limitations affect the diagnostic accuracy. Therefore, this study was designed to search for biological markers which can distinguish benign lesion from malignant lesion of thyroid. METHODS: The expression of galectin-3 in 30 specimens of thyroid cancer, 10 specimens of thyroid adenoma, and 10 specimens of nodular thyroid goiter were detected by LSAB immunocytochemistry. The results of routine pathologic examination of gland species were set as golden standard. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of impression immunocytochemistry in detecting galectin-3 were 96.66%, 100.00%, 100.00%, 95.23%, and 98.00%, respectively; those of routine impression cytology were 86.66%, 100.00%, 100.00%, 83.33%, and 92.00%, respectively; those of fine-needle aspiration biopsy (FNAB) were 86.66%, 100.00%, 100.00%, 83.33%, and 92.00%, respectively; those of FNAC were 76.66%, 100.00%, 100.00%, 74.07%, and 86.00%, respectively. Galectin-3 was commonly expressed in well-differentiated thyroid carcinoma, but didn't express in thyroid adenoma and nodular thyroid goiter. CONCLUSIONS: Galectin-3 is commonly expressed in thyroid malignant lesions, but not in benign lesions. Immunocytochemistry assay can distinguish well-differentiated thyroid carcinoma from thyroid adnoma and nodular thyroid goiter.

[Clinical analysis of sixteen cases of lymphoepithelial carcinoma of salivary gland].

BACKGROUND & OBJECTIVE: Lymphoepithelial carcinoma of salivary gland is a rare and special kind of malignant tumor, and has seldom been reported. This study was to summarize the clinical features, treatment and curative effect of this disease according to our experiences. METHODS: Clinical data of 16 patients with pathologically confirmed primary lymphoepithelial carcinoma of salivary gland, treated in Cancer Center of Sun Yat-sen University from Jan. 1990 to Sep. 2004, were retrospectively analyzed, and survival analysis was performed with Kaplan-Meier method. RESULTS: The 16 patients with lymphoepithelial carcinoma of salivary gland accounted for 3.6% of all the patients diagnosed as malignant tumors of salivary gland simultaneously in our center. All patients had tumors occurred in unilateral gland, aged 15-57 years, with the female to male ratio of 1:1. All patients were from southern China. Except for 1 patient, the rest 15 had Epstein-Barr virus (EBV) serological tests. The positive rates of EBV-VCA-IgA, EBV-EA-IgA, and EBV-DNA enzyme were 93.3%, 66.7%, and 86.7%, respectively. All patients were treated with surgery, of which 9 received surgery only, 5 received surgery plus postoperative radiotherapy, 1 received surgery plus postoperative chemoradiotherapy, 1 received surgery plus chemotherapy. Four (25.0%) patients had postoperative pathology-proved ipsilateral cervical lymph node metastasis. The 1-, 3-, and 5-year survival rates of the 16 patients were 86.15%, 48.46%, and 24.23%. CONCLUSIONS: Although lymphoepithelial carcinoma of salivary gland is poorly differentiated, the prognosis of this disease is good. Complete resection plus postoperative radiotherapy is possibly accommodating.

[Management option for cervical metastases in tongue squamous cell carcinoma with clinically N0 neck].

OBJECTIVE: This study was designed to explore the optimal management option for cervical metastases in tongue squamous cell carcinoma (SCC) with clinically N0 neck in order to avoid excessive or inadequate treatment in clinical practice. METHODS: Clinical data of 327 cases of tongue SCC with cN0 neck were retrospectively analyzed. Neck control rates affected by different pathoclinical parameters were compared. Prognosis analysis and death analysis were also performed. RESULTS: Overall 3-year survival was 69.7% (228/327), 3-year survival of neck recurrent group and non-recurrent group was 39.1% (25/64) and 77.2% (203/263), and 51.5% (51/99) of the death related to neck failure. Overall neck control rate was 80.4% (263/327); neck control rate of wait and watch group, level I neck dissection, level I + II neck dissection, supraomohyoid neck dissection, radical neck dissection, functional neck dissection, was 67.5% (27/40), 72.7% (24/33), 60.0% (15/25), 84.9% (45/55), 86.8% (131/151), 84.0% (21/25), respectively. Treatment modality and cervical lymph node involvement were independent factors for neck control. CONCLUSIONS: Neck control is a key for prognosis of tongue SCC with cN0 neck. Supraomohyoid neck dissection is the first choice in management of cervical metastases in tongue SCC with cN0 neck, during which the suspected involved lymph nodes should be sent for frozen section to determine whether comprehensive neck dissection required. Multimodal metastasis and/or capsular spread are the indications for postoperative irradiation.

[Surgical treatment of well-differentiated thyroid carcinoma invading trachea: a report of 15 cases].

BACKGROUND & OBJECTIVES: At present head and neck surgeons from many countries have different opinions on management of well-differentiated thyroid cancer (WDTC). We will discuss WDTC invading trachea surgical treatment and its clinical significance. METHODS: Retrospectively reviewed clinical data of 15 cases WDTC invading trachea, According to WDTC invading extent and grade, there were 3 kinds of surgical approaches: 1) end to end anastomosis; 2) tissue flap reconstruction; 3)larynx-tracheal dissociation. RESULTS: 15 cases underwent radical resection and reconstruct the defect of tracheal or larynx-tracheal dissociation. 2 cases received directly suture, 5 cases received sternocleidomastoid muscle flap reconstruction, 2 cases received pectorlis major muscle flap reconstruction, 2 cases received platysma flap reconstruction, 2 cases received free forearm flap with muticore titanium-board reconstruction, 2 cases received larynx-tracheal dissociation with larynx block out and tracheal fistula. 10 cases (10/15, 66.7%) received decannulation postoperation. Patients who were success fully decannulated could recover phonation and maintain airway breath. In the 5 patients who couldn't decannulate, underwent sternocleidomastoid muscle flap reconstruction, 1 underwent free forearm flap with muticore titanium-board reconstruction, 1 underwent pectorlis major muscle flap reconstruction, 2 underwent larynx-tracheal dissociation, but all of them could hardly utter voice by compress tracheostoma and needed permanent tracheostoma due to collapse of trachea. The recurrence rate of our group is 33.33%, 5 years survival rate is 88.89%. CONCLUSIONS: WDTC with trachea invading easily cause dyspnea or emptysis influencing on 5 years survival rate. We should take more actively surgical approach to resect all the tumor and involved organ, thus improve survival rate and reduce recurrence postoperation.