Decreased expression of SATB2: a novel independent prognostic marker of worse outcome in laryngeal carcinoma patients.

BACKGROUND: To investigate the expression and role of special AT-rich sequence-binding protein-2 (SATB2) in laryngeal squamous cell carcinoma (LSCC) tissue and cell line (HEp2), and to evaluate the clinical and prognostic significance of SATB2 protein in patients with LSCC. METHODS: The expression of SATB2 was examined in LSCC tissue and HEp2 cells by Western-blotting, Real-time PCR and immunohistochemical staining. Cell growth curve assay and colony formation assay were used to verify the effect of SATB2 on the proliferation and tumor progression ability of HEp2 cells. Tumor formation assay in nude mice was used to analyze the effect of SATB2 on the tumorigenicity of HEp2 cells. RESULTS: The status of SATB2 protein in carcinoma tissues is much lower than that in paracarcinoma tissues. The overall survival of the patients with high SATB2 expression was significantly higher than the low SATB2 expression group. Lower or negative SATB2 expression was significantly correlated with advanced clinical staging, histological grade and tumor recurrence. In vitro experiments demonstrated that over-expression of SATB2 in HEp2 cells inhibited cell proliferation and tumor progression ability, and down-regulation of SATB2 showed the opposite effects. Over-expression of SATB2 repressed the tumorigenicity of HEp2 cells by in vivo experiments. Moreover, multivariate analysis suggested that SATB2 expression might be an independent prognostic indicator for the survival of LSCC patients after curative surgery. CONCLUSIONS: SATB2 might involve in the development and progression of LSCC as a tumor suppressor, and thereby may be a valuable prognostic marker for LSCC patients.

ZCCHC12, a potential molecular marker of papillary thyroid carcinoma: a preliminary study.

A gene expression profile analysis using an Affymetrix HG-U133 Plus 2.0 microarray with probes for 38,500 human full-length cDNAs was performed on a primary papillary thyroid carcinoma (PTC) and a nodular goiter (NG). ZCCHC12 was the gene with the most significant differential expression between PTC and NG, and this was verified using fluorescent quantitative PCR (FQ-PCR). A total of 9,485 genes were detected with a difference in transcription levels between PTC and NG. Of these, 2,098 were up-regulated with a signal log ratio (SLR) ≥ 1 and 1,714 were down-regulated with an SLR ≤ -1. Among these up-regulated and down-regulated genes, 12 genes were significantly up-regulated (SLR ≥ 5.0) and 6 genes were significantly down-regulated (SLR ≤ -5.0). The SLR of the ZCCHC12 gene was 8.8. The results of FQ-PCR showed that the medians of the log (ZCCHC12 RNA/GAPDH RNA) in PTC and NG were 0.73 and -1.68, respectively, and the difference between them was significant (P < 0.05). There were no significant correlations between the RNA levels of the ZCCHC12 gene and the clinicopathological and biochemical parameters of PTC in our pilot study. This study showed that a number of differentially expressed genes were discovered between PTC and NG. Significantly, the number of transcript copies of the ZCCHC12 gene in PTC was higher than in NG. The verified results of FQ-PCR were consistent with the microarray screening results. The ZCCHC12 gene may be a novel diagnostic molecular marker of PTC.

[Clinical analysis of 51 cases of oral mucosal melanoma].

OBJECTIVE: To investigate the treatment and prognosis of the patients with oral mucosal melanoma (OMM). METHODS: The clinicopathological and follow-up data of patients with OMM in Sun Yat-sen University Cancer Center from January 1976 to December 2005 were analyzed retrospectively. RESULTS: Fifty-one cases were analyzed. The pathological lymph node metastasis rate was 61% (31/51) and the affected sites were confined to level I(b)-III (94%). The overall three year and five yearsurvival rates were 35% and 21% respectively. No significant difference of three year and five year survival rates were found between the group of incisional biopsy and the group of excisional biopsy. The prognosis was not affected by pigmentation. The survival rate of the patients receiving surgery combined with biotherapy or biochemotherapy was significantly higher than that of the patients treated by other modalities (P = 0.003). CONCLUSIONS: In patients with OMM, lymph node metastasis was mostly confined to level I(b)-III. Incisional biopsy and pigmentation were not associated with an unfavorable prognosis. The prognosis of the patients with OMM was poor and the patients may get a better prognosis by receiving surgery combined with biotherapy or biochemotherapy.

Different therapeutic strategies in primary salivary gland-type nasopharyngeal carcinomas.

PURPOSE OF REVIEW: Primary salivary gland-type nasopharyngeal carcinoma (PSGT-NPC) is an uncommon malignancy with aggressive behavior and poor prognosis. Its optimal treatment policy remains debated, even though recent evidence provides support for a multimodality approach. The aim of this study was to summarize the optimal management approaches and treatment outcomes of PSGT-NPCs. RECENT FINDINGS: As most of the PSGT-NPCs, such as adenoid cystic carcinoma, mucoepidermoid carcinoma and low-grade (well-differentiated) adenocarcinoma, have low sensitivity to radiation, combined surgical treatment and radiotherapy are still the main treatment approach for limited or resectable lesions. As a result of the fact that in well-differentiated PSGT-NPCs the occult neck metastasis rate is low (less than 20%), elective neck dissection is not recommended in patients with a node-negative neck. Since high-grade (poorly-differentiated) PSGT-NPCs are relatively sensitive to radiation, radiotherapy or chemoradiotherapy is currently considered as the main treatment policy for such patients. There is no evidence to indicate that chemotherapy would improve overall survival. Cranial nerve infiltration, residual tumor, and distant metastases are independent predictive factors of overall survival. SUMMARY: In most patients with PSGT-NPCs, especially for well-differentiated tumors, combined surgical treatment and radiotherapy should be recommended. For poorly-differentiated or unresectable tumors, radiotherapy or chemoradiotherapy is still considered the main treatment approach. Because of the rare incidence of PSGT-NPCs, the number of cases available for analysis is relatively small, and large multicentric studies should be conducted to further evaluate their optimal treatment policy.

Elective neck dissection in clinical stage I squamous cell carcinoma of the tongue: Does it improve regional control or survival time?

The objective of this study was to evaluate whether elective neck dissection could improve regional control or survival time in clinical stage I squamous cell carcinoma of the oral tongue (OTSCC). This was a retrospective study of patients with surgical treatment between January 1991 and December 2003. A total of 131 patients were included in the study, and all of them received operation of the primary site, while 88 cases underwent selective neck dissection simultaneously including level I-III neck dissection in 49 patients and level I-V neck dissection in 39 patients. In all these cases, the rate of occult neck metastases was 23.7%. The 4-year local control rates in patients with only primary site treatment, patients with level I-III neck dissection and patients with level I-V neck dissection were 81.0%, 83.6% and 89.1%, respectively. By univariate analyse, neck dissection did not increase regional control rate, disease free survival (DFS) or overall survival (OS). Multivariate analyses showed that neck dissection was not an independent factor for DFS or OS. This study showed that the occult neck metastases rate was 23.7% in clinical stage I OTSCC. Elective neck dissection did not significantly improve regional control, DFS and OS in clinical stage I patients. There is a need for accurate and valid methods to select the patients who would benefit from elective neck treatment.

Primary salivary gland type carcinoma of the nasopharynx: therapeutic outcomes and prognostic factors.

BACKGROUND: Primary salivary gland type nasopharyngeal carcinoma (SNPC) is a rare malignancy with diverse clinical behavior and different prognoses. Previous studies have reported on limited patient populations, and few long-term studies have outlined outcomes and prognostic factors. Furthermore, controversy exists as to the treatment policy of SNPC. The aim of this study was to define management approaches, therapeutic outcomes, and prognostic factors of SNPC. METHODS: The medical records of 67 patients with SNPC at 1 institution between 1977 and 2005 were reviewed. Patient records were analyzed for management approaches, outcomes, and prognostic factors. RESULTS: SNPC is a rare malignancy accounting for only 0.29% of nasopharyngeal malignancies, and the lymphatic metastases and distant metastases rates were 28.4% and 23.9%, respectively. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 41.1% and 57.1%, respectively; no significant differences were found in DFS or OS between different histological subtypes. A significant difference was found in OS between surgical treatment and nonsurgical treatment in T1-T2 patients with well-differentiated tumors. Multivariate analyses indicated that lymph node metastases, stage, and distant metastases were independent factors for DFS, whereas cranial nerve invasion, tumor residue, and distant metastases were independent factors affecting OS. CONCLUSIONS: SNPC is a malignancy with generally favorable prognosis. In T1-T2 patients with well-differentiated tumors, SNPC should be treated by combined surgical operation and radiotherapy. Cranial nerve invasion, tumor residue, and distant metastases were independent factors affecting OS.

[Survival and prognostic analysis of 221 patients with advanced laryngeal squamous cell carcinoma treated by surgery].

BACKGROUND AND OBJECTIVE: The prognosis of advanced squamous cell carcinoma of the larynx is poor Prognostic factors of this disease vary in different studies. This study was to analyze the most important factors affecting the prognosis of the patients with advanced (stage III and IV) squamous cell carcinoma (SCC) of the larynx. METHODS: Clinical data of 221 patients with advanced SCC of the larynx were retrospectively analyzed. Survival analysis was performed by the life table method; comparison among/between groups was performed using the log-rank test; and multivariate analysis was carried out using the Cox proportional hazard model. RESULTS: The two- and five-year overall survival rates of the 221 patients were 76.9% and 51.1%; while the 2-and 5-year disease free survival rates were 60.0% and 43.0%. Patients in stage III had better prognosis than those in stage IV. Post-operative radiotherapy improved the survival rate in patients with positive surgical margins. There was no difference in the survival rate between patients underwent partial laryngectomy and those underwent total laryngectomy. Multivariate analyses indicated that age, anatomic type, post-surgical stage, surgical margin and radiotherapy influenced the disease free survival (p<0.05), whereas, age, post-surgical stage and surgical margin affected the overall survival (p<0.05). CONCLUSIONS: The prognosis of patients with advanced SCC of the larynx receiving surgery is poor. Age, post-surgical stage and surgical margin are the most important factors affecting the overall survival.

[Clinical analysis of 53 cases of esthesioneuroblastoma].

BACKGROUND AND OBJECTIVE: The prognosis of esthesioneuroblastoma (ENB) patients is poor. This study was to analyze prognostic factors and explore a rational treatment for ENB. METHODS: Clinical data of 53 ENB patients, treated at Sun Yat-sen University Cancer Center from 1980 to 2003, were analyzed retrospectively. The correlation of prognostic factors to clinical features and treatment approaches were analyzed using the Kaplan-Meier method. Efficacy of different treatment modalities was compared. RESULTS: The five-year overall survival (OS) was 41% of all ENB patients. The five-year OS of the surgery group, radiotherapy group, chemotherapy group, surgery combined with radiotherapy and (or) chemotherapy group, chemoradiotherapy were 42%, 38%, 0, 56%, 0, respectively, which were statistically significant (p<0.05). The five-year OS of Kadish stage A, B, C patients were 100%, 37%, 31%, respectively, which were statistically significant among these three subgroups which (p<0.05). The recurrence rate over the entire period was 51%. The five-year OS of the recurrence group and recurrence-free group were 42% and 48%, respectively, without significant differences (p>0.05). CONCLUSIONS: ENB is a malignant tumor with high rates of locoregional recurrence and distant metastasis. Surgery-based multimodality is a relatively reasonable method. The prognosis of ENB is associated with the clinical stage and treatment modalities.

[Reasons for recurrence and prognostic analysis of early stage squamous cell carcinoma of the oral tongue].

BACKGROUND AND OBJECTIVE: The therapeutic outcome of early stage squamous cell carcinoma of the oral tongue (SCCOT) is generally satisfactory. Recurrence is a major factor affecting the treatment efficacy of SCCOT. This study was to investigate the reasons for recurrence and prognostic factors of SCCOT, thus to decrease the recurrence rate and improve the therapeutic effect. METHODS: In total 227 patients with SCCOT treated in Sun Yat-sen University Cancer Center from January 1992 to December 2003 were retrospectively reviewed. The Kaplan-Meier method was used to analyze the survival rate, the log-rank test was used to compare survival distributions, and the Chi-square test was adopted to compare different factors affecting recurrence. Multivariate analysis was performed using the Cox proportional hazard model. RESULTS: The recurrence rate was significantly lower in patients with well differentiated SCCOT (19.3%) than in those with moderately-poorly differentiated SCCOT (39.2%) (P=0.004), and was significantly lower in patients receiving combined therapy (15%) than in those receiving surgery alone (28%) (P=0.014). The overall 3-year and 5-year survival rates in recurrent and non-recurrent groups were 40.7% vs. 87.3% and 25.9% vs. 80.3%, respectively(P=0.000). The overall 3-year and 5-year survival rates were also significantly different in patients > or =45 years and < 45 years (P=0.021), and in those with or without neck dissection (P=0.023). CONCLUSIONS: The pathological classification and whether receiving combination therapy are the factors affecting recurrence of SCCOT. Age, neck dissection and recurrence are prognostic factors of SCCOT. Age and recurrence are independent factors of SCCOT.

[Application of various flaps to intraoral reconstruction of buccal defects after resection of buccal mucosa carcinoma].

BACKGROUND AND OBJECTIVE: Reconstructing buccal defects with proper flaps can expand the indications of surgery, improve quality of life and prolong survival. This study was to investigate the indications for such application, the selection of different kinds of flaps and the skills of the reconstructive operation. METHODS: From September 2005 to August 2007, 26 patients underwent reconstructive operation after resection of buccal mucosa carcinoma: eight had simple buccal mucosa resection, 11 had resection of the bucca cavioris and facial skin, seven had resection of the bucca cavioris, facial skin and angulus oris; besides, seven patients underwent parotid duct resection. As for the reconstructive operation, pectoralis major myocutaneous flap was used in five patients, free radial forearm flap in 11 patients, free anterolateral thigh flap in six patients, and sternodeiceomastoid myocutaneous flap in four patients. Eight patients received postoperative radiotherapy at 66-70 Gy. RESULTS: No perioperative death occurred. Necrosis happened in one patient who used free radial forearm flap; partial necrosis in one patient who used pectoralis major myocutaneous flap. The survival rate of the flaps was 96.2%. Hydrops of the operative wound happened in one patient with salivary fistula. During the follow-up of 1-3 years, seven patients had recurrence (four had recurrence in primary lesion and three in cervical lymph nodes), two died of recurrence in primary lesion. CONCLUSION: The free anterolateral thigh flap and free radial forearm flap are suitable for reconstruction of large buccal defects, and are first-choices for defects larger than 4 cm; the pectoralis major myocutaneous flap can be applied as the second-choice flap; the sternodeiceomastoid myocutaneous flap can be used for defects smaller than 4 cm.

Expression of CXCL12/CXCR4 and its correlation to prognosis in esophageal squamous cell carcinoma.

BACKGROUND AND OBJECTIVE: CXCL12/CXCR4 is expressed in many kinds of tumors, which is associated with tumor proliferation and invasion. This study was to investigate the expression of CXCL12/CXCR4, and explore its correlation to prognosis and clinicopathologic factors of esophageal squamous cell carcinoma (ESCC). METHODS: The expression of CXCL12/CXCR4 protein in 186 specimens of ESCC was assessed by immunohistochemistry. RESULTS: The positive rates of CXCL4 and CXCR12 protein in ESCC tissues were 67.2% and 63.4%, respectively. CXCL4 and CXCR12 were not expressed in 20 specimens of normal esophageal epithelium. PTNM stage and positive expression of CXCR4 were independent prognostic factors of ESCC (p < 0.05). The five-year survival rates of CXCL12-positive and CXCL12-negative groups were not significantly different (21.0% vs. 18.8%, p > 0.05), while the five-year survival rate was significantly higher in CXCR4-negative group than in CXCR4-positive group (28.5% vs. 2.2%, p < 0.05). The expression of CXCR4 was higher in the group with lymph node metastasis and pathological T3 stage than in the group without lymph node metastasis and with pathological T1-T2 stages (p < 0.05). The expression of CXCR4 was not correlated with the expression of CXCL12 in ESCC. CONCLUSIONS: CXCL12/CXCR4 is intensively expressed in esophageal squamous cell carcinoma. The level of CXCR4 is positively correlated to progression and prognosis of ESCC.

[Survival analysis of 229 patients with advanced squamous cell carcinoma of the oral tongue].

BACKGROUND & OBJECTIVE: Patients with advanced squamous cell carcinoma (SCC) of the oral tongue have poor prognosis. This study was to analyze the most important factors affecting the prognosis of the patients with advanced (stage III and IV) SCC of the oral tongue. METHODS: Complete clinical and follow-up data of 229 patients with pathologically confirmed advanced SCC of the oral tongue, initially treated at Sun Yat-sen University Cancer Center were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier analysis, comparison among groups was analyzed using log-rank test, and multivariate analysis was conducted using the Cox proportional hazard model. Independent risk factors were deducted. The risk function was established and evaluated. RESULTS: The mean survival time of the 229 patients was 80.33 months, with the two-and five-year survival rates of 50.66% and 37.99%, respectively. Univariate analysis showed that age, tongue base invasion, cervical lymphatic metastasis, stage, surgical treatment, recurrence and residual tumor were risk factors affecting prognosis (P<0.05). Multivariate analysis indicated that tumour invasion across the midline, cervical lymphatic metastases, surgical treatment, recurrence and residual tumor were independent factors for prognosis. Moreover, the risk function effectively predicted the prognosis. CONCLUSIONS: The prognosis of patients with advanced SCC of the oral tongue is poor. Tumour invasion across the midline, cervical lymphatic metastasis, surgical treatment, recurrence, and residual tumor are independent factors affecting the prognosis.

Adenoid cystic carcinoma of the nasopharynx: 27-year experience.

OBJECTIVE/HYPOTHESIS: Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with special biological features. Clear consensus is not available regarding the clinical characters, management approaches, and prognostic factors. We presented one institution's experience with this tumor and the outcomes of treatment. STUDY DESIGN: Retrospective clinical analysis. METHODS: The medical records of 26 patients with NACC at one institution between 1976 and 2003 were reviewed. Patient records were analyzed for clinical characteristics, management approaches, and outcomes. Survival analysis was performed by Kaplan-Meier method, comparison between groups was performed using log-rank test. RESULTS: The lymphatic metastases rate and distant metastases rate were 3.8% and 26.9%, respectively. Epstein-Barr virus did not have a close relationship to the incidence of NACC. The 5-year disease free survival rate and overall survival rate (OS) for all patients were 30.3% and 54.8%, respectively. In the stage I, II and III patients, the 5-year OS were 87.5% and 49.4%, respectively in patients treated mainly by combined surgical treatment with radiotherapy and those treated mainly by radiotherapy. Cranial nerves invasion, advanced stage and nonsurgical treatment indicated a significant worse OS, whereas combined surgical treatment was an independent factor affecting disease free survival rate and OS. CONCLUSIONS: NACC is a malignancy with low rate of lymphatic metastases. NACC should be treated by combined surgical operation and radiotherapy. Cranial nerves invasion, stage and treatment approach might be important factors affecting the prognosis of the patients with NACC.

[Concurrent chemoradiotherapy versus radiotherapy alone for locoregionally advanced nasopharyngeal carcinoma: a meta-analysis].

OBJECTIVE: To determine the value of concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma from the mainland of China. METHODS: Data were extracted from randomized trials comparing chemotherapy plus radiotherapy with radiotherapy alone in locally advanced nasopharyngeal carcinoma. Actuarial rates of survival and distant metastases were calculated. The followed electronic databases were searched the Chinese Biomedicine database, Pubmed, Medline, Embase and Cochrane library; Data were extracted by tow reviewers and Review manager 4.1 software was applied for statistical analysis. RESULTS: Eighteen trials with 1993 patients were include according to the including criterion. The 3-year overall survival rate of the chemoradiotherapy group and the radiotherapy group were 68.47% and 56.38% respectively, and the 5-year overall survival rate of the two groups above were 51.91% and 41.09% respectively, while the distant metastases rate of the chemoradiotherapy group and the radiotherapy group were 26.19% and 38.71% respectively. The result demonstrated that chemoradiotherapy increased overall survival by 12% at 3 years, and 11% at 5 years after treatment. After chemoradiotherapy, the rate of distant metastasis was reduce by 12%. CONCLUSIONS: In patients with locoregionally advanced nasopharyngeal carcinoma, chemoradiotherapy significantly improves overall survival at 3 years, and 5 years compared with radiotherapy alone.

[Clinical study of 36 cases with adenoid cystic carcinoma of the maxillary sinus].

OBJECTIVE: To study the clinical characters, management and the prognosis of patients with adenoid cystic carcinoma of the maxillary sinus. METHODS: The clinical data were analyzed retrospectively for 36 patients with adenoid cystic carcinoma of the maxillary sinus to evaluate the treatment results of different modalities. The contribution of every factors influencing on survival were also analyzed. Survival analysis was performed by life table method, comparison among/between groups was performed using log-rank test, and multivariate analysis was carried out using Cox proportional hazard model. RESULTS: The 5-year survival rate was 58.33% in all patients, while they were only 75.0% and 42.9% in stage III and stage IV lesions respectively. The 5-year survival rate of 66.7% was obtained in patients who received surgery combined with radiotherapy,71.4% and 12.5% respectively in those treated by surgery and by radiotherapy alone. Multivariate analysis indicated that stage, treatment modality, and the tumour residues in the primary treatment were the predict factors for the prognosis. CONCLUSIONS: Advanced adenoid cystic carcinoma should be treated by combined surgery and radiotherapy. Stage, treatment approach and short-term therapeutic response are the most important factors affecting the prognosis of the patients with adenoid cystic carcinoma of the maxillary sinus.

[Surgical treatment and long-term efficacy on stage T1-3N0 differentiated thyroid carcinoma].

BACKGROUND & OBJECTIVE: Whether to choose total thyroidectomy or lobectomy for the primary lesion of differentiated thyroid carcinoma (DTC) limited in one lobe is controversial. This study was to investigate the patterns of surgical treatment for stage T1-3N0 DTC, and observe the long-term efficacy. METHODS: Clinical data of 153 DTC patients, first treated at Cancer Center of Sun Yat-sen University from 1985 to 2000, were reviewed. The postoperative pathologic stage of these patients was T1-3N0. The multiple centricity of primary lesions, patterns of surgical treatment, and prognosis were analyzed. RESULTS: Of the 153 DTC patients, 21 had cancer multifocality: 12 had multiple cancer foci in one lobe and 9 had cancer multifocality in both lobes. Ninety-two patients received unilateral lobectomy plus isthmectomy; 44 patients received ipsilateral subtotal lobectomy plus isthmectomy. Among the 9 patients who had cancer multifocality in both lobes, 7 received unilateral lobectomy plus isthmectomy with contralateral subtotal lobectmoy and 2 received bilateral subtotal lobectomy. Eight patients, whose primary lesions were at isthmus, underwent isthmectomy plus bilateral partial lobectomy. Regional lymph node metastasis appeared in 7 patients after initial operation: 6 in the neck and 1 in the upper mediastinum. Five patients had distant metastasis after operation. The 5-, 10-and 15-year survival rates of these 153 patients were 98.7%, 96.1% and 86.9%, respectively. Age, pathologic type, tumor size and distant metastasis affected the survival (P<0.05). The patients whose age was less than 45 years, tumor size was less than 4 cm, pathologic type was papillary or mixed carcinoma, and who had no distant metastasis had relatively good prognosis. Age and distant metastasis were independent prognostic factors. CONCLUSIONS: It is feasible to perform unilateral lobectomy or subtotal lobectomy plus isthmectomy for patients with stage T1-3N0 DTC. The long-term outcomes of stage T1-3N0 DTC patients are relatively well. Age, pathologic type, tumor size and distant metastasis affect prognosis.

[Application of helix water jet to parotid surgery].

BACKGROUND & OBJECTIVE: Dissecting the facial nerves safely is an important guarantee for the accomplishment of parotidectomy and reduction of postoperative complications. This study was to explore the application of helix water jet to parotidectomy. METHODS: Clinical data of 43 patients with parotid tumors, who received operation with helix water jet from Feb. 2004 to Feb. 2005 at Cancer Center of Sun Yat-Sen University, were analyzed. Meanwhile, traditional techniques in parotidectomy was performed in 36 patients (control group). Duration of operation, postoperative drainage volume, postoperative hospitalization, and occurrence of postoperative complications, such as facial nerve dysfunction and salivary fistula, of the 2 groups were compared. RESULTS: The postoperative drainage volume was significantly lower in water jet group than in control group [(9.89+/-3.74) mL vs. (12.15+/-2.11) mL, P<0.05]. There were no significant differences in duration of operation [(90.28+/-25.30) min vs. (76.32+/-20.74) min, P>0.05], postoperative hospitalization [(6.39+/-1.38) days vs. (6.45+/-1.05) days, P>0.05] between the two groups. Of the 43 patients in water jet group, 6 (14.0%) had grade II facial nerve dysfunction and 1 (2.3%) had grade III facial nerve dysfunction; of the 36 patients in control group, 5 (13.9%) had grade II facial nerve dysfunction, 2 (5.6%) had grade III facial nerve dysfunction, 1 (2.8%) had grade IV facial nerve dysfunction and 1 (2.8%) had salivary fistula. There was no permanent facial nerve dysfunction occurred in both groups. There was no significant difference in the occurrence of complications between the two groups. Nine patients who retained nervus auricularis magnus suffered from slight numbness symptom of auricular lobule. CONCLUSION: Use of helix water jet in parotid surgery is safe and confers some advantages over conventional methods of parotid dissection.

Aurora-A, a negative prognostic marker, increases migration and decreases radiosensitivity in cancer cells.

Centrosomal Aurora-A (Aur-A) kinase ensures proper spindle assembly and accurate chromosome segregation in mitosis. Overexpression of Aur-A leads to centrosome amplification, aberrant spindle, and consequent genetic instability. In the present study, Aur-A was found to be overexpressed in laryngeal squamous cell carcinoma (LSCC). Moreover, Aur-A expression was adversely correlated with median survival, and further identified as a potential independent factor for disease prognosis. Suppression of Aurora kinase activity chemically or genetically led to LSCC Hep2 cell cycle arrest and apoptotic cell death. Importantly, we found that Aur-A increases cell migration and this novel function was correlated with Akt1 activation. The enhanced cell migration induced by Aur-A overexpression could be abrogated by either small-molecule Akt1 inhibitor or short interfering RNA. VX-680, a selective Aurora kinase inhibitor, decreased Akt1 phosphorylation at Ser(473) and inhibited cell migration, but failed to do so in constitutive active Akt1 (myr-Akt1)-overexpressed cells. Moreover, our data suggested that overexpression of Aur-A kinase might also contribute to radioresistance of LSCC. Inhibiting Aur-A by VX-680 induced expression of p53 and potently sensitized cells to radiotherapy, leading to significant cell death. Ectopic overexpression of Aur-A, however, reduced p53 level and rendered cells more resistant to irradiation. Taken together, we showed that Aur-A kinase, a negative prognostic marker, promotes migration and reduces radiosensitivity in laryngeal cancer cells.

[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.