Analysis for potential targeting genes of TPF regimen induction chemotherapy in hypopharyngeal squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the differentially expressed genes related to the chemosensitivity with the TPF regimen for hypopharyngeal squamous cell carcinoma and to measure potential functional targeting genes expressions.@*Methods@#Twenty-nine patients with primary hypopharyngeal cancer who underwent induction chemotherapy with TPF from January 2013 to December 2017 in Beijing Tongren Hospital were enrolled for microarray analysis, including 28 males and 1 female, aged from 43 to 73 years old. Among them, 16 patients were sensitive to chemotherapy while 13 patients were non-sensitive. Illumina Human HT-12 Bead Chip was applied to analyze the gene expressions and online bioinformatics analysis was used to analyze the differentially expressed genes. Reverse transcription and quantitative real-time PCR (RT-qPCR) was used to measure the mRNA expression of potential functional genes of TPF induction chemotherapy in 43 samples, 29 from original patients and 14 from additional patients. Graphpad prism 7.0 software was used for statistical analysis.@*Results@#A total of 1 381 significantly differentially expressed genes were screened out. By GO analysis, up-regulated genes included sequestering in extracellular matrix, chemokine receptor binding and potassium channel regulator activity; down-regulated genes included regulation of angiogenesis, calcium ion binding and natural killer cell activation involved in immune response. With KEGG database analysis, down-regulated pathways included ECM-receptor interaction and peroxisome and up-regulated pathways included Glutathione metabolism and PPAR signaling pathway. The expressions of CD44 and IL-6R were significantly different and appeared biologically significant. CD44 was significantly upregulated in insensitive tissues (0.54±0.06) compared with sensitive tissues (0.33±0.04)(P<0.01). IL-6R was significantly downregulated in insensitive tissues (0.44±0.03) compared with sensitive tissues. (0.68±0.03) (P<0.01).@*Conclusion@#CD44 and IL-6R may be potentially functional genes of TPF induction chemotherapy in hypopharyngeal squamous cell carcinoma.

Progress in protection techniques of parathyroid glands during thyroidectomy / 国际外科学杂志

The incidence of thyroid cancer has grown in the past 20 years, the number of patients with surgical complications grows as well. Hypoparathyroidism is one of the severe complications which reduces the quality of life after thyroidectomy. How to preserve the structure and function of parathyroid glands and to avoid the pitfalls of the operation has always been the key point of thyroidectomy. This article reviews the recent progress of embryology and surgical anatomy of parathyroid glands, identification techniques and auxiliary imaging tools for the identification and preservation of parathyroid glands in thyroidectomy.

Clinical treatment experience of thyroid cancer with heart disease / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the perioperative clinical treatment of thyroid cancer patients with heart disease.@*Methods@#A retrospective analysis was conducted on 39 thyroid cancer patients with heart disease admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Anzhen Hospital,Capital Medical University from April 2014 to February 2018,including 25 males and 14 females, the age ranged from 59 to 75 years,with an average age of 67.3±6.2 years. Perioperative clinical monitoring indicators included cardiac ultrasound left ventricular ejection fraction (LVEF), degree of vascular stenosis revealed by coronary CT, hypersensitive troponin I (TNI), b-type natriuretic peptide (BNP), fibrinogen degradation products,and coagulation indexes. This panel of patients comprised 26 cases with 50% ≤ LVEF<60%,10 cases with 40% ≤ LVEF<50%, 3 cases with 36% ≤ LVEF<40%, 27 cases with 0≤BNP<100 ng/L, 7 cases with 100≤BNP<400 ng/L, and 5 cases with 400≤BNP<700 ng/L. Coronary CT showed no coronary artery stenosis>75%. The vascular graft was patent and the coronary artery after stenting was unobstructed. For 3 patients with LVEF<40% and 5 patients with BNP>400 ng/L,cardiotonic,diuretic,and nutritional myocardial therapy were used for 1 week. SPSS 17.0 software was used to analyze the data.@*Results@#All 39 patients successfully completed the operation under general anesthesia,including 32 cases of total thyroidectomy,7 cases of glandular lobe and isthmic resection,and 40 cases of lateral neck dissection. One patient developed heart failure three days after surgery and was discharged after two weeks of treatment. No other cardiac related events,cerebrovascular and pulmonary thrombosis occurred during the perioperative period. The anesthesia preparation time was significant different between the group with 0≤BNP<100 ng/L and 50%≤LVEF<60% and the group with 0≤BNP<100 ng/L and 36%≤LVEF<50%.@*Conclusions@#Multi-indicators were utilized to adequately assess cardiac function before surgery. According to the results of cardiac ultrasound and coronary CT examination, the corresponding treatment should be conducted to improve the cardiac function. After the perioperative risk assessment and management of thyroid cancer patients with heart disease,standardized thyroid cancer surgery can be performed safely.

Exploration of feasibility and safety of transoral robotic surgery in pharyngolaryngeal tumors / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the indication, feasibility, and safety of da Vinci robotic surgical system in pharyngolaryngeal tumor resection. @*Methods@#Thirty patients were diagnosed with pharyngolaryngeal tumors and treated with a transoral robotic surgery (TORS) in Beijing Anzhen Hospital from June 1, 2016 through November 30, 2017. Inclusion criteria included lesions of the oropharynx (n=13), parapharyngeal space (n=7), larynx (n=6) and hypopharynx (n=4). Twenty cases were males and ten cases were females. The median age was 56 years old (ranging from 30 to 81 years). @*Results@#The robotic surgeries were performed successfully on 30 patients. One patient (3.3%) underwent TORS combined with a neck incision. The mean operative time was 40.7 min. The mean blood loss was 15.8 ml. The mean recovery time for oral intake was 5.3 days. The mean hospital stay was 9 days. None of the patients underwent tracheotomy or mandible split. Postoperative pathological examination showed that 18 cases (60.0%) were malignant and 1 case (5.6%) had positive surgical margin. Sixteen cases received neck dissection. No serious complications occurred during or after the operation. There was no local recurrence, metastasis or death except for regional recurrences in 2 cases (11.1%) with a follow-up of 1 to 18 months(median 13 months). @*Conclusion@#Transoral robotic surgery is a feasible, safe and effective surgical procedure with clear operation field, rapid surgical access, minimally invasive surgery, lesser hemorrhage, good cosmetic effect and fast recovery.

Preliminary study on the construction of CAR-EGFR modified T cells (EGFR-CART) in hypopharyngeal squamous cell carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE Construct and validate the EGFR-CART (Epidermal growth factor receptor-chimeric antigen receptor T) cells targeting the Fadu cell line of hypopharyngeal squamous cell carcinoma, and provide the preclinical basis for the application of CART cell technology in hypopharyngeal squamous cell carcinoma. METHODS EGFR-CART cells and CART-control cells were constructed by lentivirus transfection. The expression of EGFR antibody in CART cells was detected by FACS fluorescence detection, and the expression of EGFR in Fadu cell line and HCT-116 cell line was verified. RESULTS EGFR-CART cells and CART-control cells were successfully constructed, the infection efficiency was about 67％, and there was no significant difference between the two groups in the distribution of cell subsets. HCT-116 is selected as the non target cells of EGFR-CART, Fadu as target cell. CONCLUSION In this study, we successfully prepared and validated the EGFR-CART cells targeting the Fadu cell line of hypopharyngeal squamous cell carcinoma, and laid the foundation for the application of CART technique in the treatment of hypopharyngeal carcinoma.

Diagnosis and treatment of ectopic thyroid / 国际外科学杂志

Objective To explore the clinical features,diagnosis and treatment of ectopic thyroid lesions.Methods Retrospectively reviewed the clinical data of 15 patients with ectopic thyroid tissue from Oct.2002 to Jun 2017 in Beijing Tongren Hospital,Capital Medical University and Beijing Anzhen Hospital,Capital Medical University,and figured out the clinical features,therapy and prognosis.Among the 15 patients,there were 2 males and 13 females.There were 8 cases of lingual ectopic thyroid,3 cases of endotracheal ectopic thyroid,3 cases of thyroglossal duct ectopic thyroid,and 1 case of retropharyngeal ectopic thyroid.Follow-up were conducted during outpatient review or by telephone.Results Twelve patients received surgical treatment and the lesions were pathologically confirmed as ectopic thyroid tissue,including 2 cases of papillary thyroid carcinoma.These patients were followed up for 1 to 6 years.Their main symptoms were alleviated and the malignant patients had no recurrence or metastasis.Three patients with lingual ectopic thyroid selected observation and follow-up without any treatment and no progress was observed.Conclusions The incidence of ectopic thyroid is low and the forms are diverse.The clinician should take the possibility of ectopic thyroid and its associated pathological changes into account to avoid the complete removal of the only functional thyroid tissue without preparation.

Clinical analysis of adult rhabdomyosarcoma of the larynx / 中国耳鼻咽喉头颈外科

OBJECTIVE To summarize the clinical features, diagnosis, treatment and prognosis of laryngeal rhabdomyosarcoma.METHODS The clinical data of 5 cases of adult laryngeal rhabdomyosarcoma treated in Beijing Tongren Hospital between 2003 and 2015 were analyzed retrospectively.RESULTS All the 5 cases firstly presented with hoarseness. 1 case was treated by combined therapy (surgery followed by radiotherapy and chemotherapy). 2 patients received surgical treatment combined with chemotherapy. 1 patient received surgical treatment only. Another patient received chemotherapy only. Pathological type: 4 patients were embryonal rhabdomyosarcoma, 1 patient was pleomorphic rhabdomyosarcoma. In the follow-up of a period from 11 months to 8 years, 2 cases were alive without tumor, 3 patients were dead.CONCLUSION Adult laryngeal rhabdomyosarcoma is rare. Surgical resection combined with chemotherapy is the main treatment method, and the prognosis is related to the pathological type and tumor stage.

Grading prevention strategy for airway burn during CO2 laser surgery of larynx / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore t he significance of reducing the incidence rate of airway burn of CO2 laser laryngeal surgery by spreading the idea of grading prevention st rateg y. M ETHODS We retrospectively reviewed the data of laryngeal lesions treated by the endoscopic CO2 laser surgery from Feburary 1992 to December 2016. The period was divided into two stages, the first one is from Feburary 1992 to December 2008, and the second one is from January 2009 to December 2016. We will distinguish the difference of airway burn between the two stages. RESULTS Four cases of airway burn were found in the first stage including 3 cases of glottic cancer and 1 case of vocal cord polyp with Reink's edema. But no airway burn happened in the second stage. Two cases of endotracheal intubation cuff broken by laser were found promptly, but with FiO2 decreasing from 70% to 30%, wet gauze filling subglottic region and the endotracheal tube reserved, the laser surgery proceeded till airway burn happened. The endotracheal intubation cuffs of the remaining two cases kept intact intraoperatively, the FiO2 was 70% when airway burn happened. One case had the cervical tracheal stenosis with long-term tracheotomy, The other 3 cases had no postoperative complications. CONCLUSION The grading prevention strategy is helpful for reducing airway burn during the CO2 laser surgery of larynx.

Diagnosis and therapy of lingual ectopic thyroid / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the strategy of diagnosis and therapy of lingual ectopic thyroid(LET). METHODS We retrospectively reviewed the clinical data of6 cases of LET, and figured out the clinical features, imaging characteristics, therapy and prognosis.RESULTS 6 lingual ectopic thyroids were diagnosed by the Tc-99m thyroid static imaging; 3 cases accepted surgery, one only took oral levothyroxine, and one selected watch and see. 3 cases of lingual ectopic thyroid accepted the ectopic thyroid transposition and took oral levothyroxine postoperatively. Pharynx foreign body sensation and sleep snoring disappeared one month later. The lingual ectopic thyroid carcinoma resection was performed by direct laryngoscope in one case which was lost to follow up.CONCLUSION The thyroid static imaging is specific to the diagnosis of the LET. The indications of the surgery were obvious symptoms such as airway obstruction, snoring and pharyngeal foreign body sensation, and mass hemorrhage, cystic degeneration and carcinogenesis. The principle of therapy is to retain thyroid function as far as possible and comprehensive use of surgery, thyroid hormone replacement and iodine radiotherapy to improve symptoms, prevention and treatment of hypothyroidism.

Establishment and characterization of a laryngeal squamous cell carcinoma cell line / 中华耳鼻咽喉头颈外科杂志

Objective@#To establish a laryngeal squamous cell carcinoma (LSCC) cell line through primary cell culture and observe its biological characteristics.@*Methods@#Tissue block culture method was used for primary cell culture. After LSCC cells passed 25 times in vitro, the morphology of cells was observed, keratin was stained histochemically, cell cycle was tested by PI-FACS, and the specie of cells was detected by PCR and short tandem repeat(STR) typing.@*Results@#This newly established LSCC cell line was named as TR-LCC-1, most of the cancer cells were polygonal shape, like the cobblestone, loss of contact inhibition and with overlapping growth. Cell size was large and cell pleomorphism was very obvious. Cytokeratin staining was positive. After 6 months of continuous culture in vitro, the TR-LCC-1 cells passed more than 30 times, and cell doubling time was 201.2h. Cell cycle assay indicated that G1 phase accounted for 51.71%, S phase was 44.56%, and G2 phase was 2.28%. Mycoplasma test showed no mycoplasma contamination. Cell species identification identified TR-LCC-1 was human-derived cells. STR detection showed P26 and P6 were same, and they were different from the STR typing of disclosed cells.@*Conclusion@#The establish ment of the new laryngeal squamous carcinoma cell line TR-LCC-1 can be helpful to the research for laryngeal squamous cell cancer.

Clinical application of free anterolateral thigh flap with muscles in the reconstruction of facial defect after maxillectomy in malignant tumor / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the effect of the free anterolateral thigh myocutaneous flap on the appearance and functions after maxillectomy.METHODS The clinical data of 5 patients with malignant maxillary tumors from June,2016 to June 2017 were analyzed retrospectively.The 5 cases were T3-4N0M0 lesions.All of them received the maxillectomy and then were reconstructed with the free anterolateral thigh myocutaneous flap,and the flap was about 1.25 times of the defect in volume.RESULTS The needed volumes for the reconstruction were from 165 ml to 225 ml and the operation time of reconstruction were between 80-95 minutes.All the free flaps survived after operation.Although the reconstructed side looked swelling obviously in the first month after surgery,the appearance became good and symmetrical after the radiotherapy.No diplopia occurred and the functions of breathing,swallowing and speaking were normal.No movement disorders happened caused by the donor of thigh flap.CONCLUSION The free anterolateral thigh myocutaneous flap as the reconstructive tissue has many merits.The volume is adequate and can be regulated according to the defect.The forward appearance is better than the free anterolateral thigh flap without muscles.So the reconstruction of free anterolateral thigh myocutaneous flap is an ideal material for reconstruction because of the good functions and being easy to operate.

Survival and life quality evaluation on advanced laryngeal cancer treated with modified supracricoid partial laryngectomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the survival and functional outcomes of advanced laryngeal squamous cell carcinoma after modified supracricoid partial laryngectomy(SCPL).METHODS We selected 65 laryngeal cancer patients treated with modified supracricoid partial laryngectomy from 2002 to 2015 in our hospital.Among them,62 cases were males,3 cases were females with an age ranged from 35 to 80 years(median age 58 years)There were 26 cases with T2 stage,32 cases with T3 stage and 7 cases with T4 stage.We selected 120 laryngeal cancer patients treated with vertical partial laryngectomy at the same period as control.Then we evaluated the functional outcomes of modified supracricoid partial laryngectomy group compared with vertical partial hemilaryngectomy group.RESULTS The 5-year cumulative survival rate and decannulation rate were 82.3％ and 98.3％ for supracricoid laryngectomy group respectively.Decannulation ratewas 86.1％ for vertical partial hemilaryngectomy group(P＜0.05).However,there was no significant difference between supracricoid partial laryngectomy group and vertical partial laryngectomy group in pronunciation evaluation and abnormal deglutition.CONCLUSION Modified supracricoid partial laryngectomy is a good choice for local advanced laryngeal squamous cell carcinoma.

Expression and clinical study of Lin28A/B in head and neck squamous cell carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE Through the research of analyzing the expression level of Lin28A/B proteins in tissues of head and neck squamous cell carcinoma and the expression of the downstream miRNA genes in order to provide a new clue for the diagnoses and treatment of the head and neck squamous cell carcinoma.METHODS A retrospective study was performed in 20 patients with head and neck squamous cell carcinoma and the clinical data were recorded.The expression level of Lin28A/B proteins were detected by immunohistochemistry in HNSCCs tissues and their matched normal tissues.tThe expression level of miRNA were analyzed in 6 HNSCC patients and other 6 patients with benign pathological changes,with the application of gene chips to detect the expression.Methods of Western Blot and RT-PCR were both utilized to detect expression levels of proteins and transcriptive levels of miRNAs correspondingly,in Scc23,Tca8113 and FADU cell lines.RESULTS Over-expression of Lin28A/B were found in head and neck squamous cell carcinoma tissues and the expression had a significant relation to advanced stage or lymph node metastasis.In addition,Lin28A was expressed in cytoplasm,while Lin28B was expressed in the nucleus.Correspondingly,in miRNA array,downregulated let-7a,let-7b,let-7g and let-7f-1 were detected in HNSCCs compared with the control group.In vitro study,the over-expression of Lin28A/B was found in Scc23 and Tca8113.The results of the CE and NE confirm that Lin28A was expressed in cytoplasm,while Lin28B was expressed in the nucleus and the results were consistent with that of Immunohistochemistry.On the contrary,RT-PCR showed that Let-7a transcription was relatively low in Scc23 and Tca8113 0.46±0.02 and 0.60±0.13.CONCLUSION As a RNA-binding protein,Lin28A/B selectively inhibit the biosynthesis of let-7 family.This study showed that the overexpression of Lin28A/B in head and neck squamous cell carcinoma tissues were related to the level of malignancy and the abnormal expression of let-7 family were also found.In contrast to the Lin28A,the Lin28B was expressed in the nucleus and this result provides some new idea for the further study of functional researches and expanding experiments in next step.

Array profiling identified MiRNAs dysregulation in laryngeal squamous cell carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE The purpose of this study was to analyze the screened miRNAs related to tumorigenesis using miRNA array in laryngeal squamous cell carcinoma (LSCC), and provide a set of miRNAs that may be useful for the development of novel diagnostic markers and/or more effective therapeutic strategies from the screened miRNAs in LSCC. METHODS A total number of 5 patients who underwent surgery for primary laryngeal squamous cell carcinoma were recruited for miRNA array analysis. LSCC tissues compared with corresponding adjacent non-neoplastic tissues were analyzed by the Affymetrix GeneChip miRNA Array 3.0 to screen effective miRNAs, and the raw dataset had been submitted to Gene Expression Omnibus. Then mirfocus 3.0 database was adopted to analyze putative regulated miRNAs related to MCM4, a gene related to tumorigenesis we had studied previously in LSCC. Moreover, the selected putative regulated miRNAs were also validated by qRT-PCR in another 21 patients diagnosed as LSCC. RESULTS Analyzed by the miRNAs arrays, there were 127 miRNAs significantly related to tumorigenesis, and 78 showed a higher expression in tumor than in non-tumor tissue while 49 presented the contrasting pattern (P<0.01). Then analyzed by mirfocus 3.0 database, there were 2 putative regulated miRNAs, hsa-miR-24-3p and hsa-miR-183-5p, related to the expression of MCM4. Another miRNA we should focus on was hsa-miR-30a-5p, which was down-expressed obviously analyzed by the miRNA array. The expression of the 3 putative regulated miRNAs were also validated by qRT-PCR in another 21 patients, and the result was the same with that in miRNA array (P<0.05). CONCLUSION The 3 putative miRNAs based on miRNA array analysis, hsa-miR-24-3p, hsa-miR-183-5p and hsa-miR-30a-5p, could be considered as potential diagnostic and therapeutic markers in LSCC. The result will contribute to the understanding of the molecular basis of LSCC and help to improve the treatment.

Preliminary analysis of miRNA expression profile of chemosensitivity for TPF regimen in hypopharyngeal squamous cell carcinoma / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVEThe purpose of this study was to analyze the screened miRNAs related to the chemosensitivity for the TPF regimen of hypopharyngeal squamous cell carcinoma by miRNA array, and provide a set of miRNAs that may be useful for the development of novel diagnostic markers and more effective therapeutic strategies from the screened miRNAs.METHODSA total number of 21 patients who underwent TPF induction chemotherapy for primary hypopharyngeal squamous cell carcinoma were recruited for miRNA array analysis. 12 patients are sensitive to chemotherapy, and 9 patients are not. Moreover, the selected putative regulated miRNAs were also validated by RT-PCR in another 24 patients (14 patients are sensitive to chemotherapy, and others are not).RESULTSThere were 24 miRNA significantly differencial to the sensitivity to chemotherapy, and 6 miRNAs were up-regulated in the TPF group while 18 miRNA were down-regulated (P<0.05). To identify typical miRNA, mirfocus 3.0 database selected four miRNAs hsa-miR-211-3p, hsa-miR-4253, hsa-miR-4443, and hsa-miR-193b-3p, which were significant down-regulated in TPF-sensitive group. QRT-PCR further validated that only three miRNA (hsa-miR-4253、hsa-miR-4443、hsa-miR-193b-3p) were under-expressed in TPF-sensitive group of another 24 tissue samples (P<0.05).CONCLUSIONMiRNA hsa-miR-193b-3p, hsa-miR-4253, hsa-miR-4443 were identified in TPF-sensitive tissues by microarrays, and further validated by RT-PCR. These down-regulated miRNAs may act as novel biomarkers to classify TPF sensitivity of hypopharyngeal squamous cell carcinoma patients and will contribute to the understanding of the molecular basis of the chemosensitivity in the disease.

Localization of parathyroid glands with intravenous low-dose methylene blue in thyroidectomy / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo explore the efficacy and safety of localization for parathyroid glands with intravenous low dosage of methylene blue in thyroidectomy. METHODSWe retrospectively reviewed the clinical data of 41 patients who suffered from thyroid papillary carcinoma between Aug, 2014 and Jan, 2015 (9 males and 32 females, with a median age of 46 years). Thirty eight patients underwent primary thyroidectomy and 3 patients underwent second operation. A variety of thyroidectomy was performed in all patients, and who also underwent intravenous (3-4) mg/kg methylene blue in operation. RESULTSEighty four parathyroid glands were stained. Among 39 patients who's parathyroid glands were stained, the mean dyeing time was (31.27±9.41) min. Dyeing rates and dyeing time were not significantly different between 3 mg/kg group and 4 mg/kg group (t=0.24 and 0.20, all P>0.05). None of patients had the hypoparathyroidism problem such as peri-oral numbness, tingling, muscle aches and spasms. According to postoperative monitoring of parathyroid hormone, all of patients had no permanent hypofunction of the parathyroid gland. Neurotoxic effects and other serious side effects were not observed in all patients. CONCLUSIONIntravenous low-dose methylene blue in thyroidectomy is a safe, easy, and effective technique that facilitates rapid identification of parathyroid gland.

Clinical efficacy analysis of adult sinonasal rhabdomyosarcoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical prognostic impact factors of adult sinonasal rhabdomyosarcoma (SNRMS).@*METHOD@#The clinical features, treatment methods, and disease outcome were reviewed retrospectively for twenty-three adult SNRMS between 2006 January and 2014 December. The survival analysis was performed by Kaplan-Meier estimate and the comparison between groups by Log-rank test. Multivariate analysis was carried out by Cox proportional hazard model.@*RESULT@#Patients' ages ranged from 18 to 59 years (median, 23.2 years). With a median follow-up of 20 moths (3-47 moths), 14 cases dead and 9 cases alive, the 1-year and 2-year overall survival (OS) rates were 77.1% and 35.0%, respectively. Within the 1-year and 2-year OS rates,early stage group had a higher overall survival rates than advanced diease group (100.0%, 66.7% and 83.3%, 10.5%, P < 0.05); combined therapy group had a higher overall survival rates than single treatment group (86.7%, 50.0% and 50.8%, 0, P < 0.05). In the non-metastasis group (21 cases), 1-year and 2-year distant metastasis rates were 38.1% and 70.5%, respectively. Multivariate analysis showed that radiotherapy, chemotherapy and tumor diameter less than 5 cm were good prognostic factors (P < 0.05), while the lymph node metastasis, meningeal involvement and orbital involvement were poor prognostic factors (P < 0 05). In the 14 cases of dead patients, 92 8% (13/14) died of distant metastasis.@*CONCLUSION@#Adult RMS had a high advanced rate with poor prognosis. Distant metastasis is the leading cause of death. Controlling distant metastasis is a key to improve the survival rate.

Effect of TPF induction chemotherapy on locally advanced squamous-cell cancer of hypopharynx / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo observe the short term effects and adverse effects of induction chemotherapy with Paclitaxel,Cisplatin and Fluorouracil(TPF) in locally advanced squamous cell cancer of hypopharynx. METHODS78 cases locally advanced squamous-cell cancer of hypopharynx form jan 2011 to oct 2013 for the first time treated by TPF scheme,after 2 cycles,to recheck CT scan and evaluate therapeutic effective.RESULTSAll 78 cases patients achieved 156 cycles chemotherapy,CR was 4 cases (5.1%),PR 55 cases (70.5%),SD 17 cases (21.8%), PD 2 cases (2.6%). Total effective rate (CR+PR) was 75.6%,and with low incidence ofⅢ/Ⅳ grade side effect. Logistic regression analysis shows that there is a significant correlation between effective rate and low differentiation cancer.CONCLUSIONFor locally advanced squamous-cell cancer of hypopharynx patients,the TPF chemotherapy scheme showed good therapeutic effective and safety,could be a choice for the induction chemotherapy treatment in locally advanced squamouscell cancer of hypopharynx. The patients with low differentiation cancer may have benefit from the induction chemotherapy.

A preliminary study on genome-wide expression profiling of laryngeal squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To identify the genes differentially expressed and underlying molecular mechanism in laryngeal squamous cell carcinoma by using cDNA microarrays.</p><p><b>METHODS</b>Using Illumina Human HT-12 BeadChip, gene expressions were detected in ten pairs of laryngeal cancer tissues and adjacent normal tissues. Total RNA was extracted and reverse-transcribed into cDNA. Labeled cDNA were hybridized with cDNA microarray, data were read and images were scanned. All the samples had passed quality control testing.</p><p><b>RESULTS</b>Through Illumina Genomstudio 1.9.0 Data processing software (P < 0.05 or diffscore>13, diffscore<-13) and multiple displacement t test(FDR<0.05), 426 genes showed statistically significant differences in expressions between laryngeal tumor tissues and corresponding adjacent normal tissues, with 222 up-regulated genes and 204 down-regulated genes in laryngeal cancer tissues. These up- or down-regulated genes were indicated to involve in cellular processes relevant to the cancer phenotype, such as proliferation, cell cycle, chromosome segregation, mitosis and meiosis. These differentially expressed genes also took part in cancer related signaling pathways as well, for instance, metabolic pathways, cell cycle, DNA replication, glutathione metabolism, mucin type O-Glycan biosynthesis, drug metabolism-cytochrome P450 and so on.</p><p><b>CONCLUSION</b>The set of genes identified here and their functional annotations contribute to a better understanding of the pathogenesis of laryngeal squamous cell carcinoma from the view of multiple gene interactions and provide candidate markers for improving diagnosis, prognosis and treatment of this cancer.</p>

Retrospective analysis of upper aerodigestive tract cancer and thyroid cancer / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the definition, etiology, diagnosis, treatment and prognosis in patients with multiple primary malignant tumor of upper aerodigestive tract cancer and thyroid cancer.@*METHOD@#Retrospectively analyze the events of 7 cases with multiple primary malignant tumors of upper aerodigestive tract cancer and thyroid cancer.@*RESULT@#Lesions of upper aerodigestive tract cancer and thyroid cancer located on the same side. After 4 to 8 years of follow-up, 2 cases of hypopharyngeal cancer and thyroid cancer got poor prognosis, prognosis of other patients with early stage laryngeal cancer and thyroid cancer is better.@*CONCLUSION@#The prognosis of multiple primary malignant tumors in patients with upper aerodigestive tract cancer and thyroid cancer depends on the biological behavior of aerodigestive tract cancer.