RESUMO
BACKGROUND: Succinate dehydrogenase subunit B (SDHB) immunohistochemistry was considered a valuable tool to identify patients with inherited paraganglioma/pheochromocytoma (PGL/PCC). However, previous studies jointly analyzed 2 related but clinically distinct entities, parasympathetic head and neck paragangliomas (HNPGLs) and sympathetic PCCs/PGLs. Additionally, a role for hypoxia inducible factor-1α (HIF-1α) as a biomarker for succinate dehydrogenase (SDHx)-mutated tumors has not been studied. Here, we evaluated the utility of SDHB/HIF-1α proteins in HNPGLs and PCCs/PGLs as clinically useful biomarkers. METHODS: The SDHB/succinate dehydrogenase subunit A (SDHA)/HIF-1α immunohistochemistry analysis was performed in 158 genetically defined patients. RESULTS: Similarly to PCCs/PGLs, SDHB immune-negativity correlated with SDHx-mutations in HNPGLs (P < .0001). The HIF-1α stabilization was associated with SDHx-mutations in HNPGLs (P = .020), not in PCCs/PGLs (P = .319). However, 25% of SDHx-HNPGLs lacked HIF-1α positive cells. CONCLUSION: As in PCCs/PGLs, SDHB immunohistochemistry in HNPGLs is a valuable method for identification of candidates for SDHx-genetic testing. On the contrary, although SDHx mutations may favor HIF-1α stabilization in HNPGLs, this is not a clinically useful biomarker.
Assuntos
Neoplasias das Glândulas Suprarrenais/metabolismo , Neoplasias de Cabeça e Pescoço/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Paraganglioma Extrassuprarrenal/metabolismo , Feocromocitoma/metabolismo , Succinato Desidrogenase/genética , Neoplasias das Glândulas Suprarrenais/genética , Adulto , Biomarcadores Tumorais/metabolismo , Feminino , Mutação em Linhagem Germinativa , Neoplasias de Cabeça e Pescoço/genética , Humanos , Imuno-Histoquímica , Masculino , Paraganglioma Extrassuprarrenal/genética , Feocromocitoma/genética , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Succinato Desidrogenase/metabolismoRESUMO
Horizontal supraglottic laryngectomy (HSL) allows the preservation of a functioning larynx and avoids permanent tracheotomy. In this retrospective study we report our experience with HSL and describe the functional and oncological results of the procedure. A total of 267 previously untreated patients with squamous cell carcinoma of the supraglottis underwent a supraglottic laryngectomy at our Department from January 1978 to May 2002. The main outcome measures were: local and regional control, disease-specific survival and laryngeal preservation rate. The overall recurrence rate was 29% (78/267). The local recurrence rate was 8% (22 patients) and the regional recurrence rate was 17% (45 patients). The 5-year disease-specific survival rate was 73%. The 5-year laryngeal preservation rate was 82%. Multivariate analysis showed two parameters that were independent predictors of a reduced disease specific survival: cervical lymph node metastases of class N3 (P = 0.0003) and primary tumour classified as T4 (P = 0.004). HSL provided, in our experience, an optimal locoregional oncological control for laryngeal preservation.
