Luteolin induces apoptosis by activating Fas signaling pathway at the receptor level in laryngeal squamous cell line Hep-2 cells.

Luteolin, a naturally occurring flavonoid, possesses anti-cancer activities against several human cancers, but the exact molecular and biochemical mechanisms of above findings are not very clear, and its activity against head and neck squamous cell carcinoma (HNSCC) is seldom mentioned. In this study, we investigated luteolin against human laryngeal squamous cell line Hep-2 cells, using MTT assay, flow cytometry, Western blot and reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. Luteolin inhibited Hep-2 cells proliferation at the inhibitive concentrations of 50% (IC50) near to 50 µM and induced the apoptosis in Hep-2 cells through caspase-3 and caspase-8 activation. Up-regulation of Fas and down-regulation of long form cellular FLICE-like inhibitory protein (c-FLIPL) protein were also involved after luteolin treatment at both protein and mRNA levels. Luteolin could not only inhibit cell proliferation but also induce apoptosis by activating the Fas signaling pathway at the receptor level in laryngeal squamous cell line Hep-2 cells.

[Association between lymphangiogenesis and clinicopathological features and prognosis in laryngeal carcinoma].

OBJECTIVE: To detect lymphangiogenesis by labeling the lymphatic endothelial marker, lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1), and study the prognostic relevance of lymphangiogenesis in laryngeal squamous carcinoma. METHODS: Clinical files and specimens of 78 patients with histologically diagnosed laryngeal carcinoma were stained with LYVE-1 as a specific lymphatic endothelial marker. The lymphatic vessel density (LVD) was measured, and the correlation between LVD and clinicopathological features of the tumor cases was analyzed. RESULTS: The mean LVD in laryngeal carcinoma (13.24 ± 5.09) was significantly higher than that in adult laryngeal papilloma (5.54 ± 3.15) and squamous dysplasia (6.76 ± 4.45, P < 0.05). The LVD of poorly differentiated tumors (15.74 ± 5.24) was significantly higher than that in the moderately differentiated tumors (13.84 ± 6.20), and the LVD in the moderately differentiated tumors was significantly higher than that in the well-differentiated tumors (11.68 ± 6.34). The LVD in stage 0 to stage II group (10.66 ± 5.70) was significantly lower than that in the stage III to IV group (17.01 ± 6.35). The lymph node metastasis group (17.25 ± 7.37) was significantly higher than non-lymph node metastasis group (8.60 ± 5.23, P < 0.05). There was no significant association between LVD and age, sex, primary site and distant metastasis. The overall survival in the patients with a LVD higher than the mean value was 33.5 month, and that of cases with a LVD lower than the mean value was 81.6 month (P < 0.05). The multivariate survival analysis showed that the clinical stage and LVD were independent prognostic factors of laryngeal cancer. CONCLUSIONS: The LYVE-1 staining histochemistry demonstrates that the lymphangiogenesis occurrs mainly at the edge of the tumors, and lymphangiogenesis plays an important role in the carcinogenesis, cancer progression and lymph node metastasis in laryngeal cancer. LVD may be an independent indicator of poor prognosis of laryngeal cancer.

Overexpression of cFLIP in head and neck squamous cell carcinoma and its clinicopathologic correlations.

PURPOSE: The aim of this study was to determine the expression of cellular FLICE-like inhibitory protein (cFLIP) in head and neck squamous cell carcinoma (HNSCC) and revealed its possible correlation to Fas protein and tumour clinical parameters. METHODS: The expression of cFLIP was analysed in 58 HNSCC samples and 30 morphologically normal tissues adjacent to the carcinomas using immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR) and western blot analysis. Furthermore, its possible correlation to the expression of Fas protein and tumour clinicopathologic parameters were discussed. RESULTS: Cellular FLICE-like inhibitory protein was demonstrated to be up regulated in most HNSCC than in normal tissues by immunohistochemistry (p<0.01). Although the mRNA levels of both isoforms of cFLIP, long form (cFLIP(L)) and short form (cFLIP(S)), in HNSCC were higher than those in normal tissues (p<0.01), only cFLIP(L) protein could be detected by western blot. Furthermore, the expression of cFLIP(L) protein was significantly associated with tumour clinical stage (p<0.01) and lymph node metastasis (p=0.01). Since all of the tumours with Fas immunostaining also express cFLIP protein, there was no significant correlation between them (p>0.05). CONCLUSIONS: Overexpression of cFLIP(L) is a frequent event in HNSCC and HNSCC cells in vivo may need it to evade apoptosis mediated by Fas or other receptors, which might contribute to tumour development and progression.

Suppression of survivin expression by short hairpin RNA induces apoptosis in human laryngeal carcinoma cells.

PURPOSE: The aim of this study was to evaluate the suppression effect of survivin shRNA on the expression of the survivin gene in the human laryngeal cancer cell line Hep-2. PROCEDURES: 60 cases of laryngeal squamous-cell carcinoma (LSCC) and 10 cases of normal laryngeal mucosa were examined using immunohistochemistry to determine whether the expression of survivin correlated with tumorigenesis. Three plasmid vectors of short hairpin RNA (shRNA) specific for survivin were designed and generated. Western blot and real-time PCR analysis of survivin expression in Hep-2 cells was performed 48 h after transfection. The growth curve was used to determine the cell proliferation. Propidium iodide (PI) single staining was applied to detect the cell cycle. The apoptosis of the cells was analyzed by flow cytometry with the FITC-annexin-V/PI double staining and PI single staining. RESULTS: 68.33% (41 out of 60) of tumors were positive for survivin expression and significantly associated with lymph node metastasis and advanced stage. In contrast, no expression of survivin in normal mucosa was detected. Transfection of Hep-2 cells with survivin shRNA significantly inhibited survivin expression at both the mRNA and the protein level in Hep-2 cells. Downregulation of survivin resulted in increasing the apoptosis index, but the results showed no obvious influence on cell cycle. CONCLUSIONS: This study demonstrates that survivin shRNA effectively inhibits survivin gene expression in Hep-2 cells leading to growth suppression and apoptotic induction in Hep-2 cells.

[Surgical management and preservation of laryngeal function for senile patients with advanced laryngeal carcinoma].

OBJECTIVE: To explore the methods of surgical treatment and preservation of laryngeal function in senile patients with advanced laryngeal carcinoma. METHODS: A retrospective data review of 87 advanced laryngeal carcinoma patients aged over 65 years was carried out. Of these 87 patients treated by different modes of surgery, 48 had supraglottic cancer, 35 glottic cancer and 4 subglottic cancer. The surgery modes consisted of major partial laryngectomy in 36 patients, subtotal partial laryngectomy with laryngoplasty in 21 and total laryngectomy in 30. All patients received postoperative radiotherapy to a dose of 50-60 Gy. Kaplan-Meier method was used to analyze the survival. RESULTS: The overall 3- and 5-year survival rate was 73.2% and 67.4%, respectively. The ultimate rate of larynx preservation was 65.5%. Of 57 patients with partial laryngectomy, 46 were decannulated with a decannulation rate of 80.7%. Yet, in all patients, the nasal feeding tube was removed and food intake per os was resumed. All patients who underwent partial laryngectomy regained their phonation function. CONCLUSION: It is safe and effective to treat and preserve laryngeal function surgically in the senile patients with advanced laryngeal carcinoma. The key points to achieve this are selection of proper patient, renovation of surgical procedure and improvement of surgical skill.

[Relationship between polymorphism of N-acetyltransferase 2 and genetic susceptibility to laryngeal carcinoma].

OBJECTIVE: To investigate the relationship between polymorphism of N-acetyltransferase (NAT2) gene and genetic susceptibility to laryngeal carcinoma. METHODS: A case-control study on 62 laryngeal carcinoma patients and 56 controls was conducted. NAT2 alleles were differentiated by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) methods using originally created PCR primers and genomic DNA extracted from peripheral white blood cells. Genetic risk for NAT2 genotype was analyzed by smoking index (SI, cigarettes smoked per day x years of smoking). RESULTS: The frequency of NAT2 slow genotype was 80.6% in patients with laryngeal carcinoma and 60.7% in the controls, the difference of which was statistically significant (chi(2) = 5.70, P = 0.017). The odds ratios were 2.70 (95% CI 1.19 approximately 6.11). Among the individuals with NAT2 slow genotype at high level of cigarette smoking, there was a significantly higher risk of 5.64 (95% CI 1.77 approximately 17.92), while those at low level were considered the reference group (OR 1.38, 95% CI 0.42 approximately 4.52). CONCLUSION: NAT2 slow genotype increases the risk of susceptibility to laryngeal carcinoma. The combined effect of NAT2 slow genotype and exposure to smoking is observed during the development of laryngeal cancer.

[Preservation of laryngeal function in surgery for medial wall pyriform sinus cancer].

OBJECTIVE: To study the feasibility, surgical technique and results of laryngeal function preservation in surgical treatment for medial wall pyriform sinus cancer. METHODS: From 1992 to 1999, 31 patients with medial wall pyriform sinus cancer including stage I 1, II 4, III 14 and IV 12 lesions were treated. Partial resection of pyriform sinus and partial laryngectomy were performed, then, the remains of epiglottis and uni-pedicled sternohyoid myofascial flap were used to restore the defects of larynx. At last, the remaining hypopharyngeal mucosa was sutured to cover the wound of hypopharynx and for artificial rebuild-up. All patients received postoperative radiotherapy. RESULTS: The 3- and 5-year survival rates were 62.1% and 43.6% respectively, with 77.4% patients having laryngeal functions (voice, respiration and deglutition) completely restored and 32.6% partially restored (voice and deglutition). CONCLUSION: Conservative surgery so introduced is feasible for selected medial wall pyriform sinus cancer patients with the lesion completely resected.

[Surgical management of supraglottic laryngeal carcinoma in 182 patients with special emphasis on functional preservation].

OBJECTIVE: To explore the surgical methods and evaluate the long-term result of laryngectomy in patients with supraglottic laryngeal cancer. METHODS: 182 patients with supraglottic laryngeal carcinoma underwent operation from 1979 to 1999, with stage I 11, stage II 45, stage III 49 and stage IV 77 lesions. The choice of surgical procedure was decided with the disease condition of the larynx. The surgical procedures proposed by TD Wang were adhered to as: minor partial laryngectomy 36, major partial laryngectomy 85, subtotal partial laryngectomy with laryngoplasty 22 and total laryngectomy 39. RESULTS: The ultimate rate of larynx preservation was 78.6% (143/182) with 69.8% (88/126) in stage III and IV diseases. The decannulation rate was 81.8% in cases with preservation of laryngeal function. The overall 3- and 5-year survival rates were 82.9% and 67.3%, with 76.88% and 57.4% in the advanced (stage III and IV) cases who survived with preserved laryngeal function. They were 82.5% and 67.0% in similar advanced cases who were treated by total laryngectomy. The difference in the survival rates between these two groups was not statistically significant. CONCLUSION: It is suggested that preservation of the laryngeal function be possible for advanced supraglottic laryngeal carcinoma without compromising the remote survival rate. To improve the rate of larynx preservation, one should follow the surgical methods suggested.

[Surgical treatment of tonsillar cancer].

OBJECTIVE: To study the surgical treatment of tonsillar cancer. METHODS: Twenty-four patients with tonsillar cancer were treated with surgery and postoperative radiotherapy. The choice of surgical procedure was decided on the condition of the lesion. The tumor was resected through the transoral approach, mandibular swing approach, mandibular resection approach or hyoid approach. Surgical defect was repaired by pectoralis major myocutaneous flap, sternohyoid myofascial flap, tongue flap or soft palate flap. RESULTS: The 3- and 5-year survival rates were 76.0% and 60.8%. Function of chewing, deglutition, respiration and speech was restored well. CONCLUSION: Method of total resection of the tonsillar carcinoma through the optimum approach is best chosen according to the condition of the lesion, while preserving the oropharyngeal function. When combined with postoperative radiotherapy, the survival rate and quality of life of patients can be improved.

[Substitution of esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved].

OBJECTIVE: To study the feasibility and effect of substituting esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved. METHODS: Twenty-four patients with cervical esophageal carcinoma were retrospectively reviewed. The esophagus was resected and substituted with 19 gastric pull-up and 5 colon interposition. Nineteen patients received radiotherapy postoperatively (dose 50 - 70 Gy). RESULTS: Twenty two patients were follow up over 3 years. The 3- and 5-year survival rates for T2 were 3 and 1, for T3, T4 8 and 3, respectively. The laryngeal function preservation rate was 77% (17/24) and the decannulation rate was 75% (12/16). The complication rate was 29%. CONCLUSION: Surgical resection of cervical esophageal carcinoma with removal of the extraesophageal invaded tissues while preserving the laryngeal function is possible. The continuity of the esophagus is restored by stomach transposition and colon interposition. Combined with radiotherapy, the survival rate and life quality of the patient might be improved.

[Surgical management of laryngeal cancer and preservation of laryngeal function].

OBJECTIVE: To explore the surgical methods for laryngeal cancer and long-term effects of larygectomy. METHODS: 625 cases of laryngeal cancer at different stages, including 182 cases of supraglottic cancer, 429 cases of glottic cancer, and 14 cases of subglottic cancer, underwent operation of different kinds from 1979 to 1999. Radiotherapy was given to those with poorly differentiated squamous carcinoma or with metastasis of cervical lymph nodes postoperatively. The effects of operation, especially that on the preservation of laryngeal function was analyzed. RESULTS: Partial laryngectomy was performed on 521 of the 625 cases (83.4%) and 203 of the 305 cases at stages III and IV (66.6%). The decannulation rate was 84.07% in the cases undergoing partial laryngectomy. The nasal feeding tube was removed and peroral feeding was recovered in all patients. All cases undergoing partial laryngectomy succeeded in phonation. The overall 3-year survival rate was 89.63% and the overall 5-year survival rate was 77.36%. For the cases with laryngeal cancer at stages III and IV, the 3-year survival rate among those undergoing partial laryngectomy was 84.9%, not significantly different from that among those cases undergoing total laryngectomy (87.7%, P > 0.05); the 5-year survival rate was 66.6% among those undergoing partial laryngectomy and was 69.7% among those undergoing totals laryngectomy (P > 0.05). CONCLUSION: The rate of partial laryngectomy is rather high in this group. It is possible to preserve the laryngeal function without compromising the remote survival rate. The prerequisite for the preservation of laryngeal function is to master and choose the proper renovation methods.

[Application of epiglottis in laryngeal reconstruction].

OBJECTIVE: To observe the application value of epiglottis in laryngeal reconstruction after partial laryngectomy. METHODS: The data of 168 patients, 25 with supraglottic carcinoma (T1N0 2, T2N0 10, T2N1 1, T2N2 1, T3N0 7, T3N2 1, T4N0 2, and T4N2 1), 140 with glottic carcinoma (T1N0 36, T1N1 1, T2N0 52, T2N1 1, T2N2 1, T3N0 40, T3N2 2, T4N0 6, and T4N2 1), and 3 with subglottic carcinoma (T3N0 1, and T4N0 2), who underwent partial laryngectomy from 1982 to 1999 were summarized. The choice of surgical procedure was decided on the pathology of the larynx. Epiglottis was used in larynx reconstruction. RESULTS: Out of the 168 cases, 135 cases were decannulated with a decannulation rate of 80.36%, regained deglutation, recovered all laryngeal functions, and resumed normal diet. None presented complication of accidental aspiration. The 3-year and 5-year survival rates were 89.48% and 74.14% respectively. CONCLUSION: Epiglottis has many advantages in laryngeal reconstruction.

[Surgical treatment of advanced laryngeal cancer with preservation of laryngeal function].

OBJECTIVE: To explore the surgical methods for advanced laryngeal cancer and long term effects of laryngectomy. METHODS: Two hundred and thirty-eight cases of laryngeal cancer at different stages, including 103 cases with supraglottic cancer, 118 cases with glottic cancer, 3 cases with subglottic cancer, and 14 cases with recurrent cancer, underwent different kinds of operation from 2000 to 2010. The TNM classifications were as follows: T3 168 cases, T4 70 cases. Stage III 145 cases, Stage IV 93 cases. N0 134 cases,N1 64 cases,N2 38 cases, and N3 2 cases. The effects of operation, especially with the preservation of laryngeal function, was analyzed. The disease-free survival rate was calculated by Kaplan-Meier methods. RESULTS: Partial laryngectomy was performed on 142 of the 238 cases (59.7%). Total laryngectomy was performed on 96 cases. In 142 patients who received partial laryngectomy with preservation of laryngeal function, the trachea cannula was extracted in 90 patients, with the decannulation rate as 63.4%. The nasal feeding tube was removed and peroral feeding was recovered in all patients. The patients undergoing partial laryngectomy succeeded in phonation. The 3 years and 5 years disease-free survival rates in all patients were 81.4% and 59.5%. The 3 years and 5 years disease-free survival rate of partial laryngectomy were 82.9% and 64.3%. The 3 years and 5 years disease-free survival rates in total laryngectomy were 79.2% and 52.4%. There was no significantly different between the two groups (χ(2) = 2.478, P = 0.115). CONCLUSION: For the advanced laryngeal cancer, it is possible to preserve the laryngeal function without compromising the remote survival rate by detailed pre-operational estimation, properly selected operation and skilled surgical practice.

[Mutation and abnormal expression of FHIT gene in hypopharyngeal carcinoma].

OBJECTIVE: To analyze the mutation and abnormal expression of the FHIT gene in human hypopharyngeal carcinoma. METHOD: Matched normal and cancerous tissues from 24 patients with hypopharyngeal squamous cell carcinoma were obtained immediately after surgery. Total RNA was extracted, the FHIT gene was detected by nested RT-PCR and DNA sequencing technology. RESULT: Normal sized FHIT transcript was detected in 23 of the 24 cases of normal matched tissues. Aberrant FHIT transcripts were found in 9/24 (37.5%) cases in hypopharyngeal carcinoma. Aberrant FHIT transcripts rate of well-differentiated, moderately differentiated and poorly differentiated squamous cell carcinoma, was 28.6% (2/7), 50.0% (4/8) and 33.3% (3/9), respectively. There the carcinoma with FHIT aberrant transcripts was neither corresponding to histological grade (P>0.05) nor to lymphatic metastasis. The sequence analyses of the two aberrant cDNAs revealed absence of exon 8 and exon 7-9. All initial deletion were in conjunction of exons. CONCLUSION: High deletion rate of the FHIT gene in Chinese hypopharyngeal squamous cell carcinoma suggested the FHIT gene, a candidate tumor suppressor gene at 3p14.2, plays an important role in the tumor carcinogenesis, development and progression of the tumor, and thus may become a new prognostic marker in hypopharyngeal carcinoma.

[Comprehensive treatment of 352 cases with hypopharyngeal cancer].

OBJECTIVE: To review the experience of different surgical construction methods and comprehensive treatments for hypopharyngeal cancer. METHODS: Three hundred and fifty-two cases (According to UICC 2002 criteria, stage I, 3; II, 31; III, 134; IV, 184) with hypopharyngeal cancer were retrospectively reviewed from 1999 to 2005 in the Department of Otorhinolaryngology of Qilu Hospital of Shandong University, including 321 males and 31 females. The median age was 58 years old, ranged from 26 to 82 years old. All the tumors originated from the pyriform sinus (272), posterior pharyngeal wall (61), postcricoid area (19). There were no distant metastasis. Two hundred and fourty-one cases were surgically treated with laryngeal functions preserved and 111 cases without laryngeal functions preserved. All the patients received modified neck dissection, including both unilateral (247 patients) and bilateral (105 patients). Pharyngoesophageal defect reconstruction methods in cases with laryngeal functions preserved were: direct suture in 137, pectoralis major musculocutaneous flap in 62, split graft in 2, pectoralis major musculocutaneous flap combined with the split graft in 5, stomach pulling-up in 12, colon interposition in 23 patients. While in cases without laryngeal functions preserved the methods includes: direct suture in 54, laryngotracheal flap in 54 patients, pectoralis major musculocutaneous flap in 7, laryngotracheal flap combined with pectoralis major musculocutaneous flap in 8, stomach pulling-up in 22, colon interposition in 3 patients. All patients received radiotherapy postoperatively (dose 55 - 75 Gy). RESULTS: The overall 3 and 5 year survival rates were 65.1% (229/352) and 53.6% (142/265), respectively. For stage I, the 5 year survival rate was 3/3, stage II, 80.6%(25/31), stage III, 65.0% (67/103), stage IV, 36.7% (47/128). The 3 and 5 year survival rates in functionally preserved group were 68.0% (164/241) and 59.7% (114/191), respectively, while in non-functionally preserved group were 58.6% (65/111) and 37.8% (28/74), respectively. The cervical lymph node metastasis was found in 239 sides. Pathologic findings showed that well, moderately and lower differentiated squamous cell carcinomas were 84, 163, 105 cases, respectively. Laryngeal functions (voice, respiration and deglutition) were completely restored in 169 patients and partially restored (voice and deglutition) in 72 patients. CONCLUSIONS: Combined surgery and radiotherapy are the best choice for hypopharyngeal cancer. The continuity of the pharyngoesophagus is restored and the laryngeal function is preserved as far as possible. The preservation of laryngeal function and the laryngeal and pharyngeal reconstruction are based on the premise that the tumor was excised completely.

[Preservation of laryngeal function in surgical treatment of T3 supraglottic laryngeal carcinoma].

OBJECTIVE: To explore the feasibility,surgical techniques and the clinical curative effect of preservation of laryngeal function in surgical treatment of T3 supraglottic laryngeal carcinoma (SLC). METHOD: A retrospective review of 70 cases with T3 SLC that we treated from 1994 to 2003 were accomplished. All of the cases were treated with partial laryngectomy. Among them, 42 cases underwent supraglottic horizontal partial laryngectomy, 19 supraglottic horizontovertical laryngectomy, 8 supracricoid partial laryngectomy and 1 near total laryngectomy. All patients were received postoperation radiotherapy with the dosage for 50-60 Gy. RESULT: The 3 year and 5 year-survival rates were 79.2% and 68.4%, respectively. Out of the 70 cases, 60 cases were decannulated with a decannulation rate of 85.7%. The normal diet was resumed in all patients, no buckling and dysphagia obviously. All patients had their successful phonation, no one failure for laryngotracheal atresia. CONCLUSION: It is feasibility to preservative laryngeal function in surgical treatment of T3 SLC, if surgeons master indications correctly, use many kinds restorative procedure expertly and improve surgical skill.

[Multiple plane operations in treating severe obstructive sleep apnea-hypopnea syndrome].

OBJECTIVE: To investigate the effect and clinical value of multiple plane operations in treating severe OSAHS. METHOD: The clinical data of 28 patients with severe OSAHS were retrospectively analyzed. All the patients were performed two planes of operations or more as below: submucous nasal septum resection, nasal sinus endoscopy, adenoidectomy, uvulopalatopharyngoplasty (UPPP), tongue base incision, hyoid suspension, tongue base Coblation etc. Operations were finished in the same term or by stages. All patients underwent polysomnography(PSG) examination before operation, and 6-month and 1-year after surgical treatment separately. RESULT: No severe complication occurred, the 6-month, 1-year responders are 100% and 89.29% respectively. Both AHI and LSaO2 changed obviously (P < 0.01). CONCLUSION: Most OSAHS have multi-level obstructions in upper airway caliber, such as nasal, nasopharyngeal, velo-pharyngeal and tongue-pharyngeal obstruction. Multiple plane operations which based on idiographic obstruction sites can improve curative effect. Operation project should be established according to the conditions of upper airway and patients' intention.

[The relationship between expression of Fhit and biological behaviors of hypopharyngeal carcinoma].

OBJECTIVE: To investigate the expression of fragile histidine triad gene protein (Fhit) and the possible relationship between Fhit and biological behaviors of hypopharyngeal carcinoma. METHOD: The expression of Fhit protein in 66 cases with hypopharyngeal carcinoma were detected by rabbit antibody to human FHIT gene protein with SP immunohistochemical method. The relationship between historical grade and lymphatic metastasis were analysed. RESULT: (1) The positive expression rate of Fhit was 42.42% (28/66) in hypopharyngeal carcinoma, and 83.33% (55/66) in normal hypopharyngeal tissue, respectively. There was a significant difference in the expression of Fhit between the cancer tissue and normal tissue (P < 0.01). (2) The positive expression of Fhit in well, moderate, poor differentiated hypopharyngeal carcinoma were 65.38% (17/26), 38.10% (8/21) and 26.32% (5/19), respectively. There are significant statistic difference among them each other (P < 0.01). (3) The positive expression of Fhit was 75.00% (12/16) in the group without lymph node metastasis, and 36.00% (18/50) with lymph node metastasis. CONCLUSION: The expression of Fhit in hypopharyngeal squamous cell carcinoma lower than normal tissue. The expression of Fhit significantly associated with historical grade and lymphatic metastasis in hypopharyngeal squamous cell carcinoma. It suggested that the expression of Fhit decreased may plays an important role in the development and progression of the tumor, and thus may become a new prognostic marker in hypopharyngeal carcinoma.

[Application of epiglottic in reconstruction of traumatic laryngotracheal stenosis].

OBJECTIVE: To investigate the application and long-term results of epiglottic in reconstruction of the traumatic laryngotracheal stenosis. METHODS: From January 1988 to February 2002, 42 patients with traumatic laryngotracheal stenosis were treated, including 33 laryngeal stenosis and 9 laryngotracheal stenosis. The following surgical treatment were performed: (1) lowered epiglottic and bi-pedicled sternohyoid myofascial flap and (2) lowered epiglottic and bi-pedicled sternohyoid myofascial flap and sternocleidomastoideus clavicle membrane flap. RESULTS: Thirty-seven patients (88.1%) were successfully extubated 10 to 75 days after operation. Feeding tube lasted from 9 to 24 days, all the patients rehabilitated deglutition after surgery. The time of using stent was 9 to 19 days in 25 cases. All patients were followed up 1 year to 3 years and 4 months. The function of larynx recovered completely in 37 extubated patients and partially in 5 cannulated patients. CONCLUSION: Epiglottic has the advantages of easy gain, high anti-infection and survival rate, and stable structure. A combination of epiglottic and the bi-pedicled sternohyoid myofascial flap plus sternocleidomastoideus clavicle membrane flap can repair large laryngeal and tracheal defects.

[The application of the temporalis myofacial flap in the reconstruction of craniofacial oncologic defects].

OBJECTIVE: To explore the application of the temporalis myofacial flap(TMF) in the reconstruction of craniofacial oncologic defects. METHOD: Ten cases with craniofacial neoplasms were treated surgically using TMF to reconstruct oncologic defects. TMF during 2000-2003. was used to reconstruct cranial base in 3 cases, oropharynx in 5 cases and orbital defects in 2 cases. TMF was designed according to size and locus of defect. The sizes of the flaps ranged from 3 cm x 4 cm to 8 cm x 10 cm. RESULT: During follow-up of 8 to 50 months, there were no cases of flap loss, no cranial infection or cerebrospinal fluid leak in cranial base reconstructions, no speech or swallowing disturbance in oropharyx reconstruction. All patients were satisfied with appearance with orbital reconstruction. CONCLUSION: TMF is a useful and reliable flap for reconstruct the craniofacial oncologic defects.