Immunohistochemically stained markers (p53, PCNA, bcl-2) in dysplastic lesions of the larynx.

The percentage of malignant transformation of laryngeal dysplastic lesions is difficult to estimate. There is a need for new histological markers which could enable more objective assessment of the premalignant stages of the larynx and help in estimation of the potential of future neoplastic progression. We performed a retrospective study to determine whether immunohistochemical staining for the proliferating cell nuclear antigen (PCNA), tumour suppressor gene protein p53 and antiapoptotic protein bcl-2 may be prognostic factors in laryngeal epithelial lesions. Staining was performed on 57 paraffin-embedded biopsies from patients with clinically detected precancerous stages of the larynx. Histopathologic examination revealed normal epithelium in six cases, mild dysplasia in 20 cases, moderate dysplasia in 18 cases, severe dysplasia in seven cases, CA in situ in four cases, papilloma in one case and CA invasivum in one case. The p53 count in mild and moderate dysplasia was 26.8 and 38.6%, respectively. This difference was statistically significant. There was significant correlation between PCNA and p53 scores. There was also a relationship between the scores of these markers and bcl-2 expression. In ten out of 45 cases of dysplastic lesions the invasive cancer developed in 4 years of follow-up. The correlation between PCNA score and malignant progression of the dysplastic lesions was on the statistical borderline. There was significant relationship between malignant transformation and age of the patients.

Laryngeal cancer in Lower Silesia: descriptive analysis of 501 cases.

This paper presents a descriptive analysis of 501 cases of laryngeal cancer. The patients were classified according to their age, sex, primary tumour localisation and stage. There were 448 males and 53 females, with a male-to-female ratio of 8.5:1. The peak incidence of cancer was detected in the 6th and 7th decades of age. The most common primary tumour localisation was the glottis. Three-hundred-and-forty patients presented at advanced tumour stages (T3/T4). The proportion of patients presenting matastatic neck nodes was 29.3% and the incidence of metastatic lymph nodes increased with increasing T stage. Histopathological analysis revealed that 98% of tumours were squamous cell carcinomas. There were 125 well-differentiated, 235 moderately differentiated and 133 poorly differentiated carcinomas. Among other tumours, there was 1 adenoid squamous cell carcinoma, 1 giant cell carcinoma, 1 adenoma pleomorphicum, 1 adenoid cystic carcinoma (cylindroma), 1 haemangiopericytoma, 1 verrucous cell carcinoma, 1 lymphoepithelioma and 1 granular cell tumour.

Prognostic value of nucleolar organiser regions (AgNORs) in laryngeal cancer.

The argyrophilic nucleolar organizer regions (AgNORs) of 154 biopsy specimens of laryngeal squamous cell carcinoma were examined. The silver colloid staining technique was used. For the control, normal laryngeal epithelium obtained from 25 patients with benign lesions of the larynx was examined. There was significant difference in mean AgNORs count between control group and cancer patients. No significant correlation was found between AgNORs count and patients' age and sex, tumour site, T stage and lymph node metastasis. There was a significant correlation between AgNORs number per cell and tumour histological grading. The mean number of AgNORs per nucleus was 3.85 +/- 2.09 in patients with poor and 2.47 +/- 0.71 in patients with satisfactory clinical outcome after treatment. Significant correlation between the mean AgNORs number and survival in univariate and multivariate analysis was documented. Among clinical features the lymph node status and the T stage were important prognostic factors. We conclude that AgNORs may be a potential prognostic marker in laryngeal cancer.