Adenosquamous Carcinoma of Hypopharynx with Intestinal-Phenotype

Adenosquamous carcinomas of the head and neck (ADSCs) are rare locally aggressive malignancies characterized by the presence of two distinctive components, a squamous cell carcinoma and an adenocarcinoma. The immunophenotype of the glandular component of ADSCs has only been rarely studied but has been reported as being positive for keratin 7 (CK7) and carcinoembryonic antigen (CEA) and negative for keratin 20 (CK20). Herein, we report a case of an ADSCs of the hypopharynx composed of a superficial squamous cell carcinoma and an adenocarcinoma with an intestinal phenotype. The patient was a 62 year-old male with a T2 N0 M0 squamous cell carcinoma (SCC) of uvula and palate and a T1 N0 M0 of right hypopharynx. The ADSCs of the hypopharynx was composed of a minimally invasive SCC and an adenocarcinoma with tubulo-glandular and cribriform architecture. The neoplastic glands were positive for CK7, CK20, CDX2, CEA and Villin. The patient underwent radiotherapy to both tumors and remains well with no evidence of recurrent disease 19 months after treatment. To the best of our knowledge, this is the first report of an ADSCs of the head and neck with an intestinal phenotype in its glandular component.     

Prognoses and improvement for head and neck cancers diagnosed in Europe in early 2000s: The EUROCARE-5 population-based study

BackgroundHead and neck (H&N) cancers are a heterogeneous group of malignancies, affecting various sites, with different prognoses. The aims of this study are to analyse survival for patients with H&N cancers in relation to tumour location, to assess the change in survival between European countries, and to investigate whether survival improved over time.MethodsWe analysed about 250,000 H&N cancer cases from 86 cancer registries (CRs). Relative survival (RS) was estimated by sex, age, country and stage. We described survival time trends over 1999–2007, using the period approach. Model based survival estimates of relative excess risks (RERs) of death were also provided by country, after adjusting for sex, age and sub-site.ResultsFive-year RS was the poorest for hypopharynx (25%) and the highest for larynx (59%). Outcome was significantly better in female than in male patients. In Europe, age-standardised 5-year survival remained stable from 1999–2001 to 2005–2007 for laryngeal cancer, while it increased for all the other H&N cancers. Five-year age-standardised RS was low in Eastern countries, 47% for larynx and 28% for all the other H&N cancers combined, and high in Ireland and the United Kingdom (UK), and Northern Europe (62% and 46%). Adjustment for sub-site narrowed the difference between countries. Fifty-four percent of patients was diagnosed at advanced stage (regional or metastatic). Five-year RS for localised cases ranged between 42% (hypopharynx) and 74% (larynx).ConclusionsThis study shows survival progresses during the study period. However, slightly more than half of patients were diagnosed with regional or metastatic disease at diagnosis. Early diagnosis and timely start of treatment are crucial to reduce the European gap to further improve H&N cancers outcome.     

下咽埋藏性异物的临床处理策略

目的总结下咽埋藏性异物的诊治经验及探讨手术径路的选择。方法回顾武汉市第一医院耳鼻咽喉科近6年就诊的12例下咽埋藏性异物患者的临床资料，对患者临床表现、异物种类、异物埋藏部位、取出或手术方式、病情转归等进行总结分析，所有患者随访半年以上。结果12例患者中，6例经口内镜下直接切开取出，或在等离子刀或CO2激光辅助下切开取出；3例行颈侧入路取出；1例电子喉镜下成功取出；1例自行消失；1例未做处理、异物在观察期内包埋机化。结论下咽埋藏性异物的诊断及定位依赖于影像学检查，取出方式取决于异物埋藏的部位，首选经口内镜下取出，必要时行颈侧切开径路。     

巨噬细胞移动抑制因子在下咽癌中的表达

目的 研究下咽癌中巨噬细胞移动抑制因子(MIF)与肿瘤侵袭和转移的关系。方法 收集下咽癌标本22例,取下咽癌患者的原发灶、颈部淋巴结转移灶及癌旁组织;另取良性病变（声带息肉）标本10例作为对照,采用免疫组化方法检测MIF在各类组织中的表达,并分析其与肿瘤分期、淋巴结转移的关系。结果 下咽癌原发灶、转移灶中MIF的表达水平均明显高于癌旁组织及良性病变组织,下咽癌组织中有淋巴结转移组的表达水平高于无淋巴结转移组,临床分期Ⅲ、Ⅳ期的表达水平高于Ⅰ、Ⅱ期。结论 MIF与下咽癌的侵袭和转移有关;肿瘤临床分期越晚,其表达水平越高。     

达芬奇手术机器人辅助CO2激光切除下咽舌根肿瘤2例

目的 总结达芬奇手术机器人(DVSS)辅助CO2激光在下咽舌根肿瘤切除术中的体会。方法 回顾性分析2例下咽舌根肿瘤患者在DVSS辅助下行CO2激光切除术的临床资料,结合相关文献对该技术的优势和存在问题进行总结。结果 2例患者在DVSS辅助CO2激光下顺利切除肿瘤,术后无明显并发症,恢复良好。结论 DVSS辅助CO2激光切除下咽舌根肿瘤具有术野暴露满意、创伤小、操作方便、术后并发症少及康复时间缩短等优点。