RNA编辑酶1 mRNA在喉癌及其癌旁组织的表达及意义

目的:探讨RNA编辑酶1(RNA-dependent adenosine deam inasel,ADAR1)mRNA在喉癌及癌旁组织的表达及意义.方法:采用半定量RT-PCR分别检测51例喉癌患者的癌及癌旁组织ADAR1 mRNA的表达.结果:51例喉癌及其癌旁组织ADAR1 mRNA均有表达,相对表达量分别为2.963±0.912、0.791±0.197,两者间差异有统计学意义(P＜0.01);对照组27例ADAR1 mRNA的相对表达量为0.910±0.311,与喉癌组织比较差异有统计学意义(P＜0.01),与癌旁组织比较差异无统计学意义(P＞0.05).将喉癌组织和癌旁组织A-DAR1 mRNA表达量进行配对t检验,差异有统计学意义(P＜0.01).结论:ADAR1 mRNA在喉癌组织中表达增高,可能在喉癌的发生机制中起一定的作用.     

c-Cbl在喉癌中的表达及临床意义CSCD

目的探讨c-Cbl在喉癌组织中的表达及临床意义。方法应用免疫组化(SP)法检测40例喉癌组织、15例癌旁组织和8例喉正常黏膜组织中c-Cbl蛋白的表达情况。应用流式细胞术定量检测40例喉癌组织、13例癌旁组织和5例喉正常黏膜组织中c-Cbl的含量。结果免疫组化示喉癌组织、癌旁组织及喉正常黏膜组织中c-Cbl的表达强度呈下降趋势,3组相比有显著性差异。应用流式细胞术检测c-Cbl蛋白在喉癌组织、癌旁组织及喉正常黏膜组织中的表达量分别为1.8424±0.1814、1.6350±0.3889、1.1026±0.0181,3组相比有显著性差异。在喉癌组织中c-Cbl蛋白表达与其病理分级有关。结论 c-Cbl蛋白与喉癌的发生发展有关。     

肾上腺髓质素在人喉癌组织中的表达

目的观察肾上腺髓质素(adrenomedullin,AM)在人喉癌中的表达、分布和随着肿瘤进展其含量的变化。方法运用免疫组化方法观察喉癌组织中AM分布特点,放射免疫分别测定新鲜喉癌组织标本、非癌喉黏膜含量和喉癌患者术前血浆、健康对照血浆中AM浓度。结果选取的21例喉癌石蜡标本免疫组化染色均有AM表达,可以观察到AM表达主要在癌细胞细胞质中,高分化鳞癌癌巢周边癌细胞染色强而中心位置染色弱,中分化和低分化喉癌标本中癌巢AM染色较均一,间质染色较重。喉癌组织中AM含量为(49.67±28.33)pg/ml(x-±s,n=44,以下同),癌旁非癌喉黏膜组织(距离肿瘤1cm喉黏膜组织,组织病理证实无肿瘤浸润)AM含量为(14.71±7.17)pg/ml,肿瘤组织AM含量较癌旁非癌喉黏膜组织高(u=135.00,P<0.01)。T2、T3和T4期喉癌患者癌组织中AM含量依次为(31.52±15.22)pg/ml、(56.63±18.51)pg/ml和(96.12±18.22)pg/ml,差异有统计学意义;N0、N1期患者喉癌组织中AM含量差异无统计学意义(u=30.00,P>0.05),重新分组发现AM含量关系为(N0+N1)M0,差异有统计学意义(u=31.00,P<0.01)。喉癌患者术前血浆AM质量浓度为(10.75±2.49)pg/ml(n=20),健康对照血浆质量浓度为(9.74±2.39)pg/ml(n=20),喉癌患者术前血浆AM浓度和健康对照组间差异无统计学意义(u=153.00,P>0.05)。结论喉癌组织中存在AM高表达,喉癌组织AM含量与TNM分期有关,AM含量增加与肿瘤的进展有关。     

基质金属蛋白酶11在喉癌中的表达

目的:检测喉癌中基质金属蛋白酶11(MMP11)的表达,探讨MMP11的表达与喉癌浸润和转移的关系.方法:采用免疫组织化学法检测63例喉癌组织和相应的癌旁正常组织MMP11蛋白的表达,运用RT-PCR技术检测22例喉癌和相应的癌旁正常组织冻存标本中MMP11 mRNA水平的表达.结果:采用免疫组织化学法检测喉癌和癌旁正常组织MMP11的表达,癌组织MMP11的表达阳性率明显高于癌旁正常组织(P＜0.01).运用RT-PCR方法检测喉癌和癌旁正常组织MMP11 mRNA的表达,癌组织MMP11 mRNA的表达阳性率明显高于癌旁正常组织(P＜0.01).MMP11蛋白表达在T3 T4组高于T1 T2组(P＜0.01),淋巴结转移组高于非淋巴结转移组(P＜0.05).MMP11 mRNA表达在T3 T4组高于T1 T2组(P＜0.05),淋巴结转移组高于非淋巴结转移组(P＜0.05).MMP11蛋白及MMP11 mRNA的表达与肿瘤原发部位和分化程度无明显相关性(P＞0.05).结论:MMP11的表达与喉癌浸润和转移密切相关,可作为预测喉癌浸润和转移潜能的参考指标之一.     

微管相关蛋白1轻链3在喉癌中的表达及其意义

目的:探讨微管相关蛋白1轻链3(LC3)在喉癌中的表达及其意义.方法:采用免疫组织化学染色方法检测LC3蛋白在50例喉癌组织、45例癌旁组织、10例喉乳头状瘤及16例声带息肉中的表达情况.采用RT-PCR法检测LC3 mRNA和蛋白在41例喉癌组织、41例癌旁组织及11例声带息肉组织中的表达,并结合临床病理因素进行分析.结果:免疫组织化学结果显示LC3蛋白在喉癌组织、癌旁组织、喉乳头状瘤、声带息肉中的阳性率分别为60.0%、93.3%、90.0%、93.8%.LC3在喉癌组织中的阳性表达率明显低于癌旁及声带息肉组织(χ2=18.135,P＜0.01).RT-PCR检测结果显示LC3 mRNA在喉癌组织中相对表达量为0.57±0.08,与癌旁组织(0.99±0.11)及声带息肉组织(1.07±0.05)中的相对表达量比较差异亦有统计学意义(F=255.872,P＜0.01).LC3在喉癌中的蛋白表达与肿瘤部位、病理学分级有关(P＜0.05),与患者的年龄、T分期、临床分期及淋巴结转移无关(P＞0.05).结论:LC3在喉癌中的表达下调,自噬活性的改变可能与喉癌发生、发展有关.     

高迁移率族蛋白1在喉鳞状细胞癌组织及血清中的表达及意义

目的 研究高迁移率族蛋白1( high mobility group box-1,HMGB1) mRNA及蛋白在喉鳞状细胞癌(简称喉鳞癌)组织及患者血清中的表达及其临床意义.方法 反转录聚合酶链反应( RTPCR)及Western blot分别检测HMGB1 mRNA及蛋白在30例喉鳞癌患者肿瘤组织及癌旁黏膜组织中的表达;酶联免疫吸附试验( ELISA)检测HMGB1蛋白在喉鳞癌患者及正常志愿者血清中的表达.结果RT-PCR结果示HMGB1 mRNA(HMGB1/GAPDH)在喉鳞癌组织、癌旁黏膜组织中的相对表达量((x)±s)分别为1.25±0.12、0.32±0.04,差异有统计学意义(t=40.27,P＜0.05);Western blot结果示HMGB1蛋白(HMGB1/β-actin)在喉鳞癌和癌旁黏膜组织中的相对表达量分别为1.29 ±0.10、0.34±0.03,两组间差异有统计学意义(t=49.84,P＜0.05).结果显示HMGB1 mRNA和蛋白的表达水平与患者的T分级、临床分期、有无淋巴转移及是否吸烟有关(P值均＜0.05);而与年龄、性别、是否饮酒及肿瘤病理分级无关(P＞0.05).ELISA结果显示,喉鳞癌患者及正常志愿者血清中HMGB1质量浓度分别为(24.80±14.08) ng/ml、(23.58±14.69)ng/ml,差异无统计学意义(t=0.37,P＞0.05).结论 HMGB1 mRNA及蛋白在喉鳞癌组织中的表达显著高于癌旁黏膜组织,且表达水平与T分级、临床分期及有无淋巴转移有关.     

Neuropilin-1在喉癌组织及喉癌细胞系中的表达

目的：探讨Neuropilin-1（NRP-1）在喉癌组织及喉癌细胞系中的表达及意义。方法：采用免疫组织化学法检测NRP-1在喉癌及癌旁组织中的表达;采用RT-PCR检测NRP-1mRNA在喉癌、癌旁组织及喉癌细胞系中的表达。结果：免疫组织化学检测发现28例喉癌组织标本中NRP-1均为高表达,而相应的癌旁组织则无表达;RT-PCR检测NRP-1mRNA的表达结果显示28例喉癌组织中24例呈阳性表达,Hep-2细胞系呈阳性表达,相应的癌旁组织为阴性表达。结论：NRP-1表达于大多数喉癌组织及喉癌细胞系Hep-2中,而在癌旁组织不表达,提示NRP-1的表达可能与喉癌的发生、发展密切相关,且有较高的肿瘤特异性。     

Survivin基因在喉癌中的表达及意义

目的 研究凋亡抑制蛋白Survivin基因在喉癌组织及喉癌细胞株中的表达,探讨其在喉癌发生发展中的作用。方法 采用免疫组织化学技术,研究42例喉癌标本、20例癌旁组织、20例喉角化症、10例正常喉黏膜中Survivin 蛋白的表达情况;并用RT-PCR技术检测喉癌细胞株Hep-2中Survivin mRNA的表达。结果 正常喉黏膜中无Survivin表达, 喉癌组织中Survivin 蛋白的表达 (66.6 %) 明显高于癌旁组织 (40.0 %)和喉角化症(35.0 %)(P<0.001),喉癌组织中Survivin表达与临床分期、病理分级及有无颈淋巴结转移无明显相关性(P > 0.05)。喉癌细胞株Hep - 2中有较强Survivin mRNA的表达。结论 Survivin基因在喉癌组织及喉癌细胞株中的高表达可能与喉癌的发生关系密切,具体机制有待于进一步研究。     

Beclin1在喉鳞状细胞癌中的表达及其意义

目的 探讨自噬相关基因Beclin1在喉鳞状细胞癌(简称喉癌)中的表达及其与临床病理特征的关系.方法 采用免疫组织化学方法检测Beclin1蛋白在50例喉癌组织、45例癌旁组织、10例喉乳头状瘤及16例声带息肉组织中的表达情况,RT-PCR方法检测41喉癌组织、41癌旁组织和11例声带息肉组织中Beclin1 mRNA...     

抑癌基因CX26在喉鳞状细胞癌中的表达及临床意义

目的:观察抑癌基因CX26的mRNA和蛋白质在喉鳞状细胞癌中的表达情况,探讨CX26基因与喉鳞状细胞癌生物学行为的关系,及其与喉鳞状细胞癌发生和发展的分子机制。方法:38例喉鳞状细胞癌患者,每例患者均同时在喉癌切除手术时从喉癌肿瘤组织中心部位取癌组织(喉癌组),在肿瘤边缘外1.0cm部位取喉癌旁组织(对照组),分别采用半定量RT-PCR检测CX26mRNA的表达水平,冷冻切片免疫组织化学方法检测CX26蛋白的表达情况。结果:RT-PCR结果显示,CX26mRNA在喉癌组和对照组中均呈阳性表达;经半定量分析,CX26mRNA在喉癌组中的表达较对照组明显降低(P<0.05);免疫组织化学发现,CX26蛋白在18例(47.4%)患者的喉癌组织呈阳性表达,在34例(89.5%)患者的喉癌旁组织呈强阳性表达,CX26蛋白在两者中的阳性表达差异有统计学意义(P<0.05),并且伴有细胞内定位的改变;同时发现,CX26蛋白阳性表达率和CX26基因mRNA的表达水平在Ⅲ期和Ⅳ期喉癌组明显低于Ⅰ期和Ⅱ期(P<0.05),有颈淋巴结转移者明显低于无转移者(P<0.05),并且其表达水平随病理分化程度的降低而降低(P<0.05)。结论:CX26与喉癌的发生和发展关系密切,并可能与喉癌的预后有关。     

Treatment of Maxillary Sinus Carcinoma: Clinical Results Using the Kitasato Modality

The conventional therapeutic regimen for maxillary sinus carcinoma consists of dissection of the maxilla, full-dose irradiation and extensive chemotherapy. However, the results obtained with this treatment are often poor. Even when patients recover, their quality of life is significantly reduced as a result of deformity of facial structures and swallowing and articulation dysfunctions. A retrospective analysis of 68 patients with maxillary sinus carcinoma treated with the Kitasato modality between 1975 and 1999 was conducted. All patients underwent pergingival maxillary sinus surgery combined with pre- and postoperative irradiation therapy with standardized total doses of 16 Gy; the postoperative irradiation was given in combination with regional intra-arterial infusion chemotherapy administered via the superficial temporal artery. All visible tumor lesions were removed where possible in order to preserve or facilitate cellular immunity after surgery. The cumulative 5-year survival rates were 85.7% for Stage II patients, 88.1% for Stage III, 76.6% for Stage IVA and 75.0% for Stage IVB.     

Tongue Base Reduction with Temperature-controlled Radiofrequency Volumetric Tissue Reduction for Treatment of Obstructive Sleep Apnea Syndrome

In recent years a considerable effort has been made to establish the use of different surgical techniques for the treatment of obstructive sleep apnea syndrome (OSAS). Nevertheless, treatment of hypopharyngeal obstruction due to tongue base hypertrophy remains in many ways an unsolved problem. The aim of this study was to evaluate the safety and efficacy of tongue base reduction with temperature-controlled radiofrequency volumetric tissue reduction in the treatment of OSAS. Twenty patients with OSAS and tongue base hypertrophy were treated with radiofrequency tissue ablation. An intensified treatment protocol was used, delivering 2,800 J per treatment session under local anesthesia. Two nights of polysomnography testing were performed before and after treatment. Daytime sleepiness, snoring and postoperative morbidity were assessed using questionnaires. Mean respiratory disturbance index (RDI) was reduced from 32.1 to 24.9/h after a mean of 3.4 treatment sessions. Six patients (33%) were cured after the procedure (reduction in RDI of &#83 50% and a postoperative RDI of <15/h) and ten (55%) showed an improvement of >20% in their RDI. Daytime sleepiness and snoring improved significantly. Peri- and postoperative morbidity was low; one severe complication occurred (tongue base abscess). We were able to achieve similar cure and responder rates to those reported in a recently published pilot study but with a reduced number of treatment sessions. We believe that this technique may improve patient acceptance and have beneficial cost implications.     

Congenital nasal masses: diagnosis and management

One hundred and nine congenital nasal masses which presented to two children's hospitals over a 20 year period are reviewed. The diagnosis of the nasal mass is discussed with respect to age, mode of presentation, and site of the lesion, and a management protocol is advocated.     

Reverse Optokinetic After-nystagmus Generated by Gaze Fixation During Optokinetic Stimulation

Gaze fixation during optokinetic stimulation generates an after-nystagmus with a slow component towards the reverse direction of the optokinetic stimulation. The duration and maximum slow component velocity (SCV) of this "reverse OKAN" were observed by changing the duration, velocity and direction of the optokinetic stimulation in nine normal volunteers. The duration of reverse OKAN increased with increasing stimulation time but was unaffected by changes in the stimulation velocity. The maximum SCV of reverse OKAN decreased with an increase in the stimulation velocity but was not significantly affected by changes in the optokinetic stimulation time. There was no directional difference among the horizontal, upwards and downwards reverse OKANs. The reverse OKAN was thought to be generated by a mechanism different from the velocity storage mechanism which produced optokinetic nystagmus and the first phase of OKAN. Retinal slip during the optokinetic stimulation was considered to be an input to the mechanism which generated the reverse OKAN. We hypothesize that the mechanism causing the reverse OKAN may be a generator of the second phase of OKAN, which was also intimately connected with self-motion sensation during the optokinetic stimulation.     

Tissue-engineered human nasal septal cartilage using the alginate-recovered-chondrocyte method

OBJECTIVES: Tissue engineering of nasal septal cartilage has numerous potential applications in craniofacial reconstruction. Chondrocytes suspended in alginate gel have been shown to produce a substantial cell-associated matrix. The objective of this study was to determine whether cartilage tissue could be generated using the alginate-recovered-chondrocyte (ARC) method, in which chondrocytes are cultured in alginate as an intermediate step in tissue fabrication. METHODS: Nasal septal chondrocytes from five patient donors were isolated by enzymatic digestion, then expanded in monolayer culture. At confluency, a portion of those cells were seeded at high density onto a semipermeable membrane and cultured for 14, 21, or 28 days (monolayer group). The remaining cells were suspended in alginate and cultured until a cell-associated matrix was observed (10-17 days). Cells and their associated matrix were released from alginate (ARC group), seeded onto a semipermeable membrane, and cultured as already described. DNA (Hoechst 33258 Assay), glycosaminoglycan (GAG; dimethylmethylene blue assay), and collagen (hydroxyproline assay) were analyzed biochemically. Immunohistochemistry was performed to assess expression of collagens type I and type II. Histochemistry was performed to localize cells accumulating sulfated GAG (Alcian blue stain). RESULTS: The ARC constructs, in contrast to the monolayer constructs, had substantial structural stability and the histologic and gross appearance of cartilaginous tissue. ARC constructs demonstrated significantly greater GAG and collagen accumulation than monolayer constructs (P <.05). Histologic analysis revealed substantial GAG and collagen type II production and only moderate collagen type I production. The composition of the matrix was thus similar to that of native human septal cartilage. CONCLUSIONS: Tissue-engineered human nasal septal cartilage using the ARC method has the histologic and gross appearance of native cartilage and has biochemical composition more like that of native cartilage than monolayer constructs. This is the first report of human nasal septal neocartilage formation without the use of biodegradable scaffolds.     

Jaw osteosarcomas

Introduction

Osteosarcoma (OS) is the most frequent bone malignant tumor. It is usually found on long bones, 5 to 10% are located on jaws, accounting for 0.5 to 1% of all facial tumors. There is little published data which concerns only few patients. Our aim was to study retrospectively cases of facial bone OS in adults, and to compare our results with published data to suggest an optimal management scheme.

Patients and method

Thirty-three patients were managed for an OS, from January 1997 to January 2007. Fourteen patients with a maxillary and mandibular OS, treated in first-intention in our unit, were included. The following data were analyzed: age; personal history; circumstance of discovery; clinical, functional, and physical signs; loco-regional extension and metastasis radiological investigation. The histological slides were systematically reviewed. The protocol, therapeutic outcome, and follow-up were studied.

Results

The mean age at diagnosis was 43. Swelling was the most frequent functional sign. The mean delay before management was 3.4 months. The most frequent radiological presentation was a lytic and hyperdense image. The diagnosis was suggested after CT scan in 57.1% of cases. The biopsy was correlated to the anatomopathological analysis in 78.6% of cases. The most common treatment was surgical exeresis completed by chemotherapy. The 5-year survival rate was 50%.

Discussion

Jaw OS are specific because of their localization and specific bone ultrastructure. Their management remains controversial: should they be managed like limb OS or treated more specifically? Neoadjuvant chemotherapy, even if it delays exeresis for 3 months, seems to stop the growth or reduce the tumor. An early anatomopathological analysis of the surgical piece determines adjuvant therapy. The negative prognostic factors are: maxillary localization because of limited exeresis margins, tumoral size, and osteoblastic sub-type.     

Patterns of practice regarding surgical site infection prevention in head & neck surgery: An international survey

IntroductionHead & neck surgery encompasses a variety of surgical approaches for benign and malignant conditions. Due to the complexity in treating patients with head and neck pathology, it is necessary to adhere to basic surgical principles to decrease complications. Among them, surgical site infection can be prevented using a surgery quality protocol including the correct use of antibiotics and optimization of nutritional status.Materials and methodsA survey was sent through the YO-IFOS and SEORL-CCC international mailing list.ResultsA total of 435 surgeons completed the survey. Of the respondents, 97.7% confirm that they scrub their hands before surgery, 40.9% respondents recommend nutritional support according to sign and symptoms, 60.9% use of antibiotic prophylaxis in clean surgery and just 9.2% use clindamycin in combination.ConclusionThis survey has broadened the scope regarding H&N surgical safety around the globe. Identifying innovative ways in which surgical care may be improved is mandatory.