喉癌细胞增殖活性与组织学恶性度及预后关系的研究

应用增殖细胞核抗原（ＰＣＮＡ）单克隆抗体ＰＣ１０免疫组化法、ＤＮＡ图像分析法及核分裂像计数对７０例喉鳞状细胞癌的增殖活性进行检测。结果显示，三咱方法的检测结果具有较好的一致性。细胞增殖活性与喉癌的组织学分化程度及患者的五年生存率有密切关系（Ｐ＜０．０１，Ｐ＜０．０１）。结果表明，检测肿瘤细胞增殖活性对于判断喉癌的恶性度及估计患者的预后具有重要的意义。     

喉癌病人血清中白细胞介素－2受体和腺苷脱氢酶检测

本文应用双抗体夹心法检测喉癌病人血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ），同时还应用次氯酸钠测氨法检测血清中腺苷脱氢酶（ＡＤＡ）活性，检测结果表明，喉癌病人ｓＩＬ－２Ｒ水平明显高于正常对照组（Ｐ＜０．０１）。差异非常显著，而腺苷脱氢酶活性则低于对照组（Ｐ＜０．０１），尤其是ｓＩＬ２Ｒ水平与喉癌分型、分期有关。     

喉癌患者细胞免疫状态观察

为了观察喉癌患者细胞免疫状态，应用免疫组化技术对７０例喉癌患者的外周血Ｔ淋巴细胞亚群（ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ４／ＣＤ８）测定，并观察肿瘤组织中的浸润Ｔ淋巴细胞。结果表明：喉癌患者ＣＤ３、ＣＤ４明显低于健康人（Ｐ＜０．０５），ＣＤ８明显高于健康人（Ｐ＜０．０１），ＣＤ４／ＣＤ８明显低于健康人（Ｐ＜０．０１）。晚期喉癌患者ＣＤ４显著低于早期患者（Ｐ＜０．０１），外周血Ｔ淋巴细胞亚群检测与观察肿瘤组织中的Ｔ淋巴细胞浸润程度所表现细胞免疫状态是一致的。     

增殖细胞核抗原在喉上皮癌前病变中的表达及意义

用免疫组化技术对１１例喉上皮单纯性增生（ＳＨＥ），３２例非典型性增生（ＡＨＥ）及４２例喉鳞状细胞癌（ＬＳＣＣ）的增殖细胞核抗原（ＰＣＮＡ）表达进行了原位检测。结果表明；在ＳＨＥ、ＡＨＥ及ＬＳＣＣ中，ＰＣＮＡ指数分别为９．５７％、２７．３３％、６８．０５％，差异极有显著性意义（Ｐ＜０．００１）。在轻、中、重度ＡＨＥ中，ＰＣＮＡ指数分别为１３．７９％、３０．８４％、３９．９４％，差异有非常显著性意义（Ｐ＜０．０１）。提示ＰＣＮＡ表达程度与非典型性增生程度密切相关，是反映细胞增殖状态的生物标志，ＰＣＮＡ组化研究有助于认识喉癌前病变的本质，发展趋势及喉癌的早期诊断。     

喉癌患者血清肿瘤坏死因子水平及其临床意义

本实验通过对正常人及喉癌病人血清中肿瘤坏死因子（ＴＮＦ）活性的测定，发现两者之间差异显著（Ｐ＜０．０１），喉癌患者的血清ＴＮＦ明显高于正常人，这一结果表明：ＴＮＦ的产生与肿瘤直接相关，动态观察血清中ＴＮＦ活性变化；可作为推测病人病情变化的血清学指标。     

晚期喉癌边缘DNA含量和增殖细胞核抗原表达

目的探讨晚期喉癌边缘ＤＮＡ含量和增殖细胞核抗原（ＰＣＮＡ）表达与喉癌手术预后的关系。方法通过ＰＣＮＡ表达和ＤＮＡ含量检测，对３４例晚期喉癌边缘进行观察。结果肿瘤边缘１．０、０．５、０ｃｍ处粘膜，ＰＣＮＡ指数分别为８．６２％、１７．７６％和５０．３２％。ＤＮＡ指数分别为０．９８、１．０８２和１．４３６。统计学分析，１．０、０．５ｃｍ处粘膜与０ｃｍ处粘膜差异有显著性（Ｐ＜０．０１）。结论中、重度非典型增生的上皮在分裂，增殖等生物学行为方面已与轻度非典型增生和单纯性增生的上皮细胞不同，手术切缘应在中度非典型性增生的粘膜上皮以外，即０．５ｃｍ以外。     

喉癌下咽癌手术对甲状腺功能的影响

用放射免疫分析法对２０例喉癌下咽癌患者和２０例鼻肿瘤病人术前和术后外周血清Ｔ３、ＦＴ３、Ｔ４、ＦＴ４及ＴＳＨ测定，发现喉癌下咽癌病人术前Ｔ３及ＦＴ３较对照组呈下降趋势（Ｐ＜０．０１），且术后Ｔ３及ＦＴ３水平较术前明显下降（Ｐ＜０．０１），一般术后１０天之内恢复正常，鼻肿瘤组无此临床现象。结果显示喉癌下咽癌甲状腺功能减退，手术创伤使甲状腺功能进一步减退。建议在喉癌、下咽癌综合治疗中，应进行甲状腺功能动态测定并及时补充甲状腺激素。     

喉癌中P_53基因突变

本文采用ＰＣＲ技术对４例正常喉组织、１０例正常白细胞、３３例喉癌组织，进行Ｐ５３基因的５－６和７－８外显子检测，结果发现喉癌中Ｐ５３基因突变率为６９．６９％（２３／３３）（Ｐ＜０．０１），其中５－６外显子突变率为２４．２４％（８１３３），７８外显子突变率为４５．４５％（１５／３３）。各期喉癌Ｐ５３基因突变率无明显差异（Ｐ＞０．０５）。研究表明Ｐ５３基因的突变是喉癌发生发展过程中的一个重要机制。     

成纤维细胞生长因子与鼻息肉上皮细胞增殖

为探讨成纤维细胞生长因子（ｆｉｂｒｏｂｌａｓｔｇｒｏｗｔｈｆａｃｔｏｒ,ＦＧＦ）在鼻息肉组织中的表达及其与鼻息肉上皮细胞增殖之间的关系,将２６例鼻息肉标本及１４例下鼻甲标本行ＦＧＦ和增殖细胞抗原（ｐｒｏ－ｌｉｆｅｒａｔｉｎｇｃｅｌｎｕｃｌｅａｒａｎｔｉｇｅｎ,ＰＣＮＡ）的免疫组化染色,光镜观察,结果发现ＰＣＮＡ在鼻息肉组的阳性率（７８．６％）显著高于下鼻甲组（０．０％）,ＦＧＦ在鼻息肉组的上皮及腺体的阳性表达率明显高于下鼻甲组（Ｐ＜０．０１,Ｐ＜０．００１）,且二者的表达具有显著正相关（Ｐ＜０．０１）。我们推测ＦＧＦ对鼻息肉上皮及腺体细胞的增殖具有促进作用并参与鼻息肉的形成。     

晚期喉癌边缘DNA含量和增殖细胞核抗原表达

目的 探讨晚期喉癌边缘ＤＮＡ含量和增殖细胞核抗原（ＰＣＮＡ）表达与喉癌手术预后的关系。方法 通过ＰＣＮＡ表达和ＤＮＡ含量检测，对３４例晚期喉癌边缘进行观察。结果 肿瘤边缘１．０、０．５、０ｃｍ处粘膜，ＰＣＮＡ指数分别为８．６２％，１７．７６％和５０．３２％。ＤＮＡ指数分别为０．９８、１．０８２和１．４３６。统计学分析１．０、０．５ｃｍ处粘膜０ｃｍ处粘膜差异有显著性（Ｐ〈０．０１）。结论 中、重度非     

Papillomavirus and head and neck cancer

Tobacco and alcohol consumption are the main risk factors for head and neck cancers. Papillomavirus (HPV) infection was recently associated with the development of malignant tumors of the oropharynx, according to molecular and biological arguments. We describe the oncogenic mechanisms of HPV infections, the epidemiological and clinical aspects of associated head and neck cancers, their prognosis, and issues of specific therapeutic strategies.     

Nutrition and taste and smell dysfunction

Food selection plays a pivotal role in maintaining adequate nutrient intake, thus elucidating drivers of food choice is a meaningful strategy to maintain health and manage disease. Taste and smell are key determinants of food choice and warrant careful consideration. In this review, we first discuss how sensory stimulation influences food selection and metabolism. We then review the evidence regarding the relationship between taste and smell dysfunction and food preferences and selection, with attention given to contexts of certain chronic diseases. We conclude with brief recommendations for the management of chemosensory disorders. While sensory abilities influence food selection, the effect of taste and smell dysfunction on long-term consumption patterns and health status must be considered in light of environment, exposure, and culture.     

紫杉醇与头颈部肿瘤

为了解紫杉醇治疗鼻咽癌、喉癌及其他头颈部肿瘤的疗效及作用机理，本文分析了近年来的文献27篇。紫杉醇通过稳定微管、阻断细胞的有丝分裂和增殖，从而显著地抑制肿瘤细胞的生长并促进细胞调亡，在头颈部肿瘤同期放化疗中能起到放疗增敏作用，单独或联合其他抗癌药物治疗亦有较佳的疗效。紫杉酵是一种具有良好抗癌活性的药物，随着研究的深入，将会在头颈部肿瘤的治疗中发挥更大的作用。     

Pepsin and Laryngeal and Hypopharyngeal Carcinomas

Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, and the incidence of both is increasing. Laryngopharyngeal reflux refers to the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. It remains controversial whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria that colonize the gastrointestinal tract. Loss of epithelium in the mucous membrane of the larynx and hypopharynx is thought to be caused by pepsin. Here, we review the relationships between laryngopharyngeal reflux and both laryngeal and hypopharyngeal carcinomas, as well as the significance of pepsin, methods of clinical detection, and the mechanism of carcinogenesis.     

Head and neck anatomy and ultrasound correlation

Thorough knowledge of the complex anatomy of the head and neck is essential to understanding the ultrasonographic appearance of this region. The intimate familiarity with anatomic structures obtained by performing surgical procedures makes active radiographic imaging modalities like ultrasound especially suited for use by surgeons. An understanding of the normal sonographic appearance of head and neck structures is critical to recognizing abnormal pathology.     

Tobacco and otorhinolaryngology: Epic and disaster

More than 500 papers are retrieved from the PubMed database by the keywords “Tobacco” and “Otorhinolaryngology”, none of which, however, is devoted to the history of a plant that has a major impact on our specialty and practice. The present report describes and analyzes how tobacco conquered the world, the conflicts it triggered and the impact it has had in our field over the past centuries.     

鼻窦解剖及其变异与鼻窦炎和手术的关系

目的 探讨鼻窦解剖及其变异对鼻窦炎和手术的治疗。方法 观察１００具颅骨、１０个尸头,复习７５０例鼻窦炎鼻窦冠状ＣＴ和１０００例内窥镜鼻窦手术记录,研究中鼻甲、钩突、上颌窦自然口和鼻囟门（含上颌窦骨性裂口）、前鼻颅底、筛蝶区域和鼻中隔的解剖学和影像解剖学,分析解剖、变异与鼻窦炎和手术的关系。结果 ①中鼻甲、钩突、前鼻颅底、筛蝶区域和鼻中隔均存在解剖变异;②中鼻甲、钩突和鼻中隔的变异在有鼻窦炎侧明显多