The presence of Helicobacter pylori in the larynx pathologies

Objective

The well-known relation of Helicobacter pylori to the MALT-lymphoma and gastric carcinoma suggested a possible presence in the laryngeal tissues of patients with squamous cell carcinoma of the larynx by using Polymerase Chain Reaction (PCR) investigations, and PCR results of benign laryngeal pathologies were compared.

Methods

Polymerase Chain Reaction investigations were carried out in biopsy samples of 21 patients with squamous cell carcinoma of the larynx and of 19 patients with benign laryngeal pathologies like vocal polyp and nodules.

Results

The PCR results of 17 out of the 21 samples (80.9%) of the patients with laryngeal squamous cell carcinoma were positive for H. pylori. Moreover, any genomic material of H. pylori was not found in the PCR results of the 19 patients with benign laryngeal pathology. It was also determined that the presence of the H. pylori in the patients with laryngeal squamous cell carcinoma was statistically significant (p = 0.0001).In the patients with laryngeal squamous cell carcinoma, the comparison of the H. pylori presence within the normal and tumoral tissues revealed that 16 normal tissue samples (76.19%) were positive, while 9 of the tumoral tissue samples (42.85%) were positive. The ratio of bacterial presence in both the normal and tumor tissue samples was 38.09% (8 patients). The rates of presence revealed a statistically significant difference between the normal and tumoral tissue samples (p = 0.039).

Conclusions

The presence of the genomic material of H. pylori within the laryngeal tissue of patients with squamous cell carcinoma of the larynx is a proof of the colonization of the bacterium in that tissue. While this may suggest a possible relation of the bacterium to the development of laryngeal squamous cell carcinoma, no conclusion is possible to be drawn about the mechanism of the process.     

Prevalence of Herpes Simplex Virus in Malignant Laryngeal Lesions

Objective: To determine the prevalence of herpes simplex virus (HSV) in malignant laryngeal lesions. Study Design: Retrospective review. Materials and Methods: Paraffin‐embedded, histologically confirmed specimens containing benign laryngeal lesions, squamous cell carcinoma of the larynx, and squamous cell carcinoma of the oral cavity were identified from archived surgical specimens. Biopsies of normal‐appearing oral cavity tissue were also obtained from fresh‐frozen cadavers. These tissues were analyzed for the presence of HSV DNA using polymerase chain reaction techniques. Patient charts were reviewed for patient demographics, risk factors, stage, clinical course, treatment, and outcome. Results: HSV was detected in nine laryngeal squamous cell carcinomas (75%) and in none of the benign laryngeal lesions (P = .0001). HSV was also found in three oral cavity squamous cell carcinomas (25%) and in none of the controls (P = .049). Conclusion: HSV is more prevalent in squamous cell carcinoma of the larynx and oral cavity than in their respective control groups, suggesting a role for carcinogenesis. HSV is more prevalent in squamous cell carcinoma of the larynx than of the oral cavity. Further studies to determine the role of HSV as a cocarcinogen and its interrelationship with other environmental factors in laryngeal cancer are warranted.     

Helicobacter pylori infection in laryngeal diseases

Clinical studies have shown that Helicobacter pylori can be found not only in the mucosa of the stomach, but in the pharyngeal and laryngeal regions as well. The aim of this prospective case-control study was to identify H. pylori infection in the biopsy material from the larynx of the patients suffering from benign laryngeal diseases (vocal fold polyps, laryngitis) and laryngeal cancer and to investigate the possible relationships between the laryngeal H. pylori and patients’ socio-demographic data and laryngopharyngeal reflux. The results of the biopsy material from 67 adult patients treated for benign laryngeal diseases and laryngeal cancer and 11 individuals of the control group revealed that H. pylori infection could be identified in more than one-third of the patients. In the majority of cases H. pylori was found in the patients with chronic laryngitis (45.5 %) and laryngeal cancer (46.2 %). The findings of these sub-groups significantly differed from those of the control group (9.1 %) (p < 0.05). No significant relationships between H. pylori infection found in the laryngeal region and patients’ demographic data, their unhealthy habits and reflux-related symptoms or signs were obtained. It could be concluded that H. pylori can colonize in the larynx of patients with benign laryngeal diseases and laryngeal cancer. To clarify the role of H. pylori as a risk factor for laryngeal diseases further research is needed.     

Prognostic significance and association of Helicobacter pylori infection in pharyngolaryngeal cancer

The aim of this study is to assess the correlation between the Helicobacter pylori (H. pylori) serologic status of patients who underwent for curative resection for squamous cell carcinoma of the larynx and hypopharynx and their prognosis. From April 2004 to March 2005, we included eighty patients with laryngeal and hypopharyngeal cancer. Control group consisted of 20 healthy patients and 10 patients with Reinke’s edema. Serologic status was assessed using an enzyme-linked immunosorbent assay kit for immunoglobulin G. Patients were followed for 5 years. H. pylori-positive serologic status was statistically significant for the case subjects (70.6 v/s 29.4 %; p < 0.001). Mean overall and disease-free survival were 50.7 months (range 46.9–54.5) and 52.1 months (range 48.3–55.7), respectively. H. pylori-positive serologic status was not associated with a poor prognosis in the Cox regression model (p = 0.77). We observed a positive association between H. pylori infection and laryngeal and hypopharyngeal cancer. But we fail to confirm that the presence of H. pylori infection is associated with poor outcome or a higher recurrence rate.     

Scandinavian and Danish Societies for Head and Neck Oncology

The following are the abstracts of the 3rd meeting held in Copenhagen, 19–20 April 1991 Prognostic value of Epstein-Barr virus titres in nasopharyngeal carcinoma J. Bentzen, P. Ebbesen, H. Albeck, N. Keldsen & H. S. Hansen Clinical radiobiology of oropharyngeal carcinoma S. M. Bentzen Patients with advanced head and neck carcinoma treated before irradiation with cisplatin and 5-fluorouracil A. Berthelsen Cancer of the oropharynx: incidence reports for 1985 from Denmark, Finland, Norway and Sweden A. BIÖRKLUND, M. BOYSEN, H. S. HANSEN & H. PUHAKKA Evaluation of malignancy in oral carcinoma T. BUNDGAARD, F. B. SORENSEN, M. GAIHEDE, H. SØGAARD & J. OVERGAARD Epidermal growth factor receptor expression in normal oral mucosa, dysplasia and squamous cell carcinoma M. CHRISTENSEN, M. H. THERKILDSEN, H. ALBECK, P. BRETLAU Nimorazole as a hypoxic cell radiosensitizer in laryngeal and pharyngeal carcinoma. DAHANCA Protocol 5–85 The Danish Head and Neck Cancer Study Group Surgical complications after 50–60 Gy preoperative irradiation for carcinoma of the tongue R. GRÉNMAN, H. JOENSUU, J. SUONPÄÄ, K. AITASALO, H. PUHAKKA & E. NORDMAN Analysis of tumour growth in human squamous cell carcinoma of the head and neck region after iododeoxyuridine labelling in vivo H. GUSTAFSSON, C. BERGSTRÖM, K. NYLANDER, G. ROOS, R. STENLING & B. ZACKRISSON Importance of the time interval between preoperative radiotherapy and surgery in the treatment of oral cavity cancer O. HANSEN, J. SØRENSEN, S. SIEMSSEN & H. POULSEN Phase II trial of accelerated hyperfractionated radiotherapy in cancer of the larynx N. V. JENSEN, & L. BASTHOLT Carbacholine in the treatment of radiation induced xerostomia H. JOENSUU, P. BOSTRÖM, T. MAKKONEN & R. GRENMAN Squamous cell carcinoma of the oropharynx: therapeutic results in a series of 105 patients J. JOHANSEN & K. JØRGENSEN Radiotherapy of oropharyngeal squamous cell carcinoma L.V. JOHANSEN & J. OVERGAARD Surgical treatment of advanced oropharyngeal carcinoma J. KIRKEGAARD The status of the on-going Scandinavian study of induction chemotherapy in advanced squamous cell carcinoma of the head and neck F. Lewin Induction chemotherapy in advanced squamous cell carcinoma of the head and neck F. LEWIN, J. WENNERBERG & C. MERCKE Squamous cell carcinoma of the oropharynx: primary radiotherapy, treatment schedules and results B. LINDELØV, J. MONBERG & H. S. HANSEN The management in Scandinavia of small squamous cell carcinomas of the mobile tongue A. NATHANSON, H. HJARTARSON, A. B. JACOBSEN, J. KIRKEGAARD & J. PUKANDER Examination and rehabilitation of the oral cavity in treatment of orofacial tumours O. ODELBERG-JOHNSON, A. NILSSON & I. JÄRNESTEN Protein kinase activity in squamous cell carcinoma and normal mucosa of the oral cavity E. L. RYDELL, K. L. AXELSSON, S. HELLEM & J. OLOFSSON Evaluation of swallowing disorders of patients with head and neck cancer treated by surgery and/or radiotherapy. A rehabilitation programme N. SANDBERG, S.-Å. ALMQVIST, H. DOTEVALL, M. RUTH & P. SVENSSON A phase-III study of adjuvant 13-cis retinoic acid in squamous cell carcinomas of the mouth, pharynx and larynx P. WAHLBERG, J. WENNERBERG, A. ASK, G. FEX, L.E. RUTQVIST & F. LEVIN Heterogeneous DNA content in oral squamous carcinoma M. TYTOR, S. WINGREN & J. OLOFSSON Chemotherapy for recurrence of squamous cell head and neck cancer using infusion pumps J. WITTEN & A. Berthelsen     

Detection and Typing of Human Papillomavirus DNA in Benign and Malignant Tumours of Laryngeal Epithelium

The role of human papillomaviruses (HPV) in laryngeal squamous cell carcinoma has not yet been established. Thirty-three cases of laryngeal squamous cell carcinoma were analysed for the presence of HPV DNA and compared with 25 cases of normal larynx and 29 cases of laryngeal squamous papilloma in their positivity index. The presence of HPV DNA was analysed by using L1 consensus primers and also by primers specific for the E7 gene of HPV types 16 and 18. Four normal laryngeal samples (16%) were positive for HPV DNA against the 24 samples (82%) (p&lt;0.001) found for laryngeal papilloma and 16 (48.5%) (p&lt;0.05) found for laryngeal squamous cell carcinoma. HPV 16 was the type most frequently found in laryngeal carcinoma samples. Our results support an etiologic role for this type of HPV in the pathogenesis of laryngeal carcinoma.     

CD45RO在喉鳞状细胞癌中的表达及临床意义

目的：探讨喉鳞状细胞癌中cD45RO的表达及其临床意义,为喉鳞状细胞癌的预后评估提供新的思路,及为其生物治疗提供理论依据。方法：2010—01—2012—12期间我院确诊并手术治疗的初发喉鳞状细胞癌标本50例。另取10例喉部正常黏膜作对照分析。所有标本均经10％甲醛固定,石蜡包埋、切片。采用免疫组织化学、苏木精伊红染色方法检测CD45RO的阳性表达,分析其与喉鳞状细胞癌临床病理特征之间的关系。结果：CD45RO在正常组织及喉鳞状细胞癌中的阳性表达率分别为30％、86％。在50例喉癌病例中,CD45RO与局部淋巴结转移呈负相关（r=-0．713,P〈0．05）,与肿瘤分区呈负相关（r=-0．750,P〈0．05）,与年龄、T分类、病理分化程度、临床分期无明显相关性。结论：①CD45RO在喉鳞状细胞癌组织中的表达高于正常喉黏膜组织中的表达;②CD45RO过表达可能减少区域淋巴结转移;③CD45RO过表达可能有利于喉鳞状细胞癌患者的预后;④传统UICC—TNM分期、组织学分级评估预后不同,通过对CD45RO的检测可以从另外一个角度评估喉鳞状细胞癌的预后情况。     

Antigen retrieval: p53 staining in benign,pre-malignant and malignant tissues of the larynx

Antigen retrieval techniques have been reported to increase p53 detection. Using an antigen retrieval technique applied to immunohistochemistry, a study was performed on 67 laryngeal lesions (21 benign, 16 carcinoma in situ, 30 squamous cell carcinoma). p53 staining was observed in 30% of carcinoma in situ specimens and 53% of squamous cell carcinomas but was not detected prior to antigen retrieval in any benign lesion. However, over-expression of p53 was identified in 92.5% of benign lesions after antigen retrieval using the microwave oven heating. There was also increased p53 staining in both the carcinoma in situ (43.7%) and squamous cell carcinomas (30.0%) after antigen retrieval. We conclude that antigen retrieval using microwave oven heating increases immunohistochemical detection of p53 such that positive staining is observed in benign conditions. We postulate that this apparent over-expression is a manifestation of the wild-type protein, which may be found in more evidence in basal cells than suprabasal cells. Our results thus offer a cautionary note to such studies involving squamous cell cancers that attempt to correlate p53 over-expression with clinical parameters.     

MIF、GSK-3β在喉鳞状细胞癌中表达的临床意义及相关性研究

目的 探讨巨噬细胞移动抑制因子(MIF)及糖原合成激酶-3(GSK-3β)在喉鳞状细胞癌中表达的临床意义及相关性。 方法 采用免疫组化法检验30例喉癌患者癌组织及相应癌旁组织中MIF、GSK-3β的表达情况,并以10例非喉鳞状细胞癌患者喉部正常黏膜组织作对照;分析喉组织中MIF、GSK-3β表达与患者临床病理因素之间的关系,探讨喉鳞状细胞癌中MIF与GSK-3β表达的相关性。 结果 喉癌组织中、癌旁组织及喉正常喉黏膜中MIF表达率分别为73.33%,40.00%,20.00%,喉癌组织中、癌旁组织及喉正常喉黏膜中GSK-3β阳性表达率分别为70.00%,13.33%,20.00%;MIF、GSK-3β在喉癌中表达与肿瘤分化程度、TNM分期及淋巴结转移均相关(P<0.05);与患者年龄、性别、吸烟史和饮酒史均无相关性(P>0.05)。MIF、GSK-3β在喉癌中的表达具有相关性(r=0.592,P=0.003)。 结论 喉鳞状细胞癌中MIF、GSK-3β的高表达可促进喉癌的发生及发展,MIF、GSK-3β可作为喉癌的潜在的组织生物标志物和喉癌患者疾病进展监控及预后观测的指标。     

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。     

α-甲基酰基辅酶A消旋酶在喉癌中的表达

目的研究α-甲基酰基辅酶A消旋酶(AMACR)在喉癌中的表达,初步探讨AMACR在喉鳞癌生物学行为中的意义。方法用免疫组织化学EliVisionTMplus二步法(福州迈新)检测40例原发喉鳞癌、20例声带息肉及10例癌旁组织中AMACR的表达情况。结果40例喉癌中13例(32.5%)存在不同程度的AMACR表达,在20例声带息肉和10例正常喉组织中无AMACR表达,差异有统计学意义(P<0.01)。AMACR在高分化鳞癌和中、低分化鳞癌中表达的阳性率分别为50%、15%,差异有统计学意义(P<0.05),Ⅰ、Ⅱ期与Ⅲ、Ⅳ期喉癌AMACR阳性率无统计学意义,AMACR表达与性别、肿瘤部位、颈淋巴结转移无统计学意义(P>0.05)。结论AMACR在喉鳞癌中有阳性表达,其表达可能与分化有关,与性别、部位、临床分期、颈淋巴结转移无明显相关性。     

Preoperative circulating C‐reactive protein levels predict pathological aggressiveness in oral squamous cell carcinoma: A retrospective clinical study

Clin. Otolaryngol. 2011, 36 , 147–153 Objectives: Previous studies have demonstrated a relationship between elevated serum C‐reactive protein (CRP) levels and shorter survival in cancer patients. Few studies, however, have investigated the role of serum CRP levels in oral squamous cell carcinoma. The present study was conducted to analyze the relationship between preoperative CRP levels, clinicopathologic factors, and prognosis in oral squamous cell carcinoma patients. Design: Retrospective clinical study. Setting: University teaching hospital. Participants: Eighteen oral cavity leukoplakia and 59 oral squamous cell carcinoma patients between November 2006 and November 2009 from the Chang Gung Memorial Hospital. Outcome measures: Clinicopathologic parameters, disease‐free survival and overall survival were correlated with CRP levels. Methods: Serum CRP levels were measured preoperatively, and all oral cavity cancer patients underwent curative intent radical surgery with or without postoperative adjuvant therapy. Results: The CRP levels in leukoplakia patients were used to analyze if factors (including diabetes and liver cirrhosis, smoking, alcohol drinking and areca quid chewing) influence CRP levels, and the results demonstrated they were not associated with CRP elevation (> 5.0 mg/L) (P > 0.05). In oral cancer patients, elevated CRP levels were associated with tumor status (P = 0.005), tumor stage (P = 0.054), bone invasion (P = 0.033), lymph node metastasis (P = 0.004) and lymph node extra‐capsular spread (P = 0.018). Patients with higher CRP levels showed poorer disease‐free survival (log rank test, P < 0.001) and overall survival (log rank test, P = 0.013). Conclusions: Preoperative serum CRP levels are associated with advanced tumor stage, bone invasion, lymph node metastasis, lymph node extra‐capsular spread and patients’ survival. CRP is thus potentially a prognostic indicator, but studies with longer follow‐up will be needed to confirm its reliability.     

A possible role ofHelicobacter pylori infection in the etiology of chronic laryngitis

In order to study a possible role ofHelicobacter pylori infection in chronic laryngitis, we performed endoscopic and histological assessments in addition to a urease test for the bacterium in 35 patients with chronic hoarseness. Six of the patients investigated (17.1%) revealed a positive urease test of the laryngeal biopsy (four male and two female patients). TheseH. pylori-positive patients were treated with omeprazole and an antibiotic regimen using clarithromycin and metronidazole. This led to an eradication of theH. pylori and resolution of clinical signs and symptoms. These findings show a possible role ofH. pylori infection in the etiology of chronic laryngitis in certain patients and can be important for clinical diagnosis and treatment.     

Prognostic Value of EGFR and TGF-α in Early Laryngeal Cancer Treated With Radiotherapy

The purpose of this study was to determine the overexpression of both epidermal growth factor receptor (EGFR) and transforming growth factoralpha(TGF-α) (a ligand of EGFR) in early laryngeal squamous cell carcinoma. In addition, we attempted to evaluate the prognostic values of our findings. Expression of EGFR and TGF-α in tumor tissue was examined immunohistochemically in 68 patients who had been treated with radiotherapy for early laryngeal cancer. Overexpression of the two factors was noted in 42.6% and 55.9%, respectively. No significant differences due to age, tumor size, and location or grade of cancer tissues were seen. Higher survival rates, found in patients with EGFR (-) and TGF-α (-) tumors as compared with those with EGFR (+) and TGF-α (+) (97.4%, 100% and 86.2%, 86.8%, respectively), were not statistically significant. The recurrence rates were similar between EGFR (+) and EGFR (-) (37.9% and 35.9%, respectively). However, the recurrence rate in patients with TGF-α (+) was significantly higher (57.9%) than in those with TGF-α (-) (10%; P<.01). Therefore overexpression of TGF-α may be an important indicator for recurrence in patients with early laryngeal squamous cell carcinoma treated by irradiation. Laryngoscope, 106:884-885, 1996     

The presence of Helicobacter pylori in laryngeal squamous cell carcinoma

A definitive relationship between Helicobacter pylori (HP) and upper respiratory tract disorders has not been established. In this case–control study, we investigated the relationship between HP and laryngeal carcinoma by real-time PCR method in Turkey. 74 subjects were enrolled from patients who were admitted to the Otolaryngology Department. Formalin-fixed-paraffin-embedded tissue samples with laryngeal cancer were used and all samples were evaluated by real-time PCR method. Our study population included 72 males and 2 females with a mean age range of 62.7 years. Helicobacter Pylori was detected in only one case. The positive case was also investigated with histopathologic evaluation and HP immunohistochemistry. However, we could not detect HP in this case with both methods. This study revealed that HP might not contribute to the pathogenesis of laryngeal carcinoma. A definitive relationship between HP and upper respiratory tract disorders has not been established.     

Laser Doppler flux‐metry in laryngeal squamous cell carcinoma

Laser Doppler flux‐metry in laryngeal squamous cell carcinoma Tumour angiogenesis has recently attracted a great deal of attention as a critical part of oncogenesis and a necessary prerequisite for a malignant phenotype. Novel antiangiogenic therapy for solid tumours including laryngeal cancer is entering clinical trials. Quantifying microvessel density is considered the gold standard for measuring baseline angiogenesis and indeed ‘the response to intervention’. We hypothesize that laser Doppler flux‐metry could provide a non‐invasive reliable method of quantifying blood flux within tumours. The aims were to determine whether a laser Doppler flux meter could be used as a reliable and reproducible method of estimating blood flux in the human larynx and to establish baseline Doppler flux recordings for the human larynx. The method used was a validation study in patients with laryngeal squamous cell cancer and normal controls. Statistical analysis was performed using SPSS software. We have demonstrated good reproducibility of laser Doppler measurements in human laryngeal mucosa (correlation coefficient 0.956 @P = 0.01). We have also derived arbitrary means of laser Doppler flux‐metry in normal laryngeal mucosa and in squamous cell carcinoma of the larynx. Comparisons between normal and tumour laser Doppler flux‐metry (LDF) readings showed no significant difference. We suggest that Laser Doppler flux‐metry is a potentially useful tool with which to study blood flow in the larynx and propose arbitrary LDF levels for the normal and diseased human larynx.     

Bcl‐Xl protein expression in laryngeal squamous cell carcinoma

Bcl‐X1 protein expression in laryngeal squamous cell carcinoma The Bcl‐2 family of proteins regulate one of the steps in an evolutionary conserved apoptotic pathway. The long splice variant of Bcl‐X (Bcl‐Xl) is a potent antagonist of apoptosis. The aim of the study was to evaluate the relation between the presence of immunohistochemically detectable Bcl‐Xl protein in laryngeal squamous cell carcinomas (LSCCs) and clinicopathological data, as well as DNA ploidy status and proliferative activity. In 50 specimens of LSCC, Bcl‐Xl protein expression was evaluated immunohistochemically. Proliferative activity (SG₂M‐phase index) and DNA ploidy were measured by flow cytometry. In our study, Bcl‐Xl protein expression decreased with decreasing tumour differentiation (P = 0.04). The majority of patients with Bcl‐Xl protein immunoreactivity had no metastatic lymph node involvement (P = 0.01). Other factors such as age, gender, primary tumour size (pT) and type of cancer (keratinizing/non‐keratinizing) were not associated with Bcl‐Xl protein level. There was no correlation between Bcl‐Xl protein and SG₂M‐phase index or DNA ploidy status. Our findings show that expression of Bcl‐Xl protein is increased in a great fraction of laryngeal cancers. Further studies, however, are needed to clarify association between Bcl‐Xl protein expression and clinical course of patients.     

Investigating <Emphasis Type="Italic">Helicobacter pylori</Emphasis> in nasal polyposis using polymerase chain reaction,urease test and culture

The aim of this study was to identify the presence of Helicobacter pylori in nasal polyp specimens of patients with nasal polyposis. A cross-sectional study with control group was performed on fresh tissue samples from 25 patients with nasal polyps, and 25 persons with concha bollusa (control group). Patients with symptoms of gastroesophageal reflux (GERD) were not enrolled. Samples were studied by three methods: polymerase chain reaction (PCR), culture, and urease test. All the diagnostic tests were negative for H. pylori in both the case and control groups. In conclusion, there was no association between H. pylori and nasal polyposis in patients without GERD signs or symptoms in our study, and further studies are needed to assess other potential factors that may influence the development of nasal polyposis.