Occult nodal metastasis in head and neck carcinoma patients treated with chemoradiotherapy

Background and aimNeck lymph node metastasis plays an important role in the prognosis of patients with squamous cell carcinoma of the head and neck. The aim of this study was to evaluate the occult nodal metastasis in patients with head and neck squamous cell carcinoma (HNSCC) treated with chemo radiotherapy.MethodsIn this 5-year prospective study, patients with recurrent head and neck squamous cell carcinomas (HN-SCC) after primary treatment with chemoradiotherapy or radiotherapy that candidate for surgery were enrolled. In total, 50 patients with squamous cell carcinomas of the head and neck with N0 neck were included in the study. Age, initial location of recurrent tumor, T staging in primary and recurrent tumors, neck condition (N0 or N+), and pathology report for neck metastasis, number of affected lymph nodes and duration of tumor recurrence were examined.ResultsOut of 50 patients with mean age of 57.04 ± 14.4 years, 13 were female (26%) and 37 (74%) were male. In terms of primary tumor size, 52% (26 patients) were in T2 stage. The primary and recurrent tumor was located in the oral cavity in 33 patients (66%). Nine 0f 50 patients (18%) had occult metastases.ConclusionIt seems that END surgery is necessary for treatment the occult lymph node neck metastasis of recurrent head and neck cancers with N0 neck. Therefore, it is possible that END surgery has reduced cervical recurrence in these patients.     

Programmed death ligand-1 expression is associated with stage and histological grade of parotid carcinoma

Abstract

Background: The immune checkpoint ligand programmed death ligand-1 (PD-L1) is expressed by various cancers, including those of the head and neck. However, the role of PD-L1 is still unknown.

Objectives: To investigate the relationship between PD-L1 expression and survival rate in parotid carcinoma.

Methods: PD-L1 expression was investigated by immunohistochemical analysis in 127 patients with parotid carcinoma. The relationship between PD-L1 expression and stage, histological grade, and survival was assessed.

Results: PD-L1 expression was found in 28.3% of parotid carcinomas, with the expression being higher in tumors with a higher stage, a higher-grade, and node positive cases. However, the 5-year disease-specific survival rate was 82.2% for the patients with PD-L1 positive and 86.9% for those with PD-L1 negative tumors, showing no significant difference.

Conclusions: PD-L1 expression was positive in approximately 50% of high- grade carcinomas, which was similar to the level in head and neck squamous cell carcinoma. In patients with other cancers, it has been reported that an anti-PD-1 monoclonal antibody was more effective against tumors with higher PD-L1 expression. Therefore, it could be a possible new therapeutic option for patients with highly malignant parotid tumors that have a poor prognosis.     

Analysis of microsatellite instability in laryngeal squamous cell carcinoma

Introduction and objectivesThe literature on the involvement of microsatellite instability in head and neck squamous cell carcinoma shows great variability, probably due to differences in the testing methods. Using a consensus detection system, we aimed to reach a reliable estimate of microsatellite instability prevalence in a subset of head and neck squamous cell carcinoma cases.MethodsThe microsatellite instabilityI status of 43 patients with previously untreated primary laryngeal squamous cell carcinomas was analyzed by a multiplex polymerase chain reaction assay including 5 mononucleotide repeat markers.ResultsThirty-six cases showed a stable phenotype or a microsatellite stable phenotype (83.7%) and 7 cases (16.3%) showed an microsatellite instability-positive phenotype. One case showed instability in 3 of 5 markers, 1 case in 2 markers and 5 cases in 1 marker. The microsatellite instability-positive and stable cases did not differ with respect to age, tumour stage, lymph node or distant metastases.ConclusionsOur data showed that a proportion of laryngeal squamous cell carcinomas are microsatellite instability positive. Knowledge of microsatellite instability patient status will allow adjusting anticancer therapy at an individual level.     

Association of Mycoplasma Hominis and head and neck cancer with unknown primary

IntroductionBeside HPV infection, there is currently no evidence of association between head and neck squamous cell carcinomas and microbial infections. We report the case of a cervical squamous cell carcinoma by Mycoplasma hominis.Case summaryA 20-year-old woman, consulted for a swelling on the left cervical side. Clinical examination found a large fixed mass. Biological tests found no evidence of infection. Biopsies of the cervical lesion diagnosed an HPV negative squamous cell carcinoma. Microbiological tests of 16sRNA identification showed the presence of Mycoplasma hominis in the 3 specimens. The patient was treated by induction chemotherapy associated to antibiotherapy, followed by chemo-radiotherapy.DiscussionThe present case suggests that oropharyngeal infection by Mycoplasma hominis might be more frequent than expected, that 16sRNA is an efficient technique to isolate this pathogen and finally that further studies are required to document its potential oncogenic role in head and neck squamous cell carcinomas.     

Cell kinetic markers in cutaneous squamous and basal cell carcinoma of the head and neck

IntroductionProliferation markers play a significant role in the biologic behavior of tumors. Geminin is a known inhibitor of the cell cycle and DNA replication and has not been previously reported in cutaneous basal and squamous cell carcinomas of the head and neck.ObjectivesWe aimed to investigate proliferation markers ki67, MCM2, and geminin in head and neck cutaneous basal and squamous cell carcinomas.MethodsForty cases of each tumor were immuostained with ki67, MCM2, and geminin followed by assessment of labeling indices (LIs). MCM2/ki67- and geminin/ki67-ratios were also determined; t-test was used for statistical analysis (p < 0.05).ResultsThere was no significant difference in ki67 (p = 0.06) and MCM2 (p = 0.46) between cutaneous basal and squamous cell carcinomas; however, geminin LI was significantly higher in squamous cell carcinomas compared to cutaneous basal cell carcinomas (p < 0.001). Only geminin/ki67 showed a significant difference between the two tumors with the ratio showing significantly higher numbers in squamous cell carcinomas (p = 0.015).ConclusionsGeminin could be regarded as an effective factor in the pathogenesis of head and neck cutaneous cutaneous basal cell carcinomas and squamous cell carcinomas and may be one of the responsible elements in the difference between the biologic behavior of these tumors.     

Better outcome for parotid versus neck metastasis of head and neck cutaneous squamous cell carcinoma: a new report on reemerging data

IntroductionRegional metastases of cutaneous head and neck squamous cell carcinoma occur in approximately 5 % of cases, being the most important prognostic factor in survival, currently with no distinction between parotid and neck metastasis.ObjectiveThe purpose of this study was to evaluate the prognostic features among patients with head and neck cutaneous squamous cell carcinoma exhibiting regional metastasis.MethodsA retrospective analysis of patients with cutaneous squamous cell carcinoma who underwent parotidectomy and/or neck dissection from 2011 to 2018 at a single institution tertiary center was performed. Patient demographics, clinical, surgical and pathological information, adjuvant treatments, and outcome at last follow-up were collected. Outcomes included disease recurrence and death due to the disease. Prognostic value of clinic pathological features associated with disease-specific survival was obtained.ResultsThirty-eight cases of head and neck cutaneous squamous cell carcinoma with parotid and/or neck metastasis were identified. Overall, 18 (47.3 %) patients showed parotid metastasis alone, 12 (31.5 %) exhibited neck metastasis alone and 8 (21.0 %) had both. A primary tumor in the parotid zone (Hazard Ratio ? HR = 5.53; p = 0.02) was associated with improved disease-specific survival. Poorer disease-specific survival was observed in patients with higher primary tumor diameter (HR = 1.54; p = 0.002), higher depth of invasion (HR = 2.89; p = 0.02), invasion beyond the subcutaneous fat (HR = 5.05; p = 0.002), neck metastasis at first presentation (HR = 8.74; p < 0.001), number of positive lymph nodes (HR = 1.25; p = 0.004), and higher TNM stages (HR = 7.13; p = 0.009). Patients presenting with isolated parotid metastasis during all follow-ups had better disease-specific survival than those with neck metastasis or both (HR = 3.12; p = 0.02).ConclusionHead and neck cutaneous squamous cell carcinoma with parotid lymph node metastasis demonstrated better outcomes than cases with neck metastasis.     

Interpretation of suspect head and neck fixations seen on PET/CT in lung cancer

ObjectivesSmoking is the major risk factor for lung and head and neck cancer. The purpose of the present study was to determine the clinical impact of serendipitously revealed head and neck fixation on PET/CT in patients undergoing investigation for lung cancer.Material and methodsThe reports from PET/CT studies for patients with lung cancer from September 2005 and April 2012 were retrospectively reviewed. Head and neck incidentaloma was interpreted as suggestive of second primary malignancy. These incidental findings were compared with the final diagnosis obtained from clinical and histological investigation.ResultsFive hundred and ninety-two patients were investigated on PET/CT for lung cancer in the study period. PET/CT-positive head and neck lesions suggestive of second primary malignancy were found in 65 (11%) patients. Nasoendoscopy was performed in 23 patients and biopsy in 10. In 4 patients (17.4% of those explored), a second primary malignant lesion was proved on histology: 2 squamous cell carcinomas (larynx and oral cavity), 1 undifferentiated carcinoma (parotid), and 1 osteosarcoma (mandible). At a median 13 months’ follow-up, 3 of the 4 patients with a second primary had died from disease-related causes and 1 was free of recurrence. Metastases from lung adenocarcinoma were found in 2 patients (0.34%).ConclusionsPET/CT detected incidental head and neck malignant tumors in at least 0.68% of lung cancer patients, but in 6.4% of those with suspect head and neck fixation.     

Impact of immunohistochemistry in sentinel lymph node biopsy in head and neck cancer

To determine the sensitivity, specificity, negative predictive value (NPV) and accuracy of hematoxylin–eosin (HE) staining compared to immunohistochemistry (IHC) in sentinel lymph node (SLN) histological analyses of head and neck squamous cell carcinoma. The Clinical prospective study was carried out at Tertiary referral university hospital. Patients with oral, lip and oropharyngeal squamous cell carcinoma undergoing elective neck dissection with clinically and radiologically negative necks were included. All patients were submitted to computer tomography scan for the evaluation of lymphatic metastases. The surgical procedure consisted of tumor resection, SLN sampling and elective neck dissection. Negative SLNs via HE were then submitted for IHC analysis of cytokeratin AE1/AE3 and step serial section (SSS). The mait outcome measures were the negative predictive value of conventional HE staining techniques in the diagnosis of lymphatic metastases with the SSS/IHC analysis. Of 46 patients undergoing 63 neck procedures, 53 were SLN negative and 10 were positive on HE analysis. Using SSS/IHC analysis of these 53 negative SLNs on HE, two (3.8 %) were found to be positive. For HE, the sensitivity, specificity, NPV and accuracy were 77, 100, 94, and 95 %, respectively. With subsequent analysis with SSS/IHC, these values increased to 92, 100, 98 and 98 %, respectively. SSS/IHC is important in SLN analysis as the false negative rate decreased significantly while increasing the inherent sensitivity of the analyses.     

Oncogenes in head and neck cancer

Primary head and neck squamous cell carcinomas from 58 patients were analyzed for the presence of alterations in the K-ras, raf, and erb-B oncogenes. Analysis of 17 fresh tumor specimens using sequence analysis of target sequences amplified by the polymerase chain reaction showed no evidence of mutations in the K-ras oncogene. Thirty fresh tumor specimens were analyzed for the presence of raf gene activation using Southern blot analysis. Under these conditions, no mutations in the c-raf oncogene were detected. In this study, 6 (13%) of the 47 tumors studied displayed epidermal growth factor receptor (EGFR) gene amplification and/or gene rearrangement. Overexpression of the erb-B gene was observed in 18 (67%) of the 27 head and neck tumors studied. Those patients expressing high levels of EGFR or showing EGFR amplification had tumors that were clinically more advanced. These data suggest that amplification and over-expression of the EGFR gene may be a useful diagnostic and prognostic marker in head and neck squamous cell carcinomas.     

Growth and chemosensitivity of human head and neck cancers implanted under the kidney capsule of cyclosporine-immunosuppressed mice

Thirty-seven of 54 human squamous cell head and neck carcinomas were grown successfully at first transplant generation xenografts under the kidney capsule of conventional mice immunosuppressed by daily treatment with 60 mg/kg of cyclosporine. Eighteen different tumors were evaluated for chemosensitivity to cis-diamminedichloroplatinum (cisplatin), 5-fluorouracil, and methotrexate. Thirty-nine percent of the tumors responded to cisplatin, 19% to 5-fluorouracil, and 33% to methotrexate. This assay response is consistent with the clinical response of human squamous head and neck carcinoma to these drugs used as single agents. It is hoped that this model will become useful for new drug testing and, in certain cases, for selection of chemotherapy for patients with refractory tumors.     

Cytopathologic assessment of gloves and instruments after major head and neck surgery

PurposeTo investigate the potential for cancer cells to be transferred between anatomic sites via instruments and other materials.Materials and methodsPilot prospective study from April 2018–January 2019 at Rush University Medical Center. Glove and instrument washings were collected from 18 high-risk head and neck cancer resection cases (36 samples total). Each case maintained at least one of the following features in addition to a diagnosis of squamous cell carcinoma or sarcoma: palliative/salvage surgery, positive margins, extensive tumor burden, and/or extra capsular extension (ECE). Surgical gloves and four main instruments were placed through washings for blind cytological assessment (2 samples/case).Results18 patients undergoing surgical tumor resection for biopsy-proven squamous cell carcinoma with at least one of the aforementioned characteristics were included. 26.7% of cases had ECE, 40.0% had positive final margins and 46.7% had close final margins. Tumor locations included: oral cavity (10), neck (4), parotid gland (2), and skin (2). Malignant cells were isolated on glove washings in 1 case (5.5%). No malignant cells were isolated from instrument washings. The single case of malignant cells on glove washings occurred in a recurrent, invasive squamous cell carcinoma of the scalp with intracranial extension. Anucleated squamous cells likely from surgeon skin were isolated from 94.4% of washings. Squamous cells were differentiated from mature cells by the absence of nuclei.ConclusionsMalignant squamous cells can be isolated from surgical glove washings, supporting the practice of changing of gloves after gross tumor resection during major head and neck cancer resections.     

原发于头颈以外恶性肿瘤的颈淋巴转移临床分析

目的探讨原发于头颈以外的恶性肿瘤的颈淋巴转移规律，以期对此类疾病进一步认识，为诊断提供依据。方法回顾性分析自1989年1月至2004年6月在北京协和医院住院治疗的466例发生颈淋巴转移的恶性肿瘤患者之中的77例原发灶位于头颈以外的病例，均经病理证实为恶性肿瘤颈淋巴转移。分析其发病特点，并按照颈淋巴结LEVEL分区探讨颈淋巴转移区域的特点。结果77例原发于头颈以外的恶性肿瘤病例，原发部位包括肺、胃、食管、乳腺、结肠、纵隔、卵巢、子宫、胰腺、肝脏、肠系膜、肾上腺、直肠。81．8％（63／77）的患者发生LEVELⅤ区颈淋巴转移，其中50例为左侧LEVELⅤ区转移；11．7％（9／77）发生LEVELⅣ区转移；5．2％（4／77）发生LEVELⅢ区转移；1．3％（1／77）发生LEVELⅠ区转移。原发灶位于头颈部以外的病例占各区域全部病例的比例分别为LEVELⅠ区2．1％，LEVELⅢ区3．7％，LEVELⅣ区14．3％，LEVELⅤ区70．8％。发生颈淋巴转移的头颈外恶性肿瘤中，低分化腺癌占51．9％，中分化腺癌占15．6％，低分化鳞癌占11．7％，中分化鳞癌占10．4％，其他组织学类型占10．4％。结论头颈部以外的多个器官的恶性肿瘤均可见颈淋巴转移，其中以肺癌最为常见，胃、食管、乳腺也是常见的原发灶。头颈部以外的恶性肿瘤发生颈淋巴转移的区域集中在LEVELⅤ区，尤其是左侧LEVELⅤ区。且发生于LEVELⅤ区的肿瘤转移病例，原发肿瘤位于头颈部以外的情况多于头颈部肿瘤。发生颈淋巴转移的头颈外恶性肿瘤，分化程度以中．低分化为主。     

Photodynamic therapy and the treatment of head and neck neoplasia

Objective: To present the theory, technique, and results of photodynamic therapy for the treatment of oral, laryngeal, and head and neck cancers. Study Design: Retrospective review of the literature of more than 500 patients with head and neck cancer treated with photodynamic therapy, as well as a retrospective review of the author's 107 patients treated with photodynamic therapy for head and neck neoplasia between 1990 and 1997. Methods: The literature was retrospectively reviewed, as were patient records, and tabulaled for age, sex, site, and staging of lesions, with special focus on post-photodynamic therapy treatment outcome, long-term disease-free survival, and complications. Results: Twenty-five patients with carcinoma in situ and T1 squamous cell carcinoma of the true vocal cord who underwent photodynamic therapy treatment for cure obtained a complete response after a single photodynamic therapy treatment. Only one patient has had recurrence to date, with a cure rate to 79-month follow-up of 95%. Twenty-nine patients with carcinoma in situ and T1 recurrent squamous cell carcinomas of the oral cavity and tongue were treated. All obtained a complete response after a single photodynamic therapy treatment; however, five patients developed local recurrence with follow-up to 70 months, for an 80% cure rate. A review of 217 patients with early squamous cell carcinomas of the head and neck treated with photodynamic therapy in the literature demonstrated an 89.5% complete response rate. The most common complication in these patients was limited prolonged skin photosensitivity without any permanent sequelae. Conclusions: Photodynamic therapy is effective for treating carcinoma in situ and T1 squamous cell carcinoma of the larynx and oral cavity and may be of benefit as an adjuvant intraoperative treatment of stages III and IV tumors of the head and neck in conjunction with surgery and radiation therapy to improve cure rates. Further controlled studies need to be performed to further demonstrate the effectiveness of photodynamic therapy and the treatment of head and neck cancers.     

Incidence of synchronous malignancies found during triple endoscopy in head and neck cancer

ObjectivesTo investigate the incidence of synchronous malignancies identified during triple endoscopy in patients with head and neck squamous cell carcinoma.MethodsA retrospective chart review of patients from a tertiary academic medical center was performed. Patients with a primary head and neck squamous cell carcinoma who underwent triple endoscopy were included. Operative, radiographic, and pathology reports were reviewed to evaluate for the presence of synchronous malignancies in the aerodigestive tract diagnosed through endoscopy. Demographics, relevant medical history, including tobacco and alcohol use, and tumor characteristics were recorded. Univariate and multivariate regression analyses were conducted to assess for associations with synchronous malignancy on triple endoscopy.Results215 patients were reviewed, 164 of which had a biopsy-positive head and neck squamous cell carcinoma and underwent triple endoscopy. Synchronous lesions were found in 8 patients (4.9%). Of the synchronous lesions, only two were identified on esophagoscopy and bronchoscopy; the remaining six were found on direct laryngoscopy. Clinical comorbidities including smoking and alcohol history, tumor p16 status, and tumor stage were not associated with presence of synchronous lesions. A positive synchronous lesion on positron emission tomography was significantly correlated with finding a synchronous lesion on triple endoscopy (p = 0.006).ConclusionThis study shows the incidence of synchronous lesions on triple endoscopy to be closer to 5%. While endoscopic examination can be useful in the anatomic characterization of head and neck malignancies, the low incidence of synchronous malignancies suggests that the need for triple endoscopy may be considered on a case-by-case basis.     

Second primary tumors in head and neck cancer

IntroductionThe development of second primary tumors (SPT) in patients with head and neck squamous cell carcinoma (HNSCC) has become an increasingly important factor in clinical treatment decisions.PurposeTo define favourable clinical characteristics for overall survival, in patients with SP head and neck cancer.Material and methodRecords of 633 patients with SCC treated from 1984 to 2004 were reviewed to describe clinical characteristics of the SPT.ResultsThe overall incidence of SPT was 11%. The incidence of the index tumors was as follows: supraglottic cancer 21% and oral cancer 16%. The most common SPT occurred in head and neck area in 47%, lung in 32% and esophagus in 11%. Second primary was associated with a poor 5 years survival in patients with HN-SCC (23 versus 53% in control group).ConclusionBecause of the high rate of second primary tumors, protocols including chemoprophylaxis should be investigated. Prevention and early detection are indicated.     

乙酰肝素酶在头颈部鳞状细胞癌的表达及其临床意义

目的探讨乙酰肝素酶（heparanase，HPSE）在头颈部鳞癌的表达与临床病理特征及预后的关系。方法对62例头颈肿瘤手术切除标本进行检测，采用免疫组化技术检测HPSE在原发肿瘤组织及其淋巴转移灶中的表达，分析HPSE的表达同患者的年龄、临床分期、病理分级、有无淋巴转移及与预后的关系。结果HPSE在癌旁黏膜组织中不表达或少表达，在大多数头颈肿瘤组织中呈阳性表达，阳性表达率为69．3％（43／62），主要为胞质表达。HPSE的表达在患者的年龄、肿瘤的病理分级方面比较，差异无统计学意义（Х^2=0．05，Х^2=3．84，P值均〉0．05）；而在有无淋巴转移以及肿瘤的临床分期方面差异有统计学意义（Х^2=3．98，Х^2=8．06，P值均〈0．05）；HPSE在原发灶及其淋巴转移灶中的表达之间呈明显正相关（r=0．9162，P=0．001）；Kaplan—Meier法计算，HPSE阳性组的3年累积生存率为25．9％，HPSE阴性组的3年累积生存率为72．7％，二者差异有统计学意义（Х^2=11．607，P=0．001）。HPSE的表达和肿瘤的TNM临床分期分别为影响预后的独立因素，二者分别与患者的预后显著相关（Х^2值分别为16．86和19．73，P值均〈0．05）。结论HPSE在头颈鳞癌中表达显著增高。HPSE的表达与有无淋巴转移、肿瘤的临床分期密切相关。HPSE的表达、肿瘤的临床分期是影响患者预后的独立因素。     

Is fine needle aspiration biopsy reliable in the diagnosis of parotid tumors? Comparison of preoperative and postoperative results and the factors affecting accuracy

IntroductionFine needle aspiration biopsy is a valuable tool in preoperative evaluation of head and neck tumors. However, its accuracy in management of salivary gland tumors is debatable.ObjectiveWe aimed to investigate the efficacy and the accuracy of fine needle aspiration biopsy in parotid gland tumors.MethodsPatients who underwent parotidectomy between January 2008 and June 2017 due to parotid gland tumor were examined retrospectively. Patients with both preoperative fine needle aspiration biopsy and postoperative surgical pathologies were included. Preoperative fine needle aspiration biopsy was categorized as benign, malignant or suspicious for malignancy. Surgical pathology was grouped as benign or malignant. Surgical pathology was compared with fine needle aspiration biopsy, and sensitivity, specificity, accuracy and agreement between both tests were investigated.Results217 cases were evaluated and 23 cases were excluded because the fine needle aspiration biopsy diagnosis was non-diagnostic or unavailable. 194 cases were included. The mean age of the patients was 47.5 ± 15.88 (7–82). There were 157 benign, 37 malignant cases in fine needle aspiration biopsy, 165 benign and 29 malignant cases in surgical pathology. The most common benign tumor was pleomorphic adenoma (43.3%), and malignant tumor was mucoepidermoid carcinoma (4.13%). The diagnostic accuracy for fine needle aspiration biopsy when detecting malignancy was 86.52%. Sensitivity and specificity were 68.96% and 89.63% respectively. Positive predictive value was 54.05% and negative predictive value was 94.23%. There was moderate agreement between fine needle aspiration biopsy and surgical pathology (κ = 0.52). The sensitivity was 54.54% in tumors less than 2 cm while 77.77% in larger tumors. In tumors extending to the deep lobe, sensitivity was 80%.ConclusionFine needle aspiration biopsy is an important diagnostic tool for evaluating parotid gland tumors. It is more accurate in detecting benign tumors. In tumors greater than 2 cm and extending to the deep lobe, the sensitivity of fine needle aspiration biopsy is high. The use of fine needle aspiration biopsy in conjunction with clinical and radiological evaluation may help to reduce false positive and false negative results.     

头颈鳞癌血管生成与颈淋巴结转移相关性研究

目的 :探讨头颈鳞癌血管生成与其颈淋巴结转移的关系以及血管内皮生长因子(VEGF)在头颈鳞癌血管生成中的作用。方法 :应用免疫组化SABC法检测 5 8例头颈鳞癌组织中微血管密度 (IMVD)及VEGF的表达。结果 :5 8例头颈鳞癌组织中IMVD为 2 3.93± 8.77,肿瘤分化程度 ,高与中、高与低间 ,IMVD差异有显著性意义 (均P <0 .0 5 ) ;中与低间 ,差异无显著性意义 (P >0 .0 5 )。颈淋巴结转移组IMVD(2 7.92± 9.11)明显高于非转移组 (2 0 .6 9± 7.0 8) ,其差异有显著性意义 (P <0 .0 1)。癌组织中VEGF表达与瘤内IMVD呈正相关 (rs=0 .4 87,P <0 .0 1)。结论 :瘤内IMVD可作为预测头颈鳞癌颈淋巴结转移的一个重要指标 ;VEGF可促进头颈鳞癌血管生成。     

Analysis of 2,500 squamous cell carcinoma of the head and neck

The purpose of this paper is to define the prevalence of squamous cell carcinoma of the head and neck as seen at the ENT Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain in the last years, studying 2500 cases. Relative frequencies at the various sites, age distribution, male to female ratios, TNM stage are reported. From the results we point out that laryngeal squamous cell carcinomas (1297 cases) were more than 50% of all tumors, followed by oropharygeal carcinomas, oral cavity carcinomas and hypopharyngeal carcinomas. The mean age was 61 years, and patients with nasopharyngeal carcinomas were the youngest. 92% of the patients were males, and the highest rate of males was seen in the larynx and hypopharynx (97% males). Only 9% of the patients were non-smokers and 18% were not alcohol drinkers. Hypopharyngeal squamous cell carcinomas concentrated the highest rate of patients with severe toxic consumption. A significant proportion of earlier tumors was only seen in the larynx and oral cavity (54% and 41% Stages I-II, respectively). On the other hand, hypopharyngeal carcinoma, oropharyngeal carcinoma and nasopharyngeal carcinomas were mainly diagnosed in advanced stages.     

Evaluation and application of a broad-spectrum polymerase chain reaction assay for human papillomaviruses in the screening of squamous cell tumours of the head and neck

Objective—The results of studies analysing the prevalence of human papillomaviruses (HPVs) in squamous cell carcinomas of the head and neck region often vary depending on the different molecular biological methods applied. Focusing on the histomorphological criteria of HPV infections, the percentage of HPV-positive cancers should be higher than has been found in most studies. The aim of this study was to increase the detection spectrum of HPV polymerase chain reaction (PCR) screening using degenerate consensus primers. Material and Methods—To increase the sensitivity of the assay to one copy of HPV DNA per cell, a two-step PCR was carried out. The products were directly sequenced by means of a cycle sequencing approach. Seventy biopsies from squamous cell carcinomas of the upper aerodigestive tract were screened using the primer system. Results—According to the PCR results, 0/2 carcinomas of the floor of the mouth or tongue, 7/16 biopsies of oropharyngeal cancers, 3/13 hypopharyngeal cancers, 13/34 squamous cell carcinomas of the larynx, 4/4 biopsies from carcinomas of the nasal cavity or paranasal sinuses and 1/1 squamous cell carcinoma of the parotid gland were positive. Conclusions—This broad-spectrum PCR can effectively detect HPV in head and neck cancers.