Clear-cell carcinoma of the larynx: review of the literature apropos of a case]

Clear cell carcinoma of the larynx is exceptional. Only six cases are described in the literature. We report a new case occurring in a 58-year-old man. The treatment consisted of a total laryngectomy with lymph node dissection followed by adjuvant irradiation. Local and regional recurrence occurred after 5 months. The patient died from the tumor's evolution 12 months after the diagnosis. The prognosis of clear cell carcinoma of the larynx is similar to the clear cell carcinoma of the lung and is unfavorable.     

喉癌及其周围组织三维结构特点扫描电镜观察

目的　了解形态学与喉癌生物学特性之间的关系。方法　深低温冰冻切割法扫描电镜观察来自 12例喉癌患者及 4例非喉源性疾病死亡患者的 12 6个喉标本。结果　 ( 1)正常喉室带和声带上皮表层细胞角化现象明显 ,可见大量细胞间桥。 ( 2 )癌周围组织表层鳞状上皮形态可辨 ,但排列紊乱 ,形态变异。 ( 3)癌组织周围结构可见两种类型。浸润型周边可见淋巴细胞浸润 ,表面有若干淋巴触手。结论　形态学与喉癌生物学特性之间有密切关系 ,深低温冰冻切割法扫描电镜技术是理想的观察手段。     

成束蛋白和细胞角蛋白14在多种肿瘤组织中的表达及其鉴别诊断意义

目的 揭示成束蛋白(fascin)和细胞角蛋白14(CK14)在不同器官的相同或不同组织学类型癌组织中的表达规律,探讨其鉴别诊断的应用价值.方法 构建450例不同器官的相同或不同组织学类型癌组织芯片,用免疫组化方法检测fascin和CK14的表达情况.结果 fascin在食管、肺、喉、宫颈和外生殖器的鳞癌中弥漫高表达,阳性率分别为90.0%、90.0%、96.7%、78.6%和89.7%,在肺腺癌、胃腺癌、结直肠腺癌、肝细胞癌、胰腺导管腺癌、乳腺浸润性导管癌、甲状腺乳头状癌、子宫宫内膜样腺癌、卵巢浆液性囊腺癌和肾透明细胞癌中表达阳性率分别为38.0%、23.3%、14.3%、10.3%、73.3%、13.3%、6.7%、60.0%、66.7%和10.0%;在鳞癌和其他组织学类型肿瘤中的表达差异有统计学意义(P＜0.001).CK14在食管、肺、喉、宫颈和外生殖器鳞癌中表达阳性率分别为76.7%、36.7%、83.3%、60.7%和96.3%,而在肺腺癌、胃腺癌、结直肠腺癌、肝细胞癌、胰腺导管腺癌、乳腺浸润性导管癌、甲状腺乳头状癌、子宫宫内膜样腺癌、卵巢浆液性囊腺癌和肾透明细胞癌中表达阳性率分别为13.3%、13.3%、20.7%、41.4%、46.7%、6.7%、40.0%、13.3%、20.0%和6.7%;在鳞癌和其他组织学类型肿瘤中的表达差异有统计学意义(P＜0.001).fascin与CK14联合,在鳞癌中任一蛋白阳性率,与在其他组织学类型肿瘤中的表达差异均有统计学意义(P＜0.001).结论 fascin和CK14在多器官鳞癌呈高表达,在其他组织学类型肿瘤呈较低表达.联合检测fascin和CK14的表达,可用于鳞癌的诊断和鉴别诊断.     

喉梭型细胞癌1例报道及文献复习

目的　研究喉梭型细胞癌临床病理及免疫学特征。方法　应用上皮性抗体和间叶性抗体标记喉梭型细胞癌细胞成分 ,观察其免疫学特性。结果　喉梭型细胞癌组织中 ,上皮性癌成分均呈阳性表达 ,梭型细胞成分大部分细胞呈阳性表达。结论　梭型细胞癌是上皮性肿瘤 ,是变异的鳞状细胞癌。     

Primary oat cell carcinoma of the larynx: a case report and review of the literature.

A case of an extrapulmonary oat cell carcinoma arising in the larynx of a 45-year-old male is described. Ultrastructural study demonstrated numerous neurosecretory granules in the tumor cells identical to those described in oat cell carcinomas of the lung. Primary oat cell carcinomas of the larynx are highly malignant neoplasms. Of six previously reported acceptable cases of this rare entity, with adequate followup, all but one has died of tumor within 14 months of diagnosis. The present patient is alive without evidence of tumor 15 months following diagnosis. Aggressive therapy consisting of a combination of surgery, radiation therapy and systemic chemotherapy was utilized in this case. The use of such aggressive combination therapy appears indicated in cases of primary oat cell carcinoma of the larynx if improved survival is to be achieved.     

ki-67在喉鳞状细胞癌组织中的表达及其临床意义

目的探讨ki-67在喉鳞状细胞癌中的表达及临床意义。方法采用免疫组织化学法检测50例喉鳞状细胞癌中ki-67蛋白的表达。另选10例正常喉黏膜标本作为对照组。结果喉癌组织中ki-67总阳性率为60%,高于10例对照组的20%;ki-67的表达与喉癌的临床分期和颈部淋巴结转移有一定关系(P<0.05)。结论i-67可作为反映喉鳞状细胞癌生物学行为的客观参考指标,ki-67可作为评定喉鳞状细胞癌的进展、预测其转移的指标之一。     

Argyrophilic nucleolar organizer regions (AgNOR) in tumours of pharynx and larynx

Benign and Malignant squamous cell tumours from pharynx and larynx have been studied by silver colloidal staining technique for quantitative analysis of argyrophilic nucleolar organizer regions (AgNOR) per nucleus and to assess its significance in differentiating the benign from malignant tumours. A total of 23 neoplasms including 8 squamous papillomas from larynx, 5 squamous cell cracinomas from larynx and 10 squamous carcinomas from pharynx have been studied. AgNOR count from benign papillomas showed a mean count of 2.56 whereas that in squamous cell carcinoma of Pharynx and larynx was 12.61 and 11.43 respectively. This simple staining method can be used to differentiate benign from malignant tumours in pharynx and larynx.     

Squamous cell carcinoma of the larynx metastasized to the ampulla of Vater. Report of a case

Metastasis to the ampulla of Vater from squamous cell carcinoma of the larynx has not been reported previously. In a 71-year-old Turkish patient with squamous cell carcinoma of the larynx a polypoid tumor was observed in the ampulla of Vater. Histopathological examination revealed squamous cell carcinoma compatible with metastasis from laryngeal cancer.     

Steroid hormone receptors in human squamous carcinoma cell lines

Specific estrogen, progesterone and androgen receptors were determined in 19 well-characterized squamous-cell carcinoma (SCC) cell lines. Ten of the lines were derived from patients with SCC of the larynx and nine were from patients with SCC originating in other areas of the head and neck. Estrogen receptors (ER) were found in seven of 10 cell lines derived from squamous cancers of the larynx (70%) but in only one of the nine SCC cell lines from sites other than larynx. Progesterone receptors (PGR) were more evenly distributed. Eight of the 10 laryngeal carcinoma cell lines (80%) and five of the nine non-laryngeal SCC lines (55%) had progesterone receptors. Only one cell line, UM-SCC-10B (derived from a recurrent carcinoma of the larynx) was found to express androgen receptors (AR). Expression of specific estrogen receptors was not dependent on the sex of the patients since lines from both males and females contained receptors. These results establish that squamous carcinoma cell lines may express specific steroid hormone receptors and that cell lines from cancers of the larynx (an organ known to be androgen-responsive) are more likely to express estrogen receptors than androgen receptors. From this initial survey it appears that there is a striking difference in estrogen and progesterone receptor content between SCC cell lines originating from larynx cancers and cell lines established from squamous carcinomas of other head and neck regions. The presence of estrogen receptors in a high proportion of laryngeal carcinoma cell lines suggests that hormonal therapy may be a useful adjunctive therapy in selected patients with cancer of the larynx.     

Primary CNS lymphoma as second malignancy in a case of carcinoma larynx treated with chemoradiation

A 66-year-old male was diagnosed as carcinoma larynx in the year April 2004. He was treated with concurrent chemoradiation and remained disease free for three consecutive years. After 3 years he suddenly complained of giddiness and seizures. Magnetic Resonance Imaging of brain showed features of primary CNS lymphoma (PCNSL) which was confirmed by histopathology test. To the best of our knowledge PCNSL as second malignancy in a case of carcinoma of head and neck has not been reported till date. The PCNSL in this patient may have resulted from depressed immunity due to previous radiotherapy. Whatever may be the predisposing cause, this case is most probably the first reported case of PCNSL in a patient of squamous cell carcinoma of larynx.     

Lead article

Squamous cell carcinoma arising from upper aerodigestive tract carries with it a significant morbidity and mortality and, over the last few decades, its incidence has steadily increased. The management of patients requires thorough investigation to determine the local, regional, and distant extent of the disease, and treatment options include surgery, radiotherapy, chemotherapy, or combinations of these. Despite the large number of therapeutic and hsitopathologic studies in print, there is currently no morphologic or cytologic feature available which consistenly predicts outcome in patients with laryngeal carcinoma. The use of proliferating cell nuclear antigen (PCNA), a newly available marker of a cell’s proliferative activity ( S-phase fraction), was evaluated in 25 cases of squamous cell carcinoma of the larynx. PCNA scores differed, statistically significantly as far as the localization of the lesion, pathological grade, clinical stage, presence of lymph node metastases and prognosis of the patients were concerned. These data suggest that PCNA is an indicator of the malignant potential of the larynx. PCNA can be used in decision making for treatment and assessing prognosis in carcinoma of the larynx.     

221例晚期喉鳞癌患者术后的生存和预后分析

背景与目的：目前晚期喉鳞癌患者的预后差,针对晚期喉癌预后的相关因素的研究结果差异较大。本研究旨在总结晚期喉癌的临床特征和治疗方法,探讨影响晚期（Ⅲ～Ⅳ期）喉鳞状细胞癌患者术后生存和预后的临床病理因素。方法：回顾性分析1990年1月至2003年12月中山大学肿瘤防治中心221例晚期喉鳞癌患者的临床病理资料。应用Kaplan—Meier法分析生存结果。通过Cox回归模型确立影响患者生存预后的独立因素,并建立晚期喉鳞癌的预后模型。结果：本组221例晚期喉鳞癌患者术后的中位生存时间为96个月．2年和5年无瘤生存率分别为60．0％和43．0％;2年和5年累积生存率分别为76．9％和51．1％。Ⅲ期喉癌的无瘤和累积生存率均高于Ⅳ期;术后放疗可以提高切缘阳性患者的生存率;行部分喉切除术的患者的生存率与全喉切除术者相近。年龄、解剖分型、病理分期、手术切缘和放射治疗为影响患者无瘤生存的独立因素：而年龄、病理分期和手术切缘是影响患者累积生存率的独立因素。结论：晚期喉鳞癌患者预后差,影响患者术后累积生存率的独立因素为年龄、病理分期和手术切缘。     

Oat cell carcinoma of the larynx: response to combined modality therapy.

A patient with oat cell carcinoma of the larynx with metastasis to cervical lymph nodes is presented. Treatment with radiation and chemotherapy has achieved a sustained remission. Pretherapy staging and combined modality therapy are discussed.     

Lack of association between helicobacter pylori and laryngeal carcinoma.

Objective: To survey the role of Helicobacter pylori at the tissue level as a cause of squamous cell carcinoma of the larynx. Design:A case-control study. Setting: In an Otolaryngology Ward at an academic university. Subjects: Patients with laryngeal cancer as cases and patients with benign laryngeal lesion as controls. Main outcome measure: In all subjects, specimens of laryngeal tissue were examined by rapid urease test while histopathologic examination was achieved to detect H. Pylori. Results: Totally, 44 patients (42 men and 2 women) with squamous cell carcinoma of larynx and 30 patients (24 men and 6 women) with benign laryngeal lesions (polyp, nodule, granuloma) were studied, none of which were infected with the bacterium. Conclusion: Our results did not show H. Pylori infection among patients with laryngeal cancer (SCC) or benign laryngeal lesions. .     

喉鳞癌中p53和cyclin D1基因表达的预后意义

目的探讨抑癌基因p53和细胞周期蛋白cyclin D1在喉鳞癌中表达的预后意义.方法应用免疫组化方法SP法对56例喉鳞癌cyclin D1和p53表达进行检测.结果56例喉鳞癌中p53和cyclin D1表达阳性率分别为51.8%、42.9%.Kaplan-Meier生存分析显示p53表达和较差的预后相关(P＜0.05),cyclin D1表达阳性患者有预后较差的趋势,但差异无显著性意义(P＞0.05).结论 p53阳性表达可作为判断喉鳞癌预后的一个独立的预后指标.     

Primary oat cell carcinoma of the larynx: A case history and literature review

A case of primary oat cell carcinoma of the larynx is described and the literature reviewed. The origin of this rare tumor and the natural history of the disease are discussed. The different treatment modalities carried out so far are described.     

Primary oat cell carcinoma of the larynx: an ultrastructural study.

An extrapulmonary oat cell carcinoma arising in the larynx is described. Ultrastructurally the tumor is identical to the oat cell carcinoma of pulmonary origin. The pressure of neurosecretory granules in our case strongly suggests that the tumor is derived from Kulchitsky-like cells, a histogenesis previously proposed for oat cell carcinoma of the lung.     

Pulmonary clear cell carcinoma

A case of pulmonary clear cell carcinoma is demonstrated. A large left lower lobe mass, without lymphadenopathy was detected on a screening chest X-ray, and a left lower lobectomy was performed. The tumor was composed predominantly of clear cells with some areas showing cells typical for small cell carcinoma. Ultrastructurally, the larger clear cell had cytoplasm containing many rough endoplasmic reticuli and free ribosomes, while the smaller dark cell showed a serrated nucleus and scanty cytoplasm having many free ribosomes without neurosecretory granules. This is the first report on pulmonary clear cell carcinoma with small cell carcinoma patterns, and this case will throw doubt on the conclusion of previous studies that clear cell carcinoma is not a separate entity.     

Double primary cancer in the larynx and lung--report of 12 cases

12 patients with double primary cancers in the larynx and lung were treated from 1958 to 1984. The incidence is 1.2% (12/943) of laryngeal carcinomas, 1.3% (12/904) of multiple primary cancers, 1.4% (12/873) of double primary cancers and 39% (12/31) of double primary cancers related to laryngeal cancers. There were 9 male and 3 female. 11 of the first primary cancers occurred in the larynx and only one in the lung. All were proved to be squamous cell carcinoma. In the 11 patients whose second primaries occurred in the lung, 4 were proved to be squamous cell carcinoma, one adenocarcinoma, one oat cell carcinoma, one poorly differentiated carcinoma and one cancer unclassified. Of 10 patients in whom both the first and the second primary cancer were treated, 6 survived for more than 2 years, 4 for 3 years and one for 5 years after the second treatment. It seems that double primary cancers of the larynx and lung could yield favorable results.     

喉鳞癌全喉与喉部分切除术的远期疗效分析

目的　回顾分析声门上型及声门型喉鳞癌患者经全喉及喉部分切除治疗后的远期效果 ,提出今后治疗措施。方法　 42 3例喉癌患者中 ,声门上型 32 7例 ,声门型 96例。 2 43例全喉切除患者中 ,声门上型喉癌 2 10例 ,声门型 33例。喉部分切除的 180例中 ,声门上型 117例 ,声门型 6 3例。依照直接法计算出声门上型和声门型喉癌的全喉切除与喉部分切除的 1,3,5年生存率 ,以及各期病例的 3,5年生存率。结果　 32 7例声门上型喉癌术后 5年生存率为 72 9% ,全喉与喉部分切除的 5年生存率分别为 70 1%和 77 4% (P >0 0 5 )。 96例声门型喉癌术后 5年生存率为 86 0 % ,其中全喉与喉部分切除后的 5年生存率分别为 72 2 %和 92 3% (P <0 0 5 )。结论　喉癌治疗仍以手术为主 ,声门上型喉癌的喉部分切除与全喉切除远期疗效大致相等 ,而声门型喉癌的喉部分切除远期疗效明显高于全喉切除。在适应证选择合适的基础上 ,应大力倡导开展有利于患者生存质量的喉部分切除手术。