人咽喉部肿瘤组织HPV免疫组化及DNA斑点杂交的检测

用免疫组化及ＤＮＡ斑点杂交技术检测人咽喉部乳头状瘤及鳞状细胞癌组织中ＨＰＶ壳蛋白抗原及ＨＰＶ６、１１、１６、１８型ＤＮＡ。结果显示，５例正常粘膜、１５例声带息肉ＨＰＶ抗原及ＤＮＡ检测均阴性。１１例乳头状瘤ＨＰＶ抗原与ＨＰＶＤＮＡ阳性率均为４５．５％。２２例鳞状细胞癌ＨＰＶ抗原阳性率为２２．７％，ＨＰＶＤＮＡ阳性率为２７．３％。乳头状瘤ＨＰＶ检出率与组织学检查的结果相符。结果提示咽喉部乳头状瘤及鳞状细胞癌的发生和发展与ＨＰＶ感染有关系。     

喉气管外伤及狭窄的治疗

【目的】探讨喉外伤及狭窄的不同类型的临床治疗方法及效果。【方法】15年来收治各类喉外伤及狭窄患者38例。其中9例闭合性喉腔软组织伤,或合并软骨骨折而无移位,采用药物保守治疗,18例喉外伤颈部有开放性损伤伴有喉气管软骨损伤,或颈部无开放性损伤伴有喉气管软骨损伤,进行清创缝合,开放手术复位骨折,留置硅胶喉扩张管支撑,11例喉气管瘢痕狭窄采用瘢痕切除留置硅胶喉扩张管支撑,喉气管裂开肋软骨移植术,栅栏状喉气管成形术等方法治疗。【结果】37例患者呼吸通畅、发音满意,劳动力恢复,1例患者需终身保留气管造口。【结论】喉气管外伤应尽早明确诊断,早期治疗。喉气管外伤后瘢痕狭窄患者,根据狭窄部位和程度采取瘢痕切除留置硅胶喉扩张管支撑,栅栏状喉气管成形术及喉气管裂开肋软骨移植术,效果比较满意。     

Treatment of laryngeal cancer: the permanent challenge

There are many options to treat larynx cancers. Throughout the 20th century, surgical research has provided many partial surgery techniques (either open surgery or endoscopic CO₂ surgery). In parallel, the modification of radiotherapy schedules has notably improved the local control with definitive irradiation. The appearance of active chemotherapy regimens has also modified the concept of treatment for advanced disease, allowing a decrease in the total indications of laryngectomy, although this remains the treatment of choice in some cases. The selection of the most appropriate treatment is based on a multidisciplinary approach. Early diseases may be treated by open surgery, endoscopic laser CO₂ surgery or irradiation. Some advanced diseases may be treated by partial surgery, but the majority are theoretically candidates for radical surgery when resectable. In many instances, but not in all, chemotherapy-based larynx-preserving protocols may avoid performing such mutilating surgery. When inoperable, larynx cancers are better treated by combined chemotherapy and irradiation when the performance status of the patient is compatible with such an intensive regimen.     

二氧化碳激光及低温等离子联合术式治疗喉部巨大血管瘤的临床观察*

目的探讨支撑喉镜下二氧化碳CO_2激光及等离子消融联合术式治疗喉部巨大血管瘤的方法及疗效。方法利用支撑喉镜下CO_2激光及等离子消融联合术式微创切除15例喉部巨大血管瘤。结果所有患者术后随访9个月~3年,1例术后14个月原位复发,再次行支撑喉镜下CO_2激光及等离子消融联合术式微创切除,随访2年以上无复发。患者术后疼痛轻微,呼吸、吞咽和发音等喉功能保全好,均无气管切开,无1例患者出现呼吸困难和出血等严重并发症。结论支撑喉镜下CO_2激光及等离子消融联合术式微创切除喉部巨大血管瘤是一种微创、安全、疗效确切的治疗方法,值得临床推广。     

Association between the TAP1 gene polymorphisms and recurrent respiratory papillomatosis in patients from Western Mexico: A pilot study

BackgroundRecurrent respiratory papillomatosis (RRP) is a respiratory tract disease that affects children and adults and is characterized by the recurrent proliferation of multiple papillomas. The etiologic agent is the human papillomavirus, mainly genotypes 6 and 11. Furthermore, polymorphisms in TAP1 appear to influence the selection of antigenic peptides and the transport process to the rough endoplasmic reticulum, for their subsequent presentation to T lymphocytes, an essential process against viral diseases and tumor processes. Previous studies have shown that individuals with those polymorphisms are susceptible to immune, infectious, and tumor‐related diseases. The present study aimed to determine the association between the TAP1 rs1057141 (c.1177A>G) and rs1135216 (c.2090A>G) single nucleotide polymorphisms (SNPs) and RRP.MethodsA case–control study was carried out on a group of 70 individuals (35 controls and 35 patients). RRP diagnosis, HPV genotyping, and viral load were determined through histology and PCR. SNPs rs1057141 and rs1135216 were identified through allelic discrimination, using real‐time PCR. The haplotypic analyses were performed using the Arlequin 3.5 program.ResultsHPV‐6 and HPV‐11 were the genotypes found in the samples. In the polymorphism analysis, rs1057141 showed no significant differences (p = 0.049, CI = 0.994–7.331). In contrast, a significant difference was found in rs1135216 (p = 0.039, OR = 2.4) in the allelic analysis, as well as in the dominant (p = 0.027, OR = 3.06), codominant (p = 0.033, OR = 3.06), and additive model (p = 0.043, OR = 2.505) in subjects with the G allele.ConclusionThe G allele in rs1135216 was associated with a genetic risk of susceptibility for RRP in a population in Western Mexico.