Wioletta Pietruszewska

Publications of Wioletta Pietruszewska

• [Fungal rhinosinusitis - still unsolved problem].

  Authors: Katarzyna Dąbrowska, Zbigniew Kozłowski, Tomasz Durko, Ramzes Stańczyk, Wioletta Pietruszewska

  Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):369-76.

  Chronic rhinosinusitis (CRS) is an inflammatory disease affecting the nose and paranasal sinuses. Fungi are considered to be one of the pathogens responsible for some kinds of CRS. FungalChronic rhinosinusitis (CRS) is an inflammatory disease affecting the nose and paranasal sinuses. Fungi are considered to be one of the pathogens responsible for some kinds of CRS. Fungal rhinosinusitis - the classifications schemes, the diagnostic criteria and methods of treatment are still being discussed. 338 patients underwent the endoscopic sinus surgery due to CRS in the Otolaryngology Department of the Medical University of Lodz in the years 2009-2011 (February). The histopathological examination revealed fungi only in three patients. The authors report three cases of patients with fungal rhinosinustis - the fungal ball of the sphenoid sinus in one patients, the fungal ball of the maxillary sinus in the second one and non-invasive fungal rhinosinusitis. The different classifications and diagnostic criteria are also presented. Based on the publications using updated diagnostic standards and sensitive techniques to detect fungi, a higher number of patients can now be diagnosed with fungal rhinosinusitis.

• MUTYH Tyr165Cys, OGG1 Ser326Cys and XPD Lys751Gln polymorphisms and head neck cancer susceptibility: a case control study.

  Authors: Tomasz Sliwinski, Karolina Przybylowska, Lukasz Markiewicz, Pawel Rusin, Wioletta Pietruszewska, Hanna Zelinska-Blizniewska, Jurek Olszewski, Alina Morawiec-Sztandera, Wojciech Mlynarski, Ireneusz Majsterek

  Molecular biology reports. 02/2011; 38(2):1251-61.

  In the present study we investigated the association between three polymorphisms of the MUTYH (Tyr165Cys, rs34612342), the OGG1 (Ser326Cys, rs1052133) and the XPD (Lys751Gln, rs13181) genes with headIn the present study we investigated the association between three polymorphisms of the MUTYH (Tyr165Cys, rs34612342), the OGG1 (Ser326Cys, rs1052133) and the XPD (Lys751Gln, rs13181) genes with head and neck cancer risk. Genotypes were determined in DNA from peripheral blood lymphocytes of 265 patients with head and neck squamous cell carcinoma (HNSCC) as well as 280 cancer-free controls by PCR-restriction fragment length polymorphisms. We found an association between HNSCC and the Ser326Cys (OR 1.69; 95% CI 1.19-2.45) as well as Cys326Cys (OR 4.56; 95% CI 2.07-10.05) variants of the OGG1 gene. The gene-gene interaction between MUTYH and OGG1 as well as OGG1 and XPD polymorphic variants may contribute to higher prevalence of HNSCC. We also found an association between Ser326Cys and Cys326Cys variants of OGG1 gene and smoking status in HNSCC patients (OR 1.97; 95% CI 1.25-3.11), (OR 3.54; 95% CI 1.39-9.04), respectively. Moreover, we also observed a protective association between Tyr165Cys variant of the MUTYH gene and non-smoking status in HNSCC (OR 0.34; 95% CI 0.17-0.66). We also found a link between gene-gene interaction (MUTYH and OGG1 or OGG1 and XPD) and smoking (ORs 2.17-4.20 and 2.18-5.23) or non-smoking status (ORs 0.11 and 7.61) in HNSCC patients, respectively. In conclusion our data showed that the Ser326Cys polymorphism of the OGG1 gene may modify the risk of HNSCC associated with smoking. Finally we suggested that this polymorphism might be used as predictive factor for head and neck cancer in Polish population.

• Polymorphisms of the XRCC3 C722T and the RAD51 G135C genes and the risk of head and neck cancer in a Polish population.

  Authors: Tomasz Sliwinski, Anna Walczak, Karolina Przybylowska, Pawel Rusin, Wioletta Pietruszewska, Hanna Zielinska-Blizniewska, Jurek Olszewski, Alina Morawiec-Sztandera, Slawomir Jendrzejczyk, Wojciech Mlynarski, Ireneusz Majsterek

  Experimental and molecular pathology. 12/2010; 89(3):358-66.

  Genetic variations in DNA repair genes may affect an individual's susceptibility to head and neck cancer. We performed a case-control study to test the association between head and neck cancer riskGenetic variations in DNA repair genes may affect an individual's susceptibility to head and neck cancer. We performed a case-control study to test the association between head and neck cancer risk and two polymorphisms: the C722T of the XRCC3 and the G135C of the RAD51-genes of DNA double strand break (DSB) repair by homologous recombination (HRR). Genotypes were determined by PCR-restriction fragment length polymorphism (PCR-RFLP). DNA was isolated from peripheral blood lymphocytes of a group of 288 patients consisting of 97 subjects with precancerous hyperplastic laryngeal lesions (PHLL) and 191 subjects with head and neck squamous cell carcinoma (HNSCC) as well as 353 healthy control donors. We found an association between PHLL and the 722CT (OR 6.67; 95% CI 3.02-14.74) as well as 722TT (OR 4.65; 95% CI 2.30-9.43) variants of the XRCC3 gene. Similar relation was observed between these genotypes and HNSCC (OR 2.59; 95% CI 1.61-4.16 and OR 5.54; 95% CI 3.22-9.52, respectively). Moreover, we also observed an association between PHLL (OR 6.04; 95% CI 3.69-9.90) and HNSCC (OR 6.04; 95% CI 3.69-9.90) and the 135GC variant of the RAD51 gene. The gene-gene interaction between XRCC3 and RAD51 polymorphic variants may contribute to higher prevalence of PHLL. The increased risk of this disease was observed in case of the combination of the 722CT/135GC (OR 3.81; 95% CI 1.55-9.75) as well as the 722TT/135GC genotypes (OR 5.33; 95% CI 1.96-14.47). The presence of the same genes combinations plays a part in higher probability of HNSCC occurrence (OR 2.42; 95% CI 1.22-4.79 for 722CT/135GC and OR 3.63; 95% CI 1.69-7.76 for 722TT/135GC). We also found an association between these XRCC3 or RAD51 polymorphic variants and smoking status in PHLL (ORs 2.85-10.28 and 1.82-7.35, respectively) and HNSCC patients (ORs 2.94-13.93 and 1.36-3.94, respectively) as well as alcohol intake among PHLL (ORs 3.44-6.12 and 3.52-8.43, respectively) and HNSCC subjects (ORs 2.71-7.01 and 2.33-4.62, respectively). In conclusion our data showed that the C722T and the G135C polymorphisms of the XRCC3 and the RAD51 genes might be associated with HNSCC. Finally we suggested that these polymorphisms might be used as predictive factor of precancerous lesion for head and neck cancer in a Polish population.

• Genetic polymorphisms in DNA base excision repair gene XRCC1 and the risk of squamous cell carcinoma of the head and neck.

  Authors: Michal Kowalski, Karolina Przybylowska, Pawel Rusin, Jurek Olszewski, Alina Morawiec-Sztandera, Anna Bielecka-Kowalska, Wioletta Pietruszewska, Wojciech Mlynarski, Janusz Szemaraj, Ireneusz Majsterek

  Journal of experimental & clinical cancer research : CR. 02/2009; 28:37.

  BACKGROUND: The genes of base excision repair (BER) pathway have been extensively studied in the association with various human cancers. We performed a case-control study to test the associationBACKGROUND: The genes of base excision repair (BER) pathway have been extensively studied in the association with various human cancers. We performed a case-control study to test the association between two common single nucleotide polymorphisms (SNPs) of XRCC1 gene with human head and neck squamous cell carcinoma (HNSCC). METHODS: The genotype analysis of Arg194Trp and Arg399Gln gene polymorphisms for 92 HNSCC patients and 124 controls of cancer free subjects, in Polish population were performed using the PCR-based restriction fragment length polymorphism (PCR-RFLP) with endonuclease MspI. RESULTS: No altered risk has been found individually for these SNPs, however haplotypes analysis showed high association with head and neck cancer. The highest frequency, according to wild-type of Arg194Arg and Arg399Arg genotypes, was identified for Arg194Trp-Arg399Arg haplotype (OR, 2.96; 95% CI, 1.01-8.80). CONCLUSION: Finally, we identified the combined Arg194Trp-Arg399Arg genotype of base excision repair gene XRCC1 that was associated with HNSCC and may have an impact on identification of a high-risk cancer population.

• [Analysis of TIMP-1, TIMP-2 and TIMP-3 expression as a prognostic factor of laryngeal cancer progression]

  Authors: Wioletta Pietruszewska, Józef Kobos, Maciej Gryczyński, Tomasz Durko, Katarzyna Bojanowska-Poźniak

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):380-7.

  INTRODUCTION: Tissue inhibitors of matrix metalloproteinases (TIMPs) are natural regulator of activity of matrix metalloproteinases, that are responsible for ECM degradation. TIMPs have beenINTRODUCTION: Tissue inhibitors of matrix metalloproteinases (TIMPs) are natural regulator of activity of matrix metalloproteinases, that are responsible for ECM degradation. TIMPs have been identified in various carcinomas and in most of them dependence between TIMPs and clinical course of the disease have been observed. AIM: Of the research was to evaluate expression of TIMP-1, TIMP-2 and TIMP-3 in laryngeal cancer and to asses the prognostic significance of these factors. MATERIAL AND METHOD: 104 patients with laryngeal cancer, that underwent surgical treatment were included in the study. Only cases with at least a 5-year follow-up were included. Immunohistochemical studies were performed on formalin fixed, paraffin embedded sections by using monoclonal antibodies against TIMP-1, -2 and -3 antigens and ABC detection system. Results. TIMPs expression was cytoplasmatic, mainly in cancer cells, but also in some stromal cells. TIMP-1 and TIMP-2 correlated with grading (TIMP-1 p = 0,05; TIMP-2 p = 0,001). There was an association between TIMP-2 and TIMP-3 expression and tumor size (TIMP-2 p = 0,037; TIMP-3 p = 0,022). TIMP-3 expression correlated with clinical stage of the disease (p = 0,037). There was an association between TIMP-2 expression and nodal recurrence (p = 0,05). Both overall and disease-free survival were shorter in cases with positive TIMP-2 expression (p = 0,049). CONCLUSIONS: Our results demonstrate that there is an association between TIMPs expression and clinicopathological features of laryngeal cancer. Moreover TIMP-2 could be an important marker in prognosis of laryngeal cancer patients.

• [Results of treatment papilloma of nasal cavity and paranasal sinuses]

  Authors: Marek Łukomski, Renata Obrebka, Katarzyna Starska, Wioletta Pietruszewska, Marcin Durko, Anna Pajor, Maciej Gryczyński, Magdalena Józefowicz-Korczyńska

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(5):574-7.

  INTRODUCTION: Papilloma of the nose and paranasal sinuses is a benign tumor originated from nose mucosa. Especially inverted papilloma tumor has a significant recurrence and malignancy potentialINTRODUCTION: Papilloma of the nose and paranasal sinuses is a benign tumor originated from nose mucosa. Especially inverted papilloma tumor has a significant recurrence and malignancy potential rate. The aim of the study was the analysis of clinical and treatment outcomes of patients with papilloma of the nose and paranasal sinuses. MATERIAL AND METHODS: The retrospective analysis was curried out on 41 patients--16 with papiloma of the nasal vestibule and 25 with inverted papilloma the nose and paranasal sinuses surgically treated in I ENT Clinic Medical University in Lodz between 1998-2004 years. We analyzed patient's complains, clinical data and surgical follow-up results. RESULTS: The most frequent complains was increasing unilateral nasal obstruction and rhinorhea. Nasal vestibule papilloma were intranasal removed in all cases. In extended tumor nose and paranasal sinuses in 14 cases intranasal procedures, in 7 sublabial approached, in 4 lateral rhynothomy were performed. In 5 patient local recurrences was observed and in 3 neoplasmatic transformation. CONCLUSION: The choice of surgical management should be individual with respect to tumor localization and extension of neoplasmatic process. The treatment result depends of radical tumor resection.

• [Diagnostic and therapeutic problems in parapharyngeal space tumor--case report]

  Authors: Katarzyna Bojanowska-Poźniak, Marek Łukomski, Tomasz Durko, Wioletta Pietruszewska

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(5):631-5.

  Only 0.5% of head and neck tumors originate from parapharyngeal space. Malignant neoplasms of parapharyngeal space are exceptionally rare (20% of all tumors in this area). Their rarity form a complexOnly 0.5% of head and neck tumors originate from parapharyngeal space. Malignant neoplasms of parapharyngeal space are exceptionally rare (20% of all tumors in this area). Their rarity form a complex diagnostic and therapeutic problem. Authors reports a case of 53-year old woman with squamous cell carcinoma of parapharyngeal space that caused particular difficulties in diagnosis. Diagnostic and therapeutic procedures and preliminary outcome of treatment are presented.

• [Own experience in stapes revision surgery--analysis of indications]

  Authors: Marcin Durko, Tomasz Durko, Anna Pajor, Ramzes Stańczyk, Wioletta Pietruszewska, Katarzyna Starska, Andrzej Jankowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):468-70.

  AIM: Analysis of indications for stapes revision surgery in patients qualified for the secondary procedure at the Otosurgery Dept. Medical University of Lodz. MATERIAL AND METHODS: 25 cases of stapesAIM: Analysis of indications for stapes revision surgery in patients qualified for the secondary procedure at the Otosurgery Dept. Medical University of Lodz. MATERIAL AND METHODS: 25 cases of stapes revision surgery out of the 385 total treated surgically otosclerosis cases are discussed. RESULTS: In group A (patients after total stapedectomy) the following indications for the secondary surgical procedure were observed: 12 cases--platinum wire prosthesis displacement with ossicular chain discontinuity; 3 cases--perichondrium or adipose tissue atrophy; 2 cases of incudo-stapedial joint luxation. Group B was composed of 8 patients after stapedotomy (teflon piston operation, 0.6 mm). CONCLUSIONS: (1) The most common indication for the stapes revision surgery in patients after total stapedectomy were prosthesis displacement and necrosis of the long crus of the incus. (2) Obliteration of the stapes footplate after small fenestra operation was observed in our material to be the most frequent indication for the secondary stapes procedure.

• [Does the material of stapes prosthesis influence hearing improvement in stapes surgery--retrospective analysis of 350 cases]

  Authors: Marcin Durko, Anna Pajor, Andrzej Jankowski, Ramzes Stańczyk, Magdalena Józefowicz-Korczyńska, Wioletta Pietruszewska, Katarzyna Starska, Tomasz Durko

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):480-2.

  AIM: Retrospective analysis of the post-op hearing results in stapes surgery using different types of materials for stapes prosthesis after 12 months follow up. MATERIAL AND METHODS: The total numberAIM: Retrospective analysis of the post-op hearing results in stapes surgery using different types of materials for stapes prosthesis after 12 months follow up. MATERIAL AND METHODS: The total number of 350 otosclerosis patients who underwent surgical treatment at the Otosurgery Department, Medical University of Lodz from 1980-2002. All patients included in the study were divided into 4 groups: group 1 (N=54)--Portmann's method interposition, group 2 (N=160)--stapes replaced with the Shea-type prosthesis, group 3 (N=60)--platinum wire prosthesis (Zini-type), group 4 (N=76)--teflon-piston operation (Fisch-type). RESULTS: The 12 months post-op mean value for air-bone gap (500, 1000, 2000 Hz) presented the following values: group 1-19 dB, group 2-15.9 dB, group 3-18.4 dB, group 4-13.5 dB. The percentage of patients with the mean air-bone gap value of 15 dB or less (500, 1000, 2000 Hz) has the following values in each group: group 1-75%, group 2-81.3%, group 3-83%, group 4-85%. CONCLUSIONS: 12 months post-op hearing results compared between the 4 studied groups showed statistically not significant differences. Our experience with teflon-piston prosthesis shows the lowest post-op mean value of the air-bone gap.

• Loss of heterozygosity for Rb locus and pRb immunostaining in laryngeal cancer: a clinicopathologic, molecular and immunohistochemical study.

  Authors: Wioletta Pietruszewska, Janusz Klatka, Andrzej Borzecki, Piotr Rieske

  Folia histochemica et cytobiologica / Polish Academy of Sciences, Polish Histochemical and Cytochemical Society. 01/2008; 46(4):479-85.

  Several risk factors for the development of laryngeal cancer have been identified, such as smoking and alcohol consumption, but the molecular mechanisms related to the carcinogenesis in the larynxSeveral risk factors for the development of laryngeal cancer have been identified, such as smoking and alcohol consumption, but the molecular mechanisms related to the carcinogenesis in the larynx remain under investigation. In this context, deregulations of the cell-cycle-controling mechanisms, Rb-pathway in particular, have been suggested to be involved in the pathogenesis of laryngeal carcinoma. Our purpose was to investigate 13q14 LOH and the expression of Rb protein and their possible prognostic value in laryngeal cancer. The group of 67 patients with laryngeal cancer, surgically treated with minimum 5 years observation, was multi-variously analysed. LOH for Rb was investigated by PCR-based techniques using two microsatellite markers, D13S263 and D13S126, flanking the Rb locus. Amplification products from each polymorphism were fractionated by denaturing gel electrophoresis and detected by audioradiography. Immunohistochemical staining of paraffin specimens of laryngeal cancers was supervised by the use of monoclonal mouse antibodies IgG1 (Anti-Human Retinoblastoma Gene Product of Dako) in dilution of 1:50. Inactivation of Rb protein was assumed to represent the expression in < or =10% tumour cells. The results of each examined individual factor were compared with clinicopathologic features and the results were statistically transformed (Chi-square test with Yates' correction, Mann-Whitney test). The Kaplan and Meier model was used for overall and disease free survival curves. Only p value of less than 0,05 was considered significant. 13q14 LOH was detected in 7/67 (10,4%) of informative tumours. No correlations were found between Rb genetic alteration (LOH) and gender, age, TNM staging, histological differentiation, nodal and local recurrences (p>0.05). There was a strong association between the loss of Rb and supraglottic localisation of tumour in the larynx (p<0.01). By univariate analysis 13q14 LOH proved to be significantly related to the overall survival whereas it was not related to the quicker relapse (p=0.01, p>0.05 respectively). The genetic data were correlated with the expression of the Rb protein (p=0.001). All tumours with Rb-LOH were immunohistochemically Rb-negative. Inactivation of Rb protein was observed in 9/67 cases (13.49%) and was significantly correlated with the polymorphism of cancer cells, but not with the histological grading. We also found the correlation between reduction of Rb protein and the size of primary tumour (T) (p=0.03) and local recurrence (p=0.035). There was no significant dependence between the level of Rb protein and other histopathological and clinical features (p>0.05). To conclude, analysis of 13q14 LOH enables the assessment of biology of laryngeal cancer and it can be a prognostic factor in overall survival. Immunohistochemical analysis of Rb protein expression in neoplastic cells made it easier to evaluate the mechanisms of cancerogenesis in laryngeal cancer and is closely related to genetic alteration in Rb locus.

• [Role of IFN-gamma and TNF-alpha in etiology of nasal polyps--initial studies].

  Authors: Wioletta Pietruszewska, Izabela Olejniczak, Tomasz Durko, Wojciech Młynarski

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(1):54-8.

  Nasal polyposis is a chronic inflammatory disease of the nasal mucosa. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present studyNasal polyposis is a chronic inflammatory disease of the nasal mucosa. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of interferon gamma and TNF-alpha secreted by Th1 lymphocytes and to analyze their role in the etiology of nasal polyps. 12 patients with nasal polyposis were selected - 6 of them allergic and 6 non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Blood sample was obtained from patients and examined for the expression of IFN-gamma and TNF-alpha by intracellular staining procedure after stimulation with PMA/ionomycin and allergen. Negative correlation was found between expression of IFN-gamma and TNF-alpha after PMA/ionomycin stimulation and allergen stimulation (p > 0,05). Statistical analysis of two groups of patients demonstrated that no significant differences in the cytokine expression in allergic versus non-allergic patients were observed although mean value of IFN-gamma and TNF-alpha were lower in allergic patients in comparison to non-allergic (p > 0,05). We didn't observed any correlation between expression of INF-gamma and TNF-alpha and: coexistence of bronchial asthma, allergy to aspirin and local corticosteroid treatment. In patients with recurrent polyposis the expression of INF-gamma was significantly lower (p = 0,05). This research suggests that IFN-gamma and TNF-alpha play a role in the pathogenesis of nasal polyps but the allergic mechanism may not play a fundamental role in this process. It needs further investigations.

• Application of primary cell cultures of laryngeal carcinoma and laser scanning cytometry in the evaluation of tumor reactivity to cisplatinum.

  Authors: Janusz Klatka, Roman Paduch, Piotr Pozarowski, Wioletta Pietruszewska, Krzysztof Kupisz, Piotr Trojanowski, Jacek Roliński

  Folia histochemica et cytobiologica / Polish Academy of Sciences, Polish Histochemical and Cytochemical Society. 01/2008; 46(2):159-64.

  Unsatisfactory effects of treatment of laryngeal carcinoma patients stimulate the clinicians as well as researchers to develop new more effective treatment models and to find new reliable prognosticUnsatisfactory effects of treatment of laryngeal carcinoma patients stimulate the clinicians as well as researchers to develop new more effective treatment models and to find new reliable prognostic factors. The aim of the present study was the evaluation of the use of primary cell cultures of the laryngeal carcinoma and laser scanning cytometry (LSC) in the assessment of tumor reactivity to cisplatinum. Nineteen primary cultures of laryngeal carcinoma cells established from fragments of laryngeal carcinoma infiltrations were cultured with or without cisplatin, stained with monoclonal antibodies against P53 and BCL-2 proteins and analyzed by LSC. Cisplatin added to the culture medium leads to the significant increase of P53 expression and decrease of BCL-2 expression. Moreover, changes of P53 and BCL-2 expressions were significantly correlated. Our findings of apoptosis regulatory mechanisms could be useful in patient qualification for the chemotherapeutic follow-up treatment.

• [Application of Ljubljana classification in laryngeal precancerous lesions]

  Authors: Wioletta Pietruszewska, Katarzyna Bojanowska-Pozniak, Magdalena Józefowicz-Korczyńska, Marcin Durko, Józef Kobos

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):602-6.

  The diagnosis and treatment of laryngeal premalignant lesions has been frustrated because of failure to adequately define the histologic changes that may help in prediction of irreversible neoplasticThe diagnosis and treatment of laryngeal premalignant lesions has been frustrated because of failure to adequately define the histologic changes that may help in prediction of irreversible neoplastic transformation. To assess the grading of laryngeal hyperplastic epithelial lesion it was used a Ljubljana classification of histologic changes. It was done a retrospective study of 104 laryngeal hyperplastic lesions biopsies that were classified according to the Ljubljana classification comprising benign spinous layer augmentation (simple hyperplasia), benign basal and parabasal layer augmentation (abnormal hyperplasia), alteration of epithelial cells towards malignancy (atypical hyperplasia) and carcinoma in situ. One hundred and four biopsies with preneoplastic changes were reevaluated and classified according to Ljubljana classification. It was found 42 cases (40.4%) which showed simple, 38 (36.5%) abnormal, 21 (20.2%) atypical hyperplasia and 3 (2.9%) carcinoma in situ. Three cases of atypical hyperplasia (2.9% of all investigated cases) and one of abnormal (0.96%) progressed to invasive carcinoma during the observation ranging from 5 to 9 years (median 8.1). None of the cases classified as simple hyperplasia showed progression to malignancy. The Ljubljana classification focuses on the important clinical decision involving benign looking hyperplastic lesion that do not require strict follow-up (simple and abnormal hyperplasia); and "risky" epithelium that require close follow-up with repeated histologic assessment to recognize any malignant progression (atypical hyperplasia); and carcinoma in situ that requires fast and complete treatment. We suggest that the Ljubljana classification may give a reliable assessment of laryngeal hyperplastic epithelial lesions and can help in monitoring all those patients.

• [Assessment of tissue inhibitor of metalloproteinases-2 (TIMP-2) in laryngeal cancer]

  Authors: Katarzyna Bojanowska-Poźniak, Józef Kobos, Maciej Gryczyński, Marcin Durko, Wioletta Pietruszewska

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):612-6.

  Metalloproteinases are the proteolytic enzymes that digest components of the extracellular matrix in many physiological and pathological conditions. Their activity is regulated by their naturalMetalloproteinases are the proteolytic enzymes that digest components of the extracellular matrix in many physiological and pathological conditions. Their activity is regulated by their natural inhibitors: non-specific alpha2-macroglobulin and specific tissue inhibitors of metalloproteinases (TIMP). There are four TIMPs. TIMP-2 is the only enzyme that is expressed in constitutive manner and has the ability to inhibit activity of all metalloproteinases. TIMP-2 has been identified in many carcinomas including cancers of lung, oral cavity, breast and colon. There was correlation between TIMP-2 expression and clinical course of the disease observed in most of the neoplasm. AIM: The aim of the research was to evaluate the expression of TIMP-2 in laryngeal cancer and to assess the prognostic significance of this factor. MATERIAL AND METHOD: 104 patients with laryngeal cancer, that underwent surgical treatment were included in the study. Only cases with at least a 5-year follow-up were included. Immunohistochemical studies were performed on formalin fixed, paraffin embedded sections by using monoclonal antibodies against TIMP-2 antigen and ABC detection system. RESULTS: TIMP-2 expression was cytoplasmatic, mainly in cancer cells, but also in some stromal cells. There was correlation between TIMP-2 expression and tumor size and grading observed. We didn't find any correlation between TIMP-2 and nodal metastases, recurrence and survival. Conclusions: Our results don't suggest that TIMP-2 expression may be used as a prognostic factor in patients with laryngeal cancer. Nevertheless there are more researches needed to explain the role of TIMPs in growth and progression of neoplastic tumors.

• [Localized amyloidosis of upper respiratory tract]

  Authors: Wioletta Pietruszewska, Ilona Kurnatowska, Anna Murlewska, Marta Zapała, Małgorzata Wagrowska-Danilewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(5):730-5.

  Amyloidosis results from the deposition of amyloid proteins in organ and tissues. It can be localized or systemic. Amyloidosis may be classified as either primary or secondary. Primary is idiopathic,Amyloidosis results from the deposition of amyloid proteins in organ and tissues. It can be localized or systemic. Amyloidosis may be classified as either primary or secondary. Primary is idiopathic, whereas the secondary form is associated with chronic inflammatory or infectious process. Amyloidosis is also related to myeloma multiplex (plasmacytoma) or located as tumor like deposits in isolated organ without systemic involvement. Localized amyloidosis in the head and neck is rare and can have various manifestations. A case of surgically treated localized amyloidosis of the pharynx is presented. The study is focused on case history, results of laryngeal, general and pathological examination of the patient. Current options on the structure of amyloid, making diagnosis, treatment and prognosis in patients with amyloidosis are presented.

• [Vascular malformation of the head and neck--diagnosis and treatment]

  Authors: Magdalena Józefowicz-Korczyńska, Renata Obrebska, Katarzyna Starska, Wioletta Pietruszewska, Marcin Durko, Marek Lukomski

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(5):847-51.

  Vascular malformations are the most common anomalies appearing from birth to any adulthood. They are not clinically and morphologically homogenous group. They may occur at different place but mostVascular malformations are the most common anomalies appearing from birth to any adulthood. They are not clinically and morphologically homogenous group. They may occur at different place but most often in the subcutaneous or submucous space in the oral cavity, pharynx, the paranasal sinuses and nose. The aim of this study was to present the difficulties in diagnosis and treatment of head and neck vascular malformations in patients hospitalized in ENT Department University of Lodz from 2001 to 2006. From 17 patients with vascular malformations we choose four to careful evaluation. Two patients had neck vascular malformation, two had the paranasal and nose sinuses tumors. Presented lesions were categorized as "low-flow" vascular malformation. In two cases there was vascular and lymphatic malformation, deeply located in the neck. In two cases arisen in the nose and the paranasal sinuses, there were capillary and cavernous types. We pointed out the clinical signs and diagnostic problems in deep vascular tumors and bleeding risk concerning treatment procedure. Even a needle biopsy and radiological imagining did not confirm the preoperative diagnosis. CT and MRI is recommended to delineate the extend the lesion, and evaluation of its special anatomical location, surrounding arteries, vessels and important neck structure prior to surgery. In the paranasal and nose tumor CT could show bone destructions as well. CONCLUSIONS: Surgical careful excision has been favorable in depth neck laying and extended paranasal and nose vascular malformation. Because of the risk of bleeding careful hemostasis are important challenges in the surgical removal, so embolization is preferred in some cases.

• [Alterations of cell cycle regulating proteins: Rb, p21 and p16 in laryngeal cancer]

  Authors: Wioletta Pietruszewska, Marcin Durko, Józef Kobos

  Otolaryngologia polska. The Polish otolaryngology. 01/2007; 61(6):951-7.

  In cell cycle, most of the regulatory actions occur at the so-called restriction point (R) in the late G1 phase. Tumor suppressor genes; Rb, p53 and p21 are among the most important of the agentsIn cell cycle, most of the regulatory actions occur at the so-called restriction point (R) in the late G1 phase. Tumor suppressor genes; Rb, p53 and p21 are among the most important of the agents suppressing transition through R point. Changes in the expression of Rb (retinoblastoma) gene correlate with the presence of Rb protein and they are believed to be an early event in carcinogenesis. This issue seems to be not plainly defined in laryngeal cancer. P21 with p16, cyclin D1 and Rb genes that play a critical role in the regulation of the G1-S transition of the cell cycle, are frequently altered in several neoplastic entities. Our purpose was to investigate the possible prognostic value of p21, p16 and Rb proteins in patients with laryngeal cancer. 67 patients with laryngeal cancer was multi-variously analysed. Paraffin-embedded tissue sections were immunohistochemically stained with a monoclonal antibody raised against p21, p16 and Rb proteins using standard immunohistochemistry techniques. Low intensity (< or = 10%, 7/67) of p21 protein expression was significantly correlated with histological grading (p < 0,01) and overall and disease free survival (p < 0,05). We did not observed any correlation between p21 expression and T, N and M status and local or nodal recurrences. Absence of p16 protein expression was observed in 35/67 (52,2%) cases and was significantly correlated with N status (p = 0,03) and nodal recurrences (p = < 0,01). By univariate analysis expression of p16 protein was related with quicker relapse. Rb protein was absent in 7/67 cases (10,4%) and was related to T3 and T4 primary tumour size (p < 0,05). We did not observed any correlation between Rb and other clinocopathological features (p > 0,05). Our study has identified p21 protein expression as important biological marker which may indicate the progression of laryngeal squamous cell carcinoma. P16 protein has a prognostic value in assessment of disease free survival. Based on this findings it can be deduced that investigation of Rb, p16 and p21 proteins makes it easier to understand the process of cancerogenesis in laryngeal cancer and to establish its prognostic value further research and observations need to be attempted.

• [Expression of adhesion molecule ICAM-1 in patients with nasal polyps]

  Authors: Izabela Olejniczak, Józef Kobos, Maciej Gryczyński, Marcin Durko, Wioletta Pietruszewska

  Otolaryngologia polska. The Polish otolaryngology. 01/2007; 61(4):607-11.

  INTRODUCTION: Nasal polyposis is a chronic inflammatory disease of the nasal mucosa. The prevalence of nasal polyps seems to vary between 1 and 4% of the population. The pathogenesis of nasal polypsINTRODUCTION: Nasal polyposis is a chronic inflammatory disease of the nasal mucosa. The prevalence of nasal polyps seems to vary between 1 and 4% of the population. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of adhesion molecule ICAM-1 in patients with nasal polyps. MATERIALS AND METHODS: 53 patients with nasal polyposis were selected and divided into two groups--allergic and non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Immunohistochemical studies with monoclonal antibody against ICAM-1 antigen (NCL-CD54, Novocastra) using immunoperoxidase method were performed to evaluate expression of ICAM-1. RESULTS: Immunoexpression of ICAM-1 was present on some epithelial cells and on fibroblast, inflammatory cells and endothelium in the submucosa. The mean +/-SD values of the immunoexpression of ICAM-1 were significantly increased in dust-sensitive patients compared with dust-tolerant patients (1.93 +/- 0.83 vs 0.83 +/- 0.73 (p < 0.001). CONCLUSIONS: This research suggests that ICAM-1 plays an important role in the pathogenesis of nasal polyps and the allergic mechanism may play a fundamental role in this process. However, further examinations to confirm this need to be undertaken.

• [Immunohistochemical analysis of the fibronectin expression and its prognostic value in patients with laryngeal cancer]

  Authors: Wioletta Pietruszewska, Józef Kobos, Katarzyna Bojanowska-Poźniak, Marcin Durko, Maciej Gryczyński

  Otolaryngologia polska. The Polish otolaryngology. 01/2006; 60(5):697-702.

  Fibronectin is one of the extracellular matrix glycoprotein, that plays an important role in cancer invasion and progression. Our purpose was to evaluate fibronectin expression and its possibleFibronectin is one of the extracellular matrix glycoprotein, that plays an important role in cancer invasion and progression. Our purpose was to evaluate fibronectin expression and its possible prognostic value in laryngeal cancer. Forty-one patients (six female and thirty-five male) surgically treated for laryngeal cancer were included in the study. The expression and distribution of fibronectin was immunohistochemically determined by using monoclonal antibody against fibronectin. Low expression of fibronectin was detected around the individual carcinoma cells, but large amounts were present in the invasive tumour front and the cancer surrounding stroma was strongest positive for fibronectin. By univariate analysis the level of fibronectin expression on the border of the invasive tumour front was proved to be correlated with tumor stage (p = 0.03). There was a significant association between the defect of ECM and overall survival (p > 0.05). These observation indicates that testing the distribution and the expression of ECM seems to be useful to evaluate the histological grading of malignancy of laryngeal cancer and to be helpful to prognosticate the overall survival while measured on the border of tumour proliferative front in laryngeal patients. The results demonstrate that fibronectin amount may be useful in evaluating the invasion potential of the tumour.

• [Etiology of nasal polyps: an update]

  Authors: Wioletta Pietruszewska, Izabela Olejniczak, Magdalena Józefowicz-Korczyaska, Maciej Gryczyński

  Otolaryngologia polska. The Polish otolaryngology. 01/2006; 60(4):551-7.

  Nasal polyps are the results of chronic inflammation of nasal mucosa. Ethiopathology of nasal polyposis is still unclear and investigated. The main aim of this study was the assessment of interleukinNasal polyps are the results of chronic inflammation of nasal mucosa. Ethiopathology of nasal polyposis is still unclear and investigated. The main aim of this study was the assessment of interleukin 2 (IL-2), 4 (IL-4) and 13 (IL-13) and interferon gamma (IFN-gamma) expressions in two groups of patients with nasal polyps: non-allergic and allergic to dust. Twelve patients with nasal polyposis were selected, six of them allergic and six non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Blood sample was obtained from patients and examined for the expression of Interleukin 2, 4, and 13 and IFN-gamma by intracellular staining procedure after stimulation with PMA/ionomycin (phorbol 12-myristate 13-acetate) and allergen (D. pteronyssimus, Allergopharma). Negative correlation was found between expression of Interleukin 2, 4, 13 after PMA/ionomycin and allergen stimulation (p > 0.05) into two groups. Although mean expression of IFN-gamma and IL-2 were lower in allergic patients with nasal polyps. Mean value of IL-4 and IL-13 were higher in allergic patients in comparison to non-allergic, but the correlations were not significant. We did not find correlations between expression of investigated interleukins and bronchial asthma and ASA-intolerance existed in patients (p > 0.05). We found that expression of IFN-gamma was significantly lower in patients with polyps recurrences followed by polypectiomies (p = 0.05). In patients who used intranasal local steroid before treatment we observed significant decrease of 11-2 and 11-13 levels after allergen stimulation (p = 0.,034, p = 0.023). No specific differences of expression of investigated cytokines between allergic versus non-allergic patients suggests that the allergic mechanism may not play an fundamental role in the aetiology and formation of nasal polyps. Furthermore local steroids seem to be used in every patient after polypectomy because of their anti-inflammatory stimulation.