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Chunsun Li,
Liwei Chen,
Jialing Wang,
Liyong Zhang, Pingzhang Tang,
Suoqiang Zhai,
Weiwei Guo,
Ning Yu,
Lidong Zhao,
Mingbo Liu,
Shiming Yang
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ABSTRACT: The aim of this study was to investigate the roles of the cathepsin B cysteine protease and its endogenous inhibitor stefin A in laryngeal cancer. Immunohistochemistry was employed to detect the expression of cathepsin B and stefin A in 84 patients with laryngeal cancer, respectively. The protein expression of stefin A was negatively associated with lymphatic metastasis, recurrence of laryngeal cancer and the survival rate, which was not observed with cathepsin B protein expression. Both down-regulation of cathepsin B and up-regulation of stefin A in vitro significantly inhibited the migration, invasion and proliferation of laryngeal cancer cells, respectively. Our results strongly suggest that stefin A may be a potential predictor of laryngeal cancer and may be used in the molecular diagnosis and gene therapy of laryngeal cancer. Cathepsin B may be used as a promising therapeutic target in the treatment of laryngeal cancer.
Oncology Reports 06/2011; 26(4):869-75. · 1.84 Impact Factor
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ABSTRACT: To study the clinical characters, treatment, outcome and the factors affecting long-term treatment results of adenoid cystic carcinoma (ACC) of the nasal cavity.
The clinical data were analyzed retrospectively in 42 patients with ACC of the nasal cavity treated initially. The characters of survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Factors that might be related to the prognosis were analyzed by Log-rank test.
The 5-,10-,15-,20-year cumulative overall survival and disease-free survival rate were 88.1%, 54.4%, 35.4%, 35.4% and 60.0%, 53.1%, 30.2%, 30.2% respectively. The 5-,10-,15-,20-year cumulative local control rate were 69.5%, 62.3%, 49.8%, 49.8% respectively and the cumulative distant metastasis rate were 22.2%, 25.9%, 34.2%, 34.2% respectively. Clinical T stage was the factor affecting local control and survival (P<0.05). There was no difference in survival for patients treated by surgery along with sufficient margins, compared with patients treated by surgery combined with postoperative radiation. Patients treated with preoperative radiation had poorer local control and survival than patients treated with postoperative radiation, but there was no statistical significance (P>0.05). The most of patients (75%) died of local recurrence at the primary site.
The most frequent site of failure was local recurrence at the primary site. Patients with early stage disease are amenable to surgery alone with sufficient margins. Surgery combined with high-dose postoperative radiation improves the local control and survival in patients with positive margins, no sufficient margins or advanced disease (T3 + T4). The most of tumors could be reduced remarkably and the radical operation may be performed for the patients with unresectable advanced tumors after preoperative radiation.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 06/2011; 25(12):548-50, 553.
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ABSTRACT: To compare the oncological and functional outcomes in patients undergoing supracricoid partial laryngectomy with other traditional partial laryngectomy.
One hundred and fourteen patients treated from 1992 to 2007 were selected from all laryngeal cancer patients undergo partial laryngectomy through random match method by tumour subsite, TNM stage and age. Among them, 58 were supraglottic cancers, 56 were glottic cancers. Patients were divided into supracricoid laryngectomy group and other partial laryngectomy group. Each group includes 57 cases. We compare the 3-year and 5-year actuarial survival, local control rate and decannulation rate between two groups.
The 3-year and 5-year actuarial survival estimate was 90% and 87% for supracricoid partial laryngectomy, 97% and 92% for other partial laryngectomy (P > 0.05); Local control rate estimate was 94.2% for supracricoid laryngectomy and 91% for other partial laryngectomy(P > 0.05); Decannulation rate was 98% for supracricoid laryngectomy and 89.5% for other partial laryngectomy(P>0. 05); The decannulation was ever lower in horizontal-vertical partial laryngectomy than supracricoid partial laryngectomy (75% versus 98%, P < 0.01).
Comparing with other partial laryngectomy, supracricoid partial laryngectomy seems to have higher decannulation rate and is a considerable choice for selected laryngeal cancer.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 09/2010; 24(18):828-31.
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ABSTRACT: We retrospectively studied 329 patients with squamous cell carcinoma (SCC) of the tongue who were treated at The Chinese Academy of Medical Sciences, Peking Union Medical College, Department of Head and Neck Surgery of Cancer Hospital during the past 25 years (1975-2000). The patients were followed up for more than 36 months, and 28 (9%) developed 29 second primary carcinomas. The characteristics of the index tumour including the clinical appearance (10% nodular, 8% ulcerated), the site (10% anterior, 9% posterior, and 6% lateral), the classification (13% T1, 9% T2), the stage (12% stage I, 11% stage II, and 7% stage III), the histological appearance (7% well-differentiated, 14% moderately differentiated, 36% poorly differentiated, and 2% unknown), and the type of treatment given (18% resection only, 4% radiation only, and 6% combined treatment) were recorded. Twenty-three of the 29 second primary lesions developed in the upper aerodigestive tract with the oesophagus the most common site (79%). During the follow-up period, 14 patients died from causes associated with the second primary lesion and 5 from unrelated causes, and 9 patients were still alive at the time of follow-up. The prognosis for patients who develop second primary lesions is poor.
British Journal of Oral and Maxillofacial Surgery 02/2010; 49(1):50-2. · 1.95 Impact Factor
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ABSTRACT: To observe the surgical anatomy of the recurrent laryngeal nerve during thyroid surgery and provide theory basis for surgical experience.
The surgical anatomy of recurrent laryngeal nerve of 201 sides of 198 cases were observed during thyroid lobectomy or total thyroidectomy. The anatomical relationship of recurrent laryngeal nerve and inferior thyroid artery were recorded and classified as risk and safe types according to the recurrent laryngeal nerve easy to be injured or not.
The safe type and risk type of 117 right sides were 84.6% and 15.4%, and that of 82 left sides were 92.7% and 7.3% respectively. That indicated the incidence of risk type of the right side was higher than that of the left side.
The incidence of risk type of the right side was higher than that of the left side and more attention should be paid during thyroid lobectomy of the right sides.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 06/2005; 19(9):385-6.
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ABSTRACT: To discuss treatment options for tonsillar squamous cell carcinoma.
A total of 108 patients with biopsy-proven tonsillar squamous cell carcinoma, treated between 1984 and 2000, were reviewed, including 82 men and 26 women, with ages ranging from 19 to 70 years. Treatments consisted of either radiotherapy and surgery reserved as salvage treatment (Salvage Surgery, 83 patients), or planned surgery with preoperative radiation (Planned Surgery, 25 patients). Radiotherapy was delivered primarily in a dosage of 60 - 70 Gy for Salvage Surgery patients and 40 - 50 Gy for Planned Surgery patients. Both salvage and planned surgeries were radical, with resection of the lateral oropharyngeal wall, segmental resection of the mandible and neck dissection. The pectoralis major myocutaneous flaps were used to repair surgical defects.
The percentages of radical surgery used in the Salvage Surgery and Planned Surgery groups were 24.1% (20/83) and 88.0% (22/25), respectively (P = 0.000). The local recurrence rates were 28.9% (24/83) and 20.0% (5/25) in the Salvage Surgery and Planned Surgery groups, respectively (P = 0.378). The neck recurrence rates were 9.6% (8/83) and 8.0% (2/25) in the Salvage Surgery and Planned Surgery groups respectively (P = 0.804). The 5-year survival rates were 59.3% and 55.3% in the Salvage Surgery and Planned Surgery groups, respectively (P = 0.7056).
Although the two treatments had a similar survival rate, Salvage Surgery avoided 60% commando operations compared with the Planned Surgery group, which benefits to recovery of oral functions. Primary radiotherapy is recommended as the treatment of choice for tonsillar squamous cell carcinoma. After radical radiotherapy, salvage surgery should be undertaken in the case of tumor remnants or recurrences.
Chinese medical journal 10/2003; 116(9):1404-7. · 0.86 Impact Factor
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ABSTRACT: To study the causes of recurrence of patients with glottic cancer after partial laryngectomy and to propose some possible measures for the prevention of glottic cancer postoperative recurrence.
A retrospective review of consecutive 46 patients with recurrent glottic cancer after partial laryngectomy was conducted. The sites of primary tumors, the ways of operations and the sites of tumor recurrence were investigated.
Among 46 patients diagnosed with glottic cancer recurrence after partial laryngectomy, 32 cases were local recurrences and 14 were regional metastasis or local-regional recurrences. 13 cases of the second primary lesions in larynx were the cause of the failure and occupied 40.6% of all cases of local recurrences (13/32). In the regional metastasis, the commonest recurrent site was encountered in the upper neck. The upper neck metastasis or local recurrences were common in local recurrent cases treated by salvage surgery.
It is very important for the prevention of glottic cancer recurrence after partial laryngectomy to properly manage the upper cervical lymph node in the advanced glottic cancers and the local recurrences in larynx and to know the relation of the postoperative recurrence of glottic cancer and the second primary lesions in larynx and carry out corresponding management.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 04/2003; 17(3):129-31.
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ABSTRACT: To evaluate the clinical effect of submental island flap.
The influence of head and neck radiotherapy and neck lymph node metastasis on the flap was analysed. The clinical effect in the near future and longterm of submental island flap for defects repair was evaluated.
Thirty-eight submental island flap were applied for reconstruction of head and neck defects following cancer ablation between July of 1997 to December of 1999. 16 of these had preoperative radiotherapy at both donor site and receive site, and neck dissections with resection of primary lesions were simultaneously performed in 18 patients. The success rate was 89.5% (34 of 38). All repaired cases had well matched skin with facial surface and excellent texture for intraoral function.
Routine preoperative radiation does do not influence the success and healing of the flap. For tumor complete resection, appropriate cases should be chosen. We believe this flap is worthwhile in addition to the existing armamentarium of reconstruction options both facially and intraorally.
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 12/2002; 37(6):418-20.
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ABSTRACT: To study effective prevention and treatment of stoma recurrence after laryngectomy.
A retrospective review of 23 patients with stomal recurrence after laryngectomy was conducted. Among all 23 cases, 20 cases were referred to Cancer Hospital of Chinese Academy of Medical Science from other hospitals. The etiopathology of stomal recurrence after laryngectomy, feasibilities of various kinds of operative treatment and outcomes of clinical management in this series were analyzed.
The subglottic extension and invasion of paraglottic portion of laryngeal cancer and peritreacheal metastasis may result in stomal recurrence. The survival period of 18 cases surgically treated was longer than that of 5 cases untreated or irradiated and/or chemotherapied. The 1- and 5-year survival rates were 40.7% and 20.4%, respectively. The common complication was pharyngeal fistula. Surgical treatment may relieve local pain, improve breathing, resume swallowing and decrease cancer ulcer bleeding.
The overall prognosis of peristomal recurrence after laryngectomy was awful and dismal. Prevention should be stressed in surgical treatment of the subglottic extension, invasion of paraglottic portion and peritreacheal node metastasis. A proper surgical treatment in some cases of stomal recurrence would prolong the lifetime and advance the life quality of the patients.
Zhonghua er bi yan hou ke za zhi 11/2002; 37(5):380-3.
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ABSTRACT: To improve the early diagnosis of pulmonary embolism.
A retrospective analysis was done of 5 cases of postoperative pulmonary embolism in the department of head and neck surgery from 1993 to 1999.
5 patients: male 4, female 1; age ranged from 42 to 64 years. The unexplained dyspnea, chest pain, and sudden death were the most frequent symptoms. 4 patients were death suddenly because of the incorrect diagnosis and treatment. Only one patient was alive for the correct diagnosis and thrombolytic treatment.
Postoperative pulmonary embolism is a major cause of mortality patients undergoing head and neck surgical procedure. Mortality of pulmonary embolism could be reduced by early and correct diagnosis and treatment.
Zhonghua er bi yan hou ke za zhi 09/2002; 37(4):304-6.
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ABSTRACT: To summarize the experience in diagnosis and therapy of carotid body tumor.
A retrospective review was performed of 46 patients with carotid body tumors diagnosed and treated between February 1968 and March 2001.
Fine-needle aspiration was performed in 2 cases with the the aspirate consisted of blood cells to undergo cytological examination. Blood pool imaging was performed in 12 cases, among which 10 cases (83%) were considered as carotid body tumor. Digital subtraction angiography was performed in 5 cases, all of which were correctly diagnosed. Fifteen cases underwent ultrasound examination, 14 of which (93%) were considered as carotid body tumor. Seven cases underwent computed tomography, among which 5 cases (71%) were considered as carotid body tumor. Four cases underwent magnetic resonance imaging, all of which were correctly diagnosed and 2 of which underwent magnetic resonance angiography. All 46 cases accepted surgical operation, five of them accepted radiotherapy too. The tumors didn't recur during the follow-up period.
Ultrasonography is sufficient for the diagnosis of carotid body tumors. MRI/MRA help to draw out reasonable treatment fashion. Surgery is the first choice among treatments for carotid body tumors. Radiotherapy helps control effectively the aggression of tumors. Intraoperative meticulous dissection may decrease the incidence of postoperative complications.
Zhonghua yi xue za zhi 09/2002; 82(16):1124-6.
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ABSTRACT: To study the multidisciplinary cooperation in surgical treatment of complex head and neck tumors.
The data from 22 patients with head and neck tumors who had been given neurosurgery, orthopaedic surgery, plastic and otological surgery were reviewed from April 1995 to June 2000.
Eight of 14 cases of benign tumors had been resected radical; 5 of 8 malignant cases had been moval of macroscopic tumor and 3 received operation for symptom improvement. No surgical death and serious complications were observed. The recurrence rate benign tumors was 21.4% (3/14), all of which were operated on at other hospitals. Follow-up for a year showed that in 8 cases of malignant tumors, 3 were tumor free, 2 survived with tumor, and 3 died.
To obtain good outcome in treatment for patients with complex tumors of head and neck, cooperative efforts between multidisciplinary surgery are necessary.
Zhonghua wai ke za zhi [Chinese journal of surgery] 07/2002; 40(6):434-6.
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ABSTRACT: To seek for a better approach for the resection of skull base tumors.
A review of 84 skull base tumors resection employed unlike operative approach in the Cancer Hospital of Chinese Academy of Medical Sciences was presented. Surgical approach feature of invaded the different position of skull base, selects the best operative access for safely removes the tumor, protects the critical structure of skull base as fully as possible, and decreases the complication were discussed in this article.
Fourteen cases of benign and seventy cases of malignant underwent surgery. The tumor in 38 cases implicated parapharyngeal space and skull base. The lesion synchronously involved the anterior and middle cranial fossa in 7 cases, middle and posterior cranial fossa in 13 cases, lateral cranial base in 26 cases. The survival rate at 3 years was 68.5% (27/40) for malignant tumor. There was no operative death and severe complication in this series.
To select the best operation access should think over following factors: 1. Tumor position and the scope implicated. 2. Safely and fully removal of the tumor. 3. The limited destroy to normal function structure and receivable cosmetic effect. 4. It is convenient to reliable reconstruction.
Zhonghua er bi yan hou ke za zhi 05/2002; 37(2):95-8.
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ABSTRACT: To evaluate the rate of residual disease in the thyroid gland and rate of cervical lymph node metastasis after preliminary local resections in thyroid cancer.
From 1994 - 1999, 160 thyroid cancer patients who had previously been treated with nodulectomy or subtotal lobectomy in other hospitals were reoperated.
The rate of residual disease at the primary site was 42.5%. The lymph node metastatic rate at level VI was 28.1%. The rate of lymph node metastasis in those with enlarged lymph nodes in the ipsilateral internal jugular chain was 35.4%. The rate of laryngeal recurrent nerve injury was 12.5% at the first operation which is much higher than that of the second operation (1.9%).
Because of the high rate of local residual disease, nodulectomy or subtotal lobectomy alone is not indicated for thyroid cancer. The exploration to level VI is needed for thyroid cancer. It is of utmost importance to be familiar with laryngeal recurrent nerve anatomy in thyroid surgery.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 04/2002; 24(2):185-7.
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ABSTRACT: Even though the mortality from esophageal cancer has decreased during the last two decades nationwide in China, the mortality from esophageal cancer in high-risk areas is still at a high level. Moreover, the 5-year survival rate of patients with resectable esophageal cancer after treatment ranges between 20 and 30%, as majority of patients with esophageal cancer were diagnosed in late stages. Therefore, esophageal cancer control in high-risk areas in China remains a critical task. A strategy is proposed that the high-risk population would be screened by endoscopy with mucosal iodine staining and biopsy of all unstained lesions and diagnosis of severe dysplasia carcinoma in situ, and intra-mucosal carcinoma could be cured by radical mucosectomy. A pilot study showed that the strategy is feasible and cost-effective for the high prevalence of premalignant lesions and carcinomas in early stages. It would be expected that the mortality from esophageal cancer could be decreased in high-risk areas if the proposed strategy is carried out on a large scale.
Japanese Journal of Clinical Oncology 04/2002; 32 Suppl:S10-2. · 1.78 Impact Factor
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ABSTRACT: To approach the relation between vascular endothelial growth factor (VEGF) expression and clinical pathological character in laryngeal squamous cell carcinoma.
Immunohistochemical staining (SP) was used to evaluated the expression of VEGF and microvessel count (MVC) in tumor tissues from 87 patients with laryngeal squamous cell carcinoma.
VEGF immune response was mainly localized to the tumor cell cytoplasm, positive rate was 77%. In laryngeal squamous cell carcinoma, the wider the tumor invaded, the stronger VEGF expressed, the fewer the tumor invaded, the weaker VEGF expressed (P < 0.05); The lower the tumor differentiated, the stronger VEGF expressed, the higher the tumor differentiated, the weaker VEGF expressed (P < 0.05); The stronger VEGF expressed, the more MVC were (P < 0.01); The mean MVC in tumor tissues was obviously higher than that in surgical margin tissues (P < 0.01).
In laryngeal squamous cell carcinoma, the expression of VEGF was markedly correlated with tumor stage and differentiation, was positively correlated with MVC. As a result, VEGF may have an important role in the progression of laryngeal squamous the carcinoma.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 04/2002; 16(3):111-3.
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ABSTRACT: To explore a reasonable surgical method for improving salvagy surgery of nasopharyngeal carcinoma (NPC).
25 cases of nasopharyngeal carcinoma with salvagy surgery were reviewed. Surgical accesses include the transcervico-mandibuio-palatal, the maxillary swing approach, the transpalatal approach for removing nasopharyngeal lesion. The pectoralis major muscle flap and galea aponeurotica flap were employed to repair operative defect and protect the critical structure of parapharyngeal space and the skull base.
The operative complication rate is 16% (4/25), which are local infection and flap putrescence. The postoperative sequela such as cleft palate is slight. 18 cases were followed-up over 3 year and 8 cases died. 2 cases were lost. The 3-year survival rate is 44% (8/18).
The best operation access should be selected depending on the position and the implicated scope. Safely and fully removal of the tumor and reliably reconstruct are necessary. It is possible to improve salvage surgery effect for NPC patients.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 02/2002; 16(2):54-5.
