Objective To evaluate the effect of sternocleidomastoid island myocutaneous flap applicating in reconstructing defect of head and neck neoplasms after operation. Methods We used sternocleidomastoid island myocutaneous flap to restore defect postoperation of head and neck neoplasms for 9 patients. Five patients used flap to reconstruct defect of oral mucosal, one case pucker myocutaneous flap, part of it restore oral mucosal defect, part restore skin defect of cheek, the others reconstruct defect of cheek or parotid gland. Seven cases used polyhole titanium to reconstruct mandible bone at the same time. Results Eight cases used sternocleidomastoid island myocutaneous flap survival postoperation, one case's flap appeared necrosis of distant part and recover after one half month. Conclusion Pedical sternocleidomastoid island myocutaneous flap can provide huge flap supply, survival rate higher, easy to execute and not complex, it is suitable for clinical doctors to reconstruct defect after operation for head and neck tumors.

Objective To discuss the change of serum TGF-β1 and IL-10 in peripheral blood of rats with liver tumor treated by RFA.Methods Thirty experimental liver tumor model of SD rats were prepared by implantation of tumor particles.These rats were randomly divided equally into three groups including 1 week after RFA,2 week after RFA and control group.Peripheral blood of control group,group 1 week after RFA and group 2 week after RFA was taken out respectively without RFA,1 week and 2 week after RFA.The mononuclear cells of peripheral blood were separated by Ficoll density gradient centrifugation.The expression level of IL-10 in peripheral blood was analyzed with flowcytometry.Serum TGF-β1 were dectected by ELISA.Results The serum expression level of TGF-β1 of control group was(6.61±0.12)μg/L,and that of group 1 week and 2 week after RFA were respectively(5.63±0.46)μg/L and(5.53±0.56)μg/L.There was statistical significance for the difference between control group and group 1 week or group 2 week after RFA.The serum expression level of IL-10 of control gorup was 95.92±2.31,and that of group 1 week and 2 week after RFA were respectively 89.71±5.44 and 87.67±11.11.There was statistical significance for the difference between control group and group 1 week after RFA.Conclusions RFA can destroy the tumor tissues in situ and relief immune suppression by IL-10,TGF-β1 secreted by tumor tissue.RFA can improve differentiation and maturation of dendritic cell in local area of tumor and promate ability of antigen-presentation of body.

Objective To study the change of spleen Dendritic cells in normal rats treated by radio-frequency ablation(RFA). Methods Eighteen healthy SD rats were separated into group 1 week after RFA with 6 rats,group 2 week after RFA with 6 rats and control group with 6 rats. Spleen tissue were taken out respectively before RFA, 1 week after RFA and 2 weeks after RFA. The number and the phenotype of Dendritic cells in spleen were analyzed with flowcytometry. Results Pathologyical examination after RFA showed the characteristic that coagulation necrosis and cellular degeneration and granulation tissue forming appeared from target center to peripheral of the target. (10. 36±3. 21) % of normal rat mononuclear cells in spleen express OX-62, the ratio became (18. 03±5. 7) % 1 week after RFA and (12. 63±8. 0) % 2 weeks after RFA, the difference between group 1 week after RFA and control group was marked. (76. 33±7. 86) % of normal rat mononuclear cells in spleen express OX-6,the ratio became (78.33±7.25)% 1 week after RFA and (86. 04±7. 25) % 2 weeks after RFA, the difference between group 2 weeks after RFA and control group was marked. (63. 06±8. 77) % of normal rat mononuclear cells in spleen express CD86,the ratio was (55. 74±14. 49)% 1 week after RFA and (63.49±11.81)% 2 weeks after RFA,the difference between groups 1 week or 2 weeks after RFA and control group was not marked. Conclusions RFA can increasing the number of precursor Dendritic cells migrating from peripheral blood to spleen, and those cells may furtherly differentiate or maturate, which may be contributed to improve the ability delivery of body to antigen to a certain extent.

Objective To study changes in the expression levels of OX-62, OX-6 and CD86 of mononuclear cells and the related chemotatic factor macrophage inflammatory protein-1α (MIP-1α) in the livers of rats with Walker-256 tumors treated with radiofrequency ablation (RFA) and to elucidate the influence of RFA on differentiation and migration of liver dendritic cells(DCs).Methods Walker-256 liver tumors were induced in 60 SpragueDawley rats by implanting tumor particles. These rats were randomly divided equally into three groups from which liver tissue around the local area of the tumor was sampled at 7 d and 14 d after RFA. The mononuclear liver cells were separated with Ficoll density gradient centrifugation. The expression levels of OX-62, OX-6 and CD86 in the mononuclear cells were analyzed with flow cytometry. The expression level of MIP-1α in the liver tissue was detected by enzyme-linked immunosorbent assay (ELISA). Results The average expression of OX-6 in the control rats was 15.29 ±4.59% and those 7 d and 14 d after RFA were 34.20±11.62% and 39.18±9.14% respectively. The difference between the two RFA groups and the control group was statistically significant. The average expression rate of OX-62 in the control rats was 18.91±4.58% and those 7 d and 14 d after RFA were 24.49±4.45% and 22.77 ± 3.50% respectively. The difference between the 7 d group and the control group was significant. The average expression rate of CD86 in the control rats was 66.29±17.69% and those 7 d and 14 d after RFA were 55.29±10.69% and 55.93±12.64% respectively. These differences between both RFA groups and the controls group were not significant. The average expression level of MIP-1 α around the tumors was 232.92±54.58 pg/ml in the controls and 499.38±15.14 pg/ml and 495.90±9.94 pg/ml 7d and 14 d after RFA respectively. These differences from the controls were both statistically significant. Conclusion The expression of MIP-1α around the tumors was elevated after RFA, which could promote the migration of DCs. The changes in the expression of OX-62, OX-6 and CD86 also could reflect increased DC differentiation, which could improve local antigen-presenting capacity to a certain extent and recovery of host anti-tumor immune response.

Purpose:To investigate the curative effect of T3 lesions of supraglottic carcinoma in our hospital and discuss the management of T3 lesions.Methods:33 cases of T3 supraglottic carcinoma hospitalized in Cancer Center of Sun Yat sen University of Medical Sciences from 1982 to 1991 were reviewed. All primary lesions were resected by surgery, including 27 total laryngectomy and 6 horizontal supraglottic laryngectomy. The treatment modality of the neck was as follows: Among 13 clinically positive neck 2 underwent radical neck dissection, 11 underwent selective neck dissection. Among 20 clinically N0 cases 1 underwent elective neck dissection and the rest watchful waiting. In this group 19 cases were treated by definitive surgery, the rest 14 cases managed by surgery plus radiotherapy.Results:The 5 year survival rate in our group was 63.6%(21/33), the 5 year tumor free survival rate was 57.6%(19/33) and the 5 year cumulative survival rate by Kaplan Meier was 63.9%. The 5 year survival rate in partial laryngectomy and total laryngectomy was 80% and 59.9% respectively, no significant difference was shown by Kaplan Meier analysis(Log Rank=0.82, P =0.3646). The 5 year survival rate in definitive surgery and surgery plus radiotherapy was 56.4% and 67.3% respectively. There was also no significant difference by Kaplan Meier analysis (Log Rank=0.61, P =0.4341). 5 cases presented primary relapse and 12 cases neck relapse in our group. The primary and neck control rate was 84.8%(28/33)and 63.6%(21/33)respectively.Conclusions:For T3 subtypes with pre epiglottic space or tongue base infiltration, horizontal supraglottic laryngectomy could abtain better result. One should be careful when applying partial laryngectomy in T3 with cord fixation. Although surgery plus radiotherapy could not significantly influence survival, it could have a tendency to get higher 5 year survival rate than definitive surgery. Radiotherapy and chmotherapy need to be study further.

OBJECTIVE To assess the outcomesof three different therapeutic approaches for the treatment of T3N0M0(stage Ⅲ) glottic squamous cell carcinoma. METHODS Sixty-five cases of T3N0M0 glottic squamous cell carcinoma treated with curative intent by three different modalities include vertical hemilaryngectomy(VHL,n=21),total laryngectomy(TL,n=31)and radiotherapy(RT,n=13) were reviewed retrospectively. The survival rate,recurrence rate at the primary lesion site and jugular lymph node, and laryngeal preservation was compared among three methods. RESULTS There was no significant difference in the overall survival rates(Cox proportion hazard model) and recurrence rates at the primary lesion site or jugular lymph node among the three methods. Laryngeal function was preserved in 100% of the cases in the VHL and RT groups after initial treatment. CONCLUSION The three treatment modalities had statistically similar survival and recurrence rates. Patients treated with VHL and RT had a higher rate of laryngeal preservation compared to that of TL, hence VHL or RT is a valid alternative to TL in treating selected patients with T3N0M0 glottic squamous cell carcinoma.

Objective To investigate the treatment and prognosis of patients with papillary thyroid microcarcinoma. Methods The clinical and following-up data of 124 patients with papillary thyroid microcarcinoma treated at the Department of Head and Neck Surgery of Cancer Centre, SUN Yat-sen University from Jan 1990 to Dec 1999 were analyzed retrospectively for mortality and survival rate ( KaplanMeier). A multivariate analysis was performed in these patients by Cox proportional hazard model. Results The overall 10-year and 15-year survival rate of all 124 patients with papillary thyroid microcarcinoma were 94.9% and 92.5% respectively. The univariate analysis showed the prognostic factors significantly influencing the survival of patients included age (being worse for those of 35 years and older) at presentation, and the status of distant metastasis ( all P ＜ 0. 05 ) , while gender, incidentally found at surgery, the size of primary tumor, the status of neck lymph node metastasis, recurrence after a primary resection, and the extent of surgical resection did not significantly effect the prognosis. Multivariate analysis showed the age more than 35 years at presentation was an independent risk factor indicating worse prognosis (P = 0. 045 ). Conclusioas The prognosis of patients with papillary thyroid microcarcinoma is satisfactory, but that is poor for those patients 35 years old and up at presentation and with distant metastasis.

Objective To evaluate the clinical characters, management and prognostic factors of patients with differentiated invasive thyroid carcinoma (DITC). Methods The data were analyzed retrospectively for 114 DITC patients treated at Department of Head and Neck Surgery of Sun Yat-sen University Cancer Center. Survival analysis was performed by Kaplan-Meier method, comparison among/between groups was performed using log-rank test, and multivariate analysis was carried out using Cox proportional hazard model. Results After surgery, 68 patients were with tumor residue. The 5-year and 10-year overall survival rate were 91.9% and 80.1% respectively in all patients, while the 10-year overall survival rate were 88.5% 、78.5% and 53.1% in no tumor residue group, micro-residue group and grossresidue group respectively. This study failed to prove that radiotherapy might improve the survival rate in patients with postoperative tumor residue. Multivariate analysis indicated that age, invasion to esophagus and recurrence predict the prognosis. Conclusion DITC may be treated mainly by surgical operation. Radical resection is the key factor in the treatment of DITC. Patients with DITC have a relatively poor prognosis.Age, esophagus invasion and status of tumor residue are the most important factors affecting the prognosis.

OBJECTIVE To investigate the correlation of S-phase kinase associated protein 2 (Skp2) and p27 expression with the clinical factors and prognosis of patients with laryngeal squamou cell carcinoma (LSCC). METHODS The expressio of Skp2 and p27 in 79 specimens of LSCC and 1 specimens of adjacent normal laryngeal mucos tissues were evaluated by SP immunohistochemist methods. RESULTS The overexpression rate Skp2 was significantly higher in LSCC(53.16 %) tha in adjacent normal laryngeal mucosa tissue (0 % (P

OBJECTIVE The purpose of this studywas to investigate the correlation of E-cadherin(E-cad) and ?-catenin(?-cat) expression with clinical factors and prognosis in laryngeal squamous cell carcinoma (LSCC) patients. METHODS The expression of E-cad and ?-cat in 79 cases of LSCC and 10 cases of adjacent normal laryngeal mucosal tissues were evaluated by SP immunohistochemical methods. RESULTS All 10 normal samples were positive for expression of E-cad and ?-cat , The positive expression of E-cad and ?-cat in LSCC were 34.18 % and 40.51 % respectively. There was a statistically significant difference in the positive expression of E-cad and ?-cat between normal samples and LSCC (P