OBJECTIVETo explore the diagnosis and treatment and prognosis of sinonasal neuroendocrine carcinoma.

METHODSThe clinical data of 11 cases with sinonasal neuroendocrine carcinoma treated in Zhejiang Cancer Hospital from 1998 to 2010 were analyzed retrospectively. Ten cases were small cell type and one case was atypical carcinoid. One case by only operation, one case by only radiotherapy, one case by only chemotherapy, two cases by radiotherapy and chemotherapy, 6 cases by combined treatment based on surgery (surgery combined with radiotherapy and chemotherapy).

RESULTSAll cases have been followed up for 2 months to 12 years. Six cases by combined treatment one case died in 3 years and one case died in 4 years after treatment, one case has survived without tumor for 12 years and two cases have survived without tumor for 8 years, one case was still in treatment. Five cases of other treatment programs, four cases died in 12 months, one case died in 18 months.

CONCLUSIONSThere's no standard treatment plan. Combined treatment based on surgery should be adopted to nasal neuroendocrine carcinoma. Reccurrence is frequent and the prognosis is poor. The key to improving the survival rate of the disease is early accurate diagnosis and combined treatment.

Adult ; Aged ; Carcinoma, Neuroendocrine ; diagnosis ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; diagnosis ; therapy ; Paranasal Sinus Neoplasms ; diagnosis ; therapy ; Prognosis ; Retrospective Studies

Geodesic active contour is a useful image segmentation method, but it may fail to segment the objects disturbed by complex noises. Prior knowledge on certain object is a powerful guidance in image segmentation. In this respect, we represent the prior knowledge of region and shape of certain object in a form of speed field and incorporate it into Geodesic Active Contours. The prior region constrains the zero level set evolving in certain region and the prior shape pulls the curve to the ideal contour. Applications in a large quantity of cardiac valve echocardiographic sequences have shown that the algorithm is a more accurate and efficient image segmentation method.
Algorithms ; Computer Simulation ; Humans ; Image Enhancement ; methods ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; methods ; Mitral Valve ; diagnostic imaging ; Models, Statistical ; Models, Theoretical ; Ultrasonography

OBJECTIVETo evaluate the efficacy of surgery for the patients with pyriform sinus carcinoma and analyze the prognostic factors related to the cancer.

METHODSBetween December 1995 and December 2002, 62 patients with pyriform sinus cancer were treated in Zhejiang Tumor Hospital. There were 13 patients staged T1, 17 T2, 12 T3, 20 T4. Four patients received preoperative radiation and 40 patients had post-operative radiation. Among 62 patients, 33 patients were treated by partial laryngectomy, 29 patients were treated by total laryngectomy.

RESULTSThe survival rate was calculated with Kaplan-Meier method. The overall 3- and 5-year survival rates were 42.3% and 27.8%, respectively. The 3-year survival rate between partial and total laryngectomy was 51.9% and 29.9%. The 5-year survival rate between partial and total laryngectomy was 39.5% and 11.2% (chi2 = 4.14, P<0.05). Early stage and combined modality therapy were the independent favorable prognostic factors.

CONCLUSIONSEarly diagnosis with treatment and combined treatment are the most important factors influencing the survival of patients with pyriform sinus carcinoma. Partial laryngopharyngectomy is a suitable treatment for early and selected advanced pyriform sinus carcinoma with a good function and oncologic outcome.

Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; therapy ; Combined Modality Therapy ; Humans ; Hypopharyngeal Neoplasms ; mortality ; therapy ; Laryngectomy ; Male ; Middle Aged ; Pharyngectomy ; Pyriform Sinus ; pathology ; Survival Rate

Objective To study the clinical manifestations, radiological features, andpostoperative outcomes of patients with subependymal giant cell astrocytoma (SEGA). Methods Aretrospective analysis of the clinical presentations, imaging examinations, pathological features,treatments and follow-up results was conducted in 6 SEGA cases treated in our department from 2000 to2007. Results The most common clinical maifestations of SEGA included increased intracranialpressure and impaired visual acuity. CT scan of the tumors displayed isodensity or slightly increaseddensity with well defined border. Calcification was seen in some of the tumors. On T1-weighted magneticresonance images, the tumor masses presented with isointense or mixed signals, while on T2-weightedimages, the tumors exhibited isointense or hyperintense signals. The solid part of the tumor showedheterogeneous enhancement in contrast-enhanced imaging. No operative death occurred in these casesafter total removal of the tumors through a transcallosal approach (4 cases) or a frontal transcorticalapproach (2 cases). No postoperative tumor recurrence was found in the follow-up for 10 months to 8years. Conclusion The diagnosis of SGCA should be considered for the presence of tuberous sclerosisin the subependymal lesion adjacent to the foramen of Monro in cases presenting hydrocephalus orprogressive tumor growth. Surgical resection of the tumor should be performed as early as possible.SGCA is a benign tumor with good prognosis after a total resection. Regular follow-up examinationshould be undertaken to monitor the subependymal nodules for prevention of tumor recurrence.

OBJECTIVETo evaluate the disadvantage of nonstandard operation for thyroid papillary cancer, and the value of re-operation.

METHODSEight hundred and ninety three thyroid papillary cancer patients (332 patients who received nonstandard operation received re-operation and 561 patients who received first standard operation in Zhejiang Cancer Hospital from January 1990 to January 2000) were retrospectively reviewed.

RESULTSPathological results confirmed that there were 53.9% cases with residual cancer in re-operative specimen. The parathyroid was preserved in 74.1% cases in re-operation and 93.0% cases in standard operation (P < 0.01). The recurrent laryngeal nerve was injured in 3.3% cases in reoperation and 1.2% cases in standard operation (P < 0.05). The positive neck lymph node was 39.2% and 37.4% (P > 0.05), the 5-year local recurrence rate was 7.5% and 3.7% (P < 0.01), the total 5-year and 10-year cum-survival rates were 90.2%, 84.4% in patients with re-operation and 94.0%, 92.5% in patients with standard operation. The 10-year cum-survival rate were 67. 8% in patients with recurrence and 92. 9% in patients with non-recurrence in primary site respectively. Statistical analysis showed that the cancer recurrence influences the survival rate significantly (P < 0.01).

CONCLUSIONSIn consideration of the higher residual tumor rate in patients who received nonstandard operations, the re-operations were necessary. But the re-operation could also leads to higher recurrence rate and more functional injuries. The standardized primary operation should therefore be formulated and advocated.

Adolescent ; Adult ; Aged ; Carcinoma, Papillary ; surgery ; Child ; Female ; Humans ; Male ; Middle Aged ; Reoperation ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods ; Young Adult

Objective: To investigate the regulatory relationship of Protein Phosphatase 2 Regulatory Subunit B"Alpha ( PPP2R3A) and hexokinase 1 ( HK1) in glycolysis of hepatocellular carcinoma (HCC). Methods: In HepG2 and Huh7 cells, PPP2R3A expression was silenced by small interfering RNA (siRNA) and overexpression by plasmid transfection. The PPP2R3A-related genes were searched by RNA sequencing. Glycolysis levels were measured by glucose uptake and lactate production. QRT-PCR, ELISA, western blot and immunofluorescence assay were performed to detect the changes of PPP2R3A and HK1. Cell proliferation, migration and invasion assay were used to study the roles of HK1 regulation by PPP2R3A. Results: RNA sequencing data revealed that PPP2R3A siRNA significantly downregulated the expression of HK1. PPP2R3A gene overexpression promotes, while gene silencing suppresses, the level of HK1 and glycolysis in HCC cells. In HCC tissue samples, PPP2R3A and HK1 were colocalized in the cytoplasm, and their expression showed a positive correlation. HK1 inhibition abrogated the promotion of glycolysis, proliferation, migration and invasion by PPP2R3A overexpression in liver cancer cells. Conclusion Our findings showed the correlation of PPP2R3A and HK1 in the glycolysis of HCC, which reveals a new mechanism for the oncogenic roles of PPP2R3A in cancer.
Carcinoma, Hepatocellular/pathology* ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Glycolysis ; Hexokinase/metabolism* ; Humans ; Liver Neoplasms/pathology* ; Protein Phosphatase 2/metabolism* ; RNA, Small Interfering/metabolism*