Because of minimal donor site morbidity, adequate tissue, excellent clinical and functional results, the anterolateral thigh flap has become one of the most important tissue flaps which are used to repair the defects of head and neck. Generally, anterolateral thigh flap is mainly used to repair the maxillofacial defects in head and neck surgery. However, the anterolateral thigh flap is a better tissue flap for reconstruction of hypopharyngeal and cervical esophageal defects.
Esophagus ; surgery ; Head ; surgery ; Humans ; Hypopharynx ; surgery ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thigh

To report one case of postoperative reconstruction of facial squamous cell carcinoma by cervicotho-racic flap and temporal flap in our hospital. Clinical symptoms of the patient are facial mass and tumor ulceration.The patient had chronic bronchitis. On admission, the right side of the patient face was found to have a mass of about 6. 5 cm X 5. 0 cm, and the middle is about 2. 5 cm X 2. 5 cm X 1. 0cm ulcer, the neck has no swollen lymphnodes by palpation. After imaging and pathological examination,the patient was diagnosed as right facial squamouscell carcinoma and chronic bronchitis.
Carcinoma, Squamous Cell ; surgery ; Face ; pathology ; surgery ; Humans ; Postoperative Period ; Reconstructive Surgical Procedures ; Surgical Flaps

Objective To elucidate the relationship between LYVE-1 and VEGF-C and their expression in laryngeal squamous cell carcinoma(LSCC),and provide theoretic evidence for the judgement of metastasis and prognosis of LSCC,also for the treatment.Methods An immunohistocbemical analysis was performed to 50 specimens of LSCC with lymphatic endothelial marker LYVE-1.Quantitation of lymphangiogenesis growth factor VEGF-C by RT- PCR was performed to 30 specimens of LSCC.Finally the correlation between LVD and VEGF-C mRNA was analyzed with statistics methods.Results LYVE-1 (+) was observed in all LSCC.The median copy number of VEGF-c mRNA was 4-5-fold higher in LSCC than in adjacent normal tissue.There was correlation between tumor VEGF-C mRNA copy number and intratumoral LVD.Conclusion Lymphatic vessels existed in LSCC.There was correlation between high levels of LVD in LSCC than in normal tissue.The high level of VEGF-C may accelerate the lymphatic metastasis by promoting the proliferation of lymphatic vessel.

Humans ; Hypopharyngeal Neoplasms ; therapy ; Practice Guidelines as Topic ; Time Factors

OBJECTIVE: To investigate the presence of vasculogenic mimicry in laryngeal squamous cell carcino- ma and explore its clinical significance. METHOD: The presence of vasculogenic mimicry and expression of endotheli- um-dependent vessel in 138 laryngeal squamous cell carcinomas cases were detected by the immunohistochemistry and tissue microarray. Metlab software was used to evaluate the relationship among vasculogenic mimicry, mi- crovessel density and clinic pathological parameters in laryngeal carcinoma. RESULT: We found vasculogenic mimicry in 32 (26.23%) of 122 laryngeal carcinoma samples. The mean of microvessel density is 12.61 per high-power field. The vasculogenic mimicry and expression of endothelium-dependent vessel were not significantly related to patient age or gender, tumor location, pathology grade, T stage or N stage (P > 0.05). However, the vasculo- genic mimicry and the mean of microvessel density were a little higher in patients older than 60, with poorly differ- entiated and patients with N₁₋₃ stage. Vasculogenic mimicry was positively correlatedwith microvessel density (r = 0.1927, P < 0.05). CONCLUSION Vasculogenic mimicry can occur in laryngeal carcinoma. Moreover, vasculogenic mimicry may be associated with recurrence and metastasis in laryngeal carcinoma.
Carcinoma, Squamous Cell ; pathology ; Endothelium, Vascular ; pathology ; Head and Neck Neoplasms ; pathology ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; pathology ; Neoplasm Recurrence, Local ; Neovascularization, Pathologic ; Squamous Cell Carcinoma of Head and Neck

In order to evaluate the availability of the lateral horizontal laryngectomy and anaplasty of epiglottis to treat some patients with specific supraglottic carcinomas and hypopharyngeal carcinomas, 17 cases of laryngeal and hypopharyngeal carcinomas were retrospectively analyzed, whose tumors were located at the lateral margin of epiglottis, aryepiglottic fold, medial wall of piriform fossa and were treated by the lateral horizontal laryngectomy and anaplasty of epiglottis. The results showed that all cases took food by mouth in postoperative 9-14 days and subjected to decannulation in postoperative 9-15 days. Three cases had postoperative hoarse voice. The free-disease survival rate of 3 years was 71.4% in 14 cases followed up after the first surgical therapy, and the overall free-disease survival rate of 3 years was 85.7% after the second surgical therapy. It was concluded that the manipulations of the lateral horizontal laryngectomy and epiglottiplasty were simple. It could alleviate the postoperative symptoms of aspiration and bucking remarkably and shorten their postoperative recovery time, yet does not lower the survival rate of patients if laryngocarcinoma or hypopharyngeal carcinoma cases were properly selected.
Carcinoma, Squamous Cell/*surgery ; Epiglottis/*surgery ; Hypopharyngeal Neoplasms/surgery ; Laryngeal Neoplasms/*surgery ; Laryngectomy/*methods ; Otorhinolaryngologic Surgical Procedures/methods

Objective To detect the expression of Cancer-Testis antigen NY-ESO-1 in human laryngeal squamous carcinoma (LSC) and to explore its significance in immunotherapeutic application. Methods The expressions of NY-ESO-1 protein in the LSC and in the pathologically positive lymph nodes were detected by PV-9000 Immunohistochemistry. Western blotting was also employed to measure the expressions of NY-ESO-1 in the tumor core region(TC), the tissues at the sites of 0.5cm, 1.0cm away from LSC periphery and the distant normal larynx tissues. Results NY-ESO-1 protein expression was positive in 30 out of 69 (43.48 %) cases of LSC. The expression level of NY-ESO-1 protein were found to significantly decrease by tums in TC and corresponding adjacent tissues (P ＜0.01). None of the nine normal larynx tissues expressed NY-ESO-1 protein.It did not display an obvious correlation between the expression of NY-ESO-1 with T staging, pathological grading and lymph node metastasis (P ＞0.05). Its positive expression was found in pathologically positive cervical lymph nodes, which were significantly lower than that in the primary site (P ＜0.05). Conclusion NY-ESO-1 protein express at high level in human laryngeal squamous carcinoma, and they may play a role in genesis and development of tumors, which suggests that NY-ESO-1 gene might be used as target antigens for immunotherapy of LSC and the further research is necessary.

OBJECTIVE: To investigate the expression of Bax and PHF20 in laryngeal squamous cell carcinoma (LSCC)and to discuss their relevance and the roles in carcinogenesis and development in LSCC. METHOD: The expressions of Bax and PHF20 in the LSCC tissues and normal mucosa tissues adjacent to carcinoma were detected by SP immunohistochemistry assay. The relationship between the expressions of Bax and PHF20 and the clinicopathological characteristics including clinical stage, pathological type, histological grade and lymph node metastasis in LSCC were analyzed according to the clinical data. RESULT: (1) The expressions of Bax and PHF20 were both significantly lower in the LSCC tissue than that in the normal laryngeal tissue (P < 0.01). (2) In clinical stage grouping, there were no statistical differences of the quantity and positive rate of Bax and PHF20 expressions among supraglottic, glottic and subglottic LSCC (P > 0.05). In histological differentiation grouping, the quantity and positive rate of Bax and PHF20 expressions decreased significantly in poorly differentiated LSCC compared with the well and moderately differentiated LSCCs (P < 0.01, P < 0.05, respectively). In T stage grouping, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in T1 + T2 compared with T3 +T4 (both P < 0.01). In addition, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in LSCC with lymph node metastasis compared to that without lymph node metastasis (both P < 0.01). CONCLUSION The lack of Bax and PHF20 might contribute to the carcinogenesis and development in LSCC. The positive expression of Bax and PHF20 maybe relative to T term degree, differentiation degree and lymphamatic metastasis of LSCC.
Antigens, Neoplasm ; metabolism ; Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; Head and Neck Neoplasms ; metabolism ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; Lymphatic Metastasis ; Prognosis ; Squamous Cell Carcinoma of Head and Neck ; bcl-2-Associated X Protein ; metabolism

OBJECTIVE To observe the submucosal infiltrating extent of laryngeal carcinoma tissue by different location,different T staging and external appearance and to analyze the impact of laryngeal carcinoma submucosal infiltrating extent on surgical margin.METHODS Forty-three laryngeal en bloc specimens coming from 43 cases with laryngeal carcinoma were vertically cut-down along tumor long axis,and were slivered into sections by which laryngeal carcinoma submucosal infiltrating distance was measured under microscope.Laryngeal carcinoma latent submucosal infiltrating extent was compared among different location,different T staging and external appearance.RESULTS Basing on tumor external appearance and infiltrating extent,laryngeal carcinoma was classified into three types:exogenic type,ulcerating infiltrating type and mixed infiltrating type.Of 43 specimens,the three types were 10,8 and 25 cases respectively.There was a significant difference in submucosal infiltrating extent between T1～T2 and T3～T4 laryngeal carcinoma.There was also significant difference in submucosal infiltrating extent between exogenic type and ulcerating infiltrating type or mixed infiltrating type.CONCLUSION The submucosal infiltrating extent of laryngeal carcinoma tissue plays an important role in the surgical margin. As laryngeal carcinoma T stage developing,tumor submucosal infiltrating extent is becoming more extensive.Laryngeal carcinoma submucosal infiltrating extents in ulcerating infiltrating and mixed infiltrating type are more extensive than that in exogenic type.The partial laryngectomy should be prudent to be performed in cases with local advanced ulcerating infiltrating and mixed infiltrating laryngeal carcinoma.

OBJECTIVE: To assess and compare the two procedures, total thyroidectomy (TT) and partial thyroidectomy (PT), for papillary thyroid cancer in terms of associated injuries, postoperative complication, recurrence rate and survival, so as to provide a reference and basis for surgical procedure option of this disease. METHOD: Strictly specified into the exclusion criteria, the combination of computer retrieval and manual retrieval and retrieval systems such as CNKI, Wang Fan, PubMed, central, CBM database. Total thyroidectomy and partial thyroidectomy for the treatment of patients with thyroid papillary cancer related literature were compared, with the retrieval time until December 31, 2013. RESULT: According to the retrieval strategy 4630 literatures were found, and 20 witch matched the exclusion criteria were left, all were retrospective study. TT and PT group of recurrent laryngeal nerve injury rate are 5.9%, 2.0% respectively [OR = 0.39, 95% CI (0.17 - 0.90), P < 0.05], TT and PT group of parathyroid injury rate are respectively 4.9%, 0.8% respectively [OR = 0.23, 95% CI (0.08 - 0.68), P < 0.01]. The TT group of 10 years survival rate is 95.24% - 100%, and the PT group is 96.8% - 99.2% [OR = 0.03, 95% CI (0 - 0.34), P < 0.01]. Unstaged, unstaged TT group' postoperative recurrence rate is 4.7%, while PT group is 12.6% [OR = 3.21, 95% CI (1.57 - 6.57), P < 0. 01]. Postoperative recurrence of stage I TT group and PT group are 4.9%, 7.8% respectively [OR = 3.82, 95% CI (1. 07-13.66) P < 0.05]; The rate of stage II TT group is 0.5%, while the rate of PT group is 15.9% [OR = 17.23, 95% CI (4.03 - 73.73), P < 0.01]. CONCLUSION Different methods of primary thyroid papillary carcinoma surgical treatment can all obtaina good survival, but the rate of laryngeal recurrent nerve injury and parathyroid injury caused by partal throidectomy is relatively lower. As a result, partial thyroidectomy can be a good choice for early stage thyroid papillary carcinoma.
Carcinoma ; surgery ; Carcinoma, Papillary ; Humans ; Neoplasm Recurrence, Local ; Parathyroid Glands ; Postoperative Complications ; Recurrent Laryngeal Nerve Injuries ; Retrospective Studies ; Survival Rate ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods