OBJECTIVE: Study the clinical characteristics, treatment results and prognostic factors of hypopharyngeal carcinoma. MMETHOD: A retrospective analysis was performed of 97 hypopharyngeal cases that were treated in Department of Dtolaryngology of our hospital from January 2008 to December 2012. 93 cases of them are male patients, and 4 cases are female patients. The tumors are originated from pyriform sinus(75 cases), posterior pharyngeal wall (16 cases) and post-cricoid area (6 cases). Of the 97 patients,21 patients were treated with partial hypopharynx resection (21. 6%), 7 were treated with partial laryngectomy+ partial hypopharynx resection (7. 2%), 53 were treated with total laryngectomy+partial hypopharynx resection (54. 6%), 12 were treated with total laryngectomy and total hypopharynx resection, gastric-pharyngeal anastomosis (12. 4%) and 4 were treated with total laryngectomy and total hypopharynx resection, enteric-pharyngeal anastomosis (4. 1%). Sixty-one cases undergo postoperative radiotherapy in Oncology. Use Chi-square test to do enumeration data analysis, the survival rate is calculated with the life table method, survival analysis with Kaplan-Meier method, parallel Log-rank test. Cox regression multivariate analysis model is used to find the factors affecting prognosis. RESULT: The follow-up rate of this group was 90. 7%. All patients' 1-year survival rate is 76. 0% , 3-year survival rate is 56. 0%, pathological lymph node metastasis rate is 71. 1%, occult lymph node metastasis rate is 19. 6%. Local recurrence rate is 21. 6%. The main reasons of death in patients include : cervical lymph node metastasis in 7 patients (21. 9%), local recurrence in 12 cases (37. 5%), distant metastases in 10 patients (31. 3%) and so on. Univariate analysis showed that tumor size (P<0. 01) and tumor T stage (P<0. 05) have impact on survival prognosis, no risk factors was found with Cox regression multivariate analysis. CONCLUSION Hypopharyngeal carcinoma is difficult to be found early, prone to recurrence and metastasis after operation, carefully chosen surgical excision and neck dissection, adjuvant postoperative radiation therapy is the main treatment strategy. Posterior pharyngeal wall carcinoma tend to have higer recurrence and metastasis rate than the other two types of hypopharyngeal caocinom, and treatment would cause much larger injury, so more attention should be paid to this type of hypopharyngeal caocinom.
Carcinoma, Squamous Cell ; diagnosis ; surgery ; Female ; Head and Neck Neoplasms ; diagnosis ; surgery ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; surgery ; Hypopharynx ; surgery ; Laryngectomy ; Lymphatic Metastasis ; Male ; Neck Dissection ; Neoplasm Recurrence, Local ; Pharynx ; Prognosis ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate ; Treatment Outcome

OBJECTIVE: To discuss the function recovery and treatment effect of extended supraglottic orizontal-partial laryngectomy in the treatment of advanced laryngeal carcinoma and vallecula carcinoma. METHOD: Forty-four patients who received extended supraglottic orizontal partial laryngectomy were followed up on the survival, breath function, pronunciation and swallowing function. RESULT: The 2-year, 3-year survival rates of this group were 72.7% and 71.4%, respectively. There were no recurrence cases in this group. All cases of death were due to cervical lymph node metastasis or recurrent cervical lymph node metastasis after cervical lymph node dissection. The extractive rate of tracheostomy tube was 97.7%. Forty-two patients own good pronunciations. Two patients who received partial arytenoid cartilage resection own weaker pronunciations. After practising, all the patients can eat without the nasal feeding tube. CONCLUSION Extended supraglottic orizontalpartial laryngectomy give complete resection of the primary lesion. Patients who received extended supraglottic orizontalpartial laryngectomy have good breath, swallowing and pronunciation function.
Arytenoid Cartilage ; surgery ; Epiglottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neck Dissection ; Neoplasm Recurrence, Local ; Survival Rate ; Tracheostomy

Objective To investigate the role of CT three-dimensional reconstruction (3D-CT) in the diagnosis of bronchial foreign body.Methods Thirty-seven suspected pediatric cases of bronchial foreign bodies underwent CT scanning and 3D-CT reconstruction,whose accuracy was defined by bronchoscopical or surgical findings.Results For all the 37 cases,chest X-ray showed 8 cases (group A) had bronchial foreign body,while 29 cases(group B) were negative.In group A,CT findings suggested lung infection in 5 cases,congenital pulmonary dysplasia-lung lobe absence in 2 cases and tracheo-esophageal fistula in 1 case.In group B (29 patients),25 cases with bronchial foreign bodies were suspected by CT scanning and further bronchoscopical examination confirmed the existence of 24 cases of vegetable foreign body,one case of the tracheal tumor.For the four cases with negative result of bronchial foreign bodies after CT scanning,lung infection and laryngitis were confirmed in two cases respectively.Among the 24 surgically-confirmed cases of vegetable foreign bodies,CT scanning showed tracheobronchial foreign body in fourteen positive results,irregular tracheal stenosis in six cases and obstructive atelectasis,emphysema,pneumonia in seven each.Tracheobronchial foreign body and irregular tracheal stenosis were direct signs,accounting for 74%(20/27).Obstructive atelectasis,emphysema and pneumonia were indirect signs,accounting for 26%(7/27).Conclusion 3D-CT plays an important role in diagnosis and differential diagnosis of bronchial foreign body.

Objective:To investigate the overexpression of Stat3 and Cyclin D1 in laryngeal neoplasm with immunohistochemistry method.Method:With immunohistochemistry method, we investigated the expression of Stat3 and Cyclin D1 in laryngeal neoplasm and analysis the relationship between Stat3 and clinical pathological factor.Result:Stat3 and Cyclin D1 overexpressed in laryngeal neoplasm tissue and they have positive relationship.Conclusion:Active Stat3 may promote the transcription of target gene Cyclin D1,which could accelerate carcinomatous change.

OBJECTIVE: To study the expression of human ether-α-go-go-related gene (herg) and hERG protein expressed by the gene in laryngeal carcinoma compared with the control group(mucosa adjacent to cancer of 2 cm). METHOD: Expression of herg and hERG protein was detected by immunohistochemistry (SP) and real-time PCR in resected tissue of laryngeal carcinoma and mucosa adjacent to cancer of 2 cm. RESULT: (1) By immunohistochemistry, the positive expression rate of hERG in laryngeal carcinoma was 76.7% (23/30), while it was 10.0% (2/20) in mucosa adjacent to cancer of 2 cm, the difference between which was statistically significant (P < 0.05). (2) By real-time PCR, the expression level of herg mRNA in laryngeal carcinoma is 2.25 times higher than that in mucosa adjacent to cancer of 2 cm. CONCLUSION Herg is highly expressed in tissue of laryngeal carcinoma, and it may be have some relevance to the happening and development of laryngeal carcinoma.
ERG1 Potassium Channel ; Ether-A-Go-Go Potassium Channels ; metabolism ; Humans ; Laryngeal Neoplasms ; metabolism ; RNA, Messenger

Objective To study the expression of vascular endothelial growth factor C (VEGF-C), which is known to be capable of inducing cell proliferation of lymphatic endothelium and development of lymphatic vessels, and to study its correlation with cervical lymph node metastasis in human laryngeal carcinomas. Methods The expression of VEGF-C protein in the cancer, its adjacent tissue, and normal tissue obtained from resected specimens of 46 cases of laryngeal cancer was assessed with an immunohistochemical staining assay followed by light microscopic examination, and its relationship with cervical lymph node metastasis was analyzed. Results Immunohistochemical staining of VEGF-C was different obviously in different localities of the resected. The expression of VEGF-C protein was observed in all the central portion, peripheral tissue, and normal tissue of the postoperative specimens. The positive rate of intratumoral VEGF-C was significantly higher than that of adjacent and normal tissue. It was also noted that the positive rate of intratumoral VEGF-C was well correlated with pathological grades, T stages and stages of lymph node metastasis. Conclusions The results suggested that VEGF-C may be a factor of lymphatic metastasis of laryngeal cancer, and it is possible to be used as a predictor of lmphatic metastasis of laryngeal cancer.

OBJECTIVE: To investigate the expression of CXCR4 in maxillary sinus carcinoma cells IMC3 under hypoxia. METHOD: IMC3 cells were cultured for 6 h, 12 h, 24 h and 48 h under normoxia and hypoxia. Real-Time PCR was applied to detect the expression of mRNA of CXCR4 and immunohistochemisrty was applied to investigate its protein level. RESULT: CXCR4 mRNA level was about 0.035 under normal conditions, which was obviously upregulated by hypoxia. The mRNA levels after culturing under hypoxia for 6 h, 12 h, 24 h and 48 h were 0.283, 0.313, 0.426, 0.510 respectively. There was statistically significant difference between the mRNA levels of each two groups (P < 0.05, Mann-Whiney Test) with a time dependent course, except for the difference between the groups of 6 h and 12 h. Immunohistochemistry showed that there was almost negative staining for CXCR4 in the cell cultured in nomoxia, while stong positive staining of CXCR4 was observed in cells cultured in hypoxia . The positive staining was located mainly in the cell membrane and cytoplasm and little in the nucleus. CONCLUSION Hypoxia could induce expression of CXCR4 in IMC3 cells at both mRNA and ptrotein levels. The upregulation of CXCR4 by hypoxia showed an obvious time dependent course.
Cell Hypoxia ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; Humans ; Maxillary Sinus ; metabolism ; pathology ; Receptors, CXCR4 ; metabolism

OBJECTIVE To study the frequencyof extracapsular spread (ECS) in neck metastasis and its impact on prognosis in supraglottic carcinoma. METHODS A total of 177 patients with radical or modified neck dissection between Jan. 1994 and Dec. 1997 for supraglottic carcinoma were summarized. Transparent lymph node detection and a series of sectioning method were applied on all neck dissection specimens. The SPSS software package (version 11.5) was used to make statistical analysis. Survival curves were calculated with the Kaplan-Meier model. Impact of extracapsular spread on prognosis was assessed for significance with the Log-Rank test. RESULTS Eighty one patients were pathologically positive in neck specimens and the neck metastatic rate was 45.8 %. ECS was found in 32 cases and the ECS frequency was 39.5 % (32/81). The ECS was related with pathological N stage and the number of positive nodes. Patients with ECS had a higher possibility of regional recurrence and contralateral metastasis. The 5-year survival rates of patients with neck metastasis ECS- and patients with ECS+ were 61.9 % and 22.2 % respectively. The differences had statistically significance. CONCLUSION ECS in neck metastasis affects the prognosis in patients with supraglottic carcinoma. If bilateral neck dissection was not selected simultaneously, close follow-up on contralateral neck should be selected in patients with ECS because of a higher incidence of contralateral neck metastasis.

Objective To investigate the causes,diagnosis,treatment of the difficult postoperative decannulation resulting from tracheotomy between children and adults and the method of improving the rate of successful decannulation.Methods Clinical data of 56 cases with difficult decannulation after tracheotomy were analysed retrospectively,all the patients were admitted in our hospital between Jan 1990 and Oct 2006.All the patients were separated into two groups,children group including 24 cases of 14 months ～ 14 years old,adult group including 32 cases of age ranging 15 ～ 48 years old.The postoperative time after tracheotomy were 6 month ～ 1.5 year and 6 month ～ 2 year respectively.Results There were differences of the etiology,diagnostic choice and the clinical manifestation in the treatment of the diffficult decannulation after tracheotomy between children and adults.Children with difficult decannulation after tracheotomy occurred mainly in laryngitis and airway foreign body airway caused by obstruction retrieved after tracheotomy (14/24,58.33 ％),followed by the emergency tracheotomy,such as head and neck trauma (7/24,29.17％).Adults with difficult decannulation after tracheotomy mainly occurred in the throat caused by traumatic lesions of the larynx (including malformations,subglottic stenosis of larynx or vocal cord paralysis) (23/32,71.88％).The average block time in children with anti-inflammatory treatment was significantly lower than that in without anti-inflammatory therapy (6.2 d vs 10.1 d,t =4.26,P ＜ 0.01).However,there was no significant difference in the average block time in adults with anti-inflammatory and without anti-inflammatory treatment (t =1.63,P ＞ 0.05).In the course of treatment,rates of children consciously breathing difficulties (21/21,100％) was also significantly higher than the adult group (13/28,46.43％).Conclusion Children less than 3 years old should avoid tracheotomy.There is no definite relation between the successful treatment in the difficult decannulation and the age of the patients over 3 years old.The first failure treatment in children may be related with the local inflammation.When in treatment,doctors should observe the characteristics of respiratory difficulties,take attention to the influence of children psychological factors to the treatment.Children should be treated in the non-traumatic examination methods.

Objective To analyse the clinical characteristics of infants in two months old of lingual thyroglossal duct cysts (LTGDC) and raise the levels of diagnosis and treatment.Methods A comparative analysis was made between the clinical data of 23 cases in two months old of LTGDC and those of 20 cases in one to seven years old of cervical thyroglossal duct cysts (TGDC) (control group).Results The clinical manifestation appeared obviously differences between LTGDC and TGDC.The main performance of LTGDC was laryngeal stridor,and 74％ of them went to emergency department because of dyspnea.They would be misdiagnosed as congenital laryngomalacia or laryngomalacia with pneumonia.The lesion located in the posterosuperior of lingual bone and behind the root of tongue,which was easy to lead to throat obstruction because it extruded laryngeal cavity.Electronic laryngoscopy was the first choice,it helped to identify laryngomalacia,epiglottis cyst and hemangioma.Laryngeal CT or MRI was very important to diagnose LTGDC which was quasi-circular low density shadow with clear boundary,or not extruded to laryngeal cavity,or show lesion range and surrounding structures avoiding misdiagnosis.As treatment depended surgery which was selfretaining laryngoscope,it was minimally invasive and without scar.Cervical anterior mass in the midline was the first symptoms in all 20 cases of TGDC.The neck ultrasound examination was the first selection,and the lesion showed fluid dark space with clear boundary,it should take the neck percutaneous surgical operation.Conclusion The clinical manifestation of infants in two months old of LTGDC appears obviously different from TGDC.LTGDC is a common cause of laryngeal stridor with breathing difficulties.It will be misdiagnosed as congenital laryngomalacia and lead to asphyxia or death easily.