Objective:This study aims to investigate the influence of microvessel density（MVD） and microlymphatic vessel density（MLVD） on the prognosis of patients with hypopharyngeal squamous cell carcinoma（HPSCC） and to develop a nomogram prediction model for prognosis based on pathological characteristics. Methods:A retrospective analysis was conducted on clinicopathological and follow-up data from HPSCC patients who underwent surgical treatment at our institution between June 2010 and June 2020. Immunohistochemical staining was performed on tumor tissues and adjacent normal margin tissues to evaluate MVD and MLVD. The associations among MVD, MLVD, and clinicopathological features were analyzed. Univariate and multivariate Cox regression analyses were conducted to identify independent risk factors affecting overall survival（OS）. Based on these findings, a nomogram model was constructed and its predictive accuracy was assessed using C-index, receiver operating characteristic（ROC） curve, and calibration curve. Results:Both MVD and MLVD were significantly higher in HPSCC tumor tissues compared to normal tissues. Patients in the high MVD and high MLVD groups exhibited significantly lower OS rates than those in the low MVD and low MLVD groups. Multivariate Cox regression analysis revealed that N stage, recurrence, nerve invasion, lymph node capsule invasion, MVD, and MLVD were independent prognostic factors of OS. Based on these factors, a nomogram prognosis model was successfully constructed. The nomograms demonstrated superior performance in terms of C-index, area under the ROC curve, and calibration, outperforming the AJCC TNM staging system. Conclusion:Elevated MVD and MLVD levels are associated with poorer prognosis in HPSCC patients. The nomogram model based on pathological features provides valuable insights for clinical assessment and decision-making.
Humans ; Hypopharyngeal Neoplasms/blood supply* ; Prognosis ; Retrospective Studies ; Microvascular Density ; Nomograms ; Lymphatic Vessels/pathology* ; Male ; Female ; Middle Aged ; Carcinoma, Squamous Cell/blood supply* ; Microvessels/pathology* ; Lymphatic Metastasis ; Survival Rate

OBJECTIVE: To explore the feasible monitoring techniques for the buried free flap. METHOD: Buried free flaps in reconstruction were monitored using combined monitoring techniques in five cases of advanced hypopharyngeal cancer The monitoring effects were analyzed retrospectively. RESULT: The operations were carried out successfully and all the five patients got primary healing of incision without vascular crisis. Four patients need combined monitoring techniques to confirm the microcirculatory results of the buried free flap. CONCLUSION Application of Doppler combined with flap island was feasible on monitoring the blood supply of post-operative buried free flap, it is a good monitoring technique.
Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; surgery ; Free Tissue Flaps ; blood supply ; Head and Neck Neoplasms ; diagnostic imaging ; pathology ; surgery ; Humans ; Hypopharyngeal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Hypopharynx ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Surgical Flaps ; blood supply ; Ultrasonography, Doppler

OBJECTIVE: To investigate the expression and significance of vascular cell adhesion molecule-1 (VCAM-1) and P-selectin in hypopharyngeal carcinoma, and explore the relationship of VCAM-1, P-selectin and microvessel density (MVD). METHOD: Expression of VCAM-1 and P-selectin were detected by immunohistochemistry staining in 40 specimens of hypopharyngeal carcinoma and 10 specimens of normal mucosa of oral pharynx. MVD was assessed based on the expression of CD34. RESULT: VCAM-1 and P-selectin were detected in 26 out of 40 (65%) and 29 out of 40 (72.5%) respectively in hypopharyngeal carcinoma, but none that in normal mucosa (P<0.01). MVD in hypopharyngeal carcinoma was higher than that in normal mucosa and it was related to lymph node metastasis. MVD level was significantly higher in VCAM-1 and P-selectin-positive specimens than in negative ones (P<0.01), which also positively correlated with the expression of VCAM-1 and P-selectin (P<0.01). The expression of P-selectin positively correlated with VCAM-1 in hypopharyngeal carcinoma specimens with lymph node metastasis. CONCLUSION The higher expression of VCAM-1 and P-selectin play key roles in the invasion and metastasis of hypopharyngeal carcinoma and were correlated with vascularization.
Adult ; Aged ; Carcinoma, Squamous Cell ; blood supply ; metabolism ; pathology ; Humans ; Hypopharyngeal Neoplasms ; blood supply ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Microvessels ; Middle Aged ; Neoplasm Staging ; P-Selectin ; metabolism ; Vascular Cell Adhesion Molecule-1 ; metabolism