BACKGROUND Gastric cancer(GC)and head and neck squamous cell carcinoma(HNSCC)are common malignancies with high morbidity and mortality rates.Traditional treatments often yield limited efficacy,especially in advanced c...BACKGROUND Gastric cancer(GC)and head and neck squamous cell carcinoma(HNSCC)are common malignancies with high morbidity and mortality rates.Traditional treatments often yield limited efficacy,especially in advanced cases.Recent advancements in immunotherapy,particularly immune checkpoint inhibitors targeting programmed death-ligand 1(PD-L1),have shown promise.However,the expression and interaction of pescadillo ribosomal biogenesis factor 1(PES1)and PD-L1 in these cancers remain unclear.Understanding their roles could provide new insights into tumor biology and improve therapeutic strategies.AIM To investigate the expression levels of PES1 and PD-L1 in tumor tissues of patients with GC and HNSCC.METHODS A total of 58 cases of GC and HNSCC undergoing surgical resection were selected from January 2022 to January 2024.Paraffin specimens of GC and HNSCC tissues were taken from the patients,and the sections were subjected to staining with immunohistochemistry and hematoxylin-eosin staining,and the protein expression of PES1 and PD-L1 was observed microscopically.RESULTS Among 58 GC and HNSCC tissues,30 cases were positive and 28 cases were negative for PES1 expression,and 34 cases were positive and 24 cases were negative for PD-L1 expression.The positive expression rates of PES1 and PDL1 were 51.72% and 58.62%,respectively.PES1 expression was correlated with the TNM stage,lymph node metastasis,and the depth of infiltration(P<0.05),and PD-L1 expression was correlated with the differentiation degree,lymph node metastasis,and infiltration depth(P<0.05).CONCLUSION PES1 and PD-L1 were positively expressed in GC and HNSCC tissues and correlated with clinical features.They may serve as potential biomarkers for immune-targeted therapies.展开更多
Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can ...Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can serve as a tumor biomarker,the underlying mechanism in modulating head and neck squamous cell carcinoma(HNSCC)remains unclear.In this study,the aimed was to investigate the CXCL16 expression in HNSCC and to uncover the potential underlying mechanism.Hereby,we determined the high expression of CXCL16 in The Cancer Genome Atlas(TCGA)database,as well as in tissue samples from patients with HNSCC at our central hospital and from HNSCC cell lines.The results showed that CXCL16 knockdown inhibited the proliferation,migration,and invasion of HNSCC cells.Mechanistically,transcriptome sequencing revealed that CXCL16 may affect HNSCC cell growth by regulating the antioxidant pathway of glutathione peroxidase 1(GPX1).The reactive oxygen species(ROS)levels were elevated in small interfering CXCL16(si-CXCL16)cells,which may contribute to the inhibition of cell proliferation,migration,and invasion.Moreover,treatment of cells with the GPX1 inhibitor eldecalcitol(ED-71)revealed that HNSCC cell growth was significantly inhibited in the synergistic group of si-CXCL16 and GPX1 inhibitor compared to the si-CXCL16 group.In conclusion,CXCL16 contributed to the development of HNSCC cells by modulating the GPX1-mediated antioxidant pathway.Thus,targeting cellular CXCL16 expression seems to be a promising strategy for treating HNSCC.展开更多
BACKGROUND Patients with head and neck cancer often develop depressive symptoms during radiochemotherapy due to changes in saliva secretion,radiation-induced oral mucositis,and dysphagia.These symptoms significantly a...BACKGROUND Patients with head and neck cancer often develop depressive symptoms during radiochemotherapy due to changes in saliva secretion,radiation-induced oral mucositis,and dysphagia.These symptoms significantly affect quality of life.Although existing nursing interventions provide some relief,they have limitations in improving swallowing function and developing coping strategies.AIM To evaluate the effectiveness of tongue pressure resistance feedback training combined with empowerment education in improving depressive symptoms and swallowing function in patients with head and neck cancer undergoing radiochemotherapy.METHODS This study included 110 patients with head and neck cancer who exhibited depressive symptoms and underwent radiochemotherapy at the Affiliated Hospital of Jiangnan University between January 2021 and December 2023.Patients were randomly assigned to either a reference group or an experimental group,each comprising 55 patients.The reference group received routine care,whereas the experimental group received tongue pressure resistance feedback training and empowerment education.After 6 weeks of continuous intervention,comparisons were made between the two groups regarding depressive symptom scores,swallowing function,coping strategies,and quality of life,both pre-and post-intervention.RESULTS Following the intervention,both groups demonstrated decreased scores for depressive symptoms and swallowing function,with the experimental group showing a significantly greater reduction than the reference group(P<0.05).The experimental group also demonstrated higher confrontation scores and lower avoidance and submission scores for coping strategies than the reference group(P<0.05).Quality of life scores improved in both groups after the intervention,with the experimental group showing markedly higher scores than the reference group(P<0.05).CONCLUSION The combination of tongue pressure resistance feedback training and empowerment education is effective in alleviating depressive symptoms,enhancing swallowing function,optimizing coping strategies,and significantly improving the quality of life of patients with head and neck cancer undergoing radiochemotherapy.This approach shows promise for clinical applications and promotion.展开更多
Background:Head and neck squamous cell carcinoma(HNSCC)is a prevalent form of cancer globally,with chemoresistance posing a major challenge in treatment outcomes.The efficacy of the commonly used chemotherapeutic agent...Background:Head and neck squamous cell carcinoma(HNSCC)is a prevalent form of cancer globally,with chemoresistance posing a major challenge in treatment outcomes.The efficacy of the commonly used chemotherapeutic agent,cisplatin,is diminished in patients with poor prognoses.Methods:Various bioinformatics databases were utilized to examine Carboxylesterase 1(CES1)gene expression,clinicopathologic features,patient survival analysis,and gene function.An organoid model of HNSCC was established,along with the induction of drug-resistant HNSCC in the organoid model.CES1 expression was assessed using qRT-PCR and Western Blot,and differential markers were identified through transcriptome sequencing.Knockdown and overexpression models of CES1 were created in SCC-9 and patient-derived organoid(PDO)cells using shRNA and lentivirus to investigate the tumor biology and cisplatin resistance associated with CES1.Results:Research in bioinformatics has uncovered a strong correlation between the expression level of CES1 and the prognosis of HNSCC.The data suggests a significant link between CES1 expression and tobacco smoking.RNA-sequencing revealed a notable increase in CES1 expression in HNSCC-PDOcis-R cells compared to the parental PDO cells.Subsequently,we performed in vitro studies by HNSCC-PDO and SCC-9 and found that CES1-overexpressing cells exhibited reduced sensitivity to cisplatin and stronger tumor malignant biological behavior compared with CES1-knockdown cells.Conclusion:The observed association between CES1 expression and tobacco smoking implies a potential influence of smoking on the efficacy of cisplatin-based chemotherapy in HNSCC through the regulation of CES1 expression.展开更多
Against the backdrop of the gradual deepening of interest rate liberalization,the decline in effective credit demand,the intensification of competitive involution among commercial banks,and the complex international e...Against the backdrop of the gradual deepening of interest rate liberalization,the decline in effective credit demand,the intensification of competitive involution among commercial banks,and the complex international economic and trade situation,commercial banks in China's mainland have entered a stage of low interest rates and narrow interest margins.Coupled with the continuous exposure of risks in retail customer groups and small and micro enterprises,many commercial banks have chosen to phase in expanding and strengthening their corporate business segments to smoothly navigate economic cycles and enhance operational resilience and sustainability.How the corporate business segment optimizes its asset-liability structure through asset allocation to achieve high-quality development is a major issue worthy of consideration by the entire industry.From the perspective of a medium-sized national commercial bank,this paper explores and proposes four key basic customer groups,six asset allocation models,and fourteen key industries for layout,for reference,and research.展开更多
BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses r...BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.展开更多
BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of sali...BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of salivary fistula remains a major complication.This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.AIM To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.METHODS A total of 52 patients(44 men,8 women),aged 43 to 77 years,underwent total laryngectomy.Esophageal reconstruction was performed using either a stapler(29 patients)or a hand-sewn technique(23 patients).A surgical stapler TA was used for esophageal closure in the stapler group.Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.RESULTS A total of 22 salivary fistulas were recorded:17(77.3%)occurred following the hand-sewn technique,while 5(22.7%)developed in the stapler group.Addi-tionally,preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation.No technical complications related to the stapler device were observed.CONCLUSION Although hand-sewn closure is commonly used after total laryngectomy,stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.展开更多
Promoting chronic wound healing has always been a hot topic in the field of biomaterials due to its heavy burden on both patients’quality of life and healthcare systems.MXene is a type of two-dimensional(2D)nanomater...Promoting chronic wound healing has always been a hot topic in the field of biomaterials due to its heavy burden on both patients’quality of life and healthcare systems.MXene is a type of two-dimensional(2D)nanomaterial with a unique physical structure and surface chemical properties.The remarkable antibacterial capacity,fast photothermal response ability and electrical conductivity of MXene,indicate that MXene-based hydrogels possess considerable potential for promoting chronic wound healing.In this review,we summarize the preparation and properties of MXene,and mainly focus on the applications of MXene-based hydrogels in chronic wound healing.The purpose of this review is to provide a reference for further study and promote the application of MXene-based hydrogels in clinical practice in the future.展开更多
Objective: To explore the application effect of self-management based on Snyder’s hope theory in diabetic patients. Methods: A total of 260 patients with diabetes from a community were selected through convenient sam...Objective: To explore the application effect of self-management based on Snyder’s hope theory in diabetic patients. Methods: A total of 260 patients with diabetes from a community were selected through convenient sampling and randomly divided into an experimental group and a control group using the random number table method, with 130 cases in each group. Five cases were lost in the experimental group, resulting in 125 effective cases, while all 130 cases in the control group were effective. The control group received standard lectures on diabetes self-management behavior and traditional approaches, such as the distribution of educational manuals. The experimental group underwent a self-management behavior intervention program for diabetic patients based on Snyder’s hope theory model, encompassing three components: goals, pathways, and motivational thinking. The levels of hope and self-management behavior were compared between the two groups. Results: After the intervention, the scores for hope levels and self-management behaviors in both groups were significantly higher than those recorded before the intervention (P < 0.05). Furthermore, the hope level and self-management behavior scores of the experimental group were significantly higher than those of the control group (P < 0.05). Conclusion: The application of Snyder’s hope theory model in diabetic patients demonstrates significant benefits, improving patients’ hope levels and, consequently, enhancing their self-management behaviors.展开更多
Neuroinflammation is the primary driver and signature of many neurodevelopmental disorders.However,because neurodevelopmental disorders caused by neuroinflammation are difficult to detect at the early stage,their prog...Neuroinflammation is the primary driver and signature of many neurodevelopmental disorders.However,because neurodevelopmental disorders caused by neuroinflammation are difficult to detect at the early stage,their progression remains unclear.To date,neither animal experiments nor in vitro models have uncovered their early developmental characteristics caused by neuroinflammation.In this study,we developed a neurovascular-unit-on-a-chip(NVU-on-a-chip)to model inflammation-induced neurodevelopmental disorders.With the chip,dynamic visualization of the progression caused by neuroinflammation was clearly demonstrated,and the changes in angiogenesis and neural differentiation under neuroinflammation were replicated.In addition,the activation of astrocytes and damage to neurons and capillaries at the early stage of neurodevelopmental disorders were observed.The results revealed for the first time the structural disruption of the neurovascular units and the neurovascular coupling failure caused by neuroinflammation.Furthermore,the outcomes of anti-inflammatory intervention using ibuprofen were preliminarily demonstrated.This work provides insights into the early progression of neurodevelopmental disorders caused by neuroinflammation and offers a platform for the development of therapeutic strategies for neuroinflammation.展开更多
To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance...To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.RESULTSA total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.CONCLUSIONSurveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.展开更多
Background:p53 and DIRAS3 are tumor suppressors that are frequently silenced in tumors.In this study,we sought to determine whether the concurrent re-expression of p53 and DIRAS3 could effectively induce head and neck...Background:p53 and DIRAS3 are tumor suppressors that are frequently silenced in tumors.In this study,we sought to determine whether the concurrent re-expression of p53 and DIRAS3 could effectively induce head and neck squamous cell carcinoma(HNSCC)cell death.Methods:CAL-27 and SCC-25 cells were treated with Ad-DIRAS3 and rAd-p53 to induce re-expression of DIRAS3 and p53 respectively.The effects of DIRAS3 and p53 re-expression on the growth and apoptosis of HNSCC cells were examined by TUNEL assay,flow cytometric analysis and MTT.The effects of DIRAS3 and p53 re-expression on Akt phosphorylation,oncogene expression,and the interaction of 4 E-BP1 with eIF4 E were determined by real-time PCR,Western blotting and immunoprecipitation analysis.The ability of DIRAS3 and p53 re-expression to induce autophagy was evaluated by transmission electron microscopy,LC3 fluorescence microscopy and Western blotting.The effects of DIRAS3 and p53 re-expression on HNSCC growth were evaluated by using an orthotopic xenograft mouse model.Results:TUNEL assay and flow cytometric analysis showed that the concurrent re-expression of DIRAS3 and p53 significantly induced apoptosis(P<0.001).MTT and flow cytometric analysis revealed that DIRAS3 and p53 reexpression significantly inhibited proliferation and induced cell cycle arrest(P<0.001).Mechanistically,the concurrent re-expression of DIRAS3 and p53 down-regulated signal transducer and activation of transcription 3(STAT3)and upregulated p21WAF1/CIP1 and Bax(P<0.001).DIRAS3 and p53 re-expression also inhibited Akt phosphorylation,increased the interaction of eIF4 E with 4 E-BP1,and reduced the expression of c-Myc,cyclin D1,vascular endothelial growth factor(VEGF),fibroblast growth factor(FGF),epidermal growth factor receptor(EGFR)and Bcl-2(P<0.001).Moreover,the concurrent re-expression of DIRAS3 and p53 increased the percentage of cells with GFP-LC3 puncta compared with that in cells treated with control adenovirus(50.00%±4.55%vs.4.67%±1.25%,P<0.001).LC3 fluorescence microscopy and Western blotting further showed that DIRAS3 and p53 re-expression significantly promoted autophagic activity but also inhibited autophagic flux,resulting in overall impaired autophagy.Finally,the concurrent re-expression of DIRAS3 and p53 significantly decreased the tumor volume compared with the control group in a HNSCC xenograft mouse model[(3.12±0.75)mm^(3) vs.(189.02±17.54)mm^(3),P<0.001].Conclusions:The concurrent re-expression of DIRAS3 and p53 is a more effective approach to HNSCC treatment than current treatment strategies.展开更多
Spindle cell carcinoma of head and neck, a subtype of squamous cell carcinoma is a unique and rare neoplasm. It has a more aggressive behavior as compared to classical squomous cell carcinoma warranting surgical inter...Spindle cell carcinoma of head and neck, a subtype of squamous cell carcinoma is a unique and rare neoplasm. It has a more aggressive behavior as compared to classical squomous cell carcinoma warranting surgical interventions with wider surgical margins. Immunohistochemistry along with routine histopathology is essential in establishing the diagnosis of spindle cell carcinoma. We at Dr. B. Borooah Cancer Institute, Guwahati, a regional institute for treatment and research, hereby report 40 cases of such lesion with clinicopathological and immunohistochemical study. Out of total 40 cases included in the study group most of the cases were in the age group of 40 to 60 years. Commonest site of presentation was nasopharynx and buccal mucosa. 14 cases of the oral cavity (buccal mucosa, alveolus, oral tongue and hard palate) were treated with surgery. All the cases with disease of the larynx and hypopharynx were treated with radiotherapy and cases involving the nasopharynx received radiotherapy and chemotherapy. In the surgery group recurrence rate was found to be 71.4% and metastasis rate was 21.4%. Biopsy specimens were subjected to histopathological examination followed by immunohistochemistry. Immunohistochemical analysis show concurrent presence of malignant epithelial and sarcomatoid spindle cell components by co-expression of cytokeratin (CK) and vimentin to various degrees.展开更多
Pilomatrix Carcinoma (PC) is an exceedingly rare neoplasm. Although it has been described at various anatomical sites, fewer than 25 cases have been reported in the face and scalp. Although early recognition and treat...Pilomatrix Carcinoma (PC) is an exceedingly rare neoplasm. Although it has been described at various anatomical sites, fewer than 25 cases have been reported in the face and scalp. Although early recognition and treatment is paramount in optimization of outcomes for this aggressive carcinoma, the diagnosis is complicated by shared features with its more common benign counterpart. In patients with recurrence or rapid growth of a pilomatrixoma, pilomatrix carcinoma should be considered in the differential diagnosis.展开更多
BACKGROUND Meningiomas are benign tumors that originate from the meningothelial arachnoid cells,but they rarely develop extracranially.There is no specific surgical guideline for resecting them in the maxillary sinus,...BACKGROUND Meningiomas are benign tumors that originate from the meningothelial arachnoid cells,but they rarely develop extracranially.There is no specific surgical guideline for resecting them in the maxillary sinus,and little is known about their biological behavior and operative management.CASE SUMMARY We present a 54-year-old female patient referred to our department with a primary extracranial meningioma that presented as buccal swelling associated with headache.On clinical examination the mass was non-tender,fixed,sessile and non-pulsatile situating in the right maxillary sinus.Computed tomography scan showed a well-defined mass of 7 cm×6 cm×6 cm compressing the surrounding structures.Magnetic resonance imaging revealed a well circumscribed heterogenous lesion with necrotic center and relatively hypointense on T2-weighted imaging.Imaging studies revealed no evidence of intracranial extension and metastatic nests.Biopsy showed grade I primary extracranial with low mitotic activity.Total maxillectomy with excision of tumor and adjacent paranasal structures following reconstruction of the orbit and maxilla with tissue patch was done by the maxillofacial surgeon.The biopsy reported fibrous meningioma based on the hematoxylin and eosin section.On immunohistochemistry the tumor cells were positive for vimentin,focally positive for epithelial membrane antigen and CD99 and negative for signal transducer and activator of transcription 6.The mass was removed surgically with reconstruction,and the pathological studies confirmed the diagnosis to be an extracranial meningioma.The present study briefly reviews the current knowledge concerning the diagnosis and treatment of extracranial meningiomas in the head and neck area and offers suggestions for managing extracranial meningiomas in the paranasal sinuses.CONCLUSION To conclude,extracranial meningiomas in the paranasal sinuses may be successfully managed by surgical treatment without evident post-surgery complications.展开更多
Objective: To investigate for the feasibility and advantages performed by the unilateral big hockey stick incision (BHSI) in head and neck carcinoma. Methods: Neck dissection by using the unilateral big hockey stick i...Objective: To investigate for the feasibility and advantages performed by the unilateral big hockey stick incision (BHSI) in head and neck carcinoma. Methods: Neck dissection by using the unilateral big hockey stick incision (BHSI) was performed on 93 patients with head and neck carcinoma. Results: The big hockey stick incision has a cosmetic scar and not scar contraction and is barely visible and easily covered in hair and clothing; sufficient exposure of the operation field; a small area of marginal necrosis was occasionally seen at the apex of the skin flap due to having preoperative radiotherapy. Conclusion: The unilateral big hockey stick incision has adequate surgical access, good healing of skin flaps, and a good cosmetic result.展开更多
Introduction: The goal of this study was to analyze the causes of death in patients with loco-regionally advanced squamous cell carcinoma (HNSCC) of the head and neck treated with multimodality treatment. Materiel: Th...Introduction: The goal of this study was to analyze the causes of death in patients with loco-regionally advanced squamous cell carcinoma (HNSCC) of the head and neck treated with multimodality treatment. Materiel: The mortality records of 138 advanced head and neck patients treated in our department with surgery and adjuvant (chemo) radiotherapy from 2007 to 2013 were collected and reviewed in this study.?Results: From May 2007 to January 2013, 138 patients were followed up with a median follow-up duration of 25 months. The 5-year overall survival (OS), disease-free survival (DFS) were 45%, and 56.1%, respectively. A total of 39 patients (28%) died during the follow-up period. Clearly, in this population, loco-regional relapse accounted for one of the most cause of death but acute and late or chronic treatment-associated causes leading to death occurred in almost 8% of the patients. Furthermore, the risk of death from head and neck squamous cell carcinoma (HNSCC) was greater in patients with hypopharynx cancer. Univariate analysis indicated that patients with N2b disease and above and vascular tumor embolism had a lower overall survival (p = 0.001 and p = 0.007 respectively). The multivariate analysis showed that N2b disease and above was an independent prognostic factor for poorer loco-regional control (p = 0.001). Conclusions: Patients with locally advanced head and neck cancer treated with surgery and adjuvant (chemo) radiotherapy are potentially curable but face significant risks of mortality from causes other than disease progression.展开更多
The head and neck region encompasses structures from the base of the skull to the clavicles which include nasopharynx,oropharynx,hypopharynx,larynx and oral cavity.Tobacco,alcohol,and human papilloma virus(HPV)infecti...The head and neck region encompasses structures from the base of the skull to the clavicles which include nasopharynx,oropharynx,hypopharynx,larynx and oral cavity.Tobacco,alcohol,and human papilloma virus(HPV)infection are the three major risk factors for head and neck squamous cell carcinoma(HNSCC)in different countries.展开更多
OBJECTIVE To summarize our clinical experience in treating 31 patients with neck masses undergoing carotid artery resection without arterial anastomosis （vascular reconstruction） in Tianjin Cancer Hospital during a ...OBJECTIVE To summarize our clinical experience in treating 31 patients with neck masses undergoing carotid artery resection without arterial anastomosis （vascular reconstruction） in Tianjin Cancer Hospital during a period from 1979 to 2002. METHODS Preoperatively, patients were instructed to apply pressure to the carotid artery. Tumor excision combined with carotid artery resection （TECCAR） was conducted after an accurate testing of valid cerebral blood supply and compensation. RESULTS Among the study patients, 17 were male and 14 female, with the age ranging from 14 to 58 years. Of the 31 cases, 23 were carotid body tumors （8 malignant）, 2 vagal body tumors （1 malignant）, 4 carotid aneurysms, and 2 were metastatic tumors from the cervix involving carotid artery. Of the patients, a subtotal resection of the head and neck masses was conducted in 22 cases. Intraoperative death did not cerebrovascular complications occur, and postoperative CNS or （CVC） were not found. CONCLUSION TECCAR without arterial anastomosis is a safe and feasible procedure. In addition, this method of surgery has more advantages in comparison to an arterial anastomosis： i） Tumor resection was more complete, ii） Complications such as thrombus, infection, and lethal hemorrhage etc., were rare after surgery; iii） Postoperative radiotherapy, if needed, would be safe and acceptable; iv） It was a more simplified operational procedure.展开更多
文摘BACKGROUND Gastric cancer(GC)and head and neck squamous cell carcinoma(HNSCC)are common malignancies with high morbidity and mortality rates.Traditional treatments often yield limited efficacy,especially in advanced cases.Recent advancements in immunotherapy,particularly immune checkpoint inhibitors targeting programmed death-ligand 1(PD-L1),have shown promise.However,the expression and interaction of pescadillo ribosomal biogenesis factor 1(PES1)and PD-L1 in these cancers remain unclear.Understanding their roles could provide new insights into tumor biology and improve therapeutic strategies.AIM To investigate the expression levels of PES1 and PD-L1 in tumor tissues of patients with GC and HNSCC.METHODS A total of 58 cases of GC and HNSCC undergoing surgical resection were selected from January 2022 to January 2024.Paraffin specimens of GC and HNSCC tissues were taken from the patients,and the sections were subjected to staining with immunohistochemistry and hematoxylin-eosin staining,and the protein expression of PES1 and PD-L1 was observed microscopically.RESULTS Among 58 GC and HNSCC tissues,30 cases were positive and 28 cases were negative for PES1 expression,and 34 cases were positive and 24 cases were negative for PD-L1 expression.The positive expression rates of PES1 and PDL1 were 51.72% and 58.62%,respectively.PES1 expression was correlated with the TNM stage,lymph node metastasis,and the depth of infiltration(P<0.05),and PD-L1 expression was correlated with the differentiation degree,lymph node metastasis,and infiltration depth(P<0.05).CONCLUSION PES1 and PD-L1 were positively expressed in GC and HNSCC tissues and correlated with clinical features.They may serve as potential biomarkers for immune-targeted therapies.
基金supported by the Scientific Research Fund of the National Health Commission-Zhejiang Provincial Health Major Science and Technology Plan Project(No.WKJ-ZJ-2415)the Key Research and Development Program of Zhejiang Province(No.2024C03166)+1 种基金the Traditional Chinese Medicine Science and Technology Project of Zhejiang Province(No.2022ZB020)the Zhejiang Provincial Natural Science Foundation of China(No.LY21H160049).
文摘Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can serve as a tumor biomarker,the underlying mechanism in modulating head and neck squamous cell carcinoma(HNSCC)remains unclear.In this study,the aimed was to investigate the CXCL16 expression in HNSCC and to uncover the potential underlying mechanism.Hereby,we determined the high expression of CXCL16 in The Cancer Genome Atlas(TCGA)database,as well as in tissue samples from patients with HNSCC at our central hospital and from HNSCC cell lines.The results showed that CXCL16 knockdown inhibited the proliferation,migration,and invasion of HNSCC cells.Mechanistically,transcriptome sequencing revealed that CXCL16 may affect HNSCC cell growth by regulating the antioxidant pathway of glutathione peroxidase 1(GPX1).The reactive oxygen species(ROS)levels were elevated in small interfering CXCL16(si-CXCL16)cells,which may contribute to the inhibition of cell proliferation,migration,and invasion.Moreover,treatment of cells with the GPX1 inhibitor eldecalcitol(ED-71)revealed that HNSCC cell growth was significantly inhibited in the synergistic group of si-CXCL16 and GPX1 inhibitor compared to the si-CXCL16 group.In conclusion,CXCL16 contributed to the development of HNSCC cells by modulating the GPX1-mediated antioxidant pathway.Thus,targeting cellular CXCL16 expression seems to be a promising strategy for treating HNSCC.
文摘BACKGROUND Patients with head and neck cancer often develop depressive symptoms during radiochemotherapy due to changes in saliva secretion,radiation-induced oral mucositis,and dysphagia.These symptoms significantly affect quality of life.Although existing nursing interventions provide some relief,they have limitations in improving swallowing function and developing coping strategies.AIM To evaluate the effectiveness of tongue pressure resistance feedback training combined with empowerment education in improving depressive symptoms and swallowing function in patients with head and neck cancer undergoing radiochemotherapy.METHODS This study included 110 patients with head and neck cancer who exhibited depressive symptoms and underwent radiochemotherapy at the Affiliated Hospital of Jiangnan University between January 2021 and December 2023.Patients were randomly assigned to either a reference group or an experimental group,each comprising 55 patients.The reference group received routine care,whereas the experimental group received tongue pressure resistance feedback training and empowerment education.After 6 weeks of continuous intervention,comparisons were made between the two groups regarding depressive symptom scores,swallowing function,coping strategies,and quality of life,both pre-and post-intervention.RESULTS Following the intervention,both groups demonstrated decreased scores for depressive symptoms and swallowing function,with the experimental group showing a significantly greater reduction than the reference group(P<0.05).The experimental group also demonstrated higher confrontation scores and lower avoidance and submission scores for coping strategies than the reference group(P<0.05).Quality of life scores improved in both groups after the intervention,with the experimental group showing markedly higher scores than the reference group(P<0.05).CONCLUSION The combination of tongue pressure resistance feedback training and empowerment education is effective in alleviating depressive symptoms,enhancing swallowing function,optimizing coping strategies,and significantly improving the quality of life of patients with head and neck cancer undergoing radiochemotherapy.This approach shows promise for clinical applications and promotion.
基金supported by the National Natural Science Foundation of China(No.82160386)the Guangxi Natural Science Foundation of China(No.2024GXNSFDA010032,2023GXNSFAA026189).
文摘Background:Head and neck squamous cell carcinoma(HNSCC)is a prevalent form of cancer globally,with chemoresistance posing a major challenge in treatment outcomes.The efficacy of the commonly used chemotherapeutic agent,cisplatin,is diminished in patients with poor prognoses.Methods:Various bioinformatics databases were utilized to examine Carboxylesterase 1(CES1)gene expression,clinicopathologic features,patient survival analysis,and gene function.An organoid model of HNSCC was established,along with the induction of drug-resistant HNSCC in the organoid model.CES1 expression was assessed using qRT-PCR and Western Blot,and differential markers were identified through transcriptome sequencing.Knockdown and overexpression models of CES1 were created in SCC-9 and patient-derived organoid(PDO)cells using shRNA and lentivirus to investigate the tumor biology and cisplatin resistance associated with CES1.Results:Research in bioinformatics has uncovered a strong correlation between the expression level of CES1 and the prognosis of HNSCC.The data suggests a significant link between CES1 expression and tobacco smoking.RNA-sequencing revealed a notable increase in CES1 expression in HNSCC-PDOcis-R cells compared to the parental PDO cells.Subsequently,we performed in vitro studies by HNSCC-PDO and SCC-9 and found that CES1-overexpressing cells exhibited reduced sensitivity to cisplatin and stronger tumor malignant biological behavior compared with CES1-knockdown cells.Conclusion:The observed association between CES1 expression and tobacco smoking implies a potential influence of smoking on the efficacy of cisplatin-based chemotherapy in HNSCC through the regulation of CES1 expression.
文摘Against the backdrop of the gradual deepening of interest rate liberalization,the decline in effective credit demand,the intensification of competitive involution among commercial banks,and the complex international economic and trade situation,commercial banks in China's mainland have entered a stage of low interest rates and narrow interest margins.Coupled with the continuous exposure of risks in retail customer groups and small and micro enterprises,many commercial banks have chosen to phase in expanding and strengthening their corporate business segments to smoothly navigate economic cycles and enhance operational resilience and sustainability.How the corporate business segment optimizes its asset-liability structure through asset allocation to achieve high-quality development is a major issue worthy of consideration by the entire industry.From the perspective of a medium-sized national commercial bank,this paper explores and proposes four key basic customer groups,six asset allocation models,and fourteen key industries for layout,for reference,and research.
文摘BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.
文摘BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of salivary fistula remains a major complication.This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.AIM To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.METHODS A total of 52 patients(44 men,8 women),aged 43 to 77 years,underwent total laryngectomy.Esophageal reconstruction was performed using either a stapler(29 patients)or a hand-sewn technique(23 patients).A surgical stapler TA was used for esophageal closure in the stapler group.Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.RESULTS A total of 22 salivary fistulas were recorded:17(77.3%)occurred following the hand-sewn technique,while 5(22.7%)developed in the stapler group.Addi-tionally,preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation.No technical complications related to the stapler device were observed.CONCLUSION Although hand-sewn closure is commonly used after total laryngectomy,stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.
基金supported by National Natural Science Foundation of China(Nos.52103039 and 82370977).
文摘Promoting chronic wound healing has always been a hot topic in the field of biomaterials due to its heavy burden on both patients’quality of life and healthcare systems.MXene is a type of two-dimensional(2D)nanomaterial with a unique physical structure and surface chemical properties.The remarkable antibacterial capacity,fast photothermal response ability and electrical conductivity of MXene,indicate that MXene-based hydrogels possess considerable potential for promoting chronic wound healing.In this review,we summarize the preparation and properties of MXene,and mainly focus on the applications of MXene-based hydrogels in chronic wound healing.The purpose of this review is to provide a reference for further study and promote the application of MXene-based hydrogels in clinical practice in the future.
文摘Objective: To explore the application effect of self-management based on Snyder’s hope theory in diabetic patients. Methods: A total of 260 patients with diabetes from a community were selected through convenient sampling and randomly divided into an experimental group and a control group using the random number table method, with 130 cases in each group. Five cases were lost in the experimental group, resulting in 125 effective cases, while all 130 cases in the control group were effective. The control group received standard lectures on diabetes self-management behavior and traditional approaches, such as the distribution of educational manuals. The experimental group underwent a self-management behavior intervention program for diabetic patients based on Snyder’s hope theory model, encompassing three components: goals, pathways, and motivational thinking. The levels of hope and self-management behavior were compared between the two groups. Results: After the intervention, the scores for hope levels and self-management behaviors in both groups were significantly higher than those recorded before the intervention (P < 0.05). Furthermore, the hope level and self-management behavior scores of the experimental group were significantly higher than those of the control group (P < 0.05). Conclusion: The application of Snyder’s hope theory model in diabetic patients demonstrates significant benefits, improving patients’ hope levels and, consequently, enhancing their self-management behaviors.
基金supported by the National Key R&D Program of China(No.2018AAA0100300)the National Natural Science Foundation of China(Nos.82072018,82274375,and 82402490)+5 种基金the Anhui Provincial Science and Technology Major Project(No.202203a07020006)the Strategic Priority Research Program(C)of the Chinese Academy of Sciences(CAS)(No.XDC07040200)the Key R&D Program of Anhui Province(No.2022e07020012)the Natural Science Foundation of Anhui Province(No.2208085QH256)the Fundamental Research Funds for the Central Universities(No.WK2100000042)the China Postdoctoral Science Foundation(No.2022M713055).
文摘Neuroinflammation is the primary driver and signature of many neurodevelopmental disorders.However,because neurodevelopmental disorders caused by neuroinflammation are difficult to detect at the early stage,their progression remains unclear.To date,neither animal experiments nor in vitro models have uncovered their early developmental characteristics caused by neuroinflammation.In this study,we developed a neurovascular-unit-on-a-chip(NVU-on-a-chip)to model inflammation-induced neurodevelopmental disorders.With the chip,dynamic visualization of the progression caused by neuroinflammation was clearly demonstrated,and the changes in angiogenesis and neural differentiation under neuroinflammation were replicated.In addition,the activation of astrocytes and damage to neurons and capillaries at the early stage of neurodevelopmental disorders were observed.The results revealed for the first time the structural disruption of the neurovascular units and the neurovascular coupling failure caused by neuroinflammation.Furthermore,the outcomes of anti-inflammatory intervention using ibuprofen were preliminarily demonstrated.This work provides insights into the early progression of neurodevelopmental disorders caused by neuroinflammation and offers a platform for the development of therapeutic strategies for neuroinflammation.
文摘To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.RESULTSA total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.CONCLUSIONSurveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.
基金supported by Funding for the Basic Research of the Ministry of Sciences and Technology,Sichuan Province(2015JY0090)the National Natural Science Foundation of China(81972546,81602373)。
文摘Background:p53 and DIRAS3 are tumor suppressors that are frequently silenced in tumors.In this study,we sought to determine whether the concurrent re-expression of p53 and DIRAS3 could effectively induce head and neck squamous cell carcinoma(HNSCC)cell death.Methods:CAL-27 and SCC-25 cells were treated with Ad-DIRAS3 and rAd-p53 to induce re-expression of DIRAS3 and p53 respectively.The effects of DIRAS3 and p53 re-expression on the growth and apoptosis of HNSCC cells were examined by TUNEL assay,flow cytometric analysis and MTT.The effects of DIRAS3 and p53 re-expression on Akt phosphorylation,oncogene expression,and the interaction of 4 E-BP1 with eIF4 E were determined by real-time PCR,Western blotting and immunoprecipitation analysis.The ability of DIRAS3 and p53 re-expression to induce autophagy was evaluated by transmission electron microscopy,LC3 fluorescence microscopy and Western blotting.The effects of DIRAS3 and p53 re-expression on HNSCC growth were evaluated by using an orthotopic xenograft mouse model.Results:TUNEL assay and flow cytometric analysis showed that the concurrent re-expression of DIRAS3 and p53 significantly induced apoptosis(P<0.001).MTT and flow cytometric analysis revealed that DIRAS3 and p53 reexpression significantly inhibited proliferation and induced cell cycle arrest(P<0.001).Mechanistically,the concurrent re-expression of DIRAS3 and p53 down-regulated signal transducer and activation of transcription 3(STAT3)and upregulated p21WAF1/CIP1 and Bax(P<0.001).DIRAS3 and p53 re-expression also inhibited Akt phosphorylation,increased the interaction of eIF4 E with 4 E-BP1,and reduced the expression of c-Myc,cyclin D1,vascular endothelial growth factor(VEGF),fibroblast growth factor(FGF),epidermal growth factor receptor(EGFR)and Bcl-2(P<0.001).Moreover,the concurrent re-expression of DIRAS3 and p53 increased the percentage of cells with GFP-LC3 puncta compared with that in cells treated with control adenovirus(50.00%±4.55%vs.4.67%±1.25%,P<0.001).LC3 fluorescence microscopy and Western blotting further showed that DIRAS3 and p53 re-expression significantly promoted autophagic activity but also inhibited autophagic flux,resulting in overall impaired autophagy.Finally,the concurrent re-expression of DIRAS3 and p53 significantly decreased the tumor volume compared with the control group in a HNSCC xenograft mouse model[(3.12±0.75)mm^(3) vs.(189.02±17.54)mm^(3),P<0.001].Conclusions:The concurrent re-expression of DIRAS3 and p53 is a more effective approach to HNSCC treatment than current treatment strategies.
文摘Spindle cell carcinoma of head and neck, a subtype of squamous cell carcinoma is a unique and rare neoplasm. It has a more aggressive behavior as compared to classical squomous cell carcinoma warranting surgical interventions with wider surgical margins. Immunohistochemistry along with routine histopathology is essential in establishing the diagnosis of spindle cell carcinoma. We at Dr. B. Borooah Cancer Institute, Guwahati, a regional institute for treatment and research, hereby report 40 cases of such lesion with clinicopathological and immunohistochemical study. Out of total 40 cases included in the study group most of the cases were in the age group of 40 to 60 years. Commonest site of presentation was nasopharynx and buccal mucosa. 14 cases of the oral cavity (buccal mucosa, alveolus, oral tongue and hard palate) were treated with surgery. All the cases with disease of the larynx and hypopharynx were treated with radiotherapy and cases involving the nasopharynx received radiotherapy and chemotherapy. In the surgery group recurrence rate was found to be 71.4% and metastasis rate was 21.4%. Biopsy specimens were subjected to histopathological examination followed by immunohistochemistry. Immunohistochemical analysis show concurrent presence of malignant epithelial and sarcomatoid spindle cell components by co-expression of cytokeratin (CK) and vimentin to various degrees.
文摘Pilomatrix Carcinoma (PC) is an exceedingly rare neoplasm. Although it has been described at various anatomical sites, fewer than 25 cases have been reported in the face and scalp. Although early recognition and treatment is paramount in optimization of outcomes for this aggressive carcinoma, the diagnosis is complicated by shared features with its more common benign counterpart. In patients with recurrence or rapid growth of a pilomatrixoma, pilomatrix carcinoma should be considered in the differential diagnosis.
文摘BACKGROUND Meningiomas are benign tumors that originate from the meningothelial arachnoid cells,but they rarely develop extracranially.There is no specific surgical guideline for resecting them in the maxillary sinus,and little is known about their biological behavior and operative management.CASE SUMMARY We present a 54-year-old female patient referred to our department with a primary extracranial meningioma that presented as buccal swelling associated with headache.On clinical examination the mass was non-tender,fixed,sessile and non-pulsatile situating in the right maxillary sinus.Computed tomography scan showed a well-defined mass of 7 cm×6 cm×6 cm compressing the surrounding structures.Magnetic resonance imaging revealed a well circumscribed heterogenous lesion with necrotic center and relatively hypointense on T2-weighted imaging.Imaging studies revealed no evidence of intracranial extension and metastatic nests.Biopsy showed grade I primary extracranial with low mitotic activity.Total maxillectomy with excision of tumor and adjacent paranasal structures following reconstruction of the orbit and maxilla with tissue patch was done by the maxillofacial surgeon.The biopsy reported fibrous meningioma based on the hematoxylin and eosin section.On immunohistochemistry the tumor cells were positive for vimentin,focally positive for epithelial membrane antigen and CD99 and negative for signal transducer and activator of transcription 6.The mass was removed surgically with reconstruction,and the pathological studies confirmed the diagnosis to be an extracranial meningioma.The present study briefly reviews the current knowledge concerning the diagnosis and treatment of extracranial meningiomas in the head and neck area and offers suggestions for managing extracranial meningiomas in the paranasal sinuses.CONCLUSION To conclude,extracranial meningiomas in the paranasal sinuses may be successfully managed by surgical treatment without evident post-surgery complications.
文摘Objective: To investigate for the feasibility and advantages performed by the unilateral big hockey stick incision (BHSI) in head and neck carcinoma. Methods: Neck dissection by using the unilateral big hockey stick incision (BHSI) was performed on 93 patients with head and neck carcinoma. Results: The big hockey stick incision has a cosmetic scar and not scar contraction and is barely visible and easily covered in hair and clothing; sufficient exposure of the operation field; a small area of marginal necrosis was occasionally seen at the apex of the skin flap due to having preoperative radiotherapy. Conclusion: The unilateral big hockey stick incision has adequate surgical access, good healing of skin flaps, and a good cosmetic result.
文摘Introduction: The goal of this study was to analyze the causes of death in patients with loco-regionally advanced squamous cell carcinoma (HNSCC) of the head and neck treated with multimodality treatment. Materiel: The mortality records of 138 advanced head and neck patients treated in our department with surgery and adjuvant (chemo) radiotherapy from 2007 to 2013 were collected and reviewed in this study.?Results: From May 2007 to January 2013, 138 patients were followed up with a median follow-up duration of 25 months. The 5-year overall survival (OS), disease-free survival (DFS) were 45%, and 56.1%, respectively. A total of 39 patients (28%) died during the follow-up period. Clearly, in this population, loco-regional relapse accounted for one of the most cause of death but acute and late or chronic treatment-associated causes leading to death occurred in almost 8% of the patients. Furthermore, the risk of death from head and neck squamous cell carcinoma (HNSCC) was greater in patients with hypopharynx cancer. Univariate analysis indicated that patients with N2b disease and above and vascular tumor embolism had a lower overall survival (p = 0.001 and p = 0.007 respectively). The multivariate analysis showed that N2b disease and above was an independent prognostic factor for poorer loco-regional control (p = 0.001). Conclusions: Patients with locally advanced head and neck cancer treated with surgery and adjuvant (chemo) radiotherapy are potentially curable but face significant risks of mortality from causes other than disease progression.
文摘The head and neck region encompasses structures from the base of the skull to the clavicles which include nasopharynx,oropharynx,hypopharynx,larynx and oral cavity.Tobacco,alcohol,and human papilloma virus(HPV)infection are the three major risk factors for head and neck squamous cell carcinoma(HNSCC)in different countries.
文摘OBJECTIVE To summarize our clinical experience in treating 31 patients with neck masses undergoing carotid artery resection without arterial anastomosis （vascular reconstruction） in Tianjin Cancer Hospital during a period from 1979 to 2002. METHODS Preoperatively, patients were instructed to apply pressure to the carotid artery. Tumor excision combined with carotid artery resection （TECCAR） was conducted after an accurate testing of valid cerebral blood supply and compensation. RESULTS Among the study patients, 17 were male and 14 female, with the age ranging from 14 to 58 years. Of the 31 cases, 23 were carotid body tumors （8 malignant）, 2 vagal body tumors （1 malignant）, 4 carotid aneurysms, and 2 were metastatic tumors from the cervix involving carotid artery. Of the patients, a subtotal resection of the head and neck masses was conducted in 22 cases. Intraoperative death did not cerebrovascular complications occur, and postoperative CNS or （CVC） were not found. CONCLUSION TECCAR without arterial anastomosis is a safe and feasible procedure. In addition, this method of surgery has more advantages in comparison to an arterial anastomosis： i） Tumor resection was more complete, ii） Complications such as thrombus, infection, and lethal hemorrhage etc., were rare after surgery; iii） Postoperative radiotherapy, if needed, would be safe and acceptable; iv） It was a more simplified operational procedure.
