Objective To evaluate the expression and clinical significance of Survivin in the tissues of laryngeal carcinoma using meta-analysis. Methods The case-control studies published in China about the expression and association of clinical pathogenic features of Survivin in the tissues of laryngeal carcinoma were electronically retrieved in CBM (1994 to October 2012), CNKI (1994 to October 2012), VIP (1989 to October 2012) and WanFang Data (1996 to October 2012). The reviewers independently identified the literature according to inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results A total of 25 studies were included, involving 1 333 cases of laryngeal carcinoma and 528 cases of health laryngeal mucosa or polyp of vocal cord. The results of meta-analysis showed that, significant differences were found in groups of laryngeal carcinoma vs. health control, laryngeal carcinoma with vs. without lymphatic metastasis, clinical stages I-II vs. III-IV, cell differentiation G1 vs. G2-G3, T1 and T2 stages vs. T3 and T4 stages, and glottic carcinoma vs. non-glottic carcinoma (Plt;0.05). No significant difference was found in groups of age more than 60 vs. no less than 60, male vs. female, and smoke vs. non-smoke (Pgt;0.05). Conclusion Current domestic evidence shows that Survivin may be associated with the whole course of occurrence, advance and transfer of laryngeal carcinoma, and positively correlated to degree of tumor malignance, which may indicate poor prognosis.
【摘要】 目的 筛选人源喉癌Hep-2细胞株特异结合的短肽，作为喉癌靶向治疗的载体。 方法 体外培养Hep-2细胞株作为靶细胞，人正常喉黏膜上皮细胞为吸附细胞；用噬菌体展示十二肽库进行3轮差减筛选，随机挑取10个噬菌体克隆进行测序；采用酶联免疫吸附（enzyme linked immunosorbent assay，ELISA）法鉴定噬菌体与Hep-2细胞的结合活性；通过免疫荧光鉴定喉癌细胞特异性结合肽（F2）噬菌体阳性克隆与喉癌细胞结合的特异性。 结果 经过3轮筛选后，噬菌体在靶细胞Hep-2上出现明显富集；ELISA分析鉴定显示5个阳性克隆能与Hep-2细胞特异结合，其中F2噬菌体克隆对喉癌细胞的结合靶向性明显高于对照细胞（Plt;0.05）； 免疫荧光显色显示，F2能特异性地与喉癌细胞结合。 结论 利用噬菌体展示肽库技术，可以成功筛选到F2，其可能成为喉癌靶向治疗的载体。【Abstract】 Objective To obtain the polypeptides specifically bound to laryngeal squamous cell carcinoma line (Hep-2) and use it as a potential therapeutic vector targeting laryngeal squamous cell carcinoma patients. Methods With the Hep-2 cells as the target cells and human normal laryngeal squamous epithelial cells (HNLE cells) as the absorber cells, 3 rounds of panning from a Ph.D.-12TM phage-display peptide library were carried out. Ten randomly selected phage clones were sent for sequence detection. The affinity of phage clones was detected by enzyme-linked immunosorbent assay (ELISA). The positive phage clones (F2) specifically bound to Hep-2 were identified by immunofluorescence detection. Results After 3 rounds of screening, 5 positive phage clones showed specific binding to Hep-2 cells and the affinity of positive phage clones (F2) was significantly higher than that of the control groups (Plt;0.05). The results of immunofluorescence detection indicated that F2 could be specifically bound to Hep-2. Conclusions Phage display peptide libraries technique can successfully screen the peptide specifically bound to Hep-2 cell line. Thus, it provides a potential vector for targeting therapy of laryngeal squamous cell carcinoma patients.
【摘要】 目的 探讨喉癌组织中 EGFL7基因 mRNA表达与喉癌分化、转移及临床预后的关系。 方法 收集2008年5—11月共42例行喉癌手术患者的切除标本。用免疫组织化学法检测EGFL7蛋白在42例喉癌组织和配对癌旁组织中的表达情况，提取肿瘤及癌旁组织配对标本的总 RNA，用逆转录（RT）-PCR方法测定EGFL7基因表达，蛋白质印迹法测定EGFL7蛋白的表达，并结合临床资料，对 EGFL7基因差异表达与喉癌患者临床表现的相关性进行分析研究。 结果 对42例配对标本分别进行 EGFL7 mRNA荧光检测比较，30例标本的肿瘤组织中EGFL7基因mRNA表达明显高于癌旁正常喉组织。22例标本的肿瘤组织中EGFL7蛋白表达明显高于癌旁正常喉组织。EGFL7 mRNA的表达与喉癌淋巴结转移和浸润深度密切相关（Plt;0.05），而与患者的性别、年龄、吸烟、肿瘤分化程度等无关（Pgt;0.05）。 结论 EGFL7基因在喉癌组织中表达状态与喉癌的生长和浸润转移关系密切，EGFL7基因可望作为喉癌病情发展及指导临床治疗的标记物之一。【Abstract】 Objective To investigate the association of EGF-like-domain, multiple 7 (EGFL7) mRNA expression level with the differentiation, metastasis and prognosis of laryngocarcinoma. Methods Tissue specimens were obtained from 42 patients undergoing surgery for laryngocarcinoma between May and November, 2008. Immunohistochemistry was used to detect the level of EGFL7 in the 42 tumor tissues and matched adjacent normal tissues. Reverse transcriptional PCR (RT-PCR) was performed for amplification of EGFL7 mRNA from the 42 tumor tissues and matched adjacent normal tissues, and westerblot was adopted to determine EGFL7 protein expression. The differential EGFL7 mRNA expression was analyzed for its association with the clinical manifestations of the patients. Results EGFL7 mRNA expression was detected in all the laryngocarcinoma tissues and normal tissues adjacent to the carcinoma using fluorescence method. EGFL7 mRNA expression was significantly higher in the tumor tissues than in the adjacent tissues in 30 cases, and EGFL7 protein expression was also significantly higher in the tumor tissues than in the adjacent normal laryngeal tissues in 22 cases. Expression of EGFL7 mRNA was highly correlated with lymph node metastasis and T classification (Plt;0.05), but was not correlated with the patients’ gender, age, or tumor differentiation (Pgt;0.05). Conclusions EGFL7 mRNA expression is correlated closely with the differentiation and metastasis of laryngocarcinoma. EGFL7 may serve as a marker for assessing the progression of laryngocarcinoma and provide assistance for clinical therapeutic decisions.
ObjectiveTo explore the feasibility to restore pronunciation function by repairing partial suprahyoid epiglottis-preserved circumferential defect in near total laryngectomy with anterior medial thigh flap in advanced laryngeal cancer. Methods A retrospective study of 5 male patients with advanced laryngeal cancer between August 2019 and October 2022, aged 56-73 years, with an average age of 65 years were reviewed. The disease duration ranged from 3 to 24 months, with an average of 8 months. Tumor classification by location: 2 cases of glottic type, 2 cases of supraglottic type, and 1 case of subglottic type; TNM staging: 3 cases of T4N0M0 stage, 1 case of T4N1M0 stage, and 1 case of T4N2M0 stage; American Joint Committee on Cancer (AJCC) staging (2017): stage Ⅳ. Near total laryngectomy with partial suprahyoid epiglottis-preserved and selective bilateral neck dissection were performed before the anterior medial thigh flap was used to repair the circumferential defects. The flap size ranged from 6 cm×5 cm to 8 cm×6 cm. Four patients underwent adjuvant radiotherapy and chemotherapy after operation, while 1 patient did not receive any other adjuvant treatment such as radiochemotherapy. Results The flaps of all 5 patients survived without obvious neck infection. One patient developed a slight pharyngeal fistula after oral feeding at 1 month after operation, which healed after another week of gastric feeding. Primary healing also achieved in the thigh donor area. One patient had bilateral cervical lymph node metastasis, and 1 patient had lymph node metastasis on one side. The remaining 3 patients had no cervical nodes metastasis on both sides. All 5 patients were followed up 12-36 months, with an average of 27.6 months. Four patients had clear, audible, and hoarse voice while 1 patient (case 3) had pronunciation similar to whispering. Laryngoscopy showed that the reconstructed laryngeal inlet was fissure-shape and the reconstructed laryngo-trachea canal below the laryngeal inlet was gradually enlarged. At 1 month after operation, the gastric tube was withdrawn and the food was taken orally. There was no obvious aspiration pneumonia. The tracheostomy tube could be blocked in 4 patients for from 30 seconds to 3 minutes. Among them, 3 patients were able to make a noticeable pronunciation even when the tube was not blocked, and they were able to engage in barrier-free language communication; the tracheostomy tube could not be blocked in 1 patient who had a pronunciation similar to whispering. Preliminary voice analysis showed that the patients have a relaxed and natural pronunciation, without obvious breath-holding or air-swallowing movement, compared to patients with esophageal pronunciation. Decannulation did not achieved until the last follow-up in all 5 patients. ConclusionThe anterior medial thigh flap can repair circumferential defects after near total laryngectomy in advanced laryngeal cancer patients and achieve satisfactory pronunciation, thus can serve as an effective pronunciation rehabilitation method. The preserved part of epiglottis may play a role to prevent postoperative aspiration.
目的 研究人喉表皮癌细胞系Hep-2中乳腺癌易感基因1（BRCAl）、P53结合蛋白1（53BP1）和DNA损伤检测点介质1（MDC1）的表达及临床意义。 方法 采用逆转录聚合酶链式反应检测BRCA1、53BP1、MDC1在喉癌细胞系Hep-2中mRNA的表达，同时用免疫印迹法检测蛋白的表达。 结果 在所检测的人喉癌细胞系Hep-2中BACR1、53BP1、MDC1在基因与蛋白两个水平均有表达。 结论 BRCA1、53BP1、MDC1可能在喉癌的发生发展中有一定作用。
目的 构建沉默环氧化酶-2（COX-2）基因重组慢病毒，观察其体外侵袭的抑制作用，从而探讨干扰COX-2抑制喉癌细胞增殖的作用机理，为喉癌的治疗提供新的思路。 方法 逆转录聚合酶链反应（RT-PCR）检测COX-2基因在人表皮样喉癌细胞（Hep-2）中的表达情况。利用上海吉凯公司RNA干扰（RNAi）慢病毒表达载体系统，构建针对COX-2基因慢病毒RNAi表达载体。转染Hep-2细胞，干扰COX-2基因的表达，实时定量PCR检测干扰前后基因表达变化。利用生长曲线测定干扰载体转染前后细胞生长速度变化。流式细胞仪检测细胞的生长周期。Boyden侵袭小室法测定体外侵袭力。 结果 成功构建了COX-2慢病毒RNAi表达载体，并建立了干扰COX-2基因的Hep-2细胞系。实时定量PCR检测COX-2基因在Hep-2细胞系中过表达被显著抑制。生长曲线测定，COX-2基因干扰后细胞增殖明显变慢。流式细胞仪检测细胞的生长周期可见干扰组诱导Hep-2细胞凋亡，转染G0～G1期细胞数量明显上升，S期细胞减少，表明siRNA干扰Hep-2细胞后，细胞由G0～G1期进入到S期受到阻滞，细胞增殖速度下降。体外侵袭实验中，Hep-2-AS侵袭细胞数（31.0 ± 1.8）显著低于Hep-2细胞（104.0 ± 2.6）及Hep-2-P细胞（99.0 ± 2.7），差异有统计学意义（P＜0.05）。 结论 喉癌中过表达的COX-2基因被干扰后表达明显降低并显著抑制细胞的生长速度和侵袭能力。同时验证了COX-2基因RNA干扰在进行抗肿瘤的治疗中潜在的应用前景。
【摘要】目的探讨喉癌手术后患者对两种不同雾化方式的耐受性,为选择最佳雾化方式提供参考。方法将49例喉癌手术后患者随机分为观察组(25例)和对照组(24例),观察组采用氧气雾化吸入,对照组采用空气压缩泵雾化吸入。分别记录两组患者雾化吸入前及吸入15 min时脉搏血氧饱和度(SpO2)及心率;雾化过程中患者有无心慌、气紧等不适以及雾化后痰液的性质及量。采用SPSS 13.0软件进行统计分析。结果两组患者雾化吸入15 min时的SpO2差异有统计学意义(Plt;001),观察组高于对照组;而两组患者雾化吸入前SpO2、心率、不适主诉及雾化后痰液的性质差异均无统计学意义(Pgt;005)。结论氧气雾化吸入可以提高喉癌手术后患者雾化过程中的SpO2,使患者感觉更加舒适。【Abstract】Objective To investigate postoperative patients with laryngeal carcinoma atomization of two different forms of tolerance, in order to choose the best means of atomization. Methods Fifty postoperative patients with laryngeal carcinoma were divided into observation group using oxygen inhalation and control group using the air compression pump inhalation. Two groups of patients were recorded the value of SpO2 and heart rate before 15 minutes after the inhalation,as well as the discomforts such as flustered,gas tight during the atomization process and the nature and olume of sputum. Results The results of two groups of patients at the time of 15 minutes inhalation SpO2 statistically significant difference (Plt;001), the observation group than in the control group average SpO2 high; and two groups of patients with preinhalation SpO2 average, average heart rate, Discomfort chief complaint and the nature of sputum after aerosol compared no significant difference (Pgt;005). Conclusion Oxygen inhalation in patients with laryngeal cancer can improve the atomization process SpO2 value, so that patients feel more comfortable.
目的:探讨改良气管套管垫安置法对喉癌术后佩戴气管套管、颈部伤口敷料加压包扎期患者的适用性。方法:采用随机分组的方法将38例喉癌术后佩戴气管套管的患者分为传统组20人和改良组18人, 传统组采用“Y”型气管套管垫,改良组采用“Y”型气管套管垫,比较两组患者在更换气管套管垫时的SpO2值、SpO2降低值及刺激性咳嗽次数。结果:安置气管套管垫的过程中,改良组SpO2值高于传统组、SpO2降低值低于传统组,且发生刺激性咳嗽的次数也低于传统组,差异有统计学意义(Plt;0.01)。结论:与传统气管套管垫安置法相比,改良气管套管垫安置法能减少患者换药过程中刺激性咳嗽的次数,对SpO2值影响轻微,更适合于喉癌术后早期颈部伤口敷料加压包扎患者的换药。