- MeSH
- genderová rovnost * MeSH
- lékařský personál nemocniční MeSH
- lidé MeSH
- nemocnice MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
BACKGROUND AND OBJECTIVES: Transoral laser surgery is the optimal surgical treatment modality for the early stages of glottic cancer. To allow for further treatment to be as effective and as minimal as possible, persistent or recurrent tumors should be detected very soon. The main aim is to minimize the risk of necessity of performing a total laryngectomy. Flexible videoendoscopy with narrow band imaging (NBI) was recommended by the European Laryngological Society as a diagnostic method for the follow-up of patients treated for laryngeal cancer. Nevertheless, the efficacy of this technique has not been extensively studied in patients after transoral laser cordectomies for vocal fold cancer. The aim of this study was to evaluate the efficacy of in-office transnasal NBI flexible videoendoscopy in the follow-up of patients after transoral laser cordectomy for glottic cancer. We also focused on describing the specific characteristics of recurrent tumor appearance. MATERIALS AND METHODS: The presented study was conceived as a prospective study. Ninety-four consecutive patients who underwent transoral laser cordectomy for severe dysplasia, Tis, T1, and T2 glottic cancer in the period from June 2010 to August 2015 were enrolled in the study. All patients were postoperatively regularly followed using transnasal videoendoscopic examinations with NBI. Whenever a suspect lesion was identified during in-office examination, its nature was proven histologically. RESULTS: We discovered 23 suspect findings in 21 patients by means of flexible videoendoscopy with NBI. Fifteen (65.2%) of them were histologically confirmed as recurrent tumors, whereas in 8 (34.8%) of them, the recurrent tumor was not proven. In two patients, the recurrent tumor was evident on computed tomography or magnetic resonance imaging, but NBI endoscopy did not reveal relapsing disease. The rest (71 patients) were considered true negative. Of the 15 recurrent tumors detected by NBI-coupled videoendoscopy, 8 (53.3%) were identified as submucosal masses with nonsignificant or no vascular changes, 4 (26.7%) were noted as the progression of leukoplakia without visible vascular changes, only 2 (13.3%) showed typical vascular changes, and, in 1 (6.7%) case, evident, significantly exophytic tumor with pathological vascularization was discovered. The sensitivity, specificity, and positive and negative predictive values of the in-office transnasal videolaryngoscopy with NBI were calculated to be 88%, 92%, 71%, and 97%, respectively. CONCLUSIONS: The results of the study demonstrate that transnasal endoscopy with NBI in an outpatient setting is an excellent method for the follow-up of patients after transoral laser cordectomy for glottic cancer. The method achieves high sensitivity, specificity, and negative predictive value and a slightly low positive predictive value. Nevertheless, we must bear in mind that recurrent tumors after previous endoscopic resection may have a completely different appearance than new tumors originating from previously untreated tissues. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
- MeSH
- dospělí MeSH
- endoskopické operace přirozenými otvory * MeSH
- glottis MeSH
- laryngektomie * MeSH
- laserová terapie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru diagnostické zobrazování MeSH
- nádory hrtanu diagnostické zobrazování chirurgie MeSH
- následné studie MeSH
- prediktivní hodnota testů MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- úzkopásmové zobrazení * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Endoskopické optické zobrazovací metody pro detekci slizničních lézí v ORL oblasti byly vyvinuty s cílem lepšího a časnějšího záchytu těchto změn. Dělí se na horizontální metody, zobrazující povrch sliznice (autofluorescence, fotodynamická diagnostika, úzkopásmové zobrazení – narrow band imaging, zvětšovací a kontaktní endoskopie), a metody vertikální, umožňující zobrazit různé vrstvy sliznice (optická koherentní tomografie a konfokální endomikroskopie). Některé z nich jsou rutinně využívané v praxi, ostatní se využívají v experimentálním režimu a jejich zavedení do praxe může být otázkou blízké budoucnosti. Autoři předkládají souhrnný přehled dostupných endoskopických optických zobrazovacích metod.
Endoscopic optical imaging methods for the detection of mucosal lesions in the ENT area have been developed for better and earlier detection of these changes. They can be divided into horizontal methods group - showing the surface of the mucous membrane (autofluorescence, photodynamic diagnosis, Narrow Band Imaging, magnifying and contact endoscopy) and vertical methods group - visualizing different layers of the mucosa (optical coherence tomography and confocal endomicroscopy). Some of them are routinely used in practice, others are used in experimental mode and their introduction into practice may be a matter of the near future. The authors present a comprehensive overview of available endoscopic optical imaging methods.
- Publikační typ
- abstrakt z konference MeSH
Integration, which leads to the disruption of the circular HPV genome, is considered as a critical, albeit not obligatory, step in carcinogenic progression. Although cervical carcinomas with extrachromosomal HPV plasmid genomes have been described, the virus is integrated in 70% of HPV16-positive cervical tumours. Limited information is available about HPV integration in head and neck tumours (HNC). In this study, we have characterised the physical status of HPV in a set of tonsillar tumour samples using different methods--the mapping of E2 integration breakpoint at the mRNA level, the 3' RACE based Amplification of Papillomavirus Oncogene Transcripts (APOT) assay and Southern blot. Furthermore, the impact of HPV integration on patients' prognosis has been evaluated in a larger set of 186 patients with head and neck cancer. Based on the analysis of E2 mRNA, HPV was integrated in the host genome in 43% of the HPV-positive samples. Extrachromosomal or mixed form was present in 57%. In fresh frozen samples, the APOT and E2 mapping results were in agreement. The results were confirmed using Southern blotting. Furthermore, the type and exact site of integration were determined. The survival analysis of 186 patients revealed HPV positivity, tumour size and lymph node positivity as factors that influence disease specific survival. However, no statistically significant difference was found in disease specific survival between patients with HPV-positive integrated vs. extrachromosomal/mixed forms of the virus.
- MeSH
- infekce papilomavirem komplikace virologie MeSH
- integrace viru genetika MeSH
- lidé MeSH
- nádory hlavy a krku mortalita virologie MeSH
- prognóza MeSH
- proporcionální rizikové modely MeSH
- Southernův blotting MeSH
- spinocelulární karcinom virologie MeSH
- tonzilární nádory virologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
1 svazek : ilustrace, tabulky ; 30 cm
Detection of HPV in the oropharyngeal cancer prior to treatment selects the group of HPV positive and negative patients. In both groups a treatment response and survival rate for various treatment modalities (chemotherapy, radiotherapy, chemoradiotherapy, biological treatment with monoclonal antibodies, surgery) will be analysed. We would determine whether the prognostic advantage of patients with HPV positive tumours is treatment modality dependent. We suppose, that HPV positive patients could benefitfrom a less intensive non-surgical therapy with an equal survival rate. HPV status could soon become a tool for treatment individualisation. Direct (HPV DNA, HPV mRNA of E6 and E 2 genes) and indirect (p53, p16 proteins) markers of an active viral infection will be detected and sensitivity of HPV DNA detection by means of ISH and PCR would be compared. With the aim to find out the optimal diagnostic method for selection of patients with HPV related head and neck cancers in clinical setting.
Stanovení HPV ve vzorku orofaryngeálního dlaždicobuněčného karcinomu před léčbou selektuje skupinu pacientů s HPV pozitivními a negativními nádory. V obou skupinách bude zjišťována léčebná odpověď a přežití v závislosti na léčebných modalitách (chemoterapie, radioterapie, chemoradioterapie, biologická léčba monoklonální protilátkou, chirurgie). Bude zkoumáno, zda prognostická výhoda HPV pozitivity je vázána na způsob léčby. Předpokládáme, že HPV pozitivní pacienti by do budoucna mohli profitovat z méněintenzivní konzervativní terapie při zachování stejné prognózy. HPV status by se v krátkém časovém horizontu mohl stát významným nástrojem pro stratifikaci léčby. Detekovány budou přímé (HPV DNA, HPV mRNA genu E6 a E2) a nepřímé (exprese proteinů p53 a p16) markery aktivní virové infekce a bude srovnána senzitivita metod stanovujících přítomnost HPV DNA -PCR a ISH. Účelem je zjištění optimální diagnostické metody pro klinickou praxi k selekci pacientů s HPV pozitivními nádory hlavy a krku.
- MeSH
- DNA testy na papilomavirus MeSH
- infekce DNA virem MeSH
- infekce papilomavirem MeSH
- interpretace statistických dat MeSH
- nádory hlavy a krku MeSH
- nádory orofaryngu MeSH
- polymerázová řetězová reakce MeSH
- prognóza MeSH
- spinocelulární karcinom MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- otorinolaryngologie
- onkologie
- biologie
- NLK Publikační typ
- závěrečné zprávy o řešení grantu IGA MZ ČR
Human papillomavirus (HPV) infection is one of the most important etiologic causes of oropharyngeal head and neck squamous cell carcinoma (HNSCC). Patients with HPV-positive HNSCC were reported to have a better clinical outcome than patients with HPV-negative cancers. However, little is known about the possible causes of different clinical outcomes. In this study, we analyzed a detailed immune profile of tumor samples from HNSCC patients with respect to their HPV status. We analyzed the characteristics of immune cell infiltrates, including the frequency and distribution of antigen-presenting cells and naïve, regulatory and effector T cells and the cytokine and chemokine levels in tumor tissue. There was a profound difference in the extent and characteristics of intratumoral immune cell infiltrates in HNSCC patients based on their HPV status. In contrast to HPV-negative tumor tissues, HPV-positive tumor samples showed significantly higher numbers of infiltrating IFNγ+ CD8+ T lymphocytes, IL-17+ CD8+ T lymphocytes, myeloid dendritic cells and proinflammatory chemokines. Furthermore, HPV-positive tumors had significantly lower expression of Cox-2 mRNA and higher expression of PD1 mRNA compared to HPV-negative tumors. The presence of a high level of intratumoral immune cell infiltrates might play a crucial role in the significantly better response of HPV-positive patients to standard therapy and their favorable clinical outcome. Furthermore, characterization of the HNSCC immune profile might be a valuable prognostic tool in addition to HPV status and might help identify novel targets for therapeutic strategies, including cancer immunotherapy.
- Publikační typ
- abstrakt z konference MeSH
Dlouhodobé poruchy polykání u pacientů po resekčních operacích v orofaryngeální oblasti a následně proběhlé radioterapii či chemoradioterapii jsou udávány průměrně okolo 50 % (7). Cílem tohoto článku je poskytnout ucelený pohled na možnosti jejich vyšetření a rehabilitace. Vzhledem k faktu, že většina rozsáhlejších resekčních výkonů je v této oblasti prováděna pro zhoubné novotvary, je článek zaměřený zejména na specifiku rehabilitace tohoto spektra pacientů a možnosti ovlivnění následků radioterapie. Příčinou poruch polykání u pacientů po chirurgických výkonech v orofaryngeální oblasti jsou nejčastěji absence resekovaných částí polykacího traktu, poruchy inervace při perioperačním poškození nervového zásobení, transpozice jednotlivých částí polykacího traktu s následnou změnou jejich funkce, následky pooperačního jizvení či poradiační změny. Mezi sporné příčiny poruch polykání patří tracheostomická kanyla. Klíčová slova: poruchy polykání, resekční operace, tracheostomická kanyla
Log-term disorders of swallowing in patients after resection surgery in oropharyngeal region and subsequent radiotherapy or chemotherapy are encountered in about 50% of patients (7). The aim of this article is to provide a comprehensive view of the possibilities of their examination and rehabilitation. Due to the fact that majority of extensive resections in this region is performed for malignant neoplasms, this article is focused mainly on the specifics of rehabilitation of this spectrum of patients and the possibility of affecting the effects of radiotherapy. The most frequent causes of swallowing disorders after surgery in the oropharyngeal region lie in the absence of resected parts of the swallowing tract, disorders of innervation in perioperative damage to nervous nerve supply, transposition of individual parts f the swallowing tract with subsequent change of their function, consequences of postoperative cicatrices or post-irradiation changes. The controversial causes of swallowing disorders include tracheostomy cannula. Keywords: swallowing disorders, resection surgery, tracheostomy cannula
- MeSH
- aspirace do dýchacích cest etiologie MeSH
- aspirace žaludečního obsahu etiologie MeSH
- chuť k jídlu MeSH
- endoskopie metody MeSH
- fluoroskopie metody MeSH
- lidé MeSH
- lymfedém etiologie komplikace MeSH
- mukozitida chemicky indukované MeSH
- nádory orofaryngu * komplikace MeSH
- poruchy polykání * diagnóza etiologie klasifikace terapie MeSH
- radioterapie * škodlivé účinky MeSH
- svaly patologie MeSH
- tracheostomie škodlivé účinky MeSH
- xerostomie komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Helicobacter pylori (HP) is considered a major gastric pathogen with oncogenic potential. The aim of this study was to determine whether HP is present in oropharyngeal lymphoid tissue and whether oropharyngeal HP strains carry virulence factor genes known to be involved in gastric carcinogenesis. The study included 104 subjects (41 patients with tonsillar carcinoma, 38 with chronic tonsillitis and 25 with obstructive sleep apnoea syndrome--OSAS). Detection of specific serum anti-HP antibodies was performed with an ELISA. The presence of HP in tissue was determined by culture and real-time PCR. Detection of virulence factors genes was also performed. Specific antibodies were found in 78.05% of tumour cases, 34.21% of chronic tonsillitis cases, and 72.0% of OSAS cases. The presence of HP in the tissue was detected in 73.91% of tonsillar tumours, 70.0% of tonsillitis cases, and 69.23% of OSAS specimens. The results of the virulence factor gene analysis showed the majority of the s1b (52.4%) and m2 (59.5%) alleles of vacA gene and limited abundance of cagA gene (12.5%). Results confirm that HP may colonise oropharyngeal lymphoid tissue. Oropharyngeal HP colonisation was frequently found in the oropharyngeal cancer group and in patients with benign oropharyngeal diseases. A virulence factor gene analysis showed differences from the predominant strains most commonly found in the stomach. The strains obtained from the oropharynx differed primarily by the lower abundance of the cagA gene and carried the less virulent vacA gene allele combination.
- MeSH
- antigeny bakteriální genetika MeSH
- bakteriální proteiny genetika MeSH
- chronická nemoc MeSH
- ELISA MeSH
- faktory virulence genetika MeSH
- Helicobacter pylori genetika MeSH
- infekce vyvolané Helicobacter pylori komplikace diagnóza imunologie MeSH
- kvantitativní polymerázová řetězová reakce MeSH
- lidé MeSH
- lymfoidní tkáň mikrobiologie MeSH
- nádory hlavy a krku komplikace chirurgie MeSH
- obstrukční spánková apnoe komplikace chirurgie MeSH
- orofarynx mikrobiologie MeSH
- protilátky bakteriální imunologie MeSH
- spinocelulární karcinom komplikace chirurgie MeSH
- techniky typizace bakterií MeSH
- tonzilární nádory komplikace chirurgie MeSH
- tonzilektomie MeSH
- tonzilitida komplikace chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH