Laryngeal Cancer Dotaz Zobrazit nápovědu
PURPOSE: The principal goal of treatment of laryngeal cancer is to eliminate a tumour while preserving laryngeal function with radio(chemo)therapy being the mainstay of treatment. The aim of this report is to present the influence of comorbidities and lifestyle factors on treatment outcomes in our cohort of patients. METHODS: During the period 2009-2018, curative radio(chemo)therapy for laryngeal cancer was performed on 189 patients. RESULTS: The median OS was 50.8 months, with a mean PFS of 96.5 months, mean LC of 101.4 months and a median follow-up of 38.1 months. Acute and late treatment toxicity grade 3-4 was observed in 39.2% patients and 10.1% patients, respectively. A significant effect on overall survival was confirmed for the baseline PS (performance status), severity of weight loss, baseline haemoglobin values, history of alcohol abuse, marital status and comorbidities according to the Charlson Comorbidity Index, as well as the ACE-27 and ASA scores. CONCLUSIONS: In our cohort of patients treated with radio(chemo)therapy for laryngeal cancer, we found good therapeutic results and an acceptable side-effect profile. Statistically significant predictors of overall survival were the baseline PS, weight loss, anaemia, associated comorbidities, history of alcohol abuse and marital status.
- Klíčová slova
- Comorbidity, Concurrent chemoradiotherapy, Laryngeal cancer, Organ preservation, Radiotherapy, Treatment effectiveness,
- MeSH
- alkoholismus * etiologie MeSH
- chemoradioterapie škodlivé účinky MeSH
- komorbidita MeSH
- lidé MeSH
- nádory hrtanu * patologie MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
MicroRNAs (miRNAs) are small non-coding RNAs (18-22 nucleotides) that regulate gene expression and are associated with various diseases, including Laryngeal Cancer (LCa), which has a high mortality rate due to late diagnosis. Traditional methods for miRNA detection present several drawbacks (time-consuming steps, high cost and high false positive rate). Early-stage diagnosis and selective detection of miRNAs remain challenging. This study proposes a 3D flexible biosensor that combines nanofibers (NFs), gold nanoparticles (AuNPs), and an inverse molecular sentinel (iMS) for enzyme-free, SERS-based detection of miRNA-223-3p, evaluated as a potential LCa biomarker. The electrospun flexible nanofibers decorated with AuNPs enhance Raman signal. Selective detection of miRNA-223-3p is achieved by immobilizing an iMS-DNA probe labeled with a Raman reporter (Cyanine 3) on the AuNPs. The iMS distinctive stem-and-loop structure undergoes a conformational change upon interaction with the miRNA-223-3p, producing an "on to off" SERS signal. The proposed sensor demonstrated a linear detection range from 10 to 250 fM, with a limit of detection (LOD) of 19.50 ± 0.05 fM. The sensor selectivity was confirmed by analyzing the SERS signal behaviour in the presence of both Non-complementary miRNA and miRNA with three mismatched base pairs. This easily fabricable sensor requires no amplification and offers key advantages, including sensitivity, flexibility, and cost-effectiveness.
- Klíčová slova
- Flexible sensors, Laryngeal Cancer, Nanofiber, SERS, miRNA-223-3p,
- MeSH
- biosenzitivní techniky * metody MeSH
- časná detekce nádoru metody MeSH
- kovové nanočástice * chemie MeSH
- lidé MeSH
- limita detekce MeSH
- mikro RNA * analýza genetika MeSH
- nádory hrtanu * diagnóza genetika MeSH
- nanovlákna * chemie MeSH
- Ramanova spektroskopie * metody MeSH
- zlato * chemie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- mikro RNA * MeSH
- MIRN223 microRNA, human MeSH Prohlížeč
- zlato * MeSH
BACKGROUND: Cancers of the head and neck (HN) are heterogeneous tumors with incidence rates varying globally. In Northern Europe oral and oropharyngeal cancers are the most common individual types. Survival for HN varies by individual tumor type but for most of them survival trends are not well known over extended periods of time. METHODS: Data for a retrospective survival study were obtained for Danish, Finnish, Norwegian, and Swedish patients from the NORDCAN database from 1971 to 2020. Relative 1- and 5-year survival rates and 5/1-year conditional survival for years 2-5 were calculated. RESULTS: Both 1- and 5-year survival improved for all HN cancers but only marginally for laryngeal cancer. For the other cancers a 50-year increase in 5-year survival was about 30% units for nasopharyngeal and oropharyngeal cancers, 20% units for oral cancer and somewhat less for hypopharyngeal cancer. CONCLUSIONS: 5-year survival reached about 65% for all HN cancers, except for hypopharyngeal cancer (30%). Human papilloma virus infection is becoming a dominant risk factor for the rapidly increasing oropharyngeal cancer, the prevention of which needs to emphasize oral sex as a route of infection.
- Klíčová slova
- conditional survival, human papilloma virus, oral cancer, pharyngeal cancer,
- MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- nádory hltanu * mortalita epidemiologie MeSH
- nádory hrtanu * mortalita epidemiologie MeSH
- nádory úst mortalita epidemiologie MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Skandinávie a severské státy epidemiologie MeSH
The aim of the study was to assess the impact of factors that could predict the probability of local failure in early laryngeal squamous cell carcinoma treated with curative radiotherapy. Sixty seven patients (12 women and 55 men) with laryngeal cancer stage I (47 patients) and stage II (20 patients) were treated from 1998 to 2003 with curative radiotherapy and retrospectively evaluated. Median follow-up was 36 months (3-80). Local relapse occurred in 10 patients (15%), regional lymphnodes relapse affected 2 patients. The median time between start of radiotherapy to recurrence was 13 months (3-48). Death due to cancer occurred in 4 patients (2 died from locoregional progression of the recurrence and 2 from distant metastases), whereas 7 patients died from non-cancer related causes. The 2-year overall survival rate was 90% and 5-year OS was 79%. The 2-year local control rate was 82% and 5-year local control was 79%. In the univariate analysis there was a statistically significant decrease in local control influenced by grading (p < 0.0001). High risk group of relapse encompassed patients with at least two negative factors: supraglottic tumor, women, radiotherapy prolongation by 3 or more days and high grade tumor and has 3 times worse local control than low risk group (p=0.0125). The highest risk of local recurrence was in the first three years after radiotherapy than later (p=0.0057). On multivariate analysis unfavourable prognostic factors for local control were gender (p=0.022), presence of 2 or more negative risk factors (p=0.018) and lengths of follow up (p=0.005). Radiation dose, stage, age, hemoglobin level and anterior commissure involvement were not significant factors for local control. Overall survival was affected both in the univariate and multivariate analysis by presence of local relapse (p < 0.005) and follow up duration (p < 0.02). Anemia had borderline significance for overall survival in univariate analysis (p=0.064), but in the multivariate analysis was significant unfavourable factor (p=0.008). Other studied factors (radiation dose, anterior commissure involvement and age) were not reaching level of statistical significant value for overall survival. Close follow up strategy is recommended for high risk group of patients with two or more risk factors especially in the first three years after radiation therapy.
- MeSH
- glottis patologie účinky záření MeSH
- invazivní růst nádoru patologie MeSH
- kombinovaná terapie MeSH
- laryngektomie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru patologie radioterapie chirurgie MeSH
- míra přežití MeSH
- nádory hrtanu patologie radioterapie chirurgie MeSH
- přežití po terapii bez příznaků nemoci MeSH
- prognóza MeSH
- progrese nemoci MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- spinocelulární karcinom patologie radioterapie chirurgie MeSH
- staging nádorů MeSH
- terapie neúspěšná MeSH
- Check Tag
- 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
- MeSH
- lidé MeSH
- nádory hrtanu patologie chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- biopsie MeSH
- buněčná imunita MeSH
- dospělí MeSH
- laryngektomie MeSH
- larynx imunologie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory hrtanu imunologie mortalita chirurgie MeSH
- senioři MeSH
- spinocelulární karcinom imunologie mortalita chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
Narrow band imaging (NBI) HDTV (high definition television) magnifying endoscopy is considered to be superior for the accurate display of the microvascular patterns of superficial mucosal lesions. Observation of changes in intraepithelial papillary capillary loops (IPCL) can help distinguish benign from malignant lesions as part of an "optical biopsy." However, IPCL changes in papillomas may be mistaken for spinocellular cancer (SCC). The aim of the study was to determine whether observing microvascular changes alone is sufficient for discriminating between laryngeal SCC and papillomatosis. An additional aim was to identify associated characteristics that could clarify the diagnosis. The study included 109 patients with a suspected laryngeal tumor or papilloma. HDTV NBI magnifying endoscopy was performed during direct laryngoscopy. It was possible to visualize IPCL changes in 82 out of 109 patients (75.2%). In 71 (86.6%) patients, the diagnosis was correctly determined. In 4 (4.9%) cases, the diagnosis of SCC was expressed on the basis of finding pathologic IPCL, but histology did not demonstrate malignancy. To achieve a correct diagnosis using HDTV NBI magnifying endoscopy, it is important not only to observe changes in the shape of IPCL but also to note possible papillary structures with central-axis capillaries typical of papillomatosis.
- MeSH
- dospělí MeSH
- endoskopie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory hrtanu diagnóza patologie MeSH
- papilom diagnóza patologie 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
The roots of surgery of the larynx reach into the 19th century. After the gaining of initial experiences, a period of radical surgery followed when most tumours were treated with a total laryngectomy. The middle of the 20th century can be characterised as a period of partial laryngectomies. The mutilation of patients caused by a total laryngectomy was and is one of the main impulses that led to the development of the current phase--combined treatment (radiotherapy, systematic cytostatic chemotherapy, biological treatment, surgery as an emergency treatment). The aim is to treat carcinoma of the larynx without the actual removal of the larynx itself and with the same oncological results as would be reached in cases treated with a total laryngectomy. Despite the development of non-surgical methods, surgery of carcinoma of the larynx remains a significant part of the treatment protocol. This work covers the development of surgery of carcinoma of the larynx from a historical point of view; it also describes current types of operations and discusses the position of surgery in today's treatment algorithm.
- MeSH
- laryngektomie metody MeSH
- lidé MeSH
- nádory hrtanu chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
OBJECTIVE: Oropharyngeal/laryngeal carcinoma are common cancers of the upper aerodigestive system. Human papillomavirus (HPV) is described as the most frequent in the cancer of unknown primary. The presence of Helicobacter pylori (HP) in the oral cavity is discussed in some papers. THE AIM OF STUDY: To analyze the incidence of HPV and HP in oropharyngeal/laryngeal cancer persons versus persons with chronic tonsillar inflammation and healthy persons. METHODS: The samples were taken in three groups: (1) tissue of oropharynx/larynx cancer (103 specimens); (2) tissue of palatine tonsils (85 specimens); and (3) healthy control group (50 specimens). We analyzed the presence of HP (PCR) and HPV genomic DNA (Sacace HPV High-Risk Screen Real-TM Quant) in the samples. RESULTS: HP was detected in 86 samples (83.5%) and high-risk HPV in 62 samples (60.2%). We found a very high incidence of HP. In the cancer group, HP was detected in 82.5% cases and HPV positivity in 57.8%. In total, 7.2% of the cancer patients were negative for HP and HPV together. In turn, 53.6% of the cancer patients were positive for HP and HPV together. Four cases (4.2%) were positive for HPV only. VacA positivity was detected in 82 (79.6%) of the cancer cases and VacA negativity in 21 (20.4%) if the cancer cases. The incidence of HP in chronic inflammation (n = 85) was 65 cases (76.5%) and the incidence of HPV was 38 cases (44.7%). VacA positivity was detected in 59 (69.4%) of the chronic inflammation cases and VacA negativity was found in 26 (30.6%) of the chronic inflammation cases. Regarding the control group, we found HP positivity in 5 cases (11.1%) and HPV positivity in 19 cases (42.2%). There was VacA positivity in 6 cases (50.0%) of the control group. Statistically significantly lower prevalence of HP (p < 0.001) and HPV (p = 0.006) was found in the control group. CONCLUSIONS: We suggest that the palatine tonsils are colonized by HP. In our study, HP was present in oropharyngeal cancer in more cases in comparison with HPV infection. The presence of VacA from HP can have an influence on the human epithelial and immune cells' regulation ways. Our results do not support idea that the CagA-positive HP is a primary carcinogen in oropharyngeal area.
- Klíčová slova
- Helicobacter pylori, chronic inflammation, human papilloma virus, incidence, oropharynx, squamous cell carcinoma,
- MeSH
- Alphapapillomavirus * MeSH
- Helicobacter pylori * genetika MeSH
- infekce papilomavirem * epidemiologie MeSH
- infekce vyvolané Helicobacter pylori * epidemiologie MeSH
- lidé MeSH
- nádory hrtanu * MeSH
- orofarynx MeSH
- Papillomaviridae genetika MeSH
- séroskupina MeSH
- zánět MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
A 62-year-old woman presented with symptoms of dyspnea. Ultrasonography and computed tomography examinations revealed mass extending from the cricoid cartilage to the left lobe of thyroid gland and thyroid cartilage. Cytology revealed possibility of cartilaginous origin, which was proven to be chondrosarcoma Grade 1 from the biopsy specimen obtained during panendoscopy. She underwent one stage radical resection and immediate reconstruction of laryngeal skeleton defect by mucocartilaginous graft from the nasal septum. Her postoperative course was optimal with preservation of all the laryngeal functions. Twenty-eight months postoperatively, she had to undergo total laryngectomy as a salvage procedure for the advanced local recurrence. We report on the relatively easy technique for functional reconstruction of the large laryngeal defect with the employment of cartilage graft from the nasal septum.
- MeSH
- biopsie MeSH
- cartilago cricoidea * MeSH
- časové faktory MeSH
- chondrosarkom chirurgie MeSH
- chrupavka transplantace MeSH
- laryngektomie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- nádory hrtanu chirurgie MeSH
- nosní přepážka * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH