Objective We investigated the correlation between the expression of IL-17A in nasopharyngeal carcinoma tissues and cells and the occurrence and development of NPC was also investigated. Methods Forty-five NPC biopsy specimens from January 2014 to January 2016 were selected. Forty-five NPC tissue specimens and 45 chronic nasopharyngitis tissue samples were detected by immunohistochemistry. Statistical methods were used to analyze the correlation between IL-17A expression and the clinicopathological variables of NPC. The NPC patients were followed up. The levels of IL-17A mRNA in 40 NPC tissue specimens and 45 chronic nasopharyngitis tissue samples were detected by real-time PCR. IL-17A expression in 15 NPC tissue specimens and chronic nasopharyngitis tissue samples was further detected by Western blotting assays. Results IL-17A expression in NPC tissues was significantly higher than that of chronic nasopharyngitis tissues (P < 0.05). IL-17A was expressed in the nucleus and cytoplasm of both NPC tissues and chronic nasopharyngitis tissues. Stage III + IV NPC, tumor volume >= 50 mm, and hepatic envelope invasion and cervical lymph node metastasis were associated with significantly higher IL-17A levels versus stage I + II NPC, tumor size < 50 mm, no membrane invasion and lack of cervical lymph node metastasis (P < 0.05). IL-17A was statistically associated with tissue differentiation, serum EBV-lgA levels, and EBV infection. IL-17A-positive patients had significantly longer median survival versus IL-17A-negative patients (21.0 vs. 13.0 months, log-rank test: P < 0.05). Furthermore, 65% (26/40) of NPC tissue samples had significantly higher IL-17A mRNA levels than chronic nasopharyngitis (P < 0.05). IL-17A expression was significantly higher in NPC >= 50 mm, stage III + IV NPC and NPC with cervical lymph node invasion than its corresponding chronic nasopharyngitis tissue. Conclusion IL-17A may be involved in the regulation of various malignant biological behaviors of NPC, which is closely related to the occurrence and development of NPC.
Purpose Definitive radiotherapy (RT) is recommended by NCCN guidelines for T4b tumors of sinonasal squamous cell carcinomas (SNSCC). However, no multi-institutional clinical studies have proved its advantage over surgery-based modalities. The aim of this study was to assess the survival of T4bN0M0 SNSCC patients who received surgery plus postoperative radiation (S + PORT) compared with those who received RT. Methods This study extracted 220 patients from the SEER database from 2004 to 2015. Propensity score matching (PSM) was used to eliminate the baseline variations. Results In SEER database, 43.6% of patients received S + PORT, and subsequently followed by RT (36.4%). Five-year overall survival (OS) and cancer-specific survival rates (CSS) in S + PORT were 42.5% and 46.9%, respectively, significantly better than for RT (21.7% and 26.7%). Multivariate analysis showed that therapy of RT had higher cancer-specific mortality risk than S + PORT [hazard ratio (HR) 1.578, p = 0.032]. After PSM, 57 pairs of patients were selected. There was still a significant difference noted with regard to 5-year OS or 5-year CSS between patients receiving S + PORT and RT (43% vs 22.5%, p = 0.012; 45.8% vs 27.7%, p = 0.025). The univariate and multivariate analyses of factors predictive of CSS showed that therapy of RT (HR 1.877, p = 0.018) and primary subsite of maxillary sinus (HR 2.629, p = 0.001) were significantly correlated with adverse outcomes. Conclusion Combination of surgery and postoperative radiotherapy may contribute to prolonged survival in T4bN0M0 SNSCC. Invasion of the sites of T4b tumors is not an absolute contraindication for surgery.
Purpose To evaluate peripheral blood immunological parameters and the possible correlation with age, gender and adenoid size in children with adenoid hypertrophy with OME. Methods A total of 664 children with adenoid hypertrophy were initially enrolled in our study, of which 83 had concomitant OME. To minimize selection bias, we performed one to two propensity score matching (PSM) between children with and without OME. After PSM, 80 children with OME (OME group) and 157 children without OME (adenoid hypertrophy [AH] group) were selected. The patients' peripheral blood samples were prepared prior to surgery and their immunological parameters were compared between groups. Results Compared to the AH group, the serum level of C3 was significantly higher in the OME group (0.88 +/- 0.01 g/L vs. 0.94 +/- 0.02 g/L; p = 0.014), which was the only independent risk factor for OME (odds ratio 13.58, 95% confidence interval 1.25-147.99; p = 0.032). However, no such difference was seen for serum immunoglobulin (IgG, IgA, IgM, IgE), T cell subsets (CD3+, CD4+ and CD8+ T cells), or lymphocytes and monocytes. Further subgroup analyses showed that in children <= 5 years old, the C3 level was significantly higher in OME patients (p = 0.023). A subgroup analysis based on sex indicated that there was a significantly higher level of serum C3 (p = 0.009) and lower CD3+ and CD4+ T cells (p = 0.010 and p = 0.021, respectively) in girls with OME compared to those without OME. No association between immunological parameters and adenoid size was found. Conclusions There were no significant differences in cellular immunology and humoral immune indicators in children with adenoid hypertrophy with or without OME. In children <= 5 years old, significantly higher serum C3 levels in patients with OME demonstrate excessively activated C3 in comparison to patients without OME. For girls, a higher serum level of C3 with a lower amount of CD3+ and CD4+ T cells may be associated with OME.
ObjectiveTo evaluate the efficacy and safety of Chinese medicine in the treatment of adenoid hypertrophy in children.MethodScreening standard articles, extracting relevant data from meta-analysis, were analyzed by Revman5.1 software, by searching PubMed, Medline, VIP, Wan Fang and Chinese HowNet database 2006-2016 in traditional Chinese medicine treatment of children with adenoid literature.Results206 articles met the inclusion criteria, of which ten were selected and included in the meta-analysis, and there were 803 patients. The results showed that the remission rate of the Chinese medicine treatment group was better than that of the Western medicine group. The combined effect of the amount of OR 2.06, 95% Cl (1.45, 2.96) and the combined effect of the amount of the test Z=4.12, P<0.00001 showed the recurrence of the disease was lower in traditional Chinese medicine treatment group than the Western medicine group. The combined effect of the amount of OR 3.05, 95% Cl (2.11, 4.56) and the combined effect of the amount of the test Z=5.86, P<0.00001 showed the total effective rate is high in the traditional Chinese medicine treatment group than the Western medicine group. The difference between the combined effect of the amount of OR 2.79, 95% Cl (1.78, 5.03) and the combined effect of the amount of the test of Z=4.54, P<0.00001 was statistically significant, which showed the treatment effect of Chinese medicine group is obviously better than the Western medicine group.ConclusionThe use of Chinese medicine for the treatment of children with adenoid hypertrophy has good clinical efficacy.
BackgroundThe purpose of this study was to investigate the prognostic factors and the value of surgical treatment of patients with newly diagnosed laryngeal cancer with distant metastasis (DM).MethodsThe Surveillance, Epidemiology and End Result database (SEER) was used to analyze 446 patients with laryngeal cancer with DM at the time of initial diagnosis from 2010 to 2014.The survival prognosis of patients with DM was performed by using Kaplan-Meier and log-rank test. The prognostic factors and the effect of surgery were analyzed using the Cox regression analysis and R-language data package.ResultsThe incidence of DM was 3.21% (446/13865). Lung was the most common distant metastatic site of laryngeal cancer (62.6%), and brain metastases had the worst prognosis in patients at 2months. T stage and brain metastasis were independent risk factors affecting the survival (P<0.05). The hazard ratio (HR) of DM in T4 stage was nearly twice than that in T1 stage. Surgical treatment of primary and metastatic tumors can cause better survival for patients. Patients who didn't underwent primary tumor surgery were approximately twice as likely to die from cancer as those who did. The nomogram model was constructed to visually present the 1-, 2- and 3-year survival rates of patients.ConclusionsT stage, brain metastasis and surgical treatment are prognostic factors of patients with M1 stage laryngeal cancer. Surgical treatment of primary tumors and metastases can lead to better survival for patients.Trial registrationNot applicable.
PurposeTo investigate predictive risk factors for complications associated with migrating fish bones in the surrounding tissue of upper gastrointestinal tract.MethodsA retrospective analysis over 12years was conducted of 45 cases of buried fish bones in the surrounding tissue of upper gastrointestinal tract with complications. Meanwhile, a control group, including 39 cases of prolonged buried fish bones in the surrounding tissue of upper gastrointestinal tract without complications, was set. Patient clinical data were collected and analyzed to predict the risk factors for complications.ResultsThe results of Chi-square test and univariate analysis both showed a significant difference in length of fish bone (>2cm), a history of concurrent medical illness (diabetes mellitus and renal hypofunction), symptoms (medium or heavy pain and dysphagia), and duration of significant symptoms (>7 days) between the complication group and non-complication group. Multivariate analysis further identified length (>2cm), diabetes mellitus, medium or heavy pain, dysphagia, and duration of significant symptoms (>7 days) as independent risk factors for complications.ConclusionsThe consequences of fish bones migrating outside the upper gastrointestinal tract are various in different people. Awareness should be raised when encountering a patient ingesting a long fish bone, having a history of diabetes mellitus, presenting with significant discomforts, or these discomforts lasting for a long time. This study will help practitioners counsel their patients on the risks and `benefits of surgery versus observation of this condition.
PurposeTo establish a novel and effective reflux model with a modified nasogastric aspiration tube and to investigate the association between different types of nasogastric aspiration tubes and reflux laryngitis, we conducted this study.MethodsThirty-eight healthy New Zealand albino rabbits (2.5-3.5kg) were divided into three groups: control (CTR, n=6)non-intubated; normal nasogastric intubation (NNI, n=16)intubated with 4#, 6#, 8#, and 10# normal nasogastric aspiration tubes; and modified nasogastric intubation (MNI, n=16)intubated with 4#, 6#, 8#, and 10# modified nasogastric aspiration tubes. The laryngoscopy, body weight, and pH values at the esophageal entrance were recorded before and 1, 2, and 4 weeks after intubation. After the final laryngoscopy, the animals in groups with a pH below 4 were sacrificed to obtain histological and gene expression analysis results.ResultsThe reflux finding score (RFS) after 4 weeks showed that there was a statistically significant difference in the 8# NNI group (70.816, P<0.001), the 8# MNI group (11.5 +/- 2.517, P<0.001) and the 10# MNI (12.75 +/- 1.893, P<0.001) group compared with the control group (1.83 +/- 1.602). The pH values of these three groups were lower than 4. However, the weight loss of the rabbits in the 10# NNI and 10# MNI groups was more obvious. Submucous gland hyperplasia and inflammation were significantly increased in the 8# NNI group, 8# MNI group and the 10# MNI group, but in the level of some pro-inflammatory cytokines and COX-2, the MNI group was significantly higher than the NNI group (8# NNIx8# MNI, P<0.01; 8# MNIx10# MNI, P<0.01).Conclusion p id=Par4 This study showed that 8# modified nasogastric intubation (MNI) produces effective reflux laryngitis in the rabbits.
BackgroundGlucocorticoids are the first-line medical treatment for chronic rhinosinusitis with nasal polyps (CRSwNP), whose local metabolism is catalyzed by 11-HSD1 and 11-HSD2. This study investigates the role of 11-HSD1 and 11-HSD2 on the glucocorticoid response of CRSwNP patients and the pathogenic mechanism of these polyps.MethodsForty-three adult CRSwNP patients were enrolled in this study. We evaluated the endoscopic scores by a nasal polyp grading system before and after treatment. We estimated the response to glucocorticoids by the total endoscopic scores. The logistic regression models and inflammatory characteristic curves were conducted to explore the prediction of the response to glucocorticoid in CRSwNP. The expression of 11-HSD1 and 11-HSD2 on human sinonasal epithelial cells (HSECS) was measured under the stimulation of toll-like receptor agonists and dexamethasone.ResultsThe endoscopic scores in the CRSwNP group declined, the expression of 11-HSD1/11-HSD2 increased (r=0.5276, P=0.0011), and the cutoff value of the ratio of 11-HSD1/11-HSD2 was 0.4654 (sensitivity 79.17%, specificity 88.89%). Dexamethasone induced a decrease in the ratio of 11-HSD1/11-HSD2 (P=0.049) by the stimulation of PGN-BS.ConclusionWe found a strong correlation between the response to glucocorticoids and the ratio of 11-HSD1/11-HSD2, which could be used as a marker in predicting the level of tissue response to glucocorticoid therapy in CRSwNP. In addition, PGN-BS could also be a therapeutic target, as it is the negative factor that will decrease the sensitivity of glucocorticoids by reducing the ratio of 11-HSD1/11-HSD2.
BackgroundAllergic rhinitis (AR) has been reported to be associated with chronic rhinosinusitis (CRS). The objective of this study was to investigate the effect of AR on nasal mucosa remodeling in CRS.MethodsPatients were enrolled and divided into the following groups: CRS with nasal polyps (NP) with allergic rhinitis (AR)(CRSwNPwAR; n=20), CRS with NP without AR (CRSwNPsAR; n=20), CRS without NP with AR (CRSsNPwAR; n=20), CRS without NP without AR (CRSsNPsAR; n=20), AR without CRS (AR; n=20) and controls (n=14). Eosinophil infiltration, mucus production, and collagen deposition were examined by hematoxylin and eosin, periodic acid schiff and masson's trichrome staining, respectively. VEGF-A and microvessel density were detected by immunohistochemistry. The expression of remodeling markers, including TGF-1, MMP-7, MMP-9 and TIMP-1 were measured by Western blot.ResultsThe expression of remodeling factors, including VEGF-A, CD31, CD34 and TIMP-1 were significantly increased in CRSwAR compared to CRSsAR. Goblet cell hyperplasia, as well as VEGF-A, CD31, CD34, and MMP-9 expression were significantly higher in CRSwNPwAR compared to CRSwNPsAR. However, the expression of collagen fibers, MMP-7 and TGF-1 were significantly higher in CRSsNPwAR compared to CRSsNPsAR.ConclusionsAR could enhance the remodeling process in CRS. Moreover, AR had different effects on CRSwNP and CRSsNP.
PurposeWe conducted a meta-analysis assessing the association between the p.P240L (c.C719T) variant and the risk of nonsyndromic hearing loss (NSHL).MethodsLiteratures that reported prevalence rates were identified using PubMed, EMBASE, OVID, Cochrane library, Web of Science, Chinese National Knowledge Infrastructure, Wanfang Databases for the period from inception to August 2017. Random and fixed effects models were used to generate pooled ORs and I-2 values. The heterogeneity assumption decided the effect model.ResultsA total of four relevant studies were included in the meta-analysis. The results of meta-analysis indicated that the p.P240L variant was correlated with the risk of NHSL in Asian populations (OR=10.17, 95% CI=2.74-37.82, P=0.001). The T allele of p.P240L was associated with a 12-fold higher risk of NSHL than the C allele (OR=11.68; 95% CI=3.16-43.24, P<0.001). Specifically, p.P240L heterozygotes (OR=8.49; 95% CI=2.28-31.59, P=0.001), had a significantly higher risk of NSHL. Publication bias of our meta-analysis was attributed to the limited availability of relevant results and the number of studies included in our meta-analysis was relatively small.ConclusionsThe p.P240L variant increased the risk of NHSL in Asian populations, suggesting a remarkable ethnic specificity linked with susceptibility to this mutation.
PurposeLncRNA CASC2 plays a role as tumor suppressor gene in different types of human malignancies, while its involvement in oral squamous cell carcinoma (OSCC) is unknown. The present study aimed to investigate the involvement of lncRNA CASC2 in OSCC.MethodsIn this study, the expression of lncRNA CASC2 in tumor tissues, adjacent healthy tissues, and plasma of 122 OSCC patients as well as in plasma of 52 healthy controls was detected by RT-qPCR. Diagnostic value of lncRNA CASC2 for OSCC was evaluated by ROC curve analysis. Patients were followed up for 5years to record recurrence. LncRNA CASC2 expression vectors were transfected into cells of human OSCC cell lines, and the effects on cancer cell proliferation and miRNA-21 expression were analyzed by CCK-8 assay and RT-qPCR, respectively.ResultsWe found that CASC2 was significantly downregulated in OSCC patients than in healthy controls. Downregulation of CASC2 distinguished OSCC patients from healthy controls. Local recurrence was observed in 26 out of 122 patients and no distant recurrence was observed during follow-up. Compared with pretreatment levels, plasma levels of CASC2 were significantly increased in patients with local recurrence than in patients without recurrence. Transfection of CASC2 expression vectors led to significantly inhibited tumor cell proliferation and reduced miRNA-21 expression levels.ConclusionsWe, therefore, conclude that downregulation of lncRNA CASC2 may participate in the postoperative local recurrence of early OSCC through miRNA-21.
PurposeTo determine if treatment of nasopharyngeal carcinoma (NPC) induces early changes in amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI), and to perform a preliminary evaluation of APTw imaging in response assessment.MethodsSixteen patients with NPC planned for treatment with radiotherapy and/or chemotherapy underwent APTw imaging of the primary tumour pre-treatment and 2-week intra-treatment. Difference in pre- and intra-treatment APT mean (APT(mean)) was compared using the Wilcoxon signed rank test. Differences in APT(mean) and percentage change (%) in APT(mean) were compared between responders and non-responders based on the outcome at 6months, using the Mann-Whitney U test.ResultsAPT(mean) decreased in 9/16 (56.3%) and increased in 7/16 (43.7%) with no significant difference between the pre- and intra-treatment APT values for the whole group (p>0.05). NPC showed response in 11/16 (68.8%) and non-response in 5/11 (31.2%). There were significant differences between the % of responders and non-responders for APT(mean) (p=0.01). Responders showed % decrease in APT(mean) of -23.12% while non-responders showed a % increase in APT(mean) of +102.28%.ConclusionAPT value changes can be detected in early intra-treatment. Intra-treatment % APT(mean) shows potential in predicting short-term outcome.
PurposeTo report 5-year survival in patients with primary parotid malignant tumours and assess the impact of various factors on survival or local control among diverse histologic groups.MethodsA total of 65 patients with primary parotid malignant tumours who had surgery between 2003 and 2014 were identified. Demographic characteristics including age, T stage, N stage and clinical or pathological performance were analysed. According to risk stratification (based on pathology), 65 primary parotid malignant tumours were divided into high-risk (23, 35.38%) and low-risk (35, 53.85%) groups. Overall survival (OS) and disease-free survival (DFS) were recorded by the Kaplan-Meier methods.ResultsThe 5-year overall survival rate for primary parotid malignant tumours was 70.9%. Patients older than 60years with fixed mass, pain, facial-nerve palsy and high-grade N stage had adverse OS and DFS. Upon multivariable analysis, facial-nerve palsy (HR 24.59; 95% CI 2.338-178.446; P=0.002) was the only independent predictive factor for OS. Patients with high-risk parotid malignant types were more likely to have tumour pain, facial-nerve palsy (Chi-square test: < 0.0001 and 0.02), lymphatic metastasis and local/regional recurrence (Chi-square test: 0.008 and 0.012).ConclusionsCompared with low-risk parotid carcinoma, tumours with high-risk histological features tend to need aggressive surgical extirpation, neck dissection and postoperative radiotherapy.