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OBJECTIVE: To evaluate accuracy of preoperative tumor grade and intraoperative gross examination of myometrial invasion in patients with clinical stage I endometriod adenocarcinoma for lymphadenectomy. METHODS: Clinic-pathological data were retrospectively collected from 687 patients with clinical stage I endometriod adenocarcinoma who underwent operation in Women's Hospital, Zhejiang University School of Medicine from January 1999 to December 2008. According to postoperative histology diagnosis, accuracy of preoperative tumor grade by curettage and depth of myometrial invasion by intraoperative gross examination was evaluated, and clinic-pathological factors associated with accuracy were analyzed. RESULTS: Sensitivity, specificity, accuracy, false negative rate, false positive rate, and positive and negative predictive value for the prediction of needing for intraoperative lymphadenectomy in patients with clinical stage I endometriod adenocarcinoma were 70.4%, 80.2%, 77.6%, 12.0%, 43.0%, 57.0% and 88.0%, respectively. Analysis of muti-factors shown that patient age, tumor size, lymph node metastasis and extrauterine spread lesions were independent factors affected the accuracy of prediction (P < 0.05). CONCLUSION: Prediction of needing for lymphadenectomy by preoperative tumor grade and intraoperative gross examination of myometrial invasion is reliable in clinical stage I endometriod adenocarcinoma patients, while there is a highly false negative rate in prediction of not needing for lymphadenectomy, while other prognostic factors such as patient age, tumor size, lymph node metastasis and extrauterine spread lesion should be together considered.
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Carcinoma Endometrioide/patología , Legrado/métodos , Neoplasias Endometriales/patología , Miometrio/patología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Carcinoma Endometrioide/cirugía , Neoplasias Endometriales/cirugía , Femenino , Humanos , Histerectomía , Periodo Intraoperatorio , Escisión del Ganglio Linfático , Metástasis Linfática , Persona de Mediana Edad , Miometrio/cirugía , Invasividad Neoplásica , Estadificación de Neoplasias , Estudios Retrospectivos , Medición de Riesgo , Sensibilidad y Especificidad , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Preoperative tumor grading becomes one of the most important predictors for lymphadenectomy at primary surgery for clinical stage I endometriod adenocarcinoma. However, there is an inconsistency of tumor grade between preoperative curettage and final hysterectomy specimens, and its associated factors are poorly understood. This study aimed to evaluate the accuracy of tumor grade by preoperative curettage so as to achieve a better stratified management for clinical stage I endometriod adenocarcinoma. METHODS: Clinical data of totally 687 patients with clinical stage I endometriod adenocarcinoma who underwent preoperative curettage and primary surgery were retrospectively collected. Compared with final hysterectomy specimens, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of tumor grade by preoperative curettage were calculated and their associations with clinicopathologic parameters, including age, status of menopause, position of uterus, location and size of lesion, histological grade, depth of myometrial invasion, cervical invasion, extrauterine spread, peritoneal cytology, metastasis to retroperitoneal lymph node, serum CA125 level, and hormone receptor status, were analyzed. RESULTS: In final hysterectomy specimens, 139 of 259 grade 1 patients by curettage were upgraded to grade 1 or 2; 31 of 296 grade 2 were upgraded to grade 3, with a significantly discrepant rate of 40.9% (281/687) and an upgraded rate of 24.7% (170/687). The specificity and negative predictive value for grade 3 were 90.7% and 89.9%, while the sensitivity and positive predictive value for grade 1 were 67.1% and 40.9%, respectively. CONCLUSIONS: Preoperative tumor grade by curettage does not accurately predict final histological results, especially in those classified as grade 1. Complete surgical staging seems to be necessary for clinical stage I endometriod adenocarcinoma.
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Adenocarcinoma/diagnóstico , Legrado/métodos , Neoplasias Endometriales/diagnóstico , Estadificación de Neoplasias/métodos , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adulto , Neoplasias Endometriales/patología , Neoplasias Endometriales/cirugía , Femenino , Humanos , Histerectomía , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
OBJECTIVE: To study the long-term follow-up result of partial laryngectomy and reservation of laryngeal function. METHODS: Five hundred and fifty-nine patients who underwent partial laryngectomy from 1996 to 2002 were summarized (male 435 cases, female 124 cases). Among them, 200 cases were supraglottic carcinomas (classified accordingly by UICC standard of years 2002 into: 15 cases of I, 81 cases of II, 72 cases of III, and 32 cases of IV), 354 cases were glottic carcinomas (141 cases of I, 124 cases of II, 88 cases of III, and 1 cases of IV), 5 cases were transglottic carcinomas (2 cases of II and 3 cases of III). In common 7 kinds of operations were performed: 66 cases underwent cordectomy, 119 vertical laryngectomy, 62 horizontal supraglottic laryngectomy, 113 horizontovertical (3/4) laryngectomy, 88 subtotal laryngectomy with cricoglossoepiglottic anastomosis, 26 near total laryngectomy with cricoglossal anastomosis (with reservation of unilateral arytenoid cartilage), 85 laser laryngectomy. Two hundred and sixty-one cases underwent concurrent neck dissection (174 unilateral, 87 bilateral). Safety margin of less than or equal to 5 mm was suspected of having residual lymph node metastasis, the postoperative radiation therapy to treatment. RESULTS: All cases restored their phonation and overcame aspiration with removing nasal feeding from 7 to 24 days after operations. Four hundred and sixty-six cases were decannulated from 9 days to 3 months after operations. Decannulation rate was 98.3%. Through periodic review of out-patient clinics or telephone follow-up, family members follow-up a variety of ways, three, five or ten years follow-up rate: 99.6% (557/559), 98.2% (549/559), 95.8% (183/191), dollars lost to death. The three years survival rates were 89.6% (501/559). Among them, the survival rates for supraglottic carcinoma patients of stage I and II was 90.6%, stage III and IV 81.7%, for glottic carcinoma patient of stage I and II was 95.2%, stage III and IV 82.4%. The five years survival rates were 75.0% (419/559). Among them, the survival rates for supraglottic carcinoma patients of stage I and II was 75.0%, stage III and IV 62.5%, for glottic carcinoma patient of stage I and II was 81.8%, stage III and IV 70.6%. The ten year survival rates were 71.2% (136/191). Among them, the survival rates for supraglottic carcinoma patients of stage I and II was 69.7%, stage III and IV 65.2%, for glottic carcinoma patient of stage I and II was 77.6%, stage III and IV 72.1%. CONCLUSIONS: Partial laryngectomy is a kind of radical operation with reservation of laryngeal function. Qualities of life and curative effect, were greatly improved.
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Carcinoma de Células Escamosas/cirugía , Neoplasias Laríngeas/cirugía , Adulto , Anciano , Carcinoma de Células Escamosas/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/patología , Laringectomía , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the impact of extracapsular spread (ECS) in ipsilateral neck metastasis on prognosis and its related factors in laryngeal cancer. METHODS: The study included 184 patients who underwent laryngectomy and simultaneous radical or modified radical neck dissection between January 1994 and December 1997 for laryngeal cancer. All of them had a complete 5-year follow-up. We used transparent lymph node detection and continuous slicing method on all neck dissection specimens. Kaplan-Meier model was used for survival analysis and the log-rank test was used to assess significance. RESULTS: We found pathological neck metastases in 80 patients. Among them, 26 cases (32.5%) had ECS in ipsilateral neck. ECS incidence increased with advanced pathological N (pN) stages (pN1 3.7%, pN2a 25.0%, pN2b 50.0%, and pN2c 55.6%; P = 0.001). ECS incidence also increased with number of positive nodes (1 positive node 8.6%, 2 positive nodes 33.3%, 3 and more positive nodes 66.7%; P < 0.001). Incidences of contralateral neck metastases and ipsilateral neck recurrence in patients with ECS were higher than those in patients without ECS (46.2% vs. 24.1%, P = 0.046; 34.6% vs. 7.4%, P = 0.002). The 5-year survival rate of patients with ECS was significantly lower than that of patients without ECS (23.1% vs. 57.4%, P = 0.013). CONCLUSION: ECS is an important prognostic factor in laryngeal cancer. Patients with ECS have a higher incidence of contralateral neck metastasis, so bilateral neck dissection should be selected.
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Neoplasias Laríngeas/patología , Adulto , Anciano , Femenino , Humanos , Neoplasias Laríngeas/cirugía , Metástasis Linfática/patología , Masculino , Persona de Mediana Edad , Cuello , Disección del Cuello , Pronóstico , Análisis de SupervivenciaRESUMEN
OBJECTIVE: To evaluate the impact of extracapsular lymph node spread (ECS) in the ipsilateral neck on the contralateral neck metastasis and prognosis of laryngeal cancer. METHODS: The data of 184 laryngeal cancer patients who underwent laryngectomy and simultaneous radical or modified radical neck lymph node dissection between Jan. 1994 and Dec. 1997 were retrospectively analyzed. Of these 184 patients, 144 underwent unilateral neck lymph node dissection and 40 bilateral; 159 had supraglottic lesion and 25 transglottic. All had squamous cell carcinoma. The clinical T stage was T1 in 3, T2 63, T3 77, T4 41; N stage: NO in 123, N1 38, N2a 5, N2b 11, N2c 7. Transparent lymph node detection and continuous sectioning method were applied to all dissected neck lymph nodes. Statistical analysis was carried out using SPSS software package ( version 11.5). Survival curves were calculated through the Kaplan-Meier model. Impact of extracapsular lymph node spread in the ipsilateral neck on prognosis was assessed using the Log rank test. RESULTS: Of these 184 patients, neck lymph node metastasis was pathologically proven in 80, 26 had ECS in the ipsilateral neck with a ECS rate of 32.5% (26/80). The ECS incidence was positively correlated with advanced pathological N stage and metastatic lymph nodes (P < 0.01). The incidence of the contralateral neck metastasis and ipsilateral neck recurrence with ECS were higher than those without ECS, which was 46.2% versus 24.1%, and 34.6% versus 7.4%, respectively (P < 0.05). The 3- and 5-year survival rates of patients with ECS were significantly lower than those of patients without ECS, which was 53.9% versus 70.4%, and 23.1% versus 57.4%, respectively (P = 0.0125). CONCLUSION: Extracapsular lymph node spread is found to be an important prognostic factor in the laryngeal cancer. Bilateral neck dissection may be mandatory due to patients with ECS have a higher incidence of contralateral neck metastasis. The capsule of metastatic lymph nodes should be pathologically checked and reported in order to determine the extra-capsular spread status.
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Carcinoma de Células Escamosas/secundario , Neoplasias de Cabeza y Cuello/secundario , Neoplasias Laríngeas/patología , Ganglios Linfáticos/patología , Adulto , Anciano , Carcinoma de Células Escamosas/cirugía , Femenino , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Estimación de Kaplan-Meier , Neoplasias Laríngeas/cirugía , Laringectomía/métodos , Neoplasias Pulmonares/secundario , Metástasis Linfática , Masculino , Persona de Mediana Edad , Disección del Cuello/métodos , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Estudios RetrospectivosRESUMEN
OBJECTIVE: To explore the mRNA expression of KAI1 gene in laryngeal squamous-cell carcinoma and its clinical significance. METHODS: Fresh laryngeal cancer samples taken from 40 laryngeal carcinoma cases and normal control laryngeal tissues from 9 subjects were examined with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Moderate, low and negative expression rates of KAI1 gene mRNA in nine normal laryngeal tissues were 33.3% (3/9), 33.3% (3/9) and 33.3% (3/9), respectively. The high, moderate, low and negative expression rates of KAI1 mRNA in 25 laryngeal cancers without lymph node metastasis were 40.0% (10/25), 28.0% (7/25), 20.0% (5/25) and 12.0% (3/25), respectively. The moderate, low and negative expression rates of KAI1 mRNA in 15 laryngeal cancers with lymph node metastasis were 20.0% (3/15), 26.7% (4/15) and 53.3% (8/15), respectively. The KAI1 mRNA expression in the laryngeal cancers without lymph node metastasis was higher than that in normal laryngeal tissues (P < 0.05). The KAI1 mRNA expression in the laryngeal cancers with lymph node metastasis was lower than that in the laryngeal cancers without lymph node metastasis (P < 0.05). The high, moderate and low expression rates of KAI1 mRNA in 10 highly differentiated laryngeal cancers were 50.0% (5/10), 30.0% (3/10) and 20.0% (2/10), respectively. The high, moderate, low and negative expression rates of KAI1 mRNA in 12 low differentiation laryngeal cancers were 8.3% (1/12), 16.7% (2/12), 16.7% (2/12) and 58.3% (7/12), respectively. The differences of KAI1 mRNA expression between high and low differentiation laryngeal cancers were statistically significant (P < 0.05). CONCLUSION: The decrease of KAI1 mRNA expression may be related to lymph node metastasis and low differentiation of laryngeal squamous-cell carcinoma.
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Carcinoma de Células Escamosas/genética , Proteína Kangai-1/biosíntesis , Neoplasias Laríngeas/genética , Ganglios Linfáticos/patología , Adulto , Anciano , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patología , Femenino , Humanos , Proteína Kangai-1/genética , Neoplasias Laríngeas/metabolismo , Neoplasias Laríngeas/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , ARN Mensajero/biosíntesis , ARN Mensajero/genética , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
OBJECTIVE: To discuss the method to reconstruct laryngeal defect after vertical partial laryngectomy with resection of arytenoid cartilage. METHODS: Laryngeal defect was reconstructed with local tissues after vertical partial laryngectomy with resection of arytenoid cartilage on 87 patients with laryngeal carcinoma of glottic type (T1 7 cases, T2 54 cases, T3 26 cases). All the lesions invaded arytenoid area or vocal process. No filling tissues were used to increase the height of affected arytenoid area and no skin flap or other tissues were used to reconstruct the vocal cord in all the patients. RESULTS: All the patients recovered normal swallow in 8 to 19 days postoperation and restored phonation. The decannulation rate was 98.9% (86/87). There were no pharyngeal fistula and pulmonary complications after operation. Local infection occurred in 3 patients and was cured in 7 days. The rate of local recurrence and cervical lymph node metastasis were 8.0% (7/87), 6.9% (6/87) respectively. Lost patients were assumed to death and direct method was used to calculate survival rate. In 87 patients postoperative period was above 3 years, 5 died in 3 years and 3 were lost 3- year survival rate was 90.8% (79/87). In 63 patients postoperative period was above 5 years, 10 died in 5 years and 2 were lost. 5- year survival rate was 81.0% (51/63). CONCLUSIONS: Utilizing local tissues to reconstruct laryngeal defect after vertical partial laryngectomy with resection of arytenoid cartilage will not lead to severe dysphagia. Phonation is acceptable. It not only saves the operation time but also avoids the negative effects of immoderate reparation.
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Cartílago Aritenoides/cirugía , Carcinoma de Células Escamosas/cirugía , Neoplasias Laríngeas/cirugía , Laringe/cirugía , Procedimientos de Cirugía Plástica/métodos , Adulto , Anciano , Carcinoma de Células Escamosas/patología , Femenino , Humanos , Neoplasias Laríngeas/patología , Laringectomía , Laringe/patología , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To investigate the characteristic of cervical lymph node metastasis of hypopharyngeal carcinoma and its influence to the prognosis. METHODS: One hundred and eight hypopharyngeal carcinoma patients who accepted treatments in the 1st Affiliated Hospital of China Medical University from 1985 to 2000 were reviewed retrospectively. All of them accepted surgical treatment without pre-operative chemotherapy or radiotherapy. Stage was made according to the standard of International Union Against Cancer (UICC) in 1992. Specimens of the patients were carefully examined to confirm the primary site of the tumor and the distribution of cervical lymph node metastasis. Pathological differentiations of the tumor were classified into high, middle and low category. Kaplan-Meier method was used to estimate the 3rd, 5th years survival. RESULTS: The rates of lymph node metastasis of was 45.8% for patients with TI and T2 disease, 79.8% for those with T3 and T4, and 75.0% (81/108)for the whole patients(P < 0.05). Patients with pyriform sinus cancer occupied 92.6% (100/108) of all the cases. Cervical lymph node metastasis rate of pyriform sinus cancer and posterior pharyngeal wall cancer were 74. 0% and 87. 5% respectively (P > 0.05). Cervical lymph node metastasis rate of patients with the high, middle and low differentiation tumor were 72. 2% , 67.6% and 85.7% respectively (P > 0.05). The 3rd and 5th years survival rates of all patients were 67.53% and 29.87% respectively. The occurrence of cervical lymph node metastasis was 76.5% in the level II and III, and 8.6% in the level V and VI. CONCLUSIONS Cervical lymph node metastasis rate of hypopharyngeal carcinoma is high. Cervical lymph node metastasis was one of the most significant prognostic factors of hypopharyngeal carcinoma. With the increase of the cervical node metastasis, the 3rd and 5th years survival of the patients declined gradually.
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Neoplasias Hipofaríngeas/patología , Ganglios Linfáticos/patología , Adulto , Anciano , Femenino , Humanos , Neoplasias Hipofaríngeas/diagnóstico , Metástasis Linfática , Masculino , Persona de Mediana Edad , Cuello/patología , Pronóstico , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To detect mutations of exon 5 and exon 8 of phosphatase and tensin homology deleted on chromosome10/mutated in multiple advanced cancer1/TGF-beta regulated and epithelial cell-enriched phosphatase (PTEN/MMAC1/TEP1 for short PTEN) gene in laryngeal squamous cell carcinoma (LSCC) and analyze the relationship between the mutation and LSCC. METHODS: Fresh tumor samples from 40 LSCC patients were examined using polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) and direct DNA sequencing. RESULTS: The mutation of exon 5 and exon 8 occurred in supra-glottic laryngeal carcinoma and no mutation in the glottic laryngeal carcinoma was found. There were 6 cases of mutation for exon 5, and the mutation rate was 15%. In 2 cases, 1 base pair insertion TT-->TAT in codon 85, while in other two cases, 1 base pair deletion GCA-->GC in codon 86, and the two type mutation may result in frame shift mutation. One case had the above two type mutation simultaneously, which may result in missense mutation; 1 case had 1 base pair insertion TT-->TAT in 85 codon and 1 base pair deletion GCA-->GA, which may result in nonsense mutation. The pathology of 3/6 (50%) cases was low differentiation, and the others (3/6, 50%) were middle differentiation. Five cases had lymphatic metastasis, and the rate of which was 83.3%; the other one had no lymphatic metastasis, and the rate of which was 16.7%. There was only 1 case mutation for exon 8, and the mutation rate was 2.5%. One base pair deletion AAA-->AA in 276 codon as well as 1 base pair insertion CT-->CCT between the 336 codon and 337 codon may result in frame shift mutation. The pathology of the case was low differentiation. CONCLUSION: The codon 85,86 of PTEN gene in exon 5 may be "hot spots" in LSCC and the mutation of PTEN gene may be related with the lymphatic metastasis and middle or low differentiation.
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Carcinoma de Células Escamosas/genética , Neoplasias Laríngeas/genética , Mutación Puntual , Proteínas Tirosina Fosfatasas/genética , Adulto , Anciano , Secuencia de Bases , Cromosomas Humanos Par 10 , Análisis Mutacional de ADN , ADN de Neoplasias/análisis , Exones/genética , Femenino , Genes Supresores de Tumor , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Monoéster Fosfórico Hidrolasas/genética , Polimorfismo Conformacional Retorcido-SimpleRESUMEN
OBJECTIVE: To develop a human ovarian carcinoma SKOV3 model in severe combined immunodeficiency (SCID) mouse and to study its biologic characteristics. METHODS: Human ovarian carcinoma SKOV3 cells were injected intraperitoneally into female SCID mouse to establish a transplantation model of human ovarian carcinoma. The biological characteristics, metastasis and morphology of transplanted tumors were studied. RESULT: All tumors grew progressively with no sign of regression. The tumor cells spread around the peritoneal cavity and mainly on the diaphragm, mesentery, peritoneum and around the liver, which was confirmed by histopathology. The morphology, growth pattern and CA125 secretion of primary culture of transplanted cells remained as same as those of ovarian carcinoma cell line SKOV3. CONCLUSION: An intraperitoneal transplantation model of human ovarian carcinoma SKOV3 in SCID mice has been developed successfully, which can simulate the biological behavior of peritoneal metastasis of human ovarian carcinoma.
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Modelos Animales de Enfermedad , Neoplasias Ováricas/patología , Neoplasias Peritoneales/secundario , Animales , Femenino , Humanos , Ratones , Ratones SCID , Trasplante de Neoplasias , Neoplasias Ováricas/ultraestructura , Trasplante HeterólogoRESUMEN
OBJECTIVE: The purpose of study was to examine the mRNA expression levels of the metastasis-associated gene1 (MTA1) in laryngeal squamous cell carcinoma (LSCC), so to evaluate its relationship with metastases. METHODS: Forty-eight surgically resected primary LSCC (16 supraglotti laryngeal carcinomas with cervical lymph node metastasis, 16 supraglotti laryngeal carcinomas with cervical lymph node-negative metastasis, 16 glottic carcinoma with cervical lymph node-negative metastasis) and 16 normal laryngeal mucosa was examined for mRNA expression of MTA1 by reverse transcription-polymerase chain reaction(RT-PCR). RESULTS: The frequency of MTA1 mRNA positive expression in 16 LSCC with cervical lymph node metastasis was 100%, but no expression of MTA1 mRNA was observed in other LSCC with cervical lymph node-negative metastasis (16 supraglotti laryngeal carcinomas and 16 glottic carcinoma) and 16 normal laryngeal mucosa. CONCLUSION: MTA1 gene is strongly related to cervical lymph node metastasis of LSCC, and may serve as a early diagnosis indicator.
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Carcinoma de Células Escamosas/secundario , Histona Desacetilasas/biosíntesis , Neoplasias Laríngeas/patología , Ganglios Linfáticos/patología , Proteínas Represoras/biosíntesis , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/metabolismo , Femenino , Histona Desacetilasas/genética , Humanos , Neoplasias Laríngeas/metabolismo , Metástasis Linfática/genética , Masculino , Persona de Mediana Edad , Cuello , ARN Mensajero/biosíntesis , ARN Mensajero/genética , Proteínas Represoras/genética , TransactivadoresRESUMEN
OBJECTIVE: Explore the reformation of new vocal cord after laser cordectomy and the histological change of new vocal cord by animal experiment. METHODS: The reforming course of new vocal cord was observed by follow-up. 4 dogs underwent bilateral cordectomy (type II operation) and their larynx were analyzed anatomically and histologically eight months later. 100 cases who underwent KTP laser cordectomy were divided into 3 types according to the range and depth of the excision. RESULTS: All the dogs had reformation of vocal cords eight months later. On the surface of the reformed vocal cord, no mucous cell but squamous cells was found. Newborn ligament-like connective tissues and loose muscle fibers were found under membrane. Complete reconstruction of larynx was found in 16 cases of type I (16/16) and 54 of type II 86% (54/63). But in type III no new vocal cord was found. CONCLUSION: Formation of the new vocal cord is the result of hypertrophy of the remained vocal cord muscle, influenced by depth of the excised vocal cord using laser. The histological construction is nearly normal cord. Whether or not the laser radiation stimulate the tissue hypertrophy is need more research.
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Glotis/cirugía , Neoplasias Laríngeas/cirugía , Terapia por Láser , Pliegues Vocales/patología , Adulto , Anciano , Animales , Perros , Femenino , Estudios de Seguimiento , Humanos , Laringectomía , Masculino , Persona de Mediana Edad , Pliegues Vocales/cirugíaRESUMEN
The mechanism of telomerase activation is still not clear till now. In order to understand the expressional mode of telomerase and the mechanism of telomerase activation in laryngeal carcinogenesis, we cloned a fragment of hTERT cDNA and prepared a monoclonal antibody against hTERT. We performed immuno-histochemical staining in laryngeal cancer tissues using this antibody. We found that the frequencies of hTERT positive cells were positively correlated with undifferentiation of cancer tissues and that the expression of hTERT was positively correlated with levels of c-Myc, which suggested that c-Myc might play an important role in activation of telomerase. These results revealed that overexpression of c-Myc upregulated telomerase, which in turn resulted in immortalization of laryngeal squamous cells, and this mechanism existed not only in the initiation of laryngeal carcinogenesis but also in the whole process of cancer development.