laryngeal neoplasms

喉肿瘤
  • 文章类型: Journal Article
    目的:许多系列比较了cT1声门癌放疗或手术后的声音质量。不同的荟萃分析确定了更好的结果为放疗,而其他不确定任何差异,有些人终于找到了手术的优越性。这项研究的目的是比较接受经口手术与单纯放疗治疗cT1声门癌的患者的长期语音质量。
    方法:VOQUAL研究是一项多中心横断面试验比较研究。主要终点是两组(放疗或手术)之间的语音障碍指数比较。语音评估还包括按年级对语音质量的异质评估,粗糙度,呼吸,Asthenia,和平野报告的应变等级量表。
    结果:该研究包括41例cT1声带癌的成人患者,在两个肿瘤中心接受了声带切除术或单纯放疗。手术组的语音障碍指数值中位数为20[8;32.5],放疗组为10[4;18.5]。中值与各成分F之间无统计学差异,问卷的P和E(P=0.1585)。数字发音障碍等级的中值,粗糙度,呼吸,Asthenia,手术组为2[0;5],放疗组为2[0.25;3.75]。这些值之间没有统计学上的显著差异(P=0.78)。
    结论:我们的研究在语音障碍指数和等级的主要终点上没有显示任何显着差异,粗糙度,呼吸,Asthenia,和应变分数。
    方法:III.
    背景:VOQUAL研究于2020年7月在ClinicalTrials.gov平台上注册,编号为NCT04447456。
    OBJECTIVE: Many series have compared voice quality after radiotherapy or surgery for cT1 glottic carcinoma. Different meta-analyses identify better results for radiotherapy while others do not identify any difference, some finally find a superiority of surgery. The purpose of this study was to compare the voice quality in the long term of patients who underwent transoral surgery versus exclusive irradiation for the treatment of cT1 glottic carcinoma.
    METHODS: The VOQUAL study was a pilot comparative multicenter cross-sectional study. The primary endpoint was the Voice Handicap Index comparison between two groups (radiotherapy or surgery). The voice assessment also consisted in the heteroevaluation of voice quality by the Grade, Roughness, Breathness, Asthenia, and Strain rating scale reported by Hirano.
    RESULTS: The study included 41 adult patients with cT1 carcinoma of the vocal cord treated by cordectomy or exclusive radiation in two oncologic centers. The median Voice Handicap Index value was 20 [8; 32.5] in the surgery group and 10 [4; 18.5] in the radiotherapy group. There was no statistically significant difference between the median values and the various components F, P and E of the questionnaire (P=0.1585). The median value of the numeric dysphonia Grade, Roughness, Breathness, Asthenia, and Strain scale was 2 [0; 5] in the surgery group and 2 [0.25; 3.75] in the radiotherapy group. There was no statistically significant difference between these values (P=0.78).
    CONCLUSIONS: Our study did not show any significant difference on the primary endpoints of Voice Handicap Index and Grade, Roughness, Breathness, Asthenia, and Strain scores.
    METHODS: III.
    BACKGROUND: The VOQUAL study was registered on the ClinicalTrials.gov platform under the number NCT04447456, in July 2020.
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  • 文章类型: English Abstract
    Objective:To detect the differences in types and levels of amino acids in the peripheral serum of patients with laryngeal squamous cell carcinoma and non-tumor patients, and explore their relationship with clinical parameters of laryngeal squamous cell carcinoma as well as their clinical value in diagnosis. Methods:High-performance liquid chromatography-tandem mass spectrometry(HPLC-MS) was employed to detect the serum amino acid contents and levels of 62 patients diagnosed with laryngeal carcinoma and 141 non-tumor patients at the First Affiliated Hospital of Jinzhou Medical University between September 2018 and February 2021. The study compared the differences in 22 non-essential and essential amino acids found in the serum between the experimental group and the control group. An ROC curve and risk scoring formula of multivariate linear logic regression model was utilized to evaluate the efficiency of serum amino acids in the early diagnosis of laryngeal carcinoma. Results:There were significant differences in the contents of fourteen types of amino acids between the experimental and control groups, with thirteen amino acids showing higher levels in the experimental group(P<0.05). Seven of these amino acids were essential, including phenylalanine, threonine, leucine, valine, histidine, tyrosine, and citrulline. The other six amino acids were non-essential, including arginine, asparagine, cysteine, glycine, ornithine, and proline. Interestingly, the content of homocysteine in the experimental group was lower than that in the control group(P=0.024). Further analysis showed that patients with laryngeal squamous cell carcinoma in TNM stage Ⅰ and Ⅱ had higher serum methionine levels compared to those in stages Ⅲ and Ⅳ(P=0.026). In addition, the content of serum histidine was higher in patients with poorly differentiated squamous cell carcinoma compared to those with well-differentiated squamous cell carcinoma(P=0.041). The level of asparagine in the serum of patients with laryngeal squamous cell carcinoma older than 64 years old was lower than that in patients younger than 64 years old(P=0.033). The level of tryptophan in the serum of patients with a smoking history was lower than that in patients without a smoking history(P=0.033). The level of citrulline in the serum of patients with a history of alcohol consumption was higher than that in patients with no history of alcohol consumption(P=0.003). ROC curve analysis showed that out of the 14 different amino acids between the experimental and control groups, citrulline and cysteine were relatively effective as independent factors in the diagnosis of laryngeal squamous cell carcinoma, with an AUC of 0.856 and 0.850, respectively. Arginine was the most sensitive factor in the diagnosis of laryngeal squamous cell carcinoma(AUC=0.855). However, citrulline alone had the highest specificity(0.830) in the diagnosis of laryngeal squamous cell carcinoma, and the combination of 12 amino acids significantly improved the diagnostic efficiency of laryngeal squamous cell carcinoma, with an AUC of 0.946, sensitivity of 0.887, and specificity of 0.894. A risk score formula for a multivariate logistic regression model was established based on the differential amino acid content in the serum. The risk score of laryngeal squamous cell carcinoma group was higher than that of the non-tumor group(P<0.001). The AUC of risk score in the diagnosis of laryngeal squamous cell carcinoma was 0.953 with sensitivity and specificity of 0.957 and 0.855. Conclusion:This study found that there are differences in the contents of 14 amino acids among which 13 amino acids were increased in serum of patients with laryngeal squamous cell carcinoma, and were associated with age, clinical stage, pathological differentiation, smoking, and drinking. Combined detection of 12 amino acids can improve the diagnostic efficiency of laryngeal squamous cell carcinoma and serve as potential markers for the auxiliary diagnosis of laryngeal squamous cell carcinoma using peripheral blood samples. Additionally, the established risk score model was found to be more effective in the diagnosis of laryngeal squamous cell carcinoma, indicating its important potential value as an auxiliary diagnostic tool.
    目的:检测喉鳞状细胞癌患者与非肿瘤患者外周血清中氨基酸种类及含量差异,探讨他们与喉鳞癌各临床参数之间的关系以及在诊断中的临床价值。 方法:采用高效液相色谱-串联质谱(HPLC-MS)法检测锦州医科大学附属第一医院2018年9月-2021年2月初诊的62例喉鳞癌患者(实验组)和同时期的141例非肿瘤患者(对照组)血清22种非必需氨基酸及必需氨基酸种类与含量差异,应用ROC曲线及多元线性逻辑回归模型对差异性氨基酸在喉鳞癌早期诊断中的效能进行分析。 结果:实验组较对照组血清中有14种氨基酸含量存在差异,其中13种氨基酸含量显著高于对照组(P<0.05),包括7种必需氨基酸:苯丙氨酸、苏氨酸、亮氨酸、缬氨酸、组氨酸、酪氨酸、瓜氨酸,以及6种非必需氨基酸:精氨酸、天冬酰胺、半胱氨酸、甘氨酸、鸟氨酸、脯氨酸。而同型半胱氨酸含量明显低于对照组(P=0.024)。进一步分析表明临床早期(Ⅰ期+Ⅱ期)喉鳞癌患者血清中甲硫氨酸含量显著高于临床晚期(Ⅲ期+Ⅳ期)患者(P=0.026)。高分化鳞状细胞癌患者血清中组氨酸含量显著高于低分化鳞状细胞癌患者(P=0.041)。年龄>64岁的喉鳞癌患者血清中天冬酰胺的含量高于≤64岁的喉鳞癌患者(P=0.033),有吸烟史的喉鳞癌患者血清中色氨酸含量均低于无吸烟史患者(P=0.033),有饮酒史的喉鳞癌患者血清中瓜氨酸含量高于无饮酒史的喉鳞癌患者(P=0.003)。ROC曲线分析表明,实验组与对照组间存在差异的14种氨基酸中,除同型半胱氨酸和鸟氨酸不具备统计学意义(P>0.05),瓜氨酸和半胱氨酸作为独立因素诊断喉鳞癌的效能相对较高(AUC数值分别为0.856及0.850);而精氨酸作为单独诊断喉鳞癌因素时的灵敏度则最高(0.855);但单独使用瓜氨酸诊断喉鳞癌时其特异度最高(0.830);将12种氨基酸联合应用于检测可显著提高喉鳞癌的诊断效能,AUC为0.946,灵敏度为0.887,特异度为0.894。基于血清差异氨基酸含量建立多元线性逻辑回归模型的风险评分公式,喉鳞癌组的风险评分高于非肿瘤组(P<0.001),风险评分诊断喉鳞癌的AUC为0.953(敏感度和特异度分别为0.957和0.855)。 结论:喉鳞癌患者与非肿瘤患者比较,14种氨基酸的含量存在差异,其中13种氨基酸的含量在喉鳞癌患者血清中升高,并与年龄、临床分期、病理分化程度、吸烟以及饮酒具有相关性。联合其中12种氨基酸进行检测可提高喉鳞癌的诊断效能,具备外周血辅助诊断喉鳞癌的潜力。同时建立风险评分模型发现其对于喉鳞癌的诊断效能更高,表明该模型对于辅助诊断喉鳞癌有重要潜在价值。.
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  • 文章类型: Journal Article
    据报道,喉癌(LC)在全球所有类型的头颈部癌症中具有较高的发病率。由于涉及侵袭和转移,导致LC发病机理的机制很复杂,因此需要了解这种复杂的多步骤过程。包括基质金属蛋白酶(MMPs)在内的许多分子参与调节转移机制。此外,在包括炎症在内的多种病理和生理事件中观察到不同类型MMP的激活和表达,入侵,和转移。在MMPs的所有成员中,基质金属蛋白酶-2(MMP-2),和基质金属蛋白酶-9(MMP-9)经常被报道与肿瘤发病机制相关。本研究旨在检查MMP-2和MMP-9在LC发病机制中的参与。收集184例喉肿瘤样品以及邻近的未涉及的健康切片,以使用实时PCR和免疫组织化学(IHC)检查LC中上述基因的表达失调。实时PCR和IHC分析显示,与对照组相比,喉肿瘤中MMP-2(P<0.0001)和MMP-9(P<0.0001)基因的显着上调。Spearman相关显示,在喉发病机制中,选择的MMPs的表达失调与晚期TNM分期[MMP-2,(P<.0001);MMP-9,P<.0001]和吸烟状态[MMP-2(P<.0001);MMP-9P<.0001]呈正相关。受试者工作曲线(ROC)分析显示所述标志物在喉癌患者中具有良好的诊断/预后价值。本研究表明,发现所选MMP的显著上调与喉癌的风险增加相关,并且可以作为检测所述疾病的良好诊断标记。
    Laryngeal carcinoma (LC) is reported to have a higher incidence rate among all types of head and neck cancers around the globe. Mechanisms resulting in the pathogenesis of LC are complicated due to involvement of invasion and metastasis and there is a need to understand this complicated multistep process. Numerous molecules including matrix metalloproteinases (MMPs) are involved in regulating metastatic mechanisms. Furthermore, activation and expression of different classes of MMPs have been observed in multiple pathological and physiological events including inflammation, invasion, and metastasis. Among all members of MMPs, matrix metalloproteinases-2 (MMP-2), and matrix metalloproteinases-9 (MMP-9) have been frequently reported to correlate with tumor pathogenesis. The present study is designed to check the involvement of MMP-2 and MMP-9 in LC pathogenesis. 184 laryngeal tumor samples along with adjacent uninvolved healthy sections were collected to check the expression deregulation of the above-mentioned gene in LC using real-time PCR and immunohistochemistry (IHC). Real-time PCR and IHC analyses showed the significant upregulation of MMP-2 (P < .0001) and MMP-9 (P < .0001) genes in laryngeal tumors compared to controls. Spearman correlation showed the positive correlation of expression deregulation of selected MMPs with advanced TNM stage [MMP-2, (P < .0001); MMP-9, P < .0001] and smoking status [MMP-2 (P < .0001); MMP-9 P < .0001] in laryngeal pathogenesis. Receiver operating curve (ROC) analysis showed the good diagnostic/prognostic value of said markers in laryngeal cancer patients. The present study showed that significant upregulation of selected MMPs was found associated with an increased risk of laryngeal cancer and can act as good diagnostic markers for the detection of said disease.
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  • 文章类型: Journal Article
    目的是评估多普勒超声在诊断为喉癌和下咽癌的患者中检测颈淋巴结的诊断功效。包括2021年1月至2023年1月在耳鼻喉科接受喉癌和下咽癌手术的患者。两组,数量相等,实验组和对照组进行了超声检查和强化CT检查,分别,以及常规颈淋巴结清扫术。在耳鼻喉科有超过6年临床经验的居民进行了常规的双侧颈淋巴结触诊。灵敏度,特异性,比较不同考试方法的有效性。McNemar试验评估了触诊之间的特异性和敏感性,彩色多普勒超声,增强CT,而Kappa一致性测试评估了两种检查方法之间的一致性。数据采用SPSS23.0进行统计分析。触诊对所有颈淋巴结转移患者的诊断敏感性(DS)为52.83%,特异性为91.11%。超声检查显示颈部淋巴结转移患者的DS为77.78%,特异性为81.82%。而强化CT的DS为75.86%,特异性为60.00%。触诊与超声检查的敏感性有统计学意义(P<0.05)。在触诊和增强CT之间。增强CT与超声(P=.021)以及触诊与增强CT扫描(P=.003)之间的特异性均具有统计学意义(P<.05)。多普勒超声产生的诊断结果与喉癌和下咽癌患者的病理诊断高度一致。利用多普勒超声可以提高诊断这些癌症的准确性,帮助医生为患者制定更合适的治疗计划。
    The objective was to assess the diagnostic efficacy of Doppler ultrasound in detecting cervical lymph nodes in patients diagnosed with laryngeal and hypopharyngeal cancers. Patients undergoing surgery for laryngeal and hypopharyngeal cancers in the Otolaryngology Department from January 2021 to January 2023 were included. Two groups, with equal numbers, underwent ultrasound examination and intensive CT examination in the experimental and control groups, respectively, along with routine cervical lymph node dissection. A resident with over 6 years of clinical experience in the otolaryngology department performed routine bilateral cervical lymph node palpation. Sensitivity, specificity, and validity were compared among different examination methods. The McNemar test assessed specificity and sensitivity between palpation, color Doppler ultrasonography, and enhanced CT, while the Kappa concordance test evaluated the concordance between the 2 examination methods. Data were statistically analyzed using SPSS 23.0. Palpation showed a diagnostic sensitivity (DS) of 52.83% and specificity of 91.11% for all patients with cervical lymph node metastasis. Ultrasonography demonstrated a DS of 77.78% and specificity of 81.82% in patients with cervical lymph node metastasis, while intensive CT had a DS of 75.86% and specificity of 60.00%. Statistical significance (P < .05) was observed in the sensitivity between palpation and ultrasonography, and between palpation and enhanced CT. The specificity between enhanced CT and ultrasonography (P = .021) and between palpation and enhanced CT scan (P = .003) both showed statistical significance (P < .05). Doppler ultrasound yields diagnostic results highly consistent with pathological diagnoses in patients with laryngeal and hypopharyngeal cancers. Utilizing Doppler ultrasound can enhance the accuracy of diagnosing these cancers, aiding physicians in devising more suitable treatment plans for patients.
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  • 文章类型: Journal Article
    病毒感染被认为是喉癌的危险因素。鉴于2019年冠状病毒病(COVID-19)对喉组织的可能影响,我们采用双样本孟德尔随机化(MR)方法研究了COVID-19与喉癌之间的因果关系.
    我们利用了来自COVID-19宿主遗传学倡议(2021年1月18日发布)的第五次全基因组关联研究(GWAS)版的遗传数据和大规模喉癌GWAS,包括180例病例和218,612个欧洲血统对照。我们应用了方差逆加权,Egger先生,和加权中位数方法来推断因果关系。我们使用“留一法”进行了敏感性分析,以验证稳健性。
    我们没有发现基因预测的COVID-19与喉癌之间存在因果关系的证据[赔率(OR)=0.24(95%置信区间(CI),0.05-1.26),P=0.09]。然而,我们观察到基因预测的COVID-19住院率之间的显着负相关[OR=0.51(95%CI,0.28-0.95),P=0.03]和重症患者[OR=0.62(95%CI,0.43-0.90),P=0.01]和喉癌。值得注意的是,这项研究发现了重要的遗传变异,如rs13050728,调节干扰素α受体2(IFNAR2)的表达,表明免疫应答途径在COVID-19和癌症中的可能作用。
    这项研究揭示了COVID-19严重程度之间的潜在相互作用,遗传因素,喉癌,强调在这两种情况下研究免疫应答机制的重要性。这些发现有助于理解COVID-19与喉癌之间的复杂相互作用,并可能指导未来对免疫反应作用的研究。特别是涉及IFNAR2。
    UNASSIGNED: Viral infections have been implicated as a risk factor for laryngeal cancer. Given the possible effects of Corona virus disease 2019 (COVID-19) on the laryngeal tissue, we investigated the causal link between COVID-19 and laryngeal cancer using a two-sample Mendelian randomization (MR) approach.
    UNASSIGNED: We utilized genetic data from the 5th Genome-wide association studies (GWAS) edition of the COVID-19 Host Genetics Initiative (published on January 18, 2021) and a large-scale laryngeal cancer GWAS comprising 180 cases and 218,612 controls of European ancestry. We applied inverse variance weighting, MR Egger, and weighted median methods to infer causality. We performed sensitivity analysis using the \"leave-one-out\" method to verify robustness.
    UNASSIGNED: We found no evidence of a causal association between gene-predicted COVID-19 and laryngeal cancer [Odds ratio (OR)=0.24 (95% Confidence intervals (CI), 0.05-1.26), P=0.09]. However, we observed significant inverse associations between gene-predicted COVID-19 hospitalization [OR=0.51 (95% CI, 0.28-0.95), P=0.03] and severe patients [OR=0.62 (95% CI, 0.43-0.90), P=0.01] and laryngeal cancer. Notably, the study detected important genetic variants, such as rs13050728, that modulate the expression of interferon alpha receptor 2 (IFNAR2), indicating possible roles for immune response pathways in both COVID-19 and cancer.
    UNASSIGNED: This study reveals a potential interaction between COVID-19 severity, genetic factors, and laryngeal cancer, underscoring the importance of investigating the immune response mechanisms in both conditions. These findings contribute to the understanding of the complex interactions between COVID-19 and laryngeal cancer and may guide future research on the role of immune response, particularly involving IFNAR2.
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  • 文章类型: Journal Article
    背景:YouTube,一个广受认可的全球视频平台,在中国是无法进入的,而Bilibili和TikTok是长短视频的热门平台,分别。在这些平台上有许多与喉癌有关的视频。本研究旨在识别上传来源,内容,以及YouTube上这些视频的专题信息,Bilibili,和TikTok,并进一步评估视频质量。
    方法:在2024年1月1日,我们在YouTube上按默认排序顺序搜索了前100个视频(总共300个视频),并带有术语“喉癌”和“喉癌”,“\”在Bilibili和TikTok上。筛选视频的相关性和相似性。视频特征被记录下来,质量通过使用患者教育材料评估工具(PEMAT)进行评估,视频信息和质量指数(VIQI)全球质量评分(GQS),并修改了DISCERN(MDISCERN)。
    结果:分析包括99个YouTube视频,76来自Bilibili,73来自TikTok。视频长度的中位数为193s(YouTube),136s(比利比利),和42s(TikTok)。TikTok视频展示了更高的受众互动。Bilibili的原始含量比率最低(69.7%)。治疗是YouTube和Bilibili上最受欢迎的话题,这就是TikTok的预后。独奏叙述是所有平台上最常见的视频风格。视频上传者主要是非营利组织(YouTube),自媒体(Bilibili),和医生(TikTok)TikTok作者的认证率最高(83.3%)。视频质量,使用PEMAT评估,VIQI,GQS,和mDISCERN,不同的平台,YouTube通常显示最高分。根据GQS和mDISCERN评分,来自专业作者的视频比非专业人士的视频表现更好。Spearman相关分析表明,视频质量与观众互动之间没有很强的关系。
    结论:社交媒体平台上的视频可以在一定程度上帮助公众了解喉癌的知识。TikTok实现了最佳流量,但是YouTube上的视频质量最好。然而,所有平台的视频质量仍需提高。我们需要更多的专业上传器来改善与喉癌相关的视频质量。内容创建者还应该了解认证,原创性,以及视频拍摄的风格。至于平台,改进算法将允许用户接收更多高质量的视频。
    BACKGROUND: YouTube, a widely recognized global video platform, is inaccessible in China, whereas Bilibili and TikTok are popular platforms for long and short videos, respectively. There are many videos related to laryngeal carcinoma on these platforms. This study aims to identify upload sources, contents, and feature information of these videos on YouTube, Bilibili, and TikTok, and further evaluate the video quality.
    METHODS: On January 1, 2024, we searched the top 100 videos by default sort order (300 videos in total) with the terms \"laryngeal carcinoma\" and \"throat cancer\" on YouTube, \"\" on Bilibili and TikTok. Videos were screened for relevance and similarity. Video characteristics were documented, and quality was assessed by using the Patient Education Materials Assessment Tool (PEMAT), Video Information and Quality Index (VIQI), Global Quality Score (GQS), and modified DISCERN (mDISCERN).
    RESULTS: The analysis included 99 YouTube videos, 76 from Bilibili, and 73 from TikTok. Median video lengths were 193 s (YouTube), 136 s (Bilibili), and 42 s (TikTok). TikTok videos demonstrated higher audience interaction. Bilibili had the lowest ratio of original contents (69.7%). Treatment was the most popular topic on YouTube and Bilibili, while that was the prognosis on TikTok. Solo narration was the most common video style across all platforms. Video uploaders were predominantly non-profit organizations (YouTube), self-media (Bilibili), and doctors (TikTok), with TikTok authors having the highest certification rate (83.3%). Video quality, assessed using PEMAT, VIQI, GQS, and mDISCERN, varied across platforms, with YouTube generally showing the highest scores. Videos from professional authors performed better than videos from non-professionals based on the GQS and mDISCERN scores. Spearman correlation analysis showed no strong relationships between the video quality and the audience interaction.
    CONCLUSIONS: Videos on social media platforms can help the public learn about the knowledge of laryngeal cancer to some extent. TikTok achieves the best flow, but videos on YouTube are of the best quality. However, the video quality across all platforms still needs enhancement. We need more professional uploaders to ameliorate the video quality related to laryngeal carcinoma. Content creators also should be aware of the certification, the originality, and the style of video shooting. As for the platforms, refining the algorithm will allow users to receive more high-quality videos.
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  • 文章类型: Journal Article
    这项多中心研究的目的是评估电化学疗法(ECT)治疗头颈部粘膜肿瘤的有效性和安全性。共有71例患者的84个不同组织学的口腔结节,对ECT治疗的咽和喉进行了评估。数据是从来自欧洲10个参与中心的InspECT数据库中收集的。治疗不同组织学的原发性和复发性/继发性肿瘤。总有效率为65%,33%的完全缓解率,副作用有限。原发性和继发性肿瘤的反应率没有差异。然而,较小的肿瘤比直径大于3厘米的肿瘤反应更好。此外,治愈性治疗的肿瘤的疗效明显优于姑息性治疗.本研究证明了其可行性,在较大的头颈部粘膜病变患者队列中,ECT的安全性和有效性。根据现有数据,ECT可用于治疗复发,在某些情况下,位于口腔的原发性粘膜肿瘤,喉部,和咽部。在治愈性治疗的较小原发性肿瘤患者中获得了更好的反应。
    The aim of this multicenter study was to evaluate the effectiveness and safety of electrochemotherapy (ECT) for the treatment of mucosal tumors in the head and neck. A total of 71 patients with 84 nodules of different histologies in the oral cavity, pharynx and larynx treated by ECT were evaluated. The data were collected from the InspECT database from 10 participating centers throughout Europe. Primary and recurrent/secondary tumors of different histologies were treated. The overall response rate was 65 %, with a 33 % complete response rate with limited side effects. The response rates of the primary and secondary tumors were not different. However, smaller tumors responded better than tumors larger than 3 cm in diameter. Furthermore, the tumors that were treated with curative intent responded significantly better than those treated with palliative intent. This study demonstrated the feasibility, safety and effectiveness of ECT in a larger cohort of patients with mucosal lesions in the head and neck region. Based on the available data, ECT can be used for the treatment of recurrent and, in some cases, primary mucosal tumors located in the oral cavity, larynx, and pharynx. A better response was obtained in patients with smaller primary tumors treated with curative intent.
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  • 文章类型: Journal Article
    目的:本研究的目的是通过PCT的发生率和术后吞咽的评估来评估全喉切除术后吻合器咽部闭合的功能结局。此外,该研究旨在评估患者生存率的肿瘤结局.
    方法:这项随机临床试验是对58例接受全喉切除术的晚期喉癌患者进行的。根据喉切除术后咽部修复的方法将患者随机分为两组:手动闭合组(n=28),和订书机组(n=30)。评估和比较功能和肿瘤结果。
    结果:吻合器组的咽瘘发生率明显较低。此外,与手动组相比,吻合器组的手术时间明显缩短,吞咽功能更好。两组之间的生存率没有统计学上的显着差异。
    结论:如果考虑到原发肿瘤的适应症,吻合器是全喉切除术后咽部闭合的可靠方法。缝合器闭合减少了PCF的发生率并减少了手术时间。在不损害肿瘤结果的情况下实现良好的吞咽结果。
    OBJECTIVE: The aim of the current study was to evaluate the functional outcomes of stapler pharyngeal closure after total laryngectomy by the incidence of PCT and assessment of swallowing after surgery. In addition, the study aimed to evaluate the oncological outcomes in terms of patients\' survival rates.
    METHODS: This randomized clinical trial was conducted on 58 patients with advanced laryngeal carcinoma who underwent total laryngectomy. Patients were randomly assigned to two groups according to the method of pharyngeal repair after laryngectomy: manual closure group (n = 28), and stapler group (n = 30). Functional and oncological outcomes were assessed and compared.
    RESULTS: The incidence of pharyngocutaneous fistula was significantly less in the stapler group. Additionally, operative time was significantly shorter and swallowing function was better in the stapler group compared to the manual group. There was no statistically significant difference between groups regarding survival rates.
    CONCLUSIONS: The stapler is a reliable method for pharyngeal closure after total laryngectomy if the limits of its indications regarding the primary tumor are considered. Stapler closure decreases the incidence of PCF and decreases the surgical time. Good swallowing outcomes are achieved without compromising the oncological outcomes.
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  • 文章类型: Journal Article
    背景:尽管治疗取得了进展,喉和下咽鳞状细胞癌(SCC)的确定性(化疗)放疗后残留或复发的肿瘤在临床治疗中仍然是一个挑战,需要准确和及时的检测以获得最佳的挽救治疗.本研究旨在比较氟18(18F)氟脱氧葡萄糖(FDG)正电子发射断层扫描(PET)/计算机断层扫描(CT)和弥散加权磁共振成像(DW-MRI)在检测残留或复发中的诊断价值确定(化学)放疗后的喉和下咽SCC。
    方法:对30例喉癌(n=21)和下咽癌(n=9)进行确定性(化学)放疗后出现新症状的患者进行了前瞻性研究。同时进行了18F-FDGPET/CT和DW-MRI,并将组织病理学分析作为参考标准。
    结果:组织病理学显示20例肿瘤阳性,10例肿瘤阴性。18F-FDGPET/CT检查所有肿瘤均正确,但1例假阳性。DW-MRI在20例阳性患者中检测到18例肿瘤,并在所有阴性患者中正确排除肿瘤。18F-FDGPET/CT的敏感性和特异性分别为100%和90%,分别,而DW-MRI的值分别为90%和100%,分别。
    结论:该研究得出结论,18F-FDGPET/CT在检测喉和下咽SCC的确定性(化学)放疗后残留或复发肿瘤方面略优于DW-MRI。联合使用18F-FDGPET/CT和DW-MRI可以潜在地提高治疗反应评估的特异性。
    Despite advances in treatment, residual or recurrent tumors after definitive (chemo) radiotherapy for laryngeal and hypopharyngeal squamous cell carcinoma (SCC) remain a challenge in clinical management and require accurate and timely detection for optimal salvage therapy. This study aimed to compare the diagnostic value of Fluorine 18 (18F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and diffusion-weighted magnetic resonance imaging (DW-MRI) in detecting residual or recurrent tumors after definitive (chemo) radiotherapy for laryngeal and hypopharyngeal SCC.
    A prospective study was conducted on 30 patients who presented with new symptoms after definitive (chemo) radiotherapy for laryngeal (n = 21) and hypopharyngeal (n = 9) carcinoma. Both 18F-FDG PET/CT and DW-MRI were performed and histopathologic analysis served as the standard of reference.
    Histopathology showed 20 patients as positive and 10 as negative for tumors. 18F-FDG PET/CT detected all tumors correctly but was falsely positive in one case. DW-MRI detected tumors in 18 out of 20 positive patients and correctly excluded tumors in all negative patients. The sensitivity and specificity of 18F-FDG PET/CT were 100% and 90%, respectively, while the values for DW-MRI were 90% and 100%, respectively.
    The study concludes that 18F-FDG PET/CT is slightly superior to DW-MRI in detecting residual or recurrent tumors after definitive (chemo) radiotherapy for laryngeal and hypopharyngeal SCC. The combined use of 18F-FDG PET/CT and DW-MRI can potentially improve specificity in therapy response evaluation.
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