Laryngeal cancer

喉癌
  • 文章类型: Journal Article
    在过去的20年里,喉癌治疗的模式已经转向在不牺牲肿瘤结局的前提下保留喉功能.经口激光显微手术削弱了开放喉手术的作用。对于早期喉癌,常见的主要方式是内窥镜喉部手术和窄场放射。对于晚期喉癌,可以选择全喉切除术,然后进行放疗或放化疗。在经验丰富的双手和细致的患者选择之后,喉上骨切除术可以作为全喉切除术的可行替代方案,以保留喉功能。对于气道受损和/或喉功能障碍的患者,全喉切除术仍然是推荐的治疗方法。
    Over the last 2 decades, the paradigm of laryngeal cancer management has pivoted toward preserving laryngeal function without sacrificing oncologic outcomes. Transoral laser microsurgery has diminished the role of open laryngeal surgery. For early-stage laryngeal cancer, the common primary modalities are endoscopic laryngeal surgery and narrow field radiation. Total laryngectomy followed by either radiation or chemoradiation is option for advanced laryngeal cancer. In experienced hands and following meticulous patient selection, supracricoid laryngectomy may serve as a viable alternative to total laryngectomy to preserve laryngeal function. Total laryngectomy is still the recommended treatment in those with airway compromise and/or laryngeal dysfunction.
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  • 文章类型: Journal Article
    目的:探讨正念减压(MBSR)训练对喉癌术后患者负性情绪及社会功能的影响。
    方法:选取2017年1月至2019年12月我院收治的喉癌患者65例,根据患者意愿分为观察组33例和对照组32例。对照组给予常规干预,观察组在对照组的基础上进行正念减压训练。干预8周后对两组患者进行评价。研究工具包括焦虑自评量表(SAS)、抑郁自评量表(SDS),匹兹堡睡眠质量指数(PSQI)社会残疾筛查计划(SDSS),社会支持评定量表(SSRS),和欧洲癌症研究和治疗组织的生活质量问卷(QLQ-C30),所有评分均用于验证上述量表.通过每个量表的干预后和干预前得分之间的差异来评估MBSR的效果。均数比较采用T检验,速率比较采用Pearson检验χ2检验。
    方法:患者在喉恶性肿瘤的手术治疗过程中会产生负面情绪(文献1),这将影响他们的心理健康(文献2、3、4、5、6、7)。正念减压训练(文献10、11)可减轻恶性肿瘤患者的抑郁和焦虑(文献14、15)。根据纳入标准和排除标准(文献16和17),本研究选取两组患者,并使用包括SAS在内的研究工具获得分数(文献19),SDS(文献20),PSQI(文献21),SDSS(文献22)和QLQ-C30(文献24和25)。通过干预前后各量表评分的差异评价MBSR的效果。
    结果:干预后,两组SAS、SDS评分均低于同组治疗前(P<0.05),两组PSQI评分均低于同组治疗前(P<0.05),两组SDSS评分均低于治疗前(P<0.05),两组患者QLQ-C30评分均高于干预前(P<0.05)。
    结论:正念减压训练可以减轻喉癌患者的负面情绪,改善患者的睡眠质量。社会功能,和生活质量。值得临床推广应用。
    OBJECTIVE: To explore the influence of mindfulness-based stress reduction (MBSR) training on the negative emotions and social functioning of patients with laryngeal cancer post-operation.
    METHODS: Sixty-five patients with laryngeal cancer admitted to our hospital from January 2017 to December 2019 were selected and divided into an observation group of 33 cases and a control group of 32 cases according to the patient\'s wishes. The control group received routine intervention, while the observation group received mindfulness decompression training in addition to the control group. Both groups were evaluated after 8 weeks of intervention. The research tools included the self-rating anxiety scale (SAS), self-rating depression scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Social Disability Screening Schedule (SDSS), Social Support Rating Scale (SSRS), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30), all of the scores of them were used to verify the foregoing scale. The effects of MBSR were evaluated by the differences between the post- and pre-intervention scores in each scale. T-test was used for mean comparison and Pearson test was used for rate comparison χ2 inspection.
    METHODS: Patients will have negative emotions during the surgical treatment of laryngeal malignancies (Literature 1), which will affect their mental health (literature 2, 3, 4, 5, 6, 7). Mindfulness decompression training (literature 10, 11) can reduce the depression and anxiety of patients with malignant tumors (literature 14, 15). According to the inclusion criteria and exclusion criteria (literature 16 and 17), two groups of patients were selected in this study, and the scores were obtained using research tools including SAS (literature 19), SDS (literature 20), PSQI (literature 21), SDSS (literature 22) and QLQ-C30 (literature 24 and 25). The effect of MBSR was evaluated by the difference before and after the intervention scores in each scale.
    RESULTS: After the intervention, the scores of the SAS and SDS in the two groups were lower than before (P < 0.05), the PSQI score of the two groups was lower than before (P < 0.05), the SDSS score of the two groups was lower than before (P < 0.05), and the scores of the QLQ-C30 in the two groups were higher than before intervention (P < 0.05).
    CONCLUSIONS: Mindfulness-based stress reduction training can reduce the negative emotions of patients with laryngeal cancer and improve their quality of sleep, social functioning, and quality of life. It is worthy of clinical application.
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  • 文章类型: Systematic Review
    背景:窄带成像是一种先进的内窥镜技术,用于检测喉组织表面的变化,采用比较方法与白光内窥镜检查,以促进组织病理学检查。目的:本研究旨在通过与组织病理学检查的比较分析,评估NBI(窄带成像)在识别喉部恶性病变中的实用性和优势。方法:我们进行了系统的文献综述,利用PubMed等数据库,CNKI数据库,和Embase为我们的研究。结果:我们通过回顾文章的标题和摘要来分析文章,根据确定的标准选择我们认为相关的;在最后阶段,我们根据具体的资格标准审查了相关研究.结论:窄带成像是一种先进的内镜技术,可证明其作为诊断喉恶性病变并将其与癌前病变进行比较的工具的有效性。欧洲喉科学会已经实施了用于喉部病变的标准化分类系统,以增强数据相关性和组织。
    Background: Narrow-band imaging is an advanced endoscopic technology used to detect changes on the laryngeal tissue surface, employing a comparative approach alongside white-light endoscopy to facilitate histopathological examination. Objective: This study aimed to assess the utility and advantages of NBI (narrow-band imaging) in identifying malignant laryngeal lesions through a comparative analysis with histopathological examination. Methods: We conducted a systematic literature review, utilizing databases such as PubMed, the CNKI database, and Embase for our research. Results: We analyzed the articles by reviewing their titles and abstracts, selecting those we considered relevant based on determined criteria; in the final phase, we examined the relevant studies according to the specific eligibility criteria. Conclusions: Narrow-band imaging is an advanced endoscopic technology that demonstrates its efficacy as a tool for diagnosing malignant laryngeal lesions and comparing them to premalignant lesions. The European Society of Laryngology has implemented a standardized classification system for laryngeal lesions to enhance data correlation and organization.
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  • 文章类型: Journal Article
    喉癌表现出显著的全球健康负担,后期检测有助于降低死亡率。喉部区域图像上的喉癌诊断是计算机视觉(CV)和医学图像诊断在医学领域的关键应用。它包括检测和分析喉部的异常或癌组织,声乐和呼吸系统的一个组成部分。计算机辅助系统通过深度学习(DL)和机器学习(ML)模型利用人工智能(AI),包括卷积神经网络(CNN),用于自动疾病诊断和检测。执行各种DL和ML方法以将提取特征分类为健康组织和癌组织。本文介绍了在生物医学喉部区域图像上使用蒲公英优化算法和集成学习(LCD-DOAEL)方法的自动喉癌诊断。LCD-DOAEL方法旨在研究喉癌存在的咽喉区域的图像。在LCD-DOAEL方法中,高斯滤波(GF)方法用于消除生物医学图像中的噪声。此外,复杂和内在的特征模式可以通过MobileNetv2模型来提取。同时,DOA模型进行MobileNetV2架构的超参数选择。最后,三个分类器的集合,如双向长短期记忆(BiLSTM),正则化极限学习机(ELM),和反向传播神经网络(BPNN)模型,用于分类过程。在生物医学图像数据集上进行了一组全面的模拟,以突出LCD-DOAEL技术的有效性能。LCD-DOAEL方法的比较分析显示出优于其他现有技术的97.54%的准确性结果。
    Laryngeal cancer exhibits a notable global health burden, with later-stage detection contributing to a low mortality rate. Laryngeal cancer diagnosis on throat region images is a pivotal application of computer vision (CV) and medical image diagnoses in the medical sector. It includes detecting and analysing abnormal or cancerous tissue from the larynx, an integral part of the vocal and respiratory systems. The computer-aided system makes use of artificial intelligence (AI) through deep learning (DL) and machine learning (ML) models, including convolution neural networks (CNN), for automated disease diagnoses and detection. Various DL and ML approaches are executed to categorize the extraction feature as healthy and cancerous tissues. This article introduces an automated Laryngeal Cancer Diagnosis using the Dandelion Optimizer Algorithm with Ensemble Learning (LCD-DOAEL) method on Biomedical Throat Region Image. The LCD-DOAEL method aims to investigate the images of the throat region for the presence of laryngeal cancer. In the LCD-DOAEL method, the Gaussian filtering (GF) approach is applied to eliminate the noise in the biomedical images. Besides, the complex and intrinsic feature patterns can be extracted by the MobileNetv2 model. Meanwhile, the DOA model carries out the hyperparameter selection of MobileNetV2 architecture. Finally, the ensemble of three classifiers such as bidirectional long short-term memory (BiLSTM), regularized extreme learning machine (ELM), and backpropagation neural network (BPNN) models, are utilized for the classification process. A comprehensive set of simulations is conducted on the biomedical image dataset to highlight the efficient performance of the LCD-DOAEL technique. The comparison analysis of the LCD-DOAEL method exhibited a superior accuracy outcome of 97.54% over other existing techniques.
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  • 文章类型: Case Reports
    Lemierre综合征,一种罕见的口咽部感染并发症,以主要影响颈内静脉的化脓性血栓性静脉炎为特征,会导致败血症,血栓性梗阻,和潜在的传播到遥远的地方。我们介绍了一个54岁的男性,有慢性吸烟史和新诊断的喉癌,并发Lemierre综合征。最初的症状包括吞咽困难,呼吸困难,宫颈肿胀,随后的诊断通过超声确认颈内静脉血栓形成,CT,MRI。治疗包括广谱抗生素和抗凝,其次是癌症的肿瘤管理。该病例强调了并发恶性肿瘤带来的诊断挑战,并强调了早期识别和涉及抗生素的综合治疗的关键作用。抗凝,和肿瘤治疗.多学科合作对于在这样的复杂案例中优化结果至关重要,强调需要加强临床怀疑和及时干预,包括适当的影像学诊断,适当的抗生素覆盖率,并及时进行微生物识别,以调整抗菌治疗。
    Lemierre\'s syndrome, a rare complication of oropharyngeal infections, is characterized by septic thrombophlebitis primarily affecting the internal jugular vein, which can lead to septicemia, thrombotic obstruction, and potential dissemination to distant sites. We present the case of a 54-year-old male with a history of chronic smoking and newly diagnosed laryngeal carcinoma, complicated by Lemierre\'s syndrome. Initial symptoms included odynophagia, dyspnea, and cervical swelling, with subsequent diagnosis confirming thrombosis of the internal jugular vein via ultrasound, CT, and MRI. Treatment included broad-spectrum antibiotics and anticoagulation, followed by oncological management for the carcinoma. This case underscores the diagnostic challenge posed by concurrent malignancy and highlights the critical role of early recognition and comprehensive treatment involving antibiotics, anticoagulation, and oncological therapy. Multidisciplinary collaboration is crucial for optimizing outcomes in complex cases like this, emphasizing the need for heightened clinical suspicion and prompt intervention involving proper imaging diagnosis, appropriate antibiotic coverage, and timely microbiological recognition for adjustment of antimicrobial therapy.
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  • 文章类型: Journal Article
    喉癌仍然是一个重要的全球健康问题,晚期疾病预后不良,突出了对新诊断的需求,预后,和治疗方法。环状RNA(circularRNAs),一类共价闭合的非编码RNA,已经成为各种癌症中基因表达和细胞过程的重要调节因子,包括喉癌.这篇综述总结了目前对喉癌中circRNAs的理解,覆盖它们的生物发生,监管机制,和潜在的临床应用。我们探索circRNAs的不同功能,包括它们作为miRNA海绵的作用,蛋白质相互作用物,和直接的mRNA调节剂,以及它们对关键细胞过程如增殖的影响,入侵,和转移。这篇综述强调了有前途的circRNAs作为诊断和预后生物标志物,以及潜在的治疗目标。我们还概述了当前的circRNA调节策略,包括抑制技术,如RNA干扰和CRISPR/Cas系统,和使用载体和合成circRNAs的过表达方法。
    Laryngeal cancer remains a significant global health concern, with poor prognosis for advanced-stage disease highlighting the need for novel diagnostic, prognostic, and therapeutic approaches. Circular RNAs (circRNAs), a class of covalently closed non-coding RNAs, have emerged as important regulators of gene expression and cellular processes in various cancers, including laryngeal cancer. This review summarizes the current understanding of circRNAs in laryngeal cancer, covering their biogenesis, regulatory mechanisms, and potential clinical applications. We explore the diverse functions of circRNAs, including their roles as miRNA sponges, protein interactors, and direct mRNA regulators, and their influence on key cellular processes such as proliferation, invasion, and metastasis. The review highlights promising circRNAs as diagnostic and prognostic biomarkers, as well as potential therapeutic targets. We also outline current strategies for circRNA modulation, including suppression techniques like RNA interference and CRISPR/Cas systems, and overexpression methods using vectors and synthetic circRNAs.
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  • 文章类型: Journal Article
    目的:喉癌(LC)的早期诊断至关重要,特别是在农村地区。尽管已有关于LC识别的深度学习模型的研究,在喉科医生短缺和计算机资源有限的农村地区,选择合适的模式仍然面临挑战。我们提出了智能喉癌检测系统(ILCDS),一种基于深度学习的解决方案,专为资源有限的农村地区进行有效的LC筛查。
    方法:我们编译了一个由2023年喉镜图像组成的数据集,并应用数据增强技术进行数据集扩展。随后,我们利用了八个深度学习模型-AlexNet,VGG,ResNet,DenseNet,MobileNet,ShuffleNet,视觉变压器,和双变压器-用于LC识别。对其性能和效率进行了综合评价,选择最合适的模型来组装ILCDS。
    结果:关于性能,所有模型在测试集上的平均准确度超过90%。特别值得注意的是VGG,DenseNet,和MobileNet,超过95%的准确度,得分为95.32%,95.75%,95.99%,分别。关于效率,MobileNet的优势在于其紧凑的尺寸和快速的推理速度,使其成为融入ILCDS的理想模式。
    结论:ILCDS在保持适度的计算资源要求的同时,在LC检测中表现出了有希望的准确性。表明它有可能提高LC筛查的准确性并减轻农村地区耳鼻喉科医师的工作量。
    OBJECTIVE: Early diagnosis of laryngeal cancer (LC) is crucial, particularly in rural areas. Despite existing studies on deep learning models for LC identification, challenges remain in selecting suitable models for rural areas with shortages of laryngologists and limited computer resources. We present the intelligent laryngeal cancer detection system (ILCDS), a deep learning-based solution tailored for effective LC screening in resource-constrained rural areas.
    METHODS: We compiled a dataset comprised of 2023 laryngoscopic images and applied data augmentation techniques for dataset expansion. Subsequently, we utilized eight deep learning models-AlexNet, VGG, ResNet, DenseNet, MobileNet, ShuffleNet, Vision Transformer, and Swin Transformer-for LC identification. A comprehensive evaluation of their performances and efficiencies was conducted, and the most suitable model was selected to assemble the ILCDS.
    RESULTS: Regarding performance, all models attained an average accuracy exceeding 90 % on the test set. Particularly noteworthy are VGG, DenseNet, and MobileNet, which exceeded an accuracy of 95 %, with scores of 95.32 %, 95.75 %, and 95.99 %, respectively. Regarding efficiency, MobileNet excels owing to its compact size and fast inference speed, making it an ideal model for integration into ILCDS.
    CONCLUSIONS: The ILCDS demonstrated promising accuracy in LC detection while maintaining modest computational resource requirements, indicating its potential to enhance LC screening accuracy and alleviate the workload on otolaryngologists in rural areas.
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  • 文章类型: Journal Article
    各种癌症的存活率没有提高,包括喉癌,引起了人们对了解癌症免疫反应的兴趣。在头颈部癌症中,免疫微环境和免疫浸润等免疫调节机制在肿瘤发病机制中具有重要意义。本研究旨在探讨肿瘤浸润淋巴细胞(TIL)亚群在免疫微环境中的分布及其对肿瘤组织病理学特征和预后的影响。这项研究包括50例接受喉切除术治疗喉鳞状细胞癌的患者,在伊斯坦布尔大学-Cerrahpaša,医学院耳鼻咽喉科,2016年1月至2018年1月病理标本采用免疫组织化学方法评估CD3、CD20、CD8、CD4、CD25和FoxP3标志物的表达,识别TIL的子组。该研究旨在揭示这些亚组如何影响肿瘤组织病理学特征和生存结果。CD3、CD20和CD4的高浸润对疾病特异性生存率有积极影响,无病生存,和无复发生存。此外,总生存期受CD3和CD4高浸润的积极影响.然而,CD8,FoxP3和CD25的表达与任何生存参数之间均无明显关系。CD3,CD20和CD4阳性细胞的浸润表明强烈的抗肿瘤免疫反应,是喉癌的有利预后因素。这些发现表明,增强CD3,CD20和CD4淋巴细胞的浸润可能是值得在临床试验中探索的治疗策略。
    The absence of improvement in survival rates across various cancers, including laryngeal cancer, has led to an increasing interest in understanding the immune response to cancer. In head and neck cancers, immune modulatory mechanisms such as immune microenvironment and immune infiltration are important in cancer pathogenesis. This study aims to explore the distribution of tumor-infiltrating lymphocyte (TIL) subgroups in the immune microenvironment and evaluate their impact on tumor histopathological characteristics and prognosis. The study included 50 patients who underwent laryngectomy for laryngeal squamous cell carcinoma, in Istanbul University - Cerrahpaşa, Faculty of Medicine Department of Otorhinolaryngology, between January 2016 and January 2018. Pathology specimens were evaluated using immunohistochemistry to assess the expressions of the CD3, CD20, CD8, CD4, CD25, and FoxP3 markers, identifying subgroups of TILs. The investigation aimed to uncover how these subgroups influence tumor histopathological features and survival outcomes. The high infiltration of CD3, CD20, and CD4 had a positive impact on disease-specific survival, disease-free survival, and recurrence-free survival. In addition, overall survival was positively affected by high CD3 and CD4 infiltrations. However, no significant relationship was observed between the expressions of CD8, FoxP3, and CD25 and any of the survival parameters. The infiltration of CD3, CD20, and CD4 positive cells indicative of a robust antitumoral immune response-emerged as favorable prognostic factors in laryngeal cancer. These findings suggest that enhancing the infiltration of CD3, CD20, and CD4 lymphocytes could be a therapeutic strategy worth exploring in clinical trials.
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  • 文章类型: Journal Article
    喉癌(LC)代表了一个重大的世界卫生问题,与降低生存率归因于晚期诊断。LC的正确治疗是复杂的,尤其是在最后阶段。这种癌症是患者头颈部区域内的复杂恶性肿瘤。最近,研究人员服务于医疗顾问,以识别LC有效地开发不同的分析方法和工具。然而,这些现有的工具和技术在性能约束方面存在各种问题,比如在早期阶段检测LC的准确性较低,额外的计算复杂性,以及患者筛查中巨大的时间利用率。已经建立了有效识别LC的深度学习(DL)方法。因此,本研究使用混沌元启发式集成与DL(LCD-CMDL)技术开发了一种有效的LC检测。LCD-CMDL技术主要集中于利用喉部区域图像对LC进行检测和分类。在LCD-CMDL技术中,对比度增强过程使用CLAHE方法。对于特征提取,LCD-CMDL技术应用挤压和激励ResNet(SE-ResNet)模型从图像预处理中学习复杂和固有的特征。此外,SE-ResNet方法的超参数调整是使用混沌自适应麻雀搜索算法(CSSA)进行的。最后,应用极限学习机(ELM)模型对LC进行检测和分类。LCD-CMDL方法的性能评估是利用基准喉部区域图像数据库进行的。实验值暗示LCD-CMDL方法优于最近的最先进的方法。
    Laryngeal cancer (LC) represents a substantial world health problem, with diminished survival rates attributed to late-stage diagnoses. Correct treatment for LC is complex, particularly in the final stages. This kind of cancer is a complex malignancy inside the head and neck region of patients. Recently, researchers serving medical consultants to recognize LC efficiently develop different analysis methods and tools. However, these existing tools and techniques have various problems regarding performance constraints, like lesser accuracy in detecting LC at the early stages, additional computational complexity, and colossal time utilization in patient screening. Deep learning (DL) approaches have been established that are effective in the recognition of LC. Therefore, this study develops an efficient LC Detection using the Chaotic Metaheuristics Integration with the DL (LCD-CMDL) technique. The LCD-CMDL technique mainly focuses on detecting and classifying LC utilizing throat region images. In the LCD-CMDL technique, the contrast enhancement process uses the CLAHE approach. For feature extraction, the LCD-CMDL technique applies the Squeeze-and-Excitation ResNet (SE-ResNet) model to learn the complex and intrinsic features from the image preprocessing. Moreover, the hyperparameter tuning of the SE-ResNet approach is performed using a chaotic adaptive sparrow search algorithm (CSSA). Finally, the extreme learning machine (ELM) model was applied to detect and classify the LC. The performance evaluation of the LCD-CMDL approach occurs utilizing a benchmark throat region image database. The experimental values implied the superior performance of the LCD-CMDL approach over recent state-of-the-art approaches.
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  • 文章类型: Case Reports
    睾丸核蛋白(NUT)癌是一种罕见的肿瘤,主要来自中线结构。尽管使用了多种治疗方式,但它是一种侵袭性癌症,与低生存率相关。这里,我们介绍了一例17岁的小儿喉癌患者,这在所有报告的病例中更为罕见。患者接受手术后放疗和全身治疗,诊断后15个月死亡。这种罕见疾病的管理需要进一步调查。
    Nuclear protein in testis (NUT) carcinoma is a rare neoplasm arising mainly from midline structures. It is an aggressive type of carcinoma associated with poor survival despite the use of multiple treatment modalities. Here, we present a case of a 17-year-old paediatric patient with NUT carcinoma of larynx, which is even rarer among all reported cases. The patient underwent surgery followed by radiotherapy and systemic treatment and he died 15 months after the diagnosis. The management of this rare disease requires further investigation.
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