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EN
The authors describe the case of 62 year-old Man, heavy smoker, admitted to the hospital due to dyspnea. We report a case of a man in whom laryngeal carcinoma, and esophageal carcinoma were diagnosed simultaneously. Patient suffers also from prostate adenocarcinoma. The incidence of multiple primary malignant neoplasms is around 0,5 –10%.
EN
Introduction: The laryngeal cancer is the most frequently diagnose malignancy in head and neck region. The highest morbidity is within male patients in the age range between 50 and 70 years. The multicenter study, coordinated by Oto-laryngology Department of Medical University of Warsaw, was designed to investigate the epidemiology of laryngeal cancer in Poland from 1980 and to analyze the evolution of diagnostic and therapeutical procedures over the years.Material and methods: There was performed retrospective analysis of the medical records of patients with laryn-geal cancer hospitalized and treated in 12 otolaryngology centers in Poland from 2001 to 2010. The Microsoft Access 2003 (SP 2) platform was used to collect the data and subsequent statistical analysis.Results: There were collected data from 4124 patients, 3682 men (89,3%) and 442 women (10,7%). The largest group consisted of patients in the age range between 50 and 60 years (41,5%) and the second large group was of those be-tween 60 and 70 years (29,6%). The history of heavy cigarettes smoking was obtained from 81,3% of patients. Re-garding the staging of laryngeal cancer, there were 1634 patients with cancer stage of I or II, including 5 patients with carcinoma in situ and 2490 patients with III or IV stage. The most frequent localization of the cancer was the glottis, followed with invasion of all three laryngeal levels and tumors occupying both the epiglottis and glottis. The major-ity of patients – 1367 (33%) – has the T3 tumor advancement. The lymph nodes metastases (N) were present in 1216 (29,5%) patients and among them the N2b and N2c advancement ( lymph node larger than 6 cm, multiple) was de-tected in 533 of patients (13%). The lymph nodes involvement occurred in majority within advanced tumors of T3 or T4a. Considering the treatment options they varied depending on the staging of laryngeal cancer. The sole surgical procedures were performed in 73,7% of patients with cancer stage of I or II and in only 28.6% of patients with the stage of III or IV. The advanced tumors were in majority treated with the combined therapy: surgery and radiotherapy. The overall survival in patients with cancer stage of I and II was 64% and 61% for those with stage III and IV.Conclusions: The rate of laryngeal cancer detection is quite high in Poland, however the period from the onset of symptoms until diagnosis should be reduced. The effectiveness of surgical treatment is definitely unsatisfactory. The project to create a multicenter permanent base for monitoring the course of diagnosis and treatment in patients with laryngeal cancer surely will verify the procedures and enable to achieve better results. Continuation of this project is a task for all otorhinolaryngologists.KEYWORDS:laryngeal carcinoma, epidemiology, clinical characteristics, multicenter study
EN
The degree of activation of cells involved in cellular immune re-sponse against tumor antigens (cytotoxic lymphocytes Te) as well as efficiency of the mechanisms which promote immunosuppression (Treg - regulatory cells CD4±CD25±Foxp3±) may determine the course of the neoplastic disease. The aim of this study was to assess the function of autologous peripheral blood mononuclear cells (PBMCs) involved in the immunological processes on the basis of expression of Foxp3 and RORgamma t molecules as well as analysis of the relationships with clinical and morphological features of the tumor (pT and pN stage, G feature, degree of invasiveness according to the TFG classification) in laryngeal carcinoma. Materia! and methods: The analysis included a group of 59 patients with verified squamous celt carcinoma of the larynx. In the pathologic evaluation pTNM classification criteria, depth of invasion and degree of histological dif-ferentiation were used. Expression levels of mRNA for Foxp3 and RORgamma t in peripheral blood mononuclear cells by quantitative analysis of the amplified product in real time (real-time RT2-PCR) were evaluated. The level of Foxp3 and RORgamma t protein expression by Western blot analysis was determined. Results: In squamous celt carcinomas of the larynx, with the highest tumor aggressiveness the significantly highest level of mRNA and protein expres-sion for Foxp3 molecule were observed. The severity of Foxp3 expression at both gene and protein level were positively linearly correlated with the degree of local extent of the tumor (pT3-4), depth of invasion (invasion of cartilage) and the degree of histological differentiation (low-differentiated tumors G3). In the study group of laryngeal cancers significantly lower level of RORgamma t expression in carcinomas with less invasive changes (pT1-2, high-differentiated tumors G1, carcinomas with microinvasion without evi-dence of invasion beyond the lamina propria) was also noted. Conclusions: The study results indicate the important role of immune celt activity as indicators of advancement of clinical and morphological changes in squamous celt carcinoma of the larynx.
EN
Introduction. Results of studies analyzing the role of immunocompetent cells in tumor environment and whole peripheral blood indicate their responsibility for aggressiveness of neoplasm, prognosis and therapeutic effect. Atcivation of lymhocytes T is connected with expression the markers (antigens) on their surface. The aim of this study was the analysis of activation antigens expression on lymphocytes T in patients with laryngeal carcinoma and the connection with clinicomorphological features. Material and methods. Analysis of activation antigens expression CD69, CD71 and CD25, CD26, HLA/DR on lymphocytes T CD4+ i CD8+ in 33 patients with squamous cell carcinoma of the larynx was performed. Flow cytometry-based analysis of activation antigens in T cell cultures with and without PHA stimulation was used. The connection of these molecules and clinicomorphological features was examined (pT, pN, G, Anneroth, Batsakis and Lunas’ classifi cation). Results. The signifi cant correlation between chosen markers of activation and tumor features were noted: pT with HLA/DR/CD4, CD69CD8, CD71CD8, pN with CD26CD8, G with CD25CD8, CD71CD8, ABL score with CD25CD4. Conclusion. Our data indicated the connetion of immunocompetent cell activity and spread of neoplasm in patients with laryngeal carcinoma.
EN
The degree of activation of cells involved in cellular immune re-sponse against tumor antigens (cytotoxic lymphocytes Te) as well as efficiency of the mechanisms which promote immunosuppression (Treg — regulatory cells CD4±CD25±Foxp3±) may determine the course of the neoplastic disease. The aim of this study was to assess the function of autologous peripheral blood mononuclear cells (PBMCs) involved in the immunological processes on the basis of expression of Foxp3 and RORgamma t molecules as well as analysis of the relationships with clinical and morphological features of the tumor (pT and pN stage, G feature, degree of invasiveness according to the TFG classification) in laryngeal carcinoma. Materia! and methods: The analysis included a group of 59 patients with verified squamous celt carcinoma of the larynx. In the pathologic evaluation pTNM classification criteria, depth of invasion and degree of histological dif-ferentiation were used. Expression levels of mRNA for Foxp3 and RORgamma t in peripheral blood mononuclear cells by quantitative analysis of the amplified product in real time (real-time RT2-PCR) were evaluated. The level of Foxp3 and RORgamma t protein expression by Western blot analysis was determined. Results: In squamous celt carcinomas of the larynx, with the highest tumor aggressiveness the significantly highest level of mRNA and protein expres-sion for Foxp3 molecule were observed. The severity of Foxp3 expression at both gene and protein level were positively linearly correlated with the degree of local extent of the tumor (pT3-4), depth of invasion (invasion of cartilage) and the degree of histological differentiation (low-differentiated tumors G3). In the study group of laryngeal cancers significantly lower level of RORgamma t expression in carcinomas with less invasive changes (pT1-2, high-differentiated tumors G1, carcinomas with microinvasion without evi-dence of invasion beyond the lamina propria) was also noted. Conclusions: The study results indicate the important role of immune celt activity as indicators of advancement of clinical and morphological changes in squamous celt carcinoma of the larynx
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