Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

副鼻腔嚢胞は比較的頻度の高い疾患であり,時に複視・視力障害などの視覚障害が生じ,緊急手術が必要となる場合がある.今回われわれは過去10年間に経験した副鼻腔嚢胞の症例において,視覚障害に関する臨床的検討を行った.2010年4月1日から2020年3月31日に当院で手術を施行した副鼻腔嚢胞のうち視覚障害を伴う12例を対象とした.複視,視力障害,視野障害を視覚障害と定義した.年齢,性別,成因,症状,嚢胞の部位,初診科,手術方法,予後を診療録より後方視的に調査した.症状別延べ人数は,複視が7例,視力障害が5例,視野障害が2例であった.それぞれの主病変は上顎洞5例,前部篩骨洞1例,後部篩骨洞1例,前頭洞1例,蝶形骨洞3例であった.複視7例中6例が発症後1ヵ月以上経過しており,受診までの期間が長い傾向にあった.視力障害5例中4例が2週間以内に治療介入をされており,残りの症例は1ヵ月以上経過していた.予後について,複視は全例改善し,視力障害は全盲症例を除き元の視力レベルにまで症状が改善する良好な経過であった.発症から経過が長くても,複視や重篤でない視力障害の場合は手術加療で改善が期待される.また,重篤な視力障害を来している症例は早期診断および迅速な手術を含む加療が不可欠である.視野障害患者の報告例は少ないため,視力障害に至る前の治療介入ができるように眼科への啓発が必要だと考えられた.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J07551&link_issn=&doc_id=20240304270007&doc_link_id=%2Fdz0tokei%2F2024%2F012702%2F007%2F0121-0128%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0tokei%2F2024%2F012702%2F007%2F0121-0128%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(株)医学書院  

症例は81歳男性で、右鼻出血を主訴とした。誘因なく鼻出血が出現し、止血困難であった。右中鼻甲介内側に出血を伴う赤色腫瘍性病変を認めた。副鼻腔造影CTにて、右鼻腔内に造影効果のある長径35mmの腫瘤を認めた。骨破壊や浸潤はみられなかった。副鼻腔造影MRIでは、境界明瞭でT1で低信号、T2で高信号の造影効果をもつ腫瘤を認めた。生検を行い、glomangiopericytomaや血管系腫瘍などが疑われる所見であった。以上より、glomangiopericytomaを疑い、内視鏡手術で一塊に摘出することとした。5mmほどのマージンをつけて鼻中隔粘膜を切開し、栄養血管と考えられる蝶口蓋動脈中隔後鼻枝は焼灼・切断し、腫瘍を一塊に摘出した。術中出血量は50mLで、出血は制御可能であった。免疫染色にて、glomangiopericytomaと診断した。術後出血はなく、術後3年経過後も再発は認められていない。

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND/AIM: This study aimed to identify key molecules associated with the survival of patients with hypopharyngeal squamous cell carcinoma (HpSCC) by combining in silico and in vitro analyses. MATERIALS AND METHODS: Differentially expressed genes (DEGs) were screened using the Gene Expression Omnibus database. For DEGs, we performed functional enrichment and protein-protein interaction network analyses to identify potential biological functions and hub genes. Functional analysis of HpSCC cell lines verified the critical roles of the hub genes. RESULTS: DEGs were associated with the extracellular matrix. Among the hub genes, high expression of prolyl 4-hydroxylase subunit alpha 1 (P4HA1) was significantly associated with shorter survival. In addition, P4HA1 knockdown inhibited cell migration and colonization. Suppression of cell proliferation was demonstrated using P4HA1-selective inhibitors. CONCLUSION: P4HA1 may be a useful therapeutic target for the treatment of HpSCC.

DOI： 10.21873/anticanres.16424

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND/AIM: Previous studies have identified several inflammatory biomarkers that are useful as prognostic biomarkers for various cancer types. However, the fibrinogen-to-lymphocyte ratio (FLR) has not been addressed in head and neck squamous cell carcinoma. Here, we aimed to examine the value of pretreatment FLR as a prognostic marker in patients who received definitive radiotherapy for hypopharyngeal squamous cell carcinoma (HpSCC). PATIENTS AND METHODS: This retrospective study included 95 patients treated with definitive radiotherapy for HpSCC between 2013 and 2020. The prognostic factors for progression-free (PFS) and overall (OS) survival were identified. RESULTS: The optimal cut-off value of pretreatment FLR for discriminating PFS was 2.46. Based on this value, 57 and 38 patients were classified into groups with high and low FLR, respectively. A high FLR was significantly associated with advanced local disease and overall stage, and with the development of synchronous second primary cancer compared with a low FLR. The high FLR group had significantly lower PFS and OS rates than the low FLR group. Multivariate analysis showed that having a high pretreatment FLR was an independent prognostic factor for poorer PFS and OS [PFS: hazard ratio (HR)=2.14, 95% confidence interval (CI)=1.09-4.19, p=0.026; OS: HR=2.86, 95% CI=1.14-7.20, p=0.024]. CONCLUSION: The FLR has a clinical effect on PFS and OS in patients with HpSCC, suggesting that it has potential application as a prognostic factor for patients with HpSCC.

DOI： 10.21873/invivo.13206

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND/AIM: We evaluated the impact of FosL1, a member of the activated protein-1 family, on the pathways leading to regional metastasis of head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: We examined the influence of small interfering RNA (siRNA) and short heparin RNA (shRNA) mediated knockdown of FosL1 on cell migration, invasion, and proliferation in vitro as well as on regional metastasis in vivo. The prognostic significance of FosL1 was also analyzed using the Kaplan- Meier plotter using data from an HNSCC patient database. RESULTS: Down-regulation of FosL1 inhibited cell migration, invasion, and proliferation in vitro, decreased the incidence of regional metastases, and prolonged the survival of mice in vivo. We also determined that HNSCC patients with higher expression levels of FosL1 had a significantly shorter survival time than those with low expression of FosL1. CONCLUSION: FosL1 plays a crucial role in promoting cell migration, invasion, and proliferation in HNSCC.

DOI： 10.21873/anticanres.15119

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

To generate a reliable preclinical model system exhibiting the molecular features of salivary adenoid cystic carcinoma (ACC) whose biology is still unclear due to the paucity of stable cell cultures. To develop new in vitro and in vivo models of ACC, the techniques of organoid culture and patient-derived tumor xenograft (PDX), which have attracted attention in other malignancies in recent years, were applied. Tumor specimens from surgically resected salivary ACC were proceeded for the preparation of PDX and organoid culture. The orthotopic transplantation of patient-derived or PDX-derived organoids was demonstrated into submandibular glands of NSG mice and those histology was evaluated. PDX-derived organoid cells were evaluated for the presence of MYB-mediated fusion genes and proceeded for in vitro drug sensitivity assay. Human ACC-derived organoids were successfully generated in three-dimensional culture and confirmed the ability of these cells to form tumors by orthotopic injection. Short-term organoid cell cultures from two individual ACC PDX tumors were also established that maintain the characteristic MYBL1 translocation and histological features of the original parent and PDX tumors. Finally, the establishment of drug sensitivity tests on these short-term cultured cells was confirmed using three different agents. This is the first to report an approach for the generation of human ACC-derived organoids as in vitro and in vivo cancer models, providing insights into understanding of the ACC biology and creating personalized therapy design for patients with ACC.

DOI： 10.1002/ijc.33315

PubMed

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Language：English   Publisher：(一社)日本癌学会  

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Language：English   Publisher：(一社)日本癌学会  

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Web of Science

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Publishing type：Research paper (scientific journal)  

Background: The purpose of this study was to elucidate the efficacy of concurrent chemotherapy and analyze prognostic factors in the radiation-based therapy for early stage laryngeal squamous cell carcinoma (ELSCC). Methods: The records of 97 patients with ELSCC treated by radiation-based therapy from 2004 to 2016 were retrospectively reviewed. Eighty-one patients were treated with the combined-agent regimens during the treatment. Of the 81 patients, 58 were treated with S-1 regimen and 23 with other regimens. Clinical factors, such as concurrent chemotherapy, non-glottic subsite and the incidence of second primary cancer (SPC) were analyzed for their association with survival. Results: From the analysis of all patients, the 5-year overall survival (OS) rates were found to be significantly poorer for patients with non-glottic cancer compared to those with glottic cancer (P < 0.001), and non-glottic subsite was shown to be the only poor prognostic factor for OS by the multivariate analysis (P=0.006). SPC was responsible for two-thirds of all deaths. In the analysis of patients with stage II ELSCC, the 5-year disease-free survival (DFS) rates were significantly better for patients treated by concurrent chemoradiotherapy (CCRT) with S-1 compared to those treated by the other treatment methods, and a combination with the S-1 regimen was shown to be the only good prognostic factor for DFS by the multivariate analysis (P=0.015). Conclusions: Non-glottic subsite and SPC were associated with worsened survival. CCRT with S-1 can be a useful treatment option for stage II ELSCC.

DOI： 10.21037/tcr.2018.06.15

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Language：English   Publishing type：Research paper (scientific journal)  

We aimed to evaluate the impact of concurrent chemoradiotherapy (CCRT) on the survival of patients with squamous cell carcinoma of the temporal bone. We retrospectively analyzed the data of 13 consecutive patients who were treated by definitive radiation therapy (RT) or CCRT as the initial treatment between 1999 and 2012. There were 5 patients with stage II disease, 5 with stage III, and 3 with stage IV, as classified according to the University of Pittsburgh system. Among these, 2, 4, and 3 patients, respectively, were treated by CCRT; whereas the remaining (3 patients with stage II and 1 with stage III) were treated by RT alone. Median follow-up duration was 39 months (12-106 months) in all cases, and 61.5 months (17-70 months) in censored cases. The 5-year overall survival (OS) rates were 51 % in all patients, and 40, 100, and 0 % in patients with stage II, stage III, and stage IV disease, respectively. In patients with stage II and III disease, the 5-year OS rates were 80 % in the CCRT group and 50 % in the RT-alone group. We found better prognosis in patients with stage II and III disease who were treated by CCRT. Only 2 patients treated by CCRT experienced adverse events more than grade 3, which were neutropenia and dermatitis. There was no late adverse event of bony necrosis. Our study results indicate that CCRT is safe and very effective as a first-line treatment for stage II and III squamous cell carcinoma of the temporal bone.

DOI： 10.1007/s00405-015-3616-7

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

To assess the prognostic factors for local control in patients with early glottic cancer, we retrospectively analyzed the data of 130 consecutive patients who were treated by definitive radiation therapy (RT) or concurrent chemoradiotherapy (CRT) for early glottic squamous cell carcinoma (UICC sixth edition T1N0M0 and T2N0M0) at Kanagawa cancer center between 1999 and 2011. There were 63 patients with T1 cancer and 67 patients with T2 cancer. Twenty-one patients with T2 tumors were treated by chemoradiotherapy (CRT). The median follow-up period was 73 months (range, 22-165 months). The 5-year local control (LC) rate in all patients was 81 %. The 5-year LC rates in the patients with T1 and T2 cancer were 89 and 74 %, respectively. Univariate analysis showed that a higher T stage (T2) (p = 0.0301), anterior commissure involvement (p < 0.000001), and habitual drinking (p = 0.054) were correlated with decreased local control rate. Multivariate analysis identified only anterior commissure involvement as a significant prognostic factor for local control (LC rate 91 vs. 51 %, risk ratio 5.3, 95 % CI 2.3-12, p < 0.001). In the patients with T2 cancer, there was no statistically significant difference in the LC rate between patients who received RT alone and those who received CRT (RT alone 76 % vs. CRT 67 %; p = 0.832). The findings of this study suggest that anterior commissure involvement is a significant factor influencing the prospect of local control. CRT was not found to be effective for T2 patients in this study.

DOI： 10.1007/s00405-015-3579-8

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

The present study analyzed the outcomes of patients with early-stage hypopharyngeal squamous cell carcinoma (HPSCC) treated with radical radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). We retrospectively reviewed the clinical records of 33 patients with early-stage HPSCC who underwent RT or CCRT between January 1999 and December 2011. Of the 33 patients who were treated, 12 had Stage I and 21 had Stage II disease. Patients with Stage I were typically treated with RT, while patients with Stage II were treated with CCRT (concurrent chemotherapy: 5FU, cisplatin or TS-1). The median follow-up period was 81 months, ranging from 15 to 155 months. The 5-year overall survival rates, cause specific survival rates, locoregional control rates, and progression-free survival rates were 58, 75, 56, and 49 %, respectively. Of the 33 patients, 51 % experienced second primary malignancies. Esophageal carcinoma occurred in several cases, and was diagnosed either during screening after treatment for the second primary malignancy or simultaneously with the second primary malignancy. Advanced-stage second malignancies significantly influenced the survival of the patients and the control rate for HPSCC. Treatment emphasizing the quality of life after treatment is needed, if a poor prognosis is expected because of advanced-stage second primary malignancy.

DOI： 10.1007/s00405-014-3132-1

PubMed

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Publishing type：Research paper (scientific journal)  

Salivary duct carcinoma (SDC) is considered to be a high-grade malignant tumor with morphological resemblance to invasive ductal carcinoma of the breast, and develops high mortality. We retrospectively investigated the outcomes of 7 SDC cases (1 stageI, 1 stageII and 5 stageIVa) treated in Yokohama City University from 2003 to 2011. The treatment consisted of definitive surgery, postoperative concurrent chemoradiotherapy and adjuvant chemotherapy. The five-year disease specific survival rate was 83.3%, which was better than those of previous reports. Our multidisciplinary regimen might be an effective therapeutic option for SDC.

DOI： 10.5981/jjhnc.40.71

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Language：Japanese   Publisher：神奈川県医師会  

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Language：Japanese   Publisher：(一社)日本頭頸部癌学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：English   Publisher：日本癌学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本頭頸部癌学会  

2003年4月から2014年3月までの11年間に横須賀共済病院にて根治治療を行った下咽頭癌症例の治療成績を検討し、今後の課題を考察した。対象は前治療のない下咽頭扁平上皮癌症例76例である。観察期間中央値は60ヵ月(1〜132ヵ月)、男性67例、女性9例、年齢は中央値66歳(44〜99歳)だった。臨床病期は、stage I/II/III/IV:3/10/10/53例であった。一次治療として手術治療または化学療法併用放射線療法(Concurrent chemoradiotherapy:CCRT)を行った。喉頭温存希望症例には、術前導入化学療法(Neoadjuvant chemotherapy:NAC)を行い、その反応性により手術かCCRTを選択した。全症例の5年粗生存率、疾患特異的生存率、無病生存率、喉頭温存生存率は、52.3%、67.0%、48.8%、50.1%だった。背景因子ではT4症例、N2c-3症例が有意に予後不良だった。T4a症例に対するCCRT一次治療には限界があり、機能温存を考慮しない手術と術後CCRTを組み合わせた治療の選択が考慮された。一方、N2c-3に対しては既存の報告でも極めて予後不良と位置付けられており、現行治療では限界があると考えられた。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J04195&link_issn=&doc_id=20160518480008&doc_link_id=10.5981%2Fjjhnc.42.44&url=https%3A%2F%2Fdoi.org%2F10.5981%2Fjjhnc.42.44&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Publishing type：Book review, literature introduction, etc.  

The present study analyzed the treatment outcomes of patients with hypopharyngeal squamous cell carcinoma (HPSCC) in our institute. We retrospectively reviewed the clinical records of 76 patients with HPSCC treated definitively from 2003 to 2014. The median follow-up period was 60 months, ranging from 1 to 132 months. The number of patients with Stage I, H, IE and IV were 3, 10, 10 and 53, respectively. We performed surgery or concurrent chemoradiotherapy (CCRT) as definitive treatment. In patients with advanced stage HPSCC, we often perform neoadjuvant chemotherapy (NAC), if they strongly desire larynx preservation. Then, we decided to perform surgery or CCRT in consideration of the response to NAC. The 5-year overall survival rates, cause-specific survival rates, disease-free survival rates, and larynx preservation survival rates were 52.3, 67.0, 48.8 and 50.1%, respectively. Statistical analysis of the survival rates showed two prognostic factors: T4a disease and N2c-3 disease. Radicality of CCRT for patients with T4a disease would be underpowered. In patients with T4 disease, we should consider whether the most definitive treatment might be effective rather than larynx preservation treatment, namely, definitive treatment in combination with surgery without conservativeness and postoperative CCRT, without performing NAC which may worsen the general condition. On the other hand, we considered that there was a limit to the current definitive treatment for patients with N2c-3 disease, as noted in previous reports.

DOI： 10.5981/jjhnc.42.44

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

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Language：Japanese   Publisher：日本頭頸部癌学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本頭頸部癌学会  

唾液腺導管癌(salivary duct carcinoma: SDC)は、浸潤性乳管癌に類似した組織像を呈する高悪性度の腫瘍で、非常に予後不良な腫瘍と報告されている。今回、耳下腺原発のSDCに対する根治的手術、術後化学放射線療法、補助化学療法を含めた集学的治療の成績について検討した。対象は2003年9月から2011年3月までの間に当科で治療した耳下腺原発のSDC7症例(stage I:1例、II:1例、IVa:5例)である。切除断端に十分な安全域を設けた腫瘍切除を行い、stage IVa症例には根治的頸部郭清術を併施した。更に全例で術後に化学放射線療法および補助化学療法を施行した。5年粗生存率は83.3%であり、根治的手術、術後化学放射線療法、補助化学療法を含めた集学的治療で良好な予後が得られる可能性が示唆された。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J04195&link_issn=&doc_id=20140512480013&doc_link_id=10.5981%2Fjjhnc.40.71&url=https%3A%2F%2Fdoi.org%2F10.5981%2Fjjhnc.40.71&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：神奈川県医師会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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