[The results and toxicity of organ preservation treatment for locoregionally advanced laryngeal and hypopharyngeal cancer]

The development and treatment of periprosthetic leakage after prosthetic voice restoration. A literature review and personal experience part I: the development of periprosthetic leakage

In the past 30 years, the use of a voice prosthesis has become the treatment of choice for the restoration of speech following laryngectomy. Not only is the placement of a voice prosthesis a simple surgical procedure, but it is also associated with a low rate of complications and an excellent success rate. Approximately, 20-30 % of all patients with voice prostheses, however, develop periprosthetic leakage with aspiration over time. Periprosthetic leakage is usually caused by an enlargement of the tracheo-oesophageal fistula and substantially affects the quality of life of the patients concerned. In a retrospective analysis of our patients, the incidence of periprosthetic leakage was 35.7 % in a total of 232 patients who underwent laryngectomy during a period of 20 years. Substantial enlargement of the tracheo-oesophageal fistula which required multiple treatments occurred in 12.5 % of the patients. In this review, the various causes of fistula enlargement are discussed on the basis of the literature and the experience that we have accumulated during the past 20 years in the management of patients with voice prostheses.

[The assessment of selected molecules belonging to B7 family on the mature dendritic cells in laryngeal cancer patients]

B7-H1, B7-H2 and B7-H4 molecules play various roles in the adaptive immune system and are broadly expressed on many cells, especially those localized in cancer tissue. The aim of the study was to assess the surface expression of B7-H1, B7-H2 and B7-H4 molecules on the mature dendritic cells (DC) generated from peripheral blood monocytes of laryngeal cancer patients and healthy donors.

MATERIAL AND METHODS

Forty-four male patients treated surgically for squamous cell carcinoma of the larynx were included in the study. Peripheral blood from twelve healthy male donors was used as a control. Mononuclear cells were separated from all individuals by density gradient centrifugation, incubated with anti-CD14 microbeads, and passed through MACS separation columns. The CD14 positive cell population was used to prepare monocyte derived DC. Laryngeal cancer tissue was obtained from patients during surgical treatment and homogenized to prepare tumor cell lysates for further stimulation. We evaluated with the use of flow cytometry method the percentage of cells with an expression and mean fluorescent intensity (MFI) of surface markers, such as: CD83, B7-H1, B7-H2, B7-H4.

RESULTS

Our study revealed that the percentage of mature dendritic cells, stimulated with autologous tumor cell lysates, with the expression of B7-H1 molecule in patients was lower than in healthy donors (61.81 ± 25.58% vs 93.02 ± 4.63%, p=0.007). In laryngeal cancer patients, the percentage of CD83+/B7-H2+ cells was higher than in healthy individuals (18.32 ± 10.74% vs 2.89 ± 0.43%, p=0.019).

CONCLUSIONS

There is a relation between the presence of laryngeal cancer and the expression of B7 family molecules.