[Development and validation of nomogram for predicting prognosis of patients with laryngeal squamous cell carcinoma after surgery]

Objective:To explore the relationship between preoperative blood indexes, clinicopathological characteristics and prognosis of patients with laryngeal squamous cell carcinoma（LSCC）, and to establish a nomogram for predicting survival and recurrence time of LSCC patients. Methods:The clinical data of 530 patients with LSCC who received primary surgical treatment were analyzed retrospectively. The patients were randomly divided into training group and testing group according to the ratio of 7∶3. The nomograms of overall survival（OS） and recurrence-free survival（RFS） were constructed based on Cox regression model, and the nomograms were verified and compared with TNM stage. Results:The results of multivariate analysis showed that age, operation mode, tumor diameter, TNM stage, cervical lymph node metastasis, fibrinogen level and systemic immune inflammation index were significantly correlated with OS, while operation mode, tumor diameter, TNM stage, cervical lymph node metastasis, international normalized ratio, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio were significantly correlated with RFS. The nomograms were constructed based on the above factors. The C-indexes of the nomograms of OS and RFS in the training group were 0.755 and 0.687, respectively, which were higher than those of TNM stage（0.657 and 0.582）. In the testing group, the C-indexes of OS and RFS nomograms were 0.717 and 0.646, respectively, which were higher than those of TNM stage（0.599 and 0.528）. The area under the receiver operating characteristic curves of these nomograms were also higher than TNM stage. The calibration curves showed that the models had good consistency. Decision curve analysis（DCA） showed that these nomograms had higher clinical benefit than TNM stage. Conclusion:Based on the independent prognostic factors, the predictive nomograms of OS and RFS at 1, 3 and 5 years after LSCC were constructed, which have certain clinical significance in guiding the individualized diagnosis and treatment of LSCC.

[A comparison of the 7th and 8th edition of the AJCC TNM staging systems for predicting survival in oropharyngeal cancer]

Objective:The aim of this study is to evaluate the prognostic value of the 8th edition of AJCC TNM classification in comparison with the 7th edition for oropharyngeal cancer. Method: The clinical and pathological data of 142 patients with oropharyngeal squamous cell carcinoma were retrospectively analyzed. The p16 protein was detected by immunohistochemical staining. Survival and survival analysis were performed using the Kaplan-Meier method and the Log-rank test. Result:The 5-year disease-specific survival（DSS）,the 5-year overall survival (OS) and the median survival time for patients with oropharyngeal cancer were 55.4%,50.4% and 60.3 months, respectively. P16-immunostaining was scored positive in 39 samples (27.5%,39/142).Based on the seventh edition of AJCC staging, there were 4 patients in stage Ⅰ,17 patients in stage Ⅱ,27 patients in stage Ⅲ and 94 patients in stage Ⅳ,respectively.However, there was no significant difference in survival between the patients with stage Ⅰ-Ⅱ and those with Ⅲ-Ⅳ(5-year DSS:75.9% of stage Ⅰ-Ⅱ patients vs. 52.2% of stage Ⅲ-Ⅳ patients;P=0.109).In comparison, 22 patients were diagnosed as stage Ⅰ,24 were stage Ⅱ,27 were stage Ⅲ and 69 were stage Ⅳ using the eighth edition. The 5-year DSS for patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ was 88.4%, 80.5%, 73.2% and 29.1%, respectively. The overall difference was statistically significant (P=0.000). Conclusion:Compared with the seventh edition staging, the eighth edition of the AJCC oropharyngeal cancer staging system considers the prognosis of patients with different causes of oropharyngeal cancer, and can more accurately predict the prognosis of patients.

[Correlation between prognosis and IL-33 expression in head and neck squamous cell carcinoma]

Objective:To determine the correlation between the expression of IL-33 and significance in cancer biologial and patient's prognosis in head and neck squamous cell carcinoma (HNSCC). Method:Twenty pairs of tumor tissue and adjacent normal tissue were collected. qRT-PCR and immunohistochemistry (IHC) were used to detect the expression of IL-33 mRNA and protein in tissues. Correlation between IL-33 expression with clinicopathologic features of 107 HNSCC patients were analyzed. Result:IL-33 mRNA and protein expression levels in normal tissue were higher than paired tumor tissue. IL-33 level was significantly lower in patients with advanced T stages, lymph node metastases and advanced clinical stages, IL-33 expression was higher in well differentiated tumor than moderate or poor differentiated tumor. Low IL-33 expression predicts poor prognosis. Multivariate analysis indicated that IL-33 expression was an independent predictive factor. Conclusion:IL-33 is related with the clinicopathological features in HNSCC and could be an independent predictor of HNSCC prognosis.

[The role of CD4 ⁺ CD25 ⁺ T regs and CCL17, CCL22 in the pathogenesis of head and neck squamous cell carcinoma]

Objective:To investigate the role of CD4 ⁺ CD25 ⁺ T regs and CCL17 and CCL22 in the pathogenesis of HNSCC.Method:Twenty cases of HNSCC were enrolled. All patients were primary or recurrent after treatment (chemotherapy, surgery). The primary tumor was taken as the experimental group, and the adjacent normal tissues from the primary tumor 1-3 cm were taken as control group. CD4 ⁺ /Foxp3 and CD25⁺/Foxp3 were detected by immunofluorescence, while CCL17 and CCL22 were detected by ELISA. The difference and correlation between the amount of CD4⁺,CD25⁺ and the expression of CCL17, CCL22 were observed and analyzed.Result:The difference of mean optical density between CD4⁺/Foxp3 and CD25⁺/Foxp3 was statistically significant between the experimental group and the control group (P<0.05). The concentration of CCL17 and CCL22 was statistically different between the two groups (P<0.01). There was a positive correlation between CD25⁺and CCL17,CCL22(r=0.595, 0.720,P<0.01).Conclusion:CD4⁺CD25⁺T regs and CCL17,CCL22 played an important role in the pathogenesis of head and neck squamous cell carcinoma,both of which interacted with each other,and promoted the recurrence and metastasis of HNSCC.

[Effect of Six1,TGF-β,VEGF-C that promoting tumor lymphangiogenesis in human laryngeal carcinoma xenografts in nude mice]

Objective:To research the effect of Six1,TGF-β,VEGF-C that promoting tumor lymphangiogenesis in human laryngeal carcinoma xenografts in nude mice. Method:Technology of RNA interference was used for silencing Six1 and TGF-β genes expression in laryngeal squamous cell, preparation Six1-targeting and TGF-β-targeting siRNA for transfecting into laryngeal squamous cell carcinoma, sieve out positive clone cell and amplify. Preparing bearing cancer mice, the mice were divided into five groups, group A (untransfected),group B(empty vector), group C(Six1-siRNA),group D(TGF-β-siRNA),group E(Six1+TGF-β-siRNA). 6-12mm when the tumor has grown, the mice were sacrificed by cervical. The size of each tumor and metastasis were observed and recorded.The protein expression of Six1,TGF-β and VEGF-C was determined by immunohistochemistry and Western blot.The mRNA of Six1,TGF-β and VEGF-C was determined by RT-PCR. Result:The average tumor volume and the number of metastasis cases in group B have no statistically significant compared with group A. The average tumor volume in group C, group D and group E has no significantly reduced, but there is a clear reduction of the number of metastasis cases compared with group A. The average tumor volume and number of metastasis cases in group E has no significantly reduced compared with group C and group D. Both protein and mRNA expression of Six1, TGF-β and VEGF-C in group B had no significant difference compared with group A. In group C, group D and group E,both protein and mRNA expression of VEGF-C was decreased,difference has statistically significant compared with group A. Both protein and mRNA expression of VEGF-C in group E had no significant difference compared with group C and group D. Conclusion:Both Six1 and TGF-β can mediate tumor lymphangiogenesis and lymph node metastasis by mediate the expression of VEGF-C. Suggest that Six1,TGF-β might be a potential therapeutic target for preventing lymph node metastasis of tumor.