Evaluation of oxidant-antioxidant balance and DNA damage in blood of patients with cancer of the head and neck under the influence of copper(II) complex: Preliminary studies

Introduction: The primary aim of this research was to evaluate the oxidative stress markers and the level of oxidative DNA damage in the pathogenesis of head and neck cancer. Materials/Methods: Sixty-two subjects matched for age and gender, including 31 patients with head and neck cancer and 31 control patients without cancer symptoms, were enrolled in our study. In our work, the activity of antioxidant enzymes: catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPX), as well as a total antioxidant status (TAS), were estimated. Additionally, an alkaline comet assay was used to measure the level of DNA damage in the group of patients with head and neck cancer and the group of healthy control patients. These tests were performed on a blood sample with and without prior incubation of dinitratebis (1-phenyl-5-(2-hydroxyphenyl)-3-methyl-N1pyrazol-κN2)cooper(II). Results: Significant increases of SOD, GPX CAT, TAS (P <0.001) were seen in blood from patients with head and neck cancer and prior incubation of cooper (II) component compared to blood from healthy controls without prior incubation of analyzed chemical. Moreover, we did not observe any relationship between the level of DNA damage and the studied component dinitratebis (1-phenyl-5-(2-hydroxyphenyl)-3-methyl-N1pyrazol-κN2)cooper(II) in the group of patients with head and neck cancer or in healthy controls. Discussion: Free radicals such as reactive oxygen species, which induce oxidative stress, may contribute to head and neck carcinogenesis. Therefore, we suggest that modulation of pro-oxidant /antioxidant status might be a relevant target for both prevention and therapy.

The current application of ACOSOG Z0011 trial results: Is further implementation of sentinel lymph node intra-operative histopathological examination mandatory in breast cancer patients - a single-centre analysis

The main objective of the ACOSOG Z0011 trial was to determine the impact of abandoning complete axillary lymph node dissection (ALND) on survival of breast cancer patients with sentinel node lymph (SLN) metastasis in whom breast conserving therapy (BCT) had been performed. The aim of our study was to assess the clinical value of intra-operative histopathological examination of SLN. Our study comprised 1284 invasive breast cancer patients in whom sentinel lymph node biopsy (SLNB) was carried out. SLN intra-operative histopathological assessment was routinely performed in patients treated within the first period (07.2013-06.2014). However, the decision regarding intra-operative assessment was made by the surgeon for the patients who underwent this evaluation in the later period 07.2014-06.2015 and were submitted for BCT. BCT was performed in 72.4% of patients. In total, 316 patients (24.6%) developed SLN-metastasis. Within the period 07.2014-06.2015, SLN intra-operative microscopic evaluation was performed in 20.8% of patients submitted for BCT. ALND was omitted in 27.5% of patients demonstrating SLN metastasis, in comparison with 15.5% of the group from the previous period (p=0.0094). The proportion of patients demonstrating macrometastasis in SLN who received conservative treatment to the axilla increased from 5.4% to 23.1% (p=0.0007). The choice of SLN final histopathological assessment may allow for deferral of decision on more extensive surgery of the axilla in patients submitted for SLNB. The omission of routinely-performed SLN intra-operative histopathological evaluation has led to a statistically significant increase in the proportion of patients in whom complete ALND was avoided.

Immune checkpoints in aggressive breast cancer subtypes

Immune checkpoints are molecules referred to inhibitory pathways in the immune system that play a pivotal role in prevention of autoimmunity and oncogenesis. The aim of the study was to evaluate expression levels of selected immune checkpoints- PD-1 (programmed cell death protein 1), and PD-L1 (programmed cell death 1 ligand 1) in breast cancer patients, suitable for breast conservation and sentinel node biopsy and determine their associations with clinicopathological factors.Expression of the genes coding for PD-1 and PD-L1 was analyzed in formalin-fixed paraffin-embedded specimens using real-time PCR. mRNA expression levels were determined using beta actin (ACTB) as an endogenous control. There was a trend towards significance between higher PD-1 and PD-L1 levels in triple negative breast cancers (p=0.1). Higher PD-L1 expression was also found in aggressive breast cancer subtypes e.g. triple negative and HER2 (human epidermal growth factor receptor 2) -positive as compared with subtypes with better prognosis such as luminal A and luminal BHER2-negative (p=0.05). There was a trend towards significance in higher PD-1 levels in triple negative and HER-2 positive breast cancers (p=0.1). A statistically significant difference was found between PD-L1 expression and tumor grade (p=0.01). Elevated PD-L1 levels were noted in G3 tumors. Immunogenicity appears to be gaining importance in triple negative and HER2-positive molecular subtypes of breast cancer, and the results in this study provide a basis for further investigation into the role of immune checkpoints in breast cancer.

Does the presence of sentinel lymph node macrometastases in breast cancer patients require axillary lymph node dissection?-Single-center analysis

According to the current guidelines on treatment of breast cancer patients, identification of metastases in the sentinel lymph node (SLN (+)) is not an absolute indication for necessary axillary lymph node dissection (ALND). In our study, we present long-term outcomes of treatment among SLN(+) patients referred for conservative treatment, for example, no further ALND. A total of 3145 breast cancer patients subjected to sentinel lymph node biopsy (SLNB) between November 2008 and June 2015. SLN metastases were identified in 719 patients (22.9%). Locoregional recurrences and distant metastases as endpoints were distinquished. The mean follow-up time for patients after ALND was 36.2 months (6-74 months); 18.8 months (6-38 months) for patients with SLN macrometastases without ALND; and 34.0 months (6-74 months) for patients with micrometastases. Adjuvant ALND was performed in 626 of SLN(+) patients. Conservative treatment was applied in the remaining 93 cases. Among SLN(+) patients without adjuvant ALND, there was one case of recurrence (1.07%). In the group of patients without SLN, metastases recurrence was noted in 32 patients (1.32%). Among SLN(+) patients diagnosed with macrometastases, recurrence concerned 2.01% of analyzed cases (all subjected to ALND). Lack of radical surgical treatment in SLN(+) breast cancer patients did not lead to worsening long-term outcomes. In the occurrence of macrometastases to the sentinel lymph node, abandoning completion axillary lymph node dissection might be a reasonable option. However, it would require continuation of current research, preferably involving a clinical trial.

Effect of copper(II) the activity of glutathione peroxidase in patients with head and neck cancer

INTRODUCTION

Head and neck squamous cell carcinoma (HNSCC) accounts for about 6% of all malignant cancers. In the epidemiology of oral cavity neoplasm, important risk factors include: tobacco smoking, alcohol abuse, bad oral hygiene, papilloma virus infection, riboflavin and iron deficiency.

OBJECTIVE

The objective of the investigation was a synthesis of Cu(II) complex and the evaluation of antioxidative enzymatic barrier in red blood cells of patients with head and neck tumor as well as in the control group.

MATERIALS AND METHODS

For the investigation conduction, a consent of Bioethics Committee number RNN/142/09/KB was obtained. Blood for the examination was obtained from the patients of the Dapartment of Head and Neck Neoplasms Surgery Medical University of Łódź. The experiment was conducted on the group of 40 patients with HNSCC and 40 healthy people, using spectrophotometric method, glutathione peroxidase was marked.

RESULTS

The investigation was conducted on the hemolysate obtained from the patients that were divided into two groups - a study group (1 and 2), which consisted of patients diagnosed with head and neck cancer and a control group (1 and 2) - healthy people. A significant statistical result for GPX occurred in control-1 and study-1 group with complex compound Cu(II) (p&lt;0,001).

CONCLUSIONS

Presented research prove, that complex compound Cis-dichlorobis(N1-hydroxymethyl-3methylpyrazole-κN2)copper (II) has an impact on the activity of the antioxidative GPX enzyme.

Label-free determination of lipid composition and secondary protein structure of human salivary noncancerous and cancerous tissues by Raman microspectroscopy

The applications of optical spectroscopic methods in cancer detection open new possibilities in oncological diagnostics.

Association of microRNA-93, 190, 200b and receptor status in core biopsies from stage III breast cancer patients

Oncologists now favor more personalized treatment strategies in breast cancer patients. Gene expression analysis has been widely used, but less is known about epigenetic factors, for example, microRNAs (miRNAs). The aim of this study was to determine the relationship between selected miRNAs and receptor status in core biopsies sampled before preoperative chemotherapy in stage III locally advanced breast cancer (LABC) patients. In 37 LABC core biopsies, three miRNAs per sample were analyzed: hsa-miR-93-5p, hsa-miR-190a, and hsa-miR-200b-3p, and hsa-miR-103a-3p as an endogenous control (TaqMan(®) RT-PCR; Applied Biosystems). Receptor status was determined by a dedicated pathologist. The Mann-Whitney U, Shapiro-Wilk, and Levene's tests were used to compare related samples. Levels of miRNA-93 differed significantly in core biopsies of LABC patients with different expressions of ER (estrogen receptor) and PR (progesterone receptor). Higher levels of miRNA-93 were found in ER-negative (p=0.0027) and PR-negative patients (p=0.0185). Levels of miRNA-190 and 200b did not differ significantly in core biopsies of LABC patients who expressed ER and PR differently (p=0.7727, p=0.9434, p=0.6213, and p=0.1717). Levels of miRNA-93, 190, and 200b were not significantly different in core biopsies of LABC patients with different HER2 (human epidermal growth factor 2) expressions (p=0.8013, p=0.2609, and p=0.3222). The assessment of core biopsy miRNA profiles and receptor-based subtypes may identify new signaling pathways for improved breast cancer classification.

The cellular environment of cancerous human tissue. Interfacial and dangling water as a "hydration fingerprint"

Despite a large number of publications, the role of water in the cellular environment of biological tissue has not been clarified. Characterizing the biological interface is a key challenge in understanding the interactions of water in the tissue. Although we often assume that the properties of the bulk water can be translated to the crowded biological environment, this approach must be considerably revised when considering the biological interface. To our knowledge, few studies have directly monitored the interactions and accumulation of water in the restricted environments of the biological tissue upon realistic crowding conditions. The present study focuses on a molecular picture of water molecules at the biological interface, or specifically, water molecules adjacent to the hydrophobic and hydrophilic surfaces of normal and cancerous tissues. We recorded and analyzed the IR and Raman spectra of the νs(OH) stretching modes of water at the biological interfaces of the human breast and neck tissues. The results revealed dramatic changes in the water content in the tissue and are potentially relevant to both the fundamental problems of interfacial water modeling and the molecular diagnostics of cancer as a 'hydration fingerprint'. Herein, we will discuss the origin of the vibrational substructures observed for the νs(OH) stretching modes of water, showing that the interfacial water interacting via H-bond with other water molecules and biomolecules at the biological surface and free OH vibration of the dangling water are sensitive indicators of the pathology between the normal (noncancerous) and cancerous tissue and cancer types.

Polymorphism of the DNA repair genes RAD51 and XRCC2 in smoking- and drinking-related laryngeal cancer in a Polish population

INTRODUCTION

Cigarette smoke and alcohol can generate reactive oxygen species, which may induce DNA double-strand breaks (DSBs), the most serious DNA lesion. In humans, DSBs are repaired mainly by non-homologous end joining and homologous recombination repair (HRR). Several polymorphisms in the DNA repair gene have been extensively studied in the association with various human cancers. In the present work we investigated the association between polymorphisms of two HRR genes, XRCC2 and RAD51, and tobacco- and alcohol-related larynx cancer in a Polish population.

MATERIAL AND METHODS

Two polymorphisms of the XRCC2 gene, -41657C > T (rs718282) and 31479G > A (rs3218536), as well as one polymorphism of the RAD51 gene, -135G > C (rs1801320), were investigated by PCR-RFLP in 253 patients with larynx cancer and 253 age- and sex-matched non-cancer controls.

RESULTS

Analysis of the gene-smoking and -drinking interactions revealed a weak association between larynx cancer and the -41657C > T polymorphisms of the XRCC2 gene among the moderate alcohol drinkers. The C allele of the -135G > C polymorphism of RAD51 increased cancer risk in the smoker group. Increased risk was also found for heavy drinkers. Additionally, there were no significant differences between distributions of genotypes in subgroups assigned to different TNM stages and grades.

CONCLUSIONS

The results indicated that the -135G > C polymorphism of the RAD51 gene may be associated with smoking- and drinking-related larynx cancer in Poland.

[Causes and indwelling times of multiple voice prosthesis replacements in patients after total laryngectomy--analysis of 184 replacements in 42 patients]

INTRODUCTION

Implantation of the indwelling voice prosthesis has become the preferred method of voice rehabilitation after total laryngectomy. Frequent prosthesis dysfunction remains the major problem.

AIM

Analysis of the indwelling time and indications for multiple voice prosthesis replacements.

METHODS

Forty two patients after total laryngectomy due to laryngeal cancer (6 women and 36 men, mean age 62.1 ± 6.7 years) were included. 184 voice prosthesis replacements were analyzed (1271 patient-months).

RESULTS

Mean time between replacements was 260 ± 150 days. The indwelling time decreased from 267 days to the first replacement to 100-160 days at eighth and subsequent exchanges (p < 0.01). Most frequent indications for replacement were leakage of fluids through the prosthesis, phonation problems caused by mucosal overgrowth around the prosthesis, inaccurate sizing, deformation, and spontaneous extrusion. The lifetime of voice prostheses was positively correlated with patients' age. Mycological culture of the smear taken from tracheoesophageal fistula at first replacement was positive in 34/41 cases, at the second in 29/31 cases, the third in 29/31, and at the fourth and subsequent replacements in all specimens. Most patients indicated the following factors as possible causes of a shortened lifetime of the prosthesis: use of alcohol and coffee (34% of responders), inappropriate dietary habits (sweets and tough foodstuff - 17%), cleaning of voice prosthesis discordant with the recommendations of the manufacturer (14%).

CONCLUSIONS

Although our results confirm common indications for voice prosthesis replacement we also showed that the time between exchanges is gradually getting shorter. This observation could have implications for the current reimbursement practices.

Atypical lipomatous tumor of the cheek - a case report

Liposarcoma is the most common soft tissue malignant tumor. It mostly arises in the subcutaneous tissue of shoulders, limbs and neck, and retroperitoneal space, but head occurrence is very rare. Atypical lipomatous tumor (ALT) is a well-differentiated liposarcoma (WDLPS) and constitutes 40-45% of all liposarcoma cases. A case of 57-year-old woman with a tumor of the left cheek, causing a discreet face asymmetry is presented. The tumor was soft and caused no tenderness. The patient reported no previous injury of the region. Fine-needle aspiration biopsy (FNAB) revealed atypical cells suspected of liposarcoma. MR examination showed fascicles of adipose tissue, which made the left cheek prominent. The patient was operated under general anaesthesia. Adipose tissue of the left cheek was removed. Postoperative course was uneventful. The final histopathological diagnosis - was atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS). The patient remains under laryngological care. No recurrence of the disease has been observed during the 5 years follow-up.

Cytotoxicity and genotoxicity of capecitabine in head and neck cancer and normal cells

The interaction between a chemical and a cell may strongly depend on whether this cell is normal or pathological. Side effects of anticancer drugs may sometimes overcome their benefit action, so it is important to investigate their effect in both the target and normal cells. Capecitabine (Xeloda, CAP), a prodrug of 5-fluorouracil, is mainly used in colon cancer, but little is known about its action in head and neck cancer. We compared the cyto- and genotoxicity of CAP in head and neck HTB-43 cells and normal human lymphocytes by comet assay and flow cytometry. CAP at concentration up to 50 μM significantly decreased the viability of the cancer cells, whereas it did not affect normal lymphocytes. The drug did not interact with isolated plasmid DNA, but it damaged DNA in both cancer and normal cells. However, the extent of the damage in the former was much higher than in the latter. CAP induced apoptosis in the cancer cells, but not in normal lymphocytes. Pre-treatment of the cells with the nitrone spin traps α-(4-pyridil-1-oxide)-N-tert-butylnitrone and N-tert-butyl-α-phenylnitrone decreased the extent of CAP induced DNA damage, suggesting that free radicals may be involved in the formation of DNA lesions induced by CAP. The drug evoked an increase in the G0/G1 cell population accompanied by a decrease in the S cell population. CAP may evoke a pronounced cyto- and genotoxic effects in head and neck cancer cells, whereas it may or may not induce such effects in normal cells to far lesser extent.

Polymorphisms of the DNA repair genes XRCC1 and ERCC4 are not associated with smoking- and drinking-dependent larynx cancer in a Polish population

BACKGROUND

Tobacco smoking and alcohol drinking generate oxidative DNA damage and may contribute to larynx carcinogenesis. The X-ray repair cross complementing 1 (XRCC1) and excision repair cross-complementing rodent repair deficiency, complementation group 4 (ERCC4(XPF)) genes are important components of DNA excision repair systems, which repair DNA damage induced by various factors, including tobacco smoking and alcohol.

AIM

To investigate the association between the genotypes of the XRCC1-Arg399Gln (rs25487) and ERCC4-Arg415Gln (rs1800067) polymorphisms and smoking- and drinking-related larynx cancer in a Polish population.

METHODS

The polymorphisms were determined by PCR-RFLP method in 253 patients with squamous cell carcinoma of the larynx and 253 sex- and age-matched controls.

RESULTS

We did not find any association between the investigated polymorphisms and larynx carcinoma, dependent on either smoking or drinking status. No association was found between these polymorphisms and larynx cancer grade, stage or age at diagnosis.

CONCLUSIONS

The results indicated that Arg399Gln polymorphism of XRCC1 gene and Arg415Gln polymorphism of ERCC4 gene may not be associated with smoking- and drinking-related larynx cancer in Polish population.

Difficulties associated with the diagnosis of mycosis of the oral cavity and throat in chronic lymphocytic leukemia (CLL)

Cases of fungal infections are being encountered more often in clinical practice. The factors associated with a high risk of mycoses include, among others, corticosteroidotherapy, the administration antibiotics with wide spectrum of antibacterial properties, neutropenia, neoplasms. Fungi may play a role in cancer formation, may act as a complication in the course of treatment, and may mimic a neoplastic process by giving a similar clinical picture. In the case of fungal throat infection, patients complain of increased body temperature, a general feeling of weakness, malaise, headache, spontaneous pain intensifying during swallowing, a feeling of an obstacle in the throat or a cough. A physical examination may reveal congestion of the mucosa followed by a unilateral crater ulceration often covered with fat, as well as a thick coating, which is accompanied by foetor ex ore. The submandibular and neck lymph nodes are often greatly enlarged and painful. These symptoms may resemble those associated with the neoplastic process and changes in the course of systemic diseases (agranulocytosis). A correct diagnosis in these cases is necessary for adequate therapy. Chronic lymphocytic leukemia (CLL) is the most common type of leukemia among adults in Europe and North America. It is estimated that in Poland, CLL affects approximately 1,400 people per year. In this paper, a case of 62-years old patient with CLL with fungal infection of oral cavity and throat is presented.

The Cys326 allele of the 8-oxoguanine DNA N-glycosylase 1 gene as a risk factor in smoking- and drinking-associated larynx cancer

Tobacco smoke-related products and ethanol would induce oxidative modifications to the DNA bases, thereby contributing to larynx cancer. Human 8-oxoguanine DNA N-glycosylase 1 (hOGG1) deals with oxidative DNA damage, and the base changes in the hOGG1 gene may alter the susceptibility of the human cells to tobacco smoke-related compounds and/or ethanol. In the present work, we investigated the association between smoking, drinking or the Ser326Cys polymorphism of the hOGG1 gene and the risk of larynx cancer in a Polish population. It has been reported that the Ser326 allele exhibits higher activity than the Cys326 variant. In this study, 253 age-matched controls and 253 patients with larynx cancer were enrolled. The polymorphism was determined with DNA from blood lymphocytes by polymerase chain reaction. The frequencies (%) of the genotypes were Ser/Ser 65.6, Ser/Cys 30.4, and Cys/Cys 4.0 in the controls and those in patients were 55.7, 36.0 and 8.3, respectively. Stratification of individuals according to their smoking and drinking habits indicated that these habits might be significant risk factors in larynx cancer. The Ser/Cys and Cys/Cys genotypes are significantly associated with the increased risk of larynx cancer. These genotypes increased the risk ratio of larynx cancer among heavy smokers, but did not change the risk in former smokers and moderate smokers. These genotypes also increased the risk of larynx cancer in moderate and heavy drinkers. Therefore, the Cys326 allele of the hOGG1 gene may increase the risk of larynx cancer associated with smoking or alcohol consumption.

DNA double strand breaks repair and apoptosis induction in peripheral blood lymphocytes of head and neck cancer patients

AIM

To evaluate the generation and repair of DNA double strand breaks (DSBs) as a critical factors that define the efficiency of radiation therapy of cancer patients.

METHODS

Peripheral blood lymphocytes obtained from 18 patients with head and neck squamous cell carcinoma (HNSCC) and 18 healthy donors were studied. The efficiency of DSBs repair after genotoxic treatment with hydrogen peroxide and gamma-radiation were examined by neutral comet assay. MTT assay was used for cell viability analysis and Annexin V-FITC kit specific for kinase-3 was employed to determine apoptosis.

RESULTS

Lymphocytes from HNSCC patients were sensitive to genotoxic treatment and displayed impaired DSBs repair. Finally, as a consequence of this finding we have evidenced higher rate of apoptosis induction after gamma-radiation treatment of lymphocytes from HNSCC patients than those from healthy controls.

CONCLUSIONS

DSBs repair and increased apoptosis in cells of patients with head and neck cancer is relevant for efficient therapy of HNSCC.

Genetic polymorphisms in DNA base excision repair gene XRCC1 and the risk of squamous cell carcinoma of the head and neck

Background

The genes of base excision repair (BER) pathway have been extensively studied in the association with various human cancers. We performed a case-control study to test the association between two common single nucleotide polymorphisms (SNPs) of XRCC1 gene with human head and neck squamous cell carcinoma (HNSCC).

Methods

The genotype analysis of Arg194Trp and Arg399Gln gene polymorphisms for 92 HNSCC patients and 124 controls of cancer free subjects, in Polish population were performed using the PCR-based restriction fragment length polymorphism (PCR-RFLP) with endonuclease MspI.

Results

No altered risk has been found individually for these SNPs, however haplotypes analysis showed high association with head and neck cancer. The highest frequency, according to wild-type of Arg194Arg and Arg399Arg genotypes, was identified for Arg194Trp-Arg399Arg haplotype (OR, 2.96; 95% CI, 1.01–8.80).

Conclusion

Finally, we identified the combined Arg194Trp-Arg399Arg genotype of base excision repair gene XRCC1 that was associated with HNSCC and may have an impact on identification of a high-risk cancer population.

Polymorphisms of the DNA base excision repair gene MUTYH in head and neck cancer

BACKGROUND

Head and neck squamous cell carcinomas (HNSCC) comprise about 6% of all malignant neoplasms. The major risk factors of -HNSCC are smoking and alcohol consumption. Genetic polymorphisms of DNA repair enzymes may lead to genetic instability and carcinogenesis. MUTYH gene encodes a DNA glycosylase that can initiate the base excision repair (BER) pathway and prevent G:C > T:A transversion by excising adenine mispaired with 8-hydroxyguanine produced by reactive oxygen species (ROS).

AIM

to perform a case-control study to test the association between polymorphism in the MUTYH gene: Tyr165Cys and head and neck cancer risk progression.

METHODS

Genotypes were determined in DNA from peripheral blood lymphocytes of 193 patients (among them 97 subjects with precancerous hyperplastic laryngeal lesions and 96 subjects with head and neck cancer) and 140 age, sex and ethnic-matched cancer-free controls by tetra-primer amplification refractory mutation system PCR (T-ARMS-PCR).

RESULTS

We found an association between head and neck cancer risk and the Tyr165Tyr variant of the MUTYH gene (OR 2.18; 95% CI 1.19-3.97). For Tyr165Tyr genotype we also observed positive correlation with cancer progression assessed by tumor size (OR 4.56; 95% CI 1.60-12.95). We did not observe any correlation between Tyr165Cys polymorphism of MUTYH gene and precancerous hyperplastic laryngeal lesions risk.

CONCLUSION

The Tyr165Tyr polymorphic variant of the MUTYH gene may be associated with head and neck cancer in Polish population.

[Use of tissue autofluorescence in the diagnostics and assessment of treatment efficacy of the head end neck cancer]

There are still serious diagnostic and therapeutic challenges in case of carcinoma of the larynx, pharynx and oral cavity most often in patients after radiotherapy. An appropriate choice of a site to take a specimen for histopathology is crucial with regard to establish a diagnosis and find an origin of primary lesion and local recurrence. In this regard our attention is focused on those diagnostic methods which enable to detect even small pathologic lesions. Among them is tissue autofluorescence (DAFE). Its advantages are non-invasiveness, high sensitivity and repeatability. The aim of the study was to validate DAFE as a method for early diagnosis and monitoring of treatment efficacy of head and neck cancers. Forty seven patients were included. Each patient had a fibroscopic investigation with the use of white light and light inducing the tissue fluorescence. A specimen for the histopathology was taken from each site which showed fluorescence in order to verify the diagnosis. The presence of neoplastic lesions was always confirmed with histopathology in parallel with the assessment of the lesion area with fluorescence. DAFE is a non-invasive and useful method for the detection of early cancer lesions with the potential to assess the advances of the disease and to monitor its progress.

[Surgery treatment of salivary gland tumors]

INTRODUCTION

Tumors of parotid gland represent a diverse group of neoplasms with varied clinical behaviors.

MATERIAL AND METHODS

The diagnostic methods and treatment of salivary gland tumors are presented in this paper. The authors describe the group of 44 patients with salivary gland tumors treated surgically in ENT Departament Laryngology of Medical University in Łódź. Enucleation, partial and total parotidectomy were performed. Neurosign 100 unit was used during parotidectomy to monitoring course of facial nerve.

RESULTS

Tumor mixtus was a dominate type of tumors. Only three patients with malignant tumor had facial nerve paralysis after surgery.

CONCLUSIONS

(1) The extent of the surgical procedure depends on histopathologic diagnosis. (2) Using of facial nerve monitoring during parotid surgery improves its outcomes.

[Castleman disease--a case report]

The Castleman disease was described for the first time in 1956 by Castleman. It is a rare disease of the lymphatic tissue, manifesting in excessive proliferation of lymphocites B and plasmatic cells in lymph nodes. The etiopathogenesis if the disease still is unknown. The paper presents a case of the Castlemana disease (hyaline vascular type) in 20-year-old man with unilateral enlargement of neck lymph nodes. The case exemplifies the difficulties met in diagnostics and treatment of the Castleman disease.