Laryngeal Cancer Surgical Treatment Of Systematic Reviews And Topo Ii-alpha Expression And Laryngeal Cancer Clinical Features Of Study

Objective:To determine the effect of surgery alone or in combination with radiotherapy for the treatment of people with laryngeal cancer.Methods:Search for all the clinical controlled trails about Laryngeal Neoplasms from The Cochrane Library,Medline,Embase,CBM,CNKI. Extract the data from all the included studies and use Revman 5.0.17 to do the Meta analysis or statistical analysis if possible. To determine the effect of surgery alone or in combination with radiotherapy for laryngeal cancer. The search time ended up to March 31th, 2011.Results:63 clinical controlled trials are included in this study, 7 of which are RCTs, 1 is prospective study and others are retrospective trials. Trials were grouped into 9 main comparisons:(1)The 3-year overall survival (OS) was 85.88%. There are significant difference between Laryngofissure cordectomy and Horizontal partial laryngectomy, Laryngofissure cordectomy and Horizontal-vertical partial laryngectomy, Laryngofissure cordectomy and Subtotal laryngectomy in 3 year overall survival.The 5-year overall survival (OS) was 73.19%. There are significant difference between Laryngofissure cordectomy and Lateral vertical partial laryngectomy, Laryngofissure cordectomy and Horizontal partial laryngectomy, Laryngofissure cordectomy and Horizontal-vertical partial laryngectomy, Laryngofissure cordectomy and Subtotal laryngectomy, Vertical partial laryngectomy and Total laryngectomy, Horizontal partial laryngectomy and Total laryngectomy, Subtotal laryngectomy and Total laryngectomy in 5 year overall survival.The 10-year overall survival (OS) was54.29%. There are significant difference between Laryngofissure cordectomy and Frontolateral partial laryngectomy, Laryngofissure cordectomy and Horizontal partial laryngectomy, Laryngofissure cordectomy and Horizontal-vertical partial laryngectomy, Laryngofissure cordectomy and Extended subtotal laryngectomy, Laryngofissure cordectomy and Subtotal laryngectomy, Lateral vertical partial laryngectomy and Extended subtotal laryngectomy, Vertical partial laryngectomy and Subtotal laryngectomy, Vertical partial laryngectomy and Total laryngectomy, Horizontal partial laryngectomy and Total laryngectomy in 10 year overall survival. The quality of life in Partial laryngectomy arm is better than total laryngectomy arm. The voice functions of horizontal partial laryngectomy are better than vertical partial laryngectomy and Horizontal-vertical partial laryngectomy. There are no trials on the effects of local control rate. (2)There was no significance between surgery alone and laser surgery for local control rate,overall survival rate and voice quality. There are no trials on the effects of quality of life.(3) A statistically significant difference was shown for 3 year local control [RR=0.37 95%CI(0.22,0.61)] in favour of the surgery alone and low-dose radiation arm. There was no significance for overall survival rate, quality of life and voice quality.(4)There was no significance between laser surgery and radiotherapy for local control rate, overall survival rate and voice quality. There are no trials on the effects of quality of life.(5)The quality of life is better in surgery alone than surgery plus postoperative radiation .There was no significance between surgery alone and surgery plus postoperative radiation for local control rate, overall survival rate and voice quality.(6)There was no significance between surgery alone and Preoperative radiation plus surgery for overall survival rate. There are no trials on the effects of local control rate, quality of life and voice quality.(7)There was no significance between radiotherapy and Preoperative radiation plus surgery for overall survival rate. There are no trials on the effects of local control rate, quality of life and voice quality.(8)There was no significance between surgery plus postoperative radiation and preoperative radiation plus surgery for overall survival rate. There are no trials on the effects of local control rate, quality of life and voice quality.(9)There was no significance between surgery plus postoperative radiation and radiotherapy for local control rate and overall survival rate. There are no trials on the effects of quality of life and voice quality.Conclusions:Our study shows that,(1)The quality of life is better in partial laryngectomy than total laryngectomy.(2)The survival rate is higher in surgery alone than in low-dose arm.(3) Radiation is bad for quality of life in laryngeal cancer. There is a need for further well-designed prospective trails to provide more reliable answers to the effect of treatments for site-specific and stage-specific data in laryngeal cancer. Objective: To investigate qualitatively and quantitatively the levels of TopoⅡ-αprotein and mRNA in laryngeal squamous cell carcinomas. To explore the relationship between the abnormal TopoⅡ-αexpression and carcinogenesis of laryngeal squamous cell carcinomas.Methods: Paraffin blocks of 77 primary laryngeal squamous cell carcinomas that were treated surgically between 2005 and 2007 were retrieved from archive of Shanxi Provincial Cancer Hospital. Expression of TopoⅡ-αgenes in 22 cases of both normal laryngeal tissue and laryngeal squamous cell carcinomas from the same patients were detected by the immunohistochemistry and immunofluoresence technique. 55 cases of only laryngeal squamous cell carcinomas were collected in a tissue microarray. We used tissue microarray, immunohistochemistry and Fluorescence In situ hybridization to research amplification of TopoⅡ-αgene and polysomy 17.For statistical analyses, we used SPSS, version 15.0.A P value of less than .05 was considered statistically significant. Differences in TopoⅡ-αindex by tumor stage, tumor grade, site and lymph node metastasis were analyzed by using the Chi-square test and Fisher's exact test. By using Spearman rank correlation analysis, the correlation between TopoⅡ-αprotein expression level and amplification of TopoⅡ-αgene, TopoⅡ-αprotein expression and polysomy 17 was evaluated.Results: (1) Of 55 cases,48 were suitable for evaluation.(2) The expression of TopoⅡ-αpositive was 71.43%(50/70).(3) There was a statistically significant difference in the Topo II-αindex by tumor differentiation level (P<0.05).(4) There was a statistically significant difference in the Topo II-αindex between T3+T4 and T1+T2 group (P<0.05).(5) TopoⅡ-αprotein expression were not correlated with the tumor site(P>0.05).(6) TopoⅡ-αprotein expression were not correlated with staging and lymph node metastasis(P>0.05).(7) In laryngeal carcinoma surrounding tissue from 0.30cm to 0.50cm,TopoⅡ-αprotein expression level is different from other tissue.(8) TopoⅡ-αprotein expression level in laryngeal squamous cell carcinomas were not correlated with amplification of TopoⅡ-αgene(P>0.05);TopoⅡ-αprotein expression level was positive correlated with polysomy 17(P<0.05).Conclusions: TopoⅡ-αprotein expression level was well correlated with tumor differentiation level and T stage. TopoⅡ-αprotein expression were not correlated with the tumor site and staging and lymph node metastasis Detection of TopoⅡ-αgene products had positive effects on the treatment of laryngeal carcinoma.