Biomedical subjects
J P Rodrigo Tapia
Publications and source records attributed to J P Rodrigo Tapia.
[Inactivation of p53 and amplification of cyclin D1 in squamous cell carcinomas of the head and neck].
P53 and CCND1 (cyclin D1) genes play a critical role in the cell cycle regulation. Abnormalities of these genes are frequent in different types of cancers, including those of the head and neck. The aim of this work is to investigate whether P53 inactivation (determined by loss of heterozygosity analysis) is related to CCND1 gene amplification (determined by differential PCR analysis), and if these alterations are correlated with clinical outcome in a series of 56 patients with squamous cell carcinoma of the head and neck. Loss of heterozygosity of the P53 gene was found in 39 cases (70%) and CCND1 amplification in 17 cases (30%). Both abnormalities together were found in 11 cases (20%), without a significant association between them (P = 0.83). No relationship was found between P53 inactivation, the clinico-pathological parameters analyzed and the clinical outcome. CCND1 amplification was associated with advanced T-stages (P = 0.02), nodal metastases (P = 0.01) and a decreased survival (P = 0.002). The combination of both abnormalities shows a pattern that seems to be additive, since it was associated with an increase in tumor recurrences and a decrease in survival that was higher than for either of them individually. In conclusion, P53 and CCND1 abnormalities are frequent in squamous cell carcinomas of the head and neck. The combined analysis of these abnormalities seems to be more informative than either of them individually and may have a prognostic value in these carcinomas.
[Prognostic significance of the expression of adhesion molecules E-cadherin, Cd44s and CD44V6 in supraglottic squamous carcinoma].
OBJECTIVE: To establish the prognostic significance of the expression of adhesion molecules E-cadherin, CD44s and CD44v6 in squamous cell carcinomas of the supraglottic larynx. MATERIAL AND METHODS: The expression of the studied molecules was determined by immunohistochemistry in paraffin-embedded tissue specimens from 101 patients. RESULTS: The expression of the three molecules was reduced in carcinomas compared to normal epithelium. The cases with recurrence showed an E-cadherin and CD44s expression significantly lower than those cases without recurrence. Reduced expression of any of the three molecules correlated with a decrease in survival, although the differences were not significant. In multivariate analysis only nodal stage (N) was an independent prognostic factor. CONCLUSIONS: Although reduced expression of E-cadherin, CD44s and CD44v6 seems to be related to a poor prognosis in supraglottic squamous cell carcinomas, these changes do not offer a useful adjunct to current prognostic indicators.
[CCND1 oncogene amplification and cellular DNA content in squamous cell carcinomas of the head and neck].
Cyclin D1 protein (encoded by the CCND1 gene) contributes to the progression of the cell cycle in the G1/S checkpoint. Cyclin D1 overexpression (for instance as a consequence of CCND1 amplification) might result in loss of control over genetic damage at this point and in an accumulation of chromosomal aberrations. In this work we analyze whether CCND1 amplification is associated with a higher incidence of alterations in cellular DNA content. 31 squamous cell carcinomas of the head and neck were studied. CCND1 amplification was determined by polymerase chain reaction. Cellular DNA content was determined by flow cytometry. CCND1 amplification was found in 6 (19%) cases. Thirteen (42%) cases were diploid and 18 (58%) were aneuploid. Two (33%) of the 6 cases with CCND1 amplification were aneuploid compared with 16 (64%) of the cases without CCND1 amplification (P = 0.36). We conclude that CCND1 amplification is not associated to a higher incidence of chromosomal aberrations in squamous cell carcinomas of the head and neck.
[Relationship between the integration of human papillomavirus and loss of heterozygosity of the P53 gene in squamous cell carcinomas of the head and neck].
Human papillomavirus integration in cellular DNA and loss of heterozygosity of P53 gene are both related with tumour formation process by promoting genomic instability that leads to DNA abnormalities accumulation. In order to analyze the relationship between both events, 26 squamous cell carcinomas of the head and neck were studied. HPV 16 and 6b DNA was detected by PCR in 8 cases (31%), whereas P53 loss of heterozygosity was present in 16 cases (61%). No correlation was found between both events and they were not related to clinical factors neither the prognosis. Consequently, HPV integration and loss of heterozygosity of P53 seem to act independently in the genesis of these tumours.
[Idiopathic brain herniation in the middle ear and mastoid].
Idiopathic brain herniation into the middle ear and the mastoid process is a rare clinico-pathological entity, with only 41 cases described in the literature. It should be suspected in presence of spontaneous otoliquorrhea/rhinoliquorrhea, refractory serous otitis media, or meningitis following acute otitis media in an adult. A new case is presented, with a brief review of the pathogenesis, clinico-pathological, and radiological characteristics of these lesions.
[Risk factors in surgical wound infection in oncological surgery of the head and neck].
Although the use of antibiotic prophylaxis has significantly reduced the frequency of postoperative wound infections, they continue to be a critical issue in head and neck cancer surgery. A study was made of possible risk factors for the development of these infections. A prospective study was made of 159 patients with pharyngo-laryngeal squamous-cell carcinoma who underwent open-pharynx surgery in order to analyze the factors associated with wound infections. Postoperative wound infection was defined as purulent drainage or mucocutaneous fistula formation, or both, in the first 10 days after surgery. Potential risk factors examined were age, medical illnesses, prior surgery and radiotherapy, TNM stage, type of operative procedure, method of reconstruction, and operative time. The overall wound infection rate was 23%. Although the incidence of wound infection was higher in patients who received preoperative radiotherapy, in patients with advanced stage disease, and in those who required flap reconstruction, the only preoperative factor that significantly increased the rate of wound infection was the concurrence of medical illnesses (chronic obstructive pulmonary disease and diabetes mellitus; p = 0.018). In conclusion, the presence of prior medical diseases was the main risk factor in the development of postoperative wound infections.
[Basal cell parotid adenoma. Report of an unusual case and review of literature].
Basal cell adenoma is a subtype of salivary monomorphic adenoma that usually appears in the parotid gland. Its pathological differentiation from adenoid cyst carcinomas is difficult. It is treated by surgical excision. In this study we describe the clinical and pathological features of a case in an atypical patient.
[Molecular changes in epidermoid carcinoma of the oropharynx].
In most of the studies about molecular alterations in squamous cell carcinomas of the head and neck there is not distinction between the different subsites of this area. The objective of this study is to describe the molecular alterations in squamous cell carcinomas of the oropharynx. Twenty-nine oropharyngeal carcinomas, with a minimum follow-up of 36 months, were studied. The molecular alterations analyzed were: the amplification of 11q13 region (in the 29 cases), and the MYC and ERBB1 oncogenes (in 22 cases); the integration of Human Papillomavirus (HPV) types 6b and 16 (in 22 cases); the loss of heterozygosity (LOH) of p53 and N-acetyltransferase-2 (NAT2) gene (in 12 and 13 informative cases, respectively); and the cellular DNA content (in 13 cases). The most frequent alterations found were the LOH at p53 (67%), and NAT2 (54%) locus, followed by 11q13 amplification (49%). ERBB1 amplification was found in 14% of the cases, and MYC amplification only in one (5%). Integration of the HPV was found in 23% of the cases. Nine (69%) of the 13 analyzed cases were aneuploid. The only alteration with a prognostic significance was 11q13 amplification that showed a tendency to be associated with a higher frequency of nodal metastases and tumor recurrence.
[Preoperative evaluation in thyroplasty: the laryngeal lateral compression].
Thyroplasty type I has provided significant improvement to the treatment of patients with glottal incompetence. It is essential that patients be preoperatively evaluated using objective criteria. Laryngeal manual compression test are manipulations of the thyroid and cricoid cartilages that result in modifications of the position of the vocal folds. The most valuable laryngeal manual compression test for patients with glottal insufficiency is the lateral compression test. When this test results in a preoperative improvement in voice suggest that surgery will be successful. In this paper we present the objective evaluation of the effects of lateral compression test upon glottic incompetence by means of narrow band power spectrum analysis.
Using polymerase chain reaction to human papillomavirus in oral and pharyngolaryngeal carcinomas.
PURPOSE: Increasingly, evidence has shown that human papillomavirus (HPV) plays a role in the induction of certain carcinomas. The presence of HPV sequences in 56 previously untreated oral and pharyngolaryngeal carcinomas was examined by the polymerase chain reaction (PCR). MATERIALS AND METHODS: After DNA extraction, samples underwent 40 replication cycles with specific oligonucleotide primers corresponding to sequences from the E6 open-reading frame of HPV-6b, HPV-16, and HPV-18. To determine the E6 genomic integration, positive samples were processed with specific primers for the corresponding HPV L1 genes. Genomic HPV DNA clones into PBR 322 was used as positive control. RESULTS: HPV E6 DNA of the 6b and 16 types was detected in 14 patients (25%). The L1 gene was not present. CONCLUSION: Detected HPV E6 DNA might be integrated into the cell genome in the positive cases as indicated by the absence of the L1 gene-coding for the viral capside. Histological and survival rates, were unrelated to the presence of HPV.
[A giant bilateral concha bullosa causing nasal obstruction].
Pneumatization of the middle turbinate or concha bullosa is the most common anatomical variant of this structure. Although usually small and asymptomatic, a large concha bullosa may obstruct sinus drainage. We present an uncommon case of massive bilateral concha bullosa that produced complete obstruction of the left nasal cavity and partial obstruction of the right nasal cavity.
[The selection of cervical vessels recipients in reconstructive surgery of head and neck with free flaps].
One of the most important parameters for success in free tissue transfer to the head and neck are a proper and careful recipient vessel dissection and meticulous vascular microanastomotic technique. The principle that govern vessel positioning in the head and neck are more complex than those used in extremity free flap transfers. In this report the vascular selection as well as technical details are discussed, based on the literature data and our own experience in 20 patients.
[Analysis of rearrangements in the first exon of c-myc oncogene in squamous cell carcinoma of the head and neck].
Activation of c-myc has been implicated in the origin of different human tumors, and can be produced by diverse mechanisms as amplifications or rearrangements. We examined 55 squamous cell carcinomas of the upper aerodigestive tract for rearrangements involving the first exon of c-myc, which plays a regulatory role in the c-myc expressión. Polymerase chain reaction (PCR) amplification of different fragments of c-myc exon 1 was performed using four oligonucleotide primers that correspond to consecutive sequences from the 5' end of the c-myc exon 1, combined with one oligonucleotide that corresponds to the 3' end. Amplified c-myc PCR products appear as single bands of 580, 495, 417 and 333 base pairs on the electrophoretic analysis. Only in one case a rearrangement involving the first exon of c-myc was found. We concluded that gene rearrangement is not a common mechanism of activation of c-myc in squamous cell carcinomas of the head and neck.
[Simultaneous screening of HPV-6b and 16 in pharyngolaryngeal cancer].
It has been suggested that some human papilloma viruses (HPV) may play a causal role in cancer of the pharynx, larynx, and oral cavity, together with factors such as smoking, alcohol, toxins, and heredity. Using the polymerase chain reaction (PCR), we detected the two most common genotypes in pharyngolaryngeal cancer, HPV-6b and 16, in 15 patients from a series of 57 cases. One patient had both genotypes. The fact that this was the only positive case in which no other risk factors were present, particularly alcohol and smoking, suggests that the synergetic oncogenic action of both viruses could have played an important role in carcinogenesis.
[Amplification of oncogene c-erb-B1 and cellular DNA content in squamous cell carcinoma of the head and neck].
Tumoral DNA content was studied by flow cytometry and PCR amplification of c-erbB1 in tissue samples from 31 patients with squamous cell carcinoma of the head and neck. Eighteen cases (58%) were aneuploid and 13 (42%) were diploid. Aneuploidy correlated with pharyngeal site and poorly differentiated tumors, but not with clinical stage or metastases. Six (19.3%) cases had c-erbB1 amplification, which correlated with tumor size, nodal metastasis, poor differentiation, and hypopharyngeal site. Only 20% of patients with amplification survived 30 months, compared with 64% of patients without amplification. None of the patients with aneuploidy and c-erbB1 amplification survived more than 15 months. To conclude, the measurement of cellular DNA content and c-erbB1 amplification seem to have prognostic value in squamous cell carcinoma of the head and neck.
[Cervical lymphangioma in adults: report of three cases].
Lymphangioma is a developmental anomaly of the lymphatic system that is infrequent in children and rare in adults. The clinical diagnosis is easy and imaging techniques are useful for determining its extension. Surgical excision is the treatment of choice. The procedure is less difficult in adults than in children and recurrence is rare in complete resection. Three cases of typical adult cervical lymphangioma are reported.
[Malignant melanoma of the nasal cavity and paranasal sinuses].
Malignant melanomas represent about 3% of all nasosinusal neoplasms. They usually are located in the nasal septum and their maximum incidence is in the sixth and seventh decades. In the early stages they are asymptomatic, which delays diagnosis and reduces the possibilities of cure to 15-30%. Eight cases of nasosinusal melanoma are reported and their characteristics are reviewed with special attention to prognostic factors.