Search

The role of human papilloma viruses (HPV) in malignant and nonmalignant ENT diseases and the corresponding epidemiological burden has been widely described. International head and neck oncology community discussed growing evidence that oral HPV infection contributes to the risk of oro-pharyngeal carcinoma (OPC) and recommended HPV testing as a part of the work up for patients with OPC. Polish Society of ENT Head Neck Surgery and National Chamber of Laboratory Diagnosticians have worked together to define the minimum requirements for assigning a diagnosis of HPV-related conditions and testing strategy that include HPV specific tests in our country. This paper briefly frames the literature information concerning low risk (LR) and high risk (HR) HPV, reviews the epidemiology, general guidance on the most appropriate biomarkers for clinical assessment of HPV. The definition of HPV-related cancer was presented. The article is aiming to highlight some of major issues for the clinician dealing with patients with HPV-related morbidities and to introduce the diagnostic algorithm in Poland., (Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Aim of the Study: To compare safety, reliability and usefulness of two deafening protocols on animal mouse model, based on aminoglycosides exposure, Material and Method: Adults mice, Bulb/C, deafened with kanamycine 14 days treatment (group I), single kanamycin injection followed by etacrinic acid administration (group II) and control group. Hearing evaluation performed with ABR recordings on 6th day after drug exposure, Results: Both protocols were not able to guarantee complete ablation of the inner ear in tested animals. Although short deafening strategy was more effective (83.33% deaf mice) it was combined with high rate of mortality during general anesthesia for hearing evaluation., Conclusions: Variable outcomes in deafening mouse animal model implies the necessity of hearing evaluation every time prior to the pathophysiological as well as molecular studies. Mice exposed to severe oto- and nephrotoxic insult do not recover after anesthetic drug administration, thus harvesting inner ear tissues especially as the source of RNA should be performed immediately after ABR recordings., (Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Introduction: Hereditary haemorrhagic telangiectasia (HHT) known also as Rendu-Osler-Weber syndrome is an autosomal dominant disorder characterized by localized angiodysplasia due to mutations in ENG (endoglin, 9q34.1) or ALK-1 gene (the activin receptor-like kinase 1, 12q13). ENG and ALK-1 are found associated with two disease subtypes designated as HHT1 and HHT2, respectively. Subtype HHT1 remains in the frame of interest of laryngology because of frequent bleeding in head and neck region., Material and Method: The study was designed to identify a genetic background in a large family (29 individuals) with diagnosed HHT. Pedigree analysis showed autosomal dominant pattern of inheritance. Study design comprised segregation analysis to determine locus with subsequent direct sequencing of the gene. Four microsatelite markers (d9s61, d9s65, d12s368, d12s347) with high frequency of heterozygosity in population study were used., Results: The results concerning heterozygosity ranged from 15% to 53%. The established differences were not sufficient enough to indicate co-segregation of the studied loci. DNA sequence analysis in exon 11 of ENG gene did not reveal mutations. The latter result could be explained by an occurrence of mutations in other exons of ENG., Conclusions: The study requires continuation for gene identification and precise genotype-phenotype correlation aiming for an improvement of HHT1 therapy.

Unlabelled: Squamous cell carcinoma of the head and neck (HNSCC) is the malignant tumor arising most frequently in non-keratinized epithelial tissue of the upper part of the respiratory or gastrointestinal tracts. These tumors develop most commonly in the sixth or seventh decade of life and significantly less frequently in patients younger than 45 years defined as young adults. In literature, there are still many controversies concerning the origin of these tumors in this group of patients., Aim: To estimate the role of exogenous and epidemiological factors in etiology of HNSCC in young adults., Material and Methods: The study group consisted of 95 young adults (< or =< 45 years) with HNSCC and the control group of 95 older patients (> 45 years) with HNSCC, who were treated in the Department of Otolaryngology and Laryngological Oncology of Karol Marcinkowski University of Medical Sciences in Poznan during the period 2000-2004. The analysis was based on etiological questionnaires and the medical records of patients., Results and Conclusions: 1. A significant role of typical exogenous factors (active and passive exposure to tobacco smoke and alcohol abuse) was established in the etiology of HNSCC in young adults. 2. Daily active exposure to tobacco smoke in young adults is nearly the same as in older patients, but daily passive exposure is higher than in older patients. 3. Significantly higher alcohol consumption in young adults than in older patients, found in this study, may be one of the reasons of HNSCC onset in young age. 4. Occupational exposure to the HNSCC causative factors in young adults is not higher than in older patients. 5. A frequency of familial cancer in young adults with HNSCC seems to be higher than in older patients, but further observations are needed.

Unlabelled: Squamous cell carcinoma of the head and neck (HNSCC) is the malignant tumor arising most frequently in non-keratinized epithelial tissue of the upper part of the respiratory or gastrointestinal tracts. These tumors develop most commonly in the sixth or seventh decade of life and significantly less frequently in patients younger than 45 years defined as young adults. In literature, there are still many controversies concerning the clinical course of these tumors in this group of patients., Aim: Clinical and histopathological analysis of HNSCC in young adults., Material and Methods: The study group consisted of 95 young adults (< or = 45 years) with HNSCC and the control group of 95 older patients (> 45 years) with HNSCC, who were treated in the Department of Otolaryngology and Laryngological Oncology of Karol Marcinkowski University of Medical Sciences in Poznań during the period 2000-2004. The analysis was based on medical records of patients., Results and Conclusions: 1. In the young adults group and particularly in patients younger than 40 years there is a higher percentage of patients with oral cancer and lower percentage of patients with larynx cancer in comparison to older patients group, but in all analysed groups larynx cancer is the most frequent localization. 2. The tumors in young adults are clinically more advanced than in older patients, because young adults tend to delay the visit to physician, in spite of evident clinical symptoms. 3. HNSCC in young adults are histological more mature and less malignant.

In terms of growing interest in molecular analysis of genetically determined hearing impairment, it is of clinical importance to know problems and obstacles that arise on the way to molecular diagnosis. Although for clinicians a genetic factor as a reason for hearing problem is easier accepted, still an understanding the limits of such identification remains unclear. Technical issues, as well as social and legal aspects of genetic analysis are described. Authors try to explain why such impressive progress in understanding of hearing loss physiology, especially from the genetic point of view, does not have its transfer into clinical practice.

The occurrence of second primary tumors after curative treatment or simultaneous multiple malignancies are current problem in head and neck cancer. The mutagen sensitivity is well known marker to predict patient proneness to develop the second tumor. The frequency and localization of spontaneous and mutagen induced chromatid breaks in peripheral blood lymphocytes (PBLs) in patients with multiple primary tumors (MPT) may help in defining regions involved in cancerogenesis process. The case control study using the bleomycin sensitivity assay (number of chromatid breaks per cell (b/c) was performed in 36 patients with MPT and two control groups: 52 patients with one malignancy and 47 healthy individuals. The differences between examined patients and control groups were estimated using U Mann-Whitney test. The b/c level in PBLs of patients with MPT ranged from 0.26 to 4.12 (mean 1.53) and was significantly higher (p<0.000006) both compared with patients with one malignancy (b/c ranged from 0.02 to 3.08; mean 0.74) and healthy controls (b/c ranged from 0.04 to 1.14; mean 0.41). An increase of b/c index was observed in almost all chromosomal arms. The majority of chromosomal locations with the increased proportion of breaks in the group of patients with multiple tumors were identified as regions where loci involved in DNA repair, cell cycle regulation suppressor genes and oncogenes were found. Statistically higher induced individual susceptibility in MPT patients compared with single tumor and healthy controls was confirmed. Comparable induced mean b/c was found in patients with two smoking-related cancers as well as with not smoking related tumors.

Ionizing radiation is a known "universal carcinogen" for a wide variety of tumors in man. Human populations are exposed to radiation coming from natural and industrial environment, and from medical sources. However, these are radiotherapy patients who receive the highest doses. Radiation both mutates and sterilizes cells (lethal effect). The risk of cancer induction from cells that have received very high doses of radiation (therapeutic dose about 2 Gy) is lower then from the cells with low doses, since the majority of them will have been sterilized. The epidemiological studies based on the population of atomic bomb survivors have indicated that the most acceptable model of carcinogenesis is the linear non-threshold model. The evaluation of clinical risk related to a wide range of radiation doses, which range from 0.01 Gy to 2 Gy, is connected with many methodological problems such as: differences in treatment factors (dose range, irradiated volume, anatomical site), unknown epidemiological data (smoking abuse, comorbidity), shortening of the follow-up (short lifespan, migration), evaluation of small groups of patients. The most important difficulty is lack of the sufficient knowledge of genetic background which is probably most significant in carcinogenesis process. The introduction into clinical practice of a new sophisticated method of irradiation such as the three-dimensional conformal radiotherapy (3D CRT) or intensity modulated radiotherapy (IMRT) leads to the increase of low irradiation dose for very large volume of normal tissue. Thus, the evaluation of these new methods in the context of carcinogenesis is a very important objective in the future. Today, we can only introduce the most important questions concerned with the risk of carcinogenesis induction which await answers: what is the risk of induction of cancer due to the implementation of these new methods of treatment, and how important is this risk for clinical practice, especially in the case of combined radiochemotherapy? Despite a large body of experimental and clinical studies, radiation carcinogenesis is not fully understood yet. Additional problems related to the impact of irradiation of low dose on carcinogenesis are not resolved. For example, the bystander effect, the low dose hypersensitivity and the adaptive response could modulate the total response after irradiation, but the impact on the carciongenesis is unknown.