Juan Ignacio de Diego

Lysyl Oxidase-Like 2 as a New Poor Prognosis Marker of Squamous Cell Carcinomas

Lysyl oxidase-like 2 (Loxl2) interacts with and stabilizes Snai1 transcription factor, promoting epithelial-mesenchymal transition. Either Loxl2 or Snai1 knock-down blocks tumor growth and induces differentiation, but the specific role of each factor in tumor progression is still unknown. Comparison of the gene expression profiles of the squamous cell carcinoma cell line HaCa4 after knocking-down Loxl2 or Snai1 revealed that a subset of epidermal differentiation genes was specifically up-regulated in Loxl2-silenced cells. In agreement, although both Loxl2- and Snai1-knockdown cells showed reduced in vivo invasion, only Loxl2-silenced cells exhibited a skin-like epidermal differentiation program. In addition, we show that expression of Loxl2 and Snai1 correlates with malignant progression in a two-stage mouse skin carcinogenesis model. Furthermore, we found that increased expression of both LOXL2 and SNAI1 correlates with local recurrence in a cohort of 256 human laryngeal squamous cell carcinomas. We describe for the first time that high levels of LOXL2 are associated with decreased overall and disease-free survival in laryngeal squamous cell carcinomas, lung squamous cell carcinoma, and lymph node-negative (N(0)) breast adenocarcinomas. Altogether, our results show that LOXL2 can be used as a new poor prognosis indicator in human squamous cell carcinomas promoting malignant transformation by both SNAI1-dependent and SNAI1-independent pathways.

Idiopathic Facial Paralysis: A Randomized, Prospective, and Controlled Study Using Single‐Dose Prednisone Versus Acyclovir Three Times Daily

In a prospective, controlled, and randomized study, we compared the outcome of 101 Bells palsy patients treated with acyclovir (54 patients) or prednisone (47 patients). The acyclovir dosage was 2400 mg (800 mg three times a day) for 10 days, and prednisone was given as a single daily dose of 1 mg/kg of body weight for 10 days and tapered to 0 over the next 6 days. Minimum follow‐up was 3 months in all patients. Patients in the prednisone group had better clinical recovery than those treated with acyclovir. Less degree of neural degeneration was observed in the prednisone group compared with acyclovir patients. The incidence of sequelae was the same in both groups. According to these results, in a 10‐day treatment cycle acyclovir given 800 mg three times is not as useful as prednisone given 1 mg/kg of body weight once a day in patients with idiopathic facial nerve paralysis.

Seasonal patterns of idiopathic facial paralysis: A 16-year study

The annual frequency of Bells palsy in 16 consecutive years was investigated in a 465,000-person health area in Madrid, Spain. The annual incidence of Bells palsy per 100,000 population was found to be 24.1. The male-to-female ratio was 46:54. Seasonal difference in the incidence was noted in our series with fewer cases during summer. According to these results, the illness in Spain seems to have a similar incidence to that in Western countries. In addition to this, Bells palsy does not have an infectious epidemiologic pattern in our country, but its frequency decreases in warm weather.

Extracapsular Spread and Desmoplastic Pattern in Neck Lymph Nodes: Two Prognostic Factors of Laryngeal Cancer

The influence of extracapsular spread (ECS) and a desmoplastic pattern (DP) of metastatic cervical lymph nodes in patients with laryngeal cancer is presented. The study includes 128 patients surgically treated between 1984 and 1992 for squamous cell carcinoma of the larynx with pathologically proven lymph node metastasis. The results were studied from 2 major standpoints: survival and recurrence. The 3-year survival rates were as follows: patients without ECS 73.4%, and with ECS 28.9% (p < .001); patients without a DP 76.9%, and with a DP 43.3% (p < .03). Also, the 3-year recurrence rates in the neck showed significant differences: patients without ECS 10.7%, and with ECS 49.6% (p < .001); patients without a DP 10%, and with a DP 31.6% (p = .1142). Postoperative radiotherapy did not appear to improve the outcome.

Postoperative Radiotherapy in Patients with Positive Nodes after Functional Neck Dissection

A study was designed to assess the usefulness of postoperative radiotherapy (RT) in patients with surgically treated laryngeal and hypopharyngeal cancer with histologically proven positive neck nodes. Patients underwent operation between 1984 and 1995, with functional neck dissection (FND) being part of the treatment in all cases. The selection criteria included squamous cell carcinoma, negative margins for the primary tumor, and no previous treatment. For evaluation purposes, patients were divided into 2 groups: surgery alone versus surgery with postoperative RT. Eighty-three patients fulfilled the inclusion criteria and entered the study. All but 1 of the patients were men. The mean age was 58 years (range, 35 to 77 years). A multivariate analysis was used to analyze the prognostic parameters selected by univariate analysis, eg, age, alcohol, tumor location, T and N stages, and presence or absence of extracapsular spread and a desmoplastic pattern. Postoperative RT was not selected by univariate analysis as a prognostic factor, but was included in the multivariate analysis in order to assess its impact on survival and recurrence rates. Using the statistical method of multivariate analysis, we could not find evidence of a benefit to survival or local recurrence rates with postoperative RT in this series. Patients younger than 55 years and those with extracapsular spread had a decreased survival rate and a higher neck recurrence rate, irrespective of the treatment method.

Patency and Flow of the Internal Jugular Vein After Functional Neck Dissection

Objectives: To assess the patency and flow of the internal jugular vein after functional neck dissection.

Kaposiform hemangioendothelioma of the external auditory canal in an adult.

Kaposiform hemangioendothelioma is an uncommon vascular tumor initially reported to occur exclusively in children.

Aurora B kinase expression in laryngeal squamous cell carcinoma and its prognostic implications

García‐Fernández E, De Diego J I, Collantes‐Bellido E, Mendiola M, Prim M P, Pérez‐Fernández E, Miguel‐Martín M, Nistal M & Hardisson D
(2011) Histopathology58, 368–376
Aurora B kinase expression in laryngeal squamous cell carcinoma and its prognostic implications

Análisis de las tesis doctorales en otorrinolaringología presentadas en España en el período 1976-2005

Introduccion y objetivo La importancia de la otorrinolaringologia como disciplina independiente ha crecido en las ultimas decadas. El objetivo de este trabajo es analizar las tesis doctorales defendidas sobre el tema en Espana entre 1976 y 2005. Metodos Mediante la base de datos TESEO se obtuvieron los registros de las tesis doctorales sobre otorrinolaringologia elaboradas en Espana entre 1976 y 2005. Como criterios de busqueda empleamos los descriptores: “otorrinolaringologia”, “cirugia de garganta, nariz y oidos”, “fisiologia de la audicion”, “fisiologia del equilibrio”, “fisica de la audicion” y “bioacustica”. Resultados Se identificaron 468 tesis (15,6 tesis/ano). Del total de ellas, 343 (73,6 %) fueron leidas por otorrinolaringologos. Las universidades donde se leyeron mas tesis fueron: Valencia (Estudi General) (49), Complutense de Madrid (42), Salamanca (39), Barcelona (35) y Autonoma de Barcelona (31). El director de la tesis pudo ser identificado en 376 (80,4 %) registros; de ellos 286 (76,1 %) tenian un solo director y 90 (23,9 %) estaban codirigidas por 2 directores. Los temas mas frecuentemente abordados son los de otologia y audiologia (35,1 %). Conclusiones La otorrinolaringologia en Espana genera un numero de tesis similar a las de otras areas de conocimiento evaluadas. Su direccion tiende a ser compartida en los ultimos anos estudiados. El numero anual de tesis presentadas esta influido no solo por motivos academicos, sino tambien por razones coyunturales extraacademicas.

Sarcomatoid carcinoma of the pyriform sinus with brain and subcutaneous metastases: an unusual metastatic spread pattern

Abstract A 63-year-old man presented a polypoid tumor in the laryngeal space involving the right pyriform fossa. The patient underwent a total laryngectomy with bilateral functional neck dissection, and the diagnosis of sarcomatoid carcinoma with malignant fibrous histiocytoma-like stroma was established. The tumor showed an uncommon behavior, with distant metastases to the brain and to the subcutaneous tissue of the abdominal wall. The patient died 1 year after the development of the metastases. Despite its polypoid pattern of growth, sarcomatoid carcinoma of the larynx may behave very aggressively. It is important for clinicians to be aware of the possibility of distant subcutaneous and brain metastases in sarcomatoid tumors of the laryngeal space. If such metastases develop, the prognosis is ominous, with an average life expectancy of 3 months.