Epithelial-to-mesenchymal transition and neoangiogenesis in laryngeal squamous cell carcinoma

Biological and clinical data have indicated that epithelial-mesenchymal transition (EMT) and angiogenesis contribute to tumour growth, invasion, and metastasis. EMT is the phenomenon in which epithelial cells transform into mesenchymal cells which is mainly characterised by the loss of intercellular adhesion, and an increase in cellular migration and mobility. This study aimed to evaluate the clinicopathologic significance of the combined immunohistochemical expression E-cadherin and CD105 in 85 (43 glottic and 42 supraglottic) previously untreated patients with laryngeal squamous cell carcinoma and to assess the correlation of their expression. A staining score of E-cadherin was given based on the percentage (0–100%) of cells stained. The rounded mean value of the positive-stained microvessels for CD105 counted in four hot spots was used as the final intratumoral microvessel density (MVD). MVD was significantly higher in patients with advanced T3– T4 category (p=0.020) and TNM stage (p=0.001). Nodal metastases were more frequent in the cases with low E-cadherin expression (p=0.012). A high MVD was an independent predictor of tumour recurrence (p=0.015). The log-rank test showed a significant difference in the disease-free interval in patients stratified according to MVD (p=0.034). Expression of CD105 could help predict patients with an increased risk of developing locoregional recurrence after treatment. Reduction of E-cadherin is a potential predictor of lymph node metastases

Relationship of E-cadherin with Cervical Lymph Node Metastasis in Laryngeal Cancer

E-cadherin, a 120 kDa transmembrane protein, plays an important role in malignant progression and tumour differentiation. The loss or reduction in E-cadherin expression has been found in several tumours including laryngeal squamous cell carcinoma. The present study aimed to investigate the prognostic implications of changes in expression of the E-cadherin in laryngeal carcinoma. E-cadherin expression was determined by immunohistochemistry in paraffin- embedded tissue specimens from 80 patients. A staining score was given based on the percentage of cells stained (0–100%). E-cadherin expression varied greatly among tissue samples from 2 to 72 (median 25). Using the median expression of E-cadherin as a cut- off, 41 (51.3%) tumours were classified in the »low E-cadherin« group and the rest, 39 (48.7%) tumours, consisted the »high E-cadherin« group. We found significant differences in the staining scores of E-cadherin between those tumours with and without nodal metastases (p=0.025) and advanced clinical stage (TNM stage III and IV) (p=0.014). The results of a stepwise logistic regression analysis showed that E-cadherin staining score and the location of primary tumour were independent predictors of nodal metastases. The immunohistochemical determination of E-cadherin expression may be useful instrument to characterise the metastatic potential of carcinomas. Larger studies are needed to confirm the role of E-cadherin expression in predicting the behavior of laryngeal squamous cell carcinomas

Expression of CD105 but not of E-cadherin is associated with malignancy recurrence and disease-free interval in laryngeal cancer in men

Introduction. In this study we analyzed CD105 (endoglin) and E-cadherin expression in laryngeal squamous cell carcinoma (LSCC) to evaluate their clinicopathologic significance. Material and methods. Expression of CD105 and E-cadherin was examined immunohistochemically using paraffin-embedded archival tissues of 72 (35 glottic and 37 supraglottic) previously untreated LSCC male patients. The mean value of the positively-stained microvessels for CD105 counted in four hot spots for each case was used as the final intratumoralmicrovessel density (MVD). A staining score of E-cadherin was calculated based on the percentage of cells stained (0–100%). Results. MVD was significantly higher in patients with advanced TNM stage (P = 0.004) and younger than 65 (P = 0.008). Nodal metastases were more frequent in the cases with low E-cadherin expression (P = 0.000). Tumor recurrence was associated with advanced TNM stage (P = 0.035) and high MVD (P = 0.002). A high MVD was an independent predictor of malignancy recurrence (P = 0.021). The log-rank test showed a significant difference in the disease-free interval in patients stratified according to the MVD value (P = 0.016). Spearman’s rank correlation test did not show a significant correlation between E-cadherin and CD105 expression. Conclusions. CD105-assessed MVD and expression of E-cadherin are promising prognostic factors for the outcome of patients with LSCC. Increased expression of CD105 could help predict patients with an increased risk of developing loco-regional recurrence after surgical treatment. Decreased E-cadherin expression is a potential predictor of lymph node metastases

Valjanost, interna konzistentnost i test-retest pouzdanost prilagođenoga crnogorskoga prijevoda Indeksa vokalnih teškoća 10 (Voice Handicap Index 10)

The purpose of the this cross-sectional study was to assess clinical validity, internal consistency, and test-retest reliability of the adapted Montenegrin translation of the Voice Handicap Index 10 (VHI-10). It included 50 patients with voice disorders, divided into three subgroups according disease aetiology: structural, neurological, and functional and a control group of 50 vocally healthy participants. Mean patient VHI-10 score of 21.1±7.6 was significantly higher than the 2.3±2.5 score of controls (p<0.001). Each of the three patient subgroups also scored significantly higher than control (p<0.001). Spearman’s rank correlation coefficient of 0.90 (p<0.001) indicated a very strong correlation between the Montenegrin VHI-10 score and self-reported perception of the severity of voice disorder. Excellent internal consistency was found in the patient group, with a Cronbach’s alpha of 0.94. Test-retest reliability was also excellent, with intra class correlation coefficient of 0.98. The translated Montenegrin version of VHI-10 is a valid, reliable, and clinically useful tool for selfassessment of the severity of voice disorders in individuals with voice problems in daily practice and in research projects.Cilj istraživanja bio je procijeniti kliničku valjanost, internu konzistentnost i test-retest pouzdanost prilagođenoga crnogorskoga prijevoda Indeksa vokalnih teškoća 10 (VHI-10). U istraživanju je sudjelovalo 50 bolesnika s glasovnim poremećajima, koji su bili podijeljeni u tri podskupine prema etiologiji bolesti: strukturnu, neurološku i funkcionalnu. Kontrolnu skupinu činilo je 50 glasovno zdravih ispitanika. Prosječna ukupna ocjena VHI-10 u bolesnika iznosila je 21,1±7,6 i bila značajno veća od ukupne ocjene u kontrolnoj skupini od 2,3±2,5 (p<0,001). Svaka od triju podskupina bolesnika također je imala značajno veću ukupnu ocjenu VHI-10 od kontrolne skupine (p<0,001). Spearmanov koeficijent korelacije od 0,90 (p<0,001) pokazuje veoma jaku korelaciju između ukupne ocjene crnogorskoga VHI-10 i vlastite procjene težine glasovnoga poremećaja. U skupini bolesnika utvrđen je Cronbachov alfa koeficijent od 0,94, što upućuje na odličnu unutrašnju konzistentnost. Test-retest pouzdanost također je bila odlična, s koeficijentom korelacije od 0,98. Prilagođen crnogorski prijevod VHI-10 valjan je, pouzdan i klinički koristan upitnik za samoprocjenu težine glasovnoga poremećaja u osoba s glasovnim problemima u svakodnevnoj praksi i istraživačkim projektima

Zastupljenost pušenja i pušačke navike učenika dobi 13 do 15 godina u Crnoj Gori: rezultati globalnog istraživanja o potrošnji duhana kod mladih (GYTS) 2008.

The Global Youth Tobacco Survey (GYTS) is an international study that provides data on youth tobacco use for development of tobacco control programs. It is a school-based survey that uses a standardised methodology for sampling, core questionnaire items, training protocol, fi eld procedures, and data management. This article reports the fi ndings from a GYTS conducted in Montenegro in 2008, which included 5723 adolescents. More than 30 % of students aged 13 to 15 tried smoking, 5.1 % smoked cigarettes, and 3.6 % of students used tobacco products other than cigarettes. Four in 10 ever smokers started to smoke before the age of 10. More than half the students reported secondary smoke exposure at home. Almost all (96.5 %) current smokers bought cigarettes in a store. Two in 10 students owned an artifact with a cigarette or tobacco brand logo on it. The GYTS study has shown that there is an urgent need to introduce effective child-oriented smoking prevention programmes in early elementary school classes. These should be accompanied by public awareness campaigns on smoke-free homes.Globalno istraživanje o potrošnji duhana kod mladih (GYTS) međunarodna je studija koja pruža podatke o pušačkim navikama mladih i omogućava razvijanje programa čiji je cilj kontrola duhana. U ovom radu dati su rezultati istraživanja GYTS koje je provedeno 2008. godine u Crnoj Gori. Istraživanje GYTS provodi se u školama pri čemu je standardizirana metodologija za formiranje uzorka, upitnik, prikupljanje i obrada podataka. Ukupno su 5723 učenika sudjelovala u istraživanju. Više od 30 % učenika dobi 13 do 15 godina eksperimentiralo je cigaretama. U ovoj populaciji ima 5.1 % stalnih pušača cigareta, dok 3.6 % učenika koristi neke druge duhanske proizvode. Četiri od 10 pušača počela su pušiti prije desete godine života. Više od pola ispitanika odgovorilo je da su izloženi duhanskom dimu u svojoj kući. Gotovo svi pušači (96.5 %) najčešće kupuju cigarete u prodavaonicama. Dva od 10 ispitanika imaju neki predmet s logom proizvođača cigareta. Rezultati istraživanja pokazuju da je potrebno hitno pokrenuti preventivne programe kontrole duhana u nižim razredima osnovne škole. Također, potrebno je osmisliti i implementirati kampanje čiji je cilj podizanje svijesti građana o štetnosti pušenja u zatvorenom prostoru

Small Cell Neuroendocrine Tumor of the Larynx – A Small Case Series

Neuroendocrine tumors are the most common nonsquamous types of laryngeal neoplasms. They are classified as typical carcinoids, atypical carcinoids, small-cell neuroendocrine carcinomas, and paragangliomas. The aim of the paper is to present four patients with small-cell neuroendocrine tumor arising in larynx. There were one woman and three men whose ages were 47–77 years; all of them had metastases when first seen. The clinical presentation and management of such type of tumor are discussed. Small-cell neuroendocrine carcinomas are very aggressive neoplasms. Patients could benefit from surgery, but radiotherapy and chemotherapy remain the treatment of choice. Examination of a large series is required to define the most useful diagnostic methods and the most successful treatment modalities

Cardiovascular risk assessed by reynolds risk score in relation to waist circumference in apparently healthy middle-aged population in Montenegro

Reynolds Risk Score (RRS) is regarded as a good screening tool for cardiovascular disease (CVD) risk. Since CVD is the leading cause of death in Montenegro, we aimed to assess the risk of CVD as assessed by RRS and to examine its association with cardiometabolic parameters in apparently healthy middle-aged population. In addition, we aimed to test whether obesity had an independent influence on RRS. A total of 132 participants (mean age 56.2 +/- 6.73 years, 69% females) were included. Body mass index (BMI), waist circumference (WC), blood pressure (BP) and biochemical parameters (fasting glucose, insulin, lipid parameters, creatinine and high sensitivity C-reactive protein) were determined. Insulin resistance (HOMA-IR) and glomerular filtration rate (eGFR) were calculated. Compared with females, a significantly higher number of males were in the high RRS subgroup (chi(2) =45.9, p lt 0.001). Furthermore, significantly higher fasting glucose (p=0.030), insulin, HOMA-IR, triglycerides (p lt 0.001 all), anthropometric parameters (e.g., BMI and WC; p=0.004 and p lt 0.001, respectively), and creatinine, but lower eGFR and HDL-c (p lt 0.001 both) were recorded in the high-risk subgroup compared with low and medium risk subgroups. In all participants, in addition to LDL-c, diastolic BP and creatinine, WC was independently positively associated with RRS (beta=0.194, p=0.006; lt b> beta=0186, p=0.001; beta=0167, p=0.001; and beta=0.305, p=0.019, respectively), and 40% of variation in RRS could be explained with this model. In conclusion, middle-aged population with higher WC should be screened for RRS in order to estimate CVD risk

Relationship between Oxidative Stress, Inflammation and Dyslipidemia with Fatty Liver Index in Patients with Type 2 Diabetes Mellitus

Introduction/Aim Considering the high prevalence of nonalcoholic fatty liver disease (NAFLD) in individuals with type 2 diabetes mellitus (DM2), we aimed to investigate the potential benefit of determining markers of oxidative stress, inflammation and dyslipidemia for prediction of NAFLD, as estimated with fatty liver index (FLI) in individuals with DM2. Methods A total of 139 individuals with DM2 (of them 49.9 % females) were enrolled in cross-sectional study. Anthropometric and biochemical parameters, as well as blood pressure were obtained. A FLI was calculated. Results Multivariate logistic regression analysis showed that high density lipoprotein cholesterol (HDL-c) and malondialdehyde (MDA) were independent predictors of higher FLI [Odds ratio (OR) = 0.056, p = 0.029; and OR = 1.105, p = 0.016, respectively]. In Receiver Operating Characteristic curve analysis, the addition of fatty liver risk factors (e.g., age, gender, body height, smoking status, diabetes duration and drugs metabolized in liver) to each analysed biochemical parameter [HDL-c, non-HDL-c, high sensitivity C-reactive protein (hsCRP), MDA and advanced oxidant protein products (AOPP)] in Model 1, increased the ability to discriminate patients with and without fatty liver [Area under the curve (AUC) = 0.832, AUC = 0.808, AUC = 0.798, AUC = 0.824 and AUC = 0.743, respectively]. Model 2 (which included all five examined predictors, e.g., HDL-c, non-HDL-c, hsCRP, MDA, AOPP, and fatty liver risk factors) improved discriminative abilities for fatty liver status (AUC = 0.909). Even more, Model 2 had the highest sensitivity and specificity (89.3 % and 87.5 %, respectively) together than each predictor in Model 1. Conclusion Multimarker approach, including biomarkers of oxidative stress, dyslipidemia and inflammation, could be of benefit in identifying patients with diabetes being at high risk of fatty liver disease

Problem pušenja među mladima u Crnoj Gori - rezultati GYTS (Global Youth Tobacco Survey) istraživanja

Smoking is a burning healthcare and economy issue, especially in underdeveloped countries. The aim of this study was to determine the number of smokers among elementary school students in Montenegro and to assess the correlates of tobacco use. The study was done in 2003 using the World Health Organization Global Youth Tobacco Survey. Our data showed that children as young as ten years smoked. There were 3.6 % permanent smokers and one in three students (30.6 %) experimented with smoking. More than two thirds who smoked agreed that they should quit smoking, and three fourths tried to quit. This study has also shown that children talk too little about smoking in schools and are exposed to passive smoking at home and elsewhere. Activities to solve the elementary school smoking problem should include preventive programs to be introduced into regular school curricula because this is the only way to address the issue properly. In addition, legislation prohibiting indoor tobacco smoking should be implemented rigorously to protect children from passive smoking in public places.Pušenje duhana velik je zdravstveni i ekonomski problem, posebno u zemljama u razvoju. Istraživanje je provedeno radi utvrđivanja broja pušača u populaciji učenika osnovnih škola, kao i utvrđivanja stavova, znanja i ponašanja učenika u vezi s pušenjem. Istraživanje o potrošnji duhana kod djece u osnovnim školama u Crnoj Gori provedeno je 2003. godine po jedinstvenoj metodologiji Svjetske zdravstvene organizacije - Global Youth Tobacco Survey (GYTS). Podaci dobiveni istraživanjem pokazali su da u osnovnim školama Crne Gore postoji evidentan problem pušenja, i to već kod djece prije navršene desete godine života. U osnovnim školama postoji 3,6 % stalnih pušača, dok je jedan od troje (30,6 %) učenika eksperimentirao s cigaretama. Više od dvije trećine djece koja puše suglasno je da treba prestati s pušenjem, a tri četvrtine njih su pokušavale prestati s pušenjem. Osim toga, istraživanje je pokazalo da djeca malo govore u školama o problemu pušenja, da su osnovci konstantno izloženi utjecaju pasivnog pušenja u vlastitim kućama, kao i izvan kuće. Problem pušenja u osnovnim školama postoji i treba definirati aktivnosti za njegovo rješavanje. Prije svega, treba omogućiti uključivanje preventivnih programa u redovite obrazovne programe u školama, da bi se o problemu pušenja govorilo na adekvatan način. Također, mora se inicirati striktno provođenje “Zakona o ograničenju upotrebe duhanskih proizvoda” da bi djecu zaštitili od pasivnog pušenja