Background: Laryngeal squamous cell carcinoma (LSCC) is one of the most common tumors of the respiratory tract. Currently, the diagnosis of LSCC is mainly based on a laryngoscopy analysis and pathological findings. Deep-learning algorithms have been shown to provide accurate clinical diagnoses. Methods: We developed a deep convolutional neural network (CNN) model, and evaluated its application to narrow-band imaging (NBI) endoscopy and pathological diagnoses of LSCC at several hospitals. A total of 4,591 patients’ laryngeal NBI scans (1,927 benign and 2,664 LSCC) were used to test and validate the model. Additionally, 3,458 pathological images (752 benign and 2,706 LSCC) of 1,228 patients’ hematoxylin and eosin staining slides (318 benign and 910 LSCC) were used for the pathological diagnosis training and validation. The images were randomly divided into training, validation and testing images at the ratio of 70:15:15. An independent test cohort of LSCC NBI scans and pathological images from other institutions were also used. Results: In the NBI group, the areas under the curve of the validation, test, and independent test data sets were 0.966, 0.964, and 0.873, respectively, and those of the pathology group were 0.994, 0.981, and 0.982, respectively. Our method was highly accurate at diagnosing LSCC. Conclusions: In this study, the CNN model performed well in the NBI and pathological diagnosis of LSCC. More accurate and faster diagnoses could be achieved with the assistance of this algorithm.

Background: Hypoparathyroidism is an important factor that seriously affects the quality of life of patients after thyroidectomy. This study aimed to optimize the surgical procedure for parathyroid identification using near-infrared autofluorescence (NIRAF) during thyroidectomy.Methods: This was a prospective controlled study that included 100 patients with primary papillary thyroid carcinoma diagnosed in Beijing Tongren Hospital between June 2021 and April 2022 who were awaiting total thyroidectomy and bilateral neck dissection. The patients were randomly divided into an experimental group in whom step-by-step NIRAF imaging was used to identify parathyroid glands, and a control group in whom NIRAF was not used.Results: The number of parathyroid glands identified in the NIRAF group was higher than that in the control group (195 vs. 161, p=0.000, Z=-5.186). The proportion of patients with parathyroid glands inadvertently removed in the NIRAF group was lower than that in the control group (2.0% vs. 18.0%, respectively; p=0.008, χ^{2 =} 7.111). In the NIRAF group, we found that more than 95% of the superior parathyroid glands and more than 85% of the inferior parathyroid glands were identified before the dangerous phase, which was much higher than that in the control group. The incidences of temporary hypoparathyroidism, hypocalcemia, and symptomatic hypocalcemia were higher in the control group than those in the NIRAF group. On the first postoperative day, the average parathyroid hormone (PTH) level in the NIRAF group decreased to 38.1% of the preoperative level and that in the control group decreased to 20.0% of the preoperative level (p=0.000, Z=-3.547). On the third postoperative day, the PTH level in 74% of the patients in the NIRAF group recovered to normal levels, whereas it recovered in only 38% of the patients in the control group (p=0.000, χ^{2 =} 13.149). The PTH levels in all patients in the NIRAF group had recovered within 30 days after surgery, whereas one patient in the control group failed to return to the normal level 6 months after surgery and was diagnosed with permanent parathyroidism.Conclusions: The step-by-step NIRAF parathyroid identification method can effectively locate the parathyroid gland and protect its function.

Approximately two-thirds of hypopharyngeal squamous cell carcinoma (HPSCC) cases are diagnosed at advanced stages, with the worst prognosis among head and neck squamous cell carcinomas (HNSCCs). Identifying biomarkers for high-risk patients requiring aggressive treatment is crucial. We present mutational, transcriptomic, and proteomic studies of 103 Chinese HPSCC patients and observe a higher prevalence and poorer prognosis in males. Estrogen response pathways are up-regulated, and proteins phosphorylated by protein kinase C (PKC) and cyclin-dependent kinases (CDKs) are aberrantly regulated in HPSCC. We identify aberrant copy number regions including SOX2(3q26.33), FGFR(8p11.23), CCND1(11q13.3), CDKN2A/2B(9p21.3), and MYC(8q24.21). Human papillomavirus (HPV) status combined with highly mutated genes, such as SYNE1 in HPV(−) and MUC4 in HPV(+) patients, were assessed as prognosis markers. A predictive model involving clinical factors and expression of six genes was established and cross-site validated. These findings open new opportunities for stratifying high-risk patients and molecular targets for personalized therapeutic strategies.

Purpose: the purpose of this study was to screen peripheral blood parameters and construct models predicting the prognosis and induction chemotherapy (IC) response in locally advanced laryngeal squamous cell carcinoma (LSCC) patients. Methods: A total of 128 stage III/IVa LSCC patients (who required a total laryngectomy) were enrolled in a retrospective study from January 2013 to September 2020 at Beijing Tongren Hospital of Capital Medical University. Among them, 62 patients received IC (IC group), and 66 patients immediately underwent a total laryngectomy (TL) after diagnosis (surgery group). Demographic information and peripheral blood parameters were collected for further analysis. The overall survival (OS), progression-free survival (PFS), and disease-specific survival (DSS) were compared between the two groups. The prognosis and survival were also compared between patients with laryngeal function preservation (LFP) and those with TL. Results: The Receiver Operating Characteristic (ROC) curve for IC response in the IC group showed that the AUC of the blood model based on the four peripheral blood parameters of fibrinogen (FIB), platelet (PLT), high-density lipoprotein cholesterol (HDL), and albumin (ALB) was significantly higher than the TNM stage model’s AUC (0.7932 vs. 0.6568). We constructed a nomogram blood model to predict IC response (C-Index = 0.793). Regarding the OS of all patients, an ROC analysis for overall survival, the Kaplan–Meier (K-M) method with a log-rank test, and multivariate analysis indicated age, clinical stage, FIB, and hemoglobin (HGB) were independent prognostic factors for the OS of LSCC patients. The blood–clinical logistic model (AUC = 0.7979) was constructed based on the four prognosis factors, which were superior to the blood (AUC = 0.6867) or clinical models (AUC = 0.7145) alone to predict OS. We constructed a nomogram model based on age, clinical stage, FIB, and HGB to predict OS for LSCC patients (C-Index = 0.792). Besides this, there were no significant differences in OS, PFS, and DSS between IC and surgery groups or LFP and TL groups. Conclusion: Peripheral blood parameters help predict IC response and overall survival. Furthermore, induction chemotherapy significantly improves laryngeal function preservation without lowering the survival prognosis.

The present study aimed to investigate the microRNA (miRNA) profile in human medullary thyroid carcinoma (MTC) tissue. The GSE40807 data profile was downloaded from the Gene Expression Omnibus database. Following preprocessing, differentially expressed microRNAs (DEMs) between MTC and healthy tissues were identified. Based on the obtained DEMs, transcription factor (TF)‑miRNA and miRNA‑target gene regulatory association pairs were predicted. Finally, functional enrichment analysis was performed on target genes of DEMs. Fifteen upregulated and 17 downregulated DEMs were identified. In the constructed TF‑miRNA regulatory network, hsa‑miR‑9‑5p was regulated by 9 TFs and hsa‑miR‑1 was regulated by 8 TFs. TFs of nuclear factor of κ light polypeptide gene enhancer in B‑cells 1 (NF‑κB1) and v‑myc avian myelocytomatosis viral oncogene homolog (MYC) regulated 4 and 3 DEMs, respectively. In the miRNA‑target gene regulatory network, hsa‑miR‑1, hsa‑miR‑9‑5p, hsa‑miR‑96‑5p and hsa‑miR‑590‑5p were most upregulated. The target genes of these 4 miRNAs were primarily enriched in the mitogen activated protein kinase (MAPK) signaling pathway. Therefore, MAPK signaling pathway may serve important roles in MTC progression. In conclusion, the DEMs hsa‑miR‑1 and hsa‑miR‑9‑5p, and TFs of NF‑κB1 and MYC may be used as biomarkers for the diagnosis and treatment of MTC.

Background: We performed a paired analysis to compare the therapeutic effect between the induction chemotherapy‐based organ‐preservation approach and immediate total laryngectomy in hypopharyngeal squamous cell carcinoma patients requiring total laryngectomy.Methods: 351 patients who were treated with organ‐preservation approach were compared with 110 patients who were treated with total laryngectomy. The main measures and outcomes were progression‐free survival (PFS), overall survival (OS), and larynx function preservation survival (LFPS).Results: No statistical difference was observed for 3‐, 5‐, and 10‐year PFS and OS in two groups. In the organ‐preservation group, the 3‐, 5‐, and 10‐year LFPS was 30.7%, 23.3%, and 16.6%, respectively. The LFPS of Stage III > Stage IV, N0 > N1 > N2 > N3, T2 > T3 > T4, CR > PR > SD > PD patients (all p values <0.05).Conclusions: Survival outcomes did not significantly differ between the two groups. The organ‐preservation approach allowed more than 70% of the survivors to retain their larynx function.