WorldWideScience

Sample records for accompanying esophageal cancer

  1. Esophageal Cancer

    Science.gov (United States)

    ... from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may ... You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid ...

  2. Esophageal cancer.

    Science.gov (United States)

    Vakil, Nimish; Affi, Aboud

    2002-07-01

    Despite advances in our knowledge of esophageal cancer, 50% of patients present with incurable disease, and the overall survival after diagnosis is poor. The incidence of esophageal adenocarcinoma of the distal esophagus is rising at a rapid rate in developed countries. Recent advances in the epidemiology of esophageal cancer offer insights into preventive strategies in patients who are at risk. New developments in diagnosis may help detect the disease at an early stage. New diagnostic modalities permit more accurate staging procedures and allow appropriate selection of therapy. New studies provide more information on multimodality therapy for esophageal cancer, and new endoscopic techniques allow resection of small lesions without surgery. New stent designs provide better palliation by providing tumor ingrowth. These developments in the treatment of esophageal cancer are the focus of this review.

  3. Esophageal Cancer Prevention

    Science.gov (United States)

    ... the lower part of the esophagus, near the stomach. See the following PDQ summaries for more information about esophageal cancer: Esophageal Cancer Screening Esophageal Cancer Treatment Esophageal cancer is found more ...

  4. Esophageal cancer

    DEFF Research Database (Denmark)

    Mortensen, M. B.

    2007-01-01

    The distribution of adenocarcinomas and squamous cell carcinomas in esophageal cancer (EC) has changed, and focus directed towards tumors of the distal esophagus and the esophagogastric junction. The genetic events leading to EC are not fully clarified, but important risk factors have been...

  5. Esophageal Cancer

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  6. Radiation Therapy, Paclitaxel, and Carboplatin With or Without Trastuzumab in Treating Patients With Esophageal Cancer

    Science.gov (United States)

    2016-10-14

    Adenocarcinoma of the Gastroesophageal Junction; Esophageal Adenocarcinoma; Stage IB Esophageal Cancer; Stage IIA Esophageal Cancer; Stage IIB Esophageal Cancer; Stage IIIA Esophageal Cancer; Stage IIIB Esophageal Cancer

  7. Treatment Options by Stage (Esophageal Cancer)

    Science.gov (United States)

    ... Cancer Prevention Esophageal Cancer Screening Research Esophageal Cancer Treatment (PDQ®)–Patient Version General Information About Esophageal Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  8. Drugs Approved for Esophageal Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for esophageal cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  9. Dietary habits and esophageal cancer.

    Science.gov (United States)

    Palladino-Davis, A G; Mendez, B M; Fisichella, P M; Davis, C S

    2015-01-01

    Cancer of the esophagus is an underestimated, poorly understood, and changing disease. Its overall 5-year survival is less than 20%, even in the United States, which is largely a function of a delay in diagnosis until its more advanced stages. Additionally, the epidemiologic complexities of esophageal cancer are vast, rendering screening and prevention limited at best. First, the prevalence of esophageal cancer is unevenly distributed throughout the world. Second, the two histological forms (squamous cell and adenocarcinoma) vary in terms of their geographic prevalence and associated risk factors. Third, some populations appear at particular risk for esophageal cancer. And fourth, the incidence of esophageal cancer is in continuous flux among groups. Despite the varied prevalence and risks among populations, some factors have emerged as consistent associations while others are only now becoming more fully recognized. The most prominent, scientifically supported, and long-regarded risk factors for esophageal cancer are tobacco, alcohol, and reflux esophagitis. Inasmuch as the above are regarded as important risk factors for esophageal cancer, they are not the sole contributors. Dietary habits, nutrition, local customs, and the environment may be contributory. Along these lines, vitamins, minerals, fruits, vegetables, meats, fats, salted foods, nitrogen compounds, carcinogens, mycotoxins, and even the temperature of what we consume are increasingly regarded as potential etiologies for this deadly although potentially preventable disease. The goal of this review is to shed light on the less known role of nutrition and dietary habits in esophageal cancer.

  10. Esophageal Cancer Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing esophageal cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  11. Laboratory animal models for esophageal cancer

    Directory of Open Access Journals (Sweden)

    Dhanya Venugopalan Nair

    2016-11-01

    Full Text Available The incidence of esophageal cancer is rapidly increasing especially in developing countries. The major risk factors include unhealthy lifestyle practices such as alcohol consumption, smoking, and chewing tobacco to name a few. Diagnosis at an advanced stage and poor prognosis make esophageal cancer one of the most lethal diseases. These factors have urged further research in understanding the pathophysiology of the disease. Animal models not only aid in understanding the molecular pathogenesis of esophageal cancer but also help in developing therapeutic interventions for the disease. This review throws light on the various recent laboratory animal models for esophageal cancer.

  12. Comparative genomic analysis of esophageal cancers.

    Science.gov (United States)

    Caygill, Christine P J; Gatenby, Piers A C; Herceg, Zdenko; Lima, Sheila C S; Pinto, Luis F R; Watson, Anthony; Wu, Ming-Shiang

    2014-09-01

    The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on comparative genomic analysis of esophageal cancers: genomic polymorphisms, the genetic and epigenetic drivers in esophageal cancers, and the collection of data in the UK Barrett's Oesophagus Registry.

  13. Molecular Biology of Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    HuanXi; JanBrabender; RalfMetzger; PaulM.Schneider

    2004-01-01

    There have been many new developments in our understanding of esophageal carcinoma biology over the past several years. Information regarding both of the major forms of this disease, adenocarcinoma and squamous cell carcinoma, has accumulated in conjunction with data on precursor conditions such as Barrett's esophagus. Interesting and promising findings have included overexpression of proto-oncogenes,loss of heterozygosity at multiple chromosomal loci, tumor suppressor gene inactivation, epigenetic silencing by DNA methylation, and mutations and deletions involving the tumor suppressor gene p53. Important cancer pathways, the cyclin kinase inhibitor cascade and the DNA mismatch repair process, implicated in the genesis of multiple tumor types have also been inculpated in esophageal carcinogenesis. Alterations in the p16 and p15 cyclin kinase inhibitors including point mutations and homozygous deletions have been reported in primary esophageal tumors. Further developments in the field of molecular carcinogenesis of esophageal malignancies promise to yield improvements in prevention, early detection, prognostic categorization, and perhaps gene-based therapy of this deadly disease.

  14. A Case of Eosinophilic Esophagitis Accompanying Familial Mediterranean Fever

    Science.gov (United States)

    Rohani, Pejman; Najafi Sani, Mehri; Ahmadi, Mitra

    2017-01-01

    Background. Eosinophilic esophagitis is an inflammatory condition where there is a dense infiltration of eosinophils typically exceeding fifteen cells per high power field. Familial Mediterranean fever is an autosomal recessive disorder characterized by brief, acute, and self-limited episodes of fever and polyserositis that recur at irregular intervals. Case Presentation. A three-year-and-nine-month-old Iranian girl was admitted to our center. The patient's parents complained of a history of abdominal pain, poor appetite, and poor weight gain from 1.5 years ago and episodes of food impaction after starting solid foods. Eosinophilic esophagitis was diagnosed based on histology. Because of continuing abdominal pain after treatment of eosinophilic esophagitis, the episodic nature of disease, and the presence of fever with pain, screening for familial Mediterranean fever mutation was performed and the patient was found to be heterozygote for Mediterranean fever. Conclusion. We have reported a case of eosinophilic esophagitis coexisting with familial Mediterranean fever which has not been described previously. PMID:28255474

  15. Radiation-induced esophagitis in lung cancer

    Directory of Open Access Journals (Sweden)

    Baker S

    2016-10-01

    Full Text Available Sarah Baker, Alysa Fairchild Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada Abstract: Radiation-induced esophagitis is the most common local acute toxicity of radiotherapy (RT delivered for the curative or palliative intent treatment of lung cancer. Although concurrent chemotherapy and higher RT dose are associated with increased esophagitis risk, advancements in RT techniques as well as adherence to esophageal dosimetric constraints may reduce the incidence and severity. Mild acute esophagitis symptoms are generally self-limited, and supportive management options include analgesics, acid suppression, diet modification, treatment for candidiasis, and maintenance of adequate nutrition. Esophageal stricture is the most common late sequela from esophageal irradiation and can be addressed with endoscopic dilatation. Approaches to prevent or mitigate these toxicities are also discussed. Keywords: non–small cell lung cancer, acute, late, toxicity, stricture

  16. Palliative Endoscopic Therapy of Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    H.Schaefer; A.H.Hoelscher

    2004-01-01

    Patients with locally unresectable esophageal cancer or distant metastasis are usually treated with definite radiotherapy or radiochemotherapy. Dysphagia of these patients should further be treated by endoscopic therapy in order to maintain swallowing and oral food intake as long as possible. The same situation is present in patients with local recurrence of esophageal cancer after surgery or radiochemotherapy.

  17. Stages of Esophageal Cancer

    Science.gov (United States)

    ... stage 0 , abnormal cells are found in the mucosa or submucosa layer of the esophagus wall. These ... found. Stage IA : Cancer has formed in the mucosa or submucosa layer of the esophagus wall. The ...

  18. The Changing Face of Esophageal Cancer

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    Melhado, Rachel E., E-mail: raye732001@yahoo.co.uk; Alderson, Derek; Tucker, Olga [Academic Department of Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham (United Kingdom)

    2010-06-28

    The two main histological esophageal cancer types, adenocarcinoma and squamous cell carcinoma, differ in incidence, geographic distribution, ethnic pattern and etiology. This article focuses on epidemiology with particular reference to geographic and temporal variations in incidence, along with a review of the evidence supporting environmental and genetic factors involved in esophageal carcinogenesis. Squamous cell carcinoma of the esophagus remains predominantly a disease of the developing world. In contrast, esophageal adenocarcinoma is mainly a disease of western developed societies, associated with obesity and gastro-esophageal reflux disease. There has been a dramatic increase in the incidence of adenocarcinoma in developed countries in parallel with migration of both esophageal and gastric adenocarcinomas towards the gastro-esophageal junction.

  19. Updates on esophageal and gastric cancers

    Institute of Scientific and Technical Information of China (English)

    Amy Gallo; Charles Cha

    2006-01-01

    Esophageal and gastric cancers are both common and deadly. Patients present most often after disease progression and survival is therefore poor. Due to demographic variability and recent changes in disease incidence, much emphasis has been placed on studying risk factors for both esophageal and gastric cancers.However, with increasing understanding of these diseases, low survival rates persist and continued intensive studies are necessary to optimize treatment plans. This review article discusses updates in the evolving epidemiology, clinical presentation, risk factors,and diagnostic and treatment modalities of esophageal and gastric cancers.

  20. PET for Staging of Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    A.H.Hoelscher

    2004-01-01

    FDG-PET is of clinical value especially for detection of distant metastases or recurrent esophageal cancer. For the staging of primary tumor or locoregional lymph node metastasis PET is currently not suitable.

  1. [Current status and perspectives of radiotherapy for esophageal cancer].

    Science.gov (United States)

    Wu, S X; Wang, L H

    2016-09-23

    Esophageal cancer is one of the most common cancers in China. More than 80% of esophageal cancer patients are diagnosed at a late stage and are not eligible for surgery. Radiotherapy is one of the most important modalities in esophageal cancer treatment. Here we reviewed the advances in esophageal cancer radiotherapy and radiotherapy-based combined-modality therapy, such as optimization of radiation dose and target volume, application of precise radiotherapy technique and the integration of radiotherapy with chemotherapy and targeted therapy.

  2. Neoadjuvant Treatment for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    PaulM.Schneider; HuanXi; StephanE.Baldus; JanBrabender; RalfMetzger

    2004-01-01

    Because the conflicting data currently available from the performed randomized trials it is very difficult to provide strict guidelines for the treatment of patients with locoregional advanced esophageal cancers. Surgery however, remains the standard of care for potentially resectable disease. Preoperative chemotherapy is still controversial with two large randomized trials resulting in two different conclusions regarding the survival benefit. Preoperative chemoradiation is also controversial since only one randomized trial showed a clear survival benefit however, the patients treated with surgery alone in this trial had an unusually poor outcome. And the study by Urba et al was not powered enough to show a clear survival benefit for patients treated with neoadjuvant chemoradiation. The results of three metaanalysis of these randomized studies show lower rate of resection, higher rate of R0-resection, more often postoperative mortality and better prognosis for patients with neoadjuvant radiochemotherapy. As a consequence one may consider offering neoadjuvant chemotherapy or neoadjuvant radiochemotherapy to patients with locallyadvanced disease under the premise that patients have a good performance status and understand the controversies about this therapeutic option. Larger trials with sufficient power to clearly detect survival benefits for patients treated with neoadjuvant chemotherapy or radiochemotherapy are necessary before this therapeutic option will be the standard of care.

  3. Multidisciplinary approach for patients with esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Victoria M Villaflor; Marco E Allaix; Bruce Minsky; Fernando A Herbella; Marco G Patti

    2012-01-01

    Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced.There are no screening recommendations for patients unless they have Barrett's esophagitis or a significant family history of this disease.Often,esophageal cancer is not diagnosed until patients present with dysphagia,odynophagia,anemia or weight loss.When symptoms occur,the stage is often stage Ⅲ or greater.Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection.The treatment of patients who have locally advanced esophageal cancer is more complex and controversial.Despite multiple trials,treatment recommendations are still unclear due to conflicting data.Sadly,much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically.Additionally,studies have been underpowered or stopped early due to poor accrual.In the United States,concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient.Patients who have metastatic disease are treated palliatively.The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer,and to review the literature which guides our treatment recommendations.

  4. Minimally invasive surgery for esophageal cancer.

    Science.gov (United States)

    Santillan, Alfredo A; Farma, Jeffrey M; Meredith, Kenneth L; Shah, Nilay R; Kelley, Scott T

    2008-10-01

    Esophageal cancer represents a major public health problem worldwide. Several minimally invasive esophagectomy (MIE) techniques have been described and represent a safe alternative for the surgical management of esophageal cancer in selected centers with high volume and expertise in them. This article reviews the most recent and largest series evaluating MIE techniques. Recent larger series have shown MIE to be equivalent in postoperative morbidity and mortality rates to conventional surgery. MIE has been associated with less blood loss, less postoperative pain, and decreased intensive care unit and hospital length of stay compared with conventional surgery. Despite limited data, conventional surgery and MIE have shown no significant difference in survival, stage for stage. The myriad of MIE techniques complicates the debate of defining the optimal surgical approach for treating esophageal cancer. Randomized controlled trials comparing MIE with conventional open esophagectomy are needed to clarify the ideal procedure with the lowest postoperative morbidity, best quality of life after surgery, and long-term survival.

  5. Avoiding complications in esophageal cancer surgery

    DEFF Research Database (Denmark)

    Mortensen, Michael Bau

    2013-01-01

    Modern handling of esophageal cancer patients is based on a multidisciplinary concept, but surgery remains the primary curative treatment modality. Improvements in the perioperative care have reduced the overall morbidity and mortality, but 2-7% of the patients may still die within 30 days...... as a direct consequence of complications related to the esophagectomy procedure. Primarily based on results from randomized studies published after 2000 this review describes some of the factors that may contribute to the development of postoperative complications following esophageal cancer surgery as well...

  6. Strategies to improve the outcome of esophagectomy for esophageal cancer

    NARCIS (Netherlands)

    Boone, J.

    2009-01-01

    Esophageal cancer is the 8th most common type of malignancy in the world. For the past decades the incidence of esophageal cancer has rapidly increased, particularly due to a rise in adenocarcinoma of the esophagus. Yet, worldwide the incidence of esophageal squamous cell carcinoma (ESCC) is highest

  7. Translational Research on Esophageal Cancer: From Cell Line to Clinic

    NARCIS (Netherlands)

    J.J. Boonstra (Jurjen)

    2011-01-01

    textabstractWorldwide esophageal cancer is a signifi cant and an increasing health problem. In 2005, there were 497,700 new cases, and the prevalence is expected to increase by approximately 140% by 2025. Esophageal squamous cell carcinoma (ESCC) accounts for most of the cases of esophageal cancer w

  8. Esophageal Cancer in Iran: A Review

    Directory of Open Access Journals (Sweden)

    Siavosh Nasseri-Moghaddam

    2010-01-01

    Full Text Available Esophageal cancer is the second and third most common malignancy in Iranian malesand females, respectively, claiming lives of approximately 5800 Iranians each year.Squamous cell carcinoma (SCC is presently the most common type accounting forabout 90% of all esophageal cancers in Iran. Recent studies have shown that there isa gradual increase in the incidence of adenocarcinoma of the distal esophagus alongwith gastric cardia adenocarcinoma. Thirty-five years ago, the age standardizied rate (ASR of esophageal SCC in thecity of Gonbad (Golestan Province, northeast of Iran was found to be one of the highestrates for any single cancer that had been reported worldwide (ASR >100/105/year.Recent studies have shown that the incidence of SCC in Gonbad has declined to lessthan half of what it was in the past. This decline in the incidence of esophageal SCCparallels an improvement in the socioeconomic situation of people living in thisregion. According to recent cancer registry data in Iran there is still an obviousintracountry variability between the incidence of esophageal cancer in the south withan ASR of 3 for males and 2 for females in Kerman and 43 and 36 in the northeasternprovince of Golestan. The reasons for this very high rate of SCC in northeastern Iranhave been the subject of several studies during the past 35 years. According to resultsof these studies the suspected risk factors are: low intake of fruits and vegetables, drinkinghot tea, consumption of opium products and tobacco, H.pyloriinfection in the stomach,using unhealthy drinking water from cisterns and genetic susceptibility. The mainsuspected mutagens are polycyclic aromatic hydrocarbons (PAH and N-nitrosocompounds. In order to embark primary and secondary prevention of this fatal cancer,further prospective studies are presently underway in the region. The Golestanesophageal cancer cohort study which follows of 50,000 subjects is on going. We expectsimple and feasible evidence based

  9. Values of Seven Tumor Markers in Identiifcation and Diagnosis of Esophageal Carcinoma Accompanied by Neuroendocrine Differentiation

    Institute of Scientific and Technical Information of China (English)

    LIU Lian-ke; SHAO Ming-wen; MA Lan; SUN Jing; GUAN Dan; SHU Yongqian

    2015-01-01

    Objective:To explore the values of seven tumor markers in the identiifcation and diagnosis of esophageal carcinoma accompanied by neuroendocrine differentiation (E-NED). Methods:A total of 378 patients diagnosed as low differentiation of esophageal carcinoma in The First Affiliated Hospital with Nanjing Medical University from Jan., 2008 to Dec., 2013 were selected, in which there were 349 with esophageal carcinoma with no neuroendocrine differentiation (E-NNED, E-NNED group) and 29 with E-NED (E-NED group). The levels of seven tumor markers including synaptophysin (Syn), Chromogranin A (CgA), neuron-specific enolase (NSE), neural cell adhesion molecule (CD56), protein gene product 9.5 (PGP9.5), secretagogue (SCGN) and thyroid transcription factor-1 (TTF-1) of both groups were detected with histoimmunochemical method and the influences of the single and combined detection of above indexes on E-NED patients were analyzed. Results:Except TTF-1, expressions of Syn, CgA, NSE, CD56, PGP9.5 and SCGN in E-NED group were evidently higher than those in E-NNED group and the differences were significant (P Conclusion:PGP9.5 and SCGN can be used as neuroendocrine markers for the pathological diagnosis of E-NED and Syn + CD56, Syn + PGP9.5 and Syn + SCGN can all be used as combined detection.

  10. Proteomic profiling of fetal esophageal epithelium, esophageal cancer, and tumor-adjacent esophageal epithelium and immunohistochemical characterization of a representative differential protein, PRX6

    Science.gov (United States)

    Guo, Jun-Hui; Xing, Guo-Lan; Fang, Xin-Hui; Wu, Hui-Fang; Zhang, Bo; Yu, Jin-Zhong; Fan, Zong-Min; Wang, Li-Dong

    2017-01-01

    AIM To understand the molecular mechanism of esophageal cancer development and provide molecular markers for screening high-risk populations and early diagnosis. METHODS Two-dimensional electrophoresis combined with mass spectrometry were adopted to screen differentially expressed proteins in nine cases of fetal esophageal epithelium, eight cases of esophageal cancer, and eight cases of tumor-adjacent normal esophageal epithelium collected from fetuses of different gestational age, or esophageal cancer patients from a high-risk area of esophageal cancer in China. Immunohistochemistry (avidin-biotin-horseradish peroxidase complex method) was used to detect the expression of peroxiredoxin (PRX)6 in 91 cases of esophageal cancer, tumor-adjacent normal esophageal tissue, basal cell hyperplasia, dysplasia, and carcinoma in situ, as well as 65 cases of esophageal epithelium from fetuses at a gestational age of 3-9 mo. RESULTS After peptide mass fingerprint analysis and search of protein databases, 21 differential proteins were identified; some of which represent a protein isoform. Varying degrees of expression of PRX6 protein, which was localized mainly in the cytoplasm, were detected in adult and fetal normal esophageal tissues, precancerous lesions, and esophageal cancer. With the progression of esophageal lesions, PRX6 protein expression showed a declining trend (P PRX6 protein expression showed a declining trend with age (P PRX6 protein expression was significantly higher in well-differentiated esophageal cancer tissues than in poorly differentiated esophageal cancer tissues (P PRX6 protein is associated with fetal esophageal development and cancer differentiation. PMID:28293090

  11. Epidemiologic differences in esophageal cancer between Asian and Western populations

    Institute of Scientific and Technical Information of China (English)

    Han-Ze Zhang; Guang-Fu Jin; Hong-Bing Shen

    2012-01-01

    Esophageal cancer is a common cancer worldwide and has a poor prognosis.The incidence of esophageal squamous cell cancer has been decreasing,whereas the incidence of esophageal adenocarcinoma has been increasing rapidly,particularly in Western men.Squamous cell cancer continues to be the major type of esophageal cancer in Asia,and the main risk factors include tobacco smoking,alcohol consumption,hot beverage drinking,and poor nutrition.In contrast,esophageal adenocarcinoma predominately affects the whites,and the risk factors include smoking,obesity,and gastroesophageal reflux disease.In addition,Asians and Caucasians may have different susceptibilities to esophageal cancer due to different heritage backgrounds.However,comparison studies between these two populations are limited and need to be addressed in the near future.Ethnic differences should he taken into account in preventive and clinical practices.

  12. Study Points to Genetic Subtypes of Esophageal Cancer

    Science.gov (United States)

    A Cancer Currents blog post about a study by The Cancer Genome Atlas Research Network that identified distinct genetic and molecular changes in esophageal cancers that could improve their classification and identify potential new treatments.

  13. Technological advances in radiotherapy for esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Milan; Vosmik; Jiri; Petera; Igor; Sirak; Miroslav; Hodek; Petr; Paluska; Jiri; Dolezal; Marcela; Kopacova

    2010-01-01

    Radiotherapy with concurrent chemotherapy and surgery represent the main treatment modalities in esophageal cancer.The goal of modern radiotherapy approaches,based on recent technological advances,is to minimize post-treatment complications by improving the gross tumor volume definition (positron emission tomography-based planning),reducing interfraction motion (image-guided radiotherapy) and intrafraction motion (respiratory-gated radiotherapy),and by better dose delivery to the precisely defined planning ...

  14. Multidisciplinary management for esophageal and gastric cancer

    Directory of Open Access Journals (Sweden)

    Boniface MM

    2016-04-01

    Full Text Available Megan M Boniface,1 Sachin B Wani,2 Tracey E Schefter,3 Phillip J Koo,4 Cheryl Meguid,1 Stephen Leong,5 Jeffrey B Kaplan,6 Lisa J Wingrove,7 Martin D McCarter1 1Section of Surgical Oncology, Division of GI, Tumor and Endocrine Surgery, Department of Surgery, 2Division of Gastroenterology and Hepatology, Department of Therapeutic and Interventional Endoscopy, 3Department of Radiation Oncology, 4Division of Radiology-Nuclear Medicine, Department of Radiology, 5Division of Medical Oncology, 6Department of Pathology, University of Colorado Denver, 7Department of Food and Nutrition Services, University of Colorado Hospital Cancer Center, Aurora, CO, USA Abstract: The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical, and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making. At the University of Colorado, the Esophageal and Gastric Multidisciplinary Clinic was created to bring together all experts involved in treating these diseases at a weekly conference in order to provide patients with coordinated, individualized, and patient-centered care. This review details the essential elements and benefits of building a multidisciplinary program focused on treating esophageal and gastric cancer patients. Keywords: tumor board, upper gastrointestinal malignancies, patient centered

  15. Medicolegal aspects of esophageal cancer surgery.

    Science.gov (United States)

    De Giorgio, Fabio

    2005-01-01

    Forensic implications of esophageal cancer surgery are varied and complex depending on the field of specialization involved i.e. civil law, criminal law, insurance or social security and for the distinct probative requirements related to each field. The aim of this article is to reconstruct the logical procedure of a forensic doctor who actually examines a practical case to establish the profiles of professional responsibility in particular in civil or criminal law.

  16. Attributable causes of esophageal cancer incidence and mortality in China.

    Directory of Open Access Journals (Sweden)

    Jian-Bing Wang

    Full Text Available BACKGROUND: To estimate the contribution of tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake to esophageal cancer mortality and incidence in China. METHODOLOGY/PRINCIPAL FINDINGS: We calculated the proportion of esophageal cancer attributable to four known modifiable risk factors [population attributable fraction (PAF]. Exposure data was taken from meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were also from meta-analyses and large-scale prospective studies. Esophageal cancer mortality and incidence came from the 3(rd national death cause survey and population-based cancer registries in China. We estimated that 87,065 esophageal cancer deaths (men 67,686; women: 19,379 and 108,206 cases (men: 83,968, women: 24,238 were attributable to tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake in China in 2005. About 17.9% of esophageal cancer deaths among men and 1.9% among women were attributable to tobacco smoking. About 15.2% of esophageal cancer deaths in men and 1.3% in women were caused by alcohol drinking. Low vegetable intake was responsible for 4.3% esophageal cancer deaths in men and 4.1% in women. The fraction of esophageal cancer deaths attributable to low fruit intake was 27.1% in men and 28.0% in women. Overall, 46% of esophageal cancers (51% in men and 33% in women were attributable to these four modifiable risk factors. CONCLUSIONS/SIGNIFICANCE: Tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake were responsible for 46% of esophageal cancer mortality and incidence in China in 2005. These findings provide useful data for developing guidelines for esophageal cancer prevention and control in China.

  17. Thoracoscopic esophagectomy for intrathoracic esophageal cancer.

    Science.gov (United States)

    Osugi, Harushi; Takemura, Masashi; Lee, Sigeru; Nishikawa, Takayuki; Fukuhara, Kennichirou; Iwasaki, Hiroshi; Higashino, Masayuki

    2005-08-01

    Thoracoscopic approaches for esophageal cancer are still disparate. Complete scopic technique is feasible for esophagectomy. Mini-thoracotomy is effective for excellent exposure of the mediastinum for lymph node dissection. The magnifying effect of a video, by keeping the camera in close proximity to the dissection is essential to perform the same quality of dissection as open surgery. The benefit, for respiratory morbidity, remains to be studied in a large number of patients. Minimizing the chest wall injury contributed, to the reduction of constrictive pulmonary damage. Survival after the thoracoscopic approach was favorably compared with open surgery, when extensive lymphadenectomy was performed. Because the efficacy improves with the surgeon's experience, satisfactory outcome will only be obtained in a center performing a sufficient volume of esophageal surgery to provide the surgeon with opportunities to refine his necessary skills. Improvements in technique and instrumentation should make the procedure more accessible and steepen the learning curve.

  18. Esophageal cancer; Cancer de l'oesophage

    Energy Technology Data Exchange (ETDEWEB)

    Dupuis, O.; Ganem, G.; Denis, F. [Centre Jean-Bernard, clinique Victor-Hugo, 72 - Le Mans (France); Bera, G.; Pointreau, Y. [Clinique d' oncologie radiotherapie, Centre Henry S. Kaplan, CHU Bretonneau, 37 - Tours (France); Pradier, O. [Departement de radiotherapie, CHU de Morvan, 29 - Brest (France); Martin, P. [Centre Bourgogne, 59 - Lille (France); Mirabel, X. [Departement universitaire de radiotherapie, centre Oscar-Lambret, 59 - Lille (France)

    2010-07-01

    Esophageal cancers are highly malignant tumours with often a poor prognosis, except for minimal lesions treated with surgery. Radiation therapy, or combined radiation and chemotherapy is the most used therapeutic modality, alone or before oesophagectomy. The delineation of target volumes is now more accurate owing the possibility to use routinely the new imaging techniques (mainly PET). The aim of this work is to precise the radio-anatomical particularities, the pattern of spread of esophageal cancer and the principles of 3D conformal radiotherapy illustrated with a clinical case. (authors)

  19. Current treatment options for the management of esophageal cancer

    Directory of Open Access Journals (Sweden)

    Mawhinney MR

    2012-11-01

    Full Text Available Mark R Mawhinney, Robert E GlasgowDepartment of Surgery, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USAAbstract: In recent years, esophageal cancer characteristics and management options have evolved significantly. There has been a sharp increase in the frequency of esophageal adenocarcinoma and a decline in the frequency of squamous cell carcinoma. A more comprehensive understanding of prognostic factors influencing outcome has also been developed. This has led to more management options for esophageal cancer at all stages than ever before. A multidisciplinary, team approach to management in a high volume center is the preferred approach. Each patient should be individually assessed based on type of cancer, local or regional involvement, and his or her own functional status to determine an appropriate treatment regimen. This review will discuss management of esophageal cancer relative to disease progression and patient functional status.Keywords: esophageal adenocarcinoma, squamous cell carcinoma, treatment regimen, disease progression, patient functional status

  20. Esophageal Cancer: Role of Imaging in Primary Staging and Response Assessment Post Neoadjuvant Therapy.

    Science.gov (United States)

    Griffin, Yvette

    2016-08-01

    Advances in the early detection and treatment of esophageal cancer have meant improved survival rates for patients with esophageal cancer. Accurate pretreatment and post-neoadjuvant treatment staging of esophageal cancer is essential for assessing operability and determining the optimum treatment plan. This article reviews the multimodality imaging approach in the diagnosis, staging, and assessment of treatment response in esophageal cancer.

  1. General Information about Esophageal Cancer

    Science.gov (United States)

    ... stage 0 , abnormal cells are found in the mucosa or submucosa layer of the esophagus wall. These ... found. Stage IA : Cancer has formed in the mucosa or submucosa layer of the esophagus wall. The ...

  2. Treatment Option Overview (Esophageal Cancer)

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  3. Minimal Invasive Surgery for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    A.H.Hoelscher; Ch.Gutschow

    2004-01-01

    Thoracoscopic esophagectomy is only established in some centers and affords a cervical anastomosis because intrathoracic anastomosis as a routine is technically too difficult. Laparoscopic mobilisation of the stomach (gastrolysis) is an important contribution for minimal invasive surgery of esophageal cancer.This procedure reduces the stress of the two cavity operation for the patient and allows the construction of a comparable gastric conduit like by open surgery. The technique of laparoscopic gastrolysis as preparation for transthoracic en bloc esophagectomy is described in detail and preliminary results are briefly mentioned.

  4. Risk of treatment-related esophageal cancer among breast cancer survivors

    DEFF Research Database (Denmark)

    Morton, L M; Gilbert, E S; Hall, P

    2012-01-01

    Radiotherapy for breast cancer may expose the esophagus to ionizing radiation, but no study has evaluated esophageal cancer risk after breast cancer associated with radiation dose or systemic therapy use.......Radiotherapy for breast cancer may expose the esophagus to ionizing radiation, but no study has evaluated esophageal cancer risk after breast cancer associated with radiation dose or systemic therapy use....

  5. Esophageal and gastric cancer incidence and mortality in alendronate users

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Pazianas, Michael; Eiken, Pia Agnete

    2012-01-01

    their esophageal or gastric location could be accurately distinguished. We conducted a register-based, open cohort study using national healthcare data for Denmark. Upper endoscopy frequency, cancer incidence and mortality was examined in 30,606 alendronate users (female, age 50¿+¿) and 122,424 matched controls......Recent studies have reached conflicting conclusions regarding the risk of esophageal cancer with oral bisphosphonates. Prior studies did not record the number of cancer deaths or endoscopy rates, which could be higher in bisphosphonate users and lead to more cancers being diagnosed at a stage when....... Primary outcomes were esophageal cancer incidence and death due to esophageal cancer. The analysis showed that alendronate users were more likely to have undergone recent upper endoscopy (4.1 vs 1.7%, p¿...

  6. Tumour Debulking for Esophageal Cancer - Thermal Modalities

    Directory of Open Access Journals (Sweden)

    David Fleischer

    1992-01-01

    Full Text Available Esophageal cancer usually is discovered at a late stage and curative therapy seldom is possible. The prognosis is poor and most therapy is palliative. Endoscopic therapy commonly is employed; two common treatments involve thermal modalities. The Nd:YAG laser has been employed for 10 years and is effective in relieving obstruction in approximately 90% of cases. Re-ohstruction usually occurs in two to three months and repeat treatment may be necessary. Limitations to laser use include the fact that equipment is expensive and there are technical restrictions. An alternative thermal modality is the bipolar coagulation tumour probe which employs bipolar electrocoagulation. It is less expensive and, if the tumour is circumferential, tends to be easier to use. (It should not be used if the cancer is noncircumferential. The advantages and limitations of each modality are addressed.

  7. Expert consensus contouring guidelines for IMRT in esophageal and gastroesophageal junction cancer

    Science.gov (United States)

    Wu, Abraham J.; Bosch, Walter R.; Chang, Daniel T.; Hong, Theodore S.; Jabbour, Salma K.; Kleinberg, Lawrence R.; Mamon, Harvey J.; Thomas, Charles R.; Goodman, Karyn A.

    2015-01-01

    Purpose/Objective(s) Current guidelines for esophageal cancer contouring are derived from traditional two-dimensional fields based on bony landmarks, and do not provide sufficient anatomical detail to ensure consistent contouring for more conformal radiotherapy techniques such as intensity-modulated radiation therapy (IMRT). Therefore, we convened an expert panel with the specific aim to derive contouring guidelines and generate an atlas for the clinical target volume (CTV) in esophageal or gastroesophageal junction (GEJ) cancer. Methods and Materials Eight expert academically-based gastrointestinal radiation oncologists participated. Three sample cases were chosen: a GEJ cancer, a distal esophageal cancer, and a mid-upper esophageal cancer. Uniform CT simulation datasets and an accompanying diagnostic PET-CT were distributed to each expert, and he/she was instructed to generate gross tumor volume (GTV) and CTV contours for each case. All contours were aggregated and subjected to quantitative analysis to assess the degree of concordance between experts and generate draft consensus contours. The panel then refined these contours to generate the contouring atlas. Results Kappa statistics indicated substantial agreement between panelists for each of the three test cases. A consensus CTV atlas was generated for the three test cases, each representing common anatomic presentations of esophageal cancer. The panel agreed on guidelines and principles to facilitate the generalizability of the atlas to individual cases. Conclusions This expert panel successfully reached agreement on contouring guidelines for esophageal and GEJ IMRT and generated a reference CTV atlas. This atlas will serve as a reference for IMRT contours for clinical practice and prospective trial design. Subsequent patterns of failure analyses of clinical datasets utilizing these guidelines may require modification in the future. PMID:26104943

  8. Expert Consensus Contouring Guidelines for Intensity Modulated Radiation Therapy in Esophageal and Gastroesophageal Junction Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Abraham J., E-mail: wua@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bosch, Walter R. [Washington University, St. Louis, Missouri (United States); Chang, Daniel T. [Stanford Cancer Institute, Stanford, California (United States); Hong, Theodore S. [Massachusetts General Hospital, Boston, Massachusetts (United States); Jabbour, Salma K. [Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Kleinberg, Lawrence R. [Johns Hopkins Medical Center, Baltimore, Maryland (United States); Mamon, Harvey J. [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Thomas, Charles R. [Knight Cancer Institute, Oregon Health & Sciences University, Portland, Oregon (United States); Goodman, Karyn A. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2015-07-15

    Purpose/Objective(s): Current guidelines for esophageal cancer contouring are derived from traditional 2-dimensional fields based on bony landmarks, and they do not provide sufficient anatomic detail to ensure consistent contouring for more conformal radiation therapy techniques such as intensity modulated radiation therapy (IMRT). Therefore, we convened an expert panel with the specific aim to derive contouring guidelines and generate an atlas for the clinical target volume (CTV) in esophageal or gastroesophageal junction (GEJ) cancer. Methods and Materials: Eight expert academically based gastrointestinal radiation oncologists participated. Three sample cases were chosen: a GEJ cancer, a distal esophageal cancer, and a mid-upper esophageal cancer. Uniform computed tomographic (CT) simulation datasets and accompanying diagnostic positron emission tomographic/CT images were distributed to each expert, and the expert was instructed to generate gross tumor volume (GTV) and CTV contours for each case. All contours were aggregated and subjected to quantitative analysis to assess the degree of concordance between experts and to generate draft consensus contours. The panel then refined these contours to generate the contouring atlas. Results: The κ statistics indicated substantial agreement between panelists for each of the 3 test cases. A consensus CTV atlas was generated for the 3 test cases, each representing common anatomic presentations of esophageal cancer. The panel agreed on guidelines and principles to facilitate the generalizability of the atlas to individual cases. Conclusions: This expert panel successfully reached agreement on contouring guidelines for esophageal and GEJ IMRT and generated a reference CTV atlas. This atlas will serve as a reference for IMRT contours for clinical practice and prospective trial design. Subsequent patterns of failure analyses of clinical datasets using these guidelines may require modification in the future.

  9. Preoperative Chemotherapy, Radiation Improve Survival in Esophageal Cancer (Updated)

    Science.gov (United States)

    Patients with esophageal cancer who received chemotherapy and radiation before surgery survived, on average, nearly twice as long as patients treated with surgery alone, according to results of a randomized clinical trial published May 31, 2012, in NEJM.

  10. Palliative Endoscopic Therapy for Cancer Patients with Esophageal Fistula

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ji-chang; ZHANG Li-jian; WU Qi; ZHANG Jun; ZHOU Zong-hui; WU Yang; XU Zhao-li

    2008-01-01

    Objective:To find an effective treatment for advanced cancer patients with esophageal fistula. Methods:From 1998 to 2006, we studied 42 patients with advanced esophageal cancer and 5 lung cancer patients with carcinomatous esophageal fistula(3 females,44 males,aged 29-92 years). Ten patients with both esophageal cancer stricture and fistula were first dilated under endoscope,then a memory stent with a membrane was placed in the esophageal lumen. Others were treated only with a memory stent with a membrane,three of them with a large fistula(diameter>1.5 cm)were treated with bio-protein glue after placement of an esophageal metal stent.Results:The fistulas were covered by a stent and the patients could eat and drink immediately.Their quality of life was improved and their survival was prolonged, 44 out of 47 patients survived for>3 mo. Conclusion:Placement of esophageal stent with membrane or in combination with bio-protein glue through endoscope is an effective method for treating the bronchoesophageal fistula.

  11. XAF1 is frequently methylated in human esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Xiang-Yu Chen; Qiao-Yu He; Ming-Zhou Guo

    2012-01-01

    AIM:To explore epigenetic changes in the gene encoding X chromosome-linked inhibitor of apoptosis-associated factor 1 (XAF1) during esophageal carcinogenesis.METHODS:Methylation status of XAF1 was detected by methylation-specific polymerase chain reaction (MSP) in four esophageal cancer cell lines (KYSE30,KYSE70,BIC1 and partially methylated in TE3 cell lines),nine cases of normal mucosa,72 cases of primary esophageal cancer and matched adjacent tissue.XAF1 expression was examined by semi-quantitative reverse transcriptional polymerase chain reaction and Western blotting before and after treatment with 5-aza-deoxycytidine (5-aza-dc),a demethylating agent.To investigate the correlation of XAF1 expression and methylation status in primary esophageal cancer,immunohistochemistry for XAF1 expression was performed in 32 cases of esophageal cancer and matched adjacent tissue.The association of methylation status and clinicopathological data was analyzed by logistic regression.RESULTS:MSP results were as follows:loss of XAF1 expression was found in three of four esophageal cell lines with promoter region hypermethylation (com pletely methylated in KYSE30,KYSE70 and BIC1 cell lines and partially in TE3 cells); all nine cases of normal esophageal mucosa were unmethylated; and 54/72 (75.00%) samples from patients with esophageal cancer were methylated,and 25/72 (34.70%) matched adjacent tissues were methylated (75.00% vs 34.70%,x2 =23.5840,P =0.000).mRNA level of XAF1 measured with semi-quantitative reverse transcription polymerase chain reaction was detectable only in TE3 cells,and no expression was detected in KYSE30,KYSE70 or BIC1 cells.Protein expression was not observed in KYSE30 cells by Western blotting before treatment with 5-aza-dc.After treatment,mRNA level of XAF1 was detectable in KYSE30,KYSE70 and BIC1 cells.Protein expression was detected in KYSE30 after treatment with 5-aza-dc.Immunohistochemistry was performed on 32 cases of esophageal cancer and

  12. Advances in Radiotherapy Management of Esophageal Cancer

    Science.gov (United States)

    Verma, Vivek; Moreno, Amy C.; Lin, Steven H.

    2016-01-01

    Radiation therapy (RT) as part of multidisciplinary oncologic care has been marked by profound advancements over the past decades. As part of multimodality therapy for esophageal cancer (EC), a prime goal of RT is to minimize not only treatment toxicities, but also postoperative complications and hospitalizations. Herein, discussion commences with the historical approaches to treating EC, including seminal trials supporting multimodality therapy. Subsequently, the impact of RT techniques, including three-dimensional conformal RT, intensity-modulated RT, and proton beam therapy, is examined through available data. We further discuss existing data and the potential for further development in the future, with an appraisal of the future outlook of technological advancements of RT for EC. PMID:27775643

  13. Reflections on the New Classification of Tumors by the WHO and Changes in Esophageal Cancer in a High-risk Area

    Institute of Scientific and Technical Information of China (English)

    Zhifeng Chen

    2006-01-01

    In year 2000, a book entitled the Pathology and Genetics of Tumors of the Digestive System was published by the WHO, presenting some new diagnostic criteria and treatment principles. I have analyzed the epidemiologic change of tumors in over 30 years in the high-risk area with esophageal cancer. The following phenomenon was found: accompanied by the sharp decrease in the incidence and mortality of esophageal cancer, there was an increase in the incidence and death rate of stomach cancer involving cardiac cancer. This fact should be considered when analyzing the sharp decrease in esophageal cancer incidence and mortality rate. More attention was given to diagnosis of cardiac cancer; at the same time it is more practical to improve the early screening of cancers. To observe the development of high and lowgrade intraepithelial neoplasms will be an urgent task for esophageal cancer research in the high risk area, according to WHO's new classification.

  14. Percutaneous endoscopic gastrostomy for nutritional palliation of upper esophageal cancer unsuitable for esophageal stenting

    Directory of Open Access Journals (Sweden)

    Ana Grilo

    2012-09-01

    Full Text Available CONTEXT: Esophageal cancer is often diagnosed at an advanced stage and has a poor prognosis. Most patients with advanced esophageal cancer have significant dysphagia that contributes to weight loss and malnutrition. Esophageal stenting is a widespread palliation approach, but unsuitable for cancers near the upper esophageal sphincter, were stents are poorly tolerated. Generally, guidelines do not support endoscopic gastrostomy in this clinical setting, but it may be the best option for nutritional support. OBJECTIVE: Retrospective evaluation of patients with dysphagia caused advanced esophageal cancer, no expectation of resuming oral intake and with percutaneous endoscopic gastrostomy for comfort palliative nutrition. METHOD: We selected adult patients with unresecable esophageal cancer histological confirmed, in whom stenting was impossible due to proximal location, and chemotherapy or radiotherapy were palliative, using gastrostomy for enteral nutrition. Clinical and nutritional data were evaluated, including success of gastrostomy, procedure complications and survival after percutaneous endoscopic gastrostomy, and evolution of body mass index, albumin, transferrin and cholesterol. RESULTS: Seventeen males with stage III or IV squamous cell carcinoma fulfilled the inclusion criteria. Mean age was 60.9 years. Most of the patients had toxic habits. All underwent palliative chemotherapy or radiotherapy. Gastrostomy was successfully performed in all, but nine required prior dilatation. Most had the gastrostomy within 2 months after diagnosis. There was a buried bumper syndrome treated with tube replacement and four minor complications. There were no cases of implantation metastases or procedure related mortality. Two patients were lost and 12 died. Mean survival of deceased patients was 5.9 months. Three patients are alive 6, 14 and 17 months after the gastrostomy procedure, still increasing the mean survival. Mean body mass index and laboratory

  15. [Lugol's solution in endoscopic diagnosis of early esophageal cancer].

    Science.gov (United States)

    Wang, G; Zhou, M; Cong, Q

    1995-07-01

    About 1500 high-risk subjects of esophageal cancer were found during screening by balloon cytology and all of them were examined endoscopically. Among them, 120 were considered as having early esophageal cancer and precancerous lesions. During the examination, Lugol's solution staining was used and guiding biopsy was taken. 98 subjects with unstained lesions were found, and biopsy showed early esophageal cancer in 60 (61.2%) and moderate and severe dysplasia in 38 (38.8%). It is usually extremely difficult to detect and localize the very early esophageal mucosal and submucosal carcinoma. But endoscopic examination and using Lugol's solution staining with multiple spots biopsy from unstained area are of great assistance. Minute malignant lesions may not be overlooked.

  16. Effect of S1P5 on proliferation and migration of human esophageal cancer cells

    OpenAIRE

    Hu, Wei-Min; Li, Li; Jing, Bao-Qian; Zhao, Yong-Sheng; Wang, Chao-Li; Feng, Li; Xie, Yong-En

    2010-01-01

    AIM: To investigate the sphingosine 1-phosphate (S1P) receptor expression profile in human esophageal cancer cells and the effects of S1P5 on proliferation and migration of human esophageal cancer cells.

  17. Genetic features of metachronous esophageal cancer developed in Hodgkin's lymphoma or breast cancer long-term survivors: an exploratory study.

    Directory of Open Access Journals (Sweden)

    Elisa Boldrin

    Full Text Available BACKGROUND: Development of novel therapeutic drugs and regimens for cancer treatment has led to improvements in patient long-term survival. This success has, however, been accompanied by the increased occurrence of second primary cancers. Indeed, patients who received regional radiotherapy for Hodgkin's Lymphoma (HL or breast cancer may develop, many years later, a solid metachronous tumor in the irradiated field. Despite extensive epidemiological studies, little information is available on the genetic changes involved in the pathogenesis of these solid therapy-related neoplasms. METHODS: Using microsatellite markers located in 7 chromosomal regions frequently deleted in sporadic esophageal cancer, we investigated loss of heterozygosity (LOH and microsatellite instability (MSI in 46 paired (normal and tumor samples. Twenty samples were of esophageal carcinoma developed in HL or breast cancer long-term survivors: 14 squamous cell carcinomas (ESCC and 6 adenocarcinomas (EADC, while 26 samples, used as control, were of sporadic esophageal cancer (15 ESCC and 11 EADC. RESULTS: We found that, though the overall LOH frequency at the studied chromosomal regions was similar among metachronous and sporadic tumors, the latter exhibited a statistically different higher LOH frequency at 17q21.31 (p = 0.018. By stratifying for tumor histotype we observed that LOH at 3p24.1, 5q11.2 and 9p21.3 were more frequent in ESCC than in EADC suggesting a different role of the genetic determinants located nearby these regions in the development of the two esophageal cancer histotypes. CONCLUSIONS: Altogether, our results strengthen the genetic diversity among ESCC and EADC whether they occurred spontaneously or after therapeutic treatments. The presence of histotype-specific alterations in esophageal carcinoma arisen in HL or breast cancer long-term survivors suggests that their transformation process, though the putative different etiological origin, may retrace

  18. Esophageal Cancer in Canada: Trends according to Morphology and Anatomical Location

    Directory of Open Access Journals (Sweden)

    Michael C Otterstatter

    2012-01-01

    Full Text Available BACKGROUND: Esophageal adenocarcinoma has one of the fastest rising incidence rates and one of the lowest survival rates of any cancer type in the Western world. However, in many countries, trends in esophageal cancer differ according to tumour morphology and anatomical location. In Canada, incidence and survival trends for esophageal cancer subtypes are poorly known.

  19. DDEC: Dragon database of genes implicated in esophageal cancer

    KAUST Repository

    Essack, Magbubah

    2009-07-06

    Background: Esophageal cancer ranks eighth in order of cancer occurrence. Its lethality primarily stems from inability to detect the disease during the early organ-confined stage and the lack of effective therapies for advanced-stage disease. Moreover, the understanding of molecular processes involved in esophageal cancer is not complete, hampering the development of efficient diagnostics and therapy. Efforts made by the scientific community to improve the survival rate of esophageal cancer have resulted in a wealth of scattered information that is difficult to find and not easily amendable to data-mining. To reduce this gap and to complement available cancer related bioinformatic resources, we have developed a comprehensive database (Dragon Database of Genes Implicated in Esophageal Cancer) with esophageal cancer related information, as an integrated knowledge database aimed at representing a gateway to esophageal cancer related data. Description: Manually curated 529 genes differentially expressed in EC are contained in the database. We extracted and analyzed the promoter regions of these genes and complemented gene-related information with transcription factors that potentially control them. We further, precompiled text-mined and data-mined reports about each of these genes to allow for easy exploration of information about associations of EC-implicated genes with other human genes and proteins, metabolites and enzymes, toxins, chemicals with pharmacological effects, disease concepts and human anatomy. The resulting database, DDEC, has a useful feature to display potential associations that are rarely reported and thus difficult to identify. Moreover, DDEC enables inspection of potentially new \\'association hypotheses\\' generated based on the precompiled reports. Conclusion: We hope that this resource will serve as a useful complement to the existing public resources and as a good starting point for researchers and physicians interested in EC genetics. DDEC is

  20. Molecular epidemiology of and genetic susceptibility to esophageal cancer.

    Science.gov (United States)

    Bajpai, Manisha; Das, Kiron M; Lefferts, Joel; Lisovsky, Mikhail; Mashimo, Hiroshi; Phillips, Wayne A; Srivastava, Amitabh; To, Henry

    2014-09-01

    The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on clonal evolution in Barrett's carcinogenesis; biomarkers for early detection of esophageal cancer; the role of the methylguanine methyl transferase biomarker in the management of adenocarcinoma; and the discovery of high-risk genes in families.

  1. A second primary esophageal cancer developing 7 years after chemoradiotherapy for advanced esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Ryuichiro; Enjoji, Akihito; Okudaira, Sadayuki; Furui, Junichiro; Kanematsu, Takashi [Nagasaki Univ. (Japan). School of Medicine; Matsuo, Takeshi

    2001-07-01

    We report a rare case of advanced carcinoma and a second primary carcinoma of the esophagus, both of which were successfully cured by chemotherapy and operation at different times. In 1991, a 38-year-old Japanese man was diagnosed with advanced esophageal cancer, which was unresectable because of the bronchial invasion of the tumor. He was given chemotherapy with cisplatin (CDDP), combined with radiotherapy. During a 4-year follow-up, neither regrowth of the primary tumor nor distant metastasis occurred. In 1995, esophagoscopy demonstrated a lugol-unstained region located 3 cm distal from the area of radiation to the primary lesion shown by esophagography. Histological examination of a biopsy specimen showed the mucosa to be normal. Nevertheless, yearly surveillance by endoscopy and histological examinations showed that the mucosa of the esophagus gradually began to demonstrate mild dysplasia, followed by severe dysplasia; in 1998, a diagnosis of squamous cell carcinoma was made. Esophagectomy with lymph node dissection was performed. Microscopic examination revealed that there had been pathologic complete response for the original advanced esophageal cancer. (author)

  2. Epidemiology of esophageal cancer in Japan and China.

    Science.gov (United States)

    Lin, Yingsong; Totsuka, Yukari; He, Yutong; Kikuchi, Shogo; Qiao, Youlin; Ueda, Junko; Wei, Wenqiang; Inoue, Manami; Tanaka, Hideo

    2013-01-01

    In preparation for a collaborative multidisciplinary study of the pathogenesis of esophageal cancer, the authors reviewed the published literature to identify similarities and differences between Japan and China in esophageal cancer epidemiology. Esophageal squamous cell carcinoma (ESCC) is the predominant histologic type, while the incidence of esophageal adenocarcinoma remains extremely low in both countries. Numerous epidemiologic studies in both countries show that alcohol consumption and cigarette smoking are contributing risk factors for ESCC. There are differences, however, in many aspects of esophageal cancer between Japan and China, including cancer burden, patterns of incidence and mortality, sex ratio of mortality, risk factor profiles, and genetic variants. Overall incidence and mortality rates are higher in China than in Japan, and variation in mortality and incidence patterns is greater in China than in Japan. During the study period (1987-2000), the decline in age-adjusted mortality rates was more apparent in China than in Japan. Risk factor profiles differed between high- and low-incidence areas within China, but not in Japan. The association of smoking and drinking with ESCC risk appears to be weaker in China than in Japan. Genome-wide association studies in China showed that variants in several chromosome regions conferred increased risk, but only genetic variants in alcohol-metabolizing genes were significantly associated with ESCC risk in Japan. A well-designed multidisciplinary epidemiologic study is needed to examine the role of diet and eating habits in ESCC risk.

  3. Treatment of esophageal cancer with vindesine: an open trial.

    Science.gov (United States)

    Bezwoda, W R; Derman, D P; Weaving, A; Nissenbaum, M

    1984-05-01

    Fifty-two patients with advanced esophageal cancer have been entered in an open study with vindesine. The regimen consisted of vindesine at a dose of 3 mg/m2 as a continuous infusion over 48 hours followed by 3 mg/m2 iv weekly for 4 weeks and then by monthly maintenance therapy using the same dose. Objective response was seen in 14 (27%) patients. Patients who responded to treatment had significant prolongation of survival. Major pretreatment prognostic factors included performance status and serum albumin concentration. It is concluded that vindesine has definite, although limited, activity against esophageal cancer.

  4. [Endoscopic and histopathological studies of experimental esophageal cancer in beagles].

    Science.gov (United States)

    Takeshita, K; Sunagawa, M; Nakajima, A; Ochi, K; Habu, H; Hoshi, K

    1985-02-01

    In order to obtain a reliable experimental model simulating human esophageal cancer, endoscopic and histopathological studies were undertaken in the esophageal cancer produced in the beagle dog. Thirty-seven dogs had been given a solution of N-Ethyl-N'-nitro-N-nitrosoguanidine (ENNG) at a concentration of 150 micrograms/ml for 3-9 months. Follow-up studies included serial endoscopy and biopsy, and almost all animals were eventually sacrificed for histological examination. The results were as follows: Squamous cell carcinoma was observed in 5 out of 22 female dogs, while none in male dogs at all. For the induction of squamous cell carcinoma in the esophagus, administration in the condition of 150 micrograms/ml (75mg/day) for 6-9 months was most suitable. Almost all of esophageal lesions were protruding and well-differentiated squamous cell carcinoma with invasion of the submucosa. The stages of hyperplasia, dysplasia and squamous cell carcinoma in the esophagus were chronologically followed. Carcinoma had been observed in the stomach about 4 months prior to the appearance of esophageal carcinoma. This experimental model was proved to be useful for studies on histogenesis of human esophageal cancer both light and electron microscopically.

  5. “Layer-to-Layer” Esophagogastric Anastomosis Combined with Intrathoracic Esophageal Mucosal Extention in Patients with Esophageal and Cardia Cancer

    Institute of Scientific and Technical Information of China (English)

    SHIZhongqi; CAIPing; YANYu; CHENYinchun; LIUJunhua; YOUQinshen; CAIJixiang; XIZhongxia

    2005-01-01

    Objective: To evaluate the clinical value of intrathoracic esophagogastric “layer-to-layer” anastomosis with esophageal mucosa extended varied in plane and to study the effective methods to prevent anastomotic leaking or stricture postoperatively. Methods: From May 1985 to December 2002, 2 240 esophageal and stomach cardia cancer patients treated by intrathoracic esophagogastric “layer-to-layer”anastomosis with esophageal mucosa extended varied in plane were retrospectively analyzed. Results:There was no anastomotic leaking and severe stricture in all above cases. Conclusion: Intrathoracic esophagogastric “layer-to-layer” anastomosis with esophageal mucosal extended varied in plane is an effective method to prevent anastomotic leaking and stricture postoperatively.

  6. New York esophageal squamous cell carcinoma-1 and cancer immunotherapy.

    Science.gov (United States)

    Esfandiary, Ali; Ghafouri-Fard, Soudeh

    2015-01-01

    New York esophageal squamous cell carcinoma 1 (NY-ESO-1) is a known cancer testis gene with exceptional immunogenicity and prevalent expression in many cancer types. These characteristics have made it an appropriate vaccine candidate with the potential application against various malignancies. This article reviews recent knowledge about the NY-ESO-1 biology, function, immunogenicity and expression in cancers as well as and the results of clinical trials with this antigen.

  7. Green tea and prevention of esophageal and lung cancers.

    Science.gov (United States)

    Yuan, Jian-Min

    2011-06-01

    Green tea contains high concentrations of tea polyphenols that have shown inhibitory effects against the development, progress, and growth of carcinogen-induced tumors in animal models at different organ sites, including the esophagus and lung. Green tea polyphenols also have shown to suppress cell proliferation and induce apoptosis. Besides antioxidative property, green tea polyphenols have pro-oxidative activities under certain conditions and modulate phase II metabolic enzymes that can enhance the detoxification pathway of environmental toxicants and carcinogens. Although epidemiological studies have provided inconclusive results on the effect of green tea consumption against the development of esophageal and lung cancers in humans overall, the inverse association between green tea intake and risk of esophageal cancer risk is more consistently observed in studies with adequate control for potential confounders. Epidemiological studies also have demonstrated an inverse, albeit moderate, association between green tea consumption and lung cancer, especially in non-smokers. This article reviews data on the cancer-preventive activities of green tea extract and green tea polyphenols and possible mechanisms against the esophageal and lung carcinogenesis in experimental animals, and summarizes the current knowledge from epidemiological studies on the relationship between green tea consumption and esophageal and lung cancer risk in humans.

  8. Safrole-DNA adducts in tissues from esophageal cancer patients: clues to areca-related esophageal carcinogenesis.

    Science.gov (United States)

    Lee, Jang-Ming; Liu, Tsung-Yung; Wu, Deng-Chyang; Tang, Hseau-Chung; Leh, Julie; Wu, Ming-Tsang; Hsu, Hsao-Hsun; Huang, Pei-Ming; Chen, Jin-Shing; Lee, Chun-Jean; Lee, Yung-Chie

    2005-01-01

    Epidemiological studies have demonstrated that areca quid chewing can be an independent risk factor for developing esophageal cancer. However, no studies are available to elucidate the mechanisms of how areca induces carcinogenesis in the esophagus. Since the areca nut in Taiwan contains a high concentration of safrole, a well-known carcinogenic agent, we analyzed safrole-DNA adducts by the 32P-postlabelling method in tissue specimens from esophageal cancer patients. In total, we evaluated 47 patients with esophageal cancer (16 areca chewers and 31 non-chewers) who underwent esophagectomy at the National Taiwan University Hospital between 1996 and 2002. Of the individuals with a history of habitual areca chewing (14 cigarette smokers and two non-smokers), one of the tumor tissue samples and five of the normal esophageal mucosa samples were positive for safrole-DNA adducts. All patients positive for safrole-DNA adducts were also cigarette smokers. Such adducts could not be found in patients who did not chew areca, irrespective of their habits of alcohol consumption or cigarette smoking (psafrole was also tested in vitro in three esophageal cell lines and four cultures of primary esophageal keratinocytes. In two of the esophageal keratinocyte cultures, adduct formation was increased by treatment with safrole after induction of cytochrome P450 by 3-methyl-cholanthrene. This paper provides the first observation of how areca induces esophageal carcinogenesis, i.e., through the genotoxicity of safrole, a component of the areca juice.

  9. Delay in diagnostic workup and treatment of esophageal cancer

    NARCIS (Netherlands)

    B.A. Grotenhuis (Brechtje); P. van Hagen (Pieter); B.P.L. Wijnhoven (Bas); V.M.C.W. Spaander (Manon); H.W. Tilanus (Hugo); J.J-B. van Lanschot (Jan)

    2010-01-01

    textabstractIntroduction: Esophageal cancer should preferably be detected and treated at an early stage, but this may be prohibited by late onset of symptoms and delays in referral, diagnostic workup, and treatment. The aim of this study was to investigate the impact of these delays on outcome in pa

  10. The Role of Induction Therapy for Esophageal Cancer.

    Science.gov (United States)

    Berry, Mark F

    2016-08-01

    Survival of esophageal cancer generally is poor but has been improving. Induction chemoradiation is recommended before esophagectomy for locally advanced squamous cell carcinoma. Both induction chemotherapy and induction chemoradiation are found to be beneficial for locally advanced adenocarcinoma. Although a clear advantage of either strategy has not yet been demonstrated, consensus-based guidelines recommend induction chemoradiation for locally advanced adenocarcinoma.

  11. Early detection and determinants of esophageal cancer

    NARCIS (Netherlands)

    Bus, P.

    2014-01-01

    Barrett’s esophagus (BE) is a premalignant condition of the esophagus and characterized by the metaplastic replacement of esophageal squamous epithelium by specialized intestinal-type columnar epithelium. A BE diagnosis is based on endoscopy and histological examination of biopsies taken during endo

  12. Neoadjuvant chemotherapy or chemoradiotherapy for locally advanced esophageal cancer.

    Science.gov (United States)

    Smithers, B Mark; Thomson, Iain

    2013-11-01

    In patients with operable esophageal cancer, there is evidence supporting the use of preoperative chemotherapy or preoperative chemoradiation. The addition of radiotherapy to chemotherapy seems more relevant for the more locally advanced cancers. There is a need to examine in trials more modern chemotherapy combinations with and without concurrent radiation and for research into assessing methods for predicting outcomes from neoadjuvant therapy as part of the paradigm of therapy for this disease.

  13. [A Case of Synchronous Multiple Esophageal Cancers Composed of Squamous Cell Carcinoma and Barrett's Adenocarcinoma].

    Science.gov (United States)

    Kobayashi, Toshiyuki; Shiozaki, Atsushi; Fujiwara, Hitoshi; Konishi, Hirotaka; Arita, Tomohiro; Kosuga, Toshiyuki; Morimura, Ryo; Murayama, Yasutoshi; Komatsu, Shuhei; Kuriu, Yoshiaki; Ikoma, Hisashi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Okamoto, Kazuma; Otsuji, Eigo

    2015-11-01

    A 67-year-old man was admitted to our hospital for treatment for multiple superficial esophageal cancers. Screening upper gastrointestinal endoscopy examination revealed a superficial squamous cell carcinoma (SCC) at the middle thoracic esophagus and Barrett's epithelium and a superficial adenocarcinoma at the abdominal esophagus. We performed a subtotal esophagectomy with gastric tube reconstruction via the retrosternal route. Pathological examination revealed a Barrett's adenocarcinoma at the abdominal esophagus. Esophageal cancer is thought to be a multicentric disease, and we sometimes find multiple esophageal cancers. In Japan, most cases of multiple esophageal cancers are composed of SCCs, and the occurrence of multiple esophageal cancers composed of SCC and Barrett's adenocarcinoma is rare. In contrast, the number of the patients with Barrett's esophagus is increasing, and the number of the patients with Barrett's adenocarcinoma also seems to be on the rise. Therefore, it is important be aware of the possibility of multiple esophageal cancers composed of SCC and Barrett's adenocarcinoma while making diagnoses.

  14. Esophageal cancer management controversies: Radiation oncology point of view

    Institute of Scientific and Technical Information of China (English)

    Patricia; Tai; Edward; Yu

    2014-01-01

    Esophageal cancer treatment has evolved from single modality to trimodality therapy.There are some controversies of the role,target volumes and dose of radiotherapy(RT)in the literature over decades.The present review focuses primarily on RT as part of the treatment modalities,and highlight on the RT volume and its dose in the management of esophageal cancer.The randomized adjuvant chemoradiation(CRT)trial,intergroup trial(INT 0116)enrolled 559 patients with resected adenocarcinoma of the stomach or gastroesophageal junction.They were randomly assigned to surgery plus postoperative CRT or surgery alone.Analyses show robust treatment benefit of adjuvant CRT in most subsets for postoperative CRT.The Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study(CROSS)used a lower RT dose of41.4 Gray in 23 fractions with newer chemotherapeutic agents carboplatin and paclitaxel to achieve an excellent result.Target volume of external beam radiation therapy and its coverage have been in debate for years among radiation oncologists.Pre-operative and postoperative target volumes are designed to optimize for disease control.Esophageal brachytherapy is effective in the palliation of dysphagia,but should not be given concomitantly with chemotherapy or external beam RT.The role of brachytherapy in multimodality management requires further investigation.On-going studies of multidisciplinary treatment in locally advanced cancer include:ZTOG1201 trial(a phaseⅡtrial of neoadjuvant and adjuvant CRT)and QUINTETT(a phaseⅢtrial of neoadjuvant vs adjuvant therapy with quality of life analysis).These trials hopefully will shed more light on the future management of esophageal cancer.

  15. Prediction of Response to Multimodality Treatment in Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    RalfMetzger; HuanXi; FutoshiMiyazono; HiroshiHigashi; UteWarnecke-Eberz; StephanE.Baldus; JanBrabender; PaulM.Schneider

    2004-01-01

    Patients with locally advanced esophageal cancer have a dismal prognosis when treated exclusively by surgery. This fact prompted many investigators to apply neoadjuvant treatment strategies in an effort to improve survival. Results from phase Ⅲ randomized trials are encouraging however, they revealed that only patients with major histopathological response will benefit from treatment. Therefore, predictive molecular markers indicating response or non-response to neoadjuvant treatment would be extremely helpful in selecting patients for current and future treatment protocols. In this paper we review the role of the molecular markers ERCC1 (excision repair cross-complementing 1 gene) and c-erbB-2 (synonym:HER2/neu) in predicting response to radiochemotherapy and outcome for patients with locally advanced resectable esophageal cancers (cT2-4, Nx, M0). The results are promising and it appears that we might expect to unequivocally identify with ERCC1 and c-erbB-2 respectively, approximately up to one third of patients who fulfil the criteria for neoadjuvant treatment for locally advanced esophageal cancer but will not benefit from our treatment protocol. Integration of such markers in the clinical setting might prevent a substantial number of patients from expensive, non-effective and potentially harmful therapies, and could lead to a more individualized type of combined multimodality treatment in the near future.

  16. The genetic alteration of retinoblastoma gene in esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jae Il; Shim, Yung Mok; Kim, Chang Min [Korea Cancer Center Hospital of Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-12-01

    Retinoblastoma(RB) gene is the prototype of tumor suppressor gene and it`s alteration have been frequently observed in a large number of human tumors. To investigate the role of RB in esophageal cancer, we studied 36 esophageal cancer tissues with Southern blot analysis to detect gross LOH and PCR-SSCP method to find minute LOH and mutation, if any. In the cases with abnormalities, the nucleotide sequence analysis was performed. Allelic loss of chromosome 13q14 occurred in 20 out of 32 informative cases (62.5%) by Southern analysis. Furthermore, PCR-LOH added three positive cases. Mobility shift by PCR-SSCP was observed in one case at exon 22, which showed 1 bp deletion in codon 771 of RB gene resulting in frame shift mutation. Besides, nine PCR-band alteration in tumor tissue compared with normal tissue were observed in exon 14 and 22, but mutation was not found on sequencing analysis suggesting the epigenetic alteration in tumor tissue. Analysis of the clinical data did not show any difference depending upon RB alteration. However, the total incidence of RB gene may play an important role in the development of esophageal cancer. The main genetic alteration of RB gene was deletion detected by Southern blot and one bp deletion leading to frame shift was also observed. 8 figs, 5 tabs. (Author).

  17. Inoperable esophageal cancer and outcome of palliative care

    Institute of Scientific and Technical Information of China (English)

    Sima Besharat; Ali Jabbari; Shahryar Semnani; Abbasali Keshtkar; Jeran Marjani

    2008-01-01

    AIM: To determine the outcome of esophageal cancer patients referred for palliative care, in Gorgan and Gonbad gastrointestinal clinics, northeast of Iran.METHODS: This cross-sectional study was done on inoperable esophageal cancer cases referred to gastrointestinal clinics in Gorgan and Gonbad city (2005-2006). Demographic data were collected during the procedure and cases were followed up every one month. Improvement proportion was calculated with 95% confidence interval, to determine the rate of improvement. Survival analysis and Kaplan-Meier methods were used to estimate the duration of palliative care effectiveness.RESULTS: We recruited 39 cases into the study. Squamous cell carcinoma was the most prevalent (92.3%). The middle third of the esophagus was involved predominantly (51.3%). Dilation was the most preferred method (89.7%) and stenting was done in 4 cases. Decreasing dysphagia score was not related to palliation method or pathology type of carcinoma. Age of the patients was significantly related to the improvement of dysphagia score. Mean survival time was 137.6d and median was 103d.CONCLUSION: Results of this study showed a low survival rate after palliative care in esophageal cancer cases despite dysphagia scores' improvement after dilating or stenting.

  18. A Dilemma in Staging of Esophageal Cancer: How Should We Stage ypT0 N2 M0 Esophageal Cancer after Neoadjuvant Therapy?

    Directory of Open Access Journals (Sweden)

    Sebahattin Celik

    2015-01-01

    Full Text Available Background. Since neoadjuvant treatment in esophageal cancer began to become popular, a complete pathological response at the primary tumour site has been commonly reported. An issue of conflict is whether complete response in the esophageal lumen means that the esophagus is completely tumour-free. Another important issue is whether lymph nodes that are retrieved from pathologically complete response cases are also tumour-free or not. There is a gap in the esophageal cancer staging system for ypT0 N2 M0 tumours that have received neoadjuvant therapy. Here, we will discuss the problem about staging of esophageal cancer associated with neoadjuvant therapy. Case. A female aged 40 years complaining of dysphagia was diagnosed as having locally advanced thoracic esophageal cancer. Neoadjuvant therapy decision was taken by oncology committee. Six weeks after neoadjuvant therapy, with a curative intention, minimal invasive surgery was performed. The pathology report was as follows. “There were no neoplastic cells in the suspected area of the esophageal mucosa upon examination with all staining. There was no cancer at resection margins. Four metastatic lymph nodes were infiltrated with squamous cell cancer.” Conclusion. Despite the growing use of neoadjuvant treatment in locally advanced esophageal cancer in world, we do not have a protocol for the evaluation of these patients’ pathology reports. We believe that new studies and new ideas are needed to resolve this dilemma associated with neoadjuvant therapy.

  19. Prevention and Treatment of Esophageal Stenosis after Endoscopic Submucosal Dissection for Early Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Jing Wen

    2014-01-01

    Full Text Available Endoscopic submucosal dissection (ESD for the treatment of esophageal mucosal lesions is associated with a risk of esophageal stenosis, especially for near-circumferential or circumferential esophageal mucosal defects. Here, we review historic and modern studies on the prevention and treatment of esophageal stenosis after ESD. These methods include prevention via pharmacological treatment, endoscopic autologous cell transplantation, endoscopic esophageal dilatation, and stent placement. This short review will focus on direct prevention and treatment, which may help guide the way forward.

  20. Routine endoscopy for esophageal cancer is suggestive for patients with oral, oropharyngeal and hypopharyngeal cancer.

    Directory of Open Access Journals (Sweden)

    Shih-Han Hung

    Full Text Available BACKGROUND: This study attempted to reveal the incidence and risk of synchronous and metachronous esophageal cancer in subjects with oral, oropharyngeal and hypopharyngeal cancer based on a population-wide database in Taiwan. METHODS: We retrieved data for this cross-sectional study from the Taiwanese Longitudinal Health Insurance Database 2000. The study group included 2,965 subjects who had received their first-time diagnosis of oral/oropharyngeal/hypopharyngeal cancer in 2002∼2009. We assigned the date of their first diagnosis of oral/oropharyngeal/hypopharyngeal cancer as the index date. We also randomly retrieved 29,650 comparison subjects matched with the study subjects in terms of gender and age group. We assigned their first medical utilization that occurred in the index year as the index date for the comparison group. We further performed a conditional logistic regression to investigate the association between esophageal cancer and oral cancer. RESULTS: Results showed that prevalences of esophageal cancer within 3 months before and after the index date were respectively 2.19% and 0.04% for the study and comparison groups. A conditional logistic regression revealed that the odds ratio (OR of esophageal cancer for subjects with oral/oropharyngeal/hypopharyngeal cancer was 55.33 (95% confidence interval (CI: 29.86∼102.52 compared to comparison subjects. Furthermore, compared to comparison subjects, ORs for esophageal cancer were respectively 18.41 (95% CI: 8.50-39.85, 40.49 (95% CI: 15.11∼108.64, and 240.96 (95% CI: 125.49-462.69 for study subjects with a malignancy of the oral cavity, oropharynx, and hypopharynx. CONCLUSION: We concluded that there were relatively high chances for synchronous and metachronous esophageal cancers being detected through panendoscopy in patients with oral, oropharyngeal, and hypopharyngeal cancers. The routine use of panendoscopy in such patients should be encouraged with a higher priority.

  1. Primary esophageal and gastro-esophageal junction cancer xenograft models: clinicopathological features and engraftment.

    Science.gov (United States)

    Dodbiba, Lorin; Teichman, Jennifer; Fleet, Andrew; Thai, Henry; Sun, Bin; Panchal, Devang; Patel, Devalben; Tse, Alvina; Chen, Zhuo; Faluyi, Olusola O; Renouf, Daniel J; Girgis, Hala; Bandarchi, Bizhan; Schwock, Joerg; Xu, Wei; Bristow, Robert G; Tsao, Ming-Sound; Darling, Gail E; Ailles, Laurie E; El-Zimaity, Hala; Liu, Geoffrey

    2013-04-01

    There are very few xenograft models available for the study of esophageal (E) and gastro-esophageal junction (GEJ) cancer. Using a NOD/SCID model, we implanted 90 primary E and GEJ tumors resected from patients and six endoscopic biopsy specimens. Of 69 resected tumors with histologically confirmed viable adenocarcinoma or squamous cell carcinoma, 22 (32%) was engrafted. One of 11 tumors, considered to have had a complete pathological response to neo-adjuvant chemo-radiation, also engrafted. Of the 23 patients whose tumors were engrafted, 65% were male; 30% were early stage while 70% were late stage; 22% received neo-adjuvant chemo-radiation; 61% were GEJ cancers. Engraftment occurred in 18/54 (33%) adenocarcinomas and 5/16 (31%) squamous cell carcinomas. Small endoscopic biopsy tissue had a 50% (3/6) engraftment rate. Of the factors analyzed, pretreatment with chemo-radiation and well/moderate differentiation showed significantly lower correlation with engraftment (P<0.05). In the subset of patients who did not receive neo-adjuvant chemo-radiation, 18/41 (44%) engrafted compared with those with pretreatment where 5/29 (17%, P=0.02) engrafted. Primary xenograft lines may be continued through 4-12 passages. Xenografts maintained similar histology and morphological characteristics with only minor variations even after multiple passaging in most instances.

  2. A phase I study of concurrent chemoradiotherapy and cetuximab for locally advanced esophageal cancer

    DEFF Research Database (Denmark)

    Holländer, Cecilie; Jensen, Lene Bæksgaard; Sorensen, Morten

    2012-01-01

    To determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of concurrent chemoradiotherapy and cetuximab in patients with non-resectable locally advanced esophageal cancer.......To determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of concurrent chemoradiotherapy and cetuximab in patients with non-resectable locally advanced esophageal cancer....

  3. Differential expression analsis of matrix metallo-proteinase 20 (MMP20) in human esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The aim of this study was to investigate the different expressions of MMP20 in the process of esophageal cancer. RT-PCR, immunohistochemistry and Western blot were employed to detect the mRNA expression and protein expression of MMP20. Compared with the corresponding normal esophagus tissues, results showed the common trend of the dramatical overexpression of MMP20 in the esopha-geal cancer tissues. The analysis of MMP20 expression in different clinical early stages of esophageal cancer by RT-PCR indicated that MMP20 was much more overexpressed in the esophageal cancer with invasion than in the early stages. This suggested that MMP20 might play an important role in the progression of esophageal cancer. It probably plays a critical role in tumor invasion.

  4. Endoscopic mucosectomy: an alternative treatment for superficial esophageal cancer.

    Science.gov (United States)

    Lambert, R

    2000-01-01

    Recent trends in the management of superficial esophageal cancer consist of improved detection, pretherapeutic staging and reliable criteria for curative endoscopic therapy. The endoscopic treatment is legitimate when the cancer is at an early stage, intra-epithelial or microinvasive (m1 or m2) and N0. Submucosal cancer should not be treated with a curative intent by endotherapy. Concerning squamous cell cancer, the oriental and occidental pathologists include high-grade dysplasia in the same group as intramucosal cancer. The distinction is however maintained for adenocarcinoma in the Barrett's esophagus. Indications of endoscopic rather than surgical treatment rely on: (1) the small size of the tumor (not more than 2 cm in diameter); (2) the endoscopic morphology in the type 0 of the Japanese classification with the flat subtypes IIa and IIb rather than type IIc--there is high risk of submucosal invasion for the polypoid (type I) or ulcerated superficial cancer (type III); and (3) the endoscopic ultrasound staging, with confirmed integrity of the hyperechoic submucosal layer. The high-frequency (20 MHz) miniprobe is preferred to the standard (7.5 MHz) instrument. The elective procedure for tumor eradication is endoscopic mucosectomy. The technique is associated with a 6.8% risk of severe complications (hemorrhage or perforation) and a recurrence rate of 3%-7%. The 5-year survival rate is similar to that of surgery (over 80%). In the small group of patients with superficial esophageal cancer (less than 10% of the disease) endoscopic treatment may now be proposed in about 30% of cases, surgery is preferred for submucosal cancer and for neoplasia with a large surface. Areas of high-grade dysplasia in the Barrett's esophagus offer a new and increasing sector of indications. The concurrent endoscopic procedure of destruction--photodynamic therapy--is preferred for the destruction of lesions with poorly delineated limits.

  5. Engineering Stent Based Delivery System for Esophageal Cancer Using Docetaxel.

    Science.gov (United States)

    Shaikh, Mohsin; Choudhury, Namita Roy; Knott, Robert; Garg, Sanjay

    2015-07-01

    Esophageal cancer patients are often diagnosed as "advanced" cases. These patients are subjected to palliative stenting using self-expanding metallic stents (SEMS) to maintain oral alimentation. Unfortunately, SEMS get reoccluded due to tumor growth, in and over the stent struts. To investigate potential solutions to this problem, docetaxel (DTX) delivery films were prepared using PurSil AL 20 (PUS), which can be used as a covering material for the SEMS. Drug-polymer miscibility and interactions were studied. Bilayer films were prepared by adhering the blank film to the DTX loaded film in order to maintain the unidirectional delivery to the esophagus. In vitro release and the local DTX delivery were studied using in vitro permeation experiments. It was found that DTX and PUS were physically and chemically compatible. The bilayer films exhibited sustained release (>30 days) and minimal DTX permeation through esophageal tissues in vitro. The rate-determining step for the DTX delivery was calculated. It was found that >0.9 fraction of rate control lies with the esophageal tissues, suggesting that DTX delivery can be sustained for longer periods compared to the in vitro release observed. Thus, the bilayer films can be developed as a localized sustained delivery system in combination with the stent.

  6. Esophageal Cancer Dose Escalation Using a Simultaneous Integrated Boost Technique

    Energy Technology Data Exchange (ETDEWEB)

    Welsh, James, E-mail: jwelsh@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Palmer, Matthew B. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Liao Zhongxing [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Swisher, Steven G.; Hofstetter, Wayne L. [Department of Thoracic and Cardiovascular Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Allen, Pamela K.; Settle, Steven H.; Gomez, Daniel; Likhacheva, Anna; Cox, James D.; Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2012-01-01

    Purpose: We previously showed that 75% of radiation therapy (RT) failures in patients with unresectable esophageal cancer are in the gross tumor volume (GTV). We performed a planning study to evaluate if a simultaneous integrated boost (SIB) technique could selectively deliver a boost dose of radiation to the GTV in patients with esophageal cancer. Methods and Materials: Treatment plans were generated using four different approaches (two-dimensional conformal radiotherapy [2D-CRT] to 50.4 Gy, 2D-CRT to 64.8 Gy, intensity-modulated RT [IMRT] to 50.4 Gy, and SIB-IMRT to 64.8 Gy) and optimized for 10 patients with distal esophageal cancer. All plans were constructed to deliver the target dose in 28 fractions using heterogeneity corrections. Isodose distributions were evaluated for target coverage and normal tissue exposure. Results: The 50.4 Gy IMRT plan was associated with significant reductions in mean cardiac, pulmonary, and hepatic doses relative to the 50.4 Gy 2D-CRT plan. The 64.8 Gy SIB-IMRT plan produced a 28% increase in GTV dose and comparable normal tissue doses as the 50.4 Gy IMRT plan; compared with the 50.4 Gy 2D-CRT plan, the 64.8 Gy SIB-IMRT produced significant dose reductions to all critical structures (heart, lung, liver, and spinal cord). Conclusions: The use of SIB-IMRT allowed us to selectively increase the dose to the GTV, the area at highest risk of failure, while simultaneously reducing the dose to the normal heart, lung, and liver. Clinical implications warrant systematic evaluation.

  7. Proton Beam Therapy and Concurrent Chemotherapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Steven H., E-mail: shlin@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Komaki, Ritsuko; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wei, Caimiao [Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Myles, Bevan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Guo Xiaomao [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Palmer, Matthew [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Swisher, Stephen G.; Hofstetter, Wayne L. [Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Cox, James D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-07-01

    Purpose: Proton beam therapy (PBT) is a promising modality for the management of thoracic malignancies. We report our preliminary experience of treating esophageal cancer patients with concurrent chemotherapy (CChT) and PBT (CChT/PBT) at MD Anderson Cancer Center. Methods and Materials: This is an analysis of 62 esophageal cancer patients enrolled on a prospective study evaluating normal tissue toxicity from CChT/PBT from 2006 to 2010. Patients were treated with passive scattering PBT with two- or three-field beam arrangement using 180 to 250 MV protons. We used the Kaplan-Meier method to assess time-to-event outcomes and compared the distributions between groups using the log-rank test. Results: The median follow-up time was 20.1 months for survivors. The median age was 68 years (range, 38-86). Most patients were males (82%) who had adenocarcinomas (76%) and Stage II-III disease (84%). The median radiation dose was 50.4 Gy (RBE [relative biologic equivalence]) (range, 36-57.6). The most common grade 2 to 3 acute toxicities from CChT/PBT were esophagitis (46.8%), fatigue (43.6%), nausea (33.9%), anorexia (30.1%), and radiation dermatitis (16.1%). There were two cases of grade 2 and 3 radiation pneumonitis and two cases of grade 5 toxicities. A total of 29 patients (46.8%) received preoperative CChT/PBT, with one postoperative death. The pathologic complete response (pCR) rate for the surgical cohort was 28%, and the pCR and near CR rates (0%-1% residual cells) were 50%. While there were significantly fewer local-regional recurrences in the preoperative group (3/29) than in the definitive CChT/PBT group (16/33) (log-rank test, p = 0.005), there were no differences in distant metastatic (DM)-free interval or overall survival (OS) between the two groups. Conclusions: This is the first report of patients treated with PBT/CChT for esophageal cancer. Our data suggest that this modality is associated with a few severe toxicities, but the pathologic response and clinical

  8. Dietary Flavonoid Intake and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Cohort

    DEFF Research Database (Denmark)

    Vermeulen, Esther; Zamora-Ros, Raul; Duell, Eric J.

    2013-01-01

    flavonoid subclass and esophageal cancer, EAC, or ESCC. However, among current smokers, flavonols were statistically significantly associated with a reduced esophageal cancer risk (HR (log2) = 0.72, 95% CI: 0.56, 0.94), whereas total flavonoids, flavanols, and flavan-3-ol monomers tended to be inversely...

  9. Multidisciplinary treatment including chemoradiotherapy for advanced esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Kenji; Fukuda, Kazuhiro; Kikkawa, Nobuteru; Kobayashi, Tetsurou; Yagyu, Toshio; Hasuike, Yasunori; Mishima, Hideyuki; Shin, Eisei [Osaka National Hospital (Japan)

    1997-03-01

    Over 3 years, concurrent chemoradiotherapy was performed in 16 patients with advanced esophageal cancer (clinical Stage IV) and suspected noncurative resection. The subjects were {>=}A3 or N3, or were stage IV with distant metastasis on preoperative diagnosis. Two courses of 5FU and CDDP were given with concurrent radiotherapy. The predominant side effects were nausea, vomiting and anorexia. Mild or moderate leukopenia also occurred. The response was complete remission (CR) in two patients, partial remission (PR) in eight, minor response (MR) in two, no change (NC) in two and progressive disease (PD) in two. The overall response rate was 62.5%. Esophagectomy was performed in four patients (histological stage II in one, stage III in one, and stage IV in two). Two of 4 resected patients are alive (33.8 months), while the other died of unrelated causes. One of the 6 non-resected PR patients has survived for 18 months, but all other patients died of cancer within nine months of starting treatment. The survival rate of 16 patients undergoing chemoradiotherapy was 16.7% at one and two years. Thus, chemoradiotherapy may improve the prognosis of advanced esophageal cancer with suspected noncurative resection by increasing the response rate and the curative resection rate. (author)

  10. Eight-year experience in esophageal cancer surgery

    Directory of Open Access Journals (Sweden)

    B Thakur

    2011-01-01

    Full Text Available Aim: Esophageal cancer remains a major and lethal health problem. In Nepal, not much has been explored about its management. The aim of this study was to conduct a retrospective review of esophageal cancer patients undergoing surgery or combined modality treatment at a cancer hospital in Nepal. Materials and Methods: Resectable cases were treated primarily with surgery. Locally advanced cases with doubtful or obviously unresectability underwent preoperative chemo/radiation or chemoradiation followed by surgery. Results: Among 900 patients, 103 were treated with curative intent. Mean age of patients was 54 years, and 100% of the patients presented with complaint of dysphagia. Surgery as a single modality of treatment was done in 57% of cases, and the remaining underwent combined modality treatment. Transthoracic and transhiatal approaches were used in 95% and 5% of cases, respectively. Nodal sampling, two-field (2-FD, and three-field lymphadenectomy (3-FD were done in 18%, 59%, and 20% of cases, respectively. A majority of patients had pathological stage III disease (46.6%. In-hospitality mortality was 5%, and anastomotic leakage rate was 14%. In 87% of patients, R0 resection was achieved. Overall, 4-year survival was 20%. A R0 resection, early-stage disease and 3-FD favored the survival advantage (P < 0.05. Conclusion: The mortality, complication, and survival results were in the acceptable range. R0 resection and radical nodal dissection should be standard practice.

  11. Value of oral effervescent powder administration for multidetector CT evaluation of esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ringe, Kristina I., E-mail: ringe.kristina@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Meyer, Simone, E-mail: Meyer.simone.rad@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Ringe, Bastian P., E-mail: Ringe.bastian@mh-hannover.de [Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Winkler, Michael, E-mail: Winkler.michael@mh-hannover.de [Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Wacker, Frank, E-mail: Wacker.frank@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Raatschen, Hans-Juergen, E-mail: Raatschen.hans-juergen@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany)

    2015-02-15

    Highlights: • Oral effervescent powder improves esophageal distension and wall assessment at CT. • This technique improves detection and T staging of esophageal cancer at CT. • It can be easily adopted in clinical routine in patients with esophageal pathology. - Abstract: Purpose: To assess the value of oral effervescent powder (EP) for evaluation of esophageal distension, and for detection and staging of esophageal cancer with contrast-enhanced CT. Materials and methods: 84 patients without esophageal pathology and 52 patients with histological confirmed diagnosis of esophageal cancer were included in this prospective IRB-approved study. Half of the patients in both groups received EP prior to CT. Esophageal distension was assessed by planimetry of the inner (IA) and outer area (OA). Two blinded readers evaluated the datasets separately with regard to diagnosis of esophageal cancer (yes/no) and staging (T0-T4), if applicable. Distension results were compared (t-Test). In patients with cancer sensitivity, specificity, NPV and PPV were calculated. CT staging results were compared to histopathology (Cohen-k). Results: IA and IA/OA were significantly larger after EP as compared to the group without EP (p < 0.05). Sensitivity, specificity, NPV and PPV for cancer detection cancer were as follows: 78%/78%, 98%/98%, 95%/95%, 87%/87% with EP; 60%/68%, 98%/98%, 94%/94%, 80%/83% without EP. Staging with EP was good (k = 0.84/0.67) and moderate without EP (k = 0.58/0.59). Conclusions: Administration of EP prior to CT results in good distension of the esophagus, and improves detection and staging of esophageal cancer, as compared to control studies without EP.

  12. Esophageal motion characteristics in thoracic esophageal cancer: Impact of clinical stage T4 versus stages T1-T3

    Directory of Open Access Journals (Sweden)

    Yuta Kobayashi, MS

    2016-10-01

    Conclusions: The EM and the ITV margins in cT4 were significantly smaller than those in cT1-T3. The NM and the ITV margins of abdominal LNs were much larger than those of cervicothoracic LNs and the esophagus. In clinical radiation therapy planning for esophageal cancer, we should take cT stage into consideration.

  13. Anti-EGFR-Targeted Therapy for Esophageal and Gastric Cancers: An Evolving Concept

    Directory of Open Access Journals (Sweden)

    Tomislav Dragovich

    2009-01-01

    Full Text Available Cancers of the esophagus and stomach present a major health burden worldwide. In the past 30 years we have witnessed some interesting shifts in terms of epidemiology of esophago gastric cancers. Regardless of a world region, the majority of patients diagnosed with esophageal or gastric cancers die from progression or recurrence of their disease. While there are many active cytotoxic agents for esophageal and stomach cancers, their impact on the disease course has been modest at best. Median survival for patients with advanced gastroesophageal cancer is still less than a year. Therefore, novel strategies, based on our understanding of biology and genetics, are desperately needed. Epidermal growth factor receptor (EGFR pathway has been implicated in pathophysiology of many epithelial malignancies, including esophageal and stomach cancers. EGFR inhibitors, small molecule tyrosine kinase inhibitors and monoclonal antibodies, have been explored in patients with esophageal and gastric cancers. It appears that tumors of the distal esophagus and gastroesophageal junction (GEJ may be more sensitive to EGFR blockade than distal gastric adenocarcinomas. Investigations looking into potential molecular predictors of sensitivity to EGFR inhibitors for patients with esophageal and GEJ cancers are ongoing. While we are still searching for those predictors, it is clear that they will be different from ones identified in lung and colorectal cancers. Further development of EGFR inhibitors for esophageal and GEJ cancers should be driven by better understanding of EGFR pathway disregulation that drives cancer progression in a sensitive patient population.

  14. Usefulness of magnifying endoscopy for iodine-unstained lesions in a high-risk esophageal cancer population

    Institute of Scientific and Technical Information of China (English)

    Ik; Seong; Choi; Jae; Young; Jang; Won; Young; Cho; Tae; Hee; Lee; Hyun; Gun; Kim; Bo; Young; Lee; Soung; Won; Jeong; Joo; Young; Cho; Joon; Seong; Lee; So; Young; Jin

    2010-01-01

    AIM: To investigate the usefulness of magnified observations of iodine-unstained esophageal lesions in the histological diagnosis of esophageal mucosa abnormalities, in high-risk esophageal cancer groups. METHODS: The subjects included 38 patients who had at least one of the four criteria known to be highrisk factors for esophageal cancer. Following endoscopic observation, magnified observations were performed on iodine-unstained lesions of the esophagus. The total number of lesions was 43. These lesions we...

  15. Risk factors for esophageal cancer in a low-incidence area of Brazil

    Directory of Open Access Journals (Sweden)

    Orlando Milhomem Mota

    Full Text Available CONTEXT AND OBJECTIVESEsophageal cancer is the eighth commonest type of cancer worldwide, occupying sixth place in terms of mortality. Smoking and alcohol use are known risk factors for this type of cancer. The aim here was to evaluate the risk factors for esophageal cancer in a low-incidence area.DESIGN AND SETTINGCase-control study in Goiânia, with 99 cases of esophageal cancer and 223 controls.METHODSThe variables were sociodemographic, dietary, occupational and lifestyle data. The sample was analyzed using the chi-square test, Mann-Whitney test and Mantel-Haenszel approach for multivariate analysis. Odds ratios (OR were calculated with 5% significance and 95% confidence intervals.RESULTSThe risk of esophageal cancer was higher in patients ≥ 55 years (OR = 1.95; P < 0.001. Patients from rural areas were at greater risk of esophageal cancer (OR = 4.9; P < 0.001. Smoking was a risk factor among the cases (OR = 3.8; P < 0.001, as was exposure to woodstoves (OR = 4.42; P < 0.001. The practice of oral sex was not a risk factor (OR = 0.45; P = 0.04. Consumption of apples, pears, vegetables, cruciferous vegetables and fruit juices were protective against esophageal cancer.CONCLUSIONIn a region in which the incidence of esophageal cancer is low, the most significant risk factors were exposure to woodstoves, smoking and living in rural areas.

  16. Chemoradiotherapy for superficial (sm{sub 2}/sm{sub 3}) esophageal cancer. Chemoradiotherapy for clinical stage I esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Muro, Kei; Arai, Tatsuhiro; Hamanaka, Hisanao [National Cancer Center, Tokyo (Japan). Hospital

    2002-09-01

    We studied the clinical outcome of chemoradiotherapy for clinical Stage I squamous cell carcinoma of the esophagus. Seventy-one patients without possibility of cure by endoscopic mucosal resection (EMR) were analyzed. Patients received continuous infusion of 5FU at a dose of 700 mg/m{sup 2}/24 hours on days 1 to 4, combined with CDDP at a dose of 70 mg/m{sup 2} on day 1, and concurrent radiation therapy at a dose of 30 Gy in 15 fractions over 3 weeks. This schedule was repeated twice every 4 weeks, for a total radiation dose of 60 Gy. The 66 patients (93%) achieved a complete response. Toxicities were generally mild, but late radiation morbidity was relatively frequent. However, no toxicities interfering with function were seen. With a median follow-up duration of 23 months, the 1, 2 and 3-year survival rates were 97%, 90% and 80%, respectively. This survival rate compared with that obtained by ordinary surgery with three-field lymph node dissection. Chemoradiotherapy for clinical Stage I esophageal cancer is a promising method, because of its safety and its being a curative therapy. We should present this therapy as well as surgery as an option of possibly curative therapy to patients with clinical Stage I esophageal cancer. (author)

  17. [Indications for and limitations of HpD photodynamic therapy for esophageal cancer and gastric cancer].

    Science.gov (United States)

    Mimura, S; Ichii, M; Imanishi, K; Otani, T; Okuda, S

    1988-04-01

    HpD photodynamic therapy (PDT) was performed on 4 patients with superficial esophageal cancer, 20 patients with 22 early gastric cancer lesions and one patient with advanced gastric cancer. About 50 h before irradiation, 3 mg/kg of HpD or 1.3-2.5 mg/kg of Photofrin II was injected intravenously. The entire lesion including a 5-mm border of normal surrounding mucosa, was irradiated with an argon dye laser at 630nm wavelength with an output of 100-400mW at the tip of the fiber. Complete response (CR) to HpD-PDT was obtained in 2 of 2 mucosal esophageal cancers, and one of 2 submucosal lesions, totalling 3 of 4, and in 13 of 13 mucosal gastric cancers and 7 of 9 submucosal lesions totalling 20 of 22. The depths of cancer involvement were determined endoscopically. In Borrmann 1 lesion with muscularis externa involvement, in spite of two trials with HpD-PDT, only partial response (PR) was obtained. Tumor laser dose had to be more than 90 J/cm2, and in several cases combined hot biopsy with electrodiathermy and/or repeated HpD-PDT was needed to obtain CR. HpD-PDT is indicated for superficial esophageal cancer and depressed and/or assembled protuberant-type of early gastric cancer with poor risk.

  18. Multimodality approach for locally advanced esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Khaldoun Almhanna; Jonathan R Strosberg

    2012-01-01

    Carcinoma of the esophagus is an aggressive and lethal malignancy with an increasing incidence world-wide.Incidence rates vary internationally,with the highest rates found in Southern and Eastern Africa and Eastern Asia,and the lowest in Western and Middle Africa and Central America.Patients with locally advanced disease face a poor prognosis,with 5-year survival rates ranging from 15%-34%.Recent clinical trials have evaluated different strategies for management of locoregional cancer; however,because of stage migration and changes in disease epidemiology,applying these trials to clinical practice has become a daunting task.We searched Medline and conference abstracts for randomized studies published in the last 3 decades.We restricted our search to articles published in English.Neoadjuvant chemoradiotherapy followed by surgical resection is an accepted standard of care in the United States.Esophagectomy remains an essential component of treatment and can lead to improved overall survival,especially when performed at high volume institutions.The role of adjuvant chemotherapy following curative resection is still unclear.External beam radiation therapy alone is considered palliative and is typically reserved for patients with a poor performance status.

  19. Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko [Tokyo Women`s Medical Coll. (Japan)

    1996-10-01

    From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

  20. [Present and future state of cancer screening for esophageal cancer and gastric cancer].

    Science.gov (United States)

    Nakashima, Hirotaka; Nagahama, Ryuji; Yoshida, Misao

    2012-01-01

    Recently, endoscopic examinations have played a major role in the diagnosis and treatment in the field of gastroenterology. It is considered that endoscopy would be an important examination for cancer screening of the esophagus and the stomach. However, endoscopic services for cancer screening are in short supply. Furthermore, we have to take the complications and poor economic benefits of endoscopy in to consideration when we apply it as a practical cancer screening system. Thus, an effective primary screening system must be provided for the endoscopic screening of cancer of the esophagus and the stomach. People with a defect in aldehyde dehydrogenase-2(ALDH2)should be distinguished by their facial flushing in drinking and for their high risks of esophageal cancer. In cases with gastric cancer screening by endoscopy, an x-ray study is expected to be a primary screening because of its efficacy. It already has been recommended for population-based screening in Japanese guidelines for gastric cancer screening. In cases with opportunistic screening of gastric cancer, patients should be allowed to choose from several studies such as the x-ray study, direct endoscopy, and the so-called high risk screening of gastric cancer for estimating risks and planning of screening for gastric cancer.

  1. The role of postoperative adjuvant radiotherapy in resected esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang Geol; Kim, Choong Bae; Chung, Kyung Young; Lee, Doo Yun; Seong Jin Sil; Kim, Gwi Eon; Suh, Chang Ok [Yonsei University College of Medicine, Yonsei Cancer Center, Seoul (Korea, Republic of)

    2002-12-15

    A retrospective study was performed to evaluate whether postoperative adjuvant radiotherapy can improve survival and decrease recurrence as compared with surgery alone in resected esophageal cancer. From Jan. 1985 to Dec. 1993, among 94 esophageal cancer patients treated with surgery, fifty-one patients were included in this study. Transthoracic esophagectomy was performed in 35 patients and transhiatal esophagectomy in 16. Postoperative adjuvant radiotherapy was performed 4 weeks after surgery in 26 among 38 patients in stage II and III. A total dose of 30 {approx} 60 Gy in 1.8 Gy daily fraction, median 54 Gy over 6 weeks, was delivered in the mediastinum + both supraclavicular lymph nodes or celiac lymph nodes according to the tumor location. Forty-seven patients (92%) had squamous histology. The median follow-up period was 38 months. The overall 2-year and 5-year survival and median survival were 56.4%, 36.8% and 45 months. Two-year and 5-year survival and median survival by stage were 92%, 60.3% for stage I, 63%, 42% and 51 months for stage II and 34%, 23% and 19 months for stage III ({rho} = 0.04). For stage II and III patients, 5-year survival and median survival were 22.8%. 45 months for the surgery alone group and 37.8%, 22 months for the postoperative RT group ({rho} = 0.89). For stage III patients, 2-year survival and median survival were 0%, 11 months for the surgery alone group and 36.5%, 20 months for the postoperative RT group ({rho} = 0.14). Local and distant failure rates for stage II and III were 50%, 16% for the surgery alone and 39%, 31% for the postoperative RT group. For N1 patients, local failure rate was 71% for the surgery alone group and 37% for the postoperative RT group ({rho} = 0.19). Among 10 local failures in the postoperative RT group, in-field failures were 2, marginal failures 1, out-field 5 and anastomotic site failures 2. There were no statistically significant differences in either the overall survival or the patterns of failure

  2. Clinical evaluation of radiotherapy for advanced esophageal cancer after metallic stent placement

    Institute of Scientific and Technical Information of China (English)

    You-Tao Yu; Guang Yang; Yan Liu; Bao-Zhong Shen

    2004-01-01

    AIM: To evaluate the therapeutic effect of radiotherapy for esophageal cancer after expandable metallic stent placement.METHODS: Ten cases of advanced esophageal cancer were evaluated, 7 having complete obstruction and 3 with digestive-respiratory fistula. Ten nitinol stents were placed at the site of stenosis. Patients were treated with a total dose of 1 200 cGy divided into 3 fractions of 400 cGy 4-7 d after stents placement.RESULTS: All the 10 stents were placed successfully at one time. After radiotherapy for advanced esophageal cancer, the survival period of the cases ranged from 14 to 22 mo, with a mean survival of 17 mo. No re-stenosis occurred among all the 10 cases.CONCLUSION: Stent placement combined with radiotherapy for esophageal cancer is helpful to prolong patients' survival and reduce occurrence of re-stenosis.

  3. Mutations of p53 gene exons 4-8 in human esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Li-Ya Li; Jin-Tian Tang; Li-Qun Jia; Pei-Wen Li

    2005-01-01

    AIM: To characterize the tumor suppressor gene p53 mutations in exon 4, esophageal cancer and adjacent noncancerous tissues.METHODS: We performed p53 (exons 4-8) gene mutation analysis on 24 surgically resected human esophageal cancer specimens by PCR, single-strand conformation polymorphism, and DNA sequencing. RESULTS: p53 gene mutations were detected in 9 of 22 (40.9%) esophageal cancer specimens and 10 of 17 (58.8%) adjacent non-cancerous tissues. Eight of sixteen (50.0%) point mutations detected were G-A transitions and 9 of 18 (50.0%) p53 gene mutations occurred in exon 4 in esophageal cancer specimens. Only 1 of 11 mutations detected was G-A transition and 4 of 11 (36.4%) p53 gene mutations occurred in exon 4 in adjacent non-cancerous tissues.CONCLUSION: Mutation of p53 gene in exon 4 may play an important role in development of esophageal cancer. The observation of p53 gene mutation in adjacent noncancerous tissues suggests that p53 gene mutation may be an early event in esophageal carcinogenesis. Some clinical factors, including age, sex, pre-operation therapy and location of tumors, do not influence p53 gene mutation rates.

  4. Vegetables and fruits consumption and risk of esophageal and gastric cancer subtypes in the Netherlands Cohort Study

    NARCIS (Netherlands)

    Steevens, J.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2011-01-01

    Prospective epidemiologic data on vegetables and fruits consumption and risk of subtypes of esophageal and gastric cancer are sparse. We studied the association between vegetables and fruits consumption and risk of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), gastric c

  5. Effect of S1P5 on proliferation and migration of human esophageal cancer cells

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the sphingosine 1phosphate (S1P) receptor expression profile in human esophageal cancer cells and the effects of S1P5 on proliferation and migration of human esophageal cancer cells. METHODS: S1P receptor expression profile in human esophageal squamous cell carcinoma cell line Eca109 was detected by semiquantitative reverse trans cription polymerase chain reaction. Eca109 cells were stably transfected with S1P5EGFP or controlEGFP constructs. The relation between the responses of cell prol...

  6. Genetic polymorphisms of ADH2 and ALDH2 association with esophageal cancer risk in southwest China

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To evaluate the impact of alcohol dehydrogenase 2 (ADH2) and aldehyde dehydrogenase 2 (ALDH2)polymorphisms on esophageal cancer risk.METHODS: One hundred and ninety-one esophageal cancer patients and 198 healthy controls from Yanting County were enrolled in this study. ADH2 and ALDH2genotypes were examined by polymerase-chain-reaction with the confronting-two-pair-primer (PCR-CTPP)method. Unconditional logistic regression was used to calculate the odds ratios (OR) and 95% confidence interval (95% CI).RESULTS: Both ,ADH2*1 allele and ,ALDH2*1/*2 allele showed an increased risk of developing esophageal cancer. The adjusted OR (95% CI) for ,ADH2*1allele compared with ,ADH2*2/*2 was 1.65 (95%CI= 1.02-2.68) and 1.67 (95% CI= 1.02-2.72) for ,ALDH2*1/*2 compared with ALDH2*1/*1. A significant interaction between ,ALDH2 and drinking was detected regarding esophageal cancer risk, the OR was 1.83(95% CI = 1.13-2.95). Furthermore, when compared with ADH2*2/*2 and ALDH2*1/*1 carriers, ADH2*1 and ALDH2*2 carriers showed an elevated risk of developing esophageal cancer among non-alcohol drinkers (OR =2.46, 95% CI= 0.98-6.14), and a significantly elevated risk of developing esophageal cancer among alcohol drinkers among alcohol drinkers (OR = 9.86, 95% CI=3.10-31.38).CONCLUSION: ADH2 and ALDH2 genotypes are associated with esophageal cancer risk. ADH2*1 allele and ALDH2*2 allele carriers have a much higher risk of developing esophageal cancer, especially among alcohol drinkers.

  7. Risk indicators for esophageal cancer : Some medical conditions and tobacco-related indicators

    OpenAIRE

    Zendehdel, Kazem

    2007-01-01

    Because of little progress in the prognosis and survival of esophageal cancer patients, the early diagnosis and prevention have been prioritized. Alcohol consumption and tobacco smoking are the main risk factors of squamous cell carcinoma, and high body mass index and gastroesophageal reflux are strongly linked to adenocarcinoma of the esophagus. However underlying mechanisms for the observed associations between these risk factors and esophageal cancer are not fully unde...

  8. Neoadjuvant irinotecan, cisplatin, and concurrent radiation therapy with celecoxib for patients with locally advanced esophageal cancer

    OpenAIRE

    Cleary, James M.; Mamon, Harvey J.; Szymonifka, Jackie; Bueno, Raphael; Choi, Noah; Donahue, Dean M.; Fidias, Panos M.; Gaissert, Henning A.; Jaklitsch, Michael T.; Kulke, Matthew H.; Lynch, Thomas P.; Mentzer, Steven J.; Meyerhardt, Jeffrey A.; Swanson, Richard S.; Wain, John

    2016-01-01

    Background: Patients with locally advanced esophageal cancer who are treated with trimodality therapy have a high recurrence rate. Preclinical evidence suggests that inhibition of cyclooxygenase 2 (COX2) increases the effectiveness of chemoradiation, and observational studies in humans suggest that COX-2 inhibition may reduce esophageal cancer risk. This trial tested the safety and efficacy of combining a COX2 inhibitor, celecoxib, with neoadjuvant irinotecan/cisplatin chemoradiation. Methods...

  9. Esophageal cancer with an esophagopericardial fistula and purulent pericarditis.

    Science.gov (United States)

    Takayama, Tsugumi; Okura, Yuji; Funakoshi, Kazuhiro; Sato, Tatsuhiko; Ohi, Hiroyuki; Kato, Toshiyuki

    2013-01-01

    We herein present the case of a 56-year-old Japanese woman who developed purulent pericarditis after undergoing chemoradiotherapy for esophageal cancer. She developed epigastralgia and a fever and was admitted to our hospital. A physical examination revealed hypotension, tachycardia and pericardial friction rub. Echocardiography revealed moderate pericardial effusion. Based on these observations, the patient was diagnosed with cardiac tamponade. Computed tomography confirmed the presence of an esophagopericardial fistula. Treatment with pericardiocentesis, drainage and short-term intrapericardial administration of antibiotics relieved the patient's symptoms. Daily rinsing through a catheter with normal saline prevented relapse of the purulent pericarditis. Esophagopericardial fistulas are so rare that their treatment is not well-established. We herein report successful palliative care of a malignant esophagopericardial fistula associated with purulent pericarditis.

  10. Identification of tumor cells infiltrating into connective tissue in esophageal cancer by multiphoton microscopy

    Science.gov (United States)

    Xu, Jian; Jiang, Liwei; Kang, Deyong; Wu, Xuejing; Xu, Meifang; Zhuo, Shuangmu; Zhu, Xiaoqin; Lin, Jiangbo; Chen, Jianxin

    2016-10-01

    Esophageal cancer is one of the most common malignancies of the gastrointestinal cancers and carries poorer prognosis than other gastrointestinal cancers. In general practice, the depth of tumor infiltration in esophageal wall is crucial to establishing appropriate treatment plan which is established by detecting the tumor infiltration depth. Connective tissue is one of the main structures that form the esophageal wall. So, identification of tumor cells infiltrating into connective tissue is helping for detecting the tumor infiltration depth. Our aim is to evaluate whether multiphoton microscopy (MPM) can be used to detect tumor cells infiltrating into connective tissue in the esophageal cancer. MPM is well-suited for real-time detecting morphologic and cellular changes in fresh tissues since many endogenous fluorophores of fresh tissues are excited through two-photon excited fluorescence (TPEF) and second harmonic generation (SHG). In this work, microstructure of tumor cells and connective tissue are first studied. Then, morphological changes of collagen fibers after the infiltration of tumor cells are shown. These results show that MPM has the ability to detect tumor cells infiltrating into connective tissue in the esophageal cancer. In the future, MPM may be a promising imaging technique for detecting tumor cells in esophageal cancer.

  11. Telomerase antagonist imetelstat inhibits esophageal cancer cell growth and increases radiation-induced DNA breaks.

    Science.gov (United States)

    Wu, Xuping; Smavadati, Shirin; Nordfjäll, Katarina; Karlsson, Krister; Qvarnström, Fredrik; Simonsson, Martin; Bergqvist, Michael; Gryaznov, Sergei; Ekman, Simon; Paulsson-Karlsson, Ylva

    2012-12-01

    Telomerase is mainly active in human tumor cells, which provides an opportunity for a therapeutic window on telomerase targeting. We sought to evaluate the potential of the thio-phosphoramidate oligonucleotide inhibitor of telomerase, imetelstat, as a drug candidate for treatment of esophageal cancer. Our results showed that imetelstat inhibited telomerase activity in a dose-dependent manner in esophageal cancer cells. After only 1 week of imetelstat treatment, a reduction of colony formation ability of esophageal cancer cells was observed. Furthermore, long-term treatment with imetelstat decreased cell growth of esophageal cancer cells with different kinetics regarding telomere lengths. Short-term imetelstat treatment also increased γ-H2AX and 53BP1 foci staining in the esophageal cancer cell lines indicating a possible induction of DNA double strand breaks (DSBs). We also found that pre-treatment with imetelstat led to increased number and size of 53BP1 foci after ionizing radiation. The increase of 53BP1 foci number was especially pronounced during the first 1h of repair whereas the increase of foci size was prominent later on. This study supports the potential of imetelstat as a therapeutic agent for the treatment of esophageal cancer.

  12. Family history of cancer and risk for esophageal and gastric cancer in Shanxi, China

    Directory of Open Access Journals (Sweden)

    Goldstein Alisa

    2009-08-01

    Full Text Available Abstract Background Family history (FH by different relative types and risk of upper gastrointestinal (UGI cancers has been only rarely reported; the data on UGI cancer survival are sparse. Methods 600 esophageal squamous cell carcinoma (ESCC cases, 598 gastric cardia adenocarcinoma cases, and 316 gastric non-cardia adenocarcinoma cases, and 1514 age-, gender-, and neighborhood-matched controls were asked for FH in first degree relatives and non-blood relatives. Odds ratios (ORs and 95% confidence intervals (CIs from logistic regressions, and hazard ratios (HRs from Cox proportional hazard regressions were estimated. Results Increased ESCC risk was associated with FH of any cancer (OR = 1.72, 95% CI = 1.39–2.12, FH of any UGI cancer (OR = 2.28, 95%CI = 1.77–2.95 and FH of esophageal cancer (OR = 2.84, 95%CI = 2.09–3.86, but not FH of non-UGI cancer. Individuals with two or more affected first-degree relatives had 10-fold increased ESCC risk. FH of gastric cardia cancer was associated with an increased risk of all three cancers. Cancer in non-blood relatives was not associated with risk of any UGI cancer. FH of UGI cancer was associated with a poorer survival rate among younger ESCC cases (HR = 1.82, 95%CI = 1.01–3.29. Conclusion These data provide strong evidence that shared susceptibility is involved in esophageal carcinogenesis and also suggest a role in prognosis.

  13. The comparison between two different methods of radiotherapy in palliation and survival of patients with esophageal cancer

    Directory of Open Access Journals (Sweden)

    Keshvary M

    2001-10-01

    Full Text Available Esophageal cancer is one of the most common malignancies in our country. Patients often seek medical advice in advanced and inoperable stages or with cervical esophageal cancer, in which operation is accompanied by sever morbidity. In this conditions many of them cannot tolerate chemo-radiation, or refuse it. Therefore radiotherapy is applied as a single modality in palliation of many patients with esophageal cancer. One of the palliative radio therapeutic methods is application of 5000 CGY in 20 fractions (Long Course; but considering the great number of our patients and limited capacity of radiotherapy centers, as well as emphasis of literature on palliation with 4000 CGY in 13 fractions (short course, we decided to compare these two methods (which are both used in our departments. In this retrospective analytic study, the files of 283 patients with esophageal cancer referred to cancer institute of Imam Khomeini Hospital from 1989-1999 were studied. Patients were between 27-97 years old (mean age=58.3 and most of them were male (53.7 percent. The mean length of lesion was 8.5 cm. The most common site of lesion was middle third at esophagus (48.1 percent and the most common pathology was squamous cell carcinoma (99.6 percent. Fifty-four percent of patients were hot tea drinkers habitually. From the mentioned variables, only length of lesion had significant relationship with overall survival (P=0.04. Thirty-eight of 283 patients were excluded from analytic study because of incomplete follow-up. The number of patients had been treated by long course (5000 CGY in 20 fractions was 137 and the remainder (108 patients by short course (4000 CGY in 13 fractions. No significant difference was seen statistically between these two groups in overall and dysphagia-free survival (Kaplan-Meyer test. Also total dosage of spinal cord is lower in the short course. Thus regarding to less required time in short course and comparable palliation and survival between

  14. Mutation screening of mismatch repair gene Mlh3 in familial esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Hong-Xu Liu; Yu Li; Xue-Dong Jiang; Hong-Nian Yin; Lin Zhang; Yu Wang; Jun Yang

    2006-01-01

    AIM: To shed light on the possible role of mismatch repair gene Mlh3 in familial esophageal cancer (FEC).METHODS: A total of 66 members from 10 families suggestive of a genetic predisposition to hereditary esophageal cancer were screened for germline mutations in Mlh3 with denaturing high performance liquid chromatography (DHPLC), a newly developed method of comparative sequencing based on heteroduplex detection. For all samples exhibiting abnormal DHPLC profiles,sequence changes were evaluated by cycle sequencing.For any mutation in family members, we conducted a segregation study to compare its prevalence in sporadic esophageal cancer patients and normal controls.RESULTS: Exons of Mlh3 in all samples were successfully examined. Overall, 4 missense mutations and 3 polymorphisms were identified in 4 families. Mlh3 missense mutations in families 9 and 10 might be pathogenic, but had a reduced penetrance. While in families 1 and 7,there was no sufficient evidence supporting the monogenic explanations of esophageal cancers in families.The mutations were found in 33% of high-risk families and 50% of low-risk families.CONCLUSION: Mlh3 is a high risk gene with a reduced penetrance in some families. However, it acts as a low risk gene for esophageal cancer in most families. Mutations of Mlh3 may work together with other genes in an accumulated manner and result in an increased risk of esophageal tumor. DHPLC is a robust and sensitive technique for screening gene mutations.

  15. Overexpression of p53 Gene in Esophageal and Cervical Cancer and the Relationship with Radiotherapy Effects

    Institute of Scientific and Technical Information of China (English)

    张晓智; 王晓丽; 李旭

    2003-01-01

    Objective:To investigate the relationship between p53 protein overexpression in esophageal and cervical squamous cell cancer and their clinical radiosensitivity. Methods: The immuno-histochemical assays were done for 52 cases with esophageal and cervical squamous cell cancer. The relationship between the assay results and short-term radiotherapy was investigated. Results: p53 overer-pression was 52.38% and 35. 48% respectively, in esophageal cancer and cervical cancer;p53 over-expression in high differentiated squamous cell cancer was knver than these in moderate and poor differentiated cases(P0. 05). In the cases of cervical cancer, p53 overexpression had the less short-term effect(P0. 05).Conclusion:This study suggests that p53 gene has the certain relationship with tumor radiosensitivity.

  16. Detection and significance of epidermal growth factor receptor mutation in esophageal,esophagogastric junction and gastric cancers

    Institute of Scientific and Technical Information of China (English)

    吕萧

    2014-01-01

    Objective To detect the frequency of EGFR mutation and expression in Chinese patients with esophageal,esophagogastric junction and gastric cancers,and to clarify the value of EGFR mutation and expression in predicting the efficacy of TKI in the treatment of these tumors.Methods In this study,180 tumor samples with histologically confirmed esophageal cancer(39 cases),cancer of

  17. Efficacy of Intensity Modulated Radiation Therapy After Surgery in Early Stage of Esophageal Carcinoma;

    Science.gov (United States)

    2016-07-30

    Esophageal Neoplasm; Esophageal Cancer TNM Staging Primary Tumor (T) T2; Esophageal Cancer TNM Staging Primary Tumor (T) T3; Esophageal Cancer TNM Staging Regional Lymph Nodes (N) N0; Esophageal Cancer TNM Staging Distal Metastasis (M) M0

  18. A Survey of Esophageal Cancer in Cixian County of Hebei Province

    Institute of Scientific and Technical Information of China (English)

    JunHou; ZhifengChen; CuilanGuo; ShaosenLi; WenlongBai; GuolimngJin; YuxiaWang; FanshuMeng; FengGao; XujingLu; ZhifangWang; GangKuang

    2004-01-01

    OBJECTIVE To characterize the histologic types of esophageal cardiac mucosa by endoscopic survey in a high-risk cancer area of China. METHODS An endoscopic survey with Lugol,s staining was carried out in Cixian County, Hebei Province from December 2001 to May 2002. The data were processed using computer SPSS 10.0 software. RESULTS The incidences of mild esophagitis, moderate esophagitis, and severe esophagitis were for 2013 cases, 34.9%(703), 1.6%(33) and 0.1% (2)respectively; those with mild dysplasia, moderate dysplasia, severe dysplasia of the esophagus were 8.6% (172), 7.8% (157) and 2.6% (53) respectively; those with carcinoma in situ, intramucosal carcinoma, invasive squamous carcinoma of the esophagus were 2.5%(50), 0.2% (4) and 0.7%(14) respectively. The histologic-detecting rates of non-atrophic gastritis, and atrophic gastritis of the cardia were 36.3%(730), 11.5% (232) respectively; those with mild dysplasia, severe dysplasia of the cardia were 2.5%(51), 0.8%(17) respectively; those with intramucosal adenocarcinoma, invasive adenocarcinoma of the cardia were 0.1% (3), 0.8%(17) respectively. The early-detection rate of esophageal cancer was 79.4%(54/68). The survey rate(examined population to covered population) was 73.8% (2013/2725). CONCLUSIONS Esophageal endoscopic screening with Lugol's solution staining has an advantage over esophageal balloon cytology, in that the histological diagnoses of esophageal cardiac diseases can be obtained, thus contributing to the prevention of subsequent disease. In using the staining method the detection rate of early esophageal cancer is higher than that revealed by balloon cytology.

  19. Magnetic stent hyperthermia for esophageal cancer: an in vitro investigation in the ECA-109 cell line.

    Science.gov (United States)

    Liu, Jia-Yi; Zhao, Ling-Yun; Wang, Yu-Ying; Li, Dan-Ye; Tao, Dan; Li, Li-Ya; Tang, Jin-Tian

    2012-03-01

    Magnetic stent hyperthermia (MSH) is a novel approach for targeted thermotherapy for esophageal cancer, which is based on the mechanism that inductive heat can be generated by the esophageal stent upon exposure under an alternative magnetic field (AMF). A positive effect of MSH on esophageal cancer has been demonstrated, however, there is no study on the in vitro effects of heating treatment or of the effects of AMF exposure on human esophageal cancer cells. This study aimed to investigate the effect of MSH and of AMF exposure in esophageal cancer cells. Inductive heating characteristics of esophageal stents were assessed by exposing the stents under AMF. A rather rapid temperature rise of the Ni-Ti stent when subjected to AMF exposure was observed and the desired hyperthermic temperature could be controlled by adjusting the field parameter of the AMF. Human esophageal squamous carcinoma (ESCC) ECA-109 cells were divided into four groups: the control group, the water-bath heating group, the MSH group and the AMF exposure group. Hyperthermic temperatures were 43, 48 and 53˚C and the treatment time was in the range of 5-30 min. The MTT assay, apoptotic analysis and TUNEL staining were applied in the current investigation. Exposure of ECA-109 cells under AMF with a field intensity of 50 to 110 kA/m had negligible effect on cell viability, cell necrosis and apoptosis. Hyperthermia had a remarkable inhibitory effect on the cell viability and the effect was dependent on the thermal dose (temperature and time). The optimal thermal dose of MSH for ECA-109 cells was 48˚C for 20-30 min. The study also elucidated that there was a difference in the effects on cell necrosis and apoptosis between the heating mode of water bath and MSH. The data suggest that MSH may have clinical significance for esophageal cancer treatment.

  20. Aberrant nuclear localization of β-catenin without genetic alterations in β-catenin or Axin genes in esophageal cancer

    Directory of Open Access Journals (Sweden)

    Shinoda Noriyuki

    2007-02-01

    Full Text Available Abstract Background β-catenin is a multifunctional protein involved in two apparently independent processes: cell-cell adhesion and signal transduction. β-catenin is involved in Wnt signaling pathway that regulates cellular differentiation and proliferation. In this study, we investigated the expression pattern of β-catenin and cyclin D1 using immunohistochemistry and searched for mutations in exon 3 of the β-catenin gene and Axin gene in esophageal squamous cell carcinoma. Materials and methods Samples were obtained from 50 esophageal cancer patients. Immunohistochemical staining for β-catenin and cyclin D1 was done. Mutational analyses of the exon3 of the β-catenin gene and Axin gene were performed on tumors with nuclear β-catenin expression. Results Four (8% esophageal cancer tissues showed high nuclear β-catenin staining. Overexpression of cyclin D1 was observed in 27 out of 50 (54% patients. All four cases that showed nuclear β-catenin staining overexpressed cyclin D1. No relationship was observed between the expression pattern of β-catenin and cyclin D1 and age, sex, tumor size, stage, differentiation grade, lymph node metastasis, response to chemotherapy, or survival. No mutational change was found in β-catenin exon 3 in the four cases with nuclear β-catenin staining. Sequencing analysis of the Axin cDNA revealed only a splicing variant (108 bp deletion, position 2302–2409 which was present in the paired normal mucosa. Conclusion A fraction of esophageal squamous cell carcinomas have abnormal nuclear accumulation of β-catenin accompanied with increased cyclin D1 expression. Mutations in β-catenin or axin genes are not responsible for this abnormal localization of β-catenin.

  1. Cronkhite-Canada syndrome associated with esophageal and gastric cancers: report of a case.

    Science.gov (United States)

    Ito, Masahiro; Matsumoto, Sohei; Takayama, Tomoyoshi; Wakatsuki, Kohei; Tanaka, Tetsuya; Migita, Kazuhiro; Nakajima, Yoshiyuki

    2015-06-01

    Cronkhite-Canada Syndrome (CCS) is a rare non-inherited gastrointestinal polyposis syndrome with characteristic ectodermal changes. We report an extremely unusual case of CCS associated with primary esophageal and gastric cancers. A 74-year-old Japanese man with symptoms of anorexia and diarrhea was found to have primary esophageal and gastric cancers, as well as multiple gastric and colonic polyps. Based on the physical findings of onychodystrophy and alopecia, we diagnosed CCS. Because of his age and nutritional status, we decided to perform total gastrectomy for gastric cancer and chemoradiotherapy for esophageal cancer, upon completion of which the patient was started on steroid therapy for the CCS. After 1 week of steroid therapy, the patient's watery diarrhea improved. We recommend that for patients with CCS, the therapeutic strategy be carefully considered based on the patient's nutritional status, the severity of the CCS, and the extent of gastrointestinal cancer.

  2. Clinical and epidemiologic variations of esophageal cancer in Tanzania

    Institute of Scientific and Technical Information of China (English)

    Jaime V Gabel; Robert M Chamberlain; Twalib Ngoma; Julius Mwaiselage; Kendra K Schmid; Crispin Kahesa; Amr S Soliman

    2016-01-01

    AIM: To estimate the incidence of esophageal cancer(EC) in Kilimanjaro in comparison to other regions in Tanzania. METHODS: We also examined the clinical, epidemiologic, and geographic distribution of the 1332 EC patients diagnosed and/or treated at Ocean Road Cancer Institute(ORCI) during the period 2006-2013. Medical records were used to abstract patient information on age, sex, residence, smoking status, alcohol consumption, tumor site, histopathologic type of tumor, date and place of diagnosis, and type and date of treatment at ORCI. Regional variation of EC patients was investigated at the level of the 26 administrative regions of Tanzania. Total, age- and sex-specific incidence rates were calculated. RESULTS: Male patients 55 years and older had higher incidence of EC than female and younger patients. Of histopathologically-confirmed cases, squamous-cell carcinoma represented 90.9% of histopathologic types of tumors. The administrative regions in the central andeastern parts of Tanzania had higher incidence rates than western regions, specifically administrative regions of Kilimanjaro, Dar es Salaam, and Tanga had the highest rates. CONCLUSION: Further research should focus on investigating possible etiologic factors for EC in regions with high incidence in Tanzania.

  3. Polymorphisms of alcohol dehydrogenase-2 and aldehyde dehydrogenase-2 and esophageal cancer risk in Southeast Chinese males

    Institute of Scientific and Technical Information of China (English)

    Jian-Hua Ding; Su-Ping Li; Hai-Xia Cao; Jian-Zhong Wu; Chang-Ming Gao; Ping Su; Yan-Ting Liu; Jian-Nong Zhou; Jun Chang; Gen-Hong Yao

    2009-01-01

    AIM: To evaluate the impact of alcohol dehydrogenase-2 (ADH2) and aldehyde dehydrogenase-2 (ALDH2) polymorphisms on esophageal cancer susceptibility in Southeast Chinese males. METHODS: Two hundred and twenty-one esophageal cancer patients and 191 healthy controls from Taixing city in Jiangsu Province were enrolled in this study. ADH2 and ALDH2 genotypes were examined by polymerase chain reaction and denaturing highperformance liquid chromatography. Unconditional logistic regression was used to calculate the odds ratios (OR) and 95% confidence interval (CI). RESULTS: The ADH G allele carriers were more susceptible to esophageal cancer, but no association was found between ADH2 genotypes and risk of esophageal cancer when disregarding alcohol drinking status. Regardless of ADH2 genotype, ALDH2G/A or A/A carriers had significantly increased risk of developing esophageal cancer, with homozygous individuals showing higher esophageal cancer risk than those who were heterozygous. A significant interaction between ALDH2 and drinking was detected regarding esophageal cancer risk; the OR was 3.05 (95% CI: 1.49-6.25). Compared with non-drinkers carrying both ALDH2 G/G and ADH2 A/A, drinkers carrying both ALDH2 A allele and ADH2 G allele showed a significantly higher risk of developing esophageal cancer (OR = 8.36, 95% CI: 2.98-23.46).CONCLUSION: Both ADH2 G allele and ALDH2 A allele significantly increase the risk of esophageal cancer development in Southeast Chinese males. ALDH2 A allele significantly increases the risk of esophageal cancer development especially in alcohol drinkers. Alcohol drinkers carrying both ADH2 G allele and ALDH2 A allele have a higher risk of developing esophageal cancer.

  4. Results of Definitive Chemoradiotherapy for Unresectable Esophageal Cancer

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    Noh, O Kyu; Je, Hyoung Uk; Kim, Sung Bae [Ulsan University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2008-12-15

    To investigate the treatment outcome and failure patterns after definitive chemoradiation therapy in locally advanced, unresectable esophageal cancer. Materials and Methods: From February 1994 to December 2002, 168 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated by definitive chemoradiation therapy. External beam radiation therapy (EBRT) (42-46 Gy) was delivered to the region encompassing the primary tumor and involved lymph nodes, while the supraclavicular fossa and celiac area were included in the treatment area as a function of disease location. The administered cone-down radiation dose to the gross tumor went up to 54-66 Gy, while the fraction size of the EBRT was 1.8-2.0 Gy/fraction qd or 1.2 Gy/fraction bid. An optional high dose rate (HDR) intraluminal brachytherapy (BT) boost was also administered (Ir-192, 9-12 Gy/3 -4 fx). Two cycles of concurrent FP chemotherapy (5-FU 1,000 mg/m2/day, days 2-6, 30-34, cisplatin 60 mg/m2/day, days 1, 29) were delivered during radiotherapy with the addition of two more cycles. Results: One hundred sixty patients were analyzable for this review [median follow-up time: 10 months (range 1-149 months)]. The number of patients within AJCC stages I, II, III, and IV was 5 (3.1%), 38 (23.8%), 68 (42.5%), and 49 (30.6%), respectively. A HDR intraluminal BT was performed in 26 patients. The 160 patients had a median EBRT radiation dose of 59.4 Gy (range 44.4-66) and a total radiation dose, including BT, of 60 Gy (range 44.4-72), while 144 patients received a dose higher than 40 Gy. Despite the treatment, the disease recurrence rate was 101/160 (63.1%). Of these, the patterns of recurrence were local in 20 patients (12.5%), persistent disease and local progression in 61 (38.1%), distant metastasis in 15 (9.4%), and concomitant local and distant failure in 5 (3.1%). The overall survival rate was 31.8% at 2 years and 14.2% at 5 years (median 11.1 months). Disease-free survival was 29

  5. Flavonoids, Flavonoid Subclasses, and Esophageal Cancer Risk: A Meta-Analysis of Epidemiologic Studies.

    Science.gov (United States)

    Cui, Lingling; Liu, Xinxin; Tian, Yalan; Xie, Chen; Li, Qianwen; Cui, Han; Sun, Changqing

    2016-06-08

    Flavonoids have been suggested to play a chemopreventive role in carcinogenesis. However, the epidemiologic studies assessing dietary intake of flavonoids and esophageal cancer risk have yielded inconsistent results. This study was designed to examine the association between flavonoids, each flavonoid subclass, and the risk of esophageal cancer with a meta-analysis approach. We searched for all relevant studies with a prospective cohort or case-control study design published from January 1990 to April 2016, using PUBMED, EMBASE, and Web of Science. Pooled odds ratios (ORs) were calculated using fixed or random-effect models. In total, seven articles including 2629 cases and 481,193 non-cases were selected for the meta-analysis. Comparing the highest-intake patients with the lowest-intake patients for total flavonoids and for each flavonoid subclass, we found that anthocyanidins (OR = 0.60, 95% CI: 0.49-0.74), flavanones (OR = 0.65, 95% CI: 0.49-0.86), and flavones (OR = 0.78, 95% CI 0.64-0.95) were inversely associated with the risk of esophageal cancer. However, total flavonoids showed marginal association with esophageal cancer risk (OR = 0.78, 95% CI: 0.59-1.04). In conclusion, our study suggested that dietary intake of total flavonoids, anthocyanidins, flavanones, and flavones might reduce the risk of esophageal cancer.

  6. Fruit Consumption Reduces the Risk of Esophageal Cancer in Yanting, People's Republic of China.

    Science.gov (United States)

    Song, Qingkun; Zhao, Lin; Li, Jun; Ren, Jun

    2015-05-01

    This study aimed to investigate the contribution of fruit and family history to esophageal cancer, among residents with abnormal esophagus discovered in screening. The study was a frequency-matched case-control design in groups of normal esophagus, abnormal esophagus but not carcinoma, and esophageal squamous cell carcinoma. Odds ratio (OR) was estimated by unconditional logistic regression. Fruit intake (OR = 0.19, 95% CI = 0.06-0.56) and positive family history of esophageal cancer (OR = 3.87, 95% CI = 1.41-10.63) were associated with esophageal cancer compared to individuals with abnormal conditions of the esophagus. In individuals who consumed fruits at least once per week, the OR for family cancer history is reduced to a nonsignificant level (OR = 1.06, 95% CI = 0.07-15.91). In the individuals with abnormal esophagus at screening, fruit intake was possibly protective against esophageal cancer, even in the ones with positive family history. Local public health strategies should focus on the improvement in fruit intake.

  7. Palliative Endoscopic Therapy of Esophageal Cancer%食管癌的内镜姑息治疗

    Institute of Scientific and Technical Information of China (English)

    H.Sch(a)fer; A.H.H(o)lscher

    2004-01-01

    @@ Patients with locally unresectable esophageal cancer or distant metastasis are usually treated with definite radiotherapy or radiochemotherapy. Dysphagia of these patients should further be treated by endoscopic therapy in order to maintain swallowing and oral food intake as long as possible.The same situation is present in patients with local recurrence of esophageal cancer after surgery or radiochemotherapy.

  8. Long-term outcomes of endoscopic argon plasma coagulation (APC) therapy for early esophageal cancer and precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    王国清

    2013-01-01

    Objective To evaluate the long-term outcomes of endoscopic argon plasma coagulation (APC) therapy for early esophageal cancer and precancerous lesions.Methods One-hundred and seventy one cases with early esophageal cancer (intramucosal carcinoma) and precancerous lesions were treated by APC from 1994 to 2005,

  9. Red and processed meat consumption and the risk of esophageal and gastric cancer subtypes in the netherlands cohort study

    NARCIS (Netherlands)

    Keszei, A.P.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2012-01-01

    Background: Prospective data on red and processed meat in relation to risk of subtypes of esophageal and gastric cancer are scarce. We present analyses of association between red and processed meat and the risk of esophageal and gastric cancer subtypes within The Netherlands Cohort Study on Diet and

  10. Health-related quality of life in long-term esophageal cancer survivors after potentially curative treatment

    NARCIS (Netherlands)

    Courrech Staal, E.F.W.; van Sandick, J.W.; van Tinteren, H.; Cats, A.; Aaronson, N.K.

    2010-01-01

    Objective Clinical outcomes have been investigated extensively in studies of esophageal cancer treatment. Less is known about long-term health-related quality of life outcomes. The aim of this study was to assess a range of health-related quality of life outcomes in patients with esophageal cancer t

  11. Hydroferrate fluid, MRN-100, provides protection against chemical-induced gastric and esophageal cancer in Wistar rats.

    Science.gov (United States)

    Ghoneum, Mamdooh H; Badr El-Din, Nariman K; Abdel Fattah, Salma M; Pan, Deyu; Tolentino, Lucilene

    2015-01-01

    In the current study, we examined the protective effect of hydroferrate fluid MRN-100 against the carcinogen methylnitronitrosoguanidine (MNNG)-induced gastric and esophageal cancer in rats. MRN-100 is an iron-based compound composed of bivalent and trivalent ferrates. At 33 weeks post treatment with MNNG, rats were killed and examined for the histopathology of esophagus and stomach; liver, spleen, and total body weight; and antioxidant levels in the blood and stomach tissues. Results showed that 17/20 (85%) gastroesophageal tissues from carcinogen MNNG-treated rats developed dysplasia and cancer, as compared to 8/20 (40%) rats treated with MNNG plus MRN-100. In addition, MRN-100 exerted an antioxidant effect in both the blood and stomach tissues by increasing levels of GSH, antioxidant enzymes SOD, CAT, and GPx, and total antioxidant capacity (TAC) level. This was accompanied by a reduction in the total free-radical and malondialdehyde levels. Furthermore, MRN-100 protected against body and organ weight loss. Thus, MRN-100 exhibited significant cancer chemopreventive activity by protecting tissues against oxidative damage in rats, which may suggest its effectiveness as an adjuvant for the treatment of gastric/esophageal carcinoma.

  12. Problems and needs in patients with incurable esophageal and pancreaticobiliary cancer: a descriptive study

    NARCIS (Netherlands)

    Uitdehaag, M.J.; Verschuur, E.M.I.; Eijck, C.H. van; Gaast, A. van der; Rijt, C.C. van der; Man, R.A. de; Steyerberg, E.W.; Kuipers, E.J.; Siersema, P.D.

    2015-01-01

    Patients with incurable esophageal cancer (EC) or pancreaticobiliary cancer (PBC) often have multiple symptoms and their quality of life is poor. We investigated which problems these patients experience and how often care is expected for these problems to provide optimal professional care. Fifty-sev

  13. Is cardiac toxicity a relevant issue in the radiation treatment of esophageal cancer?

    NARCIS (Netherlands)

    Beukema, Jannet C; van Luijk, Peter; Widder, Joachim; Langendijk, Johannes A; Muijs, Christina T

    2015-01-01

    Purpose: In recent years several papers have been published on radiation-induced cardiac toxicity, especially in breast cancer patients. However, in esophageal cancer patients the radiation dose to the heart is usually markedly higher. To determine whether radiation-induced cardiac toxicity is also

  14. Gastric tube perforation after esophagectomy for esophageal cancer.

    Science.gov (United States)

    Ubukata, Hideyuki; Nakachi, Takeshi; Tabuchi, Takanobu; Nagata, Hiroyuki; Takemura, Akira; Shimazaki, Jiro; Konishi, Satoru; Tabuchi, Takafumi

    2011-05-01

    We searched for cases of perforation of the gastric tube after esophagectomy for esophageal cancer by reviewing the literature. Only 13 cases were found in the English literature, and serious complications were seen in all cases, especially in cases of posterior mediastinal reconstruction. However, in the Japanese literature serious complications were also frequently seen in retrosternal reconstruction. Gastric tubes are at a higher risk of developing an ulcer than the normal stomach, including an ulcer due to Helicobacter pylori infection, insufficient blood supply, gastric stasis, and bile juice regurgitation. H. pylori eradication and acid-suppressive medications are important preventive therapies for ordinary gastric ulcers, but for gastric tube ulcers the effects of such treatments are still controversial. We tried to determine the most appropriate treatment to avoid serious complications in the gastric tubes, but we could not confirm an optimal route because each had advantages and disadvantages. However, at least in cases with severe atrophic gastritis due to H. pylori infection or a history of frequent peptic ulcer treatment, the antesternal route is clearly the best. Many cases of gastric tube ulcers involve no pain, and vagotomy may be one of the reasons for this absence of pain. Therefore, periodic endoscopic examination may be necessary to rule out the presence of an ulcer.

  15. Expression of ECRG4, a novel esophageal cancer-related gene,downregulated by CpG island hypermethylation in human esophageal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Chun-Mei Yue; Da-Jun Deng; Mei-Xia Bi; Li-Ping Guo; Shih-Hsin Lu

    2003-01-01

    AIM: To study the mechanisms responsible for inactivation of a novel esophageal cancer related gene 4 (ECRG4) in esophageal squamous cell carcinoma (ESCC). METHODS: A pair of primers was designed to amplify a 220 bp fragment, which contains 16 CpG sites in the core promoter region of the ECRG 4 gene. PCR products of bisulfite-modified CpG islands were analyzed by denaturing high-performance liquid chromatography (DHPLC), which were confirmed by DNA sequencing. The methylation status of ECRG 4 promoter in 20 cases of esophageal cancer and the adjacent normal tissues, 5 human tumor cell lines (esophageal cancer cell line-NEC, EC109, EC9706; gastric cancer cell line- GLC; human embryo kidney cell line-Hek293)and 2 normal esophagus tissues were detected. The expression level of the ECRG 4 gene in these samples was examined by RT-PCR. RESULTS: The expression level of ECRG 4 gene was varied.Of 20 esophageal cancer tissues, nine were unexpressed,six were lowly expressed and five were highly expressed compared with the adjacent tissues and the 2 normal esophageal epithelia. In addition, 4 out of the 5 human cell lines were also unexpressed. A high frequency of methylation was revealed in 12 (8 unexpressed and 4 lowly expressed)of the 15 (80%) downregulated cancer tissues and 3 of the 4 unexpressed cell lines. No methylation peak was observed in the two highly expressed normal esophageal epithelia and the methylation frequency was low (3/20) among the 20 cases in the highly expressed adjacent tissues. The methylation status of the samples was consistent with the result of DNA sequencing. CONCLUSION: These results indicate that the inactivation of ECRG 4gene by hypermethylation is a frequent molecular event in ESCC and may be involved in the carcinogenesis of this cancer.

  16. Salivary microRNAs as promising biomarkers for detection of esophageal cancer.

    Directory of Open Access Journals (Sweden)

    Zijun Xie

    Full Text Available BACKGROUND AND PURPOSE: Tissue microRNAs (miRNAs can detect cancers and predict prognosis. Several recent studies reported that tissue, plasma, and saliva miRNAs share similar expression profiles. In this study, we investigated the discriminatory power of salivary miRNAs (including whole saliva and saliva supernatant for detection of esophageal cancer. MATERIALS AND METHODS: By Agilent microarray, six deregulated miRNAs from whole saliva samples from seven patients with esophageal cancer and three healthy controls were selected. The six selected miRNAs were subjected to validation of their expression levels by RT-qPCR using both whole saliva and saliva supernatant samples from an independent set of 39 patients with esophageal cancer and 19 healthy controls. RESULTS: Six miRNAs (miR-10b*, miR-144, miR-21, miR-451, miR-486-5p, and miR-634 were identified as targets by Agilent microarray. After validation by RT-qPCR, miR-10b*, miR-144, and miR-451 in whole saliva and miR-10b*, miR-144, miR-21, and miR-451 in saliva supernatant were significantly upregulated in patients, with sensitivities of 89.7, 92.3, 84.6, 79.5, 43.6, 89.7, and 51.3% and specificities of 57.9, 47.4, 57.9%, 57.9, 89.5, 47.4, and 84.2%, respectively. CONCLUSIONS: We found distinctive miRNAs for esophageal cancer in both whole saliva and saliva supernatant. These miRNAs possess discriminatory power for detection of esophageal cancer. Because saliva collection is noninvasive and convenient, salivary miRNAs show great promise as biomarkers for detection of esophageal cancer in areas at high risk.

  17. Cost-benefit analysis of screening for esophageal and gastric cardiac cancer

    Institute of Scientific and Technical Information of China (English)

    Wen-Qiang Wei; Chun-Xia Yang; Si-Han Lu; Juan Yang; Bian-Yun Li; Shi-Yong Lian; You-Lin Qiao

    2011-01-01

    In 2005, a program named “Early Detection and Early Treatment of Esophageal and Cardiac Cancer”(EDETEC) was initiated in China. A total of 8279 residents aged 40-69 years old were recruited into the EDETEC program in Linzhou of Henan Province between 2005 and 2008. Howerer, the cost-benefit of the EDETEC program is not very clear yet. We conducted herein a cost-benefit analysis of screening for esophageal and cardiac cancer. The assessed costs of the EDETEC program included screening costs for each subject, as well as direct and indirect treatment costs for esophageal and cardiac severe dyspiasia and cancer detected by screening. The assessed benefits of this program included the saved treatment costs, both direct and indirect, on esophageal and cardiac cancer, as well as the value of prolonged life due to screening, as determined by the human capital approach. The results showed the screening cost of finding esophageal and cardiac severe dysplasia or cancer ranged from ¥2707 to ¥4512, and the total cost on screening and treatment was ¥13 115-¥14 920. The cost benefit was ¥58 944-¥155 110 (the saved treatment cost, ¥17 730, plus the value of prolonged life,¥41 214-¥137 380). The ratio of benefit-to-cost (BCR) was 3.95-11.83. Our results suggest that EDETEC has a high benefit-to-cost ratio in China and could be instituted into high risk areas of China.

  18. Comprehensive clinical study of concurrent chemotherapy breathing IMRT middle part of locally advanced esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jae Hong; Moon, Seong Kwon [Dept. of Radiation Oncology, College of Medicine, Soonchunhyang University , Asan (Korea, Republic of); Kim, Seung Chul [Dept. of Radiology, Songho College, Hoengseong (Korea, Republic of)

    2015-12-15

    The standard treatment of locally advanced type of mid-esophageal cancer is concurrent chemoradiation therapy (CRT). We evaluated the feasibility of chemotherapy with adding docetaxel to the classical basic regimens of cisplatin plus 5-fluorouracil (5-FU) and radiotherapy up to 70.2 Gy using dose escalations for esophageal cancer. It was possible to escalate radiation treatment dose up to 70.2 Gy by the respiratory-gated intensity- modulated radiotherapy (gated-IMRT) based on the 4DCT-simulation, with improving target coverage and normal tissue (ex., lung, heart, and spinal cord) sparing. This study suggested that the definitive chemo-radiotherapy with docetaxel, cisplatin, and 5-fluorouracil (i.e., DCF-R) and gating IMRT is tolerable and active in patients with locally advanced mid-esophageal cancer (AEC)

  19. Immunohistochemical study of p53, pRb, p16 in esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zo, Jae Ill; Zo, Kyung Ja; Park, Jong Ho; Kim, Mi Hee [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1998-01-01

    To confirm the expression of molecular genetic alterations of p53, pRb, p16 in esophageal cancer and to investigate the expression of p53, pRb, p16 in esophageal cancer according to the pathologic steps of carcinogenesis, immuno-histochemistry was performed in 15 resected esophageal cancer specimens with multiple separated lesions after pathologic mapping. The accumulation of mutant p53 was observed in 60 % of dysplasia and 47 % of invasive cancer, while pRb was not detected in 91 % of dysplasia and 72.7 % of invasive cancer. But p16 was not observed in 0 % in dysplasia and 7 % of invasive cancer. But p16 was not observed in 0 % in dysplasia and 28.6 % in invasive cancer. There was no simultaneous negative pRb and p16 expression. There was no relations between p53 and p16, pRb. As a results, the expression of p53, pRb, p16 was co-related well with molecular genetic changes and inactivation of p53, pRb, p16 was co-related well with molecular genetic changes and inactivation of p53 and pRb was common and early event in esophageal carcinogenesis in Korea, but inactivation of p16 was a infrequent change. (author). 17 refs., 2 tabs., 7 figs

  20. Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study

    NARCIS (Netherlands)

    Offermans, N.S.M.; Vermeulen, R.; Burdorf, A.; Goldbohm, R.A.; Keszei, A.P.; Peters, S.; Kauppinen, T.; Kromhout, H.; Brandt, P.A. van den

    2014-01-01

    The evidence for an association between occupational asbestos exposure and esophageal, gastric and colorectal cancer is limited. We studied this association specifically addressing risk differences between relatively low and high exposure, risk associated with cancer subtypes, the influence of poten

  1. Endoscopic submucosal dissection for superficial Barrett’s esophageal cancer in the Japanese state and perspective

    Science.gov (United States)

    Yamamoto, Sachiko; Hanaoka, Noboru; Takeuchi, Yoji; Higashino, Koji; Uedo, Noriya; Iishi, Hiroyasu

    2014-01-01

    The incidence of Barrett’s esophageal cancer is one of the most rapidly increasing among all cancers in the West, and it is also expected to increase in Japan. The optimal treatment for early Barrett’s esophageal cancer remains controversial. En bloc esophagectomy with regional lymph node dissection has been considered the standard therapy. Endoscopic therapies are currently being evaluated as alternatives to esophagectomy because they can provide the least postoperative morbidity and the best quality of life. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) allow for removal of visible lesions and histopathologic review of resected tissue, which help in diagnostic staging of the disease. EMR is limited with respect to resection size, and large lesions must be resected in several fragments. Piecemeal resection of lesions is associated with high local recurrence rates, probably because of minor remnants of neoplastic tissue being left in situ. ESD provides larger specimens than does EMR in patients with early Barrett’s neoplasia. This in turn allows for more precise histological analysis and higher en bloc and curative resection rates, potentially reducing the incidence of recurrence. Detailed endoscopic examination to determine the invasion depth and spread of Barrett’s esophageal cancer is essential before ESD. The initial inspection is usually conducted with white-light imaging followed by narrow-band imaging. The ESD procedure is similar to that for lesions in other parts of the gastrointestinal tract. However, the narrow space of the esophagogastric junction and contraction of the lower esophageal sphincter sometimes disturb the visual field and endoscopic control. Skilled endoscope handling, sometimes including retroflexion, is required during ESD for Barrett’s esophageal cancer. Previous reports have shown that ESD achieves en bloc resection in >80% of lesions. Although promising short-term results are reported, a long

  2. O-6-methylguanine-deoxyribonucleic acid methyltransferase methylation enhances response to temozolomide treatment in esophageal cancer

    Directory of Open Access Journals (Sweden)

    Rifat Hasina

    2013-01-01

    Full Text Available Background: World-wide, esophageal cancer is a growing epidemic and patients frequently present with advanced disease that is surgically inoperable. Hence, chemotherapy is the predominate treatment. Cytotoxic platinum compounds are mostly used, but their efficacy is only moderate. Newer alkylating agents have shown promise in other tumor types, but little is known about their utility in esophageal cancer. Methods: We utilized archived human esophageal cancer samples and esophageal cancer cell lines to evaluate O-6-methylguanine-deoxyribonucleic acid methyltransferase (MGMT hypermethylation status and determined sensitivity to the alkylating drug temozolomide (TMZ. Immunoblot analysis was performed to determine MGMT protein expression in cell lines. To assess and confirm the effect of TMZ treatment in a methylated esophageal cancer cell line in vivo, a mouse flank xenograft tumor model was utilized. Results: Nearly 71% (12/17 of adenocarcinoma and 38% (3/8 of squamous cell carcinoma (SCC patient samples were MGMT hypermethylated. Out of four adenocarcinoma and nine SCC cell lines tested, one of each histology was hypermethylated. Immunoblot analyses confirmed that hypermethylated cell lines did not express the MGMT protein. In vitro cell viability assays showed the methylated Kyse-140 and FLO cells to be sensitive to TMZ at an IC 50 of 52-420 μM, whereas unmethylated cells Kyse-410 and SKGT-4 did not respond. In an in vivo xenograft tumor model with Kyse-140 cells, which are MGMT hypermethylated, TMZ treatment abrogated tumor growth by more than 60%. Conclusion: MGMT methylation may be an important biomarker in subsets of esophageal cancers and targeting by TMZ may be utilized to successfully treat these patients.

  3. A clinicoepidemiological study of esophageal cancer patients at the National Cancer Institute, Cairo University, Egypt

    Institute of Scientific and Technical Information of China (English)

    Soumaya Ezzat; Hisham El Hossieny; Mohamed Abd Alla; Azza Nasr; Nagwan Anter; Ahmed Adel

    2016-01-01

    Objective The purposes of this study were to (1) assess the clinicoepidemiological characteristics of esopha-geal cancer patients, (2) analyze the prognostic factors determining treatment failure and survival, and (3) evaluate the results of various treatment modalities for locoregional and disseminated disease and their ef ect on disease-free survival and overal survival (OS). Methods Clinicoepidemiological retrospective data from 81 esophageal cancer patients treated at the Na-tional Cancer Institute of Cairo between 2007 and 2011 were evaluated. Results The study showed that patients with esophageal cancer commonly present with local y advanced disease (87.7% had T-stage 3 and 12.3% had T-stage 4). There was a significant correlation between surgery and survival; patients who received radical surgery and postoperative radiation had a better median survival than patients who received radical radiotherapy (20 months vs. 16 months, respectively; P = 0.04). There was also a significant statistical correlation between radical concomitant chemoradiotherapy (NCRT) and pal iative treatment. Patients who received radical NCRT had a better median survival than patients who received pal-liative radiotherapy (16 months vs. 10 months, respectively; P = 0.001). The median fol ow-up period for al patients was 7 months. The median OS of the whole group was 12 months. The OS after 1 and 2 years was 57.8% and 15%, respectively. Conclusion High-dose NCRT is an acceptable alternative for patients unfit for surgery or with inoperable disease. High-dose radiation is more ef ective than low-dose radiation in terms of local control, time to relapse, and OS. Further study using a larger series of patients and introducing new treatment protocols is necessary for a final evaluation.

  4. Optoacoustic imaging of tissue blanching during photodynamic therapy of esophageal cancer

    Science.gov (United States)

    Jacques, Steven L.; Viator, John A.; Paltauf, Guenther

    2000-05-01

    Esophageal cancer patients often present a highly inflamed esophagus at the time of treatment by photodynamic therapy. Immediately after treatment, the inflamed vessels have been shut down and the esophagus presents a white surface. Optoacoustic imaging via an optical fiber device can provide a depth profile of the blanching of inflammation. Such a profile may be an indicator of the depth of treatment achieved by the PDT. Our progress toward developing this diagnostic for use in our clinical PDT treatments of esophageal cancer patients is presented.

  5. Current status of radiation therapy. Evidence-based medicine (EBM) of radiation therapy. Current management of patients with esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nemoto, Kenji [Tohoku Univ., Sendai (Japan). School of Medicine

    2002-03-01

    The best management for small mucosal esophageal cancer is generally endoscopic mucosal resection. However, for submucosal cancer and extensive mucosal caner, either radical surgery or radiation seems to be an equally efficacious option. Radiation therapy concurrent with chemotherapy is more effective than radiation therapy alone for patients with unresectable esophageal cancer. The key drugs are cisplatin and 5-fluorouracil. However, for patients with poor performance status or for aged patients, radiation therapy alone is still a choice of treatment. Surgery has generally been indicated for patients with resectable esophageal cancer. However, outcomes of concurrent chemoradiation therapy may be comparable with those of surgery. Therefore, a prospective randomized study should be performed to determine the best management for patients with resectable esophageal cancer. The usefulness of intra-cavitary irradiation for esophageal cancer has not been clarified. A prospective randomized trial with a large number of patients is necessary to determine the effectiveness of intra-cavitary irradiation. The best management for patients with loco-regionally recurrent esophageal cancer after surgery has not been determined. Intensive therapy should be considered if the site of recurrence is limited and the time interval from surgery to recurrence is long. Chemotherapy is essential in the management of patients with small cell esophageal cancer. However, the best local therapy has not been determined. (author)

  6. Predictors of Postoperative Complications After Trimodality Therapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jingya [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wei, Caimiao [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tucker, Susan L. [Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Myles, Bevan; Palmer, Matthew [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hofstetter, Wayne L.; Swisher, Stephen G. [Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Cox, James D.; Komaki, Ritsuko; Liao, Zhongxing [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lin, Steven H., E-mail: SHLin@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-08-01

    Purpose: While trimodality therapy for esophageal cancer has improved patient outcomes, surgical complication rates remain high. The goal of this study was to identify modifiable factors associated with postoperative complications after neoadjuvant chemoradiation. Methods and Materials: From 1998 to 2011, 444 patients were treated at our institution with surgical resection after chemoradiation. Postoperative (pulmonary, gastrointestinal [GI], cardiac, wound healing) complications were recorded up to 30 days postoperatively. Kruskal-Wallis tests and χ{sup 2} or Fisher exact tests were used to assess associations between continuous and categorical variables. Multivariate logistic regression tested the association between perioperative complications and patient or treatment factors that were significant on univariate analysis. Results: The most frequent postoperative complications after trimodality therapy were pulmonary (25%) and GI (23%). Lung capacity and the type of radiation modality used were independent predictors of pulmonary and GI complications. After adjusting for confounding factors, pulmonary and GI complications were increased in patients treated with 3-dimensional conformal radiation therapy (3D-CRT) versus intensity modulated radiation therapy (IMRT; odds ratio [OR], 2.018; 95% confidence interval [CI], 1.104-3.688; OR, 1.704; 95% CI, 1.03-2.82, respectively) and for patients treated with 3D-CRT versus proton beam therapy (PBT; OR, 3.154; 95% CI, 1.365-7.289; OR, 1.55; 95% CI, 0.78-3.08, respectively). Mean lung radiation dose (MLD) was strongly associated with pulmonary complications, and the differences in toxicities seen for the radiation modalities could be fully accounted for by the MLD delivered by each of the modalities. Conclusions: The radiation modality used can be a strong mitigating factor of postoperative complications after neoadjuvant chemoradiation.

  7. Silencing stathmin-modulating efficiency of chemotherapy for esophageal squamous cell cancer with paclitaxel.

    Science.gov (United States)

    Feng, W; Xiaoyan, X; Xuan, Y; Xiangke, L; Zichang, Y; Ran, Z; Liuxing, W; Qingxia, F

    2015-04-01

    Paclitaxel (PTX) is broadly considered the drug of choice for treating human esophageal squamous cell cancer (ESCC). However, PTX resistance often ultimately leads to treatment failure. stathmin, or Op18, is a ubiquitously expressed 19-kDa cytosolic phosphoprotein that can integrate various cellular regulatory signals. stathmin overexpression could lead to resistance to chemotherapeutic agents. In this study we investigated the effect of stathmin gene silencing, using small interfering RNA (stathmin siRNA), on the efficacy of PTX in ESCC. Transfection of stathmin siRNA could significantly inhibit stathmin mRNA and protein levels in ESCC cell lines EC9706 and Eca-109. The silencing of stathmin combined with PTX significantly inhibited the proliferation of EC9706 and Eca-109 cells, with a significantly higher proportion of cells at G2/M phase and this antiproliferative effect was accompanied by an increase in apoptosis rates and morphology changes of EC9706 and Eca-109. Thus, combined chemotherapeutic agent PTX and stathmin siRNA could potentially enhance the therapeutic outcomes of PTX in treating ESCC.

  8. [Endoscopic microwave treatment of 53 cases with esophageal and cardiac cancer].

    Science.gov (United States)

    Hu, X H

    1990-09-01

    Fifty-three cases with moderate or advanced esophageal and cardiac cancer treated by endoscopic microwave therapy are reported. The results showed that after 2 to 4 treatments, dysphagia was relieved in 52 (98%), esophageal re-expansion was seen in 48 (90%). Improvement was most pronounced in lesions predominantly shown as localized polypoid projection type. Biopsy after treatment was confirmed pathologically as necrosis in 24 cases. After treatment, the follow-up of 22 cases for over 3 months and 8 cases for over 6 months was carried out. 22/22 could maintain the therapeutic effectiveness and 5/8 were on soft diet (noodles and steamed bread). Microwave therapy is a palliative measure that can definitely improve the dysphagia in short term courses and prolong the survival. Microwave endoscopy, being easy in manipulation without complications, is very useful in the treatment of esophageal and cardiac cancers contra-indicated for surgery.

  9. Second Primary Pancreatic Adenocarcinoma Three Years After Successfully Treated Index Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Nina Nandy

    2014-01-01

    Full Text Available Context Development of a second primary malignancy after an index esophageal cancer is a rare event, primarily due to short survival of patients with esophageal cancer. However, the number of long-term esophageal cancer survivors has been increasing due to advances in early detection and therapy. Case report We report herein a case of pancreatic adenocarcinoma that developed three years after a successfully treated early-stage adenocarcinoma of the esophagus. A 70-year-old Caucasian male presented with vague complaints of nausea, vomiting and abdominal distention, with subsequent development of jaundice. A computed tomography scan of abdomen revealed a 2.9 cm soft tissue mass in the head of the pancreas and the patient underwent a Whipple’s procedure, with pathology confirming the diagnosis of pancreatic adenocarcinoma. Three years previously, the patient was successfully treated for adenocarcinoma of the esophagus via minimally invasive esophagogastrectomy. Despite chemoradiotherapy for localized disease and subsequent systemic chemotherapy for metastatic pancreatic cancer, the patient eventually succumbed to his illness. Conclusion We discuss the association between esophageal cancer and subsequent second malignancies, along with implications for surveillance and therapy.

  10. Current status of predictive biomarkers for neoadjuvant therapy in esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Norihisa; Uemura; Tadashi; Kondo

    2014-01-01

    Neoadjuvant therapy has been proven to be extremely valuable and is widely used for advanced esophageal cancer. However, a significant proportion of treated patients(60%-70%) does not respond well to neoadjuvant treatments and develop severe adverse effects. Therefore, predictive markers for individualization of multimodality treatments are urgently needed in esophageal cancer. Recently, molecular biomarkers that predict the response to neoadjuvant therapy have been explored in multimodal approaches in esophageal cancer and successful examples of biomarker identification have been reported. In this review, promising candidates for predictive molecular biomarkers developed by using multiple molecular approaches are reviewed. Moreover, treatment strategies based on the status of predicted biomarkers are discussed, while considering the international differences in the clinical background. However, in the absence of adequate treatment options related to the results of the biomarker test, the usefulness of these diagnostic tools is limited and new effective therapies for biomarker-identified nonresponders to cancer treatment should be concurrent with the progress of predictive technologies. Further improvement in the prognosis of esophageal cancer patients can be achieved through the introduction of novel therapeutic approaches in clinical practice.

  11. Association between dietary vitamin C intake and risk of esophageal cancer: A dose-response meta-analysis.

    Science.gov (United States)

    Bo, Yacong; Lu, Yan; Zhao, Yan; Zhao, Erjiang; Yuan, Ling; Lu, Weiquan; Cui, Lingling; Lu, Quanjun

    2016-04-15

    While several epidemiological studies have investigated the association between vitamin C and risk of esophageal cancer, the results remain inconsistent. In the present study, a meta-analysis was conducted to assess the impact of dietary vitamin C intake on esophageal cancer risk. Online databases were searched up to March 29, 2015, for studies on the association between dietary vitamin C intake and esophageal cancer risk. Pooled risk ratios (RRs) or odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Dose-response analyses were performed using the method of restricted cubic splines with four knots at percentiles of 5, 35, 65 and 95% of the distribution. Publication bias was estimated using Egger's tests and funnel plots. In all, 15 articles were included in this meta-analysis, including 20 studies, containing 7063 controls and 3955 cases of esophageal cancer. By comparing the highest vs. the lowest categories of vitamin C intake, we found that vitamin C was inversely associated with the risk of esophageal cancer [overall OR = 0.58, 95% CI = 0.49-0.68, I(2) = 56%]. A linear dose-response relationship was found. With an increase in dietary vitamin C intake of 50 mg/day, the risk of esophageal cancer statistically decreased by 13% (OR = 0.87, 95% CI = 0.80-0.93, p(linearity) = 0.0002). In conclusion, our analysis suggested that the higher intake of dietary vitamin C might have a protective effect against esophageal cancer.

  12. Increased serum midkine concentration as a possible tumor marker in patients with superficial esophageal cancer.

    Science.gov (United States)

    Shimada, Hideaki; Nabeya, Yoshihiro; Okazumi, Shin-ichi; Matsubara, Hisahiro; Kadomatsu, Kenji; Muramatsu, Takashi; Ikematsu, Shinya; Sakuma, Sadatoshi; Ochiai, Takenori

    2003-01-01

    Midkine, a heparin-binding growth factor, is expressed in numerous cancer tissues and is reportedly elevated in patients with various neoplasms. The aim of this study was to evaluate the clinicopathological significance of serum midkine concentration (S-MK) in patients with superficial esophageal squamous cell carcinoma (SCC). Pretreatment S-MK was measured by enzyme-linked immunosorbent assay in 135 healthy controls, 16 patients with benign esophageal disease, and 60 patients with primary superficial esophageal squamous cell cancer (SESCC). All patients with SESCC underwent curative resection. The disease was staged according to TNM/UICC guidelines. Serum concentrations of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), and cytokeratin 19 fragment (CYFRA21-1) were also evaluated in the same populations. S-MK in patients with SESCC (388+/-411 pg/ml) was significantly higher than in benign esophageal disease or healthy controls (183+/-73 and 154+/-76 pg/ml, respectively). Using the mean + 2 standard deviations of healthy control S-MK (300 pg/ml) as the cut-off level, 50% of patients with esophageal SESCC were deemed positive. This S-MK positivity rate for detecting SESCC was significantly higher than for other tumor markers. Thus, S-MK may be useful as a tumor marker to detect SESCC.

  13. Green tea consumption and risk of esophageal cancer: a meta-analysis of epidemiologic studies

    Directory of Open Access Journals (Sweden)

    Zheng Ping

    2012-11-01

    Full Text Available Abstract Background Green tea has shown the role of chemoprevention for cancer. Recently, several studies suggested that green tea intake may have effect on esophageal cancer risk, whereas the results were inconsistent. Methods We performed a meta-analysis of all English and Chinese language studies of green tea consumption and esophageal cancer risk indexed in Medline, Embase, the Science Citation Index, the Chinese Biomedical Database and Wanfang Data from 1980 to June 2012. After reviewing each study, extracting data, and evaluating heterogeneity (Chi-square-based Q test and Ι2 and publication bias (Begg and Egger test, a meta-analysis was performed to evaluate the association between high/medium/low green tea consumption and non-drinking esophageal cancer risk. Pooled relative risk (RR or odds ratio (OR with 95% confidence intervals (CIs were calculated using the fixed- or random-effect models. Results Ten eligible epidemiologic studies including 33731 participants and 3557 cases for esophageal cancer were included. Eight of which were case–control studies, and two were cohort studies. Overall, there were no association between high/medium/low green tea consumption and non-drinking risk of esophageal cancer (High: highest vs non-drinker: RR/OR = 0.76, 95% CI: 0.49 to 1.02. Medium: drinker vs non-drinker: RR/OR = 0.86, 95% CI: 0.70 to 1.03. Low: lowest vs non-drinker: RR/OR = 0.83, 95% CI: 0.58 to 1.08. When stratified analyses according to study design (case–control and cohort studies, country (China and Japan, participates source (population-based and hospital-based case–control, and gender (female and male, there were significant association between high/medium/low green tea consumption and non-drinking risk of esophageal cancer among female (High: RR/OR = 0.32, 95% CI: 0.10 to 0.54. Medium: RR/OR = 0.43, 95% CI: 0.21 to 0.66. Low: RR/OR = 0.45, 95% CI: 0.10 to 0.79, but not the others. Conclusions We did not found significant

  14. Evaluation of miR-21 and miR-375 as prognostic biomarkers in esophageal cancer

    DEFF Research Database (Denmark)

    Winther, Mette; Alsner, Jan; Tramm, Trine;

    2015-01-01

    of miR-21 and miR-375 in primary esophageal squamous cell carcinomas (ESCC) and esophagogastric adenocarcinomas (EAC). MATERIAL AND METHODS: Pre-therapeutic tumor specimens from 195 patients with loco-regional esophageal cancer treated with neoadjuvant or definitive chemoradiotherapy or perioperative...

  15. Meat intake and risk of stomach and esophageal adenocarcinoma within the European Prospective Investigation Into Cancer and Nutrition (EPIC).

    NARCIS (Netherlands)

    González, Carlos Alberto; Jakszyn, Paula; Pera, Guillem; Agudo, Antonio; Bingham, Sheila A; Palli, Domenico; Ferrari, Pietro; Boeing, Heiner; Giudice, Giuseppe del; Plebani, Mario; Carneiro, Fátima; Nesi, Gabriella; Berrino, Franco; Sacerdote, Carlotta; Tumino, Rosario; Panico, Salvatore; Berglund, Göran; Simán, Henrik; Nyrén, Olof; Hallmans, Göran; Martinez, Carmen; Dorronsoro Iraeta, Miren; Barricarte, Aurelio; Navarro, Carmen A; Quirós, José Ramón; Allen, Naomi E; Key, Timothy J; Day, Nicholas E; Linseisen, Jakob; Nagel, Gabriele; Bergmann, Manuela M; Overvad, Kim; Jensen, Majken K; Tjønneland, Anne; Olsen, Anja; Bueno-de-Mesquita, H Bas; Ocké, Marga C; Peeters, Petra H M; Numans, Mattijs E; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie-Christine; Trichopoulou, Antonia; Psaltopoulou, Theodora; Roukos, Dimitrios; Lund, Eiliv; Hemon, Bertrand; Kaaks, Rudolf; Norat, Teresa; Riboli, Elio

    2006-01-01

    BACKGROUND: Dietary factors are thought to have an important role in gastric and esophageal carcinogenesis, but evidence from cohort studies for such a role is lacking. We examined the risks of gastric cancer and esophageal adenocarcinoma associated with meat consumption within the European Prospect

  16. Integration of targeted agents in the neo-adjuvant treatment of gastro-esophageal cancers.

    Science.gov (United States)

    Power, D G; Ilson, D H

    2009-11-01

    Pre- and peri-operative strategies are becoming standard for the management of localized gastro-esophageal cancer. For localized gastric/gastro-esophageal junction (GEJ) cancer there are conflicting data that a peri-operative approach with cisplatin-based chemotherapy improves survival, with the benefits seen in esophageal cancer likely less than a 5-10% incremental improvement. Further trends toward improvement in local control and survival, when combined chemotherapy and radiation therapy are given pre-operatively, are suggested by recent phase III trials. In fit patients, a significant survival benefit with pre-operative chemoradiation is seen in those patients who achieve a pathologic complete response. In esophageal/GEJ cancer, definitive chemoradiation is now considered in medically inoperable patients. In squamous cell carcinoma of the esophagus, surgery after primary chemoradiation is not clearly associated with an improved overall survival, however, local control may be better. In localized gastric/GEJ cancer, the integration of bevacizumab with pre-operative chemotherapy is being explored in large randomized studies, and with chemoradiotherapy in pilot trials. The addition of anti-epidermal growth factor receptor and anti-human epidermal growth factor receptor-2 antibody treatment to pre-operative chemoradiation continues to be explored. Early results show the integration of targeted therapy is feasible. Metabolic imaging can predict early response to pre-operative chemotherapy and biomarkers may further predict response to pre-operative chemo-targeted therapy. A multimodality approach to localized gastro-esophageal cancer has resulted in better outcomes. For T3 or node-positive disease, surgery alone is no longer considered appropriate and neo-adjuvant therapy is recommended. The future of neo-adjuvant strategies in this disease will involve the individualization of therapy with the integration of molecular signatures, targeted therapy, metabolic imaging

  17. Circulating microRNAs: Novel biomarkers for esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Esophageal carcinogenesis is a multi-stage process, involving a variety of changes in gene expression and physiological structure change. MicroRNAs (miRNAs) are a class of small non-coding endogenous RNA molecules. Recent innovation in miRNAs profiling technology have shed new light on the pathology of esophageal carcinoma (EC), and also heralded great potential for exploring novel biomarkers for both EC diagnosis and treatment. Frequent dysregulation of miRNA in malignancy highlights the study of molecular...

  18. Leptomeningeal carcinomatosis in esophageal cancer: a case series and systematic review of the literature.

    Science.gov (United States)

    Lukas, R V; Mata-Machado, N A; Nicholas, M K; Salgia, R; Antic, T; Villaflor, V M

    2015-01-01

    The aim of this study was to more clearly define the clinical course of leptomeningeal carcinomatosis due to esophageal cancer. A single institution retrospective case series was conducted. Additionally, a systematic review of the literature was performed. We present a large case series (n = 7) of leptomeningeal carcinomatosis due to esophageal cancer. Our case series and systematic review of the literature report similar findings. In our series, we report a predominance of male patients (86%) with adenocarcinoma histology (77%). Variable onset of leptomeningeal involvement of esophageal cancer in relation to the original diagnosis of the primary disease (5 months to 3 years and 11 weeks) was noted. Disease progresses quickly and overall survival is poor, measured in weeks (2.5-16 weeks) from the diagnosis of leptomeningeal involvement. Four of our patients initiated whole-brain radiation therapy with only two completing the course prior to clinical deterioration. Our patient with the longest survival (16 weeks) received intrathecal topotecan and oral temozolomide. Leptomeningeal carcinomatosis secondary to esophageal cancer has a poor prognosis. A clearly beneficial treatment modality is lacking.

  19. Treatment-associated severe thrombocytopenia affects survival rate in esophageal cancer patients undergoing concurrent chemoradiotherapy

    Directory of Open Access Journals (Sweden)

    Y M Huang

    2015-01-01

    Full Text Available Background: Esophageal cancer is commonly treated with surgery, concurrent chemoradiotherapy (CCRT, or a combination of both. The correlation between the hematological parameters during CCRT and early survival of esophageal cancer has not been fully evaluated. Materials And Methods: We analyzed the records of 65 esophageal cancer patients treated by CCRT between 2007 and 2010 retrospectively. The association between CCRT-associated myelosuppression, demographic variables, and survival rates were analyzed by univariate and multivariate analysis. Results: The univariate analysis showed that tumor extent of T3-4, a higher stage of tumor, a lower albumin level, grade 3 or higher anemia and thrombocytopenia, and interruptions in treatment affected survival rates. Further, the multivariate analysis revealed that stage IV (P = 0.030 is an independently negative prognostic factor for a one-year survival rate. Stage IV (P = 0.035, tumor extent of T3-4 (P = 0.002, and grade 3-4 thrombocytopenia (P = 0.015 are independently negative prognostic factors for a two-year survival rate. Conclusions: Severe decrease in platelet count during CCRT independently affects survival of esophageal cancer patients in addition to stage of the tumor.

  20. Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Suk; Lee, Chang Geol; Kim, Kyung Hwan; Kim, Tae Hyung [Dept. of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    For recurrent esophageal cancer after primary definitive radiotherapy, no general treatment guidelines are available. We evaluated the toxicities and clinical outcomes of re-irradiation (re-RT) for recurrent esophageal cancer. We analyzed 10 patients with recurrent esophageal cancer treated with re-RT after primary definitive radiotherapy. The median time interval between primary radiotherapy and re-RT was 15.6 months (range, 4.8 to 36.4 months). The total dose of primary radiotherapy was a median of 50.4 Gy (range, 50.4 to 63.0 Gy). The total dose of re-RT was a median of 46.5 Gy (range, 44.0 to 50.4 Gy). The median follow-up period was 4.9 months (range, 2.6 to 11.4 months). The tumor response at 3 months after the end of re-RT was complete response (n = 2), partial response (n = 1), stable disease (n = 2), and progressive disease (n = 5). Grade 5 tracheoesophageal fistula developed in three patients. The time interval between primary radiotherapy and re-RT was less than 12 months in two of these three patients. Late toxicities included grade 1 dysphagia (n = 1). Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.

  1. FDG-PET parameters as prognostic factor in esophageal cancer patients: a review

    NARCIS (Netherlands)

    J.M.T. Omloo; M. van Heijl; O.S. Hoekstra; M.I. van Berge Henegouwen; J.J.B. van Lanschot; G.W. Sloof

    2011-01-01

    (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been used extensively to explore whether FDG Uptake can be used to provide prognostic information for esophageal cancer patients. The aim of the present review is to evaluate the literature available to date concerning the potential

  2. Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer

    NARCIS (Netherlands)

    Haj Mohammad, Nadia; Kamphuis, Martijn; Hulshof, Maarten C C M; Lutkenhaus, Lotte J; Gisbertz, Suzanne S; Bergman, Jacques J G H M; de Bruin-Bon, H A C M Rianne; Geijsen, Elisabeth D; Bel, Arjan; Boekholdt, S Mathijs; van Laarhoven, Hanneke W M

    2015-01-01

    BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) followed by surgery is considered curative intent treatment for patients with resectable esophageal cancer. The aim was to establish hemodynamic aspects of changes in heart volume and to explore whether changes in heart volume resulted in cli

  3. FDG-PET parameters as prognostic factor in esophageal cancer patients: A review

    NARCIS (Netherlands)

    J.M. Omloo (Jikke); M. van Heijl (Mark); O.S. Hoekstra (Otto); M.I. van Berge Henegouwen (Mark); J.J.B. van Lanschot (Jan); G.W. Sloof (Gerrit)

    2011-01-01

    textabstractBackground:18F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been used extensively to explore whether FDG Uptake can be used to provide prognostic information for esophageal cancer patients. The aim of the present review is to evaluate the literature available to date con

  4. The etiology of esophageal cancer in high- and low- risk areas of Jiangsu province, China

    NARCIS (Netherlands)

    Wu, M.

    2011-01-01

        [Background]Esophageal cancer (EC) remains one of the most common and fatal malignancies worldwide. The geographic variation in EC occurrence is striking, and China is an area with one of the highest incidences of EC. A number of epidemiological studies

  5. Esophagectomy as a Treatment Consideration for Early-Stage Esophageal Cancer and High-Grade Dysplasia.

    Science.gov (United States)

    McLaren, Patrick J; Dolan, James P

    2016-10-01

    In recent years, a number of endoluminal procedures such as endoscopic resection and thermal ablation have emerged as less invasive treatment options for early esophageal cancer. These therapies have demonstrated excellent oncologic outcomes for dysplasia as well as intramucosal cancers. However, few studies have directly compared long-term outcomes of endoscopic therapy versus traditional esophagectomy. Current esophagectomy techniques now deliver consistently good outcomes in the hands of experienced surgeons at high volume centers, and this option should be considered an important treatment consideration for early esophageal cancer. Under current recommendations, esophagectomy should be considered for tumors invading the submucosa, tumors with high-risk pathologic features, bulky tumors, multinodular tumors, tumors within a long segment of Barrett's esophagus, and tumors adjacent to a hiatal hernia. Likewise, individual patient factors and comorbidities must also be considered when determining the best treatment for a patient with early esophageal cancer. The risk of missing metastatic disease or recurrence that is associated with endoscopic treatment must be weighed against the surgical risks of esophagectomy. With these considerations in mind, the aim of this article is to review the current guidelines and literature that explore the role of esophagectomy for early esophageal malignancy in the era of endoscopic therapies.

  6. The anti-esophageal cancer cell activity by a novel tyrosine/phosphoinositide kinase inhibitor PP121

    Energy Technology Data Exchange (ETDEWEB)

    Peng, Yi; Zhou, Yajuan [Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071 (China); Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan 430071 (China); Cheng, Long [Department of Interventional Radiology, the Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215001 (China); Hu, Desheng; Zhou, Xiaoyi; Wang, Zhaohua [Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan 430071 (China); Xie, Conghua, E-mail: chxie_65@hotmail.com [Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071 (China); Zhou, Fuxiang, E-mail: ZhouFuxiangwuhan@126.com [Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071 (China)

    2015-09-11

    Here we explored the potential effect of PP121, a novel dual inhibitor of tyrosine and phosphoinositide kinases, against human esophageal cancer cells. We showed that PP121 exerted potent cytotoxic effect in primary (patient-derived) and established (Eca-109, TE-1 and TE-3 lines) esophageal cancer cells, possibly through activating caspase-3-dependnent apoptosis. PP121 was, however, non-cytotoxic to the normal human esophageal epithelial cells (EECs). At the molecular level, we showed that PP121 blocked Akt-mTOR (mammalian target of rapamycin) activation in esophageal cancer cells, which was restored by introducing a constitutively-active Akt (CA-Akt). Yet, CA-Akt only partly inhibited cytotoxicity by PP121 in Eca-109 cells. Importantly, we showed that PP121 inhibited nuclear factor kappa B (NFκB) signaling activation in esophageal cancer cells, which appeared independent of Akt-mTOR blockage. In vivo, oral administration of PP121 remarkably inhibited Eca-109 xenograft growth in nude mice, and significantly improved mice survival. Further, the immunohistochemistry (IHC) and Western blot assays analyzing xenografted tumors showed that PP121 inhibited Akt-mTOR and NFκB activations in vivo. Together, we demonstrate that PP121 potently inhibits esophageal cancer cells in vitro and in vivo, possibly through concurrently inhibiting Akt-mTOR and NFκB signalings. - Highlights: • PP121 is cytotoxic against primary and established esophageal cancer cells. • PP121 induces caspase-3-dependnent apoptosis in esophageal cancer cells. • PP121 blocks Akt-mTOR activation in esophageal cancer cells. • PP121 inhibits NFκB activation, independent of Akt-mTOR blockage. • PP121 inhibits Eca-109 xenograft growth and Akt-mTOR/NFκB activation in vivo.

  7. [A Case of Advanced Esophageal Cancer and Tongue Cancer Treated with Induction DCF Chemotherapy Followed by Radical Surgery].

    Science.gov (United States)

    Tanaka, Motomu; Koyanagi, Kazuo; Sugiura, Hitoshi; Kakefuda, Toshihiro

    2015-11-01

    A man in his 60s was admitted for the treatment of advanced cervical esophageal cancer with metastasis to the lymph nodes and advanced tongue cancer with metastasis to the lymph nodes. Esophageal cancer was suspected to have invaded the trachea. The tongue cancer was located on the left side and had invaded beyond the median line of the tongue. Both cancers were pathologically diagnosed as squamous cell carcinomas. Therefore, it was determined that pharyngo-laryngo- esophagectomy and total glossectomy were required prior to the treatment. However, after 2 courses of docetaxel/cisplatin/ 5-FU combined induction chemotherapy, both cancers remarkably decreased; consequently, an esophagectomy to preserve laryngeal function and partial glossectomy could be performed simultaneously. The patient is well without recurrence 1 year post-surgery.

  8. Endoscopic survey of esophageal cancer in a high-risk area of China

    Institute of Scientific and Technical Information of China (English)

    Xu-Jing Lu; Jun Hou; Zhi-Feng Chen; Cui-Lan Guo; Shao-Sen Li; Wen-Long Bai; Guo-Liang Jin; Yu-Xia Wang; Fan-Shu Meng; Feng Gao

    2004-01-01

    AIM: To characterize the histological types of esophageal and cardiac mucosa by endoscopic survey of a population in a high-risk area of esophageal cancer of China.METHODS: A selected cohort of residents in Cixian County during December 2001 and May 2002 was surveyed by using Lugol′s staining, followed by computer-based statistical analysis of the data with SPSS 10.0 software.RESULTS: Histologically, the detection rates of squamous epithelial acanthosis, squamous epithelial atrophy, and basal cell hyperplasia in the esophagus were 1.9% (38/2 013),0.1% (3/2 013) and 0.9% (18/2 013) respectively, and those of mild, moderate, and severe esophagitis were 34.9% (703/2 013), 1.6% (33/2 013) and 0.2% (2/2 013)respectively. Mild, moderate, and severe esophageal dysplasia were detected in 8.6% (172/2 013), 7.8% (157/2 013) and 2.6% (53/2 013) respectively in the selected population,whereas in situ carcinoma, intramucosal carcinoma, invasive squamous carcinoma of the esophagus in 2.5% (50/2 013),0.2% (4/2 013) and 0.7% (14/2 013) respectively. The detection rates of non-atrophic gastritis and atrophic gastritis of the cardia were 36.3% (730/2 013) and 11.5% (232/2 013) respectively,with mild and severe dysplasia of the cardia detected in 2.5% (51/2 013) and 0.8% (17/2 013), respectively, in this population; the rates of intramucosal adenocarcinoma and invasive adenocarcinoma of the cardia were 0.1% (3/2 013)and 0.8% (17/2 013) respectively. The detection rate of esophageal cancer at early stage was 79.4% (54/68). The survey rate (ratio of examined population to expected population) was 73.8% (2 013/2 725).CONCLUSION: Histologic types of the esophageal and cardiac mucosa were characterized by endoscopic survey in a high-risk population of esophageal cancer, which may help the early detection and treatment of esophageal and cardiac cancers and dysplasia, and reduce the mortality of such malignancies.

  9. Cigarette smoking and alcohol drinking and esophageal cancer risk in Taiwanese women

    Institute of Scientific and Technical Information of China (English)

    I-Chen; Wu; Deng-Chyang; Wu; Hung-Ju; Su; Hui-Jen; Tsai; Chien-Yu; Lu; Jang-Ming; Lee; Ming-Tsang; Wu

    2010-01-01

    AIM:To investigate the etiology of esophageal cancer among Taiwanese women.METHODS:This is a multi-center,hospital-based,case-control study.Case patients consisted of women who were newly diagnosed and pathology-proven to have esophageal squamous cell carcinoma(ESCC) from three large medical centers(one from Northern and two from Southern Taiwan,respectively)between August 2000 and December 2008.Each ESCC patient was matched with 4 healthy women based on age(within 3 years)and hospital of origin,from the De...

  10. Outcome of Locally Advanced Esophageal Cancer Treated with Concurrent Chemo-radiotherapy

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    Jang, Hyun Soo; Kang, Seung Hee; Jo, Sun Mi; Oh, Young Taek; Chun, Mi Son; Choi, Jin Hyuk; Kang, Seok Yun [Ajou University School of Medicine, Suwon (Korea, Republic of); Lee, Sun Young [Gonyang University School of Medicine, Daejeon (Korea, Republic of)

    2009-06-15

    We investigated the outcome and the prognostic factors of patients with locally advanced esophageal cancer who were treated with concurrent chemo-radiotherapy. Two hundred forty six patients with esophageal cancer that were treated by radiotherapy between January 1994 and July 2007. Of these, 78 patients who received radiotherapy of {>=}45 Gy with concurrent chemotherapy were retrospectively enrolled in this study. We included patients stages IIA, IIB, III, IVA, and IVB with supraclavicular metastasis in the middle/lower esophageal cancer or celiac node metastasis in cervical or upper/middle thoracic esophageal cancer. The median radiation dose was 54 Gy and the combination chemotherapy with 5-FU and cisplatin (FP chemotherapy) was given concurrently with radiotherapy in most patients (88%). The follow-up period ranged from 2 to 117 months (median 14 months). The treatment response of the 54 patients could be evaluated by computerized tomography or endoscopy. A complete response (CR) was observed in 17 patients, whereas a partial response was observed in 18 patients. In patients with a CR, the median recurrence time was 20 months and the first relapse sites constituted a locoregional failure in 3 patients and a distant failure in 7 patients. The 1-, 2-, and 5-year overall survival (OS) rates were 58.9%, 21.7%, and 12.2%, respectively. The median survival period was 14 months. A univariate analysis indicated that the treatment response and cycles of FP chemotherapy were significant prognostic factors for OS. Daily or weekly administration of cisplatin as a radiosensitizer showed a better treatment response than FP chemotherapy. This study has shown that results of concurrent chemo-radiotherapy in patients with locally advanced esophageal cancer is comparable to those of other studies. Daily or weekly cisplatin administration may be considered as an alternative treatment in patients that are medically unfit for FP chemotherapy.

  11. Esophageal cancer: The latest on chemoprevention and state of the art therapies.

    Science.gov (United States)

    Le Bras, Gregoire F; Farooq, Muhammad H; Falk, Gary W; Andl, Claudia D

    2016-11-01

    Esophageal cancer is currently the 8th most common cancer worldwide and the 6th leading cause of cancer-related mortality. Despite remarkable advances, the mortality for those suffering from esophageal cancer remains high, with 5-year survival rates of less than 20%. In part, because most patients present with late-stage disease, long-term survival even after resection and therapy is disappointingly low. As we will discuss in this review, multiple characteristics specific to the disease stage and patient must be considered when choosing a treatment plan. This article will summarize current standard therapies, potential application of chemoprevention drugs and the promise and partial failure of personalized medicine, as well as novel treatments addressing this disease.

  12. [Current status and future prospect of internal medicine treatment for advanced esophageal cancer].

    Science.gov (United States)

    Wang, F; Fan, Q X

    2016-09-23

    Esophageal cancer (EC) is one of common malignant tumors, and the incidence and mortality of EC in China rank the first place in the world. Because of the occult onset, the early atypical symptoms, and the lack of effective early diagnostic methods, most of patients are diagnosed at an advanced stage of the disease and lost the chance of surgery. Comprehensive treatment including palliative medical treatment, molecular targeted therapy, immunotherapy and so on is appropriate for these patients. How to choose the chemotherapy regimen and formulate reasonable treatment plan has become a hot spot in clinical research. Molecular targeted drugs have become a new developmental direction in cancer treatment because of their high specificity and antitumor activity, but the effects on esophageal cancer remain controversial. With the development of immune check point blockade treatment, breakthrough has been made in tumor immunotherapy, which has become an important means in cancer comprehensive treatment and shown a good prospect of treatment.

  13. Zidovudine, abacavir and lamivudine increase the radiosensitivity of human esophageal squamous cancer cell lines.

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    Chen, Xuan; Wang, Cong; Guan, Shanghui; Liu, Yuan; Han, Lihui; Cheng, Yufeng

    2016-07-01

    Telomerase is a type of reverse transcriptase that is overexpressed in almost all human tumor cells, but not in normal tissues, which provides an opportunity for radiosensitization targeting telomerase. Zidovudine, abacavir and lamivudine are reverse transcriptase inhibitors that have been applied in clinical practice for several years. We sought to explore the radiosensitization effect of these three drugs on human esophageal cancer cell lines. Eca109 and Eca9706 cells were treated with zidovudine, abacavir and lamivudine for 48 h before irradiation was administered. Samples were collected 1 h after irradiation. Clonal efficiency assay was used to evaluate the effect of the combination of these drugs with radiation doses of 2, 4, 6 and 8 Gy. DNA damage was measured by comet assay. Telomerase activity (TA) and relative telomere length (TL) were detected and evaluated by real-time PCR. Apoptosis rates were assessed by flow cytometric analysis. The results showed that all the drugs tested sensitized the esophageal squamous cell carcinoma (ESCC) cell lines to radiation through an increase in radiation-induced DNA damage and cell apoptosis, deregulation of TA and decreasing the shortened TL caused by radiation. Each of the drugs investigated (zidovudine, abacavir and lamivudine) could be used for sensitizing human esophageal cancer cell lines to radiation. Consequently, the present study supports the potential of these three drugs as therapeutic agents for the radiosensitization of esophageal squamous cell cancer.

  14. Does Metastatic Lymph Node SUVmax Predict Survival in Patients with Esophageal Cancer?

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    Betül Vatankulu

    2015-10-01

    Full Text Available Objective: We aimed to investigate the SUVmax of primary tumor and metastatic lymph node in predicting survival in patients with esophageal cancer. Methods: We retrospectively analyzed patients with esophageal cancer between 2009 and 2011 who had FDG positronemission tomography (PET/computed tomography (CT. All patients were followed-up to 2013. Clinical staging, SUVmax of primary tumor and metastatic lymph node were evaluated. Results: One hundred seven patients were included in the study. All patients were followed-up between 2 and 49 months. The mean SUVmax of primary tumor and metastatic lymph node were 19.3±8.8 and 10.4±9.1, respectively. Metastatic lymph node SUVmax had an effect in predicting survival whereas primary tumor SUVmax did not have an effect (p=0.014 and p=0.262, respectively. Multivariate Cox regression analysis showed that clinical stage of the disease was the only independent factor predicting survival (p=0.001. Conclusion: Among patients with esophageal cancer, the value of primary tumor SUVmax did not have an effect on survival. Clinical stage assessed with FDG PET/CT imaging was found to predict survival in esophageal carcinoma. Additionally, lymph node SUVmax was identified as a new parameter in predicting survival in the present study

  15. Clinical significance of GLUT-1 expression in patients with esophageal cancer treated with concurrent chemoradiotherapy.

    Science.gov (United States)

    Chiba, Itaru; Ogawa, Kazuhiko; Morioka, Takamitsu; Shimoji, Hideaki; Sunagawa, Nao; Iraha, Shiro; Nishimaki, Tadashi; Yoshimi, Naomi; Murayama, Sadayuki

    2011-01-01

    This study aimed to investigate whether glucose transporter-1 (GLUT-1) expression in a pretreatment esophageal cancer biopsy was predictive of clinical outcomes in patients with esophageal cancer undergoing concurrent chemoradiotherapy (CRT). A total of 25 patients with esophageal cancer treated with concurrent CRT were reviewed. Radiotherapy was administered up to total doses of 40-66.6 Gy (median 66.6 Gy) with a single fraction of 1.8-2 Gy. Regarding chemotherapy, cisplatin (80 mg/m(2) on day 1) and 5-fluorouracil (800 mg/m(2) on days 2-6) were used concurrently with radiotherapy, every 3-4 weeks for a total of 1-2 courses. Tissue samples from esophageal carcinoma were obtained from the 25 patients by biopsy prior to concurrent CRT, and a semiquantitative analysis of GLUT-1 expression was performed using immunohistochemical staining. High GLUT-1 expression was observed in 7 of 25 (28%) patients, and GLUT-1 expression was significantly correlated with clinical T stage (p=0.0454), clinical N stage (p=0.0324) and initial response to CRT (p=0.0185). Patients with a high GLUT-1 expression had significantly poorer local control (LC) (5-year LC 28.6%) than those with a low expression (5-year LC 73.4%, pGLUT-1 and the number of chemotherapy courses were independent prognostic factors for LC. Patients with a high GLUT-1 expression had significantly lower recurrence-free survival (RFS) compared to those with a low GLUT-1 expression (p=0.0405). Multivariate analysis revealed that GLUT-1, the number of chemotherapy courses and clinical M stage were independent prognostic factors for RFS. GLUT-1 expression was significantly correlated with clinical T stage, clinical N stage and initial response to concurrent CRT, and was predictive of LC and RFS for patients with esophageal cancer treated with concurrent CRT.

  16. Reduced esophageal cancer incidence in statin users,particularly with cyclo-oxygenase inhibition

    Institute of Scientific and Technical Information of China (English)

    Ian; Leonard; Phillip; Beales; Abigail; Hensley; Yoon; Loke

    2013-01-01

    AIM:To examine the association between statin use and the development of esophageal cancer METHODS:We performed a systematic review and meta-analysis.Multiple databases(Pubmed,EMBASE,Cochrane Library,Web of Science,Wiley Interscience and Google Scholar) were systematically searched for studies reporting the association of statin use and the development of esophageal cancer.Literature searching and data abstraction were performed independently by two separate researchers.The quality of studies reviewed was evaluated using the Newcastle-Ottawa Quality assessment scale.Meta-analysis on the relationship between statin use and cancer incidence was performed.The effect of the combination of statin plus a cyclo-oxygenase inhibitor was also examined.RESULTS:Eleven studies met eligibility criteria,9 high and 2 medium quality.All were observational studies.Studies examining adenocarcinoma development in Barrett’s esophagus included 317 cancers and 1999 controls,population-based studies examining all esophageal cancers included 371203 cancers and 6083150 controls.In the Barrett’s population the use of statins(OR = 0.57;95%CI:0.43-0.75) and cyclo-oxygenase inhibitors(OR = 0.59;95%CI:0.45-0.77) were independently associated with a reduced incidence of adenocarcinoma.Combined use of a statin plus cyclooxygenase inhibitor was associated with an even lower adenocarcinoma incidence(OR = 0.26;95%CI:0.1-0.68).There was more heterogeneity in the population-based studies but pooled adjusted data showed that statin use was associated with a lower incidence of all combined esophageal cancers(OR = 0.81;95%CI:0.75-0.88).CONCLUSION:Statin use in patients with Barrett’s oesophagus is associated with a significantly lower incidence of adenocarcinoma.The chemopreventive actions of statins,especially combined with cyclooxygenase inhibitors deserve further exploration.

  17. Totally laparoscopic gastrectomy for early gastric cancer accompanied by huge hiatal hernia: A case report.

    Science.gov (United States)

    Hagiwara, Chie; Yajima, Kazuhito; Iwasaki, Yoshiaki; Oohinata, Ryouki; Yuu, Ken; Ishiyama, Satoshi; Amaki, Misato; Nakano, Daisuke; Yamaguchi, Tatsuro; Matsumoto, Hiroshi; Takahashi, Keiichi

    2016-02-01

    We herein present a case in which we used a totally laparoscopic approach for early gastric cancer accompanied by a huge hiatal hernia. An 80-year-old Japanese woman was referred with a chief complaint of dysphagia. A clinical diagnosis of early gastric cancer, T1b (SM) N0M0, stage IA, accompanied by hiatal hernia, was made. Distal gastrectomy with D1 plus lymphadenectomy was carried out. After the gastrectomy, the hernial sac was excised and the hernial orifice was closed. Reconstruction using the Roux-en-Y method was selected. The postoperative course was uneventful and she was discharged on postoperative day 10.

  18. Matrine inhibits proliferation and induces apoptosis via BID-mediated mitochondrial pathway in esophageal cancer cells.

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    Wang, Qiao; Du, Haoxin; Geng, Guojun; Zhou, Huan; Xu, Minying; Cao, Hanwei; Zhang, Bing; Song, Gang; Hu, Tianhui

    2014-05-01

    Matrine, as a member of Sophora family, is an alkaloid found in plants, and produces plethora pharmacological effects, including anti-cancer effects. However, the mechanism involved remains largely unknown. This study is conducted to investigate the anti-cancer mechanisms of matrine in human esophageal cancer in vitro and in vivo. In human esophageal cancer cell Eca-109, matrine significantly decreased the cell viability in a dose-dependent manner, and induced apoptosis as well as cell cycle arrest in G0/G1 phase by up-regulation of P53 and P21. The expression of several apoptosis-related proteins in cells and tumor tissues were evaluated by Western blot analysis. We found that matrine induced cell apoptosis by down-regulation of the ratio of BCL-2/BID and increasing activation of caspase-9. Further studies indicated that matrine induced apoptosis of Eca-109 was through the mitochondria-mediated internal pathway, but not by death receptor-mediated extrinsic apoptotic pathway, which was confirmed by the fact that Bid translocated from the nucleus to mitochondria during the process of the apoptosis induced by matrine. In vivo study found that matrine effectively inhibited the tumor formation of Eca-109 cells in nude mice. Our study suggests that matrine could serve as a potential novel agent from natural products to treat esophageal cancer.

  19. Esophageal cancer prediction based on qualitative features using adaptive fuzzy reasoning method

    Directory of Open Access Journals (Sweden)

    Raed I. Hamed

    2015-04-01

    Full Text Available Esophageal cancer is one of the most common cancers world-wide and also the most common cause of cancer death. In this paper, we present an adaptive fuzzy reasoning algorithm for rule-based systems using fuzzy Petri nets (FPNs, where the fuzzy production rules are represented by FPN. We developed an adaptive fuzzy Petri net (AFPN reasoning algorithm as a prognostic system to predict the outcome for esophageal cancer based on the serum concentrations of C-reactive protein and albumin as a set of input variables. The system can perform fuzzy reasoning automatically to evaluate the degree of truth of the proposition representing the risk degree value with a weight value to be optimally tuned based on the observed data. In addition, the implementation process for esophageal cancer prediction is fuzzily deducted by the AFPN algorithm. Performance of the composite model is evaluated through a set of experiments. Simulations and experimental results demonstrate the effectiveness and performance of the proposed algorithms. A comparison of the predictive performance of AFPN models with other methods and the analysis of the curve showed the same results with an intuitive behavior of AFPN models.

  20. Is endoscopic ultrasound examination necessary in the management of esophageal cancer?

    Science.gov (United States)

    DaVee, Tomas; Ajani, Jaffer A; Lee, Jeffrey H

    2017-01-01

    Despite substantial efforts at early diagnosis, accurate staging and advanced treatments, esophageal cancer (EC) continues to be an ominous disease worldwide. Risk factors for esophageal carcinomas include obesity, gastroesophageal reflux disease, hard-alcohol use and tobacco smoking. Five-year survival rates have improved from 5% to 20% since the 1970s, the result of advances in diagnostic staging and treatment. As the most sensitive test for locoregional staging of EC, endoscopic ultrasound (EUS) influences the development of an optimal oncologic treatment plan for a significant minority of patients with early cancers, which appropriately balances the risks and benefits of surgery, chemotherapy and radiation. EUS is costly, and may not be available at all centers. Thus, the yield of EUS needs to be thoughtfully considered for each patient. Localized intramucosal cancers occasionally require endoscopic resection (ER) for histologic staging or treatment; EUS evaluation may detect suspicious lymph nodes prior to exposing the patient to the risks of ER. Although positron emission tomography (PET) has been increasingly utilized in staging EC, it may be unnecessary for clinical staging of early, localized EC and carries the risk of false-positive metastasis (over staging). In EC patients with evidence of advanced disease, EUS or PET may be used to define the radiotherapy field. Multimodality staging with EUS, cross-sectional imaging and histopathologic analysis of ER, remains the standard-of-care in the evaluation of early esophageal cancers. Herein, published data regarding use of EUS for intramucosal, local, regional and metastatic esophageal cancers are reviewed. An algorithm to illustrate the current use of EUS at The University of Texas MD Anderson Cancer Center is presented.

  1. Significance of somatic mutations and content alteration of mitochondrial DNA in esophageal cancer

    Directory of Open Access Journals (Sweden)

    Wang Yu-Fen

    2006-04-01

    Full Text Available Abstract Background The roles of mitochondria in energy metabolism, the generation of ROS, aging, and the initiation of apoptosis have implicated their importance in tumorigenesis. In this study we aim to establish the mutation spectrum and to understand the role of somatic mtDNA mutations in esophageal cancer. Methods The entire mitochondrial genome was screened for somatic mutations in 20 pairs (18 esophageal squamous cell carcinomas, one adenosquamous carcinoma and one adenocarcinoma of tumor/surrounding normal tissue of esophageal cancers, using temporal temperature gradient gel electrophoresis (TTGE, followed by direct DNA sequencing to identify the mutations. Results Fourteen somatic mtDNA mutations were identified in 55% (11/20 of tumors analyzed, including 2 novel missense mutations and a frameshift mutation in ND4L, ATP6 subunit, and ND4 genes respectively. Nine mutations (64% were in the D-loop region. Numerous germline variations were found, at least 10 of them were novel and five were missense mutations, some of them occurred in evolutionarily conserved domains. Using real-time quantitative PCR analysis, the mtDNA content was found to increase in some tumors and decrease in others. Analysis of molecular and other clinicopathological findings does not reveal significant correlation between somatic mtDNA mutations and mtDNA content, or between mtDNA content and metastatic status. Conclusion Our results demonstrate that somatic mtDNA mutations in esophageal cancers are frequent. Some missense and frameshift mutations may play an important role in the tumorigenesis of esophageal carcinoma. More extensive biochemical and molecular studies will be necessary to determine the pathological significance of these somatic mutations.

  2. Exosome-shuttling microRNA-21 promotes cell migration and invasion-targeting PDCD4 in esophageal cancer.

    Science.gov (United States)

    Liao, Juan; Liu, Ran; Shi, Ya-Juan; Yin, Li-Hong; Pu, Yue-Pu

    2016-06-01

    Recent evidence indicates that exosomes can mediate certain microRNAs (miRNAs) involved in a series of biological functions in tumor occurrence and development. Our previous studies showed that microRNA-21 (miR-21) was abundant in both esophageal cancer cells and their corresponding exosomes. The present study explored the function of exosome-shuttling miR-21 involved in esophageal cancer progression. We found that exosomes could be internalized from the extracellular space to the cytoplasm. The exosome-derived Cy3-labeled miR-21 mimics could be transported into recipient cells in a neutral sphingomyelinase 2 (nSMase2)-dependent manner. miR-21 overexpression from donor cells significantly promoted the migration and invasion of recipient cells by targeting programmed cell death 4 (PDCD4) and activating its downstream c-Jun N-terminal kinase (JNK) signaling pathway after co-cultivation. Our population plasma sample analysis indicated that miR-21 was upregulated significantly in plasma from esophageal cancer patients and showed a significant risk association for esophageal cancer. Our data demonstrated that a close correlation existed between exosome-shuttling miR-21 and esophageal cancer recurrence and distant metastasis. Thus, exosome-shuttling miR-21 may become a potential biomarker for prognosis among esophageal cancer patients.

  3. Overexpression of FOXO3, MYD88, and GAPDH Identified by Suppression Subtractive Hybridization in Esophageal Cancer Is Associated with Autophagy.

    Science.gov (United States)

    Soltany-Rezaee-Rad, Mohammad; Mottaghi-Dastjerdi, Negar; Setayesh, Neda; Roshandel, Gholamreza; Ebrahimifard, Farzaneh; Sepehrizadeh, Zargham

    2014-01-01

    To find genes involved in tumorigenesis and the development of esophageal cancer, the suppression subtractive hybridization (SSH) method was used to identify genes that are overexpressed in esophageal cancer tissues compared to normal esophageal tissues. In our SSH library, the forkhead box O3 (FOXO3), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and myeloid differentiation primary response 88 (MYD88) genes were the most highly upregulated genes, and they were selected for further studies because of their potential role in the induction of autophagy. Upregulation of these genes was also observed in clinical samples using qRT-PCR. In addition, coexpression analysis of the autophagy-related genes Beclin1, ATG12, Gabarapl, PIK3C3, and LC3 demonstrated a significant correlation between the differentially overexpressed genes and autophagy. Autophagy is an important mechanism in tumorigenesis and the development of chemoresistance in cancer cells. The upregulation of FOXO3, GAPDH, and MYD88 variants in esophageal cancer suggests a role for autophagy and provides new insight into the biology of esophageal cancer. We propose that FOXO3, GAPDH, and MYD88 are novel targets for combating autophagy in esophageal cancer.

  4. Overexpression of FOXO3, MYD88, and GAPDH Identified by Suppression Subtractive Hybridization in Esophageal Cancer Is Associated with Autophagy

    Directory of Open Access Journals (Sweden)

    Mohammad Soltany-Rezaee-Rad

    2014-01-01

    Full Text Available To find genes involved in tumorigenesis and the development of esophageal cancer, the suppression subtractive hybridization (SSH method was used to identify genes that are overexpressed in esophageal cancer tissues compared to normal esophageal tissues. In our SSH library, the forkhead box O3 (FOXO3, glyceraldehyde-3-phosphate dehydrogenase (GAPDH, and myeloid differentiation primary response 88 (MYD88 genes were the most highly upregulated genes, and they were selected for further studies because of their potential role in the induction of autophagy. Upregulation of these genes was also observed in clinical samples using qRT-PCR. In addition, coexpression analysis of the autophagy-related genes Beclin1, ATG12, Gabarapl, PIK3C3, and LC3 demonstrated a significant correlation between the differentially overexpressed genes and autophagy. Autophagy is an important mechanism in tumorigenesis and the development of chemoresistance in cancer cells. The upregulation of FOXO3, GAPDH, and MYD88 variants in esophageal cancer suggests a role for autophagy and provides new insight into the biology of esophageal cancer. We propose that FOXO3, GAPDH, and MYD88 are novel targets for combating autophagy in esophageal cancer.

  5. Screening of specific binding peptide targeting blood vessel of human esophageal cancer in vivo in mice

    Institute of Scientific and Technical Information of China (English)

    ZHI Min; WU Kai-chun; HAO Zhi-ming; GUO Chang-cun; YAO Jia-yin

    2011-01-01

    Background Cancer of the esophagus and gastroesophageal junction remains a virulent malignancy with poor prognosis. Rapid progresses were made in chemotherapeutic agents and the development of molecular markers allowed better identification of candidates for targeted therapy. This study aimed to identify the candidate peptides used for anti-angiogenic therapy of esophageal cancer by in vivo screening C7C peptide library for peptides binding specifically to blood vessels of human esophageal cancer.Methods The phage displayed C7C peptide library was injected intravenously into mice bearing human esophageal tumor xenografts under renal capsule. After 5 rounds of screening, 13 clones were picked up individually and sequenced.During each round of screening, titers of phage recovery were calculated from tumor xenograft and control tissues.Homing of these 9 peptides to tumor vessel was detected by calculating phage titers in the tumor xenograft and control tissues (lung and spleen) after each phage was injected into mice model, and compared with the distribution of phage M13 and Ⅷ-related antigen in tumor xenograft by immunohistochemical staining. Comparisons among groups of data were made using one-way analysis of variance (ANOVA), followed by the Bonferroni multiple comparisons test.Results The number of phage recovered from tumor tissue of each round increased gradually in tumor group while decreased in control groups (P <0.01 in tumor and spleen, P <0.05 in lung). Immunohistochemical staining showed similar staining pattern with M13 antibody or Ⅷ-related antigen antibody, suggesting that phages displaying the selected peptides could home to blood vessel of human esophageal cancer. According to their DNA, 9 corresponding peptide sequences were deduced. And the homing ability to blood vessel of phages displaying the selected peptides was confirmed by comparing with their recovery in tumor and control tissues. Two motifs, YSXNXW and PXNXXN, were also obtained by

  6. Evaluation of anti-metastatic effect of chitosan nanoparticles on esophageal cancer-associated ifbroblasts

    Institute of Scientific and Technical Information of China (English)

    Pravin D. Potdar; Aashutosh U. Shetti

    2016-01-01

    Aim: Esophageal cancer is one of the major types of cancers, causing death of approximately 5% of all cancer deaths. This is due, in large part, to both relatively ineffectual and unavailable treatment. In order to develop an effective treatment strategy against esophageal cancer, it is important to target metastatic genes. In the present study, we have used a cancer-associated ifbroblast (CAF) cell line derived from culturing peripheral blood mononuclear cells from a metastatic esophageal cancer patient to see whether chitosan nanoparticles (Ch-Np) treatment can modulate the metastatic phenotype of CAF cells by using various cellular and molecular markers.Methods: A CAF cell line was developed from peripheral blood mononuclear cells (PBMC) from a metastatic esophageal cancer patient. The cells were treated with 100 µg/mL of chitosan nanoparticlein vitro for the morphological and oncogenic characteristic studies, along with the expression of various genes involved in process of tumor development and metastasis. Techniques such as Light and Phase Contrast Microscopy, cell growth rate, Scratch metastatic assay, and molecular proifling were carried out to see changes in CAF cells before and after Ch-Np treatment.Results: It was observed that CAF cells grew in monolayer and had a doubling time of 25 ± 0.38 h. Morphologically, the cells had a ifbroblastic appearance. After treatment with 100 µg/mL of Ch-Npin vitro, there was an increased doubling time to 30 ± 0.83 h. Similarly, Scratch Assay showed an inhibition in the metastatic property of these cells. These ifndings were conifrmed with gene expression studies. It was also observed that there was complete down-regulation of metastatic genes MMP1 and MMP9 and chemokines such as CXCR-4, CXCR-7, CCR-5, and SDF-1, indicating that Ch-Np inhibited the metastatic characteristic of CAF cells.Conclusion: This study has shown that there was an inhibition of metastatic properties of CAF cells after treatment with Ch

  7. COMBINED DETECTION OF CYCLIN D1, P27 AND DNA CONTENT IN ESOPHAGEAL CANCER

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    MA Ping; YIN Yuan-qin; WANG Xiao-hua

    2006-01-01

    Objective: To investigate the expressions of cyclin D1 and p27 and DNA content in esophageal cancer and adjacent normal tissues, and to discuss the relationship between them. Methods: The cyclinD1 and p27 were detected by immunohistochemical staining; DNA content was measured by flow cytometry. Results: The positive expression rates of cyclinD1 and p27 in cancer were 45.8% and 33.3% respectively, the DNA content in the positive group of cyclinD1 was higher than that in the negative group of cyclinD1(1.54(0.21 versus 1.08(0.43, P<0.05), while the DNA content and SPF (S-phase fraction) in the positive group of p27 were lower than those in the negative group (1.10(0.19 and 5.56%(5.18% versus 1.66(0.28 and 19.78%(6.12%, P<0.05). Conclusion: The data show that the expression of cyclinD1 and p27 are related to the ontogenesis and progression of esophageal cancer. The combined detection of cyclinD1, p27 and DNA content may be indicators of diagnosis and assessment of esophageal cancer.

  8. Psychological distress among survivors of esophageal cancer: the role of illness cognitions and coping.

    Science.gov (United States)

    Dempster, Martin; McCorry, Noleen K; Brennan, Emma; Donnelly, Michael; Murray, Liam; Johnston, Brian T

    2012-04-01

    Leventhal's common sense model has provided a useful framework for explaining psychological distress in several chronic illnesses. The model indicates that a person's perception of their illness and their coping strategies are the key determinants of their experience of psychological distress. The present research examines whether illness perceptions and coping strategies are related to levels of psychological distress among survivors of esophageal cancer. Everyone registered with the Oesophageal Patients' Association in the UK was mailed a questionnaire booklet, which included the Illness Perception Questionnaire-Revised, the Cancer Coping Questionnaire, and the Hospital Anxiety and Depression Scale. Complete responses were received from 484 people. Regression models indicated that the variables measured could explain 51% of the variance in anxiety and 42% of the variance in depression. Perceptions of esophageal cancer explained the majority of this variance. Positive focus coping strategies were also found to be important in explaining psychological distress. The results of this study are consistent with previous research demonstrating that illness perceptions are stronger correlates of adaptive outcomes than coping strategies. The findings suggest that cognition-based interventions could potentially be most effective in minimizing emotional distress among survivors of esophageal cancer.

  9. Narrow-band imaging in the diagnosis of early esophageal cancer and precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    HUANG Liu-ye; CUI Jun; WU Cheng-rong; LIU Yun-xiang; XU Ning

    2009-01-01

    Background In the recent years,the incidence of esophageal cancer in China has increased.The key point for raising the survival rate is the diagnosis and treatment at an early stage.Narrow-band imaging (NBI) can enhance the contrast of the mucous membrane of the esophagus without staining.This study aimed to explore the value of NBI in the diagnosis of early esophageal cancer and precancerous lesions.Methods The esophagus was examined with ordinary endoscopy and NBI endoscopy.Pit patterns and blood capillary forms were examined with routine magnifying endoscopy and NBI endoscopy.Finally,a 1.2% Lugoul's iodine solution was used to stain the esophageal mucosal surface and a biopsy was taken at all the sites where NBI or iodine staining was positive.NBI and iodine staining scales were compared with pathologic diagnosis,which was considered as the gold standard.Results A total of 90 cases (138 lesions in total) were diagnosed as early esophageal cancer or precancerous lesions:104 lesions (75.4%) were detected with ordinary endoscopy,120 lesions (87.0%) were detected with NBI endoscopy,and 138 lesions (100%) were detected with iodine staining.The lesion detection rate of NBI was significantly lower than that of iodine staining (X2=17.176,P <0.01).However,there was no significant difference between NBI and iodine staining for the diagnosis of high grade intraepithelial neoplasia (X2=1.362,P >0.05),while the detection rate of NBI was significantly lower than that of iodine staining for the diagnosis of low grade intraepithelial neoplasia (X2=13.388,P <0.01).The pit pattern and blood capillary form of eady esophageal cancer and precancerous lesions could be demonstrated clearer with NBI than with ordinary endoscopy.Conclusions NBI can enhance the contrast of the mucous membrane of the esophagus without staining.The combination of NBI and iodine staining can raise the diagnostic rate of early esophageal cancer and precancerous lesions.

  10. Radiofrequency hyperthermia-enhanced herpes simplex virus-thymidine kinase/ganciclovir direct intratumoral gene therapy of esophageal squamous cancers

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    Shi, Yaoping; Wang, Jianfeng; Bai, Zhibin; Li, Yonggang; Qiu, Longhua; Zhai, Bo; Zhang, Feng; Yang, Xiaoming

    2016-01-01

    Despite recent advances in surgical technique and treatment strategies for esophageal cancer (EC), to effectively manage the advanced (metastatic or disseminated) and recurrent EC still remain a great challenge. The aim of this study was to determine the feasibility of using intra-esophagus radiofrequency hyperthermia to enhance local HSV-TK/ganciclovir-mediated suicide gene therapy of an innovative animal models with orthotopic esophageal squamous cancers. Human esophageal squamous cancer (ESCa) cells were labeled with lentivirus/luciferase. ESCa cells and nude rats with orthotopic ESCa were divided into in four groups (n = 6/group) and treated with: i) combination therapy of MR imaging-heating-guidewire-mediated radiofrequency hyperthermia ((RFH, 42°C) plus local HSV-TK/GCV; ii) HSV-TK/GCV alone; iii) RFH alone; and (iv) phosphate-buffered saline (PBS). Bioluminescence optical imaging and transcutaneous ultrasound imaging were used to follow up bioluminescence signal and size changes of tumors among different groups over two weeks, which were correlated with subsequent histology. We demonstrated that combination therapy of RFH with gene therapy resulted in the lowest cell proliferation (37.5±8.6%, Pbioluminescence optical imaging photon signal intensity (0.81±0.17, P<0.01) of orthotopic esophageal cancers, compared with groups treated with gene therapy alone, RFH alone and PBS. Our study indicated that intra-esophageal radiofrequency hyperthermia could enhance the HSV-TK-mediated effect on esophageal squamous cancers. PMID:27725910

  11. Near-infrared confocal micro-Raman spectroscopy combined with PCA-LDA multivariate analysis for detection of esophageal cancer

    Science.gov (United States)

    Chen, Long; Wang, Yue; Liu, Nenrong; Lin, Duo; Weng, Cuncheng; Zhang, Jixue; Zhu, Lihuan; Chen, Weisheng; Chen, Rong; Feng, Shangyuan

    2013-06-01

    The diagnostic capability of using tissue intrinsic micro-Raman signals to obtain biochemical information from human esophageal tissue is presented in this paper. Near-infrared micro-Raman spectroscopy combined with multivariate analysis was applied for discrimination of esophageal cancer tissue from normal tissue samples. Micro-Raman spectroscopy measurements were performed on 54 esophageal cancer tissues and 55 normal tissues in the 400-1750 cm-1 range. The mean Raman spectra showed significant differences between the two groups. Tentative assignments of the Raman bands in the measured tissue spectra suggested some changes in protein structure, a decrease in the relative amount of lactose, and increases in the percentages of tryptophan, collagen and phenylalanine content in esophageal cancer tissue as compared to those of a normal subject. The diagnostic algorithms based on principal component analysis (PCA) and linear discriminate analysis (LDA) achieved a diagnostic sensitivity of 87.0% and specificity of 70.9% for separating cancer from normal esophageal tissue samples. The result demonstrated that near-infrared micro-Raman spectroscopy combined with PCA-LDA analysis could be an effective and sensitive tool for identification of esophageal cancer.

  12. Pathology findings and validation of gastric and esophageal cancer cases in a European cohort (EPIC/EUR-GAST)

    DEFF Research Database (Denmark)

    Carneiro, Fátima; Moutinho, Cátia; Pera, Guillem

    2007-01-01

    OBJECTIVE: Cardia, non-cardia and intestinal and diffuse subtypes of gastric cancer may have different trends and etiological factors. However, the available information is not always collected in population cancer registries, and heterogeneous criteria have been applied for the histopathological...... classification of tumors. We describe the pathological features of incident gastric and esophageal cancers identified within the European Prospective Investigation into Cancer and Nutrition (EPIC). MATERIAL AND METHODS: In an investigation on gastric and esophageal cancer (EUR-GAST) in the EPIC project......, a validation study of diagnoses reported by EPIC centers was conducted by a European panel of pathologists. Original pathology reports, stained slides of tumors and the respective paraffin blocks were requested from the centers. RESULTS: The whole series encompassed 467 cancer cases (gastric and esophageal...

  13. Dietary N-nitroso compounds, endogenous nitrosation, and the risk of esophageal and gastric cancer subtypes in the Netherlands Cohort Study

    NARCIS (Netherlands)

    Keszei, A.P.; Goldbohm, R.A.; Schouten, L.J.; Jakszyn, P.; Brandt van den, P.

    2013-01-01

    Background: Dietary N-nitroso compounds and endogenous nitrosation are important carcinogenic factors, but human evidence of their role is scarce for esophageal cancer and inconsistent for gastric cancer. Objective: We studied the relation between risks of esophageal and gastric cancer subtypes and

  14. [Definition of accurate planning target volume margins for esophageal cancer radiotherapy].

    Science.gov (United States)

    Lesueur, P; Servagi-Vernat, S

    2016-10-01

    More than 4000 cases of esophagus neoplasms are diagnosed every year in France. Radiotherapy, which can be delivered in preoperative or exclusive with a concomitant chemotherapy, plays a central role in treatment of esophagus cancer. Even if efficacy of radiotherapy no longer has to be proved, the prognosis of esophagus cancer remains unfortunately poor with a high recurrence rate. Toxicity of esophageal radiotherapy is correlated with the irradiation volume, and limits dose escalation and local control. Esophagus is a deep thoracic organ, which undergoes cardiac and respiratory motion, making the radiotherapy delivery more difficult and increasing the planning target volume margins. Definition of accurate planning target volume margins, taking into account the esophagus' intrafraction motion and set up margins is very important to be sure to cover the clinical target volume and restrains acute and late radiotoxicity. In this article, based on a review of the literature, we propose planning target volume margins adapted to esophageal radiotherapy.

  15. Esophageal Cancer with Bone Marrow Hyperplasia Mimicking Bone Metastasis: Report of a Case

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    Hiromi Yasuda

    2016-11-01

    Full Text Available A 63-year-old man visited the clinic with numbness in the right hand. Magnetic resonance imaging demonstrated multiple low-intensity lesions in the cervical vertebrae and sacrum, which was suspicious of cervical bone metastasis. Fluorodeoxyglucose positron emission tomography/computed tomography revealed areas of increased fluorodeoxyglucose uptake in the thoracic esophagus, sternum and sacrum. A flat, elevated esophageal cancer was identified by upper gastrointestinal endoscopy, and the macroscopic appearance indicated early-stage disease. From the cervical, thoracic and abdominal computed tomography images, there were no metastatic lesions except for the bone lesions. To confirm whether the bone lesions were metastatic, we performed bone biopsy. The histopathological diagnosis was bone marrow hyperplasia. It was crucial for treatment planning to establish whether the lesions were distant metastases. Here, we report a case of esophageal cancer with bone marrow hyperplasia mimicking bone metastasis.

  16. [Usefulness of endoscopic salvage treatment in a patient with local failure esophageal cancer after CRT].

    Science.gov (United States)

    Higashino, Koji; Hanafusa, Masao; Ishihara, Ryu

    2011-11-01

    Chemoradiotherapy (CRT) is widely used as non-surgical treatment for esophageal cancer in recent years. CRT is very useful, but it allows about 40% relapse. Salvage surgery after CRT, long-term survival can be expected, but perioperative mortality is high. In contrast, EMR for local failure after definitive CRT has been reported showing a 5-year survival rate of 49. 1%. If it can safely control of local failure, then we thought it's useful for long-term survival. If the depth of invasion was to the submucosal layer of the local failure lesion, we performed an endoscopic resection. If vertical margins are positive pathologically, we have added a photodynamic therapy. In cases of difficult endoscopic resection, PDT alone was performed. We experienced a case of recurrent esophageal cancer after CRT was useful for local treatment with PDT and EMR.

  17. Thoracoscopic pericardial fenestration for persistent pericardial effusion after radiotherapy for esophageal cancer. Report of a case

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    Sakamoto, Kazuhiro; Tsuchida, Kazuhito; Ariga, Takamitsu [Yokohama Rosai Hospital (Japan)

    2002-11-01

    We performed thoracoscopic pericardial fenestration for persistent pericardial effusion after radiotherapy for esophageal cancer. An 85-year-old man who had radiation therapy (70.2 Gy) for esophageal cancer was admitted for shortness of breath. Chest computed tomography showed a pericardial effusion. During the 6 months prior to this admission, the patient had undergone percutaneous pericardial drainage 3 times for cardiac tamponade. We performed thoracoscopic partial pericardiectomy with creation of a pleuropericardial window via one access port. Histopathologically, no malignant cells were found in either the resected pericardium or the pericardial effusion. Therefore, we believe the persistent pericardial effusion was secondary to radiotherapy. There was no recurrence of the pericardial effusion for 7 months postoperatively. In summary, thoracoscopic pericardial fenestration is useful in both the diagnosis and treatment of persistent pericardial effusion. (author)

  18. Successful Management of Airway Emergency in a Patient with Esophageal Cancer

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    Samina Park

    2015-05-01

    Full Text Available A 60-year-old man with advanced esophageal cancer was admitted for surgical placement of a feeding jejunostomy tube before commencement of chemoradiotherapy. His esophageal cancer had directly invaded the posterior tracheal wall, inducing a nearly total obstruction of the distal trachea. On the day before the surgery, respiratory failure developed due to tumor progression and tracheal edema. Tracheal intubation and mechanical ventilation were attempted without success. Application of veno-venous extracorporeal membrane oxygenation (ECMO corrected the patient’s respiratory acidosis and relieved his dyspnea. With full ECMO support, he underwent tracheal stent insertion. Two hours later, he was weaned from ECMO support uneventfully. This was a successful case of tracheal stenting for airway obstruction under rescue veno-venous ECMO.

  19. Nimotuzumab combined with radiotherapy for esophageal cancer: preliminary study of a Phase II clinical trial

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    Liang J

    2013-11-01

    Full Text Available Jun Liang,1 Mingyan E,2 Gang Wu,3 Lujun Zhao,4 Xia Li,5 Xia Xiu,6 Ning Li,1 Bo Chen,1 Zhouguang Hui,1 Jima Lv,1 Hui Fang,1 Yu Tang,1 Nan Bi,1 Wenqing Wang,1 Yirui Zhai,1 Tao Li,1 Dongfu Chen,1 Shuangmei Zou,7 Ning Lu,7 Rolando Perez-Rodríguez,8 Junqi Zheng,9 Luhua Wang11Department of Radiotherapy, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; 2Department of Radiotherapy, Cancer Hospital of Harbin Medical University, Harbin, People's Republic of China; 3Department of Radiotherapy, Tongji Cancer Center Hospital, Wuhan, People's Republic of China; 4Department of Radiotherapy, Cancer Hospital of Tianjin Medical University, Tianjin, People's Republic of China; 5Department of Radiotherapy, LiaoNing Province Cancer Hospital, Shenyang, People's Republic of China; 6Department of Radiotherapy, Beijing Hospital, Beijing, People's Republic of China; 7Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; 8Center of Molecular Immunology, Havana, Cuba; 9School of Medicine, Tongji University, Shanghai, People's Republic of ChinaObjective: To determine the safety and therapeutic effects of nimotuzumab (h-R3 combined with radiotherapy in esophageal cancer.Methods: This Phase II clinical trial involved 42 patients with stage II (inoperable or refused surgery to stage IV (supraclavicular lymph node metastasis only esophageal cancers treated between November 2008 and July 2010. All patients had squamous cell carcinomas, and all received three-dimensional conformal radiotherapy and 200 mg nimotuzumab per week during radiotherapy.Results: There were 9, 25, and 8 patients with stage II, III and IV disease, respectively. All except two patients received 50–70 Gy radiation; 37 patients (88.1% received more than five nimotuzumab doses. Grade III toxicities (21.4% of all adverse events included esophagitis and gastrointestinal, dermatological and hematological

  20. Massive Endoscopic Screening for Esophageal and Gastric Cancers in a High-Risk Area of China.

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    Xianzhi Zheng

    Full Text Available This study aims to describe the findings from a massive endoscopic screening program in a high-risk area of China and to evaluate the prognosis of patients diagnosed through endoscopic screening compared with those diagnosed at usual hospital visits because of illness.In 2006, an early detection and treatment program was initiated in Yangzhong county, China. Local residents aged 40-69 years were eligible for free endoscopic screening. Endoscopic examination was performed with Lugol's iodine staining, followed by biopsies. Patients diagnosed with esophageal or gastric cancer were referred for treatment and followed to assess their long-term survival status.From 2006 through 2012, we screened 12453 participants, including 5334 (42.8% men and 7119 (57.2% women. The average age was 52.8 ± 8.0 years. We detected 166 patients with upper digestive tract cancers, including 106 cancers in the esophagus (detection rate: 0.85% and 60 cancers in the stomach (detection rate: 0.48%. Of these patients, 98.11% with esophageal cancer and 100% with gastric cancer were defined as at the early stage. In the process of follow-up, 17 patients died from cancer-related causes, and the median survival time was greater than 85 months. The overall survival rates for 1, 3 and 5 years were 98.0%, 90.0% and 89.0%, respectively. A significant positive effect was observed for the long-term survival of patients diagnosed through massive endoscopic screening.In a high-risk population, massive endoscopic screening can identify early stage carcinoma of esophageal and gastric cancers and improve patients' prognosis through early detection and treatment.

  1. Expression of a plant-associated human cancer antigen in normal,premalignant and malignant esophageal tissues

    Institute of Scientific and Technical Information of China (English)

    Jun Fu; Ping Qu; Mo Li; Hai-Mei Tian; Zhen-Hai Zheng; Xin-Wen Zheng; Wei Zhang

    2003-01-01

    AIM: To study the relationship between the expression profiles of a plant-associated human cancer antigen and carcinogenesis of esophagus and its significance. METHODS: We analyzed expression of a plant-associated human cancer antigen in biopsy specimens of normal (n=29),mildly hyperplastic (n=29), mildly (n=30), moderately (n=27)and severely dysplastic (n=29) and malignant esophageal (n=30) tissues by immunohistochemistry. RESULTS: The plant-associated human cancer antigen was mainly confined to the cytoplasm and showed diffuse type of staining. Positive staining was absent or weak in normal (0/30) and mildly hyperplastic tissue samples (2/29), while strong staining was observed in severe dysplasia (23/29) and carcinoma in situ (24/30). There was significant difference of its expression between normal mucosa and severely dysplastic tissues (P<0.001) or carcinoma in situ (P<0.001). Significant difference was also observed between mild dysplasia and severe dysplasia (P<0.001) or carcinomain situ (P<0.001). An overall trend toward increased staining intensity with increasing grade of dysplasia was found. There was a linear correlation between grade of lesions and staining intensity (r=0.794,P<0.001). Samples from esophageal cancer showed no higher levels of expression than those in severely dysplastic lesions (P>0.05). CONCLUSION: The abnormal expression of this plantassociated human cancer antigen in esophageal lesions is a frequent and early finding in the normal-dysplasiacarcinoma sequence in esophageal carcinogenesis. It might contribute to the carcinogenesis of esophageal cancer. The abnormal expression of this plant-associated human cancer antigen in esophageal lesion tissues may serve as a potential new biomarker for early identification of esophageal cancer.

  2. The Effect of Neoadjuvant Therapy on Early Complications of Esophageal Cancer Surgery

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    Mohammadtaghi Rajabi Mashhadi

    2015-07-01

    Full Text Available Introduction: Early diagnosis and appropriate treatment is required in esophageal cancer due to its invasive nature. The aim of this study was to evaluate early post-esophagectomy complications in patients with esophageal cancer who received neoadjuvant chemoradiotherapy (NACR.   Materials and Methods: This randomized clinical trial was carried out between 2009 and 2011. Patients with lower-third esophageal cancer were randomly assigned to one of two groups. The first group consisted of 50 patients receiving standard chemoradiotherapy (Group A and then undergoing surgery, and the second group consisted of 50 patients undergoing surgery only (Group B. Patients were evaluated with respect to age, gender, clinical symptoms, type of pathology, time of surgery, perioperative blood loss, and number of lymph nodes resected as well as early post-operative complicate including leakage at the anastomosis site, chylothorax and pulmonary complications, hospitalization period, and mortality rate within the first 30 days after surgery.   Results: The mean age of patients was 55 years. Seventy-two patients had squamous cell carcinoma (SCC and 28 patients had adenocarcinoma (ACC. There was no significant difference between the two groups with respect to age, gender, time of surgery, complications including anastomotic leakage, chylothorax, pulmonary complications, cardiac complications, deep venous thrombosis (DVT, or mortality. However, there was a significant difference between the two groups regarding hospital stay, time of surgery, perioperative blood loss, and number of lymph nodes resected.   Conclusion:  The use of NACR did not increase early post-operative complications or mortality among patients with esophageal cancer.

  3. Systematic review of health-related quality of life after esophagectomy for esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Marco Scarpa; Stefano Valente; Rita Alfieri; Matteo Cagol; Giorgio Diamantis; Ermanno Ancona; Carlo Castoro

    2011-01-01

    This study is aimed to assess the long-term health-related quality of life (HRQL) of patients after esopha gectomy for esophageal cancer in comparison with established norms, and to evaluate changes in HRQL during the different stages of follow-up after esophageal resection. A systematic review was performed by searching medical databases (Medline, Embase and the Cochrane Library) for potentially relevant studies that appeared between January 1975 and March 2011. Studies were included if they addressed the question of HRQL after esophageal resection for esophageal cancer. Two researchers independently performed the study selection, data extraction and analysis processes. Twenty-one observational studies were included with a total of 1282 (12-355) patients. Five studies were performed with short form-36 (SF-36) and 16 with European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 (14 of them also utilized the disease-specific 0ES18 or its previous version OES24).The analysis of long-term generic HRQL with SF-36 showed pooled scores for physical, role and social function after esophagectomy similar to United States norms, but lower pooled scores for physical function, vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 global scale during a 6-mo follow-up showed that global scale and physical function were better at the baseline. The symptom scales indicated worsened fatigue, dyspnea and diarrhea 6 mo after esophagectomy. In contrast, however, emotional function had significantly improved after 6 mo. In conclusion, short- and long-term HRQL is deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-term consequence of esophagectomy involving either the respiratory system or the alimentary tract. The short-and long-term improvement in the emotional function of patients who have undergone successful operations may be attributed to the impression that they have

  4. Two cases of cisplatin-induced permanent renal failure following neoadjuvant chemotherapy for esophageal cancer

    OpenAIRE

    Tomohiko Sasaki; Satoru Motoyama; Atsushi Komatsuda; Hiroyuki Shibata; Yusuke Sato; Kei Yoshino; Akiyuki Wakita; Hajime Saito; Akira Anbai; Mario Jin; Yoshihiro Minamiya

    2016-01-01

    Introduction: We experienced two esophageal cancer patients who developed severe acute renal failure after neoadjuvant chemotherapy with cisplatin and 5-fluorourasil. Presentation of case: After administration of cisplatin, their serum creatinine increased gradually until they required hemodialysis and their renal failure was permanent. In both cases, renal biopsy examination indicated partial recovery of the proximal tubule, but renal function did not recover. After these events, one pati...

  5. A phase I study of concurrent chemoradiotherapy and cetuximab for locally advanced esophageal cancer

    DEFF Research Database (Denmark)

    Holländer, Cecilie; Baeksgaard, Lene; Sorensen, Morten;

    2012-01-01

    AIM: To determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of concurrent chemoradiotherapy and cetuximab in patients with non-resectable locally advanced esophageal cancer. PATIENTS AND METHODS: Escalating doses of oxaliplatin every second week and daily tegafur......)) with no DLTs. Four out of 9 patients had complete response. CONCLUSION: Concomitant chemoradiotherapy and cetuximab had significant activity. DL1 was established as the MTD....

  6. Reduced 15S-Lipoxygenase-2 Expression in Esophageal Cancer Specimens and Cells and Upregulation In Vitro by the Cyclooxygenase-2 Inhibitor, NS398

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    Xiao-Chun Xu

    2003-03-01

    Full Text Available Alterations in arachidonic acid metabolism are involved in human carcinogenesis. Cyclooxygenase (COX and lipoxygenase (LOX are key enzymes in this metabolism. We analyzed the expression of 15S-lipoxygenase-2 (15-LOX-2 mRNA and protein in surgical specimens from normal (N=37 and malignant (63 esophageal tissues using in situ hybridization and immunohistochemistry (IHC, in normal (1, premalignant (1, malignant (5 esophageal cell lines using Northern and Western blotting. 15-LOX-2 was expressed in normal esophageal epithelial cells (EECs at the highest levels, whereas an SV40-immortalized HET-1A line and three of five esophageal cancer cell lines failed to express it at detectable levels. 15-LOX-2 was detected in 76% (28/37 of the normal esophageal mucosae, but only in 46% (29/63 of the cancer specimens using IHC (P<.01. Transient transfection of 15-LOX-2 expression vectors into esophageal cancer cells significantly inhibited the proliferation of 15-LOX-2-negative cancer cells. The COX-2 inhibitor, NS398, induced 15LOX-2 expression in esophageal cancer cells, which is associated with reduced cell viability. This study demonstrated that 15-LOX-2 expression is lost in esophageal cancers and that the induction of 15-LOX-2 can inhibit cancer cell proliferation. Further investigation of the effects of nonsteroidal anti-inflammatory drugs on 15-LOX-2 expression and apoptosis in esophageal cancer cells may be warranted.

  7. Time trends of esophageal cancer mortality in Linzhou city during the period 1988-2010 and a Bayesian approach projection for 2020.

    Science.gov (United States)

    Liu, Shu-Zheng; Zhang, Fang; Quan, Pei-Liang; Lu, Jian-Bang; Liu, Zhi-Cai; Sun, Xi-Bin

    2012-01-01

    In recent decades, decreasing trends in esophageal cancer mortality have been observed across China. We here describe esophageal cancer mortality trends in Linzhou city, a high-incidence region of esophageal cancer in China, during 1988-2010 and make a esophageal cancer mortality projection in the period 2011-2020 using a Bayesian approach. Age standardized mortality rates were estimated by direct standardization to the World population structure in 1985. A Bayesian age-period-cohort (BAPC) analysis was carried out in order to investigate the effect of the age, period and birth cohort on esophageal cancer mortality in Linzhou during 1988-2010 and to estimate future trends for the period 2011-2020. Age-adjusted rates for men and women decreased from 1988 to 2005 and changed little thereafter. Risk increased from 30 years of age until the very elderly. Period effects showed little variation in risk throughout 1988-2010. In contrast, a cohort effect showed risk decreased greatly in later cohorts. Forecasting, based on BAPC modeling, resulted in a increasing burden of mortality and a decreasing age standardized mortality rate of esophageal cancer in Linzhou city. The decrease of esophageal cancer mortality risk since the 1930 cohort could be attributable to the improvements of social- economic environment and lifestyle. The standardized mortality rates of esophageal cancer should decrease continually. The effect of aging on the population could explain the increase in esophageal mortality projected for 2020.

  8. Age scope of high-risk population for esophageal cancer in Ci county

    Institute of Scientific and Technical Information of China (English)

    Zhi-Feng Chen; Jun Hou; Zhen-Wei Ding; Cui-Lan Guo; Cui-Yun Qiao; Guo-Hui Song; Shao-Sen Li; Jian-Hui Zhang; Yu-Tong He

    2005-01-01

    AIM: To define the age scope of high-risk population for esophageal cancer (EC) in Ci county.METHODS: The results of endoscopic examination of 2013 subjects, cytological screening of 16 763 persons and records of 9 265 patients with EC were analyzed by Ridit methods, the standard age group was 45-49 year group.RESULTS: The average age of patients with moderate esophageal epithelium dysplasia by endoscopic examination was 53.5 years, of severe esophageal epithelium dysplasia,51.4 years, early EC, 55.6 years. The average age of stage one severe epithelium dysplasia (SEEDI) by cytological screening was 51.2 years, of stage two severe epithelium esophageal dysplasia (SEED Ⅱ) 51.6 years, of advanced EC 61.7 years. In the group of 40-year olds,the value of Ridit by pathological diagnosis was 0.46, 95%CI, 0.45-0.47, that by cytological diagnosis was 0.45, 95%CI, 0.43-0.47. As the age increased at five-year intervals,the value of Ridit increased significantly.CONCLUSION: In Ci county of a high incidence area of EC, the age definition of high-risk population should be above 45 years.

  9. Molecular Biology of Esophageal Cancer%食管癌的分子生物学

    Institute of Scientific and Technical Information of China (English)

    Huan Xi; Jan Brabender; Ralf Metzger; Paul M.Schneider

    2004-01-01

    There have been many new developments in our understanding of esophageal carcinoma biology over the past several years. Information regarding both of the major forms of this disease, adenocarcinoma and squamous cell carcinoma, has accumulated in conjunction with data on precursor conditions such as Barrett's esophagus. Interesting and promising findings have included overexpression of proto-oncogenes,loss of heterozygosity at multiple chromosomal loci, tumor suppressor gene inactivation, epigenetic silencing by DNA methylation, and mutations and deletions involving the tumor suppressor gene p53. Important cancer pathways, the cyclin kinase inhibitor cascade and the DNA mismatch repair process, implicated in the genesis of multiple .tumor types have also been inculpated in esophageal carcinogenesis. Alterations in the p16 and p15 cyclin kinase inhibitors including point mutations and homozygous deletions have been reported in primary esophageal tumors. Further developments in the field of molecular carcinogenesis of esophageal malignancies promise to yield improvements in prevention, early detection, prognostic categorization, and perhaps gene-based therapy of this deadly disease.

  10. Brain metastasis from esophageal carcinoma

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    Almasi Saeid

    2004-10-01

    Full Text Available Brain metastasis from esophageal carcinoma is rare. In our center, among 301 cases of esophageal cancer referred for radiotherapy during a 14-year period, brain metastasis from esophageal carcinoma was detected in one case. An unusual case of esophageal carcinoma that presented with brain metastasis is reported.

  11. Genomic alterations in advanced esophageal cancer may lead to subtype-specific therapies.

    Science.gov (United States)

    Forde, Patrick M; Kelly, Ronan J

    2013-01-01

    The development of targeted agents for metastatic esophageal or gastroesophageal junction (GEJ) tumors has been limited when compared with that for other common tumors. To date, the anti-human epidermal growth factor receptor-2 (HER-2) antibody, trastuzumab, in combination with chemotherapy, is the only approved novel agent for these cancers, and its use is limited to the small population of patients whose tumors overexpress HER-2. Despite recent progress in the field, median overall survival remains only 8-12 months for patients with stage IV esophageal or GEJ cancer. In this article, we examine the molecular aberrations thought to drive the development and spread of esophageal cancer and identify promising targets for specific tumor inhibition. Data from clinical studies of targeted agents are reviewed, including epidermal growth factor receptor antibodies, tyrosine kinase inhibitors, HER-2, and vascular endothelial growth factor-directed therapy. Current and future targets include MET, fibroblast growth factor receptor, and immune-based therapies. Evidence from trials to date suggests that molecularly unselected patient cohorts derive minimal benefit from most target-specific agents, suggesting that future collaborative investigation should focus on preselected molecular subgroups of patients with this challenging heterogeneous disease.

  12. Significant prognostic value of circulating tumor cells in esophageal cancer patients: A meta-analysis.

    Science.gov (United States)

    Wang, Shuyu; Du, Hongyang; Li, Guixia

    2017-02-02

    Esophageal cancer is the sixth leading cause of cancer death worldwide. Detection of circulating tumor cells (CTCs) is emerging as a novel strategy for predicting cancer patient prognosis. Here we performed a comprehensive literature search to identify relevant articles in EMbase, PubMed, EBSCO, OVID, Cochrane Database, CNKI, WanFangdata and VIPdata. Meta-analysis was conducted using Stata12.0 software, according to the inclusion and exclusion criteria, extracted data and assessment methodology. Thirteen eligible literature studies were included with a total of 979 esophageal squamous cell carcinoma patients, including 424 CTC-positive and 684 CTC-negative cases. Meta-analysis showed that the presence of CTCs was associated with both worse progression-free/disease-free survival [hazard ration (HR) = 2.32, 95% confidence interval (CI) = 1.57 - 3.43, p < 0.001] and poorer overall survival [HR = 2.64, 95% CI = 1.69 - 4.14, p < 0.001]. Further subgroup analyses demonstrated that CTC-positive patients also showed worse progression-free/disease-free survival and poorer overall survival in different subsets. In summary, our meta-analysis provides strong evidence that detection of CTCs in the peripheral blood is an independent prognostic indicator of poor outcome for esophageal squamous cell carcinoma patients.

  13. Fuzzy logic-based prognostic score for outcome prediction in esophageal cancer.

    Science.gov (United States)

    Wang, Chang-Yu; Lee, Tsair-Fwu; Fang, Chun-Hsiung; Chou, Jyh-Horng

    2012-11-01

    Given the poor prognosis of esophageal cancer and the invasiveness of combined modality treatment, improved prognostic scoring systems are needed. We developed a fuzzy logic-based system to improve the predictive performance of a risk score based on the serum concentrations of C-reactive protein (CRP) and albumin in a cohort of 271 patients with esophageal cancer before radiotherapy. Univariate and multivariate survival analyses were employed to validate the independent prognostic value of the fuzzy risk score. To further compare the predictive performance of the fuzzy risk score with other prognostic scoring systems, time-dependent receiver operating characteristic curve (ROC) analysis was used. Application of fuzzy logic to the serum values of CRP and albumin increased predictive performance for 1-year overall survival (AUC=0.773) compared with that of a single marker (AUC=0.743 and 0.700 for CRP and albumin, respectively), where the AUC denotes the area under curve. This fuzzy logic-based approach also performed consistently better than the Glasgow Prognostic Score (GPS) (AUC=0.745). Thus, application of fuzzy logic to the analysis of serum markers can more accurately predict the outcome for patients with esophageal cancer.

  14. The candidate tumor suppressor gene ECRG4 inhibits cancer cells migration and invasion in esophageal carcinoma

    Directory of Open Access Journals (Sweden)

    Lu ShihHsin

    2010-10-01

    Full Text Available Abstract Background The esophageal cancer related gene 4 (ECRG4 was initially identified and cloned in our laboratory from human normal esophageal epithelium (GenBank accession no.AF325503. ECRG4 was a new tumor suppressor gene in esophageal squamous cell carcinoma (ESCC associated with prognosis. In this study, we investigated the novel tumor-suppressing function of ECRG4 in cancer cell migration, invasion, adhesion and cell cycle regulation in ESCC. Methods Transwell and Boyden chamber experiments were utilized to examined the effects of ECRG4 expression on ESCC cells migration, invasion and adhesion. And flow cytometric analysis was used to observe the impact of ECRG4 expression on cell cycle regulation. Finally, the expression levels of cell cycle regulating proteins p53 and p21 in human ESCC cells transfected with ECRG4 gene were evaluated by Western blotting. Results The restoration of ECRG4 expression in ESCC cells inhibited cancer cells migration and invasion (P P > 0.05. Furthermore, ECRG4 could cause cell cycle G1 phase arrest in ESCC (P Conclusion ECRG4 is a candidate tumor suppressor gene which suppressed tumor cells migration and invasion without affecting cell adhesion ability in ESCC. Furthermore, ECRG4 might cause cell cycle G1 phase block possibly through inducing the increased expression of p53 and p21 proteins in ESCC.

  15. SU-C-BRA-04: Use of Esophageal Wall Thickness in Evaluation of the Response to Chemoradiation Therapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wang, J; Kligerman, S; Lu, W [University of Maryland School of Medicine, Baltimore, MD (United States); Kang, M [University of Maryland School of Medicine, Baltimore, MD (United States); Yeungnam University Medical Center, Daegu (Korea, Republic of)

    2015-06-15

    Purpose: To quantitatively evaluate the esophageal cancer response to chemoradiation therapy (CRT) by measuring the esophageal wall thickness in CT. Method: Two datasets were used in this study. The first dataset is composed of CT scans of 15 esophageal cancer patients and 15 normal controls. The second dataset is composed of 20 esophageal cancer patients who underwent PET/CT scans before (Pre-CRT) and after CRT (Post-CRT). We first segmented the esophagus using a multi-atlas-based algorithm. The esophageal wall thickness was then computed, on each slice, as the equivalent circle radius of the segmented esophagus excluding the lumen. To evaluate the changes of wall thickness, we computed the standard deviation (SD), coefficient of variation (COV, SD/Mean), and flatness [(Max–Min)/Mean] of wall thickness along the entire esophagus. Results: For the first dataset, the mean wall thickness of cancer patients and normal controls were 6.35 mm and 6.03 mm, respectively. The mean SD, COV, and flatness of the wall thickness were 2.59, 0.21, and 1.27 for the cancer patients and 1.99, 0.16, and 1.13 for normal controls. Statistically significant differences (p < 0.05) were identified in SD and flatness. For the second dataset, the mean wall thickness of pre-CRT and post-CRT patients was 7.13 mm and 6.84 mm, respectively. The mean SD, COV, and flatness were 1.81, 0.26, and 1.06 for pre-CRT and 1.69, 0.26, and 1.06 for post-CRT. Statistically significant difference was not identified for these measurements. Current results are based on the entire esophagus. We believe significant differences between pre- and post-CRT scans could be obtained, if we conduct the measurements at tumor sites. Conclusion: Results show thicker wall thickness in pre-CRT scans and differences in wall thickness changes between normal and abnormal esophagus. This demonstrated the potential of esophageal wall thickness as a marker in the tumor CRT response evaluation. This work was supported in part by

  16. Stents in patients with esophageal cancer before chemoradiotherapy: high risk of complications and no impact on the nutritional status.

    Science.gov (United States)

    Mão-de-Ferro, S; Serrano, M; Ferreira, S; Rosa, I; Lage, P; Alexandre, D P; Freire, J; Mirones, L; Casaca, R; Bettencourt, A; Pereira, A D

    2016-03-01

    Preoperative chemoradiotherapy is the standard of care for locally advanced esophageal cancer, causing persistent deterioration in the nutritional status. We performed a prospective study to evaluate the safety and efficacy of esophageal double-covered self-expandable metal stents in patients with esophageal cancer before chemoradiotherapy. The nutritional status and dysphagia were prospectively recorded. Eleven patients were included: eight were moderate and three were severely malnourished. After stent placement, dysphagia improved in all patients. With regard to complications, one patient developed an esophageal perforation that required urgent esophagectomy. Four patients presented stent migration. Three of these patients required enteral nutrition and none was submitted to surgery because of poor nutritional status. Of the other six patients, only four were operated upon. Stent placement presented a high complication rate and did not prevent weight loss or malnutrition. Other alternatives, including naso-gastric tube placement or endoscopic percutaneous gastrostomy or jejunostomy, should be considered.

  17. Rhizoma Paridis Saponins Suppresses Tumor Growth in a Rat Model of N-Nitrosomethylbenzylamine-Induced Esophageal Cancer by Inhibiting Cyclooxygenases-2 Pathway.

    Science.gov (United States)

    Yan, Shu; Tian, Shuxia; Kang, Qingwei; Xia, Yafei; Li, Caixia; Chen, Qing; Zhang, Shukun; Li, Zhigang

    2015-01-01

    Rhizoma Paridis Saponins (RPS), a natural compound purified from Rhizoma Paridis, has been found to inhibit cancer growth in vitro and in animal models of cancer. However, its effects on esophageal cancer remain unexplored. The purpose of this study was to investigate the effects of RPS on tumor growth in a rat model of esophageal cancer and the molecular mechanism underlying the effects. A rat model of esophageal cancer was established by subcutaneous injection of N-nitrosomethylbenzylamine (NMBA, 1 mg/kg) for 10 weeks. RPS (350 mg/kg or 100 mg/kg) was administered by oral gavage once daily for 24 weeks starting at the first NMBA injection. RPS significantly reduced the size and number of tumors in the esophagus of rats exposed to NMBA and inhibited the viability, migration, and invasion of esophageal cancer cells EC9706 and KYSE150 in a dose dependent manner (all P induced apoptosis and cell cycle G2/M arrest in the esophageal cancer cells. The expression of cyclooxygenases-2 (COX-2) and Cyclin D1 in rat esophageal tissues and the esophageal cancer cells were also significantly reduced by RPS (all P cancer development by promoting apoptosis and cell cycle arrest and inhibiting the COX-2 pathway. RPS might be a promising therapeutic agent for esophageal cancer.

  18. Gene expression profile of esophageal cancer in North East India by cDNA microarray analysis

    Institute of Scientific and Technical Information of China (English)

    Indranil Chattopadhyay; Sujala Kapur; Joydeep Purkayastha; Rupkumar Phukan; Amal Kataki; Jagadish Mahanta; Sunita Saxena

    2007-01-01

    AIM: To identify alterations in genes and molecular functional pathways in esophageal cancer in a high incidence region of India where there is a widespread use of tobacco and betel quid with fermented areca nuts.METHODS: Total RNA was isolated from tumor and matched normal tissue of 16 patients with esophageal squamous cell carcinoma. Pooled tumor tissue RNA was labeled with Cy3-dUTP and pooled normal tissue RNA was labeled with Cy5-dUTP by direct labeling method.The labeled probes were hybridized with human 10K cDNA chip and expression profiles were analyzed by Genespring GX V 7.3 (Silicon Genetics).RESULTS: Nine hundred twenty three genes were differentially expressed. Of these, 611 genes were upregulated and 312 genes were downregulated. Using stringent criteria (P ≤ 0.05 and ≥ 1.5 fold change),127 differentially expressed genes (87 upregulated and 40 downregulated) were identified in tumor tissue. On the basis of Gene Ontology, four different molecular functional pathways (MAPK pathway,G-protein coupled receptor family, ion transport activity,and serine or threonine kinase activity) were most significantly upregulated and six different molecular functional pathways (structural constituent of ribosome,endopeptidase inhibitor activity, structural constituent of cytoskeleton, antioxidant activity, acyl group transferase activity, eukaryotic translation elongation factor activity)were most significantly downregulated.CONCLUSION: Several genes that showed alterations in our study have also been reported from a high incidence area of esophageal cancer in China. This indicates that molecular profiles of esophageal cancer in these two different geographic locations are highly consistent.

  19. Celiac Node Failure Patterns After Definitive Chemoradiation for Esophageal Cancer in the Modern Era

    Energy Technology Data Exchange (ETDEWEB)

    Amini, Arya [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); UC Irvine School of Medicine, Irvine, California (United States); Xiao Lianchun [Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Suzuki, Akihiro; Hayashi, Yuki [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hofstetter, Wayne [Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Crane, Christopher; Komaki, Ritsuko [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Bhutani, Manoop S.; Lee, Jeffrey H.; Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Welsh, James, E-mail: jwelsh@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-06-01

    Purpose: The celiac lymph node axis acts as a gateway for metastatic systemic spread. The need for prophylactic celiac nodal coverage in chemoradiation therapy for esophageal cancer is controversial. Given the improved ability to evaluate lymph node status before treatment via positron emission tomography (PET) and endoscopic ultrasound, we hypothesized that prophylactic celiac node irradiation may not be needed for patients with localized esophageal carcinoma. Methods and Materials: We reviewed the radiation treatment volumes for 131 patients who underwent definitive chemoradiation for esophageal cancer. Patients with celiac lymph node involvement at baseline were excluded. Median radiation dose was 50.4 Gy. The location of all celiac node failures was compared with the radiation treatment plan to determine whether the failures occurred within or outside the radiation treatment field. Results: At a median follow-up time of 52.6 months (95% CI 46.1-56.7 months), 6 of 60 patients (10%) without celiac node coverage had celiac nodal failure; in 5 of these patients, the failures represented the first site of recurrence. Of the 71 patients who had celiac coverage, only 5 patients (7%) had celiac region relapse. In multivariate analyses, having a pretreatment-to-post-treatment change in standardized uptake value on PET >52% (odds ratio [OR] 0.198, p = 0.0327) and having failure in the clinical target volume (OR 10.72, p = 0.001) were associated with risk of celiac region relapse. Of those without celiac coverage, the 6 patients that later developed celiac failure had a worse median overall survival time compared with the other 54 patients who did not fail (median overall survival time: 16.5 months vs. 31.5 months, p = 0.041). Acute and late toxicities were similar in both groups. Conclusions: Although celiac lymph node failures occur in approximately 1 of 10 patients, the lack of effective salvage treatments and subsequent low morbidity may justify prophylactic treatment

  20. Local hyperthermia for esophageal cancer in a rabbit tumor model: Magnetic stent hyperthermia versus magnetic fluid hyperthermia.

    Science.gov (United States)

    Liu, Jiayi; Li, Ning; Li, Li; Li, Danye; Liu, Kai; Zhao, Lingyun; Tang, Jintian; Li, Liya

    2013-12-01

    Magnetic-mediated hyperthermia (MMH) is a promising local thermotherapy approach for cancer treatment. The present study investigated the feasibility and effectiveness of MMH in esophageal cancer using a rabbit tumor model. The therapeutic effect of two hyperthermia approaches, magnetic stent hyperthermia (MSH), in which heat is induced by the clinical stent that is placed inside the esophagus, and magnetic fluid hyperthermia (MFH), where magnetic nanoparticles are applied as the agent, was systematically evaluated. A rabbit esophageal tumor model was established by injecting VX2 carcinoma cells into the esophageal submucosa. The esophageal stent was deployed perorally into the tumor segment of the esophagus. For the MFH, magnetic nanoparticles (MNPs) were administered to the rabbits by intratumoral injection. The rabbits were exposed under a benchtop applicator using an alternative magnetic field (AMF) with 300 kHz frequency for the hyperthermia treatment. The results demonstrated that esophageal stents and MNPs had ideal inductive heating properties upon exposure under an AMF of 300 kHz. MSH, using a thermal dose of 46°C with a 10-min treatment time, demonstrated antitumor effects on the rabbit esophageal cancer. However, the rabbit esophageal wall is not heat-resistant. Therefore, a higher temperature or longer treatment time may lead to necrosis of the rabbit esophagus. MFH has a significant antitumor effect by confining the heat within the tumor site without damaging the adjacent normal tissues. The present study indicates that the two hyperthermia procedures have therapeutic effects on esophageal cancer, and that MFH may be more specific than MSH in terms of temperature control during the treatment.

  1. Citrus Fruit Intake Substantially Reduces the Risk of Esophageal Cancer: A Meta-Analysis of Epidemiologic Studies.

    Science.gov (United States)

    Wang, Anqiang; Zhu, Chengpei; Fu, Lilan; Wan, Xueshuai; Yang, Xiaobo; Zhang, Haohai; Miao, Ruoyu; He, Lian; Sang, Xinting; Zhao, Haitao

    2015-09-01

    Many epidemiologic studies indicate a potential association between fruit and vegetable intake and various cancers. The purpose of this meta-analysis is to investigate the association between citrus fruit intake and esophageal cancer risk. The authors conducted a comprehensive search on PubMed, EMBASE, and the Cochrane Library from inception until July 2014. Studies presenting information about citrus intake and esophageal cancer were analyzed. The authors extracted the categories of citrus intake, study-specific odds ratio or relative risk, and the P value and associated 95% confidence intervals for the highest versus lowest dietary intake of citrus fruit level. The association was quantified using meta-analysis of standard errors with a random-effects model. Thirteen case-control studies and 6 cohort studies were eligible for inclusion. Citrus intake may significantly reduce risk of esophageal cancer (summary odds ratio = 0.63; 95% confidence interval = 0.52-0.75; P = 0), without notable publication bias (intercept = -0.79, P = 0.288) and with significant heterogeneity across studies (I = 52%). The results from epidemiologic studies suggest an inverse association between citrus fruit intake and esophageal cancer risk. The significant effect is consistent between case-control and cohort studies. Larger prospective studies with rigorous methodology should be considered to validate the association between citrus fruits and esophageal cancer.

  2. Clinical Study of Time Optimizing of Endoscopic Photodynamic Therapy on Esophageal and/or Gastric Cardiac Cancer

    Science.gov (United States)

    2015-12-10

    Stage I Esophageal Adenocarcinoma; Stage II Esophageal Adenocarcinoma; Stage III Esophageal Adenocarcinoma; Stage I Esophageal Squamous Cell Carcinoma; Stage II Esophageal Squamous Cell Carcinoma; Stage III Esophageal Squamous Cell Carcinoma

  3. Analysis of the relationships between esophageal cancer cases and climatic factors using a Geographic Information System (GIS): a case study of Ardabil province in Iran.

    Science.gov (United States)

    Ahari, Saeid Sadeghieh; Agdam, Fridoon Babaei; Amani, Firouz; Yazdanbod, Abbas; Akhghari, Leyla

    2013-01-01

    Esophageal cancer is a mjaor health problems in many parts of the world. A geographical information system (GIS) allows investigation of the geographical distribution of diseases. The purpose of the present study was to explore the relationship between esophageal cancer and effective climatic factors using GIS. The dispersion distribution and the relationship between environmental factors effective on cancer were measured using Arc GIS. The highest degree of spread was in Germi town and the least was in Ardabil city. There was a significant relationship between effective environmental factors and esophageal cancer in Ardabil province. The results indicated that environmental factors probably are influential in determining the incidence of esophageal cancer. Also, these results can be considered as a window to future comprehensive research on esophageal cancer and related risk factors.

  4. Epidemiological studies of esophageal cancer in the era of genome-wide association studies

    Institute of Scientific and Technical Information of China (English)

    An-Hui; Wang; Yuan; Liu; Bo; Wang; Yi-Xuan; He; Ye-Xian; Fang; Yong-Ping; Yan

    2014-01-01

    Esophageal cancer(EC) caused about 395000 deaths in 2010. China has the most cases of EC and EC is the fourth leading cause of cancer death in China. Esophageal squamous cell carcinoma(ESCC) is the predominant histologic type(90%-95%), while the incidence of esophageal adenocarcinoma(EAC) remains extremely low in China. Traditional epidemiological studies have revealed that environmental carcinogens are risk factors for EC. Molecular epidemiological studies revealed that susceptibility to EC is influenced by both environmental and genetic risk factors. Of all the risk factors for EC, some are associated with the risk of ESCC and others with the risk of EAC. However, the details and mechanisms of risk factors involved in the process for EC are unclear. The advanced methods and techniques used in human genome studies bring a great opportunity for researchers to explore and identify the details of those risk factors or susceptibility genes involved inthe process of EC. Human genome epidemiology is a new branch of epidemiology, which leads the epidemiology study from the molecular epidemiology era to the era of genome wide association studies(GWAS). Here we review the epidemiological studies of EC(especially ESCC) in the era of GWAS, and provide an overview of the general risk factors and those genomic variants(genes, SNPs, miRNAs, proteins) involved in the process of ESCC.

  5. [A case of advanced esophageal cancer with direct bronchial invasion successfully treated by multidisciplinary therapy].

    Science.gov (United States)

    Haba, Yusuke; Okamoto, Koichi; Watanabe, Toshifumi; Tsukada, Tomoya; Kinoshita, Jun; Makino, Isamu; Nakamura, Keishi; Oyama, Katsunobu; Ninomiya, Itasu; Fushida, Sachio; Fujimura, Takashi; Ohta, Tetsuo

    2014-11-01

    A 66-year-old man with advanced esophageal cancer (staging Mt, 6.0 cm, cT3N0M0, cStage II) was administered neoadjuvant chemotherapy (NAC: 5-fluorouracil and cisplatin). As the tumor continued to grow after one course of NAC, video-assisted thoracoscopic surgery(VATS) was used to perform an esophagectomy along with 3-field lymph node dissection and retrosternal route reconstruction using a gastric tube. The second course of NAC was not administered. Intraoperative findings showed the direct invasion of the primary esophageal cancer into the membranous portion of the left bronchus. The maximum possible tumor tissue was resected and removed. The tumor tissue was exposed extensively to the surface of the esophageal adventitia and a residual tumor at the surface of the left bronchus was suspected. It was diagnosed as CT-pT4 (left bronchus), N0, M0, CT-pStage III. Subsequently, we administered chemoradiotherapy consisting of weekly low-dose docetaxel with radiation for the residual tumor (60 Gy/30 Fr). The patient is still alive 40 months after surgery without any signs of recurrence.

  6. Designed-seamless irradiation technique for extended whole mediastinal proton-beam irradiation for esophageal cancer

    Directory of Open Access Journals (Sweden)

    Okonogi Noriyuki

    2012-10-01

    Full Text Available Abstract Background Proton-beam therapy (PBT provides therapeutic advantages over conformal x-ray therapy in sparing organs at risk when treating esophageal cancer because of the fundamental physical dose distribution of the proton-beam. However, cases with extended esophageal lesions are difficult to treat with conventional PBT with a single isocentric field, as the length of the planning target volume (PTV is longer than the available PBT field size in many facilities. In this study, the feasibility of a practical technique to effectively match PBT fields for esophageal cancer with a larger regional field beyond the available PBT field size was investigated. Methods Twenty esophageal cancer patients with a larger regional field than the available PBT single-field size (15 cm in our facility were analyzed. The PTV was divided into two sections to be covered by a single PBT field. Subsequently, each PTV isocenter was aligned in a cranial-caudal (CC axis to rule out any influence by the movement of the treatment couch in anterior-posterior and left-right directions. To obtain the appropriate dose distributions, a designed-seamless irradiation technique (D-SLIT was proposed. This technique requires the following two adjustments: (A blocking a part of the PTV by multi-leaf collimator(s (MLCs; and (B fine-tuning the isocenter distance by the half-width of the MLC leaf (2.5 mm in our facility. After these steps, the inferior border of the cranial field was designed to match the superior border of the caudal field. Dose distributions along the CC axis around the field junction were evaluated by the treatment-planning system. Dose profiles were validated with imaging plates in all cases. Results The average and standard deviation of minimum dose, maximum dose, and dose range between maximum and minimum doses around the field junction by the treatment-planning system were 95.9 ± 3.2%, 105.3 ± 4.1%, and 9.4 ± 5.2%. The dose profile validated by the

  7. Endoscopic radiofrequency ablation therapy for the prevention of esophageal cancer in Barrett’s esophagus

    Directory of Open Access Journals (Sweden)

    Ha NH

    2015-07-01

    Full Text Available Ngoc Hoang Ha, Richard Hummel, David I WatsonDepartment of Surgery, Flinders University, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, AustraliaAbstract: Barrett’s esophagus is the only known precursor lesion for esophageal adenocarcinoma. Previous studies have shown that a variety of methods can be applied to destroy Barrett’s esophagus epithelium, and healing with a new esophageal squamous epithelium usually occurs following ablation. Radiofrequency ablation (RFA is a relatively new endoscopic technique. It has been claimed that ablation using RFA reduces the risk of cancer progression. RFA is usually easy to apply and is associated with a low risk of morbidity. It achieves complete eradication of (non dysplastic Barrett’s esophagus in most individuals, and the risk of progression to higher grades of dysplasia or cancer is reduced after RFA, although not completely eliminated. Limitations include recurrence of Barrett’s esophagus in up to one-third of individuals, a risk of “buried islands” of Barrett’s esophagus remaining below the regenerated mucosa, and uncertainty about the biological behavior of the new squamous epithelium after RFA. Current evidence supports the use of RFA in individuals with high-grade dysplasia in Barrett’s esophagus, and early stage (T1a intramucosal cancer, and select individuals with low-grade dysplasia. As accurate diagnosis of low-grade dysplasia remains difficult outside expert centers, it is probably premature to recommend routine RFA for all patients diagnosed with low-grade dysplasia in the community, despite the favorable outcomes from one randomized trial. Furthermore, long-term outcomes following ablation remain uncertain, and ongoing endoscopy surveillance is still required after RFA as progression to cancer remains a possibility. Outcomes from large studies with long-term follow-up are needed to definitively confirm that RFA ablation can reliably prevent cancer

  8. Long-term health-related quality of life for disease-free esophageal cancer patients.

    LENUS (Irish Health Repository)

    Donohoe, Claire L

    2012-02-01

    BACKGROUND: Health-related quality of life (HRQL) has been studied extensively during the first year following esophagectomy, but little is known about HRQL in long-term survivors. The aim of this study was to investigate HRQL in patients alive at least 1 year after surgical resection for esophageal cancer using validated European Organisation for Research and Treatment of Cancer (EORTC) quality of life (QOL) questionnaires (QLQ). METHODS: Eligible patients, without known disease recurrence and at least 1 year after esophagectomy, were identified from a prospectively maintained database. Patients completed general (QLQ-C30) and esophageal cancer-specific (QLQ-OES18, OG25) questionnaires. A numeric score (0-100) was computed in each conceptual area and compared with validated cancer (n = 1031) and age-matched (n = 7802) healthy populations using two-tailed unpaired t-tests. A cohort of 80 patients had pretreatment scores recorded. RESULTS: Altogether, 132 of 156 eligible patients (84%) completed the self-rated questionnaire, 105 (67.3%) were men, and the mean age was 62 years (range 29-84 years). The mean time since esophagectomy was 70.3 months (12-299 months). Global health status was significantly reduced at least 1 year after esophagectomy (mean +\\/- SD score 48.4 +\\/- 18.6) when compared with patients with esophageal cancer prior to treatment (55.6 +\\/- 24.1) and the general population (71.2 +\\/- 22.4) (p < 0.0001). In a prospective cohort of eighty patients, symptoms related to swallowing difficulty, reflux, pain, and coughing significantly decreased in the long term (p < 0.0001). The degree of subjective swallowing dysfunction was highly correlated with a poor QOL (Spearman\\'s rho = 0.508, p < 0.01). CONCLUSIONS: Global health status remains significantly reduced in long-term survivors after esophagectomy compared with population controls, and swallowing dysfunction is highly associated with this compromised QOL.

  9. ICAM1 Is a Potential Cancer Stem Cell Marker of Esophageal Squamous Cell Carcinoma.

    Directory of Open Access Journals (Sweden)

    Sheng-Ta Tsai

    Full Text Available Esophageal squamous cell carcinoma (ESCC accounts for about 90% of esophageal cancer diagnosed in Asian countries, with its incidence on the rise. Cancer stem cell (CSC; also known as tumor-initiating cells, TIC is inherently resistant to cytotoxic chemotherapy and radiation and associates with poor prognosis and therapy failure. Targeting therapy against cancer stem cell has emerged as a potential therapeutic approach to develop effective regimens. However, the suitable CSC marker of ESCC for identification and targeting is still limited. In this study, we screened the novel CSC membrane protein markers using two distinct stemness characteristics of cancer cell lines by a comparative approach. After the validation of RT-PCR, qPCR and western blot analyses, intercellular adhesion molecule 1 (ICAM1 was identified as a potential CSC marker of ESCC. ICAM1 promotes cancer cell migration, invasion as well as increasing mesenchymal marker expression and attenuating epithelial marker expression. In addition, ICAM1 contributes to CSC properties, including sphere formation, drug resistance, and tumorigenesis in mouse xenotransplantation model. Based on the analysis of ICAM1-regulated proteins, we speculated that ICAM1 regulates CSC properties partly through an ICAM1-PTTG1IP-p53-DNMT1 pathway. Moreover, we observed that ICAM1 and CD44 could have a compensation effect on maintaining the stemness characteristics of ESCC, suggesting that the combination of multi-targeting therapies should be under serious consideration to acquire a more potent therapeutic effect on CSC of ESCC.

  10. Cardiac function after chemoradiation for esophageal cancer : comparison of heart dose-volume histogram parameters to multiple gated acquisition scan changes

    NARCIS (Netherlands)

    Tripp, P; Malhotra, H K; Javle, M; Shaukat, A; Russo, R; de Boer, Sietse; Podgorsak, M; Nava, H; Yang, G Y

    2005-01-01

    In this paper we determine if preoperative chemoradiation for locally advanced esophageal cancer leads to changes in cardiac ejection fraction. This is a retrospective review of 20 patients treated at our institution for esophageal cancer between 2000 and 2002. Multiple gated acquisition cardiac sca

  11. Green tea drinking, high tea temperature and esophageal cancer in high and low risk areas of Jiangsu Province, China: a population-based case-control study

    NARCIS (Netherlands)

    Wu, M.; Liu, A.; Kampman, E.; Zhang, Zuo-Feng; Veer, van 't P.; Wu, P.; Wang, P.; Kok, F.J.; Zhao, J.

    2009-01-01

    Epidemiological studies suggested drinking green tea is inversely associated with esophageal cancer but results remain inconclusive. Moreover, inconsistent observations found high temperature drinks are associated with esophageal cancer. A population-based case-control study was conducted in a high-

  12. Green tea drinking, high tea temperature and esophageal cancer in high- and low-risk areas of Jiangsu Province, China: a population-based case-control study.

    NARCIS (Netherlands)

    Wu, M.; Liu, A.M.; Kampman, E.; Zhang, Z.F.; Veer, P. van 't; Wu, D.L.; Wang, P.H.; Yang, J.; Qin, Y.; Mu, L.N.; Kok, F.J.; Zhao, J.K.

    2009-01-01

    Epidemiological studies suggested drinking green tea is inversely associated with esophageal cancer but results remain inconclusive. Moreover, inconsistent observations found high temperature drinks are associated with esophageal cancer. A population-based case-control study was conducted in a high-

  13. Smoking and alcohol drinking increased the risk of esophageal cancer among Chinese men but not women in a high-risk population

    NARCIS (Netherlands)

    Wu, M.; Zhao, J.K.; Zhang, Z.F.; Han, R.Q.; Yang, J.; Zhou, J.Y.; Wang, X.S.; Zhang, X.F.; Liu, A.M.; Veer, P. van 't; Kok, F.J.; Kampman, E.

    2011-01-01

    Although the association for esophageal cancer with tobacco smoking and alcohol drinking has been well established, the risk appears to be less strong in China. To provide more evidence on the effect of smoking and alcohol consumption with esophageal cancer in China, particularly among Chinese women

  14. Video-assisted thoracoscopic esophagectomy in the left lateral decubitus position in an esophageal cancer patient with pectus excavatum.

    Science.gov (United States)

    Sato, Shinsuke; Nagai, Erina; Hazama, Hiroyuki; Taki, Yusuke; Takahashi, Michiro; Kyoden, Yusuke; Watanabe, Masaya; Ohata, Ko; Kanemoto, Hideyuki; Oba, Noriyuki; Takagi, Masakazu

    2015-08-01

    During thoracic cavity operations, it is difficult to obtain sufficient working space and good operative field visibility in patients with pectus excavatum because the space between the vertebral bodies and sternum is very narrow. Here, we report the successful treatment of esophageal cancer in a patient with pectus excavatum. A 77-year-old man with esophageal cancer was referred to our hospital for further treatment. He was diagnosed with multiple early esophageal squamous cell carcinomas. The patient had pectus excavatum, but because it was asymptomatic, a video-assisted thoracoscopic radical esophagectomy in the left lateral decubitus position without pectus excavatum repair was selected. Despite the patient's unusual anatomy, video-assisted thoracoscopic esophagectomy in the left decubitus position allowed for good operative field visibility, as the videoscope was inserted from the side of the diaphragm. This operative procedure is useful in patients with esophageal cancer who also have pectus excavatum. To the best of our knowledge, this is the second report of video-assisted thoracoscopic esophagectomy in an esophageal cancer patient with pectus excavatum.

  15. Study on the Functional Dynamic Changes of Peri-Operative Cellular Immunity in Esophageal and Cardiac Cancer

    Institute of Scientific and Technical Information of China (English)

    Chen Sheng; Li Shiting; Fang Youping

    2014-01-01

    Objective: To explore the systemic and local cellular immune function of patients with esophageal carcinoma or cardiac cancer. Methods: The distribution of tumor-infiltrating lymphocyte (TIL) and cancer-associated macrophage (TAM) in local tumor tissues of 52 patients with esophageal cancer or cardiac cancer were observed by immunehistochemical method. The level of peripheral SIL-2R and TNF-α of preoperative and postoperative 1, 2, 3 weeks were detected by ELISA and ABC-ELISA methods respectively, then the acquired results were compared with 30 cases of normal control group. Results:The peritumor inifltration densities of TIL and TAM was greater than that of cancer nest stroma (P<0.05). Compared with the normal control group, the levels of sIL-2R and TNF-α increased signiifcantly (P<0.01). Immune function could be suppressed by operative wound in a short time of post-operation, whose damage severity was closely associated with tumor TNM stages. Conclusion: Patients with esophageal or cardiac cancer have cellular immune function disorders. Dynamic testing of peripheral sIL-2R and TNT-α level in patients with esophageal or cardiac cancer has positive clinical signiifcance in the evaluation of cellular immune function, tumor lesion degree and curative effect.

  16. Fruit and vegetable consumption and risk of esophageal cancer: a case-control study in north-west China.

    Science.gov (United States)

    Tang, L; Lee, A H; Xu, F; Zhang, T; Lei, J; Binns, C W

    2014-01-01

    The north-western region of China carries a big burden of esophageal cancer with incidence above the national average. This study ascertained the association between fruit and vegetable consumption and the risk of esophageal cancer in this remote part of China. A case-control study was undertaken in Urumqi and Shihezi, Xinjiang Uyghur Autonomous Region of China, between 2008 and 2009. Participants were 359 incident esophageal cancer patients and 380 hospital-based controls. Information on habitual fruit and vegetable consumption was obtained by face-to-face interview using a validated semiquantitative food frequency questionnaire. Unconditional logistic regression analyses were performed to assess the strength of the associations. The esophageal cancer patients consumed significantly less fruits (mean 364.3, standard deviation [SD] 497.4 g) and vegetables (mean 711.4, SD 727.9 g) daily than their counterparts without the disease (mean 496.5, SD 634.4 g and mean 894.5, SD 746.1 g, respectively). The adjusted odds ratios were 0.48 (95% confidence interval 0.33-0.71) and 0.46 (95% confidence interval 0.32-0.68) for consuming at least 515 g of fruits and 940 g of vegetables per day, respectively, relative to at most 170 g and 520 g. With respect to nutrients contained in fruits and vegetables, intakes of vitamin C, vitamin E, β-cryptoxanthin, potassium, and magnesium at high levels also reduced the esophageal cancer risk. In conclusion, inverse associations were evident between consumption of fruits and vegetables and the risk of esophageal cancer for adults residing in north-west China.

  17. [A successful resected case of advanced esophageal cancer with early gastric cancer responding to neoadjuvant chemotherapy of docetaxel, CDDP and 5-FU].

    Science.gov (United States)

    Matsutani, Takeshi; Yoshida, Hiroshi; Sasajima, Koji; Maruyama, Hiroshi; Yokoyama, Tadashi; Matsushita, Akira; Hirakata, Atsushi; Takao, Yoshimune; Umakoshi, Michinobu; Hayakawa, Tomohiro; Katayama, Hironori; Hosone, Masaru; Uchida, Eiji

    2012-04-01

    A 72-year-old male with a chief complaint of dysphagia was admitted to our hospital. Upper gastrointestinal endoscopic examination showed double cancers with thoracic esophageal cancer in the middle esophagus and gastric cancer in the antrum. Pathological examinations of the double cancer revealed the first one to be moderately-differentiated squamous cell carcinoma and the second to be well-differentiated adenocarcinoma. Computed tomography (CT) of the chest and abdomen showed no distant or lymph node metastases. Clinical stagings of the double cancer were stage II (T2N0M0)in esophageal cancer and stage I A (T1N0M0) in gastric cancer. The patient received neoadjuvant chemotherapy using docetaxel, CDDP and 5-FU. After 2 courses of chemotherapy, the adverse event was grade 2 in leucopenia and grade 2 in alopecia. Repeated macroscopic and histological examinations after chemotherapy revealed that the esophageal cancer had significant reductions in the size of tumors, leading to a partial response, and the gastric cancer had disappeared, leading to a complete response. He underwent thoracoscopy-assisted esophagectomy in the prone position, and laparoscopy-assisted gastric tube reconstruction. This neoadjuvant chemotherapy of docetaxel, CDDP and 5-FU might be effective and tolerable as with patients with double cancer of esophageal and gastric cancers.

  18. Anatomic distribution of supraclavicular lymph node in patients with esophageal cancer

    Directory of Open Access Journals (Sweden)

    Xing J

    2016-09-01

    Full Text Available Jun Xing,1 Yijun Luo,1,2 Xiaoli Wang,1,2 Min Gao,1 Mingping Sun,1 Xiuping Ding,1 Tingyong Fan,1 Jinming Yu1 1Department of Radiation Oncology and Radiology, Shandong Cancer Hospital Affiliated to Shandong University, 2School of Medical and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, Jinan, People’s Republic of China Purpose: Definitive chemoradiation therapy remains the standard of care for patients with localized esophageal carcinoma who choose nonsurgical management. However, there is no consensus regarding delineation of the nodal clinical target volume (CTVn, especially for lower cervical lymph nodes. This study aimed to map the location of metastatic supraclavicular lymph nodes in thoracic esophageal carcinoma patients with supraclavicular node involvement and generate an atlas to delineate the CTVn for elective nodal radiation of esophageal squamous cell carcinoma. Patients and methods: In this study, the supraclavicular regional lymph node was further divided into four subgroups. The locations of the involved supraclavicular nodes for all patients were then transferred onto a template computed tomography (CT image. A volume probability map was then generated with nodal volumes, and was displayed on the template CT to provide a visual impression of nodal frequencies and anatomic distribution. Results: We identified 154 supraclavicular nodal metastases based on CT image in 96 patients. Of these, 29.2% were located in group I region, 59.7% in group II region, 10.4% in group III region, and 0.7% in group IV region. Conclusion: On the basis of our study, we suggest that the appropriate radiation field of CTVn should include the group I and II regions and the CTVn exterior margin along the lateral side of the internal jugular vein may be suitable. Keywords: esophageal carcinoma, lymph node metastasis, clinical target volume, cervical lymph node

  19. Effect of 2-(3-carboxy-1-oxopropyl) amino-2-deoxy-D-glucose on human esophageal cancer cell line

    Institute of Scientific and Technical Information of China (English)

    Jing Wu; Hong Lu; Yun Zhou; Liang Qiao; Rui Ji; Ai-Qing Wang; Wei-Min Liu; Qun-Ji Xue

    2004-01-01

    AIM: To determine whether 2-(3-carboxy-1-oxopropy1)amino-2-deoxy-D-glucose (COPADG), a derivative of Damino-glucose, inhibited the growth of human esophageal cancer cell line Eca-109.METHODS: Effects of COPADG on Eca-109 cells cultured in RPMI 1640 medium were examined by a tetrazoliumbased colorimetric assay (MTT assay).RESULTS: COPADG inhibited the growth of Eca-109 cells in a dose- and time-dependent manner; the maximum inhibition rate was 83.75%.CONCLUSION: COPADG can directly inhibit the proliferation of Eca-109 cells, which may serve as the experimental evidence for development of new drugs for esophageal cancer therapy.

  20. Clinical Study of Endostar Combined with DP Protocol in Treatment of Advanced Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Wen-ying DENG

    2015-09-01

    Full Text Available Objective: To observe the clinical outcomes of Endostar combined with DP regimen for treating advanced esophageal cancer.Methods: A total of 62 patients with advanced esophageal cancer admitted from May, 2011 to May, 2013 were enrolled for a prospective, randomized controlled trial and 2 cases were excluded from the study because of Ⅳ degree of digestive tract reaction and myelosuppression. Therefore, 60 cases could be evaluated, and then divided into combined group (given Endostar+DP plan and single chemotherapy group, 30 cases in each group. The level of VEGF, tumor size and CT perfusion (CTP parameters, including blood flow (BF, blood volume (BV, mean transit time (MTT, and permeability surface (PS before and after treatment were determined for comparison. Kaplan-Merier method was used to analyze the overall survival (OS of 2 groups.Results: The efficacy of combined group was superior to single chemotherapy group. The level of vascular endothelial growth factor (VEGF in combined group was obviously lower than that in single chemotherapy group after treatment (P<0.01. Compared with treatment before in combined group, BF, BV and PS decreased while MTT increased after treatment (P<0.05. However, there were no significant differences in single chemotherapygroup before and after treatment (P>0.05. The median OS was 30 months (95%CI: 20.935-39.065 for combined group and 21 months (95%CI: 15.109-26.591 for single chemotherapy group, respectively (P=0.048. The 1-, 2- and 3-year survival rates were 86.2%, 59.3% and 36.6% in combined group, and 70.8%, 32.1% and 17.8% in single chemotherapy group, respectively.Conclusion: Endostar can down-regulate the expression of VEGF, improve the state of hypertransfusion and high permeability of tumor vessels, has better curative effect without slighter adverse reactions, and prolong the survival time of patients with advanced esophageal cancer when combined with chemotherapy.

  1. Clinical Study of Endostar Combined with DP Protocol in Treatment of Advanced Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    DENG Wen-ying; LI Ning; LUO Su-xia

    2015-01-01

    Objective: To observe the clinical outcomes of Endostar combined with DP regimen for treating advanced esophageal cancer. Methods: A total of 62 patients with advanced esophageal cancer admitted from May, 2011 to May, 2013 were enrolled for a prospective, randomized controlled trial and 2 cases were excluded from the study because ofⅣ degree of digestive tract reaction and myelosuppression. Therefore, 60 cases could be evaluated, and then divided into combined group (given Endostar+DP plan) and single chemotherapy group, 30 cases in each group. The level of VEGF, tumor size and CT perfusion (CTP) parameters, including blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS) before and after treatment were determined for comparison. Kaplan-Merier method was used to analyze the overall survival (OS) of 2 groups. Results:The efifcacy of combined group was superior to single chemotherapy group. The level of vascular endothelial growth factor (VEGF) in combined group was obviously lower than that in single chemotherapy group after treatment (P0.05). The median OS was 30 months (95%CI: 20.935-39.065) for combined group and 21 months (95%CI: 15.109-26.591) for single chemotherapy group, respectively (P=0.048). The 1-, 2- and 3-year survival rates were 86.2%, 59.3% and 36.6% in combined group, and 70.8%, 32.1% and 17.8% in single chemotherapy group, respectively. Conclusion: Endostar can down-regulate the expression of VEGF, improve the state of hypertransfusion and high permeability of tumor vessels, has better curative effect without slighter adverse reactions, and prolong the survival time of patients with advanced esophageal cancer when combined with chemotherapy.

  2. Use of Germline Polymorphisms in Predicting Concurrent Chemoradiotherapy Response in Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Pei-Chun [Department of Statistics and Informatics Science, Providence University, Taiwan (China); Chen, Yen-Ching [Institute of Epidemiology Preventive Medicine, College of Public Health, National Taiwan University, Taiwan (China); Research Center for Gene, Environment, and Human Health, College of Public Health, National Taiwan University, Taiwan (China); Department of Public Health, Institute of Epidemiology, National Taiwan University, Taiwan (China); Lai, Liang-Chuan [Graduate Institute of Physiology, National Taiwan University, Taiwan (China); Tsai, Mong-Hsun [Institute of Biotechnology, National Taiwan University, Taiwan (China); Chen, Shin-Kuang [National Clinical Trial and Research Center, National Taiwan University Hospital, Taiwan (China); Yang, Pei-Wen; Lee, Yung-Chie [Department of Surgery, National Taiwan University Hospital, Taiwan (China); Hsiao, Chuhsing K. [Research Center for Gene, Environment, and Human Health, College of Public Health, National Taiwan University, Taiwan (China); Department of Public Health, Institute of Epidemiology, National Taiwan University, Taiwan (China); Bioinformatics and Biostatistics Core, Research Center for Medical Excellence, National Taiwan University, Taiwan (China); Lee, Jang-Ming, E-mail: jangming@ntuh.gov.tw [Department of Surgery, National Taiwan University Hospital, Taiwan (China); Chuang, Eric Y., E-mail: chuangey@ntu.edu.tw [National Clinical Trial and Research Center, National Taiwan University Hospital, Taiwan (China); Bioinformatics and Biostatistics Core, Research Center for Medical Excellence, National Taiwan University, Taiwan (China); Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taiwan (China)

    2012-04-01

    Purpose: To identify germline polymorphisms to predict concurrent chemoradiation therapy (CCRT) response in esophageal cancer patients. Materials and Methods: A total of 139 esophageal cancer patients treated with CCRT (cisplatin-based chemotherapy combined with 40 Gy of irradiation) and subsequent esophagectomy were recruited at the National Taiwan University Hospital between 1997 and 2008. After excluding confounding factors (i.e., females and patients aged {>=}70 years), 116 patients were enrolled to identify single nucleotide polymorphisms (SNPs) associated with specific CCRT responses. Genotyping arrays and mass spectrometry were used sequentially to determine germline polymorphisms from blood samples. These polymorphisms remain stable throughout disease progression, unlike somatic mutations from tumor tissues. Two-stage design and additive genetic models were adopted in this study. Results: From the 26 SNPs identified in the first stage, 2 SNPs were found to be significantly associated with CCRT response in the second stage. Single nucleotide polymorphism rs16863886, located between SGPP2 and FARSB on chromosome 2q36.1, was significantly associated with a 3.93-fold increase in pathologic complete response to CCRT (95% confidence interval 1.62-10.30) under additive models. Single nucleotide polymorphism rs4954256, located in ZRANB3 on chromosome 2q21.3, was associated with a 3.93-fold increase in pathologic complete response to CCRT (95% confidence interval 1.57-10.87). The predictive accuracy for CCRT response was 71.59% with these two SNPs combined. Conclusions: This is the first study to identify germline polymorphisms with a high accuracy for predicting CCRT response in the treatment of esophageal cancer.

  3. Management and outcomes of localized esophageal and gastroesophageal junction cancer in older patients

    Science.gov (United States)

    Qu, X.; Biagi, J.; Banashkevich, A.; Mercer, C.D.; Tremblay, L.; Mahmud, A.

    2015-01-01

    Background Older patients are commonly excluded from clinical trials in esophageal and gastroesophageal junction (gej) cancer. High-level evidence to guide management in this group is lacking. In the present study, we compared outcomes and described tolerance for curative- and noncurative-intent treatments among patients 70 years of age and older. Methods We retrospectively reviewed all patients 70 years of age and older diagnosed with localized esophageal and gej cancer at our centre between 2005 and 2012. Results The 74 patients identified had a median age of 77 years. Of those patients, 62% received curative-intent treatment, consisting mostly of concomitant chemoradiation therapy (n = 43, 93%). Median overall survival for patients receiving curative-intent treatment was 18.6 months [95% confidence interval (ci): 13.0 to 28.0 months], with 23% being long-term survivors (95% ci: 11.3% to 36.7%). In contrast, patients receiving noncurative-intent treatment had a median overall survival of 8.8 months (95% ci: 6.7 to 11.9 months), with none being long-term survivors (p dysphagia was seen after curative (81%) or palliative radiotherapy (78%) in symptomatic patients, and toxicities were manageable. The odds of not receiving curative treatment was higher by a factor of 8.5 among patients 80 years of age or older compared with those 70–79 years of age (95% ci: 2.5 to 28.7). Conclusions In managing older patients with esophageal and gej cancer, curative-intent treatment (compared with noncurative-intent treatment) leads to a significant survival benefit with a reasonable toxicity profile. Informed counselling of patients and their families about a curative treatment approach and efforts to increase awareness among oncology care providers are suggested. PMID:26715880

  4. Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Hyub; Song, Sang Yun; Shim, Hyun Jeong; Chung, Woong Ki; Ahn, Sung Ja; Yoon, Mee Sun; Jeong, Jae Uk; Song, Ju Young; Nam, Taek Keun [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2015-03-15

    To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT). We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT.

  5. Bardoxolone methyl induces apoptosis and autophagy and inhibits epithelial-to-mesenchymal transition and stemness in esophageal squamous cancer cells.

    Science.gov (United States)

    Wang, Yan-Yang; Yang, Yin-Xue; Zhao, Ren; Pan, Shu-Ting; Zhe, Hong; He, Zhi-Xu; Duan, Wei; Zhang, Xueji; Yang, Tianxin; Qiu, Jia-Xuan; Zhou, Shu-Feng

    2015-01-01

    Natural and synthetic triterpenoids have been shown to kill cancer cells via multiple mechanisms. The therapeutic effect and underlying mechanism of the synthetic triterpenoid bardoxolone methyl (C-28 methyl ester of 2-cyano-3,12-dioxoolean-1,9-dien-28-oic acid; CDDO-Me) on esophageal cancer are unclear. Herein, we aimed to investigate the anticancer effects and underlying mechanisms of CDDO-Me in human esophageal squamous cell carcinoma (ESCC) cells. Our study showed that CDDO-Me suppressed the proliferation and arrested cells in G2/M phase, and induced apoptosis in human ESCC Ec109 and KYSE70 cells. The G2/M arrest was accompanied with upregulated p21Waf1/Cip1 and p53 expression. CDDO-Me significantly decreased B-cell lymphoma-extra large (Bcl-xl), B-cell lymphoma 2 (Bcl-2), cleaved caspase-9, and cleaved poly ADP ribose polymerase (PARP) levels but increased the expression level of Bcl-2-associated X (Bax). Furthermore, CDDO-Me induced autophagy in both Ec109 and KYSE70 cells via suppression of the phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway. There were interactions between the autophagic and apoptotic pathways in Ec109 and KYSE70 cells subject to CDDO-Me treatment. CDDO-Me also scavenged reactive oxygen species through activation of the nuclear factor (erythroid-derived 2)-related factor 2 (Nrf2) pathway in Ec109 and KYSE70 cells. CDDO-Me inhibited cell invasion, epithelial-mesenchymal transition, and stemness in Ec109 and KYSE70 cells. CDDO-Me significantly downregulated E-cadherin but upregulated Snail, Slug, and zinc finger E-box-binding homeobox 1 (TCF-8/ZEB1) in Ec109 and KYSE70 cells. CDDO-Me significantly decreased the expression of octamer-4, sex determining region Y-box 2 (Sox-2), Nanog, and B lymphoma Mo-MLV insertion region 1 homolog (Bmi-1), all markers of cancer cell stemness, in Ec109 and KYSE70 cells. Taken together, these results indicate that CDDO-Me is a promising anticancer agent

  6. Radiation induced esophageal adenocarcinoma in a woman previously treated for breast cancer and renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Raissouni Soundouss

    2012-08-01

    Full Text Available Abstract Background Secondary radiation-induced cancers are rare but well-documented as long-term side effects of radiation in large populations of breast cancer survivors. Multiple neoplasms are rare. We report a case of esophageal adenocarcinoma in a patient treated previously for breast cancer and clear cell carcinoma of the kidney. Case presentation A 56 year-old non smoking woman, with no alcohol intake and no familial history of cancer; followed in the National Institute of Oncology of Rabat Morocco since 1999 for breast carcinoma, presented on consultation on January 2011 with dysphagia. Breast cancer was treated with modified radical mastectomy, 6 courses of chemotherapy based on CMF regimen and radiotherapy to breast, inner mammary chain and to pelvis as castration. Less than a year later, a renal right mass was discovered incidentally. Enlarged nephrectomy realized and showed renal cell carcinoma. A local and metastatic breast cancer recurrence occurred in 2007. Patient had 2 lines of chemotherapy and 2 lines of hormonotherapy with Letrozole and Tamoxifen assuring a stable disease. On January 2011, the patient presented dysphagia. Oesogastric endoscopy showed middle esophagus stenosing mass. Biopsy revealed adenocarcinoma. No evidence of metastasis was noticed on computed tomography and breast disease was controlled. Palliative brachytherapy to esophagus was delivered. Patient presented dysphagia due to progressive disease 4 months later. Jejunostomy was proposed but the patient refused any treatment. She died on July 2011. Conclusion We present here a multiple neoplasm in a patient with no known family history of cancers. Esophageal carcinoma is most likely induced by radiation. However the presence of a third malignancy suggests the presence of genetic disorders.

  7. Identification of differentially expressed genes in esophageal cancer through SSH in com- bination with high throughput reverse Northern screening

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    To understand the molecular mechanisms of carcinogenesis of esophagus and to isolate genes with different expression levels in esophageal cancer, suppression subtractive hybridization (SSH) was combined with PCR-based cDNA synthesis and reverse Northern on the cancer tissues and matched almost normal mucosa using 5 microgram of total RNA as starting marterial. Eight genes were found expressed differentially in esophageal cancer, in which 5 were known genes and 3 were novel ones; and 6 were down-regulated in cancer tissues, while 2 were up-regulated; 6 were of mid-high abundance and 2 were of low abundance in esophagus. The results revealed that alteration in expression level of multiple genes underlied the initiation and development of esophageal cancer. The differentially expressed genes identified in this study such as liporcotinⅠ, cystatin A, cystatin B, cytokeratin 13 may play roles in dedifferentiation, transformation and malignant proliferation of esophageal cancer. The combination of SSH with PCR-based double- strand cDNA synthesis and high throughput reverse Northern screening is an efficient way to isolate differentially expressed genes from microgram of total RNA.

  8. Transcriptional regulation of miR-146b by C/EBPβ LAP2 in esophageal cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    Li, Junxia [Department of Medical Genetics, Third Military Medical University, Chongqing (China); Shan, Fabo [Department of Pathophysiology and High Altitude Physiology, Third Military Medical University, Chongqing (China); Xiong, Gang [Department of Thoracic and Cardiac Surgery, Southwest Hospital, Third Military Medical University, Chongqing (China); Wang, Ju-Ming; Wang, Wen-Lin [Institute of Bioinformatics and Biosignal Transduction, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan, Taiwan (China); Xu, Xueqing, E-mail: buyi.chu@gmail.com [Molecular Biology Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Research Institute of Surgery and Daping Hospital, Third Military Medical University, Chongqing (China); Bai, Yun, E-mail: baiyungene@gmail.com [Department of Medical Genetics, Third Military Medical University, Chongqing (China)

    2014-03-28

    Highlights: • MiR-146b promotes esophageal cancer cell proliferation. • MiR-146b inhibits esophageal cancer cell apoptosis. • C/EBPβ directly binds to miR-146b promoter conserved region. • MiR-146b is up-regulated by C/EBPβ LAP2 transcriptional activation. - Abstract: Recent clinical study indicated that up-regulation of miR-146b was associated with poor overall survival of patients in esophageal squamous cell carcinoma. However, the underlying mechanism of miR-146b dysregulation remains to be explored. Here we report that miR-146b promotes cell proliferation and inhibits cell apoptosis in esophageal cancer cell lines. Mechanismly, two C/EBPβ binding motifs are located in the miR-146b promoter conserved region. Among the three isoforms of C/EBPβ, C/EBPβ LAP2 positively regulated miR-146b expression and increases miR-146b levels in a dose-dependent manner through transcription activation of miR-146b gene. Together, these results suggest a miR-146b regulatory mechanism involving C/EBPβ, which may contribute to the up-regulation of miR-146b in esophageal squamous cell carcinoma.

  9. Radiation treatment for newly diagnosed esophageal cancer with prior radiation to the thoracic cavity

    Energy Technology Data Exchange (ETDEWEB)

    Sponseller, Patricia, E-mail: sponselp@uw.edu [University of Wisconsin at La Crosse, La Crosse, WI (United States); Lenards, Nishele [Department of Radiation Oncology, University of Washington, Seattle, WA (United States); Kusano, Aaron; Patel, Shilpen [University of Wisconsin at La Crosse, La Crosse, WI (United States)

    2014-10-01

    The purpose of this report is to communicate the use of single-positron emission computed tomography scan in planning radiation treatments for patients with a history of radiation to the thoracic cavity. A patient presented with obstructive esophageal cancer, having previously received chemotherapy and radiation therapy to the mediastinum for non-Hodgkin lymphoma 11 years earlier. Owing to a number of comorbidities, the patient was not a surgical candidate and was referred to the University of Washington Medical Center for radiation therapy. Prior dose to the spinal cord and lung were taken into account before designing the radiation treatment plan.

  10. Impact of a Fast-track Esophagectomy Protocol on Esophageal Cancer Patient Outcomes and Hospital Charges

    DEFF Research Database (Denmark)

    Shewale, Jitesh B; Correa, Arlene M; Baker, Carla M

    2015-01-01

    OBJECTIVE: To evaluate the effects of a fast-track esophagectomy protocol (FTEP) on esophageal cancer patients' safety, length of hospital stay (LOS), and hospital charges. BACKGROUND: FTEP involved transferring patients to the telemetry unit instead of the surgical intensive care unit (SICU) after.......655; 95% confidence interval = 0.456, 0.942; P = 0.022). In addition, the median hospital charges associated with primary admission and readmission within 90 days for group B ($65,649) were lower than that for group A ($79,117; P

  11. Potential diagnostic value of serum p53 antibody for detecting esophageal cancer: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jun Zhang

    Full Text Available BACKGROUND: Mutant p53 protein overexpression has been reported to induce serum antibodies against p53. Various studies assessing the diagnostic value of serum p53 antibody in patients with esophageal cancer remain controversial. This study aims to comprehensively and quantitatively summarize the potential diagnostic value of serum p53 antibody in esophageal cancer. METHODS: We systematically searched PubMed and Embase until 31st May 2012, without language restriction. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy. Positive likelihood ratio (PLR and negative likelihood ratio (NLR were pooled separately and compared with overall accuracy measures diagnostic odds ratio (DOR and symmetric summary receiver operating characteristic (sROC. The PLR and NLR and their 95% confidence interval (CI were calculated using a fixed effects model according to the Mantel-Haensed method and random effects model based on the work of Der Simonian and laird, respectively. RESULTS: Fifteen studies (cases = 1079, controls = 2260 met the inclusion criteria for the meta-analysis. Approximately 53.33% (8/15 of the included studies were of high quality (QUADAS score≥8, which were retrospective case-control studies. The summary estimates for quantitative analysis of serum p53 antibody in the diagnosis of esophageal cancer were PLR 6.95 (95% CI: 4.77-9.51, NLR 0.75 (95%CI: 0.72-0.78 and DOR 9.65 (95%CI: 7.04-13.22. However, we found significant heterogeneity between NLRs. CONCLUSIONS: The current evidence suggests serum p53 antibody has a potential diagnostic value for esophageal cancer. However, its discrimination power is not perfect because of low sensitivity. IMPACT: These results suggest that s-p53-antibody may be useful for monitoring residual tumor cells and for aiding in the selection of candidates for less invasive treatment procedures because of the high specificity of s-p53-antibody. Further studies

  12. 食管癌的微创术%Minimal Invasive Surgery for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    A.H.H(o)lscher; Ch.Gutschow

    2004-01-01

    Thoracoscopic esophagectomy is only established in some centers and affords a cervical anastomosis because intrathoracic anastomosis as a routine is technically too difficult. Laparoscopic mobilisation of the stomach (gastrolysis) is an important contribution for minimal invasive surgery of esophageal cancer.This procedure reduces the stress of the two cavity operation for the patient and allows the construction of a comparable gastric conduit like by open surgery. The technique of laparoscopic gastrolysis as preparation for transthoracic en bloc esophagectomy is described in detail and preliminary results are briefly mentioned.

  13. [A case of metastatic esophageal cancer responding remarkably to combination chemotherapy of TS-1 and cisplatin].

    Science.gov (United States)

    Iwase, Hiroaki; Okeya, Masayuki; Shimada, Masaaki; Tsuzuki, Tomoyuki; Nakarai, Keiko; Kaida, Shogo; Doi, Reiko

    2004-05-01

    A 51-year-old male patient with esophageal cancer and cervical, thoracic and celiac artery lymph node metastases was treated by combination chemotherapy of TS-1 and cisplatin. TS-1 (80 mg/m2/day) was administered for 14 days followed by 14 days rest as 1 course. Cisplatin (70 mg/m2/day) was administered in 24-hour continuous intravenous infusion at day 8 after the start of TS-1. Before treatment, the tumor marker, CEA showed 27,060 ng/ml. After 5 courses of chemotherapy, endoscopy revealed that the primary tumor had disappeared and no cancer cells were detected by endoscopic biopsy. Chest and abdominal CT scan also showed almost total disappearance of the lymph nodes metastases. CEA decreased to 710 ng/ml. No high-grade toxicities (WHO grade 3 or 4) were seen during the chemotherapy. He is now very well. This TS-1/cisplatin chemotherapy regimen might be a useful treatment for metastatic esophageal cancer.

  14. Sympathoadrenal and hypophyseal-adrenal systems in preoperative irradiation of patients with esophageal and cardiac cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tarutinov, V.I.; Starosel' skij, I.V.; Gol' dshmidt, B.Ya.; Shmal' ko, Yu.P.; Levchenko, A.M. (Nauchno-Issledovatel' skij Rentgeno-Radiologicheskij i Onkologicheskij Inst., Kiev (Ukrainian SSR))

    1983-11-01

    A study was made of 74 patients with esophageal and cardiac cancer, Stages 3 and 4. The excretion of catecholamines, corticosteroids and their precursors was studied, tests with adrenalin before and after preoperative irradiation at a summary dose of 30 Gy were done. It has been shown that before the start of radiation therapy the excretion of catecholamines and corticosteroids is lowered, the reaction to adrenalin administration is negative in most patients, the phase syndrome of cardiac hypodynamics associated with disturbed function of the sympathoadrenal system was revealed. Preoperative irradiation in patients with esophageal and cardiac cancer results in an increased excretion of 17-ketosteroids (17-KS) and 17-ketogenic steroids, however 17-KS excretion does not reach the normal level. For better tolerance of irradiation and for a radiosensitization effect testenate is administered to patients before and during radiation therapy. The administration of testenate 7-10 days before the start and during radiotherapy proved to be effective which was confirmed by noticeable necrobiotic and necrotic changes of cancer cells.

  15. Role of Berberine on molecular markers involved in migration of esophageal cancer cells.

    Science.gov (United States)

    Mishan, M A; Ahmadiankia, N; Matin, M M; Heirani-Tabasi, A; Shahriyari, M; Bidkhori, H R; Naderi-Meshkin, H; Bahrami, A R

    2015-12-14

    Berberine is an isoquinoline alkaloid found in several plant species like famous chinese herb, Rhizoma coptidis which has been used locally as a strong gastrointestinal remedy for thousands of years. The inhibitory effects of berberine on tumor progression properties have been reported before. In this study, we investigated the effect of berberine on an esophageal cancer cell line, KYSE-30 with emphasis on its effects on the expression of certain chemokine receptors. The cytotoxic effect of berberine on KYSE-30 cells was analyzed by MTT assay. In vitro cell migration assay was also applied to the treated cells and the expression levels of the selected chemokine receptors (CXCR4 and CCR7) was measured at mRNA level. A retarded growth, associated with increasing concentrations of berberine, was obvious. On the other hand, the migration rate of the cells was decreased when they were treated with different concentrations of berberine and the expression levels of the two chemokine receptors, involved in the migration and metastasis of esophageal cancer cells, were decreased following the same treatments. With these results, we tend to conclude that berberine might be a proper candidate for further investigations, by targeting the chemokine receptors, and possible applications as anti-metastatic agent in cancer studies.

  16. Multidisciplinary team management is associated with improved outcomes after surgery for esophageal cancer.

    Science.gov (United States)

    Stephens, M R; Lewis, W G; Brewster, A E; Lord, I; Blackshaw, G R J C; Hodzovic, I; Thomas, G V; Roberts, S A; Crosby, T D L; Gent, C; Allison, M C; Shute, K

    2006-01-01

    We aim to compare the outcomes of patients undergoing R0 esophagectomy by a multidisciplinary team (MDT) with outcomes after surgery alone performed by surgeons working independently in a UK cancer unit. An historical control group of 77 consecutive patients diagnosed with esophageal cancer and undergoing surgery with curative intent by six general surgeons between 1991 and 1997 (54 R0 esophagectomies) were compared with a group of 67 consecutive patients managed by the MDT between 1998 and 2003 (53 R0 esophagectomies, 26 patients received multimodal therapy). The proportion of patients undergoing open and closed laparotomy and thoracotomy decreased from 21% and 5%, respectively, in control patients, to 13% and 0% in MDT patients (chi2 = 11.90, DF = 1, P = 0.001; chi2 = 5.45, DF = 1, P = 0.02 respectively). MDT patients had lower operative mortality (5.7%vs. 26%; chi2 = 8.22, DF = 1, P = 0.004) than control patients, and were more likely to survive 5 years (52%vs. 10%, chi2 = 15.05, P = 0.0001). In a multivariate analysis, MDT management (HR = 0.337, 95% CI = 0.201-0.564, P team management and surgical subspecialization improved outcomes after surgery significantly for patients diagnosed with esophageal cancer.

  17. Establishing magnetic resonance imaging as an accurate and reliable tool to diagnose and monitor esophageal cancer in a rat model.

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    Juliann E Kosovec

    Full Text Available OBJECTIVE: To assess the reliability of magnetic resonance imaging (MRI for detection of esophageal cancer in the Levrat model of end-to-side esophagojejunostomy. BACKGROUND: The Levrat model has proven utility in terms of its ability to replicate Barrett's carcinogenesis by inducing gastroduodenoesophageal reflux (GDER. Due to lack of data on the utility of non-invasive methods for detection of esophageal cancer, treatment efficacy studies have been limited, as adenocarcinoma histology has only been validated post-mortem. It would therefore be of great value if the validity and reliability of MRI could be established in this setting. METHODS: Chronic GDER reflux was induced in 19 male Sprague-Dawley rats using the modified Levrat model. At 40 weeks post-surgery, all animals underwent endoscopy, MRI scanning, and post-mortem histological analysis of the esophagus and anastomosis. With post-mortem histology serving as the gold standard, assessment of presence of esophageal cancer was made by five esophageal specialists and five radiologists on endoscopy and MRI, respectively. RESULTS: The accuracy of MRI and endoscopic analysis to correctly identify cancer vs. no cancer was 85.3% and 50.5%, respectively. ROC curves demonstrated that MRI rating had an AUC of 0.966 (p<0.001 and endoscopy rating had an AUC of 0.534 (p = 0.804. The sensitivity and specificity of MRI for identifying cancer vs. no-cancer was 89.1% and 80% respectively, as compared to 45.5% and 57.5% for endoscopy. False positive rates of MRI and endoscopy were 20% and 42.5%, respectively. CONCLUSIONS: MRI is a more reliable diagnostic method than endoscopy in the Levrat model. The non-invasiveness of the tool and its potential to volumetrically quantify the size and number of tumors likely makes it even more useful in evaluating novel agents and their efficacy in treatment studies of esophageal cancer.

  18. Ways of improvement of treatment of esophageal cancer

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    Kochegarov, A.A. (Uzbekskij Nauchno-Issledovatel' skij Inst. Onkologii i Radiologii, Tashkent (USSR))

    1984-01-01

    An analysis of the results of treatment of 344 patients with cancer of the thoracic part of the esophagus was performed. Out of those, 104 received surgical and combined treatment and 240 (inoperable cancer) were given radiotherapy alone or in combination with local hyperthermia, general chemotherapy or intratumoral iontophoresis of chemotherapeutic agents. The operation after Dobromyslov-Torek proved to be insufficient in most of surgical cases because there were metastatic lesions below the diaphragm. Local hyperthermia potentiated the effect of radiation treatment. The early results of treatment improved after intratumoral sarcolysin ionophoresis was used in conjunction with radiation therapy.

  19. Autophagy Accompanied with Bisdemethoxycurcumin-induced Apoptosis in Non-small Cell Lung Cancer Cells

    Institute of Scientific and Technical Information of China (English)

    XU Jin Hong; YANG He Ping; ZHOU Xiang Dong; WANG Hai Jing; GONG Liang; TANG Chun Lan

    2015-01-01

    Objective To investigate the effects of bisdemethoxycurcumin (BDMC) on non-small cell lung cancer (NSCLC) cell line, A549, and the highly metastatic lung cancer 95D cells. Methods CCK-8 assay was used to assess the effect of BDMC on cytotoxicity. Flow cytometry was used to evaluate apoptosis. Western blot analysis, electron microscopy, and quantification of GFP-LC3 punctuates were used to test the effect of BDMC on autophagy and apoptosis of lung cancer cells. Results BDMC inhibited the viability of NSCLC cells, but had no cytotoxic effects on lung small airway epithelial cells (SAECs). The apoptotic cell death induced by BDMC was accompanied with the induction of autophagy in NSCLC cells. Blockage of autophagy by the autophagy inhibitor 3-methyladenine (3-MA) repressed the growth inhibitory effects and induction of apoptosis by BDMC. In addition, BDMC treatment significantly decreased smoothened (SMO) and the transcription factor glioma-associated oncogene 1 (Gli1) expression. Furthermore, depletion of Gli1 by siRNA and cyclopamine (a specific SMO inhibitor) induced autophagy. Conclusion Aberrant activation of Hedgehog (Hh) signaling has been implicated in several human cancers, including lung cancers. The present findings provide direct evidence that BDMC-induced autophagy plays a pro-death role in NSCLC, in part, by inhibiting Hedgehog signaling.

  20. Altered LKB1/CREB-regulated transcription co-activator (CRTC) signaling axis promotes esophageal cancer cell migration and invasion.

    Science.gov (United States)

    Gu, Y; Lin, S; Li, J-L; Nakagawa, H; Chen, Z; Jin, B; Tian, L; Ucar, D A; Shen, H; Lu, J; Hochwald, S N; Kaye, F J; Wu, L

    2012-01-26

    LKB1 is a tumor susceptibility gene for the Peutz-Jeghers cancer syndrome and is a target for mutational inactivation in sporadic human malignancies. LKB1 encodes a serine/threonine kinase that has critical roles in cell growth, polarity and metabolism. A novel and important function of LKB1 is its ability to regulate the phosphorylation of CREB-regulated transcription co-activators (CRTCs) whose aberrant activation is linked with oncogenic activities. However, the roles and mechanisms of LKB1 and CRTC in the pathogenesis of esophageal cancer have not been previously investigated. In this study, we observed altered LKB1-CRTC signaling in a subset of human esophageal cancer cell lines and patient samples. LKB1 negatively regulates esophageal cancer cell migration and invasion in vitro. Mechanistically, we determined that CRTC signaling becomes activated because of LKB1 loss, which results in the transcriptional activation of specific downstream targets including LYPD3, a critical mediator for LKB1 loss-of-function. Our data indicate that de-regulated LKB1-CRTC signaling might represent a crucial mechanism for esophageal cancer progression.

  1. Endoscopic surveillance of head and neck cancer in patients with esophageal squamous cell carcinoma

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    Kato, Minoru; Ishihara, Ryu; Hamada, Kenta; Tonai, Yusuke; Yamasaki, Yasushi; Matsuura, Noriko; Kanesaka, Takashi; Yamamoto, Sachiko; Akasaka, Tomofumi; Hanaoka, Noboru; Takeuchi, Yoji; Higashino, Koji; Uedo, Noriya; Iishi, Hiroyasu

    2016-01-01

    Background and study aims: Multiple squamous cell carcinomas (SCCs) frequently arise in the upper aerodigestive tract, referred to as the field cancerization phenomenon. The aim of this study was to elucidate the detailed clinical features of second primary head and neck (H&N) SCCs arising in patients with esophageal SCC. Patients and methods: A total of 818 patients underwent endoscopic resection for superficial esophageal cancer between January 2006 and December 2013. Of these, 439 patients met our inclusion criteria, and we retrospectively investigated the incidence, primary sites, and stages of second primary H&N SCCs in these patients. Results: A total of 53 metachronous H&N SCCs developed in 40 patients after a median follow-up period of 46 months (range 9 – 109). The cumulative incidence rates of metachronous H&N SCCs at 3, 5, and 7 years were 5.3 %, 9.7 %, and 17.2 %, respectively. These lesions were frequently located at pyriform sinus or in the posterior wall of the pharynx (70 %, 37/53 lesions). Most of the lesions were detected at an early stage, though 4 lesions were associated with lymph node metastasis when their primary sites were detected (1 postcricoid area, 2 posterior wall of hypopharynx, and 1 lateral wall of oropharynx). Conclusions: Patients with esophageal SCC should undergo careful inspection of the pyriform sinus and posterior wall of the pharynx for detection of H&N SCCs. Methods to open the hypopharyngeal space, such as the Valsalva maneuver, should be included in the surveillance program. PMID:27556090

  2. Role of serum angiopoietin-2 level in screening for esophageal squamous cell cancer and its precursors

    Institute of Scientific and Technical Information of China (English)

    ZHOU Ying-zhi; FANG Xue-qiang; LI Hao; DIAO Yu-tao; YANG Yan-fang; ZHAO De-li; WU Kan; LI Hui-qing

    2007-01-01

    Background Angiopoietin-2 (Ang-2) is one of the critical regulators of tumor angiogenesis. Studies have shown a significant correlation of Ang-2 expression to tumor invasion and metastasis in various human cancers, but little is known about the serum Ang-2 (sAng-2) levels in esophageal squamous cell cancer (ESCC) and its precursors. In this study, we aimed to investigate its role in screening for ESCC and its precursors.Methods We carried out a free endoscopic screening in Feicheng City, a high ESCC incidence area in Shandong Province of China. Serum samples were collected as follows: 91 from normal subjects, 44 from patients with esophagitis,85 from patients with hyperplasia, and 13 from patients with early ESCC. In addition, 28 serum samples were obtained from patients with invasive ESCC undergoing surgery in People's Hospital of Feicheng City. All the subjects of the five groups were diagnosed by histopathology. The sAng-2 levels were tested and compared, and the diagnostic power in early or/and invasive ESCC was calculated in terms of sensitivity and other parameters.Results The sAng-2 levels were (22.0±5.5), (21.3±3.2), (20.5±3.3), (24.0±5.0), and (29.8±5.0) U/ml in normal,esophagitis, hyperplasia, early ESCC, and invasive ESCC groups respectively. It was significantly higher in early ESCC than inhyperplasia group (P=0.009). The invasive ESCC group showed the highest Ang-2 level among all groups (all P=0.000). The sensitivities of sAng-2 to early and invasive ESCC were 23.1% and 78.6% respectively.Conclusion sAng-2 level is related to carcinogenesis and progression of ESCC, but it can not be used to screen for early ESCC.

  3. siRNA-mediated downregulation of TC21 sensitizes esophageal cancer cells to cisplatin

    Institute of Scientific and Technical Information of China (English)

    Md.Raghibul Hasan; Shyam Singh Chauhan; Rinu Sharma; Ranju Ralhan

    2012-01-01

    AIM:To determine the functional significance of TC21 in esophageal squamous cell carcinoma (ESCC).METHODS:TC21 siRNA transfection was carried out using Hyperfectamine to knock down TC21,and transcripts were analyzed by reverse transcription-polymerase chain reaction and protein by Western blotting.We demonstrated the effect of TC21 downregulation of cell signaling in esophageal cancer cells by assessing the phosphorylation status of its downstream targets,phosphoinositide 3-kinase (PI3K),phosphatase and tensin homolog (PTEN),protein kinase B (pAkt),nuclear factor-κB (NF-κB) and cyclinD1 using specific antibodies.Cell survival analysis after cisplatin treatment was carried out by cell viability assay and cell cycle analysis using flow cytometry.RESULTS:TC21 knockdown in human ESCC cell line TE13 cells,showed only a marginal increase (14.2%) in cell death compared with control cells.The expressions of the signaling proteins PI3K and pAkt,transcription factor NF-κB,and cell cycle protein cyclin D1 were markedly decreased in response to TC21 downregulation,whereas the level of pPTEN,an antagonist of PI3K,was increased.In addition,we evaluated the potential of TC21 as a putative target for sensitizing ESCC cells to the chemotherapeutic agent dsplatin.Increased cell death (38.4%) was observed in cells treated with cisplatin after TC21 knockdown compared with cells which were treated with cisplatin alone (20% cell death).CONCLUSION:Results suggest that TC21 mediates its effects via the PI3K-Akt pathway,NF-κB and cydin D1,and enhances chemoresistance in esophageal cancer cells.

  4. Combined laparoscopic and thoracoscopic Ivor Lewis esophagectomy for esophageal cancer: initial experience from China

    Institute of Scientific and Technical Information of China (English)

    LI Hui; HU Bin; YOU Bin; MIAO Jin-bai; FU Yi-li; CHEN Qi-rui

    2012-01-01

    Background Minimally invasive lvor Lewis esophagectomy was usually performed with either hand-sewn or circular stapler anastomosis through a small thoracotomy or using a side-to-side stapler anastomotic technique.This study aimed to present our initial results of lvor Lewis esophagectomy using a circular-stapled anastomosis with transoral anvil technique.Methods Six patients with esophageal cancer underwent minimally invasive lvor Lewis esophagectomy with an intrathoracic circular-stapled end-to-end anastomosis.The abdominal portion was operated on laparoscopically,and the thoracic portion was done using thoracoscopic techniques.A 25 mm anvil connected to a 90 cm long delivery tube was introduced transorally to the esophageal stump in a tilted position,the anvil head was then connected to circular stapler.The anastomosis was completed under direct thoracoscopic view.Results A total of six patients in this report successfully underwent total laparoscopic and thoracoscopic lvor Lewis esophagectomy with a circular-stapled anastomosis using a transoral anvil.They were five male and one female patients,and had a mean age of 55 years (range,38-69 years).The thoracic and abdominal operations were successfully performed without any intraoperative complications or conversion to laparotomy or thoracotomy.The passage of the anvil head was technically easy and successful in all six cases.The mean overall operative time was (260±42) minutes (range,220-300 minutes),and the mean estimated blood loss was (520±160) ml (range,130-800 ml).Patients resumed a liquid oral diet on postoperative day seven.The median length of hospital stay was 17 days (range,9-25 days).The postoperative pathological diagnosis was esophageal squamous cell carcinoma in five patients and esophageal small cell carcinoma in one patient.Tumors were staged as T2N0M0 in three cases,T2N1M0 in one case,and T3N0M0 in two cases.During the mean follow-up of 2.5 months (range,2-4months),there were no intraoperative

  5. Speciation and antifungal susceptibility of esophageal candidiasis in cancer patients in a tertiary care hospital in South India

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    J. Abirami Lakshmy

    2016-01-01

    Full Text Available Esophageal candidiasis is the most common opportunistic infection in patients with altered immunity such as Human Immunodeficiency Virus (HIV infection, cancer patients on chemotherapy and radiotherapy. Neutropenia, irradiation and chemotherapy will facilitate deeper mucosal invasion leading to esophageal candidiasis. Empirical treatment of esophageal candidiasis without antifungal susceptibility testing will lead to the emergence of drug resistant species increasing the morbidity and mortality associated with cancer. The present study aimed to study the frequency of esophageal candida in individuals with cancer, species level identification and antifungal susceptibility pattern. Scrapings of whitish appearing lesions were obtained from a total of thirty five cases of endoscopically identified esophageal candidiasis were obtained from cancer patients. Identification of the Candida isolates were done by cultivation in Sabouraud dextrose agar (SDA, Gram staining, germ tube test, colony morphology in Chrom agar and corn meal agar, sugar assimilation and fermentation tests. Antifungal susceptibility was done by Microbroth dilution method for Fluconazole, Itraconazole and Amphotericin B. We found that Candida albicans was the predominant species isolated followed by Candida tropicalis and Candida glabrata. Sensitivity rates were 94%, 96% and 100% for Fluconazole, Itraconazole and Amphotericin B. Species level identification of Candida isolated from esophageal candidiasis and their antifungal sensitivity testing should be performed for early identification of resistant strains and for promptly treating the cases there by preventing the dissemination of infection in case of immune-compromised individuals. Further the susceptibility pattern will facilitate therapeutic guidance especially in individuals prone to relapse. [J Med Allied Sci 2016; 6(1: 29-34

  6. Effects of Herbal Acupuncture(Soyeum on Cancer Patients Accompanied by Pain

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    Hwa-Seung Yoo

    2003-02-01

    Full Text Available Objectives : This study was designed to evaluate effects of "Soyeum" on cancer patients accompanied by pain. Materials and Methods : We retrospectively analyzed the medical records of 9 patients accompanied by pain who had been injected with "Soyeum" for over 14 days continuously in East-West Cancer Center of Oriental Hospital of Daejeon University from June 2002 through August 2002. Results : The statistical significance between the pre-treatment and post-treatment results (Changes of Cytokine Level, QOL, BPQ and Pain relief after pain management were analyzed. Analysis of cytokines (IL-12, IFN-γ level showed that the percentage of increase of IL-12 is 60.0%, IFN-γ is 60.0%. Analysis of QOL showed that the percentage of maintenance and improvement is 77.8%. 55.5% of the patients reported a "worst pain" intensity score of 3 or greater, 44.5% reported a "least pain" intensity score of 2 or greater, and 66.7% reported "average pain" intensity score of 2 or greater. 33.3% of the patients were in pain at the time of interview and 22.2% had a current intensity score of 2 or greater. Analysis of pain relief after pain management showed that the percentage of pain relief score of 2 and 3 is 55.6%. The data was expressed as Mean±SE by using descriptive statistics. Statistical significance examined by using paired t-test. Conclusions : It is suggested that "Soyeum" has effects on pain of cancer patients, also expected that "Soyeum" is useful to improve immunoactivity and for cancer patients.

  7. Gastric-tube versus whole-stomach esophagectomy for esophageal cancer: A systematic review and meta-analysis

    Science.gov (United States)

    Zhang, Wenxiong; Yu, Dongliang; Peng, Jinhua; Xu, Jianjun; Wei, Yiping

    2017-01-01

    Objectives To conduct a systematic review and meta-analysis of studies comparing the gastric-tube vs. whole-stomach for esophageal cancer in order to determine the optimal surgical technique of esophagectomy. Methods A comprehensive literature search was performed using PubMed, EMBASE, ScienceDirect, Ovid MEDLINE, Cochrane Library, Web of Science, Google Scholar, and Scopus. Clinical trials that compared the gastric-tube versus whole-stomach for esophageal cancer were selected. The clinical endpoints included anastomotic leakage, anastomotic stenosis, reflux esophagitis, pneumonia, delayed gastric emptying, and thoracic stomach syndrome. Results A total of 6 articles (1571 patients) were included. Compared to the whole-stomach approach, the gastric-tube approach was associated with a lower incidence of reflux esophagitis (95% confidence interval [CI]: 0.16 to 0.81, p = 0.01) and thoracic stomach syndrome (95% CI: 0.17 to 0.55, p < 0.0001). The rates of anastomotic leakage, anastomotic stenosis, pneumonia, and delayed gastric emptying did not significantly differ between the two groups. Conclusions The gastric-tube esophagectomy is superior to the whole-stomach approach, as it is associated with a lower incidence of postoperative reflux esophagitis and thoracic stomach syndrome. Our findings must be validated in large-scale randomized controlled trials. PMID:28267808

  8. Comparative study of minimally invasive versus open esophagectomy for esophageal cancer in a single cancer center

    Institute of Scientific and Technical Information of China (English)

    Mu Juwei; Yuan Zuyang; Zhang Baihua; Li Ning; Lyu Fang; Mao Yousheng; Xue Qi

    2014-01-01

    Background In order to minimize the injury reaction during the surgery and reduce the morbidity rate,hence reducing the mortality rate of esophagectomy,minimally invasive esophagectomy (MIE) was introduced.The aim of this study was to compare the postoperative outcomes in patients with esophageal squamous cell carcinoma undergoing minimally invasive or open esophagectomy (OE).Methods The medical records of 176 consecutive patients,who underwent minimally invasive esophagectomy (MIE) between January 2009 and August 2013 in Cancer Institute & Hospital,Chinese Academy of Medical Sciences,were retrospectively reviewed.In the same period,142 patients who underwent OE,either Ivor Lewis or McKeown approach,were selected randomly as controls.The clinical variables of paired groups were compared,including age,sex,Charlson score,tumor location,duration of surgery,number of harvested lymph nodes,morbidity rate,the rate of leak,pulmonary morbidity rate,mortality rate,and hospital length of stay (LOS).Results The number of harvested lymph nodes was not significantly different between MIE group and OE group (median 20 vs.16,P=0.740).However,patients who underwent MIE had longer operation time than the OE group (375 vs.300 minutes,P <0.001).Overall morbidity,pulmonary morbidity,the rate of leak,in-hospital death,and hospital LOS were not significantly different between MIE and OE groups.Morbidities including anastomotic leak and pulmonary morbidity,inhospital death,hospital LOS,and hospital expenses were not significantly different between MIE and OE groups as well.Conclusions MIE and OE appear equivalent with regard to early oncological outcomes.There is a trend that hospital LOS and hospital expenses are reduced in the MIE group than the OE group.

  9. [Current status and prospect of treatment for esophageal cancer in the era of precision medicine].

    Science.gov (United States)

    Guo, X T; He, J

    2016-09-23

    Esophageal cancer (EC) is one of the most common malignant tumors around the world and has a high incidence in China. Chinese EC patients account for more than 50% in the world. The pathological subtype of EC shows a geographic distribution. Adenocarcinoma is the main pathological type in western countries, while squamous cell carcinoma is the dominant subtype in China. Thus specific diagnosis and treatment of EC are needed for Chinese patients. Although early diagnosis, progress in surgery and comprehensive treatment of EC have made remarkable achievements in China in recent years, yet the prognosis for resectable EC patients remains poor, with a 5-year survival of 30%. In addition, as the level of treatment varies significantly in different regions and centers around China, the current status of treatment for EC needs further improvement. This article reviews the advances in the treatment for EC in recent years, analyzes the present problems, and explores the perspective of the progress in esophageal cancer treatment in the era of precision medicine.

  10. A human esophageal epithelial cell model for study of radiation induced cancer and DNA repair

    Science.gov (United States)

    Huff, Janice; Patel, Zarana; Hada, Megumi; Cucinotta, Francis A.

    For cancer risk assessment in astronauts and for countermeasure development, it is essential to understand the molecular mechanisms of radiation carcinogenesis and how these mechanisms are influenced by exposure to the types of radiation found in space. We are developing an in vitro model system for the study of radiation-induced initiation and progression of esophageal carcinoma. Development of squamous cell carcinoma of the esophagus is associated with radiation exposure, as revealed by the significant enhanced in incidence rates for this type of cancer in the survivors of the atomic bomb detonations in Japan. It is also associated with poor nutritional status and micronutrient deficiencies, which are also important issues for long duration spaceflight. The possible synergies between nutritional issues and radiation exposure are unknown. Here we present the results of preliminary characterization of both normal and hTERT-immortalized esophageal epithelial cells grown in 2-dimensional culture. We analyzed DNA repair capacity by measuring the kinetics of formation and loss of gamma-H2AX foci following radiation exposure. Additionally, we analyzed induction of chromosomal aberrations using 3-color fluorescence in situ hybridization (FISH). Data were generated using both low LET (gamma rays) and high LET ions (1000 MeV/nucleon iron.

  11. A Comparison of Postoperative Early Enteral Nutrition with Delayed Enteral Nutrition in Patients with Esophageal Cancer

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    Gongchao Wang

    2015-06-01

    Full Text Available We examined esophageal cancer patients who received enteral nutrition (EN to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (Group 1, 2 and 3 based on whether they received EN within 48 h, 48 h–72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH, days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney U test and the chi square test. Statistical significance was defined as p < 0.05. Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in Group 3 (p = 0.019. Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in Group 3. It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients.

  12. Consumption of red and processed meat and esophageal cancer risk: meta-analysis.

    Science.gov (United States)

    Choi, Yuni; Song, Sujin; Song, Yoonju; Lee, Jung Eun

    2013-02-21

    To summarize the evidence about the association between red and processed meat intake and the risk of esophageal cancer, we systematically searched the PubMed and EMBASE databases up to May 2012, with a restriction to English publications, and the references of the retrieved articles. We combined the study-specific relative risks (RRs) and 95%CI, comparing the highest with the lowest categories of consumption by using a random-effects model. A total of 4 cohort studies and 23 case-control studies were included in the meta-analysis. The combined RRs (95%CI) of the cohort studies comparing the highest and lowest categories were 1.26 (1.00-1.59) for red meat and 1.25 (0.83-1.86) for processed meat. For the case-control studies, the combined RRs (95%CI) comparing the highest and lowest categories were 1.44 (1.16-1.80) for red meat and 1.36 (1.07-1.74) for processed meat. Findings from this meta-analysis suggest that a higher consumption of red meat was associated with a greater risk of esophageal cancer.

  13. Comparative outcomes for three-dimensional conformal versus intensity-modulated radiation therapy for esophageal cancer.

    Science.gov (United States)

    Freilich, J; Hoffe, S E; Almhanna, K; Dinwoodie, W; Yue, B; Fulp, W; Meredith, K L; Shridhar, R

    2015-01-01

    Emerging data suggests a benefit for using intensity modulated radiation therapy (IMRT) for the management of esophageal cancer. We retrospectively reviewed patients treated at our institution who received definitive or preoperative chemoradiation with either IMRT or 3D conformal radiation therapy (3DCRT) between October 2000 and January 2012. Kaplan Meier analysis and the Cox proportional hazard model were used to evaluate survival outcomes. We evaluated a total of 232 patients (138 IMRT, 94 3DCRT) who received a median dose of 50.4 Gy (range, 44-64.8) to gross disease. Median follow up for all patients, IMRT patients alone, and 3DCRT patients alone was 18.5 (range, 2.5-124.2), 16.5 (range, 3-59), and 25.9 months (range, 2.5-124.2), respectively. We observed no significant difference based on radiation technique (3DCRT vs. IMRT) with respect to median overall survival (OS) (median 29 vs. 32 months; P = 0.74) or median relapse free survival (median 20 vs. 25 months; P = 0.66). On multivariable analysis (MVA), surgical resection resulted in improved OS (HR 0.444; P 20% weight loss (OR 0.51; P = 0.050). Our data suggest that while IMRT-based chemoradiation for esophageal cancer does not impact survival there was significantly less toxicity. In the IMRT group there was significant decrease in weight loss and grade ≥3 toxicity compared to 3DCRT.

  14. Prognostic impact of hexokinase and glucose transporter expressions and clinicopathologic features related to F-18-FDG uptake in esophageal cancer

    NARCIS (Netherlands)

    Schreurs, Liesbeth M; Pultrum, Bareld B; Pavlov, Kirill; Pruim, Jan; Groen, Henk; Hollema, Harry; Plukker, John Theodorus

    2012-01-01

    39 Background: Elucidation of prognostic predictors based on biological viability may be useful for a better detection of patients with a high risk of relapse or death from esophageal cancer. METHODS: Maximum standardized uptake values (SUVmax) were measured in the preoperative 18F-FDG positron emis

  15. Burden of spousal caregivers of stage II and III esophageal cancer survivors 3 years after treatment with curative intent

    NARCIS (Netherlands)

    Haj Mohammad, N; Walter, A W; van Oijen, M G H; Hulshof, M C C M; Bergman, J J G H M; Anderegg, M C J; van Berge Henegouwen, M I; Henselmans, I; Sprangers, M A G; van Laarhoven, H W M

    2015-01-01

    OBJECTIVES: The aim of this study is to examine caregiver burden of spousal caregivers of patients with esophageal cancer after curative treatment with neoadjuvant chemoradiation followed by resection and to assess factors associated with caregiver burden. METHODS: In this exploratory, cross-section

  16. Impact of splenectomy on surgical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction

    NARCIS (Netherlands)

    Pultrum, B. B.; van Bastelaar, J.; Schreurs, Liesbeth; van Dullemen, H. M.; Groen, H.; Nijsten, M. W. N.; van Dam, G. M.; Plukker, J. T. H. M.

    2008-01-01

    We aim to determine the effect of splenectomy on clinical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction (GEJ) after a curative intended resection. From January 1991 to July 2004, 210 patients underwent a potentially curative gastroesophageal resection with an

  17. Prognostic Impact of Clinicopathological Features and Expression of Biomarkers Related to F-18-FDG Uptake in Esophageal Cancer

    NARCIS (Netherlands)

    Schreurs, L. M. A.; Smit, J. K.; Pavlov, K.; Pultrum, B. B.; Pruim, J.; Groen, Henk; Hollema, H.; Plukker, John Th. M.

    2014-01-01

    To analyze the association between pretreatment 18-F-fluoro-deoxyglucose (FDG) uptake and characteristics of aggressive tumor biology in predicting outcome in esophageal cancer (EC). Tumor FDG-uptake was measured by maximum standardized uptake values (SUVmax) in 47 patients undergoing esophagectomy

  18. CD44, SHH and SOX2 as novel biomarkers in esophageal cancer patients treated with neoadjuvant chemoradiotherapy

    NARCIS (Netherlands)

    Honing, Judith; Pavlov, Kirill V.; Mul, Veronique E. M.; Karrenbeld, Arend; Meijer, Coby; Faiz, Zohra; Smit, Justin K.; Hospers, Geke A. P.; Burgerhof, Johannes G. M.; Kruyt, Frank A. E.; Kleibeuker, Jan H.; Plukker, John T. M.

    2015-01-01

    Background and purpose: Neoadjuvant chemoradiotherapy (nCRT) improves survival in esophageal cancer (EC) patients, but the response to treatment is heterogeneous and little is known regarding prognostic and predictive markers in these patients. CD44, SOX2 and SHH have been implicated in resistance t

  19. Restoring KLF5 in esophageal squamous cell cancer cells activates the JNK pathway leading to apoptosis and reduced cell survival.

    Science.gov (United States)

    Tarapore, Rohinton S; Yang, Yizeng; Katz, Jonathan P

    2013-05-01

    Esophageal cancer is the eighth most common cancer in the world and has an extremely dismal prognosis, with a 5-year survival of less than 20%. Current treatment options are limited, and thus identifying new molecular targets and pathways is critical to derive novel therapies. Worldwide, more than 90% of esophageal cancers are esophageal squamous cell cancer (ESCC). Previously, we identified that Krüppel-like factor 5 (KLF5), a key transcriptional regulator normally expressed in esophageal squamous epithelial cells, is lost in human ESCC. To examine the effects of restoring KLF5 in ESCC, we transduced the human ESCC cell lines TE7 and TE15, both of which lack KLF5 expression, with retrovirus to express KLF5 upon doxycycline induction. When KLF5 was induced, ESCC cells demonstrated increased apoptosis and decreased viability, with up-regulation of the proapoptotic factor BAX. Interestingly, c-Jun N-terminal kinase (JNK) signaling, an important upstream mediator of proapoptotic pathways including BAX, was also activated following KLF5 induction. KLF5 activation of JNK signaling was mediated by KLF5 transactivation of two key upstream regulators of the JNK pathway, ASK1 and MKK4, and inhibition of JNK blocked apoptosis and normalized cell survival following KLF5 induction. Thus, restoring KLF5 in ESCC cells promotes apoptosis and decreases cell survival in a JNK-dependent manner, providing a potential therapeutic target for human ESCC.

  20. Tea and coffee consumption and risk of esophageal cancer: the European prospective investigation into cancer and nutrition study.

    Science.gov (United States)

    Zamora-Ros, Raul; Luján-Barroso, Leila; Bueno-de-Mesquita, H Bas; Dik, Vincent K; Boeing, Heiner; Steffen, Annika; Tjønneland, Anne; Olsen, Anja; Bech, Bodil Hammer; Overvad, Kim; Boutron-Ruault, Marie-Christine; Racine, Antoine; Fagherazzi, Guy; Kuhn, Tilman; Katzke, Verena; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Tumino, Rosario; Panico, Salvatore; Vineis, Paolo; Grioni, Sara; Palli, Domenico; Weiderpass, Elisabete; Skeie, Guri; Huerta, José María; Sánchez, María-José; Argüelles, Marcial; Amiano, Pilar; Ardanaz, Eva; Nilsson, Lena; Wallner, Bengt; Lindkvist, Björn; Wallström, Peter; Peeters, Petra H M; Key, Timothy J; Khaw, Kay-Thee; Wareham, Nicholas J; Freisling, Heinz; Stepien, Magdalena; Ferrari, Pietro; Gunter, Marc J; Murphy, Neil; Riboli, Elio; González, Carlos A

    2014-09-15

    Epidemiological data regarding tea and coffee consumption and risk of esophageal cancer (EC) is still inconclusive. We examined the association of tea and coffee consumption with EC risk among 442,143 men and women without cancer at baseline from 9 countries of the European Prospective Investigation into Cancer and Nutrition. Tea and coffee intakes were recorded using country-specific validated dietary questionnaires. Cox regression models were used to analyze the relationships between tea and coffee intake and EC risk. During a mean follow-up of 11.1 years, 339 participants developed EC, of which 142 were esophageal adenocarcinoma (EAC) and 174 were esophageal squamous cell carcinoma (ESCC). In the multivariable models, no significant associations between tea (mostly black tea), and coffee intake and risk of EC, EAC and ESCC were observed. In stratified analyses, among men coffee consumption was inversely related to ESCC (HR for comparison of extreme tertiles 0.42, 95% CI 0.20-0.88; p-trend=0.022), but not among women. In current smokers, a significant and inverse association was observed between ESCC risk and tea (HR 0.46, 95% CI 0.23-0.93; p-trend=0.053) and coffee consumption (HR 0.37, 95% CI 0.19-0.73; p-trend=0.011). However, no statistically significant findings were observed using the continuous variable (per 100 mL/d). These data did not show a significant association between tea and coffee consumption and EC, EAC and ESCC, although a decreased risk of ESCC among men and current smokers is suggested, but need to be confirmed in further prospective studies including more cases.

  1. Bardoxolone methyl induces apoptosis and autophagy and inhibits epithelial-to-mesenchymal transition and stemness in esophageal squamous cancer cells

    Directory of Open Access Journals (Sweden)

    Wang YY

    2015-02-01

    Full Text Available Yan-Yang Wang,1,2 Yin-Xue Yang,3 Ren Zhao,1 Shu-Ting Pan,2,4 Hong Zhe,1 Zhi-Xu He,5 Wei Duan,6 Xueji Zhang,7 Tianxin Yang,8 Jia-Xuan Qiu,4 Shu-Feng Zhou2,51Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 2Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA; 3Department of Colorectal Surgery, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 4Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 5Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino-US Joint Laboratory for Medical Sciences, Guiyang Medical University, Guiyang, People’s Republic of China; 6School of Medicine, Deakin University, Waurn Ponds, VIC, Australia; 7Research Center for Bioengineering and Sensing Technology, University of Science and Technology Beijing, Beijing, People’s Republic of China; 8Department of Internal Medicine, University of Utah and Salt Lake Veterans Affairs Medical Center, Salt Lake City, UT, USAAbstract: Natural and synthetic triterpenoids have been shown to kill cancer cells via multiple mechanisms. The therapeutic effect and underlying mechanism of the synthetic triterpenoid bardoxolone methyl (C-28 methyl ester of 2-cyano-3,12-dioxoolean-1,9-dien-28-oic acid; CDDO-Me on esophageal cancer are unclear. Herein, we aimed to investigate the anticancer effects and underlying mechanisms of CDDO-Me in human esophageal squamous cell carcinoma (ESCC cells. Our study showed that CDDO-Me suppressed the proliferation and arrested cells in G2/M phase, and induced apoptosis in human ESCC Ec109 and KYSE70 cells. The G2/M arrest was accompanied with upregulated p21Waf1/Cip1 and p53 expression. CDDO-Me significantly decreased B-cell lymphoma-extra large (Bcl-xl, B-cell lymphoma 2 (Bcl-2

  2. Relationship between proliferative activity of cancer cells and clinicopathological factors in patients with esophageal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Jun-Xing Huang; Wei Yan; Zheng-Xiang Song; Rong-Yu Qian; Ping Chen; Eeva Salminen; Jorma Toppari

    2005-01-01

    AIM: To assess whether the molecular markers of malignant tumors could improve the understanding of tumor characteristics, and to observe the characteristics of expression of cell cycle markers Ki-67 and cydin A in esophageal carcinoma and to analyze the relationship between proliferative activity of cancer cells and clinicopathological factors.METHODS: Seventy of surgically resected esophageal squamous cell carcinoma (SCC) were examined by immunohistochemistry utilizing commercially available antibodies. Nuclear staining was regarded as a positive result. At least 50 fields in each tumor and non-tumor section were evaluated at a medium power (x200) to determine the proportion of tumor cells and the staining intensity of nuclei in the entire sections.RESULTS: Ki-67 and cyclin A were only expressed in base cells of normal esophageal mucosa. The positive immunostaining of nuclei of SCC was significantly higher than that in normal esophageal mucosa (t= 13.32 and t= 7.52,respectively, P<0.01). The distribution of positively stained was more diffuse and stronger in poorly differentiated SCC. Both Ki-67 and cyclin A expressions were related to histological grades of tumors (t = 3.5675 and t = 3.916; t= 2.13, respectively, P<0.05) but not to the sex and age of the patients, tumor size, lymphatic invasion, location, or stage grouping.CONCLUSION: The proliferative activity of cancer cells may be understood by immunohistochemistry of Ki-67 and cyclin A in Chinese patients with esophageal SCC. These cell cycle markers may serve as an indicator of cancer cell proliferation rate. The overexpression of cell cycle markers Ki-67 and cyclin A suggests the poor SCC differentiation in patients with esophageal carcinoma.

  3. Epidemiology of Oral Cavity Cancers in a Country Located in the Esophageal Cancer Belt: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Babak Saedi

    2012-03-01

    Full Text Available Introduction: As one of the most common cancers among head and neck malignancies, cancer of the oral cavity probably has some variations in countries with a high prevalence of esophageal cancer.  Materials and Methods: Patients with oral cavity cancer who were treated at two tertiary referral centers from January 1999 to January 2009 were included in this study. In addition to demographic data, information regarding personal and family history of head and neck cancer, use of dentures, presence of immune deficiency, consumption of alcohol, and incidence of cigarette smoking was collected. Additionally, a history of opium usage was obtained from the participants in this study. Moreover, an appropriately matched control group was selected for comparisons between the risk factors.   Results: A total of 557 patients were entered into this study over a 10-year period, of whom 219 (39.3% were female and the remaining 338 (60.7% were male. The tongue was the most common site of cancer and 9% of the patients had a history of opium abuse, but more than half of the patients did not have any recognized risk factors. The incidence and stage of cancer had a significant relationship with cigarette smoking (P= 0.013.   Conclusion: Tongue cancer in non-smokers is the predominant pattern of oral cavity cancer in Iran.

  4. Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition.

    Science.gov (United States)

    Jeurnink, S M; Büchner, F L; Bueno-de-Mesquita, H B; Siersema, P D; Boshuizen, H C; Numans, M E; Dahm, C C; Overvad, K; Tjønneland, A; Roswall, N; Clavel-Chapelon, F; Boutron-Ruault, M C; Morois, S; Kaaks, R; Teucher, B; Boeing, H; Buijsse, B; Trichopoulou, A; Benetou, V; Zylis, D; Palli, D; Sieri, S; Vineis, P; Tumino, R; Panico, S; Ocké, M C; Peeters, P H M; Skeie, G; Brustad, M; Lund, E; Sánchez-Cantalejo, E; Navarro, C; Amiano, P; Ardanaz, E; Ramón Quirós, J; Hallmans, G; Johansson, I; Lindkvist, B; Regnér, S; Khaw, K T; Wareham, N; Key, T J; Slimani, N; Norat, T; Vergnaud, A C; Romaguera, D; Gonzalez, C A

    2012-09-15

    Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.79-0.97 and 0.76; 95% CI 0.62-0.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded.

  5. A preliminary study on ras protein expression in human esophageal cancer and precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    Jian Li; Chang Wei Feng; Zhi Guo Zhao; Qi Zhou; Li Dong Wang

    2000-01-01

    @@INTRODUCTION The esophageal carcinoma is a common malignant tumor in Linzhou City (Linxian) of Henan Province in northern China. Although the etiology and natural history of esophageal carcinoma are not clear, a substantial amount of evidence has been provided to suggest that the development of human esophageal squamous cell carcinomas (SCC) is a multistage progressive process[1-4] An early indicator of abnormality in persons predisposed to esophageal SCC is an increased proliferation of esophageal epithelial cells,morphologically manifested as basal cell hyperplasia (BCH), and dysplasia (DYS), and carcinoma in situ, which could be considered precancerous lesions of esophageal SCC[1-4].

  6. Research and control of well water pollution in high esophageal cancer areas

    Institute of Scientific and Technical Information of China (English)

    Xiu-Lan Zhang; Xiu-Lan Bai; Bing Zhang; Xing Zhang; Zhi-Feng Chen; Jun-Zhen Zhang; Shuo-Yuang Liang; Fan-Shu Men; Shu-Liang Zheng; Xiang-Ping Li

    2003-01-01

    AIM: In order to detect risk factors for esophageal cancer,a national research program was carried out during the Eighth Five-Year Plan (from 1991 to 1995). METHODS: Cixian County and Chichen County in Hebei Province were selected as the index and the control for the study fields with higher or lower incidence of esophagus cancer in China, respectively. In these areas, we investigated the pollution of three nitrogenous compounds in well water for drinking and the use of nitrogen fertilizer in farming. RESULTS: In well water, nitrate nitrogen, nitrite nitrogen and ammonia nitrogen were 8.77 mg/L, 0.014 mg/L and 0.009 mg/L in Cixian County in 1993, respectively. They were significantly higher than their levels (3.84 mg/L, 0.004 mg/L and 0.004 mg/L) in Chichen County (P<0.01, t=6.281,t=3.784,t=3.775). There was a trend that the nitrogenous compounds in well water increased from 1993 to 1996.The amount of nitrogen fertilizer used in farming was 787.6 kg per hectare land in Cixian County in 1991, significantly higher than 186 kg per hectare in Chichen County (t=9.603,P<0.001). CONCLUSION: These investigations indicate that the poilution of nitrogenous compounds in well water for drinking is closely related to the use of nitrogen fertlizer in farming, and there is a significantly positive correlation between the level of three nitrogenous compounds in well water and the mortality ofesophageal cancer (correlation coefficient =0.5992). We suggest that improvement of well system for drinking water quality should be an effective measure for esophageal cancer prevention and control in rural areas.

  7. Pretreatment with insulin enhances anticancer functions of 5-fluorouracil in human esophageal and colonic cancer cells

    Institute of Scientific and Technical Information of China (English)

    Ke ZOU; Ji-hang JU; Hong XIE

    2007-01-01

    Aim: To investigate the effects of insulin on enhancing 5-fluorouracil (5-FU) anti-cancer functions and its mechanisms in the human esophageal cancer cell line (Eca 109) and human colonic cancer cell line (Ls-174-t). Methods: The effect of insulin/5-FU combination treatment on the growth of Eca 109 and Ls-174-t cells was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay. After insulin treatment or insulin/5-FU treatment, cell cycle distri-bution of both cell lines was analyzed by flow cytometry. Western blot assay was used to assess the expression of caspase-3 and thymidylate synthase (TS).Apoptosis was detected by flow cytometry, DNA fragmentation assay, and termi-nal transferase dUTP nick end labeling assay (TUNEL). Moreover, the changes of 5-FU uptake after insulin pretreatment were detected by HPLC assay and Western blot analysis. Results: We found that insulin enhanced the inhibitory effect of 5-FU on cell proliferation when Eca 109 cells and Ls- 174-t cells were pretreated with insulin for the appropriate time. Insulin increased the cell number of the S phase and the uptake of 5-FU. Insulin/5-FU treatment enhanced apoptosis of tumor cells and upregulated the expression of cleaved caspase-3 compared with 5-FU treatment.Moreover, insulin/5-FU treatment induced the changes of free TS and the TS ternary complex level compared with 5-FU treatment in Eca 109 and Ls-174-t cells.Conclusion: These data suggest that insulin enhances anticancer functions of 5-FU when it is treated before 5-FU for the appropriate time in human esophageal and colonic cancer cell lines.

  8. Acute esophagitis for patients with local-regional advanced non small cell lung cancer treated with concurrent chemoradiotherapy

    DEFF Research Database (Denmark)

    Pan, Yi; Brink, Carsten; Knap, Marianne

    2016-01-01

    PURPOSE: Esophagitis is common in patients treated with definitive radiotherapy for local-regional advanced non small cell lung cancer (NSCLC). The purpose of this study was to estimate the dose-effect relationship using clinical and dosimetric parameters in patients receiving intensity modulated...... radiotherapy (IMRT) and concomitant chemotherapy (CCT). METHODS: Between 2009 and 2013, 117 patients with stages IIB-IIIB NSCLC were treated in a multicenter randomized phase II trial with 2 cycles of induction chemotherapy followed by IMRT and CCT. The esophagitis was prospectively scored using the Common...

  9. Cancer cell-selective promoter recognition accompanies antitumor effect by glucocorticoid receptor-targeted gold nanoparticle

    Science.gov (United States)

    Sau, Samaresh; Agarwalla, Pritha; Mukherjee, Sudip; Bag, Indira; Sreedhar, Bojja; Pal-Bhadra, Manika; Patra, Chitta Ranjan; Banerjee, Rajkumar

    2014-05-01

    Nanoparticles, such as gold nanoparticles (GNP), upon convenient modifications perform multi tasks catering to many biomedical applications. However, GNP or any other type of nanoparticles is yet to achieve the feat of intracellular regulation of endogenous genes of choice such as through manipulation of a gene-promoter in a chromosome. As for gene modulation and delivery, GNP (or other nanoparticles) showed only limited gene therapy potential, which relied on the delivery of `exogenous' genes invoking gene knockdown or replacement. Practically, there are no instances for the nanoparticle-mediated promoter regulation of `endogenous' genes, more so, as a cancer selective phenomenon. In this regard, we report the development of a simple, easily modifiable GNP-formulation, which promoted/up-regulated the expression of a specific category of `endogenous' genes, the glucocorticoid responsive genes. This genetic up-regulation was induced in only cancer cells by modified GNP-mediated transcriptional activation of its cytoplasmic receptor, glucocorticoid receptor (GR). Normal cells and their GR remained primarily unperturbed by this GNP-formulation. The most potent gene up-regulating GNP-formulation down-regulated a cancer-specific proliferative signal, phospho-Akt in cancer cells, which accompanied retardation of tumor growth in the murine melanoma model. We show that GR-targeted GNPs may find potential use in the targeting and modulation of genetic information in cancer towards developing novel anticancer therapeutics.Nanoparticles, such as gold nanoparticles (GNP), upon convenient modifications perform multi tasks catering to many biomedical applications. However, GNP or any other type of nanoparticles is yet to achieve the feat of intracellular regulation of endogenous genes of choice such as through manipulation of a gene-promoter in a chromosome. As for gene modulation and delivery, GNP (or other nanoparticles) showed only limited gene therapy potential, which relied

  10. Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young; Kwon, Hyoung Cheol; Kim, Jung Soo [Chonbuk National University Hospital, Jeonju (Korea, Republic of); Lee, Heui Kwan [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Soo Geon [Jesushospital, Jeonju (Korea, Republic of)

    2008-06-15

    We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women (mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion (17 patients), and mid portion (65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0 (7 patients), T2N0-1M0 (18 patients), T3N0-1M0 (44 patients) and T4N0-1M0 (13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response (48 patients), partial response (31 patients) and no response (3 patients). The failure patterns of the lymph node were comprised of the regional lymph node (23 patients) and the distance lymph node which included celiac axis and gastric lymph node (13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the

  11. Cytochrome P450 1B1, a novel chemopreventive target for benzo[a]pyrene-initiated human esophageal cancer.

    Science.gov (United States)

    Wen, Xia; Walle, Thomas

    2007-02-08

    Esophageal cancer is common worldwide, with poor prognosis. Smoking, including exposure to polyaromatic hydrocarbons like benzo[a]pyrene (BaP), is a major risk factor. In human esophageal HET-1A cells, we found that time-dependent BaP-DNA binding was associated with upregulation of CYP1B1, but not CYP1A1, mRNA and protein. The dietary flavonoid 5,7-dimethoxyflavone significantly inhibited BaP-DNA binding and down-regulated BaP-induced CYP1B1 mRNA and protein. 3',4'-Dimethoxyflavone was an even more potent inhibitor of CYP1B1 expression, while resveratrol had no effect. Thus, dietary methoxylated flavones inhibited BaP-induced CYP1B1 transcription in a cell-specific manner and hold promise as chemopreventive agents in esophageal carcinogenesis.

  12. α-Solanine Modulates the Radiosensitivity of Esophageal Cancer Cells by Inducing MicroRNA 138 Expression

    OpenAIRE

    Yuanyuan Wang; Jianbo Wu; Wei Guo; Qianqian Sun; Xiaonan Chen; Wenqiao Zang; Ziming Dong; Guoqiang Zhao

    2016-01-01

    Background: Esophageal cancer (EC) is one of the most common malignant tumors in the world. Due to difficulties with performing the operation, most patients choose to have palliative treatment instead. Radiotherapy is one of the main palliative treatments of EC. However, the clinical efficacy of radiotherapy is not satisfactory α-Solanine is a bioactive component of steroidal glycoalkaloids which has been demonstrated to exhibit anti-metastasis activity in different cancers. In the present st...

  13. Local hyperthermia for esophageal cancer in a rabbit tumor model: Magnetic stent hyperthermia versus magnetic fluid hyperthermia

    OpenAIRE

    LIU, Jiayi; Li, Ning; Li, Li; LI, DANYE; Liu, Kai; Zhao, Lingyun; TANG, JINTIAN; Li, Liya

    2013-01-01

    Magnetic-mediated hyperthermia (MMH) is a promising local thermotherapy approach for cancer treatment. The present study investigated the feasibility and effectiveness of MMH in esophageal cancer using a rabbit tumor model. The therapeutic effect of two hyperthermia approaches, magnetic stent hyperthermia (MSH), in which heat is induced by the clinical stent that is placed inside the esophagus, and magnetic fluid hyperthermia (MFH), where magnetic nanoparticles are applied as the agent, was s...

  14. Appropriateness of using patient-derived xenograft models for pharmacologic evaluation of novel therapies for esophageal/gastro-esophageal junction cancers.

    Directory of Open Access Journals (Sweden)

    Lorin Dodbiba

    Full Text Available The high morbidity and mortality of patients with esophageal (E and gastro-esophageal junction (GEJ cancers, warrants new pre-clinical models for drug testing. The utility of primary tumor xenografts (PTXGs as pre-clinical models was assessed. Clinicopathological, immunohistochemical markers (p53, p16, Ki-67, Her-2/neu and EGFR, and global mRNA abundance profiles were evaluated to determine selection biases of samples implanted or engrafted, compared with the underlying population. Nine primary E/GEJ adenocarcinoma xenograft lines were further characterized for the spectrum and stability of gene/protein expression over passages. Seven primary esophageal adenocarcinoma xenograft lines were treated with individual or combination chemotherapy. Tumors that were implanted (n=55 in NOD/SCID mice had features suggestive of more aggressive biology than tumors that were never implanted (n=32. Of those implanted, 21/55 engrafted; engraftment was associated with poorly differentiated tumors (p=0.04 and older patients (p=0.01. Expression of immunohistochemical markers were similar between patient sample and corresponding xenograft. mRNA differences observed between patient tumors and first passage xenografts were largely due to loss of human stroma in xenografts. mRNA patterns of early vs late passage xenografts and of small vs large tumors of the same passage were similar. Complete resistance was present in 2/7 xenografts while the remaining tumors showed varying degrees of sensitivity, that remained constant across passages. Because of their ability to recapitulate primary tumor characteristics during engraftment and across serial passaging, PTXGs can be useful clinical systems for assessment of drug sensitivity of human E/GEJ cancers.

  15. Hyperthermia by a nitinol stent in an alternating magnetic field:Safety and feasibility in rabbit esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Jumei Zhou; Ning Li; Qisheng Xia; Lehui Du; Xiaowen Wang; Linyun Zhao; Xufei Wang; Jintian Tang

    2009-01-01

    Hyperthermia by heating in-stent is a potentially new method to treat esophageal cancer.This study assessed the safety of heating the rabbit esophagus with a nitinol stent in an alternating magnetic field (AMF) and investigated whether this method offers a therapeutic option for esophageal cancer.Nitinol stents were placed in the cervical esophagi of healthy rabbits,which were heated in an AMF for different times at 43,46 and 50 ℃.The esophagi were histologically examined after a week to observe whether there was transmural necroses.Then esophageal cancer of rabbit placed nitinol stents were heated in an AMF at 46℃ for 10 min.Stents were heated to a target temperature within 5 min.The highest tolerated temperature and time for the healthy rabbit esophagus was at 46℃ for 10 min.Tumor growth was delayed by heating and it was statistically significant.Heating the rabbit esophageal wall at 46℃ for 10 min proves to be safe and effective in delaying tumor growth.

  16. Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study.

    Science.gov (United States)

    Offermans, Nadine S M; Vermeulen, Roel; Burdorf, Alex; Goldbohm, R Alexandra; Keszei, András P; Peters, Susan; Kauppinen, Timo; Kromhout, Hans; van den Brandt, Piet A

    2014-10-15

    The evidence for an association between occupational asbestos exposure and esophageal, gastric and colorectal cancer is limited. We studied this association specifically addressing risk differences between relatively low and high exposure, risk associated with cancer subtypes, the influence of potential confounders and the interaction between asbestos and smoking in relation to cancer risk. Using the Netherlands Cohort Study (n = 58,279 men, aged 55-69 years at baseline), asbestos exposure was estimated by linkage to a job-exposure matrix. After 17.3 years of follow-up, 187 esophageal, 486 gastric and 1,724 colorectal cancer cases were available for analysis. The models adjusted for age and family history of cancer showed that mainly (prolonged) exposure to high levels of asbestos was statistically significantly associated with risk of esophageal adenocarcinoma (EAC), total and distal colon cancer and rectal cancer. For overall gastric cancer and gastric non-cardia adenocarcinoma (GNCA), also exposure to lower levels of asbestos was associated. Additional adjustment for lifestyle confounders, especially smoking status, yielded non-significant associations with overall gastric cancer and GNCA in the multivariable-adjusted model, except for the prolonged highly exposed subjects (tertile 3 vs. never: HR 2.67, 95% CI: 1.11-6.44 and HR 3.35, 95% CI: 1.33-8.44, respectively). No statistically significant additive or multiplicative interaction between asbestos and smoking was observed for any of the studied cancers. This prospective population-based study showed that (prolonged) high asbestos exposure was associated with overall gastric cancer, EAC, GNCA, total and distal colon cancer and rectal cancer.

  17. Multi-susceptibility genes associated with the risk of the development stages of esophageal squamous cell cancer in Feicheng County

    Directory of Open Access Journals (Sweden)

    Yang Fang

    2011-06-01

    Full Text Available Abstract Background The purpose of this study was to evaluate the association of multi-genotype polymorphisms with the stepwise progression of esophageal squamous cell cancer (ESCC and the possibility of predicting those at higher risk. Methods A total of 1,004 subjects were recruited from Feicheng County, China, between Jan. 2004 and Dec. 2007 and examined by endoscopy for esophageal lesions. These subjects included 270 patients with basal cell hyperplasia (BCH, 262 patients with esophageal squamous cell dysplasia (ESCD, 226 patients with ESCC, and 246 controls with Lugol-voiding area but diagnosed as having normal esophageal squamous epithelial cells by histopathology. The genotypes for CYP2E1 G1259C, hOGG1 C326G, MTHFR C677T, MPO G463A, and ALDH2 allele genes were identified in blood samples collected from all participants. Results The alleles ALDH2 and MTHFR C677T were critical for determining individual susceptibility to esophageal cancer. Compared to the ALDH 1*1 genotype, the ALDH 2*2 genotype was significantly associated with increased risks of BCH, ESCD, and ESCC. However, the TT genotype of MTHFR C677T only increased the risk of ESCC. Further analysis revealed that the combination of the high-risk genotypes 2*2/1*2 of ALDH 2 and TT/TC of MTHFR C677T increased the risk of BCH by 4.0 fold, of ESCD by 3.7 fold, and ESSC by 8.72 fold. The generalized odds ratio (ORG of the two combined genotypes was 1.83 (95%CI: 1.55-2.16, indicating a strong genetic association with the risk of carcinogenic progression in the esophagus. Conclusions The study demonstrated that the genotypes ALDH2*2 and MTHFR 677TT conferred elevated risk for developing esophageal carcinoma and that the two susceptibility genotypes combined to synergistically increase the risk.

  18. The Antiproliferative Effect of Moringa oleifera Crude Aqueous Leaf Extract on Human Esophageal Cancer Cells.

    Science.gov (United States)

    Tiloke, Charlette; Phulukdaree, Alisa; Chuturgoon, Anil A

    2016-04-01

    Esophageal cancer (EC) is commonly diagnosed in South Africa (SA), with high incidences occurring in SA's black population. Moringa oleifera (MO), a multipurpose tree, is used traditionally for its nutritional and medicinal properties. It has been used for the treatment of a variety of ailments, including cancer. We investigated the antiproliferative effect of MO crude aqueous leaf extract (MOE) on a cancerous esophageal cell line (SNO). SNO cells were exposed to a range of MOE dilutions to evaluate cytotoxicity (MTT assay). Oxidative stress was determined using the TBARS assay. The comet assay was used to assess DNA damage. We then determined cell death mechanisms by measuring phosphatidylserine (PS) externalization (flow cytometry), caspase-3/7 and caspase-9 activities, and adenosine triphosphate (ATP) levels (luminometry). Protein expression of Smac/DIABLO and PARP-1 was determined by western blotting. SNO cells were treated with a range of MOE dilutions to obtain an IC50 value of 389.2 μg/mL MOE (24 h), which was used in all subsequent assays. MOE significantly increased lipid peroxidation (P < .05) and DNA fragmentation (P < .0001) in SNO cells. The induction of apoptosis was confirmed by the increase in PS externalization (P < .0001), caspase-9 (P < .05) and caspase-3/7 (P = .22) activities, and decreased ATP levels (P < .0001). MOE significantly increased both the expression of Smac/DIABLO protein and cleavage of PARP-1, resulting in an increase in the 24-kDa fragment (P < .001). MOE possesses antiproliferative effects on SNO EC cells by increasing lipid peroxidation, DNA fragmentation, and induction of apoptosis.

  19. N-acetyltransferase 2 polymorphisms and risk of esophageal cancer in a Chinese population.

    Directory of Open Access Journals (Sweden)

    Liming Wang

    Full Text Available Esophageal cancer was the fifth most commonly diagnosed cancer and the fourth leading cause of cancer-related death in China in 2009. Genetic factors might play an important role in the carcinogenesis of esophageal squamous cell carcinoma (ESCC. We conducted a hospital-based case-control study to evaluate ten NAT2 tagging single nucleotide polymorphisms (SNPs on the risk of ESCC. Six hundred and twenty-nine ESCC cases and 686 controls were recruited. Their genotypes were determined using the ligation detection reaction method. In the single locus analyses, there was a borderline statistically significant difference in genotype frequencies of NAT2 rs1565684 T>C SNP between the cases and the controls (p = 0.057. The NAT2 rs1565684 CC genotype was associated with a borderline significantly increased risk for ESCC (CC vs. TT: adjusted OR = 1.77, 95% CI = 0.97-3.21, p = 0.063 and CC vs. TT/TC: adjusted OR = 1.68, 95% CI = 0.93-3.04, p = 0.085. The association was evident among older patients and patients who never drunk. After the Bonferroni correction, in all comparison models, NAT2 rs1565684 T>C SNP was not associated with ESCC risk (p>0.05. For the other nine NAT2 SNPs, after Bonferroni correction, in all comparison models, the nine SNPs were also not associated with ESCC risk (p>0.05. Thus, nine NAT2 tagging SNPs were not associated with risk of ESCC. NAT2 rs1565684 T>C SNP might play a slight role in ESCC etiology. Additional, larger studies and tissue-specific biological characterization are required to confirm the current findings.

  20. Phase Ⅰ/Ⅱ enzyme gene polymorphisms and esophageal cancer risk: A meta-analysis of the literature

    Institute of Scientific and Technical Information of China (English)

    Chun-Xia Yang; Keitaro Matsuo; Zhi-Ming Wang; Ka-zuo Tajima

    2005-01-01

    AIM: Phase Ⅰ/Ⅱ enzymes metabolize environmental carcinogens and several functional polymorphisms have been reported in their encoding genes. Although their significance with regard to esophageal carcinogenicity has been examined epidemiologically, it remains controversial. The present systematic review of the literature was performed to clarify associations.METHODS: Eligible studies were case-control or cohort studies published until September 2004 that were written in any language. From PubMed and a manual review of reference lists in relevant review articles, we obtained 16 studies related to the CYP1A1 Ile-Val substitution in exon 7, CYP1A1MspI polymorphisms, CYP2E1 RsaI polymorphisms,GSTM1 null type, GSTT1 null type and GSTP1 Ile104Val.All were of case-control design. Summary statistics were odds ratios (ORs) comparing heterozygous-, homozygousnon-wild type or these two in combination with the homozygous wild type, or the null type with the non-null type for GSTM1 and GSTT1. A random effect model was used to estimate the summary ORs. A meta-regression analysis was applied to explore sources of heterogeneity. RESULTS: Individuals with the Ile-Val substitution in CYP1A1 exon 7 had increased esophageal cancer risk,with ORs (95%CI) compared with Ile/Ile of 1.37 (1.09-1.71),2.52 (1.62-3.91) and 1.44 (1.17-1.78) for Ile-Val, Val/Val genotype and the combined group. No significant association was found between esophageal cancer risk and the other genetic parameters.CONCLUSION: A significant association exists between the CYP1A1 Ile-Val polymorphism and risk of esophageal cancer. Polymorphisms that increase the internal exposure to activated carcinogens may increase the risk of esophageal cancer.

  1. Neoadjuvant Paclitaxel Poliglumex (PPX), Cisplatin, and Radiation (RT) for Esophageal Cancer

    Science.gov (United States)

    Ng, T.; Fontaine, J.; Dipetrillo, T.; Suntharalingam, M.; Horiba, N.; Oldenburg, N.; Oconnor, B.; Perez, K.; Birnbaum, A.; Battafarano, R.; Burrows, W.; Safran, H.

    2010-01-01

    Background: Paclitaxel poliglumex (PPX) is a drug conjugate that links paclitaxel to poly-L-glutamic acid thereby increasing its radiation enhancement factor to 4.0–8.0 compared to 1.5–2.0 for paclitaxel. In previous phase I studies, The Brown University Oncology Group evaluated PPX with concurrent radiation and PPX/cisplatin/RT. A phase II study was subsequently performed to evaluate the pathologic response rate of neoadjuvant PPX, cisplatin, and radiation for patients with esophageal cancer. Methods: Eligible patients had pathologically confirmed adenocarcinoma or squamous cell carcinoma of the esophagus or GE junction with no evidence of distant metastasis. Patients received weekly PPX 50 mg/m2 and cisplatin 25 mg/m2 for 6 weeks with concurrent 50.4 Gy of radiation. Six to eight weeks after completion of chemoradiotherapy, patients underwent surgical resection. Results: The study has completed accrual of 40 patients, 37 with adenocarcinoma and 3 with squamous cell cancer. The median age is 62 years. Toxicity data are available for the first 35 patients. Four of 35 patients experienced grade 4 non-hematologic toxicities, which included electrolyte abnormalities, glucose intolerance, hypersensitivity reaction, and thromboembolus. Eleven of 35 patients had grade 3 non-hematologic toxicities including electrolyte abnormalities (n=5), nausea (n=3), dysphagia (n=2), fatigue (n=2), glucose intolerance (n=2), and hypersensitivity reaction (n=1). Grade 3 anorexia was reported in only 1 patient who subsequently was given TPN. No patients required a feeding tube. There were no grade 4 hematologic toxicities; grade 3 hematologic toxicities included neutropenia (n=2) and anemia (n=1). Of the first 28 patients undergoing surgery, all with adenocarcinoma, 7 of 28 (25%) have had a pathologic complete response. Conclusion: PPX, cisplatin and concurrent radiation is a well tolerated, easily administered regimen for esophageal cancer with a very low incidence of significant

  2. Preliminary clinical evaluation of continuous infusion of 5-FU and low dose cisplatin (LFP) combined with radiation therapy for the treatment of advanced or recurrent esophageal cancer

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    Itoh, Satoshi; Morita, Soujiro; Hisa, Nobuaki; Tsuji, Akihito; Takamatsu, Masahiro; Takasaki, Motohiro; Horimi, Tadashi [Kochi Municipal Central Hospital (Japan)

    2000-11-01

    We evaluated the LFP combined with radiation therapy for the treatment of advanced or recurrent esophageal cancer. The patients consisted of 4 inoperable cases, 4 cases in combination with operation, and 5 cases with recurrent tumor. The response rate was 80% (CR2, PR6, NC1 and PD1). We conclude that the LFP combined with radiation therapy was effective and useful for the treatment of advanced or recurrent esophageal cancer. (author)

  3. Inhibition of Dual Specific Oncolytic Adenovirus on Esophageal Cancer via Activation of Caspases by a Mitochondrial-dependent Pathway

    Institute of Scientific and Technical Information of China (English)

    SU Jia-qiang; CHI Bao-rong; LI Xiao; LIU Lei; LIU Li-ming; QI Yan-xin; WANG Zhuo-yue; JIN Ning-yi

    2012-01-01

    We investigated the anti-tumor effects of dual cancer specific-oncolytic adenovirus Ad-VP on esophageal cancer(EC).The anti-tumor activity of Ad-VP was compared with that of the control recombinant adenoviruses (Ad-GP,Ad-Apoptin,Ad-EGFP) in human esophageal cancer cell EC-109 and human normal liver cell L02 in vitro.In 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) assays,the growth of EC-109 cells was slightly inhibited by Ad-GP.Ad-Apoptin and Ad-EGFP.However,Ad-VP induced a significant cytotoxic effect.Infection of EC-109 cells with Ad-VP resulted in a significant induction of apoptosis of them in vitro,detected by 4′,6-diamidino-2-phenylindole(DAPI) or acridine orange and ethidium bromide staining.The results of Western blot and flow cytometric assay indicate the loss of mitochondrial membrane potential(△ψm),the release of cytochrome c and the activation of caspase-3,6 and 7 in Ad-VP infiected EC-109 cells.In contrast,all these assays show almost no effects of the recombinant adenoviruses on L02 cells.These results demonstrate that the treatment of tumors with Ad-VP selectively inhibits tumor growth and induces apoptosis of esophageal cancer cells.Ad-VP may provide a novel and powerful strategy for cancer gene therapy.

  4. Putting into Evidence: The Effect of Oral Glutamine on Radiation-induced Esophagitis among Patients with Lung Cancer

    Directory of Open Access Journals (Sweden)

    Khaled Waleed Bader

    2014-07-01

    Full Text Available Oral glutamine supplementation is highly effective in preventing and delaying radiation-induced esophagitis, one of the most common discomforting side effects of radiation to the thoracic area among lung cancer patients. According to the literature, lung cancer is the leading cause of death among all cancers with the highest incidence worldwide. This paper aims to emphasize the importance of oral glutamine supplementation in preventing radiation-induced esophagitis among lung cancer patients. Several databases have been searched and seven studies included in this review (five randomized control studies, one quasi-experimental study and one systematic review with a total of 453 patients. The patients in these studies were diagnosed with lung cancer regardless of type or stage. The patients were either assigned to an intervention group (glutamine supplementation or a control group. These studies were conducted in the US, Turkey, Spain, and Greece from 2003 until 2012. The results showed that 10 mg of oral glutamine three times per day on a daily basis (from one month before starting radiation until one month after completion of radiationwas effective in preventing and delaying radiation-induced esophagitis.

  5. Takotsubo cardiomyopathy in a patient with esophageal cancer: a case report

    Directory of Open Access Journals (Sweden)

    Gangadhar Tara C

    2008-12-01

    Full Text Available Abstract Introduction Takotsubo cardiomyopathy has increasingly been reported in the medical literature in recent years. Much is still unknown regarding risk factors and clinical relationships. We contribute this case report to the growing set of literature on the topic. Case presentation We report the case of a 64-year-old woman with esophageal cancer who developed takotsubo cardiomyopathy, a form of reversible heart failure, and we present a review of the literature. Patients present with symptoms similar to an acute coronary syndrome; however, cardiac catheterization reveals patent coronary arteries, and symptoms of heart failure resolve completely within weeks. Conclusion It is important that clinicians consider takotsubo cardiomyopathy in the differential diagnosis of heart failure and gain a basic understanding of the clinical presentation and diagnosis.

  6. Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Katsunobu Yoshioka

    2009-01-01

    Full Text Available A 72-year-old woman was admitted to our hospital for esophagectomy for esophageal cancer. On the third postoperative day, she developed polyuria (3.8 L/day, massive natriuresis, hyponatremia (112 mEq/L, hyperkalemia (5.6 mEq/L, and decreased central venous pressure, which was refractory to isotonic saline infusion. Laboratory findings indicated proximal tubular injury (high urinary β2-microglobulin, coexistence of hypouricemia together with reduced aldosterone action at the cortical collecting duct. A diagnosis of salt-losing nephropathy was made and sodium correction was done with 3% saline and fludrocortisone. She responded well to therapy. The cause of hyponatremia was considered renal tubular dysfunction together with elevated antidiuretic hormone level. Postoperatively, it is important to look for the development of salt-losing nephropathy.

  7. High resolution microendoscopy for early detection of esophageal cancer in low-resource settings (Conference Presentation)

    Science.gov (United States)

    Richards-Kortum, Rebecca

    2016-03-01

    Esophageal squamous cell neoplasia (ESCN) is the sixth leading cause of cancer death worldwide. Most deaths due to ESCN occur in developing countries, with highest risk areas in northern China. Lugol's chromoendoscopy (LCE) is the gold-standard for ESCN screening; while the sensitivity of LCE for ESCN is >95%, LCE suffers poor specificity (< 65%) due to false positive findings from inflammatory lesions. High resolution microendoscopy (HRME) uses a low-cost, fiber-optic fluorescence microscope to image morphology of the surface epithelium without need for biopsy. We developed a tablet-interfaced HRME with automated, real-time image analysis. In an in vivo study of 177 patients referred for endoscopy in China, use of the algorithm identified neoplasia with a sensitivity and specificity of 95% and 91% compared to the gold standard of histology.

  8. [Treatment outcomes of patients with cervical lymph node recurrence after esophagectomy for esophageal cancer].

    Science.gov (United States)

    Takemura, Masashi; Kaibe, Nobuaki; Takii, Mamiko; Yoshida, Kayo; Niwa, Hirotaka; Oshima, Tsutomu; Kikuchi, Shoujiro; Sasako, Mitsuru

    2014-11-01

    Herein, we report the treatment outcomes of patients with limited cervical lymph node recurrence after esophagectomy for esophageal cancer. Between April 2010 and December 2013, 8 patients with cervical lymph nodes recurrence were diagnosed and treated in our department. All patients were detected with recurrent disease by using positron emission tomography computed tomography(PET-CT), and among these, 5 patients had solitary node recurrence. Initial treatments were irradiation therapy in 5 patients and lymphadenectomy in 3 patients. Four of 5 patients underwent irradiation therapy and lymphadenectomy. Four of 5 patients with solitary node recurrence are still alive without relapse of disease. In conclusion, PET-CT can be useful for early detection of recurrent disease after esophagectomy. Appropriate therapy for patients with solitary cervical lymph node recurrence is associated with long-term survival after recurrence.

  9. Comparative study of CEA and CA19-9 in esophageal, gastric and colon cancers individually and in combination (ROC curve analysis)

    Institute of Scientific and Technical Information of China (English)

    Bhawna Bagaria; Sadhna Sood; Rameshwaram Sharma; Soniya Lalwani

    2013-01-01

    Objective:To determine the clinical serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases of esophageal, gastric, and colon cancers. Methods:The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%. Receiver operating characteristic (ROC) curves were plotted. Results:Serum CEA levels were significantly higher in cancer patients than in the control group. The sensitivity of CEA was determined:in esophageal cancer, sensitivity=28%, negative predictive value (NPV)=61.72%, and AUC=0.742 (SE=0.05), with a significance level of P Conclusion:CEA exhibited the highest sensitivity for colon cancer, and CA19-9 exhibited the highest sensitivity for gastric cancer. Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.

  10. Risks and Benefits of Multimodal Esophageal Cancer Treatments: A Meta-Analysis

    Science.gov (United States)

    Sun, Lei; Zhao, Fen; Zeng, Yan; Yi, Cheng

    2017-01-01

    Background Esophageal cancer has traditionally been associated with very poor outcomes. A number of therapies are available for the treatment and palliation of esophageal cancer, but little systematic evidence compares the efficacy of different treatment strategies. This meta-analysis aimed to investigate whether treatments in addition to radiotherapy could provide better efficacy and safety. Material/Methods We identified a total of 12 eligible studies with 18 study arms by searching PubMed, the Cochrane Library, EMBASE, and Clinical Trials.gov without time or language restrictions. The final search was conducted on 17 August 2016. We calculated mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CI) for continuous and dichotomous data, respectively. Heterogeneity was calculated and reported using Tau2, Chi2, and I2 analyses. Results Twelve studies with 18 study arms were included in the analysis. Addition of surgery to chemo-radiotherapy resulted in improved median survival time (p=0.009) compared with chemo-radiotherapy alone, but all other outcomes were unaffected. Strikingly, and in contrast with patients with squamous cell carcinomas, the subset of patients with adenocarcinoma who received therapies in addition to radiotherapy showed a significant improvement in median survival time (p<0.0001), disease-free survival (p=0.007), 2-year survival rates (p=0.002), and 3-year survival rates (p=0.01). The incidence of adverse effects increased substantially with additional therapies. Conclusions This meta-analysis reveals stark differences in outcomes in patients depending on the type of carcinoma. Patients with squamous cell carcinoma should be educated about the risks and benefits of undergoing multiple therapies. PMID:28214903

  11. Preoperative Concurrent Radiochemotherapy for Locally Advanced Esophageal Cancer: Treatment Outcome and Prognostic Factors

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Young; Ahn, Yong Chan; Kim, Kwan Min; Kim, Jhing Ook; Shim, Young Mog; Im, Young Hyuck [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-09-15

    Purpose: This study reports the results of the use of preoperative concurrent radiochemotherapy (CRCT) for the treatment of locoregionally advanced esophageal cancer. Materials and Methods: From 1998 through 2005, 61 patients with intrathoracic esophageal cancer at stages II-IVB (without distant organ metastasis and presumed to be respectable) received preoperative CRCT. CRCT consisted of radiotherapy (45 Gy /25 fractions /5 weeks) and FP chemotherapy (5-FU 1 g/m2/day, days 1-4 and 29-32, Cisplatin 60 mg/m2/day, days 1 and 29). An esophagectomy was planned in 4 {approx} 6 weeks after the completion of CRCT. Results: There were two treatment-related deaths. Among the 61 patients, 53 patients underwent surgery and 17 patients achieved a pathological complete response (pCR). The overall survival (OS) rates of all 61 patients at 2 and 5 years were 59.0% and 38.0%, respectively. The rates of OS and disease-free survival (DFS) of the surgically resected patients at 2 and 5 years were 61.6%, 40.1% and 53.3%, 41.8%, respectively. By univariate analysis, achievement of pCR and a clinically uninvolved distant lymph node (cM0) were favorable prognostic factors for OS and DFS. There were 27 patients that experienced a relapse-a locoregional relapse occurred in 5 patients, a distant metastasis occurred in 12 patients and combined failure occurred in 10 patients. Conclusion: The results of the current study are favorable. pCR and an uninvolved distant lymph node were found to be favorable prognostic factors.

  12. Preoperative Chemoradiation Therapy in Combination With Panitumumab for Patients With Resectable Esophageal Cancer: The PACT Study

    Energy Technology Data Exchange (ETDEWEB)

    Kordes, Sil, E-mail: s.kordes@amc.uva.nl [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Berge Henegouwen, Mark I. van [Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Hulshof, Maarten C. [Department of Radiotherapy, Academic Medical Center, Amsterdam (Netherlands); Bergman, Jacques J.G.H.M. [Department of Gastroenterology, Academic Medical Center, Amsterdam (Netherlands); Vliet, Hans J. van der [Department of Medical Oncology, Vrije Universiteit Medical Center, Amsterdam (Netherlands); Kapiteijn, Ellen [Department of Medical Oncology, Leiden University Medical Center, Leiden (Netherlands); Laarhoven, Hanneke W.M. van; Richel, Dick J. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Klinkenbijl, Jean H.G. [Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Meijer, Sybren L. [Department of Pathology, Academic Medical Center, Amsterdam (Netherlands); Wilmink, Johanna W. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands)

    2014-09-01

    Purpose: Preoperative chemoradiation therapy (CRT) has become the standard treatment strategy for patients with resectable esophageal cancer. This multicenter phase 2 study investigated the efficacy of the addition of the epidermal growth factor receptor (EGFR) inhibitor panitumumab to a preoperative CRT regimen with carboplatin, paclitaxel, and radiation therapy in patients with resectable esophageal cancer. Methods and Materials: Patients with resectable cT1N1M0 or cT2-3N0 to -2M0 tumors received preoperative CRT consisting of panitumumab (6 mg/kg) on days 1, 15, and 29, weekly administrations of carboplatin (area under the curve [AUC] = 2), and paclitaxel (50 mg/m{sup 2}) for 5 weeks and concurrent radiation therapy (41.4 Gy in 23 fractions, 5 days per week), followed by surgery. Primary endpoint was pathologic complete response (pCR) rate. We aimed at a pCR rate of more than 40%. Furthermore, we explored the predictive value of biomarkers (EGFR, HER 2, and P53) for pCR. Results: From January 2010 until December 2011, 90 patients were enrolled. Patients were diagnosed predominantly with adenocarcinoma (AC) (80%), T3 disease (89%), and were node positive (81%). Three patients were not resected due to progressive disease. The primary aim was unmet, with a pCR rate of 22%. Patients with AC and squamous cell carcinoma reached a pCR of 14% and 47%, respectively. R0 resection was achieved in 95% of the patients. Main grade 3 toxicities were rash (12%), fatigue (11%), and nonfebrile neutropenia (11%). None of the biomarkers was predictive for response. Conclusions: The addition of panitumumab to CRT with carboplatin and paclitaxel was safe and well tolerated but could not improve pCR rate to the preset criterion of 40%.

  13. MO-F-CAMPUS-I-05: Quantitative ADC Measurement of Esophageal Cancer Before and After Chemoradiation

    Energy Technology Data Exchange (ETDEWEB)

    Yang, L [The University of Oklahoma, Tulsa, OK (United States); UT MD Anderson Cancer Center, Houston, TX (United States); Son, JB; Ma, J; Hazle, J; Carter, BW; Lin, S [UT MD Anderson Cancer Center, Houston, TX (United States); Cheng, S [The University of Oklahoma, Tulsa, OK (United States)

    2015-06-15

    Purpose: We investigated whether quantitative diffusion imaging can be used as an imaging biomarker for early prediction of treatment response of esophageal cancer. Methods: Eight patients with esophageal cancer underwent a baseline and an interim MRI studies during chemoradiation on a 3T whole body MRI scanner with an 8-channel torso phased array coil. Each MRI study contained two axial diffusion-weighted imaging (DWI) series with a conventional DWI sequence and a reduced field-of-view DWI sequence (FOCUS) of varying b-values. ADC maps with two b-values were computed from conventional DWI images using a mono-exponential model. For each of DWI sequences, separate ADCall was computed by fitting the signal intensity of images with all the b-values to a single exponential model. For the FOCUS sequence, a bi-exponential model was used to extract perfusion and diffusion coefficients (ADCperf and ADCdiff) and their contributions to the signal decay. A board-certified radiologist contoured the tumor region and mean ADC values and standard deviations of tumor and muscle ROIs were recorded from different ADC maps. Results: Our results showed that (1) the magnitude of ADCs from the same ROIs by the different analysis methods can be substantially different. (2) For a given method, the change between the baseline and interim muscle ADCs was relatively small (≤10%). In contrast, the change between the baseline and interim tumor ADCs was substantially larger, with the change in ADCdiff by FOCUS DWI showing the largest percentage change of 73.2%. (3) The range of the relative change of a specific parameter for different patients was also different. Conclusion: Presently, we do not have the final pathological confirmation of the treatment response for all the patients. However, for a few patients whose surgical specimen is available, the quantitative ADC changes have been found to be useful as a potential predictor for treatment response.

  14. Radiobiological Determination of Dose Escalation and Normal Tissue Toxicity in Definitive Chemoradiation Therapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Samantha, E-mail: Samantha.warren@oncology.ox.ac.uk [Department of Oncology, Gray Institute of Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom); Partridge, Mike [Department of Oncology, Gray Institute of Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom); Carrington, Rhys [Velindre Cancer Centre, Velindre Hospital, Cardiff (United Kingdom); Hurt, Chris [Wales Cancer Trials Unit, School of Medicine, Heath Park, Cardiff (United Kingdom); Crosby, Thomas [Velindre Cancer Centre, Velindre Hospital, Cardiff (United Kingdom); Hawkins, Maria A. [Department of Oncology, Gray Institute of Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom)

    2014-10-01

    Purpose: This study investigated the trade-off in tumor coverage and organ-at-risk sparing when applying dose escalation for concurrent chemoradiation therapy (CRT) of mid-esophageal cancer, using radiobiological modeling to estimate local control and normal tissue toxicity. Methods and Materials: Twenty-one patients with mid-esophageal cancer were selected from the SCOPE1 database (International Standard Randomised Controlled Trials number 47718479), with a mean planning target volume (PTV) of 327 cm{sup 3}. A boost volume, PTV2 (GTV + 0.5 cm margin), was created. Radiobiological modeling of tumor control probability (TCP) estimated the dose required for a clinically significant (+20%) increase in local control as 62.5 Gy/25 fractions. A RapidArc (RA) plan with a simultaneously integrated boost (SIB) to PTV2 (RA{sub 62.5}) was compared to a standard dose plan of 50 Gy/25 fractions (RA{sub 50}). Dose-volume metrics and estimates of normal tissue complication probability (NTCP) for heart and lungs were compared. Results: Clinically acceptable dose escalation was feasible for 16 of 21 patients, with significant gains (>18%) in tumor control from 38.2% (RA{sub 50}) to 56.3% (RA{sub 62.5}), and only a small increase in predicted toxicity: median heart NTCP 4.4% (RA{sub 50}) versus 5.6% (RA{sub 62.5}) P<.001 and median lung NTCP 6.5% (RA{sub 50}) versus 7.5% (RA{sub 62.5}) P<.001. Conclusions: Dose escalation to the GTV to improve local control is possible when overlap between PTV and organ-at-risk (<8% heart volume and <2.5% lung volume overlap for this study) generates only negligible increase in lung or heart toxicity. These predictions from radiobiological modeling should be tested in future clinical trials.

  15. Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Mohammadtaghi Rajabi Mashhadi

    2015-09-01

    Full Text Available Introduction: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients.   Materials and Methods: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy between September 2008 and October 2009 were randomly assigned into either enteral feeding or parenteral feeding groups, with the same calorie intake in each group. The level of serum total protein, albumin, prealbumin, transferrin, C3, C4 and hs-C-reactive protein          (hs-CRP, as well as the rate of surgical complications, restoration of bowel movements and cost was assessed in each group.   Results: Our results showed that there was no significant difference between the groups in terms of serum albumin, prealbumin or transferrin. However, C3 and C4 levels were significantly higher in the enteral feeding group compared with the parenteral group, while hs-CRP level was significantly lower in the enteral feeding group. Bowel movements were restored sooner and costs of treatment were lower in the enteral group. Postoperative complications did not differ significantly between the groups. There was one death in the parenteral group 10 days after surgery due to myocardial infarction.   Conclusion:  The results of our study showed that enteral feeding can be used effectively in the first days after surgery, with few early complications and similar nutritional outcomes compared with the parenteral method. Enteral feeding was associated with reduced inflammation and was associated with an improvement in immunological responses, quicker return of bowel movements, and reduced costs in comparison with parenteral feeding.

  16. The MicroRNAs as Prognostic Biomarkers for Survival in Esophageal Cancer: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Wenbo Fu

    2014-01-01

    Full Text Available Objectives. We performed this meta-analysis to summarize all the results from available studies, aiming delineating the prognostic role of miRNA in esophageal cancer. Design and Methods. We searched the electronic databases PubMed, EMBASE, and ISI Web of Science without time restrictions for the correlative literature to aggregate the survival results. Relevant data were extracted from studies investigating the relationship between miRNAs expression and survival in esophageal cancer patients. Pooled hazard ratios of miR-21and miR-375 for OS in ESCC were calculated. Results. A total of 25 studies involving 2,258 subjects analyzed the relationship between miRNA and prognosis of EC. In all, thirty-nine miRNAs associated with prognosis were reported in these studies. The pooled HR of higher miR-21 expression compared with lower miR-21 expression in ESCC was 1.84 (95% CI: 1.41–2.40, P<0.001, which could significantly predict poorer OS in ESCC. Besides, higher miR-375 was also a significant predictor for OS in ESCC, with a pooled HR of 0.55 (95% CI: 0.42–0.72, P<0.001. Conclusions. Our results support that miR-21 and miR-375 have a prognostic role in ESCC and may be useful therapeutic targets for the treatment of ESCC and meticulous follow-up for early detection of recurrence.

  17. Angiopoietin-1 targeted RNA interference suppresses angiogenesis and tumor growth of esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Xiao-Hong Liu; Chen-Guang Bai; Yang Yuan; De-Jun Gong; Sheng-Dong Huang

    2008-01-01

    AIM:To determine the inhibitory effect of the adenovirusbased angiopoietin-1(Ang-1) targeted small interfering RNA expression system(Ad/Ang-1si) on the expression of the Ang-1 gene,cell growth and apoptosis in human esophageal cancer cell line Eca109.METHODS:siRNA-expressing adenovirus targeting Ang-1 gene was constructed using the Ad Easy System.Cultured Eca109 cells were transfected with Ad/Ang-1si (Eca109/Ang-1si),and Ad/si was used to infect Eca109 cells as control (Eca109/si).Ang-1 gene expression and concentration was determined with RT-PCR and ELISA,respectively.Human umbilical vein endothelial cell (HUVEC)migration and proliferation were analyzed.After s.c.injection into athymic nu/nu mice,the tumor growth,vessel density and apoptosis of each group was also determined.RESULTS:HUVEC migration induced by conditioned medium from Ang-1si-transfected Eca109 cells was significantly less than that induced by conditioned medium from Eca109 cells and control adenovirustransfected Eca109 cells.Furthermore,after s.c.injection into athymic nu/nu mice,the tumor growth and cell apoptosis of Ad/Ang-1si -expressing Eca109 cells was significantly lower than that of parental or control adenovirus-transfected cells.Vessel density assessed by CD31 immunohistochemical analysis and Ang-1 expression by RT-PCR were also decreased.CONCLUSION:The targeting Ang-1 may provide a therapeutic option for esophageal cancer.

  18. A bridging stent to surgery in patients with esophageal and gastroesophageal junction cancer has a dramatic negative impact on patient survival

    DEFF Research Database (Denmark)

    Kjaer, D W; Nassar, M; Jensen, L S

    2017-01-01

    This study aimed to assess the impact of esophageal stenting on postoperative complications and survival in patients with obstructing esophageal and gastroesophageal junction (GEJ) cancer. All patients treated without neoadjuvant therapy that had an R0-resection performed for esophageal and GEJ...... cancer between January 2003 and December 2010 were identified from a prospectively maintained database. Data on stenting, postoperative mortality, morbidity, recurrence-free survival, complications, and length of hospital stay were collected. Kaplan-Meier plots for survival and recurrence-free survival...... curves were constructed for R0 resected patients. Data were compared between the stent and no-stent group by nonparametric tests. Two hundred seventy three consecutive R0 resected patients with esophageal or GEJ cancer were identified. Of these patients, 63 had a stent as a bridge to surgery. The male...

  19. Determination comparative study of esophageal cancer treatments with helical tomotherapy; Determinacion estudio comparativo de tratamientos de cancer de esofago con tomoterapia helicoidal, IMRT dinamica y 3DCRT

    Energy Technology Data Exchange (ETDEWEB)

    Pinto Monedero, M.; Sanchez Rubio, P.; Rodriguez Romero, R.

    2013-07-01

    The aim of this study was to compare the effectiveness of treatments dynamic intensity modulated radiation therapy and helical tomotherapy in cases of esophageal cancer, in terms of PTV coverage and dose reduction in OARs compared to 3D conformal radiotherapy treatments. (Author)

  20. Cancer-testis antigen expression in digestive tract carcinomas: frequent expression in esophageal squamous cell carcinoma and its precursor lesions.

    Science.gov (United States)

    Chen, Yao-Tseng; Panarelli, Nicole C; Piotti, Kathryn C; Yantiss, Rhonda K

    2014-05-01

    Cancer-testis (CT) antigens are attractive tumor antigens for cancer immunotherapy. They comprise a group of proteins normally expressed in germ cells and aberrantly activated in a variety of human cancers. The protein expression of eight cancer-testis antigens [MAGEA, NY-ESO-1, GAGE, MAGEC1 (CT7), MAGEC2 (CT10), CT45, SAGE1, and NXF2] was evaluated by immunohistochemistry in 61 esophageal carcinomas (40 adenocarcinoma and 21 squamous cell carcinoma), 50 gastric carcinomas (34 diffuse and 16 intestinal type), and 141 colorectal carcinomas. The highest frequency of expression was found in esophageal squamous cell carcinomas: Positive staining for MAGEA, CT45, CT7, SAGE1, GAGE, NXF2, NY-ESO-1, and CT10 was observed in 57%, 38%, 33%, 33%, 29%, 29%, 19%, and 14% of squamous cell carcinomas, respectively. Similar staining patterns were observed in squamous dysplasias. Expression frequencies of cancer-testis antigens were seen in 2% to 24% of gastroesophageal adenocarcinomas and were not significantly different between adenocarcinomas of the stomach versus the esophagus, or between diffuse and intestinal types of gastric adenocarcinomas. Colorectal cancers did not express NY-ESO-1, CT7, CT10, or GAGE, and only infrequently expressed SAGE1 (0.7%) MAGEA (1.4%), CT45 (3.5%), and NXF2 (8.5%). We conclude that cancer-testis antigens are frequently expressed in esophageal squamous neoplasms. Although cancer-testis antigens are generally considered to be expressed later in tumor progression, they are found in squamous dysplasias, suggesting a potential diagnostic role for cancer-testis antigens in the evaluation of premalignant squamous lesions.

  1. miRNA-mRNA crosstalk in esophageal cancer: From diagnosis to therapy.

    Science.gov (United States)

    Sharma, Priyanka; Sharma, Rinu

    2015-12-01

    The asymptomatic nature of esophageal cancer (EC) at early stages results in late clinical presentation leading to poor prognosis and limited success of therapeutic modalities. Efforts to identify diagnostic/prognostic markers have proven to be unsuccessful for translation into clinics. Hence, there is a pressing need for establishment of novel non-invasive biomarker for early diagnosis/better prognosis of EC. Recently, alteration in microRNA (miRNA) expression has emerged as an important hallmark of cancer. This review summarizes the differential expression of miRNAs in EC and addresses how their aberrant expression influences crucial biological processes such as apoptosis, cell proliferation, invasion and metastasis. Additionally, this review highlights the current status of circulating miRNA based diagnostic/prognostic markers. An effort has been made to find a connection between different miRNAs involved in EC and a detailed analysis has been done to screen out micoRNAs involved in prognosis and multidrug resistance. Further, investigation of these miRNAs would not only provide a gene therapy based strategy to prevent/treat cancer but also to reverse multidrug resistance leading to decreased requirement of harmful chemotherapeutic drugs.

  2. Serum matrix metalloproteinase 2 and tissue inhibitor of matrix metalloproteinases 2 in esophageal cancer patients.

    Science.gov (United States)

    Groblewska, Magdalena; Mroczko, Barbara; Kozlowski, Miroslaw; Niklinski, Jacek; Laudanski, Jerzy; Szmitkowski, Maciej

    2012-01-01

    The positive expression of MMP-2 and TIMP-2 were found in esophageal cancer (EC) tissue and correlated with cancer stage and clinico-pathological features of tumor and patients' survival. However, little is known about serum levels of those proteins in EC patients. The aim of the present study was to investigate the diagnostic significance of MMP-2 and TIMP-2 serum levels in EC patients in relation to clinico-pathological features of cancer. The study included 53 EC patients and 92 healthy controls. The serum levels of MMP-2, TIMP-2 and classical tumor markers CEA (carcinoembryonic antigen) and SCC (squamous cell carcinoma antigen) were assayed. The prognostic values and diagnostic criteria for the biomarkers tested were defined. Serum levels of MMP-2, TIMP-2 in EC patients were significantly lower, whereas CEA and SCC significantly higher than in control group. The diagnostic sensitivity of TIMP-2 (57%) was higher than those for other biomarkers tested and increased in combination with SCC (70%). Area under ROC curve for TIMP-2 (0.8698) was larger than for other proteins. In Cox's univariate analysis only SCC serum levels were significant prognostic factors for EC patients' survival. The results suggest the limited value of serum analyses of MMP-2 for tumor staging and prognosis in EC and the better usefulness of TIMP-2 than MMP-2 as a tumor marker in the diagnosis of EC, especially in combined use with SCC.

  3. Kimura's disease accompanied by mediastinal lymphadenopathy misdiagnosed as lung cancer: Case report and review of literatures

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    Xi SUN

    2012-06-01

    Full Text Available Objective  To further investigate the diagnostic pitfalls of Kimura's disease(KD. Methods  We report one case of Kimura's disease accompanied with mediastinal lymphadenopathy admitted to General Hospital of Chinese PLA in the year 2010. After searching on PubMed and Chinese Medical Journal Searching Engines(Wanfang data base,Cqvip data base,we have found literatures reporting another 3 cases of Kimura's disease with mediastinal lymphadenopathy. Plus the one we presented, all four patients' clinical data were collected and analyzed thereafter. Up-to-date advancement on KD's diagnosis and therapy would also be reviewed. Results  Our case, a 61-year-old male, was initially misdiagnosed as lung cancer with mediastinal metastasis in 2008, but histopathology had confirmed only eosinophil infiltration in enlarged mediasinal lymph nodes, no malignant cells were identified. In the year 2010, he complained bilateral orbital masses, one of which was surgically removed, and was later confirmed as Kimura's disease by histopathology. Clinical features of 4 patients, including our case and the other 3 retrieved in literatures, were available, 2 of whom were misdiagnosed as lung cancer while the other 2 as lymphoma in the beginning. All the 4 patients were responsive to steroid therapy. Conclusions  Kimura's disease could be associated with mediastinal lymphadenopathy which may confuse the physicians in diagnosing. Newly developed minimal invasive approaches such as endoscopic ultrasound-guided fine needle aspiration (EUS-FNA and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA are helpful for the differential diagnosis.

  4. The chest tube inserted into the stomach after a transthoracic operation for esophageal cancer:case report

    Institute of Scientific and Technical Information of China (English)

    HAN Wei-li; ZHA Yu-xin; LI Ren-yuan; NI Yi-ming; LUO Wen-zong

    2007-01-01

    @@ Surgical complications after the transthoracic operation for esophageal cancer mainly include anastomatic fistula, thoraco-stomach fistula, stenosis of anastomosis,gastric perforation, gastric volvulus, diaphragmatic hernia,wound infection, and some other pulmonary complications. Unfortunately, there are few reports about the complications caused by position change of the chest tube until now. We presented an unusual case of a patient who underwent a transthoracic operation for esophageal cancer in our department on August 17, 2006, and a lot of intragastric material was found in his chest tube 17 days later, endoscopic examination suggested that the chest tube had inserted into the stomach. We tried to discuss the etiology and clinical management for this case as well.

  5. Silencing of CXCR2 and CXCR7 protects against esophageal cancer

    Science.gov (United States)

    Wu, Kai; Cui, Lingling; Yang, Yang; Zhao, Jia; Zhu, Dengyan; Liu, Donglei; Zhang, Chunyang; Qi, Yu; Li, Xiangnan; Li, Weihao; Zhao, Song

    2016-01-01

    This study was aimed to investigate the functional roles of cytokine receptor (CXCR) CXCR2 and CXCR7 in esophageal cancer (EC). Specific small interfering RNAs (siRNA) against CXCR2 and CXCR7 were transfected into EC cell lines TE-1, EC9706, and EC109 cells. Expression of CXCR2 and CXCR7 was validated, along with cell viability, chemotaxis, apoptosis rate, and ERK1/2 pathways associated protein after transfection. Moreover, EC9706 cells treated with or without CXCR2/7 siRNA were injected into athymic nude mice. Tumor volumes were measured. Besides, immunohistochemical (IHC) staining was performed to investigate the expression of CXCR2/7 in adjacent normal tissues and tumor tissues from esophageal squamous cell carcinoma (ESCC) patients. Also, the associations between CXCR2/7 expression and clinicopathological features and progression were explored. The mRNA levels of CXCR2 and CXCR7 were significantly reduced after transfection. Silencing of CXCR2 and CXCR7 statistically decreased cell viability and chemotaxis, and increased apoptotic rate. Cells invasion was significantly reduced by silencing of CXCR2, however, no significance was found in silencing of CXCR7. The protein levels of pERK1/2 were significantly decreased by silencing of CXCR2 and CXCR7. Besides, silencing of CXCR2 and CXCR7 significantly reduced tumor growth in vivo, and associated with clinicopathological features and progression. Silencing of CXCR2 and CXCR7 protects against EC by inhibiting cell growth and chemotaxis, and inducing apoptosis though ERK1/2 pathways. Silencing of CXCR2 and CXCR7 has potentially therapeutic target for EC. PMID:27648130

  6. Effect of pre-operative neoadjuvant chemo-radiotherapy and surgical treatment on resectable esophageal cancer: a Meta-analysis

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    Wei ZHU

    2011-08-01

    Full Text Available Objective To explore the effect of pre-operative adjuvant chemo-radiotherapy and surgical treatment on resectable esophageal cancer.Methods By searching Medline,CENTRAL(the Cochrane Central Register of Controlled trials,EMBASE,CBM(China Biology Medicine and CNKI(China National Knowledge Infrastructure by computer,the data of randomized controlled trials(RCTs of neoadjuvant chemoradiotherapy and surgical treatment for resectable esophageal cancer were selected and analyzed using Stata 11.0 statistical software.The study population was patients with resectable early or medium stage esophageal cancer,the intervention was neoadjuvant chemoradiotherapy(include sequential chemoradiotherapy and concurrent chemoradiotherapy followed with surgical resection,the outcome indices were 1-and 3-year survival rates and local recurrence rate.The combined odds ratio(OR,relative risk(RR and their 95% confidence interval(CI were calculated to estimate the results.Results Nine articles including a total of 1156 patients were finally analyzed in the Meta-analysis.Among all the patients,579 received neoadjuvant chemoradiotherapy(study group and 577 received surgical treatment only(control group.Compared the study group and control group,the OR of 1-and 3-year survival rate was 1.06(95%CI=0.94-1.19,Z=0.97,P=0.33 and 1.30(95%CI=1.07.-1.57,Z=2.67,P=0.008,respectively,and the RR of local recurrence rate was 0.75(95%CI=0.50-1.12,Z=1.40,P=0.162.Conclusions Neoadjuvant chemoradiotherapy could improve the 3-year survival rate of patients with resectable esophageal cancer,but could not decrease the local recurrence rate.

  7. 食管癌药物治疗的研究进展%Progress in medication treatment of esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    李向柯; 樊青霞

    2012-01-01

    食管癌是我国常见的恶性肿瘤之一,临床应用手术、化疗及放疗等相结合的综合治疗模式治疗食管癌已成为共识,尽管还没有标准的治疗方案,但术前行新辅助放化疗,再手术(三联治疗),其中术后切缘阳性、淋巴结转移等高危因素者,积极行术后辅助治疗,不能手术者可行根治性放化疗,已成为NCCN指南推荐的综合治疗模式.近年来,临床试验研究证实靶向药物能进一步改善食管癌的预后.如何选择化疗药物、制定合理的治疗模式成为临床研究的热点,本文就食管癌药物治疗的临床研究进展作一综述.%Esophageal cancer is one of the common malignant tumors. Multimodality treatment (including surgery, chemotherapy and radiotherapy) of esophageal cancer has become a consensus. Although there is currently no standard treatment, neoadjuvant chemoradiotherapy followed by surgery and postoperative adjuvant radiotherapy or chemotherapy based on risk factors, such as positive surgical margin and lymph node metastasis, and definitive chemoradiotherapy when inoperable, has been recommended by the NCCN Guidelines. In recent years, clinical trials show that targeted drugs can further improve the prognosis of esophageal cancer. How to choose chemotherapy drugs and develop reasonable treatment modality has become a hotspot of clinical research. This article aims to review recent progress in medication treatment of esophageal cancer.

  8. An EGFR/HER2-Bispecific and enediyne-energized fusion protein shows high efficacy against esophageal cancer.

    Directory of Open Access Journals (Sweden)

    Xiao-Fang Guo

    Full Text Available Esophageal cancer is one of the most common cancers, and the 5-year survival rate is less than 10% due to lack of effective therapeutic agents. This study was to evaluate antitumor activity of Ec-LDP-Hr-AE, a recently developed bispecific enediyne-energized fusion protein targeting both epidermal growth factor receptor (EGFR and epidermal growth factor receptor 2 (HER2, on esophageal cancer. The fusion protein Ec-LDP-Hr-AE consists of two oligopeptide ligands and an enediyne antibiotic lidamycin (LDM for receptor binding and cell killing, respectively. The current study demonstrated that Ec-LDP-Hr had high affinity to bind to esophageal squamous cell carcinoma (ESCC cells, and enediyne-energized fusion protein Ec-LDP-Hr-AE showed potent cytotoxicity to ESCC cells with differential expression of EGFR and HER2. Ec-LDP-Hr-AE could cause significant G2-M arrest in EC9706 and KYSE150 cells, and it also induced apoptosis in ESCC cells in a dosage-dependent manner. Western blot assays showed that Ec-LDP-Hr-AE promoted caspase-3 and caspase-7 activities as well as PARP cleavage. Moreover, Ec-LDP-Hr-AE inhibited cell proliferation via decreasing phosphorylation of EGFR and HER2, and further exerted inhibition of the activation of their downstream signaling molecules. In vivo, at a tolerated dose, Ec-LDP-Hr-AE inhibited tumor growth by 88% when it was administered to nude mice bearing human ESCC cell KYSE150 xenografts. These results indicated that Ec-LDP-Hr-AE exhibited potent anti-caner efficacy on ESCC, suggesting it could be a promising candidate for targeted therapy of esophageal cancer.

  9. Transketolase Serves a Poor Prognosticator in Esophageal Cancer by Promoting Cell Invasion via Epithelial-Mesenchymal Transition

    Science.gov (United States)

    Chao, Yin-Kai; Peng, Ta-Lun; Chuang, Wen-Yu; Yeh, Chi-Ju; Li, Yan-Liang; Lu, Ya-Ching; Cheng, Ann-Joy

    2016-01-01

    Background: To characterize the potential function and clinical significance of Transketolase (TKT) in esophageal cancer. Methods: High invasive esophageal squamous cell carcinoma (ESCC) cell line CE48T/VGH was used. Cellular functions in response to TKT modulation were examined, including cell growth, migration and invasion. The underlying molecules involved in the TKT regulatory mechanism were determined by western blot and confocal microscopic analysis. Clinically, TKT expressions in 76 ESCC patients were assessed by immunohistochemical (IHC) method, and the association with treatment outcome was determined. Results: TKT silencing inhibited cell migration and invasion but had a minimal effect on cell growth. This TKT silencing also induced the reversion of epithelial-mesenchymal transition (EMT), as evidenced by the spindle to cuboidal morphological change, increased the expression of epithelial markers (γ-catenin), and decreased the levels of mesenchymal markers (fibronectin and N-cadherin). Mechanically, TKT was shown to modulate the EMT through the pERK-Slug/Snail-associated signaling pathway. Clinically, a high level of TKT in the cancer tissues of patients with esophageal squamous cell carcinoma was associated with poor survival (P = 0.042). In the multivariate analysis, a high TKT level was also shown to be an independent unfavorable prognostic factor (Odds ratio: 1.827, 95% confidence interval: 1.045-3.196, P = 0.035). Conclusions: TKT contributes to esophageal cancer by promoting cell invasion via meditating EMT process. Clinically, the over-expression of TKT in ESCC patients predicts poorer survival. TKT inhibition may be a useful strategy to intervene in cancer cell invasion and metastasis, which may lead to better prognosis for ESCC patients. PMID:27698919

  10. Managing esophageal fistulae by endoscopic transluminal drainage in esophageal cancer patients with superior mediastinal sepsis after esophagectomy

    Institute of Scientific and Technical Information of China (English)

    Yu-Zhen Zheng; Shu-Qin Dai; Hong-Bo Shan; Xiao-Yan Gao; Lan-Jun Zhang; Xun Cao; Jian-Fei Zhu

    2013-01-01

    The management of postoperative leaks into the mediastinum after esophagectomy remains a challenge.We describe our clinical management of this complication through endoscopic transluminal drainage.Between 2008 and 2011,4 patients with esophageal squamous cell carcinoma (ESCC) who underwent McKeown-type esophagectomy with two-field lymphadenectomy experienced complicated anastomotic fistulae in the presence of superior mediastinal sepsis.All 4 patients underwent endoscopic transluminal drainage,and all survived.The mean healing period was 50 days (range,31 to 58 days),the mean stay in the intensive care unit was 7.3 days (range,1 to 18 days),and the mean hospital stay was 64.5 days (range,49 to 70 days).Endoscopically guided transluminal drainage should be considered for ESCC patients with superior mediastinal fistulae after esophagectomy.

  11. The MUC4 membrane-bound mucin regulates esophageal cancer cell proliferation and migration properties: Implication for S100A4 protein

    Energy Technology Data Exchange (ETDEWEB)

    Bruyere, Emilie; Jonckheere, Nicolas; Frenois, Frederic [Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 ' Mucins, Epithelial Differentiation and Carcinogenesis' , rue Polonovski, 59045 Lille Cedex (France); Universite Lille-Nord de France, 1 place de Verdun, 59045 Lille Cedex (France); Mariette, Christophe [Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 ' Mucins, Epithelial Differentiation and Carcinogenesis' , rue Polonovski, 59045 Lille Cedex (France); Universite Lille-Nord de France, 1 place de Verdun, 59045 Lille Cedex (France); Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, 1 place de Verdun, 59045 Lille Cedex (France); Van Seuningen, Isabelle, E-mail: isabelle.vanseuningen@inserm.fr [Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 ' Mucins, Epithelial Differentiation and Carcinogenesis' , rue Polonovski, 59045 Lille Cedex (France); Universite Lille-Nord de France, 1 place de Verdun, 59045 Lille Cedex (France)

    2011-09-23

    Highlights: {yields} Loss of MUC4 reduces proliferation of esophageal cancer cells. {yields} MUC4 inhibition impairs migration of esophageal cancer cells but not their invasion. {yields} Loss of MUC4 significantly reduces in vivo tumor growth. {yields} Decrease of S100A4 induced by MUC4 inhibition impairs proliferation and migration. -- Abstract: MUC4 is a membrane-bound mucin known to participate in tumor progression. It has been shown that MUC4 pattern of expression is modified during esophageal carcinogenesis, with a progressive increase from metaplastic lesions to adenocarcinoma. The principal cause of development of esophageal adenocarcinoma is the gastro-esophageal reflux, and MUC4 was previously shown to be upregulated by several bile acids present in reflux. In this report, our aim was thus to determine whether MUC4 plays a role in biological properties of human esophageal cancer cells. For that stable MUC4-deficient cancer cell lines (shMUC4 cells) were established using a shRNA approach. In vitro (proliferation, migration and invasion) and in vivo (tumor growth following subcutaneous xenografts in SCID mice) biological properties of shMUC4 cells were analyzed. Our results show that shMUC4 cells were less proliferative, had decreased migration properties and did not express S100A4 protein when compared with MUC4 expressing cells. Absence of MUC4 did not impair shMUC4 invasiveness. Subcutaneous xenografts showed a significant decrease in tumor size when cells did not express MUC4. Altogether, these data indicate that MUC4 plays a key role in proliferative and migrating properties of esophageal cancer cells as well as is a tumor growth promoter. MUC4 mucin appears thus as a good therapeutic target to slow-down esophageal tumor progression.

  12. SU-E-T-07: 4DCT Robust Optimization for Esophageal Cancer Using Intensity Modulated Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Liao, L [Proton Therapy Center, UT MD Anderson Cancer Center, Houston, TX (United States); Department of Industrial Engineering, University of Houston, Houston, TX (United States); Yu, J; Zhu, X; Li, H; Zhang, X [Proton Therapy Center, UT MD Anderson Cancer Center, Houston, TX (United States); Li, Y [Proton Therapy Center, UT MD Anderson Cancer Center, Houston, TX (United States); Varian Medical Systems, Houston, TX (United States); Lim, G [Department of Industrial Engineering, University of Houston, Houston, TX (United States)

    2015-06-15

    Purpose: To develop a 4DCT robust optimization method to reduce the dosimetric impact from respiratory motion in intensity modulated proton therapy (IMPT) for esophageal cancer. Methods: Four esophageal cancer patients were selected for this study. The different phases of CT from a set of 4DCT were incorporated into the worst-case dose distribution robust optimization algorithm. 4DCT robust treatment plans were designed and compared with the conventional non-robust plans. Result doses were calculated on the average and maximum inhale/exhale phases of 4DCT. Dose volume histogram (DVH) band graphic and ΔD95%, ΔD98%, ΔD5%, ΔD2% of CTV between different phases were used to evaluate the robustness of the plans. Results: Compare to the IMPT plans optimized using conventional methods, the 4DCT robust IMPT plans can achieve the same quality in nominal cases, while yield a better robustness to breathing motion. The mean ΔD95%, ΔD98%, ΔD5% and ΔD2% of CTV are 6%, 3.2%, 0.9% and 1% for the robustly optimized plans vs. 16.2%, 11.8%, 1.6% and 3.3% from the conventional non-robust plans. Conclusion: A 4DCT robust optimization method was proposed for esophageal cancer using IMPT. We demonstrate that the 4DCT robust optimization can mitigate the dose deviation caused by the diaphragm motion.

  13. Effects of stathmin 1 silencing by siRNA on sensitivity of esophageal cancer cells Eca-109 to paclitaxel.

    Science.gov (United States)

    Zhu, H W; Jiang, D; Xie, Z Y; Zhou, M H; Sun, D Y; Zhao, Y G

    2015-12-29

    We investigated the effects of stathmin 1 (STMN1) silencing by small interfering (siRNA) on the sensitivity of esophageal cancer cells Eca-109 to paclitaxel. STMN1 siRNA was transiently transfected into Eca-109 cells. The effects of transfection were detected by quantitative polymerase chain reaction and western blotting. The effects of STMN1 silencing by siRNA on the sensitivity of esophageal cancer cells Eca-109 to paclitaxel was tested by MTT and colony formation assays. Hoechst 33258 nuclear staining was used to investigate the differences in Eca-109 cell apoptosis induced by paclitaxel. STMN1 siRNA was successfully transfected and the expression of STMN1 was inhibited. The sensitivity of STMN1 siRNA-transfected Eca-109 cells to paclitaxel was significantly increased (P < 0.01). The apoptosis of Eca-109 cells significantly increased following treatment with paclitaxel (P < 0.01). STMN1 silencing by siRNA may enhance the sensitivity of esophageal cancer cells Eca-109 to paclitaxel and induce apoptosis.

  14. Influence of different operation methods for the pain stress and digestive function of patients with esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Long Zhao

    2016-01-01

    Objective:To observe and compare the influence state of different operation methods for the pain stress and digestive function of patients with esophageal cancer. Methods:A total of 56 patients with esophageal cancer treated with surgery in our hospital from January 2013 to August 2015 were selected as the research object. According to the differences of operation methods, 56 cases were divided into Group A (thoracotomy group) 28 cases and Group B (thoracic surgery group) 28 cases, then the serum levels of pain stress and gastrointestinal hormones, stomach digestive function indexes of two groups at the 1st day before the surgery and at the 1st, 3rd and 7th day after the surgery were compared. Results:The serum levels of pain stress and gastrointestinal hormones, stomach digestive function indexes of two groups at the 1st day before the surgery were compared. Those statistical indexes of Group B at the 1st, 3rd and 7th day after the surgery were all obviously better than those of Group A, and there are significant differences. Conclusion:The influence of thoracoscopic surgery for the pain stress and digestive function of patients with esophageal cancer are obviously better than those of thoracic surgery, and it has better control effect for the postoperative discomfort and digestive function of patients.

  15. Gefitinib, an epidermal growth factor receptor blockade agent, shows additional or synergistic effects on the radiosensitivity of esophageal cancer cells in vitro.

    Directory of Open Access Journals (Sweden)

    Taira,Naruto

    2006-02-01

    Full Text Available

    Human esophageal cancers have been shown to express high levels of epidermal growth factor receptor (EGFR and a relationship between high EGFR expression and local advance, the number of lymph node metastases, life expectancy, and sensitivity to chemo-radiotherapy has been demonstrated. We examined the use of gefitinib, an orally active EGFR-selective tyrosine kinase inhibitor, as a new strategy for treatment of esophageal carcinoma. The effects of gefitinib were evaluated in monotherapy and in combination with radiotherapy in human esophageal carcinoma cell lines. Gefitinib produced a dose-dependent inhibition of cellular proliferation in all of the 8 esophageal carcinoma cell lines examined, with IC50 values ranging from 5.7 microM to 36.9 microM. In combination, gefitinib and radiotherapy showed a synergistic effect in 2 human esophageal carcinoma cell lines and an additive effect in 5 cell lines. Western blotting demonstrated that gefitinib blocked activation of the EGFR-extracellular signal-regulated kinase (Erk pathway and the EGFR-phosphoinositide-3 kinase (PI3K-Akt pathway after irradiation. These results suggest that further evaluation of EGFR blockade as a treatment for esophageal cancer should be performed, and that radiotherapy combined with EGFR blockade may enhance the response of esophageal carcinoma to therapy.

  16. Involvement of serum retinoids and Leiden mutation in patients with esophageal, gastric, liver, pancreatic, and colorectal cancers in Hungary

    Institute of Scientific and Technical Information of China (English)

    Gyula Mózsik; Zoltán Matus; Béla Melegh; Gy(o)rgy Rumi; András D(o)m(o)t(o)r; Mária Figler; Beáta Gasztonyi; El(o)d Papp; Alajos Pár; Gabriella Pár; József Belágyi

    2005-01-01

    AIM: To analyze the serum levels of retinoids and Leiden mutation in patients with esophageal, gastric, liver,pancreatic, and colorectal cancers.METHODS: The changes in serum levels of retinoids (vitamin A, α- and β-carotene, α- and β-cryptoxanthin,zeaxanthin, lutein) and Leiden mutation were measured by high liquid performance chromatography (HPLC)and polymerase chain reaction (PCR) in 107 patients (70 males/37 females) with esophageal (0/8), gastric (16/5), liver (8/7), pancreatic (6/4), and colorectal (30/21including 9 patients suffering from in situ colon cancer)cancer. Fifty-seven healthy subjects (in matched groups)for controls of serum retinoids and 600 healthy blood donors for Leiden mutation were used.RESULTS: The serum levels of vitamin A and zeaxanthin were decreased significantly in all groups of patients with gastrointestinal (GI) tumors except for vitamin A in patients with pancreatic cancer. No changes were obtained in the serum levels of α- and β-carotene,α- and β-cryptoxanthin, zeaxanthin, lutein in patients with GI cancer. The prevalence of Leiden mutation significantly increased in all groups of patients with GI cancer.CONCLUSION: Retinoids (as environmental factors)are decreased significantly with increased prevalence of Leiden mutation (as a genetic factor) in patients before the clinical manifestation of histologically different (planocellular and hepatocellular carcinoma, and adenocarcinoma) GI cancer.

  17. The long-term spatial-temporal trends and burden of esophageal cancer in one high-risk area: A population-registered study in Feicheng, China

    Science.gov (United States)

    Sun, Xiubin; Zhao, Deli; Liu, Yi; Liu, Yunxia; Yuan, Zhongshang; Wang, Jialin; Xue, Fuzhong

    2017-01-01

    Background Feicheng County is a high-risk area for esophageal cancer in Shandong province, China. It is important to determine the long-term spatio-temporal trends in epidemiological characteristics and the burden of esophageal cancer, especially since the implementation of the national esophageal cancer screening program for early detection and treatment in 2005. Methods The data collected in Feicheng County from 2001 to 2012 was extracted from the whole-population cancer registry system. The incidence, mortality, disability-adjusted life years (DALY) and changing trends in esophageal cancer according to age and sex were calculated and described. Results The incidence rate of esophageal cancer in Feicheng was consistently high, and increased significantly for male, but not for female from 2001 to 2012, according to the joinpoint regression analysis. The highest and lowest yearly crude incidence rates were 160.78 and 95.97 per 100000 for males, and 81.36 and 52.17 per 100000 for females. The highest and lowest crude yearly mortality rates were 122.26 and 94.40 per 100000 for males, and 60.75 and 49.35 per 100000for females. Esophageal squamous cell carcinoma was the main pathology type and the tumor location changed significantly from 2001 to 2012. Overall, the DALY remained roughly stable and was estimated as 11.50 for males and 4.90 for females per 1000 people. The burden was mainly caused by premature death. There is an obvious spatial pattern in the distribution of incidence density and burden. Conclusion Esophageal cancer remains a public health issue in Feicheng County with a high incidence, mortality and disease burden. The incidence and burden have obvious spatial heterogeneity, and further studies should be conducted to identify geographical risk factors for precise local prevention and control measures. PMID:28267769

  18. Relationships between esophageal cancer and spatial environment factors by using Geographic Information System.

    Science.gov (United States)

    Wu, Ku-Sheng; Huo, Xia; Zhu, Guang-Hui

    2008-04-15

    To explore the relationships between esophageal cancer (EC) and climatic, geographic factors in China by using Geographic Information System, database of EC mortality of 237 sampling areas surveyed in 1990-1992 was established in Excel and linked with the digital polygon maps of study areas. Geographic and climate data of sampling areas were extracted from the raster dataset and finished in Arc/Info 9.0 and ENVI4.2 software by using spatial analysis. Spearman correlation analysis and multiple regression analysis after principal component analysis (PCA) were performed to analyze the relationship between EC and these factors. The counties that have the highest EC morality show significant aggregation. Spearman correlation analysis shows weak negative correlation between precipitation, water-heat index (WHI), highest/lowest temperature and EC mortality, and weak positive correlation between drought index (DI), wind speed, population density and EC mortality. Multiple linear regression analysis indicated that the variables associated with EC mortality were precipitation, temperature, wind speed, elevation, DI, WHI and normalized difference vegetation index (NDVI) of July. Our study suggested that the high-risk areas of EC in China are mostly drought and low altitude areas relatively. There were relatively lower NDVI in summer and higher wind speed in these areas. GIS can be applied to cancer epidemiology study and will exert active effect, which should be further explored.

  19. Drinking water: a risk factor for high incidence of esophageal cancer in Anyang, China.

    Science.gov (United States)

    Cao, Wenbo; Han, Jianying; Yuan, Yi; Xu, Zhixiang; Yang, Shengli; He, Weixin

    2016-06-01

    Anyang is known to be a high-incidence area of esophageal cancer (EC) in China. Among a long list of risk factors, the quality of drinking water was evaluated. We have selected 3806 individuals and collected 550 drinking water samples correspondent with this not-matched case-control survey. There are 531 EC patients included based on Population Cancer Registry from 92 townships, of which 3275 controls with long-lived aged over 90 years and free from EC are used as controls in the same regions. Our result suggests that the quality of drinking water is a highly associated risk factor for EC. The residential ecological environment and the quality of water resource positively link with each other. The analysis of water samples also demonstrated that the concentrations of methyl ethylamine, morpholine, N-methylbenzylamine, nitrate and chloride in water from springs and rivers are higher than those in well and tap water (P = 0.001). Micronuclei formation tests show that well water and tap water in these regions have no mutagenicity.

  20. EPIDEMIC STRENGTH OF CARDIA AND DISTANT STOMACH CANCER IN THE HIGH RISK REGION OF ESOPHAGEAL CANCER AND THEIR IMPLICATION TO EDOSCOPIC SCREENING

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li-wei; Yong-wei; MA Cai-fen; SHAN Bao-en; WANG Shi-jie; WEN Deng-gui; LI Ying-sai; YU Wei-fang; WANG Shun-ping; ER Li-mian; CONG Qing-wen; WANG Jun-he; LI Su-ping

    2006-01-01

    Objective: To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region. Methods: Comparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old. Results: The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70~80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach. Conclusion: The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important.

  1. Vascular endothelial growth factor C (VEGF-C in esophageal cancer correlates with lymph node metastasis and poor patient prognosis

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    Naganawa Yasuhiro

    2010-06-01

    Full Text Available Abstract Background The diagnosis of lymph node metastasis in esophageal cancer by the presence and number of metastatic lymph nodes is an extremely important prognostic factor. In addition, the indication of non-surgical therapy is gaining more attention. Vascular endothelial growth factor C (VEGF-C is potentially lymphangiogenic and selectively induces hyperplasia of the lymphatic vasculature. In this study, we investigated the expression of VEGF-C and whether it correlated with various clinico-pathologic findings. Methods KYSE series of esophageal cancer cell lines and 106 patients with primary esophageal squamous cell carcinomas who had undergone radical esophagectomy were analyzed. VEGF-C mRNA expression was determined by quantitative RT-PCR. Results High expression of VEGF-C was detected in most of the KYSE cell lines, especially KYSE410, yet, in an esophageal normal epithelium cell line, Het-1A, VEGF-C was not detected. In the clinical specimen, the expression of VEGF-C in the cancerous tissue was higher than in the corresponding noncancerous esophageal mucosa (p = 0.026. The expression of VEGF-C was found to be higher in Stage2B-4A tumors than in Stage0-2A tumors (p = 0.049. When the patients were divided into two groups according to their expression levels of VEGF-C (a group of 53 cases with high expression and a group of 53 cases with low expression, the patients with high VEGF-C expression had significantly shorter survival after surgery than the patients with low expression (p = 0.0065. Although univariate analysis showed that high expression of VEGF-C was a statistically significant prognostic factor, this was not shown in multivariate analysis. In the subgroup of patients with Tis and T1 tumors, the expression of VEGF-C was higher in N1 tumors than in N0 tumors (p = 0.029. The survival rate of patients from the high expression group (n = 10 was lower than that in the low expression group (n = 11, and all the patients in the low

  2. Impact of 18-fluorodeoxyglucose positron emission tomography on computed tomography defined target volumes in radiation treatment planning of esophageal cancer: reduction in geographic misses with equal inter-observer variability: PET/CT improves esophageal target definition.

    Science.gov (United States)

    Schreurs, L M A; Busz, D M; Paardekooper, G M R M; Beukema, J C; Jager, P L; Van der Jagt, E J; van Dam, G M; Groen, H; Plukker, J Th M; Langendijk, J A

    2010-08-01

    Target volume definition in modern radiotherapy is based on planning computed tomography (CT). So far, 18-fluorodeoxyglucose positron emission tomography (FDG-PET) has not been included in planning modality in volume definition of esophageal cancer. This study evaluates fusion of FDG-PET and CT in patients with esophageal cancer in terms of geographic misses and inter-observer variability in volume definition. In 28 esophageal cancer patients, gross, clinical and planning tumor volumes (GTV; CTV; PTV) were defined on planning CT by three radiation oncologists. After software-based emission tomography and computed tomography (PET/CT) fusion, tumor delineations were redefined by the same radiation-oncologists. Concordance indexes (CCI's) for CT and PET/CT based GTV, CTV and PTV were calculated for each pair of observers. Incorporation of PET/CT modified tumor delineation in 17/28 subjects (61%) in cranial and/or caudal direction. Mean concordance indexes for CT-based CTV and PTV were 72 (55-86)% and 77 (61-88)%, respectively, vs. 72 (47-99)% and 76 (54-87)% for PET/CT-based CTV and PTV. Paired analyses showed no significant difference in CCI between CT and PET/CT. Combining FDG-PET and CT may improve target volume definition with less geographic misses, but without significant effects on inter-observer variability in esophageal cancer.

  3. Methylation in esophageal carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    Da-Long Wu; Feng-Ying Sui; Xiao-Ming Jiang; Xiao-Hong Jiang

    2006-01-01

    Genetic abnormalities of proto-oncogenes and tumor suppressor genes have been demonstrated to be changes that are frequently involved in esophageal cancer pathogenesis. However, hypermethylation of CpG islands, an epigenetic event, is coming more and more into focus in carcinogenesis of the esophagus. Recent studies have proved that promoter hypermethylation of tumor suppressor genes is frequently observed in esophageal carcinomas and seems to play an important role in the pathogenesis of this tumor type. In this review, we will discuss current research on genes that are hypermethylated in human esophageal cancer and precancerous lesions of the esophagus. We will also discuss the potential use of hypermethylated genes as targets for detection, prognosis and treatment of esophageal cancer.

  4. Phase I Trial of Escalating-dose Cisplatin with 5-fluorouracil and Concurrent Radiotherapy in Chinese Patients with Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Zhao,Yan-Nan

    2008-02-01

    Full Text Available We defined the maximum-tolerated dose (MTD of chemoradiotherapy (cisplatin (CDDP with 5-fluorouracil (5-FU and concurrent chemoradiotherapy for Chinese patients with esophageal cancer. Twenty-one previously untreated patients with primary esophageal cancer were entered into this study. Escalating doses of CDDP with 5-FU were administered in a modified Fibonacci sequence, with concurrent conventional fractionation radiotherapy (CFR of 60 Gy or 50 Gy. The starting doses were CDDP 37.5 mg/m2 on day 1, and 5-FU 500 mg/m2 on days 1-5, respectively. The regimen was repeated 4 times every 28 days. If no dose-limiting toxicity (DLT was observed, the next dose level was applied. The procedures were repeated until DLT appeared. The MTD was declared to be 1 dose level below the level at which DLT appeared. DLT was grade 3 radiation-induced esophagitis at a dose level of CDDP 60 mg/m2 with 5-FU 700 mg/m2 and concurrent 60 Gy CFR. MTD was defined as CDDP 52.5 mg/m2 with 5-FU 700 mg/m2 and concurrent 50 Gy CFR. The MTD of CDDP with 5-FU and in concurrent chemoradiotherapy for Chinese patients with esophageal cancer is CDDP 52.5 mg/m2 on day 1 and 5FU 700 mg/m2 on days 1-5, repeated 4 times every 28 days, and concurrent 50 Gy CFR. Further evaluation of this regimen in a prospective phase II trial is ongoing.

  5. 18F-FDG PET-CT after Neoadjuvant Chemoradiotherapy in Esophageal Cancer Patients to Optimize Surgical Decision Making.

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    Maarten C J Anderegg

    Full Text Available Prognosis of esophageal cancer patients can be significantly improved by neoadjuvant chemoradiotherapy (nCRT. Given the aggressive nature of esophageal tumors, it is conceivable that in a significant portion of patients treated with nCRT, dissemination already becomes manifest during the period of nCRT. The aim of this retrospective study was to determine the value and diagnostic accuracy of PET-CT after neoadjuvant chemoradiotherapy to identify patients with metastases preoperatively in order to prevent non-curative surgery.From January 2011 until February 2013 esophageal cancer patients deemed eligible for a curative approach with nCRT and surgical resection underwent a PET-CT after completion of nCRT. If abnormalities on PET-CT were suspected metastases, histological proof was acquired. A clinical decision model was designed to assess the cost-effectiveness of this diagnostic strategy.156 patients underwent a PET-CT after nCRT. In 31 patients (19.9% PET-CT showed abnormalities suspicious for dissemination, resulting in 17 cases of proven metastases (10.9%. Of the patients without proven metastases 133 patients were operated. In 6 of these 133 cases distant metastases were detected intraoperatively, corresponding to 4.5% false-negative results. The standard introduction of a post-neoadjuvant therapy PET-CT led to a reduction of overall health care costs per patient compared to a scenario without restaging with PET-CT ($34,088 vs. $36,490.In 10.9% of esophageal cancer patients distant metastases were detected by standard PET-CT after neoadjuvant chemoradiotherapy. To avoid non-curative resections we advocate post-neoadjuvant therapy PET-CT as a cost-effective step in the standard work-up of candidates for surgery.

  6. Phase I study of photodynamic therapy using talaporfin sodium and diode laser for local failure after chemoradiotherapy for esophageal cancer

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    Yano Tomonori

    2012-07-01

    Full Text Available Abstract Background Photodynamic therapy (PDT is a less invasive and effective salvage treatment for local failure after chemoradiotherapy (CRT for esophageal cancer, however it causes a high rate of skin phototoxicity and requires a long sun shade period. Talaporfin sodium is a rapidly cleared photosensitizer that is expected to have less phototoxicity. This study was undertaken to clarify the optimum laser fluence rate of PDT using talaporfin sodium and a diode laser for patients with local failure after CRT or radiotherapy (RT for esophageal cancer. Methods This phase I, laser dose escalation study used a fixed dose (40 mg/m2 of intravenous talaporfin sodium administered 4 to 6 hours before irradiation in patients with local failure limited to T2 after CRT or RT (≥ 50 Gy. The primary endpoint was to assess the dose limiting toxicity (DLT of PDT, and the secondary endpoints were to evaluate the adverse events and toxicity related to PDT. The starting fluence of the 664 nm diode laser was 50 J/cm2, with an escalation plan to 75 J/cm2 and 100 J/cm2. Results 9 patients with local failure after CRT or RT for ESCC were enrolled and treated in groups of 3 individuals to the third fluence level. No DLT was observed at any fluence level. Phototoxicity was not observed, but one subject had grade 1 fever, three had grade 1 esophageal pain, and 1 had grade 1 dysphagia. Five of 9 patients (55.6% achieved a complete response after PDT. Conclusions PDT using talaporfin sodium and a diode laser was safe for local failure after RT in patients with esophageal cancer. The recommended fluence for the following phase II study is 100 J/cm2.

  7. Phase I trial of escalating-dose cisplatin with 5-fluorouracil and concurrent radiotherapy in Chinese patients with esophageal cancer.

    Science.gov (United States)

    Lin, Qiang; Gao, Xian-Shu; Qiao, Xue-Ying; Zhou, Zhi-Guo; Zhang, Ping; Chen, Kun; Zhao, Yan-Nan; Asaumi, Junichi

    2008-02-01

    We defined the maximum-tolerated dose (MTD) of chemoradiotherapy (cisplatin (CDDP) with 5-fluorouracil (5-FU) and concurrent chemoradiotherapy) for Chinese patients with esophageal cancer. Twenty-one previously untreated patients with primary esophageal cancer were entered into this study. Escalating doses of CDDP with 5-FU were administered in a modified Fibonacci sequence, with concurrent conventional fractionation radiotherapy (CFR) of 60 Gy or 50 Gy. The starting doses were CDDP 37.5 mg/m2 on day 1, and 5-FU 500 mg/m2 on days 1-5, respectively. The regimen was repeated 4 times every 28 days. If no dose-limiting toxicity (DLT) was observed, the next dose level was applied. The procedures were repeated until DLT appeared. The MTD was declared to be 1 dose level below the level at which DLT appeared. DLT was grade 3 radiation-induced esophagitis at a dose level of CDDP 60 mg/m2 with 5-FU 700 mg/m2 and concurrent 60 Gy CFR. MTD was defined as CDDP 52.5 mg/m2 with 5-FU 700 mg/m2 and concurrent 50 Gy CFR. The MTD of CDDP with 5-FU and in concurrent chemoradiotherapy for Chinese patients with esophageal cancer is CDDP 52.5 mg/m2 on day 1 and 5FU 700 mg/m2 on days 1-5, repeated 4 times every 28 days, and concurrent 50 Gy CFR. Further evaluation of this regimen in a prospective phase II trial is ongoing.

  8. Clinical evaluation on cardiac enlargement in patients with esophageal cancer treated by radiotherapy with or without chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sasamoto, Ryuta [Niigata Univ. (Japan). School of Medicine

    2002-09-01

    Recent literature on chemoradiotherapy for esophageal cancer report the comparable survival results as surgery, and suggest the importance of management for the late adverse effect of chemoradiotherapy. The aim of this study is to investigate the incidence and risk factors of cardiomegaly after chemoradiotherapy using low dose continuous infusion of 5FU/CDDP+5FU for esophageal cancer. Fifty-one patients with stage I-IVA esophageal cancer who were treated by radiotherapy with more than 50 Gy with or without chemotherapy and followed up for more than 6 months were analyzed. Sixteen patients were treated by radiation alone and 35 patients were treated by chemoradiotherapy. A change of CTR (cardio-thoracic ratio) was defined as the difference between CTR in the pre-treatment X-ray film and CTR in the post-treatment X-ray film with maximum cardiac silhouette. A change of CTR by more than 10% was defined as ''significant cardiomegaly''. In this study cardiac area-dose'', which is the sum of the products of cardiac area within every radiation field and its target dose, was calculated in each patient as a radiation parameter. Significant cardiomegaly was noted in 1 patient (6%) in the radiation alone group, in 8 patients (23%) in the chemoradiotherapy group and in 9 patients (18%) in the total population. In cases with more than 0.4 m{sup 2}{center_dot}Gy in cardiac area-dose, CTR elevation was significantly higher than in cases with less than 0.4m{sup 2}{center_dot}Gy. More than moderate pleural effusion was noted in 5 patients (10%). Chronic pericardial effusion and subsequent cardiac tamponade was considered to be one of the contributing factors for pleural effusion, because increases of pleural effusion coincided with CTR elevations in 3 cases. In addition, the fact that no case had right-sided unilateral pleural effusion suggested the direct effect of radiation to the pleura. Significant cardiomegaly was seen in 18% of 51 patients with

  9. Bile salts inhibit growth and induce apoptosis of human esophageal cancer cell line

    Institute of Scientific and Technical Information of China (English)

    Ru Zhang; Jun Gong; Hui Wang; Li Wang

    2005-01-01

    AIM: To explore the effect of six bile salts, including glycocholate (GC), glycochenodeoxycholate (GCDC), glycodeoxycholate (GDC), taurocholate (TC), taurochenodeoxycholate (TCDC), taurodeoxycholate (TDC), and two bile acids including cholic acid (CA) and deoxycholic acid (DCA) on esophageal cancer Eca109 cell line.METHODS: Eca109 cells were exposed to six bile salts, two bile acids and the mixed bile salts at different concentrations for 24-72 h. 3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect the cell proliferation. Apoptotic morphology was observed by phase-contrast video microscopy and deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL)assay. Sub-G1 DNA fragmentations and early apoptosis cells were assayed by flow cytometry (FCM) with propidium iodide (PI) staining and annexin V-FITC conjugated with PI staining. Apoptosis DNA ladders on agarose were observed. Activation of caspase-3 was assayed by FCM with FITC-conjugated monoclonal rabbit anti-active caspase3 antibody and expressions of Bcl-2 and Bax proteins were examined immunocytochemically in 500 μmol/L-TC-induced apoptosis cells.RESULTS: Five bile salts except for GC, and two bile acids and the mixed bile salts could initiate growth inhibition of Eca109 cells in a dose- and time-dependent manner.TUNEL, FCM, and DNA ladder assays all demonstrated apoptosis induced by bile salts and bile acids at 500 μmol/L,except for GC. Early apoptosis cell percentages in Eca109 cells treated with GCDC, GDC, TC, TCDC, TDC,CA at 500 μmol/L for 12 h, DCA at 500 μmol/L for 6 h,and mixed bile salts at 1 000 μmol/L for 12 h were 7.5%,8.7%, 14.8%, 8.9%, 7.8%, 9.3%, 22.6% and 12.5%,respectively, all were significantly higher than that in control (1.9%). About 22% of the cell population treated with TC at 500 μmol/L for 24 h had detectable active caspase-3, and were higher than that in the control (1%). Immunocytochemical assay suggested that TC down-regulated Bcl

  10. Risk factors and survival analysis of the esophageal cancer in the population of Jammu, India

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    S Sehgal

    2012-01-01

    Full Text Available Objective: To identify the risk factors of esophageal cancer and study their effect on the survival rates patients of Jammu region, India. Materials and Methods: Detailed information was collected on socio-demographic, dietary and clinico-pathological parameters for 200 case control pairs. Discrete (categorical data of 2 independent groups (control and cases were summarized in frequency (% and compared by using Chi-square (χ2 test. The mean age of two independent groups was compared by independent Student′s t-test. To find out potential risk factor (s, the variable (s found significant in univariate analysis were further subjected to multivariate logistic regression analysis. The association of potential risk factors with patients survival (3-year overall survival was done by Kaplan-Meier survival curve analysis using Log-rank test. A 2-tailed (a = 2 P < 0.05 was considered statistically significant. Results: Out of the 63 response parameters, seven were found highly significant on multivariate analysis. The mean (± SD age was 56.74 ± 10.76 years, the proportions of males were higher than females, mostly illiterate and lower income group. Among dietary characteristics, snuff was highest (OR = 3.86, 95% CI = 2.46-6.08 followed by salt tea (OR = 2.53, 95% CI = 1.49-4.29, smoking (OR = 1.97, 95% CI = 1.18-3.30, sundried food (OR = 1.77, 95% CI = 1.10-2.85 and red chilly (OR = 1.76, 95% CI = 1.07-2.89. Probability of survival lowered significantly (P < 0.05 or P < 0.01 or P < 0.001 in those consuming tobacco in the form of snuff (Log-rank c 2 = 24.62, P = 0.000 and smoking (Log-rank c 2 = 5.20, P = 0.023 as compared to those who did not take these. Conclusions: The analysis finally established snuff (smokeless tobacco as the most powerful risk factor of esophageal cancer in Jammu region, followed by the salt tea, smoking and the sundried food.

  11. Impact of different IMRT techniques to improve conformity and normal tissue sparing in upper esophageal cancer

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    Amin E Amin

    2015-03-01

    Full Text Available Purpose: Intensity modulated radiotherapy (IMRT for cervical esophageal cancer is challenging. Although IMRT techniques using inverse planning algorithms are facilitating the treatment planning process, the irradiation dose to the normal tissues can be a critical issue. This study was performed to investigate the effect of beam numbers and their directions and local optimization on: (1 dose conformity and homogeneity to the planning target volume (PTV and (2 dose to the organ at risks (OARs.Methods: Four upper esophageal cancer cases were randomly selected for this treatment planning study. Eight IMRT plans were generated for each case with the same dose-volume constraints but with different beam numbers and arrangements. Local optimization using regular structures drawn automatically around the PTV with margins from 0.5-1.5 cm was performed. IMRT plans were evaluated with respect to isodose distributions, dose-volume histograms (DVHs parameters, homogeneity index (HI, and conformity index (CI. The statistical comparison between the types of plans was done using the One Way ANOVA test.Results: The results showed that IMRT using three or five beams was not sufficient to obtain good dose optimization. The seven field plans showed the best coverage for the PTV with tolerable doses for the OARs, and the beam orientation was very critical. Increasing beams (Bs number from 7 to 13 did not show significant differences in the PTV coverage, while the mean lung dose was increased. The PTV coverage were 95.1, 95.1, 98.1, 97.3, 97.3, 97.3, 97.0, and 97.0% for 3Bs, 5Bs, 7Bs, 9Bs, 13Bs, 7Bs(30, 7Bs(60 (beam angles were changed from 0o to 30o and 60o, and 7Bs(R (seven IMRT plans with ring, respectively. The mean heart dose did not exceed 0.36 Gy with p < 0.05. For lung doses, the best plan was the one with 9Bs which reduced lung volume doses V20Gy (% and V30Gy (%, and reduced mean lung dose from 5.4 to 4.5 Gy with p < 0.05 for 7Bs(R plans. IMRT improved the

  12. Selenium Status and the Risk of Esophageal and Gastric Cancer Subtypes: The Netherlands Cohort Study

    NARCIS (Netherlands)

    Steevens, J.; Brandt, P.A. van den; Goldbohm, R.A.; Schouten, L.J.

    2010-01-01

    Background & Aims: Selenium may protect against the development of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), and gastric cardia adenocarcinoma (GCA). Only in very few studies have the associations with ESCC and GCA been investigated, and no epidemiologic studies exi

  13. Combining proteomics, serum biomarkers and bioinformatics to discriminate between esophageal squamous cell carcinoma and pre-cancerous lesion

    Institute of Scientific and Technical Information of China (English)

    Xiao-hui ZHAI; Jie-kai YU; Chen LIN; Li-dong WANG; Shu ZHENG

    2012-01-01

    Objective: Biomarker assay is a noninvasive method for the early detection of esophageal squamous cell carcinoma (ESCC).Searching for new biomarkers with high specificity and sensitivity is very important for the early detection of ESCC.Serum surface-enhanced laser desorption/ionization-time of flight mass spectrometry (SELDI-TOF-MS) is a high throughput technology for identifying cancer biomarkers using drops of sera.Methods: In this study,185 serum samples were taken from ESCC patients in a high incidence area and screened by SELDI.A support vector machine (SVM) algorithm was adopted to analyze the samples.Results: The SVM patterns successfully distinguished ESCC from pre-cancerous lesions (PCLs).Also,types of PCL,including dysplasia (DYS) and basal cell hyperplasia (BCH),and healthy controls (HC) were distinguished with an accuracy of 95.2% (DYS),96.6% (BCH),and 93.8% (HC),respectively.A marker of 25.1 kDa was identified in the ESCC patterns whose peak intensity was observed to increase significantly during the development of esophageal carcinogenesis,and to decrease obviously after surgery.Conclusions: We selected five ESCC biomarkers to form a diagnostic pattern which can discriminate among the different stages of esophageal carcinogenesis.This pattern can significantly improve the detection of ESCC.

  14. A comparative analysis by SAGE of gene expression profiles of esophageal adenocarcinoma and esophageal squamous cell carcinoma

    NARCIS (Netherlands)

    van Baal, Jantine W. P. M.; Milana, Francesco; Rygiel, Agnieszka M.; Sondermeijer, Carine M. T.; Spek, C. Arnold; Bergman, Jacques J. G. H. M.; Peppelenbosch, Maikel P.; Krishnadath, Kausilia K.

    2008-01-01

    Esophageal adenocarcinoma (EA) and esophageal squamous cell carcinoma (ESCC) are the two main types of esophageal cancer. Despite extensive research the exact molecular basis of these cancers is unclear. Therefore we evaluated the transcriptome of EA in comparison to non-dysplastic Barrett's esophag

  15. [Historic significance and future prospect of cancer high incidence scenes in China based on the development of esophageal cancer high incidence scene in Linzhou, Henan province].

    Science.gov (United States)

    Wei, W W

    2016-09-23

    Cancer high incidence scenes are specific and distinguishing characteristics of cancer prevention in China, which not only have made significant contributions to cancer control with Chinese characteristics, but also benefited the masses in cancer high incidence areas and have achieved a great deal of success. These achievements affect not only the prevention and control of cancer, but also of chronic non-communicable diseases both in China and in the world. This paper reviews the history, successes and problems of cancer prevention and control in esophageal cancer high incidence areas in Linzhou City, Henan Province and other provinces in China, and point out the future direction of cancer high incidence scenes on the basis of opportunities and challenges to be faced in modern era.

  16. Chromosome 11 aneusomy in esophageal cancers and precancerous lesions-an early event in neoplastic transformation: An interphase fluorescence in situ hybridization study from south India

    Institute of Scientific and Technical Information of China (English)

    Vasavi Mohan; Shivani Ponnala; Hemakumar M Reddy; Radha Sistla; Rachel A Jesudasan; Yog Raj Ahuja; Qurratulain Hasan

    2007-01-01

    AIM: To detect aneusomic changes with respect to chromosome 11 copy number in esophageal precancers and cancers wherein the generation of cancer-specific phenotypes is believed to be associated with specific chromosomal aneuploidies.METHODS: We performed fluorescence in situ hybridization (FISH) on esophageal tissue paraffin sections to analyze changes in chromosome 11 copy number using apotome-generated images by optical sectioning microscopy. Sections were prepared from esophageal tumor tissue, tissues showing preneoplastic changes and histologically normal tissues (control)obtained from patients referred to the clinic for endoscopic evaluation.RESULTS: Our results demonstrated that aneusomy was seen in all the cancers and preneoplastic tissues, while none of the controls showed aneusomic cells. There was no increase in aneusomy from precancers to cancers.CONCLUSION: Our results suggest that evaluation of chromosome 11 aneusomy in esophageal tissue using FISH with an appropriate signal capture-analysis system, can be used as an ancillary molecular marker predictive of early neoplastic changes. Future studies can be directed towards the genes on chromosome 11,which may play a role in the neoplastic transformation of esophageal precancerous lesions to cancers.

  17. Pre-operative chemoradiation therapy with 5-fluorouracil and low-dose daily cisplatin for esophageal cancer. A preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Shimoyama, Shouji; Konishi, Toshiro; Kawahara, Masaki; Ito, Akihiko; Hoji, Keiichi; Takeda, Yuichi; Oba, Hiroshi; Shimizu, Seiichiro [Showa General Hospital, Kodaira, Tokyo (Japan); Kaminishi, Michio

    1999-03-01

    A combination of chemotherapy and radiotherapy (chemoradiation therapy; CRT) has recently been developed to improve the survival of esophageal cancer patients. However, the optimal choice of chemotherapeutic agents and their doses, as well as chemotherapy and radiotherapy regimens, remain unclear. Based on recent advances in knowledge on the radiosensitizing and biochemical modulation effects of chemotherapeutic agents, we have recently developed concurrent CRT which consisted of continuous 5-fluorouracil (5FU) administration (600 mg/m{sup 2}/day, days 1-5) combined with a low dose of daily cisplatin administration (10 mg/m{sup 2}/day, days 1-5, and 5 or 10 mg/m{sup 2}/day, days 8-12 and 15-19) before each fraction of radiation (2 Gy each). To evaluate the efficacy and safety of our concurrent CRT, 10 esophageal cancer patients received one or one and a half courses of the CRT. All patients tolerated and completed a full course of the CRT. The effectiveness of the CRT on the primary tumor included pathologically or endoscopically complete responses in three patients (30%), partial response in five (50%), no response in two (20%) and tumoral downstaging (T-classification) in five (50%). Grade 2 and Grade 3 toxicity, seen in six patients, did not affect surgical operation. No patients showed CRT-related deaths. Eight patients (80%) underwent resection with no operative mortality. Of these, two patients (25%) showed pathologically or endoscopically complete responses, and four (50%) showed partial response. Three patients died of cancer after resection. The two inoperable patients showed a pathologically complete response and partial response, respectively. They were relieved of their cancer-related complaints and were living without hospitalization at the time of this analysis. These results suggest that the concurrent CRT based on the theoretical backgrounds is effective and has acceptable toxicities with maintaining its efficacy for the treatment of esophageal

  18. Intensity-modulated radiation therapy with concurrent chemotherapy for locally advanced cervical and upper thoracic esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Shu-Lian Wang; Zhongxing Liao; Helen Liu; Jaffer Ajani; Stephen Swisher; James D Cox; Ritsuko Komaki

    2006-01-01

    AIM: To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer.METHODS: A retrospective study was performed on 7 patients who were definitively treated with IMRT and concurrent chemotherapy. Patients who did not receive IMRT radiation and concurrent chemotherapy were not included in this analysis. IMRT plans were evaluated to assess the tumor coverage and normal tissue avoidance. Treatment response was evaluated and toxicities were assessed.RESULTS: Five- to nine-beam IMRT were used to deliver a total dose of 59.4-66 Gy (median: 64.8 Gy) to the primary tumor with 6-MV photons. The minimum dose received by the planning tumor volume (PTV) of the gross tumor volume boost was 91.2%-98.2% of the prescription dose (standard deviation [SD]: 3.7%-5.7%).tumor volume was 93.8%-104.8% (SD: 4.3%-11.1%)of the prescribed dose. With a median follow-up of 15 mo (range: 3-21 mo), all 6 evaluable patients achieved complete response. Of them, 2 developed local recurrences and 2 had distant metastases, 3 survived with no evidence of disease. After treatment, 2 patients developed esophageal stricture requiring frequent dilation and 1 patient developed tracheal-esophageal fistula.CONCLUSION: Concurrent IMRT and chemotherapy resulted in an excellent early response in patients with locally advanced cervical and upper thoracic esophageal cancer. However, local and distant recurrence and toxicity remain to be a problem. Innovative approaches are needed to improve the outcome.

  19. Chemoprevention of esophageal cancer with black raspberries, their component anthocyanins, and a major anthocyanin metabolite, protocatechuic acid.

    Science.gov (United States)

    Peiffer, Daniel S; Zimmerman, Noah P; Wang, Li-Shu; Ransom, Benjamin W S; Carmella, Steven G; Kuo, Chieh-Ti; Siddiqui, Jibran; Chen, Jo-Hsin; Oshima, Kiyoko; Huang, Yi-Wen; Hecht, Stephen S; Stoner, Gary D

    2014-06-01

    Diets containing either freeze-dried black raspberries (BRBs) or their polyphenolic anthocyanins (ACs) have been shown to inhibit the development of N-nitrosomethylbenzylamine (NMBA)-induced esophageal cancer in rats. The present study was conducted to determine whether PCA, a major microbial metabolite of black raspberry (BRB) ACs, also prevents NMBA-induced esophageal cancer in rats. F344 rats were injected with NMBA three times a week for 5 weeks and then fed control or experimental diets containing 6.1% BRBs, an anthocyanin (AC)-enriched fraction derived from BRBs, or protocatechuic acid (PCA). Animals were exsanguinated at weeks 15, 25, and 35 to quantify the development of preneoplastic lesions and tumors in the esophagus, and to relate this to the expression of inflammatory biomarkers. At weeks 15 and 25, all experimental diets were equally effective in reducing NMBA-induced esophageal tumorigenesis, as well as in reducing the expression of pentraxin-3 (PTX3), a cytokine produced by peripheral blood mononuclear cells in response to interleukin (IL)-1β and TNF-α. All experimental diets were also active at reducing tumorigenesis at week 35; however, the BRB diet was significantly more effective than the AC and PCA diets. Furthermore, all experimental diets inhibited inflammation in the esophagus via reducing biomarker (COX-2, iNOS, p-NF-κB, and sEH) and cytokine (PTX3) expression. Overall, our data suggest that BRBs, their component ACs, and PCA inhibit NMBA-induced esophageal tumorigenesis, at least in part, by their inhibitory effects on genes associated with inflammation.

  20. High intake of folate from food sources is associated with reduced risk of esophageal cancer in an Australian population.

    Science.gov (United States)

    Ibiebele, Torukiri I; Hughes, Maria Celia; Pandeya, Nirmala; Zhao, Zhen; Montgomery, Grant; Hayward, Nick; Green, Adèle C; Whiteman, David C; Webb, Penelope M

    2011-02-01

    Folate plays a key role in DNA synthesis and methylation. Limited evidence suggests high intake may reduce risks of esophageal cancer overall; however, associations with esophageal cancer subtypes and Barrett's esophagus (BE), a precancerous lesion, remain unexplored. We evaluated the relation between intake of folate, B vitamins, and methyl-group donors (methionine, choline, betaine) from foods and supplements, polymorphisms in key folate-metabolizing genes, and risk of BE, esophageal adenocarcinoma (EAC), and esophageal squamous cell carcinoma (ESCC) in 2 population-based case-control studies in Australia. BE patients without (n = 266) or with (n = 101) dysplasia were compared with population controls (n = 577); similarly, EAC (n = 636) or ESCC (n = 245) patients were compared with population controls (n = 1507) using multivariable adjusted logistic regression. Increasing intake of folate from foods was associated with reduced EAC risk (P-trend = 0.01) and mitigated the increased risks of ESCC associated with smoking and alcohol consumption. In contrast, high intake of folic acid from supplements was associated with a significantly elevated risk of BE with dysplasia. High intakes of riboflavin and methionine from food were associated with increased EAC risk, whereas increasing betaine intake was associated with reduced risks of BE without (P-trend = 0.004) or with dysplasia (P-trend = 0.02). Supplemental thiamin, riboflavin, niacin, and vitamin B-12 were associated with increased EAC risk. There were no consistent associations between genetic polymorphisms studied and BE or EAC risk. High intake of folate-containing foods may reduce risk of EAC, but our data raise the possibility that folic acid supplementation may increase risks of BE with dysplasia and EAC.

  1. Treatment results of chemoradiation for T1 esophageal cancer with lymph node metastases

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    Itoh, Yoshiyuki [Nishio Municipal Hospital, Aichi (Japan); Fuwa, Nobukazu; Matsumoto, Akira; Asano, Akiko; Sasaoka, Masahiro

    2000-04-01

    We clinically evaluated 12 patients with advanced superficial esophageal cancer who had undergone chemoradiotherapy. A retrospective analysis was performed between October 1992 and December 1998 on 12 patients with M1 metastasis in lymph nodes or direct invasion of enlarged lymph nodes (A3) to adjacent structures. Combined treatment with radiotherapy and chemotherapy was applied to all patients. High-dose cisplatin (CDDP) and 5-fluorouracil (5FU) were administered to five patients, low-dose CDDP and 5-FU to five patients, and others to two patients. Ten patients were treated by external irradiation alone, and two patients were treated by external and intracavitary irradiation. Of the 12 patients, the response of the primary tumor to this therapy resulted in 11 CRs (91.6%) and one PR, while the response of the largest metastatic lesion in lymph nodes in each patient resulted in three CRs (25%), four PRs (33.3%), and five NCs (41.6%). The 2-year survival rate of all patients was 51.9%, and MST was 28.9 months. The 2-year survival rates of the M1 and A3 patients were 60.0% and 41.7%, respectively. This study revealed that the present chemotherapy regimen is ineffective in treating metastatic lymph node lesions. Therefore, it will be necessary to evaluate the effectiveness of chemoradiotherapeutic agents from the perspective of their effects on metastatic lymph nodes. (author)

  2. Neoadjuvant Treatment for Esophageal Cancer%食管癌的新辅助治疗

    Institute of Scientific and Technical Information of China (English)

    Paul M.Schneider; Huan Xi; Stephan E.Baldus; Jan Brabender; Ralf Metzger

    2004-01-01

    Because the conflicting data currently available from the performed randomized trials it is very difficult to provide strict guidelines for the treatment of patients with locoregional advanced esophageal cancers. Surgery however, remains the standard of care for potentially resectable disease. Preoperative chemotherapy is still controversial with two large randomized trials resulting in two different conclusions regarding the survival benefit. Preoperative chemoradiation is also controversial since only one randomized trial showed a clear survival benefit however, the patients treated with surgery alone in this trial had an unusually poor outcome. And the study by Urba et al was not powered enough to show a clear survival benefit for patients treated with neoadjuvant chemoradiation. The results of three metaanalysis of these randomized studies show lower rate of resection, higher rate of R0-resection, more often postoperative mortality and better prognosis for patients with neoadjuvant radiochemotherapy. As a consequence one may consider offering neoadjuvant chemotherapy or neoadjuvant radiochemotherapy to patients with locallyadvanced disease under the premise that patients have a good performance status and understand the controversies about this therapeutic option. Larger trials with sufficient power to clearly detect survival benefits for patients treated with neoadjuvant chemotherapy or radiochemotherapyare necessary before this therapeutic option will be the standard of care.

  3. Serum concentrations of antibiotics during severe invasive surgery such as esophagectomy for esophageal cancer.

    Science.gov (United States)

    Owaki, Tetsuhiro; Okumura, Hiroshi; Uchikado, Yasuto; Sasaki, Ken; Matsumoto, Masataka; Omoto, Itaru; Setoyama, Tetsuro; Kita, Yoshiaki; Sakurai, Toshihide; Matsushita, Daisuke; Ishigami, Sumiya; Ueno, Shinichi; Natsugoe, Shoji

    2013-01-01

    This study was performed to confirm the antibiotic regimen during a severe invasive surgery, such as esophagectomy, with a long procedure and a large amount of normal volumes of infusion. Ten patients with esophageal cancer were enrolled in this study, and cefmetazole sodium concentrations in serum were measured during esophagectomy. The ranges of minimum inhibitory concentrations for 90% of isolates of cefmetazole sodium for microorganisms in our institutions for 8 years were investigated. The maximum concentration was 83.9 μg/mL just after the completion of infusion, and its half-life was 1.5 hours. Serum concentration of cefmetazole sodium was kept above 16 μg/mL for 4 hours during esophagectomy. It was kept above 32 μg/mL for 2.5 hours after injection. There are almost no differences in the pharmacokinetics of cefmetazole sodium between common use and during esophagectomy. In addition, additive infusion of antibiotics 4 hours after the first infusion was recommended during esophagectomy.

  4. Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China

    Institute of Scientific and Technical Information of China (English)

    Juan Yang; Wen-Qiang Wei; Jin Niu; Zhi-Cai Liu; Chun-Xia Yang; You-Lin Qiao

    2012-01-01

    AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer (EC) in high-risk areas of China.METHODS:Markov model-based analyses were conducted to compare the net present values (NPVs) and the benefit-cost ratios (BCRs) of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data.RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV (international dollar-I$55 million) and BCR (2.52).Screening six times between 40-70 years at a 5-year interval [i.e.,six times(40)f-strategy] yielded the highest NPV (I$99 million) and BCR (3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR.CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.

  5. Detection of Apoptotic Inhibitor Gene Survivin in Peripheral Blood of Patients with Esophageal Cancer by Real-time Fluorescence Quantitative PCR and its Clinical Signiifcance

    Institute of Scientific and Technical Information of China (English)

    CHEN Sheng

    2014-01-01

    Objective:To explore the clinical signiifcance of apoptotic inhibitor gene Survivin in peripheral blood of patients with esophageal cancer. Methods:Real-time lfuorescence quantitative PCR was used to detect the expression of Survivin mRNA in peripheral blood of 93 patients with benign and malignant esophageal lesions. The relationship of Survivin mRNA expression and clinicopathologic feature was observed. Results:The expression of Survivin mRNA in peripheral blood which was associated with differentiated degree and clinical staging was progressively increased from benign lesion to carcinoma in situ and invasive carcinoma. Conclusion:The expression of Survivin mRNA in peripheral blood is significantly related to the genesis and progression of esophageal carcinoma. Real-time fluorescence quantitative PCR used to detect the expression of Survivin m-RNA in peripheral blood may be more convenient for diagnosing and guiding the treatment of esophageal carcinoma.

  6. Induction chemoradiation therapy prior to esophagectomy is associated with superior long-term survival for esophageal cancer.

    Science.gov (United States)

    Speicher, P J; Wang, X; Englum, B R; Ganapathi, A M; Yerokun, B; Hartwig, M G; D'Amico, T A; Berry, M F

    2015-01-01

    The purpose of this study was to examine the role of induction chemoradiation in the treatment of potentially resectable locally advanced (T2-3N0 and T1-3N+) esophageal cancer utilizing a large national database. The National Cancer Data Base (NCDB) was queried for all patients undergoing esophagectomy for clinical T2-3N0 and T1-3N+ esophageal cancer of the mid- or lower esophagus. Patients were stratified by the use of induction chemoradiation therapy versus surgery-first. Trends were assessed with the Cochran-Armitage test. Predictors of receiving induction therapy were evaluated with multivariable logistic regression. A propensity-matched analysis was conducted to compare outcomes between groups, and the Kaplan-Meier method was used to estimate long-term survival. Within the NCDB, 7921 patients were identified, of which 6103 (77.0%) were treated with chemoradiation prior to esophagectomy, while the remaining 1818 (23.0%) were managed with surgery-first. Use of induction therapy increased over time, with an absolute increase of 11.8% from 2003-2011 (P induction therapy was associated with higher rates of negative margins and shorter hospital length of stay, but no differences in unplanned readmission and 30-day mortality rates. In unadjusted survival analysis, induction therapy was associated with better long-term survival compared to a strategy of surgery-first, with 5-year survival rates of 37.2% versus 28.6%, P induction therapy maintained a significant survival advantage over surgery-first (5-year survival: 37.9% vs. 28.7%, P induction chemoradiation therapy prior to surgical resection is associated with significant improvement in long-term survival, even after adjusting for confounders with a propensity model. Induction therapy should be considered in all medically appropriate patients with resectable cT2-3N0 and cT1-3N+ esophageal cancer, prior to esophagectomy.

  7. Esophageal cancer metabolite biomarkers detected by LC-MS and NMR methods.

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    Jian Zhang

    Full Text Available BACKGROUND: Esophageal adenocarcinoma (EAC is a rarely curable disease and is rapidly rising worldwide in incidence. Barret's esophagus (BE and high-grade dysplasia (HGD are considered major risk factors for invasive adenocarcinoma. In the current study, unbiased global metabolic profiling methods were applied to serum samples from patients with EAC, BE and HGD, and healthy individuals, in order to identify metabolite based biomarkers associated with the early stages of EAC with the goal of improving prognostication. METHODOLOGY/PRINCIPAL FINDINGS: Serum metabolite profiles from patients with EAC (n = 67, BE (n = 3, HGD (n = 9 and healthy volunteers (n = 34 were obtained using high performance liquid chromatography-mass spectrometry (LC-MS methods. Twelve metabolites differed significantly (p<0.05 between EAC patients and healthy controls. A partial least-squares discriminant analysis (PLS-DA model had good accuracy with the area under the receiver operative characteristic curve (AUROC of 0.82. However, when the results of LC-MS were combined with 8 metabolites detected by nuclear magnetic resonance (NMR in a previous study, the combination of NMR and MS detected metabolites provided a much superior performance, with AUROC = 0.95. Further, mean values of 12 of these metabolites varied consistently from healthy controls to the high-risk individuals (BE and HGD patients and EAC subjects. Altered metabolic pathways including a number of amino acid pathways and energy metabolism were identified based on altered levels of numerous metabolites. CONCLUSIONS/SIGNIFICANCE: Metabolic profiles derived from the combination of LC-MS and NMR methods readily distinguish EAC patients and potentially promise important routes to understanding the carcinogenesis and detecting the cancer. Differences in the metabolic profiles between high-risk individuals and the EAC indicate the possibility of identifying the patients at risk much earlier to

  8. Subamolide A Induces Mitotic Catastrophe Accompanied by Apoptosis in Human Lung Cancer Cells

    OpenAIRE

    Jen-Yu Hung; Ching-Wen Wen; Ya-Ling Hsu; En-Shyh Lin; Ming-Shyan Huang; Chung-Yi Chen; Po-Lin Kuo

    2013-01-01

    This study investigated the anticancer effects of subamolide A (Sub-A), isolated from Cinnamomum subavenium, on human nonsmall cell lung cancer cell lines A549 and NCI-H460. Treatment of cancer cells with Sub-A resulted in decreased cell viability of both lung cancer cell lines. Sub-A induced lung cancer cell death by triggering mitotic catastrophe with apoptosis. It triggered oxidant stress, indicated by increased cellular reactive oxygen species (ROS) production and decreased glutathione le...

  9. Gastroesophageal reflux leads to esophageal cancer in a surgical model with mice

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    Chen Xiaoxin

    2009-07-01

    Full Text Available Abstract Background Esophago-gastroduodenal anastomosis with rats mimics the development of human Barrett's esophagus and esophageal adenocarcinoma by introducing mixed reflux of gastric and duodenal contents into the esophagus. However, use of this rat model for mechanistic and chemopreventive studies is limited due to lack of genetically modified rat strains. Therefore, a mouse model of esophageal adenocarcinoma is needed. Methods We performed reflux surgery on wild-type, p53A135V transgenic, and INK4a/Arf+/- mice of A/J strain. Some mice were also treated with omeprazole (1,400 ppm in diet, iron (50 mg/kg/m, i.p., or gastrectomy plus iron. Mouse esophagi were harvested at 20, 40 or 80 weeks after surgery for histopathological analysis. Results At week 20, we observed metaplasia in wild-type mice (5%, 1/20 and p53A135V mice (5.3%, 1/19. At week 40, metaplasia was found in wild-type mice (16.2%, 6/37, p53A135V mice (4.8%, 2/42, and wild-type mice also receiving gastrectomy and iron (6.7%, 1/15. Esophageal squamous cell carcinoma developed in INK4a/Arf+/- mice (7.1%, 1/14, and wild-type mice receiving gastrectomy and iron (21.4%, 3/14. Among 13 wild-type mice which were given iron from week 40 to 80, twelve (92.3% developed squamous cell carcinoma at week 80. None of these mice developed esophageal adenocarcinoma. Conclusion Surgically induced gastroesophageal reflux produced esophageal squamous cell carcinoma, but not esophageal adenocarcinoma, in mice. Dominant negative p53 mutation, heterozygous loss of INK4a/Arf, antacid treatment, iron supplementation, or gastrectomy failed to promote esophageal adenocarcinoma in these mice. Further studies are needed in order to develop a mouse model of esophageal adenocarcinoma.

  10. Functional Haplotypes in the Promoter of Matrix Metalloproteinase-2 Predict Risk of the Occurrence and Metastasis of Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    ChunyuanYu; YifengZhou; XiaopingMiao; PingXiong; WenTan; DongxinLin

    2005-01-01

    Matrix metalloproteinase-2 (MMP-2) plays important roles in cancer development and aggression. Our previous studies revealed a strong association between the MMP-2 -1306C/T polymorphism and risk of several cancers. A novel -735C/T polymorphism in MMP-2 promoter has been identified but the function is undefined. This study examined our hypothesis that these two polymorphisms might have functional relevance and impact on risk of esophageal squamous cell carcinoma in the context of haplotype. Genotypes and haplotypes were analyzed in 527 cases and 777 controls and odds ratios (ORs) and 95% confidence intervals (CIs)were estimated by logistic regression. The function of the polymorphisms was examined by electrophoretic mobility shift assays, luciferase gene expression assays, and reverse transcriptase-PCR analyses. It was found that the -735C→T transition disrupts an Spl site and displays a lowerpromoter activity. The C_1306-C-735 haplotype had 7-fold increased luciferase expression and 3.7-fold increased MMPo2 mRNA levels in esopha-gcal tissues compared with the T-1306-T-735 haplotype. A case-control analysis revealed a 1.52-fold (95% CI=1.17-1.96) or 1.30-fold (95%CI = 1.04-1.63) excess risk of developing esophageal squamous cell carcinoma for the -1306CC or -735CC genotype carriers compared with noncarriers, respectively. A greater association was observed between elevated risk of developing esophageal squamous cell carcinoma andC-1306 or C-735 allele containing haplotypes, with the risk being highest for the C-1306-C-735 haplotype compared with the T-1306-T-735 haplotype(OR = 6.53; 95% CI = 2.78-15.33). The C-1306-C-735 haplotype was also associated with increased risk for distant metastasis of esophageal squamous cell carcinoma (OR = 3.34; 95% CI = 1.16-9.63). These findings suggest that the C-1306-C-735 haplotype in the MMpo2 promoter contributes to risk of the occurrence and metastasis of esophageal squamous cell carcinoma by increasing expression of MMP-2.

  11. Thrombocytes Correlate with Lymphangiogenesis in Human Esophageal Cancer and Mediate Growth of Lymphatic Endothelial Cells In Vitro.

    Science.gov (United States)

    Schoppmann, Sebastian F; Alidzanovic, Lejla; Schultheis, Andrea; Perkmann, Thomas; Brostjan, Christine; Birner, Peter

    2013-01-01

    Recent data provide evidence for an important role of thrombocytes in lymphangiogenesis within human malignant disease. The aim of this study was to investigate the role of thrombocytes in lymphangiogenesis in human esophageal cancer. Perioperative peripheral blood platelet counts (PBPC) were evaluated retrospectively in 320 patients with esophageal cancer, comprising 184 adenocarcinomas (AC), and 136 squamous cell carcinomas (SCC). Data on lymphangiogenesis evaluated by anti-podoplanin immunostaining were available from previous studies, platelets within the tumor tissue were assessed by CD61 immunostaining. For in vitro studies, human lymphatic endothelial cells (LECs) were isolated and co-cultured with peripheral blood platelets. Stromal thrombocytic clusters (STC) were evident in 82 samples (25.6%), and vascular thrombocytic clusters (VTC) in 56 (17.5%). STC and VTC were associated with a significantly higher PBPC at investigation of all cases. The presence of STC was associated with higher lymphatic microvessel density (p<0.001), PBPC and STC were associated with lymphovascular invasion of tumor cells in a regression model. The presence of STCs was associated with shorter DFS of all patients (p = 0.036, Breslow test), and VTC with shorter DFS in in SCC (p = 0.025, Breslow test). In cell culture, LEC proliferation was enhanced by co-culture with human platelets in a dose- and time-dependent manner mediated by the release of PDGF-BB and VEGF-C. Platelets play an important role in lymphangiogenesis and lymphovascular invasion in esophageal cancer, influencing prognosis. So the disruption of signaling pathways between platelets, tumor cells and lymphatic endothelium might be of benefit for patients.

  12. Thrombocytes Correlate with Lymphangiogenesis in Human Esophageal Cancer and Mediate Growth of Lymphatic Endothelial Cells In Vitro.

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    Sebastian F Schoppmann

    Full Text Available Recent data provide evidence for an important role of thrombocytes in lymphangiogenesis within human malignant disease. The aim of this study was to investigate the role of thrombocytes in lymphangiogenesis in human esophageal cancer. Perioperative peripheral blood platelet counts (PBPC were evaluated retrospectively in 320 patients with esophageal cancer, comprising 184 adenocarcinomas (AC, and 136 squamous cell carcinomas (SCC. Data on lymphangiogenesis evaluated by anti-podoplanin immunostaining were available from previous studies, platelets within the tumor tissue were assessed by CD61 immunostaining. For in vitro studies, human lymphatic endothelial cells (LECs were isolated and co-cultured with peripheral blood platelets. Stromal thrombocytic clusters (STC were evident in 82 samples (25.6%, and vascular thrombocytic clusters (VTC in 56 (17.5%. STC and VTC were associated with a significantly higher PBPC at investigation of all cases. The presence of STC was associated with higher lymphatic microvessel density (p<0.001, PBPC and STC were associated with lymphovascular invasion of tumor cells in a regression model. The presence of STCs was associated with shorter DFS of all patients (p = 0.036, Breslow test, and VTC with shorter DFS in in SCC (p = 0.025, Breslow test. In cell culture, LEC proliferation was enhanced by co-culture with human platelets in a dose- and time-dependent manner mediated by the release of PDGF-BB and VEGF-C. Platelets play an important role in lymphangiogenesis and lymphovascular invasion in esophageal cancer, influencing prognosis. So the disruption of signaling pathways between platelets, tumor cells and lymphatic endothelium might be of benefit for patients.

  13. 经右胸-食管裂孔游离胃治疗胸上中段食管癌%An operation via right thoracic-esophageal hiatus for cancer of upper or middle esophageal

    Institute of Scientific and Technical Information of China (English)

    王超峰; 许赓

    2016-01-01

    目的:研究经右胸切口-食管裂孔游离胃治疗胸上中段食管癌的可行性。方法对46例上中段食管癌患者行经右胸切口,扩大食管裂孔,经食管裂孔游离胃,行食管胃右胸顶吻合或左颈部吻合。结果肿瘤切除率100%(46/46)。发生颈部吻合口瘘1例(2.17%,1/46),胃残端瘘1例(2.17%,1/46),肺部并发症患者5例(10.87%,5/46),喉返神经损伤患者1例(2.17%,1/46)。1例(2.17%,1/46)残胃瘘患者死亡。结论对于中上段食管癌患者,经右胸切口-食管裂孔游离胃是一种较为理想的手术方式。%Objective To investigate the feasibility of an operation via right thoracic-esophageal hiatus for cancer of upper or middle esophageal.Methods Form 2009 to 2013,46 patients of cancer of upper or middle esophageal are operated via right thoracic,Enlarging esophageal hiatus,mobilizing the stomach through esophageal hiatus;the esophagus and stomach are anastomosed located in right cupula pleurae or left neck.Results 46(100%) patients underwent the complete resection.The main complications include neck anastomotic stoma fistula(2.17% 1/46), gastric stump fistula(2.17% 1/46),lung diseases(10.87%,5/46),injury of recurrent nerve(2.17% 1/46).1(2.17% 1/46) patient was death because of gastric stump fistula. Conclusion Operation via right thoracic-esophageal hiatus is a effective for patients with cancer of upper or middle esophageal.

  14. Endoscopic Submucosal Dissection for Early Esophageal Cancer and Esophageal Precancerous Lesions%内镜黏膜下剥离术治疗早期食管癌及食管癌前病变

    Institute of Scientific and Technical Information of China (English)

    薛鹏星; 周旋光; 陈娟

    2012-01-01

    Objective The efficacy of endoscopic submucosal dissection (ESD) in the treatment of early esophageal cancer and esophageal precancerous lesions was studied. Methods 4 patients with early esophageal cancer and 21 patients with esophageal precancerous lesions were treated by ESD after confirming the lesion range and invasion depth. Endoscopic ultrasonography was used to measure the invasion depth and lugol's staining was applied in measuring lesion range. Intraoperative mapping, submucosal injection, marginal mucosa incision, split and wound treatment were utilized as well. Results All lesions were completely removed, and no perforation or bleeding occurred during the operation. In the third month one patient was found to have esophageal stenosis which was relieved after a dilation. To random visit the patients 3, 6 and 12 months after operation, there was no recurrence. Conclusion ESD is a safe way to treat early esophageal cancer and esophageal precancerous lesions.%研究内镜黏膜下剥离术(ESD)治疗早期食管癌及食管癌前病变的治疗价值。对25例早期食管癌及食管癌前病变在确定病变范围及浸润深度后行黏膜下剥离术。先超声内镜判断浸润深度及利用Lugol液染色确定病灶范围,后采用术中标记、粘膜下注射、边缘粘膜切开、剥离及创面处理等方法。结果显示,病灶完整切除,术中无穿孔、出血;术后3、6、12月常规随访,均无复发。1例术后3个月出现食管狭窄,给予扩张后狭窄缓解。结果表明,对早期食管癌及食管癌前病变,内镜黏膜下剥离术是一种安全的内镜下治疗方法。

  15. Current and Emerging Systemic Therapy in Gastro-Esophageal Cancer "The Old and New Therapy for Metastatic Disease, The Role of Adjuvant and Neoadjuvant Therapy for Localized Disease".

    Science.gov (United States)

    Lim, Bora; Jiang, Yixing

    2015-01-01

    Cancers of esophagus and stomach are common malignant diseases worldwide, and they are associated with serious morbidity and high mortality rates. When diagnosed at an early stage, gastro-esophageal cancers are potentially curable. Neo-adjuvant or adjuvant therapies using both chemotherapy and radiation therapy have been shown to reduce the risk of local recurrence and distant metastasis. For advanced or metastatic tumors, systemic chemotherapy offers symptomatic palliation and moderate benefits in survival. With recent advances in anti-cancer therapeutics, progress has been made to improve treatment response and life expectancy in patients with advanced gastro-esophageal cancers. Furthermore, the clinical use of molecularly targeted agents in combination with cytotoxic chemotherapeutics is being evaluated in a number of ongoing clinical trials. In this article, we review currently used standard systemic therapies including recently evolving targeted therapies for metastatic gastro-esophageal cancers, as well as the proven role and the regimens that are used as neoadjuvant and adjuvant treatment in localized gastro-esophageal cancers.

  16. The medicinal fungus Antrodia cinnamomea regulates DNA repair and enhances the radiosensitivity of human esophageal cancer cells

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    Liu YM

    2016-10-01

    Full Text Available Yu-Ming Liu,1–3,* Yu-Kuo Liu,4,* Ling-Wei Wang,1,3 Yu-Chuen Huang,5,6 Pin-I Huang,1,3 Tung-Hu Tsai,2 Yu-Jen Chen2,7 1Department of Oncology, Division of Radiation Oncology, Taipei Veterans General Hospital, 2School of Medicine, Institute of Traditional Medicine, National Yang Ming University, Taipei, 3School of Medicine, National Yang Ming University, Taipei, 4Department of Chemical and Material Engineering, Chang Gung University, Taoyuan City, 5Department of Medical Research, China Medical University Hospital, 6School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, 7Department of Radiation Oncology, MacKay Memorial Hospital, New Taipei City, Taiwan *These authors contributed equally to this work Abstract: This study investigated the adjunctive effects of Antrodia cinnamomea mycelial fermentation broth (AC-MFB, a Taiwanese medicinal fungus, in enhancing the radiosensitivity of esophageal cancer cells. Human CE81T/VGH squamous and BE3 adenocarcinoma esophageal cancer cells were used in this study. A colony formation assay showed that pretreatment with AC-MFB decreased the survival of irradiated esophageal cancer cells, with a maximum sensitizer enhancement ratio of 1.91% and 37% survival. A DNA histogram study showed that AC-MFB pretreatment enhanced cell cycle arrest at the G2/M phase, the most radiosensitive phase. An immunofluorescence assay and a Western blotting assay showed that AC-MFB delayed the abrogation of γ-H2AX, upregulated p21 expression, and attenuated the radiation-induced phosphorylation of ataxia telangiectasia-mutated kinase and checkpoint kinase 2. An in vivo validation study showed that AC-MFB treatment tended to have a synergistic effect with radiation on the tumor growth delay of CE81T/VGH cells in BALB/c mice. These data suggest that this edible fungus product could enhance the effect of radiotherapy against esophageal cancer. Keywords: mycelial, G2/M, fermentation broth

  17. A case of radiation induced pleuritis and pericarditis three and a half years chemotherapy for advanced esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Yasuo; Sakai, Kunio; Sugita, Tohru; Tsuchida, Emiko; Sasamoto, Ryota [Niigata Univ. (Japan). School of Medicine; Sueyama, Hiroo

    1998-12-01

    A 67-year-old man who had been treated three and a half years ago with chemoradiotherapy using concurrent low-dose 5-FU continuous infusion for advanced esophageal cancer (T4N1M0) developed massive unilateral pleural effusion and pericardial effusion with no evidence of tumor recurrence. The pleural fluid was a serohemorrhagic exudate without malignant cells and bacterial infection. The pleural and pericardial effusion were remarkably improved after chest tube drainage and pleurodesis. Radiation-induced pleuritis and pericarditis were considered to be the possible cause of massive pleural and pericardial effusion. (author)

  18. Relationship between genetic polymorphisms of ALDH2 and ADH1B and esophageal cancer risk:A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Akira; Yokoyama; Tetsuji; Yokoyama

    2010-01-01

    AIM:To evaluate the contribution of alcohol dehydrogenase-1B(ADH1B)and aldehyde dehydrogenase-2 (ALDH2)polymorphisms to the risk of esophageal cancer.METHODS:Nineteen articles were included by searching MEDLINE,EMBASE and the Chinese Biomedical Database,13 on ADH1B and 18 on ALDH2.We performed a meta-analysis of case-control studies including 13 studies on ADH1B(cases/controls:2390/7100)and 18 studies on ALDH2(2631/6030).RESULTS:The crude odds ratio[OR(95%confidence interval)]was 2.91(2.04-4.14)for ADH1B*1/...

  19. Effects of environment, genetics and data analysis pitfalls in an esophageal cancer genome-wide association study.

    Directory of Open Access Journals (Sweden)

    Alexander Statnikov

    Full Text Available BACKGROUND: The development of new high-throughput genotyping technologies has allowed fast evaluation of single nucleotide polymorphisms (SNPs on a genome-wide scale. Several recent genome-wide association studies employing these technologies suggest that panels of SNPs can be a useful tool for predicting cancer susceptibility and discovery of potentially important new disease loci. METHODOLOGY/PRINCIPAL FINDINGS: In the present paper we undertake a careful examination of the relative significance of genetics, environmental factors, and biases of the data analysis protocol that was used in a previously published genome-wide association study. That prior study reported a nearly perfect discrimination of esophageal cancer patients and healthy controls on the basis of only genetic information. On the other hand, our results strongly suggest that SNPs in this dataset are not statistically linked to the phenotype, while several environmental factors and especially family history of esophageal cancer (a proxy to both environmental and genetic factors have only a modest association with the disease. CONCLUSIONS/SIGNIFICANCE: The main component of the previously claimed strong discriminatory signal is due to several data analysis pitfalls that in combination led to the strongly optimistic results. Such pitfalls are preventable and should be avoided in future studies since they create misleading conclusions and generate many false leads for subsequent research.

  20. Symptomatic radiation-induced cardiac disease in long-term survivors of esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Iwahashi, Noriaki; Kosuge, Masami; Kimura, Kazuo [Division of Cardiology, Yokohama City University Medical Center, Yokohama (Japan); Sakamaki, Kentaro [Department of Biostatistics, Yokohama City University Medical Center, Yokohama (Japan); Kunisaki, Chikara [Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama (Japan); Ogino, Ichiro; Watanabe, Shigenobu

    2016-06-15

    To evaluate clinical and dosimetric factors retrospectively affecting the risk of symptomatic cardiac disease (SCD) in esophageal cancer patients treated with radiotherapy. A total of 343 patients with newly diagnosed esophageal cancer were managed with concurrent chemoradiotherapy or radiotherapy alone. Of these, 58 patients were followed at our hospital for at least 4 years. Median clinical follow-up was 79 months. Cardiac toxicity was determined by Common Terminology Criteria for Adverse Events (CTCAE) v. 4.0. The maximum and mean doses to the heart and percentage of the volume were calculated from the dose-volume histograms. SCD manifested in 11 patients. The heart diseases included three pericardial effusions, one pericardial effusion with valvular disease and paroxysmal atrial tachycardia, three atrial fibrillations, one sinus tachycardia, one coronary artery disease, one chest pain with strongly suspected coronary artery disease, and one congestive heart failure. The actual incidence of SCD was 13.8 % at 5 years. Univariate and multivariate analyses of continuous variables revealed that the risk of developing an SCD depended on the volume of the heart receiving a dose greater than 45 Gy (V45), 50 Gy (V50), and 55 Gy (V55). No other clinical factors were found to influence the risk of SCD. For V45, V50, and V55, the lowest significant cutoff values were 15, 10, and 5 %, respectively. High-dose and large-volume irradiation of the heart increased the risk of SCD in long-term survivors. Using modern radiotherapy techniques, it is important to minimize the heart dose-volume parameters without reducing the tumor dose. (orig.) [German] Beurteilung von klinischen und dosimetrischen Faktoren, die mit Risiken eines retrospektiven Auftretens von symptomatischen Herzerkrankungen (SCD) bei Patienten zusammenhaengen, die aufgrund eines Oesophaguskarzinoms strahlentherapeutisch behandelt wurden. Insgesamt 343 Patienten mit neu diagnostiziertem Oesophaguskarzinom wurden mit

  1. Transforming growth factor-beta1 promotes the migration and invasion of sphere-forming stem-like cell subpopulations in esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yue, Dongli; Zhang, Zhen; Li, Jieyao; Chen, Xinfeng [Biotherapy Center, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou 450052, Henan, PR China (China); Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052 (China); Ping, Yu; Liu, Shasha [Biotherapy Center, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou 450052, Henan, PR China (China); School of Life Sciences, Zhengzhou University, Zhengzhou 450000 (China); Shi, Xiaojuan; Li, Lifeng [Biotherapy Center, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou 450052, Henan, PR China (China); Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052 (China); Wang, Liping [Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052 (China); Huang, Lan [Biotherapy Center, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou 450052, Henan, PR China (China); Zhang, Bin [Biotherapy Center, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou 450052, Henan, PR China (China); Robert H. Lurie Comprehensive Cancer Center, Department of Medicine-Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 (United States); Sun, Yan [Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052 (China); Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences (China); and others

    2015-08-01

    Esophageal cancer is one of the most lethal solid malignancies. Mounting evidence demonstrates that cancer stem cells (CSCs) are able to cause tumor initiation, metastasis and responsible for chemotherapy and radiotherapy failures. As CSCs are thought to be the main reason of therapeutic failure, these cells must be effectively targeted to elicit long-lasting therapeutic responses. We aimed to enrich and identify the esophageal cancer cell subpopulation with stem-like properties and help to develop new target therapy strategies for CSCs. Here, we found esophageal cancer cells KYSE70 and TE1 could form spheres in ultra low attachment surface culture and be serially passaged. Sphere-forming cells could redifferentiate and acquire morphology comparable to parental cells, when return to adherent culture. The sphere-forming cells possessed the key criteria that define CSCs: persistent self-renewal, overexpression of stemness genes (SOX2, ALDH1A1 and KLF4), reduced expression of differentiation marker CK4, chemoresistance, strong invasion and enhanced tumorigenic potential. SB525334, transforming growth factor-beta 1(TGF-β1) inhibitor, significantly inhibited migration and invasion of sphere-forming stem-like cells and had no effect on sphere-forming ability. In conclusion, esophageal cancer sphere-forming cells from KYSE70 and TE1 cultured in ultra low attachment surface possess cancer stem cell properties, providing a model for CSCs targeted therapy. TGF-β1 promotes the migration and invasion of sphere-forming stem-like cells, which may guide future studies on therapeutic strategies targeting these cells. - Highlights: • Esophageal cancer sphere-forming cells possess cancer stem cell properties. • Sphere-forming cells enhance TGF-β1 pathway activity. • TGF-β 1 inhibitor suppresses the migration and invasion of sphere-forming cells.

  2. Combined treatment of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer

    Institute of Scientific and Technical Information of China (English)

    Tian-Jie Qin; Gai-Li An; Xin-Han Zhao; Fang Tian; Xiao-Hua Li; Juan-Wen Lian; Bo-Rong Pan; Shan-Zhi Gu

    2009-01-01

    AIM: To investigate the efficacy and side effects of the combined therapy of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer (ESCC) and the survival of the patients. METHODS: Sixty-four patients (median age of 63 years) with histological or cytological confirmation of ESCC received oxaliplatin 120 mg/m2 intravenously on day 1 and capecitabine 1000 mg/m2 orally twice daily on days 1 to 14 in a 21-d treatment cycle as palliative chemotherapy. Each patient received at least two cycles of treatment. The efficacy, side effects and patient survival were evaluated. RESULTS: The partial response (PR) rate was 43.8% (28/64). Stable disease (SD) rate was 47.9% (26/64), and disease progression rate was 15.6% (10/64). The clinical benefit rate (PR + SD) was 84.4%. The main toxicities were leukopenia (50.0%), nausea and vomiting (51.6%), diarrhea (50.0%), stomatitis (39.1%), polyneuropathy (37.5%) and hand-foot syndrome (37.5%). No grade 4 event in the entire cohort was found. The median progression-free survival was 4 mo, median overall survival was 10 mo (95% CI: 8.3-11.7 mo), and the 1- and 2-year survival rates were 38.1% and 8.2%, respectively. High Karnofsky index, single metastatic lesion and response to the regimen indicated respectively good prognosis. CONCLUSION: Oxaliplatin plus capecitabine regimen is effective and tolerable in metastatic ESCC patients. The regimen has improved the survival moderately and merits further studies.

  3. Long-Term Survivorship of Esophageal Cancer Patients Treated with Radical Intent

    Directory of Open Access Journals (Sweden)

    Alex Agranovich

    2008-01-01

    Full Text Available To investigate the recent trends in definitive management of esophageal cancer, the records of 138 consecutive patients treated with radical intent in a single institution between 1995 and 2003 were reviewed and analyzed. The median follow-up period was 5.7 years (range 1.1 to 10.4 years. Seventy-seven patients were treated with radiation therapy (RT only and 61 with combined regimens (CRT, in which RT was combined with either radical surgery or chemotherapy, or both. The overall survival of the entire cohort was 32% over two years and 20% over five years. The survivorship in the RT group was 17% over two years and 5% over five years. In the CRT group, 51% and 35% survived over two and five years, respectively. From all the potential prognostic factors examined by univariate and multivariate analyses, only male sex and use of CRT were strongly associated with better survivorship. There was no significant difference in the outcomes among the different regimens of CRT. Survivorship was not affected by the location or histology of the tumour, clinical stage, dose of RT or use of endoluminal brachytherapy in addition to external beam RT. There was a greater tendency to use RT only more often in older patients, but patient age did not affect survivorship. The proportion of patients treated with CRT did not change significantly over the last versus the first four years of the observed period. Combined regimens are undoubtedly superior to RT as a single modality. The long-term survivorship of patients in a subgroup of our patients treated with combined modality protocols compared favourably with the previously reported results in the literature and specifically in prospective randomized trials. However, the optimal combined modality regimen is yet to be defined.

  4. Genetic susceptibility and environmental factors of esophageal cancer in Xi'an

    Institute of Scientific and Technical Information of China (English)

    An-Hui Wang; Chang-Sheng Sun; Liang-Shou Li; Jiu-Yi Huang; Qing-Shu Chen; De-Zhong Xu

    2004-01-01

    AIM: To analyse the role of genetic susceptibility and environmental factors in the process of esophageal cancer (EC) formation in Xi'an, China.METHODS: A hospital based case-control study, combined with molecular epidemiological method, was carried out. A total of 127 EC cases and 101 controls were interviewed with questionnaires containing demographic items, habit of tobacco smoking, alcohol drinking, and family history of EC.Polymorphism of CYP1A1 and GSTM1 of 127 EC cases and 101 controls were detected by PCR method. The interactions between genetic susceptibility and environmental factors were also discussed.RESULTS: Tobacco smoking, alcohol drinking and a family history of EC were risk factors for EC with an OR of 2.04(95% CI 1.15-3.60), 3.45(95% CI 1.74-6.91), 3.14 (95%CI 1.28-7.94), respectively. Individuals carrying CYP1A1 Val/Valgenotype compared to those with CYP1A1 Ile/Ile genotype had an increased risk for EC (OR 3.35, 95% CI 1.49-7.61). GSTM1 deletion genotype was a risk factor for EC (OR1.81, 95% CI 1.03-3.18). Gene-environment interaction analysis showed that CYP1A1 Val/Valgenotype, GSTM1 deletion genotype had synergetic interactions with tobacco smoking, alcohol drinking and family history of EC.CONCLUSION: Tobacco smoking, alcohol drinking and a family history of EC are risk factors for EC. CYP1A1 Val/'Va/and GSTM1 deletion genotypes are genetic susceptibility biomarkers for EC. There are synergic interactions between genetic susceptibility and environmental factors.

  5. Dosimetric comparison using different multileaf collimeters in intensity-modulated radiotherapy for upper thoracic esophageal cancer

    Directory of Open Access Journals (Sweden)

    Fu Yuchuan

    2010-07-01

    Full Text Available Abstract Purpose To study the impacts of multileaf collimators (MLC width [standard MLC width of 10 mm (sMLC and micro-MLC width of 4 mm (mMLC] in the intensity-modulated radiotherapy (IMRT planning for the upper thoracic esophageal cancer (UTEC. Methods and materials 10 patients with UTEC were retrospectively planned with the sMLC and the mMLC. The monitor unites (MUs and dose volume histogram-based parameters [conformity index (CI and homogeneous index (HI] were compared between the IMRT plans with sMLC and with mMLC. Results The IMRT plans with the mMLC were more efficient (average MUs: 703.1 ± 68.3 than plans with the sMLC (average MUs: 833.4 ± 73.8 (p p 5 (3260.3 ± 374.0 vs 3404.5 ± 374.4/gEUD (1815.1 ± 281.7 vs 1849.2 ± 297.6 of the spinal cord, the V10 (33.2 ± 6.5 vs 34.0 ± 6.7, V20 (16.0 ± 4.6 vs 16.6 ± 4.7, MLD (866.2 ± 174.1 vs 887.9 ± 172.1 and gEUD (938.6 ± 175.2 vs 956.8 ± 171.0 of the lungs were observed in the plans with the mMLC, respectively (p Conclusions Comparing to the sMLC, the mMLC not only demonstrated higher efficiencies and more optimal target coverage, but also considerably improved the dose sparing of OARs in the IMRT planning for UTEC.

  6. Volumetric Modulated Arc Therapy vs. IMRT for the Treatment of Distal Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Van Benthuysen, Liam, E-mail: liam.vanbenthuysen@roswellpark.org; Hales, Lee; Podgorsak, Matthew B.

    2011-01-01

    Several studies have demonstrated that volumetric modulated arc therapy (VMAT) has the ability to reduce monitor units and treatment time when compared with intensity-modulated radiation therapy (IMRT). This study aims to demonstrate that VMAT is able to provide adequate organs at risk (OAR) sparing and planning target volume (PTV) coverage for adenocarcinoma of the distal esophagus while reducing monitor units and treatment time. Fourteen patients having been treated previously for esophageal cancer were planned using both VMAT and IMRT techniques. Dosimetric quality was evaluated based on doses to several OARs, as well as coverage of the PTV. Treatment times were assessed by recording the number of monitor units required for dose delivery. Body V{sub 5} was also recorded to evaluate the increased volume of healthy tissue irradiated to low doses. Dosimetric differences in OAR sparing between VMAT and IMRT were comparable. PTV coverage was similar for the 2 techniques but it was found that IMRT was capable of delivering a slightly more homogenous dose distribution. Of the 14 patients, 12 were treated with a single arc and 2 were treated with a double arc. Single-arc plans reduced monitor units by 42% when compared with the IMRT plans. Double-arc plans reduced monitor units by 67% when compared with IMRT. The V{sub 5} for the body was found to be 18% greater for VMAT than for IMRT. VMAT has the capability to decrease treatment times over IMRT while still providing similar OAR sparing and PTV coverage. Although there will be a smaller risk of patient movement during VMAT treatments, this advantage comes at the cost of delivering small doses to a greater volume of the patient.

  7. Volumetric modulated arc therapy vs. IMRT for the treatment of distal esophageal cancer.

    Science.gov (United States)

    Van Benthuysen, Liam; Hales, Lee; Podgorsak, Matthew B

    2011-01-01

    Several studies have demonstrated that volumetric modulated arc therapy (VMAT) has the ability to reduce monitor units and treatment time when compared with intensity-modulated radiation therapy (IMRT). This study aims to demonstrate that VMAT is able to provide adequate organs at risk (OAR) sparing and planning target volume (PTV) coverage for adenocarcinoma of the distal esophagus while reducing monitor units and treatment time. Fourteen patients having been treated previously for esophageal cancer were planned using both VMAT and IMRT techniques. Dosimetric quality was evaluated based on doses to several OARs, as well as coverage of the PTV. Treatment times were assessed by recording the number of monitor units required for dose delivery. Body V(5) was also recorded to evaluate the increased volume of healthy tissue irradiated to low doses. Dosimetric differences in OAR sparing between VMAT and IMRT were comparable. PTV coverage was similar for the 2 techniques but it was found that IMRT was capable of delivering a slightly more homogenous dose distribution. Of the 14 patients, 12 were treated with a single arc and 2 were treated with a double arc. Single-arc plans reduced monitor units by 42% when compared with the IMRT plans. Double-arc plans reduced monitor units by 67% when compared with IMRT. The V(5) for the body was found to be 18% greater for VMAT than for IMRT. VMAT has the capability to decrease treatment times over IMRT while still providing similar OAR sparing and PTV coverage. Although there will be a smaller risk of patient movement during VMAT treatments, this advantage comes at the cost of delivering small doses to a greater volume of the patient.

  8. Changing incidence of esophageal cancer among white women: analysis of SEER data (1992–2010)

    Science.gov (United States)

    Raman, Rachna; Deorah, Sundeep; McDowell, Bradley D.; Hejleh, Taher Abu; Lynch, Charles F.

    2015-01-01

    Aim of the study To analyse trends in the incidence rates of adenocarcinoma and squamous cell carcinoma of the oesophagus (ACE and SCC, respectively) in white women between 1992 and 2010. Material and methods We used data from the Surveillance, Epidemiology, and End Results (SEER program to identify cases of esophageal cancer). Age adjusted incidence rates (IR) were calculated for ACE and SCC for two different time periods (1992–1996 and 2006–2010) and stratified by age, stage, and histologic type. We used joinpoint analysis to detect changes in rates between 1992 and 2010. Results Between the time periods 1992–1996 and 2006–2010, the age-adjusted incidence rates for SCC in white women decreased from 1.2/100,000 to 0.8/100,000 personyears, and for ACE it increased from 0.5/100,000 to 0.7/100,000 personyears. Similar to white men, the increase in the incidence of ACE was consistent for all stages and all age groups in white women. However, it was most pronounced in women aged 45–59 years, where the incidence of ACE (0.9/100,000 person-years) in 2006–2010 exceeded the incidence of SCC (0.6/100,000 person-years). On joinpoint regression analysis, an inflection point was seen in 1999 for ACE, indicating a slower rate of increase for ACE after 1999 (annual percentage change of 8.00 before 1999 vs. 0.88 starting in 1999). Conclusions The incidence of ACE is increasing in white women, irrespective of age or stage. Indeed, ACE is now more common than SCC in white women between 45 and 59 years of age. PMID:26557784

  9. Patient feature based dosimetric Pareto front prediction in esophageal cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jiazhou; Zhao, Kuaike; Peng, Jiayuan; Xie, Jiang; Chen, Junchao; Zhang, Zhen; Hu, Weigang, E-mail: jackhuwg@gmail.com [Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032 (China); Jin, Xiance [The 1st Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang 325000 (China); Studenski, Matthew [Department of Radiation Oncology, University of Miami-Miller School of Medicine, Miami, Florida 33136 (United States)

    2015-02-15

    Purpose: To investigate the feasibility of the dosimetric Pareto front (PF) prediction based on patient’s anatomic and dosimetric parameters for esophageal cancer patients. Methods: Eighty esophagus patients in the authors’ institution were enrolled in this study. A total of 2928 intensity-modulated radiotherapy plans were obtained and used to generate PF for each patient. On average, each patient had 36.6 plans. The anatomic and dosimetric features were extracted from these plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose, and PTV homogeneity index were recorded for each plan. Principal component analysis was used to extract overlap volume histogram (OVH) features between PTV and other organs at risk. The full dataset was separated into two parts; a training dataset and a validation dataset. The prediction outcomes were the MHD and MLD. The spearman’s rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The stepwise multiple regression method was used to fit the PF. The cross validation method was used to evaluate the model. Results: With 1000 repetitions, the mean prediction error of the MHD was 469 cGy. The most correlated factor was the first principal components of the OVH between heart and PTV and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 284 cGy. The most correlated factors were the first principal components of the OVH between heart and PTV and the overlap between lung and PTV in Z-axis. Conclusions: It is feasible to use patients’ anatomic and dosimetric features to generate a predicted Pareto front. Additional samples and further studies are required improve the prediction model.

  10. A germline predictive signature of response to platinum chemotherapy in esophageal cancer.

    Science.gov (United States)

    Rumiato, Enrica; Boldrin, Elisa; Malacrida, Sandro; Battaglia, Giorgio; Bocus, Paolo; Castoro, Carlo; Cagol, Matteo; Chiarion-Sileni, Vanna; Ruol, Alberto; Amadori, Alberto; Saggioro, Daniela

    2016-05-01

    Platinum-based neoadjuvant therapy is the standard treatment for esophageal cancer (EC). At present, no reliable response markers exist, and patient therapeutic outcome is variable and very often unpredictable. The aim of this study was to understand the contribution of host constitutive DNA polymorphisms in discriminating between responder and nonresponder patients. DNA collected from 120 EC patients treated with platinum-based neoadjuvant chemotherapy was analyzed using drug metabolism enzymes and transporters (DMET) array platform that interrogates polymorphisms in 225 genes of drug metabolism and disposition. Four gene variants of DNA repair machinery, 2 in ERCC1 (rs11615; rs3212986), and 2 in XPD (rs1799793; rs13181) were also studied. Association analysis was performed with pTest software and corrected by permutation test. Predictive models of response were created using the receiver-operating characteristics curve approach and adjusted by the bootstrap procedure. Sixteen single nucleotide polymorphisms (SNPs) of the DMET array resulted significantly associated with either good or poor response; no association was found for the 4 variants mapping in DNA repair genes. The predictive power of 5 DMET SNPs mapping in ABCC2, ABCC3, CYP2A6, PPARG, and SLC7A8 genes was greater than that of clinical factors alone (area under the curve [AUC] = 0.74 vs 0.62). Interestingly, their combination with the clinical variables significantly increased the predictivity of the model (AUC = 0.78 vs 0.62, P = 0.0016). In conclusion, we identified a genetic signature of response to platinum-based neoadjuvant chemotherapy in EC patients. Our results also disclose the potential benefit of combining genetic and clinical variables for personalized EC management.

  11. 外放疗联合食管支架治疗不可手术食管癌患者的Meta分析%Systematic review of esophageal stents plus radiotherapy in the treatment of patients with inoperable esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    贺生亮; 韩彪; 马敏杰; 魏宁; 杨侃; 张瑜

    2013-01-01

    Objective To evaluate the efficiency and safety of esophageal stents combined with radiotherapy compared with esophageal stents alone in the treatment of advanced esophageal cancer.Methods CBM,VIP,CNKI,Cochrane Library,Pubmed and Embase etc were searched by computer begining from the establishment of these datebases to December 2012.The related references as well as communicated with other researchers were also traced to obtain certain informations.Randomized and quasi-randomized controlled trials compared esophageal stents plus radiotherapy with esophageal stents alone in the treatment of advanced esophageal cancer were included.The statistical software RevMan 5.0 was used.Results Seven published articals were included (443 patients),and all trails methodological quality were grade C.The results of Metaanalysis showed that compared with esophageal stents along,esophageal stents combined with radiotherapy improve 1-year survival rates and reduce the local recurrence rates.Gastrointestinal bleeding rates,chest pain rates,gastro-esophageal reflux rates remained similarily.Conclusion Compared with esophageal stents along,esophageal stents combined with radiotherapy can improve 1-year survival rates and reduce the local recurrence rates.%目的 评价食管支架联合外放疗与单纯食管支架治疗晚期食管癌患者的疗效和安全性.方法 通过计算机检索中国生物医学文献数据库、中文科技期刊数据库、中国期刊全文数据库、Cochrane Library、Pubmed和Embase等数据库,检索时间为各数据库建库至2012年12月30日,同时辅助其他检索,收集有关食管支架联合外照射与单纯食管支架治疗中晚期食管癌的随机和半随机对照试验.采用RevMan5.0软件进行统计学分析.结果 共收集到7个已发表的随机对照试验,443例患者方法学质量评价均为C级.Meta分析结果显示,与单纯食管支架置人组比较,食管支架联合外放疗可提高中晚期食管癌患者的1

  12. Significant association among the Fas -670 A/G (rs1800682) polymorphism and esophageal cancer, hepatocellular carcinoma, and prostate cancer susceptibility: a meta-analysis.

    Science.gov (United States)

    Liu, Tao; Zuo, Li; Li, Lin; Yin, Lei; Liang, Kai; Yu, Hongyuan; Ren, Hui; Zhou, Wen; Jing, Hongwei; Liu, Yang; Kong, Chuize

    2014-11-01

    The Fas gene plays a key role in regulation of apoptotic cell death, and corruption of this signaling pathway has been shown to participate in immune escape and tumorgenesis. Single-nucleotide polymorphism in the promoter of Fas gene at position -670 A/G may affect its expression and play an important role in the pathology of many kinds of cancer. The association between Fas -670 A/G polymorphism and cancer risk is still controversial and ambiguous. Therefore, we conducted a meta-analysis of the currently literature to clarify this relationship. We conducted a search in the PubMed, EMbase, CNKI, and WanFang databases, covering all papers published by May 5, 2014. Overall, 59 case-control studies with 17,035 cases and 23,155 controls were retrieved based on the search criteria for cancer susceptibility related to -670 A/G polymorphism in Fas gene. Odds ratios (OR) and 95% confidence intervals (CI) revealed association strengths. Although no significant relationship was detected between Fas -670 A/G polymorphism and whole cancer risk, in the ethnicity subgroup, significant associations were found in three types of cancer: prostate cancer (OR = 1.06, 95% CI = 1.01-1.11 for A-allele vs. G-allele); hepatocellular carcinoma (OR = 0.89, 95% CI = 0.80-0.99 for AG vs. GG); esophageal cancer (OR = 0.95, 95% CI = 0.92-0.99 for AA + AG vs. GG). Moreover, lower cancer risk was found in smokers carried A-allele, when compared to smokers carried the GG genotype. The Fas -670 A/G polymorphism may be associated with esophageal cancer, hepatocellular carcinoma, and prostate cancer susceptibility from our meta-analysis. Studies with larger samples and gene-environment interactions are warranted to understand the role of Fas -670 A/G polymorphism for cancer risk.

  13. NcoI TNF-beta gene polymorphism and TNF expression are associated with an increased risk of developing Barrett's esophagus and esophageal adenocarcinoma

    NARCIS (Netherlands)

    Menke, Vivianda; van Zoest, Katinka P. M.; Moons, Leon M. G.; Hansen, Bettina; Pot, Raymond G. J.; Siersema, Peter D.; Kusters, Johannes G.; Kuipers, Ernst J.

    2012-01-01

    Objective. Esophageal cancer development is a sequence that starts with reflux esophagitis (RE), followed by Barrett's esophagitis (BE), dysplasia, and finally esophageal adenocarcinoma (EAC). Tumor necrosis factor (TNF) is a potent antineoplastic agent, hence DNA polymorphisms that reduce TNF level

  14. Determination of Internal Target Volume for Radiation Treatment Planning of Esophageal Cancer by Using 4-Dimensional Computed Tomography (4DCT)

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xiaojian [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Lu, Haijun [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Radiation Oncology Center, Affiliated Hospital of Medical College, Qingdao University, Qingdao (China); Tai, An; Johnstone, Candice; Gore, Elizabeth [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Li, X. Allen, E-mail: ali@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)

    2014-09-01

    Purpose: To determine an efficient strategy for the generation of the internal target volume (ITV) for radiation treatment planning for esophageal cancer using 4-dimensional computed tomography (4DCT). Methods and Materials: 4DCT sets acquired for 20 patients with esophageal carcinoma were analyzed. Each of the 4DCT sets was binned into 10 respiratory phases. For each patient, the gross tumor volume (GTV) was delineated on the 4DCT set at each phase. Various strategies to derive ITV were explored, including the volume from the maximum intensity projection (MIP; ITV{sub M}IP), unions of the GTVs from selected multiple phases ITV2 (0% and 50% phases), ITV3 (ITV2 plus 80%), and ITV4 (ITV3 plus 60%), as well as the volumes expanded from ITV2 and ITV3 with a uniform margin. These ITVs were compared to ITV10 (the union of the GTVs for all 10 phases) and the differences were measured with the overlap ratio (OR) and relative volume ratio (RVR) relative to ITV10 (ITVx/ITV10). Results: For all patients studied, the average GTV from a single phase was 84.9% of ITV10. The average ORs were 91.2%, 91.3%, 94.5%, and 96.4% for ITV{sub M}IP, ITV2, ITV3, and ITV4, respectively. Low ORs were associated with irregular breathing patterns. ITV3s plus 1 mm uniform margins (ITV3+1) led to an average OR of 98.1% and an average RVR of 106.4%. Conclusions: The ITV generated directly from MIP underestimates the range of the respiration motion for esophageal cancer. The ITV generated from 3 phases (ITV3) may be used for regular breathers, whereas the ITV generated from 4 phases (ITV4) or ITV3 plus a 1-mm uniform margin may be applied for irregular breathers.

  15. Effects of Lipid Emulsions in Parenteral Nutrition of Esophageal Cancer Surgical Patients Receiving Enteral Nutrition: A Comparative Analysis

    Directory of Open Access Journals (Sweden)

    Wu-Ping Wang

    2013-12-01

    Full Text Available Background: Olive oil-based lipid emulsion (LE and medium chain triglyceride/long chain triglyceride (MCT/LCT emulsion are both LEs with low ω-6 polyunsaturated fat acids (PUFAs content. However, which one of these LEs is associated with a lower infection risk in patients receiving parenteral nutrition (PN remains unclear. The aim of the study was to compare the effects of the two LEs in PN in esophageal cancer patients undergoing surgery. Methods: Patients with resectable esophageal carcinoma were recruited and allocated randomly to two groups. The test group was given enteral nutrition (EN with PN containing olive oil-based LE after tumor resection for ≥7 days, and the patients in the control group were supported by EN with MCT/LCT emulsion-based PN after surgery for the same time period. Immunological markers and inflammatory indicators were tested and perioperative clinical outcomes were determined. The trial was registered in the Chinese Clinical Trial Register, number ChiCTR-TRC-13003562. 94 Patients were recruited, and grouped (olive oil-based LE, n = 46 and MCT/LCT, n = 48, matched for sex, age, body mass index, histological type, TNM stage, and nutrition risk screening (NRS 2002 score. Results: There were no differences in perioperative fever (>38 °C, infectious complications, length of hospital stay (>14 days, length of critical care stay (>2 days, time for oral food intake, and in-hospital mortality between the two groups. The test group showed a higher increase in IgG level compared with the MCT/LCT group (p = 0.028. There was no difference in other immunological markers and inflammatory indicators between the two groups. Conclusion: PN containing olive oil-based or MCT/LCT LEs had similar effects on perioperative outcome, cell-mediated immune function and inflammatory response in esophageal cancer patients who had undergone surgery and were receiving EN.

  16. Subamolide a induces mitotic catastrophe accompanied by apoptosis in human lung cancer cells.

    Science.gov (United States)

    Hung, Jen-Yu; Wen, Ching-Wen; Hsu, Ya-Ling; Lin, En-Shyh; Huang, Ming-Shyan; Chen, Chung-Yi; Kuo, Po-Lin

    2013-01-01

    This study investigated the anticancer effects of subamolide A (Sub-A), isolated from Cinnamomum subavenium, on human nonsmall cell lung cancer cell lines A549 and NCI-H460. Treatment of cancer cells with Sub-A resulted in decreased cell viability of both lung cancer cell lines. Sub-A induced lung cancer cell death by triggering mitotic catastrophe with apoptosis. It triggered oxidant stress, indicated by increased cellular reactive oxygen species (ROS) production and decreased glutathione level. The elevated ROS triggered the activation of ataxia-telangiectasia mutation (ATM), which further enhanced the ATF3 upregulation and subsequently enhanced p53 function by phosphorylation at Serine 15 and Serine 392. The antioxidant, EUK8, significantly decreased mitotic catastrophe by inhibiting ATM activation, ATF3 expression, and p53 phosphorylation. The reduction of ATM and ATF3 expression by shRNA decreased Sub-A-mediated p53 phosphorylation and mitotic catastrophe. Sub-A also caused a dramatic 70% reduction in tumor size in an animal model. Taken together, cell death of lung cancer cells in response to Sub-A is dependent on ROS generation, which triggers mitotic catastrophe followed by apoptosis. Therefore, Sub-A may be a novel anticancer agent for the treatment of nonsmall cell lung cancer.

  17. Subamolide A Induces Mitotic Catastrophe Accompanied by Apoptosis in Human Lung Cancer Cells

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    Jen-Yu Hung

    2013-01-01

    Full Text Available This study investigated the anticancer effects of subamolide A (Sub-A, isolated from Cinnamomum subavenium, on human nonsmall cell lung cancer cell lines A549 and NCI-H460. Treatment of cancer cells with Sub-A resulted in decreased cell viability of both lung cancer cell lines. Sub-A induced lung cancer cell death by triggering mitotic catastrophe with apoptosis. It triggered oxidant stress, indicated by increased cellular reactive oxygen species (ROS production and decreased glutathione level. The elevated ROS triggered the activation of ataxia-telangiectasia mutation (ATM, which further enhanced the ATF3 upregulation and subsequently enhanced p53 function by phosphorylation at Serine 15 and Serine 392. The antioxidant, EUK8, significantly decreased mitotic catastrophe by inhibiting ATM activation, ATF3 expression, and p53 phosphorylation. The reduction of ATM and ATF3 expression by shRNA decreased Sub-A-mediated p53 phosphorylation and mitotic catastrophe. Sub-A also caused a dramatic 70% reduction in tumor size in an animal model. Taken together, cell death of lung cancer cells in response to Sub-A is dependent on ROS generation, which triggers mitotic catastrophe followed by apoptosis. Therefore, Sub-A may be a novel anticancer agent for the treatment of nonsmall cell lung cancer.

  18. Early Esophageal Cancer Specific Survival Is Unaffected by Anatomical Location of Tumor: A Population-Based Study

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    Rajan N. Amin

    2016-01-01

    Full Text Available Background. Approximately one-fifth of all esophageal cancer cases are defined as early esophageal cancer (EEC. Although endoscopic therapy (ET has been shown to be equally effective as esophagectomy (EST in patients with EEC, there is little information comparing the survival outcomes of the two therapies based on anatomical location. Methods. A population-based study was conducted and the data was obtained from Surveillance, Epidemiology, and End Results program. Patients with EEC (i.e., stages Tis and T1a and treated with either ET or EST were analyzed to compare EEC-related survival for three different locations of tumor. Results. The overall EEC-specific 1-year and 5-year mean (±SE survival rates were 11.66±0.05 and 52.80±0.58 months, respectively. Tumors located in lower third had better 5-year survival compared to those located in middle third (83.50% versus 73.10%, p<0.01. However, when adjusted for age, race, gender, marital status, grade, stage of tumor, histological type, and treatment modality, there was no significant difference. Conclusion. The EEC-specific 1-year or 5-year adjusted survival did not differ by anatomic location of the tumor. Therefore, ET might serve as a minimally invasive yet effective alternative to EST to treat EEC.

  19. Early Esophageal Cancer Specific Survival Is Unaffected by Anatomical Location of Tumor: A Population-Based Study

    Science.gov (United States)

    Parikh, Samip J.; Gangireddy, Venu Gopala Reddy; Kanneganti, Praveen; Talla, Swathi; Daram, Sumanth

    2016-01-01

    Background. Approximately one-fifth of all esophageal cancer cases are defined as early esophageal cancer (EEC). Although endoscopic therapy (ET) has been shown to be equally effective as esophagectomy (EST) in patients with EEC, there is little information comparing the survival outcomes of the two therapies based on anatomical location. Methods. A population-based study was conducted and the data was obtained from Surveillance, Epidemiology, and End Results program. Patients with EEC (i.e., stages Tis and T1a) and treated with either ET or EST were analyzed to compare EEC-related survival for three different locations of tumor. Results. The overall EEC-specific 1-year and 5-year mean (±SE) survival rates were 11.66 ± 0.05 and 52.80 ± 0.58 months, respectively. Tumors located in lower third had better 5-year survival compared to those located in middle third (83.50% versus 73.10%, p < 0.01). However, when adjusted for age, race, gender, marital status, grade, stage of tumor, histological type, and treatment modality, there was no significant difference. Conclusion. The EEC-specific 1-year or 5-year adjusted survival did not differ by anatomic location of the tumor. Therefore, ET might serve as a minimally invasive yet effective alternative to EST to treat EEC. PMID:27559535

  20. Comparison of planning target volumes based on three-dimensional and four-dimensional CT imaging of thoracic esophageal cancer

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    Wang W

    2016-08-01

    Full Text Available Wei Wang, Jianbin Li, Yingjie Zhang, Qian Shao, Min Xu, Tingyong Fan, Jinzhi Wang Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Shandong, People’s Republic of China Background and purpose: To investigate the definition of planning target volumes (PTVs based on four-dimensional computed tomography (4DCT compared with conventional PTV definition and PTV definition using asymmetrical margins for thoracic primary esophageal cancer. Materials and methods: Forty-three patients with esophageal cancer underwent 3DCT and 4DCT simulation scans during free breathing. The motions of primary tumors located in the proximal (group A, middle (group B, and distal (group C thoracic esophagus were obtained from the 4DCT scans. PTV3D was defined on 3DCT using the tumor motion measured based on 4DCT, PTV conventional (PTVconv was defined on 3DCT by adding a 1.0 cm margin to the clinical target volume, and PTV4D was defined as the union of the target volumes contoured on the ten phases of the 4DCT images. The centroid positions, volumetric differences, and dice similarity coefficients were evaluated for all PTVs. Results: The median centroid shifts between PTV3D and PTV4D and between PTVconv and PTV4D in all three dimensions were <0.3 cm for the three groups. The median size ratios of PTV4D to PTV3D were 0.80, 0.88, and 0.71, and PTV4D to PTVconv were 0.67, 0.73, and 0.76 (χ2=–3.18, –2.98, and –3.06; P=0.001, 0.003, and 0.002 for groups A, B, and C, respectively. The dice similarity coefficients were 0.87, 0.90, and 0.81 between PTV4D and PTV3D and 0.80, 0.84, and 0.83 between PTV4D and PTVconv (χ2=–3.18, –2.98, and –3.06; P=0.001, 0.003, and 0.002 for groups A, B, and C, respectively. The difference between the degree of inclusion of PTV4D in PTV3D and that of PTV4D in PTVconv was <2% for all groups. Compared with PTVconv, the amount of irradiated normal tissue

  1. Dietician-delivered intensive nutritional support is associated with a decrease in severe postoperative complications after surgery in patients with esophageal cancer.

    Science.gov (United States)

    Ligthart-Melis, G C; Weijs, P J M; te Boveldt, N D; Buskermolen, S; Earthman, C P; Verheul, H M W; de Lange-de Klerk, E S M; van Weyenberg, S J B; van der Peet, D L

    2013-08-01

    The aim of this study was to evaluate the effect of dietician-delivered intensive nutritional support (INS) on postoperative outcome in patients with esophageal cancer. Approximately 50-80% of patients with esophageal cancer are malnourished at the time of diagnosis. Malnutrition enhances the risk of postoperative complications, resulting in delay of postoperative recovery and impairment of quality of life. Sixty-five patients with esophageal cancer were included. All patients who received surgery (n = 28) in the time frame between March 2009 and April 2010, the first year after the start of INS, were included in the INS intervention group. The control group (n = 37) consisted of patients who received surgery during the 3 years before the start of INS. Logistic regression analysis was used to compare differences in severity of postoperative complications using the Dindo classification. Linear regression was applied to evaluate differences in preoperative weight change. The adjusted odds ratio for developing serious complications after surgery of INS compared with the control group was 0.23 (95% confidence interval: 0.053-0.97; P = 0.045). Benefit was mainly observed in patients who received neoadjuvant therapy before esophagectomy (n = 35). The INS program furthermore resulted in a relative preoperative weight gain in comparison with the control group of +4.8% (P = 0.009, adjusted) in these neoadjuvant-treated patients. This study shows that dietician-delivered INS preserves preoperative weight and decreases severe postoperative complications in patients with esophageal cancer.

  2. Importance of fluorodeoxyglucose-positron emission tomography (FDG-PET) and endoscopic ultrasonography parameters in predicting survival following surgery for esophageal cancer

    NARCIS (Netherlands)

    Omloo, J. M. T.; Sloof, G. W.; Boellaard, R.; Hoekstra, O. S.; Jager, P. L.; van Dullemen, H. M.; Fockens, P.; Plukker, J. T. M.; van Lanschot, J. J. B.

    2008-01-01

    Background and study aims: To assess the prognostic importance of standardized uptake value (SUV) for 18F-fluorodeoxyglucose (FDG) at positron emission tomography (PET) and of EUS parameters, in esophageal cancer patients primarily treated by surgery. Patients and methods: Between October 2002 and A

  3. The Incremental Value of Subjective and Quantitative Assessment of 18F-FDG PET for the Prediction of Pathologic Complete Response to Preoperative Chemoradiotherapy in Esophageal Cancer

    NARCIS (Netherlands)

    van Rossum, Peter S N; Fried, David V; Zhang, Lifei; Hofstetter, Wayne L; van Vulpen, Marco; Meijer, Gert J; Court, Laurence E; Lin, Steven H

    2016-01-01

    UNLABELLED: A reliable prediction of a pathologic complete response (pathCR) to chemoradiotherapy before surgery for esophageal cancer would enable investigators to study the feasibility and outcome of an organ-preserving strategy after chemoradiotherapy. So far no clinical parameters or diagnostic

  4. [A case of double advanced cancer with esophageal and hypopharyngeal carcinoma responding completely to combination chemotherapy of docetaxel/5-fluorouracil and nedaplatin with radiation].

    Science.gov (United States)

    Matsutani, Takeshi; Sasajima, Koji; Kobayashi, Yuko; Suzuki, Seiji; Maruyama, Hiroshi; Miyamoto, Masayuki; Yokoyama, Tadashi; Sugiura, Atsushi; Matsushita, Akira; Yanagi, Ken; Matsuda, Akihisa; Arai, Hiroki; Nishi, Yoshifumi; Wakabayashi, Hideyuki; Tajiri, Takashi

    2009-05-01

    A 69-year-old male was admitted to our hospital because of dysphagia. The diagnosis was double cancer with hypopharyngeal and esophageal carcinoma from upper gastrointestinal endoscopic examination. Pathological examinations of the double cancer revealed moderately-differentiated squamous cell carcinoma. Computed tomography(CT)of the neck and abdomen showed metastases of the right neck and cardiac lymph nodes. Clinical stagings of the double cancer were Stage III (T1, N1, M0)in hypopharyngeal carcinoma and Stage III (T3, N1, M0)in esophageal carcinoma, respectively. He received radiation therapy in combination with chemotherapy using docetaxel(DOC), 5-fluorouracil (5-FU)and nedaplatin(CDGP). After this combination chemoradiation therapy(CRT), the adverse event was grade 2 in leucopenia and grade 2 in gastrointestinal toxicity. Repeated macroscopic and histological examinations after CRT revealed disappearance of the hypopharyngeal and advanced esophageal carcinoma with lymph node metastasis, leading to a complete response(CR). He had maintained CR for the 20 months since undergoing CRT. This combination chemotherapy of DOC, 5-FU and CDGP with radiation may well be effective and tolerable for patients with double cancer of hypopharyngeal and esophageal carcinoma.

  5. The usefulness of three-dimensional cell culture in induction of cancer stem cells from esophageal squamous cell carcinoma cell lines

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    Fujiwara, Daisuke [Department of Esophageal and Gastroenterological Surgery, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421 (Japan); Kato, Kazunori, E-mail: kzkatou@juntendo.ac.jp [Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe, Saitama 350-8585 (Japan); Department of Atopy Research Center, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421 (Japan); Nohara, Shigeo; Iwanuma, Yoshimi; Kajiyama, Yoshiaki [Department of Esophageal and Gastroenterological Surgery, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421 (Japan)

    2013-05-17

    Highlights: •Spheroids were created from esophageal carcinoma cells using NanoCulture® Plates. •The proportion of strongly ALDH-positive cells increased in 3-D culture. •Expression of cancer stem cell-related genes was enhanced in 3-D culture. •CA-9 expression was enhanced, suggesting hypoxia had been induced in 3-D culture. •Drug resistance was increased. 3-D culture is useful for inducing cancer stem cells. -- Abstract: In recent years, research on resistance to chemotherapy and radiotherapy in cancer treatment has come under the spotlight, and researchers have also begun investigating the relationship between resistance and cancer stem cells. Cancer stem cells are assumed to be present in esophageal cancer, but experimental methods for identification and culture of these cells have not yet been established. To solve this problem, we created spheroids using a NanoCulture® Plate (NCP) for 3-dimensional (3-D) cell culture, which was designed as a means for experimentally reproducing the 3-D structures found in the body. We investigated the potential for induction of cancer stem cells from esophageal cancer cells. Using flow cytometry we analyzed the expression of surface antigen markers CD44, CD133, CD338 (ABCG2), CD318 (CDCP1), and CD326 (EpCAM), which are known cancer stem cell markers. None of these surface antigen markers showed enhanced expression in 3-D cultured cells. We then analyzed aldehyde dehydrogenase (ALDH) enzymatic activity using the ALDEFLUOR reagent, which can identify immature cells such as stem cells and precursor cells. 3-D-cultured cells were strongly positive for ALDH enzyme activity. We also analyzed the expression of the stem cell-related genes Sox-2, Nanog, Oct3/4, and Lin28 using RT-PCR. Expression of Sox-2, Nanog, and Lin28 was enhanced. Analysis of expression of the hypoxic surface antigen marker carbonic anhydrase-9 (CA-9), which is an indicator of cancer stem cell induction and maintenance, revealed that CA-9 expression

  6. Volumetric modulated arc therapy vs. c-IMRT for the treatment of upper thoracic esophageal cancer.

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    Wu-Zhe Zhang

    Full Text Available To compare plans using volumetric-modulated arc therapy (VMAT with conventional sliding window intensity-modulated radiation therapy (c-IMRT to treat upper thoracic esophageal cancer (EC.CT datasets of 11 patients with upper thoracic EC were identified. Four plans were generated for each patient: c-IMRT with 5 fields (5F and VMAT with a single arc (1A, two arcs (2A, or three arcs (3A. The prescribed doses were 64 Gy/32 F for the primary tumor (PTV64. The dose-volume histogram data, the number of monitoring units (MUs and the treatment time (TT for the different plans were compared.All of the plans generated similar dose distributions for PTVs and organs at risk (OARs, except that the 2A- and 3A-VMAT plans yielded a significantly higher conformity index (CI than the c-IMRT plan. The CI of the PTV64 was improved by increasing the number of arcs in the VMAT plans. The maximum spinal cord dose and the planning risk volume of the spinal cord dose for the two techniques were similar. The 2A- and 3A-VMAT plans yielded lower mean lung doses and heart V50 values than the c-IMRT. The V20 and V30 for the lungs in all of the VMAT plans were lower than those in the c-IMRT plan, at the expense of increasing V5, V10 and V13. The VMAT plan resulted in significant reductions in MUs and TT.The 2A-VMAT plan appeared to spare the lungs from moderate-dose irradiation most effectively of all plans, at the expense of increasing the low-dose irradiation volume, and also significantly reduced the number of required MUs and the TT. The CI of the PTVs and the OARs was improved by increasing the arc-number from 1 to 2; however, no significant improvement was observed using the 3A-VMAT, except for an increase in the TT.

  7. TP53 Arg72Pro polymorphism is associated with esophageal cancer risk: A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    De-Ke Jiang; Lei Yao; Wen-Zhang Wang; Bo Peng; Wei-Hua Ren; Xian-Mei Yang; Long Yu

    2011-01-01

    AIM: To investigate the association between TP53 Ar-g72Pro polymorphism and esophageal cancer (EC) risk using meta-analysis.METHODS: All eligible studies published before March 1, 2010 were selected by searching PubMed using key-words “p53” or “TP53”, “polymorphism” or “variation”, “esophageal” and “cancer” or “carcinoma”. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were assessed for EC risk associated with TP53 Arg72Pro polymorphism using fixed- and random-effects models.RESULTS: Nine case-control studies involving 5545 subjects were included in this meta-analysis. Signifi-cantly reduced risk of EC was associated with TP53 genotypes for Arg/Arg + Arg/Pro vs Pro/Pro (OR = 0.73, 95% CI: 0.57-0.94, P = 0.014). Subgroup analy-ses according to the source of controls and the speci-mens used for determining TP53 Arg72Pro genotypes or sample size showed that significantly reduced risk was observed only in studies which have population-based controls (Arg/Arg vs Pro/Pro: OR = 0.56, 95% CI: 0.47-0.66, P < 0.001), and use white blood cells or normal tissue to assess TP53 genotypes of cases (Arg/Arg vs Pro/Pro: OR = 0.56, 95% CI: 0.47-0.65, P < 0.001) or include at least 200 subjects (Arg/Arg vs Pro/Pro: OR = 0.56, 95% CI: 0.47-0.65, P < 0.001). Analysis restricted to well-designed studies also sup-ported the significantly decreased risk of EC (Arg/Arg vs Pro/Pro: OR = 0.54, 95% CI: 0.46-0.64, P < 0.001). CONCLUSION: TP53 Arg72 carriers are significantly as-sociated with decreased EC risk. Nevertheless, more well-designed studies are needed to confirm our findings.

  8. Learning curve and interobserver agreement of confocal laser endomicroscopy for detecting precancerous or early-stage esophageal squamous cancer.

    Directory of Open Access Journals (Sweden)

    Jing Liu

    Full Text Available Confocal laser endomicroscopy (CLE can provide in vivo subcellular resolution images of esophageal lesions. However, the learning curve in interpreting CLE images of precancerous or early-stage esophageal squamous cancer is unknown. The goal of this study is to evaluate the diagnostic accuracy and inter-observer agreement for differentiating esophageal lesions in CLE images among experienced and inexperienced observers and to assess the learning curve.After a short training, 8 experienced and 14 inexperienced endoscopists evaluated in sequence 4 sets of high-quality CLE images. Their diagnoses were corrected and discussed after each set. For each image, the diagnostic results, confidence in diagnosis, quality and time to evaluate were recorded.Overall, diagnostic accuracy was greater for the second, third, fourth set of images as compared with the initial set (odds ratio [OR] 2.01, 95% CI 1.22-3.31; 7.95, 3.74-16.87; and 6.45, 3.14-13.27, respectively, with no difference between the third and fourth sets in accuracy (p = 0.67. Previous experience affected the diagnostic accuracy only in the first set of images (OR 3.70, 1.87-7.29, p<0.001. Inter-observer agreement was higher for experienced than inexperienced endoscopists (0.732 vs. 0.666, p<0.01.CLE is a promising technology that can be quickly learned after a short training period; previous experience is associated with diagnostic accuracy only at the initial stage of learning.

  9. miR-30b inhibits cancer cell growth, migration, and invasion by targeting homeobox A1 in esophageal cancer.

    Science.gov (United States)

    Li, Qing; Zhang, Xuan; Li, Ning; Liu, Qin; Chen, Dongfeng

    2017-02-09

    Emerging evidence has shown that microRNAs (miRNAs) play important roles in tumor development and progression. In particular, miR-30b is thought to be closely related to the migration, invasion, proliferation, communication, and drug resistance of tumor cells. However, the potential value of miR-30b in human esophageal cancer (EC) remains unclear. In this study, we investigated the biological functions of miR-30b and its potential role in EC. The results indicated that the expression levels of miR-30b were decreased in EC tissues and were correlated with invasion classification (P < 0.01), lymph node metastasis (P < 0.01), and pathological stage (P < 0.05). Log-rank tests demonstrated that low expression of miR-30bwas strongly correlated with poor overall survival in patients with EC (P < 0.05). Moreover, overexpression of miR-30b markedly inhibited the growth, migration, and invasion of ECA109 and TE-1 cells by directly downregulating homeobox A1 (HOXA1). When HOXA1 was reintroduced into miR-30b-transfected ECA109 or TE-1 cells, the inhibitory effects of miR-30b on EC cell growth, migration, and invasion were markedly reversed. In conclusion, our findings demonstrated that miR-30b could inhibit tumor cell growth, migration, and invasion by directly targeting HOXA1 in EC cells.

  10. Analysis of Intensity-Modulated Radiation Therapy (IMRT), Proton and 3D Conformal Radiotherapy (3D-CRT) for Reducing Perioperative Cardiopulmonary Complications in Esophageal Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ling, Ted C.; Slater, Jerry M.; Nookala, Prashanth; Mifflin, Rachel; Grove, Roger; Ly, Anh M.; Patyal, Baldev; Slater, Jerry D.; Yang, Gary Y., E-mail: gyang@llu.edu [Department of Radiation Medicine, Loma Linda University Medical Center, 11234 Anderson Street, A875, Loma Linda, CA 92354 (United States)

    2014-12-05

    Background. While neoadjuvant concurrent chemoradiotherapy has improved outcomes for esophageal cancer patients, surgical complication rates remain high. The most frequent perioperative complications after trimodality therapy were cardiopulmonary in nature. The radiation modality utilized can be a strong mitigating factor of perioperative complications given the location of the esophagus and its proximity to the heart and lungs. The purpose of this study is to make a dosimetric comparison of Intensity-Modulated Radiation Therapy (IMRT), proton and 3D conformal radiotherapy (3D-CRT) with regard to reducing perioperative cardiopulmonary complications in esophageal cancer patients. Materials. Ten patients with esophageal cancer treated between 2010 and 2013 were evaluated in this study. All patients were simulated with contrast-enhanced CT imaging. Separate treatment plans using proton radiotherapy, IMRT, and 3D-CRT modalities were created for each patient. Dose-volume histograms were calculated and analyzed to compare plans between the three modalities. The organs at risk (OAR) being evaluated in this study are the heart, lungs, and spinal cord. To determine statistical significance, ANOVA and two-tailed paired t-tests were performed for all data parameters. Results. The proton plans showed decreased dose to various volumes of the heart and lungs in comparison to both the IMRT and 3D-CRT plans. There was no difference between the IMRT and 3D-CRT plans in dose delivered to the lung or heart. This finding was seen consistently across the parameters analyzed in this study. Conclusions. In patients receiving radiation therapy for esophageal cancer, proton plans are technically feasible while achieving adequate coverage with lower doses delivered to the lungs and cardiac structures. This may result in decreased cardiopulmonary toxicity and less morbidity to esophageal cancer patients.

  11. A Phase II Study of a Paclitaxel-Based Chemoradiation Regimen With Selective Surgical Salvage for Resectable Locoregionally Advanced Esophageal Cancer: Initial Reporting of RTOG 0246

    Energy Technology Data Exchange (ETDEWEB)

    Swisher, Stephen G., E-mail: sswisher@mdanderson.org [Department of Thoracic and Cardiovascular Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Winter, Kathryn A. [Headquarters, Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Komaki, Ritsuko U. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Wu, Tsung T. [Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota (United States); Hofstetter, Wayne L. [Department of Thoracic and Cardiovascular Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Konski, Andre A. [Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Willett, Christopher G. [Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2012-04-01

    Purpose: The strategy of definitive chemoradiation with selective surgical salvage in locoregionally advanced esophageal cancer was evaluated in a Phase II trial in Radiation Therapy Oncology Group (RTOG)-affiliated sites. Methods and Materials: The study was designed to detect an improvement in 1-year survival from 60% to 77.5% ({alpha} = 0.05; power = 80%). Definitive chemoradiation involved induction chemotherapy with 5-fluorouracil (5-FU) (650 mg/mg{sup 2}/day), cisplatin (15 mg/mg{sup 2}/day), and paclitaxel (200 mg/mg{sup 2}/day) for two cycles, followed by concurrent chemoradiation with 50.4 Gy (1.8 Gy/fraction) and daily 5-FU (300 mg/mg{sup 2}/day) with cisplatin (15 mg/mg{sup 2}/day) over the first 5 days. Salvage surgical resection was considered for patients with residual or recurrent esophageal cancer who did not have systemic disease. Results: Forty-three patients with nonmetastatic resectable esophageal cancer were entered from Sept 2003 to March 2006. Forty-one patients were eligible for analysis. Clinical stage was {>=}T3 in 31 patients (76%) and N1 in 29 patients (71%), with adenocarcinoma histology in 30 patients (73%). Thirty-seven patients (90%) completed induction chemotherapy followed by concurrent chemoradiation. Twenty-eight patients (68%) experienced Grade 3+ nonhematologic toxicity. Four treatment-related deaths were noted. Twenty-one patients underwent surgery following definitive chemoradiation because of residual (17 patients) or recurrent (3 patients) esophageal cancer,and 1 patient because of choice. Median follow-up of live patients was 22 months, with an estimated 1-year survival of 71%. Conclusions: In this Phase II trial (RTOG 0246) evaluating selective surgical salvage after definitive chemoradiation in locoregionally advanced esophageal cancer, the hypothesized 1-year RTOG survival rate (77.5%) was not achieved (1 year, 71%; 95% confidence interval< 54%-82%).

  12. [Colon cancer: a rare complication in a colonic esophageal segment after coloesophagoplasty].

    Science.gov (United States)

    Martín, Miguel Angel; Ferrás, Albio

    2005-01-01

    We report the case of a 65-year-old woman who presented to the Hermanos Ameijeiras Hospital in Cuba due to dysphagia for the previous 5 months. Forty years previously, she had undergone esophagocoloplasty for caustic esophagitis. Adenocarcinoma was diagnosed in the colonic interposition. The tumor was resected with oncologic margins and food transit was successfully restored.

  13. An Interdisciplinary Nutrition Support Team Improves Clinical and Hospitalized Outcomes of Esophageal Cancer Patients with Concurrent Chemoradiotherapy

    Institute of Scientific and Technical Information of China (English)

    Ming-Hua Cong; Shu-Luan Li; Guo-Wei Cheng; Jin-Ying Liu; Chen-Xin Song; Ying-Bing Deng; Wei-Hu Shang

    2015-01-01

    Background: The prevalence of malnutrition is very high in patients with cancer.The purpose of this study was to investigate whether or not a nutrition support team (NST) could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT).Methods: Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group.The nutritional statuses of 25 patients in the NST group were managed by the NST.The other 25 patients in the control group underwent the supervision of radiotherapy practitioners.At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated.Besides, the length of hospital stay (LOS) and the in-patient cost were also compared between these two groups.Results: At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB), transferrin, andALB parameters (P =0.001, 0.000, and 0.000, respectively).The complication incidences, including bone marrow suppression (20% vs.48%, P =0.037) and complications related infections (12% vs.44%, P=0.012), in the NST group were lower and significantly different from the control group.In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs.76%, P =0.103).Furthermore, the average LOS was decreased by 4.5 days (P =0.001) and in-patient cost was reduced to 1.26 4 0.75 thousand US dollars person-times (P ≥ 0.05) in the NST group.Conclusions: A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF.Moreover, the NST could be helpful on reducing LOS and in-patient costs.

  14. SnoN/SKIL modulates proliferation through control of hsa-miR-720 transcription in esophageal cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    Shinozuka, Eriko; Miyashita, Masao [Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602 (Japan); Mizuguchi, Yoshiaki, E-mail: yoshi1224@gmail.com [Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602 (Japan); Akagi, Ichiro [Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602 (Japan); Kikuchi, Kunio [Department of Molecular Anatomy and Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602 (Japan); Makino, Hiroshi; Matsutani, Takeshi; Hagiwara, Nobutoshi; Nomura, Tsutomu; Uchida, Eiji [Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602 (Japan); Takizawa, Toshihiro, E-mail: t-takizawa@nms.ac.jp [Department of Molecular Anatomy and Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602 (Japan)

    2013-01-04

    Highlights: Black-Right-Pointing-Pointer SnoN modulated miR-720, miR-1274A, and miR-1274B expression levels in TE-1 cells. Black-Right-Pointing-Pointer miR-720 and miR-1274A suppressed the expression of target proteins p63 and ADAM9. Black-Right-Pointing-Pointer Silencing of SnoN significantly upregulated cell proliferation in TE-1 cells. Black-Right-Pointing-Pointer Esophageal cancer tissues have lower SnoN expression levels than normal tissues. Black-Right-Pointing-Pointer Esophageal cancer tissues have higher miR-720 expression levels than normal tissues. -- Abstract: It is now evident that changes in microRNA are involved in cancer progression, but the mechanisms of transcriptional regulation of miRNAs remain unknown. Ski-related novel gene (SnoN/SKIL), a transcription co-factor, acts as a potential key regulator within a complex network of p53 transcriptional repressors. SnoN has pro- and anti-oncogenic functions in the regulation of cell proliferation, senescence, apoptosis, and differentiation. We characterized the roles of SnoN in miRNA transcriptional regulation and its effects on cell proliferation using esophageal squamous cell carcinoma (ESCC) cells. Silencing of SnoN altered a set of miRNA expression profiles in TE-1cells, and the expression levels of miR-720, miR-1274A, and miR-1274B were modulated by SnoN. The expression of these miRNAs resulted in changes to the target protein p63 and a disintegrin and metalloproteinase domain 9 (ADAM9). Furthermore, silencing of SnoN significantly upregulated cell proliferation in TE-1 cells, indicating a potential anti-oncogenic function. These results support our observation that cancer tissues have lower expression levels of SnoN, miR-720, and miR-1274A compared to adjacent normal tissues from ESCC patients. These data demonstrate a novel mechanism of miRNA regulation, leading to changes in cell proliferation.

  15. Multiple von Meyenburg complexes mimicking diffuse liver metastases from esophageal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Stefan Fritz; Thilo Hackert; Hendrik Blaker; Werner Hartwig; Lutz Schneider; Markus W Buchler; Jens Werner

    2006-01-01

    Von Meyenburg complexes are benign liver lesions consisting of adenomatous bile duct proliferates. We present two patients suffering from esophageal cancer accompanied by the occurrence of von Meyenburg complexes.Preoperative computerized tomography (CT) of the liver had not shown these lesions. In one of the patients, diffuse nodular manifestation was found in both liver lobes,mimicking diffuse hepatic metastases. Intraoperative frozen section revealed the benign nature of the lesions in both cases. The patients underwent esophageal resection without complications. To the best of our knowledge, the coincidence of von Meyenburg complexes and esophageal cancer has never been reported before. This uncommon entity should be taken into consideration as a differential diagnosis of liver lesions in malignancies. It underlines the importance of intraoperative frozen section for liver lesions of unknown origin.

  16. Epidermization in the esophageal mucosa: unusual epithelial changes clearly detected by Lugol's staining.

    Science.gov (United States)

    Nakanishi, Y; Ochiai, A; Shimoda, T; Yamaguchi, H; Tachimori, Y; Kato, H; Watanabe, H; Hirohashi, S

    1997-05-01

    A 58-year-old Japanese man with superficial esophageal cancer accompanied by unusual epithelial changes, including esophageal mucosal epidermization, is reported. Staining with Lugol's iodine clearly showed irregular unstained lesions, which could not be seen clearly macroscopically, in the resected specimen. Histologic examination of the irregular unstained areas showed definite granular and horny layers regarded as epidermization, acanthosis with slight nuclear enlargement, and epithelial atrophy. The immunohistochemical staining patterns of keratins in the epidermized and atrophic lesions were similar to those in the epidermis, and the keratin staining patterns of the acanthotic lesion were similar to those of the oral epithelium.

  17. Prognostic Impact of the 6th and 7th American Joint Committee on Cancer TNM Staging Systems on Esophageal Cancer Patients Treated With Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Motoo, E-mail: excell@hkg.odn.ne.jp [Department of Clinical Oncology, Aichi Cancer Center Hospital (Japan); Department of Radiation Oncology, Aichi Cancer Center Hospital (Japan); Shitara, Kohei [Department of Clinical Oncology, Aichi Cancer Center Hospital (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center Hospital (Japan); Hatooka, Shunzo [Department of Thoracic Surgery, Aichi Cancer Center Hospital (Japan); Mizota, Ayako; Kondoh, Chihiro; Yokota, Tomoya; Takahari, Daisuke; Ura, Takashi; Muro, Kei [Department of Clinical Oncology, Aichi Cancer Center Hospital (Japan)

    2012-02-01

    Purpose: The new 7th edition of the American Joint Committee on Cancer TNM staging system is based on pathologic data from esophageal cancers treated by surgery alone. There is no information available on evaluation of the new staging system with regard to prognosis of patients treated with chemoradiotherapy (CRT). The objective of this study was to evaluate the prognostic impact of the new staging system on esophageal cancer patients treated with CRT. Methods and Materials: A retrospective review was performed on 301 consecutive esophageal squamous cell carcinoma patients treated with CRT. Comparisons were made of the prognostic impacts of the 6th and 7th staging systems and the prognostic impacts of stage and prognostic groups, which were newly defined in the 7th edition. Results: There were significant differences between Stages I and III (p < 0.01) according to both editions. However, the 7th edition poorly distinguishes the prognoses of Stages III and IV (p = 0.36 by multivariate analysis) in comparison to the 6th edition (p = 0.08 by multivariate analysis), although these differences were not significant. For all patients, T, M, and gender were independent prognostic factors by multivariate analysis (p < 0.05). For the Stage I and II prognostic groups, survival curves showed a stepwise decrease with increase in stage, except for Stage IIA. However, there were no significant differences seen between each prognostic stage. Conclusions: Our study indicates there are several problems with the 7th TNM staging system regarding prognostic factors in patients undergoing CRT.

  18. Psychosocial Accompaniment

    Directory of Open Access Journals (Sweden)

    Mary Watkins

    2015-08-01

    Full Text Available This essay advocates for a paradigm shift in psychology toward the activity and ethics of accompaniment. Accompaniment requires a reorientation of the subjectivity, interpersonal practices, and critical understanding of the accompanier so that (she can stand alongside others who desire listening, witnessing, advocacy, space to develop critical inquiry and research, and joint imagination and action to address desired and needed changes. The idea of “accompaniment” emerged in liberation theology in Latin America, and migrated into liberatory forms of psychology as “psychosocial accompaniment.” This essay explores accompaniment and its ethics from a phenomenological perspective, highlighting differences from mainstream stances in psychology. Attention is also given to the effects of accompaniment on the accompanier. Efforts to decolonize psychology require careful attention to the psychic decolonization of its practitioners and to the cultivation of decolonizing interpersonal practices that provide a relational and ethical foundation for joint research, restorative healing, and transformative action. Such practices endeavor through dialogue to build mutual respect and understanding, promote effective solidarity, and contribute to the empowerment of those marginalized. The decolonization of psychology should enable practitioners to be more effective in working for increased social, economic, and environmental justice; peace building and reconciliation; and local and global ecological sustainability.

  19. Esophageal strictures during treatment for acute lymphoblastic leukemia.

    LENUS (Irish Health Repository)

    Kelly, Kevin

    2012-02-01

    Esophageal stricture is a rare complication of paediatric cancer treatment that usually occurs after esophageal exposure to radiotherapy. We describe 4 cases of esophageal stricture during chemotherapy for acute lymphoblastic leukemia. All patients presented with refractory vomiting and were diagnosed with radiologic contrast studies. None of the patients had received radiotherapy. Esophageal candidiasis was seen in 2 patients but the remaining 2 patients had earlier systemic candidiasis. High-dose dexamethasone may predispose these children to both esophageal candidiasis and peptic esophagitis. The etiology of esophageal strictures during treatment for acute leukemia is likely to be multifactorial but systemic candidiasis may play a significant role.

  20. Response Assessment and Prediction in Esophageal Cancer Patients via F-18 FDG PET/CT Scans

    Science.gov (United States)

    Higgins, Kyle J.

    Purpose: The purpose of this study is to utilize F-18 FDG PET/CT scans to determine an indicator for the response of esophageal cancer patients during radiation therapy. There is a need for such an indicator since local failures are quite common in esophageal cancer patients despite modern treatment techniques. If an indicator is found, a patient's treatment strategy may be altered to possibly improve the outcome. This is investigated with various standard uptake volume (SUV) metrics along with image texture features. The metrics and features showing the most promise and indicating response are used in logistic regression analysis to find an equation for the prediction of response. Materials and Methods: 28 patients underwent F-18 FDG PET/CT scans prior to the start of radiation therapy (RT). A second PET/CT scan was administered following the delivery of ~32 Gray (Gy) of dose. A physician contoured gross tumor volume (GTV) was used to delineate a PET based GTV (GTV-pre-PET) based on a threshold of >40% and >20% of the maximum SUV value in the GTV. Deformable registration was used in VelocityAI software to register the pre-treatment and intra-treatment CT scans so that the GTV-pre-PET contours could be transferred from the pre to intra scans (GTV-intra-PET). The fractional decrease in the maximum, mean, volume to the highest intensity 10%-90%, and combination SUV metrics of the significant previous SUV metrics were compared to post-treatment pathologic response for an indication of response. Next for the >40% threshold, texture features based on a neighborhood gray-tone dimension matrix (NGTDM) were analyzed. The fractional decrease in coarseness, contrast, busyness, complexity, and texture strength were compared to the pathologic response of the patients. From these previous two types of analysis, SUV and texture features, the two most significant results were used in logistic regression analysis to find an equation to predict the probability of a non

  1. Effects of a Regional Chinese Diet and Its Vitamin Supplementation on Proliferation of Human Esophageal Cancer Cell Lines

    Institute of Scientific and Technical Information of China (English)

    YAN JIANG; HuI-ZHANG DU; WEN-YI ZHU; HUI-JUAN XIAO; CHENG-YU HUANG

    2008-01-01

    Objective To study the effects of a local diet popular in Yanting region (YT diet) on the proliferation of two human cell lines (Eta-109 esophageal squamous cell carcinoma line and HL7702 normal liver epithelial cell line) in rats by a ero-physiological approach. Methods Male SD rats were divided into six groups and fed respectively with a conventional diet and the YT diet (one of the five experimental diets) supplemented with two vitamin mixtures (Mix.1: vitamins A, E, and folio acid; Mix.2: mix.l plus riboflavin and vitamin C) at two different doses. On the 30th day, sera were collected from the rats and added into a medium for cell culture, with 10% FBS used as a serum control. The effects were assessed by MTI" assay, DNA synthesis and flow cytometry assays. Results Compared with the control, the sera from rats fed with the YT diet significantly promoted the proliferation of Eca-109 cells, which was, however, reversed by the supplementation with two vitamin mixtures at high doses. Surprisingly, the same treatment produced contrary effects on HL7702 cells as compared with Eca-109 cells. Conclusion The sera from rats fed with the YT diet could promote the proliferation of human esophageal cancer cell line Eca-109, whereas the sera from those fed with the YT diet supplemented with vitamin mixtures might have inhibitory effects on the proliferation of Eca-109 cells.

  2. Expression of heparanase mRNA in anti-sense oligonucleotide-transfected human esophageal cancer EC9706 cells

    Institute of Scientific and Technical Information of China (English)

    Kui-Sheng Chen; Lan Zhang; Lin Tang; Yun-Han Zhang; Dong-Ling Gao; Liang Yan; Lei Zhang

    2005-01-01

    AIM: To investigate the effects of anti-sense oligonucleotides (ASODNs) on mRNA expression of heparanase in human esophageal cancer EC9706 cells.METHODS: One non-sense oligonucleotide (N-ODN) and five ASODNs against different heparanase mRNA sites were transfected into EC9706 cells, then the expression of heparanase mRNA in EC9706 cells was studied byin situ hybridization.RESULTS: The expression of heparanase mRNA could be inhibited by ASODNs.There was no significant difference among five ASODNs (P>0.05), but there was a significant difference between ASODNs and N-ODN or non-transfected group (ASODN1: 2.25±0.25, ASODN2: 2.21±0.23, ASODN3:2.23±0.23, ASODN4:2.25±0.24 vs N-ODN: 3.47±2.80 or non- transfected group: 3.51±2.93 respectively, P<0.05).CONCLUSION: The expression of heparanase mRNA in EC9706 cells can be inhibited by ASODNs in vivo, and heparanase ASODNs can inhibit metastasis of esophageal squamous cell carcinoma or other tumors by inhibiting the expression of heparanase.

  3. α-Solanine Modulates the Radiosensitivity of Esophageal Cancer Cells by Inducing MicroRNA 138 Expression

    Directory of Open Access Journals (Sweden)

    Yuanyuan Wang

    2016-08-01

    Full Text Available Background: Esophageal cancer (EC is one of the most common malignant tumors in the world. Due to difficulties with performing the operation, most patients choose to have palliative treatment instead. Radiotherapy is one of the main palliative treatments of EC. However, the clinical efficacy of radiotherapy is not satisfactory α-Solanine is a bioactive component of steroidal glycoalkaloids which has been demonstrated to exhibit anti-metastasis activity in different cancers. In the present study, we determined the effect of α-solanine on the radiosensitivity of EC cells and priliminarily explored the underlying molecular mechanisms. Methods: Cell Counting Kit-8 (CCK-8 assay was conducted to found the cytotoxic effect of α-solanine on EC cells. CCK-8 assay and colony-forming survival assays were performed to explore the effect of α-solanine on cell viability and proliferation of EC cells after irradiation. Immunofluorescence and comet assays were used to detect the effect of α-solanine on DNA repair capacity of EC cells after irradiation. The flow cytometry (FCM and Hoechst/PI staining were conductd to study the effect of α-solanine on apoptosis of EC cells after irradiation. Results: The cytotoxic effect of α-solanine to EC cells was dose-dependent. The results of CCK-8, colony-forming survival assay, immunofluorescence, comet assay, FCM and Hoechst/PI staining showed that α-solanine could enhance the radiosensitivity of EC cells. α-Solanine could downregulate Survivin expression level by upregulating miR-138 expression in EC cells. Upregulation of miR-138 and knock down Survivin both enhanced the radiosensitivity of EC cells. Moreover, Survivin could restore the effect of α-solanine and miR-138 on radiosensitivity of EC cells. Conclusions: α-solanine could enhance the radiosensitivity of esophageal cancer cells by inducing microRNA-138 expression, and probably be an effective radiosensitizer in treating EC.

  4. Anticachectic effects of Coptidis rhizoma, an anti-inflammatory herb, on esophageal cancer cells that produce interleukin 6.

    Science.gov (United States)

    Iizuka, N; Miyamoto, K; Hazama, S; Yoshino, S; Yoshimura, K; Okita, K; Fukumoto, T; Yamamoto, S; Tangoku, A; Oka, M

    2000-09-29

    Herbs as alternative cancer therapies have attracted a great deal of recent attention due to their low toxicity and costs. In this study, the antitumor activity and anticachectic effect of Coptidis rhizoma, an anti-inflammatory herb, were investigated in nude mice carrying a human esophageal cancer cell line YES-2, which constitutively secretes interleukin-6 (IL-6) and induces cachexia when injected into these mice. In this study, in vivo growth of YES-2 cells was not affected by an oral supplement containing the extract powder of C. rhizoma at a final concentration of 1% (CR supplement). However, in comparison with normal diet, CR supplement significantly attenuated weight loss of tumor-bearing mice without a change in food or water intake. Tumor IL-6 levels were significantly lower in mice treated with CR supplement than in control mice (P<0.001). Serum IL-6 was detectable in four (50%) of eight control mice; IL-6 was not detected in mice treated with CR supplement. We also confirmed that berberine (8-32 microM), a major component of C. rhizoma, dose-dependently inhibited secretion of IL-6 by YES-2 cells in vitro. Moreover, reverse transcription-PCR assay showed that treatment of YES-2 cells with berberine (8-32 microM) for 24 h reduced IL-6 mRNA expression. Our results suggest that C. rhizoma may have an anticachectic effect on esophageal cancer and an effect is associated with the ability of berberine to down-regulate tumor IL-6 production.

  5. Genome-wide changes accompanying knockdown of fatty acid synthase in breast cancer

    Directory of Open Access Journals (Sweden)

    Smith Jeffrey W

    2007-06-01

    Full Text Available Abstract Background The lipogenic enzyme fatty acid synthase (FAS is up-regulated in a wide variety of cancers, and is considered a potential metabolic oncogene by virtue of its ability to enhance tumor cell survival. Inhibition of tumor FAS causes both cell cycle arrest and apoptosis, indicating FAS is a promising target for cancer treatment. Results Here, we used gene expression profiling to conduct a global study of the cellular processes affected by siRNA mediated knockdown of FAS in MDA-MB-435 mammary carcinoma cells. The study identified 169 up-regulated genes (≥ 1.5 fold and 110 down-regulated genes (≤ 0.67 fold in response to knockdown of FAS. These genes regulate several aspects of tumor function, including metabolism, cell survival/proliferation, DNA replication/transcription, and protein degradation. Quantitative pathway analysis using Gene Set Enrichment Analysis software further revealed that the most pronounced effect of FAS knockdown was down-regulation in pathways that regulate lipid metabolism, glycolysis, the TCA cycle and oxidative phosphorylation. These changes were coupled with up-regulation in genes involved in cell cycle arrest and death receptor mediated apoptotic pathways. Conclusion Together these findings reveal a wide network of pathways that are influenced in response to FAS knockdown and provide new insight into the role of this enzyme in tumor cell survival and proliferation.

  6. Randomized Phase 2 Trial of S1 and Oxaliplatin-Based Chemoradiotherapy With or Without Induction Chemotherapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Dok Hyun [Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Jang, Geundoo [Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Seoul (Korea, Republic of); Kim, Jong Hoon [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Yong-Hee [Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Ji Youn [Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Hyeong Ryul [Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Jung, Hwoon-Yong; Lee, Gin-Hyug [Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Song, Ho Young [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Cho, Kyung-Ja [Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Ryu, Jin-Sook [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sung-Bae, E-mail: sbkim3@amc.seoul.kr [Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-03-01

    Purpose: To assess, in a randomized, phase 2 trial, the efficacy and safety of chemoradiotherapy with or without induction chemotherapy (ICT) of S1 and oxaliplatin for esophageal cancer. Patients and Methods: Patients with stage II, III, or IVA esophageal cancer were randomly allocated to either 2 cycles of ICT (oxaliplatin 130 mg/m{sup 2} on day 1 and S1 at 40 mg/m{sup 2} twice daily on days 1-14, every 3 weeks) followed by concurrent chemoradiotherapy (CCRT) (46 Gy, 2 Gy/d with oxaliplatin 130 mg/m{sup 2} on days 1 and 21 and S1 30 mg/m{sup 2} twice daily, 5 days per week during radiation therapy) and esophagectomy (arm A), or the same CCRT followed by esophagectomy without ICT (arm B). The primary endpoint was the pathologic complete response (pCR) rate. Results: A total of 97 patients were randomized (arm A/B, 47/50), 70 of whom underwent esophagectomy (arm A/B, 34/36). The intention-to-treat pCR rate was 23.4% (95% confidence interval [CI] 11.2-35.6%) in arm A and 38% (95% CI 24.5% to 51.5%) in arm B. With a median follow-up duration of 30.3 months, the 2-year progression-free survival rate was 58.4% in arm A and 58.6% in arm B, whereas the 2-year overall survival rate was 60.7% and 63.7%, respectively. Grade 3 or 4 thrombocytopenia during CCRT was more common in arm A than in arm B (35.4% vs 4.1%). The relative dose intensity of S1 (89.5% ± 20.6% vs 98.3% ± 5.2%, P=.005) and oxaliplatin (91.4% ± 16.8% vs 99.0% ± 4.2%, P=.007) during CCRT was lower in arm A compared with arm B. Three patients in arm A, compared with none in arm B, died within 90 days after surgery. Conclusions: Combination chemotherapy of S1 and oxaliplatin is an effective chemoradiotherapy regimen to treat esophageal cancer. However, we failed to show that the addition of ICT to the regimen can improve the pCR rate.

  7. Esophageal cancer risk by type of alcohol drinking and smoking: a case-control study in Spain

    Directory of Open Access Journals (Sweden)

    Porta Miquel

    2008-08-01

    Full Text Available Abstract Background The effect of tobacco smoking and alcohol drinking on esophageal cancer (EC has never been explored in Spain where black tobacco and wine consumptions are quite prevalent. We estimated the independent effect of different alcoholic beverages and type of tobacco smoking on the risk of EC and its main histological cell type (squamous cell carcinoma in a hospital-based case-control study in a Mediterranean area of Spain. Methods We only included incident cases with histologically confirmed EC (n = 202. Controls were frequency-matched to cases by age, sex and province (n = 455. Information on risk factors was elicited by trained interviewers using structured questionnaires. Multiple logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals (CI. Results Alcohol drinking and tobacco smoking were strong and independent risk factors for esophageal cancer. Alcohol was a potent risk factor with a clear dose-response relationship, particularly for esophageal squamous-cell cancer. Compared to never-drinkers, the risk for heaviest drinkers (≥ 75 g/day of pure ethanol was 7.65 (95%CI, 3.16–18.49; and compared with never-smokers, the risk for heaviest smokers (≥ 30 cigarettes/day was 5.07 (95%CI, 2.06–12.47. A low consumption of only wine and/or beer (1–24 g/d did not increase the risk whereas a strong positive trend was observed for all types of alcoholic beverages that included any combination of hard liquors with beer and/or wine (p-trend Conclusion Our study shows that the risk of EC, and particularly the squamous cell type, is strongly associated with alcohol drinking. The consumption of any combination of hard liquors seems to be harmful whereas a low consumption of only wine may not. This may relates to the presence of certain antioxidant compounds found in wine but practically lacking in liquors. Tobacco smoking is also a clear risk factor, black more than blond.

  8. Unexpected esophageal diseases appeared in thyroid resections

    OpenAIRE

    Ye-huan, Liu; Shi-xu, Lyu; Yi-li, Zhou; Ou-chen, Wang; Xiao-hua, Zhang

    2015-01-01

    Objective In order to avoid the misdiagnosis of thyroid diseases, we need to discuss the clinical features and diagnostic methods of cervical esophageal cancer and Zenker’s diverticulum. Methods The clinical and laboratory data of seven cases were reviewed retrospectively, and in all cases, esophageal-related diseases were misdiagnosed as thyroid diseases preoperatively. Among them, two cases were cervical esophageal cancer metastasized to thyroids but initially, they were misdiagnosed as thy...

  9. Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

    Science.gov (United States)

    Hsu, Chi-Kuei; Lai, Chih-Cheng

    2016-01-01

    This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD) in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05). A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]). The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012). In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians. PMID:28028458

  10. Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Chi-Kuei Hsu

    2016-12-01

    Full Text Available This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05. A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]. The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012. In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians.

  11. The Clinical Research in Advanced Stage Gastric Cancer Accompanying Hemorrhage with EHLF Chemotherapy and Thrombin to Take Orally

    Institute of Scientific and Technical Information of China (English)

    Chen Huoguo

    2003-01-01

    Purpose:Study therapeutic effectiveness about EHLF chemotherapy and thrombin to take orally in advanced stage gastriccancer accompanying hemorrhage.Methods:76 cases were divided into two groups at random,that were diagnosed by pathology andclinical. Research group included medicine:(etoposide)VP-16,100 mg intravenous drip,d1~3;(hydroxycamptothecin)HCPT, 10mg,ivtravenous drip,d1~5;(calciumfolinate)CF, 100 mg,intravenous drip,d1~5;(fluorouracil)5-Fu,0.5,intravenous drip,d1~5;thrombin,5oou,oral administration,three times in a day, d1~7.Matched control:normal regulation to medicine in gastric hemorrhye.Results:Effective rate in research group was 78.4%,obvious better than one in matched control 28.2%(P<0.01),bad reaction wasslight, life quantity was obvious exaltation.Conclusion:EHLF chemotherapy and thrombin to take orally was used as treatment project inadranced stage gastric cancer accompanying hemorrhage,good result in research group. It is worthy to deserve further reseach.

  12. Surgical perspectives in gastrointestinal disease: A study of quality of life outcomes in esophageal, pancreatic, colon, and rectal cancers

    Institute of Scientific and Technical Information of China (English)

    Kate V Viola; Charlotte Ariyan; Julie Ann Sosa

    2006-01-01

    Outcomes assessment in surgery traditionally has included data regarding peri-operative mortality and morbidity, as well as long-term survival and recurrence in surgical oncology. However, quality of life (QOL) is another important patient-related outcome measure.QOL data can be used to tailor treatment and improve clinical outcomes by detecting physical or psychological problems in patients that otherwise might be overlooked,but which have profound implications for the effective delivery of care. We review several well-validated QOL instruments developed specifically for use in patients with gastrointestinal malignancies, including esophageal,pancreatic and colorectal cancers, and conclude that QOL assessment routinely should be included in clinical trials of novel treatments.

  13. Successful outcome after combined chemotherapeutic and surgical management in a case of esophageal cancer with breast and brain relapse

    Institute of Scientific and Technical Information of China (English)

    Davide Adriano Santeufemia; Antonio Farris; Gianfranca Piredda; Giovanni Maria Fadda; Paolo Cossu Rocca; Salvatore Costantino; Giovanni Sanna; Maria Giuseppa Sarobba; Maria Antonietta Pinna; Carlo Putzu

    2006-01-01

    Esophageal cancer (EC) is a highly lethal disease. Approximately 50% of patients present with metastatic EC and most patients with localized EC will have local recurrence or develop metastases, despite potentially curative local therapy. The most common sites of distant recurrence are represented by lung, liver and bone while brain and breast metastases are rare. Usually patients with advanced disease are not treated aggressively and their median survival is six months. We report a woman patient who developed breast and brain metastases after curative surgery. We treated her with a highly aggressive chemotherapeutic and surgical combination resulting in a complete remission of the disease even after 11-year follow-up. We think that in super selected patients with more than one metastasis, when functional status is good and metastases are technically resectable, a surgical excision may be considered as a salvage option and chemotherapy should be delivered to allow a systemic control.

  14. Survey on the pollution of drinking water in Cixian area with the highestincidence rate of esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Xiu Lan Zhang; Suo Yuan Liang; Xue Dong Li; Shao Sheng Li; Cui Yun Qiao; Hai Guang Li

    2000-01-01

    AIM To understand the pollution status of drinking water in Cixian area and to find out a way to solute it.METHODS Contents of nitrate nitrogen, nitrite nitrogen and ammonia nitrogen were measured andcompared with controls and national standards.RESULTS Levels of nitrate nitrogen, nitrite nitrogen and ammonia nitrogen were higher than the nationalpermissive levels by 20.60%, 50.50% and 33.30% respectively. Also the levels in Cixian are significantlyhigher than those of a controls areas of Chicheng - a county with very low incidence rate of esophagealcancer.CONCLUSION Three nitrogen levels in drinking water correlate both with the amount of N-containingfertilizer used in these areas and the mortality rates of esophageal cancer.

  15. Diaphragmatic hernia complicated with intestinal obstruction with colon perforation after surgery for esophageal cancer: a case report

    Institute of Scientific and Technical Information of China (English)

    Chao Sun; Hongcan Shi; Kang Wang

    2012-01-01

    We reported a case of diaphragmatic hernia complicated with intestinal obstruction with colon perforation after surgery for esophageal cancer. In this case, the conservative treatment took too long, which delayed the diagnosis and treatment and resulted in colon perforation. After computed tomography confirmed the diagnosis, an emergency operation was performed. During the operation, we found colon perforation. Because pollution of thoracic cavity was serious, we performed proximal end colon neostomy. The patient recovered and discharged with active treatment 35 days after operation. We consider surgical repair of the diaphragmatic hernia is recommended to avoid the potentially disastrous complications, such as strangulation or perforation of the herniated contents, which can threaten the life of the patient if diagnosis is delayed.

  16. Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer

    Institute of Scientific and Technical Information of China (English)

    Guiping Yu; Guoqiang Chen; Bin Huang; Wenlong Shao; Guangqiao Zeng

    2013-01-01

    Objective:To explore the effect of early enteral nutrition (EN) on postoperative nutritional status,intestinal permeability,and immune function in elderly patients with esophageal cancer or cardiac cancer.Methods:A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study.They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes.The body weight,time to first flatus/defecation,average hospital stay,complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed.Peripheral blood samples were collected on the days 1,4 and 7 after surgery.The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability.The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier.The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzymelinked immunosorbent assay (ELISA).Results:After the surgery,the time to first flatus/defecation,average hospital stay,and complications were significandy less in the EN group than those in the PN group (P<0.05),whereas the EN group had significantly higher albumin levels than the PN group (P<0.05).On the 7th postoperative day,the DAO activity,D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P<0.05).In addition,the EN group had significantly higher IgA,IgG,IgM,and CD4 levels than the PN group (P<0.05) but significantly lower IL-2,IL-6,and TNF-α levels (P<0.05).Conclusions:In elderly patients with esophageal cancer or cardiac cancer,early EN after surgery can effectively improve the nutritional status,protect intestinal mucosal barrier (by reducing plasma endoxins),and enhance the

  17. Cutaneous Metastases From Esophageal Adenocarcinoma

    Science.gov (United States)

    Triantafyllou, Stamatina; Georgia, Doulami; Gavriella-Zoi, Vrakopoulou; Dimitrios, Mpistarakis; Stulianos, Katsaragakis; Theodoros, Liakakos; Georgios, Zografos; Dimitrios, Theodorou

    2015-01-01

    The aim of this study is to present 2 rare cases of cutaneous metastases originated from adenocarcinoma of the gastro-esophageal junction, thus, underline the need for early diagnosis and possible treatment of suspicious skin lesions among patients with esophageal malignancy. Metastatic cancer to the skin originated from internal malignancies, mostly lung cancer, breast cancer, and colorectal cancer, constitute 0.5 to 9% of all metastatic cancers.5,8,15 Skin metastases, mainly from squamous cell carcinomas of the esophagus, are rarely reported. Cutaneous metastasis is a finding indicating progressiveness of the disease.17 More precisely, median survival is estimated approximately 4.7 months.2,14 This study is a retrospective review of 2 cases of patients with adenocarcinoma of the esophagus and a review of the literature. Two patients aged 60 and 32 years old, respectively, underwent esophagectomy. Both pathologic reports disclosed adenocarcinoma of the gastro-esophageal junction staged T3 N2 M0 (stage IIIB). During follow-up time, the 2 patients were diagnosed with cutaneous metastases originated from the primary esophageal tumor 11 and 4 months after surgery, respectively. The first patient is alive 37 months after diagnosis, while the second one died 16 months after surgery. Cutaneous metastasis caused by esophageal adenocarcinoma is possible. Therefore, follow-up of patients who were diagnosed with esophageal malignancy and underwent esophagectomy is mandatory in order to reveal early surgical stages. PMID:25785344

  18. Esophageal malignancy: A growing concern

    Institute of Scientific and Technical Information of China (English)

    Jianyuan Chai; M Mazen Jamal

    2012-01-01

    Esophageal cancer is mainly found in Asia and east Africa and is one of the deadliest cancers in the world.However,it has not garnered much attention in the Western world due to its low incidence rate.An increasing amount of data indicate that esophageal cancer,particularly esophageal adenocarcinoma,has been rising by 6-fold annually and is now becoming the fastest growing cancer in the United States.This rise has been associated with the increase of the obese population,as abdominal fat puts extra pressure on the stomach and causes gastroesophageal reflux disease (GERD).Long standing GERD can induce esophagitis and metaplasia and,ultimately,leads to adenocarcinoma.Acid suppression has been the main strategy to treat GERD; however,it has not been proven to control esophageal malignancy effectively.In fact,its side effects have triggered multiple warnings from regulatory agencies.The high mortality and fast growth of esophageal cancer demand more vigorous efforts to look into its deeper mechanisms and come up with better therapeutic options.

  19. Comparison between the deconvolution and maximum slope 64-MDCT perfusion analysis of the esophageal cancer: Is conversion possible?

    Energy Technology Data Exchange (ETDEWEB)

    Djuric-Stefanovic, A., E-mail: avstefan@eunet.rs [Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Saranovic, Dj., E-mail: crvzve4@gmail.com [Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Masulovic, D., E-mail: draganmasulovic@yahoo.com [Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Ivanovic, A., E-mail: flydoc@eunet.rs [Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Pesko, P., E-mail: predragpesko@yahoo.com [Clinic of Digestive Surgery (First Surgical Clinic), Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia)

    2013-10-01

    Purpose: To estimate if CT perfusion parameter values of the esophageal cancer, which were obtained with the deconvolution-based software and maximum slope algorithm are in agreement, or at least interchangeable. Methods: 278 esophageal tumor ROIs, derived from 35 CT perfusion studies that were performed with a 64-MDCT, were analyzed. “Slice-by-slice” and average “whole-covered-tumor-volume” analysis was performed. Tumor blood flow and blood volume were manually calculated from the arterial tumor-time–density graphs, according to the maximum slope methodology (BF{sub ms} and BV{sub ms}), and compared with the corresponding perfusion values, which were automatically computed by commercial deconvolution-based software (BF{sub deconvolution} and BV{sub deconvolution}), for the same tumor ROIs. Statistical analysis was performed using Wilcoxon matched-pairs test, paired-samples t-test, Spearman and Pearson correlation coefficients, and Bland–Altman agreement plots. Results: BF{sub deconvolution} (median: 74.75 ml/min/100 g, range, 18.00–230.5) significantly exceeded the BF{sub ms} (25.39 ml/min/100 g, range, 7.13–96.41) (Z = −14.390, p < 0.001), while BV{sub deconvolution} (median: 5.70 ml/100 g, range: 2.10–15.90) descended the BV{sub ms} (9.37 ml/100 g, range: 3.44–19.40) (Z = −13.868, p < 0.001). Both pairs of perfusion measurements significantly correlated with each other: BF{sub deconvolution}, versus BF{sub ms} (r{sub S} = 0.585, p < 0.001), and BV{sub deconvolution}, versus BV{sub ms} (r{sub S} = 0.602, p < 0.001). Geometric mean BF{sub deconvolution}/BF{sub ms} ratio was 2.8 (range, 1.1–6.8), while geometric mean BV{sub deconvolution}/BV{sub ms} ratio was 0.6 (range, 0.3–1.1), within 95% limits of agreement. Conclusions: Significantly different CT perfusion values of the esophageal cancer blood flow and blood volume were obtained by deconvolution-based and maximum slope-based algorithms, although they correlated significantly with

  20. Clinical Outcome in Definitive Concurrent Chemoradiation With Weekly Paclitaxel and Carboplatin for Locally Advanced Esophageal and Junctional Cancer.

    Science.gov (United States)

    Noronha, Vanita; Prabhash, Kumar; Joshi, Amit; Patil, Vijay Maruti; Talole, Sanjay; Nakti, Dipti; Sahu, Arvind; Shah, Srushti; Ghosh-Laskar, Sarbani; Patil, Prachi S; Mehta, Shaesta A; Jambhekar, Nirmala; Mahajan, Abhishek; Purandare, Nilendu

    2016-01-01

    There are little data on the efficacy and safety of taxane/platinum with definitive radiotherapy (RT) for esophageal/GEJ cancer. This article is a retrospective analysis of patients who received weekly paclitaxel 50 mg/m(2) and carboplatin AUC 2 with radical definitive RT for locally advanced esophageal/GEJ cancer. Between February 2011 and July 2014, 179 patients were included. The median age was 54 years. Ninety-two percent of patients had squamous histology. Mean RT dose was 58.7 Gy in 32 fractions over 53 days, with mean of six chemotherapy cycles. Fifty-six percent of patients developed ≥grade 3 acute toxicities, commonly febrile neutropenia (12%) and infection (11%); ≥grade 3 laboratory abnormalities included hyponatremia (38%), leukopenia (49%), neutropenia (27%), and anemia (16%). Twelve percent of patients developed ≥grade 3 chronic toxicity. Fatal toxicities included six during CRT, eight within 30 days of completing CRT, and three chronic. Radiologic response was 49% (CR 5.6%, PR 43%). Follow-up endoscopy showed remission in 53% and residual disease in 14%. At a median follow-up of 28 months, median PFS was 11 months (95% CI: 8-13.9), median OS was 19 months (95% CI: 15.4-22.6), and estimated 1-year, 2-year, and 3-year survivals were 70%, 47%, and 39%, respectively. Weekly paclitaxel-carboplatin concurrently with definitive RT is efficacious with manageable toxicity. [The trial was registered with the Clinical Trials Registry-India (CTRI), registration number: CTRI/2014/07/004776.].

  1. 食管癌相关microRNA研究进展%Research progress of esophageal cancer related microRNA

    Institute of Scientific and Technical Information of China (English)

    任玉龙; 乌宇新; 邢龙; 张彬

    2016-01-01

    Esophageal cancer is a malignant lesion of the esophagus,which is made from the squamous epithelium or glandular epithelium of the esophagus.Its main characteristic are the high degree of malignancy,the incidence of occult,and no typical clinical symptoms early generally.The typical clinical symptoms are in the middle or late stage.The 5-year survival rate is low,the prognosis is poor,and there is no specific marker at present.The clinical diagnosis is mainly diagnosed by endoscopic biopsy.With the discovery of microRNA and the further study of its role in the development of disease,more and more experiments shows that the occurrence,development and prognosis of esophageal cancer are closely related with the microRNA.%食管癌是指食管鳞状上皮或腺上皮恶性病变。其主要特点是恶性程度高,发病隐匿,早期一般无典型临床症状,有典型性临床症状的患者大多处在疾病中晚期,术后5年生存率低,预后差。目前尚无特异性的标记物,临床主要以内镜活检确诊。随着microRNA的发现及对其在疾病发生、发展中的作用的深入研究,越来越多的实验表明食管癌的发生、发展及预后与microRNA关系密切。

  2. Long-term outcome of mitomycin C- and 5-FU-based primary radiochemotherapy for esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, Maria; Zehentmayr, Franz; Niyazi, Maximilian; Ganswindt, Ute; Haimerl, Wolfgang; Belka, Claus [Dept. of Radiation Oncology, Univ. Hospital Munich, LMU (Germany); Schmidt, Michael [Inst. for Biometry and Epidemiology, Univ. Hospital Munich, LMU (Germany); Hoelzel, Dieter [Tumor Registry Munich, Univ. Hospital Munich, LMU (Germany)

    2010-07-15

    Background and purpose: for definitive radiochemotherapy, 5-fluorouracil/cisplatin protocols have been considered the standard of care for esophageal carcinoma over the last 2 decades. By contrast, most patients treated at the University Hospital, LMU Munich, Germany, received 5-fluorouracil/mitomycin C. The objective of this retrospective analysis was to determine the value of 5-fluorouracil/mitomycin-C-based therapy. Patients and methods: tumor stage, treatment received, and outcome data of patients treated for esophageal cancer between 1982 and 2007 were collected; endpoint of the analysis was overall survival. Results: 298 patients with inoperable cancer of the esophagus were identified (16.8% adenocarcinoma, 77.5% squamous cell carcinoma). At diagnosis, 61.7% (184/298) had UICC stage III-IV, 54.4% (162/298) positive lymph nodes, and 26.5% (79/298) metastatic disease. 74.5% of all patients (222/298) received radiation doses between 55 and 65 Gy, 65.8% (196/298) were subjected to concomitant chemotherapy. The median follow-up period (patients alive) was 4.1 years. A significant increase of overall survival (p < 0.0001) in the radiochemotherapy versus the radiotherapy=alone group was observed. 52% (102/196) in the 5-fluorouracil/mitomycin C group had tumor stages comparable to the RTOG 85-01 study cohort (T1-3 N0-1 M0). The median survival in this subgroup was 18.2 months, 3- and 5-year survival rates were 22.7% (21/102) and 15.0% (13/102), respectively. Conclusion: despite being nominally inferior to platinum-based radiochemotherapy, the overall survival rates are in a similar range. Thus, the mitomycin-C-based radiochemotherapy approach may considered to be as effective as the standard therapy. However, there is no randomized trial available in order to prove the equality. (orig.)

  3. 通辽市蒙古族食道癌危险因素分析%Analyzing risk factors of esophageal cancer of the Mongols in Tongliao City

    Institute of Scientific and Technical Information of China (English)

    乌力吉白乙

    2014-01-01

    目的:探讨通辽市蒙古族食道癌现状及其发病原因。方法:查阅通辽市二级以上医院2011-01~12收治的食道癌患者,掌握通辽市食道癌的检出率,分析通辽市蒙古族食道癌危险因素、年龄分布、性别、职业、病理分型等方面的差别。结果:蒙古族食道癌检出率远高于汉族,蒙古族中又以农民发病率最高。结论:蒙古族食道癌发病率较高,其发病原因可能与热饮习惯、长期吃酸菜、烟草和酒精等因素有关,需要引起足够的重视。%AIM:To study the situation and pathogenesis of e-sophageal cancer of the Mongols in Tongliao city.METHODS:By referring to esophageal cancer patients of over Grade II hospi-tals in Tongliao city from January 2011 to December 2011,we had mastered detection rate of esophageal cancer in Tongliao,and an-alyzed the difference in risk factors,age distribution,gender,oc-cupation,pathological typing and other aspects of the esophageal cancer of Mongolia Nationality.RESULTS:The detection rate of esophageal cancer in Mongolia Nationality was much higher than that of Han Nationality,Mongolia Nationality with the highest in-cidence in farmers.CONCLUSION:Mongolia Nationality e-sophageal cancer incidence is higher,possibly associated with hot drinking habits,long-term sauerkraut eating,tobacco and alco-hol,and other factors,also needing enough attention.

  4. Lack of association between EPHX1 polymorphism and esophageal cancer risk: evidence from meta-analysis.

    Science.gov (United States)

    Yan, Y L; Chen, X; Liang, H J; Wang, J; Li, T J; Li, R L; Li, S; Qin, X

    2015-01-01

    The microsomal epoxide hydrolase 1 (EPHX1) Tyr113His and His139Arg polymorphisms have been reported to be associated with esophageal cancer (EC) risk, yet the results of these previous results have been inconsistent or controversial. The objective of this study was to explore whether the EPHX1 Tyr113His and His139Arg polymorphisms confer risk to EC. The relevant studies were identified through a search of PubMed, Excerpta Medica Database (Embase), Elsevier Science Direct, and Chinese Biomedical Literature Database until May 2013. The association between the EPHX1 Tyr113His and His139Arg polymorphisms and EC risk was pooled by odds ratios (ORs) together with their 95% confidence intervals (95%CIs). A total of eight case-control studies with 1163 EC patients and 1868 controls (seven studies for both Tyr113His and His139Arg polymorphisms, one study only for Tyr113His polymorphism) were eventually identified. We found no association between EPHX1 Tyr113His and His139Arg polymorphisms and EC risk in overall population (For Tyr113His: His vs. Tyr: OR = 1.05, 95%CI = 0.95-1.15, P = 0.379; His/His vs. Tyr/Tyr: OR = 1.04, 95%CI = 0.88-1.22, P = 0.208; His/Tyr vs. Tyr/Tyr: OR = 0.96, 95%CI = 0.80-1.15, P = 0.577; His/His vs. His/Tyr + Tyr/Tyr: OR = 1.10, 95%CI = 0.96-1.26, P = 0.164; His/His + His/Tyr vs. Tyr/Tyr: OR = 1.01, 95%CI = 0.90-1.12, P = 0.543. For His139Arg: Arg vs. His: OR = 1.04, 95%CI = 0.94-1.14, P = 0.465; Arg/Arg vs. His/His: OR = 1.06, 95%CI = 0.91-1.24, P = 0.470; Arg/His vs. His/His: OR = 1.03, 95%CI = 0.91-1.16, P = 0.673; Arg/Arg vs. Arg/His + His/His: OR = 1.04, 95%CI = 0.85-1.27, P = 0.708; Arg/Arg + Arg/His vs. His/His: OR = 1.02, 95%CI = 0.93-1.13, P = 0.617). In subgroup analysis based on ethnicity, significant association has been found in neither EPHX1 Tyr113His nor His139Arg polymorphism. The current meta

  5. 惠州客家人群食管癌EGFR蛋白表达及与MAPK信号通路相关性的初步研究%Preliminary study in Huizhou Hakka population of esophageal cancer EGFR protein expression and correlation with MAPK signaling pathway

    Institute of Scientific and Technical Information of China (English)

    裴小娟; 杨清绪; 邹冬梅; 朱影玲

    2012-01-01

    Objective To investigate the expression of EGFR protein in esophageal cancer of Huizhou Hakka population, discussing the relationship EGFR and MAPK activation of signal transduction in the occurrence and development of esophageal cancer of Huizhou Hakka population. Methods Immunohistochemical staining and Western blot was employed to detect the expression of EGFR, MAPK and p-ERKl/2 protein expression in 53 cases of esophageal cancer and normal esophageal tissues adjacent to cancer. Results EGFR and p-ERKl/2 expression in esophageal cancer were significantly higher than in normal esophageal tissues adjacent to cancer (P < 0.01); the lower the degree of differentiation, the higher expression of EGFR and p-ERKl/2; expression of EGFR and p-ERKl/2 with lymph node metastasis patients were higher than who without lymph node metastasis (P < 0.01); positive expression rate of p-ERK1/2 with the superficial myometrial infiltration patients was remarkablely lower than that of depth of myometrial infiltration (P < 0.05). Conclusion EGFR/ MAPK signal transduction is closely related to the occurrence and development of esophageal cancer in Huizhou Hakka population. Accompanied by EGFR over expression, elevating the level of activated MAPK (ERK1/2) signaling pathway, so EGFR /ERK proteins may to provide a new target for early gene therapy in Huizhou Hakka population esophageal cancer.%目的 检测EGFR在惠州客家人群食管癌组织的表达,探讨EGFR与惠州客家人群食管癌发生发展之间的关系及与MAPK信号传导激活状态的相关性.方法 采用免疫组织化学及免疫蛋白印迹方法,检测53例惠州客家人群食管癌和癌旁正常组织标本中EGFR、MAPK(ERK1/2)和p-ERK1/2蛋白的表达.结果 EGFR和p-ERK1/2在食管癌组织中的表达率显著高于癌旁正常组织(P < 0.01);分化程度越低,EGFR和p-ERK1/2的表达越高;有淋巴结转移患者EGFR和p-ERK1/2的表达明显高于无淋巴转移者(P < 0.01);

  6. Effects of silencing the ATP-binding cassette protein E1 gene by electroporation on the proliferation and migration of EC109 human esophageal cancer cells.

    Science.gov (United States)

    Li, Xiao-Rui; Yang, Liu-Zhong; Huo, Xiao-Qing; Wang, Ying; Yang, Qing-Hui; Zhang, Qing-Qin

    2015-07-01

    In the present study, the gene expression of ATP-binding cassette protein E1 (ABCE1) in the EC109 human esophageal cancer cell line was silenced using electroporation to examine the effect if the ABCE1 gene on the growth migration and cell cycle of cancer cells. The small interference (si)RNA sequence of ABCE1 was designed and synthesized to transfect the EC109 cells by electroporation. The mRNA and protein expression levels of ABCE1 were then detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and western blot analysis. The analysis of the cell cycle and apoptosis was performed using flow cytometry. The effect of silencing the ABCE1 gene on the proliferation, migration and invasive ability of the EC109 human esophageal cancer cells were assessed using a Cell counting kit-8 (CCK-8) and with proliferation, wound-healing and cell invasion assays. The mRNA and protein expression levels of ABCE1 were significantly lower in the experimental group compared with the control group (Pmigration capacity of the cells in the experimental group was significantly decreased (Pmigration in esophageal cancer and silencing the ABCE1 gene by electroporation can significantly reduce the proliferation, invasion and migration capacity of EC109 cells in vitro.

  7. Germline and somatic genetic predictors of pathological response in neoadjuvant settings of rectal and esophageal cancers: systematic review and meta-analysis.

    Science.gov (United States)

    Salnikova, L E; Kolobkov, D S

    2016-06-01

    Oncologists have pointed out an urgent need for biomarkers that can be useful for clinical application to predict the susceptibility of patients to preoperative therapy. This review collects, evaluates and combines data on the influence of reported somatic and germline genetic variations on histological tumor regression in neoadjuvant settings of rectal and esophageal cancers. Five hundred and twenty-seven articles were identified, 204 retrieved and 61 studies included. Among 24 and 14 genetic markers reported for rectal and esophageal cancers, respectively, significant associations in meta-analyses were demonstrated for the following markers. In rectal cancer, major response was more frequent in carriers of the TYMS genotype 2 R/2 R-2 R/3 R (rs34743033), MTHFR genotype 677C/C (rs1801133), wild-type TP53 and KRAS genes. In esophageal cancer, successful therapy appeared to correlate with wild-type TP53. These results may be useful for future research directions to translate reported data into practical clinical use.

  8. 高龄食管癌患者术后早期肠内营养并发症的防治%Prevention and treatment of early postoperative enteral nutrition complications in elderly esophageal cancer patients

    Institute of Scientific and Technical Information of China (English)

    夏晓明; 施仁忠; 张亚锋

    2012-01-01

    Objective To study the prevention and treatment of the complications during early postoperative enteral nutrition in the elderly patients with esophageal cancer.Methods The early enteral nutrition were carried out in 67 cases of esophageal cancer over 70 years old.The prevention and treatment of the complications during the early enteral nutrition were analyzed.Results There were 39 cases with diarrhea(58.21%),7 cases with metabolic disorder( 10.45% ),15 cases with the nutritional tube obstruction ( 22.39% ).After receiving active treatment for the complications,48 cases complete enteral nutrition.14 cases (20.90%) changed to mixed nutrition,5 cases changed to parenteral nutrition (7.46% ).Conclusions The complications of the early enteral nutrition in the elderly patients have some relation with the injected method of nutrient solution,the status of intestine function,and other diseases accompanied,etc.After receiving positive treatment,most patients were able to tolerate enteral nutrition.The early postoperative enteral nutrition is still the preferred option in the elderly patients with esophageal cancer.%目的 探讨高龄食管癌患者术后早期肠内营养并发症的防治对策.方法 对67例70岁以上食管癌患者术后进行早期肠内营养,分析早期肠内营养期间并发症的预防与治疗.结果 67例患者中发生腹泻39例,占58.21%,代谢紊乱7例,占10.45%,营养管方面并发症15例,占22.39%.针对并发症原因进行积极处理,48例完成肠内营养,占71.64%,14例改为混合营养,占20.90%,5例改为肠外营养,占7.46%.结论 高龄患者肠内营养并发症主要与营养液输入方法、肠道功能、伴随疾病等因素有关,经过积极处理后大多数患者均能够耐受肠内营养,肠内营养仍然是高龄患者优先选择的营养方法.

  9. Clinical study of non-specific cell mediated immunity in the patients with esophageal cancer. Influence of preoperative irradiation and surgical intervention

    Energy Technology Data Exchange (ETDEWEB)

    Nakata, Yoshitaka

    1987-06-01

    Few data are available to elucidate the influence of combined preoperative irradiation and surgery on the non-specific cell mediated immunity of patients with esophageal cancer. In vitro and in vivo examinations of the non-specific cell mediated immunity were made before and after irradiation and surgery in 108 patients with esophageal cancer. Decreased immune competence was noticeable one month after surgery in the irradiated group