Latest insights into the global epidemiological features,screening,early diagnosis and prognosis prediction of esophageal squamous cell carcinoma

As a highly invasive carcinoma,esophageal cancer(EC)was the eighth most prevalent malignancy and the sixth leading cause of cancer-related death worldwide in 2020.Esophageal squamous cell carcinoma(ESCC)is the major histological subtype of EC,and its incidence and mortality rates are decreasing globally.Due to the lack of specific early symptoms,ESCC patients are usually diagnosed with advanced-stage disease with a poor prognosis,and the incidence and mortality rates are still high in many countries,especially in China.Therefore,enormous challenges still exist in the management of ESCC,and novel strategies are urgently needed to further decrease the incidence and mortality rates of ESCC.Although the key molecular mechanisms underlying ESCC pathogenesis have not been fully elucidated,certain promising biomarkers are being investigated to facilitate clinical decision-making.With the advent and advancement of highthroughput technologies,such as genomics,proteomics and metabolomics,valuable biomarkers with high sensitivity,specificity and stability could be identified for ESCC.Herein,we aimed to determine the epidemiological features of ESCC in different regions of the world,especially in China,and focused on novel molecular biomarkers associated with ESCC screening,early diagnosis and prognosis prediction.

Effect of negative remodeling of the side branch ostium on the efficacy of a two-stent strategy for distal left main bifurcation lesions:an intravascular ultrasound study

OBJECTIVES To investigate whether negative remodeling(NR)detected by intravascular ultrasound(IVUS)of the side branch ostium(SBO)would affect in-stent neointimal hyperplasia(NIH)at the one-year follow-up and the clinical outcome of target lesion failure(TLF)at the long-term follow-up for patients with left main bifurcation(LMb)lesions treated with a two-stent strategy.METHODS A total of 328 patients with de novo true complex LMb lesions who underwent a 2-stent strategy of percutaneous coronary intervention(PCI)treatment guided by IVUS were enrolled in this study.We divided the study into two phases.Of all the patients,48 patients who had complete IVUS detection pre-and post-PCI and at the 1-year follow-up were enrolled in phase I analysis,which aimed to analyze the correlation between NR and in-stent NIH at SBO at the 1-year follow-up.If the correlation was confirmed,the cutoff value of the remodeling index(RI)for predicting NIH≥50%was analyzed next.The phase II analysis focused on the incidence of TLF as the primary endpoint at the 1-to 5-year follow-up for all 328 patients by grouping based on the cutoff value of RI.RESULTS In phase I:according to the results of a binary logistic regression analysis and receiver operating characteristic(ROC)analysis,the RI cutoff value predicting percent NIH≥50%was 0.85 based on the ROC curve analysis,with a sensitivity of 85.7%,a specificity of 88.3%,and an AUC of 0.893(0.778,1.000),P=0.002.In phase II:the TLR rate(35.8%vs.5.3%,P<0.0001)was significantly higher in the several NR(sNR,defined as RI≤0.85)group than in the non-sNR group.CONCLUSION The NR of LCxO is associated with more in-stent NIH post-PCI for distal LMb lesions with a 2-stent strategy,and NR with RI≤0.85 is linked to percent NIH area≥50%at the 1-year follow-up and more TLF at the 5-year follow-up.