Clinicopathological Features and Prognosis of Small Cell Carcinoma of the Cervix

Small cell carcinoma of cervix (SCCC) is a rare disease with highly aggressive behaviour and is pathologically hard to diagnose.In this study, the clinicopathological features, diagnosis, treatment and prognosis of the condition were examined.Clinical records and follow-up data of 7 cases of SCCC were retrospectively studied.Our results showed that five non-recurrent cases initially presented irregular vaginal bleeding or increased apocenosis of varying degrees.Pathological examination revealed that the stroma was diffusely infiltrated with small monomorphous cells ranging from round to oval shape.Three cases were immunohistochemically confirmed.One case was accompanied with squamous cell cancer.Of the 7 cases, one case was classified as stage Ⅰb 1, two stageⅠ b2, one stage Ⅱ a, one stage Ⅱb , and one stage Ⅲ b.On the basis of their stages of condition, one subject with stage III b underwent chemotherapy, and one with stage Ib2 received extensive hysterectomy plus pelvic lymphadenectomy, while the other 5 cases were treated by extensive hysterectomy and pelvic lymphadenectomy in combination with pre-and/or post-operative adjuvant chemotherapy and radiotherapy.Of the 7 patients, 4 had relapse-free survival of 14, 14, 16 and 28 months respectively.It is concluded that SCCC is an aggressive tumor with propensity for early pelvis lymph node metastases.Early-stage patients should be treated by extensive hysterectomy and pelvic lymphadenectomy in combination with pre-and/or post-operative adjuvant chemotherapy and radiotherapy.

Papillary serous carcinoma of the uterine cervix:a clinicopathological analysis of 4 cases and a literature review

Objective To investigate the clinicopathological characteristics and clinical treatment outcomes of patients with papillary serous carcinoma of the uterine cervix(PSCC).Methods In this study, 4 patients with histologically confirmed papillary serous carcinoma of the uterine cervix were retrospectively investigated. Pap smears, human papillomavirus(HPV) screening, tumor marker status, biopsy analysis, and relevant imaging examinations were conducted for the confirmation of primary diagnosis and recurrence. Patients underwent surgery, chemotherapy, or radiotherapy, and survival were the main endpoint.Results The 4 patients were diagnosed with IB1, IB1, IIA, or IIIB disease. Two patients(2/4) presented with recurrence within 18 months after primary therapy. Compared with chemotherapy alone(progressionfree survival(PFS): 11 months), radiotherapy combined with adjuvant chemotherapy showed favorable PFS rates(PFS: 20, 36, 13 months in 3 cases), although valid statistical analysis was not feasible because of the small sample size. The 5-year survival rate was 0%, and the 3-year survival rate was 75%. Our data, in agreement with the literature evidence, showed that the number of moderate-risk and high-risk factors in patients diagnosed with PSCC at an early stage was higher than that in patients diagnosed with common adenocarcinoma/squamous carcinoma of the uterine cervix.Conclusion PSCC has a poor clinical prognosis, and compared with chemotherapy alone, radiotherapy combined with adjuvant chemotherapy may lead to improved PFS.

The role of punch biopsy in the management of carcinoma of the cervix in a low resource centre

Background: Carcinoma of the cervix is the commonest malignant tumor of the female genital tract in Northern Nigeria and the leading cause of cancer-related death in women in developing countries. The predicament is further worsened by poor uptake of cytological screening programs, which are either not available or where available are underutilized due ?to lack of widespread awareness and the cost as ???an average Nigerian earns less than a dollar per day. In addition to the above constrains, majority of these patients also presents late to the hospital for intervention. Objective: To emphasize the significance of punch biopsy and clinical staging of advanced carcinoma of the cervix and see how we can shift from our traditional, Examination under Anesthesia (EUA) to Clinical staging and punch biopsy for advanced carcinoma of the cervix. Methodology: Review of existing literature and experience from our own center. Results: The punch biopsy has 88.8% positive predictive value in making a diagnosis of cancer of the cervix. Late presentation was as high as 81.7 percent for carcinoma of the cervix in our centre. The patients present late for care;majority actually presents in stages III & IV when little or nothing can be done for them. Conclusion: In view of these predicaments that face a gynecological oncologist practicing in low resources settings like ours, there is a need to consider the role of punch biopsy, clinical staging and radio-logical assessment for making a diagnosis, especially among those women who cannot afford EUA or are having renal complication that makes EUA unachievable.

Does Change in the Effect of Source Strength of the High Dose Rate ¹⁹²Iridium Radio-Isotope on Local Control and Late Normal Tissue Toxicity (Bladder and Rectum) in the Treatment of Carcinoma Cervix

Aim: To analyse and assess the effect of dose rate of 192ir-source strength on late complications and local control rate during treatment of carcinoma cervix. Materials and Methods: One hundred and two cases of carcinoma cervix were included in the study. All patients were treated with a curative intent with radical dose of radiation as per the department protocol. All patients were treated with both EBRT plus Brachytherapy with Inj. Cisplatin 40 mg/m2 weekly. Patients were divided into 2 groups based on activity i.e. group A (10-6Ci) and group B (5-2Ci). After brachytherapy, point doses were analysed based on ICRU 38 recommendations. During follow up, morbidities were evaluated using RTOG grading system. Results: There was no difference in local control and distant metastasis in both groups after six months of follow up. Late Complications were comparable in both groups irrespective of source strength. Bladder complications were minimal with no significant difference in both study groups. Further Patients were divided into four groups i.e. BED of ICRU rectal point (3 and ≥100 Gy3) and source strength (10-6Ci and 5-2Ci), when BED was >100 Gy3 resulted in higher late rectal complication rate (P 3. Conclusion: This study suggests that change in source activity did not make a difference in local control, late rectal and bladder morbidities at 6 months of follow up. Longer follow up is required to assess long term results and morbidities.

Adenoid Cystic Carcinoma of the Cervix: Case Report

Adenoid cystic carcinoma (ACC) is usually an epithelial neoplasm of the salivary glands but can also occur in the lacrimal glands and the mucous glands of the respiratory tract, breasts and skin. Very rarely, it may affect the uterine cervix. We report here a case of a woman with postmenopausal bleeding for 7 months, who on physical examination presented with a vegetative and friable tumor lesion in the uterine cervix, measuring about 5 cm in diameter. The abdominal and pelvic computed tomography scans showed a hypodense and heterogeneous mass in the cervix and uterine isthmus. Histopathological examination and immunohistochemical assays confirmed the diagnosis of ACC. The different pathological aspects, therapeutic options and prognostic factors of ACC are discussed.

Analysis of 30 patients with persistent or recurrent squamous cell carcinoma of the cervix within one year after concurrent chemoradiotherapy

Objective： To investigate the recurrence sites, risk factors, and prognosis of＇patients with persistent or recurrent squamous cell carcinoma （SCC） of the cervix within one year after undergoing concurrent chemoradiotherapy （CCRT）. Methods： Clinical data of 30 patients with persistent or recurrent SCC of the cervix within one year after CCRT between July 2006 and July 2011 were analyzed retrospectively： These data were compared with those of 35 SCC cases with no signs of recurrence after complete remission. These 35 patients were treated during the same period （between 2,006 and Z011） and selected randomly. Results： Among these 30 patients, 25 exhibited distant metastases of which 14 were observed within 6 months after CCRT. Univariate analysis showed higher incidence of pelvic or para-aortic lymphadenectasis and SCC-ag 〉 10 ng/mL in the group with persistent or recurrent disease before treatment （P〈0.01）. Multivariate analysis by logistic regression revealed that the pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉 10 ng/mL were the independent risk factors. Palliative chemotherapy was the main treatment option for patients with persistent or recurrent disease. The 2-year survival rate was 21.7%, and the median survival time was 17 months. Conclusion： Patients with persistent or recurrent SCC of the cervix after CCRT exhibited a high rate of distant metastasis with poor prognosis. The pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉10 ng/mL were identified as the independent risk factors for persistent or recurrent SCC within i year after CCRT.

Clear Cell Carcinoma of the Uterine Cervix Arising from an Interstitial Cyst Complicated with Endometriosis: A Case Report

Clear cell carcinoma (CCC) of the uterine cervix is rare, and its etiology is unclear, except for reports of prenatal diethylstilbestrol (DES) exposure. In this case report of a 78-year-old postmenopausal Japanese woman with pelvic endometriosis, cervical CCC presented as a deep interstitial tumor, strongly suggesting the patient suffered from cervical endometriosis for a long time. A cystic lesion without solid components was detected in the uterine cervix. Although the patient had regular gynecological examinations every 6 months, she presented 5 years later with a complaint of watery vaginal discharge. Ultrasonography and magnetic resonance imaging (MRI) detected a uterine cervical cystic mass with a solid component. Although no malignancy was confirmed preoperatively, surgery was performed under a high suspicion of cervical cancer. Intraoperative pathology revealed CCC in a solid tumor, so debulking surgery, including lymphadenectomy, was done. Endometrial tissue was found adjacent to the tumor, strongly suggesting the tumor arose from cervical endometriosis. Because endometriosis in ectopic sites carries a risk of carcinogenesis, as is the case in ovarian endometriosis, it may be recommended that a cervical cystic lesion with pelvic endometriosis should be followed up regularly for the early detection of uterine cancer.

Analysis of Prognosis and Prognostic Factors of Cervical Adenocarcinoma and Adenosqumous Carcinoma of the Cervix

OBJECTIVE To analyze clinical characteristics and treatment methods of the patients with adenocarcinoma of the uterine cervix （AUC） and adenosquamous carcinoma of the cervix （ASCC）. To compare the survival time of the patients in 2 groups and analyze the prognostic factors. METHODS Clinical data of both 123 patients with AUC and 32 patients with ASCC treated at the Cancer Hospital, Chinese Academy of Medical Science （CAMS） ＆ Peking Union Medical College （PUMC）, were retrospectively analyzed. RESULTS The median age of the AUC patients was 50 years, and that of the ASCC patients was 44, P = 0.019. Poorly-differentiated （grade 3） cases accounted for 59.5% of the total ASCC patients, while only 32.5% of the AUC patients were in grade 3, P = 0.002. In 123 AUC patients, relapse or failure of the treatment occurred in 63 of the patients （51.2%）, and the median relapse time was 6 months （0-59 months）. In 32 ASCC patients, relapse or failure of the treatment occurred in 8 of these patients （51.2%）, with a median relapse time of 4.5 months （0-52 months）. The overall 5-year survival rate of the AUC patients was 49.8%, which was significantly lower than that of the ASCC patients （74.1%）, P = 0.015. The 5-year survival rates of the ASCC patients in Stage Ⅰ-Ⅲ were higher than that of the AUC patients with the same stages. However, statistical significant difference could only be found among the patients in Stage II, P = 0.006. The 5-year survival rates of the ASCC patients with various differential grade were higher than those of the AUC patients with the same differential grade, but statistical significant difference could only be found among the patients in the two groups with moderately differentiation, P = 0.039. It was found by Cox regression analysis that only clinical stage （P 〈 0.001） and histological type （P = 0.046） were the independent prognostic factors. CONCLUSION Clinical stage and histological type were the independent prognostic factors of the AUC and ASCC patients. The prOgnosis of ASCC patients is better than that of the AUC patients.

STAGE IB, HA AND PROXIMAL IIB, CARCINOMA OF THE UTERINE CERVIX, TREATED BY IRRADIATION ALONE OR IN COMBINATION WITH SURGERY

This is a report of a nonrandomized comparison of treatment results of 139 patients with stage IB, HA and proximal IIB carcinoma of the uterine cervix treated by radiation alone and 113 treated with a combination of radiation and surgery. The five-year tumor free acturial survival for the patients with stage IB either with irradiation alone (RT) or combined with surgery (RS) was approximately 87%. For stage Ⅱ the tumor free actuarial five-year survival 79% with patients of RS, and 76% with RT. In the 113 patients treated with RS there were 18 (16%). In the 139 patients treated by RT there were 18 (13%) recurrences of pelvic, 4 local recurrences, 11 combined with parametrial, and free parametrial recurrences. There was no significant difference in the survival and recurrence rate of the patients treated with either method. Major complications were comparable in both groups (RT approximately 25% and RS approximately 10%), but 2/3 of those complications recovered without sequelae. The most frequent minor complication in the patients treated with RT was rectosigmoiditis.

Adenoid Basal Carcinoma of the Cervix with Squamous Differentiation:A Case Report and Literature Review

Adenoid basal carcinoma(ABC)of the cervix is a rare and low-incidence low-grade cervical cancer.In our practice,we encountered a case of cervical ABC with squamous differentiation and high-grade squamous intraepithelial lesion(HSIL)with gland involvement in the peripheral cervix.Reviewing relevant literature and analyzing its clinical manifestations,pathological morphology,and immunohistochemical characteristics would help deepen the understanding of this malignant tumor,so as to make a comprehensive diagnosis with differential diagnosis and prevent misdiagnosis.

Effects of three-dimensional conformal radiotherapy on the esophageal carcinoma

Objective： Radiation therapy is an important component of the multidisciplinary management of esophageal carcinoma. Three-dimensional conformal radiation therapy requires the precise definition of the target volume. We aimed to compare the treatment results and radiation toxicities between three-dimensional conformal radiotherapy （3D-CRT） and conventional radiotherapy （CR） for patients with cervical and thoracic esophageal carcinoma. Methods： From June 2004 to December 2006, a random study was performed on 106 patients treated with 3D-CRT or CR, 53 patients in each group. The patients in CR group received conventional radiotherapy in 2.0 Gy/f, 5 f/week and total dose was 66-70 Gy in 6.5 or 7 weeks. The patients in 3D-CRT group were treated by 3D-CRT in 2.0 Gy/f, 5 f/week and total dose was 64-70 Gy in 6 weeks. The local control rates, survival rates and radiation toxicities for the two groups were investigated. Results： The 1-year and 3-year local control rates were 83.0% and 60.4% in 3D-CRT group and 64.2% （x^2 = 4.853, P = 0.028） and 32.1% （x^2 = 9.812, P = 0.002） in CR group. The 1-year and 3-year survival rates were 73.6% and 50.9% in 3D-CRT group and 54.7% （x^2 = 4.102, P = 0.043） and 32.1% （x^2 = 3.886, P = 0.049） in CR group. Between the two groups, there was no significant difference in radiation toxicities. Conclusien： The 1-year and 3-year local control rates and survival rates of patients with esophageal carcinoma treated by 3D-CRT is superior to CR. However, longer-term results and radiation toxicity need further study which involves more patients and prolonged follow-up.

Dosimetric Comparison of Fixed and Flexible Geometry ICRT Applicators in Patients Treated for Carcinoma Cervix

In intracavitary radiotherapy (ICRT) for cancer cervix, applicator geometry has the potential to impact the doses to organs at risk (OARs) and the coverage of the target volume. At our centre two Varian made Fletcher-style applicator sets, namely defined (fixed) geometry and flexible geometry, are used for ICRT. In the present work, the two types of applicators were compared dosimetrically as per the recommendations of the International Commission on Radiation Units and Measurements (ICRU-38) while delivering high dose rate brachytherapy. Twenty four patients who underwent ICRT were considered for this study. Radiographic method was used for treatment planning on Abacus planning system. ICRU-38 recommended parameters were estimated and compared. Flexible geometry applicator showed 8.8% and 16% higher bladder and rectum point doses as compared to the fixed geometry one but the difference was statistically not significant. The thickness of the pear-shaped isodose volume was larger for the flexible geometry implant also indicating towards higher doses to OARs. The higher bladder and rectum point doses in the case of flexible applicator will need to be validated by a larger data set.

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.

MicroRNAs:A novel signature in the metastasis of esophageal squamous cell carcinoma

Esophageal squamous cell carcinoma(ESCC)is a malignant epithelial tumor,characterized by squamous cell differentiation,it is the sixth leading cause of cancer-related deaths globally.The increased mortality rate of ESCC patients is predominantly due to the advanced stage of the disease when discovered,coupled with higher risk of metastasis,which is an exceedingly malignant charac-teristic of cancer,frequently leading to a high mortality rate.Unfortunately,there is currently no specific and effective marker to predict and treat metastasis in ESCC.MicroRNAs(miRNAs)are a class of small non-coding RNA molecules,approximately 22 nucleotides in length.miRNAs are vital in modulating gene expression and serve pivotal regulatory roles in the occurrence,progression,and prognosis of cancer.Here,we have examined the literature to highlight the intimate correlations between miRNAs and ESCC metastasis,and show that ESCC metastasis is predominantly regulated or regulated by genetic and epigenetic factors.This review proposes a potential role for miRNAs as diagnostic and therapeutic biomarkers for metastasis in ESCC metastasis,with the ultimate aim of reducing the mortality rate among patients with ESCC.

Role of deubiquitinase JOSD2 in the pathogenesis of esophageal squamous cell carcinoma

BACKGROUND Esophageal squamous cell carcinoma(ESCC)is a deadly malignancy with limited treatment options.Deubiquitinases(DUBs)have been confirmed to play a crucial role in the development of malignant tumors.JOSD2 is a DUB involved in con-trolling protein deubiquitination and influencing critical cellular processes in cancer.AIM To investigate the impact of JOSD2 on the progression of ESCC.METHODS Bioinformatic analyses were employed to explore the expression,prognosis,and enriched pathways associated with JOSD2 in ESCC.Lentiviral transduction was utilized to manipulate JOSD2 expression in ESCC cell lines(KYSE30 and RESULTS )Preliminary research indicated that JOSD2 was highly expressed in ESCC tissues,which was associated with poor prognosis.Further analysis demonstrated that JOSD2 was upregulated in ESCC cell lines compared to normal esophageal cells.JOSD2 knockdown inhibited ESCC cell activity,including proliferation and colony-forming ability.Moreover,JOSD2 knockdown decreased the drug resistance and migration of ESCC cells,while JOSD2 overexpression enhanced these phenotypes.In vivo xenograft assays further confirmed that JOSD2 promoted tumor proliferation and drug resistance in ESCC.Mechanistically,JOSD2 appears to activate the MAPK/ERK and PI3K/AKT signaling pathways.Mass spectrometry was used to identify crucial substrate proteins that interact with JOSD2,which identified the four primary proteins that bind to JOSD2,namely USP47,IGKV2D-29,HSP90AB1,and PRMT5.CONCLUSION JOSD2 plays a crucial role in enhancing the proliferation,migration,and drug resistance of ESCC,suggesting that JOSD2 is a potential therapeutic target in ESCC.

Cetuximab combined with chemotherapy for simultaneous esophageal squamous cell carcinoma and colon adenocarcinoma:A case report

BACKGROUND Multiple primary carcinomas(MPCs)are defined as two or more independent primary cancers that occur simultaneously or sequentially in the same individual.Synchronous MPCs are rarer than solitary cancers or metachronous MPCs.Accurate diagnoses of synchronous MPCs and the choice of treatment are critical for successful outcomes in these cases.CASE SUMMARY A 64-year-old patient presented with dysphagia,without obvious cause.A diagnosis of synchronous esophageal squamous cell carcinoma and colon adenocarcinoma with liver metastasis was confirmed based on examination and laboratory results.After multi-disciplinary consultations,combination chemotherapy(a 3-wk cycle with oxaliplatin 212 mg administered on day 1 and capecitabine 1.5 g twice daily on days 1-14)and esophageal cancer radiotherapy were initiated.Based on the results of genetic testing,we switched to a regimen of leucovorin+fluorouracil+oxaliplatin and cetuximab regimen for 8 cycles.Subsequently,capecitabine and bevacizumab were administered until the most recent follow-up,at which the tumor remained stable.CONCLUSION Successful cetuximab chemotherapy treatment provides a reference for the nonoperative and homogeneous treatment of different pathological types of synchronous MCPs.

Impact of baseline steroids on the efficacy of neoadjuvant immunochemotherapy in locally advanced esophageal squamous cell carcinoma

BACKGROUND Immunochemotherapy involving the combination of programmed cell death 1/programmed cell death ligand 1 inhibitors with chemotherapy has advanced the treatment of locally advanced esophageal squamous cell carcinoma(ESCC).The use of corticosteroids as pretreatment might reduce immunotherapy efficacy.AIM To investigate the impact of baseline corticosteroid use on neoadjuvant immunochemotherapy(nIC)outcomes in locally advanced ESCC patients.METHODS Patients with locally advanced ESCC who received nIC at Sun Yat-sen University Cancer Center and the Third Affiliated Hospital of Sun Yat-sen University were included.Patients were divided into dexamethasone and antihistamine groups on the basis of the administered pretreatment.Antiallergic efficacy and safety were evaluated,as well as its impact on short-term efficacy[complete pathological response(pCR),major pathological response(MPR)]and long-term efficacy[overall survival(OS),progression-free survival(PFS)]of nIC.RESULTS From September 2019 to September 2023,142 patients were analyzed.No severe treatment-related adverse events or deaths were observed.Allergy occurrence was greater in the antihistamine group(P=0.014).Short-term efficacy was not significantly different:The pCR rates were 29.9%and 40.0%,and the MPR rates were 57.9%and 65.7%in the dexamethasone and antihistamine groups,respectively.The long-term efficacy was not significantly different:The 2 years OS rates were 95.2%and 93.5%,and the 2 years PFS rates were 90.3%and 87.8%.Subgroup analysis revealed no difference in OS between the 20 mg dexamethasone group and the<20 mg dexamethasone group,but PFS was significantly greater in the 20 mg dexamethasone group(93.9%vs 56.4%,P=0.001).CONCLUSION Dexamethasone or antihistamines can be used before nIC in locally advanced ESCC without affecting short-or long-term efficacy.Administering 20 mg dexamethasone before nIC may improve PFS in ESCC.

Artificial intelligence enhances the management of esophageal squamous cell carcinoma in the precision oncology era

Esophageal squamous cell carcinoma(ESCC)is the most common histological type of esophageal cancer with a poor prognosis.Early diagnosis and prognosis assessment are crucial for improving the survival rate of ESCC patients.With the advancement of artificial intelligence(AI)technology and the proliferation of medical digital information,AI has demonstrated promising sensitivity and accuracy in assisting precise detection,treatment decision-making,and prognosis assessment of ESCC.It has become a unique opportunity to enhance comprehen-sive clinical management of ESCC in the era of precision oncology.This review examines how AI is applied to the diagnosis,treatment,and prognosis assessment of ESCC in the era of precision oncology,and analyzes the challenges and potential opportunities that AI faces in clinical translation.Through insights into future prospects,it is hoped that this review will contribute to the real-world application of AI in future clinical settings,ultimately alleviating the disease burden caused by ESCC.

Rare esophageal carcinoma-primary adenoid cystic carcinoma of the esophagus: A case report

BACKGROUND Esophageal adenoid cystic carcinoma(EACC)is an exceedingly rare malignant tumor of the esophagus,posing significant challenges in the clinic.CASE SUMMARY This report detailed the case of a 72-year-old male whose diagnosis of EACC was confirmed through postoperative histopathological examination.The patient underwent thoracoscopy-assisted radical resection of the esophageal tumor,coupled with lymph node dissection.Pathological findings revealed an adenoid cystic carcinoma infiltrating the entire layer of the muscularis propria,locally extending into the outer membrane of the esophageal fiber,involving the cardia and exhibiting no lymph node metastasis.The patient’s condition was classified as primary EACC,T3N0M0,per the American Joint Committee on Cancer(2017;8th edition).One month after surgery,the patient received postoperative adjuvant radiation therapy.CONCLUSION In addressing the rarity and high potential for biopsy misdiagnosis of EACC,this study delved into its diagnostic methods and treatment.

Aryl hydrocarbon receptor dynamics in esophageal squamous cell carcinoma:From immune modulation to therapeutic opportunities

Esophageal squamous cell carcinoma(ESCC)is a substantial global health burden.Immune escape mechanisms are important in ESCC progression,enabling cancer cells to escape the surveillance of the host immune system.One key player in this process is the Aryl Hydrocarbon Receptor(AhR),which influences multiple cellular processes,including proliferation,differentiation,metabolism,and immune regulation.Dysregulated AhR signaling participates in ESCC development by stimulating carcinogenesis,epithelial-mesenchymal transition,and immune escape.Targeting AhR signaling is a potential therapeutic approach for ESCC,with AhR ligands showing efficacy in preclinical studies.Additionally,modification of AhR ligands and combination therapies present new opportunities for therapeutic intervention.This review aims to address the knowledge gap related to the role of AhR signaling in ESCC pathogenesis and immune escape.