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Endoscopic and surgical resection of T1a/T1b esophageal neoplasms: A systematic review 被引量:44
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作者 George Sgourakis Ines Gockel Hauke Lang 《World Journal of Gastroenterology》 SCIE CAS 2013年第9期1424-1437,共14页
AIM: To investigate potential therapeutic recommendations for endoscopic and surgical resection of T1a/ T1b esophageal neoplasms. METHODS: A thorough search of electronic databases MEDLINE, Embase, Pubmed and Cochrane... AIM: To investigate potential therapeutic recommendations for endoscopic and surgical resection of T1a/ T1b esophageal neoplasms. METHODS: A thorough search of electronic databases MEDLINE, Embase, Pubmed and Cochrane Library, from 1997 up to January 2011 was performed. An analysis was carried out, pooling the effects of outcomes of 4241 patients enrolled in 80 retrospective studies. For comparisons across studies, each reporting on only one endoscopic method, we used a random effects meta-regression of the log-odds of the outcome of treatment in each study. "Neural networks" as a data mining technique was employed in order to establish a prediction model of lymph node status in superficial submucosal esophageal carcinoma. Another data mining technique, the "feature selection and root cause analysis", was used to identify the most impor-tant predictors of local recurrence and metachronous cancer development in endoscopically resected patients, and lymph node positivity in squamous carcinoma (SCC) and adenocarcinoma (ADC) separately in surgically resected patients. RESULTS: Endoscopically resected patients: Low grade dysplasia was observed in 4% of patients, high grade dysplasia in 14.6%, carcinoma in situ in 19%, mucosal cancer in 54%, and submucosal cancer in 16% of patients. There were no significant differences between endoscopic mucosal resection and endoscopic submucosal dissection (ESD) for the following parameters: complications, patients submitted to surgery, positive margins, lymph node positivity, local recurrence and metachronous cancer. With regard to piecemeal resection, ESD performed better since the number of cases was significantly less [coefficient: -7.709438, 95%CI: (-11.03803, -4.380844), P < 0.001]; hence local recurrence rates were significantly lower [coefficient: -4.033528, 95%CI: (-6.151498, -1.915559),P < 0.01]. A higher rate of esophageal stenosis was observed following ESD [coefficient: 7.322266, 95%CI: (3.810146, 10.83439), P < 0.001]. A significantly greater number of SCC patients were submitted to surgery (log-odds, ADC: -2.1206 ± 0.6249 vs SCC: 4.1356 ± 0.4038, P < 0.05). The odds for re-classification of tumor stage after endoscopic resection were 53% and 39% for ADC and SCC, respectively. Local tumor recurrence was best predicted by grade 3 differentiation and piecemeal resection, metachronous cancer development by the carcinoma in situ component, and lymph node positivity by lymphovascular invasion. With regard to surgically resected patients: Significant differences in patients with positive lymph nodes were observed between ADC and SCC [coefficient: 1.889569, 95%CI: (0.3945146, 3.384624), P<0.01). In contrast, lymphovascular and microvascular invasion and grade 3 patients between histologic types were comparable, the respective rank order of the predictors of lymph node positivity was: Grade 3, lymphovascular invasion (L+), microvascular invasion (V+), submucosal (Sm) 3 invasion, Sm2 invasion and Sm1 invasion. Histologic type (ADC/SCC) was not included in the model. The best predictors for SCC lymph node positivity were Sm3 invasion and (V+). For ADC, the most important predictor was (L+). CONCLUSION: Local tumor recurrence is predicted by grade 3, metachronous cancer by the carcinoma insitu component, and lymph node positivity by L+. T1b cancer should be treated with surgical resection. 展开更多
关键词 SUPERFICIAL esophageal cancer ENDOSCOPIC resection Mucosal infiltration SUBMUCOSAL involvement Recurrent tumor Controversies in treatment Squamous cell carcinoma Adenocarcinoma Lymphatic invasion Vascular invasion SUBMUCOSAL LAYER SUPERFICIAL SUBMUCOSAL LAYER Middle third SUBMUCOSAL LAYER Deep third SUBMUCOSAL LAYER esophageal cancer ENDOSCOPIC GASTROINTESTINAL surgical procedures ENDOSCOPIC GASTROINTESTINAL surgery Lymph node dissection Dysplasia
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Resection of early esophageal neoplasms: The pendulum swings from surgical to endoscopic management 被引量:4
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作者 Vedha Sanghi Hina Amin +1 位作者 Madhusudhan R Sanaka Prashanthi N Thota 《World Journal of Gastrointestinal Endoscopy》 CAS 2019年第10期491-503,共13页
Esophageal cancer is a highly lethal disease and is the sixth leading cause of cancer related mortality in the world.The standard treatment is esophagectomy which is associated with significant morbidity and mortality... Esophageal cancer is a highly lethal disease and is the sixth leading cause of cancer related mortality in the world.The standard treatment is esophagectomy which is associated with significant morbidity and mortality.This led to development of minimally invasive,organ sparing endoscopic therapies which have comparable outcomes to esophagectomy in early cancer.These include endoscopic mucosal resection and endoscopic submucosal dissection.In early squamous cell cancer,endoscopic submucosal dissection is preferred as it is associated with cause specific 5-year survival rates of 100%for M1 and M2 tumors and 85%for M3 and SM1 tumors and low recurrence rates.In early adenocarcinoma,endoscopic resection of visible abnormalities is followed by ablation of the remaining flat Barrett’s mucosa to prevent recurrences.Radiofrequency ablation is the most widely used ablation modality with others being cryotherapy and argon plasma coagulation.Focal endoscopic mucosal resection followed by radiofrequency ablation leads to eradication of neoplasia in 93.4%of patients and eradication of intestinal metaplasia in 73.1%of patients.Innovative techniques such as submucosal tunneling with endoscopic resection are developed for management of submucosal tumors of the esophagus.This review includes a discussion of various endoscopic techniques and their clinical outcomes in early squamous cell cancer,adenocarcinoma and submucosal tumors.An overview of comparison between esophagectomy and endoscopic therapy are also presented. 展开更多
关键词 esophageal cancer SUBMUCOSAL tumors SUBMUCOSAL tunneling Barretts ESOPHAGUS DYSPLASIA Adenocarcinoma ENDOSCOPIC therapy Radiofrequency ablation ENDOSCOPIC MUCOSAL RESECTION
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Endoscopic submucosal dissection for superficial esophageal neoplasms 被引量:32
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作者 Satoshi Ono Mitsuhiro Fujishiro Kazuhiko Koike 《World Journal of Gastrointestinal Endoscopy》 CAS 2012年第5期162-166,共5页
Endoscopic submucosal dissection(ESD) is currently accepted as the major treatment modality for superficial neoplasms in the gastrointestinal tract including the esophagus.An important advantage of ESD is its effectiv... Endoscopic submucosal dissection(ESD) is currently accepted as the major treatment modality for superficial neoplasms in the gastrointestinal tract including the esophagus.An important advantage of ESD is its effectiveness in resecting lesions regardless of their size and severity of fibrosis.Based on excellent outcomes for esophageal neoplasms with a small likelihood of lymph node metastasis,the number of ESD candidates has increased.On the other hand,ESD still requires highly skilled endoscopists due to technical difficulties.To avoid unnecessary complications including perforation and postoperative stricture,the indications for ESD require careful consideration and a full understanding of this modality.This article,in the highlight topic series,provides detailed information on the indication,procedure,outcome,complications and their prevention in ESD of superficial esophageal neoplasms. 展开更多
关键词 Complications Endoscopic SUBMUCOSAL DISSECTION esophageal neoplasm INDICATION Outcome SQUAMOUS cell carcinoma
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Risk factors for Mallory-Weiss Tear during endoscopic submucosal dissection of superficial esophageal neoplasms 被引量:4
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作者 Wei Chen Xiao-Nan Zhu +3 位作者 Jin Wang Lin-Lin Zhu Tao Gan Jin-Lin Yang 《World Journal of Gastroenterology》 SCIE CAS 2019年第34期5174-5184,共11页
BACKGROUND Adverse events during endoscopic submucosal dissection(ESD)of superficial esophageal neoplasms,such as perforation and bleeding,have been welldocumented.However,the Mallory-Weiss Tear(MWT)during esophageal ... BACKGROUND Adverse events during endoscopic submucosal dissection(ESD)of superficial esophageal neoplasms,such as perforation and bleeding,have been welldocumented.However,the Mallory-Weiss Tear(MWT)during esophageal ESD remains under investigation.AIM To investigate the incidence and risk factors of the MWT during esophageal ESD.METHODS From June 2014 to July 2017,patients with superficial esophageal neoplasms who received ESD in our institution were retrospectively analyzed.The clinicopathological characteristics of the patients were collected.Patients were divided into an MWT group and non-MWT group based on whether MWT occurred during ESD.The incidence of MWTs was determined,and the risk factors for MWT were then further explored.RESULTS A total of 337 patients with 373 lesions treated by ESD were analyzed.Twenty patients developed MWTs during ESD(5.4%).Multivariate analysis identified that female sex(OR=5.36,95%CI:1.47-19.50,P=0.011)and procedure time longer than 88.5 min(OR=3.953,95%CI:1.497-10.417,P=0.005)were independent risk factors for an MWT during ESD.The cutoff value of the procedure time for an MWT was 88.5 min(sensitivity,65.0%;specificity,70.8%).Seven of the MWT patients received endoscopic hemostasis.All patients recovered satisfactorily without surgery for the laceration.CONCLUSION The incidence of MWTs during esophageal ESD was much higher than expected.Although most cases have a benign course,fatal conditions may occur.We recommend inspection of the stomach during and after the ESD procedure for timely management in cases of bleeding MWTs or even perforation outside of the procedure region. 展开更多
关键词 SUPERFICIAL esophageal neoplasmS Endoscopic SUBMUCOSAL DISSECTION Mallory-Weiss TEAR Incidence Risk factors
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Endoscopic submucosal dissection for early esophageal neoplasms using the stag beetle knife 被引量:7
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作者 Toshio Kuwai Toshiki Yamaguchi +10 位作者 Hiroki Imagawa Ryoichi Miura Yuki Sumida Takeshi Takasago Yuki Miyasako Tomoyuki Nishimura Sumio Iio Atsushi Yamaguchi Hirotaka Kouno Hiroshi Kohno Sauid Ishaq 《World Journal of Gastroenterology》 SCIE CAS 2018年第15期1632-1640,共9页
AIM To determine short-and long-term outcomes of endoscopic submucosal dissection(ESD) using the stag beetle(SB) knife, a scissor-shaped device.METHODS Seventy consecutive patients with 96 early esophageal neoplasms, ... AIM To determine short-and long-term outcomes of endoscopic submucosal dissection(ESD) using the stag beetle(SB) knife, a scissor-shaped device.METHODS Seventy consecutive patients with 96 early esophageal neoplasms, who underwent ESD using a SB knife at Kure Medical Center and Chugoku Cancer Center, Japan, between April 2010 and August 2016, were retrospectively evaluated. Clinicopathological characteristics of lesions and procedural adverse events were assessed. Therapeutic success was evaluated on the basis of en bloc, histologically complete, and curative or non-curative resection rates. Overall and tumor-specific survival, local or distant recurrence, and 3-and 5-year cumulative overall metachronous cancer rates were also assessed.RESULTS Eligible patients had dysplasia/intraepithelial neoplasia(22%) or early cancers(squamous cell carcinoma, 78%). The median procedural time was 60 min and on average, the lesions measured 24 mm in diameter, yielding 33-mm tissue defects. The en bloc resection rate was 100%, with 95% and 81% of dissections deemed histologically complete and curative, respectively. All procedures were completed without accidental incisions/perforations or delayed bleeding. During follow-up(mean, 35 ± 23 mo), no local recurrences or metastases were observed. The 3-and 5-year survival rates were 83% and 70%, respectively, with corresponding rates of 85% and 75% for curative resections and 74% and 49% for noncurative resections. The 3-and 5-year cumulative rates of metachronous cancer in the patients with curative resections were 14% and 26%, respectively.CONCLUSION ESD procedures using the SB knife are feasible, safe, and effective for treating early esophageal neoplasms, yielding favorable short-and long-term outcomes. 展开更多
关键词 neoplasms STAG BEETLE KNIFE esophageal Endoscopic SUBMUCOSAL DISSECTION Outcome measures
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Personalized targeted therapy for esophageal squamous cell carcinoma 被引量:13
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作者 Xiaozheng Kang Keneng Chen +3 位作者 Yicheng Li Jianying Li Thomas A D'Amico Xiaoxin Chen 《World Journal of Gastroenterology》 SCIE CAS 2015年第25期7648-7658,共11页
Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personali... Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personalized oncology care. One of the most pressing problems facing this issue is to improve the understanding of the newly available genomic data, and identify the driver-gene mutations, pathways, and networks. The emergence of a legion of novel targeted agents has generated much hope and hype regarding more potent treatment regimens, but the accuracy of drug selection is still arguable. Other problems, such as cancer heterogeneity, drug resistance, exceptional responders, and side effects, have to be surmounted. Evolving topics in personalized oncology, such as interpretation of genomics data, issues in targeted therapy, research approaches for targeted therapy, and future perspectives, will be discussed in this editorial. 展开更多
关键词 Cancer heterogeneity Cultured tumorcells Driver mutation Drug side effects esophagealsquamous cell carcinoma Exceptional RESPONDER Highthroughputnucleotide sequencing neoplasm DRUGRESISTANCE PERSONALIZED medicine XENOGRAFT model
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Immunotherapy for esophageal cancer:Where are we now and where can we go 被引量:2
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作者 Yoshiaki Shoji Kazuo Koyanagi +8 位作者 Kohei Kanamori Kohei Tajima Mika Ogimi Yamato Ninomiya Miho Yamamoto Akihito Kazuno Kazuhito Nabeshima Takayuki Nishi Masaki Mori 《World Journal of Gastroenterology》 SCIE CAS 2024年第19期2496-2501,共6页
Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monocl... Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monoclonal antibodies that selectively inhibit programmed cell death-1(PD-1)activity has now become standard of care in the treatment of ESCC in metastatic settings,and has a high expectation to provide clinical benefit during perioperative period.Further,anti-cytotoxic T-lymphocyte–associated protein 4(CTLA-4)monoclonal antibody has also been approved in the treatment of recurrent/metastatic ESCC in combination with anti-PD-1 antibody.Well understanding of the existing evidence of immune-based treatments for ESCC,as well as recent clinical trials on various combinations with chemotherapy for different clinical settings including neoadjuvant,adjuvant,and metastatic diseases,may provide future prospects of ESCC treatment for better patient outcomes. 展开更多
关键词 esophageal cancer IMMUNOTHERAPY Immune checkpoint inhibitor Programmed cell death-1 Anti-cytotoxic T-lymphocyte-associated protein 4 Neoadjuvant therapy Adjuvant therapy Clinical trials Combination therapy
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European vs 2015-World Health Organization clinical molecular and pathological classification of myeloproliferative neoplasms 被引量:3
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作者 Jan Jacques Michiels Fransje Valster +2 位作者 Jenne Wielenga Katrien Schelfout Hendrik De Raeve 《World Journal of Hematology》 2015年第3期16-53,共38页
The BCR/ABL fusion gene or the Ph^1-chromosome in the t(9;22)(q34;q11)exerts a high tyrokinase acticity,which is the cause of chronic myeloid leukemia(CML).The1990 Hannover Bone Marrow Classification separated CML fro... The BCR/ABL fusion gene or the Ph^1-chromosome in the t(9;22)(q34;q11)exerts a high tyrokinase acticity,which is the cause of chronic myeloid leukemia(CML).The1990 Hannover Bone Marrow Classification separated CML from the myeloproliferative disorders essential thrombocythemia(ET),polycythemia vera(PV)and chronic megakaryocytic granulocytic myeloproliferation(CMGM).The 2006-2008 European Clinical Molecular and Pathological(ECMP)criteria discovered 3variants of thrombocythemia:ET with features of PV(prodromal PV),"true"ET and ET associated with CMGM.The 2008 World Health Organization(WHO)-ECMP and 2014 WHO-CMP classifications defined three phenotypes of JAK2^(V617F)mutated ET:normocellular ET(WHO-ET),hypercelluar ET due to increased erythropoiesis(prodromal PV)and ET with hypercellular megakaryocytic-granulocytic myeloproliferation.The JAK2^(V617F)mutation load in heterozygous WHO-ET is low and associated with normal life expectance.The hetero/homozygous JAK2^(V617F)mutation load in PV and myelofibrosis is related to myeloproliferative neoplasm(MPN)disease burden in terms of symptomaticsplenomegaly,constitutional symptoms,bone marrow hypercellularity and myelofibrosis.JAK2 exon 12mutated MPN presents as idiopathic eryhrocythemia and early stage PV.According to 2014 WHO-CMP criteria JAK2 wild type MPL^(515)mutated ET is the second distinct thrombocythemia featured by clustered giant megakaryocytes with hyperlobulated stag-horn-like nuclei,in a normocellular bone marrow consistent with the diagnosis of"true"ET.JAK2/MPL wild type,calreticulin mutated hypercellular ET appears to be the third distinct thrombocythemia characterized by clustered larged immature dysmorphic megakaryocytes and bulky(bulbous)hyperchromatic nuclei consistent with CMGM or primary megakaryocytic granulocytic myeloproliferation. 展开更多
关键词 MYELOPROLIFERATIVE disorders Essential THROMBOCYTHEMIA Primary megakaryocytic granulocytic myeloproliferation MYELOFIBROSIS JAK2V617F MUTATION MPL515 MUTATION CALRETICULIN MUTATION JAK2 wild type MYELOPROLIFERATIVE neoplasm Bone marrow pathology POLYCYTHEMIA vera
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Is Helicobacter pylori infection protective against esophageal cancer?
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作者 Rick Maity Arkadeep Dhali Jyotirmoy Biswas 《World Journal of Gastroenterology》 SCIE CAS 2024年第38期4168-4174,共7页
Helicobacter pylori(H.pylori)infection affects a substantial proportion of the global population and causes various gastric disorders,including gastric cancer.Recent studies have found an inverse relationship between ... Helicobacter pylori(H.pylori)infection affects a substantial proportion of the global population and causes various gastric disorders,including gastric cancer.Recent studies have found an inverse relationship between H.pylori infection and eso-phageal cancer(EC),suggesting a protective role against EC.This editorial focuses on the possible mechanisms underlying the role of H.pylori infection in EC and explores the role of gut microbiota in esophageal carcinogenesis and the prac-ticality of H.pylori eradication.EC has two major subtypes:Esophageal squamous cell carcinoma(ESCC)and esophageal adenocarcinoma(EAC),which have different etiologies and risk factors.Gut microbiota can contribute to EC via inflammation-induced carcinogenesis,immunomodulation,lactagenesis,and genotoxin production.H.pylori infection is said to be inversely related to EAC,protecting against EAC by inducing atrophic gastritis,altering serum ghrelin levels,and triggering cancer cell apoptosis.Though H.pylori infection has no significant association with ESCC,COX-2-1195 polymorphisms and endogenous nitrosamine production can impact the risk of ESCC in H.pylori-infected in-dividuals.There are concerns regarding a plausible increase in EC after H.pylori eradication treatments.However,H.pylori eradication is not associated with an increased risk of EC,making it safe from an EC perspective. 展开更多
关键词 Helicobacter pylori Helicobacter pylori infection esophageal cancer esophageal squamous cell carcinoma esophageal adenocarcinoma Barretts esophagus MICROBIOTA DYSBIOSIS ERADICATION
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GSTM1,GSTT1,GSTP1 and CYP1A1 genetic polymorphisms and susceptibility to esophageal cancer in a French population:Different pattern of squamous cell carcinoma and adenocarcinoma 被引量:7
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作者 Ahmed Abbas Karine Delvinquière +4 位作者 Mathilde Lechevrel Pierre Lebailly Pascal Gauduchon Guy Launoy Fran ois Sichel 《World Journal of Gastroenterology》 SCIE CAS CSCD 2004年第23期3389-3393,共5页
AIM:To evaluate the association between CYP1A1 and GSTs genetic polymorphisms and susceptibility to esophageal squamous cell carcinoma(SCC)and esophageal adenocarcinoma(ADC)in a high risk area of northwest of France. ... AIM:To evaluate the association between CYP1A1 and GSTs genetic polymorphisms and susceptibility to esophageal squamous cell carcinoma(SCC)and esophageal adenocarcinoma(ADC)in a high risk area of northwest of France. METHODS:A case-control study was conducted to investigate the genetic polymorphisms of these enzymes (CYPIAI*2C and GSTP1 exon 7 Val alleles,GSTMI*2/*2 and GSTTl *2/*2 null genotypes).A total of 79 esophageal cancer cases and 130 controls were recruited. RESULTS:GSTMI*2/*2 and CYPIAI*IA/*2C genotype frequencies were higher among squamous cell carcinomas at a level dose to statistical significance(OR =1.83,95% CI 0.88-3.83,P=0.11;OR=3.03,95% CI 0.93-9.90,P=0.07, respectively).For GSTP1 polymorphism,no difference was found between controls and cases,whatever their histological status.Lower frequency of GSTT1 deletion was observed in ADC group compared to controls with a statistically significant difference(OR=13.31,95% CI 1.66-106.92,P<0.01). CONCLUSION:In SCC,our results are consistent with the strong association of this kind of tumour with tobacco exposure.In ADC,our results suggest 3 distinct hypotheses: (1)activation of exogenous procarcinogens,such as small halogenated compounds by GSTT1;(2)contribution of GSTT1 to the inflammatory response of esophageal mucosa,which is known to be a strong risk factor for ADC, possibly through leukotriene synthesis;(3)higher sensitivity to the inflammatory process associated with intracellular depletion of glutathione. 展开更多
关键词 ACYLTRANSFERASES ADENOCARCINOMA Adult Aged Aged 80 and over Carcinoma Squamous Cell Case-Control Studies Cytochrome P-450 CYP1A1 esophageal neoplasms Female France Genetic Predisposition to Disease Genotype Glutathione Transferase Humans Male Middle Aged Polymorphism Genetic Research Support Non-U.S. Gov't Risk Factors
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Useful strategies to prevent severe stricture after endoscopic submucosal dissection for superficial esophageal neoplasm 被引量:8
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作者 Kaname Uno Katsunori Iijima +1 位作者 Tomoyuki Koike Tooru Shimosegawa 《World Journal of Gastroenterology》 SCIE CAS 2015年第23期7120-7133,共14页
The minimal invasiveness of endoscopic submucosal dissection(ESD) prompted us to apply this technique to large-size early esophageal squamous cell carcinoma and Barrett's adenocarcinoma, despite the limitationsin ... The minimal invasiveness of endoscopic submucosal dissection(ESD) prompted us to apply this technique to large-size early esophageal squamous cell carcinoma and Barrett's adenocarcinoma, despite the limitationsin the study population and surveillance duration. A post-ESD ulceration of greater than three-fourths of esophageal circumference was advocated as an important risk factor for refractory strictures that require several sessions of dilation therapy. Most of the preoperative conditions are asymptomatic, but dilatation treatment for dysphagia associated with the stricture has potential risks of severe complications and a worsening of quality of life. Possible mechanisms of dysphasia were demonstrated based on dysmotility and pathological abnormalities at the site:(1) delayed mucosal healing;(2) severe inflammation and disorganized fibrosis with abundant extracellular matrices in the submucosa; and(3) atrophy in the muscularis proper. However, reports on the administration of anti-scarring agents, preventive dilation therapies, and regenerative medicine demonstrated limited success in stricture prevention, and there were discrepancies in the study designs and protocols of these reports. The development and consequent long-term assessments of new prophylactic technologies on the promotion of wound healing and control of the inflammatory/tumor microenvironment will require collaboration among various research fields because of the limited accuracy of preoperative staging and high-risk of local recurrence. 展开更多
关键词 esophageal STRICTURE DYSPHASIA Endoscopicsubmucosal DISSECTION
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Prevalence of Helicobacter pylori infection among patients with esophageal carcinoma 被引量:3
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作者 Miriam López-Gómez Maria Morales +4 位作者 Rebeca Fuerte Marta Muñoz Pedro-David Delgado-López Jorge Francisco Gómez-Cerezo Enrique Casado 《World Journal of Gastroenterology》 SCIE CAS 2024年第29期3479-3487,共9页
BACKGROUND Helicobacter pylori(H.pylori)is a widespread microorganism related to gastric adenocarcinoma(AC).In contrast,it has been reported that an inverse association exists between H.pylori infection and esophageal... BACKGROUND Helicobacter pylori(H.pylori)is a widespread microorganism related to gastric adenocarcinoma(AC).In contrast,it has been reported that an inverse association exists between H.pylori infection and esophageal carcinoma.The mechanisms underlying this supposedly protective effect remain controversial.AIM To determine the prevalence of H.pylori infection in esophageal carcinoma patients,we performed a retrospective observational study of esophageal tumors diagnosed in our hospital.METHODS We retrospectively reviewed the prevalence of H.pylori infection in a cohort of patients diagnosed with esophageal carcinoma.Concomitant or previous proton pump inhibitor(PPI)usage was also recorded.RESULTS A total of 89 patients with esophageal carcinoma(69 males,77.5%),with a mean age of 66 years(range,26-93 years)were included.AC was the most frequent pathological variant(n=47,52.8%),followed by squamous cell carcinoma(n=37,41.6%).Fourteen ACs(29.8%)originated in the gastroesophageal junction and 33(70.2%)in the esophageal body.Overall,54 patients(60.7%)presented at stages III and IV.Previous H.pylori infection occurred only in 4 patients(4.5%),3 with AC(6.3%of all ACs)and 1 with squamous cell carcinoma(2.7%of all squamous cell tumors).All patients with previous H.pylori infection had stage III-IV.Only one patient had received prior H.pylori eradication therapy,whereas 86(96.6%)had received previous or concomitant PPI treatment.CONCLUSION In our cohort of patients,and after histologic evaluation of paraffin-embedded primary tumors,we found a very low prevalence of previous H.pylori infection.We also reviewed the medical history of the patients,concluding that the majority had received or were on PPI treatment.The minimal prevalence of H.pylori infection found in this cohort of patients with esophageal carcinoma suggests a protective role. 展开更多
关键词 Helicobacter pylori ERADICATION esophageal tumor DYSBIOSIS Proton pump inhibitors CARCINOGENESIS MICROBIOTA Incidence
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Combination of concurrent endoscopic submucosal dissection and modified peroral endoscopic myotomy for an achalasia patient with synchronous early esophageal neoplasms 被引量:2
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作者 Sha Shi Kuangi Fu +2 位作者 Xin-Qian Dong Yu-Jing Hao Sen-Lin Li 《World Journal of Gastrointestinal Endoscopy》 CAS 2017年第2期99-104,共6页
with an increased risk for developing esophageal squamous cell carcinoma. In our paper, we introduced an achalasia patient combined with synchronous early esophageal neoplasms. We performed a combination of concurrent... with an increased risk for developing esophageal squamous cell carcinoma. In our paper, we introduced an achalasia patient combined with synchronous early esophageal neoplasms. We performed a combination of concurrent endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM). No complications other than postoperative pain that needed morphine treatment for two days had occurred. Dysphagia was significantly improved. Neither reflux nor cough occurred. The short-term efficacy and safety of our case is favorable and suggests that concurrent ESD and POEM could be a treatment option to such patients. 展开更多
关键词 ACHALASIA Early esophageal neoplasm Endoscopic submucosal dissection Modified peroral endoscopic myotomy
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Issues and controversies in esophageal inlet patch 被引量:9
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作者 Adriana Ciocalteu Petrica Popa +1 位作者 Mircea Ionescu Dan Ionut Gheonea 《World Journal of Gastroenterology》 SCIE CAS 2019年第30期4061-4073,共13页
The proximal esophagus is rarely examined,and its inspection is often inadequate.Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus,a r... The proximal esophagus is rarely examined,and its inspection is often inadequate.Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus,a region in which their prevalence is likely underestimated.Various studies have reported correlations between these esophageal marks with different issues such as Barrett’s esophagus,but these findings remain controversial.Conflicting reports complicate the process of interpreting the clinical features of esophageal inlet patches and underestimate their importance.Unfortunately,the limited clinical data and statistical analyses make reaching any conclusions difficult.It is hypothesized that inlet patches are correlated with various esophageal and extraesophageal symptoms,diagnoses and the personalized therapeutic management of patients with inlet patches as well as the differential diagnosis for premalignant lesions or early cancers.Due to its potential underdiagnosis,there are no consensus guidelines for the management and follow up of inlet patches.This review focuses on questions that were raised from published literature on esophageal inlet patches in adults. 展开更多
关键词 INLET PATCH Ectopic GASTRIC MUCOSA Heterotopic GASTRIC MUCOSA esophageal cancer Narrow band imaging Optical chromoendoscopy Cervical ESOPHAGUS Functional dyspepsia Barretts ESOPHAGUS Helicobacter pylori
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Importance of early detection of esophageal cancer before the tumor progresses too much for effective treatment
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作者 Takashi Ono 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第8期3382-3385,共4页
This editorial comments on an article by Qu et al published in the World Journal of Gastrointestinal Oncology.It focuses on the importance of early detection of esophageal cancer,including recurrence or secondary mali... This editorial comments on an article by Qu et al published in the World Journal of Gastrointestinal Oncology.It focuses on the importance of early detection of esophageal cancer,including recurrence or secondary malignancy after chemoradiotherapy(CRT).Endoscopic resection is the first choice for treatment for esophageal cancer remaining within the mucous membrane,while surgery or radical CRT are treatment options for advanced stages depending on the patient’s general condition and desire.Although these treatments are potentially curative,they are more invasive than endoscopic resection.Early-stage esophageal cancer is often asymptomatic and difficult to detect.Uniform periodic endoscopy is unrealistic.Although less burdensome tests exist,including liquid biopsy and urinary biomarkers,these have not yet been widely used in clinical practice.Early detection is important after radical CRT because the local recurrence rate is higher than that after surgery.However,endoscopic resection or photodynamic therapy is indicated if detected in the early stages,and positive results have been reported.Early detection of esophageal cancer is crucial.Endoscopy is the main diagnostic method;however,new and less burdensome methods should be established to ensure early treatment for patients with esophageal cancer. 展开更多
关键词 esophageal neoplasms Screening ENDOSCOPY PROGNOSIS Endoscopic mucosal resection Endoscopic submucosal dissection Photodynamic therapy
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Endoscopic assessment and management of early esophageal adenocarcinoma 被引量:4
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作者 Ghassan M Hammoud Hazem Hammad Jamal A Ibdah 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2014年第8期275-288,共14页
Esophageal carcinoma affects more than 450000people worldwide and the incidence is rapidly increasing.In the United States and Europe,esophageal adenocarcinoma has superseded esophageal squamous cell carcinoma in its ... Esophageal carcinoma affects more than 450000people worldwide and the incidence is rapidly increasing.In the United States and Europe,esophageal adenocarcinoma has superseded esophageal squamous cell carcinoma in its incidence.Esophageal cancer has a high mortality rates secondary to the late presentation of most patients at advanced stages.Endoscopic screening is recommended for patients with multiple risk factors for cancer in Barrett’s esophagus.These risk factors include chronic gastroesophageal reflux disease,hiatal hernia,advanced age,male sex,white race,cigarette smoking,and obesity.The annual risk of esophageal cancer is approximately 0.25%for patients without dysplasia and 6%for patients with high-grade dysplasia.Twenty percent of all esophageal adenocarcinoma in the United States is early stage with disease confined to the mucosa or submucosa.The significant morbidity and mortality of esophagectomy make endoscopic treatment an attractive option.The American Gastroenterological Association recommends endoscopic eradication therapy for patients with high-grade dysplasia.Endoscopic modalities for treatment of early esophageal adenocarcinoma include endoscopic resection techniques and endoscopic ablative techniques such as radiofrequency ablation,photodynamic therapy and cryoablation.Endoscopic therapy should be precluded to patients with no evidence of lymphovascular invasion.Local tumor recurrence is low after endoscopic therapy and is predicted by poor differentiation of tumor,positive lymph node and submucosal invasion.Surgical resection should be offered to patients with deep submucosal invasion. 展开更多
关键词 esophageal adenocarcinoma High grade dysplasia endoscopic ultrasound GASTROesophageal REFLUX Barretts esophagus CHROMOENDOSCOPY Narrow band imaging ENDOSCOPIC MUCOSAL resection Radiofrequency ablation
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Endoscopic submucosal tunnel dissection for largesuperficial esophageal squamous cell neoplasms 被引量:19
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作者 Ya-Qi Zhai Hui-Kai Li En-Qiang Linghu 《World Journal of Gastroenterology》 SCIE CAS 2016年第1期435-445,共11页
Endoscopic submucosal dissection(ESD)is a wellestablished treatment for superficial esophageal squamous cell neoplasms(SESCNs)with no risk of lymphatic metastasis.However,for large SESCNs,especially when exceeding two... Endoscopic submucosal dissection(ESD)is a wellestablished treatment for superficial esophageal squamous cell neoplasms(SESCNs)with no risk of lymphatic metastasis.However,for large SESCNs,especially when exceeding two-thirds of the esophageal circumference,conventional ESD is time-consuming and has an increased risk of adverse events.Based on the submucosal tunnel conception,endoscopic submucosal tunnel dissection(ESTD)was first introduced by us to remove large SESCNs,with excellent results.Studies from different centers also reported favorable results.Compared with conventional ESD,ESTD has a more rapid dissection speed and R0 resection rate.Currently in China,ESTD for large SESCNs is an important part of the digestive endoscopic tunnel technique,as is peroral endoscopic myotomy for achalasia and submucosal tunnel endoscopic resection for submucosal tumors of the muscularis propria.However,not all patients with SESCNs are candidates for ESTD,and postoperative esophageal strictures should also be taken into consideration,especially for lesions with a circumference greater than three-quarters.In this article,we describe our experience,review the literature of ESTD,and provide detailed information on indications,standard procedures,outcomes,and complications of ESTD. 展开更多
关键词 ENDOSCOPIC SUBMUCOSAL TUNNEL DISSECTION esophageal SQUAMOUS cell neoplasms Digestiveendoscopic TUNNEL technique ENDOSCOPIC submucosaldissection
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Prognostic implications of FGFR1 and MYC status in esophageal squamous cell carcinoma 被引量:1
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作者 Dohee Kwon Ji Yun Yun +2 位作者 Bhumsuk Keam Young Tae Kim Yoon Kyung Jeon 《World Journal of Gastroenterology》 SCIE CAS 2016年第44期9803-9812,共10页
AIM To investigate the clinicopathological features and prognostic implications of combined MYC and fibroblast growth factor receptor 1(FGFR1) status in esophageal squamous cell carcinomas(ESCCs). METHODS All patients... AIM To investigate the clinicopathological features and prognostic implications of combined MYC and fibroblast growth factor receptor 1(FGFR1) status in esophageal squamous cell carcinomas(ESCCs). METHODS All patients with ESCC(n = 180) underwent surgical resection at Seoul National University Hospital sometime between 2000 and 2013. A tissue microarray was constructed using cores obtained from representative tumor areas of formalin-fixed, paraffin-embedded tissue blocks. FGFR1 and MYC copy numbers were quantified using fluorescence in situ hybridization. The level of MYC expression was determined using immunohistochemistry. FGFR1 and MYC amplification status was compared between primary and metastatic lymph nodes. Univariate and multivariate survival analyses were performed according to adjuvant therapy status.RESULTS FGFR1 and MYC amplifications were observed in 21.4%(37/173) and 54.2%(91/168) of patients, respectively, while MYC expression was observed in 58.9%(106/180) of patients. There was a positive correlation between MYC amplification and overexpression(P = 0.002). Although FGFR1 amplification was not associated with MYC amplification or expression, 12.3%(20/163) of patients exhibited both FGFR1 amplification and MYC expression. There was also a correlation in FGFR1 amplification status between matched primary tumors and metastatic lymph nodes(P < 0.001). MYC expression was higher in ESCCs with p T1(P < 0.001) and in those with no lymph node metastasis(P = 0.023). MYC expression was associated with prolonged diseasefree survival(P = 0.036) and overall survival(OS)(P = 0.017) but was not an independent prognostic factor. FGFR1 amplification was an independent predictor for prolonged OS in all patients(P = 0.029) and in those who did not receive adjuvant therapy(P = 0.013). Combined FGFR1 amplification and MYC expression predicted better OS in patients who did not receive adjuvant therapy(P = 0.034) but not in those who did receive adjuvant therapy.CONCLUSION FGFR1 amplification and MYC expression have prognostic implications in resected ESCCs with respect to adjuvant therapy. The role of FGFR1-targeted therapy in ESCC remains to be explored. 展开更多
关键词 RECEPTOR TYROSINE kinase FIBROBLAST growth factor RECEPTOR 1 MYC esophageal SQUAMOUS cell carcinoma Gene amplification Prognosis Fluorescent in situ hybridization
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Experimental and clinic-opathologic study on the relationship between transcription factor Egr-1 and esophageal carcinoma 被引量:20
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作者 Ming-Yao Wu Mao-Huai Chen Ying-Rui Liang Guo-Zhao Meng Huan-Xing Yang Chu-Xiang Zhuang Department of Pathology,Shantou University Medical College,Shantou 515031,Guangdong Province,China Supported by the National Natural Science Foundation of China,No.39670298. 《World Journal of Gastroenterology》 SCIE CAS CSCD 2001年第4期490-495,共6页
AIM: To observe the growth suppression effect of exogenous introduction of early growth response gene-1 (Egr-1 gene) on esophageal carcinoma tissue as well as on esophageal carcinoma cell line Eca109 and to explore th... AIM: To observe the growth suppression effect of exogenous introduction of early growth response gene-1 (Egr-1 gene) on esophageal carcinoma tissue as well as on esophageal carcinoma cell line Eca109 and to explore the potential application of Egr-1 gene in gene therapy of tumor. METHODS: Eukaryotic expression vector of PCMV-Egr-1 plasmid was introduced into Eca109 cell line which expressed no Egr-1 protein originally with lipofectamine transfection method. The introduction and expression of PCMV-Egr-1 plasmid into Eca109 cell line was confirmed by G418 selection culture, PCR amplification of neogene contained in the vector, Western blot analysis and immunocytochemical analysis. The cell growth curve, soft agar colony formation rate and tumorigenicity in SCID mice were examined to demonstrate the growth suppression effect of exogenous Egr-1 gene on Eca109 cell line. The Egr-1 mRNA and Egr-1 protein were also detected in 50 surgical specimens of esophageal carcinoma by in situ hybridization and immunohistochemistry. RESULTS: Exogenous Egr-1 gene was introduced successfully into Eca109 cell line and expressed Egr-1 protein stably. The transfected Eca109 cell line grew more slowly than control Eca109 as shown by cell growth curves, the soft agar colony formation rate (4.0% vs 6.9%, P 【 0.01) and the average growth rate of tumor in SCID mice (35.5 +/- 7.6 vs 65.8 +/- 7.6, P 【 0.05). The expression level of Egr-1 mRNA and protein significantly increased in dysplastic epithelia adjacent to cancer rather than in cancer tissues (65.8% vs 20.0% by ISH and 57.9% vs 0.01). CONCLUSION: Exogenous Egr-1 gene shows the strong effect of growth inhibition in Eca109 cell line. Egr-1 in the cancer tissue shows down-regulated expression that supports the inhibited function of Egr-1 in cancer growth and suggests Egr-1 may have an important role in gene therapy of esophageal carcinoma. 展开更多
关键词 Gene Expression Regulation Neoplastic Animals Blotting Western Carcinogenicity Tests Cell Division DNA-Binding Proteins Early Growth Response Protein 1 esophageal neoplasms Humans Immediate-Early Proteins MICE Mice SCID Plasmids Research Support Non-U.S. Gov't Transcription Factors Transfection Tumor Cells Cultured
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Prevalence of malignant neoplasms in celiac disease patients-a nationwide United States population-based study
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作者 Maryam Bilal Haider Ali Al Sbihi +1 位作者 Sushmitha Nanja Reddy Peter Green 《World Journal of Clinical Oncology》 2024年第8期1048-1060,共13页
BACKGROUND Celiac disease(CeD)is an autoimmune disorder triggered by the immune response to gluten in genetically predisposed individuals.Recent research has unveiled a heightened risk of developing specific malignant... BACKGROUND Celiac disease(CeD)is an autoimmune disorder triggered by the immune response to gluten in genetically predisposed individuals.Recent research has unveiled a heightened risk of developing specific malignant neoplasms(MN)and various malignancies,including gastrointestinal,lymphomas,skin,and others,in individuals with CeD.AIM To investigate the prevalence of MN in hospitalized CeD patients in the United States.METHODS Using data from the National Inpatient Sample spanning two decades,from January 2000 to December 2019,we identified 529842 CeD patients,of which 78128(14.75%)had MN.Propensity score matching,based on age,sex,race,and calendar year,was employed to compare CeD patients with the general non-CeD population at a 1:1 ratio.RESULTS Positive associations were observed for several malignancies,including small intestine,lymphoma,nonmelanoma skin,liver,melanoma skin,pancreas myelodysplastic syndrome,biliary,stomach,and other neuroendocrine tumors(excluding small and large intestine malignant carcinoid),leukemia,uterus,and testis.Conversely,CeD patients exhibited a reduced risk of respiratory and secondary malignancies.Moreover,certain malignancies showed null associations with CeD,including head and neck,nervous system,esophagus,colorectal,anus,breast,malignant carcinoids,bone and connective tissues,myeloma,cervix,and ovary cancers.CONCLUSION Our study is unique in highlighting the detailed results of positive,negative,or null associations between different hematologic and solid malignancies and CeD.Furthermore,it offers insights into evolving trends in CeD hospital outcomes,shedding light on advancements in its management over the past two decades.These findings contribute valuable information to the understanding of CeD’s impact on health and healthcare utilization. 展开更多
关键词 Celiac disease Malignant neoplasm Autoimmune disorder Hospitalized patients Healthcare utilization Gastrointestinal malignancies LYMPHOMAS EPIDEMIOLOGY
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