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 c...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 ?ndings have included overexpression of proto-oncogenes, loss of heterozygosity at multiple chromosomal loci, tumor suppressor gene inactivation, epigenetic silenc- ing 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 ?eld of molecular carcinogen- esis of esophageal malignancies promise to yield improvements in prevention, early detection, prognostic categorization, and perhaps gene-based therapy of this deadly disease.展开更多
OBJECTIVE It has been shown that application of molecular biological techniques to surgical margins of some cancers could predict risk of local recurrence. However, the optimal length of surgical resection with tumor-...OBJECTIVE It has been shown that application of molecular biological techniques to surgical margins of some cancers could predict risk of local recurrence. However, the optimal length of surgical resection with tumor-free surgical margins for esophageal squamous cell carcinoma (ES-CC) is unknown. This study was conducted to evaluate the optimal length of surgical resection for ESCC with molecularly tumor-free surgical margins marked by p53 and Ki67. METHODS Surgical specimens from 70 patients with ESCC were collected for study. The lengths of the upper margin, tumor, and lower margin of every specimen were measured during the operation. Each specimen was divided into three large pathologic sections, stained with H&E and immunohistochemically for p53 and Ki67, and examined microscopically. The lengths of the upper and lower resection ends were measured for p53 and Ki67 positive expression. The actual surgical lengths were calculated by the principle of rational shrinkage. RESULTS All surgical margins were histologically tumor-free, while the positive rates of p53 and Ki67 were 66% and 54%. The positive rates of p53 and Ki67 in the upper resection end were 17% and 20%. The mean lengths of the upper resection end showing p53 and Ki67 positive expression were 1.08±1.12 cm and 1.64±1.01 cm, and the maximum lengths were 3.73 cm and 3.26 cm. The positive rates of p53 and Ki67 in the lower resection end were 20% and 23%. The mean lengths of the lower resection end of p53 and Ki67 with positive expression were 1.11±1.15 cm and 1.34±0.94 cm, and the maximum lengths were 3.73 cm and 3.61 cm. CONCLUSION The optimal length of surgical resection with molecularly tumor-free surgical margins of ESCC is not more than 5 cm.展开更多
Rhabdomyomatous well-differentiated esophageal liposarcomas are extremely rare. As of August 2016, only one other such case has been reported in the Englishlanguage medical literature. Liposarcomas in general are one ...Rhabdomyomatous well-differentiated esophageal liposarcomas are extremely rare. As of August 2016, only one other such case has been reported in the Englishlanguage medical literature. Liposarcomas in general are one of the most common soft tissue neoplasms in adults, but the incidence of primary esophageal liposarcomas is exceptionally low. There have been only 42 reported cases of primary liposarcoma of the esophagus worldwide thus far. These malignancies are harbored within giant fibrovascular polyps, which slowly grow within the esophageal lumen causing obstructing symptoms. We hereby present the case of a 68-year-old male patient who came in with a 2-mo history of worsening intermittent dysphagia, persistent cough, and postprandial retrosternal pain. After an esophagogastroduodenoscopy, a computed tomographic scan, and a diagnostic endoscopy, complete endoscopic resection was performed of the 13 cm×6 cm×2.6 cm fibrovascular polyp. A literature review was done and results are presented herein.展开更多
文摘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 ?ndings have included overexpression of proto-oncogenes, loss of heterozygosity at multiple chromosomal loci, tumor suppressor gene inactivation, epigenetic silenc- ing 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 ?eld of molecular carcinogen- esis of esophageal malignancies promise to yield improvements in prevention, early detection, prognostic categorization, and perhaps gene-based therapy of this deadly disease.
基金This work was supported by the China Guangdong Province Medical Science Research Grant (No. B2003053).
文摘OBJECTIVE It has been shown that application of molecular biological techniques to surgical margins of some cancers could predict risk of local recurrence. However, the optimal length of surgical resection with tumor-free surgical margins for esophageal squamous cell carcinoma (ES-CC) is unknown. This study was conducted to evaluate the optimal length of surgical resection for ESCC with molecularly tumor-free surgical margins marked by p53 and Ki67. METHODS Surgical specimens from 70 patients with ESCC were collected for study. The lengths of the upper margin, tumor, and lower margin of every specimen were measured during the operation. Each specimen was divided into three large pathologic sections, stained with H&E and immunohistochemically for p53 and Ki67, and examined microscopically. The lengths of the upper and lower resection ends were measured for p53 and Ki67 positive expression. The actual surgical lengths were calculated by the principle of rational shrinkage. RESULTS All surgical margins were histologically tumor-free, while the positive rates of p53 and Ki67 were 66% and 54%. The positive rates of p53 and Ki67 in the upper resection end were 17% and 20%. The mean lengths of the upper resection end showing p53 and Ki67 positive expression were 1.08±1.12 cm and 1.64±1.01 cm, and the maximum lengths were 3.73 cm and 3.26 cm. The positive rates of p53 and Ki67 in the lower resection end were 20% and 23%. The mean lengths of the lower resection end of p53 and Ki67 with positive expression were 1.11±1.15 cm and 1.34±0.94 cm, and the maximum lengths were 3.73 cm and 3.61 cm. CONCLUSION The optimal length of surgical resection with molecularly tumor-free surgical margins of ESCC is not more than 5 cm.
文摘Rhabdomyomatous well-differentiated esophageal liposarcomas are extremely rare. As of August 2016, only one other such case has been reported in the Englishlanguage medical literature. Liposarcomas in general are one of the most common soft tissue neoplasms in adults, but the incidence of primary esophageal liposarcomas is exceptionally low. There have been only 42 reported cases of primary liposarcoma of the esophagus worldwide thus far. These malignancies are harbored within giant fibrovascular polyps, which slowly grow within the esophageal lumen causing obstructing symptoms. We hereby present the case of a 68-year-old male patient who came in with a 2-mo history of worsening intermittent dysphagia, persistent cough, and postprandial retrosternal pain. After an esophagogastroduodenoscopy, a computed tomographic scan, and a diagnostic endoscopy, complete endoscopic resection was performed of the 13 cm×6 cm×2.6 cm fibrovascular polyp. A literature review was done and results are presented herein.
