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Journal of Clinical Laboratory Analysis Jun 2021The goal of our study was to screen tumor grade-related lncRNAs and mRNAs to reveal the underlying molecular mechanism of esophagus squamous cell carcinoma (ESCC).
BACKGROUND
The goal of our study was to screen tumor grade-related lncRNAs and mRNAs to reveal the underlying molecular mechanism of esophagus squamous cell carcinoma (ESCC).
METHODS
The lncRNA and mRNA sequencing data were obtained from The Cancer Genome Atlas (TCGA). Tumor grade correlation analysis of lncRNAs and mRNAs was executed, followed by the functional enrichment analysis of all tumor grade-related mRNAs. The differentially expression mRNAs (DEmRNAs) and differentially expressed lncRNAs (DElncRNAs) were obtained. PPI network and DEmRNA-DElncRNA interaction analysis were constructed. The functional annotation of the DEmRNAs co-expressed with DElncRNAs was performed. The expression levels of the candidate genes were validated using qRT-PCR.
RESULTS
A total of 1864 tumor grade-related mRNAs (846 positively related and 1018 negatively related) and 552 tumor grade-related lncRNAs (331 positively related and 221 negatively related) were obtained. The top 10 significantly grade-related mRNAs and lncRNAs included CA12, FABP4, DECR1, BAIAP2, IL1RAPL2, PPARD, LAD1, TSPAN10, LDOC1, ZNF853, RP11-25G10.2, RP11-557H15.3, RP11-521D12.5, CHKB-AS1, RP11-219B4.3, CH17-335B8.4, RP11-99 J16-A.2, CTB-111H14.1, ADNP-AS1, and JHDM1D-AS1. SFN, IL1RAPL2, and RP11-25G10.2 were overlapped from grade 1, grade 2, and grade 3. PPI network showed that top 10 proteins with higher degrees, including GNAI1, RAP2B, GNAZ, SHH, ADCY1, PRKAR2B, SH3GL1, GNA15, and ARRB1. A DElncRNAs-nearby DEmRNAs network was constructed to obtain hub lncRNAs including ADAMTS9-AS2, RP11-210 M15.2, RP11-13 K12.1, ZBED3-AS1, and RP11-25G10.2. Except for RP11-25G10.2, ADAMTS9-AS1, ZBED3-AS1, SFN, ATP1A2, and GNA15 were consistent with our TCGA analysis.
CONCLUSIONS
Alterations of DEmRNAs and DElncRNAs may provide key insights into the molecular mechanisms of ESCC.
Topics: Biomarkers, Tumor; Computational Biology; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Gene Regulatory Networks; Humans; Neoplasm Grading; RNA, Long Noncoding; RNA, Messenger
PubMed: 33960436
DOI: 10.1002/jcla.23797 -
Discovery Medicine Sep 2013Gastroesophageal cancer (GEC), comprising proximal esophagogastric junction (EGJ) and distal gastric cancer (GC), is a significant public health concern. The... (Review)
Review
Gastroesophageal cancer (GEC), comprising proximal esophagogastric junction (EGJ) and distal gastric cancer (GC), is a significant public health concern. The epidemiology of these tumors has significantly changed over the past several decades especially in developed countries. There is a recognized decrease in incidence and mortality of distal GC and an increase in incidence and mortality of proximal EGJ cancer. The changing epidemiology is thought to be mainly due to changing trends of risk factors such as lower incidence of Helicobacter pylori infection and increasing incidence of obesity and gastroesophageal reflux. Histologically, EGJ cancers are adenocarcinoma (AC), while distal esophagus may be squamous cell carcinoma (SCC) or AC. Distal GC is predominantly AC. Following anatomical and histological distinction, tumors are staged with endoscopic ultrasound (EUS), computerized tomography (CT), and often positron emission tomography (PET) with or without diagnostic laparoscopic and peritoneal washing. Accurate staging of tumors, with emphasis on excluding occult metastasis, is imperative to avoid unnecessary surgical resection. Therefore, it is crucial to understand how these tumors are classified, the associated epidemiology, and the current standards of staging prior to selecting the appropriate course of therapy. In this review we will discuss the epidemiology, classification, and staging of locally advanced GEC.
Topics: Animals; Esophageal Neoplasms; Gastroesophageal Reflux; Helicobacter Infections; Helicobacter pylori; Humans; Incidence; Neoplasm Staging; Stomach Neoplasms
PubMed: 23998446
DOI: No ID Found -
Arquivos de Gastroenterologia 2017Most prevalent esophageal neoplasm is squamous cell carcinoma and adenocarcinoma. Other tumors are uncommon and poorly studied. Primary neuroendocrine esophageal... (Review)
Review
BACKGROUND:
Most prevalent esophageal neoplasm is squamous cell carcinoma and adenocarcinoma. Other tumors are uncommon and poorly studied. Primary neuroendocrine esophageal neoplasm is a rare carcinoma and most of its therapy management is based on lung neuroendocrine studies. Neuroendocrine tumors can be clustered in the following subtypes: high grade (small cell carcinoma or large cell carcinoma) and low grade (carcinoids).
OBJECTIVE:
The present study aims to assess clinical and pathological neuroendocrine esophageal tumors in a single oncologic center.
METHODS:
A retrospective analysis of patients and review of the literatures was performed.
RESULTS:
Fourteen patients were identified as neuroendocrine tumors, 11 male and 3 female patients. Mean age was 67.3 years old. Ten patients were classified as small cell, 3 as large cell and 1 as carcinoid. Four patients presented squamous cell carcinoma simultaneously and 1 also presented adenocarcinoma. Main sites of metastasis were liver, peritoneum, lung and bones. Most patients died before 2 years of follow-up. Patient with longer survival died at 35 months after diagnosis.
CONCLUSION:
Neuroendocrine esophageal tumors are rare; affect mainly men in their sixties or seventies. High grade tumors can be mixed to other subtypes neoplasms, such as adenocarcinoma and squamous cell carcinoma. Most of these patients have poor overall survival rates.
Topics: Aged; Esophageal Neoplasms; Female; Humans; Immunohistochemistry; Kaplan-Meier Estimate; Male; Middle Aged; Neuroendocrine Tumors; Retrospective Studies
PubMed: 28079231
DOI: 10.1590/S0004-2803.2017v54n1-01 -
Current Treatment Options in Oncology Jul 2015Opinion statement: Adenocarcinoma of the esophagus is increasing in incidence in Western nations leading to increased interest in and opportunity to study optimal... (Review)
Review
Opinion statement: Adenocarcinoma of the esophagus is increasing in incidence in Western nations leading to increased interest in and opportunity to study optimal management. Randomized trials have now robustly demonstrated the preoperative therapy with chemoradiotherapy and chemotherapy alone improves survival outcome for the bulk of curable patients, those with locally advanced T1N1M0 and T2-3 N0-1 M0 disease. Evidence suggests but does not confirm that radiation-containing regimens are more beneficial. Clinical staging is designed to exclude patients with T1N0M0 disease who may be treated with surgery alone and those with metastatic disease who may not benefit from intensive local therapy. The approach to clinical staging includes endoscopy with ultrasound and fine needle aspirate to assess local and regional disease, supplemented by CT and PET scanning primarily to exclude metastatic disease. Minimally invasive approaches to esophagectomy may be used with the goal of reducing complications, but there is no evidence that mortality or ultimate outcome is improved.
Topics: Adenocarcinoma; Combined Modality Therapy; Consensus; Esophageal Neoplasms; Esophagectomy; Esophagogastric Junction; Humans; Neoadjuvant Therapy; Neoplasm Staging; Patient Selection; Prognosis; Randomized Controlled Trials as Topic; Stomach Neoplasms
PubMed: 26112428
DOI: 10.1007/s11864-015-0352-6 -
World Journal of Gastroenterology Nov 2018Esophageal cancer (EC) presents a high mortality rate, mainly due to its aggressive nature. Squamous cell carcinoma is the most common histological type worldwide,... (Review)
Review
Esophageal cancer (EC) presents a high mortality rate, mainly due to its aggressive nature. Squamous cell carcinoma is the most common histological type worldwide, though, a continuous increase in esophageal adenocarcinomas has been noted in the past decades. Common risk factors associated with EC include smoking, alcohol consumption, gastroesophageal reflux disease, Barrett's esophagus and obesity. In an effort to overcome chemotherapy resistance in oncology, it was discovered that histone acetylation/deacetylation equilibrium is altered in carcinogenesis, leading to changes in chromatin structure and altering expression of genes important in the cell cycle, differentiation and apoptosis. Based on this knowledge, histone acetylation was addressed as a potential novel chemotherapy drug target to repress cancer cell proliferation. There are four classes of histone deacetylases (HDACs) inhibitors with a variety of different mechanisms of actions that render them possible anti-cancer drugs. They arrest the cell cycle, inhibit differentiation and angiogenesis and induce apoptosis. They do not necessarily act on histone proteins, since they can also exert indirect anti-cancer effects, by modifying various cellular proteins. In addition, HDACs have also been associated with increased chemotherapy resistance. Based on the literature, HDACs have been associated with EC, with surveys revealing that increased expression of certain HDACs correlates with advanced TNM stages, tumor grade, metastatic potential and decreased 5-year overall and disease-free survival. The aim of this survey is to elucidate the molecular identity and mechanism of action of HDAC inhibitors as well as verify their potential utility as anti-cancer agents in esophageal cancer.
Topics: Acetylation; Antineoplastic Agents; Carcinogenesis; Carcinoma, Squamous Cell; Disease-Free Survival; Drug Resistance, Neoplasm; Esophageal Neoplasms; Esophagus; Histone Deacetylase Inhibitors; Histone Deacetylases; Histones; Humans; Protein Processing, Post-Translational
PubMed: 30416311
DOI: 10.3748/wjg.v24.i41.4635 -
International Journal of Surgery... Aug 2020Esophageal cancer (EC) is the sixth most common cause of cancer-related mortality in the world. Currently, surgery is the recommended treatment modality when possible.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Esophageal cancer (EC) is the sixth most common cause of cancer-related mortality in the world. Currently, surgery is the recommended treatment modality when possible. The outcomes of surgery alone are poor, and postoperative radiotherapy (PORT) has been used to patients with esophageal squamous cell carcinoma (ESCC) for years. However, the value of PORT for patients with ESCC after curative resection remains controversial. To assess the benefits and harms of postoperative radiotherapy compared with surgery alone for patients with ESCC we performed in this meta-analysis.
METHOD
A comprehensive electronic literature search was performed via the Cochrane Library, MEDLINE and EMBASE from January 1st, 1990 to October 1st, 2018 for relevant trials. The primary outcomes of interest are overall survival (OS) and disease-free survival (DFS). A meta-analysis was performed to calculate the hazard ratio (HR) with 95% confidence interval (CI).
RESULTS
Three randomized controlled trials (RCTs) and seven retrospective studies (RS) were included, for a total of 5640 patients with 1774 in the PORT group and 3866 in the surgery alone group respectively. Meta-analysis showed there were significant increases both for OS (HR 0.86, 95%CI 0.79-0.93, p = 0.0004) and DFS (HR 0.74, 95%CI 0.63-0.87, p = 0.004) for patients administered PORT compared with surgery alone. Regarding the postoperative recurrence, PORT can significantly reduce the local recurrence rate (OR 0.34, 95%CI 0.29-0.40, p < 0.00001), while it showed no difference in distant metastasis (OR 1.09, 95%CI 0.91-1.30, p = 0.37). Subgroup analysis demonstrated PORT can improve the OS for patients with positive lymph node (N+, HR 0.73, 95%CI 0.59-0.90, p < 0.00001), curative resection (R0 resection, HR 0.81, 95%CI 0.73-0.90, p < 0.0001) and T3 stage (HR 0.84, 95%CI 0.80-1.0, p = 0.05).
CONCLUSIONS
PORT improved the OS and DFS for patients with ESCC compared with surgery alone, and significantly reduced the local recurrence. PORT showed survival benefits for specific subgroups such as patients with positive lymph node, R0 resection margin and T3 stage.
Topics: Adult; Disease-Free Survival; Epithelial Cells; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Esophagus; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Postoperative Period; Proportional Hazards Models; Radiotherapy; Radiotherapy, Adjuvant; Randomized Controlled Trials as Topic; Retrospective Studies
PubMed: 32659390
DOI: 10.1016/j.ijsu.2020.06.046 -
Chinese Journal of Cancer Oct 2010Esophageal cancer is the 7th leading cause of cancer deaths worldwide. While squamous cell carcinoma is the most prevalent histology internationally, adenocarcinoma of... (Review)
Review
Esophageal cancer is the 7th leading cause of cancer deaths worldwide. While squamous cell carcinoma is the most prevalent histology internationally, adenocarcinoma of the distal esophagus accounts for nearly 50% of cases in developed countries due to the differences in the etiologic factors such as gastroesophageal reflux disease (GERD) and obesity that predominate. While surgery is the mainstay of treatment of this disease, the utilization of chemoradiation, either used postoperatively or neoadjuvantly, has become a standard practice in the United States. What is the optimal management approach is still an area of contention, however, and may be different in different regions around the world. This article reviews some of these controversies, including the role for surgery in patients treated with definitive chemoradiation. At the end, we will also outline recommendations regarding radiotherapy procedures and techniques.
Topics: Adenocarcinoma; Carcinoma, Squamous Cell; Chemoradiotherapy; Esophageal Neoplasms; Esophagectomy; Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Risk Factors
PubMed: 20868553
DOI: 10.5732/cjc.010.10151 -
In Vivo (Athens, Greece) 2022Neoadjuvant chemotherapy (NAC) followed by surgery is a standard treatment for patients with locally advanced esophageal cancer. This study aimed to identify patients... (Review)
Review
BACKGROUND/AIM
Neoadjuvant chemotherapy (NAC) followed by surgery is a standard treatment for patients with locally advanced esophageal cancer. This study aimed to identify patients who might be eligible for postoperative adjuvant therapy.
PATIENTS AND METHODS
We reviewed the surgical outcomes of 84 patients who received NAC followed by esophagectomy to treat esophageal squamous cell carcinoma (ESCC) and revealed prognostic factors associated with locally advanced ESCC.
RESULTS
Univariate and multivariate analyses revealed the pretreatment level of squamous cell carcinoma-related antigen [SCC-A; hazard ratio (HR)=1.50, p=0.01], ypT ≥3 (HR=2.51; p=0.04), ypN ≥1 (HR=5.87; p=0.01), ypM1 (HR=2.38; p=0.049), and lymphovascular invasion (HR=3.12, p=0.049) as significant independent covariates for recurrence-free survival (RFS). The 5-year RFS rates for patients with 0-1, 2-3, or 4-5 of these indicators of poor prognosis were 97.1%, 51.2%, and 6.7% (p≤0.001 for all). Recurrence rates among these groups also significantly differed at 2.9%, 50.0%, and 93.3% (p<0.0001).
CONCLUSION
Pretreatment SCC-A, ypT, ypN, ypM, and lymphovascular invasion were significantly associated with RFS in patients with ESCC who received NAC followed by surgery. The status of these prognostic factors in ESCC might indicate a need for postoperative adjuvant therapy after NAC followed by surgery.
Topics: Humans; Esophageal Squamous Cell Carcinoma; Neoadjuvant Therapy; Esophageal Neoplasms; Prognosis; Carcinoma, Squamous Cell; Retrospective Studies; Neoplasm Staging; Chemotherapy, Adjuvant
PubMed: 36309376
DOI: 10.21873/invivo.13025 -
Gastroenterology Jan 2024Antireflux treatment is recommended to reduce esophageal adenocarcinoma in patients with Barrett's esophagus. Antireflux surgery (fundoplication) counteracts...
BACKGROUND & AIMS
Antireflux treatment is recommended to reduce esophageal adenocarcinoma in patients with Barrett's esophagus. Antireflux surgery (fundoplication) counteracts gastroesophageal reflux of all types of carcinogenic gastric content and reduces esophageal acid exposure to a greater extent than antireflux medication (eg, proton pump inhibitors). We examined the hypothesis that antireflux surgery prevents esophageal adenocarcinoma to a larger degree than antireflux medication in patients with Barrett's esophagus.
METHODS
This multinational and population-based cohort study included all patients with a diagnosis of Barrett's esophagus in any of the national patient registries in Denmark (2012-2020), Finland (1987-1996 and 2010-2020), Norway (2008-2020), or Sweden (2006-2020). Patients who underwent antireflux surgery were compared with nonoperated patients using antireflux medication. The risk of esophageal adenocarcinoma was calculated using multivariable Cox regression, providing hazard ratios (HRs) and 95% CIs adjusted for age, sex, country, calendar year, and comorbidity.
RESULTS
The cohort consisted of 33,939 patients with Barrett's esophagus. Of these, 542 (1.6%) had undergone antireflux surgery. During up to 32 years of follow-up, the overall HR was not decreased in patients having undergone antireflux surgery compared with nonoperated patients using antireflux medication, but rather increased (adjusted HR, 1.9; 95% CI, 1.1-3.5). In addition, HRs did not decrease with longer follow-up, but instead increased for each follow-up category, from 1.8 (95% CI, 0.6-5.0) within 1-4 years of follow-up to 4.4 (95% CI, 1.4-13.5) after 10-32 years of follow-up.
CONCLUSIONS
Patients with Barrett's esophagus who undergo antireflux surgery do not seem to have a lower risk of esophageal adenocarcinoma than those using antireflux medication.
Topics: Humans; Barrett Esophagus; Cohort Studies; Esophageal Neoplasms; Adenocarcinoma; Fundoplication
PubMed: 37690771
DOI: 10.1053/j.gastro.2023.08.050 -
World Journal of Gastroenterology Dec 2004To analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma (SCC) of the esophagus and to review the literature on this... (Review)
Review
AIM
To analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma (SCC) of the esophagus and to review the literature on this entity.
METHODS
The records of 9 patients with primary esophageal small cell carcinoma were examined and the demographic data, presenting symptoms, methods of tumor diagnosis, and types of treatment given, response to treatment, pathologic findings, and clinical outcome were reviewed. Features of mixed patterns of histological differentiation and lymph node metastases were specifically sought.
RESULTS
All the patients reported dysphagia, weight loss and chest pain as the initial symptoms. In 5 cases the tumors were located in the mid-esophagus, 3 cases in the lower third of the esophagus and 1 case in the upper third. The average length of esophageal involvement was 5 cm. They underwent radical resection, regional lymph node clearance and esophageal-stomach anastomosis in thorax or at neck. Two patients had a stage IIa disease, five had a stage IIb disease, and the other two had a stage III disease of International Union Contrele Cancer (UICC). All of them were histologically and immunohistochemically confirmed SCC of esophagus. Immunohistochemical staining for neuron-specific enolase (NSE), synaptophsin (Syn) and chromogranin A exhibited strong immunoreactivity in all specimens. Three of the nine resected specimens showed foci of squamous cell carcinoma in situ. Metastasis was present in 7 of 9 adjacent lymph nodes. All the patients survived the operations and made an uneventful postoperative recovery. They received adjuvant systemic chemotherapy and local radiation therapy after discharge. During follow-up, three patients developed multiple liver, brain, lung and bone metastases and died between 5 and 18 mo after the diagnosis. Three patients developed widespread metastasis disease and died between 18 and 37 mo after the diagnosis. There was no local tumor recurrence in these 6 patients. The other three patients were lost during follow-up.
CONCLUSION
Primary small cell carcinoma of the esophagus is a rare but very malignant tumor. Radical resection combined with chemotherapy and radiotherapy is helpful in limited stage cases.
Topics: Aged; Carcinoma, Small Cell; Esophageal Neoplasms; Female; Humans; Male; Middle Aged; Neoplasm Staging
PubMed: 15534932
DOI: 10.3748/wjg.v10.i24.3680