bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS02.054: EXPRESSION OF THE DESMOSOME-RELATED MOLECULE PERIPLAKIN IS ASSOCIATED WITH ADVANCED STAGE AND POOR PROGNOSIS OF ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Yamada Kazuhiko , Hagiwara Teruki , Sezaki Takuhito , Igari Toru , Yokoi Chizu , Nohara Kyoko , Terayama Masahiro , Kataoka Atsuko , Yamashita Satoshi , Dohi Taeko , Kawamura Yuki I , Kokudo Norihiro 
Published: September 2018

Abstract

Background
Our previous report showed that periplakin (PPL), a member of the plakin family of proteins, was expressed in all the normal esophageal squamous cells, except the Ki67 + basal cell layer; however, PPL-negative cells were observed in esophageal squamous cell carcinoma (ESCC) tissue samples and the proportion of PPL-positive areas in tumors showed considerable variation. In this study, we analyzed the relationships between PPL expression in tumors and the clinicopathological features of ESCC.

Methods
PPL expression was evaluated by immunostaining ESCC samples from 70 patients who underwent surgery and we classi ed the samples into PPL-negative and PPL-positive groups based on the proportion of PPL-positive areas in tumors, and the relationships among PPL expression, clinical features, and the ESCC prognosis were analyzed. ESCC cell line KYSE270 cells were stably transfected with the PPL expression vector and their growth was assessed by colony formation assay and subcutaneous xenografts in athymic mice.

Results
As found in our previous study, decreased PPL staining intensity was observed in all of the cancer tissues analyzed, compared with that observed in paired normal esophageal mucosae; however, the PPL-positive group (the percentage of PPL-positive tumor cells was > 20% on immunostaining) exhibited positive associations with the pT classi cation (larger primary tumor) (P = 0.029), pN classi cation (lymph node metastasis) (P = 0.0462), and advanced stages of cancer (P = 0.0253). High PPL expression was observed in all of 26 lymph node metastases analyzed. Furthermore, patients with PPL-positive tumors showed poor postoperative prognosis compared to those with PPL-negative ones. Forced expression of PPL in the KYSE270 ESCC cell line induced a strati ed structure and colony formation. In addition, PPL-transfected cells formed larger tumors in nude mice than mock-transfected cells, suggesting that relatively high PPL expression in tumors may facilitate cell-cell adhesion by desmosome formation and eventual cell growth in vivo.

Conclusion
PPL expression was generally reduced in ESCC compared with paired non-cancer tissue; however, relatively high levels of PPL expression in tumors correlated with tumor progression, lymph node metastasis, advanced stage cancer, and a poor prognosis.

Disclosure
All authors have declared no conflicts of interest.
PS02.061: TRANILAST: SPECIFIC INHIBITOR OF TRPV2 IS THERAPEUTIC AGENT OF ESOPHAGEAL CANCER STEM CELLS
Authors: Katsurahara Keita , Shiozaki Atsushi , Kudou Michihiro , Shoda Katsutoshi , Arita Tomohiro , Konishi Hirotaka , Morimura Ryo , Murayama Yasutoshi , Kuriu Yoshiaki , Kubota Takeshi , Ikoma Hisashi , Nakanishi Masayoshi , Okamoto Kazuma , Otsuji Eigo 
Published: September 2018

Abstract

Background
Recent studies revealed that membrane proteins, such as ion transporters, are specifically activated in cancer stem cells (CSCs). Therefore, these molecules are receiving a great attention as new chemotherapeutic targets of malignant tumor. This study aimed to investigate the expression and activity of ion transport-related molecules in CSCs of esophageal squamous cell carcinoma (ESCC).

Methods
We sorted cells with high expression of ALDH1A1 via FACS, and then, CSCs were generated using the sphere formation assay. The gene expression profiles of CSCs were examined using a microarray analysis. Candidate genes of membrane proteins activated in CSCs were selected based on that microarray data. Anticancer effects induced by inhibition of the selected proteins were examined.

Results
ALDH1A1 mRNA and protein levels were certainly upregulated in CSCs compared with non-CSCs. Obtained CSCs were resistant to Cisplatin and had the ability of re-differentiation. The results of the microarray analysis revealed that expressions of 50 genes of plasma membrane proteins were changed in CSCs, and that several genes related to ion channels, including transient receptor potential cation channel subfamily V member 2 (TRPV2), were upregulated. The upregulation of TRPV2 mRNA were also validated in CSCs derived from two types of esophageal cancer cell lines using RT-PCR method. Tranilast, which is specific TRPV2 inhibitor, was more cytotoxic at lower concentration in CSCs than in non-CSCs, and effectively decreased the number of tumorspheres. Further, Tranilast significantly decreased the cell population with high ALDH1A1 expression in esophageal cancer cells.

Conclusion
The results of the present study suggest that TRPV2 is involved in the maintenance of CSCs, and Tranilast, which is specific inhibitor of TRPV2, becomes a promising targeted therapeutic agent against ESCC.

Disclosure
All authors have declared no conflicts of interest.
PS02.062: CONFOCAL LASER ENDOMICROSCOPY IN THE ASSESSMENT OF PERSISTENT/RECURRENT INTESTINAL METAPLASIA/NEOPLASIA AFTER ENDOSCOPIC TREATMENT OF BORN
Authors: Krajciova Jana , Kollar Marek , Maluskova Jana , Kment Martin , Vackova Zuzana , Spicak Julius , Martinek Jan 
Published: September 2018

Abstract

Background
Patients after endoscopic treatment of Barrett's esophagus related neoplasia (BORN) should undergo regular endoscopic surveillance with biopsies to detect recurrent intestinal metaplasia (IM) or neoplasia (N). Probe-based confocal laser endomicroscopy (pCLE) offers detailed examination of cellular structures and may examine larger areas compared to standard biopsy.

Methods
A single center, prospective, controlled and pathologist-blinded (still ongoing) study in patients undergoing surveillance endoscopy after endoscopic treatment of BORN. pCLE images were obtained from the neo-Z-line (in few cases including macroscopically visible tongues), the cardia and the esophagus. Thereafter, standard biopsies were taken and sent for histopathological analysis (minimally 4 biopsies from macroscopically normal neo-Z-line, 2 biopsies from the cardia and the esophagus and targeted biopsies from visible abnormalities, if present).

Results
We examined 34 patients, from these 14 patients (41%) had the initial diagnosis of low-grade intraepithelial neoplasia (LGIN), 8 patients (24%) had high-grade intraepithelial neoplasia (HGIN) and 12 patients (35%) had an early adenocarcinoma (EAC). Three patients (9%) underwent endoscopic resection (ER), in 18 patients (53%) we performed ER or dissection of all visible lesions followed by radiofrequency ablation (RFA), and 13 patients (38%) had RFA as a single treatment modality.
Persistent/recurrent IM was detected only at the level of neo-Z-line in 8 patients (24%, 8/34 pts) by both methods. pCLE but not biopsies detected persistent/recurrent IM in 2 patients (6%, 2/34), another 2 patients had IM present in biopsies but not in pCLE. pCLE diagnosed one patient with recurrent LGIN in a macroscopic visible tongue arising from neo-Z-line, which was not confirmed in biopsies (there was only agreement in persistent IM detected by both methods).
Sensitivity and specificity of pCLE in detection of persistent/recurrent IM was 80% (95% CI 44–98) and 92% (95% CI 73–99), respectively, with a positive predictive value of 80% (95% CI 51–94) and a negative predictive value of 92% (95% CI 76–98). Agreement of pCLE and histopathological findings was 88%.

Conclusion
pCLE seems comparable to standard biopsies in detection of persistent/recurrent IM after endoscopic treatment of BORN. Nevertheless, these results need to be confirmed in a larger cohort of patients.

Disclosure
All authors have declared no conflicts of interest.
PS02.063: FALSE POSITIVE CASES OF FDG-PET/CT IN METASTASIS OF ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Naomoto Yoshio , Yamatsuji Tomoki , Takaoka Munenori , Haisa Minoru , Manabe Noriaki 
Published: September 2018

Abstract

Background
PET-CTs are useful for diagnosing primary and metastatic lesions of esophageal cancer. Although the number of cases are few, false positives exist in which an inflammatory tumor mass and a non-specific tumor mass are difficult to differentiate.

Methods
The subjects had suspected metastasis from a PET-CT which occurred before the operation of esophageal cancer. However, after surgery, biopsy and/or follow-up observation, only the cases that were confirmed as metastasis negative were considered to be PET-CT false positives.

Results
There were three cases of preoperative PET/CT false positives. Bone metastasis was originally suspected in two cases, but they were later found to be bone metastasis negative after a preoperative bone biopsy and clinical course observation. The other cases suspected of mediastinal lymph node metastasis was diagnosed as inflammatory lymphadenopathy by a pathological examination.

Conclusion
Conducting a PET/CT is useful when diagnosing esophageal cancer metastasis, but there should be an awareness of the possibility of false positives.

Disclosure
All authors have declared no conflicts of interest.
PS02.064: ACCURACY OF F-18-FDG-PET/CT IN MONITORING TUMOUR RESPONSE AFTER NEOADJUVANT CHEMORADIOTHERAPY IN PATIENTS WITH OESOPHAGEAL CANCER
Authors: Valkema Maria , Noordman B , Wijnhoven Bas P L , Spaander M C W , Lagarde Sjoerd M , Ruurda Jelle , Nieuwenhuijzen Grard A P , Van Berge Henegouwen M I , Sosef M N , Siersema P D , Van Lanschot J J B , Valkema R 
Published: September 2018

Abstract

Background
Neoadjuvant chemoradiotherapy (nCRT) induces a pathologically complete response in approximately 30% of patients with oesophageal cancer. To explore the possibility of safe postponement of surgery, accurate clinical response evaluations are needed to exclude residual disease. The present study aims to assess the value of F-18-FDG-PET/CT for the detection of residual tumour (> 10% tumour cells = TRG3–4 vs. no vital cells = TRG1) or metastases after nCRT.

Methods
FDG-PET/CT at baseline and 12 weeks after nCRT was performed according to the European Association of Nuclear Medicine guidelines 1.0 (2.3MBq/kg F-18-FDG; scanning 60 ± 5min.) and the protocol of the preSANO study. Qualitative analysis included sensitive reading of presence of residual tumour and/or metastases. A lesion was considered FDG-positive, when any uptake in the lesion itself was above the adjacent oesophageal background uptake. Quantitatively, SUV/lean body mass (SUL) measurements at tumour, lymph nodes, oesophagus, liver and bloodpool were recorded and compared with pathology (resection specimen: gold standard).

Results
Some 129 of 207 patients with FDG-avid tumours at baseline proceeded to FDG-PET/CT at around 12 weeks after nCRT just before surgery. Forty-one of 129 patients had TRG3–4, of whom 6 were missed on FDG-PET/CT (15% false negative) with SULmax 2.07 ± 0.25, SUL-ratio tumour/oesophagus (SULR) 1.35 ± 0.14. Sensitivity for TRG2–3-4 vs. TRG1 was 57/71 (80%). SULmax and SULR of FDG-positives were 3.76 ± 1.33 and 1.82 ± 0.69 respectively, compared to SULmax 2.21 ± 0.42 and SULR 1.31 ± 0.22 in FDG-negatives. Distant metastases were detected in 18 of 190 (10%) patients. Of all patients with postponed surgery, 12 had ≥ 1 additional FDG-PET/CT during follow-up (25–49.7 weeks after nCRT). Eventually, 4 patients underwent surgery. Three of 4 had increased FDG-signal and TRG3–4; 1 patient had decreased FDG-signal and no tumour left (TRG1).

Conclusion
FDG-PET/CT at around 12 weeks after nCRT misses TRG3–4 tumours in 15% and detects residual TRG2–3-4 in 80%. Furthermore, PET-CT detects distant metastases in 10% of patients after nCRT. These data indicate that serial FDG-PET may become valuable in an active surveillance approach.

Disclosure
All authors have declared no conflicts of interest.
PS02.065: UTILITY OF FDG-PET TO PREDICT LONG TERM PROGNOSIS FOR PATIENTS WITH ESOPHAGEAL CANCER RECEIVING NEOADJUVANT CHEMORADIOTHERAPY FOLLOWED BY SURGERY
Authors: Emi Manabu , Hamai Yoichi , Ibuki Yuta , Okada Morihito 
Published: September 2018

Abstract

Background
There are no prognostic factor for patients with esophagectomy using neoadjvant chemoradiotherapy (nCRT) except for the pathological complete response (pCR). This study aimed to determine the ability of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) to predict prognosis of trimodality therapy on esophageal squamous cell carcinoma (ESCC).

Methods
A series of 90 patients with esophageal squamous cell carcinoma without cervical esophageal underwent sub-total esophagectomy after neoadjvant chemoradiotherapy in the period between October 2006 and January 2013 at our institution. The study included 119 (75 men, 15 women; median age,67) patients with locally advanced ESCC (Stage IB/IIAB/IIIABC/IV: 3/14/64/9). The responses were monitored using FDG-PET before and after nCRT followed by surgery. FDG-PET complete response (PET-CR) after chemoradiotherapy was defined as standardized uptake value less than 2.5. Prognostic factors were determined by uni- and multivariate analysis.

Results
The 5-year overall survival (OS) rates of all patients were 55.3%. Thirty-nine (43.3%) patients achieved a pathological complete response (pCR) after nCRT. Sixty-five percent achieved a PET-CR. PET-CR did not predict for improved outcomes for trimodality therapy (5-year OS 61.5% vs 43.8% P = 0.137).The optimal cutoffs for the rate of decreases in the maximum standard uptake value (SUVmax) determined from receiver operating characteristic (ROC) curves were 75 (AUC, 0.64; 95% CI, 0.54–0.75; P = 0.01) for predicting a pCR. A nonsignificant association was seen in prognosis at the the rate of decreases in SUVmax (P = 0.0823).The PET negative lymph nodes before treatment group showed a higher OS than in the PET-N positive group (5-Y OS 75.0% vs 46.9% P = 0.0036). Multivariate Cox regression analyses identified pCR (hazard ratio [HR], 3.271; confidence interval [CI], 1.568–6.828) and PET-N negative (HR 0.311, CI 0.163–0.592), as the prognostic factor.

Conclusion
Analysis of SUVmax of the primary tumor and lymph node before and after nCRT revealed that PET-N positive before treatment is long term prognostic factor.

Disclosure
All authors have declared no conflicts of interest.
PS02.066: ROLE OF 18F-FDG-PET/CT IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA AFTER NEOADJUVANT CHEMORADIOTHERAPY
Authors: Hirashima Tadahiro , Sasaki Ken , Uchikado Yasuto , Omoto Itaru , Osako Yusaku , Okumura Hiroshi , Setoyama Tetsuro , Owaki Tetsuhiro , Natsugoe Shoji 
Published: September 2018

Abstract

Background
The aim of this study was to assess the role of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) in predicting pathological response and survival in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT).

Methods
Thirty patients with advanced ESCC received nCRT followed by surgery, and underwent FDG-PET/CT twice before and after nCRT. We compared the results of FDG-PET/CT with the pathological results and prognosis.

Results
Pathological response was found to correlate with the maximum standardised uptake value (SUVmax) after nCRT and the rate of decrease of SUVmax. Using univariate analysis, pN, SUVmax after nCRT and the rate of decrease of SUVmax were found to be prognostic factors. Multivariate analysis revealed that only pN was an independent prognostic factor

Conclusion
The prediction of pathological response and prognosis using FDG-PET/CT is not as reliable as pathological detection of lymph node metastasis, but could be a useful method contributing to treatment decisions. Neoadjuvant chemoradiotherapy (nCRT) plus surgery has been shown to improve survival rates and should be regarded as a standard of care for patients with locally advanced esophageal squamous cell carcinoma (ESCC). Appropriate evaluation of nCRT efficacy based on noninvasive parameters might help in individualizing treatments for patients with ESCC. 18F-fluorodeoxyglucose positronemission tomography/computed tomography (FDG-PET/CT) reflects tumor cell viability based on enhanced FDG uptake as a result of increased glucose metabolism. FDG-PET/CT is useful for the staging of advanced ESCC before treatment, and for evaluating the response to nCRT; however, findings from currently available studies in this regard are controversial. In the present study, we examined the role and usefulness of FDG-PET/CT in decisions regarding staging, prediction of histopathological response, and overall survival in patients with advanced ESCC treated with nCRT; this was achieved by analyzing the maximum standardized uptake value (SUVmax) before and after treatment, and the rate of decrease of SUVmax.

Disclosure
All authors have declared no conflicts of interest.
PS02.069: CERVICAL GASTROPLASTY ANASTOMOSIS AFTER ESOPHAGECTOMY: INDOCYANINE GREEN FLUORESCENCE IMAGING EVALUATION AND TECHNICAL SURGICAL ASPECTS
Authors: Takeda Flavio , Ribeiro Jr Ulysses , Sallum Rubens , Mariano Rocha Julio , Duarte Andre , Zaidan Evelise , Cecconello Ivan 
Published: September 2018

Abstract

Description
One of the most frequent complication after esophagectomy is the anastomotic leakage, which is a determiming factor of morbidity and mortality after surgical treatment. The best location for the esophagogastric anastomosis (cervical or intra-thoracic) has been topic of discussion for many years, and surgical aspects as resected margins, recurrent nerve trauma and mainly the vascularization of the anastomosis. In this video we performed a cervical gastroplasty anastomosis (McKeown), side-to-side, stapled (linear stapler) with a thin gastric tube conduit, and after that we aimed to determine the feasibility and usefulness of indocyanine green (ICG) fluorescence imaging to evaluate the gastric conduit perfusion during an esophagectomy. After pulling up the gastric conduit trhought the mediastinum and after performing the cervical anastomosis, 5 mg of ICG was in jected as a bolus and visual assessment of the blood supply of the gastric conduit was seen. This patient was a 63 years old, male, with adenocarcinoma of esophago-gastric junction (Siewert II) underwent to neoadjuvant quimiotherapy (FOLFOX regimen) and submitted after 3 cycles to esophagectomy (thoracoscopy and laparoscopy). No fistula was found in post operative follow-up, and either complications.

Disclosure
All authors have declared no conflicts of interest.
PS02.070: DEEP NEURAL NETWORK TO PREDICT POOR PROGNOSTIC FACTORS IN PATIENTS WITH ESOPHAGEAL CANCER
Authors: Hsu Po-Kuei , Yeh Joe 
Published: September 2018

Abstract

Background
Both lymphovascular invasion, which is characterized by penetration of tumor cells into the peritumoural vascular or lymphatic network, and perineural invasion, which is characterized by involvement of tumor cells surrounding nerve fibers, are considered as an important step for tumor spreading, and are known poor prognostic factors in esophageal cancer. However, the information of these histological features is unavailable until pathological examination of surgical resected specimens. We aim to predict the presence or absence of these factors by positron emission tomography images during staging workup.

Methods
The positron emission tomography images before treatment and pathological reports of 278 patients who underwent esophagectomy for squamous cell carcinoma were collected. Stepwise convolutional neural network was constructed to distinguish patient with either lymphovascular invasion or perineural invasion from those without.

Results
Randomly selected 248 patients were included in the testing set. Stepwise approach was used in training our custom neural network. The performance of fine-tuned neural network was tested in another independent 30 patients. The accuracy rate of predicting the presence or absence of either lymphovascular invasion or perineural invasion was 66.7% (20 of 30 were accurate).

Conclusion
Using pre-treatment positron emission tomography images alone to predict the presence of absence of poor prognostic histological factors, i.e. lymphovascular invasion or perineural invasion, with deep convolutional neural network is possible. The technique of deep learning may identify patients with poor prognosis and enable personalized medicine in esophageal cancer.

Disclosure
All authors have declared no conflicts of interest.
PS02.071: EVALUATION OF CIRCULATING TUMOR CELLS IN ESOPHAGEAL CANCER PATIENTS
Authors: Ujiie Daisuke , Ohki Shinji , Okayama Hirokazu , Yamada Leo , Tada Takeshi , Hanayama Hiroyuki , Hayase Suguru , Gonda Kenji , Saze Zenichiro , Momma Tomoyuki , Kono Koji 
Published: September 2018

Abstract

Background
Circulating tumor cells (CTCs) in patients with malignant tumors can be used as a prognostic marker. Recently the existence of mesenchymal CTCs have been detected by new methods. However, it has been not yet clarified how CTCs are associated with the treatment effects in esophageal cancer patients. We assessed CTCs in esophageal cancer patients and investigated the relationship between CTCs and treatment effect.

Methods
Seven patients who had potential of curative resection have been enrolled and peripheral blood samples (10ml) were collected before and after treatment. All patients received chemotherapy (5-FU and cisplatin) and four patients of them received as neoadjuvant therapy. Other patients received only chemotherapy and radiation therapy without operation. CTCs were analyzed using a Microfluidic Chip devise provide with the Nihon Gene Research Laboratories. This system can isolates CTCs from blood samples, based on their size and deformability differences from blood cells. Phenotypes of CTCs are determined by staining and scanning systems. A previous report revealed that this method had higher sensitivity for CTCs than conventional methods (the Cell Search system) in 61 metastatic breast cancer.

Results
Treatments effects were stable disease or better in all cases. Multiple CTCs were detected in all cases before treatment. Five patients had epithelial CTCs and others had only mesenchymal CTCs. Total number of CTCs after treatment whose data can be available decreased except for two cases. One patient had no CTC after treatment. Two cases have been currently analyzing.

Conclusion
CTCs may exist almost all patients of Stage II or more esophageal cancer. Decreasing the number of CTCs after treatment suggests some relationship between CTCs and treatment effect, and the accumulation of more cases is necessary.

Disclosure
All authors have declared no conflicts of interest.