crossing96/oncoscreening huggingface dataset:
Efficacy of the first-line immune checkpoint inhibitor plus chemotherapy for gastroesophageal cancer: A meta-analysis of phase III trials including unreported PD-L1 subgroups.	The treatment paradigm for gastroesophageal cancers is evolving with immune checkpoint inhibitors (ICIs) as first-line therapy, making it crucial to understand their efficacy across patient subgroups, especially concerning PD-L1 expression. We performed a meta-analysis of Phase III randomized controlled trials targeting the effectiveness of ICIs with or without chemotherapy for advanced/metastatic HER2-negative gastroesophageal adenocarcinoma (GEA) or esophageal squamous cell carcinoma (ESCC). Kaplan-Meier (KM) curves of all-comer populations and subgroups according to reported PD-L1 cut-offs were extracted from published reports. Using KMSubtraction algorithm, unreported PD-L1 subgroup survival data were reconstructed by utilizing published KM survival curves. Thirteen first-line phase III RCTs involving 11,795 patients with GEA or ESCC were included. For GEA, ICI with or without chemotherapy showed longer OS in patients with PD-L1 combined positive score ≥1 (HR 0.77, 95 % confidence intervals [CI] 0.71-0.83 for ICI plus chemotherapy; HR 0.86, 95 %CI 0.75-1.01 for ICI alone) compared to chemotherapy alone, showing less benefits in low PD-L1 subgroups. ICI, with or without chemotherapy displayed survival benefits among PD-L1 tumor proportion score ≥1 % for ESCC (HR 0.62, 95 %CI 0.52-0.74 for ICI plus chemotherapy; HR 0.67, 95 %CI 0.54-0.84 for ICI alone) compared to chemotherapy alone. ICI combinations were similarly beneficial for Asian and global patients with GEA or ESCC. In conclusion, this meta-analysis, which includes unreported PD-L1 subgroups show benefit of ICIs with or without chemotherapy as a first-line treatment for advanced gastroesophageal cancers, particularly among patients with high PD-L1 expression.	esophagus
Long-term trends in the clinical management and outcomes of patients with gastroesophageal cancer in Norway.	BACKGROUND AND PURPOSE: Gastroesophageal cancers are highly prevalent internationally, with many patients diagnosed with metastatic disease, leading to challenging treatment and poor survival. This study uses real-world evidence from a population-level database to describe demographics, clinical characteristics, initial treatment patterns, and survival for patients with gastroesophageal cancer in Norway. MATERIAL AND METHODS: Individual patient data was sourced from the Cancer Registry of Norway for patients diagnosed with oesophageal squamous cell carcinoma (ESCC), oesophageal adenocarcinoma (EAC), gastroesophageal junction cancer (GEJC), and gastric cancer from 2001 to 2021, with follow-up from diagnosis to death or last follow-up. Treatment patterns were captured from 2010 to 2022, defined as curative or palliative based on surgery, chemotherapy, and radiotherapy. RESULTS AND INTERPRETATION: The cohort included 14,334 Norwegian patients with gastroesophageal cancer; predominantly male, mean age 69-73 years, with a median follow-up of 9-11 months across cancer subtypes. Approximately 40% of patients received curative treatment, and multi-modality treatments increased for EAC, GEJC, and ESCC. Median survival ranged from 6 to 11 months for patients treated palliatively, and 17-95 months for those treated with curative intent. Interestingly, median survival was higher for patients with EAC and GEJC treated with neoadjuvant chemotherapy (86.1 and 75.1 months) versus neoadjuvant chemoradiotherapy (49.1 and 42.1 months), which was confirmed by a multivariate Cox regression model adjusted for age, sex, and disease stage. This study demonstrates that multimodal treatment strategies, consisting of chemotherapy and surgery, may be associated with improved survival outcomes for gastroesophageal cancers. Future studies are required to identify optimum treatment strategies for gastroesophageal cancer subtypes.	esophagus
A model of basement membrane-related regulators for prediction of prognoses in esophageal cancer and verification in vitro.	Emerging evidence suggests the importance of basement membrane components in cancer metastasis; however, their specific roles in esophageal carcinoma remain underexplored. To investigate this, we analyzed 152 esophageal cancer and 11 normal esophageal tissue samples, identifying basement membrane-related prognostic signatures through differential gene expression profiling and Least Absolute Shrinkage and Selection Operator regression. A six-gene panel (LAMC2, GPC2, AGRN, ITGA3, LAMA3, and LOXL4) demonstrated robust predictive capacity, which we subsequently integrated with clinical features via nomogram modeling to predict overall survival. Our computational analyses revealed distinct tumor microenvironment immune cell profiles and chemotherapeutic drug sensitivities across risk strata. We performed an immunohistochemical assay to confirm increased tumor tissue expression, thereby reinforcing the clinical relevance of these biomarkers. Experimental validation using KYSE-150 esophageal squamous carcinoma cells demonstrated that while LAMC2 knockdown attenuated cellular migration, AGRN, GPC2, ITGA3, LAMA3, and LOXL4 suppression enhanced migratory capacity. Proliferation assays further revealed increased growth rates upon GPC2, ITGA3, and LAMA3 expression inhibition. Our results established a basement membrane-derived risk model for esophageal carcinoma and revealed the roles of the model genes in tumor progression regulation. This model advances prognostic stratification and provides insights into therapeutic targets.	esophagus
Single-Port Subcostal Robot-Assisted Minimally Invasive Esophagectomy-How to Do It?	Minimally invasive robot-assisted esophagectomies have proven superior to traditional open surgery. While transhiatal and transthoracic approaches are common, subcostal access remains less frequent in minimally invasive esophageal surgery. Recent advancements in robotic systems, such as the da Vinci Single-Port (SP), now facilitate precise subcostal access. This innovation holds potential to reduce postoperative pain, enhance patient mobility, and broaden surgical options for patients with multiple health conditions. The Single-Port Subcostal Robot-Assisted Minimal Invasive Esophagectomy (SP SC RAMIE) utilizes an SP and laparoscopic approach, enabling effective mediastinal dissection and esophageal mobilization with radical lymphadenectomy. This novel technique shows promise, especially for frail patients with multiple comorbidities who stand to benefit greatly from expedited recovery pathways. Nonetheless, further exploration is necessary to fully assess its clinical effectiveness and reproducibility.	esophagus
Risk factors for upper extremity deep vein thrombosis after esophagectomy for esophageal cancer in retrosternal reconstruction.	BACKGROUND: Upper extremity deep vein thrombosis (UEDVT) is a fatal postoperative complication that can cause pulmonary embolism (PE). There have been few reports on the relationship between esophageal cancer and UEDVT. The aim of this study is to analyze the risk factors for UEDVT in esophageal cancer. METHODS: Seventy-five cases of thoracic esophageal cancer who underwent one-stage curative resection and reconstructive surgery from May 2019 to June 2022 were included. The stomach or ileocolon was selected as the reconstructive graft. All cases requiring chemotherapy were treated with a peripheral central venous catheter (PICC). To evaluate the width of the retrosternal space, the retrosternal ratio and the cross-sectional area of the graft intestine were measured at the level of the left brachiocephalic vein. RESULTS: UEDVT was observed in 11 patients (14.7%) and occurred only with gastric tube reconstruction (p = 0.02). The width of the retrosternal space was significantly different between the UEDVT and non-UEDVT groups (p = 0.002). The cross-sectional area of reconstructive organ was larger in the stomach than in the ileocolon (p < 0.01). Patients with a history of PICC insertion from the left side had a higher incidence of UEDVT (p = 0.025). CONCLUSIONS: In esophagectomy, gastric tube reconstruction, a retrosternal ratio less than 0.16, and history of PICC insertion from the left side are risk factors for UEDVT.	esophagus
Multi-omic profiling identifies KRT1 as a predictor of immune infiltration and prognosis in gastroesophageal junction cancer.	Gastroesophageal junction cancer (GEJ) is typically investigated alongside gastric or esophageal cancers. However, separate molecular profiles and immune cell infiltration of GEJ remain largely unknown. This study screened for hub genes in GEJ, studied their function and regulation in biological processes, and investigated their relationship with the infiltration of immune cells into tumors. Datasets were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus public databases. Molecular profiling revealed significant down-regulated expression of key genes in GEJ and enrichment in pathways related to epithelial cell differentiation and development, and structural constituents of skin epidermis. Prognostic analysis showed that patients with low KRT1, Desmocollin 2, and Envoplakin expression had a worse prognosis. There was a strong correlation between the levels of KRT1 and both the tumor mutational burden and immune cell infiltration. Single gene pathway enrichment analysis and in vitro experiments confirmed that cancer cell proliferation, migration, and invasion were suppressed by KRT1 via the AKT/mTOR pathway. In conclusion, this multi-dimensional study analyzed the molecular alterations and oncological mechanisms underlying the progression of GEJ. KRT1 is a promising candidate biomarker for the molecular and immunological characterization of GEJ and for prognosis prediction.	esophagus
Dynamics in distress and quality of life in patients undergoing radiation therapy: a prospective cohort study.	PURPOSE: This study used a mobile-based assessment tool to evaluate the dynamics of distress and quality of life (QoL) in patients with esophageal, head and neck, and rectal cancers undergoing radiation therapy (RT). METHODS: A prospective cohort study was conducted between November 2022 and July 2023 and included 100 patients who had completed assessments at pre-RT, weeks 2, 4, and 6 of RT, and 1 month post-treatment. The National Comprehensive Cancer Network Distress Thermometer and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire were used. RESULTS: All patients showed a 100% response rate to the mobile-based assessment at pre-RT, week 6, and post-treatment, with a 95% response rate at weeks 2 and 4 of RT. Of the 100 patients, 33% experienced marked distress pre-RT, with distress levels peaking at 67% at weeks 2 and 4. More than 50% of the patients reported experiencing sleep disturbance, fatigue, worry, or anxiety post-treatment. Their QoL dropped significantly during treatment from levels in weeks 2 and 4 and returned to pre-treatment levels post-RT. Higher distress was consistently correlated with poorer QoL. Emotional and physical issues such as pain and sleep disturbance were significantly associated with poor QoL pre- and post-RT. CONCLUSION: RT was associated with increased distress and a temporary reduction in QoL. Key factors including sleep problems, fatigue, and emotional distress require targeted interventions to improve patient outcomes. Mobile technology use has proven effective in tracking distress and QoL in patients with cancer undergoing RT.	esophagus
A CNN-transformer-based hybrid U-shape model with long-range relay for esophagus 3D CT image gross tumor volume segmentation.	BACKGROUND: Accurate and reliable segmentation of esophageal gross tumor volume (GTV) in computed tomography (CT) is beneficial for diagnosing and treating. However, this remains a challenging task because the esophagus has a variable shape and extensive vertical range, resulting in tumors potentially appearing at any position within it. PURPOSE: This study introduces a novel CNN-transformer-based U-shape model (LRRM-U-TransNet) designed to enhance the segmentation accuracy of esophageal GTV. By leveraging advanced deep learning techniques, we aim to address the challenges posed by the variable shape and extensive range of the esophagus, ultimately improving diagnostic and treatment outcomes. METHODS: Specifically, we propose a long-range relay mechanism to converge all layer feature information by progressively passing adjacent layer feature maps in the pixel and semantic pathways. Moreover, we propose two ready-to-use blocks to implement this mechanism concretely. The Dual FastViT block interacts with feature maps from two paths to enhance feature representation capabilities. The Dual AxialViT block acts as a secondary auxiliary bottleneck to acquire global information for more precise feature map reconstruction. RESULTS: We build a new esophageal tumor dataset with 1665 real-world patient CT samples annotated by five expert radiologists and employ multiple evaluation metrics to validate our model. Results of a five-fold cross-validation on this dataset show that LRRM-U-TransNet achieves a Dice coefficient of 0.834, a Jaccard coefficient of 0.730, a Precision of 0.840, a HD95 of 3.234 mm, and a Volume Similarity of 0.143. CONCLUSIONS: We propose a CNN-Transformer hybrid deep learning network to improve the segmentation effect of esophageal tumors. We utilize the local and global information between shallower and deeper layers to prevent early information loss and enhance the cross-layer communication. To validate our model, we collect a dataset composed of 1665 CT images of esophageal tumors from Sichuan Tumor Hospital. The results show that our model outperforms the state-of-the-art models. It is of great significance to improve the accuracy and clinical application of esophageal tumor segmentation.	esophagus
Immunotherapy-associated autoimmune hemolytic anemia induced by anti-PD-1 therapy in esophageal cancer: A case report and literature review.	RATIONALE: Numerous immune checkpoint inhibitors have been approved for clinical use in metastatic advanced esophageal cancer. While immunotherapy brings therapeutic benefits, immune-related adverse events (irAEs) should nevertheless not be overlooked. This paper reports on the first documented case of Autoimmune hemolytic anemia (AIHA) caused by anti-programmed cell death protein-1 therapy in esophageal squamous cancer. PATIENT CONCERNS: An 84-year-old female patient with metastatic squamous esophageal cancer developed chest tightness, generalized weakness, and a yellowing of the skin after 2 cycles of sintilimab treatment. DIAGNOSES: Initial examination revealed severe anemia with elevated levels of bilirubin, reticulocytes, lactate dehydrogenase, decreased levels of haptoglobin, and a positive direct antihuman globulin test. The patient was diagnosed with immunotherapy-associated AIHA. INTERVENTIONS: The patient was promptly treated with corticosteroids and human immunoglobulin, supportive transfusion with washed erythrocytes. OUTCOMES: Her AIHA was controlled after treatment. Subsequent immunotherapy was not continued, and there was no recurrence of AIHA. LESSONS: We have identified a rare case of serious adverse reaction caused by anti-PD-1 therapy. We summarize the clinical presentations, diagnosis, and treatment of this case of immunotherapy-related AIHA and discuss the pathogenesis and therapeutic advances in immunotherapy-related AIHA, as well as sintilimab-induced irAEs, in detail. These findings underscore the importance of the early detection, diagnosis, and treatment of these rare and potentially fatal irAEs.	esophagus
MUC15 acts as a tumor suppressor gene which correlates with prognosis and immune infiltration in esophageal squamous cell carcinoma.	Esophageal squamous cell carcinoma (ESCC), as a common malignant tumor of the digestive system, has been a challenge in improving and prolonging the postoperative survival of patients. This study aims to identify novel biomarkers that can guide the clinical diagnosis and treatment by using bioinformatics methods. The RNA-seq data and corresponding clinical data of ESCC were downloaded from the TCGA and GEO database. Weighted co-expression network analysis (WGCNA) was used to identify candidate biomarkers. The LASSO analysis was performed to classify the biomarkers. ROC curve and AUC were used to evaluate the sensitivity and specificity of biomarkers. CIBERSORT was applied to estimate the relative abundances of immune cell types through gene expression profiling. Univariate and multiple Cox regression were performed to screen out prognostic factors. MUC15, which abnormally expressed in different physiological processes and participates in inhibiting or promoting function in different types of tumors, was selected of candidate biomarker. Finally, we validated the expression of MUC15 in ESCC tissues and its inhibitory effect on cell function through in vitro and in vivo experiments. In conclusion, we identified MUC15 could serve as a tumor suppressor gene and may become a promising candidate for individualized clinical diagnosis and treatment of ESCC.	esophagus
Clinical application of equation predicting appendicular skeletal muscle mass in patients with esophageal cancer: A retrospective analysis of a cross-sectional study.	BACKGROUND: Dual-energy X-ray absorptiometry and bioelectrical impedance analysis (BIA) are used to measure appendicular skeletal muscle mass (ASM). However, these two methods can be contraindicated in some cases. Therefore, equations have been developed to predict ASM using anthropometric parameters, which is a less expensive and more feasible approach. This study evaluated the correlation between the predicted ASM calculated using a previously reported prediction equation and the actual ASM measured using BIA. Moreover, we determined their degree of agreement in diagnosing sarcopenia in patients with esophageal cancer. MATERIALS AND METHODS: From a previous study involving 119 patients with esophageal cancer, perioperative anthropometric parameters (height, weight, waist and circumference), and grip strength (GS) were obtained to calculate ASM in Japanese participants using a previously reported prediction equation (Furushima equation). The validity of the predicted ASM was evaluated by comparing it with the actual ASM measured using BIA. Moreover, we determined the ability of the predicted ASM and GS results to diagnose sarcopenia in patients with esophageal cancer before and 4 weeks after surgery. RESULTS: A moderate agreement (before surgery: Lin concordance correlation coefficient [CCC] = 0.88; 4 weeks after surgery: Lin CCC = 0.89) was observed between the predicted ASM and the actual ASM. Furthermore, the predicted and measured ASM values showed substantial agreement in diagnosing sarcopenia (before surgery: κ statistics = 0.61; 4 weeks after surgery: κ statistic = 0.65). CONCLUSION: The equation developed for predicting ASM in Japanese participants can be applied to patients with esophageal cancer.	esophagus
FAO-fueled OXPHOS and NRF2-mediated stress resilience in MICs drive lymph node metastasis.	Metastasis is an inefficient process requiring cancer cells to adapt metabolically for survival and colonization in new environments. The contributions of tumor metabolic reprogramming to lymph node (LN) metastasis and its underlying mechanisms remain elusive. Through single-cell RNA sequencing, we identified rare metastasis-initiating cells (MICs) with stem-like properties that drive early LN metastasis. Integrated transcriptome, lipidomic, metabolomic, and functional analyses demonstrated that MICs depend on oxidative phosphorylation (OXPHOS) fueled by fatty acid oxidation (FAO) in the lipid-rich LN microenvironment. Mechanistically, the NRF2-SLC7A11 axis promotes glutathione synthesis to mitigate oxidative stress, thereby enhancing stress resistance and metastatic potential of MICs. Inhibition of NRF2-SLC7A11 reduced LN metastasis and sensitized tumors to cisplatin. Clinically, elevated NRF2-SLC7A11 expression was observed in tumors, with high expression correlating with LN metastasis, chemoresistance, and poor prognosis in esophageal squamous cell carcinoma (ESCC). These findings highlight the pivotal roles of FAO-fueled OXPHOS and NRF2 in LN metastasis and suggest targeting these pathways as a promising therapeutic strategy for metastatic ESCC.	esophagus
Ultrasound image-based paravertebral nerve block combined with general anesthesia in laparoscopic radical resection of esophageal cancer : Paravertebral nerve block versus general anesthesia in the treatment of esophageal cancer: a randomized controlled trial.	BACKGROUND: Thoracic epidural analgesia (TEA) is the gold standard for analgesia after thoracotomy, but it has limitations. There are few studies on the analgesic effect of ultrasound-guided paravertebral nerve block (PVB) combined with general anesthesia in esophageal cancer surgery. METHODS: 52 TLE patients from November 2020 - November 2021 were randomly divided into Group G (general anesthesia, n = 26) and Group G + P (ultrasound - guided PVB + general anesthesia, n = 26). General data, intraoperative/postoperative indicators, VAS scores, HR, MAP, NTI, and patient satisfaction were recorded. RESULTS: There were no significant differences in general data such as age, gender, BMI, and ASA grade between the two groups (P > 0.05). The intraoperative dosages of propofol, remifentanil, and sufentanil in Group G + P were significantly lower than those in Group G, while the dosage of phenylephrine was higher. The extubation time, PACU stay time, and postoperative hospital stay in Group G + P were shorter, the dosage of sufentanil in PACU was less, and the incidence of agitation was lower. The VAS scores of Group G + P in the resting and coughing states at multiple time points such as waking up, leaving the PACU, and after surgery were significantly lower than those of Group G. There was no significant difference in HR between the two groups at most time points during the operation. The MAP of Group G was higher than that of Group G + P at time points t8 and t9, and there were significant differences in NTI between the two groups from t2 to t7. The satisfaction rate of patients in Group G + P (96.14%) was significantly higher than that in Group G (80.76%). CONCLUSION: Ultrasound - guided PVB combined with general anesthesia reduces opioid use, eases pain, lowers agitation, shortens hospital stay, and boosts satisfaction in esophageal cancer surgery patients.	esophagus
MEIS1 knockdown upregulates WNT signaling pathway genes in esophageal squamous cell carcinoma.	BACKGROUND: The transcription factor MEIS1 belongs to the 3-amino acid loop extension (TALE) family of homeodomain proteins which plays various functions in normal and tumor cell progression. The canonical WNT/β-catenin pathway governs a plethora of biological processes including cell proliferation, differentiation, and tumor development. In the present study, the effect of MEIS1 gene silencing was assessed on WNT pathway genes in esophageal squamous cell carcinoma (ESCC) cells. MATERIALS AND METHODS: Along with the packaging plasmids, the pLKO.1-MEIS1 plasmid was cotransfected into HEK293T to generate lentiviral particles, followed by transduction of a semi-confluent KYSE-30 cell culture. After total RNA extraction and cDNA synthesis, comparative real-time PCR was applied to assess the efficiency of MEIS1 knockdown and the expression of genes related to the WNT signaling pathway. RESULTS: The results revealed effective downregulation of MEIS1 in KYSE-30 cells. Interestingly, MEIS1 silencing led to a substantial overexpression of WNT pathway key components while the expression of negative regulators of this pathway was substantially decreased. CONCLUSIONS: Our data suggest that MEIS1 gene probably induces WNT/β-catenin pathway deactivation in ESCC cells. Consequently, the inverse correlation of MEIS1 expression and WNT signaling pathway activation may introduce a new molecular linkage through ESCC progression and aggressiveness.	esophagus