crossing96/oncoscreening huggingface dataset:
Endoscopic stenting: where are we now and where can we go?	Self expanding metal stents (SEMS) play an important role in the management of malignant obstructing lesions in the gastrointestinal tract. Traditionally, they have been used for palliation in malignant gastric outlet and colonic obstruction and esophageal malignancy. The development of the polyflex stent, which is a removable self expanding plastic stent, allows temporary stent insertion for benign esophageal disease and possibly for patients undergoing neoadjuvant chemotherapy prior to esophagectomy. Potential complications of SEMS insertion include perforation, tumour overgrowth or ingrowth, and stent migration. Newer stents are being developed with the aim of increasing technical and clinical success rates, while reducing complication rates. Other areas of development include biodegradable stents for benign disease and radioactive or drug-eluting stents for malignant disease. It is hoped that, in the future, newer stents will improve our management of these difficult conditions and, possibly, provide prognostic as well as symptomatic benefit in the setting of malignant obstruction.	esophagus
Changes of serum p53 antibodies and clinical significance of radiotherapy for esophageal squamous cell carcinoma.	AIM: To explore the relationship between serum p53 antibodies (p53-Abs) and clinicopathological characteristics and therapeutic effect in patients with esophageal carcinoma (EC), and to investigate sequential changing regularity of serum p53-Abs after radiotherapy. METHODS: The serum p53-Ab levels were detected in 46 EC patients and 30 healthy adults by enzyme linked immunosorbent assay (ELISA). The blood samples were collected on the day before radiotherapy and on the administration of an irradiation dose of 20 Gy/10 f/12 d, 40 Gy/20 f/24 d and 60 Gy/30 f/36 d after radiotherapy. RESULTS: The level and positive rate of serum p53-Abs in EC patients were significantly higher than those in normal individuals (P<0.05). Serum anti-p53 antibodies were positive in 18 of 46 EC patients (39.1%). The positive rate of p53-Abs in EC was related to histological grade, disease stage and lymph node metastasis (P<0.05), but it was not significantly related to sex, age and to the size and site of tumor. The level and positive rate of p53-Abs had significant differences between before radiotherapy and after administration of an irradiation dose of 40 Gy/20 f/24 d and 60 Gy/30 f/36 d (P<0.05 or P<0.01). The positive rate of p53-Abs in EC patients with effect was significantly lower than that in those without effect after radiotherapy (P<0.0001). CONCLUSION: Detection of serum p53-Abs is helpful to the diagnosis of esophageal carcinoma. Monitoring for sequential change of serum p53-Abs before and after radiotherapy in patients with esophageal carcinoma is also useful to evaluate the response to the treatment and prognosis of the patients.	esophagus
Use of novel autoantibody and cancer-related protein arrays for the detection of esophageal adenocarcinoma in serum.	OBJECTIVE: The aim of this study was to evaluate the feasibility of using novel autoantibody and cancer-related protein arrays to identify potential biomarkers for the early detection of esophageal adenocarcinoma in serum. METHODS: Sera from 18 patients with esophageal adenocarcinoma and 14 with gastroesophageal reflux disease were added to microarrays designed to detect circulating autoantibodies to 51 tumor-associated antigens. Sera from the same patients were also added to a 53-plex assay for various cancer-related proteins. Cutoff values at 3 standard deviations above the mean expression of gastroesophageal reflux disease were used as a boundary for positivity. RESULTS: Nine proteins and 11 autoantibodies were able to individually segregate at least 1 esophageal adenocarcinoma sample from gastroesophageal reflux disease by means of cutoff values. The most discriminative marker was Fas ligand in the protein array, which was associated with 83.3% sensitivity and 100% specificity. The best performing autoantibody, NY-ESO-1, detected 3 esophageal adenocarcinoma samples. When both of these markers were combined, a sensitivity of 88.9% and specificity of 100% were attained. CONCLUSIONS: Cancer-related protein and autoantibody arrays provide a technically simple and rapid method of identifying potential biomarkers for the detection of esophageal adenocarcinoma in serum. Furthermore, combining these platforms improves the diagnostic power of either platform alone. Integrating technologies that detect the expression of multiple proteins and autoantibodies in serum may provide a noninvasive and accurate method of detecting early esophageal adenocarcinoma.	esophagus
Mutations in Fbx4 inhibit dimerization of the SCF(Fbx4) ligase and contribute to cyclin D1 overexpression in human cancer.	SCF(Fbx4) was recently identified as the E3 ligase for cyclin D1. We now describe cell-cycle-dependent phosphorylation and dimerization of Fbx4 that is regulated by GSK3beta and is defective in human cancer. We present data demonstrating that a pathway involving Ras-Akt-GSK3beta controls the temporal phosphorylation and dimerization of the SCF(Fbx4) E3 ligase. Inhibition of Fbx4 activity results in accumulation of nuclear cyclin D1 and oncogenic transformation. The importance of this regulatory pathway for normal cell growth is emphasized by the prevalence of mutations in Fbx4 in human cancer that impair dimerization. Collectively, these data reveal that inactivation of the cyclin D1 E3 ligase likely contributes to cyclin D1 overexpression in a significant fraction of human cancer.	esophagus
Evidence-based choice of esophageal stent for the palliative management of malignant dysphagia.	BACKGROUND: The type of stent used for the management of patients with malignant dysphagia is chosen according to subjective physician's preference. There is no recent study available to provide updated evidence on early outcomes related to the use of different types of stents. METHODS: A literature search was performed using Embase, MEDLINE, Cochrane Library, and Google Scholar databases for comparative studies assessing different types of stents. The primary end point was stent-related mortality; secondary end points included: stent-related morbidity, successful palliation of dysphagia, and 30-day mortality. A random-effects model was used and heterogeneity was assessed. RESULTS: Twelve studies that included 911 patients compared metallic (46.54%) and plastic stents (53.45%), and eight studies that included 564 patients compared covered (43.26%) and uncovered metal stents (56.73%). Meta-analysis of randomized, controlled trials showed that metallic stents were associated with significantly reduced stent-related mortality (1.7% vs. 11.1% for the plastic group, odds ratio (OR), 0.2; 95% confidence interval (CI), 0.06-0.74; P = 0.02), morbidity in the form of reduced esophageal perforation (1.4% vs. 9.4% for plastic stent, OR, 0.27; 95% CI, 0.08-0.89; P = 0.03), and stent migration, yet increased rate of tumor in-growth (13% vs. 1.6% for plastic stents, OR, 4.84; 95% CI, 0.99-23.76; P = 0.05). Covered metallic stents had significantly less tumor in-growth than the uncovered and an increased migration rate. There was no significant difference between metallic and plastic stents in terms of any other stent-related morbidity and 30-day mortality. CONCLUSION: Self-expanding metallic stents are superior to plastic stents in terms of stent insertion-related mortality, morbidity, and quality of palliation. The uncovered variety is disadvantaged by high rate of tumor in-growth; adequately designed randomized, controlled trials need to examine outcomes and cost-effectiveness of covered versus uncovered metallic stents.	esophagus
Esophagectomy in patients 80 years of age and older with carcinoma of the thoracic esophagus.	BACKGROUND: The purpose of this study was to clarify the indications for an esophagectomy in elderly patients (especially patients over 80 years of age) with esophageal cancer. METHODS: A total of 668 patients with thoracic esophageal cancer who underwent an esophagectomy by the transthoracic approach were divided into three groups according to age, namely, groups I (>80 years, n=16), II (70-79 years, n=158), and III (<or=69 years, n=494). In group I, surgery was only done in patients with PS 0 or 1, as well as normal cardiac and pulmonary functions. RESULTS: The incidence of preoperative pulmonary risk was 16% and 7% in groups II and III, respectively (P<0.01). The morbidity rates of group II and III were 42% and 32%, respectively (P<0.05). Pulmonary complications occurred in 18% and 10%, respectively, and cardiovascular complications occurred in 11% and 4%, respectively (P<0.01). In group I, the morbidity and 30-day mortality rates were 25% and 0%, respectively, and pulmonary and cardiovascular complications occurred only in one patient each (6%). No significant differences were observed in cause-specific survival. CONCLUSIONS: In the elderly, preoperative pulmonary risk is frequently present, and careful perioperative management is needed while paying special attention to pulmonary and cardiovascular complications. However, when the indications for surgery can be strictly determined, an esophagectomy is considered a viable treatment alternative with satisfactory prognosis even in patients 80 years of age and older without any increased morbidity or mortality.	esophagus
[Perioperative management and prevention of complication for salvage esophagectomy after definitive chemoradiotherapy].	Salvage esophagectomy has been increasing as a second-line treatment after failure of definitive chemoradiotherapy (CRT) for esophageal cancer. A number of patients who have received CRT, especially those who have residual tumors and shorter waiting times until operation, have developed malnutrition and problems in their immunologic condition because of decreasing oral intake and bone marrow suppression. Because high-dose radiation causes inflammation, fibrosis and peripheral circulatory disturbance of various tissues in the treatment fields, salvage surgery can be a technically difficult operation. In our previous experience, postoperative complications of salvage esophagectomy are more frequent and more serious than that of planned esophagectomy. For example, we have experienced necrosis of the reconstructed gastric tube, esophago-tracheal fistula, mediastinal abscess, hard-to-treat acute respiratory distress syndrome (ARDS) and so on. In particular, respiratory tract necrosis or perforation is the most critical complication and frequently becomes lethal. Patients who undergo a salvage esophagectomy have a significantly higher risk of pulmonary and cardiac complication, and have high rates of repeated surgery. Rapid diagnosis and appropriate treatment of complications are necessary to reduce postoperative mortality. To improve the overall outcome, it is very important to better understand the condition of patients after CRT, so appropriate surgery can be carefully planned. Furthermore, it is absolutely essential to perform the operation with great care and to meticulously manage the perioperative care for salvage esophagectomy.	esophagus
[Postoperative nutritional management for esophageal cancer patients].	High incidence of malnutrition is found in esophageal cancer patients. It is well known that to maintain good nutritional preoperative condition is very important to prevent postoperative morbidity and mortality. Hence, preoperative oral or nasogastric feeding is recommended when the patient is malnourished, at a total dose of 30 kcal/kg/day. During postoperative period, enteral nutrition should be primarily performed because of its favorable effects on immune-status and intestinal integrity to avoid septic complications. It is also important to keep circulatory volume sufficient to provide oxygen demand during catabolic phase, which leads earlier recovery from critical illness. Enteral nutrition should be immediately started afterward. An initial dose of 5-10 kcal/kg/day of the enteral nutrition is performed from the 1st or 2nd postoperative day and gradually increased to the full dose at 30 kcal/kg/ day. In cases of not administering scheduled dose of the enteral nutrition, either total or peripheral parenteral nutrition is required complementing total caloric intake. When total parenteral nutrition is used, blood glucose level should be controlled less than 150 mg/dl by pertinently administering insulin or limiting glycemic intake. Immunonutrition is promising nutritional management for critical surgical patients such as those performed esophageal cancer surgery. Continuing immune-enhancing diet at a dose of 750 to 1,000 ml/day for 5 to 7 days before surgery is necessary to bring good postoperative outcome.	esophagus
Clinical applications of 18F-fluorodeoxyglucose positron emission tomography in gastrointestinal stromal tumor of the esophagus.	Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms affecting the gastrointestinal tract. Esophageal GISTs are very rare, but recognition of esophageal GISTs has been increasing recently. We report a patient with an esophageal GIST that showed increased uptake on 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET). In this case, preoperative diagnosis was assumed to be esophageal cancer, but postoperative histopathological and immunohistochemical examination showed it to be a malignant GIST. We also found an activating mutation of kit in this patient; the mutation type was an in-frame deletion of a portion of the juxtamembrane domain (exon11). FDG-PET is useful not only for evaluating the bioactivity but also the malignant potential of esophageal GISTs.	esophagus
Plasma DNA is more reliable than carcinoembryonic antigen for diagnosis of recurrent esophageal cancer.	BACKGROUND: Carcinoembryonic antigen (CEA) and plasma DNA are known to be elevated in patients with esophageal cancer and are higher in patients with disseminated disease. The sensitivity and specificity of these markers in the diagnosis of recurrent esophageal cancer have not been compared. STUDY DESIGN: Plasma DNA was measured using polymerase chain reaction in 45 patients with esophageal cancer and 44 asymptomatic volunteers. The 95(th) percentile (19 ng /mL) in the volunteers was used to define normal. Thirty-nine patients had localized cancer and underwent resection, and six had disseminated disease at operation. Plasma DNA was measured preoperatively in all patients, with serum CEA measured in 31. Plasma DNA was measured sequentially during followup in 21 patients, including 7 who developed recurrence. CEA was measured in 14 of 21 patients who had sequential plasma DNA measured and in 6 of 7 patients with recurrence. CEA levels greater than 5.0 ng/mL were used as cut-off. RESULTS: Plasma DNA was more sensitive than CEA for detecting unresectable esophageal cancer (100% versus 40%), but it had a lower specificity (22% versus 89%). The positive predictive value (19% versus 40%) and negative predictive value (100% versus 89%) were similar for plasma DNA and serum CEA, respectively. Plasma DNA was also more sensitive than CEA in detecting recurrent esophageal cancer (100% versus 33%). The specificity and positive predictive values were 100% for both tests, but the negative predictive values were higher for plasma DNA. Plasma DNA rose before there was clinical evidence of recurrence in 67% compared with only 17% for CEA. CONCLUSIONS: Elevated plasma DNA is an extremely reliable indicator of the presence of recurrent disease, and, in the majority of patients, it rises before clinical evidence of recurrence. In contrast, a normal CEA should be interpreted cautiously, because it does not exclude recurrent disease.	esophagus
[Fascin expression in human epithelial tumors and its clinical significance].	OBJECTIVE: To investigate the expression of FSCN1 in human epithelial tumors and their clinical significance. METHODS: FSCN1 expression was examined immunohistochemically in specimens of human epithelial tumors, including 26 cases of lung cancer, 33 cervical cancer, 22 ovarian cancer, 38 esophageal cancer, 24 pancreatic cancer, 23 gastric cancer, 29 laryngocarcinoma, 17 primary hepatocellular carcinoma, 34 colorectal cancer, 33 breast cancer, 24 nasopharyngeal carcinoma and their corresponding normal tissues. RESULTS: The positivity rates of FSCN1 expression in epithelial tissues and epithelial tumors were 6.3% (5/80) and 58.7% (178/303), respectively. FSCN1 showed higher expressions in cervical cancer, ovarian cancer, esophageal cancer, pancreatic cancer, gastric cancer, laryngocarcinoma, colorectal cancer, breast cancer and nasopharyngeal carcinoma, but lower or no expression in the corresponding normal tissues (P<0.05). In gastric cancer and nasopharyngeal carcinoma, the edges of the tumors were more strongly stained for FSCN1 than the interior of the tumor. CONCLUSION: FSCN1 expression is significantly upregulated in human epithelial tumors in close correlation with tumor occurrence and progression.	esophagus
Long-term health-related quality of life following surgery for oesophageal cancer.	BACKGROUND: The aim of the study was to assess health-related quality of life (HRQL) in patients with surgically cured oesophageal cancer. METHODS: A Swedish nationwide cohort of patients undergoing oesophagectomy for cancer between April 2001 and January 2004 was studied prospectively, and compared with a Swedish age- and sex-adjusted reference population. Validated European Organisation for Research and Treatment of Cancer quality of life questionnaires were used to assess HRQL at 6 months and 3 years after surgery. A mean score difference of 10 or more between groups was considered clinically relevant and tested further for statistical significance. RESULTS: Of 358 patients, 117 (32.7 per cent) survived for at least 3 years. Of these, 87 patients (74.4 per cent) responded to the questionnaires. Six months after surgery, most aspects of HRQL were substantially worse than in the reference population with no improvement at 3 years. Patients alive at 3 years reported significantly poorer role and social function, and significantly more problems with fatigue, diarrhoea, appetite loss, nausea and vomiting, than in the reference population. CONCLUSION: HRQL in long-term survivors after oesophagectomy does not improve between 6 months and 3 years after surgery, and is worse than that in a comparable reference population.	esophagus
Thoracic empyema and lung abscess resulting from gastropulmonary fistula as a complication of esophagectomy.	A benign fistula between the gastric tube and the airway resulting from esophagectomy is a rare complication, but it is a potentially life-threatening status. We present a 59-year-old man with thoracic empyema and lung abscess resulting from a benign gastric tube-to-pulmonary fistula caused by a penetration of the peptic ulcer in the gastric tube four years after an esophagectomy for esophageal cancer. After a thorough conservative management of infection and nutrition, the fistula was successfully repaired surgically with direct closure. The postoperative course was uneventful. Two years and nine months later, the patient retains satisfactory oral feeding status and is in good general condition.	esophagus
Two cases of early-stage esophageal malignant melanoma with long-term survival.	Herein is described two patients with early-stage primary malignant melanoma of the esophagus with long-term survival who were treated with esophagectomy. Both tumors had similar pathological findings, and were mainly at the stage of radial growth phase. Widespread melanoses were present in the mucosa surrounding the tumors in both cases. The two patients recovered uneventfully after surgery and were in remission at follow up of 33 months and 53 months.	esophagus
High incidence of non-upper aerodigestive primary tumors in patients with esophageal cancer.	Earlier reports have described an association between esophageal cancer (EC) and high incidence of other primary tumors (OPTs) of the upper aerodigestive tract and breast cancer. We evaluated the incidence of non-upper aerodigestive OPTs among Israeli EC patients; 2328 EC patients were retrieved from the Israeli National Cancer Registry between 1980 and 2004. The relative risk of OPTs for EC patients was measured using standardized incidence ratio (SIR). Two cohorts, Israeli National Cancer Registry registered colorectal cancer (CRC) patients and the general Israeli population, were used for reference; 297 EC patients (12.7%) had OPTs, including breast (18.9%), CRC (16.2%), prostate (8.8%), and bladder (8.4%) cancers. Upper aerodigestive OPTs were less common. Most OPTs were identified before (74.4%) or simultaneously with (13.8%) EC diagnosis. The median time interval between OPTs diagnoses and EC development was 6.0 years. The incidence of OPTs was significantly higher among EC patients compared with CRC patients (SIR: 2.05, P < 0.01) or the general Israeli population (SIR: 3.90, 95% CI: 3.46-4.34, P < 0.01) regardless of gender or tumor histology. Patients with EC have high incidence of non-upper aerodigestive malignancies. Unlike previous reports, the distribution of OPTs in EC seems to represent the relative incidences of these cancers in the western populations.	esophagus
The esophageal remnant after gastric interposition.	Gastric interposition is usually considered the reconstruction of choice following esophageal resection. However, a number of reports show that esophagectomy followed by a gastric transplant is associated with poor quality of life and significant reflux esophagitis in the esophageal remnant. The aim of this work is to review the factors affecting the mucosa of the esophageal remnant when using the stomach. A Medline was conducted. Additional references and search pathways were sourced from the references of reviewed articles. Reflux disease is considered an unavoidable consequence of esophageal resection followed by gastric interposition. Mucosal damage from acid and bile exposure in the esophageal remnant affects approximatively 50% of these patients. There is usually no correlation between symptoms and the presence of mucosal damage in the remaining esophagus. Endoscopy and endoscopic biopsies are the only reliable methods to document the status of the mucosa. When present, reflux esophagitis shows a progression from inflammation to erosions and to the development of columnar lined metaplasia. Esophageal and gastric function, gastric drainage operation, level of the anastomosis, route of reconstruction, and patients' position after the operation have all been shown to influence the severity and extent of damage in the esophageal remnant. Prevention and treatment of esophagitis in the remaining esophagus are discussed. When the stomach is used as a substitute to reconstruct the esophagus whether for malignant or benign conditions, an in vivo model of reflux diseases is created. Studies using this model may help clarify molecular and cellular events that lead to irreversible insult on the esophageal mucosa. Improvement to the reconstruction itself must be sought to favor better results with the gastric transplant.	esophagus