crossing96/oncoscreening huggingface dataset:
Tumor Regression Grade as a Predictor of Adjuvant Therapy Benefits in Esophageal Squamous Cell Carcinoma Patients After Neoadjuvant Therapy.	BACKGROUND: Neoadjuvant therapy followed by surgery is preferred for locally advanced esophageal squamous cell carcinoma (ESCC), but the necessity of adjuvant therapy remains controversial. Tumor regression grade (TRG) reflects the response to neoadjuvant therapy and may predict patient prognosis, yet its role in guiding adjuvant therapy remains unexplored. This study aimed to explore the role of TRG and other clinical characteristics in predicting the efficacy of postoperative adjuvant therapy in ESCC patients receiving neoadjuvant therapy. METHODS: This study included patients who underwent R0 esophagectomy for thoracic ESCC after neoadjuvant therapy between January 2016 and December 2021 across three high-volume centers. Patients were assessed by TRG and divided into good responders (TRG 0-1) and poor responders (TRG 2-3). RESULTS: Among 416 patients with a median follow-up of 52 months, adjuvant therapy extended median survival by 8 months, which was statistically insignificant (p = 0.28). In the TRG 0-1 subgroup, those receiving adjuvant therapy had 3-year and 5-year OS rates of 94.6% and 86.8%, compared to 78.8% and 71.6% for the observation group (p = 0.02). Multivariable Cox regression showed adjuvant therapy was associated with reduced mortality in the TRG 0-1 (HR 0.32; 95% CI 0.14-0.73; p = 0.006), positive lymph nodes (HR 0.53; 95% CI 0.36-0.78; p = 0.001), and ypT3-4 subgroups (HR 0.63; 95% CI 0.43-0.92; p = 0.017). CONCLUSIONS: TRG is a promising predictor of the prognostic value of adjuvant therapy in ESCC patients. Patients with a good TRG response, positive lymph nodes, and ypT3-4 stage benefit from adjuvant therapy.	esophagus
A pilot study of tegafur-uracil maintenance on survival in patients with esophageal squamous cell carcinoma following definitive chemoradiotherapy.	Little was known regarding the maintenance role in patients with ESCC.This study evaluates the impact of Tegafur-Uracil (UFUR) maintenance on survival in patients with ESCC following definitive concurrent chemoradiotherapy (dCCRT). Patients with pathologically confirmed ESCC and treated with dCCRT were analyzed retrospectively. Patients were stratified into UFUR (+) and UFUR (-) groups based on maintenance or not after dCCRT. Oncologic outcomes, including progression-free survival (PFS), overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS), were compared between the groups. Multivariate Cox regression analysis was performed to identify independent predictors of survival. A total of 198 ESCC patients were included into our study. UFUR maintenance significantly reduced the overall recurrence rate (55% vs. 74%, p = 0.009), primarily driven by a reduction in distant metastases (44% vs. 63%, p < 0.001). The UFUR (+) group demonstrated markedly improved median OS (37.3 vs. 18.6 months, p = 0.002) and PFS (28.3 vs. 15.2 months, p = 0.014). Superior LRFS and DMFS were observed in the UFUR (+) group than those in UFUR (-) group, accounting for 29.6 vs. 13.4 months (p = 0.002) and 33.3 vs. 19.0 months (p = 0.010), respectively. Subgroup analyses revealed that UFUR(+) provided consistent benefits across all stages and all dCCRT responses. Multivariate analysis identified UFUR maintenance as an independent predictor of survival, alongside tumor stage and response to dCCRT. UFUR maintenance significantly improves outcomes in patients with ESCC following dCCRT, which might be considered as part of personalized treatment strategies to optimize prognosis in ESCC.	esophagus
NK cell function down regulated by HMGB2 through ANGPT1/PI3K/AKT pathway and its effect on esophageal squamous carcinoma cells.	Natural killer (NK) cells are crucial for immune defense against tumors, but their function is often impaired in the tumor microenvironment. High mobility group box 2 (HMGB2), a chromatin-associated protein, is implicated in various cancers, yet its role in regulating NK cells, particularly in esophageal squamous cell carcinoma (ESCC), is unclear. We conducted transcriptomic and proteomic analyses of peripheral blood mononuclear cells (PBMCs) from ESCC patients and healthy donors to identify immunoregulatory molecules. Flow cytometry confirmed upregulation of HMGB2 in NK cells from ESCC patients, correlating with advanced tumor stage. Using RNA interference, CRISPR/Cas9, and overexpression methods, we modulated HMGB2 in NK-92 cells and assessed their cytotoxicity against ESCC cells. HMGB2 silencing or knockout enhanced NK cell cytotoxicity, evidenced by increased granzyme B, perforin, IFN-γ, and TNF-α, and higher tumor cell lysis. Conversely, HMGB2 overexpression suppressed these effects. Mechanistically, HMGB2 ablation induced ANGPT1 expression and activated the PI3K/AKT pathway. ANGPT1 knockdown in KO-HMGB2 NK cells reduced PI3K/AKT activation, confirming the involvement of the ANGPT1/PI3K/AKT axis in enhanced NK cell function. These results indicate that HMGB2 inhibits NK cell-mediated anti-tumor immunity in ESCC. HMGB2 depletion enhances NK cell cytotoxicity via the ANGPT1/PI3K/AKT pathway, suggesting its potential as a therapeutic target to improve NK cell-based immunotherapy in ESCC.	esophagus
Sponge cytology combined with endoscopy in patients with long-segment Barrett's esophagus: A retrospective case series and literature review.	This study summarized the clinical characteristics and endoscopic findings in patients with long-segment Barrett's esophagus through a retrospective analysis of the clinical data of three patients with long-segment Barrett's esophagus. Data from patients, including demographic characteristics, medical history, endoscopy findings, pathological diagnosis, and esophageal sponge cytology results were analyzed, and a literature review was performed. Three patients were included; all were male with a mean age of 67.3 ± 7.1 years. Symptoms encompassed heartburn (3/3), acid reflux (2/3), belching (1/3), retrosternal pain (1/3), abdominal distension (1/3), and dysphagia (1/3). Risk factors included alcohol use (3/3), consumption of pickled and hot foods or beverages (3/3), smoking (1/3), and familial esophageal disease history (1/3). Endoscopically, Prague C & M criteria measurements were C(13)M(15), C(4)M(10), and C(6)M(7), with long-segment Barrett's esophagus lesions spanning the upper/middle/lower esophagus; all showed circumferential involvement and coexisted with gastroesophageal reflux disease. Concurrently, two patients presented with all the following three conditions: hiatal hernia, chronic atrophic gastritis, and Helicobacter pylori infection. Pathologically, one patient showed early intramucosal adenocarcinoma, whereas two had intestinal metaplasia. Sponge cytology identified grade 3 atypical cells in one patient and grade 2 hyperplasia in two patients. In conclusion, long-segment Barrett's esophagus is strongly associated with gastroesophageal reflux disease and necessitates endoscopic surveillance, whereas sponge cytology screening has shown initial feasibility but requires standardized protocols and multicenter validation for clinical integration.	esophagus
Re-considering the role of tumour length in oesophageal cancer staging: A prospective study from a tertiary care setting in South Asia.	OBJECTIVES: To specifically evaluate the association between pre-neoadjuvant computed tomography-defined tumour length and clinical tumour-node-metastasis staging in oesophageal cancer patients. METHODS: The prospective study was conducted from August 2021 to August 2022 at the Dr Ruth K.M. Pfau Civil Hospital in Karachi, and comprised biopsy-confirmed oesophageal cancer inpatients. The tumour length was measured using preneoadjuvant computed tomography scans, and these were evaluated against clinical tumour-node-metastasis staging and other patient characteristics. Data was analysed using SPSS 26. RESULTS: Of the 171 patients, 90(52.6%) were females and 81(47.4%) were males. The overall mean age was 47.46±14.12 years (range: 17-80 years). The tumour length determined by pre-neoadjuvant computed tomography scans as <5 cm, 5-10cm and >10cm showed significant correlations with tumour stage (p=0.006) and metastasis (p=0.011). Univariate analysis indicated that tumour stage 3 (p=0.020) and metastasis (p=0.005) were significantly associated with tumour length >10cm. Multivariate analysis confirmed that tumour stage 3 was significantly linked to tumour length >10cm (p=0.039). CONCLUSION: The tumour length determined by pre-neoadjuvant computed tomography scans in oesophageal cancer staging significantly correlated with clinical tumour-node-metastasis.	esophagus
Digital TNA-CHA-TR-FRET platform for ultrasensitive miRNA detection in serum: A diagnostic tool for early esophageal cancer.	"Catalytic hairpin assembly (CHA) offers significant potential for point-of-care nucleic acid detection due to its enzyme-free, isothermal amplification. However, its clinical translation is hindered by critical limitations: background leakage, matrix interference in complex samples like serum, and insufficient quantitative accuracy. To address these challenges, we developed a novel Digital TNA-CHA-TR-FRET platform for ultrasensitive miRNA detection. Firstly, we introduced Threose Nucleic Acid (TNA) modifications at the stem ends of the hairpin DNA probes (TNA-CHA). This modification significantly increased probe thermal stability, effectively suppressing background leakage caused by transient DNA breathing while maintaining catalytic efficiency, with optimal performance achieved using two TNA base pairs. Secondly, to overcome serum autofluorescence interference, we integrated TNA-CHA with Time-Resolved Fluorescence Resonance Energy Transfer (TR-FRET). The time-delayed measurement window of TR-FRET effectively filtered out short-lived background fluorescence, achieving an impressive limit of detection of 1 aM in serum. Thirdly, to resolve the poor linearity and repeatability inherent to CHA kinetics, we incorporated a microfluidic digital partitioning strategy (digital-TNA-CHA-TR-FRET). Partitioning the reaction into nanoliter droplets significantly improved linear correlation (R(2) = 0.986) and repeatability (CV <5 % across concentrations). Clinically validated for early esophageal cancer diagnosis using serum miRNAs (miRNA21, miRNA25, miRNA93) on 100 samples (50 patients, 50 controls), our platform demonstrated high diagnostic performance using a ""two-positive-out-of-three"" miRNA logic gate: 96 % sensitivity, 90 % specificity, and 93 % accuracy. This integrated platform provides a powerful tool for non-invasive, early cancer diagnosis."	esophagus
Life satisfaction moderates associations between resilience and postoperative symptom burden in oesophageal cancer: A moderated network analysis.	"PURPOSE: To examine whether life satisfaction moderates associations between resilience and postoperative symptom burden among patients with oesophageal cancer. METHODS: In a cross-sectional analysis of the ""Be Resilient to Oesophageal Cancer"" (BROC) programme, we studied 418 patients recruited from three hospitals in Anhui, China (August 2022-August 2023). Symptom burden was assessed with the Convalescent Symptom Assessment Scale for Oesophagectomy Patients; resilience with the 25-item Connor-Davidson Resilience Scale; and life satisfaction with the Satisfaction With Life Scale. We estimated a moderated network model to evaluate pairwise associations among symptoms and resilience nodes conditional on life satisfaction. Centrality was quantified using Expected Influence (EI). Significant moderated edges were examined with linear moderation tests and Johnson-Neyman analysis. RESULTS: In the network, ""late symptoms"" were identified as the most central symptom (EI = 1.52), with the strongest association observed between ""optimism"" and ""persistent symptoms"" (r = 0.29). Moderation analyses indicated that higher life satisfaction strengthened the inverse association between strength and late symptoms (β = -0.021, SE = 0.010, P = 0.039) and weakened the positive association between strength and optimism (β = -0.013, SE = 0.005, P < 0.001). Johnson-Neyman analysis revealed similar patterns. CONCLUSION: Life satisfaction modifies resilience-symptom associations in patients with oesophageal cancer. Screening and targeting life satisfaction may enhance the symptomatic benefits associated with resilience, informing postoperative supportive care strategies. However, the cross-sectional design precludes definitive causal inferences regarding the observed moderation effects."	esophagus
Cost-Effectiveness of Pembrolizumab Plus Trastuzumab and Chemotherapy Versus Trastuzumab Plus Chemotherapy as First-Line Treatment of HER2-Positive Gastric or Gastroesophageal Junction Adenocarcinoma in China.	OBJECTIVE: This study aimed to evaluate the cost-effectiveness of pembrolizumab in combination with trastuzumab and chemotherapy (PEM + TRAS + Chemo) as a first-line treatment for patients with advanced HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma from the perspective of the Chinese healthcare system. METHODS: Clinical data from the KEYNOTE-811 trial were used to develop a partitioned survival model for HER2-positive gastric or GEJ adenocarcinoma. The model estimated quality-adjusted life years (QALYs), life years (LYs), and total lifetime costs. The primary outcome was the Incremental Cost-Effectiveness Ratio (ICER), reflecting the cost per additional QALY. Only direct medical costs were considered, with drug prices sourced from the China Drug Bidding Database and other costs and utility values derived from published literature. Uncertainty analyses were conducted to test the robustness of the model, and subgroup analyses were performed to assess cost-effectiveness in different patient populations. RESULTS: In the base-case analysis, the PEM + TRAS + Chemo regimen increased LYs by 0.17 and QALYs by 0.19, at an additional cost of $9874.08, resulting in an ICER of $53,160.95/QALY, which exceeds three times the per capita GDP of China ($39,999.86). Subgroup analysis based on the patient's programmed death-ligand 1 (PD-L1) combined positive score (CPS) showed that for PD-L1 (CPS ≥ 1) patients, the ICER was $49,849.43 per QALY. Uncertainty analysis indicated that the proportion of patients receiving subsequent systemic treatment had the most significant impact on the model results. CONCLUSION: In China, for first-line treatment of HER2-positive advanced gastric or GEJ adenocarcinoma, the PEM + TRAS + Chemo regimen is not cost-effective when compared to the TRAS + Chemo regimen, unless the price of pembrolizumab is reduced.	esophagus
Long-term outcome of patient choice of surgery or active surveillance following a clinical complete response to neoadjuvant chemoradiotherapy for oesophageal cancer.	INTRODUCTION: Conventional treatment pathways propel oesophageal cancer patients who achieve a clinical complete response (cCR) to neoadjuvant chemoradiation therapy (NCRT) towards oesophagectomy, though a proportion of cCR patients will have a pathological complete response (pCR) and cannot benefit from resection but are exposed to its surgical and quality-of-life risks. While we cannot accurately identify pCR patients prior to resection, we hypothesised that affording cCR patients a choice between immediate surgery and active surveillance would not compromise their overall survival. METHODS: A retrospective single centre analysis was performed. In total, 205 oesophageal cancer patients were treated with curative intent in one surgical unit between 1998 and 2019, of these 80 patients (52 %) had a cCR to NCRT. All cCR patients had been offered the choice of immediate surgery or active surveillance, with salvage oesophagectomy if locoregional disease recurred. A prospectively maintained database, electronic hospital and community care records were reviewed. All patients were followed until death and censored at five years following diagnosis. RESULTS: Of 80 cCR patients, 51 (63.8 %; mean age 59-years) chose surgery and 29 (36.3 %; mean age 70-years) chose active surveillance [of whom 7 (24.1 %) developed locoregional recurrence and were offered salvage surgery]. Median age-adjusted survival for the surveillance group was 28.1 (IQR 15.5 to 60.0) months and 52.0 months for the surgery group (IQR 12.3 to 60.0), which was not statistically significant (p = 0.485). CONCLUSION: This study found that affording oesophageal cancer patients with a cCR to NCRT the choice between immediate surgery and active surveillance did not compromise their overall survival and supports future studies with larger patient populations to further examine this hypothesis.	esophagus
Longitudinal changes in tumor morphology and body composition following neoadjuvant chemotherapy predict progression-free survival in adenocarcinoma of the esophagogastric junction: A multi-center study.	OBJECTIVES: This study aimed to investigate the predictive value of longitudinal changes in tumor morphology and body composition during neoadjuvant chemotherapy (NAC) for progression-free survival (PFS) following radical resection of adenocarcinoma of the esophagogastric junction (AEG). METHODS: This retrospective study included 258 AEG patients receiving NAC at three hospitals. Clinical and pathological data were collected. Tumor morphological and body composition parameters were quantitatively assessed on venous phase CT images at pre-treatment (Pre) and post-treatment (Post) time points. The two measurements were compared and the reduction rate (Δ%) was calculated. Multivariate Cox regression analysis was used to identify independent predictors of PFS in AEG patients and a nomogram model was developed. The incremental predictive value of tumor morphological and body composition parameters was evaluated using the concordance index (C-index), net reclassification improvement, and integrated discrimination improvement. The goodness-of-fit of models was assessed via the Akaike information criterion and χ(2) likelihood ratio test. The performance of the nomogram was evaluated by the area under the time-dependent receiver operating characteristic (tdROC) curve, calibration curves, and decision curve analysis. High-risk and low-risk subgroup analyses were performed according to nomogram scores. RESULTS: Multivariate Cox regression analysis showed that ypTNM staging, Post-tumor volume, and Δ%-skeletal muscle index (SMI) were independent predictors of PFS. The nomogram incorporating these predictors demonstrated significantly superior discrimination over ypTNM staging alone in both the training cohort (C-index: 0.744; 95 % CI: 0.670-0.790; P = 0.004) and an external validation cohort (C-index: 0.738; 95 % CI: 0.615-0.807; P = 0.024). tdROC analysis showed that the nomogram achieved area under the curve (AUC) values of 0.815 and 0.791 for predicting 1- and 2-year PFS, respectively, in the training cohort. These findings were corroborated in the external validation cohort, with corresponding AUCs of 0.761 and 0.746 for 1- and 2-year PFS, respectively. Moreover, according to the score of the nomogram, patients can be effectively divided into low-risk and high-risk groups. CONCLUSION: The nomogram, incorporating ypTNM staging, Post-tumor volume, and Δ%-SMI, demonstrated robust performance in predicting PFS in AEG patients. This model significantly outperformed traditional ypTNM staging alone and may help guide personalized postoperative monitoring strategies.	esophagus
Treatment patterns, health care resource utilization and costs, and clinical outcomes among older adult patients with advanced HER2-positive gastric or gastroesophageal junction adenocarcinoma.	BACKGROUND: Trastuzumab-based regimens are the historical standard first-line (1L) treatments for HER2+ advanced gastric/gastroesophageal junction (GEJ) adenocarcinoma. With pembrolizumab recently approved in combination with trastuzumab and chemotherapy as 1L treatment for patients with a programmed death-ligand 1 combined positive score of 1 or higher, establishing real-world benchmarks for patients' real-world outcomes from the preimmunotherapy era is essential. OBJECTIVE: To assess the real-world treatment patterns and the clinical and economic impact of 1L trastuzumab-based regimens among patients with HER2+ advanced gastric/GEJ adenocarcinoma. METHODS: This retrospective study used the Surveillance, Epidemiology, and End Results-Medicare linked database (January 1, 2011, to December 31, 2019) to identify patients with HER2+ advanced gastric/GEJ adenocarcinoma who initiated a 1L trastuzumab-containing regimen (index date). Outcomes during follow-up (from index to death/data end) included health care resource utilization (HCRU), health care costs (2022 US dollars), 1L to 3L treatments, real-world overall survival (rwOS), and real-world time to next treatment or death (rwTNTD). All-cause and cancer-related HCRU and costs were assessed during preprogression, postprogression, and terminal care periods. rwOS and rwTNTD were assessed in the overall cohort and in subgroups by 1L therapy. RESULTS: Among 315 included patients (mean age 73.9 ± 5.9 years; 77.1% male; 84.1% stage IV at initial diagnosis; 58.7% gastric adenocarcinoma), the most common 1L regimen was trastuzumab + chemotherapy doublet (57.8%), with the mean time to 1L initiation being 2.2 ± 3.3 months. Nearly half (49.5%) received 2L and, among them, 46.8% proceeded to 3L. Cancer-related inpatient admissions occurred among 52.9%, 64.2%, and 46.6% of patients during the preprogression, postprogression, and terminal care periods, with mean lengths of stay of 1.1, 1.1, and 3.9 days/person-month, respectively. The mean monthly all-cause total health care costs were $12,356, $13,545, and $19,085 during the above periods, respectively. In the overall cohort, median rwOS and rwTNTD were 15.3 (95% CI = 13.2-16.9) and 8.3 (6.7- 8.9) months, respectively, which varied across subgroups by 1L regimen. The trastuzumab + chemo-monotherapy subgroup was older (mean age 78 years) with median rwOS of 12.0 (95% CI = 8.3-14.9) months. CONCLUSIONS: Prior to the advent of immuno-oncology agents for HER2+ advanced gastric/GEJ adenocarcinoma (2011-2019), the economic burden was substantial throughout patients' treatment journey, whereas OS ranged from 12.0 to 15.3 months. During this period, trastuzumab with chemo-monotherapy backbones was often used in older patients. These real-world benchmarks offer valuable context for evaluating the impact of newer therapies in this population.	esophagus