crossing96/oncoscreening huggingface dataset:
Facial flushing response to alcohol and the risk of esophageal squamous cell carcinoma: A comprehensive systematic review and meta-analysis.	OBJECTIVE: The alcohol flushing response is common among ethnic East Asian populations, and has been associated with an increased risk in developing esophageal cancer, especially squamous cell esophageal cancer (ESCC). We aimed to quantify the relationship between the facial flushing response to alcohol consumption and ESCC. METHODS: We conducted a meta-analysis of studies reporting on the association between the facial flushing response to alcohol consumption and ESCC. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random effects model for the risk of ESCC associated with the facial flushing response in general, as well for different levels of alcohol consumption. Four databases, Medline, PubMed, Embase, and Current Contents Connect, were searched to 31 August 2015. RESULTS: Seven studies, with 1014 ESCC cases, met the inclusion criteria. There was a positive relationship between the flushing response and ESCC (OR 1.97; 95% CI 1.25-3.13). Heterogeneity was observed (I(2)= 80%, P<0.001). Publication bias was not present. An increased risk of ESCC was present in the moderate and heavy drinkers who experienced flushing, compared with moderate and heavy drinkers who did not (OR 2.54; 95% CI 1.64-3.91, and OR 2.90; 95% CI 1.82-4.82, respectively). CONCLUSION: Individuals who experience a facial flushing response to alcohol intake may be at increased risk of developing ESCC, particularly if they are moderate to heavy drinkers.	esophagus
Increased WNT6 expression in tumor cells predicts unfavorable survival in esophageal squamous cell carcinoma patients.	WNT proteins are a family of secreted, cysteine-rich proteins containing 19 members. Signaling through WNT proteins is reported to be involved in carcinogenesis and cancer progression of gastrointestinal tumors, such as gastric cancer and colon cancer. The expression status of WNT6 in ESCCs and their clinico-prognostic significances remain to be elucidated. In this study, One-hundred and thirty-six patients with ESCC were explored. Paraffin-embedded tumor sections were stained with WNT6 antibody. The correlations between WNT6 expression and survival parameters were analyzed. The overall frequency of WNT6 over-expression was 50.7% (69/136) of advanced EC patients. For DMS and OS, over-expression of WNT6 remained the independent factor for worse prognosis (hazard ratio (HR), 2.425; 95% CI, 1.631-3.605; P < 0.001 for OS and HR, 2.238; 95% CI, 1.507-3.323; P < 0.001 for DMS, respectively). To conclude, our results support the concept that WNT6 may play a role in tumor progression. WNT6 over-expression inversely correlates with the poor long-term survival in ESCC patients. WNT6 can be considered as a predictor for recurrence.	esophagus
Low expression of KLF17 is associated with tumor invasion in esophageal carcinoma.	PURPOSE: KLF17 belongs to the Sp/KLF zinc-finger protein family as a regulator in tumor development. However, its expression and biologic function has remained unclear in EC. METHODS: The esophageal carcinoma tissue samples and adjacent normal tissues were obtained from the Second Hospital of Hebei Medical University. Immunohistochemistry, Western blot, and transfection were applied to evaluate the expression and clinical significance of KLF17 in esophageal cancer. RESULTS: In this study, we showed that KLF17 was overexpressed in esophageal normal samples compared to the cancer. Moreover, KLF17 was upregulated at lymph node non-metastatic cancer tissues when compared to metastatic cancer tissues. KLF17 overexpression decreased EC cell proliferation, migration and invasion ability. In contrast, the knockdown of KLF17 increased EC cell proliferation, migration and invasion ability. CONCLUSION: These results suggest that KLF17 inhibits tumor development and may serve as a potential therapeutic target.	esophagus
Expression of RKIP, E-cadherin and NF-kB p65 in esophageal squamous cell carcinoma and their correlations.	To detect the expression of RKIP, E-cadherin and NF-kB p65 in esophageal squamous cell carcinoma (ESCC) and study their correlations. Steptavidin-peroxidase (S-P) method was employed to detect the expressions of RKIP, E-cadherin and NF-kB p65 in ESCC tissues from 77 cases and paracancerous tissues from 77 cases. The correlations between their expressions and clinicopathological indices and between the expressions of these proteins themselves were analyzed. The expressions of RKIP and E-cadherin in ESCC tissues were obviously lower than those in the paracancerous tissues (P<0.01); the expressions in ESCC tissues from cases with lymph node metastasis were lower than those from cases without lymph node metastasis (P<0.01); the expression of RKIP was positively correlated with the expression of E-cadherin in ESCC tissues (P<0.01). The expression of NF-kB p65 in ESCC tissues was correlated with clinical staging, lymph node metastasis and tumor differentiation (P<0.01); the expression of RKIP was negatively correlated with the expression of NF-kB p65 in ESCC tissues (P<0.05). Downregulation or depletion of RKIP was related to the onset and progression of ESCC, and facilitated the invasion and metastasis of ESCC by downregulating E-cadherin and upregulating NF-kB p65.	esophagus
Expression of cystatin C and its effect on EC9706 cells in esophageal carcinoma.	OBJECTIVE: To investigate the expression of cystatin C gene and its effect on the proliferation, apoptosis and invasiveness of EC9706 cells in esophageal carcinoma. METHODS: 56 cases of esophageal carcinoma were randomly collected from our hospital. Samples of human esophageal carcinomas and matched normal esophageal mucosal epithelium were selected by resection operation from these patients. Expression of cathepsin B and cystatin C in these specimens were determined by immunohistochemistry and qRT-PCR. Next, lentiviral vectors of over-expression and interference for cystatin C gene were constructed, and both were transfected into EC9706 cells, and then the levels of cystatin C mRNA and protein were detected by qRT-PCR and Western blot. The effect of over and low-expressed cystatin C on the proliferation, apoptosis and invasiveness of esophageal carcinoma cells were detected by MTT assay, flow cytometry and Transwell assay. RESULTS: Compared with normal esophageal epithelial tissues, mRNA and protein levels of cathepsin B and cystatin C in esophageal carcinoma tissues were significantly increased (P<0.05). Lentiviral vectors of over-expression and interference for cystatin C gene were successfully transfected into EC9706 cells. Over or low-expression cystatin C had no effect on EC9706 cells proliferation but had a reverse relationship with the apoptosis. However, cystatin C over-expression significantly decreased tumor invasiveness (P<0.05) while the invasiveness of EC9706 cells was significantly enhanced by RNAi-mediated abrogation of cystatin C gene expression (P<0.05). CONCLUSION: Over-expressed cystatin C could inhibit the invasiveness of esophageal carcinoma cells.	esophagus
An Interdisciplinary Nutrition Support Team Improves Clinical and Hospitalized Outcomes of Esophageal Cancer Patients with Concurrent Chemoradiotherapy.	BACKGROUND: The prevalence of malnutrition is very high in patients with cancer. The purpose of this study was to investigate whether or not a nutrition support team (NST) could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT). METHODS: Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group. The nutritional statuses of 25 patients in the NST group were managed by the NST. The other 25 patients in the control group underwent the supervision of radiotherapy practitioners. At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay (LOS) and the in-patient cost were also compared between these two groups. RESULTS: At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB), transferrin, and ALB parameters (P = 0.001, 0.000, and 0.000, respectively). The complication incidences, including bone marrow suppression (20% vs. 48%, P = 0.037) and complications related infections (12% vs. 44%, P = 0.012), in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs. 76%, P = 0.103). Furthermore, the average LOS was decreased by 4.5 days (P = 0.001) and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times (P > 0.05) in the NST group. CONCLUSIONS: A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.	esophagus
Risk adjustment models for short-term outcomes after surgical resection for oesophagogastric cancer.	BACKGROUND: Outcomes for oesophagogastric cancer surgery are compared with the aim of benchmarking quality of care. Adjusting for patient characteristics is crucial to avoid biased comparisons between providers. The study objective was to develop a case-mix adjustment model for comparing 30- and 90-day mortality and anastomotic leakage rates after oesophagogastric cancer resections. METHODS: The study reviewed existing models, considered expert opinion and examined audit data in order to select predictors that were consequently used to develop a case-mix adjustment model for the National Oesophago-Gastric Cancer Audit, covering England and Wales. Models were developed on patients undergoing surgical resection between April 2011 and March 2013 using logistic regression. Model calibration and discrimination was quantified using a bootstrap procedure. RESULTS: Most existing risk models for oesophagogastric resections were methodologically weak, outdated or based on detailed laboratory data that are not generally available. In 4882 patients with oesophagogastric cancer used for model development, 30- and 90-day mortality rates were 2·3 and 4·4 per cent respectively, and 6·2 per cent of patients developed an anastomotic leak. The internally validated models, based on predictors selected from the literature, showed moderate discrimination (area under the receiver operating characteristic (ROC) curve 0·646 for 30-day mortality, 0·664 for 90-day mortality and 0·587 for anastomotic leakage) and good calibration. CONCLUSION: Based on available data, three case-mix adjustment models for postoperative outcomes in patients undergoing curative surgery for oesophagogastric cancer were developed. These models should be used for risk adjustment when assessing hospital performance in the National Health Service, and tested in other large health systems.	esophagus
Nationwide analysis of short-term surgical outcomes of minimally invasive esophagectomy for malignancy.	BACKGROUND: Minimally invasive esophagectomy (MIE) is being increasingly utilized for esophageal cancer. It is unclear if MIE if being safely performed with satisfactory outcomes across the USA. We aimed to analyze the short-term surgical outcomes of MIE as compared to open esophagectomy (OE). METHODS: The National Cancer Database (NCDB) was queried for patients who underwent MIE or OE for esophageal malignancy between 2010 and 2011. Margin positivity, lymph node retrieval, 30-day mortality, 30-day unplanned readmission rate and hospital length of stay. RESULTS: A total of 4047 patients were identified; 3050 (75.4%) underwent OE, and 997 (24.6%) underwent MIE. The proportion of MIE increased from 21.9% in 2010 to 27.4% in 2011 (p < 0.001). The conversion rate was 13.7%. There were no differences in-patient or tumor characteristics between the two cohorts. OE and MIE were comparable in terms of margin positive resection rate (7.4% vs. 8.1%, p = 0.48), 30-day unplanned readmission rate (7.6% vs. 7.2%, p = 0.64) and 30-day mortality rate (4.3% vs. 3.3%, p = 0.71). Compared to OE, MIE was associated with higher node retrieval (median 12 vs 14, p < 0.001), and shorter hospital stay (median 11.0 vs 10.0 days, p < 0.001). Logistic regression analysis showed that surgical approach (OE vs MIE) was not associated with 30-day mortality rate. In an ANCOVA analysis, MIE was independently associated with a shorter hospital stay compared to OE (estimated mean difference 1.57 ± 0.53 days, p = 0.003). MIE patients who underwent conversion had a longer hospital stay compared to those who did not (11.0 vs 10.0 days, p = 0.02). CONCLUSION: MIE is being offered more frequently to patients with esophageal cancer, and maybe accompanied with better short-term outcomes including shorter hospital stay when compared to open esophagectomy.	esophagus
Hiatal Herniation After Transhiatal Esophagectomy: an Underreported Complication.	INTRODUCTION: The incidence and presentation of hiatal hernias after esophagectomy (HHAE) are not well characterized, and may be changing with increased survival from esophageal cancer. The aims of this study were to define the incidence and presentation of HHAE in our population of patients undergoing transhiatal esophagectomy (THE), as it may have implications for management. METHODS: A retrospective cohort study (2004-2013) was performed of esophageal cancer patients who underwent THE. To determine the presence or absence of HHAE independent of the original radiology report, a radiologist sub-specializing in body imaging independently reviewed post-operative computed tomography images. A time-to-event competing risk analysis was performed to estimate the cumulative incidence of HHAE. RESULTS: Among 192 patients, the two-year cumulative incidence of HHAE was 14 % (95 % confidence interval 7.5-21 %). Of the 22 patients determined to have HHAE by independent expert radiologist review, only 11 (50 %) were identified by the original interpreting radiologist. Seven patients were symptomatic, and each underwent hiatal hernia repair (4 via laparotomy, 3 via laparoscopy). CONCLUSION: HHAE is not rare and is often unrecognized. As more patients with esophageal cancer survive, the number of patients becoming symptomatic and requiring repair may also rise. Therefore, it is important to consider this diagnosis when following patients long-term after esophagectomy.	esophagus
A Nomogram to Predict Prognostic Value of Red Cell Distribution Width in Patients with Esophageal Cancer.	OBJECTIVES: The prognostic value of inflammatory index in esophageal cancer (EC) was not established. In the present study, we initially used a nomogram to predict prognostic value of red cell distribution width (RDW) in patients with esophageal squamous cell carcinoma (ESCC). METHODS: A total of 277 ESCC patients were included in this retrospective study. Kaplan-Meier method was used to calculate the cancer-specific survival (CSS). A nomogram was established to predict the prognosis for CSS. RESULTS: The mean value of RDW was 14.5 ± 2.3%. The patients were then divided into two groups: RDW ≥ 14.5% and RDW < 14.5%. Patients with RDW < 14.5% had a significantly better 5-year CSS than patients with RDW ≥ 14.5% (43.9% versus 23.3%, P < 0.001). RDW was an independent prognostic factor in patients with ESCC (P = 0.036). A nomogram could be more accurate for CSS. Harrell's c-index for CSS prediction was 0.68. CONCLUSION: RDW was a potential prognostic biomarker in patients with ESCC. The nomogram based on CSS could be used as an accurately prognostic prediction for patients with ESCC.	esophagus
CXCR4 Expression is Associated with Poor Prognosis in Patients with Esophageal Squamous Cell Carcinoma.	BACKGROUND: Chemokines and their receptors are known to play important roles in the tumorigenesis of many malignancies. The chemokine CXCL12 and its receptors CXCR4 and CXCR7 were suggested to be involved in cancer invasion and metastasis. The aim of this retrospective study was to evaluate the prognostic impact of the expressions of CXCL12, CXCR4 and CXCR7 in patients with esophageal squamous cell carcinoma (ESCC). METHODS: We used immunohistochemistry (IHC) and reverse transcriptase-polymerase chain reaction (RT-PCR) to evaluate the expressions of CXCL12, CXCR4, and CXCR7 in ESCC patients' tumor biopsy specimens obtained during preoperative endoscopy or surgery. These results were compared with the patients' clinicopathological parameters and survival. RESULTS: IHC was conducted for 172 patients. High expression of CXCR4 in the cytoplasm and nuclei and that of CXCR7 were associated with poor cause-specific survival (CSS) (P= .002 and .010, respectively). The specimens from 52 of the 172 patients were examined by RT-PCR and quantitative real-time PCR. The expression levels of messenger RNA (mRNA) of CXCR4 and CXCR7 were significantly increased in the tumors compared with normal esophageal mucosae (P < .0001). The expression level of mRNA of CXCR4 was associated with poor recurrence-free survival and CSS (P = .012 and .038, respectively). CONCLUSIONS: CXCR4 expression is associated with poor prognosis in patients with ESCC.	esophagus
Open three-stage transthoracic oesophagectomy versus minimally invasive thoraco-laparoscopic oesophagectomy for oesophageal cancer: protocol for a multicentre prospective, open and parallel, randomised controlled trial.	INTRODUCTION: Oesophageal cancer is the eighth most common cause of cancer worldwide. In 2009 in China, the incidence and death rate of oesophageal cancer was 22.14 per 100 000 person-years and 16.77 per 100 000 person-years, respectively, the highest in the world. Minimally invasive oesophagectomy (MIO) was introduced into clinical practice with the aim of reducing the morbidity rate. The mechanisms of MIO may lie in minimising the reaction to surgical injury and inflammation. There are some randomised trials regarding minimally invasive versus open oesophagectomy, with 100-850 subjects enrolled. To date, no large randomised controlled trial comparing minimally invasive versus open oesophagectomy has been reported in China, where squamous cell carcinoma predominated over adenocarcinoma of the oesophagus. METHODS AND ANALYSIS: This is a 3 year multicentre, prospective, randomised, open and parallel controlled trial, which aims to compare the effectiveness of minimally invasive thoraco-laparoscopic oesophagectomy to open three-stage transthoracic oesophagectomy for resectable oesophageal cancer. Group A patients receive MIO which involves thoracoscopic oesophagectomy and laparoscopic gastric mobilisation with cervical anastomosis. Group B patients receive the open three-stage transthoracic oesophagectomy which involves a right thoracotomy and laparotomy with cervical anastomosis. Primary endpoints include respiratory complications within 30 days after operation. The secondary endpoints include other postoperative complications, influences on pulmonary function, intraoperative data including blood loss, operative time, the number and location of lymph nodes dissected, and mortality in hospital, the length of hospital stay, total expenses in hospital, mortality within 30 days, survival rate after 2 years, postoperative pain, and health-related quality of life (HRQoL). Three hundred and twenty-four patients in each group will be needed and a total of 648 patients will finally be enrolled into the study. ETHICS AND DISSEMINATION: The study protocol has been approved by the Institutional Ethics Committees of all participating institutions. The findings of this trial will be disseminated to patients and through peer-reviewed publications and international presentations. TRIAL REGISTRATION NUMBER: NCT02355249.	esophagus
Randomized controlled trial to investigate the effect of metal clips on early migration during stent implantation for malignant esophageal stricture.	BACKGROUND: The rate of stent migration, especially in the short term after implantation, is high in the treatment process. We sought to explore an effective method for preventing early migration after stent implantation for malignant esophageal stricture and to provide the basis for clinical treatment. METHODS: We conducted a prospective, open-label, parallel-assignment randomized controlled trial with patients undergoing stent implantation for malignant esophageal stricture. The proximal segments of stents in the treatment group were fixed with 2 metal clips during the perioperative period of esophageal stent implantation, while no treatment was used in the control group. All patients underwent radiography at 3 and 7 days and 1 and 3 months after placement to assess the stent migration. RESULTS: There were 83 patients in our study. Demographic characteristics were similar between the groups. There was no stent migration observed in the treatment group within 2 weeks of the operation, while stent migration was observed in 6 of 41 (14.6%) cases in the control group, occurring at 3 and 7 days after placement. There were no perioperative complications. CONCLUSION: Perioperative fixation of the proximal segments of stents with metal clips is effective in preventing early stent migration.	esophagus
A Systematic Review of Esophageal MicroRNA Markers for Diagnosis and Monitoring of Barrett's Esophagus.	BACKGROUND: Esophageal epithelial microRNAs may be used to diagnose Barrett's esophagus (BE) and possibly monitor its progression to esophageal adenocarcinoma (EAC). AIMS: We reviewed studies that have investigated this to identify microRNAs with high biomarker potential for screening and disease monitoring in BE. METHODS: PubMed and EMBASE databases were searched for studies that quantified esophageal epithelial microRNAs. Publications reporting microRNA comparisons of normal, non-dysplastic BE, BE with high-grade dysplasia (HGD), and EAC tissues using both unbiased discovery and independent validation phases were reviewed. RESULTS: Eleven studies on microRNA expression differences between normal epithelium and non-dysplastic BE (seven studies), HGD (4) or EAC (7), or between non-dysplastic BE and HGD (3) or EAC (6) were identified, and the findings of their validation phase were analyzed. Increased miR-192, -194, and -215, and reduced miR-203 and -205 expression in BE compared to normal was noticed by all 4-6 of the seven studies that examined these microRNAs. In heterogeneity tests of the reported fold-change values, the I (2) statistics were 7.9-17.1 % (all P < 0.05). Elevated miR-192, -194, and -215, and diminished miR-203 and -205 levels were also noted for comparisons of HGD or EAC against normal. In contrast, a consistent microRNA expression difference was absent for the comparisons of HGD or EAC against BE. CONCLUSIONS: MicroRNAs miR-192, -194, -203, -205, and -215 are promising tissue biomarkers for diagnosing BE. Cross-sectional data suggest that microRNAs may have a limited role in separating BE from HGD/EAC epithelia but need further testing in longitudinal follow-up studies.	esophagus