crossing96/oncoscreening huggingface dataset:
The multidimensional regulatory network of the PD‑1/PD‑L1 axis in the esophageal squamous cell carcinoma microenvironment: Implications for novel combination therapies and precision immunotherapy (Review).	Esophageal cancer is a highly prevalent malignancy worldwide. Although immunotherapy, particularly programmed cell death‑1/programmed cell death ligand 1 (PD‑1/PD‑L1) inhibitors, has notably improved patient outcomes, the overall response rate remains limited. This limited efficacy is largely attributed to complex immunosuppressive networks within the tumor microenvironment (TME). The present review systematically dissects the multifaceted regulatory mechanisms of the PD‑1/PD‑L1 signaling axis in the TME of esophageal squamous cell carcinoma (ESCC), and its impact on immunotherapeutic efficacy. Emerging evidence indicates that multiple immunosuppressive mechanisms within the TME shape the response to immune checkpoint inhibitors: Regulatory T cells enhance immunosuppression via the TGF‑β‑PD‑1/PD‑L1 axis; IL‑6/STAT3 signaling upregulates PD‑L1 expression and mitochondrial remodeling and amino acid network regulation exacerbate T cell exhaustion. Meanwhile, tertiary lymphoid structure (TLS) maturation is positively associated with clinical prognosis by promoting tissue‑resident memory T cell activation and enhancing antitumor immunity. By contrast, the predictive value of tumor mutational burden (TMB) is constrained by TME heterogeneity. Emerging strategies highlight the predictive potential of TLS maturity and TMB, although the predictive relevance of TMB in ESCC remains inconsistent. Combination approaches show promise in reversing T/natural killer cell exhaustion and remodeling immunosuppressive TMEs. Future research should combine multi‑omics data with clinical information to develop personalized immunotherapy models for ESCC.	esophagus
Narrow Band Imaging and Artificial Intelligence for Detection and Characterization of Barrett's Esophagus Neoplasia.	Barrett's esophagus (BE), a premalignant condition linked to chronic gastroesohageal reflux disease, increases the risk of esophageal adenocarcinoma. Surveillance faces challenges including sampling error and subtle neoplastic changes. Enhanced imaging technologies like narrow band imaging and artificial intelligence improve dysplasia detection and risk stratification. This review explores their evolving roles in BE diagnosis and management.	esophagus
Health-related quality of life in esophageal cancer: a state-of-the-art review of patient-reported outcomes and an evidence and gap map.	Esophageal cancer represents a substantial global health challenge, marked by poor prognosis, even after curative treatment. Health-related quality of life is crucial for evaluating the treatment efficacy and long-term outcomes in patients with esophageal cancer. This state-of-the-art review and evidence gap map sought to identify existing research on the impact of interventions on health-related quality of life in adults with esophageal cancer, providing a comprehensive overview of various health-related quality of life aspects following diagnosis and treatment. This review entailed a systematic literature search, data extraction, and analysis, with the findings visualized in an evidence and gap map. The review synthesized key insights from the literature, focusing on clinical context, treatment, health-related quality of life outcomes, and interventions to enhance health-related quality of life. The evidence and gap map revealed that most studies concentrated on surgical interventions, chemotherapy/chemoradiotherapy, supportive care, and lifestyle interventions, primarily evaluating the overall quality of life, symptom burden, and emotional and psychological health. Several areas remain unexplored, including cognitive and existential well-being, social functioning, and the impact of specific interventions such as immunotherapy. This review underscores the need for high-quality longitudinal studies assessing long-term health-related quality of life, the inclusion of health-related quality of life as a primary or key secondary endpoint in future trials, and improved methodological quality of systematic reviews. Addressing these gaps will contribute to a more patient-centered, evidence-based approach to esophageal cancer care.	esophagus
The Rare Upper Thoracic and Cervical Esophageal GIST Resected Through Thoracoscopic Esophageal Mobilization and a Cervical Approach: A Case Report.	BACKGROUND: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm arising from the digestive tract; however, esophageal GIST is a very rare entity and represents < 1% of all GIST cases. Furthermore, esophageal GIST is most commonly located in the lower esophagus, while esophageal GIST in the upper esophagus is rare among them. Therefore there are very few reports regarding their resection methods. CASE: This report describes a very rare resectable case of large upper esophageal GIST that extended to the cervical esophagus to be completely resected by performing thoracoscopic mobilization of the esophagus, followed by transection of the cervical esophagus via a cervical approach. The operative procedure was as follows: ensuring an adequate macroscopic margin for esophageal resection from within the thoracic cavity was judged to be difficult; therefore, only dissection of the thoracic and cervical esophagus was performed with thoracoscopic procedure, and the cervical esophagus was resected via a cervical approach. The abdominal procedure was carried out laparoscopically, and the specimen, including the tumor, was extracted from a small incision. Next, reconstruction using a gastric tube via a retrosternal approach was done. We also describe a literature review of upper esophageal GISTs. CONCLUSION: The surgical approach of large tumors of the upper thoracic and cervical esophageal GIST, including esophageal resection and reconstruction methods, needs to be carefully considered in advance. A cervical approach for esophageal resection is considered useful when it is difficult to resect the tumor's proximal end within the thoracic cavity safely.	esophagus
Swallowable expandable fibrous capsules for nonendoscopic sampling of esophageal cells.	Esophageal adenocarcinoma is a highly lethal malignancy with a 5-year survival rate of only 18.8%, largely due to late-stage diagnosis in the absence of effective population-wide screening. Survival improves to 42.9% when detected at a localized stage (I/II). More than 90% of esophageal adenocarcinoma cases are diagnosed without prior identification of Barrett's esophagus, its only known precursor. We present a swallowable, string-tethered capsule that expands in the stomach to enable atraumatic retrieval of esophageal epithelial cells without sedation or endoscopic guidance, completing the procedure in under 3 minutes. Capsules are fabricated via gas-foamed expansion of nanofiber mats or hybrid aerogel formation, enabling rapid in situ reexpansion upon gastric fluid exposure and safe retrieval. In swine studies, capsules dissolved within 2 minutes, reexpanded within seconds, required minimal retrieval force, and consistently captured intact epithelial layers without injury. This platform could enable low-cost, high-throughput esophageal sampling in primary care and resource-limited settings.	esophagus
Deciphering precursor cell dynamics in esophageal preneoplasia via genetic barcoding and single-cell transcriptomics.	Although histologically normal, esophageal preneoplastic cells harbor early genetic alterations and likely exhibit lineage plasticity. However, their origins and trajectories remain unclear. To address this, we combined genetic barcoding with single-cell RNA sequencing to trace the lineage of esophageal preneoplastic cells. We identified a distinct progenitor-like cell population with high plasticity. Through a scoring system, these high-plasticity cells are mapped, revealing their contributions to proliferative and basal cell populations. This approach uncovers molecular markers, including Nfib and Qk, that define these precursor cells, validated by spatial transcriptomics and a Trp53 Cdkn2a Notch1 mouse model. These findings provide critical insights into early tumorigenesis, highlighting the potential of precursor cells as biomarkers for early detection and therapeutic targets of esophageal squamous cell cancer. By elucidating the cellular dynamics underlying esophageal preneoplasia, this research lays the foundation for strategies to prevent malignant progression, offering broader implications for improving cancer diagnostics and treatment approaches.	esophagus
Prognostic value of miR-21 in colorectal cancer, pancreatic ductal adenocarcinoma, and esophageal squamous cell carcinoma: updated systematic review and meta-analysis.	OBJECTIVE: This study aims to conduct a systematic review of the prognostic value of miR-21 expression levels in patients with colorectal cancer (CRC), pancreatic ductal adenocarcinoma (PDAC), and esophageal squamous cell carcinoma (ESCC). METHODS AND RESULTS: We searched the PubMed, Embase, and CENTRAL databases for relevant studies published up to August 25, 2023. Sixteen studies, totaling 3096 patients, were included. High miR-21 expression was associated with higher hazard ratio (HR) values and decreased overall survival (OS) in CRC and PDAC, but this effect was not statistically significant in ESCC. The pooled HRs for CRC, PDAC, and ESCC were 1.54 (95% confidence interval [CI]: 1.14-2.07; P = 0.004; I2 = 71%), 2.11 (95% CI: 1.81-2.46; P < 0.001; I2 = 0%), and 1.79 (95% CI: 0.82-3.92; P = 0.15; I2 = 75%), respectively. Patients with high miR-21 expression had higher HR values and decreased disease-free survival (DFS) compared to those with low miR-21 expression in all three cancer types. The pooled HRs for CRC, PDAC, and ESCC were 1.88 (95% CI: 1.36-2.60; P < 0.001; I2 = 59%), 2.04 (95% CI: 1.34-3.11; P < 0.001; I2 = 17%), and 1.77 (95% CI: 1.04-3.03; P = 0.04; I2 = 36%), respectively. CONCLUSION: Elevated miR-21 expression levels are associated with poorer OS and DFS in patients with CRC, pancreatic cancer, and esophageal cancer. However, due to heterogeneity in the results, further large-sample, high-quality studies are needed to validate these findings.	esophagus
The Therapeutic Effectiveness of 3-dimensional Video-assisted Thoracic Surgery in the Management of Oesophageal Cancer.	OBJECTIVES: The comparative benefits of 3-dimensional (3D) versus 2-dimensional (2D) video-assisted thoracic surgery (VATS) for oesophageal cancer remain uncertain. This meta-analysis aims to assess the efficacy and safety profiles of 3D and 2D VATS procedures in the management of oesophageal cancer. METHODS: A comprehensive literature search was conducted utilizing the PubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases for studies published up to August 2025. Eligible studies were those comparing the efficacy and safety profiles of 3D versus 2D VATS. For data synthesis, continuous variables were evaluated using standardized mean differences (SMD), while dichotomous outcomes were assessed with odds ratios (ORs); all effect measures are reported with 95% confidence intervals (CIs) and corresponding P-values. RESULTS: Eight studies involving 1273 patients (608 undergoing 3D VATS and 665 undergoing 2D VATS) demonstrated that the 3D VATS approach was associated with significantly decreased intraoperative blood loss (-2.27; 95% CI: -3.45 to -1.09; P < .05) and reduced operative duration (-0.65; 95% CI: -1.15 to -0.16; P < .05) compared to the 2D technique. However, no statistically significant differences were observed between the 2 groups in terms of postoperative drainage time, postoperative hospitalization duration, total postoperative drainage volume, incidence of postoperative complications, and number of lymph node dissection. CONCLUSIONS: This meta-analytic study demonstrates that potential clinical benefits of 3D VATS over the 2D approach for oesophageal cancer resection, such as decreased intraoperative blood loss and reduced operative duration.	esophagus
[Prediction of cervical anastomosis failure after McKeown esophagectomy].	OBJECTIVE: To identify the risk factors of cervical anastomosis failure after McKeown esophagectomy and to create a prognostic model predicting the risk of anastomosis failure. MATERIAL AND METHODS: There were 69 esophagectomies between January 1, 2019 and December 31, 2023 for cancer of the middle thoracic esophagus. Significant predictors of cervical anastomosis failure were identified. RESULTS: The incidence of anastomosis failure after McKeown surgery was 18.8%. Logistic regression analysis showed that platelet-lymphocyte ratio (OR=1.141; 95% CI: 1.003-1.297), prognostic nutritional index (OR=0.576; 95% CI: 0.339-0.979), and systemic immune-inflammation index (OR=1.010; 95% CI: 1.004-1.016) were independent risk factors of anastomosis failure after McKeown esophagectomy. AUC was 0.953 ± 0.042 (95% CI 0.872-1.000). The model was significant (p<0.001). Sensitivity and specificity of the model were 84.6% and 87.5%, respectively. Furthermore, we developed a nomogram for predicting cervical anastomosis failure after McKeown surgery using artificial intelligence and machine learning. A comprehensive analysis and validation of prognostic model demonstrated its significance. CONCLUSIONS: PNI, NLR and SII are significant predictive factors of cervical anastomotic leakage after McKeown esophagectomy. A nomogram was developed to predict the probability of anastomotic leakage.	esophagus
Clinical Significance of Molar Count in Esophageal Squamous Cell Carcinoma: Propensity Score Matching Study.	BACKGROUND/AIM: Emerging evidence suggests that oral health influences the prognosis of esophageal squamous cell carcinoma, with tooth loss linked to poorer outcomes and higher risk of postoperative pneumonia. While the number of teeth has been associated with esophageal squamous cell carcinoma risk, the prognostic role of molars, which play key roles in masticatory function, remains underexplored. Therefore, this study evaluated the prognostic significance of the number of remaining molars in patients undergoing esophagectomy for esophageal squamous cell carcinoma. PATIENTS AND METHODS: This retrospective study analyzed data from 272 patients with esophageal squamous cell carcinoma who underwent surgery and preoperative dental assessment. The patients were categorized into two groups based on the number of molars (≥7 vs. <7), and propensity score matching was applied to control for confounding variables. Survival outcomes were analyzed using Kaplan-Meier curves and Cox regression analysis. RESULTS: After propensity score matching, 68 matched pairs were analyzed. The group with ≥7 molars showed significantly better overall survival (57.0% vs. 36.1%, p=0.0284) and recurrence-free survival (RFS; 52.3% vs. 32.2%, p=0.0498) compared with the group with <7 molars. Multivariate analysis identified postoperative pneumonia and advanced pathological stage as independent predictors of poor survival. CONCLUSION: The number of remaining molars could serve as a prognostic marker in patients with esophageal squamous cell carcinoma. Maintaining molars may improve clinical outcomes, emphasizing the role of oral health in the perioperative management of esophageal cancer.	esophagus
Genomic Instability is Widespread in Esophageal Squamous Dysplasia and Increases During the Progression to Cancer.	"BACKGROUND: Research on the molecular progression of esophageal squamous dysplasia to cancer remains limited. The majority of prior studies have focused on morphological precancerous lesions sampled adjacent to tumors, and have relied primarily on the analysis of data from whole-exome sequencing. METHODS: To investigate the development of esophageal squamous cell carcinoma (ESCC), whole genome analysis was conducted on 13 precancerous tissues and 15 ESCC tissues. Field effects were avoided by using biopsies of squamous dysplasia from patients without concurrent tumor, thereby allowing study of molecular alterations associated with the true precancerous state. RESULTS: Our results revealed frequent copy number alterations (CNAs) and structural variants (SVs) in esophageal squamous dysplasia. These changes were also detected in ESCC, indicating that genomic instability markers such as CNAs and SVs occur at an early stage and persist throughout ESCC evolution. The detection of TP53 mutations and CASP8 deletions in both premalignant lesions and ESCC suggests they may be early driving events during esophageal carcinogenesis. Mutations in MUC5B were observed in 7.7% of precancerous lesions and 6.7% of ESCC. Moreover, these mutations were associated with a higher tumor mutational burden (TMB) and an immune ""hot"" tumor microenvironment. Apolipoprotein B mRNA-editing catalytic polypeptide-like (APOBEC) enzyme-associated mutational signatures were exclusively identified in ESCC and may further exacerbate genomic instability in the more advanced stages of tumorigenesis. Significantly higher ploidy alterations levels were detected in ESCC compared to squamous dysplasia. Moreover, the cohort that underwent local recurrence of dysplasia within two years had significantly elevated ploidy alterations levels compared to those with no long-term recurrence. These results indicate that elevated levels of aneuploidy and genomic instability were associated with tumor progression and local recurrence of dysplasia. CONCLUSIONS: Mutations in TP53 and MUC5B, as well as deletion of CASP8, may be early driver events in carcinogenesis and could precede the emergence of the APOBEC mutation signature. Moreover, ploidy alterations confer a selective advantage to genomically unstable cells, thereby promoting their progression toward malignant transformation. Collectively, our results demonstrate that genomic instability is prevalent in precancerous lesions and intensifies during the late stages of tumor progression. Cells with a certain level of genomic instability appear to possess a competitive advantage for malignant transformation."	esophagus
[Tertiary Lymphoid Structures as Predictive Biomarkers for Immune Checkpoint Inhibitor Therapy in Esophageal Cancer].	While immune checkpoint inhibitors(ICIs)have dramatically improved treatment outcomes for esophageal cancer in recent years, substantial interpatient variability in therapeutic response remains a major clinical challenge. The development of reliable predictive biomarkers to identify patients likely to benefit from ICI therapy is thus an urgent priority. Conventional biomarkers such as programmed death‒ligand 1(PD‒L1)expression, tumor mutational burden(TMB), and microsatellite instability(MSI)have shown limited predictive utility and clinical applicability in esophageal cancer. These markers primarily reflect tumor‒intrinsic properties and may fail to capture the complex interplay between the tumor and its immune microenvironment. Tertiary lymphoid structures(TLS), ectopic lymphoid aggregates formed within the tumor microenvironment, have recently emerged as promising immune‒related biomarkers. TLS represent organized immune cell niches capable of facilitating local antigen presentation and adaptive immune activation. In this review, we provide an overview of key phase Ⅲ clinical trials of ICIs in esophageal cancer, with a particular focus on the biomarkers used in each study. We then summarize the structural and functional characteristics of TLS and highlight accumulating evidence supporting their value as predictive indicators of ICI efficacy. We further compare TLS with existing biomarkers, discussing the advantages and limitations of TLS assessment in clinical settings. Finally, we explore the future potential of TLS as both a biomarker and a therapeutic target, including the development of strategies aimed at promoting TLS formation to enhance anti‒tumor immunity. TLS offer a novel, immune microenvironment‒reflective dimension to patient stratification, and their integration into biomarker frameworks may refine personalized immunotherapy approaches for esophageal cancer.	esophagus
Cell-free DNA methylation and fragmentomics-based liquid biopsy for accurate esophageal cancer detection.	BACKGROUND: Cell-free DNA is a promising source of biomarkers for early cancer detection and carries tumor-driven methylation and fragmentation features that have achieved good diagnostic efficacy across various cancers. However, there were no studies that detected both of them for esophageal cancer diagnosis. METHODS: In this study, we analyzed the cfDNA methylation and fragmentation markers for accurate esophageal cancer detection. Using cfMeDIP-seq, we profiled 145 plasma samples from healthy controls and esophageal cancer patients. We used multiple algorithms to identify cfDNA methylation markers and fragmentation markers to evaluate the efficacy of early esophageal cancer detection. RESULTS: Finally, we identified 25 cfDNA methylation and fragmentation markers and constructed a machine-learning model, which achieved a sensitivity of 99% and specificity of 97.82% in an independent cohort. These results indicate that methylation and fragmentomics biomarkers based on cfMeDIP-seq can accurately distinguish esophageal cancer patients from non-tumor controls. CONCLUSION: Our study based on cfMeDIP-seq highlights the efficacy of cfDNA methylation and fragmentation histology markers in diagnosing esophageal cancer and provides a direction for subsequent research.	esophagus
Clinical Benefits of Combination Immunotherapy Over Standard Immunotherapy Monotherapy in Previously Treated Advanced Esophageal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.	PURPOSE: Programmed cell death protein 1 (PD-1) inhibitor monotherapy is the standard second-line treatment for esophageal squamous cell carcinoma (ESCC), but the clinical response and survival outcomes still remain unsatisfactory. This systematic review aims to assess the efficacy and safety of combined immunotherapy strategies in previously treated ESCC patients. METHODS AND MATERIALS: Studies involving previously treated ESCC patients treated with either combined immunotherapy or PD-1 inhibitor monotherapy as second- or later-line treatment were searched up to November 30, 2023. Pooled rates of objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (TRAEs) were compared. RESULTS: A total of 19 studies involving 3007 ESCC patients were included in the pooled analysis. Among them, 1308 patients received immunotherapy monotherapy. Combination immunotherapy included PD-1 inhibitor combined with chemotherapy (123 patients), anti-angiogenesis therapy (291 patients), chemoradiotherapy (49 patients), TIGIT inhibitor (62 patients), and anti-EGFR antibody (28 patients). Patients receiving combination immunotherapy had significantly higher ORR, DCR, PFS, and OS rates compared to those receiving PD-1 inhibitor monotherapy or chemotherapy (ORR: 35.5% vs. 19.8% vs. 13.0%, p = 0.000; DCR: 84.8% vs. 51.2% vs. 55.2%, p = 0.000). Subgroup analysis demonstrated that second-line combination immunotherapy significantly improved response and survival rates compared to PD-1 inhibitor monotherapy in immunotherapy-naive ESCC patients. The limited data showed that PD-1 inhibitors combined with both anti-angiogenesis agents and chemotherapy as second-line therapy improved response and survival rates compared to PD-1 inhibitor monotherapy. Notably, the PD-1 inhibitor combined with anti-angiogenesis therapy or chemotherapy also showed high antitumor activity in immunotherapy-treated ESCC patients. Combination therapy was associated with higher treatment-related but manageable toxicity compared with PD-1 inhibitor monotherapy. CONCLUSIONS: Based on the limited data, combined immunotherapy provides additional clinical benefits over standard PD-1 inhibitor monotherapy in second-line treatments for both immunotherapy-naive and previously immunotherapy-treated ESCC patients.	esophagus