crossing96/oncoscreening huggingface dataset:
Oncological outcomes of thoracic duct preservation and resection for esophageal carcinoma based on an understanding of its surgical microanatomy in the era of minimally invasive esophagectomy and neoadjuvant chemotherapy.	BACKGROUND: Although the oncological benefits of thoracic duct (TD) resection have been reported, recent research has questioned its impact on survival. With advancements in minimally invasive esophagectomy (MIE) and a deeper understanding of the microanatomy, standardizing techniques for TD resection/preservation have become increasingly important. We demonstrated a minimally invasive surgical procedure for esophagectomy, with and without TD resection, in patients who received neoadjuvant chemotherapy. METHODS: This multicenter, retrospective cohort study evaluated patients with cT1-3 thoracic esophageal cancer who underwent thoracoscopic McKeown esophagectomy after neoadjuvant chemotherapy at two Japanese cancer centers between 2012 and 2019. The effects of TD preservation and resection were compared using propensity score-matching. Short- and long-term outcomes were analyzed. RESULTS: We showed the standard procedure for TD resection and preservation and demonstrated that recognizing membrane structures is crucial for precise resection of the esophagus and regional lymph nodes. After matching, 255 patients in each group were analyzed. The TD resection group showed no significant differences in short-term outcomes, complication rates, or thoracic lymph node harvest compared to the TD preservation group. Both groups had similar 5-year overall and recurrence-free survival rates, with no significant differences in recurrence patterns. CONCLUSIONS: In the context of modern esophageal carcinoma treatment, in which MIE and neoadjuvant chemotherapy are standard practices, the impact of TD resection on prognosis is limited. Recognizing membrane structures is crucial for accurate esophagectomy using the MIE approach.	esophagus
Unique Microbial Characterisation of Oesophageal Squamous Cell Carcinoma Patients with Different Dietary Habits Based on Light Gradient Boosting Machine Learning Classifier.	Objectives: The microbiome plays an important role in cancer, but the relationship between dietary habits and the microbiota in oesophageal squamous cell carcinoma (ESCC) is not clear. The aim of this study is to explore the complex relationship between the microbiota in oesophagal tissue and dietary habits in ESCC patients. Methods: 173 ESCC patients were included. The method of 16S rRNA sequencing was used to analyze microbial composition and diversity. The LEfSe and Boruta methods were used to screen important microbes, and the LightGBM algorithm distinguished microbes associated with different dietary habits. PICRUST2 and DESeq2 predicted microbial function and screened differential functions. The Pearson test was used to analyze correlations between microbes and functions, and SPARCC microbial symbiotic networks and Cytoscape were used to determine microbial interactions. Results: Significant differences in microbial composition were observed among ESCC patients with different dietary habits. LEfSe and Boruta identified three, six, and two significantly different bacteria in the FF/FP, FF/PF, and FF/PP groups, respectively, with AUC values of 0.683, 0.830, and 0.715. PICRUST2 and DESeq2 analysis revealed 3, 11, and 5 significantly different metabolic pathways in each group. Eubacterium_B sulci was positively correlated with PWY-6285, PWY-3801, and PWY-5823. PWY-6397 was positively correlated with undefinded (Fusobacterium_C). Microbial network analysis confirmed unique microbial characteristics in different diet groups. Conclusions: Different dietary habits lead to alterations in Eubacterium_B sulci and undefinded (Fusobacterium_C) and related functional pathways.	esophagus
Exploring predictive biomarkers of efficacy and survival with nivolumab treatment for unresectable/recurrent esophageal squamous cell carcinoma.	BACKGROUND: Programmed cell death protein-1 (PD-1) blockade has improved survival for patients with esophageal squamous cell carcinoma (ESCC), but response rates are low. Biomarkers to predict who will benefit from PD-1 blockade are urgently needed. METHODS: This multicenter study involved 250 patients with recurrent/unresectable advanced ESCC receiving nivolumab as second- or later-line therapy. We assessed tumor-infiltrating T lymphocytes (TILs) and tertiary lymphoid structure (TLS) density using immunohistochemistry and hematoxylin/eosin staining in surgical specimens and pre-nivolumab endoscopic biopsies. RESULTS: In surgical specimens, clinical response (vs. non-response) to nivolumab correlated significantly with CD8(+) lymphocyte count (160 vs. 95.2 cells/field, P = 0.0494), CD8/Foxp3 ratio (6.52 vs. 2.72, P = 0.0053), and TLS density (0.21/mm(2) vs. 0.10/mm(2), P = 0.0005). In terms of overall survival, multivariate analysis identified CD8/Foxp3 ratio (hazard ratio [HR] = 1.83, P = 0.0050) and TLS density (HR = 1.67, P = 0.0171 as independent prognostic parameters in surgical specimens. Similarly, in endoscopic biopsies, clinical response (vs. non-response) to nivolumab correlated significantly with CD8(+) counts (254 cells/mm(2) vs. 124 cells/mm(2), P = 0.0344), CCR8(+) lymphocyte count (62.6 cells/mm(2) vs. 140 cells/mm(2), P = 0.0355), CD8/Foxp3 ratio (2.09 vs. 0.89, P = 0.040), and CD8/CCR8 ratio (2.34 vs. 0.89, P = 0.0020). Multivariate analysis also identified CD8/CCR8 ratio in endoscopic biopsies (HR = 1.66, P = 0.0313) as an independent prognostic parameter. CONCLUSIONS: CD8(+) and CCR8(+) cell counts, CD8/Foxp3 and CD8/CCR8 ratios, and TLS density may be predictive biomarkers of therapeutic efficacy and survival with PD-1 blockade for ESCC.	esophagus
A Procedural Transhiatal Approach for the Thoracic Para-Aortic Lymph Node: A Case Report.	The thoracic posterior para-aortic lymph node (TPAN) is classified as an extra-regional lymph node in esophageal cancer, with metastasis indicating poor prognosis. However, some cases with suspected TPAN metastasis may benefit from esophagectomy with lymph node dissection, including TPAN. This report presents the case of a 58-year-old man with upper thoracic esophageal squamous cell carcinoma and suspected simultaneous TPAN metastasis who underwent neoadjuvant chemotherapy followed by thoracoscopic subtotal esophagectomy and procedural transhiatal TPAN dissection. This transhiatal approach provided direct access to the lymph node without additional thoracic incisions, ensuring safe resection in coordination with the assistant and following anatomical landmarks systematically. Pathological examination showed a false-positive TPAN finding, though the patient later developed distant recurrence. Compared with conventional approaches, this transhiatal technique allows for procedural and reproducible lymphadenectomy while minimizing respiratory burden. This case highlights the feasibility of a transhiatal approach for TPAN dissection.	esophagus
Efficacy evaluation and prognostic prediction of endoscopic ultrasound for neoadjuvant immunotherapy in esophageal cancer.	BACKGROUND AND OBJECTIVES: Neoadjuvant immunotherapy combined with chemotherapy or chemoradiotherapy has emerged as a promising approach in the treatment of esophageal cancer. However, there is a lack of comprehensive understanding regarding the clinical factors that can predict patient response to this therapy. The aim of this study was to develop a predictive model for assessing the efficacy of neoadjuvant immunotherapy in patients undergoing surgical treatment. METHODS: This study retrospectively enrolled 220 consecutive patients with preoperative immunotherapy combined chemotherapy or chemoradiotherapy. A logistic regression was used to evaluate the association between pathologic complete response (pCR) and endoscopic ultrasound parameters, constructing a predictive model for treatment response. Additional, overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method, and Cox regression analyses were introduced to explore the associations between EUS factors after neoadjuvant immunotherapy. RESULTS: Logistic regression analysis identified that the significant predictors of pCR were treatment regimen, negative biopsy findings, RECIST assessment, endoscopic ultrasound responder, and downstaging in uN. A predictive model including above five variables was generated, and area under the curve was 0.840(95%CI 0.78-0.89), this nomogram was also adequately validated internally. In the cox regression analyses, EUS responder was found to be a significant predictor of overall survival with a hazard ratio (HR) of 0.38(95%CI 0.15-0.98), whereas only pCR status was a significant predictor of PFS (HR 0.80; 95%CI 0.01-0.60). CONCLUSIONS: EUS responder can serve as a valuable predictor of the efficacy of adjuvant immunotherapy combined with chemotherapy or chemoradiotherapy, as well as of survival outcomes.	esophagus
TAK1-mediated phosphorylation of PLCE1 represses PIP2 hydrolysis to impede esophageal squamous cancer metastasis.	TAK1 is a serine/threonine protein kinase that is a key regulator in a wide variety of cellular processes. However, the functions and mechanisms involved in cancer metastasis are still not well understood. Here, we found that TAK1 knockdown promoted esophageal squamous cancer carcinoma (ESCC) migration and invasion, whereas TAK1 overexpression resulted in the opposite outcome. These in vitro findings were recapitulated in vivo in a xenograft metastatic mouse model. Mechanistically, co-immunoprecipitation and mass spectrometry demonstrated that TAK1 interacted with phospholipase C epsilon 1 (PLCE1) and phosphorylated PLCE1 at serine 1060 (S1060). Functional studies revealed that phosphorylation at S1060 in PLCE1 resulted in decreased enzyme activity, leading to the repression of phosphatidylinositol 4,5-bisphosphate (PIP2) hydrolysis. As a result, the degradation products of PIP2 including diacylglycerol (DAG) and inositol IP3 were reduced, which thereby suppressed signal transduction in the axis of PKC/GSK-3β/β-Catenin. Consequently, expression of cancer metastasis-related genes was impeded by TAK1. Overall, our data indicate that TAK1 plays a negative role in ESCC metastasis, which depends on the TAK1-induced phosphorylation of PLCE1 at S1060.	esophagus
Paclitaxel/Luteolin Coloaded Dual-Functional Liposomes for Esophageal Cancer Therapy.	Combination therapy integrating chemotherapeutic agents with natural bioactive ingredients represents an attractive strategy for esophageal squamous cell carcinoma (ESCC) treatment, yet achieving tumor-specific co-delivery remains a critical challenge. Herein, we report that the combination of luteolin (LUT) and paclitaxel (PTX) exerts a remarkable synergy in ESCC treatment, while concurrently alleviating PTX-induced hepatotoxicity; EA2 aptamer has been identified for its exceptional specificity and strong affinity toward Catenin Alpha 1 protein (CTNNA1) in ESCC cells. Leveraging this specificity, nanosized EA2-modified pH-sensitive liposomes (EA2-PSL-PTX/LUT) are successfully developed with effective co-loading, controlled release, and good biostability. EA2-PSL-PTX/LUT exhibits stimuli-triggered release in the acidic tumor microenvironment and facilitates specific cellular uptake and endosomal escape in ESCC cells. In vivo imaging confirms precise tumor localization, deep tumor penetration, and prolonged retention of the nanocarrier. In vitro and in vivo findings validate that the nanocarrier potentiates synergistic inhibitions of PTX and LUT. Notably, EA2-PSL-PTX/LUT significantly activates the tumor microenvironment by promoting dendritic cell maturation and T cell infiltration. And the immunosuppressive microenvironment has been remodeled by decreasing myeloid-derived suppressor cells and regulatory T cell accumulation. This study provides a strategy for precise delivery of combinational chemotherapeutic drugs for ESCC targeted therapy.	esophagus
The role of squamous cell carcinoma antigen and cytokeratin 19 fragment in predicting the outcome of esophageal cancer patients: insights from a meta-analysis.	BACKGROUND: The accurate prognostication and recurrence monitoring of esophageal cancer (EC) are pivotal yet challenging. Despite the promising roles of squamous cell carcinoma antigen (SCC) and cytokeratin 19 fragment (CK19 Fragment) as cancer biomarkers in EC, their prognostic value remains unquantified. This meta-analysis is the first to quantitatively assess the relationship between serum levels of SCC and CK19 Fragment and EC prognosis, aiming to bridge this knowledge gap. METHODS: We conducted a comprehensive and systematic literature search across PubMed, Web of Science, Cochrane Library, and Embase databases, and Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and other survival outcomes were extracted and analyzed using random-effects or fixed-effects models depending on heterogeneity among the studies. RESULTS: 7309 patients from 29 studies were finally included in this meta-analysis. The quantitively summarized data revealed that elevated level of SCC and CK19 Fragment in serum was significantly correlated to poorer prognosis of EC patients with the pooled HR of OS was 1.25 (95%CI: 1.04-1.50, P < 0.05) and 1.69 (95%CI: 1.25-1.27, P < 0.05), respectively. Subgroup analyses indicated that the prognostic value of these biomarkers varied across different patient populations and treatment modalities. CONCLUSION: This meta-analysis demonstrated that SCC and CK19 Fragment levels in serum were both strong prognostic biomarkers of EC patients. The elevated level of SCC and CK19 Fragment in serum was significantly associated with worse survival outcomes, advocating for the integration of these biomarkers into prognostic assessments to improve decision-making processes in the management of EC. REGISTRATION NUMBER: CRD42022311617.	esophagus
Navigating Diagnosis and Management for Takotsubo Syndrome Following Esophageal Cancer Surgery.	Takotsubo syndrome (TTS), despite its low incidence, often remains underrecognized or misdiagnosed due to its clinical similarity to acute coronary syndromes and atypical cardiac manifestations in critically ill patients. This applied clinical evidence presents a case of a 72-year-old male patient who developed TTS following esophagectomy. The discussion focuses on the most appropriate diagnostic approach for critically ill patients presenting with chest pain in the intensive care unit (ICU). In addition, it explores the optimal management strategy for TTS in the context of rapid atrial fibrillation and pulmonary complications, emphasizing the importance of timely recognition and targeted intervention.	esophagus
Thoracic muscle mass predicts survival among patients with locally advanced esophageal cancer.	BACKGROUND & AIMS: There is limited literature evaluating muscle mass at the fourth thoracic (T4) vertebrae using computed tomography (CT) images, with no studies evaluating T4 muscle mass in esophageal cancer. METHODS: In this retrospective cohort study, body composition analysis using skeletal muscle index (SMI) was conducted at T4 and L3. Overall survival (OS) and disease-free survival (DFS) were evaluated using Kaplan-Meier curves and log-rank tests, as well as multivariable cox proportional hazards models. Correlation analysis and evaluation of fixed and proportional bias was conducted. Low muscle mass was defined by the lowest quartile of the SMI distribution from the post-neoadjuvant CT: <30.4 cm(2)/m(2) (females) and <42.2 cm(2)/m(2) (males) for L3, and <35.4 cm(2)/m(2) (females) and <52.6 cm(2)/m(2) (males) for T4. RESULTS: Of the 120 patients included, eight (8.2 %) patients had T4-low muscle mass at the staging CT which increased to 25 (25.8 %) at the post-neoadjuvant CT. On multivariable analysis, T4-low muscle mass was associated with worse overall survival (OS) (HR 2.51, 95 % CI 1.47-4.29, p = 0.001) and disease-free survival (DFS) (HR 1.88, 95 % CI 1.09-3.24, p = 0.022). T4-SMI was higher than L3-SMI at both the staging (65.4 ± 13.6 cm(2)/m(2) versus 51.1 ± 10.0 cm(2)/m(2), p < 0.001) and post-neoadjuvant (57.8 ± 12.7 cm(2)/m(2) versus 45.8 ± 9.3 cm(2)/m(2), p < 0.001) CT scans. The correlation (R-value) between T4 and L3 SMI was greater than 0.6 (0.62-0.81) for all staging intervals. CONCLUSION: Our findings support using low muscle mass at T4 as a prognostic indicator for OS and DFS. These findings can be extrapolated to tumor groups, such as lung cancer, where L3-low muscle mass status is not routinely available.	esophagus
Imaging features and preoperative diagnostic insights of esophageal schwannomas as a rare type.	PURPOSE: We aimed to analyze and summarize the key features of esophageal schwannomas to provide new insights into preoperative diagnosis and enhance clinical recognition. METHODS: Twenty-one consecutive patients with pathologically confirmed esophageal schwannoma who underwent surgical resection between January 2013 and January 2023 were enrolled. Imaging results from barium swallow, CT, MRI, (18)F-FDG PET-CT, esophagoscopy, and endoscopic ultrasound were compiled and analyzed. RESULTS: Our cohort comprised 10 males and 11 females, with mean age of 55.86 ± 9.09 years. The mean tumor size was 5.69 ± 1.32 cm, with tumors commonly located in the upper to middle esophagus. 83.3 % (10/12) presented smooth filling defects with intact canal walls in barium meal. Most tumors (71.4 %, 15/21) were oval-shaped, exhibiting intracavitary growth with well-defined borders. Mild enhancement was observed on CT with pre-contrast attenuation of 36.0 ± 53.87 HU and post-contrast enhancement of 52.75 ± 7.45 HU. Most lesions showed plateau dynamic enhancement on MRI (85.7 %, 6/7). Air crescent signs (95.2 %, 20/21) and fascicular signs (87.5 %, 7/8) were observed in most cases. Neither calcifications nor target signs were observed, and cystic changes were infrequent. All lesions showed high uptake on PET-CT (SUVmax: 11.19 ± 3.41). Endoscopic lesions typically exhibit smooth surfaces, soft textures, and colors ranging from normal to slightly lighter hues (94.7 %, 18/19). Endoscopic ultrasound indicated minimal blood flow within lesions (53.8 %, 7/13), and elastography displayed a blue-green pattern (100 %, 5/5). CONCLUSION: Esophageal schwannomas exhibit distinct imaging characteristics. MRI provides additional diagnostic information for more accurate evaluation, while high metabolic activity on PET-CT may mimic malignancy.	esophagus
Artificial intelligence-aided optical biopsy improves the diagnosis of esophageal squamous neoplasm.	BACKGROUND: Early detection of esophageal squamous neoplasms (ESN) is essential for improving patient prognosis. Optical diagnosis of ESN remains challenging. Probe-based confocal laser endomicroscopy (pCLE) enables accurate in vivo histological observation and optical biopsy of ESN. However, interpretation of pCLE images requires histopathological expertise and extensive training. Artificial intelligence (AI) has been widely applied in digestive endoscopy; however, AI for pCLE diagnosis of ESN has not been reported. AIM: To develop a pCLE computer-aided diagnostic system for ESN and assess its diagnostic performance and assistant efficiency for nonexpert endoscopists. METHODS: The intelligent confocal laser endomicroscopy (iCLE) system consists of image recognition (based on inception-ResNet V2), video diagnosis, and quality judgment modules. This system was developed using pCLE images and videos and evaluated through image and prospective video recognition tests. Patients between June 2020 and January 2023 were prospectively enrolled. Expert and non-expert endoscopists and the iCLE independently performed diagnoses for pCLE videos, with histopathology as the gold standard. Thereafter, the non-expert endoscopists performed a second assessment with iCLE assistance. RESULTS: A total of 25056 images from 2803 patients were selected for iCLE training and validation. Another 2442 images from 226 patients were used for testing. iCLE achieved a high accuracy of 98.3%, sensitivity of 95.3% and specificity of 98.8% for diagnosing ESN images. A total of 2581 patients underwent upper gastrointestinal pCLE examination and were prospectively screened; 54 patients with suspected ESN were enrolled. Overall, 187 videos from 67 lesions were assessed by iCLE, three nonexpert and three expert endoscopists. iCLE achieved a high accuracy, sensitivity and specificity of 90.9%, 92.0%, and 90.2%, respectively. Compared to experts, iCLE showed significantly higher sensitivity (92.0% vs 80.4%; P < 0.001) and negative predictive value (94.4% vs 87.7%; P = 0.003). With iCLE assistance, nonexpert endoscopists showed significant improvements in accuracy (from 83.6% to 88.6%) and sensitivity (from 76.0% to 89.8%). CONCLUSION: iCLE system demonstrated high diagnostic performance for ESN. It can assist nonexpert endoscopists in improving the diagnostic efficiency of pCLE for ESN and has the potential for reducing unnecessary biopsies.	esophagus
Targeting LTBP2 Derived from Cancer-Associated Fibroblasts Sensitizes Esophageal Squamous Cell Carcinoma to Chemotherapy.	Cancer-associated fibroblasts (CAF) are pivotal constituents of the tumor microenvironment that significantly influence cancer aggressiveness through the secretion of various factors. A more detailed characterization of the specific secretions exclusive to CAFs that drive tumor progression could identify potential targets to perturb this intracellular cross-talk. In this study, we identified latent TGFβ-binding protein 2 (LTBP2) as a unique protein secreted exclusively by esophageal squamous cell carcinoma (ESCC) CAFs that promotes metastasis and chemoresistance. LTBP2 exerted its oncogenic effects by interacting with integrin α6β4, which serves as a functional receptor, and thereby activating Src signaling in ESCC cells. Notably, targeting LTBP2 with specific antagonistic antibodies markedly increased the susceptibility of ESCC cells to chemotherapeutic agents. These findings highlight the pivotal role of LTBP2 as a crucial mediator of CAF-induced cancer cell aggression and introduce it as a promising target to enhance chemotherapeutic efficacy in ESCC. SIGNIFICANCE: CAF-secreted LTBP2 binds integrin α6β4 and activates Src signaling to drive metastasis and chemoresistance in esophageal cancer, highlighting LTBP2 as a key regulator of CAF-mediated tumor progression that can be therapeutically targeted.	esophagus
101 Machine Learning Algorithms for Mining Esophageal Squamous Cell Carcinoma Neoantigen Prognostic Models in Single-Cell Data.	Esophageal squamous cell carcinoma (ESCC) is one of the most aggressive malignant tumors in the digestive tract, characterized by a high recurrence rate and inadequate immunotherapy options. We analyzed mutation data of ESCC from public databases and employed 10 machine learning algorithms to generate 101 algorithm combinations. Based on the optimal range determined by the concordance index, we randomly selected one combination from the best-performing algorithms to construct a prognostic model consisting of five genes (DLX5, MAGEA4, PMEPA1, RCN1, and TIMP1). By validating the correlation between the prognostic model and antigen-presenting cells (APCs), we revealed the antigen-presentation efficacy of the model. Through the analysis of immune infiltration in ESCC, we uncovered the mechanisms of immune evasion associated with the disease. In addition, we examined the potential impact of the five prognostic genes on ESCC progression. Based on these insights, we identified anti-tumor small-molecule compounds targeting these prognostic genes. This study primarily simulates the tumor microenvironment (TME) and antigen presentation processes in ESCC patients, predicting the role of the neoantigen-based prognostic model in ESCC patients and their potential responses to immunotherapy. These results suggest a potential approach for identifying therapeutic targets in ESCC, which may contribute to the development of more effective treatment strategies.	esophagus