crossing96/oncoscreening huggingface dataset:
Predicting Postoperative Recurrence Using a Support Vector Machine for Patients With Esophageal Squamous Cell Carcinoma: Machine Learning Modeling Development and Validation Study.	BACKGROUND: While numerous models have been developed to predict overall survival in postoperative patients with esophageal squamous cell carcinoma (ESCC), few have specifically focused on predicting postoperative recurrence. OBJECTIVE: This study aimed to develop and validate a support vector machine (SVM)-based predictive model for evaluating recurrence risk and identifying associated factors in ESCC patients following surgery. METHODS: We retrospectively analyzed clinical data from 311 ESCC patients who underwent surgery at Jinling Hospital between June 2014 and November 2016, with follow-up until October 2021 (median of 36 follow-up months, range 0-93.5 months). After excluding cases with incomplete data (n=1), 310 eligible patients were randomly allocated into test (n=106), validation 1 (n=103), and validation 2 (n=101) cohorts. Using SVM algorithms, patients were stratified into high- or low-recurrence-risk groups. Model performance was assessed using sensitivity, specificity, the Youden index, positive predictive value, and negative predictive value. Calibration curves were generated to evaluate model accuracy and reliability. Statistical analyses were performed using SPSS (version 22.0; IBM Corp) and R (version 3.6.1; R Foundation for Statistical Computing). RESULTS: In all cohorts, SVM7 (incorporating tumor node metastasis [TNM] stage, adjuvant therapy, differentiation, tumor size, and complications) demonstrated significantly higher sensitivity in predicting recurrence than SVM6 (based on the Eastern Cooperative Oncology Group performance status, neutrophil-to-lymphocyte ratio, and CY211) (P<.001). The composite model SVM6+8 (combining SVM6 and SVM8 [SVM7 excluding complications]) achieved recurrence prediction sensitivities of 94%, 79.59%, and 72.73% in the test, validation 1, and validation 2 groups, respectively; with specificities of 98.11%, 69.84%, and 78.43%. These results were comparable to SVM6+TNM (SVM6 combined with TNM staging) but outperformed SVM6 alone (P<.001). Survival analysis revealed significantly longer disease-free survival in the SVM6+TNM-predicted low-risk group compared to the high-risk group, with a marked difference in recurrence rates (P<.001). CONCLUSIONS: The proposed SVM-based model enables accurate prediction of postoperative recurrence in ESCC patients with high sensitivity, specificity, and discriminative power, offering a valuable tool for clinical risk stratification.	esophagus
Clinical Outcomes and Prognostic Factors in Patients Undergoing Salvage Endoscopic Therapy for cT1N0M0 Local Failure After Chemoradiotherapy for Esophageal Cancer: A Multicenter Retrospective Study.	OBJECTIVES: Salvage endoscopic therapy is increasingly recommended for localized, superficial failure at the primary site after chemoradiotherapy for esophageal squamous cell carcinoma. This multicenter retrospective study aimed to evaluate the clinical outcomes and prognostic factors associated with overall survival in patients who underwent salvage endoscopic therapy for cT1N0M0 local failure after chemoradiotherapy or radiotherapy for esophageal squamous cell carcinoma. METHODS: We retrospectively analyzed patients with cT1N0M0 local failure after chemoradiotherapy or radiotherapy who underwent endoscopic resection or photodynamic therapy using talaporfin sodium at two Japanese institutions between 2012 and 2021. Clinical outcomes and prognostic factors for overall survival were assessed using multivariate analysis. RESULTS: Complete resection was achieved in 63 of 84 patients (75%) who underwent endoscopic resection, and a local complete response was achieved in 50 of 81 patients (62%) who underwent photodynamic therapy. During a median follow-up of 34 months (range, 2-109 months), 3-year overall survival, disease-specific survival, local recurrence-free survival, and esophagectomy-free survival rates were 79%, 88%, 54%, and 79%, respectively. A high Charlson Comorbidity Index (≥ 3; hazard ratio: 3.3) was significantly associated with poor overall survival (3-year overall survival rate: 64%), although the 3-year disease-specific survival in this group remained high at 94%. CONCLUSIONS: We clarified the clinical outcomes and prognosis of salvage endoscopic therapy for cT1 local failure. The Charlson Comorbidity Index may serve as a useful prognostic factor to aid in clinical decision-making.	esophagus
Prevalence and distribution of human papillomavirus type 16 in esophageal squamous cell carcinoma and its association with p16(INK4A) expression: A large-scale study in Japan.	The infection rate of human papillomavirus (HPV) in esophageal squamous cell carcinoma (ESCC) varies widely (0 %-88.9 %), and the diagnostic utility of p16(INK4A) as a surrogate marker remains controversial. Moreover, the distribution of HPV infection in ESCC has not been previously investigated. Patients with ESCC who underwent esophagectomy without neoadjuvant therapy between 2007 and 2022 were included in this study. Three formalin-fixed, paraffin-embedded blocks (oral side, tumor, and esophagogastric junction (EGJ)) were collected. p16(INK4A) expression was assessed by immunohistochemistry (positivity defined as a labeling index of ≥10 %), whereas HPV type 16 DNA was detected by polymerase chain reaction. The distribution of HPV distribution was also assessed. In total, 158 patients were analyzed. p16(INK4A) was detected in 19.0 % (30/158) and HPV DNA in 3.8 % (6/158) of tumor samples. The sensitivity and positive predictive value of p16(INK4A) immunohistochemistry for detecting HPV DNA were 100 % and 20.0 %, respectively. HPV DNA was also detected in 3.6 % (5/137) of the oral side and 2.7 % (4/146) of EGJ samples. Infectious mapping revealed a random distribution pattern across the three anatomical regions. This large-scale study demonstrated a low prevalence of HPV infection in ESCC and indicated that p16(INK4A) immunohistochemistry may aid in reducing the risk of missing patients with HPV-positive tumors. Notably, the random-like distribution of HPV DNA across the three anatomical sites suggests partial viral clearance by the host immune response. These findings underscore the potential for false-negative results in biopsy specimens obtained from non-infected regions in otherwise HPV-positive patients.	esophagus
Rare bleeding source in esophageal carcinoma - a case of upper gastrointestinal hemorrhage from intercostal artery pseudoaneurysm: A case report and literature review.	RATIONALE: Transcatheter arterial embolization (TAE) serves as a critical intervention for upper gastrointestinal bleeding (UGIB) when endoscopic therapy fails or the bleeding source cannot be localized. The intercostal artery is an exceedingly rare source vessel for UGIB. This report describes a case of UGIB caused by a pseudoaneurysm of the left intercostal artery in a patient with esophageal carcinoma, along with a review of the relevant literature. PATIENT CONCERNS: The patient presented to our hospital due to UGIH. DIAGNOSES: UGIH. INTERVENTIONS: After admission, failure of medical therapy prompted emergency endoscopy, which revealed an active pulsatile bleeding. Following unsuccessful endoscopic hemostasis, emergency TAE was performed, achieving successful embolization of a pseudoaneurysm in the left intercostal artery. OUTCOMES: Postoperatively, the patient's hemoglobin levels remained stable, and no further bleeding was observed. LESSONS: Multidisciplinary collaborative management is essential for UGIB. TAE should be considered when conventional therapies fail. During TAE, if routine angiography of suspected culprit vessels yields negative results, a high index of suspicion for rare ectopic feeding arteries (e.g., intercostal arteries) is required. This case report aims to enhance the diagnostic and embolization proficiency of interventional radiologists in managing UGIB caused by such uncommon aberrant vessels.	esophagus
Triptonide suppresses the FOXK1/AKT2 axis to reverse malignant phenotype and improve cisplatin efficacy in esophageal squamous cell carcinoma.	BACKGROUND: Cisplatin resistance significantly limits the effectiveness of chemotherapy in esophageal squamous cell carcinoma (ESCC). Understanding the molecular mechanisms driving resistance is essential for improving treatment outcomes. OBJECTIVE: This study aimed to investigate the role of the FOXK1/AKT2 axis in cisplatin resistance in ESCC cells and to evaluate the potential of triptonide in reversing this resistance. METHODS: Cisplatin sensitivity was assessed in ESCC cell lines with altered FOXK1 expression. A cisplatin-resistant TE1 cell line (TE1-R) was established by prolonged low-dose cisplatin exposure. Luciferase reporter assays were conducted to determine whether FOXK1 activates AKT2 transcription. Cell viability, colony formation, apoptosis assays, and expression analysis of apoptosis-related genes were performed to examine the effects of FOXK1, AKT2, and triptonide. RESULTS: FOXK1 overexpression reduced cisplatin sensitivity in ESCC cells, while FOXK1 knockdown restored sensitivity in TE1-R cells. FOXK1 directly enhanced AKT2 transcription by binding to its promoter region. The FOXK1/AKT2 axis promoted cell proliferation and suppressed cisplatin-induced apoptosis. Triptonide treatment downregulated FOXK1 and AKT2 expression, inhibited proliferation, induced apoptosis, and sensitized ESCC cells to cisplatin in a synergistic manner. CONCLUSIONS: The FOXK1/AKT2 signaling axis contributes to cisplatin resistance in ESCC. Triptonide reverses resistance by inhibiting this axis, offering a promising strategy to enhance cisplatin efficacy in ESCC therapy.	esophagus
Efficacy and safety analysis of immune checkpoint inhibitor rechallenge in advanced esophageal squamous cell carcinoma: A retrospective study.	New treatment strategies are needed for patients who relapse during or following first-line immune checkpoint inhibitor-based treatment for esophageal squamous cell carcinoma (ESCC). Second-line immune checkpoint inhibitors (ICI) rechallenge aims to reactivate the immune system's response to tumor cells and may improve the prognosis of patients who progressed during or after completing previous treatment. The purpose of this study is to explore the effectiveness and safety of second-line ICI rechallenge therapy in the treatment of advanced ESCC. We retrospectively reviewed the records of patients with advanced ESCC at the Department of Oncology of Jiangsu Cancer Hospital (January 2021 to June 2023) who had at least one measurable lesion at progression after first-line immunotherapy, received at least two cycles of second-line treatment, and who had subsequently undergone radiographic response assessment. The primary outcomes of interest were the progression-free survival (PFS)and overall survival (OS). Treatment-related adverse events were also recorded. In the ICI rechallenge and non-ICI rechallenge groups, the objective response rate (ORR) was 15.4% and 11.8%, the disease control rate (DCR) was 67.6% and 44.1% (P = .011). Compared with the non-ICI rechallenge group, median PFS2 in the ICI rechallenge group was significantly prolonged (5.63 vs. 3.03 months, hazard ratio [HR] = 0.45, 95% confidence interval [CI]: 0.28, 0.73; P = .001), while there was no statistically significant difference in median OS (12.33 vs. 7.10 months, HR: 0.80, 95% CI: 0.51, 1.27; P = .344). ICI rechallenge therapy and radiotherapy administered during second-line treatment were recognized as independent predictive factors influencing PFS2. These findings suggest that second-line ICI rechallenge is tolerable and could benefit a subset of patients with advanced ESCC.	esophagus
Serum creatinine to cystatin C ratio is a prognostic indicator in esophageal squamous cell carcinoma receiving neoadjuvant immunochemotherapy.	BACKGROUND: This study aimed to explore the relationship between pretreatment serum creatinine to cystatin C ratio (CCR) and prognosis in patients with esophageal squamous cell carcinoma (ESCC) receiving neoadjuvant immunochemotherapy (NICT). METHODS: Two hundred and two ESCC patients who received NICT were included in the current retrospective study. The restricted cubic spline displayed the non-linear relationship between prognosis and CCR. The association between overall survival (OS)/disease-free survival (DFS) and CCR was also investigated. Kaplan-Meier methods and Cox proportional hazard regression analyses were employed. RESULTS: The connection between DFS/OS and CCR suggested that their interaction was non-linear. The restricted cubic spline (RCS) model identified 97.5 as the ideal cutoff point for CCR and divided it into 2 groups. Patients exhibiting low CCR demonstrated significantly worse 3-year DFS (48.5% vs. 74.3%, P<0.001) and OS (62.9% vs. 82.9%, P=0.001) compared to those with high CCR. The results indicated that CCR had prognostic significance for the ESCC cases stratified according to subgroup analyses. Compared to the low CCR group, subsequent multivariate analysis revealed that the high CCR group reduced the risk of recurrence by 56.0% (P=0.001) and the risk of death by 51.8% (P=0.013), respectively. CONCLUSION: The therapeutic efficacy of NICT for ESCC can be predicted by pretreatment CCR. Although the CCR may not have attained a very high quality, it still holds certain significance for clinical practice in ESCC patients undergoing NICT.	esophagus
Discovery and validation of proliferative exhausted T cells as a favorable prognostic biomarker in esophageal squamous cell carcinoma.	Esophageal squamous cell carcinoma (ESCC) is an aggressive malignancy with limited therapies and poor prognosis. While exhausted T cell (Tex) heterogeneity under chronic antigen stimulation is recognized, the role of Tex subsets in shaping the tumor microenvironment (TME) and influencing ESCC outcomes remains unclear. We integrated single-cell RNA sequencing, TCR sequencing, microarray, and bulk RNA sequencing to dissect Tex cells. We identified a novel proliferative Tex (prolif Tex) subset across discovery and validation cohorts, with high infiltration correlating significantly with an improved patient survival. Pseudotime trajectories suggested prolif Tex originated from Tex cells, while TCR sequencing revealed clonal expansion and shared receptor repertoires between Tex and prolif Tex. Neoadjuvant chemo-immunotherapy reduced prolif Tex proportions and differentiation potential in ESCC samples. A machine learning-derived prognostic model was developed using prolif Tex subset-specific genes and validated via qRT-PCR using in-house ESCC samples. Experimental validation confirmed differential expression of candidate genes in tumors versus normal tissues, with high ESCO2 expression linked to prolonged survival. Our findings unveil prolif Tex cells as a novel TME subset in ESCC, where its abundance predicts favorable outcomes. The prolif Tex-based prognostic model demonstrates strong prognostic value and validated hub genes offer potential biomarkers and therapeutic targets. Our findings underscore the potential of prolif Tex cells as a biomarker and therapeutic target in ESCC.	esophagus
Real-world outcomes after concurrent chemo-radiotherapy in patients with locally advanced esophageal and gastroesophageal junction cancer.	BACKGROUND AND PURPOSE: Standard treatment for esophageal (EC) and gastroesophageal junction (GEJ) cancer includes neoadjuvant chemo-radiotherapy (nCRT), followed by surgery or definitive chemo-radiotherapy (dCRT) for inoperable patients. This study assessed real-world survival and morbidity in EC patients treated with radiotherapy (RT). Patient/material and methods: In this retrospective study, 417 patients with EC or GEJ cancer received nCRT or dCRT between 2012 and 2021 at a single center. We evaluated overall survival (OS), loco-regional control, progression-free survival, failure patterns, and toxicity. Data were sourced from clinical and treatment records. Patients were treated following national guidelines and received intensity-modulated radiotherapy and daily cone-beam Computed Tomography (CT) for setup. Radiotherapy doses were 41.4-66 Gy in 23-33 fractions. RESULTS: Of the patients, 250 received nCRT, and 167 received dCRT. Most (86%) had T3-T4 tumors, and 65% had node-positive disease. Histologies were adenocarcinoma (50%) and squamous cell carcinoma (45%). A total of 88% completed RT, and 92.4% of nCRT patients proceeded to surgery. Median OS was 31 months for nCRT and 24 months for dCRT; 3-year OS was 46% and 38%, respectively. Disease recurrence occurred in 46% with a median interval of 20 months. Multivariable analysis identified OS-associated factors for both nCRT and dCRT. Acute toxicity was common but generally mild; late side effects were not systematically recorded. INTERPRETATION: In clinical practice, OS after nCRT or dCRT was as expected. Most patients undergoing nCRT proceeded to surgery. Toxicity was frequent but manageable.	esophagus
Multimodal CT and MRI Radiomics Integrated with Clinical Models Predict Pathological Complete Response in ESCC Following Neoadjuvant Immunochemotherapy.	BACKGROUND: This research focused on evaluating the utility of multimodal radiomics integrated with machine learning to predict pathological complete response (pCR) in a prospective cohort of esophageal squamous cell carcinoma (ESCC) patients undergoing neoadjuvant immunochemotherapy (nICT). METHODS: We retrospectively analyzed prospectively collected trial data from 66 ESCC patients. Radiomic features were extracted from computed tomography (CT) and magnetic resonance imaging (MRI) images. Four machine learning algorithms-Random Forest (RF), logistic regression, Support Vector Machine, and Extreme Gradient Boosting (XGBoost)-were applied with leave-one-out cross-validation to predict pCR after nICT. The predictive performance of the models was evaluated using receiver operating characteristic curve analysis. RESULTS: In total, 851 features were identified. Among the four machine learning algorithms, the XGBoost machine learning method demonstrated the best model performance across CT, MRI, and clinical feature-based models. Furthermore, the integrated model demonstrated superior performance compared to individual models based solely on CT, MRI, or clinical features across all machine learning algorithms. Among these, the XGboost-based integrated model achieved the highest performance on the test set, with an AUC of 0.961, a TPR of 84.2%, a TNR of 95.7%, a PPV 88.9% of and a NPV of 93.8%. Decision curve analysis validated the model's robust clinical utility, with calibration curves demonstrating strong concordance between predicted and observed therapeutic responses. CONCLUSIONS: The study demonstrates the potential for predicting pCR in patients with ESCC treated with standardized neoadjuvant chemotherapy and PD-1 inhibitors using machine learning methods that integrate multimodal CT and MRI images with clinical features.	esophagus
Cancer Incidence in Japanese Patients With Long-Segment Barrett's Esophagus-Japan Nationwide 10-Year Prospective Cohort Study.	OBJECTIVES: The incidence of esophageal adenocarcinoma (EAC) arising in patients with long-segment Barrett's esophagus (LSBE) in Japan remains to be elucidated. This study aims to investigate the incidence of EAC in Japanese LSBE cases. METHODS: This is a multicenter prospective cohort study involving 32 hospitals throughout Japan. Consecutive patients with Barrett's esophagus with a maximal length of ≥ 3 cm were prospectively enrolled. The study was initiated in June 2011, and the eligible cases were scheduled to undergo subsequent annual endoscopies for 10 years, concluding in December 2021. The cancer incidence was calculated with 95% confidence intervals and expressed as %/year of follow-up. RESULTS: The initial registry comprised 343 participants. After excluding 16 cases with prevalent EAC and 60 cases with < 1 year of follow-up, a total of 267 cases with LSBE were followed up for 1-10 years (58.0 ± 35.5 months), making the total patient-years 1290.4. During the observation period, 13 new EACs were identified, leading to an estimated EAC incidence of 1.01 (0.57-1.73)%/year. All the incident EAC cases were diagnosed as early cancers. Individuals who developed EAC demonstrated a higher prevalence of ever smoking (76.9% vs. 33.5%, p = 0.002) compared to those who did not. CONCLUSIONS: This prospective, 10-year follow-up study revealed a substantial EAC incidence in Japanese LSBE cases, 1.01 (0.57-1.73)%/year, similar to values reported in Western countries. This result is a significant indicator for developing effective endoscopy surveillance for Japanese LSBE. UMIN000016043.	esophagus
Oropharyngeal microbiome dysbiosis in esophageal squamous cell carcinoma: taxonomic shifts, metabolic reprogramming, and geographic disparities in a high-incidence cohort.	BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is a leading cause of cancer mortality globally, with pronounced geographic disparities in incidence. Emerging evidence links oral microbiome dysbiosis to ESCC pathogenesis, yet comprehensive insights into microbial diversity, taxonomic shifts, and functional alterations in high-risk populations remain limited. METHODS: Using 16S rRNA amplicon sequencing, we compared the oral microbiome of ESCC patients and healthy controls from a high-incidence region in Northwest China. Alpha and beta diversity metrics, taxonomic composition, and predicted functional pathways were analyzed to identify microbial signatures associated with ESCC. RESULTS: ESCC patients exhibited significantly elevated microbial richness (observed amplicon sequence variants (ASVs), Chao1, ACE; p < 0.05) but comparable Shannon/Simpson diversity to controls. Unique amplicon sequence variants (ASVs) were more prevalent in ESCC samples, and principal component analysis confirmed distinct community structures (p < 0.05). Taxonomically, Streptococcus and Neisseria dominated both groups, but ESCC patients showed enrichment of Gemella (p = 0.0003) and Corynebacterium (p < 0.00001), alongside depletion of Prevotella_7 (p = 0.0002) and Moraxella (p < 0.001). Functional profiling revealed upregulated amino acid metabolism (e.g., beta-alanine and valine degradation) and downregulated carbohydrate metabolism in ESCC-associated microbiota. CONCLUSION: This study uncovers unique oral microbial signatures in ESCC patients from a high-incidence region, characterized by increased richness, taxon-specific shifts, and metabolic reprogramming favoring amino acid catabolism. These findings highlight the potential of microbial biomarkers for ESCC detection and provide mechanistic insights into microbiome-driven carcinogenesis. The geographic specificity of the cohort underscores the urgency of tailored interventions in high-risk populations and advances our understanding of microbial contributions to esophageal cancer.	esophagus