crossing96/oncoscreening huggingface dataset:
Comparison of standardized uptake value-based positron emission tomography and computed tomography target volumes in esophageal cancer patients undergoing radiotherapy.	PURPOSE: To study various standardized uptake value (SUV)-based approaches to ascertain the best strategy for delineating metabolic tumor volumes (MTV). METHODS AND MATERIALS: Twenty-two consecutive previously treated esophageal cancer patients with positron emission tomography (PET) imaging and computed tomography (CT)-based radiotherapy plans were studied. At the level of the tumor epicenter, MTVs were delineated at 11 different thresholds: SUV ≥2, ≥2.5, ≥3, ≥3.5 (SUV(n)); ≥40%, ≥45%, and ≥50% of the maximum (SUV(n%)); and mean liver SUV + 1, 2, 3, and 4 standard deviations (SUV(Lnσ)). The volume ratio and conformality index were determined between MTVs, and the corresponding CT/endoscopic ultrasound-based gross tumor volume (GTV) at the epicenter. Means were analyzed by one-way analysis of variance for repeated measures and further compared using a paired t test for repeated measures. RESULTS: The mean conformality indices ranged from 0.33 to 0.48, being significantly (p < 0.05) closest to 1 at SUV(2.5) (0.47 ± 0.03) and SUV(L4σ) (0.48 ± 0.03). The mean volume ratios ranged from 0.39 to 2.82, being significantly closest to 1 at SUV(2.5) (1.18 ± 0.36) and SUV(L4σ) (1.09 ± 0.15). The mean value of the SUVs calculated using the SUV(L4σ) approach was 2.4. CONCLUSIONS: Regardless of the SUV thresholding method used (i.e., absolute or relative to liver mean), a threshold of approximately 2.5 yields the highest conformality index and best approximates the CT-based GTV at the epicenter. These findings may ultimately aid radiation oncologists in the delineation of the entire GTV in esophageal cancer patients.	esophagus
Mass spectrometric detection of candidate protein biomarkers of cancer cachexia in human urine.	Increased membrane permeability and myofibrillar protein breakdown are established features of cancer cachexia. Proteins released from cachectic muscle may be excreted in urine to act as biomarkers of the cachectic process. One-dimensional SDS polyacrylamide gel electrophoresis followed by matrix-assisted laser desorption/ionisation or liquid chromatography tandem mass spectrometry was used to compare the protein content of urine from cachectic (>10% weight loss) (n=8) and weight-stable (n=8) gastro-oesophageal cancer patients and healthy controls (n=8). Plasma creatine kinase concentration was used as a marker of gross muscle breakdown. The number of protein species identified in cachectic samples (median 42; range 28-61; total 199) was greater than that identified in weight-stable cancer (median 15; range 9-28; total 79) and control samples (median 12.5; range 5-18; total 49) (P<0.001). Many of the proteins identified have not been reported previously in the urine of cancer patients. Proteins identified specifically in cachectic samples included muscle (myosin species), cytoskeletal (alpha-spectrin; nischarin) and microtubule-associated proteins (microtubule-actin crosslinking factor; microtubule-associated protein-1B; bullous pemphigoid antigen 1), whereas immunoglobulin kappa-light chain and zinc alpha-2 glycoprotein appeared to represent markers of cancer. The presence of myosin in urine (without an increase in plasma creatine kinase) is consistent with a specific loss of myosin as part of the cachectic process. Urinary proteomics using mass spectrometry can identify muscle-specific and non-muscle-specific candidate biomarkers of cancer cachexia.	esophagus
CYP2E1 Rsa I/Pst I polymorphism and esophageal cancer risk: a meta-analysis based on 1,088 cases and 2,238 controls.	The common functional CYP2E1 Rsa I/Pst I polymorphism may influence the risk of esophageal cancer. However, the published results are conflicting. We therefore conducted a meta-analysis comprised of 11 published case-control studies with 1,088 cases and 2,238 controls. Odds ratios (ORs) with 95% confidence interval (CIs) were used to assess the strength of the association. Overall, the pooled ORs were 0.53 (95% CI = 0.31-0.89, P (heterogeneity) < 0.001) and 0.57 (95% CI = 0.34-0.96, P (heterogeneity) < 0.001), for the heterogeneity c1/c2 and c2 allele carriers (c1/c2 + c2/c2) compared with the homozygous c1/c2, respectively. In subgroup analysis by race, the same significant risks were found among Asians (for c2 vs. c1: OR = 0.64, 95% CI = 0.43-0.95, P (heterogeneity) < 0.001; for c1/c2 vs. c1/c1: OR = 0.48, 95% CI = 0.28-0.82, P (heterogeneity) < 0.001; for c1/c2 + c2/c2 vs. c1/c1: OR = 0.51, 95% CI = 0.30-0.86, P (heterogeneity) < 0.001). In conclusion, our meta-analysis demonstrates that CYP2E1 Rsa I/Pst I c2 allele may be a decreased risk factor for developing esophageal cancer among Asians populations.	esophagus
[A 1:2 matched case-control study on the interaction of HPV16E6 and HLA-DR9 allele to esophageal cancer in Kazakh ethnicity, Xinjiang].	OBJECTIVE: To evaluate the role and the association between HPV16E6 infection and HLA-DR9 immune-associated gene to esophageal cancer (EC) in Kazakh of Xinjiang, China. METHODS: A 1:2 matched case-control study was conducted with 63 cases of EC and 126 controls involved. The controls were matched by sex, nationality, area of residence and age within 5-year difference. HPV16E6 and HLA-DR9 allele were identified by PCR-SSP. Interaction was performed to identify risk factors. RESULTS: HPV16E6 infection and HLA-DR9 allele positive status were the risk factors for EC, with OR values as 2.67 (95%CI: 1.38 - 5.17) and 3.83 (95%CI: 1.48 - 9.96) respectively. The rate of HPV16E6 infection in individuals with HLA-DR9 allele was different from the ones who were HLA-DR9 allele free (chi(2) = 7.57, P = 0.006), with OR value as 5.79 (95%CI: 1.53 - 21.87). In the controls, the rates of HPV16E6 infection were 22.2% and 16.2% among individuals with HLA-DR9 allele atatus as positive or negative, and without statistically significant difference. Interaction analysis showed there was an interaction of HPV16E6 with HLA-DR9 and were higher than the sum of the two factors presented individually. CONCLUSION: In our study, we found that the HLA-DR9 allele and HPV16E6 infection had a function of synergy in the process of malignant transformation of esophageal epithelial cells, and jointly promoting the occurrence and development of EC.	esophagus
Expression and significance of tumor drug resistance related proteins and beta-catenin in esophageal squamous cell carcinoma.	BACKGROUND AND OBJECTIVE: As chemotherapy is generally used in the clinical treatment of cancer, the problem of multidrug resistance (MDR) of tumors against the chemotherapeutic agents becomes more and more serious. It has been the major cause for the failure of the chemotherapy. We detected the expressions of beta-catenin and tumor drug resistance related proteins, MRP2, P-gp, and Bcl-2, in esophageal squamous cell carcinoma (ESCC) to explore their function and correlation in the occurrence and development of MDR in ESCC. METHODS: We used the tissue microarray technique, immunohistochemistry, and image analysis methods to detect the expressions of MRP2, P-gp, beta-catenin, and Bcl-2 proteins and analyze their relationships with clinical data in a ESCC tissue microarray consisting of 582 specimens of ESCC, 294 specimens of normal mucosa, 92 specimens of basal cell hyperplasia, and 87 specimens of dysplasia adjacent to cancer tissue. RESULTS: The integral optical density (IOD) of MRP2 and Bcl-2, which was 195.7 +/- 175.9 x 10(3)) and 90.5 +/- 112.5 x 10(3)), respectively, was significantly higher in ESCC than in normal mucosa, which was 104.8 +/- 86.1 x103) and 25.2 +/- 46.6 x 10(3)), respectively (P < 0.01). The IOD of P-gp and beta-catenin, which was 57.7 +/- 75.5 x 10(3)) and 32.0 +/- 47.0 x 10(3)) respectively, was significantly lower in ESCC than in normal mucosa, which was 114.8 +/- 106.6 x 10(3)) and 46.1 +/- 35.7 x 10(3)), respectively (P < 0.01). According to the following order, well differentiated moderately differentiated poorly differentiated, the IOD of MRP2 increased in ESCC (P < 0.01). The IOD of beta-catenin was higher in poorly differentiated ESCC than in well or moderately differentiated ESCC (P < 0.01). The IOD of Bcl-2 was lower in well differentiated ESCC than in poorly and moderately differentiated ESCC (P < 0.01). The IOD of beta-catenin and Bcl-2 was higher in the ESCC of specimens with infiltration depths that were in membrane mucosa than those in the muscular layer or serous coat (P < 0.01). The IOD of Bcl-2 was significantly higher in cases with lymph node metastasis than in cases without (P < 0.01). Positive correlations which were respectively between the expressions of P-gp and MRP2, the expressions of P-gp and Bcl-2 were found (r = 0.288 and r = 0.253, respectively, P < 0.01). CONCLUSIONS: MRP2, P-gp, and Bcl-2 may be taken as prognostic factors for MDR of ESCC. beta-catenin may play an important role in carcinogenesis and progression of ESCC.	esophagus
Sex differences in the incidence of gastrointestinal adenocarcinoma in Sweden 1970-2006.	BACKGROUND: Oesophageal and gastric adenocarcinoma share a male predominance not seen for other adenocarcinomas of the gastrointestinal tract. These sex differences are not explained by known risk factors. An endogenous factor, such as premenopausal oestrogen exposure, may act protectively in favour of women and might be detected by scrutinising sex ratios and incidence rates stratified by age. METHODS: The Swedish Cancer Register was used to collect primary oesophageal, gastric cardia, non-cardia gastric, colonic and pancreatic adenocarcinoma cases aged 25-84, during the study period of 1970-2006. Cases were divided into five-year age groups and crude incidence rates and male: female ratios were calculated. Evaluating potential time period effect, the corresponding results from 1970-1986 and 1987-2006 were also derived. RESULTS: The sex ratio for oesophageal adenocarcinoma ranged from approximately 10:1 to 4:1, presenting a seemingly consistent decline with age. The sex ratio for non-cardia gastric adenocarcinoma, however, increased with age to reach 2:1 at a point one to two decades after menopause, where the ratio levelled off and eventually declined. There was no discernible time period effect concerning any type of adenocarcinoma. The ratios for gastric cardia, colonic and pancreatic adenocarcinoma were stable with age. CONCLUSION: This study indicates separate patterns of age-dependency of the sex difference in oesophageal and non-cardia gastric adenocarcinoma incidence. The non-cardia gastric adenocarcinoma pattern might be due to a protective effect during premenopausal years for the female population, while the seemingly steady decline in sex ratio in oesophageal adenocarcinoma indicates a mechanism independent of menopause.	esophagus
Five common cancers in Iran.	Iran as a developing nation is in epidemiological transition from communicable to non-communicable diseases. Although, cancer is the third cause of death in Iran, it;s mortality are on the rise during recent decades. This mini-review was carried out to provide a general viewpoint on common cancers incidence in Iran and to explain incidental differences that may help us to establish early detection programs and investigate population risk factors. A detailed PubMed, Scopus and Google scholar search were made from 2000 to 2009. The basic inclusion criteria were all relevant studies focused on cancer epidemiological data from Iran. Overall age-standard incidence rate per 100 000 population according to primary site is 110.43 in males and 98.23 in females. The five most common cancers (except skin cancer) are stomach, esophagus, colon-rectum, bladder and leukemia in males, and in females are breast, esophagus, stomach, colon-rectum and cervix uteri. The incidence rates of gastrointestinal cancers are high in Iran (it is one of the known areas with a high incidence of GI cancers). Breast cancer mainly affects Iranian women about a decade earlier than Western countries and younger cases are affected by an increasing rate of colorectal cancer in Iran, near the Western rates.	esophagus
Extended esophagectomy in elderly patients with esophageal cancer: minor effect of age alone in determining the postoperative course and survival.	BACKGROUND: Elderly patients who undergo esophagectomy for cancer often have a high prevalence of coexisting diseases, which may adversely affect their postoperative course. We determined the relationship of advanced age (i.e., > or =70 years) with outcome and evaluated age as a selection criterion for surgery. METHODS: Between January 1991 and January 2007, we performed a curative-intent extended transthoracic esophagectomy in 234 patients with cancer of the esophagus. Patients were divided into two age groups: <70 years (group I; 170 patients) and > or =70 years (group II; 64 patients). RESULTS: Both groups were comparable regarding comorbidity (American Society of Anesthesiologists classification), and tumor and surgical characteristics. The overall in-hospital mortality rate was 6.2% (group I, 5%, vs. group II, 11%, P = 0.09). Advanced age was not a prognostic factor for developing postoperative complications (odds ratio, 1.578; 95% confidence interval, 0.857-2.904; P = 0.143). The overall number of complications was equal with 58% in group I vs. 69% in group II (P = 0.142). Moreover, the occurrence of complications in elderly patients did not influence survival (P = 0.174). Recurrences developed more in patients <70 years (58% vs. 42%, P = 0.028). The overall 5-year survival was 35%, and, when included, postoperative mortality was 33% in both groups (P = 0.676).The presence of comorbidity was an independent prognostic factor for survival (P = 0.002). CONCLUSIONS: Advanced age (> or =70 years) has minor influence on postoperative course, recurrent disease, and survival in patients who underwent an extended esophagectomy. Age alone is not a prognostic indicator for survival. We propose that a radical resection should not be withheld in elderly patients with limited frailty and comorbidity.	esophagus
Endoscopic resection for Barrett's high-grade dysplasia and early esophageal adenocarcinoma: an essential staging procedure with long-term therapeutic benefit.	OBJECTIVES: Patients with Barrett's high-grade dysplasia (HGD) or early esophageal adenocarcinoma (EAC) that is shown on biopsy alone continue to undergo esophagectomy without more definitive histological staging. Endoscopic resection (ER) may provide more accurate histological grading and local tumor (T) staging, definitive therapy, and complete Barrett's excision (CBE); however, long-term outcome data are limited. Our objective was to demonstrate the effect on histological grade or local T stage, efficacy, safety and long-term outcome of ER for Barrett's HGD/EAC and of CBE in suitable patients. METHODS: This prospective study at two Australian academic hospitals involved 75 consecutive patients over 7 years undergoing ER for biopsy-proven HGD or EAC, using multiband mucosectomy or cap technique. In addition, CBE by 2-3-stage radical mucosectomy was attempted for all Barrett's segments<or=3 cm in length in patients aged<75 years with minimal comorbidities. RESULTS: Biopsy histology showed HGD in 89% of patients and EAC in 11%. However, ER histology resulted in altered grading or staging in 48% of patients (down 28%, up 20%), with HGD in 53%, low-grade dysplasia (LGD) in 19%, mucosal adenocarcinoma in 13%, submucosal adenocarcinoma in 9%, and no dysplasia in 4% of patients. The CBE success rate was 94%. Complications were one aspiration (hospitalization with full recovery) and six strictures successfully dilated endoscopically. During the mean follow-up of 31 months (range 3-89), there was no recurrence at ER sites, 11% developed metachronous lesions and five patients underwent esophagectomy for ER-demonstrated submucosal invasion. Esophagectomy specimens were T0N0M0 in three and T1N0M0 in two patients. There were no deaths due to adenocarcinoma. CONCLUSIONS: ER alters histological grade or local T stage in 48% of patients and dramatically reduces esophagectomy rates by providing safe and effective therapy. ER has a high success rate (94%) for CBE in short segment Barrett's esophagus.	esophagus
Clinical outcomes of using a conservative approach of late esophageal stent placement in palliation of malignant dysphagia.	BACKGROUND: Esophageal stents have been used as first-line treatment for palliation of malignant dysphagia, but this is associated with significant complications. The present study evaluated clinical outcomes and survival in patients with malignant dysphagia with esophageal stent placement who did not respond to prior chemoradiation or endoscopic modalities. PATIENTS AND METHODS: Patients with esophageal cancer, who had esophageal stents, were retrospectively reviewed from the electronic medical records. The patient demographics, type of stent placed, dysphagia scores, stent-related complications, and survival were recorded. RESULTS: Thirty-five patients with esophageal cancer received a total of 41 stents. There were 25 males and 10 females with mean age of 69.8 years. Twenty-two patients had esophageal adenocarcinoma, ten patients had squamous cell carcinoma, and three had poorly differentiated tumor. Esophageal malignancy was early stage (I, II) in 10 patients and advanced (III, IV) in 24 patients. Three patients had upper esophageal involvement, eight patients had mid-esophageal involvement; distal esophageal malignancy was present in 24 patients with 10 patients having gastroesophageal junction involvement. Six patients presented with tracheoesophageal fistula. Nine patients had prior esophagectomy. Thirty-three patients had chemoradiation, and 32 patients had other endoscopic therapies previously. Twelve of the 35 (33%) patients developed stent-related complications; nine patients had dysphagia due to various causes; one patient each developed aspiration, intractable hiccups, and intractable vomiting after stent placement, respectively. Nine patients underwent a repeat esophagogastroduodenoscopy. Development of stent-related complications was not significantly associated with poor survival. CONCLUSIONS: The clinical outcomes for patients with esophageal stent placement for malignant dysphagia after chemoradiation and other endoscopic treatments is not worse than that reported in patients where esophageal stent placement was used as first-line treatment.	esophagus
Modulation of growth in human esophageal adenocarcinoma cells by group IIa secretory phospholipase A(2).	OBJECTIVE: Esophageal adenocarcinoma is thought to arise from lesions produced by chronic esophageal inflammation. Secretory phospholipase A(2) is an important mediator of mucosal response to gastroesophageal reflux, but its role in the function of mature cancer cells is unclear. We sought to determine the influence of group IIa secretory phospholipase A(2) on proliferation of human esophageal adenocarcinoma cells. METHODS: FLO-1 and OE33 cells derived from human esophageal adenocarcinoma were cultured with standard techniques. Cells were treated with 1-, 5-, 10-, and 20-mumol/L doses of 5-(4-benzyloxyphenyl)-4S-(7-phenylheptanoylamino)pentanoic acid, a specific inhibitor of group IIa secretory phospholipase A(2), for 72 hours. Gene for group IIa secretory phospholipase A(2)(PLA2G2A) was overexpressed and silenced with lentiviral infection techniques. Cell proliferation and viability were measured with standard 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide and bromodeoxyuridine incorporation assays. All assays were performed in triplicate. PLA2G2A expression was measured with quantitative reverse transcriptase polymerase chain reaction; protein levels were detected with immunofluorescence microscopy. Statistical analysis was by analysis of variance with Fisher post hoc analysis. RESULTS: Secretory phospholipase A(2) protein was found in both malignant esophageal adenocarcinoma cell lines. Treatment with specific group IIa secretory phospholipase A(2) inhibitor resulted in dose-dependent reductions in growth and cell number in both cell lines. Overexpression of PLA2G2A resulted in enhanced cancer cell growth, whereas gene knockdown attenuated growth. CONCLUSIONS: Group IIa secretory phospholipase A(2) appears significant in growth and proliferation of human esophageal adenocarcinoma cells. Secretory phospholipase A(2) inhibition should be studied further regarding potential chemopreventive and therapeutic properties in esophageal adenocarcinoma.	esophagus
Fasting and cancer treatment in humans: A case series report.	Short-term fasting (48 hours) was shown to be effective in protecting normal cells and mice but not cancer cells against high dose chemotherapy, termed Differential Stress Resistance (DSR), but the feasibility and effect of fasting in cancer patients undergoing chemotherapy is unknown. Here we describe 10 cases in which patients diagnosed with a variety of malignancies had voluntarily fasted prior to (48-140 hours) and/or following (5-56 hours) chemotherapy. None of these patients, who received an average of 4 cycles of various chemotherapy drugs in combination with fasting, reported significant side effects caused by the fasting itself other than hunger and lightheadedness. Chemotherapy associated toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) of the National Cancer Institute (NCI). The six patients who underwent chemotherapy with or without fasting reported a reduction in fatigue, weakness, and gastrointestinal side effects while fasting. In those patients whose cancer progression could be assessed, fasting did not prevent the chemotherapy-induced reduction of tumor volume or tumor markers. Although the 10 cases presented here suggest that fasting in combination with chemotherapy is feasible, safe, and has the potential to ameliorate side effects caused by chemotherapies, they are not meant to establish practice guidelines for patients undergoing chemotherapy. Only controlled-randomized clinical trials will determine the effect of fasting on clinical outcomes including quality of life and therapeutic index.	esophagus
Significance of palisading longitudinal esophagus vessels: identification of the true esophagogastric junction has histopathological and oncological considerations.	BACKGROUND: Identification of the true esophagogastric junction (EGJ) is essential for diagnosis of Barrett's esophagus. AIMS: To determine whether the lower end of palisading longitudinal esophagus vessels (PLEV) is a novel and reliable marker for histological identification of the EGJ, and to investigate how short-segment Barrett's esophagus develops. METHODS: Using 87 formalin-fixed esophagogastrectomy specimens of squamous cell carcinoma of upper or middle esophagus, the entire lower esophagus area including the putative EGJ was histologically examined. The EGJ was first determined on each longitudinal section by the most distal end of the esophageal glands proper, squamous islands, or multilayered epithelium. The most distal end of PLEV was identified thereafter. If this end was distal to the above markers, it was judged as the novel point of the EGJ. A circular reference line was set to the middle level of the angle of His. Distances from this line to the squamocolumnar junction (SCJ) or EGJ were measured. RESULTS: The distances to the SCJ or EGJ on the lesser curvature side were significantly longer than those on the greater curvature side (P < 0.0001). The extent of Barrett's epithelium was significantly longer on the lesser curvature side than on the greater curvature side (P < 0.005). The SCJ line, the conventional EGJ line, and the EGJ line determined by conventional factors combined with the most distal end of PLEV were located proximal to distal, in that order (P < 0.0001). CONCLUSIONS: The lower end of PLEV is a feasible histological marker of the EGJ.	esophagus