crossing96/oncoscreening huggingface dataset:
ID1 promotes the progression of esophageal cancer via modulating PTEN/YAP/galectin-3 signaling pathway induced proliferation and immune suppression.	Esophageal cancer (EC) is a highly aggressive malignancy. ID1, a transcription factor overexpressed in multiple cancers, promotes tumor progression, but its molecular mechanisms in EC remain unclear. We hypothesized that ID1 drives EC progression by regulating the PTEN/YAP/Galectin-3 axis to induce proliferation and immune suppression. Bioinformatics analysis was employed to predict and validate the interactions between genes in esophageal cancer; protein expression levels, including ID1 and PTEN, were assessed using western blotting and immunofluorescence; tumor cell proliferation was evaluated with the CCK-8 assay; and macrophage phagocytosis function was tested through engulfment assays. Additionally, the effects of ID1 on esophageal cancer were investigated using subcutaneous tumor transplantation experiments in nude mice and immunohistochemical staining experiments of human cancerous tissues and peritumoral tissues. ID1 was found to inhibit the action of NFIC. When ID1 was overexpressed, there was a decrease in the expression levels of NFIC, PTEN, and p-YAP, and an increase in the levels of Galectin-3, Myc, CD47, and cyclin-A1. Overexpression of ID1 significantly enhanced the proliferation of esophageal cancer cells and improved the phagocytic ability of macrophages, whereas after treatment with PTEN agonists and YAP inhibitors, the proliferation of esophageal cancer cells decreased markedly, and the phagocytic ability of macrophages was reduced. Furthermore, overexpression of ID1 promoted the progression of esophageal cancer, and the expression of ID1 in human cancerous tissues was significantly higher than that in peritumoral tissues. ID1 promotes the progression of esophageal cancer by inducing proliferation and immune suppression through regulation of the PTEN/YAP/Galectin-3 signaling pathway.	esophagus
MRI based fractal analysis of esophageal squamous cell carcinoma to preoperatively predict lymphnode metastasis.	PURPOSE: To develop an MRI fractal-based quantitative model of resectable esophageal squamous cell carcinoma (ESCC) to predict regional lymphnode metastasis (LNM). METHODS: 132 consecutive ESCC patients undergoing preoperative MRI scans including T(1)-weighted imaging (T(1)WI), T(2)-weighted imaging (T(2)WI), T(1)-weighted contrast-enhancement (T(1)CE) and diffusion-weighted imaging (DWI) at b-values of 200, 500, 800, 1000 and 1200 s/mm(2) were prospectively enrolled from two centers, among which 110 from center 1 were randomly stratified into training (n = 88) and internal validation (n = 22) cohorts, and 22 from center 2 formed the external validation cohort (n = 22). Fractal parameters including fractal dimension (FD) and lacunarity (LAC), and gross tumor volume (GTV) were measured. A predictive model combining fractal and volumetric parameters was developed using logistic regression to predict LNM, with postoperative histopathological evaluation serving as the reference standard. Area under the receiver operating characteristic curve (AUC) was used to evaluate prediction performance in cohorts. RESULTS: In training cohort, lower FD on T(1)WI, T(2)WI and DWI (b = 200, 500, 800, 1000, 1200 s/mm(2)), and higher FD, lacunarity and GTV on T(1)CE were associated with regional LNM (Estimate: -8.35 to 16.98, all p-values < 0.05). A model by combining GTV, FD, and LAC on T(1)CE with a cutoff of 0.47 to predict LNM showed superior performance (AUC: 0.895) compared with individual predictors. The performance was validated in internal (AUC: 0.862) and external (AUC: 0.836) validation cohorts. CONCLUSION: This study developed an MRI based fractal-analysis model to well predict regional LNM secondary to resectable ESCC.	esophagus
Analysis of in-hospital mortality following transthoracic esophagectomy for cancer.	In-hospital mortality following esophagectomy for cancer has markedly decreased over the last few decades, with reported death rates below 5% considered a benchmark for quality of care. Although large registry studies have focused on reaching this benchmark, little is known about the underlying cause of death and the possibility of preventing a lethal outcome. The aim of this multicenter study was to perform an in-depth analysis of in-hospital mortality following esophagectomy for cancer. Data were obtained from four European esophageal cancer centers analyzing their prospective databases between January 2010 and June 2020. All patients with an in-hospital lethal postoperative course (Clavien-Dindo V) following elective transthoracic esophagectomy were included. Data collection comprised baseline characteristics, preoperative comorbidities, surgical procedures, postoperative complications, and their management. In each participating center, cases were retrospectively assessed for (1) the selection of patients for esophagectomy based on their individual comorbidities, (2) intraoperative, and (3) postoperative complications and their management to finally classify the management of each section as adequate, non-adequate, or undetermined. One hundred and twenty-one out of 3899 patients died following esophagectomy, amounting to an in-hospital mortality rate of 3.1%. Patients deceased on a median of 32 days after surgery (IQR: 18-60). Following surgery, a total of 294 major complications were identified in the 121 patients (mean 2.4 ± 1.2) with anastomotic leakage (AL) reported most often in 65 patients (53.7%). AL was considered as leading cause of death in 44 patients (36.4%) followed by acute respiratory distress syndrome (ARDS) in 15 patients (12.4%). Assessment of preoperative patient selection revealed a non-adequate workup in only two patients (1.4%). During surgery, six patients (4.6%) suffered complications, which were deemed adequately treated in retrospective assessment. In eight patients (6.6%), postoperative management was deemed non-adequate; in seven of eight cases, recognition and initiation of treatment for AL were considered delayed. Despite technical advances, AL remains the leading cause of death following esophagectomy, contributing to a significantly prolonged clinical course and lethal outcome. In contrast to other published series, assessment of this homogenous patient cohort in expert centers revealed only a low rate of preventable mortality with respect to the preoperative patient selection and postoperative complication management. However, modification of AL management might be considered to reduce the overall death rate.	esophagus
Whole grains temper immune-mediated inflammation in Chinese esophageal squamous-cell carcinoma survivors: a multicenter questionnaire study.	OBJECTIVES: To examine whether habitual whole-grain intake is associated with lower patient-reported systemic inflammatory distress among ambulatory survivors of esophageal squamous-cell carcinoma (ESCC). METHODS: We conducted a cross-sectional questionnaire study (May 2023-July 2025) at four tertiary hospitals in Shanxi Province among adults with stage I-IIIA ESCC (n = 392). A validated semi-quantitative food frequency questionnaire quantified five whole-grain categories. Exposures were modeled as grams/day(-)¹ (sex-specific quartiles; continuous per 10 g), an energy-adjusted density metric (g/1,000 kcal), and a diversity score (0-5 categories consumed ≥ once/week). Systemic inflammatory symptoms were measured with the seven-item Inflammation Distress Index (IDI). Multivariable logistic models estimated adjusted odds ratios (aORs) for elevated IDI (≥ 10); γ-log generalized linear models analyzed continuous IDI; restricted cubic splines assessed dose-response. Models adjusted for sociodemographic, clinical, and behavioral covariates, with total energy included when grams were exposed. RESULTS: Median whole-grain intake was 35.4 g/day(-)¹ (IQR 22.1-58.7); 28.1% had elevated IDI. Prevalence declined across quartiles (39.8%, 34.7%, 25.5%, 12.2%). Fully adjusted aORs (vs. Q1) were 0.95 (0.62-1.47), 0.49 (0.31-0.76), and 0.19 (0.11-0.33) for Q2-Q4 (p-trend < 0.001). Each 10 g/day(-)¹ increment corresponded to a 6% lower mean IDI (mean ratio 0.94; 0.92-0.96). Splines showed a steep inverse slope up to ~60 g/day(-)¹ with a plateau (p-nonlinearity = 0.031). Findings were consistent by stage (interaction p = 0.59) and smoking status (p = 0.67), robust in sensitivity analyses, and supported by density (Q4 vs. Q1 aOR 0.21; per +5 g/1,000 kcal(-)¹ aOR 0.93) and diversity (per +1 category aOR 0.86; ≥ 3 vs. 0-1 aOR 0.48) metrics. CONCLUSION: In Shanxi ESCC survivorship care, higher whole-grain intake-particularly ~50 g/day(-)¹ and with greater variety-aligns with substantially lower systemic inflammatory distress, supporting grain-centered dietary counseling.	esophagus
Surgical Treatment of Acute Symptomatic Postesophagectomy Diaphragmatic Hernia.	Background: Postesophagectomy diaphragmatic hernia (PEDH) is a rare yet potentially life-threatening complication following esophagectomy, particularly when acute symptoms such as ischemia or organ perforation arise. Prompt diagnosis and emergency surgical intervention are crucial. This study reports the experience of a tertiary care center in managing acute symptomatic PEDH. Methods: We performed a retrospective analysis of patients who underwent esophagectomy for cancer at our institution between 2013 and 2023. Early PEDH was defined as hernia onset within 30 days postoperatively. Patients presenting with respiratory symptoms, volvulus, ischemia, or perforation underwent emergency surgery. Primary outcomes included the method of diaphragmatic repair, use of mesh, and surgical success. Results: Out of 358 patients, 11 (3.1%) developed PEDH requiring emergency surgery. Five cases were early PEDH and 3 developed an anastomotic leak. Organ or omental resection was performed in 4 patients. Laparoscopic repair was successful in 8 cases, while 2 patients required laparotomy and thoracotomy. Cruroplasty was performed in 8 patients, in 2 a mesh was added and in 6 the falciform ligament was used to buttress the closure. Mortality was nil. Recurrence rate was 18%. No preoperative risk factors for PEDH were identified. Conclusions: Diaphragmatic hernia is a rare but serious complication after esophagectomy, often associated with high morbidity and mortality. Early recognition is critical and life-saving. In high-volume centers, laparoscopic repair is the preferred approach and the decision to perform cruroplasty with or without mesh reinforcement should be individualized based on patient characteristics.	esophagus
Comparison of Fibrillin-1 and Fibrillin-2 Gene Expression Level in Esophageal Squamous Cell Carcinoma Tumor Tissue and Tumor Margin Tissue.	BACKGROUND: Esophageal cancer is one of the most devastating cancers of the gastrointestinal tract. We will compare the expression levels of fibrillin-1 (FBN1) and fibrillin-2 (FBN2), a family of extracellular matrix glycoproteins, in esophageal cancer with normal adjacent tumor tissue. METHODS: In this cross-sectional study, 22 esophageal squamous cell carcinoma (ESCC) tumor samples and their matched adjacent normal tissues were collected from hospitals in Gorgan City (Golestan, Iran) between 2020 and 2022. After RNA extraction and cDNA synthesis, we measured the semi-quantitative gene expression level using real-time polymerase chain reaction (PCR). Data from this study were analyzed using SPSS software (version 18), and results were considered statistically significant when the P was <0.05. The primary statistical analyses used in this study were the Paired Samples t test and the Wilcoxon signed-rank test. RESULTS: The expression of the FBN1 gene decreased in tumor tissue compared to normal tissue (the FBN1 gene fold change=0.5472±0.149, P=0.007), and the FBN2 gene expression increased in tumor tissue compared to normal tissue (the FBN2 gene fold change=7.341±1.299, P<0.0001). We found no significant association between FBN1 and FBN2 gene expression and the clinicopathological features. CONCLUSION: The change in FBN1 and FBN2 expression levels in the tumor tissue compared to normal tissue in ESCC suggests that FBN1 and FBN2 genes can be considered therapeutic targets for ESCC.	esophagus
APE1 mediates chemoresistance in esophageal squamous cell carcinoma by remodeling the immunosuppressive microenvironment.	INTRODUCTION: Squamous cell carcinoma of the esophagus (ESCC) has poor prognosis after surgery and adjuvant chemotherapy. Biomarkers predicting treatment efficacy are urgently needed. This study investigated apurinic/apyrimidinic endonuclease 1 (APE1), a key DNA repair enzyme, as a prognostic biomarker in ESCC patients receiving postoperative chemotherapy. METHODS: To assess the relationship between APE1 expression and survival outcomes post-adjuvant chemotherapy. 115 ESCC patients receiving surgery and platinum-based chemotherapy were retrospectively enrolled. APE1 expression (low, medium, high) was determined by immunohistochemistry (IHC). Furthermore, external validation was performed using a tissue microarray cohort of 110 post-chemotherapy ESCC patients and the GES5325 dataset. Survival was analyzed using Kaplan-Meier and Cox regression. The tumor immune microenvironment was characterized by multiplex immunofluorescence (mIF). RESULTS: High APE1 expression correlated significantly with advanced T stage (p=0.005) and neural invasion (p=0.036). The high-expression group had significantly worse 5-year OS (27% vs. 91.4%) and DFS (14.3% vs. 55.3%) than the low-expression group (p<0.001), confirmed in public databases. Multivariate analysis identified APE1 expression (DFS: HR=4.600, 95% CI 1.285-16.466; OS: HR=16.001, 95% CI 4.826-53.061) and clinical stage as independent prognostic factors. Additionally, external validation was carried out using tissue microarrays and the GEO database to confirm the reliability. mIF analysis revealed significantly increased infiltration of FOXP3(+) regulatory T cells (Treg) and cancer-associated fibroblasts (CAFs) in the APE1-high group. DISCUSSION: High APE1 expression is an independent predictor of poor prognosis in ESCC patients receiving postoperative chemotherapy, associated with Treg and CAFs-mediated immunosuppression. APE1 serves as a prognostic biomarker linked to immunosuppression, enabling personalized adjuvant therapy.	esophagus
FSCN1 regulates TGF-β signalling to promote esophageal squamous cell carcinoma metastasis via stabilizing THBS1 mRNA.	Esophageal squamous cell carcinoma (ESCC), the predominant histological subtype of esophageal cancer worldwide, is a leading cause of cancer-related mortality. Although Fascin actin-bundling protein 1 (FSCN1), an actin family member, is well-characterized for its role in facilitating tumor cell migration and invasion through cytoskeletal remodeling, its function as an RNA-binding protein remains poorly understood. Here we show that FSCN1 directly interacts with THBS1 mRNA via its RNA-binding capacity, with the binding localized to the coding sequence region. Functionally, FSCN1 stabilizes THBS1 transcripts to enhance protein expression, thereby activating TGF-β signaling to drive ESCC metastasis in vivo and in vitro, utilizing esophageal cancer cell lines and subcutaneous xenograft and lung metastasis models established in 8-week-old male BALB/c nu/nu nude mice. Clinically, FSCN1 and THBS1 are significantly co-overexpressed in ESCC tissues, correlating with advanced disease stages. Notably, hyperacetylation of FSCN1 attenuates its RNA-binding activity, leading to THBS1 mRNA destabilization and consequent suppression of metastatic potential. Our findings reveal a novel RNA-binding function of FSCN1 in posttranscriptional regulation of THBS1, establishing the FSCN1/THBS1/TGF-β axis as a critical driver of ESCC progression. The acetylation-dependent modulation of this pathway highlights the potential therapeutic vulnerability of metastatic ESCC cells.	esophagus
Radiation regulates the expression of HLA-I in esophageal squamous cell carcinoma through interferon-γ.	Radiotherapy serves as a crucial therapeutic modality for esophageal squamous cell carcinoma (ESCC). Beyond its role in tumor growth control, radiotherapy also exerts immunomodulatory effects on tumors and their microenvironment. This study investigates the potential impact of radiation on human leukocyte antigen class I (HLA-I) and the underlying mechanisms of tumor immunity. Changes in peripheral blood β2-microglobulin (β2M) levels were assessed pre- and post-radiotherapy. ESCC cells were subjected to radiation, and the expression of HLA-I was evaluated using reverse transcription polymerase chain reaction (RT-PCR) and Western blotting. Differential gene expression analysis was conducted utilizing The Cancer Genome Atlas (TCGA) and transcriptome sequencing to explore the molecular mechanisms by which radiation may influence HLA-I expression. Interferon-gamma (IFN-γ) was identified as a central regulator of HLA-I expression by STRING database. ESCC cell lines were co-cultured with immune cells, following radiation exposure, the levels of secreted IFN-γ in the culture medium were quantified. Changes in T cells and dendritic cells (DCs) were detected via immunofluorescence. The study found that elevated β2M expression in peripheral blood cells of patients with ESCC was significantly associated with improved Disease-Free Survival (DFS). Radiation treatment was observed to enhance the expression of HLA-I in ESCC cells. Analysis of TCGA data and gene transcriptome sequencing identified the cytokine-cytokine receptor interaction as the most enriched pathway. IFN-γ was identified as the central cytokine in regulating HLA-I expression, with the capability to induce its expression. When ESCC cells were co-cultured with immune cells and treated with radiation, there was an increase in IFN-γ concentration in the medium, accompanied by altered distributions of DCs and T cells. These findings suggest that radiation may influence immune cells through the modulation of IFN-γ.	esophagus
Robot-assisted (da Vinci) versus conventional esophagectomy for resectable esophageal cancer: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.	Robot-assisted minimally invasive esophagectomy (RAMIE) using the da Vinci system has emerged as a promising alternative to conventional approaches for treating resectable esophageal cancer. However, high-quality evidence comparing RAMIE and conventional esophagectomy remains limited. This systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420251158840). We systematically searched multiple databases, MEDLINE (Ovid), PubMed, Embase (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, the Web of Science Core Collection, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) from inception to September 2025 for randomized controlled trials comparing da Vinci robot-assisted esophagectomy with conventional approaches (minimally invasive or open esophagectomy) in adults with resectable esophageal cancer. The primary outcomes included anastomotic leak, pneumonia, R0 resection, and 90-day mortality. Secondary outcomes included operative metrics, hospital stay, and complications. Random-effects meta-analyses were performed using risk ratios for dichotomous outcomes and mean differences for continuous outcomes. Evidence certainty was assessed using the GRADE methodology. Three randomized controlled trials including 549 patients (284 RAMIE, 265 conventional) were analyzed. RAMIE demonstrated statistically significant but clinically modest reduction in intraoperative blood loss (mean difference - 68.34 mL, 95% CI - 134.48 to - 2.20, P = 0.04; low certainty). No significant differences were observed in anastomotic leak (RR 1.24, 95% CI 0.83-1.86; low certainty), pneumonia (RR 0.71, 95% CI 0.47-1.06; low certainty), R0 resection (RR 0.99, 95% CI 0.94-1.04; moderate certainty), 90-day mortality (RR 1.66, 95% CI 0.34-8.11; very low certainty), hospital length of stay (MD - 3.26 days, 95% CI - 8.33 to 1.82; very low certainty), or ICU length of stay (MD - 0.10 days, 95% CI - 0.39 to 0.20; moderate certainty). Recurrent laryngeal nerve palsy showed no significant difference (RR 0.87, 95% CI 0.51-1.48; very low certainty) with substantial heterogeneity (I²=66%) due to variable assessment methods and timing. GRADE certainty ranged from very low to moderate across outcomes, predominantly limited by imprecision and inconsistency. Importantly, no trials evaluated robot-assisted anastomotic reconstruction, limiting assessment of robotic surgery's full potential. Robot-assisted esophagectomy demonstrated comparable short-term safety and oncological adequacy to conventional approaches, with statistically but not clinically significant reduction in blood loss (- 68 mL). Current evidence supports RAMIE as viable but does not assess potential benefits in robot-assisted intrathoracic anastomoses, lymphadenectomy quality, or functional recovery. Future trials addressing these gaps are needed.	esophagus
Toward standardization in esophageal cancer surgery: patterns of practice across high-volume European centers.	Esophageal cancer (EC) remains a leading cause of cancer-related mortality worldwide. For patients with locally advanced, non-metastatic EC, advances in perioperative care, and surgical techniques have led to improved outcomes; however, significant variation persists, and standardization remains limited. This study aimed to characterize current practice patterns among expert surgeons at high-volume European centers through a structured, in-depth survey. Eight expert upper gastrointestinal surgeons from European centers performing >60 esophagectomies annually participated in comprehensive interviews. Topics included preoperative care pathways for distal esophageal/gastroesophageal junction adenocarcinoma, technical aspects of Ivor Lewis esophagectomy, and postoperative recovery protocols. Additional focus areas included multidisciplinary team involvement, allied health integration, research program participation, and follow-up strategies. Widespread agreement (7-8 of 8 centers) was observed in several domains: national EC care regionalization, multidisciplinary cancer conference review of all patients, institutional EC research programs, use of prospective national/international databases, application of CROSS chemoradiotherapy for squamous cell carcinoma, and perioperative FLOT chemotherapy for adenocarcinoma. Common surgical techniques included minimally invasive Ivor Lewis esophagectomy, two-field lymphadenectomy with en-bloc thoracic duct ligation, nasogastric tube placement, omental wrap of the anastomosis, and Enhanced Recovery After Surgery-based postoperative protocols. The majority of centers (5-6/8) performed routine preoperative optimization (nutrition, smoking cessation, frailty screening, oral hygiene/microbiome assessment), jejunostomy placement, and postoperative contrast swallow studies. Areas with notable variability (≤4/8 centers) included intraoperative crural closure, pyloric drainage procedures, gastric conduit sizing, postoperative pain management, and follow-up imaging timelines. High-volume European centers demonstrated strong alignment in several programmatic and perioperative elements of EC care, particularly around enhanced recovery pathways and preoperative optimization. Nonetheless, key intraoperative and postoperative variations persist, highlighting opportunities for future research, consensus building, and standardization to improve patient outcomes.	esophagus