crossing96/oncoscreening huggingface dataset:
Treatment decision support for esophageal cancer based on PET/CT data using deep learning.	BACKGROUND: Making precise treatment decisions in esophageal cancer is essential for enhancing patient outcomes and avoiding overtreatment. Traditional approaches relying on special features or shallow learning models often fail to capture the complex, multi-scale patterns embedded in PET/CT imaging data. Recent advances in deep learning provide an opportunity to build more robust, data-driven systems for predictive modeling in oncology. METHODS: We propose a novel deep learning model that integrates convolutional and transformer-based components based on PET/CT data to support treatment decisions for esophageal cancer. The architecture introduces a Convolutional Feature Extractor with split-based residual blocks for efficient local feature capture, a Multi-scale Pooling module for spatial context aggregation, and an Multilayer Perceptron block for predicting. The model was evaluated using several performance metrics such as AUCROC, F1 score, Balanced Accuracy and benchmarked against state-of-the-art convolutional and transformer backbones such as ConvNeXt and Vision Transformer. RESULTS: The proposed model achieved superior performance across all evaluation metrics, including an AUCROC of 0.9935 and a Balanced Accuracy of 0.9630, outperforming existing models. These results validate the effectiveness of combining local-global representation learning through custom-designed modules. In addition, we conducted ablation studies to further demonstrate the individual contributions and effectiveness of each component within the proposed architecture. By systematically removing or replacing specific modules such as the Convolutional Feature Extractor and Multi-scale Pooling, we observed consistent performance degradation, which highlights the necessity and complementary roles of these components in achieving optimal predictive accuracy. CONCLUSIONS: This study presents a novel hybrid deep learning architecture that enhances treatment decision support for esophageal cancer by leveraging multi-scale spatial encoding. The empirical evidence demonstrates that tailored architectural innovations significantly improve predictive accuracy over existing methods.	esophagus
[Expression of Concern] Radiosensitization of esophageal carcinoma cells by knockdown of RNF2 expression.	Following the publication of the above paper, it was drawn to the Editor's attention by a concerned reader that certain of the westen blot data included in Fig. 4C and D looked strikingly similar, such that the same data may have been included more than once in these figure parts to show the results of differently performed experiments. Upon performing an independent analysis of the data in the Editorial Office, it also came to light that data featured in Fig. 3A of the above paper had been re‑used in a figure in a paper featuring some of the same authors that was published in the journal Scientific Reports. The authors were contacted by the Editorial Office to offer an explanation for this possible anomaly in the presentation of the data in this paper, although up to this time, no response from them has been forthcoming. Owing to the fact that the Editorial Office has been made aware of potential issues surrounding the scientific integrity of this paper, we are issuing an Expression of Concern to notify readers of this potential problem while the Editorial Office continues to investigate this matter further. [International Journal of Oncology 48: 1985‑1996, 2016; DOI: 10.3892/ijo.2016.3404].	esophagus
Site-specific prevalence of the NFE2L2 mutation in esophageal squamous cell carcinoma.	BACKGROUND: Precision medicine for esophageal squamous cell carcinoma (ESCC) has not been implemented owing to a lack of site-specific therapeutic markers and biomarkers. We hypothesized that the genomic background of each subsite of the esophagus might be different, allowing us to develop site-specific treatment strategies (cervical, upper thoracic, middle thoracic and lower thoracic). METHODS: This was a single-center retrospective cohort study. Patients diagnosed with ESCC who underwent comprehensive genomic profiling (CGP) at Keio University Hospital between April 2017 and March 2024 were recruited. Genomic profiles were analyzed and compared across esophageal subsites. RESULTS: Among the 107 patients with ESCC who underwent CGP, 6 were cervical, 16 were upper thoracic, 54 were middle thoracic, and 31 were lower thoracic. The most frequently altered genes were TP53, followed by CDKN2A and NFE2L2. The frequency of NFE2L2 mutations was significantly higher in the middle thoracic region (P = 0.041). The mutation rate increased from Stage I to IV (P = 0.0046). NFE2L2 mutations were rarely observed in early-stage cancers, suggesting that they may subsequently be acquired during growth and metastasis. Furthermore, a significant association was observed between a history of heavy alcohol consumption and NFE2L2 mutations. The overall survival of patients with unresectable or metastatic ESCC harboring NFE2L2 mutations was 12.0 months, compared to 29.7 months in patients without the mutations (HR: 2.37, P = 0.047). CONCLUSION: NFE2L2 mutations were more common in the middle thoracic esophagus, appeared to be associated with tumor progression, and were linked to poor prognosis.	esophagus
Selection and validation of a cell-internalizing DNA aptamer targeting esophageal squamous cell carcinoma.	Esophageal squamous cell carcinoma (ESCC) is the main histological subtype of esophageal cancer and one of the major causes of cancer-related death worldwide. Currently, an effective targeted therapy for ESCC is still lacking. Aptamers have been widely used as an effective tool to identify cell surface targets because of their high affinity and specificity. Accordingly, screening internalized aptamers targeting ESCC can promote the development of targeted drug delivery for this disease. Taking KYSE450 cells as the targets, we used the cell-based Systematic Evolution of Ligands by EXponential enrichment (cell-SELEX) protocol combined with a cell internalization strategy to screen aptamers. After 17 rounds of positive and negative strict screening, we confirmed that the best candidate aptamer was Ap1 and obtained its derived aptamer Ap1-1 through sequence optimization. In vitro experiments showed that Ap1-1 could bind many ESCC cell lines, and its dissociation constant was as low as 22.54 nmol/L, showing excellent cell-internalization ability. In an ESCC xenograft tumor model, Ap1-1 showed significant tumor targeting, and its accumulation in tumor tissue was significantly higher than that in the liver, kidney, and other organs 24 h after administration, indicating that it may have a long half-life in vivo and favorable pharmacokinetic characteristics. Based on the excellent tumor-targeting and internalization properties of aptamer Ap1-1, it is expected to be developed as a new molecular tool for targeted therapy and provide a new strategy for precise ESCC treatment.	esophagus
Establishment of a Chinese library of patient-derived xenografts from gastrointestinal cancers.	BACKGROUND: Patient-derived xenografts (PDX) models have been regarded as an important tool for preclinical research. The aim of this study was to establish a Chinese PDX library from gastrointestinal cancers, especially esophageal squamous cell carcinoma (ESCC), esophagogastric junction adenocarcinoma (EGJAC), and gastric adenocarcinoma (GAC). METHODS: 1001 surgical tissues or endoscopic biopsy tissues of gastrointestinal cancers were subcutaneously implanted into NOD/SCID mice between January 2013 and August 2015. Engraftment rates, latency period of xenograft formation, patients' clinicopathological characteristics and survival associated with xenografts for ESCC, EGJAC and GAC were assessed. RESULTS: 208 PDX models were established (20.8%, 208/1001), among which 82 were from ESCC (21.2%, 82/386), 31 from EGJAC (16.9%, 31/183), and 29 from GAC (10.9%, 29/266). The average latency period of xenograft formation of ESCC, EGJAC, and GAC was 76.2, 90.5, and 85.2 days, respectively, for the first passage, and decreased to 52.5, 54.8, and 52.6 days, respectively for the second passage. For ESCC, gender, specimen type and differentiation were associated with engraftment; and for GAC, the factors associated with engraftment were age, specimen type, differentiation, and Lauren classification. The median follow-up of patients with ESCC, EGJAC and GAC was 46, 64 and 64 months, respectively. For GAC, the survival time of patients from whom the tumor tissues achieved successful engraftment was significantly shorter than that without xenograft formation. CONCLUSIONS: We established a Chinese PDX library from gastrointestinal cancers, especially ESCC, a characteristic tumor type in China, providing a platform for drug development and individualized therapy.	esophagus
Simultaneous cholecystectomy during esophagectomy: A systematic review and meta-analysis on gallstone formation and subsequent cholecystectomy rates.	BACKGROUND: The necessity of performing simultaneous cholecystectomy (simCCE) during esophagectomy remains controversial, as postoperative biliary complications may occur due to vagal denervation and anatomical alterations. However, the incidence and need for subsequent cholecystectomy (subCCE) in these patients remain unclear. This meta-analysis aims to provide a pooled estimate of gallstone formation and subCCE rates following esophagectomy for cancer. METHODS: A systematic literature search was conducted following PRISMA guidelines using PubMed, Embase, Web of Science, and CENTRAL. Studies reporting the incidence of symptomatic gallstones and subCCE after esophagectomy for cancer were included. A meta-analysis of proportions was conducted to estimate the pooled incidence of gallstone formation and subCCE rates. Random-effects models were applied, with heterogeneity quantified using the I(2) statistic and further explored through meta-regression. Results were visually presented using forest plots. Risk of bias was assessed using Joanna Briggs Institute Critical Appraisal Checklist. RESULTS: In five studies comprising 1557 patients the overall pooled subCCE proportion was estimated to be 2.0 % (95 % CI: 0.8 %-5.1 %). The pooled analysis of gallstone formation compromised four studies with 1493 patients and estimated a pooled gallstone formation rate of 9.3 % (95 % CI: 4.6 %-18.1 %). Among patients who developed gallstones (n = 109), 14.5 % (95 % CI: 4.0 %-41.0 %) required a subCCE. CONCLUSION: High heterogeneity was observed among studies reporting subCCE rates, and most lacked data on surgical access and procedure-related complications. A risk-adapted approach to simCCE should be considered, and future prospective studies are needed to refine patient selection, explore medical prophylaxis strategies and evaluate long-term and patient-reported outcomes.	esophagus
Implementation and effectiveness of robot-assisted minimally invasive oesophagectomy (RAMIO): a systematic review using the IDEAL framework.	BACKGROUND: Robot-assisted minimally invasive oesophagectomy (RAMIO) is increasingly used for oesophageal cancer surgery, yet its adoption may have outpaced structured evaluation. This systematic review assessed RAMIO's development through the IDEAL framework and synthesized evidence from RCTs and long-term studies. METHODS: A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library on 1 June 2025 for studies comparing RAMIO with open oesophagectomy or minimally invasive oesophagectomy. Non-comparative, non-English, protocol, and review articles were excluded. Two reviewers independently screened and extracted data, classifying studies according to IDEAL stages. Outcomes were presented in a narrative overview. Risk of bias was assessed using RoB-2 for RCTs and ROBINS-I for long-term studies. The protocol was registered in PROSPERO (CRD42022352208). RESULTS: A total of 104 studies involving 133 107 patients published between 2002 and 2025 were included. Of these, 86 were IDEAL stage 2B, four stage 3 (RCTs), and 14 stage 4 (long-term follow up studies). Generally, RAMIO research followed the IDEAL pathway, although several stage 4 studies preceded stage 3 evaluations. None explicitly referenced the IDEAL framework. RCTs demonstrated some benefits of RAMIO, including fewer complications and faster recovery, whereas long-term outcomes remain uncertain. Studies on long-term outcomes varied in design and were often at risk of bias. CONCLUSION: RAMIO may offer perioperative benefits, but high-quality evidence is limited. Few RCTs exist, and long-term benefits are unclear. Although RAMIO development aligns broadly with IDEAL stages, explicit framework adherence is lacking. Future trials should adopt structured IDEAL-guided designs and standardised reporting.	esophagus
The metabolic profile of lean patients with esophageal adenocarcinoma and Barrett's esophagus.	Central obesity is a risk factor for esophageal adenocarcinoma (EAC) independent of acid reflux. However, about a quarter of patients with Barrett's esophagus (BE) and EAC have a normal body mass index (BMI). One hypothesis is that chronic systemic inflammation is as critical to the cancer pathway than the BMI alone. Therefore, we hypothesized that lean patients with BE/EAC would have a high prevalence of metabolic diseases. We aimed to compare metabolic diseases among lean patients with BE/EAC and overweight/obese BE/EAC and lean control without BE/EAC. We performed a propensity score-matched case-control study including patients with BE/EAC and a control group without BE/EAC from the Rochester Epidemiology Project (REP). The groups were compared using chi-square χ 2 and Student t-test as appropriate. Adjusted logistic regression models were used to compare the association with metabolic diseases. We included a total of 2504 patients (631 EAC, 621 BE, and 1252 controls). A quarter of patients (24.6%) with BE/EAC were lean. When compared to controls without BE/EAC, lean patients with BE were more likely to have diabetes (32.2% vs. 11.2%, P < 0.001) and hyperlipidemia (76.2% vs. 53%, P < 0.001). When comparing lean EAC patients to controls without BE/EAC, lean patients had a higher association with smoking (73.3% vs. 58.6%, P: 0.002) and diabetes (18.7% vs. 11.2%, P: 0.03). When compared to overweight/obese BE patients, lean BE were less likely to have NASH (7.7% vs. 20.3%, P: 0.001), diabetes (32.3% vs. 42.1%, P: 0.03), hyperlipidemia (77.2% vs. 87%, P: 0.003), and metabolic syndrome (24% vs. 54%, P < 0.001). Similarly, when compared to overweight/obese patients with EAC, lean EAC patients were less likely to have NASH (0% vs. 15.5%, P < 0.001), diabetes (18.7% vs. 34.1%, P < 0.001), hyperlipidemia (37.3% vs. 51.8%, P: 0.002), hypertension (37.3% vs. 55.3%, P < 0.001), and metabolic syndrome (8% vs. 37.6%, P < 0.001). A quarter of patients with BE/EAC are lean. Although lean BE/EAC patients have a more favorable metabolic profile compared to overweight/obese BE/EAC patients, diabetes and smoking are more common among lean patients with EAC compared to lean controls. The higher association with smoking and diabetes among lean EAC challenges traditional risk factor paradigms, suggesting a significant role for insulin resistance and chronic inflammation in EAC pathogenesis, especially in patients without typical risk factors. BMI-determined obesity may need to be supplemented with inflammatory metabolic diseases to improve assessment of BE/EAC risk in lean patients.	esophagus
Treatment Outcomes of Esophageal Cancer in Malawi: An Analysis of Overall Survival and Patient-Reported Outcomes.	PURPOSE: Esophageal squamous cell carcinoma (ESCC) is a prevalent cancer in eastern Africa. Optimal management strategies in eastern Africa have not been well established. This study aimed to evaluate ESCC treatment outcomes at Kamuzu Central Hospital (KCH), a national cancer center in Malawi. METHODS: This prospective, observational, cohort study was conducted as part of a multicenter collaboration within the African Esophageal Cancer Consortium (ClinicalTrials.gov identifier: NCT05177393). Patients who presented to KCH with esophageal cancer (EC) were recruited from June 2021 to December 2022. Data on patient and treatment characteristics were collected using interviews and chart review. Mobile phone outreach was used to assess patient-reported outcomes (PROs). PROs were analyzed using linear mixed modeling. Kaplan-Meier method with log-rank test and Cox proportional hazards regression were used to evaluate overall survival by treatment group. RESULTS: A total of 148 of 150 eligible patients enrolled. Of 114 with biopsy-proven EC, 97% (n = 111) had ESCC. Most were documented as having localized disease; however, 56% did not complete staging imaging. Forty-seven percent received supportive care, 30% self-expandable metallic stent (SEMS), 20% chemotherapy, and 3% SEMS plus chemotherapy. SEMS was associated with the highest proportion experiencing dysphagia improvement (SEMS 68% v chemotherapy 63% v supportive care 39%). Twelve-month survival rate was the highest in the chemotherapy arm (29% v supportive care 19% v SEMS 6%, log-rank P = .018). CONCLUSION: ESCC remains a highly fatal malignancy in Malawi. Most patients at KCH are treated with SEMS or supportive care. Although data must be interpreted with caution given likely confounding, chemotherapy was associated with the highest 12-month survival rate as compared with SEMS and supportive care, whereas SEMS was associated with the highest likelihood of improved dysphagia.	esophagus
Esophageal cancer mortality trends in the United States: a comprehensive longitudinal study (1999-2023) using CDC WONDER data.	BACKGROUND: Esophageal cancer continues to pose a significant public health challenge worldwide. However, the extent to which advancements in treatment have reduced mortality at the population level remains unclear. This study examines trends in esophageal cancer mortality in the United States from 1999 to 2023, focusing on variations based on sex, ethnicity, urbanization level, census region, and age group. METHODS: Mortality data were obtained from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database using ICD-10 codes (C15.0-C15.9) to identify esophageal cancer-related deaths. The analysis included individuals aged 25 years and older. Temporal trends in age-adjusted mortality rates (AAMR) were analyzed using the Joinpoint Regression Program. Data were stratified by census region, metropolitan/non-metropolitan residence, and state. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated along with their 95% confidence intervals (CI). RESULTS: Between 1999 and 2023, a total of 357,606 deaths from esophageal cancer were recorded. A significant decline in the mortality rate was observed over this period, with the overall AAMR decreasing from 6.74 to 5.61 per 100,000, corresponding to an AAPC of -0.81* (*p-value < 0.05). Decline in the mortality rate was evident across nearly all ethnic groups, with the exception of the non-Hispanic (NH) white group. The most significant reduction was observed among non-Hispanic Black individuals (AAPC: -4.07*). Significant sex-based disparities persisted throughout the study period, with men consistently experiencing higher mortality rates than women. Geographically, mortality trends diverged: metropolitan areas experienced a significant decline (AAPC: -1.09*), whereas non-metropolitan areas experienced a significant increase (AAPC: 0.48*). Pronounced regional disparities were also noted, with the western and northeastern regions demonstrating the most substantial improvements. Age-specific analyses revealed a significant reduction in the mortality rate across the majority of age groups; however, among adults aged 85 years and older, the mortality rates remained stable. CONCLUSION: Despite an overall decline in the mortality rate of esophageal cancer, significant disparities persist across geographic, urban-rural, and age subgroups. These findings highlight the need for targeted public health interventions to address ongoing inequalities, particularly among NH white individuals, those living in non-metropolitan areas, and older adult.	esophagus
MicroRNA 196a contributes to the aggressiveness of esophageal adenocarcinoma through the MYC/TERT/NFκB axis.	Barrett's esophagus (BE) is a premalignant lesion that can lead to an invasive esophageal adenocarcinoma (EAC), a type of cancer that usually has a poor outcome. We have previously described a set of four microRNAs (miR-192, 194, 196a and b) that are markers of the disease's progression. To determine whether these miRNAs might also be drivers of invasive EAC development, their overexpression in EAC cells was analyzed. Only the overexpression of miR-196a and miR-196b induced a phenotype switch in non-invasive EAC cells, resembling epithelial-to-mesenchymal transition (EMT). The overexpression of miR-196a promoted EMT and increased cell motility and NFκB signaling. Mechanistically, miR-196a targets the inhibitor of NFκB alpha NFKBIa and also leads to c-MYC protein accumulation by down-regulating VCP expression. This in turn up-regulated TERT expression and reinforced NFκB signaling. NFκB signaling, TERT, and c-MYC inhibition resulted in a reversed-EMT phenotype, with decreased EMT hallmarks and cell motility in miR-196a overexpressing cells. Finally, an immunohistochemical analysis of BE tissue samples showed that c-MYC, TERT, and NFκB signaling increased in BE patients who developed EAC, more so than in patients that did not. The high expression of miR-196a induces aggressive features in non-invasive EAC cells. These effects are dependent on the c-MYC/TERT/NFκB signaling molecular axis. BE patients and non-invasive EAC patients with high miR-196a expression could benefit from therapeutic interventions to prevent EMT or activation of the molecular pathway described in this study.	esophagus
Association between triclosan/triclocarban exposure and esophageal carcinoma development: A nested case-control study in a prospective cohort.	Triclosan (TCS) and triclocarban (TCC), widely used estrogen-mimicking antimicrobials in personal care products, raise health concerns due to their long-term environmental persistence. However, epidemiological evidence remains sparse. This prospective nested case-control study evaluated associations between serum TCS/TCC concentrations and esophageal squamous cell carcinoma (ESCC) incidence. We enrolled 400 age- and sex-matched participants, collecting baseline epidemiological data and measuring serum TCS/TCC via high-resolution liquid chromatography-mass spectrometry. Multivariable logistic regression, followed by subgroup and sensitivity analyses, assessed associations. A significant non-linear relationship emerged for TCC: participants with serum levels of 1.73-7.21 ng/L had a fully adjusted odds ratio (OR) of 3.46 (95 % CI: 1.48-8.07) for ESCC compared to those with levels < 1.73 ng/L. In contrast, TCS exposure showed no significant association, suggesting divergent biological mechanisms despite structural similarity. This study identifies TCC as a novel ESCC risk factor, highlighting potential health risks and supporting stricter regulation of TCC in consumer products.	esophagus