crossing96/oncoscreening huggingface dataset:
Prognostic significance of NBS1 and Snail expression in esophageal squamous cell carcinoma.	BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is a lethal malignancy, but only limited molecular markers can predict its prognosis. Recently, a DNA double-strand break repair protein Nijmegen breakage syndrome 1 (NBS1) was reported to induce Snail expression and predict poor prognosis in head and neck cancers. However, the clinicopathologic roles of NBS1 and Snail in ESCC remain unclear. METHODS: From January 1995 to September 1999, tissue samples from 153 patients with ESCC who underwent esophagectomies at our institutions were collected and made into tissue core arrays for study. Expression of NBS1 and Snail was examined by immunohistochemical staining. The clinicopathologic data were analyzed, and some additional studies were performed to explore the relationship between NBS1 and Snail. RESULTS: NBS1 overexpression was observed in 28.1% (43/153) of ESCC, whereas Snail overexpression was observed in 26.1% (40/153) of ESCC. Overexpression of NBS1 correlated inversely with nodal status (P = 0.009) and was associated with better overall survival (P = 0.002). On the other hand, overexpression of Snail correlated positively with lymphovascular invasion (P = 0.034) and was associated with worse overall survival (P = 0.036). Meanwhile, NBS1 overexpression correlated inversely with Snail overexpression marginally (P = 0.084). Using the Cox regression analysis, T status (P = 0.006), M status (P = 0.008), and NBS1 overexpression (P = 0.007) were the independent factors of overall survival. CONCLUSIONS: Our results showed that NBS1 overexpression was an independent factor of better survival and Snail overexpression predicted a worse survival in ESCC. Combination of NBS1 plus Snail expression status could be used as a predictor of prognosis in ESCC.	esophagus
Nonsteroidal anti-inflammatory drugs and statins have chemopreventative effects in patients with Barrett's esophagus.	BACKGROUND & AIMS: The incidence of Barrett's esophagus and esophageal adenocarcinoma has increased despite surveillance of patients with Barrett's esophagus. Limited data indicate that nonsteroidal anti-inflammatory drug (NSAID) and statin use reduce the risk for esophageal adenocarcinoma. We investigated whether NSAID or statin use reduces the risk of neoplastic progression from Barrett's esophagus. METHODS: We performed a prospective study of 570 patients with Barrett's esophagus at 3 academic and 12 regional Dutch hospitals. Information on medication use was collected in patient interviews at each surveillance visit and cross-checked with pharmacy records. Patients completed a questionnaire about use of over-the-counter medication. Incident cases of high-grade dysplasia and adenocarcinoma were identified during the follow-up period. RESULTS: During a median follow-up period of 4.5 years, 38 patients (7%) developed high-grade dysplasia or adenocarcinoma. After Barrett's esophagus had been diagnosed, 318 patients (56%) used NSAIDs for a median duration of 2 months, 161 (28%) used aspirin for a median duration of 5 years, 209 (37%) used statins for a median duration of 5 years, and 107 (19%) used NSAIDs and statins. NSAID and statin use were each associated with a reduced risk of neoplastic progression (hazard ratio [HR], 0.47; P = .030 and HR, 0.46; P = .048, respectively). Use of a combination of NSAIDs and statins increased the protective effect (HR, 0.22; P = .028). CONCLUSIONS: NSAID and statin use reduce the risk of neoplastic progression in patients with Barrett's esophagus. Use of a combination of NSAIDs and statins appears to have an additive protective effect.	esophagus
Toll-like receptor 9 is a novel biomarker for esophageal squamous cell dysplasia and squamous cell carcinoma progression.	BACKGROUND: Stimulation of Toll-like receptor 9 (TLR9) has been linked to invasion in various cancer cells in vitro. We investigated TLR9 expression in normal, dysplastic and malignant esophageal squamous epithelium. METHODS: TLR9 expression was analyzed by immunohistochemistry in 46 cases of esophageal squamous cell carcinoma, including 12 cases with adjacent squamous dysplasia and 24 cases with normal esophageal epithelium. TLR9 expression was compared with tumor grade, stage, proliferation, apoptosis and vascular density. RESULTS: In normal esophageal squamous epithelium, TLR9 staining intensity decreased linearly from the basal layers to the superficial layers (p < 0.001). Strong TLR9 expression was detected across full thickness of high-grade dysplasia, the intensity clearly differing from the normal squamous epithelium and squamous cell carcinoma (p < 0.001). All squamous cell carcinomas exhibited TLR9 expression that was positively associated with a high grade (p < 0.05), the presence of lymph node metastases (p < 0.05) and previously undetected distant metastases (p < 0.05). CONCLUSIONS: Expression of TLR9 in the basal parts of normal esophageal epithelium suggests a role related to cell proliferation and differentation. TLR9 upregulation detected in dysplastic epithelium and in disseminated carcinomas indicates that this protein may serve as a novel marker for esophageal squamous dysplasia and carcinoma with metastatic potential.	esophagus
[Expression of ERK1/2 MAPK signaling transduction pathway in esophageal cancers in Kazakh patients].	OBJECTIVE: To investigate the expression variation and significance of ERK1/2 MAPK signaling transduction pathway in the pathogenesis of esophageal squamous cell carcinoma (ESCC) in Kazakh patients. METHODS: The expression level of p-ERK1/2 after serum starvation and treatment with U0126 inhibitor was detected in esophageal cancer cell line EC9706 by Western blot assay. The mRNA level of total ERK1/2 (t-ERK1/2) and expression level of t-ERK1/2 and p-ERK1/2 proteins of 25 pairs of ESCC and adjacent normal esophageal mucosal tissues of Kazakh patients were examined and identified by real-time quantitative PCR (qRT-PCR) and Western blotting, respectively. The expression of p-ERK1/2 protein was verified by immunohistochemistry in 126 paraffin-embeded specimens, including 19 normal esophageal mucosa, 55 esophageal carcinomas in situ and 52 invasive carcinomas. RESULTS: ERK1/2 MAPK signaling transduction pathway was in an active status in the EC9706 cells. The expression level of p-ERK1/2 in Ec9706 cells reached a peak at 10 min after transient serum stimulation, and p-ERK1/2 expression was totally restrained after the treatment with 50 µmol/L U0126. In the 25 pairs of ESCC and adjacent normal mucosa, the t-ERK1 mRNA level was 1.92 ± 3.49 in the ESCC tissues and 3.67 ± 7.47 in the adjacent normal mucosa. The t-ERK1 mRNA level in ESCC tissues was significantly lower than that in adjacent normal mucosa (P < 0.05), whereas there was no significant difference of t-ERK2 mRNA level between them(P > 0.05). The expression levels of p-ERK1 and p-ERK2 proteins were 0.87 ± 0.14 and 0.79 ± 0.10 in the ESCC tissues, and 1.10 ± 0.13 and 1.32 ± 0.12 in the adjacent normal mucosae. p-ERK1/2 protein in the ESCC tissues was significantly lower than that in the adjacent normal tissue (P < 0.01). However, there was no significant difference between their t-ERK1/2 protein levels (P > 0.05). In the 126 cases of paraffin-embeded specimens, positive expressions of both p-ERK1 and p-ERK2 in esophageal cancer tissues were 7.7% (4/52), significantly lower than those in adjacent normal mucosa (31.6%, 6/19) and carcinoma in situ (85.5%, 47/55, P < 0.05). CONCLUSIONS: ERK1/2 MAPK signaling pathway is in an active status in esophageal cancer and adjacent normal mucosa. Our results imply that the activation of p-ERK1/2 MAPK signaling transduction pathway plays a role in the early pathogenesis of ESCC in Kazakh patients.	esophagus
Primary gastric cancer in an oesophageal gastric graft after oesophagectomy.	OBJECTIVE: Recent advances in surgical treatment of oesophageal cancer have improved the prognosis of early, locally advanced oesophageal cancer. Primary cancer from oesophageal graft is rare, but has been detected in long-term survivor. We analyzed data from patients who developed primary gastric cancer in an oesophageal graft to evaluate strategies of treatment and their outcomes. METHODS: We retrospectively reviewed data from patients who developed primary gastric cancer in oesophageal graft at Samsung Medical Center between September 1994 and December 2009. The clinico-pathologic features and prognoses were investigated. Long-term survival rate was determined by Kaplan-Meier analysis. RESULTS: Ten primary gastric graft cancers (five early gastric cancer (EGC), five advanced gastric cancer (AGC)) were diagnosed. The mean age was 69.0 (range 59.6-74.6). Initial operation was Ivor-Lewis transthoracic oesophagectomy in eight cases and three-field lymphadenectomy in two. The median period to detection of the primary gastric graft cancer after oesophagectomy was 50 (9-102) months. Seven gastric graft cancers were diagnosed by regular endoscopic examination. EGCs were treated with ESD in two cases, partial resection of stomach in one, and oesophagocolojejunostomy in three, including one patient who underwent the operation after ESD. AGCs were treated with chemotherapy in one case, supportive care in one, and oesophagocolojejunostomy in three. There was no adjuvant chemotherapy used in any case. The median follow-up period after second operation was 14 months (range 1-97). Six patients survived during this period. Three of the five AGC patients died. The estimated 5-year survival rate of our cases was 70%. CONCLUSIONS: In areas of high prevalence of stomach cancer, regular endoscopic examinations of oesophageal gastric grafts may help in the early detection of primary gastric graft cancer. Reoperation with a colon graft is a potential treatment option for primary gastric graft cancer.	esophagus
The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with esophageal cancer.	BACKGROUND: There is a paucity of data evaluating whether a multidisciplinary conference coordinating surgery, chemotherapy and radiation therapy translates into better patient care. This review compares the experiences of patients with esophageal cancer before and after the formation of a prospective, multidisciplinary thoracic malignancy conference (TMC). METHODS: The records of patients with carcinoma of the esophagus at a tertiary care hospital were reviewed for completeness of staging, multidisciplinary evaluation before the initiation of therapy, time from pathologic diagnosis to treatment, multimodality therapy, and adherence to national treatment guidelines. Summary data were compared for patients treated before and after the TMC was initiated. RESULTS: Between 2001 and 2007, 117 patients were treated before the initiation of the TMC and 138 patients within the TMC. The number of patients receiving, respectively, a complete staging evaluation (67% and 97%, p < 0.0001), multidisciplinary evaluation before therapy (72% and 98%, p < 0.0001), and adherence to National Comprehensive Cancer Network treatment guidelines (83% and 98%, p < 0.0001) all increased significantly, whereas mean days from diagnosis to treatment significantly decreased (27 and 16, respectively; p < 0.0001). CONCLUSIONS: A multidisciplinary TMC increased the percentage of patients receiving complete staging, a multidisciplinary evaluation, and adherence to nationally accepted care guidelines while decreasing the interval from diagnosis to treatment significantly. While the ultimate goal of treatment is to improve patient survival, the surrogate variables examined in this review indicate that patients with esophageal cancer benefit from being evaluated in a prospective, multidisciplinary manner.	esophagus
[Clinical study on improving decreased gastrointestinal motility of post-operative esophageal cancer patients by unblocking the interior and purgation method].	OBJECTIVE: To observe the clinical effect of unblocking the interior and purgation method on improving decreased gastrointestinal motility of post-operative esophageal cancer patients, and to study its mechanisms. METHODS: 60 patients with post-operative esophageal cancer were randomly assigned to two groups, the treatment group and the control group, 30 in each group. Routine therapies were given to the two groups. Chinese drugs with unblocking the interior and purgation action was infused by enteral nutrition tube to patients in the treatment group, while normal saline was infused to those in the control group. The first flatus time, the first defecation time, the bowel tones recovery time after operation, and the total amount of the gastric juice draining between the first day and the third day after operation of all patients were recorded. Plasma motilin (MTL) and vasoactive intestinal peptide (VIP) contents were detected before operation and the fourth day after operation. RESULTS: The first flatus time, the first defecation time, the bowel tones recovery time after operation, and the total amount of the gastric juice draining were less in the treatment group than in the control group, showing statistical difference (P<0.05, P<0.01). The post-operative MTL contents were higher and VIP contents lower in the treatment group than in the control group, showing statistical difference (P<0.05, P<0.01). There was no significant difference in plasmal MTL and VIP contents of the treatment group between before and after treatment (P>0.05). But there was significant difference in plasmal MTL and VIP contents of the control group between before and after treatment (P<0.01). CONCLUSION: Unblocking the interior and purgation method could significantly promote the gastrointestinal motility recovery of post-operative esophageal cancer patients, showing good clinical effect.	esophagus
Prognosis in adenocarcinomas of lower oesophagus, gastro-oesophageal junction and cardia evaluated by uPAR-immunohistochemistry.	Adenocarcinomas of lower oesophagus, gastro-oesophageal junction and cardia in humans are highly invasive tumours with poor prognosis. The localisation of urokinase-type plasminogen activator receptor (uPAR) was determined in 66 patients; 60 with adenocarcinomas and six cases with Barrett's oesophagus. uPAR was expressed in nearly all cases of invasive adenocarcinomas by populations of cancer cells, macrophages and myofibroblasts at both the invasion front and the tumour core. In areas with high-grade dysplasia or with Barrett's metaplasia adjacent to the tumour tissue, no uPAR-immunoreactivity was found. High local expression of uPAR, therefore, appears to be a characteristic marker for invasive behaviour in this tumour, suggesting that uPAR's contribution to matrix degradation during invasive growth is a late event in carcinogenesis. Using a scoring system for semiquantitative estimation of uPAR-positivity on immmunohistochemically stained specimens, a significant association was found between poor overall survival and high uPAR-score for cancer cells in the tumour core and for macrophages peripherally at the tumour invasion zone. In multivariate analysis, these two uPAR-scores were confirmed as highly significant prognostic parameters independent of Tumour, Node, Metastasis (TNM)-stage and World Health Organization (WHO) classification. The proteolytic action of these malignant and nonmalignant accessory cells thus seemed to follow two main patterns: one dominated by uPAR positive cancer cells and one by uPAR-positive macrophages. Scoring of uPAR-positivity might be a useful parameter for onset of invasion and prognosis in these adenocarcinomas.	esophagus
Successful double lumen tube insertion in a patient with unanticipated laryngeal and tracheal web.	A 45-year-old female patient admitted for surgical management of carcinoma esophagus, presented with difficulty in insertion of left-sided 37 F and 35 F double lumen tube (Mallinckrodt® Broncho-Cath). Fiberoptic bronchoscopy revealed a subglottic web in the larynx just below the vocal cords and a tracheal web just above the carina. Differential lung ventilation could be achieved with a 35 F internal diameter double lumen tube (Portex® Blueline® Endobronchial tube).	esophagus
ALCAM (CD166) expression and serum levels are markers for poor survival of esophageal cancer patients.	The expression of the activated leukocyte cell adhesion molecule (ALCAM and CD166) is increased in various types of cancer. We aimed to evaluate its role as a prognostic marker for esophageal cancer (EC). We retrospectively analyzed ALCAM expression in 299 primary lesions, 147 lymph node and 46 distant metastases from EC patients, on a tissue microarray using immunohistochemistry. Bone marrow samples from representative cancer patients (n = 16), taken before primary surgery, were stained by double-immunofluorescence for ALCAM and cytokeratins (CK). Blood serum samples from 236 cancer patients and 127 controls were analyzed for serum ALCAM (s-ALCAM) by ELISA. The immunohistochemical analysis showed increased ALCAM expression in the majority of lesions (primary tumor 71%, lymph node 76% and distant metastases 80%). ALCAM expression was not associated with histopathological parameters except for tumor grading (p = 0.015). ALCAM-positive patients had significantly worse recurrence-free and overall survival (OS; p = 0.002). Disseminated tumor cells (DTC) in bone marrow showed two phenotypes, ALCAM+/CK+ (36%) and ALCAM-/CK+ (64%). Multivariate analysis revealed that ALCAM expression and elevated s-ALCAM serum values are powerful prognostic variables for OS in patients with EC (hazard ratio [HR] 3.987, 95% confidence interval [95%CI] 1.906-8.340, p < 0.001 and HR 1.915, 95%CI 1.021-3.592, p = 0.043). The results of our study provide preliminary evidence for the potential clinical utility of ALCAM as a prognostic biomarker for EC, which might be a basis for future clinical application. In addition, ALCAM expression in a subset of DTC of the bone marrow indicates a potential function in the metastatic cascade of EC.	esophagus
A randomized controlled trial of conventional fraction and late course accelerated hyperfraction three-dimensional conformal radiotherapy for esophageal cancer.	We compared the curative and side-effects in esophageal carcinoma treated by conventional fraction (CF) and late course accelerated hyperfraction (LCAF) three-dimensional conformal radiotherapy. Ninety-eight patients were randomly assigned to two different radiotherapy model groups. Fifty patients were treated using CF three-dimensional conformal radiotherapy at a total dose of 60-68 Gy; 2 Gy/F; 5 fractions/week (median 64 Gy), 48 patients were treated with LCAF (First CF-treated at the dose 40 Gy. Later, LCAF-treated 1.5 Gy/F; 2 fractions/day; 21-27 Gy; a total dose of 61-67 Gy; median 64 Gy). The data showed that the 1-, 2- and 3-year-survival rates in LCAF group were 79.2, 56.3, and 43.8%, compared to 74, 54, and 36% in CF group (P = 0.476). The 1-, 2- and 3-year-local control rates in LCAF group were 81.3, 62.5, and 50%, compared to 78, 58, and 42% in CF group (P = 0.454). In CF group, the incidence of radiation-induced esophagitis was lower than that in LCAF group (72 vs. 93.8%; P = 0.008) and there was no significant difference between rates of radiation-induced pneumonitis in CF and LCAF groups (10 vs. 6.25%; P = 0.498). It was concluded that the 1-, 2- and 3-year-local control and survival rates of esophageal carcinoma patients treated with LCAF were slightly better than CF radiotherapy; however, the radiation side-effects in LCAF group were greater than those in CF group.	esophagus
Expression of immunoglobulin G in esophageal squamous cell carcinomas and its association with tumor grade and Ki67.	We and other research groups have previously shown that various cancer types can express immunoglobulin G, but investigation on of immunoglobulin G expression in esophageal cancer, a highly malignant tumor, and its biological significance has been lacking. In this study, we examined immunoglobulin G protein and its messenger RNA, as well as the expressions of recombination-activating gene 1, recombination-activating gene 2, and activation-induced cytidine deaminase in 142 cases of esophageal cancer tissues, and 2 esophageal cancer cell lines (Eca109, SHEEC). We also compared their expressions with tumor grade and a proliferation marker, Ki67. We used immunohistochemistry, immunofluorescence, in situ hybridization, laser microdissection coupled with reverse transcriptase polymerase chain reaction, and Western blot analysis. We detected transcripts of immunoglobulin G 1 heavy-chain constant region, immunoglobulin-κ and λ-light chains, immunoglobulin G variable region, and recombination-activating genes 1 and 2 in both esophageal cancer tissues and cell lines, whereas activation-induced cytidine deaminase was not detected. No immunoglobulin G receptor subtypes were detected. Statistic analysis revealed that immunoglobulin G expression correlated well with tumor grades (P < .001) and with the proliferation marker Ki67 (P < .001). Our results indicate that human esophageal cancer cells are capable of synthesizing immunoglobulin G, which is likely involved in the growth and proliferation of this highly malignant cancer and might also be used as a prognostic indicator in esophageal squamous cell carcinomas.	esophagus
[Particular aspects of endoprosthesis in malignant advanced pharingeal-esophageal stenosis].	INTRODUCTION: The esophageal neoplasm is currently the seventh cause of death through cancer worlwide. In the developing countries it is situated on the fifth place and has one of the worst prognostics for a neoplasm. Due to the specifical intratoracical topography, clinically inaccesible and without symptoms, the disease is rather incurable when the disphagia appears. MATERIAL AND METHOD: The esophageal prosthesis procedure through laparogastroscopical approach, used by us, is an original one, noninvasive, acknowledged both nationally and internationally. The endoprosthesis esophageal cases belong to three Clinics of Surgery (Clinic Surgery 2 from Sibiu, Clinic Surgery 1 from Braila, Clinic of Surgery 4, Bucharest) on a period of 14 years (1996-2009), identically coordinated. RESULTS AND DISCUSSIONS: Out of the 68 patients, 18 cases have been cancers situated in the medial and inferior third and 28 have been eso-cardial-tuberositary neoplasms. In the cases of the high malignant pharingeal-esophageal stenosis, the placement of the prosthesis (different prosthesis adapted to this particular situation) in areas of aerial-digestive junction implies significant technical difficulties especially in the option with the conservation of the larinx as a fonatory and respiratory solution. CONCLUSIONS: Our original procedure, simple and efficient presents numerous advantages which allow the widening of the indications of stent gastroenterology: firm traction, the possibility of catheterism through narrow lumens of 1-2 mm, sometimes anfractuous, the distal visibility, the visual placement or expanding of the prosthesis, the evaluation of the intraoperatory visceral or parietal methastasis and eventually the avoidance of the gastrostomic invalidation.	esophagus
Bisphosphonates in the treatment of osteoporosis: a review of their contribution and controversies.	The bisphosphonates have revolutionized the therapy of osteoporosis, particularly the prevention of vertebral and hip fractures. The development of tools for defining absolute fracture risk facilitates their targeting to appropriate, at-risk individuals. Prescribers need to be aware of their common side effects (gastrointestinal intolerance with oral dosing and flu-like illness following intravenous use). Whether these agents carry a real risk of other problems such as osteonecrosis of the jaw and subtrochanteric fractures remains uncertain at the present time. If the association of these problems with bisphosphonates is real, it is important that the major therapeutic benefits that can accrue from bisphosphonates' appropriate targeted use are not lost as a result of the anxiety concerning these extremely rare adverse events.	esophagus