crossing96/oncoscreening huggingface dataset:
Impact of negative lymph node removal on survival in esophageal cancer: a systematic review and meta-analysis.	BACKGROUND: Recent studies have reported that a high number of negative lymph nodes (NLNs) removed can be associated with improved survival in esophageal cancer( EC) after surgery; however, the effect size of a high number of removed NLNs on survival rates has been reported to vary, which may be due to the small sample size of early studies. This meta-analysis aimed to evaluate the effect of the high number of NLNs removed on the survival rate of patients with EC after surgery. METHODS: We searched PubMed, Embase, Scopus, Web of Science, and Google Scholar databases with relevant Mesh terms to find studies that investigated the effect of the number of NLNs resected on the survival of EC patients after surgery until February 17, 2025. This systematic review was conducted based on the PRISMA 2020 checklist. Cochran's I(2) was used to evaluate heterogeneity between studies. Publication bias was evaluated using the Egger test. Heterogeneity between studies was controlled by meta-regression. Finally, eight studies involving 5,521 EC patients were included. RESULTS: The survival rate in patients whose number of removed NLNs ≥ 19 was significantly better than those with removed NLNs < 19 (HR: 0.88, 95% CI: 0.81, 0.95, I(2) = 84.4). Subgroup analysis of 8 studies showed that the protective effect of the high number of removed NLNs) ≥ 19 (was greater in adenocarcinoma patients than in SCC (Pooled HR: 0.63 vs. 0.88). CONCLUSION: The high number of NLNs removed (≥ 19) during surgery was associated with improved survival after surgery, especially in patients with adenocarcinoma. Removing ≥ 19 NLNs significantly improves survival in EC patients, particularly those with adenocarcinoma. This threshold should be incorporated into surgical guidelines.	esophagus
Relationship Between Human Papilloma Virus and Upper Gastrointestinal Cancers.	The human papillomavirus (HPV) is an oncogenic DNA virus that is the most commonly transmitted sexually transmitted virus. There is substantial evidence that HPV is associated with different types of cancer. While the majority of studies have concentrated on urogenital system cancers and head and neck cancers, the relationship between HPV and gastrointestinal system cancers, particularly esophageal cancers, has also been the subject of investigation. Given that HPV is a disease that can be prevented through vaccination and treated with antiviral agents, identifying the types of cancers associated with the pathogen may inform the treatment of these cancers. This comprehensive review examines the relationship between HPV and cancers of the upper gastrointestinal tract, highlighting the oncogenic mechanisms of the virus and its reported prevalence. A deeper understanding of HPV's association with cancer is relevant to the further development of cancer therapies.	esophagus
Loss of FXR or Bile Acid-dependent Inhibition Accelerate Carcinogenesis of Gastroesophageal Adenocarcinoma.	BACKGROUND & AIMS: The incidence of Barrett esophagus (BE) and gastroesophageal adenocarcinoma (GEAC) correlates with obesity and a diet rich in fat. Bile acids (BAs) support fat digestion and undergo microbial metabolism in the gut. The farnesoid X receptor (FXR) is an important modulator of the BA homeostasis. When activated, FXR can inhibit cancer-related processes, and thus, it is an appealing therapeutic target. Here, we assess the effect of diet on the microbiota-BA axis and evaluate the role of FXR in disease progression. METHODS: L2-IL1B mice (mouse model of BE and GEAC) under different diets, and L2-IL1B-FXR KO-mice were characterized. L2-IL1B-derived organoids were exposed to different BAs and to the FXR agonist obeticholic acid (OCA). The BA profile in serum and stool of healthy controls and patients with BE and GEAC was assessed. RESULTS: Here we show that a high-fat diet accelerated tumorigenesis in L2-IL1B mice while increasing BA levels and altering the composition of the gut microbiota. Although upregulated in BE, expression of FXR was downregulated in GEAC in mice and humans. In L2-IL1B mice, FXR knockout enhanced the dysplastic phenotype and increased Lgr5 progenitor cell numbers. Treatment of murine BE organoids and L2-IL1B mice with OCA notably ameliorated the phenotype. CONCLUSION: GEAC carcinogenesis appears to be partially driven via loss or inhibition of FXR on progenitor cells at the gastroesophageal junction. Considering that the resulting aggravation in the phenotype could be reversed with OCA treatment, we suggest that FXR agonists have great potential as a preventive strategy against GEAC progression.	esophagus
Cost-effectiveness of PD-1 inhibitors combined with chemotherapy for first-line treatment of oesophageal squamous cell carcinoma in China: a comprehensive analysis.	BACKGROUND: Programmed death-1 (PD-1) inhibitors combined with chemotherapy have become a standard first-line treatment for advanced oesophageal squamous cell carcinoma (ESCC). Given the high costs associated with immunotherapy, evaluating the cost-effectiveness of different PD-1 inhibitors in the Chinese healthcare setting is essential for guiding treatment decisions and policy development. METHODS: A cost-effectiveness analysis was conducted comparing six PD-1 inhibitors-sintilimab, toripalimab, tislelizumab, camrelizumab, serplulimab, and pembrolizumab-combined with chemotherapy for first-line treatment of advanced ESCC. A partitioned survival model was used to calculate incremental cost-effectiveness ratios (ICERs) from healthcare system perspective, with a willingness-to-pay (WTP) threshold set at $36,598.19 per quality-adjusted life year (QALY). Sensitivity analyses were performed to evaluate the robustness of the results. RESULTS: The ICERs for toripalimab, camrelizumab, pembrolizumab, serplulimab, sintilimab, and tislelizumab were $32,356.79/QALY, $48,410.64/QALY, $312,743.54/QALY, $121,200.84/QALY, $29,663.42/QALY, and $35,304.33/QALY, respectively. Sintilimab, toripalimab, and tislelizumab were below the WTP threshold. Among all regimens, the top three in life years (LYs) gained were toripalimab, serplulimab, and tislelizumab. Sensitivity analysis showed that utility values and drug prices were key factors influencing ICERs. Probabilistic analysis indicated that toripalimab, sintilimab, and tislelizumab had the highest probabilities of being cost-effective, at 83.1%, 81.4%, and 70.0%, respectively. CONCLUSION: Sintilimab, toripalimab, and tislelizumab are the most cost-effective PD-1 inhibitors when combined with chemotherapy for the first-line treatment of advanced ESCC in China, with ICERs below the WTP threshold. While all six PD-1 inhibitors demonstrated clinical benefits, pembrolizumab and serplulimab were less favourable from a cost-effectiveness standpoint. Sensitivity analysis confirmed that drug prices and utility values are significant determinants of cost-effectiveness.	esophagus
Study on the learning curve for thoracoscopic and laparoscopic radical resection of esophageal cancer.	BACKGROUND: The procedure for thoracoscopic and laparoscopic radical resection of esophageal cancer is complicated, so the operation time is long, which can easily negatively affect the self-confidence of young thoracic surgeons. This retrospective cohort study aimed to improve young thoracic surgeons' understanding of this type of surgery by analyzing the learning curve. METHODS: From October 2017 to August 2018, 64 patients who underwent thoracoscopic and laparoscopic radical resection of esophageal cancer by a single team were reviewed by a retrospective cohort study. These patients were divided into four groups according to the date of operation. The baseline data, operation time, the amount of bleeding during the operation, and the number of lymph nodes sampled were compared. Then, the quality of the different stages of the operation was analyzed and evaluated. RESULTS: There were no significant differences in the general baseline data, chest tube duration, or number of samples collected from the right laryngeal nodes among the four groups (p > 0.05). With the accumulation of experience, several key measures of surgical benefit were significantly different among the four groups. Specifically, the operation time became shorter, the amount of bleeding gradually decreased, the number of lymph nodes sampled gradually increased, and the number of left para-recurrent laryngeal nerve lymph nodes sampled gradually increased (p < 0.05). CONCLUSION: According to the learning curve, approximately 16 patients needed to complete this type of operation in 300 min, and 22 patients needed to be independently sampled from more than 20 lymph nodes.	esophagus
miR-103 promotes esophageal squamous cell carcinoma metastasis by targeting FOXP1.	Esophageal squamous cell carcinoma (ESCC), a prevalent malignancy within the digestive tract, is associated with a significantly high mortality rate. MicroRNAs were already demonstrated to work in a wide range of tumors. The objective of the present research was to elucidate the involvement of miR-103 in the pathogenesis of ESCC and to explore its underlying mechanisms of action. Real-time quantitative polymerase chain reaction was used to detect miR-103 expressions in ESCC tissues and cells. The clinical significance of these expressions was assessed by a series of statistical analyses. Transwell assay was used to study the impact of miR-103 on migration and invasion ability of ESCC cells. Furthermore, a dual luciferase reporter gene method was adopted to study the association of miR-103 with the targeting of forkhead box protein 1 (FOXP1). miR-103 was significantly up-regulation in ESCC tissues and cell lines. Clinically, high miR-103 expression was associated with negative prognosis in ESCC. The low miR-103 expression significantly inhibited cell proliferation, migration and invasion in ESCC cell lines. Furthermore, miR-103 regulated the mechanism of action of ESCC by targeting FOXP1. In this study, we found that miR-103 may serve as a biomarker for ESCC prognosis. miR-103 may promote ESCC cell metastasis by targeting FOXP1. These studies may elucidate the potential of miR-103 as a novel target for the treatment of ESCC.	esophagus
Challenges in Implementing Endoscopic Artificial Intelligence: The Impact of Real-World Imaging Conditions on Barrett's Neoplasia Detection.	BACKGROUND: Endoscopic deep learning systems are often developed using high-quality imagery obtained from expert centers. Therefore, they may underperform in community hospitals where image quality is more heterogeneous. OBJECTIVE: This study aimed to quantify the performance degradation of a computer aided detection system for Barrett's neoplasia, trained on expert images, when exposed to more heterogeneous imaging conditions representative of daily clinical practice. Further, we evaluated strategies to mitigate this performance loss. METHODS: We developed a computer aided detection system using 1011 high-quality, expert-acquired images from 373 Barrett's patients. We assessed its performance on high, moderate and low image quality test sets, each containing images from an independent group of 117 Barrett's patients. These test sets reflected the varied image quality of routine patient care and contained artefacts such as insufficient mucosal cleaning and inadequate esophageal expansion. We then applied three methods to improve the algorithm's robustness to data heterogeneity: inclusion of more diverse training data, domain-specific pretraining and architectural optimization. RESULTS: The computer aided detection system, when trained exclusively on high-quality data, achieved area under the curve (AUC), sensitivity and specificity scores of 83%, 85% and 67% on the high quality test set. AUC and sensitivity were significantly lower with 80% (p < 0.001) and 62% (p = 0.002) on the moderate-quality and 71% (p > 0.001) and 47% (p = 0.002) on the low-quality test set. Incorporating robustness-enhancing strategies significantly improved the AUC, sensitivity and specificity to 92% (p = 0.004), 88% (p = 0.84) and 81% (p = 0.003) on the high-quality test set, 93% (p = 0.006), 86% (p = 0.01) and 83% (p = 0.09) on the moderate-quality test set and 84% (p = 0.001), 78% (p = 0.002) and 77% (p = 0.23) on the low-quality test set. CONCLUSION: Endoscopic deep learning systems trained solely on high-quality images may not perform well when exposed to heterogeneous imagery, as found in routine practice. Robustness-enhancing training strategies can increase the likelihood of successful clinical implementation.	esophagus
[Comparison of clinical outcomes between Ivor-Lewis and Mckeown esophagectomy for middle or lower esophageal cancer].	Objective: To compare the short-term and long-term clinical effects of Ivor-Lewis and Mckeown esophagectomy in the treatment of middle or lower thoracic esophageal cancer. Methods: The clinical data of 716 patients with middle and lower thoracic esophageal cancer who underwent radical resection of Ivor Lewis or McKeown esophageal cancer in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Science from March 2015 to October 2018 were analyzed retrospectively, and the perioperative indicators, postoperative complications and survival of the two surgical methods were compared. Results: Among 716 patients, 135 patients underwent Ivor Lewis esophagectomy and 581 patients underwent McKeown esophagectomy. Mckeown group was significantly superior to Ivor Lewis group in terms of total number of lymph node dissection [median number was 27 (19~37) vs 25(18~33)], total number of lymph node dissection stations [median number was 5(4~7) vs 5(4~5)], and number of lymph nodes dissection along recurrent laryngeal nerve [median number was 3 (1~6) vs 0 (0~3), P＜0.05]. However, the incidence of recurrent laryngeal nerve palsy in Mckeown group was significantly higher than that in Ivor Lewis group [10.7% (62/581) vs 1.5%(2/135), P＜0.001]. There was no significant difference in the 1 -, 3 -, 5-year overall survival between the Ivor Lewis group(91.0%, 70.5%, 52.9%) and the Mckeown group (89.7%, 68.4%, 62.4%, P＞0.05), and there was also no significant difference in the 1 -, 3 -, 5-year disease free survival between the Ivor Lewis group(77.0%, 54.1%, 44.0%) and the Mckeown group (78.3%, 59.0%, 52.8%, P＞0.05). Conclusions: Ivor Lewis esophagectomy and Mckeown esophagectomy are feasible, safe, good short-term efficacy and similar survival rate for middle and lower thoracic esophageal cancer. Ivor Lewis surgery has lower incidence of recurrent laryngeal nerve palsy. Mckeown operation has more advantages in lymph node dissection, especially in lymph node dissection beside the recurrent laryngeal nerve.	esophagus
Inhibition of JAK2/STAT3 by pacritinib synergizes with chemotherapy in esophageal carcinoma.	The poor outcomes associated with esophageal carcinoma, particularly in advanced stages, necessitate the development of new treatment strategies. This study examines the efficacy of pacritinib, a multi-kinase inhibitor, both alone and in combination with carboplatin, in preclinical esophageal carcinoma models. Six esophageal carcinoma cell lines (KYSE-70, OE33, FLO-1, KYAE-1, ESO 26, and HCE-6) were treated with pacritinib, resulting in a dose-dependent reduction in cell viability. Combination index (CI) analysis demonstrated strong synergy between pacritinib and carboplatin across this panel of cell lines. In in vivo esophageal carcinoma xenograft model, pacritinib alone significantly reduced tumor growth and improved survival rates compared to control. Notably, the combination of pacritinib and carboplatin further reduced tumor growth and improved survival rates compared to either treatment alone. Toxicity assessment showed that neither single-agent nor combination treatment resulted in significantly altered levels of body weight and serum markers, supporting the safety profile of pacritinib in combination with carboplatin. Mechanistic studies revealed that while pacritinib inhibited the phosphorylation of JAK, STAT3, and IRAK1 in esophageal carcinoma cells, it is the suppression of the JAK/STAT3 pathway, rather than IRAK1, that is responsible for the synergistic effect with carboplatin. Our findings indicate that pacritinib possesses potent anti-tumor activity in esophageal carcinoma and enhances the efficacy of carboplatin through the suppression of JAK/STAT3 signaling, warranting further clinical investigation.	esophagus
Correlative analysis of immune-related thyroid dysfunction and prognosis in patients with advanced esophageal squamous cell carcinoma.	To explore the clinical characteristics of immune-related thyroid dysfunction (TD) and its correlation with prognosis. By collecting the clinical data of 116 patients with advanced esophageal squamous cell carcinoma (ESCC) who received programmed death receptor-1 (PD-1) inhibitor treatment, we analyzed the clinical characteristics of immune-related TD and its influencing factors and compared the prognostic differences among patients in different groups. Immune-related TD occurred in 45 (38.8%) patients after PD-1 inhibitor treatment, and the median time to its occurrence was 11.3 weeks. The toxicity of immune-related TD was grade 1 or grade 2 and only required symptomatic treatment. Female patients, as well as those with an Eastern Cooperative Oncology Group Performance Status less than equal to 1, no lymph node metastasis, no history of drinking, and high baseline thyroid-stimulating hormone levels, were likely to develop immune-related TD. Compared with the patients in the group without immune-related TD [TD(-)], the median progression-free survival (mPFS) and median overall survival (mOS) of the patients in the immune-related TD [TD(+)] group were significantly prolonged (mPFS: 12.6 vs. 6.5 months, P  = 0.001; mOS: 20.2 vs. 11.2 months, P  < 0.001). Further subgroup analysis showed that compared with the patients in the group without immune-related overt TD (Overt_TD), the patients in the Overt_TD group had a longer PFS (mPFS: 12.4 vs. 7.3 months, P  = 0.015) and OS (mOS: 20.2 vs. 12.2 months, P  = 0.001). The 60-, 90-, and 120-day landmark analysis further confirmed that immune-related TD was significantly associated with the improvement of PFS and OS. Multivariate Cox regression analysis indicated that immune-related TD was an independent prognostic factor for PFS ( P = 0.015) and OS ( P  = 0.004). Immune-related TD is a very common immune-related adverse event. It is safe and manageable and has potential prognostic value for patients with advanced ESCC treated with PD-1 inhibitors.	esophagus
Management of a patient with primary adenocarcinoma of the proximal third of the esophagus: a case report.	BACKGROUND: Cervical esophageal adenocarcinoma is a rare tumor often associated with Barrett's esophagus, and its prevalence is lower than distal esophageal adenocarcinoma. Upper esophageal malignancies are usually squamous cell carcinomata; about 5% of these cases are seen during upper gastrointestinal endoscopy. CASE PRESENTATION: We present a patient (a 39-year-old Iranian man) with invasive adenocarcinoma of the proximal third of the esophagus, who was referred to the hospital with no endoscopic or histopathologic evidence of Barrett's esophagus. We discuss the probable cause of this tumor and treatment options and emphasize the importance of recognizing and managing this rare disease. CONCLUSIONS: This case highlights the rarity of this adenocarcinoma and emphasizes the potential of chemotherapy as a standalone treatment, as well as the need for personalized therapeutic strategies and further research for the management of esophageal cancer.	esophagus
Establishment and characterization of novel patient-derived esophageal tumoroids with long-term cultivability.	Esophageal cancer is an aggressive and fatal disease classified into two distinct histologic types: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). To develop novel therapeutic strategies, it is important to establish preclinical models of esophageal carcinoma. In this study, we successfully established three types of human esophageal cancer organoids (tumoroids) from surgical specimens for long-term culture. Two of the tumoroids were derived from ESCC and one from EAC, which arose from Barrett's esophagus. Whole-exome sequencing revealed that the tumoroids inherited genetic mutations from the parental tumors and patient-derived tumor xenografts closely mimicked the pathology of the original esophageal cancers. In addition to whole-exome analysis, copy number and immunohistochemical analyses demonstrated HER2 expression and amplification as well as HER3 expression and mutation in esophageal tumoroids derived from adenocarcinoma in Barrett's esophagus. HER2-targeting antibody-drug conjugates (ADCs), trastuzumab deruxtecan (T-DXd), and patritumab deruxtecan (P-DXd) effectively suppressed the viability of the tumoroids. Therefore, the establishment of esophageal tumoroids with long-term cultivability makes it possible to obtain reproducible basic data, including drug sensitivity studies, which are important for the development of personalized therapies and treatment strategies.	esophagus
The correlation between intrathoracic herniation of the gastric tube and postoperative complications and the efficacy of laparoscopic retrosternal route creation.	BACKGROUND: Gastric tube prolapse into the thoracic cavity in retrosternal route reconstruction during esophagectomy is known as intrathoracic herniation of the gastric tube (IHGT). However, few reports have determined whether a correlation exists between IHGT and postoperative complications. Moreover, the optimal procedure for avoiding IHGT remains unclear. METHODS: This retrospective study included 200 patients who had undergone subtotal esophagectomy and retrosternal gastric tube reconstruction at a single institution. The diagnosis of IHGT was defined as a gastric tube herniation length of ≥ 5 cm on plain chest radiography. The frequency of postoperative complications in patients with IHGT was measured to determine any correlation. The incidence of IHGT in a laparoscopic retrosternal route creation group was also measured and the efficacy of this procedure was investigated. RESULTS: The overall incidence of IHGT was 7.5%. The incidence of grade II or higher anastomotic leakage and atelectasis was significantly higher in the IHGT( +) (anastomotic leakage, 26.7% vs. 4.3%, P = 0.007; atelectasis, 40.0% vs. 13.5%, P = 0.016). In univariate analysis, IHGT( +) showed a significantly higher incidence of anastomotic leakage (OR 7.88, P = 0.007). In multivariate analysis, IHGT was an independent risk factor for atelectasis (OR 5.03, P = 0.005). Furthermore, the incidence of IHGT was significantly lower in the laparoscopic group (2.0% vs. 13.0%, P = 0.005). CONCLUSION: Our findings show that IHGT may be correlated with grade II or higher anastomotic leakage and atelectasis. Laparoscopic retrosternal route creation may be effective in avoiding IHGT and contributes to a reduction in postoperative complications.	esophagus