crossing96/oncoscreening huggingface dataset:
Incidence and risk factors for respiratory complications in patients undergoing esophagectomy for malignancy: a NSQIP analysis.	Respiratory complications are the most frequent adverse events in patients undergoing esophagectomy for cancer, and their occurrence may negatively affect postoperative recovery and outcomes. We queried the American College of Surgeons National Surgical Quality Improvement Program dataset to study the rate and influence of pneumonia, unplanned intubation, and ventilator dependency >48 hours on the early outcomes after esophagectomy and risk factors for their development. We included adult patients with an esophageal or gastric cancer diagnosis who were treated with esophagectomy between 2005 and 2012 and grouped them into 2 categories with respect to development of respiratory complications. Early surgical outcomes (including 30-day mortality, overall morbidity, return to operating room, and length of hospital stay) were compared. Risk factors associated with respiratory complications after esophagectomy were assessed using modified Poisson regression. A total of 2945 patients were identified and respiratory complications were observed in 687 (23.3%) of them. We observed a significant decrease in respiratory complication rates after esophagectomy throughout the studied years. Patients who developed respiratory complications were older and had more comorbidities and longer operative time. These patients also had statistically significantly higher rates of 30-day mortality and overall morbidity and were more likely to return to the operating room and to stay in the hospital longer. On multivariable analysis, numerous factors, including advanced age, smoking, alcohol use, dyspnea, history of chronic obstructive pulmonary disease, and prolonged operative time, were found to be risk factors for developing respiratory complications. As the development of respiratory complications leads to worse early surgical outcomes after esophagectomy, efforts should be made to prevent their occurrence by identifying patients with significant risk factors.	esophagus
Meta-analysis of Barrett's esophagus in China.	"AIM: To investigate the epidemiology and characteristics of Barrett's esophagus (BE) in China and compare with cases in the west. METHODS: Studies were retrieved from the China National Knowledge Infrastructure and PubMed databases using the terms ""Barrett"" and ""Barrett AND China"", respectively, as well as published studies about BE in China from 2000 to 2011. The researchers reviewed the titles and abstracts of all search results to determine whether or not the literature was relevant to the current topic of this research. The references listed in the studies were also searched. Inclusion and exclusion criteria for the literature were appropriately established, and the data reported in the selected studies were analyzed. Finally, a meta-analysis was performed. RESULTS: The current research included 3873 cases of BE from 69 studies. The endoscopic detection rate of BE in China was 1%. The ratio of male to female cases was 1.781 to 1, and the average age of BE patients was 49.07 ± 5.09 years. Island-type and short-segment BE were the most common endoscopic manifestations, accounting for 4.48% and 80.3%, respectively, of all cases studied. Cardiac-type BE was observed in 40.0% of the cases, representing the most common histological characteristic of the condition. Cancer incidence was 1.418 per 1000 person-years. CONCLUSION: Average age of BE patients in China is lower than in Western countries. Endoscopic detection and cancer incidence were also lower in China."	esophagus
Assessment of the diagnostic performance and interobserver variability of endocytoscopy in Barrett's esophagus: a pilot ex-vivo study.	AIM: To investigate a classification of endocytoscopy (ECS) images in Barrett's esophagus (BE) and evaluate its diagnostic performance and interobserver variability. METHODS: ECS was applied to surveillance endoscopic mucosal resection (EMR) specimens of BE ex-vivo. The mucosal surface of specimen was stained with 1% methylene blue and surveyed with a catheter-type endocytoscope. We selected still images that were most representative of the endoscopically suspect lesion and matched with the final histopathological diagnosis to accomplish accurate correlation. The diagnostic performance and inter-observer variability of the new classification scheme were assessed in a blinded fashion by physicians with expertise in both BE and ECS and inexperienced physicians with no prior exposure to ECS. RESULTS: Three staff physicians and 22 gastroenterology fellows classified eight randomly assigned unknown still ECS pictures (two images per each classification) into one of four histopathologic categories as follows: (1) BEC1-squamous epithelium; (2) BEC2-BE without dysplasia; (3) BEC3-BE with dysplasia; and (4) BEC4-esophageal adenocarcinoma (EAC) in BE. Accuracy of diagnosis in staff physicians and clinical fellows were, respectively, 100% and 99.4% for BEC1, 95.8% and 83.0% for BEC2, 91.7% and 83.0% for BEC3, and 95.8% and 98.3% for BEC4. Interobserver agreement of the faculty physicians and fellows in classifying each category were 0.932 and 0.897, respectively. CONCLUSION: This is the first study to investigate classification system of ECS in BE. This ex-vivo pilot study demonstrated acceptable diagnostic accuracy and excellent interobserver agreement.	esophagus
Novel drug discovery system for cancer stem cells in human squamous cell carcinoma of the esophagus.	Cancer stem cells (CSCs) have been identified in several tumor tissues. Since CSCs are resistant to cancer therapies, including chemotherapy and radiation therapy, and can even remain after therapies, tumor tissue often regrows and relapses. Thus, identification of CSCs and treatment targeting CSCs are required to treat tumor tissues. Reportedly, a fluorescent vector consisting of fluorescein ZsGreen fused to the carboxyl-terminal region of ornithine decarboxylase (cODC) was used to detect CSCs or therapy-resistant cancer cells in tumor tissues of the brain, pancreas and liver. Cells transfected with the fluorescent vector can express a fluorescein fused to cODC and become fluorescent only when the fusion protein is accumulated. In the present study, CSCs or therapy-resistant cancer cells were identified with the fluorescent vector in esophageal squamous cell carcinoma. The use of this fluorescent vector in drug screening enabled the detection of three drugs, AKT inhibitor XI, ERK inhibitor II and JAK inhibitor I, which target malignant CSCs.	esophagus
Quality of life after surgical treatment of early Barrett's cancer: a prospective comparison of the Ivor-Lewis resection versus the modified Merendino resection.	INTRODUCTION: The Merendino (MER) procedure has been evaluated as an alternative to transthoracic esophageal resection (TER) for early stage Barrett's carcinoma. Apart from reducing morbidity and mortality, improvements concerning postoperative health-related quality of life (HRQL) have been postulated. The aim of our study was to compare HRQL between these procedures. MATERIALS AND METHODS: Between July 2000 and July 2007, 117 patients with early Barrett's carcinoma underwent surgery. Patients with tumor recurrence were excluded from the study. HRQL was assessed 1 and 2 years after surgery using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (EORTC-QLQ-C30) and the QLQ-OES18 module. Patients recently diagnosed with early Barrett's carcinoma served as controls. Symptoms that showed a difference of more than ten between the control and the study groups were considered clinically relevant and were tested for significant differences between the study groups using the Mann-Whitney U test (p < 0.05). RESULTS: The response rates for the questionnaires ranged between 70 and 93 %. In the MER group, more items reflected a clinical relevant impairment of HRQL than in the TER group. Significant complaints in the MER group included nausea/vomiting, appetite loss, local pain, difficulties with social eating, and choking. Moreover, we found a significant restriction concerning global health and emotional and social functioning in this group 1 year after surgery. 2 years postoperatively, hardly any differences between the operative techniques could be detected. The only symptom in favor of the MER procedure was a better dysphagia score postoperatively. CONCLUSION: Our study suggests that MER procedure is not superior to subtotal esophagectomy with regard to HRQL.	esophagus
The potential of photodynamic therapy to treat esophageal candidiasis coexisting with esophageal cancer.	BACKGROUND: Photodynamic therapy (PDT) has been used in recent years to deal with fungal infections because of the prevalence of fungi resistance to drugs. However, PDT for gastrointestinal fungal infection has not been reported. This study was conducted to assess the potential of PDT to deal with esophageal candidiasis. METHODS: Two male patients with histological evidence of esophageal candidiasis coexisting with esophageal cancer were included in this retrospective study. Both patients were treated with PDT. This treatment was repeated at least 1month after the initial PDT if the patient still had residual cancer or esophageal candidiasis. Short-term efficacy was evaluated on the basis of endoscopy and histology findings. Further follow-up data were obtained from endoscopy results or telephone conversation. RESULTS: The esophageal candidiasis located 21-24cm and 25-28cm from the incisors of case 1 reached complete remission after one and two PDT sessions, respectively. The esophageal cancer coexisting with esophageal candidiasis located 21-24cm from the incisors reached complete remission after two PDT sessions. No recurrence was found at a 14-month follow-up. The esophageal cancer located 30-35cm from the incisors reached partial response after three PDT sessions. Both of the esophageal candidiasis and the coexisting esophageal cancer at 23-26cm from the incisors of case 2 reached complete remission and the esophageal cancer at 34-37cm from the incisors reached complete remission after one PDT session. No recurrence was found at a 24-month follow-up. There were no serious adverse events found in either of the two cases. CONCLUSION: Results of this preliminary study indicate that PDT may be a potential method to deal with esophageal candidiasis.	esophagus
CYP1A1 genetic polymorphisms and risk for esophageal cancer: a case-control study in central China.	The purpose of this study was to evaluate the associations of CYP1A1 genetic polymorphisms with the risk of developing esophageal cancer (EC). A case-control study was carried out in a Chinese population in which 157 hospital based EC cases and 157 population based healthy controls with 1:1 match by age and sex were included. PCR based restriction fragment length polymorphisms (PCR-RFLP) were used to detect genotypes in case and control groups. For the CYP1A1 Ile/Val polymorphism, comparing with wild genotype Ile/Ile, both the heterozygote genotype Ile/Val and the combined variant genotype Ile/Val+Val/Val increased the risk of esophageal cancer (OR: 2.05, 95%CI: 1.19-3.54, OR: 1.86, 95%CI: 1.11-3.12). No significant association was found between the CYP1A1 MspI polymorphism and EC. According to analysis of combined genotypes, the TC/AG combined genotype which contained both variant alleles of these two polymorphisms increased the risk of developing EC (OR: 2.12, 95%CI: 1.16-3.85). Our results suggested that genetic polymorphisms of CYP1A1 may increase the susceptibility to EC.	esophagus
[Prevention and treatment of complications during and after endoscopic mucosal band ligation for esophageal precancerous lesions and early cancer].	OBJECTIVE: To investigate the prevention and treatment of complications during and after endoscopic mucosal band ligation (EMBL) for precancerous lesions and early cancer in the esophagus. METHODS: Clinical data of 47 patients with esophageal precancerous lesions and early cancer undergoing EMBL in our center from June 2011 to August 2013 were reviewed retrospectively. Complications and associated treatment during operation, after operation and during follow-up were analyzed. RESULTS: Complications during operation included 7 cases of bleeding (14.9%) and 1 case of perforation (2.1%), who received hot biopsy forceps and argon plasma coagulation to stop bleeding successfully, and titanium clamp to suture wound surface. No cutaneous emphysema and pneumothorax occurred. Complications after operation included 1 case of delayed bleeding (2.1%) who received blood stopping under gastroscope, 2 cases of mediastinal and subcutaneous emphysema (4.3%), 6 cases of pleural effusion (12.8%), and 5 cases of minor inflammation or segmental atelectasis of pulmonary (10.6%), who all received successful conservative treatment. Seven cases of esophageal stricture occurred during follow-up, who were improved by balloon dilatation and metal-film stent placement. No deaths associated with EMBL occurred. All the complications were cured through conservative treatment. No additional surgery associated with the complications was needed. Post-operative pathology revealed 1 case was chronic inflammatory hyperplasia, 11 were low-grade intraepithelial tumor, 15 were high-grade intraepithelial tumor, 8 were carcinoma in situ, 12 were squamous cancer (8 with invasion into mucous muscular layer, 4 into submucous layer). Only 1 case of submucous cancer needed transthorax esophageal cancer radical operation because of dangerous margin. No relapse case was found during followed-up. CONCLUSION: EMBL can treat the esophageal precancerous lesions and early esophageal cancer effectively and its complications can be managed with conservative therapy usually.	esophagus
Slug is a predictor of poor prognosis in esophageal squamous cell carcinoma patients.	BACKGROUND: Slug, a regulator of epithelial mesenchymal transition, was identified to be differentially expressed in esophageal squamous cell carcinoma (ESCC) using cDNA microarrays by our laboratory. This study aimed to determine the clinical significance of Slug overexpression in ESCC and determine its correlation with clinicopathological parameters and disease prognosis for ESCC patients. METHODS: Immunohistochemical analysis of Slug expression was carried out in archived tissue sections from 91 ESCCs, 61 dysplastic and 47 histologically normal esophageal tissues. Slug immunopositivity in epithelial cells was correlated with clinicopathological parameters and disease prognosis over up to 7.5 years for ESCC patients. RESULTS: Increased expression of Slug was observed in esophageal dysplasia [cytoplasmic, 24/61 (39.3%) cases, p = 0.001, odd's ratio (OR) = 4.7; nuclear, 11/61 (18%) cases, p < 0.001, OR = 1.36] in comparison with normal esophageal tissues. The Slug expression was further increased in ESCCs [cytoplasmic, 64/91 (70.3%) p < 0.001, OR = 10.0; nuclear, 27/91 (29.7%) p < 0.001, OR = 1.42]. Kaplan Meier survival analysis showed significant association of nuclear Slug accumulation with reduced disease free survival of ESCC patients (median disease free survival (DFS) = 6 months, as compared to those that did not show overexpression, DFS = 18 months; p = 0.006). In multivariate Cox regression analysis nuclear Slug expression [p= 0.005, Hazard's ratio (HR) = 2.269, 95% CI = 1.289 - 3.996] emerged as the most significant independent predictor of poor prognosis for ESCC patients. CONCLUSIONS: Alterations in Slug expression occur in early stages of development of ESCC and are sustained during disease progression. Slug may serve as a diagnostic biomarker and as a predictor of poor disease prognosis to identify ESCC patients that are likely to show recurrence of the disease.	esophagus
Frequency, characterization, and prognostic analysis of PIK3CA gene mutations in Chinese esophageal squamous cell carcinoma.	PIK3CA gene mutations are found in numerous cancers but correlate differently with prognosis. Although the frequency of PIK3CA gene mutation in esophageal squamous cell carcinoma (ESCC) has been previously studied, a prognostic analysis has not been reported. Ninety-six surgically resected ESCC tissues were collected from Chinese patients and DNA was extracted. Gene mutations in PIK3CA (exons 9 and 20), EGFR (exons 18, 19, 20 and 21), KRAS (exons 2 and 3), and BRAF (exons 11 and 15) were screened using mutant-enriched liquid chip technology. PIK3CA gene mutations were identified in 12 of 96 ESCC cases (12.5%). No mutations were identified in EGFR, KRAS or BRAF genes in this study. Correlations between clinicopathological features and PIK3CA mutation status were analyzed and finally, patient survival information was used to determine the prognostic significance of PIK3CA mutation. Interestingly, the frequency of PIK3CA mutation was higher in female ESCC patients (31.3%, 5/16) than in males (8.8%, 7/80), and higher in patients with non-lymph node metastasis (19.6%, 10/51, P = .013) than in patients with lymph node metastasis (4.4%, 2/45, P = .025). Furthermore, patients with PIK3CA-mutated tumors showed a trend towards favorable overall survival (P = .085) but not disease-free survival (P = .238), suggesting that PIK3CA gene status may be a favorable predictive marker in ESCC patients.	esophagus
[Comparison of long-term health-related quality of life in patients with different methods of reconstruction after oncologic esophagectomy].	OBJECTIVE: To explore the effects of reconstructing method (narrow gastric tube (NGT) versus whole stomach (WS)) on health-related quality of life (HRQL) in patients during a 3-year follow-up. METHODS: In a prospective randomized single-center study from 2007 to 2008, 104 patients underwent esophagectomy for cancer. They were divided into NGT (n = 52) and WS (n = 52) groups. To assess HRQL, a questionnaire in references to EORTC-QLQ-C30 and QLQ-OES18 was administered at 3 weeks, 6 months, 1 year, 2 year and 3 years post-operation. Their clinical data were collected prospectively and follow-up was performed regularly. RESULTS: The patients in the NGT group reported significantly (P < 0.05) better average scores of HRQL at both 6 months and 1 year.However, no significant difference in average scores of HRQL was found at 3 years. Patients in the NGT group reported significantly (P < 0.05) better scores of reflux at 3 weeks, 6 months and 1 year.Nausea was the only item with significant difference on HRQL at 2 years and 3 years.No significant difference existed between two groups with regards to cumulative survival rate at 3 years. CONCLUSION: No significant difference existed between two groups with regards to cumulative survival rate at 3 years. The patients with gastric tube reconstruction after oncologic esophagectomy present better HRQL.Further studies are warranted to perform survival analysis beyond 3 year post-operation.	esophagus
Enucleation of esophageal submucosal tumors: a single institution's experience.	BACKGROUND: Esophageal submucosal tumors (SMTs) are usually benign, and surgical enucleation is widely accepted as the treatment of choice. The goals of this study were to investigate the surgical outcomes after enucleation of esophageal SMTs and to establish the feasibility of video-assisted thoracoscopic enucleation. METHODS: We performed a retrospective review of 87 patients who underwent enucleation of esophageal SMTs between 1995 and 2011 at Samsung Medical Center. RESULTS: There were 59 men and 28 women in the study group, with a mean age of 43.3 years (range, 20-73 years). Fifty-eight (67%) patients were asymptomatic. Among the remaining patients, the most common symptom was dysphagia (n=12). Transthoracic approaches were used in 79 patients, including 63 patients who underwent video-assisted thoracoscopic enucleation. Transabdominal approaches were performed in 8 patients. Pathologic diagnosis included leiomyoma (n=78 [89.7%]), gastrointestinal stromal tumors (GISTs) (n=5 [5.7%]), schwannoma (n=3 [3.4%]), and hemangioma (n=1 [1.1%]). The thoracoscopic enucleation group had a significantly shorter median hospital stay compared with the thoracotomy groups (5 versus 6 days; p=0.013). Overall, there were 2 postoperative leaks, including in 1 patient who underwent reoperation after enucleation. With the exception of 2 patients, there was no other major complications. One patient underwent esophagectomy for tumor recurrence after enucleation of GISTs. CONCLUSIONS: Overall, surgical outcomes were excellent after enucleation. The thoracoscopic approach was feasible for most patients and was correlated with a shorter hospital stay. However, careful management is warranted after enucleation of GISTs considering the recurrence risk.	esophagus
Ethnic inequalities in time to diagnosis of cancer: a systematic review.	BACKGROUND: Minimising diagnostic delays in cancer may help improve survival. Ethnic minorities have worse outcomes in some cancer types when compared to the majority; this may relate in part to differences during the diagnostic phase. Only a few British studies have specifically explored this relationship, and no synthesis of these exists. The present study aimed to systematically review evidence on ethnic inequalities in cancer diagnosis, focussing on patient and primary care intervals of diagnosis. METHODS: Six electronic databases were searched. Included studies were those conducted in the UK or elsewhere (where access to healthcare is comparable to the NHS) and those that described a time element during diagnosis. Study quality was evaluated using the Critical Appraisal Skills Programme (CASP) checklist for cohort studies and synthesis method was narrative. RESULTS: Seven of 8,520 studies retrieved by our search met the review criteria; six conducted in the UK, and one in New Zealand. Five (including one covering several sites) focused on breast cancer, one on prostate, and one on oesophagogastric cancer. The studies employed different methods of ascertainment and definition of ethnic groups and defined diagnostic delay in a non-standardised way; therefore, narrative synthesis was performed. In breast cancer, three studies reported longer diagnostic intervals among ethnic minorities and two found no evidence of differences by ethnicity. There was some evidence of longer diagnostic and referral intervals among ethnic minorities in oesophagogastric and colorectal cancers, but no evidence of this in prostate, non-Hodgkin's lymphoma, lung, and ovarian cancers. None of the studies identified shorter patient or primary care intervals in ethnic minorities. CONCLUSIONS: Existing studies provide insufficient evidence to confirm or refute ethnic inequalities in diagnostic intervals of cancer. Further studies are necessary to examine common cancer types including those frequently found in ethnic minorities (in addition to those covered here) and using current definitions of intervals in cancer diagnosis.	esophagus