crossing96/oncoscreening huggingface dataset:
Trend in incidence of adenocarcinoma of the esophagus in Japan, 1993-2001.	BACKGROUND: Several studies with population-based cancer registry data have suggested that incidence of adenocarcinoma of the esophagus has been increasing since 1970 in some European and North American countries and Australia. However, data from Asian countries with regard to the incidence of esophageal cancer by histological type based on the population-based cancer registry are lacking. The aim of this study was to describe the incidence of esophageal cancer by histological type in a Japanese population. METHODS: Cancer incidence data for 1993-2001 from 15 population-based cancer registries were collected by the Japan Cancer Surveillance Research Group in 2005. We used data from eight registries corresponding to inclusion criteria for data quality. RESULTS: Squamous cell carcinoma remains the predominant type in all esophageal cancers in Japan. The ratio of squamous cell carcinoma to adenocarcinoma is 26:1. For adenocarcinoma, estimated average annual percentage change was 4.7% (95% confidence interval: 0.7, 8.9) in men and 6.0% (2.4, 9.8) in women. Age-adjusted incidence rate (the world standard population) per 100 000 for 2001 was 0.3 in men and 0.05 in women. Incidence of squamous cell carcinoma was increasing slightly in men and nearly constant in women. Age-adjusted incidence rate for 2001 was 8.2 in men and 1.0 in women. CONCLUSION: No dramatic increase in adenocarcinoma has occurred, and absolute incidence remains low in Japan.	esophagus
[Barret esophagus--molecular biology].	Increasing incidence of adenocarcinoma of the esophagus is nowadays observed in western countries. Estimation of the unique molecules may, in the future, lead to early diagnostics of pathological changes in the Barret esophagus and identification of the patient at risk from cancerogenesis. The aim of this study is to explain terminology of Barret esophagus, basis of histopatology, diagnostics and to show molecules which have crucial significance in cancerogenesis.	esophagus
Refining esophageal cancer staging after neoadjuvant therapy: importance of treatment response.	OBJECTIVE: Accurate staging is vital for esophageal cancer management. The utility of the American Joint Committee on Cancer (AJCC) staging system 6th edition for esophageal cancer has been questioned for resected patients who receive neoadjuvant chemoradiotherapy (CRT). This study was undertaken to assess the AJCC staging system for patients with esophageal cancer that have received neoadjuvant CRT and to identify clinicopathological variables that predict survival. METHODS: Review of a prospective esophageal cancer database was undertaken for patients that received neoadjuvant CRT and resection. Primary tumor response was defined as major (</=10% residual tumor cells) or minor (>10% residual tumor cells). Cox regression and concordance analyses were used to determine prognostic factors. Median follow-up was 61 months. RESULTS: Of 131 patients with invasive cancer, there were 40/131 (31%) with squamous cell carcinoma (SCC) and 88/131 (65%) with adenocarcinoma. The procedure-related mortality rate was 3.8%. Median survival was 33 months. A major response was demonstrated by 79/131 (60%) patients. Survival analyses found that the AJCC 6th edition was unable to discriminate between stages 0, I, and IIa or stages IIb and III. Multivariate survival analyses found age, pretreatment tumor length >6 cm, positive lymph nodes, and a major tumor response were independent prognostic factors. These data were used to derive a new staging system that had improved discrimination of stage groups over the current AJCC system. CONCLUSION: The current AJCC staging system for esophageal cancer is inadequate for patients that receive neoadjuvant CRT. Refinement of the AJCC staging system should include primary tumor response for patients receiving neoadjuvant CRT.	esophagus
Genome-wide analysis of genetic alterations in Barrett's adenocarcinoma using single nucleotide polymorphism arrays.	We performed genome-wide analysis of copy-number changes and loss of heterozygosity (LOH) in Barrett's esophageal adenocarcinoma by single nucleotide polymorphism (SNP) microarrays to identify associated genomic alterations. DNA from 27 esophageal adenocarcinomas and 14 matching normal tissues was subjected to SNP microarrays. The data were analyzed using dChipSNP software. Copy-number changes occurring in at least 25% of the cases and LOH occurring in at least 19% were regarded as relevant changes. As a validation, fluorescence in situ hybridization (FISH) of 8q24.21 (CMYC) and 8p23.1 (SOX7) was performed. Previously described genomic alterations in esophageal adenocarcinomas could be confirmed by SNP microarrays, such as amplification on 8q (CMYC, confirmed by FISH) and 20q13 or deletion/LOH on 3p (FHIT) and 9p (CDKN2A). Moreover, frequent gains were detected on 2p23.3, 7q11.22, 13q31.1, 14q32.31, 17q23.2 and 20q13.2 harboring several novel candidate genes. The highest copy numbers were seen on 8p23.1, the location of SOX7, which could be demonstrated to be involved in amplification by FISH. A nuclear overexpression of the transcription factor SOX7 could be detected by immunohistochemistry in two amplified tumors. Copy-number losses were seen on 18q21.32 and 20p11.21, harboring interesting candidate genes, such as CDH20 and CST4. Finally, a novel LOH region could be identified on 6p in at least 19% of the cases. In conclusion, SNP microarrays are a valuable tool to detect DNA copy-number changes and LOH at a high resolution. Using this technique, we identified several novel genes and DNA regions associated with esophageal adenocarcinoma.	esophagus
Association of the polymorphisms of MTHFR C677T, VDR C352T, and MPO G463A with risk for esophageal squamous cell dysplasia and carcinoma.	BACKGROUND: From January 2004 to December 2006 a program of endoscopic screening for esophageal lesions was carried out in the high incidence area of esophageal cancer in Feicheng County, China. It provided the samples to evaluate the association of polymorphisms of methylenetetrahydrofolate reductase (MTHFR) C677T, vitamin D receptor (VDR) C352T, and myeloperoxidase (MPO) G463A genotypes with esophageal squamous cell dysplasia and carcinoma. METHODS: The subjects in the study were divided into 127 dysplasia cases, 126 squamous cell carcinoma cases, and 169 normal controls. Analyses of the MTHFR C677T, VDR C352T, and MPO G463A genotypes were performed using the PCR-restriction fragment length polymorphism (RFLP) method, whereas the multinomial logistic regression model was used in the data analysis to assess the odds ratios (ORs) related to dysplasia and carcinoma. RESULTS: Compared with the CC genotype of MTHFR C677T, the TT/TC of the genotype significantly increased the risk of the esophageal squamous cells dysplasia [OR, 2.25; 95% confidence interval (CI), 1.18-4.31]; the OR of esophageal squamous cancer was 1.58 (95% CI, 0.85-2.97) after adjustments for age, sex, and years of education. There was an interaction between the TT/TC genotype and alcohol drinking, smoking, and family history of esophageal cancer in the risk of esophageal dysplasia and carcinoma. CONCLUSIONS: Neither the VDR C352T nor the MPO G463A genotype had manifested association with the dysplasia and carcinoma of the disease, whereas the MTHFR 677TT genotype may be a genetic risk factor for esophageal dysplasia and carcinoma.	esophagus
Histological assessment of oesophageal columnar mucosa.	This review presents the pathological features of Barrett's oesophagus, with an emphasis on the role of pathologists in the diagnosis, surveillance and treatment of the disease. The diagnosis of Barrett's oesophagus is based both on endoscopy and histology. The surveillance of patients relies on systematic biopsy sampling, looking for dysplasia - intraepithelial neoplasia. Well established classifications of dysplasia are now used by pathologists, but there remain problems with this marker. Therefore, many alternative biomarkers have been proposed, that remain of limited interest in daily practice, including DNA-ploidy, proliferation markers, and p53 abnormalities. Endoscopic improvements already allow a better selection of biopsies, and it may be that new technologies will allow 'virtual biopsies'. The role of pathologists is now extended to the evaluation of new therapeutic modalities of early neoplastic lesions in Barrett's oesophagus, especially endoscopic mucosal resection.	esophagus
Replication of a genome-wide case-control study of esophageal squamous cell carcinoma.	In a previous pilot case-control study of individuals diagnosed with esophageal squamous cell carcinoma (ESCC) and matched controls from a high-risk area in China, we identified 38 single nucleotide polymorphisms (SNPs) associated with ESCC located in or near one of 33 genes. In our study, we attempted to replicate the results of these 38 gene-related SNPs in a new sample of 300 ESCC cases and 300 matched controls from the same study conducted in Shanxi Province, China. Among 36 evaluable SNPs, 4 were significant in one or more analyses, including SNPs located in EPHB1, PGLYRP2, PIK3C3 and SLC9A9, although the odds ratios (ORs) for these genotypes were modest. Associations were found with EPHB1/rs1515366 (OR 0.92, 95% CI 0.86-0.99; p = 0.019), PIK3C3/rs52911 (OR 0.93, 95% CI 0.88-0.99; p = 0.02) and PGLYRP2/rs959117 (OR 0.93, 95% CI, 0.86-1.01; p = 0.061) in general linear models (additive mode); and the genotype distribution differed between cases and controls for SLC9A9/rs956062 (p = 0.024). To examine these 4 genes in more detail, 40 HapMap-based tag SNPs from these 4 genes were evaluated in the same subjects and 7 additional SNPs associated with ESCC were identified. Further confirmation of these findings in other populations and other studies are needed to determine if the signals from these SNPs are indirectly associated due to linkage disequilibrium, or are directly related to biologic function and the development of ESCC.	esophagus
So-called carcinosarcoma of the esophagus: report of a case.	The carcinosarcoma of the esophagus is a rare malignant neoplasm consisting of both carcinomatous and sarcomatous components. A case of so-called carcinosarcoma of the esophagus is described herein. A 69-year-old man presented with dysphagia and was admitted to our hospital. Imaging studies revealed a localized ulcerative tumor in the middle intrathoracic esophagus without any invasion or metastasis. The patient was initially thought to have squamous cell carcinoma and underwent subtotal esophagectomy with lymphadenectomy. Final diagnosis of the tumor was so-called carcinosarcoma of the esophagus. The patient had an uneventful postoperative course and showed no evidence of recurrence or metastasis in the 4-year postoperative period.	esophagus
[Analysis of lymph node metastasis in the thoracic esophageal squamous cell carcinoma].	OBJECTIVE: To assess the metastatic frequency in different groups of lymph nodes and its influencing factors of the thoracic esophageal squamous cell carcinoma (ESCC) in order to determine the extent of lymphadenectomy during esophagectomy. METHODS: The clinical data of 730 patients with ESCC who underwent esophagectomy and lymphadenectomy were analyzed retrospectively. RESULTS: Of 730 patients, 166 had metastasis to the para-esophageal lymph nodes (22.7%), 90 to the left gastric artery lymph nodes (12.3%), 67 to the lymph nodes around gastric cardia, and 15 to the subcrinal lymph nodes (2.1%). Univariate analysis showed that metastasis to the subcrinal lymph node was positively correlated with the length and differentiation of tumor (P < 0.05), but it was not correlated with any the above parameters when analyzed by multivariate analysis. The metastasis to the para-esophageal lymph node was positively correlated with the length, invasion depth and differentiation of tumor by univariate and multivariate analysis (P < 0.05). The metastasis to the lymph nodes around gastric cardia and metastasis to left gastric artery lymph nodes were positively correlated with the position and invasion depth of tumor by univariate and multivariate analysis (P < 0.05). CONCLUSION: Lymph nodes of the para-esophagus, gastric cardia and left gastric artery usually have high frequency to harber mestastasis, therefore, it was suggested that the lymph nodes in these groups should be dissected during esophagectormy with two-field lymphadenectomy for thoracic esophageal squamous cell carcinoma. Whereas for those patients with the lesion < 3 cm in length or with tumor invasion confined within the esophageal wall or with a lesion located at the upper or lower third of the thoracic esophagus, the subcrinal lymph nodes may not be necessarily dissected.	esophagus
Better assessment of nodal metastases by PET/CT fusion compared to side-by-side PET/CT in oesophageal cancer.	BACKGROUND: Recently, positron emission tomography/computed tomography (PET/CT) has been introduced in the staging of oesophageal cancer. The impact of PET/CT fusion in comparison with side-by-side PET/CT in these tumours, was analyzed. PATIENTS AND METHODS: In 61 patients, 18-F-fluorodeoxyglucose (FDG)-PET and multidetector (md)-CT were performed within a two week interval. Software-fusion of md-CT and FDG-PET was correlated with side-by-side FDG-PET/CT reading by two independent investigators. The gold standard was the pathological outcome or clinical evidence of progression during the first year of follow-up. RESULTS: In 18 patients (18/61; 30%), nodal staging improved with software-fusion. The number of nodal metastases increased in five patients and decreased in four patients, leading to up-staging in one patient (2%) and down-staging in three patients (5%). In nine cases (15%), certainty and localization of metastases improved. However, the number of distant metastases did not change and software-fusion did not have an influence on resectability. CONCLUSION: PET/CT fusion substantially improves detection and localization of nodal metastases and may have an impact on locoregional treatment options.	esophagus
Influence of induction chemotherapy and class of cytotoxics on pathologic response and survival after preoperative chemoradiation in patients with carcinoma of the esophagus.	BACKGROUND: Patients with localized esophageal cancer (LEC) have diverse outcomes (post-therapy pathologic response, disease-free survival [DFS], and overall survival [OS]) after preoperative chemoradiation (P-CTRT), dictated also by inherent molecular heterogeneity. Whether the type of therapy influences the outcomes remains largely unanswered. It is hypothesized that induction chemotherapy (IC) or the type of cytotoxics used would not influence patient outcomes. METHODS: In this retrospective analysis, consecutive patients with LEC who had P-CTRT were analyzed. Data were collected regarding age, sex, baseline clinical stage, location, type of cytotoxics, post-therapy pathology, DFS, and OS. IC and the type of cytotoxics used were found to be correlated with DFS, OS, and post-therapy pathologic response. RESULTS: A total of 180 patients with LEC (119 had IC before P-CTRT, all had received 5-fluorouracil, 87 had received a taxane, and 57 had received a platinol) were analyzed. The median survival (MS) of all patients was 57.7 months and the 3-year and 5-year OS rates were 65.4% and 46.5%, respectively. The type of therapy appeared to have no influence on the outcome: IC versus no IC (P = .58) or platinol versus taxane versus platinol plus taxane (P = .63). Similarly, the type of pathologic response was not found to be influenced by IC (P = .18) or the type of cytotoxics used (P = .42). The data were similar for DFS. CONCLUSIONS: IC or the type of cytotoxics used with radiation for patients with LEC does not appear to influence OS, DFS, or the type of pathologic response after therapy, suggesting that a plateau has been reached. It remains to be seen whether the use of biochemoradiotherapy can provide an advantage in outcome.	esophagus
Association of ECRG2 TCA short tandem repeat polymorphism with the risk of oesophageal cancer in a North Indian population.	Oesophageal cancer-related gene (ECRG2) is a tumour suppressor gene and it has been suggested that a triplet TCA short tandem repeat (STR) in the noncoding region of exon 4 plays a role in genetic susceptibility to oesophageal cancer. In the present study, ECRG2 STR polymorphism was studied in 134 patients with oesophageal cancer and 194 controls, using PCR and polyacrylamide gel electrophoresis. The results showed a higher frequency of the ECRG2 TCA (3)/TCA (4) genotype in cancer patients than in controls (odds ratio 2.6, 95% CI 1.0-6.4, p = 0.03). The association of the ECRG2 TCA (3)/TCA (4) genotype with clinical characteristics showed an increased risk for squamous cell histology (2.8, 95% CI 1.1-7.1, p = 0.03), while no association with tumor location or lymph node involvement was observed. Interaction of tobacco, alcohol and occupational exposure with the ECRG2 genotypes did not show modulation of risk. In conclusion, the ECRG2 TCA (3)/TCA (4) genotype is associated with the risk of oesophageal carcinoma in a North Indian population.	esophagus
Treatment results of adenocarcinoma of the gastroesophageal junction.	BACKGROUND/AIMS: In the treatment of cardiac cancer, the selection of surgical procedures is controversial. METHODOLOGY: In this study 297 resectable adenocarcinomas arising around the GE junction, that had their center within 5cm oral and aboral of the anatomical GE junction, were analyzed. They were subdivided into those with the tumor center located more than 1cm above the GE junction (Type 1, N = 7), those with the tumor center located within 1cm oral and 2cm aboral of the GE junction (Type 2) and those with the tumor center 2cm below the junction (Type 3). Type 2 and 3 are subdivided into four groups as Type 2A (N = 47), 2B (N = 18), 3A (N = 37) and 3B (N = 188). Type 2A and 3A have esophageal invasion and Type 2B and 3B have no esophageal invasion. Thoraco-abdominal approach and transhiatal resection were done in 65 and 35 patients. Left and right thoracotomies were performed in 60 and 5 patients, respectively. RESULTS: Esophageal invasion distance of 83 among 84 Type 2A and 3A tumors limited within 5cm from the GE junction. The maximum esophageal length by transhiatal approach was 6cm. Postoperative mortality rates after transhiatal approach and thoracotomy were 0% and 5.8%, respectively. One patient of Type 2A with No110 involvement survived longer than 5 years. No patients with Type 2A and 3A had recurrence in the upper mediastinal nodes after transhiatal approach and left thoracotomy. Mediastinal node involvement was found in 3 of 7 Type 1 tumors. Cox regression analyses revealed that the esophageal invasion distance (< 3cm vs. > 3cm), lymph node status (N0 vs. N2) and extent of lymph node dissection (D1 vs. D2) are the independent prognostic factors. CONCLUSION: Dissection of the lower thoracic paraesophageal nodes is recommended if the esophageal invasion longer than 1cm. Almost all Type 2A and 3A tumors can be treated by transhiatal approach without positive esophageal margin under a routine use of intraoperative frozen section. Right thoracotomy and the dissection of the upper mediastinal nodes are recommended for Type 1 tumor. Cardiac resection with D2 dissection is indicated for Type 1 and T1 tumors of Type 2. Total gastrectomy +D2 dissection is recommended for T2-3 tumors of Type 2 and T1-4 tumors of Type 3. Treatment should be selected according to the proposed classification.	esophagus
Esophageal granular cell tumor covered by intramucosal squamous cell carcinoma: report of a case.	We report a case of a granular cell tumor (GCT) covered by squamous cell carcinoma (SCC) in the esophagus. A 69-year-old Japanese man was admitted to our hospital for treatment of superficial esophageal cancer detected by upper gastrointestinal endoscopy. Endoscopic examination revealed a shallow ulcer in the esophagus, 28-32 cm from the incisor teeth. The pathological findings of a biopsy of the lesion were moderately differentiated SCC. Thus, we performed partial esophagectomy with two-field (thoraco-abdominal) lymph node dissection. Microscopic examination of the surgical specimen revealed intraepithelial SCC with minimal invasion, and a GCT, 3 x 1 mm in size, in the submucosa just beneath the SCC. Cytoplasmic granules in the GCT were positive for periodic acid-Schiff. Immunohistochemically, the GCT was strongly positive for S-100 protein. To our knowledge, this is the first published report of a GCT covered by SCC in the esophagus.	esophagus
Primary esophageal diffuse large B-cell lymphoma: report of a case.	Primary esophageal lymphoma is very rare, with fewer than 25 cases documented in the English-language literature. We report a case of primary diffuse large B-cell lymphoma of the esophagus in a 42-year-old woman. Barium esophagogram revealed almost complete esophageal obstruction at the level of the cervical esophagus, and flexible endoscopy showed a circumferential submucosal tumor covered with intact mucosa. Neck magnetic resonance imaging (MRI) showed a wide cervical mass circumferentially encompassing the lumen of the cervical esophagus. Biopsies taken with multiple forceps during flexible and rigid esophagoscopy were nondiagnostic. Finally, external esophageal wall biopsies taken during neck exploration provided information that helped us establish the diagnosis. Pathohistological findings confirmed non-Hodgkin's lymphoma of the diffuse large B-cell type. The patient was treated with combined immunochemotherapy, consisting of rituximab plus cyclophosphamide, vincristine, adriablastin, and prednisone (CHOP), followed by irradiation. A complete response was achieved, and 3 years after diagnosis and treatment the patient was disease-free.	esophagus
SnoN overexpression is predictive of poor survival in patients with esophageal squamous cell carcinoma.	BACKGROUND: Earlier studies have identified the minimal overlapping region of amplification at 3q26 in esophageal squamous cell carcinoma (ESCC) by comparative genomic hybridization (CGH) analysis. These include PIK3CA which encodes the p110alpha catalytic subunit of phosphatidylinositol (PI) 3-kinase, a telomerase RNA component (TERC), a squamous cell carcinoma-related oncogene (SCCRO), ecotropic viral integration site-1 (EVI-1), and a Ski-related novel oncogene (SnoN). In the present study, we investigated the mRNA levels of four candidate genes (TERC, SCCRO, EVI-1, and SnoN) to determine whether genes other than PIK3CA are targets for amplification at 3q26 in ESCC. And also, we examined SnoN expression in ESCC samples. METHODS: Fifty-nine representative cases with ESCC were selected from our archives. We performed quantitative RT-PCR of four candidate genes (TERC, SCCRO, EVI-1, and SnoN) and immunohistochemistry for SnoN. Finally, we correlated these findings with the clinicopathological characteristics to determine their interrelationship. RESULTS: Among the four genes we tested, only SnoN mRNA was consistently overexpressed in primary ESCC, compared with those in corresponding nontumorous esophageal epithelia (P < 0.001). Immunoreactive SnoN was detectable in 31 of 59 (52.5%) esophageal squamous cell carcinoma specimens. The levels of SnoN expression were found to correlate with the depth of invasion and recurrence (P < 0.05). Furthermore, patients with positive staining for SnoN displayed more unfavorable outcomes than patients with negative staining (P < 0.05). CONCLUSION: SnoN is likely to be the target of the amplification at 3q26 in ESCC and plays an important role in the development of ESCC, influencing disease-specific survival.	esophagus