crossing96/oncoscreening huggingface dataset:
Chemoradiation in the management of esophageal cancer.	The combination of chemotherapy, fluorouracil and cisplatin, and radiation has improved outcome for patients with esophageal cancer. A randomized controlled trial confirmed a long-term survival benefit when this chemotherapy was added to radiotherapy for squamous cell carcinoma, but the approach has not been definitively assessed in patients with adenocarcinoma. Preoperative chemoradiotherapy has been tested in numerous phase II studies and underpowered or flawed phase III studies. Nevertheless, collectively, the evidence strongly suggests that preoperative chemoradiotherapy improves outcome, and thus, this strategy has become a standard treatment option. Attempts to improve outcome by intensifying conventional cytotoxic drugs or increasing the radiation dose have not been successful. Camptothecin and taxane-based regimens combined with radiation have altered the toxicity profile, but substantial improvement in survival outcomes has yet to be demonstrated. Future improvements will likely require the incorporation of targeted agents that add minimally to existing toxicity, the use of molecular predictors of response to individualize selection of the chemotherapeutic regimen, and early identification of responders such that therapy might be altered dynamically.	esophagus
Esophageal stents for malignant strictures close to the upper esophageal sphincter.	BACKGROUND: Self-expanding stents are a well-accepted palliative treatment modality for strictures resulting from esophageal carcinoma. However, the use of stents close to the upper esophageal sphincter (UES) is considered to be limited by patient intolerance caused by pain and globus sensation and an increased risk of complications, particularly tracheoesophageal fistula formation and aspiration pneumonia. OBJECTIVE: Our purpose was to determine the efficacy and safety of stent placement in patients with a malignant obstruction close to the UES. DESIGN: Evaluation of 104 patients with dysphagia from a malignant stricture close to the UES treated in the period 1996-2006. SETTING: Single university center. PATIENTS: Patients with primary esophageal carcinoma (n = 66) or recurrent cancer after gastric tube interposition (n = 38) within 8 cm distance distal of the UES. Twenty-four (23%) patients also had a tracheoesophageal fistula. INTERVENTIONS: Stent placement. MAIN OUTCOME MEASUREMENTS: Functional and technical outcome, survival, complications, and recurrent dysphagia. Analyses were performed by chi(2) test, Kaplan-Meier curves, and log-rank testing. RESULTS: Mean distance from the UES to the upper tumor margin was 4.9 +/- 2.6 cm and to the upper stent margin 3.1 +/- 2.3 cm. The procedure was technically successful in 100 of 104 (96%) patients. Fistula sealing was achieved in 19 of 24 (79%) patients. After 4 weeks, dysphagia had improved from a median score of 3 (liquids only) to 1 (some difficulties with solids). Total complications were seen in 34 of 104 (33%) patients. Of these, major complications (aspiration pneumonia [9], hemorrhage [8], fistula [7], and perforation [2]) occurred in 22 (21%) patients, whereas pain after stent placement was observed in 16 (15%) patients. Recurrent dysphagia occurred in 29 (28%) patients and was mainly caused by tissue ingrowth or overgrowth (n = 10), food bolus obstruction (n = 7), stent migration (n = 3), or other reasons (n = 11), such as persistent fistula (n = 5), difficulty with swallowing (n = 4), and dislocation of the stent (n = 2). Eight (8%) patients complained of globus sensation; however, in none of the patients was stent removal indicated. LIMITATIONS: Retrospective design. CONCLUSIONS: Stent placement is safe and effective for the palliation of dysphagia and sealing of fistulas in patients with a malignant stricture close to the UES. On the basis of these results, stent placement may be considered for palliation in this group of patients with an otherwise dismal prognosis.	esophagus
Endoscopic ultrasound with conventional probe and miniprobe in preoperative staging of esophageal cancer.	BACKGROUND: Using an endoscopic ultrasound (EUS) miniprobe, even highly stenotic esophageal cancers precluding the passage of a conventional probe can be examined without prior dilatation. OBJECTIVE: To assess: (1) staging accuracy of conventional EUS probe and miniprobe, (2) variables influencing staging accuracy, (3) endoscopic features predicting tumor stage. METHODS: Ninety-seven consecutive patients with esophageal cancer undergoing complete surgical resection were included. Preoperative EUS was performed using a conventional probe in nonstenotic tumors and a miniprobe in stenotic tumors. Accuracy of EUS for T and N stages was compared to pathohistological staging. RESULTS: Overall EUS staging accuracy was 73.2% for T stage and 74.2% for N stage. It was similar for the miniprobe used in stenotic tumors vs the conventional probe used in nonstenotic tumors. Based on EUS, 84.5% of the patients would have been assigned to the appropriate therapy protocol (primary surgery vs neoadjuvant therapy). Endoscopic tumor features had no influence on staging accuracy. Tumor length >5 cm predicted advanced T and nodal positive stages. CONCLUSIONS: The miniprobe allows adequate EUS staging of stenotic esophageal tumors precluding the passage of a conventional probe. Therefore, dilatation therapy of stenotic cancers to conduct conventional EUS should be avoided.	esophagus
[TAp63gamma-induced apoptosis mediated by apoptosis inducing factor in human esophageal squamous carcinoma EC9706 cells].	OBJECTIVE: To study the molecular mechanism of TAp63gamma-induced cell apoptosis. METHODS: Transcription and protein expression of apoptosis inducing factor and p63 were investigated by immunohistochemistry and RT-PCR in human esophageal squamous carcinoma cell line EC9706 respectively. Twenty-four hours after transfection with pcDNA3.1-TAp63gamma, the apoptosis and translocation of apoptosis inducing factor in EC9706 cells were studied by flow cytometry, laser confocal microscopy and mitochondrial/cytosol/nuclear extraction analysis respectively. Down-regulation of apoptosis inducing factor protein was achieved by RNAi and pretreatment with caspase inhibitor zVAD.fmk of EC9706 cells. RESULTS: Presence of protein expressions of apoptosis inducing factor and absence of TAp63gamma was observed in the cytoplasm of untransfected cells. RT-PCR verified the subtype of p63 in EC9706 cells was DeltaNp63. After 24 hours of transfection, both nuclear and cytoplasmic expression of apoptosis inducing factor protein were observed in cells transfected with TAp63gamma and p53 expression vectors, but not in cells transfected with control vector. Cell apoptosis rates were 1.37%, 13.64%, 4.52%, 4.03% and 1.91% in the pcDNA3.1 transfection group, pcDNA3.1-TAp63gamma transfection group, apoptosis inducing factor siRNA and pcDNA3.1-TAp63gamma transfection group, zVAD.fmk treatment group, and the group receiving apoptosis inducing factor siRNA, plus zVAD.fmk treatment and pcDNA3.1-TAp63gamma transfection, respectively. CONCLUSIONS: Apoptosis inducing factor of EC9706 cells is released from mitochondria into both the cytoplasm and nucleus during TAp63gamma induced apoptosis. Down-regulation of apoptosis inducing factor inhibits TAp63gamma-induced apoptosis. Overall, TAp63gamma-induced apoptosis is dependent on the expression of apoptosis inducing factor and caspase.	esophagus
[Small interfering RNA suppression of transducer and activator of transcription 3 (STAT3) signaling pathway: inhibitory effect on proliferation of human esophageal squamous carcinoma cells].	OBJECTIVE: To investigate the efficiency of blockage of constitutively activated STAT3 signaling by small interfering RNA (siRNA), and to explore the inhibitory effects on the proliferation of human esophageal squamous carcinoma cells (EC9706 and Eca109). METHODS: EC9706 and Eca109 were transfected with chemical synthesized STAT3 siRNA (100 nmol/L). RT-PCR and Western blot were used to detect STAT3 mRNA and protein expression, including phosphorylated-STAT3 (p-STAT3) before and after the transfection respectively. The changes of DNA-binding activity and cell proliferation were evaluated by electrophoretic mobility gel shift assay and MTT, respectively. Stages of cell cycle were determined by flow cytometry. RESULTS: Expression levels of STAT3 mRNA and STAT3, p-STAT3 proteins were progressively inhibited by STAT3 siRNA at various time points after transfection. STAT3-DNA-binding activity was suppressed after transfection evidenced by electrophoretic mobility gel shift assay. The cell cycle was arrested at G(0)/G(1) phase along with a significant inhibition of cell proliferation after STAT3 siRNA treatment. CONCLUSION: STAT3 siRNA specifically and efficiently blocks the constitutively activated STAT3 signaling pathway in human esophageal squamous carcinoma cells, resulting in cell cycle arrest and proliferation inhibition.	esophagus
[Expression of human Sel-1-like gene and its significance in esophageal cancer].	OBJECTIVE: To study the expression of SEL1L (human Sel-1-like gene) mRNA and protein and its significance in esophageal cancer. METHODS: Immunohistochemical staining (S-P method) for SEL1L protein was performed in 90 samples of esophageal squamous cell carcinoma, 35 samples of normal esophageal mucosa 5 cm away from the tumor, 60 samples of esophageal mucosa adjacent to the tumor and 20 samples of esophageal squamous dysplasia. In situ hybridization for SEL1L mRNA was also carried out in the esophageal carcinoma cases and normal esophageal mucosa distant from and adjacent to the tumor. RESULTS: The positive rate of SEL1L mRNA was higher in esophageal carcinoma (80.0%, 72/90), as compared with that in normal esophageal mucosa distant from (14.3%, 5/35) and adjacent to (16.7%, 10/60) the tumor (P < 0.01). The positive rate of SEL1L mRNA in tumors with lymph node metastasis (92.7%, 38/41) was higher than that in tumors without lymph node metastasis (69.4%, 34/49) (P < 0.01). On the other hand, the expression rate of SEL1L protein was higher in esophageal carcinoma (87.8%, 79/90) and esophageal dysplasia (90.0%, 18/20), as compared with that in normal esophageal mucosa distant from (14.3%, 5/35) and adjacent to (13.3%, 8/60) the tumor (P < 0.01). The expression of SEL1L protein in esophageal cancer however did not correlate with age and sex of the patient, tumor location, tumor size, degree of differentiation, depth of tumor invasion, lymph node metastasis and tumor clinical stage (P > 0.05). A positive correlation was found between the expression of SEL1L mRNA and SEL1L protein (r = 0.492, P < 0.01). CONCLUSIONS: L1L protein expression is regulated at the transcriptional level. The high SEL1L protein expression is mainly the result of increased transcription. Overexpression of SEL1L protein is likely an early event during the pathogenesis of esophageal squamous cell carcinoma. SEL1L protein may serve as an important biomarker in identifying patients with higher risk of developing esophageal cancer.	esophagus
Mistaken identity of widely used esophageal adenocarcinoma cell line TE-7.	Cancer of the esophagus is the seventh leading cause of cancer death worldwide. Esophageal carcinoma cell lines are useful models to study the biological and genetic alterations in these tumors. An important prerequisite of cell line research is the authenticity of the used cell lines because the mistaken identity of a cell line may lead to invalid conclusions. Estimates indicate that up to 36% of the cell lines are of a different origin or species than supposed. The TE series, established in late 1970s and early 1980s by Nishihira et al. in Japan, is one of the first esophageal cancer cell line series that was used throughout the world. Fourteen TE cell lines were derived from human esophageal squamous cell carcinomas and one, TE-7, was derived from a primary esophageal adenocarcinoma. In numerous studies, this TE-7 cell line was used as a model for esophageal adenocarcinoma because it is one of the few esophageal adenocarcinoma cell lines existing. We investigated the authenticity of the esophageal adenocarcinoma cell line TE-7 by xenografting, short tandem repeat profiling, mutation analyses, and array-comparative genomic hybridization and showed that cell line TE-7 shared the same genotype as the esophageal squamous cell carcinoma cell lines TE-2, TE-3, TE-12, and TE-13. In addition, for more than a decade, independent TE-7 cultures from Japan, United States, United Kingdom, France, and the Netherlands had the same genotype. Examination of the TE-7 cell line xenograft revealed the histology of a squamous cell carcinoma. We conclude that the TE-7 cell line, used in several laboratories throughout the world, is not an adenocarcinoma, but a squamous cell carcinoma cell line. Furthermore, the cell lines TE-2, TE-3, TE-7, TE-12, and TE-13 should be regarded as one single squamous cell carcinoma cell line.	esophagus
Hodgkin's disease of the oesophagus: a literature review.	Hodgkin's disease rarely involves the gastrointestinal tract. Primary Hodgkin disease of the oesophagus seems to be extremely rare. We report a case of classical Hodgkin's disease involving lower end of oesophagus.	esophagus
Rare cerebellar metastases from oesophageal carcinoma.	BACKGROUND: Metastatic oesophageal carcinoma to the brain is an uncommon diagnosis that may cause abnormal neurological findings. AIMS: The case of a 56-year-old man who presented with brain secondaries as an initial manifestation of carcinoma of oesophagus is presented and the unique characteristics highlighted. RESULTS: Patient survival was for 12 months after initial presentation and treatment. CONCLUSION: Oesophageal carcinoma is a recognised cause of intracerebral metastatic tumours, though this is an uncommon occurrence.	esophagus
Chemoprevention of carcinogenic progression to esophageal adenocarcinoma by the manganese superoxide dismutase supplementation.	PURPOSE: Oxidative stress is related to the carcinogenic pathway of reflux esophagitis to Barrett's metaplasia to esophageal adenocarcinoma (EAC). Recent studies have shown that a decreased manganese superoxide dismutase (MnSOD) level is associated with the increased incidences of Barrett's esophagus (BE) and EAC. The aim of this study was to investigate MnSOD supplementation as a chemopreventive agent to prevent oxidative injury and subsequent BE and EAC formation. EXPERIMENTAL DESIGN: Our esophagoduodenal anastomotic (EDA) model was done on rats according to our established procedure and treated with Mn(III)tetrakis(4-benzoic acid) porphyrin (MnTBAP; 10 mg/kg, i.p. every 3 days). Histologic changes were determined after the EDA model at 1, 3, and 6 months. Lipid peroxidation and 8-hydroxy-deoxyguanosine for DNA oxidative damage were determined by thiobarbituric acid-reactive substance assay and immunohistochemical staining. Enzymatic activities of MnSOD and Cu/ZnSOD were evaluated, and the rate of proliferation was determined by proliferating cell nuclear antigen staining. RESULTS: Severe esophagitis was seen in 100% of the EDA rats, and morphologic transformation within the esophageal epithelium was observed with intestinal metaplasia (40% of animals) and cancer (40% of animals) identified after 3 months. Decreased oxidative damage, along with the decreased degree of esophagitis and incidence of BE (20%) and EAC (0%), was found in MnTBAP-treated EDA rats comparing with the saline-treated EDA control. Decreased proliferation (46%) and increased SOD enzymatic activities (25%) were also found in the EDA rats treated with MnTBAP. CONCLUSION: MnTBAP protected rat esophageal epithelium from oxidative injury induced by EDA, and it could prevent the transformation of esophageal epithelial cell to BE to EAC by preservation of antioxidants.	esophagus
Staging work-up of patients with esophageal cancer.	Accurate staging of disease in patients with newly diagnosed esophageal cancer is necessary in order to instigate appropriate curative or palliative therapy. The guidelines presented in this paper are suggested for the initial work-up of patients with newly diagnosed esophageal cancer, yet may be varied according to local preferences and availability of imaging technologies.	esophagus
Metastatic esophageal adenocarcinoma presenting in the iris.	PURPOSE: To report a case of metastatic esophageal adenocarcinoma presenting as an acute primary iris tumor of unknown origin. DESIGN: Interventional, clinicopathologic case report. METHODS: A 47-year-old healthy man sought treatment for a three-week history of a progressively enlarging red spot on the left iris. Presentation, local and systemic evaluation, and treatment are described. RESULTS: Iris biopsy revealed the lesion represented metastasis, and a systemic evaluation later revealed the primary source as esophageal adenocarcinoma. The patient began systemic chemotherapy. CONCLUSIONS: Metastatic iris lesions can have atypical presentations. Tissue biopsy, tumor antigens, and a thorough systemic evaluation are crucial in identification of primary tumors in cases of unknown metastatic origin.	esophagus
Clinical impact of lymphadenectomy extent in resectable esophageal cancer.	Esophageal cancer (EC) frequently presents with advanced stages and is associated with high recurrence rates after esophagectomy. The value of an extended lymph node dissection (ELND) remains unclear in this setting. An EC data set was created from the Surveillance, Epidemiology, and End-Results 1973-2003 database. Relationships between the number of lymph nodes (LNs) examined and overall survival (OS) were analyzed. From a cohort of 40,129 EC patients, 5,620 individuals were selected. The median age was 65 (range: 11-102), and 75% were men. The median tumor size was 5.0 cm (0.1-30). On multivariate analysis, total LN count (or negative LN count, respectively) was an independent prognostic variable, aside from age, race, resection status, radiation, T category, N category (all at p < 0.0001), and M category (p = 0.0003). Higher total LN count (>30) and negative LN count (>15) categories were associated with best OS and lowest 90-day mortality (p < 0.0001). The numeric LN effect on OS was independent from nodal status or histology. Greater total and negative LN counts are associated with longer EC survival. Although the mechanism remains uncertain, it does not appear to be limited to stage migration. ELND during potentially curative esophagectomy for EC can be supported by the data.	esophagus
[Endoscopic diagnosis of tissue atypism (EA) in the pharyngeal and esophageal squamous epithelium; IPCL pattern classification and ECA classification].	Standard magnifying endoscopy has around 100 fold magnifying power. Intra-epithelial papillary capillary loop (IPCL) pattern is diagnosed with it. Narrow band imaging system (NBI) is extremely useful to recognize IPCL well as a brown spot. In IPCL type classification, type I mainly includes normal epithelium. Type Il corresponds to inflammatory change or non-neoplastic tissue and type Ill reflects border line lesions. Type IV strongly suggests carcinoma in situ. Type V-1 is definitely diagnosed as carcinoma in situ. Endocytoscopy has around 500 fold magnification, which enables observation of cell and nucleus. Endocytoscopic images are classified into 5 categories from normal epithelium to malignant tissue as endocytoscopic atypism classification (ECA classification). ECA IV and V are considered to be treated in clinical setting.	esophagus
[Simulation of thoracoscopic esophagectomy by three-dimensional computed tomography].	The virtual operative field of thoracoscopic surgery for esophageal cancer was created by three-dimensional (3D) computed tomography (CT) imaging. Major vessels, bone, trachea, bronchi, lung, esophagus, lymph nodes and broncial arteries were constructed by a Zio M900 workstation from multidetector-row CT scanning data. The mediastinal lymph nodes and bilateral bronchial arteries were drawn by a free-hand tool. The static images and fry-through movies by a virtual endoscopy mode were useful for simulation of the endoscopic surgery, which is usually performed in very limited viewing. The location of lymph nodes and bronchial arteries in relation to the adjacent anatomical structures was realized by this virtual vision. The bronchial arteries should be preserved to avoid tracheobronchial ischemia, especially in case of salvage surgery after definitive chemoradiotherapy. The left bronchial arteries had many anatomical variations, so that 3D CT images were helpful to identify and to preserve the left bronchial arteries. In conclusion, the simulation of thoracoscopic esophagectomy by 3D CT is thought to contribute to safty and precise navigation for this kind of surgery.	esophagus
Endoscopic stenting of esophageal cancer: the clinical impact.	PURPOSE OF REVIEW: To summarize the most relevant articles with regard to endoscopic stenting of esophageal cancer published in 2006. RECENT FINDINGS: In 2006, there were two studies on esophageal stents with experimental designs and adequate size to contribute to an evaluation of esophageal stent technology. A study on an antireflux stent will not measurably change the current use of this device, but emphasizes the need for additional investigation. A study on a self-expanding plastic stent was the largest study to date demonstrating a self-expanding plastic stent to be comparable to self-expanding metal stents. Other published studies in 2006 on esophageal stents include review articles, case reports and small case series that are not addressed in this review. SUMMARY: Self-expanding metal stents remain an important option for the treatment of patients with tracheoesophageal fistulae and esophageal malignancies. Recent innovations are dominated by a shift toward self-expanding esophageal stents that are potentially removable. Such potentially removable stents allow for expanded clinical applications and will be the focus of publications in 2007.	esophagus
FDG-PET/CT tumor segmentation-derived indices of metabolic activity to assess response to neoadjuvant therapy and progression-free survival in esophageal cancer: correlation with histopathology results.	PURPOSE: To evaluate the diagnostic and prognostic abilities of PET tumor segmentation-derived indices of metabolic activity for the assessment of response to neoadjuvant chemoradiotherapy and progression-free survival in patients with esophageal cancer. METHODS: Twenty-five patients with histologically confirmed esophageal cancer were retrospectively evaluated. The patients underwent PET-CT imaging before and after completion of neoadjuvant therapy. Images were evaluated visually and quantitatively with a three-dimensional threshold-based region-growing program, which calculates SUVm, SUVa of the entire tumor, metabolic tumor length (Lm) and volume (Vm) before and after therapy (SUVm1, SUVm2, SUVa1, SUVa2, Lm1, Lm2, Vm1, and Vm2, respectively). Percentage changes in these metabolic variables before and after therapy were also calculated (%SUVm, %SUVa, %Lm, %Vm, respectively). RESULTS: SUVm1 (P = 0.018), SUVa1 (P = 0.019), Lm1 (P = 0.016), and Vm1 (P = 0.016) correlated with T-status. Advanced stage tumors (T3 + T4) had significantly higher glucose metabolism, metabolic length, and volume. Moreover, Lm1 >47.4 mm and Vm1 >29 cm3 were the best predictors of the level of tumor invasiveness. SUVm1 >12.7 and SUVa1 >5.9 could differentiate patients with positive lymph nodes from those without at presentation. %SUVa >32.3% and the SUVa1 >5.5 proved to be reliable predictors of pathologic response. SUVa2 >3.55 and SUVm2 >4.35 were the best predictors of disease progression during follow-up, with the latter having the best prognostic value. CONCLUSIONS: This study showed that FDG-PET tumor segmentation-derived indices of metabolic activity play a definite role in the evaluation of response to neoadjuvant chemoradiotherapy and progression-free survival in patients with esophageal cancer.	esophagus