crossing96/oncoscreening huggingface dataset:
Prognostic value of lymph node metastases and lymph node ratio in esophageal squamous cell carcinoma.	AIMS: Although the positive lymph node (LN) metastasis in patients with thoracic esophageal squamous cell carcinoma carcinoma (SCC) has been reported to be a risk factor to reduce long-term survival, only a few studies have so far evaluated the lymph node metastasis among this group of patients. The purpose of this study was to evaluate the impact of lymph node positivity and ratio on survival of esophageal SCC. METHODS: All patients undergoing esophagectomy at the Forth Hospital of Hebei Medical University between January 1986 and December 2002 were reviewed. Survival curves were estimated using the Kaplan-Meier method. RESULTS: Of 1,325 patients with invasive cancer, had squamous cell cancer of the esophagus. Median overall survival (OS) of the entire group was 36.7 months and 5-year OS was 39.3%. The most significant prognostic factor for overall survival was the presence of positive LN (P<0.01). Additionally, patients with zero involved LN had a 5-year survival of 49.1%, while patients with 1-3 positive LN and >3 positive LN had 5-year survival of 19.5% and 11.0%, respectively (P<0.01). Finally, an increasing ratio of positive to examined LN was linearly associated with a worsening 5-year survival, patients with <25%, 25%-50% and >50% positive LN had 5-year survival of 47.53%, 14.6% and 8.9%, respectively (P<0.01). CONCLUSION: Increasing number of positive LN in patients with esophageal cancer and increasing ratio of metastatic to examine LN portend a poor prognosis. These factors should play an important role in predicting prognosis of patients.	esophagus
A rare complication of esophageal stent: spinal epidural abscess.	The esophageal stent is used extensively for a malignant stricture, and many complications have been reported. We present a case of esophageal cancer with surgical esophageal stenting. Spinal epidural abscess occurred postoperatively, and we believe that the pathogenesis may be related to the esophageal stent.	esophagus
Colon interposition after esophagectomy with extended lymphadenectomy for esophageal cancer.	BACKGROUND: The purpose of this retrospective study was to investigate the feasibility of colon interposition procedures after esophagectomy with extended lymphadenectomy. METHODS: Between 1990 and 2008, 95 consecutive patients underwent colon interposition after esophagectomy with extended lymphadenectomy for esophageal cancer in our Institution. We reviewed clinical data and long-term survival, and also investigated the association between anastomotic leakage and clinicopathologic findings. RESULTS: We applied three-field lymphadenectomy to 71 patients and two-field to 24 patients, by a right thoracotomy. Ninety-two patients underwent reconstruction by a retrosternal route, and a posterior mediastinal route was applied to only three patients. We performed hand-sewn anastomosis in the neck in all cases. Three patients required microvascular surgery. Sixty-one patients (64%) experienced postoperative morbidity, most commonly pulmonary complications. Anastomotic leakage occurred in 12 patients (13%). No colon conduit necrosis was detected. Overall mortality, including hospital mortality, was 5.3%. Dysphagia (39%) and diarrhea (38%) were common and stricture was low (6%) after discharge. The overall 5-year survival rate was 43%. During the latter period (1998 to 2008), when ileocolon grafts evolved as the primary choice for interposition, the rate of leakage decreased from 17% (1990 to 1997) to 5.4%. No mortality was recorded during the latter period. CONCLUSIONS: Results from this study demonstrate that colon interposition after esophagectomy with extended lymphadenectomy is feasible and can have a favorable outcome.	esophagus
Long-term weight change after oesophageal cancer surgery.	BACKGROUND: Malnutrition is common after oesophageal cancer surgery. This study investigated weight changes and the risk of malnutrition among long-term survivors. METHODS: A nationwide cohort study was conducted in Sweden in 2001-2004, with follow-up to 2008. Weight was assessed before oesophagectomy, after 6 months and at 3 years. Logistic regression was performed with adjustment for confounders. Odds ratios (ORs) for postoperative weight loss of at least 15 per cent were estimated. RESULTS: Some 203 patients survived at least 3 years after oesophagectomy. Continuous weight loss occurred for up to 3 years. Women and men had a similar risk of malnutrition after 3 years (OR 0.85 (95 per cent confidence interval 0.24 to 2.98)). In overweight patients (preoperative body mass index at least 25 kg/m(2)) the risk of malnutrition was increased almost fivefold at 6 months (OR 4.90 (2.27 to 10.59)) and 3 years (OR 4.60 (1.80 to 11.78)). There was no difference in weight loss at 6 months between survivors and those who died between 6 months and 3 years after surgery (OR 1.11 (0.64 to 1.94)). CONCLUSION: Weight loss can be long lasting after oesophagectomy; overweight patients are at particularly increased risk of malnutrition.	esophagus
Imaging of subsquamous Barrett's epithelium with ultrahigh-resolution optical coherence tomography: a histologic correlation study.	BACKGROUND: Optical coherence tomography (OCT) is being developed as a potentially valuable method for high-resolution cross-sectional imaging of the esophageal mucosal and submucosal layers. One potential application of OCT imaging is to identify subsquamous Barrett's epithelium in patients who have undergone ablative therapy, which is not visible on standard endoscopic examination. However, histologic correlation confirming the ability of OCT to image subsquamous Barrett's epithelium has yet to be performed. DESIGN: Histologic correlation study. OBJECTIVE: To perform histologic correlation of ultrahigh-resolution optical coherence tomography (UHR-OCT) imaging for identification of subsquamous Barrett's epithelium. SETTING: Academic Medical Center (University of Washington, Seattle, WA). PATIENTS: Fourteen patients with pathologic biopsy specimens, proven to be high-grade dysplasia or adenocarcinoma underwent esophagectomy. INTERVENTIONS: UHR-OCT imaging was performed on ex vivo esophagectomy specimens immediately after resection. MAIN OUTCOME MEASUREMENTS: Correlation of UHR-OCT images with histologic images. RESULTS: Subsquamous Barrett's epithelium was clearly identified by using UHR-OCT images and was confirmed by corresponding histology. LIMITATIONS: Difficulty distinguishing some subsquamous Barrett's glands from blood vessels in ex vivo tissue (because of the lack of blood flow) in some cases. Imaging was performed with a bench-top system. CONCLUSIONS: Results from this study demonstrate that UHR-OCT imaging is capable of identifying subsquamous Barrett's epithelium.	esophagus
[Surgical approach in the management of oesophageal tumours: considerations based on therapeutic results].	"Over the last two decades, oesophageal cancers, although considered among the most malignant visceral tumours, have witnessed a gradual increase in survival rates at a distance after surgery. The aims of the study were to present the results of our surgical approach and, on this basis, to discuss a number of considerations regarding the type of intervention to be adopted. In a retrospective study we recruited 105 patients with oesophageal cancer treated with various types of oesophageal resection, with or without thoracotomy, in the Division of General Surgery of the Civic Hospital of Sondrio. The postoperative mortality rate was 12%, with 40.2% of non-lethal complications. The average overall survival, whether in patients R0 or not, was 31.2 months (range: 1-167), with actuarial survival rates of 63.2% at one year, 30.3% at three years and 22.1% at five years. This was not significantly influenced by the type of surgery or by the location or histology of the cancer, while TNM stage, degree of parietal infiltration and the presence or absence of lymph-node metastases were significant factors. Although we limited the lymphadenectomy to ""standard or extended two-field"" operations, our overall survival at five years was similar to that of surgeons advocating much more extensive lymphadenectomy. In our case most of the relapses occurred at the systemic level and in the short term, on average after 12.7 months, meaning that micrometastases were probably already present at the time of intervention (82.4% of these patients, in fact, had stage N1 cancers). We prefer cervical anastomosis owing to the possibility it affords of greater oesophageal resection and to its relative safety in case of dehiscence. We always perform a right cervicotomy, which allows us to avoid having to move the patient on the operating table and to have fewer injuries to the recurrent nerve."	esophagus
[Prognostic significance of the Mandard TRG classification after induction therapy in carcinoma of the oesophagus and cardia].	Mandard's tumor regression grade (TRG) is widely used to evaluate the pathological response to induction therapy with concurrent chemoradiotherapy in cancer of the oesophagus or gastro-oesophageal junction. The aim of this study was to evaluate the prognostic significance and clinical applicability of TRG. From 2000 to 2007, 108 patients with squamous cell carcinoma of the oesophagus (57 cases) or Siewert type I and II adenocarcinoma of the cardia (51 cases) were treated with induction chemoradiotherapy followed by surgery in the 1st Division of General Surgery of the University of Verona. The treatment was identical for all patients and consisted of cisplatin, 5 FU and docetaxel together with 50 Gy of concurrent radiotherapy. The treatment-induced response was evaluated by TRG. Fifty-one, 24, 17, 9 and 7 patients were classified, respectively, as TRG1, 2, 3 4 and 5. Fifty-two patients died of the disease. Disease-related survival decreased with the increase in TRG class in node-negative patients (p < 0.001), while in N+ patients it was poor, irrespective of TRG class (p = 0.241). Mandard TRG is therefore useful for staging patients undergoing preoperative chemoradiotherapy, because it displays high prognostic significance. In our study, however, N was the main prognostic factor and for this reason it is mandatory to consider nodal status along with TRG. Moreover, among N negative patients, the prognosis of each different TRG class is statistically different and for this reason different TRG classes cannot be grouped together.	esophagus
Localization of indoleamine 2,3-dioxygenase in human esophageal squamous cell carcinomas.	Immunosuppressive factors derived from the tumor and nontumor cells present in the tumor microenvironment contribute to tumor escape from host immune attack. Recently, the tryptophan-catabolizing enzyme indoleamine 2,3-dioxygenase (IDO) derived from both the tumor cells and surrounding nontumor cells was found to function as a critical immunosuppressive factor. While the expression of IDO is intensively under investigation in many types of cancers, little information is available in esophageal squamous cell carcinomas (ESCC) thus far. In this study, we have therefore investigated the cellular localization of IDO in 45 ESSCs and ten morphologically normal esophageal tissues; the correlation of IDO with clinicopathological parameters was also analyzed. Immunohistochemistry (IHC) analysis revealed that the density of IDO-positive cells was increased in ESCCs relative to controls (P < 0.01). These cells were distributed as clusters and formed a patchy pattern in both the cancerous epithelium and the surrounding noncancerous cells. Double IHC further confirmed that many IDO-positive cells in the tumor stroma were smooth-muscle-actin-alpha-positive myofibroblasts, CD68-positive macrophages, and S100-positive dendritic cells. Statistical analysis showed that the densities of IDO-positive cells were not significantly correlated with tumor clinical parameters (tumor invasion depth, node metastasis, and TNM stages) and lymphocytic infiltration. Our current findings suggested that the increased IDO expression in ESCCs is from a mixed cellular source (both cancer cells and noncancerous cells). Further studies on immune cell functional analysis are required in the future.	esophagus
Loss of imprinting of the insulin-like growth factor II (IGF2) gene in esophageal normal and adenocarcinoma tissues.	To evaluate loss of imprinting (LOI) and expression of the IGF2 gene in matched esophageal normal and adenocarcinoma tissues, we studied a prospective cohort of 77 patients who underwent esophageal resection between 1998 and 2003. IGF2 imprinting status was determined by reverse transcription-polymerase chain reaction (PCR) following ApaI digestion, and quantitative PCR was used to evaluate IGF2 expression, which was correlated with clinicopathologic findings, disease-free and overall survival. In total, 32% (14/44) of informative tissues showed loss of IGF2 imprinting, with a strong correlation between the tumor and normal esophageal epithelia (Kappa = 0.89, P < 0.01). Normal epithelia with LOI had increased expression of IGF2 [median: 2.91, 95% confidence interval (CI): 0.93-5.06] compared with imprinted normal epithelia (median: 1.13, 95% CI: 0.85-1.39) (P = 0.03). In contrast, tumors with LOI had significantly reduced IGF2 expression (median: 1.87, 95% CI: 0.53-5.21) compared with normally imprinted tumors (median: 6.79, 95% CI: 3.39-15.89) (P = 0.016). Patients below the age of 65 years with normally imprinted tumors had significantly reduced 5 year disease-free survival (DFS) (24%) compared with patients whose tumors had LOI for IGF2 (55%) (P = 0.03). Cox regression analysis showed that IGF2 overexpression was associated with significantly reduced disease-free survival (P = 0.04). We conclude that in a subgroup of younger patients, loss of IGF2 imprinting was associated with improved outcome following esophageal resection. Expression of IGF2 in esophageal adenocarcinoma and normal esophageal epithelia depended on imprinting status and tissue type, suggesting novel molecular regulatory mechanisms in esophageal tumorigenesis.	esophagus
Poor outcome of oesophageal adenocarcinoma after prior antireflux surgery.	AIMS: Gastro-oesophageal reflux disease is an important risk factor for oesophageal adenocarcinoma, but abolishing reflux through surgery has not been shown to reduce this risk. The purpose of this study is to report on adenocarcinomas occurring after previous antireflux surgery and their long-term outcome. PATIENTS AND METHODS: Six hundred and forty three patients underwent surgical resection in our unit for oesophagogastric adenocarcinoma between 2000 and 2009. Nine of these had antireflux surgery a median of 6.9 (mean of 9.3) years previously. Clinical and pathological characteristics and outcome (in terms of survival) are described for this patient group. The patients who had prior antireflux surgery were compared to matched control patients for disease free survival. RESULTS: Disease free survival in our antireflux patients was 25.1% as compared to 72.1% in controls at 3 years. (Log rank test p=0.004). CONCLUSIONS: Patients who have undergone antireflux surgery for chronic gastro-oesophageal reflux disease can develop adenocarcinoma and need to be monitored closely. The outcome following surgery appears greatly worse for patients with previous antireflux surgery than age/sex/stage/treatment matched controls in this small study.	esophagus
Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: a prospective cohort study.	OBJECTIVE: Alcohol consumption and cigarette smoking may be differentially associated with oesophageal squamous cell carcinoma (OSCC), oesophageal adenocarcinoma (OAC), gastric cardia adenocarcinoma (GCA) and gastric non-cardia adenocarcinoma (GNCA). However, because this was based on retrospective studies, these hypotheses were examined in a prospective cohort. METHODS: The prospective Netherlands Cohort Study consists of 120 852 participants who completed a baseline questionnaire on diet and other cancer risk factors in 1986. After 16.3 years of follow-up, 107 OSCC, 145 OAC, 164 GCA and 491 GNCA cases were available for analysis using Cox proportional hazards models and the case-cohort approach. RESULTS: The multivariable adjusted incidence rate ratio (RR) for OSCC was 4.61 (95% CI 2.24 to 9.50) for > or = 30 g ethanol/day compared with abstainers (p trend <0.001), while no associations with alcohol were found for OAC, GCA or GNCA. Compared with never smokers, current smokers had RRs varying from 1.60 for GCA to 2.63 for OSCC, and were statistically significant or borderline statistically significant. Frequency, duration and pack-years of smoking were independently associated with risk of all four cancers. A positive interaction was found between alcohol consumption and smoking status regarding OSCC risk. The RR for current smokers who consumed >15 g/day of ethanol was 8.05 (95% CI 3.89 to 16.60; p interaction = 0.65), when compared with never smokers who consumed <5 g/day of ethanol. CONCLUSIONS: This prospective study found alcohol consumption to be associated with increased risk of only OSCC. Cigarette smoking was associated with risk of all four cancers.	esophagus
How does inflammation cause Barrett's metaplasia?	Oesophageal adenocarcinoma conveys a poor prognosis and has a rapidly increasing incidence. Similarly, Barrett's metaplasia (a precursor lesion for oesophageal adenocarcinoma) has an increasing incidence. Both oesophageal adenocarcinoma and Barrett's metaplasia are more common in the context of inflammation as a result of acid and bile reflux. The cytokine profile of Barrett's metaplasia is predominantly a T-helper 2 response that contrasts with the T-helper 1 response in normal and inflamed oesophagus and normal intestine. A key transcription factor in the development of Barrett's metaplasia, CDX2, has recently been shown to be induced in response to inflammatory mediators. The mechanism for induction of CDX2 is dependent on nuclear factor kappa B, a crucial transcription factor in the inflammatory response. Understanding the role of oesophageal inflammation will provide important insight into the development of Barrett's metaplasia and oesophageal cancer.	esophagus
Does daily alcohol and/or cigarette consumption cause low-grade dysplasia, a precursor of esophageal squamous cell carcinoma?	BACKGROUND: Cigarette smoking and alcohol consumption are well-known risk factors for esophageal squamous cell carcinoma (ESCC), which has a very poor prognosis. Successful screening strategies for precursor lesions that can be targets for early detection and treatment are required to prevent ESCC. METHODS: This is a prospectively cross-sectional study. To clarify whether daily smoking and/or alcohol consumption are risk factors for dysplasia, which is the initial lesion leading to ESCC. Lugol chromoendoscopy was performed in 1,345 eligible individuals. Six hundred ninety individuals had daily smoking and/or alcohol consumption; 655 individuals did not smoke and drink alcohol. The effects of smoking and alcohol consumption among high-grade dysplasia (HGD), low-grade dysplasia (LGD), and controls without dysplasia were evaluated using multiple logistic regression analysis. RESULTS: Among 1,345 individuals, 17 HGD and 23 LGD lesions were confirmed histologically. The prevalence of both smoking and drinking consumption was significantly higher in HGD than in LGD individuals (age and sex adjusted odds ratio; 113.0, 95% confidence interval; 6.26), whereas no significant difference was seen in both consumption between LGD individuals and controls (odds ratio; 1.29, 95% confidence interval; 0.33-6.37). Approximately 70% of HGD individuals, but only 13% of LGD individuals, both smoked and consumed alcohol. CONCLUSIONS: Daily cigarette and alcohol consumption were not the risk factors for LGD, however, consumption of both were high-risk factors for HGD. We suggest that documenting the difference of risk factors for LGD and HGD can assist in the development of effective screening, early detection, and prevention strategies for ESCC.	esophagus
Expression of nucleostemin, epidermal growth factor and epidermal growth factor receptor in human esophageal squamous cell carcinoma tissues.	OBJECTIVE: To determine the expression of nucleostemin (NS), epidermal growth factor (EGF) and epidermal growth factor receptor (EGFR) mRNA in human esophageal squamous cell carcinoma (ESCC) tissues and their association in a human ESCC cell line. METHODS: The expression of NS, EGF and EGFR mRNA was determined in paired normal esophageal and ESCC tissues of 62 patients using in situ hybridization. The association between NS and EGF or EGFR was examined using immunoblotting and real time polymerase chain reaction in a human ESCC cell line transfected with NS siRNA or treated with a selective EGFR inhibitor. RESULTS: In normal esophageal and ESCC tissues, the positive detection rates were 21.0% (13/62) and 69.4% (43/62) for NS mRNA staining, 40.3% (25/62) and 77.4% (48/62) for EGF mRNA staining, and 30.6% (19/62) and 75.8% (41/62) for EGFR mRNA staining, respectively. These results indicated that NS, EGF and EGFR mRNA expression was upregulated mostly in ESCC tissues. Moreover, the expression of NS, EGF and EGFR mRNA was positively correlated with tumor grade, invasion and lymphatic metastasis of ESCC cells. NS mRNA was co-expressed with EGF and EGFR mRNA in ESCC tissues. The in vitro studies using a human ESCC cell line showed that knockdown of NS with NS siRNA significantly reduced EGF and EGFR expression. However, inhibition of the EGFR kinase activity with a specific EGFR kinase inhibitor had minimal effect on NS expression. CONCLUSION: The upregulation of NS, EGF and EGFR mRNA frequently occurs in ESCC tissues and is associated with malignancy of human esophageal squamous tumors. NS is required for EGF and EGFR expression.	esophagus
Twist, an independent prognostic marker for predicting distant metastasis and survival rates of esophageal squamous cell carcinoma patients.	The transcription factor Twist plays a key role in cancer metastasis. The present study aimed at investigating clinical Twist expression in patients with esophageal squamous cell carcinoma (ESCC) in order to correlate the Twist levels with the patients' survival rates and their other clinical parameters. Immunohistochemical staining using polyclonal Twist antibody was performed on paraffin embedded specimens of 112 ESCC patients and non-neoplastic esophageal epithelium used as a control. The overall staining intensity was analyzed along with clinicopathologic data and prognosis of ESCC. Twist expression was significantly higher in ESCC than in non-neoplastic oesophageal epithelium (P < 0.001). The Twist expression directly correlated with distant metastasis after esophagectomy (P = 0.001). Kaplan-Meier estimate in conjunction with the log-rank test revealed an inverse proportion relationship between postoperative survival rates of the patients and their Twist expression levels (log-rank, P < 0.001). In addition, Cox mono-variate analysis revealed that T/N classification, pTNM stage, distant metastasis and Twist expression were significantly correlated with mortality risk of patients after operation (P < 0.05). By Cox multi-variate analysis, Twist expression (risk ratio = 2.394; P < 0.001) and N classification were identified as the independent prognostic factors of patient survival. In conclusion, upregulated Twist expression in the primary ESCC significantly correlates with the high risk of subsequent development of distant metastasis and low postoperative survival rates; the latter was not significantly correlated with patients' age, gender, tumor location and differentiation. Twist may serve as an independent prognostic marker for predicting development of distant metastasis in ESCC patients and their survival.	esophagus