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Zhang G, Li J, Li S, Wang Y. Exploring Spatial Trends and Influencing Factors for Gastric Cancer Based on Bayesian Statistics: A Case Study of Shanxi, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1824. [PMID: 30142954 PMCID: PMC6165541 DOI: 10.3390/ijerph15091824] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 08/13/2018] [Accepted: 08/22/2018] [Indexed: 02/06/2023]
Abstract
Gastric cancer (GC) is the fourth most common type of cancer and the second leading cause of cancer-related deaths worldwide. To detect the spatial trends of GC risk based on hospital-diagnosed patients, this study presented a selection probability model and integrated it into the Bayesian spatial statistical model. Then, the spatial pattern of GC risk in Shanxi Province in north central China was estimated. In addition, factors influencing GC were investigated mainly using the Bayesian Lasso model. The spatial variability of GC risk in Shanxi has the conspicuous feature of being 'high in the south and low in the north'. The highest GC relative risk was 1.291 (95% highest posterior density: 0.789⁻4.002). The univariable analysis and Bayesian Lasso regression results showed that a diverse dietary structure and increased consumption of beef and cow milk were significantly (p ≤ 0.08) and in high probability (greater than 68%) negatively associated with GC risk. Pork production per capita has a positive correlation with GC risk. Moreover, four geographic factors, namely, temperature, terrain, vegetation cover, and precipitation, showed significant (p < 0.05) associations with GC risk based on univariable analysis, and associated with GC risks in high probability (greater than 60%) inferred from Bayesian Lasso regression model.
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Affiliation(s)
- Gehong Zhang
- Medical Imaging Department, Shanxi Medical University, Taiyuan 030001, Shanxi, China.
| | - Junming Li
- School of Statistics, Shanxi University of Finance and Economics, Taiyuan 030006, Shanxi, China.
| | - Sijin Li
- Medical Imaging Department, Shanxi Medical University, Taiyuan 030001, Shanxi, China.
| | - Yang Wang
- Medical Imaging Department, Shanxi Medical University, Taiyuan 030001, Shanxi, China.
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Bakhti SZ, Latifi-Navid S, Zahri S, Bakhti FS, Hajavi N, Yazdanbod A. Are Helicobacter pylori highly cytotoxic genotypes and cardia gastric adenocarcinoma linked? Lessons from Iran. Cancer Biomark 2018; 21:235-246. [PMID: 29036792 DOI: 10.3233/cbm-170701] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although the most extensive studies revealed the role of H. pylori VacA and CagA toxins in the development of gastric adenocarcinoma, the magnitude of this association and the correlations of vacA mosaicism and cagA status with cardia gastric adenocarcinoma (CGA) still remain controversial. OBJECTIVE We aimed to examine the linkage of H. pylori highly cytotoxic genotypes to CGA in Iranian populations as a model. METHODS A total of 601 Iranian patients were enrolled. Biopsies were cultured, genotyped, and anatomically and histologically classified. RESULTS The vacA c1 genotype, but not cagA status, showed a strong association with the risk of both CGA and non-cardia adenocarcinoma (NCGA), whether the controls were non-tumors, as those with either non-atrophic gastritis or peptic ulcerations, (the OR (95%CI) was 14.11 (4.91-40.52) and 9.59 (4.06-22.65), respectively) or those with NAG (the OR (95%CI) was 10.71 (3.49-32.82) and 8.11 (3.26-20.16), respectively). The vacA c1/cagA+ genotype was significantly associated with an increased risk of NCGA, whether the controls were non-tumors or those with NAG; the adjusted risk was 4.706 (1.41-15.67) and 4.85 (1.42-16.51), respectively. CONCLUSIONS The H. pylori vacA c1 genotype, but not cagA status, might be the first important bacterial biomarker for predicting the cardia adenocarcinoma risk in male patients aged ⩾ 55 in Iran.
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Affiliation(s)
- Seyedeh Zahra Bakhti
- Department of Biology, Faculty of Sciences, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran
| | - Saeid Latifi-Navid
- Department of Biology, Faculty of Sciences, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran.,Biosciences and Biotechnology Research Center, Faculty of Advanced Technologies, University of Mohaghegh Ardabili, Namin 56318-51167, Iran
| | - Saber Zahri
- Department of Biology, Faculty of Sciences, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran
| | - Fatemeh Sadat Bakhti
- Department of Biostatistics, Faculty of Public Health, Mazandaran University of Medical Sciences, Sari 48471-16548, Iran
| | - Naser Hajavi
- Gastrointestinal Cancer Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Abbas Yazdanbod
- Gastrointestinal Cancer Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran.,Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
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Wu SG, Zhang WW, Sun JY, Li FY, Lin Q, He ZY. Patterns of Distant Metastasis Between Histological Types in Esophageal Cancer. Front Oncol 2018; 8:302. [PMID: 30135855 PMCID: PMC6092597 DOI: 10.3389/fonc.2018.00302] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/18/2018] [Indexed: 12/25/2022] Open
Abstract
Introduction: Distant metastasis remains the major cause of treatment failure in esophageal cancer, though there have been few large-scale studies of the patterns of distant metastasis in different histological types. We investigated the patterns of distant metastasis in esophageal adenocarcinoma (AC) and squamous cell carcinoma (SCC) using a population-based approach. Methods: Patients with de novo stage IV esophageal cancer at diagnosis were identified using the Surveillance, Epidemiology, and End Results database. Multivariable logistic regression was performed to identify potential risk factors for site-specific distant metastasis to the distant lymph nodes, bone, liver, brain, and lung at diagnosis. Results: We identified 1,470 patients with complete data for analysis including 1,096 (74.6%) patients with AC and 374 (25.4%) patients with SCC. A total of 2,243 sites of distant metastasis were observed, the liver was the most common site of distant metastasis (727, 32.4%), followed by the distant lymph nodes (637, 28.4%), lung (459, 20.5%), bone (344, 15.3%), and brain (76, 3.4%). Multivariable logistic regression showed that compared to patients with SCC, patients with AC were more likely to have metastasis to the brain (odds ratio [OR] 3.026, 95% confidence interval [CI] 1.441-6.357, p = 0.003) and liver (OR 1.848, 95% CI 1.394–2.451, p < 0.001), and less likely to have metastasis to the lung (OR 0.404, 95% CI 0.316–0.516, p < 0.001). Histological type had no effect on metastasis to the distant lymph nodes or bone. Conclusions: Patients with esophageal AC are more likely to present with liver and brain metastases, and less likely to present with lung metastasis than patients with esophageal SCC.
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Affiliation(s)
- San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Hospital, First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wen-Wen Zhang
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Jia-Yuan Sun
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Feng-Yan Li
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Qin Lin
- Department of Radiation Oncology, Xiamen Cancer Hospital, First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Zhen-Yu He
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
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Chou SH, Tung YC, Wu LS, Chang CJ, Kung S, Chu PH. Severity of chronic periodontitis and risk of gastrointestinal cancers: A population-based follow-up study from Taiwan. Medicine (Baltimore) 2018; 97:e11386. [PMID: 29979428 PMCID: PMC6076176 DOI: 10.1097/md.0000000000011386] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 06/11/2018] [Indexed: 01/10/2023] Open
Abstract
The present study aimed to assess the association between the severity of chronic periodontitis and the risk of gastrointestinal (GI) cancers by investigating whether severe chronic periodontitis (CP), rather than mild CP, correlates with an increased risk of total or individual GI cancers.Adults (≥18 years) with mild and severe CP were identified from a random sample of 2 million insured patients in the National Health Insurance Research Database (2001-2010). After propensity score matching, 25,485 individuals, each with mild or severe CP, were included for comparison. The primary endpoint was the incidence of total or individual GI cancers, including cancers of the esophagus, stomach, small intestine, colon/rectum, and pancreas. Cox proportional hazard models with the robust aggregated sandwich estimator were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for known risk factors.GI cancers occurred in 275 individuals with mild CP and 324 individuals with severe CP. After adjusting for known risk factors, severe CP was not associated with an increased risk of total GI cancer relative to mild CP (HR: 0.99, 95% CI: 0.84-1.16) or individual GI cancers, including esophageal (HR: 1.15, 95% CI: 0.62-2.15), gastric (HR: 1.01, 95% CI: 0.68-1.49), small intestinal (HR: 0.70, 95% CI: 0.22-2.22), colorectal (HR: 0.95, 95% CI: 0.78-1.16), and pancreatic cancers (HR: 0.90, 95% CI: 0.47-1.75).Severe CP was not associated with an increased risk of total or individual GI cancers when compared with mild CP.
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Affiliation(s)
- Shing-Hsien Chou
- Department of Cardiology
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University
| | | | | | - Chee-Jen Chang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University
| | - Suefang Kung
- Section of Periodontics, Department of Dentistry, Chang Gung Memorial Hospital, Taoyuan
- Cheers Dental Clinic, New Taipei, Taiwan
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Lin X, Peng L, Xu X, Chen Y, Zhang Y, Huo X. Connecting gastrointestinal cancer risk to cadmium and lead exposure in the Chaoshan population of Southeast China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:17611-17619. [PMID: 29667054 DOI: 10.1007/s11356-018-1914-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 04/02/2018] [Indexed: 02/05/2023]
Abstract
Cadmium (Cd) and lead (Pb) pose a serious threat to human health because of its carcinogenicity. China ranks first according to the Global Cancer Report for 2014 in newly diagnosed gastrointestinal cancers and cancer deaths. The aim of the present study was to evaluate the association of Cd and Pb burden with the risk of gastrointestinal cancers in a hospital-based case-control study from southern regions of China, Chaoshan area. A total of 279 hospitalized patients were recruited in this study, of which 167 were gastrointestinal cancer cases (70 esophageal cancer, 51 gastric cancer, and 46 colorectal cancer), and 112 controls were recruited from two hospitals in the Chaoshan area of southeast China. Basic clinical data and information on gender, age, and other demographic characteristics were collected from medical records. Blood Cd and Pb levels were detected by graphite furnace atomizer absorption spectrophotometry (GFAAS). Blood Cd/Pb levels and over-limit ratios between cases and controls were compared by Mann-Whitney U and Kruskal-Wallis H tests. We used logistic regression to estimate odds ratios (ORs) as measures of relative risk and explored the relationships between blood Cd/Pb levels and gastrointestinal cancer risk and clinicopathological characteristics. Median levels of blood Cd and Pb in cases (2.12 and 60.03 μg/L, respectively) were significantly higher than those of controls (1.47 and 53.84 μg/L, respectively). The over-limit ratios for Cd (≥ 5 μg/L) and Pb (≥ 100 μg/L) in the cases were both higher than that of controls. Blood Cd levels had a tendency to accumulate in the human body with gender, age, and tobacco smoking, while blood Pb levels only were associated with tobacco smoking. The logistic regression model illustrated that gastrointestinal cancers were significantly associated with blood Cd levels and blood Pb levels. The concentrations of Cd and Pb in patients with T3 + T4 stage were markedly higher than in patients with T1 + T2. On the other hand, blood Cd levels were dramatically increased in the distant -metastasis (M1). Blood Cd and Pb levels are significantly higher in gastrointestinal cancers compared to controls. Cd and Pb appear to be risk factors for gastrointestinal cancers in Chaoshan region, and higher levels of Cd and Pb may promote the occurrence and progression of gastrointestinal cancers.
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Affiliation(s)
- Xueqiong Lin
- Clinical Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Lin Peng
- Clinical Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases, Shantou University Medical College, Shantou, 515041, Guangdong, China
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yanrong Chen
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases, Shantou University Medical College, Shantou, 515041, Guangdong, China
- Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yuling Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 510632, Guangdong, China.
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Elghali MA, Gouader A, Bouriga R, Mahjoub M, Jarrar MS, Ziadi S, Mokni M, Hamila F, Ltaeif R. Gastric Adenocarcinomas in Central Tunisia: Evolution Specificities through Two Decades and Relation with Helicobacter pylori. Oncology 2018; 95:121-128. [PMID: 29694966 DOI: 10.1159/000488488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 03/15/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION In developed countries, authors have reported variations over time in the seat and histological type of gastric adenocarcinomas, which were explained by Helicobacter pylori infection (HPI) incidence changes. In North-African countries and the Arabic world, epidemiological changes in gastric adenocarcinomas are still unknown. Our study aims to explore and to describe those changes in central Tunisia. MATERIALS AND METHODS This is a retrospective observational and descriptive study including 876 cases based on the National Central Tunisian Register of Cancers over a period of 21 years. Two groups were formed and compared (group A: 337 patients from 1995 to 2005; group B: 539 patients from 2006 to 2015). RESULTS HPI decreased from 32.6% in group A to 11.2% in group B (p < 0.05). Signet ring cell carcinomas increased in 2 decades from 14% in group A to 36% in group B (p < 0.05). Proximal cancers were 16.61% in group A and increased to 19.66% in group B (p = 0.3). Total gastrectomy rate was 10.4% in group A versus 23.2% in group B (p < 0.05). CONCLUSION This study has shown a significant increase of signet ring cell carcinomas with a simultaneous decrease in HPI in the last decade in central Tunisia.
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Affiliation(s)
| | - Amine Gouader
- Department of Digestive Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Rym Bouriga
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Mahjoub
- Department of Epidemiology and Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Salah Jarrar
- Department of Digestive Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Sonia Ziadi
- Department of Pathology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Moncef Mokni
- Department of Pathology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Fahmi Hamila
- Department of Digestive Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Rached Ltaeif
- Department of Digestive Surgery, Farhat Hached University Hospital, Sousse, Tunisia
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Tian D, Mo SJ, Han LK, Cheng L, Huang H, Hao S, Guan YL, Jiang KY, Deng JY, Feng HH, Wen HY, Fu MY. Investigation of Dietary Factors and Esophageal Cancer Knowledge: Comparison of Rural Residents in High- and Low-incidence Areas. Sci Rep 2018; 8:4914. [PMID: 29559669 PMCID: PMC5861081 DOI: 10.1038/s41598-018-23251-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/08/2018] [Indexed: 12/16/2022] Open
Abstract
To compare the differences in dietary status and knowledge of esophageal cancer (EC) between residents of high- and low-incidence areas. We investigated dietary conditions and EC knowledge among residents in high- and low-EC incidence areas (Yanting and Qingzhen counties). Residents in Yanting consumed more pickled vegetables, salted meat and barbecued food (P < 0.05). Analysis of the past ten-year trend in Yanting consumed fresh vegetables/fruits, beans, sauerkraut, hot food, and barbecued food had gradually increased, and the trend was less than that in Qingzhen County. However, the gradual increasing trend in consumption of pickled vegetables, pickled meat, and spicy food over the past 10 years was greater (P < 0.05). Drinking water in Yanting County was healthier than that in Qingzhen County (P < 0.05). In terms of EC knowledge, the proportions of residents in Yanting who had a clear understanding, knowledge or had heard of EC or knew the common causes, primary symptoms, therapeutic measures, preventive measures, and government interventions for EC were all higher than in Qingzhen (P < 0.05). Residents in Yanting had greater EC knowledge but more harmful dietary habits than those in Qingzhen.
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Affiliation(s)
- Dong Tian
- Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Shuai-Jia Mo
- College of Basic Medicine, North Sichuan Medical College, Nanchong, 637000, China
| | - Lian-Kui Han
- Department of Thoracic Surgery, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Liang Cheng
- Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Heng Huang
- College of Basic Medicine, North Sichuan Medical College, Nanchong, 637000, China
| | - Shuai Hao
- College of Basic Medicine, North Sichuan Medical College, Nanchong, 637000, China
| | - Ye-Lan Guan
- College of Basic Medicine, North Sichuan Medical College, Nanchong, 637000, China
| | - Kai-Yuan Jiang
- College of Basic Medicine, North Sichuan Medical College, Nanchong, 637000, China
| | - Jing-Ya Deng
- College of Basic Medicine, North Sichuan Medical College, Nanchong, 637000, China
| | - Hu-Hao Feng
- College of Basic Medicine, North Sichuan Medical College, Nanchong, 637000, China
| | - Hong-Ying Wen
- Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
| | - Mao-Yong Fu
- Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
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Fiscon V, Portale G, Migliorini G, Frigo F. Laparoscopic-assisted total gastrectomy for adenocarcinoma in a western country: Safety and oncological issues. TUMORI JOURNAL 2018; 97:304-8. [DOI: 10.1177/030089161109700308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Laparoscopic total gastrectomy for adenocarcinoma is a widely diffused operation in eastern countries, but there are only a few reports from western centers. We assessed a single surgeon's experience at a single, nonacademic, community hospital. Methods Short-term outcome of patients undergoing laparoscopic total gastrectomy for adenocarcinoma (June 2005-March 2010) was assessed. Results Fourteen patients (5 males, 9 females; median age, 66.8 years [interquartile range, 59.7–71.8]) underwent laparoscopic total gastrectomy. The median operative time was 240 min. There were five stage 1 patients, five stage 2, and four stage 3; R0 resection was obtained in all 14 patients, and the median number of lymph nodes retrieved was 38. Mortality and overall morbidity rates were 0% and 35.7%, respectively. Conclusions The outcomes of laparoscopic total gastrectomy for adenocarcinoma performed by a well-trained laparoscopic surgeon working in a community hospital are good in terms of safety for the patients and response to the oncological criteria used in open surgery.
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Affiliation(s)
- Valentino Fiscon
- Department of General Surgery, Azienda ULSS 15 ‘Alta Padovana’, Cittadella (Padua), Italy
| | - Giuseppe Portale
- Department of General Surgery, Azienda ULSS 15 ‘Alta Padovana’, Cittadella (Padua), Italy
| | - Giovanni Migliorini
- Department of General Surgery, Azienda ULSS 15 ‘Alta Padovana’, Cittadella (Padua), Italy
| | - Flavio Frigo
- Department of General Surgery, Azienda ULSS 15 ‘Alta Padovana’, Cittadella (Padua), Italy
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Rezaei-Tavirani M, Rezaei-Taviran S, Mansouri M, Rostami-Nejad M, Rezaei-Tavirani M. Protein-Protein Interaction Network Analysis for a Biomarker Panel Related to Human Esophageal Adenocarcinoma. Asian Pac J Cancer Prev 2017; 18:3357-3363. [PMID: 29286604 PMCID: PMC5980895 DOI: 10.22034/apjcp.2017.18.12.3357] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Esophageal adenocarcinoma (EAC) is one of the mostlethal cancers in the world with a very poor prognosis. Identification of molecular diagnostic methods is an important goal. Since protein-protein interaction (PPI) network analysis is a suitable method for molecular assessment, in the present research a PPI network related to EAC was targeted. Material and Method: Cytoscape software and its applications including STRING DB, Cluster ONE and ClueGO were applied to analyze the PPI network. Result: Among 182 EAC-related proteins which were identified, 129 were included in a main connected component. Proteins based on centrality analysis of characteristics such as degree, betweenness, closeness and stress were screened and key nodes were introduced. Two clusters were determined of which only one was significant statistically. Gene ontology revealed 50 terms in three groups associated with EAC. Conclusion: The findings indicate nine crucial proteins could form a candidate biomarker panel for EAC. Furthermore, an important cluster with 27 proteins related to the disease was identified. Gene ontology analysis of this cluster showed main related terms to closely correspond with those for colorectal cancer.
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60
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Wu SG, Zhang WW, He ZY, Sun JY, Chen YX, Guo L. Sites of metastasis and overall survival in esophageal cancer: a population-based study. Cancer Manag Res 2017; 9:781-788. [PMID: 29255373 PMCID: PMC5723120 DOI: 10.2147/cmar.s150350] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background There are few population-based studies of the sites of distant metastasis (DM) and survival from esophageal cancer (EC). The aim of this study was to assess the patterns and survival outcomes for site-specific DM from EC using a population-based approach. Methods Patients diagnosed with de novo stage IV EC between 2010 and 2014 were identified from the Surveillance, Epidemiology, and End Results program database. Overall survival (OS) was compared according to the site of DM. Results We included 3218 patients in this study; the most common site of DM was the liver, followed by distant lymph nodes, lung, bone and brain. Median OS for patients with liver, distant lymph node, lung, bone, and brain metastases was 5, 10, 6, 4, and 6 months, respectively (p<0.001). Site and number of distant metastases were independent prognostic factors for OS. In patients with a single site of DM, using liver metastases as reference, OS was lower for bone metastases (p=0.026) and higher for distant lymph node metastases (p=0.008), while brain (p=0.653) or lung (p=0.081) metastases had similar OS compared with liver metastases. Similar site-specific survival differences were observed in the subgroup with esophageal adenocarcinoma. However, distant lymph node metastases was associated with better survival (p=0.002) compared to liver, bone, or lung metastases in esophageal squamous cell carcinoma. Conclusion Site of metastasis affects survival in metastatic EC; OS was worst for bone metastases and greatest for distant lymph node metastases.
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Affiliation(s)
- San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen
| | - Wen-Wen Zhang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou
| | - Zhen-Yu He
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou
| | - Jia-Yuan Sun
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou
| | - Yong-Xiong Chen
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College, Xiamen University, Xiamen
| | - Ling Guo
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China
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Sun L, Subar AF, Bosire C, Dawsey SM, Kahle LL, Zimmerman TP, Abnet CC, Heller R, Graubard BI, Cook MB, Petrick JL. Dietary Flavonoid Intake Reduces the Risk of Head and Neck but Not Esophageal or Gastric Cancer in US Men and Women. J Nutr 2017; 147:1729-1738. [PMID: 28724656 PMCID: PMC5572494 DOI: 10.3945/jn.117.251579] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 04/02/2017] [Accepted: 06/14/2017] [Indexed: 01/28/2023] Open
Abstract
Background: Flavonoids are bioactive polyphenolic compounds found in fruits, vegetables, and beverages of plant origin. Previous studies have shown that flavonoid intake reduces the risk of certain cancers; however, few studies to date have examined associations of flavonoids with upper gastrointestinal cancers or used prospective cohorts.Objective: Our study examined the association between intake of flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones) and risk of head and neck, esophageal, and gastric cancers.Methods: The NIH-AARP Diet and Health Study is a prospective cohort study that consists of 469,008 participants. Over a mean 12-y follow-up, 2453 head and neck (including 1078 oral cavity, 424 pharyngeal, and 817 laryngeal), 1165 esophageal (890 adenocarcinoma and 275 squamous cell carcinoma), and 1297 gastric (625 cardia and 672 noncardia) cancer cases were identified. We used Cox proportional hazards regression models to estimate HRs and CIs for the associations between flavonoid intake assessed at study baseline and cancer outcomes. For 56 hypotheses examined, P-trend values were adjusted using the Benjamini-Hochberg (BH) procedure for false discovery rate control.Results: The highest quintile of total flavonoid intake was associated with a 24% lower risk of head and neck cancer (HR: 0.76; 95% CI: 0.66, 0.86; BH-adjusted 95% CI: 0.63, 0.91; P-trend = 0.02) compared with the lowest quintile. Notably, anthocyanidins were associated with a 28% lower risk of head and neck cancer (HR: 0.72; 95% CI: 0.62, 0.82; BH-adjusted 95% CI: 0.59, 0.87; P-trend = 0.0005), and flavanones were associated with a 22% lower risk of head and neck cancer (HR: 0.78; 95% CI: 0.68, 0.89; BH-adjusted 95% CI: 0.64, 0.94; P-trend: 0.02). No associations between flavonoid intake and risk of esophageal or gastric cancers were found.Conclusions: Our results indicate that flavonoid intake is associated with lower head and neck cancer risk. These associations suggest a protective effect of dietary flavonoids on head and neck cancer risk, and thus potential as a risk reduction strategy.
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Affiliation(s)
- Lucy Sun
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Divisions of Cancer Epidemiology and Genetics and
| | - Amy F Subar
- Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | | | | | | | | | | | - Ruth Heller
- Divisions of Cancer Epidemiology and Genetics and,Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv-Yafo, Israel
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Hashemian M, Murphy G, Etemadi A, Dawsey SM, Liao LM, Abnet CC. Nut and peanut butter consumption and the risk of esophageal and gastric cancer subtypes. Am J Clin Nutr 2017; 106:858-864. [PMID: 28768652 PMCID: PMC5573026 DOI: 10.3945/ajcn.117.159467] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/29/2017] [Indexed: 12/15/2022] Open
Abstract
Background: Nut consumption has been associated with decreased risk of colorectal, endometrial, lung, and pancreatic cancers. Polyphenols, fiber, vitamins, and minerals in nuts may confer this observed protective effect. To our knowledge, no prospective study has evaluated the effect of nut consumption on esophageal and gastric cancers.Objective: The objective was to evaluate the associations between nut and peanut butter consumption and the risk of esophageal and gastric cancers and their different subtypes.Design: In this study we used data from the NIH-AARP Diet and Health Study, which enrolled 566,407 persons who were 50-71 y old at baseline (1995-1996). The median follow-up time was 15.5 y. Intakes of nuts and peanut butter were assessed through the use of a validated food-frequency questionnaire. We used Cox proportional hazard models to estimate HRs and 95% CIs for esophageal and gastric cancers and their subtypes.Results: We identified 966 incident cases of esophageal adenocarcinomas, 323 cases of esophageal squamous cell carcinoma, 698 cases of gastric cardia adenocarcinoma, and 732 cases of gastric noncardia adenocarcinoma. Compared with those who did not consume nuts or peanut butter [lowest category of consumption (C0)], participants in the highest category of nut consumption (C3) had a lower risk of developing gastric noncardia adenocarcinoma [C3 compared with C0, HR: 0.73 (95% CI: 0.57, 0.94)]. This inverse association was also seen for peanut butter consumption [C3 compared with C0, HR: 0.75 (95% CI: 0.60, 0.94)]. We observed no significant associations between the highest and lowest intakes of nuts or peanut butter and the risk of gastric cardia adenocarcinoma, esophageal adenocarcinoma, or esophageal squamous cell carcinoma.Conclusions: Among older American adults, both nut and peanut butter consumption were inversely associated with the risk of gastric noncardia adenocarcinoma. This trial was registered at clinicaltrials.gov as NCT00340015.
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Affiliation(s)
- Maryam Hashemian
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD;,Departments of Nutrition and Biochemistry, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran; and,Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gwen Murphy
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Linda M Liao
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD;
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Gao S, Li S, Duan X, Gu Z, Ma Z, Yuan X, Feng X, Wang H. Inhibition of glycogen synthase kinase 3 beta (GSK3β) suppresses the progression of esophageal squamous cell carcinoma by modifying STAT3 activity. Mol Carcinog 2017; 56:2301-2316. [PMID: 28574599 DOI: 10.1002/mc.22685] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/13/2017] [Accepted: 06/01/2017] [Indexed: 12/26/2022]
Abstract
Although GSK3β has been reported to have contrasting effects on the progression of different tumors, it's possible functions in esophageal squamous cell carcinoma (ESCC) and the related molecular mechanisms remain unknown. Here, we investigated the expression, function, and molecular mechanism of GSK3β in the development of ESCC in vitro and in vivo. Though the expression of total GSK3β was significantly increased, the phosphorylated (inactivated) form of GSK3β (Ser9) was concurrently decreased in the cancerous tissues of patients with ESCC compared with controls, suggesting that GSK3β activity was enhanced in cancerous tissues. Further pathological data analysis revealed that higher GSK3β expression was associated with poorer differentiation, higher metastasis rates, and worse prognosis of ESCC. These results were confirmed in different ESCC cell lines using a pharmacological inhibitor and specific siRNA to block GSK3β. Using a cancer phospho-antibody array, we found that STAT3 is a target of GSK3β. GSK3 inhibition reduced STAT3 phosphorylation, and overexpression of constitutively active GSK3β had the opposite effect. Moreover, STAT3 inhibition mimicked the effects of GSK3β inhibition on ESCC cell migration and viability, while overexpression of a plasmid encoding mutant STAT3 (Y705F) abrogated these effects, and these results were further substantiated by clinicopathological data. In addition, a GSK3 inhibitor (LiCl) and/or STAT3 inhibitor (WP-1066) efficiently suppressed the growth of ESCC cells in a xenograft tumor model. Altogether, these results reveal that higher GSK3β expression promotes ESCC progression through STAT3 in vitro and in vivo, and GSK3β-STAT3 signaling could be a potential therapeutic target for ESCC treatment.
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Affiliation(s)
- Shegan Gao
- Henan Key Laboratory of Cancer Epigenetics; Cancer Hospital, The First Affiliated Hospital, College of Clinical Medicine, Medical college of Henan University of Science and Technology, Luoyang, China
| | - Shuoguo Li
- Henan Key Laboratory of Cancer Epigenetics; Cancer Hospital, The First Affiliated Hospital, College of Clinical Medicine, Medical college of Henan University of Science and Technology, Luoyang, China
| | - Xiaoxian Duan
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky
| | - Zhen Gu
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky
| | - Zhikun Ma
- Henan Key Laboratory of Cancer Epigenetics; Cancer Hospital, The First Affiliated Hospital, College of Clinical Medicine, Medical college of Henan University of Science and Technology, Luoyang, China
| | - Xiang Yuan
- Henan Key Laboratory of Cancer Epigenetics; Cancer Hospital, The First Affiliated Hospital, College of Clinical Medicine, Medical college of Henan University of Science and Technology, Luoyang, China
| | - Xiaoshan Feng
- Henan Key Laboratory of Cancer Epigenetics; Cancer Hospital, The First Affiliated Hospital, College of Clinical Medicine, Medical college of Henan University of Science and Technology, Luoyang, China
| | - Huizhi Wang
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky
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Shaikh T, Meyer JE, Horwitz EM. Optimal Use of Combined Modality Therapy in the Treatment of Esophageal Cancer. Surg Oncol Clin N Am 2017; 26:405-429. [DOI: 10.1016/j.soc.2017.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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65
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Apfel T, Lopez R, Sanaka MR, Thota PN. Risk of progression of Barrett's esophagus in patients with cirrhosis. World J Gastroenterol 2017; 23:3287-3294. [PMID: 28566888 PMCID: PMC5434434 DOI: 10.3748/wjg.v23.i18.3287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/11/2017] [Accepted: 04/21/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To study Barrett’s esophagus (BE) in cirrhosis and assess progression to esophageal adenocarcinoma (EAC) compared to non-cirrhotic BE controls.
METHODS Cirrhotic patients who were found to have endoscopic evidence of BE confirmed by the presence of intestinal metaplasia on histology from 1/1/2000 to 12/1/2015 at Cleveland Clinic were included. Cirrhotic patients were matched 1:4 to BE controls without cirrhosis. Age, gender, race, BE length, hiatal hernia size, Child-Pugh (CP) class and histological findings were recorded. Cases and controls without high-grade dysplasia (HGD)/EAC and who had follow-up endoscopies were studied for incidence of dysplasia/EAC and to assess progression rates. Univariable conditional logistic regression was done to assess differences in baseline characteristics between the two groups.
RESULTS A total of 57 patients with cirrhosis and BE were matched with 228 controls (BE without cirrhosis). The prevalence of dysplasia in cirrhosis and controls were similar with 8.8% vs 12% with low grade dysplasia (LGD) and 12.3 % vs 19.7% with HGD or EAC (P = 0.1). In the incidence cohort of 44 patients with median follow-up time of 2.7 years [interquartile range 1.0, 4.8], there were 7 cases of LGD, 2 cases of HGD, and 2 cases of EAC. There were no differences in incidence rates of HGD/EAC in nondysplastic BE between cirrhotic cases and noncirrhotic controls (1.4 vs 1.1 per 100 person- years, P = 0.8). In LGD, cirrhotic patients were found to have higher rates of progression to HGD/EAC compared to control group though this did not reach statistical significance (13.7 vs 8.1 per 100 person- years, P = 0.51). A significant association was found between a higher CP class and neoplastic progression of BE in cirrhotic patients (HR =7.9, 95%CI: 2.0-30.9, P = 0.003).
CONCLUSION Cirrhotics with worsening liver function are at increased risk of progression of BE. More frequent endoscopic surveillance might be warranted in such patients.
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Proximal gastrectomy with exclusion of no. 3b lesser curvature lymph node dissection could be indicated for patients with advanced upper-third gastric cancer. Gastric Cancer 2017; 20:528-535. [PMID: 27379895 DOI: 10.1007/s10120-016-0624-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/25/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Proximal gastrectomy has been introduced for early gastric cancer located in the upper third of the stomach, but expansion of its indication to advanced tumors has not been generally accepted in terms of lesser curvature lymph node dissection. METHODS We reviewed the medical records of 385 patients with tumors in the upper third of the stomach, and the incidence of metastasis and the therapeutic index related to the proximal (no. 3a) and distal (no. 3b) lymph nodes of the lesser curvature were analyzed and compared with those of tumors in the middle third (n = 1093) and lower third (n = 922) of the stomach. RESULTS The no. 3a rate of metastasis from advanced tumors in the upper third of the stomach was significantly higher than that from tumors in the middle third or lower third of the stomach. The no. 3b metastasis rate did not show any significant differences between the three locations, but the therapeutic index of no. 3b lymph nodes in the upper third of the stomach (1.7) was far lower than that in the middle third (7.1) or lower third (7.0). Further, the rate of metastasis from tumors with the distal border ending in the upper third of the stomach (2.2 %) was significantly (P < 0.0001) lower than that from tumors located in the upper third of the stomach but extending to the middle third (19.6 %), as well as from tumors located in middle third (17.1 %) or lower third (19.6 %), with the therapeutic index being only 1.1. The four no.-3b-positive tumors all measured more than 40 mm, and included one T3 tumor and three T4 tumors. CONCLUSION Proximal gastrectomy with exclusion of no. 3b lymphadenectomy could be indicated for at least T2 tumors measuring less than 40 mm localized in the upper third of the stomach.
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Guo W, Dong Z, Liu S, Qiao Y, Kuang G, Guo Y, Shen S, Liang J. Promoter hypermethylation-mediated downregulation of miR-770 and its host gene MEG3, a long non-coding RNA, in the development of gastric cardia adenocarcinoma. Mol Carcinog 2017; 56:1924-1934. [PMID: 28345805 DOI: 10.1002/mc.22650] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/23/2017] [Indexed: 12/24/2022]
Abstract
Maternally expressed gene 3 (MEG3) is an imprinted gene located at 14q32 which encodes an lncRNA and is downregulated in an expanding list of cancer cell lines and primary human cancers. The miR-770 is transcribed from the intronic sequence of MEG3 and MEG3 may be the host gene for miR-770. However, the biological role of MEG3 and miR-770 in gastric cardia adenocarcinoma (GCA) development and prognosis is poorly defined. The present study was to investigate the function and methylation status of MEG3 in GCA, and further to detect the functional association of miR-770 and its host gene MEG3 in GCA carcinogenesis and prognosis. MEG3 and miR-770 was significantly downregulated in GCA patients and cell lines, and their expression was associated with TNM stage and lymph node metastasis. Overexpression of MEG3 and miR-770 inhibited gastric cancer cell proliferation and invasion in vitro. Furthermore, the expression level of MEG3 and miR-770 was significantly increased in cancer cells after treated with 5-Aza-dC. The aberrant hypermethylation of proximal promoter and enhancer region of MEG3 was detected in GCA tissues. In addition, the proximal promoter and enhancer region hypermethylation and dysregulation of MEG3 and miR-770 were associated with poorer GCA patients' survival. These findings suggest that miR-770 and its host gene MEG3 may play tumor suppressor role and hypermethylation of proximal promoter and enhancer region may be one of the critical mechanisms in inactivation of MEG3 and miR-770 in GCA development. MEG3 and miR-770 may be used as potential biomarkers in predicting GCA patients' prognosis.
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Affiliation(s)
- Wei Guo
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhiming Dong
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Shengnan Liu
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yiling Qiao
- Special Care Hospital of Hebei Province, Shijiazhuang, Hebei, China
| | - Gang Kuang
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yanli Guo
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Supeng Shen
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jia Liang
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Abstract
Gastric adenocarcinoma, esophageal adenocarcinoma, and esophageal squamous cell carcinoma are among the most prevalent and deadly of malignancies worldwide. Screening and prevention programs will be critical to finally improving outcomes in these diseases. For gastric adenocarcinoma, screening in high-risk populations has significantly reduced mortality. More research is needed on screening high-risk individuals in low-risk populations. For esophageal adenocarcinoma, work is needed to develop efficient and effective techniques in mass screening programs. For most Western populations, current screening is not cost effective. Avoiding environmental risk factors is critical to reducing the incidence of this deadly illness.
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Affiliation(s)
- Liam Zakko
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 2nd St. SW, Rochester, MN 55905, USA
| | - Lori Lutzke
- Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street Northwest, Rochester, MN, USA
| | - Kenneth K Wang
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 2nd St. SW, Rochester, MN 55905, USA.
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Peng F, Hu D, Lin X, Chen G, Liang B, Zhang H, Dong X, Lin J, Zheng X, Niu W. Analysis of Preoperative Metabolic Risk Factors Affecting the Prognosis of Patients with Esophageal Squamous Cell Carcinoma: The Fujian Prospective Investigation of Cancer (FIESTA) Study. EBioMedicine 2017; 16:115-123. [PMID: 28163045 PMCID: PMC5474505 DOI: 10.1016/j.ebiom.2017.01.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/14/2017] [Accepted: 01/25/2017] [Indexed: 01/15/2023] Open
Abstract
Some metabolic factors have been shown to be associated with an increased risk of esophageal cancer; however the association with its prognosis is rarely reported. Here, we assessed the prediction of preoperative metabolic syndrome and its single components for esophageal cancer mortality by analyzing a subset of data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. Between 2000 and 2010, patients who underwent three-field lymphadenectomy were eligible for inclusion. Blood/tissue specimens, demographic and clinicopathologic data were collected at baseline. Metabolic syndrome is defined by the criteria proposed by Chinese Diabetes Society. In this study, analysis was restricted to esophageal squamous cell carcinoma (ESCC) due to the limited number of other histological types. The median follow-up in 2396 ESCC patients (males/females: 1822/574) was 38.2months (range, 0.5-180months). The multivariate-adjusted hazard ratio (HR) of metabolic syndrome for ESCC mortality was statistically significant in males (HR, 95% confidence interval, P: 1.45, 1.14-1.83, 0.002), but not in females (1.46, 0.92-2.31, 0.107). For single metabolic components, the multivariate-adjusted HRs were significant for hyperglycemia (1.98, 1.68-2.33, <0.001) and dyslipidemia (1.41, 1.20-1.65, <0.001) in males and for hyperglycemia (1.76, 1.23-2.51, <0.001) in females, independent of clinicopathologic characteristics and obesity. In tree-structured survival analysis, the top splitting factor in both genders was tumor-node-metastasis stage, followed by regional lymph node metastasis. Taken together, our findings demonstrate that preoperative metabolic syndrome was a significant independent predictor of ESCC mortality in males, and this effect was largely mediated by glyeolipid metabolism disorder.
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Affiliation(s)
- Feng Peng
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Dan Hu
- Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xiandong Lin
- Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Gang Chen
- Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Binying Liang
- Department of Medical Record, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Hejun Zhang
- Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xiaoqun Dong
- Department of Gastroenterology, Stephenson Cancer Center, Department of Internal Medicine, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jinxiu Lin
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Xiongwei Zheng
- Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Wenquan Niu
- State Key Laboratory of Medical Genomics, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China..
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Aho JM, Nenadic IZ, Aristizabal S, Wigle DA, Tschumperlin DJ, Urban MW. Use of Shear Wave Ultrasound Vibrometry for Detection of Simulated Esophageal Malignancy in Ex Vivo Porcine Esophagi. Biomed Phys Eng Express 2016; 2:065002. [PMID: 28948043 PMCID: PMC5609727 DOI: 10.1088/2057-1976/2/6/065002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Esophageal cancer is a malignant neoplasm with poor outcomes. Determination of local disease progression is a major determining factor in treatment modality, radiation dose, radiation field and subsequent surgical therapy. Discrimination of true tumor extent is difficult given the similarity of soft tissues of the malignancy compared to non-malignant tissues using current imaging modalities. A possible method to discriminate between these tissues may be to exploit mechanical properties to diagnostic advantage, as malignant tissues tend to be stiffer relative to normal adjacent tissue. Shear waves propagate faster in stiffer tissues relative to softer tissues. This may be measured by using ultrasound based shear wave vibrometry. In this method, acoustic radiation force is used to create a shear wave in the tissue of interest and ultrafast ultrasound imaging is used to track the propagating wave to measure the wave velocity and estimate the shear moduli. In this study we created simulated malignant lesions (1.5 cm length) using radiofrequency ablation in ex vivo esophageal samples with varied progression (partial thickness n = 4, and full thickness n = 5) and used normal regions of the same esophageal specimen as controls. Shear wave vibrometry was used to measure shear wave group velocity and shear wave phase velocity in the ex vivo specimens. These values were used to estimate shear moduli using an elastic shear wave model and elastic and viscoelastic Lamb wave models. Our results show that the group and phase velocities increase due to both full and mucosal ablation, and that discrimination may be provided by higher order analysis using viscoelastic Lamb wave fitting. This technique may have application for determination of extent of early esophageal malignancy and warrants further investigation using in vivo approaches to determine performance compared to current imaging modalities.
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Affiliation(s)
- Johnathon M. Aho
- Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN 55905
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905
| | - Ivan Z. Nenadic
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905
| | - Sara Aristizabal
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905
| | - Dennis A. Wigle
- Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN 55905
| | - Daniel J. Tschumperlin
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905
| | - Matthew W. Urban
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN 55905
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Liu W, Dong Z, Liang J, Guo X, Guo Y, Shen S, Kuang G, Guo W. Downregulation of Potential Tumor Suppressor miR-203a by Promoter Methylation Contributes to the Invasiveness of Gastric Cardia Adenocarcinoma. Cancer Invest 2016; 34:506-516. [PMID: 27791400 DOI: 10.1080/07357907.2016.1242010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Like many tumor suppressor genes, some miRNA genes harboring CpG islands undergo methylation-mediated silencing. In the study, we found significant downregulation and proximal promoter methylation of miR-203a and miR-203b in gastric cardia adenocarcinoma (GCA) tissues. The methylation status of miR-203a and miR-203b in tumor tissues was negatively correlated with their expression level. GCA patients in stage III and IV with reduced expression or hypermethylation of miR-203a demonstrated poor patient survival. In all, miR-203a and miR-203b may function as tumor suppressive miRNAs, and reactivation of miR-203a may have therapeutic potential and may be used as prognostic marker for GCA patients.
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Affiliation(s)
- Wei Liu
- a Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China.,b Surgical Oncology Department , Cangzhou Central Hospital , Cangzhou , Hebei , China
| | - Zhiming Dong
- a Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Jia Liang
- a Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Xin Guo
- a Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Yanli Guo
- a Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Supeng Shen
- a Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Gang Kuang
- a Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Wei Guo
- a Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
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Lin MQ, Li YP, Wu SG, Sun JY, Lin HX, Zhang SY, He ZY. Differences in esophageal cancer characteristics and survival between Chinese and Caucasian patients in the SEER database. Onco Targets Ther 2016; 9:6435-6444. [PMID: 27799791 PMCID: PMC5077267 DOI: 10.2147/ott.s112038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background To compare the clinicopathologic characteristics and survival of Chinese and Caucasian esophageal cancer (EC) patients residing in the US, using a population-based national registry (Surveillance Epidemiology and End Results [SEER]) database. Methods Patients with EC were identified from the SEER program from 1988 to 2012. Kaplan–Meier survival methods and Cox proportional hazards regression were performed. Results A total of 479 Chinese and 35,748 Caucasian EC patients were identified. Compared with Caucasian patients, the Chinese patients had a later year of diagnosis, remained married after EC was diagnosed, had esophageal squamous cell carcinomas (ESCCs) more frequently, had tumors located in the upper-third and middle-third of the esophagus more frequently, and fewer patients presented with poorly/undifferentiated EC and underwent cancer-directed surgery. In Chinese patients, the incidence of esophageal adenocarcinomas (EACs) increased from 1988 to 2012 (P=0.054), and the majority of EAC patients had tumors located in the lower thoracic esophagus. The overall survival (OS) was not significantly different between Chinese and Caucasian patients (P=0.767). However, Chinese patients with ESCC had a significantly better OS when compared to their Caucasian counterparts, whereas there was no significant difference in the OS between Chinese and Caucasian patients with EAC. Conclusion The presenting demographic features, tumor characteristics, and outcomes of EC patients differed between Chinese and Caucasian patients residing in the US. Chinese patients diagnosed with EAC tended to share similar clinical features with their Caucasian counterparts, and the Chinese patients with ESCC had better OS than their Caucasian counterparts.
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Affiliation(s)
- Min-Qiang Lin
- Department of Scientific Management, The First Affiliated Hospital of Xiamen University, Xiamen
| | - Yue-Ping Li
- Public Health School of Fujian Medical University, Fuzhou
| | - San-Gang Wu
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen
| | - Jia-Yuan Sun
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou
| | - Huan-Xin Lin
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou
| | - Shi-Yang Zhang
- Department of Hospital Infection Management, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China
| | - Zhen-Yu He
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou
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73
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Le Bras GF, Farooq MH, Falk GW, Andl CD. Esophageal cancer: The latest on chemoprevention and state of the art therapies. Pharmacol Res 2016; 113:236-244. [PMID: 27565381 DOI: 10.1016/j.phrs.2016.08.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/11/2016] [Accepted: 08/16/2016] [Indexed: 02/07/2023]
Abstract
Esophageal cancer is currently the 8th most common cancer worldwide and the 6th leading cause of cancer-related mortality. Despite remarkable advances, the mortality for those suffering from esophageal cancer remains high, with 5-year survival rates of less than 20%. In part, because most patients present with late-stage disease, long-term survival even after resection and therapy is disappointingly low. As we will discuss in this review, multiple characteristics specific to the disease stage and patient must be considered when choosing a treatment plan. This article will summarize current standard therapies, potential application of chemoprevention drugs and the promise and partial failure of personalized medicine, as well as novel treatments addressing this disease.
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Affiliation(s)
- Gregoire F Le Bras
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Muhammad H Farooq
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Gary W Falk
- Division of Gastroenterology, Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Claudia D Andl
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, United States.
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Lichthardt S, Kerscher A, Dietz UA, Jurowich C, Kunzmann V, von Rahden BHA, Germer CT, Wiegering A. Original article: role of adjuvant chemotherapy in a perioperative chemotherapy regimen for gastric cancer. BMC Cancer 2016; 16:650. [PMID: 27538392 PMCID: PMC4991066 DOI: 10.1186/s12885-016-2708-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 08/11/2016] [Indexed: 11/17/2022] Open
Abstract
Background Multimodal treatment strategies – perioperative chemotherapy (CTx) and radical surgery – are currently accepted as treatment standard for locally advanced gastric cancer. However, the role of adjuvant postoperative CTx (postCTx) in addition to neoadjuvant preoperative CTx (preCTx) in this setting remains controversial. Methods Between 4/2006 and 12/2013, 116 patients with locally advanced gastric cancer were treated with preCTx. 72 patients (62 %), in whom complete tumor resection (R0, subtotal/total gastrectomy with D2-lymphadenectomy) was achieved, were divided into two groups, one of which receiving adjuvant therapy (n = 52) and one without (n = 20). These groups were analyzed with regard to survival and exclusion criteria for adjuvant therapy. Results Postoperative complications, as well as their severity grade, did not correlate with fewer postCTx cycles administered (p = n.s.). Long-term survival was shorter in patients receiving postCTx in comparison to patients without postCTx, but did not show statistical significance. In per protocol analysis by excluding two patients with perioperative death, a shorter 3-year survival rate was observed in patients receiving postCTx compared to patients without postCTx (3-year survival: 71.2 % postCTx group vs. 90.0 % non-postCTx group; p = 0.038). Conclusion These results appear contradicting to the anticipated outcome. While speculative, they question the value of post-CTx. Prospectively randomized studies are needed to elucidate the role of postCTx.
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Affiliation(s)
- Sven Lichthardt
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr.6, 97080, Wuerzburg, Germany
| | - Alexander Kerscher
- Comprehensive Cancer Centre Mainfranken, University Hospital, University of Wuerzburg, Josef-Schneiderstr. 6, 97080, Wuerzburg, Germany
| | - Ulrich A Dietz
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr.6, 97080, Wuerzburg, Germany
| | - Christian Jurowich
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr.6, 97080, Wuerzburg, Germany
| | - Volker Kunzmann
- Comprehensive Cancer Centre Mainfranken, University Hospital, University of Wuerzburg, Josef-Schneiderstr. 6, 97080, Wuerzburg, Germany.,Department of Internal Medicine II, University of Wuerzburg Medical Center, Oberduerrbacherstr.2, 97080, Wuerzburg, Germany
| | - Burkhard H A von Rahden
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr.6, 97080, Wuerzburg, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr.6, 97080, Wuerzburg, Germany.,Comprehensive Cancer Centre Mainfranken, University Hospital, University of Wuerzburg, Josef-Schneiderstr. 6, 97080, Wuerzburg, Germany
| | - Armin Wiegering
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr.6, 97080, Wuerzburg, Germany. .,Department of Biochemistry and Molecular Biology, University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany.
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Huang YK, Kang WM, Ma ZQ, Liu YQ, Zhou L, Yu JC. Body mass index, serum total cholesterol, and risk of gastric high-grade dysplasia: A case-control study among Chinese adults. Medicine (Baltimore) 2016; 95:e4730. [PMID: 27583914 PMCID: PMC5008598 DOI: 10.1097/md.0000000000004730] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Obesity is related to an increased risk of gastric cardia cancer. However, the influences of excess body weight and serum total cholesterol on the risk of gastric high-grade dysplasia have not been fully characterized.A case-control study was conducted to explore the relationships between body mass index (BMI), serum total cholesterol level, and the risk of gastric high-grade dysplasia in Chinese adults. A total of 893 consecutive patients with gastric high-grade dysplasia (537 men and 356 women) and 902 controls (543 men and 359 women) were enrolled from January 2000 to October 2015. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, and a multivariate analysis was conducted.After adjusting for age, alcohol consumption, smoking status, family history of gastric cancer or esophageal cancer, and serum total cholesterol level, a BMI ranging from 27.5 to 29.9 was significantly related to an increased risk of gastric high-grade dysplasia in both men (adjusted OR = 1.87, 95% CI = 1.24-2.81) and women (adjusted OR = 2.72, 95% CI = 1.44-5.16). The 2 highest BMI categories (27.5-29.9 and ≥30.0) were identified as risk factors for gastric cardia high-grade dysplasia in both men (BMI = 27.5-29.9: adjusted OR = 1.78, 95% CI = 1.02-3.10; BMI ≥ 30.0: adjusted OR = 2.54, 95% CI = 1.27-5.08) and women (BMI = 27.5-29.9: adjusted OR = 2.88, 95% CI = 1.27-6.55; BMI ≥ 30.0: adjusted OR = 2.77, 95% CI = 1.36-5.64), whereas only a BMI ranging from 27.5 to 29.9 was a risk factor for gastric noncardia high-grade dysplasia in both men (adjusted OR = 1.98, 95% CI = 1.25-3.14) and women (adjusted OR = 2.88, 95% CI = 1.43-5.81). In addition, higher serum total cholesterol was associated with an increased risk of gastric noncardia high-grade dysplasia (adjusted OR = 1.83, 95% CI = 1.25-2.69) in women.Increased BMI was associated with an increased risk of gastric high-grade dysplasia in both men and women, and higher serum total cholesterol increased the risk of gastric noncardia high-grade dysplasia in women.
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Affiliation(s)
- Ya-Kai Huang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Wei-Ming Kang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Zhi-Qiang Ma
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yu-Qin Liu
- Cell Culture Center, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Zhou
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Jian-Chun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- Correspondence: Jian-Chun Yu, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China (e-mail: )
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Ghaus S, Neumann H, Muhammad H, Tontini GE, Ishaq S. Diagnosis and Surveillance of Barrett's Esophagus: Addressing the Transatlantic Divide. Dig Dis Sci 2016; 61:2185-2193. [PMID: 27038446 DOI: 10.1007/s10620-016-4138-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/19/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Barrett's esophagus is a premalignant condition of the esophagus leading to esophageal adenocarcinoma. No consensus exists between the UK and USA concerning the diagnosis of Barrett's esophagus. Although the diagnostic procedure is common, the required findings and diagnostic criteria vary. Both guidelines require endoscopy showing columnar epithelia lining the esophagus, but the US guidelines require the additional finding of intestinal metaplasia on biopsy to confirm diagnosis. Achievement of a consensus is of particular importance due to the established progression from Barrett's esophagus to esophageal adenocarcinoma. Of further importance is the increasing incidence of esophageal adenocarcinoma, a condition with poor overall survival, leading to various opinions on the utility of surveillance in patients. DISCUSSION A review of the vast array of literature revealed that substantial evidence exists in favor of both diagnostic criteria; hence, there is no easy way to identify the "correct" method of diagnosing Barrett's esophagus. USA recommends surveillance of Barrett's esophagus, whereas UK does not advocate it unless dysplasia is present. Surveillance was found to be effective, but this varied as did cost-effectiveness. Further research into diagnostic methods for Barrett's esophagus is needed to address areas of limited understanding, such that agreement can be reached and practice standardized. Surveillance was generally advocated, but with different criteria and time intervals, and new methods are being evaluated.
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Affiliation(s)
- Saad Ghaus
- Gastroenterology Department, Dudley Group Hospitals, Birmingham City University, Birmingham, UK
- University of Birmingham, Birmingham, UK
| | - Helmut Neumann
- Department of Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Humayun Muhammad
- Gastroenterology Department, Dudley Group Hospitals, Birmingham City University, Birmingham, UK
| | - Gian Eugenio Tontini
- Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Sauid Ishaq
- Gastroenterology Department, Dudley Group Hospitals, Birmingham City University, Birmingham, UK.
- St. George's University, St. George, Grenada, West Indies.
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de Souza Giusti ACB, de Oliveira Salvador PTC, dos Santos J, Meira KC, Camacho AR, Guimarães RM, Souza DLB. Trends and predictions for gastric cancer mortality in Brazil. World J Gastroenterol 2016; 22:6527-6538. [PMID: 27605887 PMCID: PMC4968132 DOI: 10.3748/wjg.v22.i28.6527] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/18/2016] [Accepted: 06/13/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze the effect of age-period and birth cohort on gastric cancer mortality, in Brazil and across its five geographic regions, by sex, in the population over 20 years of age, as well as make projections for the period 2010-2029.
METHODS: An ecological study is presented herein, which distributed gastric cancer-related deaths in Brazil and its geographic regions. The effects of age-period and birth cohort were calculated by the Poisson regression model and projections were made with the age-period-cohort model in the statistical program R.
RESULTS: Progressive reduction of mortality rates was observed in the 1980’s, and then higher and lower mortality rates were verified in the 2000’s, for both sexes, in Brazil and for the South, Southeast and Midwest regions. A progressive decrease in mortality rates was observed for the Northeast (both sexes) and North (men only) regions within the period 1995-1999, followed by rising rates.
CONCLUSION: Regional differences were demonstrated in the mortality rates for gastric cancer in Brazil, and the least developed regions of the country will present increases in projected mortality rates.
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78
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Kim GH, Liang PS, Bang SJ, Hwang JH. Screening and surveillance for gastric cancer in the United States: Is it needed? Gastrointest Endosc 2016; 84:18-28. [PMID: 26940296 DOI: 10.1016/j.gie.2016.02.028] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/19/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Although the incidence of gastric cancer in the United States is relatively low, the incidence of gastric cancer is higher than for esophageal cancer, for which clear guidelines for screening and surveillance exist. With the increasing availability of endoscopic therapy, such as endoscopic submucosal dissection, for treating advanced dysplasia and early gastric cancer, establishing guidelines for screening and surveillance of patients who are at high risk of developing gastric cancer has the potential to diagnose and treat gastric cancer at an earlier stage and improve mortality from gastric cancer. The aims of this article were to review the data regarding the risk factors for developing gastric cancer, methods for gastric cancer screening, and results of national screening programs. METHODS A review of the existing literature related to the aims was performed. RESULTS Risk factors for gastric cancer that were identified include race/ethnicity (East Asian, Russian, or South American), first-degree relative diagnosed with gastric cancer, positive Helicobacter pylori status, and presence of atrophic gastritis or intestinal metaplasia. Endoscopy has the highest rate of detecting gastric cancer compared with other gastric cancer screening methods. The national screening program in Japan has demonstrated a mortality reduction from gastric cancer based on cohort data. CONCLUSIONS Gastric cancer screening with endoscopy should be considered in individuals who are immigrants from regions associated with a high risk of gastric cancer (East Asia, Russia, or South America) or who have a family history of gastric cancer. Those with findings of atrophic gastritis or intestinal metaplasia on screening endoscopy should undergo surveillance endoscopy every 1 to 2 years. Large prospective multicenter studies are needed to further identify additional risk factors for developing gastric cancer and to assess whether gastric cancer screening programs for high-risk populations in the United States would result in improved mortality.
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Affiliation(s)
- Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Peter S Liang
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sung Jo Bang
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Joo Ha Hwang
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA
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Cardia and Non-Cardia Gastric Cancer Have Similar Stage-for-Stage Prognoses After R0 Resection: a Large-Scale, Multicenter Study in China. J Gastrointest Surg 2016; 20:700-7. [PMID: 26831062 DOI: 10.1007/s11605-016-3089-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/19/2016] [Indexed: 01/31/2023]
Abstract
Although the clinicopathological features of cardia gastric cancer (GC) differ from those of non-cardia GC, it is unclear whether the former has poorer prognosis than the latter. The aim of this study was to compare clinicopathological characteristics and prognosis between cardia and non-cardia GC. From December 2009 to December 2011, 1633 patients who had undergone R0 resection of GC at four Chinese centers were enrolled in this study. Their clinicopathological features and survival outcomes were evaluated. Compared with non-cardia GC, cardia GC was associated with a significantly higher proportion of male patients, older age, more advanced pathological stage, and less-favorable clinicopathological features at diagnosis. The 5-year survival rate was significantly lower in the cardia GC group than in the non-cardia GC group. However, no significant difference in overall survival (OS) was observed between the two groups at any pathological TNM stage. Pathological stage was confirmed as an independent prognostic factor of OS. More advanced disease represents most of the cases in this Chinese population. Compared with patients with non-cardia GC, patients with cardia GC were diagnosed at a more advanced stage and had worse prognosis after undergoing R0 resection. However, cardia and non-cardia GCs have similar stage-for-stage prognoses.
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Obeid T, Krishnan A, Abdalla G, Schweitzer M, Magnuson T, Steele KE. GERD Is Associated with Higher Long-Term Reoperation Rates After Bariatric Surgery. J Gastrointest Surg 2016; 20:119-24; discussion 124. [PMID: 26489741 DOI: 10.1007/s11605-015-2993-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/13/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although bariatric surgery is a safe and effective treatment for morbid obesity, long-term reoperation remains a significant source of morbidity and mortality for the patient. METHODS We performed a retrospective analysis of all patients undergoing laparoscopic gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG) surgeries at our institution between 2009 and 2013. Main outcome of interest was reoperation rate up to current date. Final logistic regression model included age, gender, BMI at time of operation, race (Caucasian vs African American), surgery time, length of stay, history of diabetes, history of gastroesophageal reflux disease (GERD), type of surgery, and readmission. RESULTS A total of 533 patients underwent either LGBP or LSG surgery between 2009 and 2013. Overall reoperation rate was 9.0% and mean follow-up was 43.9 months (median 45). When stratified by race, preoperative GERD in Caucasians was associated with a significant 2.2-fold increased risk of reoperation (OR 2.2, 95% CI 1.0–4.8, P = .043). GERD in African Americans had a small nonsignificant increased risk. Other significant predictors included length of stay and readmission (OR 2.1, P = 0.029; OR 5.0, P < 0.000). CONCLUSION Preoperative GERD in Caucasian bariatric patients is associated with a higher risk of reoperation. Lengthy hospital stay and readmission within 30 days of laparoscopic bariatric surgery are independent predictors of higher reoperation rates.
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Guo J, Yu X, Gu J, Lin Z, Zhao G, Xu F, Lu C, Ge D. Regulation of CXCR4/AKT-signaling-induced cell invasion and tumor metastasis by RhoA, Rac-1, and Cdc42 in human esophageal cancer. Tumour Biol 2015; 37:6371-8. [PMID: 26631033 DOI: 10.1007/s13277-015-4504-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/24/2015] [Indexed: 12/11/2022] Open
Abstract
CXC chemokines and their cognate receptors have been implicated wildly in cancer pathogenesis. In the present study, we report a critical cause relationship between CXCR4 expression and tumorigenesis in the setting of human esophageal squamous cell carcinoma (ESCC). In ESCC cells, CXCR4 expression was significantly higher than in human esophageal epithelial cells (HEEC). Reduction of CXCR4 in ESCC cells reduced cell proliferation and invasion in vitro and tumor growth in vivo. Among the potential downstream targets of CXCR4-CXCL12 are RhoA, Rac-1, and Cdc42, which are likely to contribute to the invasiveness of ESCC cells. Finally, we found that CXCR4-CXCL12/AKT axis regulates RhoA, Rac-1, and Cdc42 to modulate cell invasion and tumor metastasis. Together, these results demonstrate a role for CXCR4 in ESCC metastasis and progression and suggest potential targets for therapeutic intervention.
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Affiliation(s)
- Jing Guo
- Department of Thoracic Surgery, Ningbo No.1 Hospital, Ningbo, Zhejiang Province, People's Republic of China
| | - Xiaofang Yu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jie Gu
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin RD, Shanghai, 200032, People's Republic of China
| | - Zongwu Lin
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin RD, Shanghai, 200032, People's Republic of China
| | - Guangyin Zhao
- Shanghai No.1 Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Fengkai Xu
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin RD, Shanghai, 200032, People's Republic of China
| | - Chunlai Lu
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin RD, Shanghai, 200032, People's Republic of China.
| | - Di Ge
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin RD, Shanghai, 200032, People's Republic of China.
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Li JW, Tan MTK, Ang TL, Teo EK. Chemoprevention trials of GI cancers in Asia. Best Pract Res Clin Gastroenterol 2015; 29:967-78. [PMID: 26651257 DOI: 10.1016/j.bpg.2015.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 09/02/2015] [Indexed: 01/31/2023]
Abstract
Cancers are among the leading causes of morbidity and mortality worldwide, with gastrointestinal (GI) luminal cancers accounting for a large proportion of cancer incidence. Chemoprevention of GI luminal cancers is important to reduce this cancer burden. Screening for and eradication of Helicobacter pylori (H. pylori) in areas with high gastric cancer incidence is a safe and effective strategy to decrease the incidence of gastric cancer. Eradication of H. pylori also seems to be effective in preventing metachronous cancer development after endoscopic resection of early gastric cancer. For the average risk individual, COX inhibitors may have a role in reducing the incidence of adenoma formation as well as colorectal cancer, bearing in mind its inherent risks. There is currently insufficient evidence to recommend a chemoprevention agent against esophageal and small intestine cancer.
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Affiliation(s)
- James Weiquan Li
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.
| | | | - Tiing Leong Ang
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.
| | - Eng Kiong Teo
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.
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Changing incidence of esophageal cancer among white women: analysis of SEER data (1992-2010). Contemp Oncol (Pozn) 2015; 19:338-40. [PMID: 26557784 PMCID: PMC4631308 DOI: 10.5114/wo.2015.54390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 01/05/2015] [Accepted: 04/07/2015] [Indexed: 11/17/2022] Open
Abstract
AIM OF THE STUDY To analyse trends in the incidence rates of adenocarcinoma and squamous cell carcinoma of the oesophagus (ACE and SCC, respectively) in white women between 1992 and 2010. MATERIAL AND METHODS We used data from the Surveillance, Epidemiology, and End Results (SEER program to identify cases of esophageal cancer). Age adjusted incidence rates (IR) were calculated for ACE and SCC for two different time periods (1992-1996 and 2006-2010) and stratified by age, stage, and histologic type. We used joinpoint analysis to detect changes in rates between 1992 and 2010. RESULTS Between the time periods 1992-1996 and 2006-2010, the age-adjusted incidence rates for SCC in white women decreased from 1.2/100,000 to 0.8/100,000 personyears, and for ACE it increased from 0.5/100,000 to 0.7/100,000 personyears. Similar to white men, the increase in the incidence of ACE was consistent for all stages and all age groups in white women. However, it was most pronounced in women aged 45-59 years, where the incidence of ACE (0.9/100,000 person-years) in 2006-2010 exceeded the incidence of SCC (0.6/100,000 person-years). On joinpoint regression analysis, an inflection point was seen in 1999 for ACE, indicating a slower rate of increase for ACE after 1999 (annual percentage change of 8.00 before 1999 vs. 0.88 starting in 1999). CONCLUSIONS The incidence of ACE is increasing in white women, irrespective of age or stage. Indeed, ACE is now more common than SCC in white women between 45 and 59 years of age.
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Guo W, Dong Z, Guo Y, Shen S, Guo X, Kuang G, Yang Z. Decreased expression and frequent promoter hypermethylation of RASSF2 and RASSF6 correlate with malignant progression and poor prognosis of gastric cardia adenocarcinoma. Mol Carcinog 2015; 55:1655-1666. [PMID: 26456015 DOI: 10.1002/mc.22416] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/28/2015] [Accepted: 09/14/2015] [Indexed: 12/17/2022]
Abstract
The RAS-association domain family (RASSF) consists of 10 members, and several members act as tumor suppressor genes and epigenetically inactivated in different tumor types. The present study investigated the role and methylation status of RASSF2, RASSF3, RASSF4, and RASSF6 in the pathogenesis and prognosis of GCA. Quantitative real-time RT-PCR, Western blot, and immunohistochemistry (IHC) methods were used respectively to detect the expression of RASSF2, RASSF3, RASSF4, and RASSF6 in 135 GCA cases and BS-MSP method was used to clarify the methylation status of these four genes. Decreased mRNA and protein expression of RASSF2, RASSF3, RASSF4, and RASSF6 were detected in GCA tumor tissues. Aberrant CpG island methylation of RASSF2, RASSF4, and RASSF6 were detected in GCA tumor tissues and were inversely correlated with the expression levels of these genes. Both of RASSF2 and RASSF6 expression and methylation were associated with TNM stage, depth of invasion, LN metastasis, distant metastasis or recurrence, and UGIC family history. GCA patients with simultaneous negative protein expression of RASSF2 and RASSF6 or with simultaneous methylation of both genes demonstrated poor patient survival. These results suggest that down-regulation of RASSF2, RASSF3, RASSF4, and RASSF6 is a tumor-specific phenomenon and the inactivation of RASSF2 and RASSF6 may be associated with tumor progression. Inactivation of RASSF2, RASSF4, and RASSF6 through CpG island methylation may play important roles in GCA carcinogenesis. A combination of RASSF2 and RASSF6 expression or hypermethylation may serve as useful prognostic biomarker for GCA. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Wei Guo
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhiming Dong
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Yanli Guo
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Supeng Shen
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xin Guo
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Gang Kuang
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhibin Yang
- Laboratory of Pathology, Hebei Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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85
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Abstract
In the esophagus two different kinds of primary neoplasias may arise: squamocellular carcinomas (SCC) and esophageal adenocarcinomas (EAC). Although both types of carcinoma are rare diseases, especially the incidence of EAC rose in the last years. The management of esophageal cancer is challenging. There are no specific symptoms of early esophageal cancers. Due to this fact, most of the esophageal cancers are found incidentally, and only 12.5% of esophageal tumors are endoscopically resectable. Gastroscopy is the gold standard for the diagnosis of esophageal cancer. The sensitivity of detecting early-stage carcinoma may be improved by adjunct techniques such as chromoendoscopy, virtual chromoendoscopy, magnification endoscopy, and other advanced endoscopic imaging techniques. The diagnosis of esophageal cancer can be verified with targeted biopsies. Accurate staging information is crucial for establishing appropriate treatment choices for esophageal cancer, while the depth of the tumor determines the feasibility of therapy. In terms of staging, endosonography, abdominal ultrasound, and computed tomography scan of the thorax and abdomen should thus be performed before initiation of therapy.
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Affiliation(s)
- Volker Meves
- Internal Medicine, Vivantes Klinikum im Friedrichshain, University Teaching Hospital of the Humboldt University Berlin (Charité), Berlin, Germany
| | - Angelika Behrens
- Internal Medicine, Vivantes Klinikum im Friedrichshain, University Teaching Hospital of the Humboldt University Berlin (Charité), Berlin, Germany
| | - Jürgen Pohl
- Internal Medicine, Vivantes Klinikum im Friedrichshain, University Teaching Hospital of the Humboldt University Berlin (Charité), Berlin, Germany
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86
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Zhang WB, Gu HY, Shi YJ, Shao AZ, Chen SC, Yin J, Jiang PC. RANK rs1805034 T>C Polymorphism Is Associated with Susceptibility to Gastric Cardia Adenocarcinoma in a Chinese Population. Oncol Res Treat 2015; 38:503-10. [PMID: 26451891 DOI: 10.1159/000440855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 09/04/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Gastric cardia adenocarcinoma (GCA) is a common malignant tumor of the digestive tract with a high incidence in China. Genetic factors such as single nucleotide polymorphisms (SNPs) may contribute to the carcinogenesis of GCA. METHODS We conducted a hospital-based case-control study to evaluate the genetic association of functional SNPs with susceptibility to GCA development. A total of 330 GCA cases and 608 controls were recruited for this study. The SNPs OPG rs3102735 T>C and rs2073618 G>C, RANK rs1805034 T>C, and RANKL rs9533156 T>C and rs2277438 A>G were determined using the ligation detection reaction method. RESULTS Our findings suggest that RANK rs1805034 T>C is associated with susceptibility to GCA, which is more evident among male patients, elderly patients (≥ 60 years), smokers, and patients who do not consume alcohol. CONCLUSION Based on our findings, the functional SNP RANK rs1805034 T>C may be an indicator for individual susceptibility to GCA. However, further larger studies with other ethnic populations and tissue-specific biological characterization are required to confirm the current findings.
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Affiliation(s)
- Wen-Bo Zhang
- Department of General Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, China
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87
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Shi N, Jin F, Zhang X, Clinton SK, Pan Z, Chen T. Overexpression of human β-defensin 2 promotes growth and invasion during esophageal carcinogenesis. Oncotarget 2015; 5:11333-44. [PMID: 25226614 PMCID: PMC4294379 DOI: 10.18632/oncotarget.2416] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/28/2014] [Indexed: 11/25/2022] Open
Abstract
Human β-defensin 2 (HBD-2) is an antimicrobial peptide produced by mucosal surfaces in response to microbial exposure or inflammatory cytokines. Although HBD-2 is expressed in the esophagus in response to stress and infectious agents, little is known regarding its expression and functional role in esophageal carcinogenesis. In the current investigation, normal esophagus and N-nitrosomethylbenzylamine (NMBA)-induced precancerous and papillomatous lesions of the rat esophagus were characterized for HBD-2 encoding gene Defb4 and protein. HBD-2 was found to be overexpressed in esophagi of rats treated with NMBA compared to animals in control group. Results of Real-time PCR, Western blot and immunohistochemistry demonstrated a positive correlation between the overexpression of HBD-2 and the progression of rat squamous cell carcinogenesis (SCC) in the esophagus. We also observed that HBD-2 is overexpressed in tumor tissues removed from patients with esophageal SCC. Moreover, Defb4 silencing in vitro suppresses the tumor cell proliferation, mobility and invasion in esophageal SCC cell line KYSE-150. The results from this study provide experimental evidence that HBD-2 may play an oncogenic role in the initiation and progression of esophageal SCC and thus serves as a target for chemopreventive and therapeutic interventions.
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Affiliation(s)
- Ni Shi
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Feng Jin
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Xiaoli Zhang
- Center for Biostatistics, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, Ohio
| | - Steven K Clinton
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Zui Pan
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Tong Chen
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
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88
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Wang W, Zheng C, Fang C, Li P, Xie J, Lin J, Zhan Y, Li W, Chen Y, Sun X, Xu D, Li Y, Huang C, Zhou Z. Time trends of clinicopathologic features and surgical treatment for gastric cancer: Results from 2 high-volume institutions in southern China. Surgery 2015. [PMID: 26210225 DOI: 10.1016/j.surg.2015.04.038] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The objective of this study was to evaluate the time-related trends of tumor characteristics and postoperative survival of patients with gastric cancer (GC) in 2 high-volume centers in high incidence areas of southern China. METHODS Based on the meticulously collected data from 5,327 patients with GC treated with operative intervention at Sun Yat-sen University Cancer Center and Fujian Medical University Union Hospital, we analyzed the differences in clinicopathologic features and postoperative survival over the following 4 consecutive periods: 1991-1995 (period 1), 1996-2000 (period 2), 2001-2005 (period 3), and 2006-2010 (period 4). RESULTS Tumor size decreased (P = .001), but the proportion of poorly differentiated tumors increased (P < .001) over the study periods. Early GC was diagnosed more often in later periods, gradually increasing from 7 to 15% (P < .001). A surprising improvement was observed in the mean number of retrieved lymph nodes, ranging from 10.36 to 26.22 (P < .001). The radical resection rate increased from 88 to 93%. The overall 5-year survival rate improved steadily over the 4 periods, from 39 to 53% (P < .001). Multivariate analysis revealed that age, tumor location, histologic type, tumor size, depth of invasion, lymphatic invasion, number of retrieved lymph nodes, radical resection, and time periods were independent prognostic factors. CONCLUSION The clinicopathologic features of tumors changed during the observation period in our region. The increasingly early detection of patients with GC and more standardized regimens for operative management, including routinely performed D2 lymphadenectomy, most likely resulted in the increase in overall survival.
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Affiliation(s)
- Wei Wang
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Chaohui Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, P.R. China
| | - Cheng Fang
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Ping Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, P.R. China
| | - Jianwei Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, P.R. China
| | - Jianxian Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, P.R. China
| | - Youqing Zhan
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Wei Li
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Yingbo Chen
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Xiaowei Sun
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Dazhi Xu
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Yuanfang Li
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Changming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, P.R. China.
| | - Zhiwei Zhou
- Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.
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89
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Nelson KS, Brearley AM, Haines SJ. Evidence-based assessment of well-established interventions: the parachute and the epidural hematoma. Neurosurgery 2015; 75:552-9; discussion 559. [PMID: 25050576 DOI: 10.1227/neu.0000000000000504] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The methods of evidence-based medicine are a relatively recent development in the understanding of clinical practice. They are criticized as not providing support for interventions long held to be highly effective based on experience that predated the availability of evidence-based analysis. OBJECTIVE To determine if the methods of evidence-based medicine can be successfully applied to interventions established before those methods were developed. METHODS Systematic review of English language literature on the natural history and treated prognosis of acute epidural hematoma and analysis of existing data on mortality associated with parachute use. DATA SOURCES Sources of data included Medline, Old Medline, Science Citation Index, British and US Parachute Associations, and Federal Aviation Administration and National Transportation Safety Board databases (both of the United States). Also included were national databases reporting mortality and total number of parachute uses. RESULTS The estimated mortality of falling from an airplane with an ineffective parachute is 74% (69-79). Mortality associated with effective parachute deployment is between 0.0011% and 0.0017%. For acute epidural hematoma, estimated mortality is 98.54% (95.1-99.9) without treatment and 12.9% (10.5-15.3) with treatment. The number needed to treat to prevent 1 death for the parachute is estimated to be 1.35 (1.27-1.45) and for epidural hematoma 1.17 (1.13-1.22) (95% binomial confidence intervals in parentheses). CONCLUSION The methods of evidence-based medicine are robust and can deal with interventions of great face validity and those considered well established before such methods were well developed. We propose initial criteria for evaluating the quality of evidence supporting long-established interventions.
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Affiliation(s)
- Kyle S Nelson
- *Department of Neurosurgery, University of Nebraska Medical Center, Section of Neurosurgery, Omaha, Nebraska; ‡Biostatistical Design and Analysis Center (BDAC), Clinical and Translational Science Institute (CTSI), School of Public Health, University of Minnesota Academic Health Center, Minneapolis, Minnesota; and §Department of Neurosurgery, University of Minnesota School of Medicine, Minneapolis, Minnesota
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90
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González-Fernández C, Barreto-Zúñiga R, Grajales-Figueroa G, Martínez Lozano JA. Endomicroscopia láser confocal con sonda en pacientes con esófago de Barrett. ENDOSCOPIA 2015. [DOI: 10.1016/j.endomx.2015.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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91
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Zeb MH, Baruah A, Kossak SK, Buttar NS. Chemoprevention in Barrett's Esophagus: Current Status. Gastroenterol Clin North Am 2015; 44:391-413. [PMID: 26021201 DOI: 10.1016/j.gtc.2015.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chemoprevention in Barrett's esophagus is currently applied only in research settings. Identifying pathways that can be targeted by safe, pharmaceutical or natural compounds is key to expanding the scope of chemoprevention. Defining meaningful surrogate markers of cancer progression is critical to test the efficacy of chemopreventive approaches. Combinatorial chemoprevention that targets multiple components of the same pathway or parallel pathways could reduce the risk and improve the efficacy of chemoprevention. Here we discuss the role of chemoprevention as an independent or an adjuvant management option in BE-associated esophageal adenocarcinoma.
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Affiliation(s)
- Muhammad H Zeb
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Anushka Baruah
- Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, 1901 W. Harrison Street, Chicago, IL 60612, USA
| | - Sarah K Kossak
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Navtej S Buttar
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
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92
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Fang C, Huang Q, Lu L, Shi J, Sun Q, Xu GF, Gold J, Mashimo H, Zou XP. Risk factors of early proximal gastric carcinoma in Chinese diagnosed using WHO criteria. J Dig Dis 2015; 16:327-36. [PMID: 25754397 DOI: 10.1111/1751-2980.12240] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The incidence of proximal gastric carcinoma (PGC) is rising worldwide for unknown reasons. Herein we compare the risk factors of early PGC with distal gastric carcinoma (DGC) in patients treated at a single tertiary hospital in China. METHODS Risk factors of 379 consecutive surgically resected early gastric carcinoma (EGC) diagnosed according to the 2010 World Health Organization criteria were studied by reviewing their medical records and esophagogastroduodenoscopy/biopsy findings and interviewing patients and family members for the patients' history of environmental toxin exposure (ETE), dietary habits, family (FCH) and personal cancer history (PCH) and survival. Differences between PGC (n = 115), DGC (n = 264) and age-matched and gender-matched controls (n = 225) were compared. RESULTS Proportion of early PGC in all EGC patients was increased significantly (P < 0.05). The independent risk factors for both PGC and DGC identified by multivariate analysis were intake of preserved food and little fruit, and gastric mucosal intestinal metaplasia and atrophy (all P < 0.05). Advanced age (odds ratio [OR] 9.83, P < 0.01), PCH (OR 5.09, P < 0.05), a high body mass index (>24 kg/m(2) ) (OR 2.79, P < 0.01) and ETE (OR 2.31, P < 0.05) were independent risk factors for PGC, but not male gender, tobacco or alcohol abuse, hiatus hernia, gastroesophageal reflux disease or columnar-lined esophagus. In contrast, FCH (OR 2.34, P < 0.01) and Helicobacter pylori infection (OR 2.81, P < 0.001) were independent risk factors for DGC. CONCLUSION Independent risk factors for PGC in Chinese patients differ from those of DGC or esophageal adenocarcinoma, supporting the classification of PGC as a separate gastric carcinoma entity in the Chinese populations.
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Affiliation(s)
- Cheng Fang
- Department of Gastroenterology, The Affiliated Drum Tower Clinical Medical School, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Qin Huang
- Department of Pathology, The Affiliated Drum Tower Hospital of Nanjing University, Nanjing, Jiangsu Province, China.,Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System and Harvard Medical School, West Roxbury, Boston, MA, USA
| | - Lin Lu
- Department of Rheumatology and Immunology, The Affiliated Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Jiong Shi
- Department of Pathology, The Affiliated Drum Tower Hospital of Nanjing University, Nanjing, Jiangsu Province, China
| | - Qi Sun
- Department of Pathology, The Affiliated Drum Tower Hospital of Nanjing University, Nanjing, Jiangsu Province, China
| | - Gui Fang Xu
- Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Nanjing, Jiangsu Province, China
| | - Jason Gold
- Department of Surgery, Veterans Affairs Boston Healthcare System and Harvard Medical School, West Roxbury, Boston, MA, USA
| | - Hiroshi Mashimo
- Department of Gastroenterology, Veterans Affairs Boston Healthcare System and Harvard Medical School, West Roxbury, Boston, MA, USA
| | - Xiao Ping Zou
- Department of Gastroenterology, The Affiliated Drum Tower Clinical Medical School, Nanjing Medical University, Nanjing, Jiangsu Province, China.,Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Nanjing, Jiangsu Province, China
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93
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Kaz AM, Grady WM, Stachler MD, Bass AJ. Genetic and Epigenetic Alterations in Barrett's Esophagus and Esophageal Adenocarcinoma. Gastroenterol Clin North Am 2015; 44:473-89. [PMID: 26021206 PMCID: PMC4449457 DOI: 10.1016/j.gtc.2015.02.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Esophageal adenocarcinoma (EAC) develops from Barrett's esophagus (BE), wherein normal squamous epithelia is replaced by specialized intestinal metaplasia in response to chronic gastroesophageal acid reflux. BE can progress to low- and high-grade dysplasia, intramucosal, and invasive carcinoma. Both BE and EAC are characterized by loss of heterozygosity, aneuploidy, specific genetic mutations, and clonal diversity. Given the limitations of histopathology, genomic and epigenomic analyses may improve the precision of risk stratification. Assays to detect molecular alterations associated with neoplastic progression could be used to improve the pathologic assessment of BE/EAC and to select high-risk patients for more intensive surveillance.
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Affiliation(s)
- Andrew M. Kaz
- VA Puget Sound Health Care System, R&D Department, Seattle, WA,Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA,University of Washington School of Medicine, Department of Internal Medicine, Seattle, WA
| | - William M. Grady
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA,University of Washington School of Medicine, Department of Internal Medicine, Seattle, WA
| | - Matthew D. Stachler
- Department of Pathology, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA
| | - Adam J. Bass
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
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94
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Dann GC, Squires MH, Postlewait LM, Kooby DA, Poultsides GA, Weber SM, Bloomston M, Fields RC, Pawlik TM, Votanopoulos KI, Schmidt CR, Ejaz A, Acher AW, Worhunsky DJ, Saunders N, Swords DS, Jin LX, Cho CS, Winslow ER, Russell MC, Staley CA, Maithel SK, Cardona K. Value of Peritoneal Drain Placement After Total Gastrectomy for Gastric Adenocarcinoma: A Multi-institutional Analysis from the US Gastric Cancer Collaborative. Ann Surg Oncol 2015; 22 Suppl 3:S888-97. [PMID: 26023037 DOI: 10.1245/s10434-015-4636-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND The effect of routine drainage after abdominal surgery with enteric anastomoses is controversial. In particular, the role of peritoneal drain (PD) placement after total gastrectomy for adenocarcinoma is not well established. METHODS Patients who underwent total gastrectomy for gastric adenocarcinoma (GAC) at seven institutions from the US Gastric Cancer Collaborative, from 2000 to 2012, were identified. The association of PD placement with postoperative outcomes was analyzed. RESULTS Overall, 344 patients were identified and 253 (74 %) patients received a PD. The anastomotic leak rate was 9 %. Those with PD placement had similar American Society of Anesthesiologists score, tumor size, TNM stage, and the need for additional organ resection when compared with their counterparts. No difference was observed in the rate of any complication (54 vs. 48 %; p = 0.45), major complication (25 vs. 24 %; p = 0.90), or 30-day mortality (7 vs. 4 %; p = 0.51) between the two groups. In addition, no difference in anastomotic leak (9 vs. 10 %; p = 0.90), the need for secondary drainage (10 vs. 9 %; p = 0.92), or reoperation (13 vs. 8 %; p = 0.28) was identified. On multivariate analysis, PD placement was not associated with decreased postoperative complications. Subset analysis, stratified by patients who did not undergo concomitant pancreatectomy (n = 319) or those who experienced anastomotic leak (n = 31), similarly demonstrated no association of PD placement with reduced complications or mortality. CONCLUSIONS PD placement after total gastrectomy for GAC is associated with neither a decrease in the frequency and severity of adverse postoperative outcomes, including anastomotic leak and mortality, nor a decrease in the need for secondary drainage procedures or reoperation. Routine use of PDs is not warranted.
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Affiliation(s)
- Gregory C Dann
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Malcolm H Squires
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Lauren M Postlewait
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - David A Kooby
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - George A Poultsides
- Department of Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Sharon M Weber
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mark Bloomston
- Division of Surgical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Ryan C Fields
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Timothy M Pawlik
- Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Carl R Schmidt
- Division of Surgical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Aslam Ejaz
- Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Alexandra W Acher
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - David J Worhunsky
- Department of Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Neil Saunders
- Division of Surgical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Douglas S Swords
- Department of Surgery, Wake Forest University, Winston-Salem, NC, USA
| | - Linda X Jin
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Clifford S Cho
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Emily R Winslow
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Maria C Russell
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Charles A Staley
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Shishir K Maithel
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Kenneth Cardona
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
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Dolak W, Mesteri I, Asari R, Preusser M, Tribl B, Wrba F, Schoppmann SF, Hejna M, Trauner M, Häfner M, Püspök A. A pilot study of the endomicroscopic assessment of tumor extension in Barrett's esophagus-associated neoplasia before endoscopic resection. Endosc Int Open 2015; 3:E19-28. [PMID: 26134766 PMCID: PMC4423329 DOI: 10.1055/s-0034-1377935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 07/15/2014] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND AND STUDY AIMS Barrett's esophagus (BE) - associated neoplasia can be treated endoscopically, but accurate assessment before intervention is challenging. This study aimed to investigate the role of confocal laser endomicroscopy (CLE) as an adjunct in the endoscopic treatment of BE-associated neoplasia by assessing lateral tumor and subsquamous tumor (SST) extension. PATIENTS AND METHODS In the context of a prospective, single-arm pilot clinical trial, patients referred for endoscopic resection of BE-associated neoplasia (high grade dysplasia and esophageal adenocarcinoma) underwent high definition, white light endoscopy with narrow-band imaging (NBI). Then, CLE mapping of suspected neoplastic lesions was performed by another endoscopist, partially blinded to the previous findings, before the patients underwent endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), depending on lesion size and anticipated histology. RESULTS In 7 of 38 patients (18 %), CLE revealed additional neoplastic tissue compared with prior white light endoscopy and NBI: 2 concomitant lesions, 2 cases of lateral tumor extension within the Barrett's epithelium, and 3 cases of previously undetected SST extension. Overall, en bloc resection (tumor-free lateral margin) was achieved in 28 of 34 neoplastic lesions (82 %), and complete resection (tumor-free lateral and basal margins) in 21 of 34 neoplastic lesions (62 %). CONCLUSIONS CLE-assisted endoscopic resection of BE-associated neoplasia was safe and effective in this study, as proved by a high additional diagnostic yield of CLE (including visualization of occult SST extension) and a favorable rate of en bloc resection. The clinical value of CLE for assisting endoscopic therapy of BE-associated neoplasia deserves further evaluation in randomized controlled trials.
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Affiliation(s)
- Werner Dolak
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria,Corresponding author Werner Dolak, MD Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaWaehringer Guertel 18-201090 ViennaAustria+43 1 40400 47350
| | - Ildiko Mesteri
- Clinical Institute of Pathology, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Reza Asari
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Matthias Preusser
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Barbara Tribl
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Friedrich Wrba
- Clinical Institute of Pathology, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Sebastian F. Schoppmann
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Michael Hejna
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Michael Häfner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
| | - Andreas Püspök
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center, Vienna, Austria
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96
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Baruah A, Buttar NS. Chemoprevention in Barrett's oesophagus. Best Pract Res Clin Gastroenterol 2015; 29:151-65. [PMID: 25743463 DOI: 10.1016/j.bpg.2014.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 12/11/2014] [Indexed: 01/31/2023]
Abstract
Increasing incidence of oesophageal adenocarcinoma along with poor survival entails novel preventive strategies. Agents that target pro-oncogenic pathways in Barrett's mucosa could halt this neoplastic transformation. In this review, we will use epidemiological associations and molecular mechanisms to identify novel chemoprevention targets in Barrett's oesophagus. We will also discuss recent chemoprevention trials.
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Affiliation(s)
- Anushka Baruah
- Mayo Clinic College of Medicine, Department of Gastroenterology and Hepatology, Rochester, MN, USA
| | - Navtej S Buttar
- Mayo Clinic College of Medicine, Department of Gastroenterology and Hepatology, Rochester, MN, USA.
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97
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98
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Multidisciplinary cancer care may impact on the postoperative mortality and survival of patients with oesophageal and oesophagogastric junction cancer: a retrospective cohort study. Clin Transl Oncol 2014; 17:247-56. [DOI: 10.1007/s12094-014-1221-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 08/23/2014] [Indexed: 10/24/2022]
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99
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Xu X, Xu L, Gao F, Wang J, Ye J, Zhou M, Zhu Y, Tao L. Identification of a novel gene fusion (BMX-ARHGAP) in gastric cardia adenocarcinoma. Diagn Pathol 2014; 9:218. [PMID: 25499959 PMCID: PMC4282731 DOI: 10.1186/s13000-014-0218-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/27/2014] [Indexed: 12/31/2022] Open
Abstract
Background Gastric cardia adenocarcinoma (GCA) is one of the major causes of cancer related mortality worldwide. We aim to provide new understanding in the pathogenesis of GCA through investigations on gene expression alterations. Methods We preformed RNA-Seq for one pair of GCA and matched non-tumor tissues. Differentially expressed genes (DEGs) and fusion genes were acquired. PCR and gel analysis in additional 14 pairs of samples were performed to validate the chimeric transcripts. Results 1590 up-regulated and 709 down-regulated genes were detected. Functional analysis revealed that these DEGs were significantly overrepresented in gene ontology items of cell cycle, tumor invasion and proliferation. Moreover, we firstly discovered 3 fusion genes in GCA, including BMX-ARHGAP, LRP5- LITAF and CBX3-C15orf57. The chimeric transcript BMX-ARHGAP was validated and recurrently occurred in 4/15 independent tumor tissues. Conclusions Our results may provide new understanding of GCA and biomarkers for further therapeutic studies. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_218
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Affiliation(s)
- Xiaofeng Xu
- Clinical Laboratory, People's hospital, Jingjiang, 214500, Jiangsu, China.
| | - Lifang Xu
- Department of Gastroenterology, People's hospital, Jingjiang, 214500, Jiangsu, China.
| | - Feng Gao
- Department of General Surgery, People's hospital, Jingjiang, 214500, Jiangsu, China.
| | - Jianjiang Wang
- Department of General Surgery, People's hospital, Jingjiang, 214500, Jiangsu, China.
| | - Jinsong Ye
- Clinical Laboratory, People's hospital, Jingjiang, 214500, Jiangsu, China.
| | - Mingxian Zhou
- Clinical Laboratory, People's hospital, Jingjiang, 214500, Jiangsu, China.
| | - Yunling Zhu
- Clinical Laboratory, People's hospital, Jingjiang, 214500, Jiangsu, China.
| | - Lan Tao
- Clinical Laboratory, People's hospital, Jingjiang, 214500, Jiangsu, China.
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100
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Weledji EP, Enow Orock G, Ngowe MN. Intestinal metaplasia and anastomotic recurrence of gastric carcinoma. J Gastrointest Oncol 2014; 5:474-80. [PMID: 25436128 DOI: 10.3978/j.issn.2078-6891.2014.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 06/29/2014] [Indexed: 12/16/2022] Open
Abstract
Intestinal metaplasia (IM) of the stomach has been shown to increase the relative risk of gastric cancer. Endoscopic surveillance has been proposed and advocated for populations at risk. Those patients who had undergone surgery for gastric malignancy exhibited precancerous lesions such as atrophic gastritis and IM, and the possibility of anastomotic recurrence is higher than for the patients who had undergone benign gastric surgery. At present, there are no other recognized good markers of gastric dysplasia or cancer. We reviewed the literature on IM of the stomach to ascertain whether residual premalignant (type III) IM may predispose to anastomotic recurrence of gastric cancer.
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Affiliation(s)
- Elroy Patrick Weledji
- 1 Department of Surgery, 2 Department of Pathology, Faculty of Health Sciences, University of Buea, Buea, S.W. Region, Cameroon
| | - George Enow Orock
- 1 Department of Surgery, 2 Department of Pathology, Faculty of Health Sciences, University of Buea, Buea, S.W. Region, Cameroon
| | - Marcelin Ngowe Ngowe
- 1 Department of Surgery, 2 Department of Pathology, Faculty of Health Sciences, University of Buea, Buea, S.W. Region, Cameroon
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