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Zhang Z, Huang C, Xu M. Influence of metabolic syndrome on prognosis of patients with surgically treated esophageal cancer: a meta-analysis. Diabetol Metab Syndr 2024; 16:111. [PMID: 38783372 PMCID: PMC11112923 DOI: 10.1186/s13098-024-01335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/13/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) has been related to the increased incidence of esophageal cancer (EC). The aim of the study was to evaluate the influence of MetS on prognosis of patients with surgically treated EC in a systematic review and meta-analysis. METHODS An extensive search was conducted on PubMed, Embase, Web of Science, Wanfang, and CNKI to identify relevant cohort studies. Random-effects models were employed to combine the findings, taking into account the potential influence of heterogeneity. RESULTS Seven cohort studies involving 4332 patients with stage I-III EC who received surgical resection were included. At baseline, 608 (14.0%) patients had MetS. Pooled results suggested that MetS were associated with a higher risk of postoperative complications (risk ratio [RR]: 1.30, 95% confidence interval [CI]: 1.03 to 1.64, p = 0.03; I2 = 0%). However, the overall survival (RR: 1.07, 95% CI: 0.75 to 1.52, p = 0.71; I2 = 80%) and progression-free survival (RR: 1.27, 95% CI: 0.53 to 3.00, p = 0.59; I2 = 80%) were not significantly different between patients with and without MetS. Subgroup analyses suggested that the results were not significantly modified by study design (prospective or retrospective), histological type of EC (squamous cell carcinoma or adenocarcinoma), or diagnostic criteria for MetS (p values indicating subgroup difference all > 0.05). CONCLUSION Although MetS may be associated with a moderately increased risk of postoperative complications in patients with EC under surgical resection, the long-term survival may not be different between patients with and without MetS.
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Affiliation(s)
- Zhao Zhang
- Department of Breast Oncology, Hainan Cancer Hospital, The Affiliated Cancer Hospital of Hainan Medical University, 570311, Haikou City, Hainan Province, China
| | - Congcong Huang
- Department of Thoracic Surgery, Hainan Cancer Hospital, The Affiliated Cancer Hospital of Hainan Medical University, No. 9, Changbin West Fourth Street, Xiuying District, 570311, Haikou City, Hainan Province, China.
| | - Mengshan Xu
- Department of Breast Oncology, Hainan Cancer Hospital, The Affiliated Cancer Hospital of Hainan Medical University, 570311, Haikou City, Hainan Province, China
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Gao Y, Ye LS, Li X, Yu B, Liao K, Xie J, Du J, Zhang QY, Hu B. Effect of vinegar supplementation on patients with esophageal lesions lightly stained with Lugol's iodine solution: Prospective single-centre trial. World J Gastrointest Endosc 2024; 16:259-272. [PMID: 38813576 PMCID: PMC11130546 DOI: 10.4253/wjge.v16.i5.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/12/2024] [Accepted: 04/22/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Esophageal chromoendoscopy with iodine solution is important for detecting early esophageal cancer. The effect of routine treatment for lesions lightly stained with Lugol's iodine solution is limited, and the addition of natural substances to a regular diet is becoming increasingly common. Vinegar has antitumor effects as reported in previous studies. AIM To evaluate whether vinegar supplementation could improve the prognosis of patients with lightly stained esophageal lesions. METHODS This prospective single-centre trial included consecutive patients with lightly stained lesions between June 2020 and April 2022. Patients in the experimental group received increased amounts of vinegar for 6 months. The primary outcome of the study was the clinical therapeutic effect. Complications related to vinegar ingestion and adverse events were also recorded in detail. RESULTS A total of 166 patients were included in the final analysis. There was no significant difference in the baseline data between the two groups. Intention-to-treat (ITT) analysis demonstrated that the rates at which endoscopic characteristics improved were 33.72% in the experimental group and 20.00% in the conventional group (P = 0.007); and the rates at which biopsy pathology improved were 19.77% and 8.75%, respectively (P = 0.011). Additional vinegar consumption had a statistically protective effect on the rate at which endoscopic characteristics improved [hazard ratio (HR) ITT = 2.183, 95%CI: 1.183-4.028; HRper-protocol (PP) = 2.307, 95%CI: 1.202-4.426] and biopsy pathology improved (HRITT = 2.931, 95%CI: 1.212-7.089; HRPP = 3.320, 95%CI: 1.295-8.507). No statistically significant effect of increased vinegar consumption on preventing high-grade intraepithelial neoplasia or early cancer was observed (HRITT = 0.382, 95%CI: 0.079-1.846; HRPP = 0.382, 95%CI: 0.079-1.846). The subgroup analyses indicated that the overall therapeutic improvement of endoscopic characteristics and biopsy pathology seemed more obvious in older (age > 60) male patients with small lesions (lesion size ≤ 0.5 cm). Three patients in the experimental group reported acid regurgitation and heartburn. No adverse event during gastroscopy were recorded during follow-up. CONCLUSION A moderately increased ingestion of vinegar could not directly reduce the risk of esophageal cancer in the mucosa dysplasia population, but it improved the endoscopic characteristics and ameliorated the biopsy pathology to a certain extent. Further research is needed to verify the effect of nutritional intervention on precancerous esophageal lesions.
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Affiliation(s)
- Yuan Gao
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xu Li
- Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu 610065, Sichuan Province, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610044, Sichuan Province, China
| | - Ke Liao
- Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jia Xie
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jiang Du
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiong-Ying Zhang
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
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Perry R, Barbosa JP, Perry I, Barbosa J. Short-term outcomes of robot-assisted versus conventional minimally invasive esophagectomy for esophageal cancer: a systematic review and meta-analysis of 18,187 patients. J Robot Surg 2024; 18:125. [PMID: 38492067 PMCID: PMC10944433 DOI: 10.1007/s11701-024-01880-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/20/2024] [Indexed: 03/18/2024]
Abstract
The role of robotic surgery in the curative-intent treatment of esophageal cancer patients is yet to be defined. To compare short-term outcomes between conventional minimally invasive (cMIE) and robot-assisted minimally invasive esophagectomy (RAMIE) in esophageal cancer patients. PubMed, Web of Science and Cochrane Library were systematically searched. The included studies compared short-term outcomes between cMIE and RAMIE. Individual risk of bias was calculated using the MINORS and RoB2 scales. There were no statistically significant differences between RAMIE and cMIE regarding conversion to open procedure, mean number of harvested lymph nodes in the mediastinum, abdomen and along the right recurrent laryngeal nerve (RLN), 30- and 90-day mortality rates, chyle leakage, RLN palsy as well as cardiac and infectious complication rates. Estimated blood loss (MD - 71.78 mL, p < 0.00001), total number of harvested lymph nodes (MD 2.18 nodes, p < 0.0001) and along the left RLN (MD 0.73 nodes, p = 0.03), pulmonary complications (RR 0.70, p = 0.001) and length of hospital stay (MD - 3.03 days, p < 0.0001) are outcomes that favored RAMIE. A significantly shorter operating time (MD 29.01 min, p = 0.004) and a lower rate of anastomotic leakage (RR 1.23, p = 0.0005) were seen in cMIE. RAMIE has indicated to be a safe and feasible alternative to cMIE, with a tendency towards superiority in blood loss, lymph node yield, pulmonary complications and length of hospital stay. There was significant heterogeneity among studies for some of the outcomes measured. Further studies are necessary to confirm these results and overcome current limitations.
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Affiliation(s)
- Rui Perry
- Faculty of Medicine, University of Porto, Porto, Portugal.
| | - José Pedro Barbosa
- Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Stomatology, São João University Hospital Center, Porto, Portugal
| | - Isabel Perry
- Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - José Barbosa
- Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of General Surgery, São João University Hospital Center, Porto, Portugal
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4
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Liang F, Xu H, Cheng H, Zhao Y, Zhang J. Patient-derived tumor models: a suitable tool for preclinical studies on esophageal cancer. Cancer Gene Ther 2023; 30:1443-1455. [PMID: 37537209 DOI: 10.1038/s41417-023-00652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
Esophageal cancer (EC) is the tenth most common cancer worldwide and has high morbidity and mortality. Its main subtypes include esophageal squamous cell carcinoma and esophageal adenocarcinoma, which are usually diagnosed during their advanced stages. The biological defects and inability of preclinical models to summarize completely the etiology of multiple factors, the complexity of the tumor microenvironment, and the genetic heterogeneity of tumors severely limit the clinical treatment of EC. Patient-derived models of EC not only retain the tissue structure, cell morphology, and differentiation characteristics of the original tumor, they also retain tumor heterogeneity. Therefore, compared with other preclinical models, they can better predict the efficacy of candidate drugs, explore novel biomarkers, combine with clinical trials, and effectively improve patient prognosis. This review discusses the methods and animals used to establish patient-derived models and genetically engineered mouse models, especially patient-derived xenograft models. It also discusses their advantages, applications, and limitations as preclinical experimental research tools to provide an important reference for the precise personalized treatment of EC and improve the prognosis of patients.
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Affiliation(s)
- Fan Liang
- Institutes of Health Central Plains, Xinxiang Medical University, Xinxiang, 453003, China
| | - Hongyan Xu
- School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Hongwei Cheng
- Institutes of Health Central Plains, Xinxiang Medical University, Xinxiang, 453003, China
| | - Yabo Zhao
- School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Junhe Zhang
- Institutes of Health Central Plains, Xinxiang Medical University, Xinxiang, 453003, China.
- School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China.
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5
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Dhanasopon AP. New molecular and immunologic targets of therapy for esophageal cancer and the prospects for ongoing and future clinical trials. J Surg Oncol 2023; 127:239-243. [PMID: 36630099 DOI: 10.1002/jso.27194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 01/12/2023]
Abstract
Esophageal cancer is a deadly disease worldwide. Advancements in diagnosis, surgical technique, chemotherapy, and radiotherapy have improved survival over the years. While targeted therapy and immunotherapy have significantly impacted survival for patients with advanced disease, they have also been demonstrating efficacy when added to trimodality therapy for locoregional disease. This review focuses on molecular and immunologic targets of therapy for esophageal cancer and the prospects for ongoing and future clinical trials.
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Affiliation(s)
- Andrew P Dhanasopon
- Department of Surgery, Section of Thoracic Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
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6
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Gao S, Liu S, Wei W, Qi Y, Meng F. Advances in targeting of miR‑10‑associated lncRNAs/circRNAs for the management of cancer (Review). Oncol Lett 2023; 25:89. [PMID: 36817057 PMCID: PMC9931999 DOI: 10.3892/ol.2023.13675] [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: 09/13/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
With advancements in sequencing technologies, an increasing number of aberrantly expressed long-non-coding RNAs (lncRNAs) and circular RNAs (circRNAs) have been identified in various types of cancer. lncRNAs and circRNAs are now well-established tumor-influencing factors in cancer, driving not only tumor proliferation and invasion, but also cancer progression, drug resistance and metastatic recurrence. The majority of lncRNAs and circRNAs influence cancer progression by targeting microRNAs (miRNAs/miRs). miR-10a and miR-10b, key members of the miR-10 family, have been shown to play important regulatory roles in cell proliferation, differentiation to cancer progression, and development. Manual evaluation and grouping according to different types of competing endogenous RNA and tumor was performed. The review outlined the current state of knowledge on the regulation of miR-10 family-related lncRNAs and circRNAs. The involvement of lncRNAs and circRNAs in the biogenesis, maturation and function of malignant tumors through the miR-10 family, and the key gene targets and signaling cascades that lncRNAs and circRNAs regulate through the miR-10 family were summarized. Based on the findings of this review, it can be hypothesized that lncRNAs and circRNAs targeting the miR-10 family may serve as diagnostic/prognostic markers and/or therapeutic targets for the management of cancer.
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Affiliation(s)
- Shengyu Gao
- School of Basic Medicine, Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China,Department of General Surgery I, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Shuang Liu
- School of Basic Medicine, Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Weiwei Wei
- Department of General Surgery I, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Yanxiu Qi
- Department of General Surgery I, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Fanshi Meng
- School of Basic Medicine, Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China,Department of General Surgery I, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China,Correspondence to: Professor Fanshi Meng, Department of General Surgery I, The First Affiliated Hospital of Jiamusi University, 348 Dexiang Street, Jiamusi, Heilongjiang 154002, P.R. China, E-mail:
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7
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Reza JA, Bakhos C, Su S, Petrov R, Abbas AE. Robotic Belsey Mark IV Repair of the Paraesophageal Hernia. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2023; 18:84-89. [PMID: 36744735 DOI: 10.1177/15569845221150014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Surgical repair of paraesophageal hernias in patients with hostile abdomen is challenging. Despite its utility as an open procedure, the adoption of the minimally invasive Belsey Mark IV procedure has been limited because of the complexity of using traditional video-assisted thoracoscopic instrumentation. The robotic platform offers additional degrees of freedom, which enables minimally invasive transthoracic approach despite challenging anatomy. The purpose of this article is to describe a technique of robotic approach for the Belsey Mark IV operation. METHODS We retrospectively reviewed 5 cases of the robotic Belsey Mark IV procedure completed at a single institution between June 2018 and November 2021. Data were collected from a review of the medical records, including operative reports, anesthesia records, imaging, and clinical notes. The operative technique is described in the present article. There were 4 men and 1 woman. The average age of the patients was 64.4 ± 13.6 years, with an average body mass index of 24.5 kg/m2. Three patients had undergone previous transabdominal hiatal hernia repair, and 2 of them had 2 prior repairs. One patient underwent simultaneous pulmonary left lower lobectomy for cancer with the Belsey Mark IV procedure. RESULTS The average operative time was 209 ± 95 min (110 to 360 min). The average postoperative length of stay was 4.2 days, and 2 patients experienced complications including bleeding and persistent air leak (after lobectomy). The average blood loss was 67 ± 25 mL. CONCLUSIONS The robotic platform enables a transthoracic minimally invasive approach to the Belsey Mark IV operation.
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Affiliation(s)
- Joseph A Reza
- Department of Thoracic Medicine and Surgery, Division of Thoracic Surgery, Temple University Hospital, Philadelphia, PA, USA
| | - Charles Bakhos
- Department of Thoracic Medicine and Surgery, Division of Thoracic Surgery, Temple University Hospital, Philadelphia, PA, USA
| | - Stacey Su
- Department of Surgical Oncology, Division of Thoracic Surgery, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Roman Petrov
- Department of Thoracic Medicine and Surgery, Division of Thoracic Surgery, Temple University Hospital, Philadelphia, PA, USA
| | - Abbas E Abbas
- Department of Surgery, Division of Thoracic Surgery, Brown University, Providence, RI, USA
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8
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Siddiqi A, Johnston FM. The Perioperative and Operative Management of Esophageal and Gastric Cancer. Surg Oncol Clin N Am 2023; 32:65-81. [PMID: 36410922 DOI: 10.1016/j.soc.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Optimal management of esophageal and gastric cancer during the perioperative period requires a coordinated multidisciplinary treatment effort. Accurate staging guides treatment strategy. Advances in minimally invasive surgery and endoscopy have reduced risks associated with resection while maintaining oncological standards. Although the standard perioperative chemo-and radiotherapy regimens have not yet been established, randomized control trials exploring this subject show promising results.
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Affiliation(s)
- Amn Siddiqi
- Department of Surgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Fabian M Johnston
- Division of Gastrointestinal Surgical Oncology, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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Zhu JL, Xue WB, Jiang ZB, Feng W, Liu YC, Nie XY, Jin LY. Long noncoding RNA CDKN2B-AS1 silencing protects against esophageal cancer cell invasion and migration by inactivating the TFAP2A/FSCN1 axis. Kaohsiung J Med Sci 2022; 38:1144-1154. [PMID: 36161699 DOI: 10.1002/kjm2.12596] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/17/2022] [Accepted: 08/25/2022] [Indexed: 12/15/2022] Open
Abstract
Esophageal cancer (EC) is the most aggressive malignancy in the gastrointestinal tract. Long noncoding RNA cyclin-dependent kinase inhibitor 2 B antisense RNA 1 (CDKN2B-AS1) is implicated in EC development. However, the specific mechanisms involved remain poorly defined. Therefore, this research aimed to explore the mechanism of action of CDKN2B-AS1 in EC. Quantitative real-time polymerase chain reaction was conducted to measure CDKN2B-AS1 expression in EC cells and western blotting was utilized to evaluate transcription factor AP-2 alpha (TFAP2A) and fascin actin-bundling protein 1 (FSCN1) expression. After gain-of-function and loss-of-function assays, cell proliferation, migration, invasion, apoptosis, and apoptosis-related protein expression were assessed using cell counting kit-8, scratch tests, Transwell assays, flow cytometry, and western blotting, respectively. The binding relationship between CDKN2B-AS1 and TFAP2A was assessed by RNA immunoprecipitation and RNA pull-down assays. The binding relationship between TFAP2A and FSCN1 was evaluated using dual-luciferase reporter and chromatin immunoprecipitation assays. Tumor xenografts from nude mice were used for in vivo verification. CDKN2B-AS1, TFAP2A, and FSCN1 were upregulated in EC cells. Mechanistically, CDKN2B-AS1 transcriptionally activated FSCN1 by recruiting TFAP2A to the FSCN1 promoter. Silencing CDKN2B-AS1 or TFAP2A suppressed EC cell proliferative, migrating, and invasive properties and augmented apoptosis. TFAP2A was bound to CDKN2B-AS1 and the FSCN1 promoter. Overexpression of TFAP2A or FSCN1 abolished the effects of CDKN2B-AS1-silencing on EC cell function. CDKN2B-AS1 silencing curtailed tumorigenesis in nude mice, which was nullified by the upregulation of TFAP2A or FSCN1. Our findings demonstrated the antioncogenic effects of silencing CDKN2B-AS1 in EC through inactivation of the TFAP2A/FSCN1 axis.
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Affiliation(s)
- Jia-Liang Zhu
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Wen-Bo Xue
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Zhi-Bin Jiang
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Wei Feng
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yi-Cai Liu
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xiong-Ying Nie
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Long-Yu Jin
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital, Central South University, Changsha, People's Republic of China
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miR-18a-5p and ATM Expression in Esophageal Squamous Cell Carcinoma and Their Correlations with Clinicopathological Features. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5260608. [PMID: 36267307 PMCID: PMC9578886 DOI: 10.1155/2022/5260608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/23/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022]
Abstract
Objective. To investigate miR-18a-5p and ataxia telangiectasia muted (ATM) expression in esophageal squamous cell carcinoma (ESCC) and their correlations with clinicopathological features. Methods. The subjects of this study were 62 ESCC patients (research group, RG) and 57 healthy controls (control group, CG) presented to our hospital between July 2019 and April 2020. Peripheral blood (PB) miR-18a-5p and ATM levels in these participants were quantified via qRT-PCR, and the correlations of the two genes with ESCC patients’ clinicopathological characteristics were investigated. In addition, a two-year follow-up was performed on ESCC patients to understand their survival, so as to further determine the prognostic utility of miR-18a-5p and ATM in ESCC. Factors influencing patient outcomes were identified by COX analysis. Results. PB miR-18a-5p expression was higher in RG compared with CG, while ATM was lower, suggesting an inverse connection between the two genes in ESCC (
). miR-18a-5p and ATM levels were determined to be strongly linked to TNM stage, differentiation degree, and lymph node metastasis in ESCC patients (
and
). The patients who succumbed to the disease exhibited higher miR-18a-5p and lower ATM than the survival (
). ROC analysis suggested favorable evaluation effects of miR-18a-5p and ATM on the occurrence and prognostic death of ESCC (
). Further, these two genes were identified by the COX analysis to be factors independently affecting the prognosis of ESCC. Conclusion. miR-18a-5p is highly expressed in ESCC, and ATM is underexpressed, both of which are closely linked to the pathological process of ESCC and have a good evaluation effect on the occurrence and prognosis of ESCC, which may become a breakthrough in future diagnosis and treatment of ESCC.
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Study on the Application Value of Concurrent Chemoradiotherapy and Clinical Nursing Pathway for Postoperative Patients with Esophageal Cancer. JOURNAL OF ONCOLOGY 2022; 2022:2216529. [PMID: 36157239 PMCID: PMC9499755 DOI: 10.1155/2022/2216529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022]
Abstract
Backgrounds To observe the value of concurrent chemoradiotherapy and clinical nursing pathway for postoperative patients with esophageal cancer (EC). Methods A total of 88 postoperative EC patients were divided into the radiotherapy group (RG group, 44 cases) and the chemoradiotherapy group (CRG group, 44 cases). The RG group received single three-dimensional conformal radiotherapy+clinical nursing pathway, and the CRG group was combined with chemotherapy on this basis. The 5-year overall survival rate, progression-free survival rate, pathological remission and survival rate, lymph node metastasis and survival rate, quality of life analysis, tumor-related factor level, and incidence of adverse reactions were compared between the two groups. Results The overall survival rates at 1, 3, and 5 years were 93.18%, 56.82%, and 50.0% in the CRG group and 86.36%, 52.27%, and 43.18% in the RG group, respectively. The 5-year progression-free survival rate of the CRG group was 60.87%, which was clearly higher than that of the RG group (33.33%). The 1-, 3-, and 5-year overall survival rates of pCR and NpCR patients were 90.48%, 80.95%, and 61.90% and 89.55%, 44.78%, and 38.81%, respectively. The overall 1-year, 3-year, and 5-year survival rates were 81.08%, 37.84, and 24.32% and 96.08%, 66.67%, and 62.75% in patients with lymph node metastasis and nonlymph node metastasis, respectively, with statistical significant differences. The emotional function, physical function, cough, pain, and eating difficulty in the CRG group were better than those in the RG group. After treatment, serum CEA, SCC, CYFRA21-1, and CA199 levels in the CRG group were obviously downregulated compared with those in the RG group. There was no obvious difference in the incidence of adverse reactions between the CRG group and the RG group. Conclusion Single radiotherapy and concurrent chemoradiotherapy can be used as effective means in the treatment of EC. Moreover, the quality of life and survival time of the concurrent chemoradiotherapy group were dramatically better than those of the single radiotherapy group, and the antitumor ability of the concurrent chemoradiotherapy group was stronger.
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12
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Byiringiro I, Aurit SJ, Nandipati KC. Long-term survival outcomes associated with robotic-assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer. Surg Endosc 2022; 37:4018-4027. [PMID: 36097100 DOI: 10.1007/s00464-022-09588-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 08/25/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Minimally Invasive esophagectomy for esophageal cancer is associated with less morbidity compared to open approach. Whether robotic-assisted minimally invasive esophagectomy (RAMIE) results in better long-term survival compared with open esophagectomy (OE) and minimally invasive esophagectomy (MIE) is unclear. METHODS We analyzed data from the National Cancer Database (NCDB) for patients with primary esophageal cancers who underwent esophagectomy in 2010-2017. Those with unknown staging, distant metastasis, or diagnosed with another cancer were excluded. Patients were stratified by RAMIE, MIE, and OE operative techniques. The Kaplan-Meier method and associated log-rank test were employed to compare unadjusted survival outcomes by surgical technique, our primary outcome. Multivariable Cox proportional hazards regression model was employed to discern factors independently contributing to survival. RESULTS A total of 5170 patients who underwent esophagectomy were included in the analysis; 428 underwent RAMIE, 1417 underwent MIE, and 3325 underwent OE. Overall median survival was 42 months. In comparison to RAMIE, there was an increased risk of death for those that underwent either MIE [Hazard Ratio (HR) = 1.19; 95% Confidence Interval (CI): > 1.00 to 1.41; P < 0.047)] or OE (HR = 1.22; 95% CI: 1.04 to 1.43; P < 0.017). Academic vs community program facility type was associated with decreased risk of death (HR = 0.84; 95% CI: 0.76 to 0.93; P < 0.001). In general, males from areas of lower income with advanced stages of cancer who received neoadjuvant chemotherapy or radiation were at increased risk of death. Factors that were not associated with survival included race and ethnicity, Charlson-Devo Score, type of health insurance, zipcode level education, and population density. CONCLUSIONS Overall survival was significantly longer in patients with esophageal cancers that underwent RAMIE in comparison to either MIE or OE in a 7-year NCDB cohort study.
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Affiliation(s)
- Innocent Byiringiro
- Department of Surgery, Creighton University School of Medicine, Omaha, NE, USA
| | - Sarah J Aurit
- Department of Medicine/Clinical Research and Evaluative Sciences, Statistician, Creighton University School of Medicine, Omaha, NE, USA
| | - Kalyana C Nandipati
- Department of Surgery, Director of Esophageal Center, Creighton School of Medicine, 7710 Mercy Road, Suite 501, Omaha, NE, 68124, USA.
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Zhang F, Liao L, Wei S, Lu Y. Risk Factors of Acute Radiation-Induced Lung Injury Induced by Radiotherapy for Esophageal Cancer. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2416196. [PMID: 35872959 PMCID: PMC9300318 DOI: 10.1155/2022/2416196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 12/24/2022]
Abstract
Objective To investigate the risk factors of acute radiation-induced lung injury (acute RILI) induced by radiotherapy for esophageal cancer. Methods A total of 206 patients with esophageal cancer who received radiotherapy in our hospital from January 2017 to March 2020 were selected. The general data such as gender, age, and comorbidities of the patients were collected, as well as the levels of cytokines (TNF-α, TNF-β, and IL-6) in peripheral blood before radiotherapy; radiotherapy dose-related parameters were recorded during radiotherapy. Follow-up was 12 months after radiotherapy. The patients with induced acute RILI after radiotherapy were set as the observation group (n = 75). Patients without acute RILI after radiotherapy were set as the control group (n = 131). Univariate and multivariate logistic regression analysis was performed on the risk factors of acute RILI induced by radiotherapy for esophageal cancer. Results Univariate analysis and multivariate logistic regression analysis showed that the combined diabetes, total radiation dose, combined lung disease, physical factors (V30, Dmean), and preradiotherapy cytokine (TNF-α, TNF-β, and IL-6) elevated level was an independent risk factor for radiotherapy-induced acute RILI in esophageal cancer (P < 0.05). Conclusion Concomitant diabetes, total radiation dose, lung disease, physical factors (V30, Dmean), and levels of cytokines (TNF-α, TNF-β, and IL-6) before radiation therapy are risk factors for acute RILI induced by radiation therapy in esophageal cancer. The possibility of acute RILI should be comprehensively assessed according to the patient's condition, and the radiotherapy regimen should be adjusted to reduce and avoid the induction of acute radiation-induced lung injury.
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Affiliation(s)
- Faen Zhang
- Department of Oncology, The People's Hospital of Hechi, Guangxi 547000, China
| | - Lihua Liao
- Department of Oncology, The People's Hospital of Hechi, Guangxi 547000, China
| | - Song Wei
- Department of Oncology, The People's Hospital of Hechi, Guangxi 547000, China
| | - Yuqing Lu
- Department of Oncology, The People's Hospital of Hechi, Guangxi 547000, China
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Wang Q, Sun Z, Xu X, Ma X, Zhao X, Ye Q. The Evaluation of a SEER-Based Nomogram in Predicting the Survival of Patients Treated with Neoadjuvant Therapy Followed by Esophagectomy. Front Surg 2022; 9:853093. [PMID: 35846961 PMCID: PMC9276989 DOI: 10.3389/fsurg.2022.853093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background A novel nomogram based on the Surveillance, Epidemiology, and End Results (SEER) database has been developed to predict the survival of patients with esophageal carcinoma who received neoadjuvant therapy followed by surgery. We aimed to evaluate the accuracy and value of the nomogram with an external validation cohort. Methods A total of 2,224 patients in SEER database were divided into the training cohort (n = 1556) and the internal validation cohort (n = 668), while 77 patients in our institute were enrolled in the external validation cohort. A Cox proportional hazards regression model was used to develop a nomogram based on the training cohort, while the C-indexes, the calibration curves, receiver operating characteristics curve (ROC), and Kaplan-Meier survival curve were applied in the internal and external validation cohort. Results Five independent risk factors were identified and integrated into the nomogram (C-index = 0.645, 95%CI 0.627–0.663). The nomogram exhibited good prognostic value in the internal validation cohort (C-index = 0.648 95%CI 0.622–0.674). However, the C-index, calibration plot, receiver operating characteristics curve (ROC) analysis, Kaplan-Meier survival curve of the nomogram in the external validation cohort were not as good as the training and internal validation cohort (C-index = 0.584 95%CI 0.445–0.723). Further analysis demonstrated that the resection margin involvement (R0, R1, or R2 resection) was an independent risk factor for the patients, which was not included in the SEER cohort. Conclusions the nomogram based on the SEER database fails to accurately predict the prognosis of the patients in the external validation cohort, which can be caused by the absence of essential information from the SEER database.
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Affiliation(s)
- Qing Wang
- Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, ShanghaiChina
| | - Zhiyong Sun
- Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, ShanghaiChina
| | - Xin Xu
- Department of Radiation Oncology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiumei Ma
- Department of Radiation Oncology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaojing Zhao
- Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, ShanghaiChina
- Correspondence: Qing Ye Xiaojing Zhao
| | - Qing Ye
- Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, ShanghaiChina
- Correspondence: Qing Ye Xiaojing Zhao
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