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Hicheri C, Azimuddin AM, Kortum A, Bailey J, Tang Y, Schwarz RA, Rosen D, Jain S, Mansour NM, Groth S, Vasavada S, Rao A, Maliga A, Gallego L, Carns J, Anandasabapathy S, Richards-Kortum R. Design and Evaluation of ScanCap: A Low-Cost, Reusable Tethered Capsule Endoscope with Blue-Green Illumination Imaging for Unsedated Screening and Early Detection of Barrett's Esophagus. Bioengineering (Basel) 2024; 11:557. [PMID: 38927792 PMCID: PMC11200367 DOI: 10.3390/bioengineering11060557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/15/2024] [Accepted: 05/19/2024] [Indexed: 06/28/2024] Open
Abstract
Esophageal carcinoma is the sixth-leading cause of cancer death worldwide. A precursor to esophageal adenocarcinoma (EAC) is Barrett's Esophagus (BE). Early-stage diagnosis and treatment of esophageal neoplasia (Barrett's with high-grade dysplasia/intramucosal cancer) increase the five-year survival rate from 10% to 98%. BE is a global challenge; however, current endoscopes for early BE detection are costly and require extensive infrastructure for patient examination and sedation. We describe the design and evaluation of the first prototype of ScanCap, a high-resolution optical endoscopy system with a reusable, low-cost tethered capsule, designed to provide high-definition, blue-green illumination imaging for the early detection of BE in unsedated patients. The tethered capsule (12.8 mm diameter, 35.5 mm length) contains a color camera and rotating mirror and is designed to be swallowed; images are collected as the capsule is retracted manually via the tether. The tether provides electrical power and illumination at wavelengths of 415 nm and 565 nm and transmits data from the camera to a tablet. The ScanCap prototype capsule was used to image the oral mucosa in normal volunteers and ex vivo esophageal resections; images were compared to those obtained using an Olympus CV-180 endoscope. Images of superficial capillaries in intact oral mucosa were clearly visible in ScanCap images. Diagnostically relevant features of BE, including irregular Z-lines, distorted mucosa, and dilated vasculature, were clearly visible in ScanCap images of ex vivo esophageal specimens.
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Affiliation(s)
- Cheima Hicheri
- Department of Bioengineering, Rice University, Houston, TX 77030, USA; (C.H.); (R.A.S.)
| | - Ahad M. Azimuddin
- Houston Methodist Hospital, Houston, TX 77030, USA;
- Texas A&M School of Medicine, Houston, TX 77030, USA
| | - Alex Kortum
- Department of Bioengineering, Rice University, Houston, TX 77030, USA; (C.H.); (R.A.S.)
| | - Joseph Bailey
- Rice360 Institute for Global Health Technologies, Rice University, Houston, TX 77030, USA
| | - Yubo Tang
- Department of Bioengineering, Rice University, Houston, TX 77030, USA; (C.H.); (R.A.S.)
| | - Richard A. Schwarz
- Department of Bioengineering, Rice University, Houston, TX 77030, USA; (C.H.); (R.A.S.)
| | - Daniel Rosen
- Baylor College of Medicine, Houston, TX 77030, USA (L.G.)
| | - Shilpa Jain
- Baylor College of Medicine, Houston, TX 77030, USA (L.G.)
| | | | - Shawn Groth
- Baylor College of Medicine, Houston, TX 77030, USA (L.G.)
| | | | - Ashwin Rao
- Baylor College of Medicine, Houston, TX 77030, USA (L.G.)
| | | | - Leslie Gallego
- Baylor College of Medicine, Houston, TX 77030, USA (L.G.)
| | - Jennifer Carns
- Department of Bioengineering, Rice University, Houston, TX 77030, USA; (C.H.); (R.A.S.)
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Wang F, Luo M, Cheng Y. KLF5 promotes esophageal squamous cell cancer through the transcriptional activation of FGFBP1. Med Oncol 2023; 41:17. [PMID: 38087142 PMCID: PMC10716083 DOI: 10.1007/s12032-023-02244-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/19/2023] [Indexed: 12/18/2023]
Abstract
Krüpple-like factor 5 (KLF5) is a zinc-finger-containing transcription factor implicated in several human malignancies, but its potential regulatory mechanisms implicated in esophageal squamous cell carcinoma (ESCC) remain elusive. Here, we show that KLF5 is upregulated in ESCC, where its level was significantly associated with tumor differentiation and lymph node metastasis status. Upregulated KLF5 expression promoted the proliferation, migration, and invasion of ESCC cells. Reduced KLF5 showed the opposite effects. Mechanistically, KLF5 exerts its tumor promotion effect by up-regulating fibroblast growth factor binding protein 1 (FGF-BP1) and snail family transcriptional repressor 2 (SNAIL2). KLF5 binds to the promoter regions of FGF-BP1 and transcriptionally activates its expression. Our study indicated that KLF5 could promote esophageal squamous cell cancer proliferation, migration, and invasion by upregulating FGF-BP1/SNAIL2 signaling. Our work suggests that KLF5 might be a proto-oncogene in ESCC and implicated in ESCC metastasis.
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Affiliation(s)
- Fengyun Wang
- Department of Oncology, First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou, Inner Mongolia, China
| | - Ming Luo
- Imaging Department, Third Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China
| | - Yufeng Cheng
- Department of Radiotherapy, Qilu Hospital, Cheeloo College of Medicine, Shandong University, No.107, West Wenhua Road, Lixia District, Jinan, Shandong, China.
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Feng Y, Liang Y, Yao B, Xu J, Zang J, Zhang Y, Zhang J, Xu G, Wei B, Yao X, Huang P, Shi R. A Rapid Cytological Screening as pre-Endoscopy Screening for Early Esophageal Squamous Cell Lesions: A Prospective Pilot Study from a Chinese Academic Center. Technol Cancer Res Treat 2022; 21:15330338211066200. [PMID: 35040718 PMCID: PMC8811134 DOI: 10.1177/15330338211066200] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 10/24/2021] [Accepted: 11/24/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Cytological detection of early esophageal squamous cell carcinoma (ESCC) remains challenging. Therefore, we introduced a rapid cytological screening method and evaluated its efficacy as a pre-endoscopy screening for early ESCC and precursor lesions. Methods: This method consisted of a sponge sample retrieval, automatic liquid-based cytological treatment and slides preparation, computer-assisted screening and manual diagnosis. Efficacy for detection of early ESCC and precursor lesions was evaluated. Also, diagnostic efficiency was compared with manual diagnosis. Results: Eighty-three patients with early ESCC and precursor lesions and 2,090 asymptomatic participants with high risks of ESCC were enrolled. Whole procedure was accomplished within two working days. Abnormal cells were detected in all 83 patients, and in 272 (13.01%) subjects among 2,090 asymptomatic participants. Early ESCC, high-grade intraepithelial neoplasia, low-grade intraepithelial neoplasia and reflux esophagitis and normal endoscopic findings were detected in 8, 13, 11, 187 and 53 participants with abnormal cells, respectively. The calculated sensitivity, specificity, positive predictive value and negative predictive value for detection of early ESCC and precursor lesions were 100%, 88.34%, 11.76%, and 100%, respectively. Compared with manual diagnosis, this method was accomplished in a shorter time duration (5.4 ± 0.45 min vs 320.2 ± 132.4 min, p < 0.001), a higher diagnostic accuracy (96.7% vs74.4%, p = 0.015) and a better inter-observer agreement (93.3% vs66.7%, K = 0.286, p < 0.001). Conclusions: Our study provides a promising methodology as pre-endoscopy screening for early ESCC and precursor lesions.
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Affiliation(s)
- Yadong Feng
- Department of Gastroenterology, Zhongda Hospital, School of
Medicine, Southeast University, 87 Dingjiaqiao Road, 210009, Nanjing, China
| | - Yan Liang
- Nanjing Medical University, 101 Longmian Road, 211166, Nanjing,
China
| | - Bin Yao
- Nanjing Froeasy Technology Development CO., LTD, C1 Building, Red
Maple Park of Technological Industry, 210046, Nanjing, China
| | - Jiajia Xu
- Department of Pathology, Zhongda Hospital, School of Medicine,
Southeast University, 87 Dingjiaqiao Road, 210009, Nanjing, China
| | - Juncai Zang
- Nanjing Froeasy Technology Development CO., LTD, C1 Building, Red
Maple Park of Technological Industry, 210046, Nanjing, China
| | - Youyu Zhang
- Department of Gastroenterology, Zhongda Hospital, School of
Medicine, Southeast University, 87 Dingjiaqiao Road, 210009, Nanjing, China
| | - Jiong Zhang
- Department of Gastroenterology, Zhongda Hospital, School of
Medicine, Southeast University, 87 Dingjiaqiao Road, 210009, Nanjing, China
| | - Guangpeng Xu
- Nanjing Froeasy Technology Development CO., LTD, C1 Building, Red
Maple Park of Technological Industry, 210046, Nanjing, China
| | - Bo Wei
- Nanjing Froeasy Technology Development CO., LTD, C1 Building, Red
Maple Park of Technological Industry, 210046, Nanjing, China
| | - Xiangyi Yao
- Faculty of Art Economic, University of Manitoba, 60 Shore Street,
Winnipeg, Canada, r3T 2C8
| | - Peilin Huang
- Research Institution of Southeast University, 87 Dingjiaqiao Road,
210009, Nanjing, China
| | - Ruihua Shi
- Department of Gastroenterology, Zhongda Hospital, School of
Medicine, Southeast University, 87 Dingjiaqiao Road, 210009, Nanjing, China
- Nanjing Medical University, 101 Longmian Road, 211166, Nanjing,
China
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Li Y, Xu J, Gu Y, Sun X, Dong H, Chen C. The Disease and Economic Burdens of Oesophageal Cancer in China from 2013 to 2030: A Dynamic Cohort Modelling Study. JMIR Public Health Surveill 2021; 8:e33191. [PMID: 34963658 PMCID: PMC8928052 DOI: 10.2196/33191] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/15/2021] [Accepted: 12/28/2021] [Indexed: 01/17/2023] Open
Abstract
Background Esophageal cancer (EC) is the sixth leading cause of tumor-related deaths worldwide. Estimates of the EC burden are necessary and could offer evidence-based suggestions for local cancer control. Objective The aim of this study was to predict the disease burden of EC in China through the estimation of disability-adjusted life years (DALYs) and direct medical expenditure by sex from 2013 to 2030. Methods A dynamic cohort Markov model was developed to simulate EC prevalence, DALYs, and direct medical expenditure by sex. Input data were collected from the China Statistical Yearbooks, Statistical Report of China Children’s Development, World Population Prospects 2019, and published papers. The JoinPoint Regression Program was used to calculate the average annual percentage change (AAPC) of DALY rates, whereas the average annual growth rate (AAGR) was applied to analyze the changing direct medical expenditure trend over time. Results From 2013 to 2030, the predicted EC prevalence is projected to increase from 61.0 to 64.5 per 100,000 people, with annual EC cases increasing by 11.5% (from 835,600 to 931,800). The DALYs will increase by 21.3% (from 30,034,000 to 36,444,000), and the years of life lost (YLL) will account for over 90% of the DALYs. The DALY rates per 100,000 people will increase from 219.2 to 252.3; however, there was a difference between sexes, with an increase from 302.9 to 384.3 in males and a decline from 131.2 to 115.9 in females. The AAPC was 0.8% (95% CI 0.8% to 0.9%), 1.4% (95% CI 1.3% to 1.5%), and –0.7% (95% CI –0.8% to –0.7%) for both sexes, males, and females, respectively. The direct medical expenditure will increase by 128.7% (from US $33.4 to US $76.4 billion), with an AAGR of 5.0%. The direct medical expenditure is 2-3 times higher in males than in females. Conclusions EC still causes severe disease and economic burdens. YLL are responsible for the majority of DALYs, which highlights an urgent need to establish a beneficial policy to reduce the EC burden.
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Affiliation(s)
- Yuanyuan Li
- Science and Education Department, Hangzhou Ninth People's Hospital, Qiantang district, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, CN
| | - Junfang Xu
- Center for Health Policy Studies, School of Public Health, Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, CN
| | - Yuxuan Gu
- Center for Health Policy Studies, School of Public Health, Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, CN
| | - Xueshan Sun
- Center for Health Policy Studies, School of Public Health, Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, CN
| | - Hengjin Dong
- Center for Health Policy Studies, School of Public Health, Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, CN
| | - Changgui Chen
- Science and Education Department, Hangzhou Ninth People's Hospital, Qiantang district, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Qiantang district, Yipeng Rd 98, Hangzhou, CN
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Han J, Wang L, Zhang H, Ma S, Li Y, Wang Z, Zhu G, Zhao D, Wang J, Xue F. Development and Validation of an Esophageal Squamous Cell Carcinoma Risk Prediction Model for Rural Chinese: Multicenter Cohort Study. Front Oncol 2021; 11:729471. [PMID: 34527592 PMCID: PMC8435773 DOI: 10.3389/fonc.2021.729471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There are rare prediction models for esophageal squamous cell carcinoma (ESCC) for rural Chinese population. We aimed to develop and validate a prediction model for ESCC based on a cohort study for the population. METHODS Data of 115,686 participants were collected from esophageal cancer (EC) early diagnosis and treatment of cancer program as derivation cohort while data of 54,750 participants were collected as validation cohort. Risk factors considered included age, sex, smoking status, alcohol drinking status, body mass index (BMI), tea drinking status, marital status, annual household income, source of drinking water, education level, and diet habit. Cox proportional hazards model was used to develop ESCC prediction model at 5 years. Calibration ability, discrimination ability, and decision curve analysis were analyzed in both derivation and validation cohort. A score model was developed based on prediction model. RESULTS One hundred eighty-six cases were diagnosed during 556,949.40 person-years follow-up in the derivation cohort while 120 cases from 277,302.70 in the validation cohort. Prediction model included the following variables: age, sex, alcohol drinking status, BMI, tea drinking status, and fresh fruit. The model had good discrimination and calibration performance: R 2, D statistic, and Harrell's C statistic of prediction model were 43.56%, 1.70, and 0.798 in derivation cohort and 45.19%, 1.62, and 0.787 in validation cohort. The calibration analysis showed good coherence between predicted probabilities and observed probabilities while decision curve analysis showed clinical usefulness. The score model was as follows: age (3 for 45-49 years old; 4 for 50-54 years old; 7 for 55-59 years old; 9 for 60-64 years; 10 for 65-69 years), sex (5 for men), BMI (1 for ≤25), alcohol drinking status (2 for alcohol drinkers), tea drinking status (2 for tea drinkers), and fresh fruit (2 for never) and showed good discrimination ability with area under the curve and its 95% confidence interval of 0.792 (0.761,0.822) in the deviation cohort and 0.773 (0.736,0.811) in the validation cohort. The calibration analysis showed great coherence between predicted probabilities and observed probabilities. CONCLUSIONS We developed and validated an ESCC prediction model using cohort study with good discrimination and calibration capability which can be used for EC screening for rural Chinese population.
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Affiliation(s)
- Junming Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute for Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lijie Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute for Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huan Zhang
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Siqi Ma
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Yan Li
- Cancer Prevention and Treatment Center, Feicheng People’s Hospital, Feicheng, China
| | - Zhongli Wang
- Institute for Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Gaopei Zhu
- Department of Health Statistics, School of Public Health, Weifang Medical University, Weifang, China
| | - Deli Zhao
- Cancer Prevention and Treatment Center, Feicheng People’s Hospital, Feicheng, China
| | - Jialin Wang
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- Department of Human Resource, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute for Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Rehabilitation Nursing Intervention Can Improve Dysphagia and Quality of Life of Patients Undergoing Radiotherapy for Esophageal Cancer. JOURNAL OF ONCOLOGY 2021; 2021:3711699. [PMID: 34394350 PMCID: PMC8360714 DOI: 10.1155/2021/3711699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/29/2021] [Indexed: 12/27/2022]
Abstract
Objective To seek the improvement of rehabilitation nursing intervention on dysphagia and quality of life of patients with esophageal cancer undergoing radiotherapy. Methods A total of 109 patients with esophageal cancer undergoing radiotherapy were selected as research objects. According to the random number table, they were separated into the control group (CG) and intervention group (IG), with 45 cases in CG and 64 cases in IG. In CG, patients were given routine nursing intervention, while those in IG were given rehabilitation nursing intervention. After intervention, the degree of acute radiation injury and the improvement of swallowing function were observed to compare the self-nursing ability, quality of life, and incidence of complications between the two groups. Results The degree of injury in CG was heavier than that in IG. The improvement of swallowing function in IG was better than that in CG. The scores of self-nursing ability and life quality in IG were higher than those in CG, with statistically significant differences (p < 0.05). The incidence of complications in IG was obviously lower than that in CG (p < 0.05). Conclusion Rehabilitation nursing intervention can ameliorate dysphagia, improve the quality of life, and reduce the incidence of complications for patients with esophageal cancer undergoing radiotherapy. It is worthy of clinical application.
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Cao M, Li H, Sun D, He S, Yu Y, Li J, Chen H, Shi J, Ren J, Li N, Chen W. Cancer screening in China: The current status, challenges, and suggestions. Cancer Lett 2021; 506:120-127. [PMID: 33684533 DOI: 10.1016/j.canlet.2021.02.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/29/2021] [Accepted: 02/22/2021] [Indexed: 12/14/2022]
Abstract
Substantial progress has been made in cancer screening in China due to the substantial efforts of all levels of the government. Four large-scale population-based screening programs have been launched since 2005. In these programs, individuals at high risk for the most common types of cancer are screened with no cost. However, there are still wide gaps remaining between the cancer screening objectives and reality. In this review, we summarize the current status of cancer screening, identify the major achievements and challenges of cancer screening, and propose some suggested improvements based on the existing evidence. The main challenges include low participation rates, the uneven distribution of medical sources, inadequate funding, and insufficient screening quality. Some suggestions that should be considered to improve the quality of cancer screening include advertising to increase awareness, providing universal training of staff involved in screening programs, optimizing the definition of high-risk populations, integrating new technologies into cancer screening programs, and implementing appropriate management measures among individuals with positive screening results.
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Affiliation(s)
- Maomao Cao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - He Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Dianqin Sun
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Siyi He
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yiwen Yu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jiang Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Hongda Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jufang Shi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jiansong Ren
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Ni Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Wanqing Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Cao S, Zhang W, Shen P, Xu R. Low STMN1 is associated with better prognosis in Asian patients with esophageal cancers: A meta-analysis. J Gastroenterol Hepatol 2020; 35:1668-1675. [PMID: 32250469 DOI: 10.1111/jgh.15062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/20/2019] [Accepted: 03/29/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIM The role of STMN1 in the development and progression of esophageal carcinoma is not yet determined. The present study aimed to systematically evaluate the correlation between STMN1 and prognosis of patients with esophageal carcinoma. METHODS Electronic databases including PubMed, Embase, the Cochrane library, and Chinese Biomedical Literature Database (CBM) were searched to identify studies evaluating the impact of STMN1 on the survival of esophageal cancer patients, without the language limitation. Two investigators screened the literature according to the inclusion and exclusion criteria and evaluated the quality of the included studies. The combined analysis was performed using RevMan 5.3 software. RESULTS A total of eight studies, involving 1240 esophageal carcinoma patients, were included in this retrospective design. Meta-analysis showed that esophageal carcinoma patients with low STMN1 had a superior overall survival and disease-free survival than those with high expression of STMN1. Compared with the high expression of STMN1, the 5-year survival rate was significantly higher in patients with low level of STMN1. Patients with high STMN1 expression had a higher risk of experiencing clinical grade III-IV disease, lymph node metastasis, and tumor invasion than those with low STMN1. CONCLUSION STMN1 is an indicator for the prognosis of esophageal carcinoma patients.
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Affiliation(s)
- Shasha Cao
- Department of Molecular Pathology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of Science and Technology, Anyang, China
| | - Wei Zhang
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peihong Shen
- Department of Pathology, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou, China
| | - Ruiping Xu
- Department of Medicine, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of Science and Technology, Anyang, China
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Li Y, Du L, Wang Y, Gu Y, Zhen X, Hu X, Sun X, Dong H. Modeling the Cost-effectiveness of Esophageal Cancer Screening in China. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2020; 18:33. [PMID: 32944005 PMCID: PMC7488134 DOI: 10.1186/s12962-020-00230-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 09/02/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study aimed to examine the cost-effectiveness of one-time standard endoscopic screening with Lugol's iodine staining for esophageal cancer (EC) in China. METHODS A Markov decision analysis model with eleven states was built. Individuals aged 40 to 69 years were classified into six age groups in five-year intervals. Three different strategies were adopted for each cohort: (1) no screening; (2) one-time endoscopic screening with Lugol's iodine staining with an annual follow-up for low-grade intraepithelial neoplasia (LGIN); and (3) one-time endoscopic screening with Lugol's iodine staining without follow-up. Quality-adjusted life-years (QALYs) indicated the effectiveness of the model. The incremental cost-effectiveness ratio (ICER) was used as the evaluation indicator. Sensitivity analysis was performed to assess the robustness of the model. RESULTS One-time screening with follow-up was the undominated strategy for individuals aged 40-44 and 45-49 years, which saved USD 10,942.57 and USD 6611.73 per QALY gained compared to nonscreening strategy. For those aged 50-69 years, the nonscreening scenarios were undominated. One-time screening without follow-up was the extended dominated strategy. Compared to screening strategies without follow-up, all the screening strategies with follow-up were more cost-effective, with the ICER increasing from 299.57 USD/QALY for individuals aged 40-44 years to 1617.72 USD/QALY for individuals aged 65-69 years. Probabilistic sensitivity analysis (PSA) supported the results of the base case analysis. CONCLUSIONS One-time EC screening with follow-up targeting individuals aged 40-49 years was the most cost-effective strategy.
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Affiliation(s)
- Yuanyuan Li
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., 310058 Hangzhou, Zhejiang China
| | - Lingbin Du
- Department of Cancer Prevention, Institute of Cancer Research and Basic Medical Science of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, 38 Banshan Guangqiao Rd., 310022 Hangzhou, Zhejiang China
| | - Youqing Wang
- Department of Cancer Prevention, Institute of Cancer Research and Basic Medical Science of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, 38 Banshan Guangqiao Rd., 310022 Hangzhou, Zhejiang China
| | - Yuxuan Gu
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., 310058 Hangzhou, Zhejiang China
| | - Xuemei Zhen
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., 310058 Hangzhou, Zhejiang China
| | - Xiaoqian Hu
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., 310058 Hangzhou, Zhejiang China
| | - Xueshan Sun
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., 310058 Hangzhou, Zhejiang China
| | - Hengjin Dong
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., 310058 Hangzhou, Zhejiang China
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Li Z, Qian J, Li J, Zhu C. Clinical Significance of Serum Chemokines in Esophageal Cancer. Med Sci Monit 2019; 25:5850-5855. [PMID: 31385574 PMCID: PMC6693365 DOI: 10.12659/msm.916846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The aim of this study was to detect the expression levels of chemokines (CX3CL1, CXCL-11, CXCL-12, CCL3, CCL4, and CCL20) in the serum of esophageal cancer patients and a normal control group, and to explore the correlations of those expression levels with the pathological type, progression, and metastasis of esophageal cancer. MATERIAL AND METHODS A total of 50 normal people and 50 untreated patients initially diagnosed with esophageal cancer (including 17 cases of non-metastatic esophageal cancer, 33 cases of metastatic esophageal cancer, 36 cases of esophageal squamous cell carcinoma and 14 cases of esophageal adenocarcinoma) were collected. The liquid chip (Luminex) technology was applied to detect the expression levels of the above-mentioned serum chemokines in the two groups. The results were analyzed using Statistical Product and Service Solution 20.0 software. RESULTS The expression levels of CX3CL1, CXCL-12, and CCL20 in esophageal cancer group were evidently higher than those in normal control group (P<0.001, P<0.001 and P=0.003, respectively). There were no statistically significant differences in chemokine expressions between metastatic esophageal cancer group and non-metastatic esophageal cancer group (P>0.05). The expression level of serum CCL4 in esophageal adenocarcinoma group was remarkably higher than that in esophageal squamous cell carcinoma group [18.45 (11.94) versus 13.37 (9.29), Z=-2.039, P=0.031]. In esophageal cancer group and normal control group, the serum CX3CL1 was positively correlated with CCL20 (r=0.649, P<0.001, r=0.758, P<0.001). CONCLUSIONS The expressions of serum CX3CL1, CXCL-12, and CCL20 are increased markedly in the patients, which may promote the occurrence, development and metastasis of esophageal cancer.
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Affiliation(s)
- Zhixiang Li
- Department of Tumor Surgery, The 1st Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
| | - Jun Qian
- Department of Tumor Surgery, The 1st Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
| | - Jing Li
- Department of Tumor Surgery, The 1st Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
| | - Chao Zhu
- Department of Tumor Surgery, The 1st Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
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