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Tang B, Wu F, Peng L, Leng X, Han Y, Wang Q, Wu J, Orlandini LC. Computed tomography-based radiomics nomogram for prediction of lympho-vascular and perineural invasion in esophageal squamous cell cancer patients: a retrospective cohort study. Cancer Imaging 2024; 24:131. [PMID: 39367492 PMCID: PMC11451056 DOI: 10.1186/s40644-024-00781-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 09/30/2024] [Indexed: 10/06/2024] Open
Abstract
PURPOSE Lympho-vascular invasion (LVI) and perineural invasion (PNI) have been established as prognostic factors in various types of cancers. The preoperative prediction of LVI and PNI has the potential to guide personalized medicine strategies for patients with esophageal squamous cell cancer (ESCC). This study investigates whether radiomics features derived from preoperative contrast-enhanced CT could predict LVI and PNI in ESCC patients. METHODS AND MATERIALS A retrospective cohort of 544 ESCC patients who underwent esophagectomy were included in this study. Preoperative contrast-enhanced CT images, pathological results of PNI and LVI, and clinical characteristics were collected. For each patient, the gross tumor volume (GTV-T) and lymph nodes volume (GTV-N) were delineated and four categories of radiomics features (first-order, shape, textural and wavelet) were extracted from GTV-T and GTV-N. The Mann-Whitney U test was used to select significant features associated with LVI and PNI in turn. Subsequently, radiomics signatures for LVI and PNI were constructed using LASSO regression with ten-fold cross-validation. Significant clinical characteristics were combined with radiomics signature to develop two nomogram models for predicting LVI and PNI, respectively. The area under the curve (AUC) and calibration curve were used to evaluate the predictive performance of the models. RESULTS The radiomics signature for LVI prediction consisted of 28 features, while the PNI radiomics signature comprised 14 features. The AUCs of the LVI radiomics signature were 0.77 and 0.74 in the training and validation groups, respectively, while the AUCs of the PNI radiomics signature were 0.69 and 0.68 in the training and validation groups. The nomograms incorporating radiomics signatures and significant clinical characteristics such as age, gender, thrombin time and D-Dimer showed improved predictive performance for both LVI (AUC: 0.82 and 0.80 in the training and validation group) and PNI (AUC: 0.75 and 0.72 in the training and validation groups) compared to the radiomics signature alone. CONCLUSION The radiomics features extracted from preoperative contrast-enhanced CT of gross tumor and lymph nodes have demonstrated their potential in predicting LVI and PNI in ESCC patients. Furthermore, the incorporation of clinical characteristics has shown additional value, resulting in improved predictive performance.
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Affiliation(s)
- Bin Tang
- Department of Radiation Oncology, Radiation Onocology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Fan Wu
- Department of Radiation Oncology, Radiation Onocology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Lin Peng
- Department of Thoracic Surgery, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Xuefeng Leng
- Department of Thoracic Surgery, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Yongtao Han
- Department of Thoracic Surgery, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Qifeng Wang
- Department of Radiation Oncology, Radiation Onocology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China.
| | - Junxiang Wu
- Department of Radiation Oncology, Radiation Onocology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China.
| | - Lucia Clara Orlandini
- Department of Radiation Oncology, Radiation Onocology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China
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Ng HY, Ko JMY, Lam KO, Kwong DLW, Lo AWI, Wong IYH, Wong CLY, Chan SY, Chan KK, Law TT, Dai W, Fong HCH, Choy FSF, Lo CK, Chen C, Law SYK, Lung ML. Circulating Tumor DNA Dynamics as Prognostic Markers in Locally Advanced and Metastatic Esophageal Squamous Cell Carcinoma. JAMA Surg 2023; 158:1141-1150. [PMID: 37728901 PMCID: PMC10512170 DOI: 10.1001/jamasurg.2023.4395] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/10/2023] [Indexed: 09/22/2023]
Abstract
Importance Esophageal squamous cell carcinoma (ESCC) is a deadly disease with frequent recurrence. There are unmet needs for prognostic biomarkers for dynamically monitoring disease progression and detecting minimal residual disease. Objective To examine whether circulating tumor DNA is clinically useful as a prognostic biomarker for ESCC recurrence and patient survival. Design, Setting, and Participants This single-center, population-based cohort study consecutively enrolled 147 patients receiving curative (n = 74) or palliative (n = 73) treatment at the surgery and clinical oncology departments of Queen Mary Hospital in Hong Kong from August 1, 2016, to September 31, 2021. Patients were followed up for 2 years. Plasma samples were collected at different longitudinal time points for a prospective circulating tumor DNA (ctDNA) next-generation sequencing profiling study of 77 actionable genes. Intervention Patients were treated with up-front surgery, neoadjuvant chemoradiotherapy plus surgery with or without adjuvant therapy, or palliative chemotherapy (CT). Main Outcomes and Measures Detection of circulating tumor DNA (ctDNA), progression-free survival (PFS), and overall survival (OS). Results A total of 478 serial plasma samples from 147 patients with locoregional or metastatic ESCC were prospectively analyzed. Among the 74 patients in the curative group (median [range] age, 66 [46-85] years; 56 [76.0%] male), 44 (59.5%) relapsed and 36 (48.6%) died. For patients receiving curative surgical treatment, a high ctDNA level (hazard ratio [HR], 7.84; 95% CI, 1.87-32.97; P = .005) and ctDNA alterations (HR, 5.71; 95% CI, 1.81-17.97; P = .003) at 6 months postoperation were independently associated with poor OS. Among patients receiving neoadjuvant chemoradiotherapy, postneoadjuvant ctDNA alterations were associated with poor PFS (HR, 3.16; 95% CI, 1.17-8.52; P = .02). In the 73 patients in the palliative group (median [range] age, 63 [45-82] years; 63 [86.0%] male), 71 (97.3%) had disease relapse and 68 (93.2%) died. Detectable pre-CT NFE2L2 alterations were independently associated with PFS (HR, 2.99; 95% CI, 1.35-6.61; P = .007) and OS (HR, 28.39; 95% CI, 7.26-111.03; P = 1.52 × 10-6), whereas high ctDNA levels (HR, 2.41; 95% CI, 1.18-4.95; P = .02) and alterations in pre-cycle III ctDNA (HR, 1.99; 95% CI, 1.03-3.85; P = .04) showed weaker associations with PFS. Alterations in pre-CT ctDNA were independently associated with OS (HR, 4.46; 95% CI, 1.86-10.69; P = 7.97 × 10-4). Conclusions and Relevance The findings of this cohort study indicate that prognostic models incorporating ctDNA features are useful in ESCC. Both ctDNA level and NFE2L2 alterations pre-CT and before cycle III were found to be important prognostic factors in palliative groups, and ctDNA alterations after treatment and at 6 months after surgery may define high-risk groups for recurrence in the curative group. High-risk patients can benefit by a timely switch to the next therapeutic options.
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Affiliation(s)
- Hoi Yan Ng
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Josephine Mun Yee Ko
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Ka On Lam
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Dora Lai Wan Kwong
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Anthony Wing Ip Lo
- Division of Anatomical Pathology, Queen Mary Hospital, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Ian Yu Hong Wong
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Claudia Lai Yin Wong
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Siu Yin Chan
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Kwan Kit Chan
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Tsz Ting Law
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Wei Dai
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Henry Chun Hung Fong
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Faith Sin Fai Choy
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Chun Kit Lo
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Cancan Chen
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Simon Ying Kit Law
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Maria Li Lung
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
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Wang Y, Bai G, Huang W, Zhang H, Chen W. A radiomics nomogram based on contrast-enhanced CT for preoperative prediction of Lymphovascular invasion in esophageal squamous cell carcinoma. Front Oncol 2023; 13:1208756. [PMID: 37465108 PMCID: PMC10351375 DOI: 10.3389/fonc.2023.1208756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
Background and purpose To develop a radiomics nomogram based on contrast-enhanced computed tomography (CECT) for preoperative prediction of lymphovascular invasion (LVI) status of esophageal squamous cell carcinoma (ESCC). Materials and methods The clinical and imaging data of 258 patients with ESCC who underwent surgical resection and were confirmed by pathology from June 2017 to December 2021 were retrospectively analyzed.The clinical imaging features and radiomic features were extracted from arterial-phase CECT. The least absolute shrinkage and selection operator (LASSO) regression model was used for radiomics feature selection and signature construction. Multivariate logistic regression analysis was used to develop a radiomics nomogram prediction model. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate the performance and clinical effectiveness of the model in preoperative prediction of LVI status. Results We constructed a radiomics signature based on eight radiomics features after dimensionality reduction. In the training cohort, the area under the curve (AUC) of radiomics signature was 0.805 (95% CI: 0.740-0.860), and in the validation cohort it was 0.836 (95% CI: 0.735-0.911). There were four predictive factors that made up the individualized nomogram prediction model: radiomic signatures, TNRs, tumor lengths, and tumor thicknesses.The accuracy of the nomogram for LVI prediction in the training and validation cohorts was 0.790 and 0.768, respectively, the specificity was 0.800 and 0.618, and the sensitivity was 0.786 and 0.917, respectively. The Delong test results showed that the AUC value of the nomogram model was significantly higher than that of the clinical model and radiomics model in the training and validation cohort(P<0.05). DCA results showed that the radiomics nomogram model had higher overall benefits than the clinical model and the radiomics model. Conclusions This study proposes a radiomics nomogram based on CECT radiomics signature and clinical image features, which is helpful for preoperative individualized prediction of LVI status in ESCC.
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Richter F, Henssen C, Steiert TA, Meissner T, Mehdorn AS, Röcken C, Franke A, Egberts JH, Becker T, Sebens S, Forster M. Combining Solid and Liquid Biopsy for Therapy Monitoring in Esophageal Cancer. Int J Mol Sci 2023; 24:10673. [PMID: 37445849 DOI: 10.3390/ijms241310673] [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: 03/15/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023] Open
Abstract
Esophageal cancer (EC) has one of the highest mortality rates among cancers, making it imperative that therapies are optimized and dynamically adapted to individuals. In this regard, liquid biopsy is an increasingly important method for residual disease monitoring. However, conflicting detection rates (14% versus 60%) and varying cell-free circulating tumor DNA (ctDNA) levels (0.07% versus 0.5%) have been observed in previous studies. Here, we aim to resolve this discrepancy. For 19 EC patients, a complete set of cell-free DNA (cfDNA), formalin-fixed paraffin-embedded tumor tissue (TT) DNA and leukocyte DNA was sequenced (139 libraries). cfDNA was examined in biological duplicates and/or longitudinally, and TT DNA was examined in technical duplicates. In baseline cfDNA, mutations were detected in 12 out of 19 patients (63%); the median ctDNA level was 0.4%. Longitudinal ctDNA changes were consistent with clinical presentation. Considerable mutational diversity was observed in TT, with fewer mutations in cfDNA. The most recurrently mutated genes in TT were TP53, SMAD4, TSHZ3, and SETBP1, with SETBP1 being reported for the first time. ctDNA in blood can be used for therapy monitoring of EC patients. However, a combination of solid and liquid samples should be used to help guide individualized EC therapy.
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Affiliation(s)
- Florian Richter
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany
| | - Clara Henssen
- Institute of Clinical Molecular Biology, Kiel University, 24105 Kiel, Germany
| | | | - Tobias Meissner
- Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, SD 57105, USA
| | - Anne-Sophie Mehdorn
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, University Hospital Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Kiel University, 24105 Kiel, Germany
| | - Jan-Hendrik Egberts
- Department of Surgery, Israelitisches Krankenhaus Hamburg, 22297 Hamburg, Germany
| | - Thomas Becker
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany
| | - Susanne Sebens
- Institute for Experimental Cancer Research, Kiel University, University Hospital Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany
| | - Michael Forster
- Institute of Clinical Molecular Biology, Kiel University, 24105 Kiel, Germany
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Chen W, Wang Y, Bai G, Hu C. Can Lymphovascular Invasion be Predicted by Preoperative Contrast-Enhanced CT in Esophageal Squamous Cell Carcinoma? Technol Cancer Res Treat 2022; 21:15330338221111229. [PMID: 35790460 PMCID: PMC9340382 DOI: 10.1177/15330338221111229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To explore whether preoperative contrast-enhanced
computed tomogrpahy (CT) can predict lymphovascular invasion (LVI) in esophageal
squamous cell carcinoma (ESCC), and provide a reliable reference for the
formulation of clinical individualized treatment plans. Methods:
This retrospective study enrolled 228 patients with surgically resected and
pathologically confirmed ESCC, including 36 patients with LVI and 192 patients
without LVI. All patients underwent contrast-enhanced CT (CECT) scan within 2
weeks before the operation. Tumor size (including tumor length and maximum tumor
thickness), tumor-to-normal wall enhancement ratio (TNR), and gross tumor volume
(GTV) were obtained. All clinical features and CECT-derived parameters
associated with LVI were analyzed by univariate and multivariate analysis. The
independent predictors for LVI were identified, and their combination was built
by multivariate logistic regression analysis, using the significant variables
from the univariate analysis as inputs. Results: Univariate
analysis of clinical features and CECT-derived parameters revealed that age,
TNR, and clinical N stage (cN stage) were significantly associated with LVI. The
multivariable analysis results demonstrated that age (odds ratio [OR]: 5.32, 95%
confidence interval [CI]: 2.224-12.743, P<.001), TNR (OR:
5.399, 95% CI: 1.609-18.110, P = .006), and cN stage (cN1:
OR: 2.874, 95% CI: 1.182-6.989, P = .02; cN2: OR: 6.876, 95%
CI: 2.222-21.227) were identified to be independent predictors for LVI. The
combination of age, TNR, and cN stage achieved a relatively higher area under
the curve (AUC) (0.798), accuracy (ACC) (65.4%), sensitivity (SEN) (69.4%),
specificity (SPE) (79.7%), positive predictive value (PPV) (77.4%), and negative
predictive value (NPV) (71.6%). Conclusions: The combination of
clinical features and CECT-derived parameters may be effective in predicting LVI
status preoperatively in ESCC.
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Affiliation(s)
- Wei Chen
- The First Affiliated Hospital of Soochow
University, Suzhou, Jiangsu, China
| | - Yating Wang
- The Affiliated Huai’an No. 1 People’s
Hospital of Nanjing Medical University, Huai’an, Jiangsu, China
| | - Genji Bai
- The Affiliated Huai’an No. 1 People’s
Hospital of Nanjing Medical University, Huai’an, Jiangsu, China
| | - Chunhong Hu
- The First Affiliated Hospital of Soochow
University, Suzhou, Jiangsu, China
- Chunhong Hu, Department of Radiology, The
First Affiliated Hospital of Soochow University, No. 188 Ten Catalpa Street,
Suzhou, Jiangsu 215006, China.
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Sidhu MS, Paul D, Jain S, Brar GS, Sood S, Jain K. Prognostic factor for recurrence in esophagus cancer patients who underwent surgery for curative intent: A single-institution analysis. J Cancer Res Ther 2021; 17:1376-1381. [PMID: 34596602 DOI: 10.4103/jcrt.jcrt_1702_20] [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: 11/04/2022]
Abstract
Objective The purpose of this study is to analyze predisposing factors for a higher risk of recurrence in esophageal cancer patient who underwent surgery for curative intent and to do survival analysis of prognostic factors. Materials and Methods Between February 2018 and March 2020, we retrospectively identified 28 cases staged T1b to T4a managed electively at our institute as per multidisciplinary management plan. Demographic, clinical, radiological, operative, histopathological parameters, upfront surgery done or not, type of preoperative, and adjuvant treatment used and whether neoadjuvant or adjuvant therapy was planned along with waiting time for surgery, were assessed as potential risk factors. End point of study was to find potential risk factors for recurrence and to do their subgroup survival analysis. Results The recurrence rate in our study was 25% with a mean follow-up of 24 months. The median time of recurrence was 8.5 months, all recurrence occurred within 1 year. Overall DFS at 2 years was 72%. On univariate analysis, following prognostic factors were associated with high risk of recurrence, male sex X2 (1) =4.42, p = 0.035; histology subtype of adenocarcinoma X2 (1) = 7.07, p = 0.008; margin positive X2 (1) =3.76, p = 0.05; presence of lymph vascular invasion (LVI) X2 (1) =7.88, p = 0.005; presence of perineural invasion (PNI) X2 (1) =5.97, p = 0.015; postoperative T size >4 cm X2 (1) =3.86, p = 0.049; and nodal positivity X2 (3) =13.47, p = 0.004. Conclusions Male sex, adenocarcinoma histological subtype, positive resected margin, presence of LVI and PNI, postoperative T size >4 cm, and high postoperative nodal positivity and whether neoadjuvant versus adjuvant therapy given (on K. M analysis) were the identified predictors of recurrence which compromised DFS.
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Affiliation(s)
- Manjinder S Sidhu
- Department of Radiation Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Davinder Paul
- Department of Medical Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Sumeet Jain
- Department of Surgical Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Gurpreet S Brar
- Department of Surgical Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Sandhya Sood
- Department of Radiation Oncology, DMCH cancer center, Ludhiana, Punjab, India
| | - Kunal Jain
- Department of Medical Oncology, DMCH cancer center, Ludhiana, Punjab, India
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Liu T, Yao Q, Jin H. Plasma Circulating Tumor DNA Sequencing Predicts Minimal Residual Disease in Resectable Esophageal Squamous Cell Carcinoma. Front Oncol 2021; 11:616209. [PMID: 34094900 PMCID: PMC8173109 DOI: 10.3389/fonc.2021.616209] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/22/2021] [Indexed: 12/12/2022] Open
Abstract
Esophageal squamous cell carcinoma (ESCC) is lethal as tumors are rarely detected at an early stage and have a high recurrence rate. There are no particularly useful biomarkers for the prognostic prediction of ESCC. Circulating tumor DNA (ctDNA) is becoming an important biomarker for non-invasive diagnosis and monitoring tumor prognosis. Here, we aimed to analyze variations in plasma cell-free DNA (cfDNA) amount to search for minimal residual disease (MRD). Plasma and white blood cells (WBCs) of 60 patients were collected before tumor resection and a week after surgery. Tumor specimens were also collected as formalin-fixed paraffin-embedded (FFPE) samples. All samples were extracted to analyze the genetic alterations of 61 genes using capture-based next-generation sequencing (NGS). Tumor variants were detected in 38 patients with ESCC, and the two driver genes with the highest mutation frequency were TP53 and PIK3CA. Of the pre-surgical plasma cfDNA samples, 73.7% of identified variants matched the tissue. In patients who did not receive adjuvant therapy after surgery, postoperative cfDNA-positive patients had shorter overall survival (hazard ratios (HR), 25.8; 95% CI, 2.7–242.6; P = 0.004) and were more likely to relapse than postoperative cfDNA-negative patients (HR, 184.6; 95% CI, 3.6–9576.9; P = 0.01). Detection of ctDNA after surgical tumor excision is associated with tumor relapse and disease-specific survival, and can be used as a prognostic biomarker for MRD detection in ESCC.
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Affiliation(s)
- Tao Liu
- Department of Thoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Qianqian Yao
- Department of Medical Science, Shanghai AccuraGen Biotechnology Co., Ltd., Shanghai, China
| | - Hai Jin
- Department of Thoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
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Li Y, Yu M, Wang G, Yang L, Ma C, Wang M, Yue M, Cong M, Ren J, Shi G. Contrast-Enhanced CT-Based Radiomics Analysis in Predicting Lymphovascular Invasion in Esophageal Squamous Cell Carcinoma. Front Oncol 2021; 11:644165. [PMID: 34055613 PMCID: PMC8162215 DOI: 10.3389/fonc.2021.644165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/08/2021] [Indexed: 01/03/2023] Open
Abstract
Objectives To develop a radiomics model based on contrast-enhanced CT (CECT) to predict the lymphovascular invasion (LVI) in esophageal squamous cell carcinoma (ESCC) and provide decision-making support for clinicians. Patients and Methods This retrospective study enrolled 334 patients with surgically resected and pathologically confirmed ESCC, including 96 patients with LVI and 238 patients without LVI. All enrolled patients were randomly divided into a training cohort and a testing cohort at a ratio of 7:3, with the training cohort containing 234 patients (68 patients with LVI and 166 without LVI) and the testing cohort containing 100 patients (28 patients with LVI and 72 without LVI). All patients underwent preoperative CECT scans within 2 weeks before operation. Quantitative radiomics features were extracted from CECT images, and the least absolute shrinkage and selection operator (LASSO) method was applied to select radiomics features. Logistic regression (Logistic), support vector machine (SVM), and decision tree (Tree) methods were separately used to establish radiomics models to predict the LVI status in ESCC, and the best model was selected to calculate Radscore, which combined with two clinical CT predictors to build a combined model. The clinical model was also developed by using logistic regression. The receiver characteristic curve (ROC) and decision curve (DCA) analysis were used to evaluate the model performance in predicting the LVI status in ESCC. Results In the radiomics model, Sphericity and gray-level non-uniformity (GLNU) were the most significant radiomics features for predicting LVI. In the clinical model, the maximum tumor thickness based on CECT (cThick) in patients with LVI was significantly greater than that in patients without LVI (P<0.001). Patients with LVI had higher clinical N stage based on CECT (cN stage) than patients without LVI (P<0.001). The ROC analysis showed that both the radiomics model (AUC values were 0.847 and 0.826 in the training and testing cohort, respectively) and the combined model (0.876 and 0.867, respectively) performed better than the clinical model (0.775 and 0.798, respectively), with the combined model exhibiting the best performance. Conclusions The combined model incorporating radiomics features and clinical CT predictors may potentially predict the LVI status in ESCC and provide support for clinical treatment decisions.
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Affiliation(s)
- Yang Li
- Department of Computed Tomography and Magnetic Resonance, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meng Yu
- Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guangda Wang
- Department of Computed Tomography and Magnetic Resonance, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Li Yang
- Department of Computed Tomography and Magnetic Resonance, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chongfei Ma
- Department of Computed Tomography and Magnetic Resonance, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Mingbo Wang
- Department of Thoracic Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meng Yue
- Department of Pathology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Mengdi Cong
- Department of Computed Tomography and Magnetic Resonance, Children's Hospital of Hebei Province, Shijiazhuang, China
| | | | - Gaofeng Shi
- Department of Computed Tomography and Magnetic Resonance, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Khan M, Urooj N, Syed AA, Khattak S, Kazmi A, Ashraf MI, Batool S. Prognostic Factors for Recurrence in Esophageal Cancer Patients Treated With Neoadjuvant Therapy and Surgery: A Single-institution Analysis. Cureus 2020; 12:e8108. [PMID: 32542161 PMCID: PMC7292711 DOI: 10.7759/cureus.8108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/11/2020] [Indexed: 12/16/2022] Open
Abstract
Background The purpose of this study is to analyze potential predisposing factors for a higher risk of recurrence in our esophageal cancer patients managed with neoadjuvant chemotherapy, radiation therapy, and surgery, and to determine their impact on disease-free survival (DFS) and time to recurrence. Methods A total of 154 of 232 patients staged T1b to T4a managed electively at our institute from July 2005 through July 2015 with a tri-modality approach were retrospectively evaluated. Basic demographic, clinical, radiological, operative, and pathological disease-related parameters, along with waiting time for surgery and type of neoadjuvant modality used, were assessed as potential risk factors. The primary endpoint was the impact of these on the risk of recurrence. The secondary endpoint was to study their relation on DFS and time to recurrence. Results The recurrence rate in this particular study was 33.1% over a median follow-up of 35 months (interquartile range = 19-50.3). The median time to recurrence was 12 months, and 94% of recurrences occurred within two years. The median DFS was 33 months, and the one- and three-year DFS was 90% and 72%, respectively. On univariate and multivariate analysis, a complete pathological response (hazard ratio [HR]: 3.8, 95% confidence interval [CI]: 1.41-10.11), negative resection margins (HR: 5.9, 95% CI: 1.69-20.45), and a low nodal index (HR: 6.3, 95% CI: 1.37-28.67 for an index of 0.1-0.2; and HR: 15.2, 95% CI: 0.96-241.73 for an index of >0.2) were found as statistically significant (P = < 0.05) for risk to recurrence. In addition to these three, a low comorbidity index (P = 0.03; HR: 3.5; 95% CI: 1.16-10.52) was an individual positive predictor of DFS. Conclusions A complete pathological response, low nodal index, and margin-negative resection were the identified predictors of freedom from recurrence, with a better DFS and a low comorbidity index as additional indicators of prolonged DFS.
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Affiliation(s)
- Misbah Khan
- Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Namra Urooj
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Aamir Ali Syed
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Shahid Khattak
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Ather Kazmi
- Radation Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Mohammad I Ashraf
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Sadaf Batool
- Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
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10
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Jeong DY, Lee KS, Choi JY, Chung MJ, Min YW, Kim HK, Zo JI, Shim YM, Sun JM. Surgically Resected Esophageal Squamous Cell Carcinoma: Patient Survival and Clinicopathological Prognostic Factors. Sci Rep 2020; 10:5077. [PMID: 32193500 PMCID: PMC7081270 DOI: 10.1038/s41598-020-62028-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 03/06/2020] [Indexed: 11/09/2022] Open
Abstract
We aimed to report patients' survival after surgical resection of eSCC and to ascertain the clinical, imaging, and pathological factors related to patient prognosis. This retrospective study included 435 patients with eSCC of <stage T2 (median follow-up period, 49.3 months). A total of 103 (23.7%) patients died, and 89 (20.5%) experienced recurrence during follow-up. The maximum standardized uptake value (SUVmax) on positron emission tomography (PET)/computed tomography (CT) of the primary tumor was significantly correlated with tumor length, nodal metastasis, and pathologic T stage in a positive linear fashion. In the multivariate analysis, higher SUVmax on PET/CT was a negative prognostic factor for both disease-free survival (DFS) and overall survival (OS). Contrarily, the presence of nodal metastasis was a prognostic factor only for DFS, and pathologic T stage only for OS. By applying SUVmax cut-off, both DFS and OS were significantly different among three groups when divided by cut-off values (A: SUVmax ≤ 3.05, B: SUVmax 3.06 - 5.64, C: SUVmax ≥ 5.65). In patients with a surgically resectable eSCC, measuring the SUVmax of the primary tumor during PET/CT can help predict patient survival. Additionally, PET/CT renders triage criterion for endoscopic submucosal dissection (ESD; T1a cancer and SUVmax, ≤3.05).
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Affiliation(s)
- Dong Young Jeong
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Kyung Soo Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea.
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Myung Jin Chung
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Yang Won Min
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Hong Kwan Kim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Jae Ill Zo
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Young Mog Shim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Jong-Mu Sun
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
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11
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Luo YG, Duan LW, Ji X, Jia WY, Liu Y, Sun ML, Liu GM. Expression of miR-1304 in patients with esophageal carcinoma and risk factors for recurrence. World J Gastroenterol 2020; 26:670-685. [PMID: 32103875 PMCID: PMC7029348 DOI: 10.3748/wjg.v26.i6.670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/01/2020] [Accepted: 01/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Esophageal carcinoma is a malignant gastrointestinal tumor with a very poor prognosis. MicroRNA (miR)-1304 is a newly discovered non-coding RNA, which shows differential expression in other cancers, and its clinical value in esophageal carcinoma remains unclear.
AIM To explore the expression of miR-1304 in patients with esophageal carcinoma and its clinical value.
METHODS The expression of miR-1304 in patients with esophageal carcinoma was analyzed based on the data on miR in esophageal carcinoma downloaded from The Cancer Genome Atlas database. Quantitative real-time polymerase chain reaction was adopted to determine the expression of miR-1304 in the tissues and serum of patients. The clinical diagnostic value of miR-1304 and independent factors for recurrence and prognosis of esophageal carcinoma were then analyzed. The potential target genes of miR-1304 were predicted, and then analyzed based on gene ontology, Kyoto Encyclopedia of Genes, and Genomes, and protein-protein interaction.
RESULTS The expression of miR-1304 in the tissues and serum of patients with esophageal carcinoma increased, and was also increased according to the database. Patients with high expression of miR-1304 suffered increased rates of tumor ≥ 3 cm, low differentiation and stage II + III. miR-1304 had a diagnostic value in identifying esophageal carcinoma, tumor size, differentiation and TNM stage. Tumor size, differentiation, TNM stage, and miR-1304 were independent risk factors for recurrence of esophageal carcinoma, and they had certain predictive and diagnostic value for the recurrence of esophageal carcinoma. Seventy-eight patients showed a 3-year survival rate of 38.46%, and patients with high expression of miR-1304 had a relatively lower survival rate. Multivariate analysis revealed that tumor size, differentiation, recurrence and miR-1304 were independent factors for the prognosis of patients. MiRTarBase, miRDB, and Targetscan predicted 20 target genes in total. Gene ontology enrichment analysis found 18 functions with aP < 0.05, and Kyoto Encyclopedia of Genes, and Genomes analysis found 11 signal pathways with aP < 0.05. String analysis of protein co-expression found 269 relationship pairs, of which co-expression with epidermal growth factor was the most common.
CONCLUSION miR-1304 can be used as a potential indicator for the diagnosis and recurrence of esophageal carcinoma and for survival of patients with this disease.
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Affiliation(s)
- Yun-Gang Luo
- Jilin Provincial Medicine Anti-Tumor Engineering Center, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
- Department of Stomatology, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Li-Wei Duan
- Department of Gastroenterology, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Xuan Ji
- Jilin Provincial Medicine Anti-Tumor Engineering Center, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
- Department of Stomatology, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Wen-Yuan Jia
- Jilin Provincial Medicine Anti-Tumor Engineering Center, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Yun Liu
- Jilin Provincial Medicine Anti-Tumor Engineering Center, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
- Department of Stomatology, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Mao-Lei Sun
- Jilin Provincial Medicine Anti-Tumor Engineering Center, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
- Department of Stomatology, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Guo-Min Liu
- Jilin Provincial Medicine Anti-Tumor Engineering Center, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
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12
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Shi Y, Ge X, Gao Z, Liu S, Sun X, Luo J. Gross tumor volume is an independent prognostic factor in patients with postoperative locoregional recurrence of esophageal squamous cell carcinoma. Oncol Lett 2019; 18:2388-2393. [PMID: 31452733 PMCID: PMC6676668 DOI: 10.3892/ol.2019.10529] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/10/2019] [Indexed: 02/01/2023] Open
Abstract
Many cases of esophageal squamous cell carcinoma (ESCC) involve lymph node and distant metastases after esophagectomy, and most patients relapse within 2 years. Intensity-modulated radiotherapy (IMRT) is an important treatment for these cases of recurrence in ESCC and is widely used in clinical practice. A retrospective study of 137 postoperative patients with locoregional recurrences of ESCC who received IMRT was carried out. Kaplan-Meier survival curves and log-rank tests of univariate analysis was performed to assess whether there was a significant association between demographic and clinical features and death after recurrence. For multivariate analysis, the statistically significant results from the Kaplan-Meier method were subjected to Cox regression analysis. A total of 109 male and 28 female patients were included. There were 21 (15.3%), 58 (42.3%), 36 (26.3%), 3 (2.2%), 17 (12.4%), and 2 (1.5%) recurrences in the anastomotic, supraclavicular, mediastinal, tumor bed, polyregional, and abdominal regions, respectively. Univariate analysis showed that the gross tumor volume (GTV) of radiation (<27 vs. ≥27 cm3) and the number of lymph nodes were significantly associated with survival. The survival rates of patients at 1, 2, 3 and 5 years with GTV<27 cm3 were 72.7, 51.5, 37.1 and 25.9%, respectively, and with GTV≥27 cm3 were 63.7, 26.9, 17.9 and 0%, respectively. The significant independent prognostic factor was GTV [<27 vs. ≥27 cm3; hazard ratio (HR), 1.746; 95% confidence interval (CI), 1.112–2.741]. In conclusion, GTV of radiation (<27 vs. ≥27 cm3) is an independent factor in predicting locoregional recurrence after ESCC. Patients with GTV<27 cm3 are likely to have a better prognosis.
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Affiliation(s)
- Yu Shi
- Department of Radiotherapy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.,Department of Radiotherapy, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Xiaolin Ge
- Department of Radiotherapy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Zhenzhen Gao
- Department of Radiotherapy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.,Department of Oncology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314000, P.R. China
| | - Shenxiang Liu
- Department of Radiotherapy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.,Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu 225100, P.R. China
| | - Xinchen Sun
- Department of Radiotherapy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Jinhua Luo
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
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13
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Hu J, Zhu D, Yang Y. Diagnostic value of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography for preoperative lymph node metastasis of esophageal cancer: A meta-analysis. Medicine (Baltimore) 2018; 97:e13722. [PMID: 30558091 PMCID: PMC6319779 DOI: 10.1097/md.0000000000013722] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/22/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE We determined the value of F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) for the assessment of preoperative lymph node metastases in patients with esophageal cancer. METHODS We searched electronic database indexes for articles on PET/CT assessment of lymph node status. Information including true positives, false positives, false negatives, and true negatives was obtained. Based on these data, the pooled sensitivity, specificity, diagnostic odds ratio, and likelihood ratio were calculated using bivariate models and receiver operating characteristic curves (ROCs) were drawn. RESULTS Patients without neoadjuvant treatment had a pooled sensitivity and specificity (95% confidence interval [CI]) of 0.57 (0.45-0.69) and 0.91 (0.85-0.95), respectively. Patients who received neoadjuvant treatment had a pooled sensitivity and specificity of 0.53 (0.35-0.70) and 0.96 (0.86-0.99), respectively. CONCLUSIONS The PET/CT has a high diagnostic specificity but its diagnostic sensitivity is low; thus, its diagnosis findings cannot accurately reflect the lymph node status.
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Affiliation(s)
- Jingfeng Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan 450052, China
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14
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Chen H, Zhang ZQ, Zhao B, Ning WL, Wang XY, Zhou F. Clinical significance of ALDH1 combined with DAPI expression in patients with esophageal carcinoma. Oncol Lett 2017; 14:4878-4882. [PMID: 29085496 DOI: 10.3892/ol.2017.6743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 05/08/2017] [Indexed: 12/25/2022] Open
Abstract
Esophageal carcinoma is the most common type of tumor, with the incidence in China accounting for 50% of cases worldwide and the majority of patients not surviving due to tumor recurrence. According to the cancer stem cell theory, tumor development and recurrence is due to the excitation of a cancer stem cell. Aldehyde dehydrogenase 1 (ALDH1) is an appropriate marker for cancer stem cells and the present study aimed at determining the function of ALDH1 in human esophageal carcinoma. Indirect fluorescence antibody staining was used to investigate the association between the level of ALDH1 protein expression and clinicopathological parameters, including sex, age, vein invasion, degree of tumor cell differentiation and clinical stage. DAPI was used to stain the nuclei of tumor cells and exclude non-tumor cells. The results of the present study revealed that ALDH1 expression was associated with the level of tumor cell differentiation, tumor-node-metastasis stage and lymphatic invasion. In addition, increased expression of ALDH1 was identified in esophageal carcinoma tissues compared with in healthy esophageal tissues. Therefore, ALDH1 may be used as a parameter for the pathology of esophageal carcinoma.
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Affiliation(s)
- Hong Chen
- Center of Individualized Medicine Diagnosis and Treatment, The First Hospital of Qiqihar, Qiqihar, Heilongjiang 161005, P.R. China
| | - Zhi-Qiang Zhang
- Department of First General Surgery, The First Hospital of Harbin, Harbin, Heilongjiang 150010, P.R. China
| | - Bin Zhao
- Department of Anorectal Surgery, The First Hospital Affiliated of Jiamusi University, Jiamusi, Heilongjiang 154000, P.R. China
| | - Wen-Long Ning
- Department of Emergency, The First Hospital of Qiqihar, Qiqihar, Heilongjiang 161005, P.R. China
| | - Xue-Yan Wang
- Department of Public Health, The First Hospital of Qiqihar, Qiqihar, Heilongjiang 161005, P.R. China
| | - Fei Zhou
- Department of Second General Surgery, The First Hospital of Qiqihar, Qiqihar, Heilongjiang 161005, P.R. China.,Harbin Medical University Clinical Post-Doctor, Harbin, Heilongjiang 150001, P.R. China
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15
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Shen WB, Gao HM, Zhu SC, Li YM, Li SG, Xu JR. Analysis of the causes of failure after radical surgery in patients with PT 3N 0M 0 thoracic esophageal squamous cell carcinoma and consideration of postoperative radiotherapy. World J Surg Oncol 2017; 15:192. [PMID: 29070049 PMCID: PMC5657067 DOI: 10.1186/s12957-017-1259-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/15/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Five-year overall survival rate of TESCC after surgery is low (approximately 30% to 60%), so it is meaningful to discuss the significance of PORT. METHODS We retrospectively collected the data of 227 patients with PT3N0M0 esophageal cancer (EC). The failure pattern after surgery was analyzed. Difference of adjuvant PORT in patients with PT3N0M0 TESCC and the appropriate population were explored based on the relevant studies. RESULTS There were 58 cases with intrathoracic locoregional recurrence (LRR) after radical surgery and 27 cases with distant metastasis, including 10 cases of recurrence. The recurrence rate of mediastinal lymph nodes in the thoracic cavity was 50.0%. Univariate analysis revealed that compared with patients with middle and lower thoracic EC, the 3/5-year survival rate of patients with upper thoracic EC was significantly lower, accompanied with remarkably higher thoracic LRR. Compared with those with moderately- and well-differentiated TESCC, the 3/5-year survival rate of patients with poorly differentiated TESCC was significantly lower, whereas the distant metastasis rate was notably higher. Multivariate analysis revealed that different lesion locations and different pathologic differentiation were the independent prognostic factors. The lesion location and degree of differentiation were the independent influencing factors for thoracic LRR and distant metastasis, respectively. CONCLUSION The intrathoracic LRR is the major failure pattern for patients with PT3N0M0 TESCC after conventional two-field lymphadenectomy. In addition, recurrence rate of PT3N0M0 TESCC was significantly higher in upper thoracic EC than in middle and lower thoracic EC. PORT is recommended to patients with PT3N0M0 upper TESCC.
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Affiliation(s)
- Wen-Bin Shen
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankan Road, Chang'an District, Shijiazhaung, 050011, China
| | - Hong-Mei Gao
- Department of Radiation, The First Hospital of Shijiazhaung, Shijiazhaung, 050011, China
| | - Shu-Chai Zhu
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankan Road, Chang'an District, Shijiazhaung, 050011, China.
| | - You-Mei Li
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankan Road, Chang'an District, Shijiazhaung, 050011, China
| | - Shu-Guang Li
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankan Road, Chang'an District, Shijiazhaung, 050011, China
| | - Jin-Rui Xu
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankan Road, Chang'an District, Shijiazhaung, 050011, China
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16
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Tan HZ, Wu ZY, Wu JY, Long L, Jiao JW, Peng YH, Xu YW, Li SS, Wang W, Zhang JJ, Li EM, Xu LY. Single nucleotide polymorphism rs13042395 in the SLC52A3 gene as a biomarker for regional lymph node metastasis and relapse-free survival of esophageal squamous cell carcinoma patients. BMC Cancer 2016; 16:560. [PMID: 27472962 PMCID: PMC4966773 DOI: 10.1186/s12885-016-2588-3] [Citation(s) in RCA: 8] [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: 08/12/2015] [Accepted: 06/23/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND SLC52A3 was recently identified as a susceptibility gene for esophageal squamous cell carcinoma (ESCC). However, associations between the single nucleotide polymorphisms (SNPs) rs13042395 (C > T) and rs3746803 (G > A) in SLC52A3 and risk, tumor characteristics and survival of ESCC patients remain inconclusive and of unknown prognostic significance. METHODS Analyses of the association between SNPs in SLC52A3 and ESCC risk were performed on 479 ESCC cases, together with 479 controls, in a case-control study. Blood samples for cases and controls were collected and genotyped by real-time polymerase chain reaction (PCR) using TaqMan assays. Among the 479 ESCC cases, 343 cases with complete clinical data were used to investigate the association between SNPs and ESCC clinical characteristics; 288 cases with complete clinical data and 5-year follow-up data were used to analyze the association between SNPs and prognosis. Dual luciferase reporter assays and electrophoretic mobility shift assays (EMSAs) were used to investigate the biological function of rs13042395. RESULTS No association was found between SLC52A3 rs3746803 and susceptibility, tumor characteristics or survival of ESCC patients. For rs13042395, TT genotype carriers were likely to have reduced lymph node metastasis (odds ratio (OR) = 0.55, 95 % confidence interval (CI), 0.31-0.98) and longer relapse-free survival time (P = 0.03) . Also, both rs13042395 (hazard ratio (HR) = 0.62, 95 % CI, 0.38-0.99) and regional lymph node metastasis (HR = 2.06, 95 % CI, 1.36-3.13 for N1 vs. N0; HR = 2.88, 95 % CI, 1.70-4.86 for N2 vs. N0; HR = 2.08, 95 % CI, 1.01-4.30 for N3 vs. N0) were independent factors affecting relapse-free survival for ESCC patients who underwent surgery. Dual luciferase reporter assays and EMSAs suggested that the CC genotype of rs13042395 enhanced SLC52A3 expression, probably via binding with specific transcription factors. CONCLUSIONS The rs13042395 polymorphism in SLC52A3 is associated with regional lymph node metastasis and relapse-free survival in ESCC patients.
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Affiliation(s)
- Hua-Zhen Tan
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
| | - Zhi-Yong Wu
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Oncologic Surgery, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-Sen University, Shantou, 515041 China
| | - Jian-Yi Wu
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
| | - Lin Long
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
| | - Ji-Wei Jiao
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
| | - Yu-Hui Peng
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Clinical Laboratory, Cancer Hospital of Shantou University Medical College, No.7, Raoping Road, Shantou, Guangdong 515041 China
| | - Yi-Wei Xu
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Clinical Laboratory, Cancer Hospital of Shantou University Medical College, No.7, Raoping Road, Shantou, Guangdong 515041 China
| | - Shan-Shan Li
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
| | - Wei Wang
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
| | - Jian-Jun Zhang
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Preventive Medicine, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
| | - En-Min Li
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
| | - Li-Yan Xu
- Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
- Institute of Oncologic Pathology, Shantou University Medical College, No. 22, Xinling Road, Shantou, 515041 China
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