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Jiang KY, Zhang SX, Hu WL, Deng ZQ, Zhang JJ, Guo XG, Jian SH, Zhou HN, Tian D. Prognostic factors for patients with pathologic T1-T2N+ esophageal squamous cell carcinoma: A retrospective study with external validation. Surgery 2024:S0039-6060(24)00326-X. [PMID: 38902127 DOI: 10.1016/j.surg.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/05/2024] [Accepted: 05/18/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Lymph node metastasis is significantly associated with a worse prognosis in patients with localized early-stage esophageal squamous cell carcinoma. This study aimed to explore the prognostic factors and develop a nomogram for predicting survival in patients with pathologic T1-2N+ esophageal squamous cell carcinoma. METHODS Between 2014 and 2022, patients with pT1-2N+ esophageal squamous cell carcinoma who underwent esophagectomy with lymphadenectomy at 2 institutes were reviewed and assigned to training and external validation cohorts. Independent prognostic factors were identified via univariate and multivariate Cox regression analyses. The nomogram model was developed and evaluated by the area under the receiver operating characteristic curve and calibration curve. RESULTS In total, 268 patients with a median age of 65 years (range, 40-82) were included and assigned to training (n = 190) and external validation (n = 78) cohorts. The Cox proportional hazards model demonstrated that body mass index (P = .031), surgical approach (P < .001), T stage (P = .015), and Clavien-Dindo classification (P < .001) were independent prognostic factors in the training cohort. The nomogram showed good discrimination, with an area under the receiver operating characteristic curve for 1-year, 3-year, and 5-year of 0.810, 0.789, and 0.809 in the training cohort and 0.782, 0.679, and 0.698 in the validation cohort. The calibration curve showed that the predicted survival probability was in good agreement with the actual survival probability. CONCLUSION Lower body mass index, left surgical approach, T2 stage, and Clavien-Dindo classification grade III to V were related to worse prognosis in patients with pT1-T2N+ esophageal squamous cell carcinoma. The developed nomogram may predict individual survival accurately.
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Affiliation(s)
- Kai-Yuan Jiang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China; Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sheng-Xuan Zhang
- College of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Wen-Long Hu
- College of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Zhi-Qiang Deng
- College of Medical Imaging, North Sichuan Medical College, Nanchong, China
| | - Jun-Jie Zhang
- College of Medical Imaging, North Sichuan Medical College, Nanchong, China
| | - Xiao-Guang Guo
- School of Biomedical Engineering, Hainan University, Haikou, China
| | - Shun-Hai Jian
- Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Hai-Ning Zhou
- Department of Thoracic Surgery, Suining Central Hospital, Suining, China.
| | - Dong Tian
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
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Lei LL, Song X, Zhao XK, Xu RH, Wei MX, Sun L, Wang PP, Yang MM, Hu JF, Zhong K, Han WL, Han XN, Fan ZM, Wang R, Li B, Zhou FY, Wang XZ, Zhang LG, Bao QD, Qin YR, Chang ZW, Ku JW, Yang HJ, Yuan L, Ren JL, Li XM, Wang LD. Long-term effect of hospital volume on the postoperative prognosis of 158,618 patients with esophageal squamous cell carcinoma in China. Front Oncol 2022; 12:1056086. [PMID: 36873301 PMCID: PMC9978392 DOI: 10.3389/fonc.2022.1056086] [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: 09/28/2022] [Accepted: 12/16/2022] [Indexed: 02/18/2023] Open
Abstract
Background The impact of hospital volume on the long-term survival of esophageal squamous cell carcinoma (ESCC) has not been well assessed in China, especially for stage I-III stage ESCC. We performed a large sample size study to assess the relationships between hospital volume and the effectiveness of ESCC treatment and the hospital volume value at the lowest risk of all-cause mortality after esophagectomy in China. Aim To investigate the prognostic value of hospital volume for assessing postoperative long-term survival of ESCC patients in China. Methods The date of 158,618 patients with ESCC were collected from a database (1973-2020) established by the State Key Laboratory for Esophageal Cancer Prevention and Treatment, the database includes 500,000 patients with detailed clinical information of pathological diagnosis and staging, treatment approaches and survival follow-up for esophageal and gastric cardia cancers. Intergroup comparisons of patient and treatment characteristics were conducted with the X2 test and analysis of variance. The Kaplan-Meier method with the log-rank test was used to draw the survival curves for the variables tested. A Multivariate Cox proportional hazards regression model was used to analyze the independent prognostic factors for overall survival. The relationship between hospital volume and all-cause mortality was assessed using restricted cubic splines from Cox proportional hazards models. The primary outcome was all-cause mortality. Results In both 1973-1996 and 1997-2020, patients with stage I-III stage ESCC who underwent surgery in high volume hospitals had better survival than those who underwent surgery in low volume hospitals (both P<0.05). And high volume hospital was an independent factor for better prognosis in ESCC patients. The relationship between hospital volume and the risk of all-cause mortality was half-U-shaped, but overall, hospital volume was a protective factor for esophageal cancer patients after surgery (HR<1). The concentration of hospital volume associated with the lowest risk of all-cause mortality was 1027 cases/year in the overall enrolled patients. Conclusion Hospital volume can be used as an indicator to predict the postoperative survival of ESCC patients. Our results suggest that the centralized management of esophageal cancer surgery is meaningful to improve the survival of ESCC patients in China, but the hospital volume should preferably not be higher than 1027 cases/year. Core tip Hospital volume is considered to be a prognostic factor for many complex diseases. However, the impact of hospital volume on long-term survival after esophagectomy has not been well evaluated in China. Based on a large sample size of 158,618 ESCC patients in China spanning 47 years (1973-2020), We found that hospital volume can be used as a predictor of postoperative survival in patients with ESCC, and identified hospital volume thresholds with the lowest risk of death from all causes. This may provide an important basis for patients to choose hospitals and have a significant impact on the centralized management of hospital surgery.
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Affiliation(s)
- Ling-Ling Lei
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xin Song
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xue-Ke Zhao
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Rui-Hua Xu
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Meng-Xia Wei
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Lin Sun
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Pan-Pan Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Miao-Miao Yang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Jing-Feng Hu
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Kan Zhong
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Wen-Li Han
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xue-Na Han
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Zong-Min Fan
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Ran Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Bei Li
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Fu-You Zhou
- Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang, Henan, China
| | - Xian-Zeng Wang
- Department of Thoracic Surgery, Linzhou People's Hospital, Linzhou, Henan, China
| | - Li-Guo Zhang
- Department of Thoracic Surgery, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Qi-De Bao
- Department of Oncology, Anyang District Hospital, Anyang, Henan, China
| | - Yan-Ru Qin
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhi-Wei Chang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jian-Wei Ku
- Department of Gastroenterology, The Second Affiliated Hospital of Nanyang Medical College, Nanyang, Henan, China
| | - Hai-Jun Yang
- Department of Pathology, Anyang Tumor Hospital, Anyang, Henan, China
| | - Ling Yuan
- Department of Radiotherapy, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, Henan, China
| | - Jing-Li Ren
- Department of Pathology, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xue-Min Li
- Department of Pathology, Hebei Provincial Cixian People's Hospital, Cixian, Hebei, China
| | - Li-Dong Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
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Xue Y, Chen D, Wang W, Wang W, Chen L, Sang Y, Chen Y, Xu W. Comparison of Ivor Lewis and Sweet esophagectomy for middle and lower esophageal squamous cell carcinoma: A systematic review and pooled analysis. EClinicalMedicine 2020; 27:100497. [PMID: 33089129 PMCID: PMC7559873 DOI: 10.1016/j.eclinm.2020.100497] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Lack of robust evidence highlights the important need to address the controversy on the clinical safety and effectiveness between Ivor Lewis versus Sweet procedure for middle and lower esophageal squamous cell carcinoma (ESCC). METHODS Search results were filtered according to certain criteria and were analyzed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS The inter-study heterogeneity was high. Ivor Lewis procedure might be associated with longer operation time (p < 0.01) and higher lymph node yield (p < 0.01) compared with Sweet procedure. There was no significant difference in the length of hospital stay and postoperative complications with similar reoperation rate between the two procedures (p > 0.05). As the combined analysis of survival data revealed, there was no statistical difference in the oncologic efficacy of them (p = 0.97). INTERPRETATION The present study based on retrospective data with high heterogeneity indicated that Ivor Lewis esophagectomy might be associated with increased lymph node yield but longer operation time than Sweet. Prospective studies are warranted to compare the long-term survival of Ivor Lewis esophagectomy versus Sweet for middle and lower ESCC.
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Affiliation(s)
- Yuhang Xue
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Donglai Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Wei Wang
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Wenjia Wang
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Lei Chen
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yonghua Sang
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
- Corresponding authors.
| | - Yongbing Chen
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
- Corresponding authors.
| | - Weihua Xu
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
- Corresponding authors.
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4
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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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5
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Feng Y, Wu N, Yan S, Wang X, Yang Y. Comparison of Ivor Lewis esophagectomy and Sweet esophagectomy for the treatment of middle-lower esophageal squamous cell carcinoma. J Thorac Dis 2019; 11:3584-3592. [PMID: 31559065 DOI: 10.21037/jtd.2019.07.68] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background For cancer of the middle and/or lower segment of thoracic esophagus, the Ivor Lewis esophagectomy is the mainstream standard surgery, whereas the Sweet procedure is widely used in China. As no consensus has been reached about the choice of different thoracic approaches, we designed this retrospective study to investigate and compare oncological benefits of the two surgical approaches. Methods After propensity score matching, 150 patients who underwent the Sweet or Ivor Lewis esophagectomy from August 2003 to December 2009 in the Beijing Cancer Hospital were reviewed. We compared the postoperative recovery, nutritional parameters, and survival of the two different surgical approaches. Results The 5-year overall survival (OS) rate for the whole group was 48.5%, and the 10-year OS rate was 35.6%. The Ivor Lewis group had a longer operation time, longer duration of chest tube drainage, and a larger volume of total thoracic drainage. No significant differences were found between the two groups in terms of the duration of systemic inflammatory response syndrome (SIRS), length of postoperative hospital stay, duration of postoperative nasogastric tube use, incidence of major complications, and nutritional status after the esophagectomy. The OS rates were similar in both groups. Conclusions The Sweet and Ivor Lewis esophagectomy are both safe and effective. A change of the surgical incision may not be the best way to increase survival, and the choice of surgical procedure should depend on the preference of the thoracic surgeon to secure the safety of the operation.
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Affiliation(s)
- Yuan Feng
- Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Cancer Hospital and Institute, Peking University School of Oncology, Beijing 100142, China
| | - Nan Wu
- Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Cancer Hospital and Institute, Peking University School of Oncology, Beijing 100142, China
| | - Shi Yan
- Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Cancer Hospital and Institute, Peking University School of Oncology, Beijing 100142, China
| | - Xing Wang
- Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Cancer Hospital and Institute, Peking University School of Oncology, Beijing 100142, China
| | - Yue Yang
- Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Cancer Hospital and Institute, Peking University School of Oncology, Beijing 100142, China
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6
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Gu T, Chen W, Chen L, Wang G, Li T, Zhu Y, Gao X. Expression and function of tetraspanin 1 in esophageal carcinoma. Oncol Lett 2017; 14:6815-6822. [PMID: 29422958 DOI: 10.3892/ol.2017.7028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 05/25/2017] [Indexed: 11/05/2022] Open
Abstract
The present study explored the expression of tetraspanin 1 (TSPAN1) in esophageal carcinoma (EC) and its association with clinicopathological factors. TSPAN1 small interfering RNA (siRNA) was designed to target the TSPAN1 gene in Eca-109 cells in order to explore the biological function of TSPAN1 in the proliferation and apoptosis of EC. The results demonstrated that the level of TSPAN1 expression in EC tissue was significantly increased compared with that in adjacent normal tissue (P<0.001). TSPAN1 expression was also associated with histological differentiation, depth of invasion, lymph node metastasis (all P<0.05) and Ki-67 (P<0.01). However, no association was observed between TSPAN expression and gender, age or location (P>0.05). In addition, silencing TSPAN1 markedly inhibited proliferation while increasing the apoptosis rate of Eca-109 cells, which was demonstrated by detecting the expression of the cell proliferation-associated gene Ki-67 and the apoptotic gene caspase-3 (P<0.05). Taken together, these results indicated that TSPAN1 functions as a tumor-associated gene in EC through promoting cell proliferation and suppressing apoptosis, and siRNA technology may provide an advanced alternative in the development of therapeutics for EC.
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Affiliation(s)
- Tingting Gu
- Department of Pathological Anatomy, Nantong University, Nantong, Jiangsu 226001, P.R. China.,Department of Pathology, Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Suzhou, Jiangsu 215300, P.R. China
| | - Weiwei Chen
- Department of Pathological Anatomy, Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Li Chen
- Department of Pathological Anatomy, Nantong University, Nantong, Jiangsu 226001, P.R. China.,Department of Pathology, Affiliated Tumor Hospital, Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Guilan Wang
- Department of Pathological Anatomy, Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Tiejun Li
- Research and Development Department, Biomics Biotechnologies Co., Ltd., Nantong University, Nantong, Jiangsu 226016, P.R. China
| | - Yuanyuan Zhu
- Research and Development Department, Biomics Biotechnologies Co., Ltd., Nantong University, Nantong, Jiangsu 226016, P.R. China
| | - Xiaojiao Gao
- Department of Pathology, Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Suzhou, Jiangsu 215300, P.R. China
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7
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Chen JY, Yang H, Wen J, Luo KJ, Liu QW, Lei JY, Zhen YZ, Fu JH. Association between positive murine double minute 2 expression and clinicopathological characteristics of esophageal squamous cell carcinoma: a meta-analysis. Dis Esophagus 2016; 29:856-863. [PMID: 25873358 DOI: 10.1111/dote.12361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The correlations of murine double minute 2 (MDM2) T309G and esophageal cancer were elucidated because the association between MDM2 expression states and clinicopathological parameters of esophageal squamous cell carcinoma (ESCC) is controversial. We conducted a meta-analysis on studies screened from PubMed, Web of Science, Embase, the Cochrane Library, and the Chinese Biomedical Literature Databases that were published before October 2014. All studies describing the association between MDM2 and ESCC were traced. Meta-analysis was performed using the STATA software (Stata Corp., College Station, TX, USA). A total of 9 studies with 707 cases and 324 controls were included. MDM2 expression was higher in ESCC than in normal esophageal epithelium (odds ratio [OR] 10.38, 95% confidence interval [CI] 6.42-16.78, P < 0.001). High MDM2 expression was associated with early primary tumor stage (T1/T2 vs. T3/T4, OR 0.59, 95% CI 0.38-0.92, P = 0.018) and increased risk of regional lymph node metastasis (N0 vs. N1, OR 1.66, 95% CI 1.03-2.67, P = 0.039). However, no relationship was observed between MDM2 expression and the risk of distant metastasis (OR = 2.09, 95% CI 1.00-4.36, P = 0.050), and MDM2 was not significantly correlated with TP53 expression (OR 1.22, 95% CI 0.53-2.77, P = 0.643). Our analysis suggests that MDM2 acts as a potent marker of early primary tumor stage but higher risk of regional lymph node metastasis in ESCC. However, because of the limited number of studies included, the result should be further clarified by well-designed prospective studies.
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Affiliation(s)
- J Y Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - H Yang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - J Wen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - K J Luo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - Q W Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - J Y Lei
- Clinical Epidemiology and Biostatistics Department, Karolinska Institute, Stockholm, Sweden
| | - Y Z Zhen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - J H Fu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. .,Guangdong Esophageal Cancer Institute, Guangzhou, China.
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8
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Nozaki I, Kato K, Igaki H, Ito Y, Daiko H, Yano M, Udagawa H, Mizusawa J, Katayama H, Nakamura K, Kitagawa Y. Evaluation of safety profile of thoracoscopic esophagectomy for T1bN0M0 cancer using data from JCOG0502: a prospective multicenter study. Surg Endosc 2015; 29:3519-26. [PMID: 25676203 PMCID: PMC4648951 DOI: 10.1007/s00464-015-4102-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/26/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Thoracoscopic esophagectomy is rapidly and increasingly being used worldwide because it is a less invasive alternative to open esophagectomy. However, few prospective multicenter studies have evaluated its safety profile. This study aimed to evaluate the safety profile of thoracoscopic esophagectomy using perioperative data from the Japan Clinical Oncology Group Study (JCOG0502). METHODS JCOG0502 is a four-arm prospective study comparing esophagectomy with chemoradiotherapy for esophageal cancer, with randomized and patient preference arms. Patients with clinical stage T1bN0M0 esophageal cancer were enrolled until patient accrual was completed. Open or thoracoscopic esophagectomy was selected at the surgeon's discretion. Perioperative complications were defined as adverse events of ≥grade 2 as per Common Terminology Criteria for Adverse Events ver. 3.0. RESULTS A total of 379 patients were enrolled between December 2006 and February 2013. Of the 210 patients who underwent surgery, 109 patients underwent open esophagectomy, and 101 patients underwent thoracoscopic esophagectomy. Although thoracoscopic esophagectomy decreased the incidence of postoperative atelectasis (open: 22.0%, thoracoscopy: 10.9%; P = 0.041), reoperation was more frequent in the thoracoscopy group (open: 1.8%, thoracoscopy: 9.9%; P = 0.016). The incidence of overall complications did not differ between the two groups (open: 44.0%, thoracoscopy: 44.6%; P = 1.00). There was one in-hospital death in each group (open: 0.9%, thoracoscopy: 1.0 %; P = 1.00). CONCLUSIONS Thoracoscopic esophagectomy is a safe procedure with morbidity and mortality comparable with those of open esophagectomy. However, it is associated with a higher frequency of reoperation.
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Affiliation(s)
- Isao Nozaki
- Department of Surgery, Shikoku Cancer Center Hospital, 160 Minami-umemoto, Matsuyama, 791-0280, Japan.
| | - Ken Kato
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyasu Igaki
- Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshinori Ito
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Daiko
- Department of Esophageal Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Masahiko Yano
- Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Harushi Udagawa
- Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan
| | - Junki Mizusawa
- JCOG Data Center/Operations Office, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
| | - Hiroshi Katayama
- JCOG Data Center/Operations Office, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
| | - Kenichi Nakamura
- JCOG Data Center/Operations Office, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Du Y, Yan SM, Gu WY, He F, Huang LY, Li M, Yuan Y, Chen RH, Zhong Q, Li MZ, Li Y, Zeng MS. Decreased Expression of FADS1 Predicts a Poor Prognosis in Patients with Esophageal Squamous Cell Carcinoma. Asian Pac J Cancer Prev 2015; 16:5089-94. [DOI: 10.7314/apjcp.2015.16.12.5089] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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10
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Xing YL, Wang YC. Influence of autologous and homologous blood transfusion on interleukins and tumor necrosis factor-α in peri-operative patients with esophageal cancer. Asian Pac J Cancer Prev 2015; 15:7831-4. [PMID: 25292072 DOI: 10.7314/apjcp.2014.15.18.7831] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To explore the influence of different ways of blood transfusion on the expression levels of interleukins (IL) and tumor necrosis factor-α (TNF-α) inperi-operative patients with esophageal cancer. MATERIALS AND METHODS A total of 80 patients with esophageal cancer who underwent radical operations were selected as study patients and randomly divided into an observation group (treated with autologous blood transfusion) and control group (with homologous blood transfusion). Changes of intra-operative indexes and peri-operative blood indexes, from hemoglobin (Hb) and hematocrit value (Hct), to levels of inflammatory factors like interleukins-6 (IL-6), IL-8, IL-10 and tumor necrosis factor-α (TNF-α) were compared. RESULTS Operations for patients in both groups were successfully conducted, and no significant differences in mean surgical duration and intra-operative hemorrhage volume, fluid infusion volume and blood transfusion volume were detected (p>0.05). Compared with values before surgery, Hb and Hct levels decreased significantly while white blood cell count (WBC) increased 1, 5 and 7 d after operation (p<0.05, p<0.01). In addition, WBC was apparently higher in observation group than in control group 5 and 7 d after operation (p<0.01). Compared with before surgery, in the observation group, levels of IL-6, IL-8 and IL-10 had no significant differences after operation (P>0.05), but TNF-α level increased y (p<0.01), whereas in control group, IL-6 level had no significant difference (p>0.05), IL-8 level decreased obviously (p<0.05), IL-10 level increased markedly first and then decreased gradually as time passed but its level remained elevated (p<0.01), and TNF-α level increased first and then decreased, and there was no significant difference 7 d after operation (p>0.05). CONCLUSIONS Decreased IL-8 and increased IL-10 levels are two important reasons forimmunosuppression after homologous blood transfusion, whereas autologous blood transfusion can alleviate this while increasing the TNF-α level, which also has potential to improve anti-tumor immunity in the human body.
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Affiliation(s)
- Yue-Li Xing
- Department of Blood Transfusion, Binzhou Medical University Hospital, Binzhou, China E-mail :
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11
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Zhao L, Wei ZB, Yang CQ, Chen JJ, Li D, Ji AF, Ma L. Effects of PLCE1 gene silencing by RNA interference on cell cycling and apoptosis in esophageal carcinoma cells. Asian Pac J Cancer Prev 2015; 15:5437-42. [PMID: 25041015 DOI: 10.7314/apjcp.2014.15.13.5437] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Esophageal squamous cell carcinoma (ESCC) is one of the most malignancies with a poor prognosis. The phospholipase C? gene (PLCE1) encodes a novel ras-related protein effector mediating the effects of R-Ras on the actin cytoskeleton and membrane protrusion. However, molecular mechanisms pertinent to ESCC are unclear. We therefore designed PLCE1-special small interfering RNA and transfected to esophageal squamous cell (EC) 9706 cells to investigate the effects of PLCE1 gene silencing on the cell cycle and apoptosis of ESCC and indicate its important role in the development of ESCC. Esophageal cancer tissue specimens and normal esophageal mucosa were obtained and assayed by immunohistochemical staining to confirm overexpression of PLCE1 in neoplasias. Fluorescence microscopy was used to examine transfection efficiency, while the result of PLCE1 silencing was examined by reverse transcription (RT-PCR). Flow cytometry and annexin V apoptosis assays were used to assess the cell cycle and apoptosis, respectively. Expression of cyclin D1 and caspase-3 was detected by Western-blotting. The level of PLCE1 protein in esophageal cancer tissue was significantly higher than that in normal tissue. After transfection, the expression of PLCE1 mRNA in EC 9706 was significantly reduced, compared with the control group. Furthermore, flow cytometry results suggested that the PLCE1 gene silencing arrested the cell cycle in the G0/G1 phase; apoptosis was significantly higher than in the negative control group and mock group. PLCE1 gene silencing by RNAi resulted in decreased expression of cyclin D1 and increased expression of caspase-3. Our study suggests that PLCE1 may be an oncogene and play an important role in esophageal carcinogenesis through regulating proteins which control cell cycling and apoptosis.
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Affiliation(s)
- Li Zhao
- Department of Endoscopy, Peace Hospital Attached to Changzhi Medical College, Changzhi, China E-mail :
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12
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Wang J, Ge J, Zhang XH, Liu JY, Yang CM, Zhao SL. Endoscopic submucosal dissection versus endoscopic mucosal resection for the treatment of early esophageal carcinoma: a meta-analysis. Asian Pac J Cancer Prev 2014; 15:1803-6. [PMID: 24641412 DOI: 10.7314/apjcp.2014.15.4.1803] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Endoscopic submucosal dissection (ESD) was originally developed for en bloc resection of large, flat gastrointestinal lesions. Compared with endoscopic mucosal resection (EMR), ESD is considered to be more time consuming and have more complications for treatment of early esophageal carcinoma, such as bleeding, stenosis and perforation. The objective of this study was to compare the efficacy and safety of ESD and EMR for such lesions. We searched databases, such as PubMed, EMBASE, Cochrane Library and Science Citation Index updated to 2013 for related trials. In the meta-analysis, the main outcome measurements were the en bloc resection rate, the histologically resection rate and the local recurrence rate. We also compared the operation time and the incidences of procedure-related complications. Five trials were identified, and a total of 710 patients and 795 lesions were included. The en bloc and histologically complete resection rates were higher in the ESD group compared with the EMR group (odds ratio (OR) 27.3; 95% CI, 11.5-64.8; OR 18.4; 95% CI, 8.82-38.59). The local recurrence rate was lower in the ESD group (OR 0.13, 95 % CI 0.04-0.43). The meta-analysis also showed ESD was more time consuming, but did not increase the complication rate (P=0.76). The results implied that compared with EMR, ESD showed better en bloc and histologically resection rates, and lower local recurrence, without increasing the incidence of procedure-related complications in the treatment of early esophageal carcinoma.
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Affiliation(s)
- Jing Wang
- Provincial Hospital Affiliated to Shandong University, Jinan, China E-mail :
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13
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Lu J, Lu N, Xue L, Jin M. Different expression of miRNAs in early esophageal squamous cell carcinoma with differential prognosis. Dis Esophagus 2014; 28:386-93. [PMID: 24697845 DOI: 10.1111/dote.12201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patients at the same pathological stage of early esophageal squamous cell carcinoma (ESCC) have significantly different prognoses. The aim of this study was to explore the relationship between specific microRNAs (miRNAs) in two groups of early ESCC patients who had different prognoses at the pT1N0 stage, and to study the prognostic significance of different miRNAs in early ESCC metastasis. We tried to identify prognostic markers that may be helpful in the selection of appropriate treatment for patients with early ESCC. We used TaqMan Human miRNA Arrays to detect and analyze bioinformatically the expression profiles of miRNAs in two groups, and the reverse transcription polymerase chain reaction method to verify the differences in miRNA expression. The miRNA arrays revealed a total of 29 markedly downregulated miRNAs in the survival group compared with the deceased group. Such miRNAs were associated with lympho-vascular invasion and metastasis, and acted as predictive markers of lympho-vascular invasion and metastasis. The detection of these miRNAs forms an important basis for the treatment of early ESCC. It can also help determine those patients with early ESCC who are good candidates for endoscopic resection treatment and those who need additional treatment after endoscopic resection.
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Affiliation(s)
- J Lu
- Department of Pathology, Beijing Chaoyang Hospital, Capital University, Beijing, China
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