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1.
Medicine (Baltimore) ; 99(31): e21426, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756148

RESUMO

Although many studies in China have found that environmental or lifestyle factors are major contributors to the etiology of esophageal cancer, most of the patients in the above studies are in the middle and late stages, the early-stage patients account for a small proportion. To clarify the risk/protective factors contributing to early lesions, we conducted the present cross-sectional study.A total of 2925 healthy controls and 402 patients with esophageal precancerous lesions were included in our study by endoscopic examination. Information on risk/protective factors was collected by personal interview, and unconditional logistic regression was used to determine adjusted odds ratios (AORs) by the maximum-likelihood method.Smoking >20 pack-years (AOR = 1.48), duration of drinking >30 years (AOR = 1.40), alcohol consumption >100 mL/d (AOR = 1.44), gastroesophageal reflux disease (AOR = 1.75), esophagitis (AOR = 1.25), a family history of esophageal cancer (AOR = 1.92), or stomach cancer (AOR = 1.92) were significant risk factors for esophageal precancerous lesions. There was a negative correlation between abdominal obesity and early esophageal cancer and precancerous lesions (AOR = 0.75). In addition, we found that there was a synergistic effect between a family history of esophageal cancer and drinking (AOR = 3.00) and smoking (AOR = 2.90).Lifestyle risk factors, genetic factors, and upper gastrointestinal diseases are associated with the development of esophageal precancerous lesions. These results highlight the need for primary prevention to reduce the future burden of cancer and other chronic diseases in high-risk areas of rural China.


Assuntos
Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Adulto , China/epidemiologia , Estudos Transversais , Detecção Precoce de Câncer , Neoplasias Esofágicas/prevenção & controle , Carcinoma de Células Escamosas do Esôfago/prevenção & controle , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Fatores de Risco , População Rural , Inquéritos e Questionários
2.
Virchows Arch ; 477(5): 697-704, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32524184

RESUMO

Few data are available concerning human papillomavirus (HPV) in early esophageal squamous cell carcinoma (ESCC) in Western population. Our study intended to determine the prevalence of HPV infection and the histological characteristics in such early tumors. A monocentric and retrospective study was conducted including 86 patients with early ESCC treated by endoscopic resection or esophagectomy, from 2012 to 2018. Histopathological prognostic criteria were evaluated. Immunohistochemistry for p16 and p53 and an HPV mRNA in situ hybridization were performed. The tumors were composed of 25 (29%) in situ carcinomas, 21 (24%) intramucosal carcinomas, and 40 (47%) submucosal carcinomas, of which 34 had a deep infiltration (> 200 µm). Emboli, present in 12 cases, were associated with deep infiltration. P16-positive ESCC accounted for 21% of the patients. It was not correlated with active HPV infection as no cases were found to be positive in RISH analysis for RNA detection of this virus. However, there was a correlation between p16 expression and alcohol or tobacco consumption. The only histopathological criterion correlated with p16 positivity was marked inflammatory infiltrate. Local or distant neoplastic recurrence occurred in 25% of patients. Overall survival was 95.8% and local or metastatic recurrence-free survival was 75%. There was a correlation between positive resection margins and tumor recurrence. In contrast to oropharynx carcinoma, our study showed that ESCC were not associated with an active HPV infection, highlighting the negligible role of this virus in early ESCC carcinogenesis in the Western world.


Assuntos
Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Infecções por Papillomavirus/epidemiologia , Idoso , Biomarcadores Tumorais/análise , Inibidor p16 de Quinase Dependente de Ciclina/análise , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/virologia , Carcinoma de Células Escamosas do Esôfago/secundário , Carcinoma de Células Escamosas do Esôfago/cirurgia , Carcinoma de Células Escamosas do Esôfago/virologia , Esofagectomia , Feminino , Humanos , Imuno-Histoquímica , Hibridização In Situ , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasia Residual , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Paris , Prevalência , RNA Viral/genética , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Proteína Supressora de Tumor p53/análise
3.
Carcinogenesis ; 41(6): 761-768, 2020 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-32047883

RESUMO

N 6-methyladenosine (m6A) is an abundant modification in RNAs that affects RNA metabolism, and it is reported to be closely related to cancer occurrence and metastasis. In this study, we focused on evaluating the associations between genetic variants in m6A modification genes and the risk of esophageal squamous-cell carcinoma (ESCC). By integrating data of our previous genome-wide association studies and the predictions of several annotation tools, we identified a single nucleotide polymorphism, rs2416282 in the promoter of YTHDC2, that was significantly associated with the susceptibility of ESCC (odds ratio = 0.84, 95% CI: 0.77-0.92, P = 2.81 × 10-4). Through further functional experiments in vitro, we demonstrated that rs2416282 regulated YTHDC2 expression. Knockdown of YTHDC2 substantially promoted the proliferation rate of ESCC cells by affecting several cancer-related signaling pathways. Our results suggested that rs2416282 contributed to ESCC risk by regulating YTHDC2 expression. This study provided us a valuable insight into the roles of genetic variants in m6A modification genes for ESCC susceptibility and may contribute to the prevention of this disease in the future.


Assuntos
Adenosina/análogos & derivados , Biomarcadores Tumorais/genética , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/patologia , Polimorfismo de Nucleotídeo Único , RNA Helicases/genética , Processamento Pós-Transcricional do RNA , Adenosina/química , Apoptose , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , Proliferação de Células , China/epidemiologia , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/genética , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/genética , Regulação Neoplásica da Expressão Gênica , Humanos , Prognóstico , RNA Helicases/química , Células Tumorais Cultivadas
4.
Am J Gastroenterol ; 115(1): 73-78, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31821177

RESUMO

OBJECTIVES: Esophageal cancer is a highly fatal malignant neoplasm, with 2 etiologically different histological types. A large prospective study is expected to elucidate the specific risk of the 90% subtype of esophageal cancer, esophageal squamous cell carcinoma (ESCC), with metformin therapy. This study aims to determine the association between metformin use and incident ESCC risk. METHODS: This was a nationwide population-based prospective cohort study conducted in Sweden in 2005-2015. Among 8.4 million participants identified in the cohort, 411,603 (5%) were metformin users. The users were compared with 10 times as many frequency-matched nonusers of metformin (n = 4,116,030) by age and sex. Metformin use was treated as a time-varying variate, and multivariable cause-specific proportional hazards model was used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for ESCC, adjusted for age, sex, calendar year, residence area, tobacco smoking, alcohol overconsumption, and use of nonsteroidal anti-inflammatory drugs or statins. RESULTS: The incidence rates of ESCC were 3.5 per 100,000 person-years among the metformin users and 5.3 per 100,000 person-years in the nonusers. Metformin users overall were at a decreased risk of ESCC compared with nonusers (HR 0.68, 95% CI 0.54-0.85). The decrease in risk was more pronounced in new metformin users (HR 0.44, 95% CI 0.28-0.64) and participants aged 60-69 years (HR 0.45, 95% CI 0.31-0.66). DISCUSSION: Metformin use decreases the risk of developing ESCC.


Assuntos
Neoplasias Esofágicas/prevenção & controle , Carcinoma de Células Escamosas do Esôfago/prevenção & controle , Metformina/farmacologia , Vigilância da População , Sistema de Registros , Medição de Risco/métodos , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/diagnóstico , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Feminino , Seguimentos , Humanos , Hipoglicemiantes/farmacologia , Incidência , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Prognóstico , Estudos Prospectivos , Fatores de Risco , Suécia/epidemiologia
5.
Int J Cancer ; 146(1): 18-25, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30891750

RESUMO

Previous studies have reported an association between hot tea drinking and risk of esophageal cancer, but no study has examined this association using prospectively and objectively measured tea drinking temperature. We examined the association of tea drinking temperature, measured both objectively and subjectively at study baseline, with future risk of esophageal squamous cell carcinoma (ESCC) in a prospective study. We measured tea drinking temperature using validated methods and collected data on several other tea drinking habits and potential confounders of interest at baseline in the Golestan Cohort Study, a population-based prospective study of 50,045 individuals aged 40-75 years, established in 2004-2008 in northeastern Iran. Study participants were followed-up for a median duration of 10.1 years (505,865 person-years). During 2004-2017, 317 new cases of ESCC were identified. The objectively measured tea temperature (HR 1.41, 95% CI 1.10-1.81; for ≥60°C vs. <60°C), reported preference for very hot tea drinking (HR 2.41, 95% CI 1.27-4.56; for "very hot" vs. "cold/lukewarm"), and reported shorter time from pouring tea to drinking (HR 1.51, 95% CI 1.01-2.26; for <2 vs. ≥6 min) were all associated with ESCC risk. In analysis of the combined effects of measured temperature and amount, compared to those who drank less than 700 ml of tea/day at <60°C, drinking 700 mL/day or more at a higher-temperature (≥60°C) was consistently associated with an about 90% increase in ESCC risk. Our results substantially strengthen the existing evidence supporting an association between hot beverage drinking and ESCC.


Assuntos
Ingestão de Líquidos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Temperatura Alta , Chá , Adulto , Idoso , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
6.
BMC Complement Altern Med ; 19(1): 358, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31822288

RESUMO

BACKGROUND: No previous study has investigated the association between oolong tea consumption and esophageal squamous cell carcinoma (ESCC), we aim to elucidate the association between oolong tea consumption and ESCC and its joint effects with a novel composite index. METHODS: In a hospital-based case-control study, 646 cases of ESCC patients and 646 sex and age matched controls were recruited. A composite index was calculated to evaluate the role of demographic characteristics and life exposure factors in ESCC. Unconditional logistic regression was used to calculate the point estimates between oolong tea consumption and risk of ESCC. RESULTS: No statistically significant association was found between oolong tea consumption and ESCC (OR = 1.39, 95% CI: 0.94-2.05). However, drinking hot oolong tea associated with increased risk of ESCC (OR = 1.60, 95% Cl: 1.06-2.41). Furthermore, drinking hot oolong tea increased ESCC risk in the high-risk group (composite index> 0.55) (OR = 3.14, 95% CI: 1.93-5.11), but not in the low-risk group (composite index≤0.55) (OR = 1.16, 95% CI: 0.74-1.83). Drinking warm oolong tea did not influence the risk of ESCC. CONCLUSIONS: No association between oolong tea consumption and risk of ESCC were found, however, drinking hot oolong tea significantly increased the risk of ESCC, especially in high-risk populations.


Assuntos
Dieta/estatística & dados numéricos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Chá , Estudos de Casos e Controles , Feminino , Temperatura Alta , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances
7.
BMC Cancer ; 19(1): 1218, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842816

RESUMO

BACKGROUND: Consumption of moldy food has previously been identified as a risk factor for esophageal squamous cell carcinoma (ESCC) in high-risk countries; however, what contributing roles these dietary carcinogenic mycotoxins play in the etiology of ESCC are largely unknown. METHODS: A mycotoxin biomarker-incorporated, population-based case-control study was performed in Huaian area, Jiangsu Province, one of the two high-risk areas in China. Exposure biomarkers of aflatoxins (AF) and fumonisins (FN) were quantitatively analyzed using HPLC-fluorescence techniques. RESULTS: Among the cases (n = 190), the median levels of AF biomarker, serum AFB1-lysine adduct, and FN biomarker, urinary FB1, were 1.77 pg/mg albumin and 176.13 pg/mg creatinine, respectively. Among the controls (n = 380), the median levels of AFB1-lysine adduct and urinary FB1 were 1.49 pg/mg albumin and 56.92 pg/mg creatinine, respectively. These mycotoxin exposure biomarker levels were significantly higher in cases as compared to controls (p <  0.05 and 0.01, respectively). An increased risk to ESCC was associated with exposure to both AFB1 and FB1 (p <  0.001 for both). CONCLUSIONS: Mycotoxin exposure, especially to AFB1 and FB1, was associated with the risk of ESCC, and a greater-than-additive interaction between co-exposures to these two mycotoxins may contribute to the increased risk of ESCC in Huaian area, China.


Assuntos
Aflatoxinas/toxicidade , Exposição Dietética , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Fumonisinas/toxicidade , Aflatoxinas/sangue , Idoso , Biomarcadores/sangue , Biomarcadores/urina , China , Cromatografia Líquida de Alta Pressão , Neoplasias Esofágicas/induzido quimicamente , Carcinoma de Células Escamosas do Esôfago/induzido quimicamente , Feminino , Contaminação de Alimentos , Fumonisinas/urina , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1104-1109, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683395

RESUMO

Objective: To analyze the related factors of esophageal squamous cell carcinoma and precancerous lesions among residents aged 40-69 years old in rural areas of Shandong Province. Methods: In October 2018, 300 villages in 13 counties of the Shandong upper gastrointestinal cancerearly diagnosis and treatment projectin 2017 were selected as research areas, and 30 400 residents aged 40-69 were recruited in this study. The demographic characteristics, health status and lifestyle information were collected through the questionnaire survey, and endoscope iodine staining and indicative biopsy methods were used for cancer screening among eligible people.The multivariate logistic regression model was used to analyze the risk factors for esophageal cancer and precancerous lesions. Results: The subjects in this study were (56.42±7.24) years old, including 13 193 males (43.40%).There were 936 cases of esophageal cancer and precancerous lesions (3.08%), including 521 males and 415 females.Compared with women, 40-49 years old, high level education, drinking tap water, regular intake of meat, eggs and milk, and family average annual income more than 30 000 RMB, men (OR=1.90, 95%CI: 1.65-2.19), 60-69 years old (OR=5.28, 95%CI: 4.11-7.30), primary school education or below (OR=1.50, 95%CI: 1.20-1.89), drinking groundwater (OR=1.71, 95%CI: 1.38-2.13), never eating meat, eggs and milk (OR=1.48, 95%CI: 1.22-1.80), and family average annual income less than 30 000 RMB (OR=1.41, 95%CI: 1.16-1.70) would increase the risk of esophageal cancer and precancerous lesions. Conclusion: The gender, age, educational level, annual household income, drinking water source, the frequency of eating meat, egg and milk were related to the occurrence of esophageal cancer and precancerous lesions among 40-69 years old residents in rural areas of Shandong Province.


Assuntos
Detecção Precoce de Câncer , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/patologia , Lesões Pré-Cancerosas/patologia , População Rural/estatística & dados numéricos , Adulto , Idoso , Biópsia , China/epidemiologia , Endoscopia , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/epidemiologia , Fatores de Risco
9.
Medicine (Baltimore) ; 98(42): e17637, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626150

RESUMO

The purpose of this study was to assess the impact of tumor burden on the survival of patients with pathologic T3N0M0 (pT3N0M0) esophageal squamous cell carcinoma (ESCC).A total of 84 patients with pathologic T3N0M0 ESCC treated with radical esophagectomy and 3-field lymphadenectomy (3-FL) from January 2008 to December 2009 in our center were analyzed. Receiver-operating characteristic (ROC) curve analysis was performed to calculate the optimal cutoff value. The Kaplan-Meier method and log-rank test were used to assess the overall survival (OS) differences between groups. A regression model was applied to identify prognostic factors for OS. Propensity score matching (PSM) was performed to adjust for the imbalance and indication biases in the 2 groups.The median follow-up time was 62 months (range, 1-84 months), and the 5-year OS rate was 62% (95% confidence interval, 52.2-71.8%). According to the ROC curve analysis, the optimal cutoff values for the maximal esophageal wall thickness, tumor length, and tumor volume were 1.3 cm, 5.9 cm, and 18.6 cc, respectively. Univariate analysis revealed that maximal esophageal wall thickness >1.3 cm (P = .014), tumor volume >18.6 cc (P < .001), and vascular invasion (P < .001) were significantly associated with OS. The multivariate Cox regression model identified tumor volume and vascular invasion as factors affecting OS. After propensity matching, patients with a tumor volume ≤18.6 cc had a better OS than those with a tumor volume >18.6 cc (5-year OS, 85% vs 50%, P = .008).Tumor volume may serve as a good prognostic factor for patients with pT3N0M0 ESCC treated with radical esophagectomy and 3-FL. Larger-scale studies are warranted to validate these findings.


Assuntos
Carcinoma de Células Escamosas do Esôfago/diagnóstico , Estadiamento de Neoplasias/métodos , Pontuação de Propensão , Carga Tumoral , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Esofagectomia , Feminino , Seguimentos , Humanos , Imageamento Tridimensional , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências , Fatores de Tempo , Tomografia Computadorizada por Raios X
10.
Wei Sheng Yan Jiu ; 48(5): 757-764, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31601316

RESUMO

OBJECTIVE: To elucidate the association between lifestyle and dietary factors and esophageal squamous cell carcinoma( ESCC) in three different sections of the esophagus. METHODS: From January 2010 to December 2016, a hospital-based case-control study was conducted, and a total of 550 patients with ESCC and gender and age( ±3 age) frequency-matched 550 cancer-free control subjects were recruited in this study. Odds ratios( ORs) and their corresponding 95% confidence intervals( CIs) were calculated by using unconditional binary or multinomial logistic regression. Multiple correspondence analysis( MCA) was applied to illustrate the influence of the risk factors on different sections of the esophagus. RESULTS: Tea drinking was associated with lower risk of upper( Ut) and lower thoracic( Lt) ESCC( OR = 0. 40, 95% CI 0. 22-0. 73; OR= 0. 50, 95% CI 0. 31-0. 81; for Ut and Lt, respectively), and lower intake of vegetables increased the risk of Ut and Lt ESCC( OR = 3. 93, 95% CI 1. 61-9. 61; OR =2. 68, 95% CI 1. 30-5. 53; for Ut and Lt, respectively). Intake of hot food, hard food and lower intake of fruits were associated with an elevated risk of the ESCC in all subsites( P<0. 05). The strength of association between drinking and ESCC was lower in middle thoracic( Mt) compared with the Lt ESCC( OR = 0. 58, 95% CI 0. 35-0. 98). Moreover, this reduction of association strength were also found in eating hot food( OR = 0. 45, 95%CI 0. 27-0. 76) and lower intake of vegetables( Ut OR = 0. 44, 95% CI 0. 20-0. 99). However, the association between lower intake of fruits and the Mt ESCC risk was stronger compared with Lt ESCC( OR = 1. 66, 95% CI 1. 08-2. 55). In additional, the association between lower intake of fruits and the Ut ESCC risk was stronger compared with Mt ESCC. Joint category plot of MCA also identified the heterogeneous associations between risk factors and different sections of the esophagus. CONCLUSION: Differences in risk factors of ESCC in different subsites, intake of hot food, hard food, and lower intake of vegetables were common risk factors for three subsites of ESCC.


Assuntos
Dieta/estatística & dados numéricos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Estudos de Casos e Controles , China/epidemiologia , Comportamento Alimentar , Humanos , Estilo de Vida , Fatores de Risco
11.
Pathog Dis ; 77(5)2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31504479

RESUMO

This study aimed to investigate the role of high-risk human papillomavirus (Hr-HPV) in Somalian and Turkish patients with esophageal squamous cell carcinoma (ESCC). In the sections obtained from paraffin-embedded blocks, the results of invasive tumor, peripheral tumor dysplasia and normal mucosa were examined. Samples containing 45 and 47 ESCC, 46 and 42 dysplasia in Somalian (n = 52) and Turkish (n = 53) cases, respectively, were included in the study. We examined the presence of 14 types of Hr-HPV in ESCC collected from Somalia and Turkey by Aptima® Panther System. Hr-HPV types were not detected in Somalian cases. p16INK4a is positive in 5 (11.4%) tumors and 6 (13%) dysplasia. p53 is positive in 28 (62.2%) tumors and 35 (76.1%) dysplasia. HPV16-18/45 are positive only in one of the Turkish cases. p16INK4a is positive in 5 (10.6%) tumors and 4 (9.5%) dysplasia. p53 is positive in 31 (63.3%) tumors and 24 (57.1%) dysplasia. No reaction was detected in normal mucosa samples in both countries. This study is regional. Although the findings did not reflect the general population, the present study shows that the effect of HPV on carcinogenesis in Somalian and Turkish ESCC patients was not significant.


Assuntos
Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/virologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/virologia , Papillomaviridae/classificação , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Genótipo , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Papillomaviridae/genética , Patologia Molecular , Somália/epidemiologia , Turquia/epidemiologia , Adulto Jovem
12.
Surgery ; 166(6): 1033-1040, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31493901

RESUMO

BACKGROUND: It is important to understand the sites and the frequency of metastasis to perform less invasive treatments for superficial esophageal cancer, such as minimized or focused lymphadenectomy, endoscopic resection, and chemoradiotherapy. The distribution pattern and frequency of metastases from superficial esophageal cancer, however, have not been well elucidated. METHODS: In 342 patients with superficial esophageal squamous cell carcinoma who underwent esophagectomy, the sites and frequency of any metastasis, including lymph node metastasis at the time of esophagectomy, lymph node recurrence, and hematologic metastases were investigated. Factors associated with the likelihood of metastasis and prognosis were also examined. RESULTS: The incidence of lymph node metastasis increased with tumor depth (m2 = 7%; m3 = 17%; sm1 = 29%; sm2 = 41%; and sm3 = 42%). Lymph node metastases were observed most frequently in upper mediastinal lymph nodes, such as upper paratracheal lymph nodes, and in perigastric lymph nodes, such as paracardial lymph nodes and the left gastric lymph nodes. Lymph node metastases were also observed across a broad range of lymph nodes, including cervical, mediastinal, and abdominal lymph node regions, irrespective of tumor location. The 5-year overall survival and disease-specific survival rates were 78% and 89%, respectively. Submucosal invasion and lymphatic invasion were identified as independent factors associated with metastasis. Lymphatic invasion was also identified as an independent factor associated with disease-specific survival. CONCLUSION: The present study shows that metastasis can occur in a wide range of lymph node stations even in superficial esophageal squamous cell carcinoma. Together with the finding that lymphatic invasion is an independent prognostic factor, this study may help determine the treatment strategy for superficial esophageal squamous cell carcinoma.


Assuntos
Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Metástase Linfática , Recidiva Local de Neoplasia/epidemiologia , Idoso , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/secundário , Carcinoma de Células Escamosas do Esôfago/cirurgia , Esofagectomia , Feminino , Seguimentos , Humanos , Incidência , Estimativa de Kaplan-Meier , Excisão de Linfonodo , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/prevenção & controle , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
13.
Cancer Biomark ; 25(3): 243-250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31282406

RESUMO

OBJECTIVE: The aim of this study was to evaluate the prognostic value of a novel tumor marker index (TMI) based on preoperative serum levels of squamous cell carcinoma antigen (SCC) and cytokeratin 19 fragment (CYFRA 21-1) for patients with resectable esophageal squamous cell carcinoma (ESCC). METHODS: A total of 315 ESCC patients who had underwent curative surgery between 2008 and 2012 were retrospectively included in this study. The TMI was defined as the geometric mean of normalized SCC and CYFRA21-1 levels. Univariate and multivariate survival analyses were performed to confirm the clinical and prognostic significance of preoperative SCC and CYFRA 21-1 levels and TMI. RESULTS: Elevated preoperative SCC was associated with histological grade, pT status, lymph node status and TNM stage. Elevated preoperative CYFRA 21-1 was correlated with tumor size, lymph node status and TNM stage. The overall survival of patients with elevated SCC and CYFRA 21-1 levels was significantly poorer than that of patients with normal levels. Multivariate survival analysis identified that preoperative SCC (P= 0.353) and CYFRA 21-1 (P= 0.139) were not independent prognostic factors. The cut-off value of TMI based on SCC and CYFRA 21-1 was 0.531, and the patients were subdivided into high and low TMI groups. The 5-year survival rate of patients with high TMI was 30.9%, which was significantly lower than that of patients with low TMI (50.4%, P< 0.05). Multivariate analysis identified the TMI (HR 1.371; 95% CI 1.024-1.836; P= 0.034) as an independent prognostic factor. CONCLUSIONS: Elevated preoperative SCC and CYFRA 21-1 levels were associated with aggressive cancer behavior in ESCC. The TMI based on preoperative SCC and CYFRA 21-1 might serve as a novel marker that can be used to predict the prognosis of ESCC patients.


Assuntos
Antígenos de Neoplasias/genética , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas do Esôfago/genética , Queratina-19/genética , Serpinas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígeno Carcinoembrionário/genética , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Taxa de Sobrevida
14.
Environ Health ; 18(1): 60, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262333

RESUMO

BACKGROUND: The link between use of solid biomass fuel (wood, charcoal, coal, dung, and crop residues) for cooking and/or heating and esophageal squamous cell carcinoma (ESCC) is inconclusive. OBJECTIVE: We systematically reviewed the literature and performed a meta-analysis to determine whether cooking fuel type influences esophageal squamous cell carcinoma. METHODS: We searched MEDLINE, EMBASE, Web of Knowledge and Cochrane Database of Systematic Reviews for studies investigating cooking fuel and ESCC from 2000 until March 2019. We performed random effects meta-analysis stratified by the continent, World Bank's country income classifications and fuel type and calculated pooled odds ratios and 95% CIs for the risk of esophageal squamous cell carcinoma in biomass fuel users compared with non-users. RESULTS: Our analysis included 16 studies (all case-control) with 16,189 participants (5233 cases and 10,956 controls) that compared risk of ESCC among those using nonsolid fuels and biomass fuels. We found use of biomass fuel was associated with Esophageal squamous cell carcinoma with a pooled odds ratio (OR) 3.02 (95% CI 2.22, 4.11, heterogeneity (I2) = 79%). In sub-group analyses by continent, Africa (OR 3.35, 95%CI 2.34, 4.80, I2 = 73.4%) and Asia (OR 3.08, 95%CI 1.27, 7.43, I2 = 81.7%) had the highest odds of ESCC. Use of wood as fuel had the highest odds of 3.90, 95% CI 2.25, 6.77, I2 = 63.5%). No significant publication bias was detected. CONCLUSIONS: Biomass fuel is associated with increased risk of Esophageal squamous cell carcinoma. Biomass fuel status should be considered in the risk assessment for Esophageal squamous cell carcinoma.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Biomassa , Culinária , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Calefação , Carvão Vegetal/efeitos adversos , Carvão Mineral/efeitos adversos , Neoplasias Esofágicas/induzido quimicamente , Carcinoma de Células Escamosas do Esôfago/induzido quimicamente , Fezes , Humanos , Fatores de Risco , Madeira/efeitos adversos
15.
Biomed Res Int ; 2019: 2741598, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31240208

RESUMO

Objective: This study constructs, calibrates, and verifies a mathematical simulation model designed to project the natural history of ESCC and is intended to serve as a platform for testing the benefits and cost-effectiveness of primary and secondary ESCC prevention alternatives. Methods: The mathematical model illustrates the natural history of ESCC as a sequence of transitions among health states, including the primary health states (e.g., normal mucosa, precancerous lesions, and undetected and detected cancer). Using established calibration approaches, the parameter sets related to progression rates between health states were optimized to lead the model outputs to match the observed data (specifically, the prevalence of precancerous lesions and incidence of ESCC from the published literature in Chinese high-risk regions). As illustrative examples of clinical and policy application, the calibrated and validated model retrospectively simulate the potential benefit of two reported ESCC screening programs. Results: Nearly 1,000 good-fitting parameter sets were identified from 1,000,000 simulated sets. Model outcomes had sufficient calibration fit to the calibration targets. Additionally, the verification analyses showed reasonable external consistency between the model-predicted effectiveness of ESCC screening and the reported data from clinical trials. Conclusions: This parameterized mathematical model offers a tool for future research investigating benefits, costs, and cost-effectiveness related to ESCC prevention and treatment.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Programas de Rastreamento/métodos , Modelos Teóricos , Calibragem , China/epidemiologia , Análise Custo-Benefício , Progressão da Doença , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/prevenção & controle , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/prevenção & controle , Carcinoma de Células Escamosas do Esôfago/terapia , Humanos , Incidência , Prevalência , Estudos Retrospectivos
16.
Interact Cardiovasc Thorac Surg ; 29(4): 510-516, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31169876

RESUMO

OBJECTIVES: Melanoma-associated antigen A1 (MAGEA1) is a potential target for immunotherapy and has been associated with poor survival rate in several cancers. However, little is known about the prognostic predictive value of MAGEA1 in oesophageal squamous cell carcinoma (OSCC). This study aims to determine whether the expression of MAGEA1 is an independent predictor of survival in patients with resectable OSCC. METHODS: A retrospective analysis was performed on a large cohort of 197 patients with OSCC who underwent radical surgical treatment in the Department of Thoracic Surgery between January 2006 and December 2012. The expression of MAGEA1 in OSCC and matched normal oesophageal mucosa specimens from these patients was detected by immunohistochemistry with tissue microarray technology. RESULTS: The MAGEA1 protein was expressed in the cytoplasm and nucleus of tumour cells. The positive expression rate of MAGEA1 was significantly higher in OSCC tissue than in normal oesophageal mucosa (73.6% vs 5.6%, P < 0.001). MAGEA1 expression had no correlations with sex, age, history of smoking, alcohol consumption, family history of upper gastrointestinal cancer, T stage, lymph node metastasis, grade/location of the tumour or TNM stage (all at P > 0.05). Compared with those with negative MAGEA1 expression, patients with positive MAGEA1 expression were associated with a reduced overall survival rate (5-year survival rate: 53.8% vs 37.2%; P = 0.018). The multivariable analysis revealed that MAGEA1 expression is an independent predictor of prognosis (P = 0.007, hazard ratio 1.85, 95% confidence interval 1.19-2.89). CONCLUSIONS: The expression of MAGEA1 is abundant in Chinese patients with OSCC and is related to a worse clinical outcome. MAGEA1 may be a useful prognostic factor in patients with resectable OSCC.


Assuntos
Neoplasias Esofágicas/metabolismo , Carcinoma de Células Escamosas do Esôfago/metabolismo , Esofagectomia , Estadiamento de Neoplasias , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/biossíntese , China/epidemiologia , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/patologia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Antígenos Específicos de Melanoma/biossíntese , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida/tendências
17.
Surg Clin North Am ; 99(3): 479-499, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31047037

RESUMO

Human evolutionary genetic divergence and distinctive environmental exposures have contributed to the development of clinicopathologic variations of esophageal cancer in Eastern and Western countries. Different treatment strategies have derived from the disparate regional experiences. Treatment strategy is more standardized in the West. Trimodality treatment with neoadjuvant chemoradiation followed by surgery is widely accepted as the standard treatment of locally advanced esophageal adenocarcinoma and esophageal squamous cell carcinoma. Trimodality treatment has not been adopted in many Eastern countries, and standard treatment is neoadjuvant chemotherapy. Several randomized trials are ongoing that may alter the standard management of esophageal cancer worldwide.


Assuntos
Adenocarcinoma/terapia , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas do Esôfago/terapia , Adenocarcinoma/epidemiologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia/métodos , Terapia Combinada/métodos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Esofagectomia/métodos , Previsões , Humanos , Excisão de Linfonodo/métodos , Terapia Neoadjuvante/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Salvação/métodos , Resultado do Tratamento
18.
Ann Thorac Surg ; 108(6): 1717-1723, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31039351

RESUMO

BACKGROUND: Nodal skip metastasis (NSM) is a prognostic factor in certain malignant tumors, but the clinical and prognostic implications of NSM in esophageal squamous cell carcinoma (ESCC) are still unclear. The study aimed to assess its risk factors and prognostic value in thoracic ESCC. METHODS: A retrospective study was conducted in patients with thoracic ESCC who underwent esophagectomy from March 2009 to March 2012 in the Department of Thoracic Surgery, West China Hospital, Sichuan University. The prognostic implications and risk factors of NSM were assessed in our study. RESULTS: The incidence of NSM in the entire cohort was 37.9%. Tumor location (P = .016), pT stage (P = .029), and pN stage (P < .001) were identified to be independent risk factors for NSM. The overall survival (OS) was similar between patients with and without NSM. The OS had no significant difference between pN1 patients with and without NSM, whereas the OS was significantly worse in pN2 patients with NSM than those without NSM (P = .001). The OS was similar between patients with NSM level 1 and NSM level 2, but the OS was significantly better in patients with NSM level 1 than NSM level 2 among patients with lower thoracic ESCC (P = .013). CONCLUSIONS: The effect of NSM on prognosis of thoracic ESCC may be mainly reflected in patients with pN2 stage. The prognostic value of NSM level for thoracic ESCC may be mainly reflected in patients with lower thoracic tumor.


Assuntos
Carcinoma de Células Escamosas do Esôfago/secundário , Excisão de Linfonodo/métodos , Linfonodos/cirurgia , Estadiamento de Neoplasias , Medição de Risco/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Esofagectomia , Feminino , Humanos , Incidência , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências
19.
J Pak Med Assoc ; 69(5): 738-740, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31105301

RESUMO

To determine the frequency of human papilloma virus (HPV) in patients with oesophageal squamous cell carcinoma. A descriptive, cross-sectional method was adopted and the study was conducted in the histopathology department of Rehman Medical Institute, Peshawar, Pakistan, from January to June 2017, and included patients with Oesophageal squamous cell carcinoma. Non-probability consecutive sampling technique was used. SPSS v.22 was used for data analysis. Out of 121 patients, 67(55.37%) were male and 54(44.62%) were female. The overall mean age was 50±1.72 years. Most of the patients were in the age group of over 50 years and only 12% were in the age group below 40 years. In our study patients with oesophageal squamous cell carcinma, human papillomavirus was found in 3%.


Assuntos
Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Infecções por Papillomavirus/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia
20.
Ecotoxicol Environ Saf ; 178: 79-85, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-30999183

RESUMO

BACKGROUND: Despite decades of research and intervention programs, the epidemic of esophageal squamous cell carcinoma (ESCC) in the Taihang Mountain area of north China has not seen convincing explanation by any risk factor yet and the incidence has not seen a substantial decrease. Based on recently disclosed association of aridity and wheat consumption with esophageal cancer, we revisited the hypothesis of biogenic silica in esophageal cancer development. METHODS: From the archives of the Pathology Department of Heping Hospital, Changzhi Medical College, we selected three pairs of formalin-fixed samples, tumor tissues and distant normal tissues, of three patients operated for ESCC who had no history of workplace exposure to silica dust. Two pairs of dried tissue samples were used for phytolith (silica body) analysis and another pair for microanalysis with Transmission Electron Microscope (TEM). RESULTS: One of the phytoliths in ESCC tumor tissue was similar to the prickle hair on the surface of wheat bract. In the mineral particles detected in the tumor tissue the predominant elements were Si, Ca, and P, whereas Si signals were not obvious in the distant normal tissue. CONCLUSIONS: The preliminary findings on the detection of phytoliths and the higher than normal Si concentration in ESCC tumor tissue warrants further testing the role of biogenic silica in esophageal cancer.


Assuntos
Exposição Dietética/efeitos adversos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Dióxido de Silício/análise , Triticum/química , Adulto , China/epidemiologia , Neoplasias Esofágicas/química , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/química , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Dióxido de Silício/administração & dosagem , Dióxido de Silício/efeitos adversos , Triticum/ultraestrutura
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