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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1084-1087, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683391

RESUMO

The screening, early diagnosis and early treatment project of the upper gastrointestinal cancer had achieved good results since its launch. However, from a national perspective, the endoscopic screening of upper gastrointestinal cancer was still not optimistic, such as the poor rate of the early diagnosis, the low rate of 5-year survival in rural areas, and the disparity of the standardized screening and diagnosis in different areas. Therefore, the situation of upper gastrointestinal cancer prevention and treatment is still severe. Under the guidance of the "Healthy China 2030" plan, based on the international experience and domestic actual circumstance, it is suggested that the screening of high-risk population in high-risk areas should be changed into the opportunistic screening in primary medical institutions. The opportunistic screening could expand the coverage of the screening, early diagnosis and early treatment project of the upper gastrointestinal cancer, and increase the early diagnosis rate in rural areas and primary medical institutions, which could improve the 5-year survival rate of patients with the upper gastrointestinal cancer, and then achieve the sustainable development of the cancer prevention and treatment in China.


Assuntos
Detecção Precoce de Câncer , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/terapia , Programas de Rastreamento/métodos , China , Endoscopia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/etnologia , Humanos , Programas de Rastreamento/tendências , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/etnologia
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1094-1097, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683393

RESUMO

Objective: To estimate the incidence and mortality rates of esophageal cancer in China in 2015. Methods: Based on the data quality review and assessment, the esophageal cancer data from 368 cancer registries in 31 provinces (autonomous regions and municipalities) in China were included in this study. According to the national population data in 2015, the nationwide incidence and mortality of the esophageal cancer were estimated. Chinese standard population in 2000 and world Segi's population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). Results: The 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. There were 245 651 new esophageal cancer cases estimated in China in 2015, with a crude incidence rate of 17.87/100 000. The ASR China and ASR world were 11.14/100 000 and 11.28/100 000, respectively. The estimated number of esophageal cancer death was 188 044 in China in 2015, with a crude mortality rate of 13.68/100 000; The ASR China and ASR world mortality rates were 8.33/100 000 and 8.36/100 000, respectively. The ASR China incidence and mortality of esophageal cancer in males were higher in males (16.50/100 000 and 12.66/100 000) than those in females (5.92/100 000 and 4.17/100 000), and they were higher in rural areas (15.95/1100 000 and 11.67/100 000) than those in urban areas (7.59/100 000 and 5.87/100 000). Conclusion: The incidence and mortality of esophageal cancer in China are higher than the global average. The disparity of the incidence and mortality rates of esophageal cancer significantly differed in genders and areas.


Assuntos
Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/mortalidade , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , China/epidemiologia , Neoplasias Esofágicas/etnologia , Feminino , Humanos , Incidência , Masculino , Vigilância da População , Sistema de Registros
3.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1115-1118, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683397

RESUMO

Objective: To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. Methods: From 2009 to 2015, 31 natural villages with high-incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub-district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost-effectiveness analysis and cost-benefit analysis, were performed to evaluate the current screening schemes. Results: The mean age of all respondents were (53.60±8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high-grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively; the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness-cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. Conclusions: The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.


Assuntos
Cárdia/patologia , Detecção Precoce de Câncer/economia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/economia , Programas de Rastreamento/economia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/economia , Adulto , Idoso , China/epidemiologia , Análise Custo-Benefício , Neoplasias Esofágicas/etnologia , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Neoplasias Gástricas/etnologia
4.
Gastroenterology ; 156(5): 1404-1415, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30578782

RESUMO

BACKGROUND & AIMS: African American and European American individuals have a similar prevalence of gastroesophageal reflux disease (GERD), yet esophageal adenocarcinoma (EAC) disproportionately affects European American individuals. We investigated whether the esophageal squamous mucosa of African American individuals has features that protect against GERD-induced damage, compared with European American individuals. METHODS: We performed transcriptional profile analysis of esophageal squamous mucosa tissues from 20 African American and 20 European American individuals (24 with no disease and 16 with Barrett's esophagus and/or EAC). We confirmed our findings in a cohort of 56 patients and analyzed DNA samples from patients to identify associated variants. Observations were validated using matched genomic sequence and expression data from lymphoblasts from the 1000 Genomes Project. A panel of esophageal samples from African American and European American subjects was used to confirm allele-related differences in protein levels. The esophageal squamous-derived cell line Het-1A and a rat esophagogastroduodenal anastomosis model for reflux-generated esophageal damage were used to investigate the effects of the DNA-damaging agent cumene-hydroperoxide (cum-OOH) and a chemopreventive cranberry proanthocyanidin (C-PAC) extract, respectively, on levels of protein and messenger RNA (mRNA). RESULTS: We found significantly higher levels of glutathione S-transferase theta 2 (GSTT2) mRNA in squamous mucosa from African American compared with European American individuals and associated these with variants within the GSTT2 locus in African American individuals. We confirmed that 2 previously identified genomic variants at the GSTT2 locus, a 37-kb deletion and a 17-bp promoter duplication, reduce expression of GSTT2 in tissues from European American individuals. The nonduplicated 17-bp promoter was more common in tissue samples from populations of African descendant. GSTT2 protected Het-1A esophageal squamous cells from cum-OOH-induced DNA damage. Addition of C-PAC increased GSTT2 expression in Het-1A cells incubated with cum-OOH and in rats with reflux-induced esophageal damage. C-PAC also reduced levels of DNA damage in reflux-exposed rat esophagi, as observed by reduced levels of phospho-H2A histone family member X. CONCLUSIONS: We found GSTT2 to protect esophageal squamous cells against DNA damage from genotoxic stress and that GSTT2 expression can be induced by C-PAC. Increased levels of GSTT2 in esophageal tissues of African American individuals might protect them from GERD-induced damage and contribute to the low incidence of EAC in this population.


Assuntos
Adenocarcinoma/genética , Afro-Americanos/genética , Esôfago de Barrett/genética , Dano ao DNA , Mucosa Esofágica/enzimologia , Neoplasias Esofágicas/genética , Grupo com Ancestrais do Continente Europeu/genética , Refluxo Gastroesofágico/genética , Glutationa Transferase/genética , Adenocarcinoma/enzimologia , Adenocarcinoma/etnologia , Adenocarcinoma/patologia , Animais , Esôfago de Barrett/enzimologia , Esôfago de Barrett/etnologia , Esôfago de Barrett/patologia , Modelos Animais de Doenças , Mucosa Esofágica/patologia , Neoplasias Esofágicas/enzimologia , Neoplasias Esofágicas/etnologia , Neoplasias Esofágicas/patologia , Feminino , Refluxo Gastroesofágico/enzimologia , Refluxo Gastroesofágico/etnologia , Refluxo Gastroesofágico/patologia , Glutationa Transferase/metabolismo , Células HeLa , Histonas/metabolismo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fosfoproteínas/metabolismo , Fosforilação , Fatores de Proteção , Ratos Sprague-Dawley , Fatores de Risco , Estados Unidos/epidemiologia , Regulação para Cima
5.
Stat Methods Med Res ; 27(9): 2641-2656, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30103662

RESUMO

We establish a zero-inflated (random-effects) logistic-Gaussian model for clustered binary data in which members of clusters in one latent class have a zero response with probability one, and members of clusters in a second latent class yield correlated outcomes. Response probabilities in terms of random-effects models are formulated, and maximum marginal likelihood estimation procedures based on Gaussian quadrature are developed. Application to esophageal cancer data in Chinese families is presented.


Assuntos
Análise por Conglomerados , Interpretação Estatística de Dados , Algoritmos , China , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/etnologia , Feminino , Humanos , Masculino , Distribuição Normal , Distribuição de Poisson , Análise de Regressão
6.
Am J Surg ; 216(4): 778-781, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30077314

RESUMO

BACKGROUND: African Americans with esophageal cancer have a higher mortality rate than Caucasians. We hypothesized that nutritional status, as reflected by preoperative albumin, might explain these disparities. METHODS: The National Surgical Quality Improvement Program database was queried for patients undergoing esophagectomy for esophageal cancer between 2005 and 2015. Preoperative albumin was divided into five categories (<3.0, 3.0-3.4, 3.5-3.9, 4.0-4.4, and >4.4). Univariate and multivariable regression statistics were performed to determine an association between preoperative albumin levels on mortality. RESULTS: 3228 patients were studied. While preoperative albumin was associated with lower body mass index, more severe preoperative weight loss, and more respiratory comorbidities (p-values <0.05), albumin levels were not associated with race. On multivariable models including race and other covariates, we found no association of serum albumin and mortality. CONCLUSIONS: We found that race was an independent predictor of mortality for patients undergoing esophagectomy. However, preoperative albumin did not explain these disparities.


Assuntos
Afro-Americanos , Neoplasias Esofágicas/mortalidade , Esofagectomia , Grupo com Ancestrais do Continente Europeu , Disparidades nos Níveis de Saúde , Desnutrição/complicações , Albumina Sérica/metabolismo , Adulto , Idoso , Biomarcadores/sangue , Bases de Dados Factuais , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/etnologia , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Modelos Logísticos , Masculino , Desnutrição/sangue , Desnutrição/diagnóstico , Pessoa de Meia-Idade , Estado Nutricional , Período Pré-Operatório , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Estados Unidos/epidemiologia
7.
Clin Lab ; 64(7): 1249-1257, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30146847

RESUMO

BACKGROUND: Recently, esophageal cancer has become more common in China. To find a molecular biomarker will provide a handy way to improve precancerous diagnosis and evaluate the state of lymph node metastasis, improving prognosis. The present study aimed to investigate the expression level of hsa-miR-6743-5p in 25 esophageal tissues and to estimate the correlation between clinicopathological features of esophageal squamous cell cancer with miR-6743-5p expression. METHODS: Quantitative reverse transcription polymerase chain reaction was performed to examine the expression level of miR-6743-5p in 25 pairs of esophageal cancer tissues and adjacent non-cancerous tissues. The correlation between miR-6743-5p level and clinical characteristics was determined. RESULTS: The examined esophageal squamous cell cancer tissues exhibited no statistical difference on miR-6743-5p expression compared to the adjacent non-tumor tissues. miR-6743-5p was positively associated with lymph node metastasis. Downregulation of miR-6743-5p was found in the patients with lymph node metastasis while upregulation of miR-6743-5p was found in those without lymph node metastasis. CONCLUSIONS: Our study suggests that the expression of miR-6743-5p is different in different lymph node metastasis statuses. miR-6743-5p expression is downregulated in patients with lymph node metastasis in esophageal cancer.


Assuntos
Carcinoma de Células Escamosas/genética , Neoplasias Esofágicas/genética , Regulação Neoplásica da Expressão Gênica , MicroRNAs/genética , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/etnologia , Carcinoma de Células Escamosas/patologia , China , Regulação para Baixo , Neoplasias Esofágicas/etnologia , Neoplasias Esofágicas/patologia , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico
8.
Dig Dis Sci ; 63(11): 2880-2888, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30109578

RESUMO

BACKGROUND: Survival outcome disparities among esophageal cancer patients exist, but are not fully understood. AIMS: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to determine whether survival differences among racial/ethnic patient populations persist after adjusting for demographic and clinical characteristics. METHODS: Our study included T1-3N0M0 adenocarcinoma and squamous cell cancer patients diagnosed between 2003 and 2011. We compared survival among two racial/ethnic patient subgroups using Cox proportional hazards methods, adjusting for age, sex, histology, marital status, socioeconomics, SEER region, comorbidities, T stage, tumor location, diagnosis year, and treatment received. RESULTS: Among 2025 patients, 87.9% were White and 12.1% were Nonwhite. Median survival was 18.7 months for Whites vs 13.8 months for Nonwhites (p = 0.01). In the unadjusted model, Nonwhite patients had higher risk of mortality (HR = 1.29, 95% CI 1.11-1.49, p < 0.0001) when compared to White patients; however, in the Cox regression adjusted model there was no significant difference (HR = 0.94, 95% CI 0.80-1.10, p = 0.44). Surgery, chemotherapy, younger age, lower T stage, and lower Charlson comorbidity score were significant predictors in the full adjusted model. CONCLUSIONS: Differences in mortality risk by race/ethnicity appear to be largely explained by additional factors. In particular, associations were seen in surgery and T stage. Further research is needed to understand potential mechanisms underlying the differences and to better target patients who can benefit from treatment options.


Assuntos
Adenocarcinoma/mortalidade , Carcinoma de Células Escamosas/mortalidade , Neoplasias Esofágicas/mortalidade , Adenocarcinoma/etnologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/etnologia , Neoplasias Esofágicas/etnologia , Feminino , Humanos , Masculino , Programa de SEER
9.
Cancer Sci ; 109(6): 1995-2002, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29635717

RESUMO

Efficacy of endoscopic screening for esophageal cancer is not sufficiently definitive and lacks randomized controlled trial evidence. The present study proved short-term screening efficacy through describing and comparing disease stage distributions of intervention and control populations. Villages from Linzhou and Cixian were cluster randomly allocated to the intervention or to the control group and the target population of 52 729 and 43 068 individuals was 40-69 years old, respectively, and the actual enrolled numbers were 18 316 and 21 178, respectively. TNM stage information and study-defined stage information of esophageal cases from 2012 to 2016 were collected. Stage distributions were compared between the intervention and control groups in the total target population, as well as in the subgroup populations in terms of enrolment and before or after intervention. There were a total of 199 and 141 esophageal cancer cases in the intervention and control groups, respectively. For the target population, distributions of TNM stage were borderline significant between the two groups after intervention (P = .093). However, subgroup analysis of the enrolled population during the after-intervention period had statistical significance for both TNM and study-defined stage. Natural TNM stage distributions were approximately 32%, 41%, 24% and 3% for stages I to IV vs 71%, 19%, 7% and 3% in the intervention population. The natural study-defined stage distributions from early, middle to advanced stages were approximately 18%, 49% and 33% vs 59%, 33% and 8%. Early-stage esophageal cancer cases accounted for a higher proportion after endoscopy screening, and the efficacy in the target population depends on the intervention compliance.


Assuntos
Detecção Precoce de Câncer/métodos , Endoscopia/métodos , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/epidemiologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Estudos de Coortes , Neoplasias Esofágicas/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Inquéritos e Questionários
10.
Ann Thorac Surg ; 106(2): 346-353, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29684373

RESUMO

BACKGROUND: Utilization of high-volume hospitals (HVH) for esophagectomy has been associated with improved perioperative outcomes and reduced mortality. We aimed to test the hypothesis that black-white racial disparities exist in HVH utilization and identify predictors of in-hospital surgical outcomes of esophageal cancer while adjusting for HVH utilization patterns. METHODS: We queried the New York Statewide Planning and Research Cooperative System database (1995 to 2012) for esophageal cancer patients who underwent surgical resection exclusively. Only records for patients with self-reported white or black race and a valid New York State ZIP code were included (n = 2,895). Analysis was performed to identify factors associated with HVH hospital (≥20 esophagectomies/year) utilization and determine predictors of complications and in-hospital mortality. RESULTS: Black patients (361 [12.5%]) were significantly different (p < 0.001) than their white counterparts in the proportion of women, Medicaid, income distribution, and privately insured individuals. Although 55% patients overall utilized an HVH, blacks were significantly less likely to utilize an HVH than whites (odds ratio [OR], 0.18; 95% confidence interval [CI], 0.14 to 0.24), even though 74.5% resided within 8.9 miles of one. Operations performed at HVHs were associated with lower in-hospital mortality (OR, 0.48; 95% CI, 0.35 to 0.65); however, mortality remained higher for blacks (OR, 2.04; 95% CI, 1.65 to 3.30; propensity matched OR, 2.45; 95% CI, 1.5 to 4.03). CONCLUSIONS: Black patients were less likely to undergo esophagectomy at an HVH and experienced higher mortality. Efforts should be made to understand factors influencing patients' decision process and improve referral practices to ensure optimal care is provided across all segments of the population, irrespective of race, insurance, or income status.


Assuntos
Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/cirurgia , Disparidades em Assistência à Saúde/etnologia , Mortalidade Hospitalar , Hospitais com Alto Volume de Atendimentos/estatística & dados numéricos , Afro-Americanos/estatística & dados numéricos , Idoso , Estudos de Coortes , Bases de Dados Factuais , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/etnologia , Esofagectomia/métodos , Esofagectomia/mortalidade , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New York , Razão de Chances , Valor Preditivo dos Testes , Pontuação de Propensão , Estudos Retrospectivos , Medição de Risco , Fatores Socioeconômicos , Análise de Sobrevida , Resultado do Tratamento
11.
Hum Pathol ; 76: 156-166, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29534888

RESUMO

Endoscopic resection (ER) has become the standard therapy for superficial Barrett's carcinoma (BC) in Japan and other countries. Patients undergoing ER sometimes require additional treatment because of recurrence of lymph node metastasis (LNM). We attempted to clarify the histopathologic risk factors for LNM, and the difference between these risk factors for Japanese patients and the conventional risk factors documented for Western patients. This multi-center study included 12 leading institutions belonging to the Japan Research Society for Early Esophageal Cancer and Chromoendoscopy, and was based on a questionnaire designed to gather data on the features of superficial BC cases, except for high-grade intraepithelial neoplasia, treated at those institutions. These features were assessed using the standardized pathologic approach employed in Japan, whereby surgically and endoscopically resected specimens are cut into parallel slices 4-5 mm and 2 mm thick, respectively. Seventy-four surgically resected (SR) and 201 ER specimens were analyzed separately. Significant risk factors for LNM were almost the same as conventional risk factors, such as tumor size (cut-off value; 17.5 mm) and depth, vessel infiltration, presence of poorly differentiated components, and the depth (cut-off value; 990 µm) and width (cut-off value; 4300 µm) of the submucosal component, in addition to growth pattern (a protruding or flat elevated pattern) and the presence of infiltrative growth. Histopathologic examination revealed that BC cases without invasion to the deep muscularis mucosae (DMM) had almost no risk of LNM. Detailed histopathologic evaluation of thin-slice preparations of ER specimens is considered highly important for prognostication.


Assuntos
Esôfago de Barrett/patologia , Neoplasias Esofágicas/patologia , Idoso , Grupo com Ancestrais do Continente Asiático , Esôfago de Barrett/etnologia , Esôfago de Barrett/cirurgia , Biópsia , Neoplasias Esofágicas/etnologia , Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Esofagoscopia/métodos , Feminino , Humanos , Japão/epidemiologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Fatores de Risco , Resultado do Tratamento
12.
Nat Commun ; 8(1): 1533, 2017 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-29142225

RESUMO

Esophageal squamous cell carcinoma is a major histological type of esophageal cancer, with distinct incidence and survival patterns among races. Although previous studies have characterized somatic mutations in this disease, a rigorous comparison between different patient populations has not been conducted. Here we sequence the samples of 316 Chinese patients, combine them with those from The Cancer Genome Atlas, and perform a comparative analysis between Asian and Caucasian patients. We find that mutated CSMD3 is associated with better prognosis in Asian patients. Applying a robust computational strategy that adjusts for both technical and biological confounding factors, we find that TP53, EP300, and NFE2L2 show higher mutational frequencies in Asian patients. Moreover, NFE2L2 mutations correlate with the allele status of a nearby high-Fst SNP, suggesting their potential interaction. Our study provides insights into the molecular basis underlying the striking racial disparities of this disease, and represents a general computational framework for such a cross-population comparison.


Assuntos
Carcinoma de Células Escamosas/genética , Neoplasias Esofágicas/genética , Predisposição Genética para Doença/genética , Genômica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/genética , Carcinoma de Células Escamosas/etnologia , China , Neoplasias Esofágicas/etnologia , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Frequência do Gene , Predisposição Genética para Doença/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Mutação
13.
Cancer Biomark ; 21(1): 65-71, 2017 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-29060926

RESUMO

BACKGROUND: The most important anti-tumor immune response is mediated by T lymphocytes. The interaction of programmed death-1 ligand-1 (PD-L1) with its receptor provides an inhibitory signal in T lymphocytes activation and proliferation. OBJECTIVE: This study aimed to investigate whether polymorphisms of PD-L1 were associated with the risk and prognosis of esophageal squamous cell carcinoma (ESCC) in a high-incidence population from Northern China. METHODS: PD-L1 rs2890658 A/C and rs4143815 C/G single nucleotide polymorphisms (SNPs) were genotyped by polymerase chain reaction ligase detection reaction (PCR-LDR) method in 575 ESCC patients and 577 healthy controls. RESULTS: There was no significant difference in the genotype frequencies of these two SNPs between the ESCC patients and the healthy controls. However, for rs2890658 A/C SNP, compared with the C/C genotype, the A/C genotype increased the risk of ESCC for the smokers (OR = 1.513, 95% CI = 1.006-2.287). Among the 575 ESCC patients, the survival information of 202 ESCC patients was collected. Neither the rs2890658 A/C SNP nor the rs4143815 C/G SNP was associated with the survival of ESCC patients. CONCLUSIONS: PD-L1 rs2890658 A/C SNP might be used as risk marker of the susceptibility to ESCC for the Han nationality in a high-incidence population from Northern China.


Assuntos
Antígeno B7-H1/genética , Carcinoma de Células Escamosas/genética , Neoplasias Esofágicas/genética , Predisposição Genética para Doença/genética , Polimorfismo de Nucleotídeo Único , Fumantes , Grupo com Ancestrais do Continente Asiático/genética , Carcinoma de Células Escamosas/etnologia , China/epidemiologia , Neoplasias Esofágicas/etnologia , Feminino , Frequência do Gene , Predisposição Genética para Doença/etnologia , Genótipo , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco
14.
J Healthc Eng ; 2017: 4620732, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29065605

RESUMO

Esophageal cancer is one of the fastest rising types of cancers in China. The Kazak nationality is the highest-risk group in Xinjiang. In this work, an effective computer-aided diagnostic system is developed to assist physicians in interpreting digital X-ray image features and improving the quality of diagnosis. The modules of the proposed system include image preprocessing, feature extraction, feature selection, image classification, and performance evaluation. 300 original esophageal X-ray images were resized to a region of interest and then enhanced by the median filter and histogram equalization method. 37 features from textural, frequency, and complexity domains were extracted. Both sequential forward selection and principal component analysis methods were employed to select the discriminative features for classification. Then, support vector machine and K-nearest neighbors were applied to classify the esophageal cancer images with respect to their specific types. The classification performance was evaluated in terms of the area under the receiver operating characteristic curve, accuracy, precision, and recall, respectively. Experimental results show that the classification performance of the proposed system outperforms the conventional visual inspection approaches in terms of diagnostic quality and processing time. Therefore, the proposed computer-aided diagnostic system is promising for the diagnostics of esophageal cancer.


Assuntos
Diagnóstico por Computador , Neoplasias Esofágicas/diagnóstico por imagem , Raios X , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Grupo com Ancestrais do Continente Asiático , China , Neoplasias Esofágicas/etnologia , Grupos Étnicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
PLoS One ; 12(10): e0184962, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29073141

RESUMO

BACKGROUND: Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) are far more prevalent in European Americans than in African Americans. Hypothesizing that this racial disparity in prevalence might represent a genetic susceptibility, we used an admixture mapping approach to interrogate disease association with genomic differences between European and African ancestry. METHODS: Formalin fixed paraffin embedded samples were identified from 54 African Americans with BE or EAC through review of surgical pathology databases at participating Barrett's Esophagus Translational Research Network (BETRNet) institutions. DNA was extracted from normal tissue, and genotyped on the Illumina OmniQuad SNP chip. Case-only admixture mapping analysis was performed on the data from both all 54 cases and also on a subset of 28 cases with high genotyping quality. Haplotype phases were inferred with Beagle 3.3.2, and local African and European ancestries were inferred with SABER plus. Disease association was tested by estimating and testing excess European ancestry and contrasting it to excess African ancestry. RESULTS: Both datasets, the 54 cases and the 28 cases, identified two admixture regions. An association of excess European ancestry on chromosome 11p reached a 5% genome-wide significance threshold, corresponding to -log10(P) = 4.28. A second peak on chromosome 8q reached -log10(P) = 2.73. The converse analysis examining excess African ancestry found no genetic regions with significant excess African ancestry associated with BE and EAC. On average, the regions on chromosomes 8q and 11p showed excess European ancestry of 15% and 20%, respectively. CONCLUSIONS: Chromosomal regions on 11p15 and 8q22-24 are associated with excess European ancestry in African Americans with BE and EAC. Because GWAS have not reported any variants in these two regions, low frequency and/or rare disease associated variants that confer susceptibility to developing BE and EAC may be driving the observed European ancestry association evidence.


Assuntos
Adenocarcinoma/genética , Afro-Americanos , Esôfago de Barrett/genética , Neoplasias Esofágicas/genética , Predisposição Genética para Doença , Adenocarcinoma/etnologia , Esôfago de Barrett/etnologia , Neoplasias Esofágicas/etnologia , Humanos
16.
Medicine (Baltimore) ; 96(35): e7944, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28858123

RESUMO

BACKGROUND: Many studies have showed that diabetes mellitus (DM) might be a risk factor for certain types of cancers. However, there are still inconsistent results on the effects of DM on the risk of esophageal cancer (EC). The objective of this study is to investigate the association and to quantify the correlation between DM and EC by a meta-analysis. METHODS: The initial search identified 339 articles. Those publications that did not report the exact number of EC cases were removed. Finally, 13 meaningful studies were extracted from the databases of PubMed, MEDLINE, and Web of Science. All pooled analyses of risk ratios (RRs) and 95% confidence intervals (CIs) were assessed by a random-effect or fixed-effect model. Subgroup analysis was implemented on the basis of the sex or ethnicity. I value was used to assess heterogeneity, and funnel plot analysis was for publication bias. RESULTS: The result showed that there was a positive correlation between type 2 diabetes mellitus (T2DM) and EC risk (RR = 1.28, 95% CI: 1.12-1.47, P < .001). Subgroup analysis based on gender showed that male was an important risk factor for EC (RR = 1.53, 95% CI: 1.44-1.62, P < .001), but female was not (RR = 1.23, 95% CI: 0.41-3.69, P = .71). In addition, subgroup analysis based on ethnicity showed that DM was significantly correlated to EC in North America subjects (RR = 1.39, 95% CI: 1.31-1.47, P < .001), and in Europe subjects (RR = 1.37, 95% CI: 1.02-1.83, P = .04), whereas no correlation was found in Asian subjects (RR = 0.98, 95% CI: 0.50-1.95, P = .96). Furthermore, DM had a correlation to an increased risk of esophageal adenocarcinoma (EAC) (RR = 1.43, 95% CI: 1.35-1.51, P < .001). CONCLUSION: This meta-analysis indicates that DM is positively correlated to EC. However, the results should be interpreted with caution because of the limitations on potential clinical confounding factors in each study included in this meta-analysis.


Assuntos
Adenocarcinoma/complicações , Diabetes Mellitus Tipo 2/complicações , Neoplasias Esofágicas/complicações , Adenocarcinoma/etnologia , Diabetes Mellitus Tipo 2/etnologia , Neoplasias Esofágicas/etnologia , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Sexuais
17.
PLoS One ; 12(8): e0183782, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28832659

RESUMO

BACKGROUND: Esophageal cancer makes up approximately 1% of all diagnosed cancers in the US. There is a persistent disparity in incidence and cancer-related mortality rates among different races for esophageal squamous cell carcinoma (SCC). Most previous studies investigated racial disparities between black and white patients, occasionally examining disparities for Hispanic patients. Studies including Asians/Pacific Islanders (API) as a subgroup are rare. Our objective was to determine whether there is an association between race and cancer-related survival in patients with esophageal SCC. METHODS AND FINDINGS: This was a retrospective cohort study using the National Cancer Institute's Surveillance, Epidemiology, and End Result (SEER) database. The SEER registry is a national database that collects information on all incident cancer cases in 13 states of the United States and covers nearly 26% of the US population Patients aged 18 and over of White, Black, or Asian/Pacific Islander (API) race with diagnosed esophageal SCC from 1973 to 2013 were included (n = 13,857). To examine overall survival, Kaplan-Meier curves were estimated for each race and the log-rank test was used to compare survival distributions. Cox proportional hazards models were used to estimate unadjusted and adjusted hazard ratios with 95% confidence intervals. The final adjusted model controlled for sex, marital status, age at diagnosis, decade of diagnosis, ethnicity, stage at diagnosis, and form of treatment. Additional analyses stratified by decade of diagnosis were conducted to explore possible changes in survival disparities over time. After adjustment for potential confounders, black patients had a statistically significantly higher hazard ratio compared to white patients (HR 1.08; 95% confidence interval (CI) 1.03-1.13). However, API patients did not show a statistically significant difference in survival compared with white patients (HR 1.00; 95% CI 0.93-1.07). Patients diagnosed between 1973 and 1979 had twice the hazard of death compared to those diagnosed between 2000 and 2013 (HR 2.05, 95% CI 1.93-2.19). Patients diagnosed in 1980-1989 and 1990-1999 had had HRs of 1.59 (95% CI 1.51-1.68) and 1.33 (95% CI 1.26-1.41), respectively. After stratification according to decade of diagnosis, the HR for black patients compared with white patients was 1.14 (95% CI 1.02-1.29) in 1973-1979 and 1.12 (95% CI 1.03-1.23) in 1980-1989. These disparities were not observed after 1990; the HR for black patients compared with white patients was 1.03 (95% CI 0.93-1.13) in 1990-1999 and 1.05 (95% CI 0.96-1.15) in 2000-2013. CONCLUSIONS: Black patients with esophageal SCC were found to have a higher hazard of death compared to white and API patients. Survival disparities between races appear to have decreased over time. Future research that takes insurance status and other social determinants of health into account should be conducted to further explore possible disparities by race.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Grupos Populacionais , Análise de Sobrevida , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/etnologia , Neoplasias Esofágicas/etnologia , Carcinoma de Células Escamosas do Esôfago , Feminino , História do Século XX , História do Século XXI , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
18.
Epigenetics ; 12(8): 698-707, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28703658

RESUMO

Dysregulation of miR-203 by promoter methylation is associated with the development of various cancers. We aimed to explore the underlying link between promoter methylation and miR-203 expression in Kazakh esophageal squamous cell carcinoma (ESCC). MassARRAY® System spectrometry was used to quantitatively analyze the DNA methylation of 32 CpG sites within miR-203 in 99 Kazakh ESCC and 46 normal esophageal tissues (NETs) with similar population characteristics. We conducted real-time PCR to detect miR-203 expression levels and evaluated their association with methylation. Eleven CpG units within miR-203 promoter were frequently hypermethylated in ESCC compared with NETs (P < 0.05). The hypermethylation of several CpG units positively correlated with age, lower esophagus, constrictive type of ESCC, and moderately differentiated ESCC. Given the involvement of human papillomavirus (HPV) in etiology of ESCC was confirmed from our previous reports, herein we found that CpG units within miR-203 in HPV16-positive ESCC are more heavily methylated. Furthermore, miR-203 expression showed a nearly 4.5-fold decrease in ESCC than NETs (0.206 ± 0.336 vs. 0.908 ± 1.424, P < 0.001) and was significantly associated with lymph node metastasis (P = 0.012). The expression of miR-203 with 11 completely hypermethylated CpG units was approximately 6.5-fold lower than that with at least 1 unmethylated CpG unit (P < 0.001) and especially the CpG_15.16 and CpG_31.32 with higher methylation levels in ESCC tissues exhibited lower expression levels of miR-203, which indicated a reverse association between miR-203 methylation and expression. Hypermethylated miR-203 is a potential biomarker and targeted delivery of miR-203 could therefore serve as a preventive or therapeutic strategy for Kazakh ESCC.


Assuntos
Carcinoma de Células Escamosas/genética , Metilação de DNA , Neoplasias Esofágicas/genética , Inativação Gênica , MicroRNAs/genética , Idoso , Grupo com Ancestrais do Continente Asiático , Carcinoma de Células Escamosas/etnologia , Carcinoma de Células Escamosas/patologia , Ilhas de CpG , Neoplasias Esofágicas/etnologia , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
Am J Epidemiol ; 186(12): 1341-1351, 2017 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-28641390

RESUMO

Racial and ethnic disparities in the incidence of esophageal cancer have not been thoroughly characterized with quantitative health-disparity measures. Using data from 1992-2013 from 13 US cancer registries in the Surveillance, Epidemiology, and End Results database, we assessed such disparities according to histological type, based on a variety of disparity metrics. The age-standardized incidence rate of squamous cell carcinoma (SCC) was highest among black persons, while adenocarcinoma mainly affected white men. The rate of SCC decreased over time in all racial/ethnic groups, and this was most pronounced in black persons (by 5.7% per year among men and 5.0% among women). The adenocarcinoma rate rose among non-Hispanic whites and among black men. Racial/ethnic disparities in the incidence of total esophageal cancer decreased over time, which was due mainly to reduced disparities in SCC. The 2 absolute disparity measures-range difference and between-group variance-for adenocarcinoma rose by 3.2% and 6.8% per year, respectively, in men and by 1.8% and 5.3% per year, respectively, in women. This study demonstrates decreased racial/ethnic disparities in the incidence of esophageal SCC over time in the United States, while disparities increased in adenocarcinoma incidence as measured on the absolute scale.


Assuntos
Grupos de Populações Continentais/estatística & dados numéricos , Neoplasias Esofágicas/etnologia , Grupos Étnicos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Adenocarcinoma/etnologia , Carcinoma de Células Escamosas/etnologia , Carcinoma de Células Escamosas do Esôfago , Feminino , Humanos , Incidência , Masculino , Programa de SEER , Distribuição por Sexo , Estados Unidos/epidemiologia
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(6): 784-788, 2017 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-28647983

RESUMO

Objective: To analyze the epidemiological features, spectrum and case fatality of malignant tumor patients in Shenzhen city, to provide evidence for the development of prevention and treatment strategies on malignant tumor in Shenzhen. Methods: All the hospitalized malignant tumor patients including deaths, were monitored from 1995 to 2014 in Shenzhen, and data was analyzed by SPSS 20.0 software. Results: There were 160 988 inpatients of malignant tumors between 1995 and 2014 in Shenzhen. The top three hospitalized tumors were lung (13.64%), liver (11.13%) and breast (7.86%) cancers. Numbers of the malignant tumor inpatients had been rapidly increasing during the past 20 years, 12.3 times in 2014 higher than in 1995. The total number of deaths due to malignant tumors was 19 460. Deaths of the top three malignant tumors were lung (24.40%), liver (19.84%) and colorectal (8.63%) cancers and the number of deaths was increasing, 12.5 times higher in 2014 than in 1995. The overall case fatality rate was 12.09%. The annual percent change (APC) of malignant tumors case fatality rate was 9.7%(95%CI: 2.0%-18.0%), during 1995-2003, with an increasing trend (t=2.72, P<0.05). The APC of case fatality rate during 2003-2014 was -3.4%(95%CI: -7.6%-1.1%), but the decreasing trend (t=-1.63, P>0.05) was not statistically significant. The top three major malignant tumors related to case fatality rate were lung cancer (21.62%), liver cancer (21.39%), and esophageal cancer (16.50%). The case fatality rates of leukemia and liver cancer had decreased during the past 20 years. The case fatality rates of cancers in lung, esophagus, stomach, breast, colorectal and nasopharyngeal, had all increased. The number of male patients was significantly exceeding the females (χ(2)=41.691, P<0.01), with sex ratio as 1.65∶1. From age 35 and on, the number of deaths due to malignant tumors increased significantly, with the peak after 60 years of age. Conclusions: The number of malignant tumor inpatients had an annual increase as well as the case fatality rate. Cancers in lung, liver appeared the leading causes of death among the malignant tumor patients, with elderly in particular. Strategies related to the prevention and treatment of cancers in lung, liver should be strengthened.


Assuntos
Hospitalização/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Neoplasias/mortalidade , Adulto , Idoso , Causas de Morte , Neoplasias Esofágicas/etnologia , Neoplasias Esofágicas/mortalidade , Feminino , Humanos , Neoplasias Hepáticas/etnologia , Neoplasias Hepáticas/mortalidade , Neoplasias Pulmonares/etnologia , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias/etnologia , Sistema de Registros , Taxa de Sobrevida
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