Impact of deep muscle invasion on nodal status and survival in patients with pT2 esophageal squamous cancer.

BACKGROUND: Whether T2 esophageal squamous cell carcinoma should be subclassified remains controversial. We aimed to investigate the impact of the depth of muscularis propria invasion on nodal status and survival outcomes. METHODS: We identified patients with pT2 esophageal squamous cell carcinoma who underwent primary surgery from January 2009 to June 2017. Clinical data were extracted from prospectively maintained databases. Tumor muscularis propria invasion was stratified into superficial or deep. Binary logistic regression was used to determine risk factors for lymph node metastases. The impact of the depth of muscularis propria invasion on survival was investigated using Kaplan‒Meier analysis and a Cox proportional hazard regression model. RESULTS: A total of 750 patients from three institutes were investigated. The depth of muscularis propria invasion (odds ratio [OR]: 3.95, 95% confidence interval [CI]: 2.46-6.35; p < 0.001) was correlated with lymph node metastases using logistic regression. T substage (hazard ratio [HR]: 1.37, 95% CI: 1.05-1.79; p < 0.001) and N status (HR: 1.51, 95% CI: 1.05-2.17; p < 0.001) were independent risk factors in multivariate Cox regression analysis. The deep muscle invasion was associated with worse overall survival (HR: 1.52, 95% CI: 1.19-1.94; p = 0.001) than superficial, specifically in T2N0 patients (HR: 1.38, 95% CI: 1.08-1.94; p = 0.035). CONCLUSIONS: We found that deep muscle invasion was associated with significantly worse outcomes and recommended the substaging of pT2 esophageal squamous cell carcinoma in routine pathological examination.

Limited-stage small cell carcinoma of the esophagus treated with curative esophagectomy: A multicenter retrospective cohort study.

BACKGROUND: This study aimed to investigate the efficacy of surgery in the treatment of small cell carcinoma of the esophagus (SCCE) and explore potential prognostic factors. METHODS: We screened patients with SCCE who underwent esophagectomy from 2010 to 2018 at three institutes. Differences in survival were analyzed using the Kaplan-Meier method and log-rank test. The prognostic factors were identified using univariate and multivariate analyses. RESULTS: A total of 69 patients were included. Multivariate analysis showed that TNM stage (hazard ratio [HR]: 4.10, 95% confidence interval [CI]: 1.57-10.75, p = 0.004) and adjuvant therapy (HR: 0.28, 95% CI: 0.16-0.51, p < 0.001) were independent prognostic factors. Stage I, stage IIA, and stage IIB disease were merged into the surgery response disease (SRD), whereas stage III disease into the surgery nonresponse disease (SNRD). The SRD group had significantly improved survival compared to the SNRD group (HR: 0.33, 95% CI: 0.19-0.58, p < 0.001). In addition, adjuvant therapy increased survival benefit in the SNRD group (p < 0.001) but not in the SRD group (p = 0.061). CONCLUSIONS: Surgery alone appears to be adequate for disease control in the SRD group, whereas multimodality therapy was associated with improved survival in the SNRD group.

First Report of root rot Caused by Fusarium solani and F. breve on kiwifruit in China.

China is considered as the main producer of kiwifruit (Actinidia spp.) in the world. During 2020-2021, root rot (~8000 plants, ~5% disease incidence) of 3-year-old kiwifruit (cv. Xuxiang) was observed in Lujiang County (117°24'E, 31°15'N), Anhui, China. This disease usually occurred in fields with poor drainage in hot and humid summers. Symptoms started on leaves showing dehydration and curling, the last root of diseased plant turned black and died. Dig out the skin on rotten root was cracking and flaking and white mycelium covered on surface. Twenty rotten tissues from ten plants were cut and surface disinfected with 1% NaOCl for 5 min, rinsed in sterile water, and cultured on potato dextrose agar (PDA) at 25 ± 2°C in the dark. Fifteen fungal isolates were obtained. The first type (KWRR1, 3-10) was cotton-like, reverse with white outer margin, and light brown inner region on PDA. The second type (KWRR2, 11-15) was cotton-like on PDA but appeared pale yellow in reverse. On oatmeal agar, the KWRR1 colony was flat with little aerial hyphae and was red, while KWRR2 was hyaline. On carnation leaf agar (CLA), microconidia of the KWRR1 and KWRR2 isolates were reniform, fusiform or oblong, 0-1 septate, and measuring 1.9-4.3×8.4-15.7 µm and 3.0-3.8×8.2-16.7 µm, respectively (n=50). The macroconidia of KWRR1 were straight or moderately curved, 3-5 septa (2.7-4.6×21.5-52.6 µm in size, n=50). For KWRR2, the macroconidia were straight or slightly curved and with 3-4 septate, 4.1-4.8×26.1-30.8 µm (n=50). Chlamydospores of the KWRR1 and KWRR2 isolates were 1-2 celled, irregular globose, measuring 4.5-8.5 µm and 7.6-9.0 µm diam, respectively (n=50). To identify the isolates, four DNA fragments (RPB1, RPB2, ITS and TEF-1α) were amplified and sequenced from all isolates (O'Donnell, et al. 2012; White et al. 1990; O'Donnell et al. 2022). BLAST analysis of the RPB1, RPB2, ITS and TEF-1α sequences of the KWRR1 isolates (OL474057, OL474055, OL468550, OP382187) showed highest identity with F. solani (NRRL66304; MW218134, KT313623, KT313633, KT313611) at 98.2%-99.8%, while KWRR2 (OL505579, OL474056, OL468551, OP382188) showed that their homology with F. breve (NRRL28009; HM347149, EF470136, DQ094351, DQ246869) at 98.2%-99.4%. F. solani and F. breve belong to clade 3 of the F. solani species complex (FSSC) (Geiser et al. 2021). Phylogenetic analysis based on RPB2, ITS and TEF-1α sequences with MEGA7 software (Sisic et al. 2018), placed the KWRR1 sequences with F. solani (FSSC5), while there of KWRR2 nested with F. breve (FSSC15). One-year-old seedlings (n=6) of 'Xu Xiang', growing in a greenhouse (at 28℃, relative humidity 80%), were inoculated by drenching the soil with a conidial suspension with one of the two isolates (30 ml, 106 conidia/ml). Control plants (n=6) were inoculated with sterilized water and the pathogenicity assay was repeated three times. One month post-inoculation, the leaves of inoculated plants became chlorotic, wilted and died, whereas the controls were disease-free. F. solani and F. breve were successfully reisolated from diseased samples (n=6) and verified based on morphology and sequencing as described above, fulfilling Koch's postulates. Members of the FSSC cause root rot on many hosts (Coleman. 2016; Schroers et al. 2016), but this is the first report of F. solani and F. breve causing root rot disease on kiwifruit in China. The result will serve as the foundation for management of root rot of kiwifruit.

Photosynthetic energy storage efficiency in Chlamydomonas reinhardtii, based on microsecond photoacoustics.

Using a novel, pulsed micro-second time-resolved photoacoustic (PA) instrument, we measured thermal dissipation and energy storage (ES) in the intact cells of wild type (WT) Chlamydomonas reinhardtii, and mutants lacking either PSI or PSII reaction centers (RCs). On this time scale, the kinetic contributions of the thermal expansion component due to heat dissipation of absorbed energy and the negative volume change due to electrostriction induced by charge separation in each of the photosystems could be readily distinguished. Kinetic analysis revealed that PSI and PSII RCs exhibit strikingly different PA signals where PSI is characterized by a strong electrostriction signal and a weak thermal expansion component while PSII has a small electrostriction component and large thermal expansion. The calculated ES efficiencies at ~10 µs were estimated to be 80 ± 5 and 50 ± 13% for PSII-deficient mutants and PSI-deficient mutants, respectively, and 67 ± 2% for WT. The overall ES efficiency was positively correlated with the ratio of PSI to PSI + PSII. Our results suggest that the shallow excitonic trap in PSII limits the efficiency of ES as a result of an evolutionary frozen metabolic framework of two photosystems in all oxygenic photoautotrophs.