Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monocl...Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monoclonal antibodies that selectively inhibit programmed cell death-1(PD-1)activity has now become standard of care in the treatment of ESCC in metastatic settings,and has a high expectation to provide clinical benefit during perioperative period.Further,anti-cytotoxic T-lymphocyte–associated protein 4(CTLA-4)monoclonal antibody has also been approved in the treatment of recurrent/metastatic ESCC in combination with anti-PD-1 antibody.Well understanding of the existing evidence of immune-based treatments for ESCC,as well as recent clinical trials on various combinations with chemotherapy for different clinical settings including neoadjuvant,adjuvant,and metastatic diseases,may provide future prospects of ESCC treatment for better patient outcomes.展开更多
Helicobacter pylori(H.pylori)infection affects a substantial proportion of the global population and causes various gastric disorders,including gastric cancer.Recent studies have found an inverse relationship between ...Helicobacter pylori(H.pylori)infection affects a substantial proportion of the global population and causes various gastric disorders,including gastric cancer.Recent studies have found an inverse relationship between H.pylori infection and eso-phageal cancer(EC),suggesting a protective role against EC.This editorial focuses on the possible mechanisms underlying the role of H.pylori infection in EC and explores the role of gut microbiota in esophageal carcinogenesis and the prac-ticality of H.pylori eradication.EC has two major subtypes:Esophageal squamous cell carcinoma(ESCC)and esophageal adenocarcinoma(EAC),which have different etiologies and risk factors.Gut microbiota can contribute to EC via inflammation-induced carcinogenesis,immunomodulation,lactagenesis,and genotoxin production.H.pylori infection is said to be inversely related to EAC,protecting against EAC by inducing atrophic gastritis,altering serum ghrelin levels,and triggering cancer cell apoptosis.Though H.pylori infection has no significant association with ESCC,COX-2-1195 polymorphisms and endogenous nitrosamine production can impact the risk of ESCC in H.pylori-infected in-dividuals.There are concerns regarding a plausible increase in EC after H.pylori eradication treatments.However,H.pylori eradication is not associated with an increased risk of EC,making it safe from an EC perspective.展开更多
Objective:This study aimed to provide a comprehensive overview of the global burden of esophageal cancer(EC)and determine the temporal trends and factors influencing changes in the global burden.Methods:The latest inc...Objective:This study aimed to provide a comprehensive overview of the global burden of esophageal cancer(EC)and determine the temporal trends and factors influencing changes in the global burden.Methods:The latest incidence and mortality data for EC worldwide were obtained from GLOBALCAN 2022.The mortality and disability-adjusted life years(DALYs)rates for EC from 1990±2019 were sourced from the 2019 Global Burden of Diseases.Trends in EC mortality and DALYs attributable to 11 risk factors or clusters of risk were analyzed using the joinpoint regression model.The trends in age-related EC burden were assessed using a decomposition approach.Results:An estimated 511,054 new cases of EC were diagnosed in 2022 with 445,391 deaths worldwide.Approximately 75%of cases and deaths occurred in Asia.Nearly 50%of global EC deaths and DALYs were attributed to tobacco use in men in 2019,while 20%were attributed to high body mass index(BMI)in women.From 1990±2019,EC deaths and DALYs attributable to almost all risk factors had declining trends,while EC deaths and DALYs attributed to high BMI in men had upward trends.The age-related EC burden exhibited an upward trend driven by population growth and aging,which contributed to 307.4 thousand deaths and 7.2 million DALYs due to EC.Conclusions:The EC burden remains substantial worldwide.Effective tobacco and obesity control measures are critical for addressing the risk-attributable burden of EC.Population growth and aging pose challenges for EC prevention and control efforts.展开更多
Esophageal cancer ranks among the most prevalent malignant tumors globally,primarily due to its highly aggressive nature and poor survival rates.According to the 2020 global cancer statistics,there were approximately ...Esophageal cancer ranks among the most prevalent malignant tumors globally,primarily due to its highly aggressive nature and poor survival rates.According to the 2020 global cancer statistics,there were approximately 604000 new cases of esophageal cancer,resulting in 544000 deaths.The 5-year survival rate hovers around a mere 15%-25%.Notably,distinct variations exist in the risk factors associated with the two primary histological types,influencing their worldwide incidence and distribution.Squamous cell carcinoma displays a high incidence in specific regions,such as certain areas in China,where it meets the cost-effect-iveness criteria for widespread endoscopy-based early diagnosis within the local population.Conversely,adenocarcinoma(EAC)represents the most common histological subtype of esophageal cancer in Europe and the United States.The role of early diagnosis in cases of EAC originating from Barrett's esophagus(BE)remains a subject of controversy.The effectiveness of early detection for EAC,particularly those arising from BE,continues to be a debated topic.The variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer diagnoses.In areas with higher incidences,such as China and Japan,early diagnosis is more common,which has led to the advancement of endoscopic methods as definitive treatments.These techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal functionality.Early screening,prompt diagnosis,and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.展开更多
As a highly invasive malignancy,esophageal cancer(EC)is a global health issue,and was the eighth most prevalent cancer and the sixth leading cause of cancerrelated death worldwide in 2020.Due to its highly immunogenic...As a highly invasive malignancy,esophageal cancer(EC)is a global health issue,and was the eighth most prevalent cancer and the sixth leading cause of cancerrelated death worldwide in 2020.Due to its highly immunogenic nature,emerging immunotherapy approaches,such as immune checkpoint blockade,have demonstrated promising efficacy in treating EC;however,certain limitations and challenges still exist.In addition,tumors may exhibit primary or acquired resistance to immunotherapy in the tumor immune microenvironment(TIME);thus,understanding the TIME is urgent and crucial,especially given the importance of an immunosuppressive microenvironment in tumor progression.The aim of this review was to better elucidate the mechanisms of the suppressive TIME,including cell infiltration,immune cell subsets,cytokines and signaling pathways in the tumor microenvironment of EC patients,as well as the downregulated expression of major histocompatibility complex molecules in tumor cells,to obtain a better understanding of the differences in EC patient responses to immunotherapeutic strategies and accurately predict the efficacy of immunotherapies.Therefore,personalized treatments could be developed to maximize the advantages of immunotherapy.展开更多
AIM:To evaluate the association between CYP1A1 and GSTs genetic polymorphisms and susceptibility to esophageal squamous cell carcinoma(SCC)and esophageal adenocarcinoma(ADC)in a high risk area of northwest of France. ...AIM:To evaluate the association between CYP1A1 and GSTs genetic polymorphisms and susceptibility to esophageal squamous cell carcinoma(SCC)and esophageal adenocarcinoma(ADC)in a high risk area of northwest of France. METHODS:A case-control study was conducted to investigate the genetic polymorphisms of these enzymes (CYPIAI*2C and GSTP1 exon 7 Val alleles,GSTMI*2/*2 and GSTTl *2/*2 null genotypes).A total of 79 esophageal cancer cases and 130 controls were recruited. RESULTS:GSTMI*2/*2 and CYPIAI*IA/*2C genotype frequencies were higher among squamous cell carcinomas at a level dose to statistical significance(OR =1.83,95% CI 0.88-3.83,P=0.11;OR=3.03,95% CI 0.93-9.90,P=0.07, respectively).For GSTP1 polymorphism,no difference was found between controls and cases,whatever their histological status.Lower frequency of GSTT1 deletion was observed in ADC group compared to controls with a statistically significant difference(OR=13.31,95% CI 1.66-106.92,P<0.01). CONCLUSION:In SCC,our results are consistent with the strong association of this kind of tumour with tobacco exposure.In ADC,our results suggest 3 distinct hypotheses: (1)activation of exogenous procarcinogens,such as small halogenated compounds by GSTT1;(2)contribution of GSTT1 to the inflammatory response of esophageal mucosa,which is known to be a strong risk factor for ADC, possibly through leukotriene synthesis;(3)higher sensitivity to the inflammatory process associated with intracellular depletion of glutathione.展开更多
Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation...Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.展开更多
BACKGROUND Esophageal cancer(EC)often occurs in the elderly,with approximately 33%of patients aged≥75 years at the time of diagnosis.AIM To evaluate the prognostic factors for radiotherapy(RT)in elderly patients with...BACKGROUND Esophageal cancer(EC)often occurs in the elderly,with approximately 33%of patients aged≥75 years at the time of diagnosis.AIM To evaluate the prognostic factors for radiotherapy(RT)in elderly patients with unresectable EC.METHODS We retrospectively analyzed the clinical characteristics,toxic reactions,and survival information of EC patients aged≥75 years who underwent intensity-modulated RT at Lu’an Hospital of Anhui Medical University between January 2016 and September 2023.Kaplan-Meier analysis was used to draw the overall survival(OS)curves,and Cox regression analysis was employed to evaluate the influence of various clinical factors on the prognosis.RESULTS A total of 139 patients were enrolled.The median follow-up time was 52.0 months.The median OS was 20.0 months.The 1-year,2-year,3-year,and 5-year OS rates were 69.8%,38.7%,28.2%,and 17.5%,respectively.Univariate analysis showed that age,radiation dose,and chemotherapy had no significant impact on prognosis.Multivariate analysis indicated that clinical stage[Ⅲ-Ⅳa vsⅠ-Ⅱ,hazard ratio(HR)=2.421,95%confidence interval(CI):1.242-4.718,P=0.009;IVb vsⅠ-Ⅱ,HR=4.222,95%CI:1.888-9.438,P<0.001),Charlson comorbidity index(CCI)(0 vs≥1,HR=1.539,95%CI:1.015-2.332,P=0.042),and nutritional risk screening 2002(NRS2002)(<3 vs≥3,HR=2.491,95%CI:1.601-3.875,P<0.001)were independent prognostic factors for OS.CONCLUSION Our results suggest that CCI and NRS2002 were independent prognostic factors of OS for unresectable elderly EC patients undergoing RT.For elderly patients with EC,full attention should be given to biological age-related indicators,such as comorbidities and nutrition,when formulating treatment protocols.These factors should be considered in future clinical practice.展开更多
BACKGROUND The effectiveness of neoadjuvant therapy in esophageal cancer(EC)treatment is still a subject of debate.AIM To compare the clinical efficacy and toxic side effects between neoadjuvant chemoradiotherapy(nCRT...BACKGROUND The effectiveness of neoadjuvant therapy in esophageal cancer(EC)treatment is still a subject of debate.AIM To compare the clinical efficacy and toxic side effects between neoadjuvant chemoradiotherapy(nCRT)and neoadjuvant chemotherapy(nCT)for locally advanced EC(LAEC).METHODS A comprehensive search was conducted using multiple databases,including PubMed,EMBASE,MEDLINE,Science Direct,The Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,Chinese Science and Technology Journal Database,and Chinese Biomedical Literature Database Article.Studies up to December 2022 comparing nCRT and nCT in patients with EC were selected.RESULTS The analysis revealed significant differences between nCRT and nCT in terms of disease-free survival.The results indicated that nCRT provided better outcomes in terms of the 3-year overall survival rate(OSR)[odds ratio(OR)=0.95],complete response rate(OR=3.15),and R0 clearance rate(CR)(OR=2.25).However,nCT demonstrated a better 5-year OSR(OR=1.02)than nCRT.Moreover,when compared to nCRT,nCT showed reduced risks of cardiac complications(OR=1.15)and pulmonary complications(OR=1.30).CONCLUSION Overall,both nCRT and nCT were effective in terms of survival outcomes for LAEC.However,nCT exhibited better performance in terms of postoperative complications.展开更多
BACKGROUND Esophageal cancer is the sixth leading cause of cancer-related death and eighth most common cancer,affecting>450000 people worldwide.Esophageal squamous cell carcinoma is the most common histological typ...BACKGROUND Esophageal cancer is the sixth leading cause of cancer-related death and eighth most common cancer,affecting>450000 people worldwide.Esophageal squamous cell carcinoma is the most common histological type,whereas esophageal adenoid cystic carcinoma(EACC)is rare.The liver is the most common distant metastatic site in esophageal cancer.Anal metastasis is rare and has not been reported in clinical practice before.Here,we report anal metastases in a patient with EACC after regular chemotherapy and surgical resection.CASE SUMMARY A 61-year-old esophageal cancer patient was found to have lung and brain metastases during standardized treatment.The patient’s treatment plan was continuously adjusted according to the latest treatment guidelines.However,the patient subsequently noticed rectal bleeding and itching,and after obtaining pathology results at the local hospital,anal metastasis of esophageal cancer was diagnosed.CONCLUSION Postoperative pathology and immunohistochemistry confirmed EACC with rare anal metastasis.More exploration of EACC diagnosis and treatment is needed.展开更多
BACKGROUND Gastroesophageal reflux disease(GERD)is a common complication of esophageal cancer surgery that can affect quality of life and increase the risk of esophageal stricture and anastomotic leakage.Wendan Decoct...BACKGROUND Gastroesophageal reflux disease(GERD)is a common complication of esophageal cancer surgery that can affect quality of life and increase the risk of esophageal stricture and anastomotic leakage.Wendan Decoction(WDD)is a traditional Chinese herbal formula used to treat various gastrointestinal disorders,such as gastritis,functional dyspepsia,and irritable bowel syndrome.Mosapride,a prokinetic agent,functions as a selective 5-hydroxytryptamine 4 agonist,enhancing gastrointestinal motility.AIM To evaluate the therapeutic effects of WDD combined with mosapride on GERD after esophageal cancer surgery.METHODS Eighty patients with GERD were randomly divided into treatment(receiving WDD combined with mosapride)and control(receiving mosapride alone)groups.The treatment was conducted from January 2021 to January 2023.The primary outcome was improved GERD symptoms as measured using the reflux disease questionnaire(RDQ).The secondary outcomes were improved esophageal motility(measured using esophageal manometry),gastric emptying(measured using gastric scintigraphy),and quality of life[measured via the Short Form-36(SF-36)Health Survey].RESULTS The treatment group showed a notably reduced RDQ score and improved esophageal motility parameters,such as lower esophageal sphincter pressure,peristaltic amplitude,and peristaltic velocity compared to the control group.The treatment group showed significantly higher gastric emptying rates and SF-36 scores(in both physical and mental domains)compared to the control group.No serious adverse effects were observed in either group.CONCLUSION WDD combined with mosapride is an effective and safe therapy for GERD after esophageal cancer surgery.It can improve GERD symptoms,esophageal motility,gastric emptying,and the quality of life of patients.Further studies with larger sample sizes and longer follow-up periods are required to confirm these findings.展开更多
BACKGROUND Traditional methods cannot clearly visualize esophageal cancer(EC)tumor contours and metastases,which limits the clinical application of da Vinci robotassisted surgery.AIM To investigate the efficacy of the...BACKGROUND Traditional methods cannot clearly visualize esophageal cancer(EC)tumor contours and metastases,which limits the clinical application of da Vinci robotassisted surgery.AIM To investigate the efficacy of the da Vinci robot in combination with nanocarbon lymph node tracers in radical surgery of EC.METHODS In total,104 patients with early-stage EC who were admitted to Liuzhou worker's Hospital from January 2020 to June 2023 were enrolled.The patients were assigned to an observation group(n=52),which underwent da Vinci robot-assisted minimally invasive esophagectomy(RAMIE)with the intraoperative use of nanocarbon tracers,and a control group(n=52),which underwent traditional surgery treatment.The operation time,intraoperative blood loss,postoperative drainage tube indwelling time,hospital stay,number of lymph nodes dissected,incidence of complications,and long-term curative effects were comparatively analyzed.The postoperative stress response C-reactive protein(CRP),cortisol,epinephrine(E)and inflammatory response interleukin(IL)-6,IL-8,IL-10,and tumor necrosis factor-alpha(TNF-α)were evaluated.RESULTS Compared with the control group,the observation group had significantly lower postoperative CRP,cortisol,and E levels(P<0.05)with a milder inflammatory response,as indicated by lower IL-6,IL-10,and TNF-αlevels(P<0.05).Patients who underwent RAMIE had less intraoperative blood loss and shorter operation times and hospital stays than those who underwent traditional surgery.The average number of dissected lymph nodes,time of lymph node dissection,and mean smallest lymph node diameter were all significantly lower in the observation group(P<0.05).The rate of postoperative complications was 5.77%in the observation group,significantly lower than the 15.38%observed in the control group.Furthermore,the lymphatic metastasis rate,reoperation rate,and 12-and 24-month cumulative mortality in the observation group were 1.92%,0%,0%,and 0%,respectively,all of which were significantly lower than those in the control group(P<0.05).CONCLUSION The treatment of EC using the da Vinci robot combined with nanocarbon lymph node tracers can achieve good surgical outcomes and demonstrates promising clinical applications.展开更多
Esophageal cancer(EC)is an aggressive malignancy with a poor prognosis.Various factors,including dietary habits,and antacid and antibiotic use,have been shown to influence the esophageal microbiome.Conversely,enrichme...Esophageal cancer(EC)is an aggressive malignancy with a poor prognosis.Various factors,including dietary habits,and antacid and antibiotic use,have been shown to influence the esophageal microbiome.Conversely,enrichment and diversity of the esophageal microbiome can also impact its function.Recent studies have revealed prevalent changes in the esophageal microbiome among patients with EC,thus suggesting the potential contribution of the esophageal microbiome to EC development.Additionally,distinct microbiome compositions have been observed in patients with different responses to radiotherapy and chemotherapy,indicating the role of the esophageal microbiome in modulating treatment outcomes.In this review,we have examined previous studies on the esophageal microbiome in healthy individuals and patients with EC or other esophageal diseases,with a focus on identifying microbial communities associated with EC pathogenesis and prognosis.Understanding the role of the microbiome in EC may aid in early detection and optimized treatment strategies,ultimately leading to better outcomes for patients.展开更多
Background:Esophageal cancer(EC)remains a global health challenge due to its poor prognosis.China and the United States of America(USA)represent two distinct epicenters of EC burden.Understanding the EC disparities in...Background:Esophageal cancer(EC)remains a global health challenge due to its poor prognosis.China and the United States of America(USA)represent two distinct epicenters of EC burden.Understanding the EC disparities in these two countries is vital for tailoring prevention strategies,optimizing treatment,and enhancing outcomes in both countries.Yet,there lacks a comprehensive comparison of EC characteristics between the two countries.Methods:In this multicenter,retrospective hospital-based study,we enrolled primary EC patients who received their initial treatment at one of 23 hospitals in China during 2016-2017.Using electronic medical records and cancer registration records,information on demographics,lifestyle,and clinicopathological characteristics(in-cluding tumor site,pathology,stage,metastases,differentiation,and treatment)were collected.Additionally,we compared these data with the clinicopathological information of invasive EC patients diagnosed in 2016-2017 from the Surveillance,Epidemiology,and End Results(SEER)database in the USA.Results:A total of 6,658 EC patients in China and 8,555 EC patients in the USA were included finally.85.5%(n=5,694)of EC were esophageal squamous cell carcinoma(ESCC)in China,while esophageal adenocarcinoma(EAC)was prominent in the USA(58.9%,n=5,041).Among EC patients with known staging,the proportion of early stage was higher in China compared to the USA(48.3%vs.30.5%).Among ESCC patients,early-stage cases were higher in China than in the USA(49.8%vs.31.8%),while among EAC patients,late-stage cases were higher in China than in the USA(77.3%vs.68.5%)(all P<0.001).In China,EC mainly occurred in the middle third(60.2%)of the esophagus,whereas in the USA,it was more common in the lower third(59.9%)of the organ.Compared with EC patients with known metastatic status in the USA,China had fewer cases of lymph node metastases(51.4%vs.57.7%)and distant metastases(7.9%vs.33.8%).Regarding treatment,China had more surgical therapy(53.7%vs.22.6%),less radiotherapy(35.6%vs.53.3%),and less chemotherapy(46.7%vs.59.7%)compared to the USA.Conclusions:This study reveals notable disparities in EC between China and the USA,encompassing epidemi-ological,clinicopathological,and treatment dimensions.These findings provide insight for tailored strategies addressing regional variations in clinicopathological and therapeutic characteristics.展开更多
Esophageal cancer is an upper gastrointestinal malignancy with a bleak prognosis.It is still being explored in depth due to its complex molecular mechanisms of occurrence and development.Lipids play a crucial role in ...Esophageal cancer is an upper gastrointestinal malignancy with a bleak prognosis.It is still being explored in depth due to its complex molecular mechanisms of occurrence and development.Lipids play a crucial role in cells by participating in energy supply,biofilm formation,and signal transduction processes,and lipid metabolic reprogramming also constitutes a significant characteristic of malignant tumors.More and more studies have found esophageal cancer has obvious lipid metabolism abnormalities throughout its beginning,progress,and treatment resistance.The inhibition of tumor growth and the enhancement of antitumor therapy efficacy can be achieved through the regulation of lipid metabolism.Therefore,we reviewed and analyzed the research results and latest findings for lipid metabolism and associated analysis techniques in esophageal cancer,and comprehensively proved the value of lipid metabolic reprogramming in the evolution and treatment resistance of esophageal cancer,as well as its significance in exploring potential therapeutic targets and biomarkers.展开更多
This editorial comments on an article by Qu et al published in the World Journal of Gastrointestinal Oncology.It focuses on the importance of early detection of esophageal cancer,including recurrence or secondary mali...This editorial comments on an article by Qu et al published in the World Journal of Gastrointestinal Oncology.It focuses on the importance of early detection of esophageal cancer,including recurrence or secondary malignancy after chemoradiotherapy(CRT).Endoscopic resection is the first choice for treatment for esophageal cancer remaining within the mucous membrane,while surgery or radical CRT are treatment options for advanced stages depending on the patient’s general condition and desire.Although these treatments are potentially curative,they are more invasive than endoscopic resection.Early-stage esophageal cancer is often asymptomatic and difficult to detect.Uniform periodic endoscopy is unrealistic.Although less burdensome tests exist,including liquid biopsy and urinary biomarkers,these have not yet been widely used in clinical practice.Early detection is important after radical CRT because the local recurrence rate is higher than that after surgery.However,endoscopic resection or photodynamic therapy is indicated if detected in the early stages,and positive results have been reported.Early detection of esophageal cancer is crucial.Endoscopy is the main diagnostic method;however,new and less burdensome methods should be established to ensure early treatment for patients with esophageal cancer.展开更多
To confirm the relationship between Circ_0003855 and EC,we purchased the Human esophageal carcinoma cell line Eca109 and normal human esophageal epithelial cells HEEC,and the expression levels of Circ_0003855,miR-622,...To confirm the relationship between Circ_0003855 and EC,we purchased the Human esophageal carcinoma cell line Eca109 and normal human esophageal epithelial cells HEEC,and the expression levels of Circ_0003855,miR-622,and FLOT1 were detected.The results show that Circ_0003855 and FLOT1 were highly expressed in Eca109 cells,while miR-622 was lowly expressed(p<0.05).Subsequently,Circ_0003855 small interfering RNA(si-Circ_0003855)and its negative control(si-NC)were used to detect changes in cellular biological behaviors.We found that the activity of Eca109 cells was reduced after interfering with the expression of Circ_0003855,and miR-622 expression was elevated,while FLOT1 was decreased(p<0.05).Additionally,si-Circ_0003855 and miR-622 inhibitor sequence(miR-622-inhibition)were co-transfected into cells with miR-622-inhibition alone,and untreated Eca109 cells were used as a control to detect the expression of FLOT1.Co-transfection of si-Circ_0003855 and miR-622-inhibition showed no significant difference in FLOT1 expression compared to the control cells(p>0.05).Synthesizing the results of these experiments above,we believe that interfering with the expression of Circ_0003855 can inhibit the activity of EC cells,and its mechanism is related to miR-622 and FLOT1.展开更多
This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology,focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achie...This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology,focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achieving“early detection”.The five-year age-standardized net survival for esophageal cancer patients falls short of expectations.Early detection and accurate diagnosis are critical strategies for improving the treatment outcomes of esophageal cancer.While advancements in endoscopic technology have been significant,there seems to be an excessive emphasis on the latest high-end endoscopic devices and various endoscopic resection techniques.Therefore,it is imperative to redirect focus towards proactive early detection strategies for esophageal cancer,investigate the most cost-effective screening methods suitable for different regions,and persistently explore practical solutions to improve the five-year survival rate of patients with esophageal cancer.展开更多
The incidence of esophageal cancer,namely the adenocarcinoma subtype,continues to increase exponentially on an annual basis.The indolent nature of the disease renders a significant proportion inoperable at first prese...The incidence of esophageal cancer,namely the adenocarcinoma subtype,continues to increase exponentially on an annual basis.The indolent nature of the disease renders a significant proportion inoperable at first presentation,however,with the increased utilisation of endoscopy,many early lesions are now being identified which are suitable for endotherapeutic approaches.This article details the options available for dealing with early esophageal cancer by endoscopic mean obviating the need for surgery thereby avoiding the potential morbidity and mortality of such intervention.展开更多
Esophageal cancer(EC)is an aggressive malignancy with a poor prognosis,ranking seventh in incidence and sixth cancer-related deaths globally.EC is classified in two main types,the esophageal squamous cell carcinoma(ES...Esophageal cancer(EC)is an aggressive malignancy with a poor prognosis,ranking seventh in incidence and sixth cancer-related deaths globally.EC is classified in two main types,the esophageal squamous cell carcinoma(ESCC)and esophageal adenocarcinoma(EAC),with ESCC being more common in Eastern Europe,South Asia,and Africa,while EAC is prevalent in Western Europe and North America.Molecular analysis identifies three subgroups of ESCC,each with distinct genetic mutations and treatment responses.Early-stage EC is often difficult to detect,leading to late-stage diagnoses that necessitate systemic drug therapies,including molecular-targeted therapies and immunotherapies.Immunotherapy,particularly immune checkpoint inhibitor,has shown promising results in improving survival rates for metastatic or persistent EC.It is particularly important to target to multidisciplinary combination therapies,integrating surgery,chemoradiotherapy,targeted therapy and immunotherapy.Additionally,radioimmunotherapy is being explored for its potential to enhance treatment efficacy,especially in advanced and metastatic tumors.However,the pathological complete response rate to neoadjuvant chemoradiotherapy remains suboptimal,highlighting the need for novel treatment strategies.Future research should focus on optimizing treatment combinations and identifying predictive biomarkers to improve clinical outcomes for EC patients.展开更多
文摘Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monoclonal antibodies that selectively inhibit programmed cell death-1(PD-1)activity has now become standard of care in the treatment of ESCC in metastatic settings,and has a high expectation to provide clinical benefit during perioperative period.Further,anti-cytotoxic T-lymphocyte–associated protein 4(CTLA-4)monoclonal antibody has also been approved in the treatment of recurrent/metastatic ESCC in combination with anti-PD-1 antibody.Well understanding of the existing evidence of immune-based treatments for ESCC,as well as recent clinical trials on various combinations with chemotherapy for different clinical settings including neoadjuvant,adjuvant,and metastatic diseases,may provide future prospects of ESCC treatment for better patient outcomes.
文摘Helicobacter pylori(H.pylori)infection affects a substantial proportion of the global population and causes various gastric disorders,including gastric cancer.Recent studies have found an inverse relationship between H.pylori infection and eso-phageal cancer(EC),suggesting a protective role against EC.This editorial focuses on the possible mechanisms underlying the role of H.pylori infection in EC and explores the role of gut microbiota in esophageal carcinogenesis and the prac-ticality of H.pylori eradication.EC has two major subtypes:Esophageal squamous cell carcinoma(ESCC)and esophageal adenocarcinoma(EAC),which have different etiologies and risk factors.Gut microbiota can contribute to EC via inflammation-induced carcinogenesis,immunomodulation,lactagenesis,and genotoxin production.H.pylori infection is said to be inversely related to EAC,protecting against EAC by inducing atrophic gastritis,altering serum ghrelin levels,and triggering cancer cell apoptosis.Though H.pylori infection has no significant association with ESCC,COX-2-1195 polymorphisms and endogenous nitrosamine production can impact the risk of ESCC in H.pylori-infected in-dividuals.There are concerns regarding a plausible increase in EC after H.pylori eradication treatments.However,H.pylori eradication is not associated with an increased risk of EC,making it safe from an EC perspective.
基金funded by the National Natural Science Foundation of China (Grant No. 82273721)Capital’s Funds for Health Improvement and Research (Grant No. 2024-1G-4023)。
文摘Objective:This study aimed to provide a comprehensive overview of the global burden of esophageal cancer(EC)and determine the temporal trends and factors influencing changes in the global burden.Methods:The latest incidence and mortality data for EC worldwide were obtained from GLOBALCAN 2022.The mortality and disability-adjusted life years(DALYs)rates for EC from 1990±2019 were sourced from the 2019 Global Burden of Diseases.Trends in EC mortality and DALYs attributable to 11 risk factors or clusters of risk were analyzed using the joinpoint regression model.The trends in age-related EC burden were assessed using a decomposition approach.Results:An estimated 511,054 new cases of EC were diagnosed in 2022 with 445,391 deaths worldwide.Approximately 75%of cases and deaths occurred in Asia.Nearly 50%of global EC deaths and DALYs were attributed to tobacco use in men in 2019,while 20%were attributed to high body mass index(BMI)in women.From 1990±2019,EC deaths and DALYs attributable to almost all risk factors had declining trends,while EC deaths and DALYs attributed to high BMI in men had upward trends.The age-related EC burden exhibited an upward trend driven by population growth and aging,which contributed to 307.4 thousand deaths and 7.2 million DALYs due to EC.Conclusions:The EC burden remains substantial worldwide.Effective tobacco and obesity control measures are critical for addressing the risk-attributable burden of EC.Population growth and aging pose challenges for EC prevention and control efforts.
基金Supported by Shandong Province Medical and Health Science and Technology Development Plan Project,No.202203030713Clinical Research Funding of Shandong Medical Association-Qilu Specialization,No.YXH2022ZX02031Science and Technology Program of Yantai Affiliated Hospital of Binzhou Medical University,No.YTFY2022KYQD06.
文摘Esophageal cancer ranks among the most prevalent malignant tumors globally,primarily due to its highly aggressive nature and poor survival rates.According to the 2020 global cancer statistics,there were approximately 604000 new cases of esophageal cancer,resulting in 544000 deaths.The 5-year survival rate hovers around a mere 15%-25%.Notably,distinct variations exist in the risk factors associated with the two primary histological types,influencing their worldwide incidence and distribution.Squamous cell carcinoma displays a high incidence in specific regions,such as certain areas in China,where it meets the cost-effect-iveness criteria for widespread endoscopy-based early diagnosis within the local population.Conversely,adenocarcinoma(EAC)represents the most common histological subtype of esophageal cancer in Europe and the United States.The role of early diagnosis in cases of EAC originating from Barrett's esophagus(BE)remains a subject of controversy.The effectiveness of early detection for EAC,particularly those arising from BE,continues to be a debated topic.The variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer diagnoses.In areas with higher incidences,such as China and Japan,early diagnosis is more common,which has led to the advancement of endoscopic methods as definitive treatments.These techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal functionality.Early screening,prompt diagnosis,and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.
基金Supported by Xi’an Municipal Health Commission of China,No.2022qn07 and No.2023ms11.
文摘As a highly invasive malignancy,esophageal cancer(EC)is a global health issue,and was the eighth most prevalent cancer and the sixth leading cause of cancerrelated death worldwide in 2020.Due to its highly immunogenic nature,emerging immunotherapy approaches,such as immune checkpoint blockade,have demonstrated promising efficacy in treating EC;however,certain limitations and challenges still exist.In addition,tumors may exhibit primary or acquired resistance to immunotherapy in the tumor immune microenvironment(TIME);thus,understanding the TIME is urgent and crucial,especially given the importance of an immunosuppressive microenvironment in tumor progression.The aim of this review was to better elucidate the mechanisms of the suppressive TIME,including cell infiltration,immune cell subsets,cytokines and signaling pathways in the tumor microenvironment of EC patients,as well as the downregulated expression of major histocompatibility complex molecules in tumor cells,to obtain a better understanding of the differences in EC patient responses to immunotherapeutic strategies and accurately predict the efficacy of immunotherapies.Therefore,personalized treatments could be developed to maximize the advantages of immunotherapy.
基金Supported by the Grants From Ligue Nationale Contre le Cancer,Comités Départementaux de la Manche,de l'Orne et du Calvados and from Université de Metz
文摘AIM:To evaluate the association between CYP1A1 and GSTs genetic polymorphisms and susceptibility to esophageal squamous cell carcinoma(SCC)and esophageal adenocarcinoma(ADC)in a high risk area of northwest of France. METHODS:A case-control study was conducted to investigate the genetic polymorphisms of these enzymes (CYPIAI*2C and GSTP1 exon 7 Val alleles,GSTMI*2/*2 and GSTTl *2/*2 null genotypes).A total of 79 esophageal cancer cases and 130 controls were recruited. RESULTS:GSTMI*2/*2 and CYPIAI*IA/*2C genotype frequencies were higher among squamous cell carcinomas at a level dose to statistical significance(OR =1.83,95% CI 0.88-3.83,P=0.11;OR=3.03,95% CI 0.93-9.90,P=0.07, respectively).For GSTP1 polymorphism,no difference was found between controls and cases,whatever their histological status.Lower frequency of GSTT1 deletion was observed in ADC group compared to controls with a statistically significant difference(OR=13.31,95% CI 1.66-106.92,P<0.01). CONCLUSION:In SCC,our results are consistent with the strong association of this kind of tumour with tobacco exposure.In ADC,our results suggest 3 distinct hypotheses: (1)activation of exogenous procarcinogens,such as small halogenated compounds by GSTT1;(2)contribution of GSTT1 to the inflammatory response of esophageal mucosa,which is known to be a strong risk factor for ADC, possibly through leukotriene synthesis;(3)higher sensitivity to the inflammatory process associated with intracellular depletion of glutathione.
基金supported by grants from the Beijing Nova Program (No. Z201100006820069)CAMS Innovation Fund for Medical Sciences (CIFMS, No. 2021-I2M-1-023, 2021-I2M-1-010)Talent Incentive Program of Cancer Hospital Chinese Academy of Medical Sciences (Hope Star)。
文摘Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.
基金Supported by the Science and Technology Program of Lu’an,No.2022 Lakj042.
文摘BACKGROUND Esophageal cancer(EC)often occurs in the elderly,with approximately 33%of patients aged≥75 years at the time of diagnosis.AIM To evaluate the prognostic factors for radiotherapy(RT)in elderly patients with unresectable EC.METHODS We retrospectively analyzed the clinical characteristics,toxic reactions,and survival information of EC patients aged≥75 years who underwent intensity-modulated RT at Lu’an Hospital of Anhui Medical University between January 2016 and September 2023.Kaplan-Meier analysis was used to draw the overall survival(OS)curves,and Cox regression analysis was employed to evaluate the influence of various clinical factors on the prognosis.RESULTS A total of 139 patients were enrolled.The median follow-up time was 52.0 months.The median OS was 20.0 months.The 1-year,2-year,3-year,and 5-year OS rates were 69.8%,38.7%,28.2%,and 17.5%,respectively.Univariate analysis showed that age,radiation dose,and chemotherapy had no significant impact on prognosis.Multivariate analysis indicated that clinical stage[Ⅲ-Ⅳa vsⅠ-Ⅱ,hazard ratio(HR)=2.421,95%confidence interval(CI):1.242-4.718,P=0.009;IVb vsⅠ-Ⅱ,HR=4.222,95%CI:1.888-9.438,P<0.001),Charlson comorbidity index(CCI)(0 vs≥1,HR=1.539,95%CI:1.015-2.332,P=0.042),and nutritional risk screening 2002(NRS2002)(<3 vs≥3,HR=2.491,95%CI:1.601-3.875,P<0.001)were independent prognostic factors for OS.CONCLUSION Our results suggest that CCI and NRS2002 were independent prognostic factors of OS for unresectable elderly EC patients undergoing RT.For elderly patients with EC,full attention should be given to biological age-related indicators,such as comorbidities and nutrition,when formulating treatment protocols.These factors should be considered in future clinical practice.
文摘BACKGROUND The effectiveness of neoadjuvant therapy in esophageal cancer(EC)treatment is still a subject of debate.AIM To compare the clinical efficacy and toxic side effects between neoadjuvant chemoradiotherapy(nCRT)and neoadjuvant chemotherapy(nCT)for locally advanced EC(LAEC).METHODS A comprehensive search was conducted using multiple databases,including PubMed,EMBASE,MEDLINE,Science Direct,The Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,Chinese Science and Technology Journal Database,and Chinese Biomedical Literature Database Article.Studies up to December 2022 comparing nCRT and nCT in patients with EC were selected.RESULTS The analysis revealed significant differences between nCRT and nCT in terms of disease-free survival.The results indicated that nCRT provided better outcomes in terms of the 3-year overall survival rate(OSR)[odds ratio(OR)=0.95],complete response rate(OR=3.15),and R0 clearance rate(CR)(OR=2.25).However,nCT demonstrated a better 5-year OSR(OR=1.02)than nCRT.Moreover,when compared to nCRT,nCT showed reduced risks of cardiac complications(OR=1.15)and pulmonary complications(OR=1.30).CONCLUSION Overall,both nCRT and nCT were effective in terms of survival outcomes for LAEC.However,nCT exhibited better performance in terms of postoperative complications.
基金National Natural Science Foundation of China,No.82072721and Natural Science Foundation of Jiangsu Province of China,No.BK20201493.
文摘BACKGROUND Esophageal cancer is the sixth leading cause of cancer-related death and eighth most common cancer,affecting>450000 people worldwide.Esophageal squamous cell carcinoma is the most common histological type,whereas esophageal adenoid cystic carcinoma(EACC)is rare.The liver is the most common distant metastatic site in esophageal cancer.Anal metastasis is rare and has not been reported in clinical practice before.Here,we report anal metastases in a patient with EACC after regular chemotherapy and surgical resection.CASE SUMMARY A 61-year-old esophageal cancer patient was found to have lung and brain metastases during standardized treatment.The patient’s treatment plan was continuously adjusted according to the latest treatment guidelines.However,the patient subsequently noticed rectal bleeding and itching,and after obtaining pathology results at the local hospital,anal metastasis of esophageal cancer was diagnosed.CONCLUSION Postoperative pathology and immunohistochemistry confirmed EACC with rare anal metastasis.More exploration of EACC diagnosis and treatment is needed.
文摘BACKGROUND Gastroesophageal reflux disease(GERD)is a common complication of esophageal cancer surgery that can affect quality of life and increase the risk of esophageal stricture and anastomotic leakage.Wendan Decoction(WDD)is a traditional Chinese herbal formula used to treat various gastrointestinal disorders,such as gastritis,functional dyspepsia,and irritable bowel syndrome.Mosapride,a prokinetic agent,functions as a selective 5-hydroxytryptamine 4 agonist,enhancing gastrointestinal motility.AIM To evaluate the therapeutic effects of WDD combined with mosapride on GERD after esophageal cancer surgery.METHODS Eighty patients with GERD were randomly divided into treatment(receiving WDD combined with mosapride)and control(receiving mosapride alone)groups.The treatment was conducted from January 2021 to January 2023.The primary outcome was improved GERD symptoms as measured using the reflux disease questionnaire(RDQ).The secondary outcomes were improved esophageal motility(measured using esophageal manometry),gastric emptying(measured using gastric scintigraphy),and quality of life[measured via the Short Form-36(SF-36)Health Survey].RESULTS The treatment group showed a notably reduced RDQ score and improved esophageal motility parameters,such as lower esophageal sphincter pressure,peristaltic amplitude,and peristaltic velocity compared to the control group.The treatment group showed significantly higher gastric emptying rates and SF-36 scores(in both physical and mental domains)compared to the control group.No serious adverse effects were observed in either group.CONCLUSION WDD combined with mosapride is an effective and safe therapy for GERD after esophageal cancer surgery.It can improve GERD symptoms,esophageal motility,gastric emptying,and the quality of life of patients.Further studies with larger sample sizes and longer follow-up periods are required to confirm these findings.
基金Supported by Guangxi Health Department Scientific Research Program,No.Z20200206Project of Guangxi Liuzhou Science and Technology Bureau,No.2024YB0101B010。
文摘BACKGROUND Traditional methods cannot clearly visualize esophageal cancer(EC)tumor contours and metastases,which limits the clinical application of da Vinci robotassisted surgery.AIM To investigate the efficacy of the da Vinci robot in combination with nanocarbon lymph node tracers in radical surgery of EC.METHODS In total,104 patients with early-stage EC who were admitted to Liuzhou worker's Hospital from January 2020 to June 2023 were enrolled.The patients were assigned to an observation group(n=52),which underwent da Vinci robot-assisted minimally invasive esophagectomy(RAMIE)with the intraoperative use of nanocarbon tracers,and a control group(n=52),which underwent traditional surgery treatment.The operation time,intraoperative blood loss,postoperative drainage tube indwelling time,hospital stay,number of lymph nodes dissected,incidence of complications,and long-term curative effects were comparatively analyzed.The postoperative stress response C-reactive protein(CRP),cortisol,epinephrine(E)and inflammatory response interleukin(IL)-6,IL-8,IL-10,and tumor necrosis factor-alpha(TNF-α)were evaluated.RESULTS Compared with the control group,the observation group had significantly lower postoperative CRP,cortisol,and E levels(P<0.05)with a milder inflammatory response,as indicated by lower IL-6,IL-10,and TNF-αlevels(P<0.05).Patients who underwent RAMIE had less intraoperative blood loss and shorter operation times and hospital stays than those who underwent traditional surgery.The average number of dissected lymph nodes,time of lymph node dissection,and mean smallest lymph node diameter were all significantly lower in the observation group(P<0.05).The rate of postoperative complications was 5.77%in the observation group,significantly lower than the 15.38%observed in the control group.Furthermore,the lymphatic metastasis rate,reoperation rate,and 12-and 24-month cumulative mortality in the observation group were 1.92%,0%,0%,and 0%,respectively,all of which were significantly lower than those in the control group(P<0.05).CONCLUSION The treatment of EC using the da Vinci robot combined with nanocarbon lymph node tracers can achieve good surgical outcomes and demonstrates promising clinical applications.
基金supported by grants from the Health Commission of Henan Province(Grant No.SBGJ20211008)the Henan Provincial Department of Science and Technology(Grant No.222300420574)。
文摘Esophageal cancer(EC)is an aggressive malignancy with a poor prognosis.Various factors,including dietary habits,and antacid and antibiotic use,have been shown to influence the esophageal microbiome.Conversely,enrichment and diversity of the esophageal microbiome can also impact its function.Recent studies have revealed prevalent changes in the esophageal microbiome among patients with EC,thus suggesting the potential contribution of the esophageal microbiome to EC development.Additionally,distinct microbiome compositions have been observed in patients with different responses to radiotherapy and chemotherapy,indicating the role of the esophageal microbiome in modulating treatment outcomes.In this review,we have examined previous studies on the esophageal microbiome in healthy individuals and patients with EC or other esophageal diseases,with a focus on identifying microbial communities associated with EC pathogenesis and prognosis.Understanding the role of the microbiome in EC may aid in early detection and optimized treatment strategies,ultimately leading to better outcomes for patients.
基金supported by the National Key R&D Program of China(grant number:2022YFC3600805,2016YFC1302502).
文摘Background:Esophageal cancer(EC)remains a global health challenge due to its poor prognosis.China and the United States of America(USA)represent two distinct epicenters of EC burden.Understanding the EC disparities in these two countries is vital for tailoring prevention strategies,optimizing treatment,and enhancing outcomes in both countries.Yet,there lacks a comprehensive comparison of EC characteristics between the two countries.Methods:In this multicenter,retrospective hospital-based study,we enrolled primary EC patients who received their initial treatment at one of 23 hospitals in China during 2016-2017.Using electronic medical records and cancer registration records,information on demographics,lifestyle,and clinicopathological characteristics(in-cluding tumor site,pathology,stage,metastases,differentiation,and treatment)were collected.Additionally,we compared these data with the clinicopathological information of invasive EC patients diagnosed in 2016-2017 from the Surveillance,Epidemiology,and End Results(SEER)database in the USA.Results:A total of 6,658 EC patients in China and 8,555 EC patients in the USA were included finally.85.5%(n=5,694)of EC were esophageal squamous cell carcinoma(ESCC)in China,while esophageal adenocarcinoma(EAC)was prominent in the USA(58.9%,n=5,041).Among EC patients with known staging,the proportion of early stage was higher in China compared to the USA(48.3%vs.30.5%).Among ESCC patients,early-stage cases were higher in China than in the USA(49.8%vs.31.8%),while among EAC patients,late-stage cases were higher in China than in the USA(77.3%vs.68.5%)(all P<0.001).In China,EC mainly occurred in the middle third(60.2%)of the esophagus,whereas in the USA,it was more common in the lower third(59.9%)of the organ.Compared with EC patients with known metastatic status in the USA,China had fewer cases of lymph node metastases(51.4%vs.57.7%)and distant metastases(7.9%vs.33.8%).Regarding treatment,China had more surgical therapy(53.7%vs.22.6%),less radiotherapy(35.6%vs.53.3%),and less chemotherapy(46.7%vs.59.7%)compared to the USA.Conclusions:This study reveals notable disparities in EC between China and the USA,encompassing epidemi-ological,clinicopathological,and treatment dimensions.These findings provide insight for tailored strategies addressing regional variations in clinicopathological and therapeutic characteristics.
基金supported by the National Natural Science Foundation of China(Grant Nos.:22176195 and 82127801)National Key R&D Program of China(Grant No.:2022YFF0705003)+5 种基金the Shenzhen Key Laboratory of Precision Diagnosis and Treatment of Depression(Grant No.:ZDSYS20220606100606014)the Guangdong Province Zhu Jiang Talents Plan,China(Grant No.:2021QN02Y028)the Natural Science Foundation of Guangdong Province,China(Grant No.:2021A1515010171)the Key Program of Fundamental Research in Shenzhen,China(Grant No.:JCYJ20210324115811031)the Sustainable Development Program of Shenzhen,China(Grant No.:KCXFZ202002011008124)the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital&Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen(Grant Nos.:SZ2020ZD002 and SZ2020QN005).
文摘Esophageal cancer is an upper gastrointestinal malignancy with a bleak prognosis.It is still being explored in depth due to its complex molecular mechanisms of occurrence and development.Lipids play a crucial role in cells by participating in energy supply,biofilm formation,and signal transduction processes,and lipid metabolic reprogramming also constitutes a significant characteristic of malignant tumors.More and more studies have found esophageal cancer has obvious lipid metabolism abnormalities throughout its beginning,progress,and treatment resistance.The inhibition of tumor growth and the enhancement of antitumor therapy efficacy can be achieved through the regulation of lipid metabolism.Therefore,we reviewed and analyzed the research results and latest findings for lipid metabolism and associated analysis techniques in esophageal cancer,and comprehensively proved the value of lipid metabolic reprogramming in the evolution and treatment resistance of esophageal cancer,as well as its significance in exploring potential therapeutic targets and biomarkers.
文摘This editorial comments on an article by Qu et al published in the World Journal of Gastrointestinal Oncology.It focuses on the importance of early detection of esophageal cancer,including recurrence or secondary malignancy after chemoradiotherapy(CRT).Endoscopic resection is the first choice for treatment for esophageal cancer remaining within the mucous membrane,while surgery or radical CRT are treatment options for advanced stages depending on the patient’s general condition and desire.Although these treatments are potentially curative,they are more invasive than endoscopic resection.Early-stage esophageal cancer is often asymptomatic and difficult to detect.Uniform periodic endoscopy is unrealistic.Although less burdensome tests exist,including liquid biopsy and urinary biomarkers,these have not yet been widely used in clinical practice.Early detection is important after radical CRT because the local recurrence rate is higher than that after surgery.However,endoscopic resection or photodynamic therapy is indicated if detected in the early stages,and positive results have been reported.Early detection of esophageal cancer is crucial.Endoscopy is the main diagnostic method;however,new and less burdensome methods should be established to ensure early treatment for patients with esophageal cancer.
文摘To confirm the relationship between Circ_0003855 and EC,we purchased the Human esophageal carcinoma cell line Eca109 and normal human esophageal epithelial cells HEEC,and the expression levels of Circ_0003855,miR-622,and FLOT1 were detected.The results show that Circ_0003855 and FLOT1 were highly expressed in Eca109 cells,while miR-622 was lowly expressed(p<0.05).Subsequently,Circ_0003855 small interfering RNA(si-Circ_0003855)and its negative control(si-NC)were used to detect changes in cellular biological behaviors.We found that the activity of Eca109 cells was reduced after interfering with the expression of Circ_0003855,and miR-622 expression was elevated,while FLOT1 was decreased(p<0.05).Additionally,si-Circ_0003855 and miR-622 inhibitor sequence(miR-622-inhibition)were co-transfected into cells with miR-622-inhibition alone,and untreated Eca109 cells were used as a control to detect the expression of FLOT1.Co-transfection of si-Circ_0003855 and miR-622-inhibition showed no significant difference in FLOT1 expression compared to the control cells(p>0.05).Synthesizing the results of these experiments above,we believe that interfering with the expression of Circ_0003855 can inhibit the activity of EC cells,and its mechanism is related to miR-622 and FLOT1.
基金Supported by the Education and Teaching Reform Project,the First Clinical College of Chongqing Medical University,No.CMER202305Program for Youth Innovation in Future Medicine,Chongqing Medical University,No.W0138.
文摘This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology,focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achieving“early detection”.The five-year age-standardized net survival for esophageal cancer patients falls short of expectations.Early detection and accurate diagnosis are critical strategies for improving the treatment outcomes of esophageal cancer.While advancements in endoscopic technology have been significant,there seems to be an excessive emphasis on the latest high-end endoscopic devices and various endoscopic resection techniques.Therefore,it is imperative to redirect focus towards proactive early detection strategies for esophageal cancer,investigate the most cost-effective screening methods suitable for different regions,and persistently explore practical solutions to improve the five-year survival rate of patients with esophageal cancer.
文摘The incidence of esophageal cancer,namely the adenocarcinoma subtype,continues to increase exponentially on an annual basis.The indolent nature of the disease renders a significant proportion inoperable at first presentation,however,with the increased utilisation of endoscopy,many early lesions are now being identified which are suitable for endotherapeutic approaches.This article details the options available for dealing with early esophageal cancer by endoscopic mean obviating the need for surgery thereby avoiding the potential morbidity and mortality of such intervention.
文摘Esophageal cancer(EC)is an aggressive malignancy with a poor prognosis,ranking seventh in incidence and sixth cancer-related deaths globally.EC is classified in two main types,the esophageal squamous cell carcinoma(ESCC)and esophageal adenocarcinoma(EAC),with ESCC being more common in Eastern Europe,South Asia,and Africa,while EAC is prevalent in Western Europe and North America.Molecular analysis identifies three subgroups of ESCC,each with distinct genetic mutations and treatment responses.Early-stage EC is often difficult to detect,leading to late-stage diagnoses that necessitate systemic drug therapies,including molecular-targeted therapies and immunotherapies.Immunotherapy,particularly immune checkpoint inhibitor,has shown promising results in improving survival rates for metastatic or persistent EC.It is particularly important to target to multidisciplinary combination therapies,integrating surgery,chemoradiotherapy,targeted therapy and immunotherapy.Additionally,radioimmunotherapy is being explored for its potential to enhance treatment efficacy,especially in advanced and metastatic tumors.However,the pathological complete response rate to neoadjuvant chemoradiotherapy remains suboptimal,highlighting the need for novel treatment strategies.Future research should focus on optimizing treatment combinations and identifying predictive biomarkers to improve clinical outcomes for EC patients.
