• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.1783-1786
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• 2012

Objectives: To analyze esophageal cancer incidence and pathological data of Zhongshan in China in 1970-2007, and to provide scientific information for its prevention and control. Methods: From Zhongshan Cancer Registry esophageal cancer incident and pathological data were obtained. Pathological proportions and trends were calculated and analyzed. Results: Although there was a continuously and obviously increasing trend for male incidence rates in 1970-2007 in Zhongshan, squamous cell carcinoma (SCC) and adenocarcinoma (AD) incident proportions during 1990-2007 remained relatively stable. Moreover, SCC was the major pathological type, accounting for 70.6 percent of all new cases, while AD were relatively few and accounted for only 2.66 percent throughout the period. Conclusion: The male esophageal cancer incident pattern in Zhongshan in 1970-2007 was quite different from most other domestic areas. The data suggest that etiological analysis should be enhanced for improved control in Zhongshan.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1911-1918
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• 2013

This meta-analysis was conducted to evaluate the association between intake of carotenoids and risk of esophageal cancer. A systematic search using PubMed, Cochrane Library, Web of Science, Scopus, CNKI, and CBM (updated to 6 May 2012) identified ten articles meeting the inclusion criteria with 1,958 cases of esophageal cancer and 4,529 controls. Higher intake of beta-carotene, alpha-carotene, lycopene, beta-cryptoxanthin, lutein, and zeaxanthin reduced esophageal cancer risk with pooled ORs of 0.58 (95% CI 0.44, 0.77), 0.81 (95% CI 0.70, 0.94), 0.75 (95% CI 0.64, 0.86), 0.80 (95% CI 0.66, 0.97), and 0.71 (95% CI 0.59, 0.87), respectively. In subgroup analyses, beta-carotene showed protective effects against esophageal adenocarcinoma in studies located in Europe and North America. Alpha-carotene, lycopene, and beta-cryptoxanthin showed protection against esophageal squamous cell cancer. This meta-analysis suggested that higher intake of carotenoids (beta-carotene, alpha-carotene, lycopene, beta-cryptoxanthin, lutein, and zeaxanthin) is associated with lower risk of esophageal cancer. Further research with large-sample studies need to be conducted to better clarify the potentially protective mechanisms of carotenoid associations risk of different types of esophageal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.4967-4971
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• 2012

Background/Aims: Glutathione S-transferase T1 (GSTT1), a phase-II enzyme, plays an important role in detoxification of carcinogen electrophiles. Many studies have investigated the association between GSTT1 polymorphism and esophageal cancer risk in Asian populations, but its actual impact is not clear owing to apparent inconsistencies among those studies. Thus, a meta-analysis was performed to explore the effect of GSTT1 polymorphism on the risk of developing esophageal cancer. Methods: A literature search of PubMed, Embase, and Wanfang databases up to August 2012 was conducted and 15 eligible papers were finally selected, involving a total of 1,626 esophageal cancer cases and 2,216 controls. We used the pooled odds ratio (OR) with its corresponding 95% confidence interval (95%CI) to estimate the association of GSTT1 polymorphism with esophageal cancer risk. Subgroup analyses and sensitivity analyses were performed to further identify the association. Results: Meta-analysis of total studies showed the null genotype of GSTT1 was significantly associated with an increased risk of esophageal cancer in Asians (OR=1.26, 95%CI=1.05-1.52, $P_{OR}=0.015$, $I^2=42.7%$). Subgroup analyses by sample size and countries also identified a significant association. Sensitivity analysis further demonstrated a relationship of GSTT1 polymorphism to esophageal cancer risk in Asians. Conclusions: The present meta-analysis of available data showed a significant association between the null genotype of GSTT1 and an increased risk of esophageal cancer in Asians, particularly in China.

• Journal of Digestive Cancer Research
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• v.11 no.2
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• pp.61-65
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• 2023

Globally, esophageal cancer is the seventh most common cancer, and the male-to-female ratio in esophageal adenocarcinoma (EAC) is significantly imbalanced at 4:1 to 8:1. Obesity, reflux, and smoking are known risk factors for this sex difference; however, fully explaining this remains challenging. Studies have investigated the link between exogenous sex hormones and esophageal cancer occurrence. A meta-analysis revealed a lower risk of EAC in female who had undergone hormone replacement therapy. Androgen-deprivation therapy in patients with prostate cancer was associated with a decreased risk of EAC. Tissue-based studies have reported varied results regarding the relationship between estrogen receptor expression and survival in female patients with esophageal squamous cell carcinoma (ESCC). Circulating hormone studies have suggested that higher testosterone and luteinizing hormone levels decreased EAC risk in men, and free testosterone was inversely correlated in female with ESCC. However, a high androgen-estrogen ratio in male patients with EAC was linked to increased odds of EAC. Sex hormones influence carcinogenesis, affecting cell proliferation, differentiation, metabolism, inflammation, and cell death. The studies were limited by the small sample size and varying hormone measurement methods; thus, future studies with definitive conclusions on the association between esophageal cancer and sex hormones are warranted.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1419-1422
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• 2014

Objective: To summarize the endoscopic screening findings in high-risk population of esophageal and gastric carcinoma and analyze influential factors related to screening. Methods: In seven selected cities and counties with high incidences of esophageal carcinoma, people at age of 40-69 were set as the target population. Those with gastroscopy contradictions were excluded, and all who were voluntary and willing to comply with the medical requirements were subjected to endoscopic screening and histological examination for esophageal, gastric cardia and gastric carcinoma in accordance with national technical manual for early detection and treatment of cancer. Results: In three years, 36,154 people were screened, and 16,847 (46.60%) cases were found to have precancerous lesions. A total of 875 cases were found to have cancers (2.42%), and among them 739 cases had early stage with an early diagnosis rate is 84.5%. Some 715 patients underwent prompt treatment and the success rate was 81.8%. Conclusions: In a high-risk population of esophageal and gastric carcinoma, it is feasible to implement early detection and treatment by endoscopic screening. Screening can identify potential invasive carcinoma, early stage carcinoma and precancerous lesions, improving efficacy through early detection and treatment. The exploratory analysis of related influential factors will help broad implementation of early detection and treatment for esophageal and gastric carcinoma.

• Tuberculosis and Respiratory Diseases
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• v.74 no.3
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• pp.129-133
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• 2013

The presence of epidermal growth factor receptor (EGFR ) mutation is a prognostic and predictive marker for EGFR-tyrosine kinase inhibitor (TKI) therapy. However, inevitably, relapse occurs due to the development of acquired resistance, such as T790M mutation. We report a case of repeated responses to EGFR-TKIs in a never-smoked woman with adenocarcinoma. After six cycles of gemcitabine and cisplatin, the patient was treated by gefitinib for 4 months until progression. Following the six cycles of third-line pemetrexed, gefitinib retreatment was initiated and continued with a partial response for 6 months. After progression, she was recruited for an irreversible EGFR inhibitor trial, and the time to progression was 11 months. Although EGFR direct sequencing on the initial diagnostic specimen revealed a wild-type, we performed a rebiopsy from the progressed subcarinal node at the end of the trial. The result of peptide nucleic acid clamping showed L858R/L861Q.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.529-533
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• 1985

Though esophageal cancer was not a common disease, early metastasis and direct extension to adjacent organ were important on the treatment of disease. Therefore, palliative operation was often useful in advanced esophageal cancer. Between June 1985 through July 1985, we treated three cases of inoperable esophageal cancer with Celestin`s endo-esophageal tube by esophageal intubation. Three operations were done under general anesthesia. Celestin`s tube were inserted via oral cavity and additional traction on stomach were applied. After complete insertion of tube was done, the distal end of Celestin`s tube was modified in length. Also stay suture was applied between tube and stomach wall was applied. Postoperative esophagogram revealed good esophageal patency through Celestin`s tube. Clinically, swallowing difficulty was much improved after operation.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9955-9960
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• 2014

Background: Promoter hypermethylation is a common event in human cancer. O6-methylguanine-DNA methyltransferase (MGMT) is a gene involved in DNA repair, which is methylated in a variety of cancers. We aimed to explore the methylation status of MGMT gene among the North Eastern population where esophageal cancer incidence and exposure to carcinogens like nitrosamines is high. Materials and Methods: A total of 100 newly diagnosed esophageal cancer cases along with equal number of age, sex and ethnicity matched controls were included in this study. Methylation specific PCR was used to determine the MGMT methylation status in serum samples. Results: Aberrant promoter methylation of the MGMT gene was detected in 70% of esophageal cancer cases. Hypermethylation of MGMT gene was found to be influenced by environmental factors like betel quid and tobacco which contain potent carcinogens like nitrosamines. Tobacco chewing and tobacco smoking habit synergistically with MGMT methylation elevated the risk for esophageal cancer development [adjusted OR=5.02, 95% CI=1.35-18.74; p=0.010 for tobacco chewing and Adjusted OR=3.00, 95% CI=1.22-7.36; p=0.014 for tobacco smoking]. Conclusions: Results suggest that the DNA hypermethylation of MGMT is an important mechanism for MGMT gene silencing resulting in esophageal cancer development and is influenced by the environmental factors. Thus MGMT hypermethylation can be used as a biomarker for esophageal cancer in high incidence region of North East India.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5787-5792
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• 2015

Background: Reported age standardized incidence rates for esophageal cancer in Iran are 0.88 and 6.15 for females and males, at fifth and the eighth ranks, respectively, of cancers overall. The present study aimed to map relative risk using more realistic and less problematic methods than common estimators. Materials and Methods: In this ecological investigation, the studied population consisted of all esophageal cancer patients in Iran from 2005 to 2007. The Bayesian multilevel space-time model with three levels of county, province, and time was used to measure the relative risk of esophageal cancer. Analyses were conducted using R package INLA. Results: The total number of registered patients was 7,160. According to the results, the three-level model with adjustment for risk factors of physical activity and smoking had the best fit among all models. The overall temporal trend was significantly increasing. At county level, Ahar, Marand, Salmas, Bojnoord, Saghez, Sarakhs, Shahroud and Torbatejam had the highest relative risks. Physical activity was found to have significant direct association with risk of developing esophageal cancer. Conclusions: Given to great variation across geographical areas, many different factors affect the incidence of esophageal cancer. Conducting further studies at the individual level in areas with high incidence could provide more detailed information on risk factors of esophageal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.271-274
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• 2015

Background: To explore vascular endothelial growth factor C (VEGF-C) and VEGF-D expression and its correlation with lymph node metastasis in esophageal squamous cell cancer (ESCC) tissue. Materials and Methods: Immunohistochemical methods were applied to detect the levels of VEGF-C and VEGF-D expression in 64 surgicall removal ESCC tissues, tissues adjacent to cancer and normal tissues, and the relationship between VEGF-C and VEGF-D expression and lymph node metastasis was analyzed. Results: Both VEGF-C and VEGF-D were expressed by varying degrees in esophageal cancer tissue, the tissue adjacent to cancer and normal tissue, and the positive expression rate went down successively. The positive expression rates of VEGF-C (59.4%) and VEGF-D (43.8%) in esophageal cancer tissue were significantly higher than in the tissue adjacent to cancer (34.4%, 15.6%) and normal tissue (20.3%, 12.5%), respectively, in which significant differences were manifested (p<0.01). Positive expression rates of VEGF-C and VEGF-D in esophageal cancers with lymph node metastasis were markedly higher than without such metastasis (p<0.01), while those in the tissue with TNM staging I~II were markedly lower than that with TNM staging III~IV (p<0.01). Conclusions: Both VEGF-C and VEGF-D are highly expressed in ESCC tissue, which may be related to the lymph node metastasis of cancer cells. Hence, VEGF-C and VEGF-D can be clinically considered as important reference indexes of lymph node metastasis in esophageal cancer.