• 제목/요약/키워드: Esophageal cancer

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상부 식도암에서 수술적 치료의 유용성 (The Role of Surgery for the Treatment of Upper Esophageal Cancer)

  • 박재길;사영조;남상용;박건
    • Journal of Chest Surgery
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    • 제40권10호
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    • pp.685-690
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    • 2007
  • 배경: 상부 식도암에 대한 종래의 표준적 치료는 방사선 조사였으나 결과는 만족스럽지 않았으며, 아직도 수술적 치료를 적용하는 데에는 의견의 차이가 있다. 저자들은 상부식도암에 대하여 수술적 치료를 적극적으로 시행하여 왔으며, 그의 효과를 분석해 보고자 하였다. 대상 및 방법: 1995년부터 2005년까지 저자들이 수술을 시행한 식도암 증례는 모두 147예였으며, 이들을 상부 식도암(경부 및 상흉부 식도암) 23예와 하부 식도암(중, 하흉부 및 복부 식도암) 124예의 2군으로 구분하여, 수술의 완전 절제율과 수술의 합병증 및 사망률, 재발률,그리고 생존율 등을 비교함으로써 양군에서의 수술의 유용성을 비교해 보았다. 결과: 양 군 간에 병기 분포는 유사하였으며, 완전 절제율에서도 유의한 차이를 발견할 수 없었다. 수술의 합병증 발생률은 상부 식도암군에서 유의하게 높았으나(39.1% vs 16.9%, p<0.05), 수술 사망률이나 재발률 및 장기 생존율에서의 차이는 없었다. 결론: 양 군 간에 수술 사망률이나 수술의 효과 면에서 차이가 없어 상부 식도암에서도 수술적 치료는 유용하다고 판단되었으나, 향후 보다 많은 증례의 분석이 필요할 것이라고 생각한다.

경부식도암 및 하부인두암에서 근치적 전후두인두식도절제술 후 위를 이용한 재건술의 의의 (Use of the Stomach as an Esophageal Substitute after Total Pharyngolaryngoesophagectomy for Treating Cervical Esophageal Cancer or Hypopharyngeal Cancer)

  • 이상혁;이상훈;윤호영;김충배
    • Journal of Gastric Cancer
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    • 제7권4호
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    • pp.200-205
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    • 2007
  • 목적: 하부인두암 및 경부식도암 환자에서 근치적 전인두후두식도절제술시 위를 이용한 재건술 후 수술의 결과를 분석하고자 한다. 대상 및 방법: 1991년부터 2006년까지 하인두암 및 경부식도암에서 전인두후두식도절제술을 시행하였고, 재건술을 개흉술 없이, 경열공적으로 위를 이용하여 하인두위 문합술을 시행한 23예를 대상으로 하였다. 수술 후 합병증에 대해서는 신체검사소견과 수술 후 시행한 식도조영술의 결과에 따라 분류하였고, 퇴원 후 외래추적조사 시 환자의 증상 및 신체검사소견상 협착이나 재발의 가능성이 있는 환자에서 시행한 흉부 X-선 검사, 식도내시경 및 식도조영술을 바탕으로 분석하였다. 결과: 수술 후 사망한 환자는 2예(8.8%)였으며, 4예(4.4%)에서 누출이 있었으나, 공장루를 통해 경장영양으로 해결되었으며, 협착은 없었다. 호흡기합병증은 폐렴 1예, 기흉 1예였다. 수술 후에 연하곤란은 없었으나, 2000년 이후 유분부성형술을 시행하지 않으므로, 일시적으로 정체증상을 호소한 환자가 1예 있었다. 결론: 하인두암이나 경부식도암에서 근치적 절제 후 위장관 재건술시 위를 이용하는 것은 충분한 길이를 얻을 수 있어, 원활한 혈액공급이 가능하여 조직괴사나 문합부 누출 및 협착 등의 합병증이 적으며, 술식의 시간이 빠르다. 또한 모든 문합이 경부에서 이루어지므로 문합부의 누출이 발생하더라도 쉽게 치료되어 수술 후 이환율과 사망률이 감소한다는 장점이 있다.

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식도 질환의 외과적 치료 (Surgical Treatment of Esophageal Disease)

  • 우석정
    • Journal of Chest Surgery
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    • 제26권8호
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    • pp.627-632
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    • 1993
  • A clinical study was performed on 64 cases of the esophageal diseases experienced at the Department of Thoracic & Cardiovascular Surgery of Kyungpook University Hospital from Jan. 1988 through Dec. 1992. The results were as follows: The most common esophageal disease was cancer which occurred in 37.5% of the total. In esophageal cancer patients, 24 cases were operated on and cancer resection was feasible in 19 cases with 2 cases of hospital death. The overall 1 year survival rate was 41.6% and the most favorable follow up result was revealed in stage I group. Esophageal stricture occurred in 22 cases and its causes were alkali and acid. The most common stricture site was mid-esphagus. Colon interposition was performed on 15 cases. Achalasia occured in 8 cases and was treated with modified Heller`s myotomy. Esophageal perforation occurred in 6 cases and its operative mortality rate was 16.6%. Two patients with congenital bronchoesophageal fistula were treated with surgical division. The first case, which occurred in an adult, is of Braimbridge,s typeII classification. The second one which occured in an child with sequestration, is of Braimbridge,s type IV classification. Diverticulectomy was performed in 1 case of esophageal diverticulum. Enucleation of tumor was performed in 1 case of esophageal leiomyoma.

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MSP58 Knockdown Inhibits the Proliferation of Esophageal Squamous Cell Carcinoma in Vitro and in Vivo

  • Xu, Chun-Sheng;Zheng, Jian-Yong;Zhang, Hai-Long;Zhao, Hua-Dong;Zhang, Jing;Wu, Guo-Qiang;Wu, Lin;Wang, Qing;Wang, Wei-Zhong;Zhang, Jian
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3233-3238
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    • 2012
  • Esophageal carcinoma (EC) is one of the most aggressive cancers with a poor prognosis. Understanding the molecular mechanisms underlying esophageal cancer progression is a high priority for improved EC diagnosis and prognosis. Recently, MSP58 was shown to behave as an oncogene in colorectal carcinomas and gliomas. However, little is known about its function in esophageal carcinomas. We therefore examined the effects of MSP58 knockdown on the growth of esophageal squamous cell carcinoma (ESCC) cells in vitro and in vivo in order to gain a better understanding of its potential as a tumor therapeutic target. We employed lentiviral-mediated small hairpin RNA (shRNA) to knock down the expression of MSP58 in the ESCC cell lines Eca-109 and EC9706 and demonstrated inhibition of ESCC cell proliferation and colony formation in vitro. Furthermore, flow cytometry and western blot analyses revealed that MSP58 depletion induced cell cycle arrest by regulating the expression of P21, CDK4 and cyclin D1. Notably, the downregulation of MSP58 significantly inhibited the growth of ESCC xenografts in nude mice. Our results suggest that MSP58 may play an important role in ESCC progression.

Different Association of Manganese Superoxide Dismutase Gene Polymorphisms with Risk of Prostate, Esophageal, and Lung Cancers: Evidence from a Meta-analysis of 20,025 Subjects

  • Sun, Guo-Gui;Wang, Ya-Di;Lu, Yi-Fang;Hu, Wan-Ning
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1937-1943
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    • 2013
  • Altered expression or function of manganese superoxide dismutase (MnSOD) has been shown to be associated with cancer risk but assessment of gene polymorphisms has resulted in inconclusive data. Here a search of published data was made and 22 studies were recruited, covering 20,025 case and control subjects, for meta-analyses of the association of MnSOD polymorphisms with the risk of prostate, esophageal, and lung cancers. The data on 12 studies of prostate cancer (including 4,182 cases and 6,885 controls) showed a statistically significant association with the risk of development in co-dominant models and dominant models, but not in the recessive model. Subgroup analysis showed there was no statistically significant association of MnSOD polymorphisms with aggressive or nonaggressive prostate cancer in different genetic models. In addition, the data on four studies of esophageal cancer containing 620 cases and 909 controls showed a statistically significant association between MnSOD polymorphisms and risk in all comparison models. In contrast, the data on six studies of lung cancer with 3,375 cases and 4,050 controls showed that MnSOD polymorphisms were significantly associated with the decreased risk of lung cancer in the homozygote and dominant models, but not the heterozygote model. A subgroup analysis of the combination of MnSOD polymorphisms with tobacco smokers did not show any significant association with lung cancer risk, histological type, or clinical stage of lung cancer. The data from the current study indicated that the Ala allele MnSOD polymorphism is associated with increased risk of prostate and esophageal cancers, but with decreased risk of lung cancer. The underlying molecular mechanisms warrant further investigation.

흉부식도암의 외과적 치료 (Surgical Treatment of Thoracic Esophageal Cancer)

  • 박창권
    • 대한기관식도과학회지
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    • 제9권1호
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    • pp.39-46
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    • 2003
  • Surgery remains the standard treatment for resectable thoracic esophageal cancer but that is justified only when acceptably low morbidity and mortality rates can be achieved even for advanced disease. The appropriate extent of resection to achieve the best outcome is the most controversial aspect of treating esopahgeal cancer and the optimal excent of lymphadenectomy also remains controversial. Until data from prospective randomized trials showing a clear benefit using a particular approach are available, surgeons should perform their better judgement in individualizing and selecting the most appropriate surgical approach to provide the best chance of cure or lasting palliation for this disease that challanges both patient and surgeon. Further studies are necessary to examine the utility and efficacy of each approach in treating thoracic esophageal cancer either alone or in combination with other modalities.

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Mini-Array of Multiple Tumor-associated Antigens (TAAs) in the Immunodiagnosis of Esophageal Cancer

  • Qin, Jie-Jie;Wang, Xiao-Rui;Wang, Peng;Ren, Peng-Fei;Shi, Jian-Xiang;Zhang, Hong-Fei;Xia, Jun-Fen;Wang, Kai-Juan;Song, Chun-Hua;Dai, Li-Ping;Zhang, Jian-Ying
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권6호
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    • pp.2635-2640
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    • 2014
  • Sera of cancer patients may contain antibodies that react with a unique group of autologous cellular antigens called tumor-associated antigens (TAAs). The present study aimed to determine whether a mini-array of multiple TAAs would enhance antibody detection and be a useful approach in esophageal cancer detection and diagnosis. Our mini-array of multiple TAAs consisted of eleven antigens, p53, pl6, Impl, CyclinB1, C-myc, RalA, p62, Survivin, Koc, CyclinD1 and CyclinE full-length recombinant proteins. Enzyme-linked immunosorbent assays (ELISA) were used to detect autoantibodies against eleven selected TAAs in 174 sera from patients with esophageal cancer, as well as 242 sera from normal individuals. In addition, positive results of ELISA were confirmed by Western blotting. In a parallel screening trial, with the successive addition of antigen to a final total of eleven TAAs, there was a stepwise increase in positive antibody reactions. The eleven TAAs were the best parallel combination, and the sensitivity and specificity in diagnosing esophageal cancer was 75.3% and 81.0%, respectively. The positive and negative predictive values were 74.0% and 82.0%, respectively, indicating that the parallel assay of eleven TAAs raised the diagnostic precision significantly. In addition, the levels of antibodies to seven antigens, comprising p53, Impl, C-myc, RalA, p62, Survivin, and CyclinD1, were significantly different in various stages of esophageal cancer, which showed that autoantibodies may be involved in the pathogenesis and progression of esophageal cancer. All in all, this study further supports our previous hypothesis that a combination of antibodies might acquire higher sensitivity for the diagnosis of certain types of cancer. A customized mini-array of multiple carefully-selected TAAs is able to enhance autoantibody detection in the immunodiagnosis of esophageal cancer and autoantibodies to TAAs might be reference indicators of clinical stage.

Clinical Research on Albumin-Bound Paclitaxel-Based Chemotherapy for Advanced Esophageal Cancer

  • Yuan, Yuan;Zhang, Yan;Shi, Lin;Mei, Jing-Feng;Feng, Jif-Eng;Shen, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.4993-4996
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    • 2015
  • Background: To evaluate the efficacy and safety of albumin-bound paclitaxel-based chemotherapy in treatment for patients with advanced esophageal cancer who failed in first-line chemotherapy. Materials and Methods: We collected29 advanced esophageal cancer patients who received albumin-bound paclitaxel-based chemotherapy fromJune 2009 to September 2013, and the efficacy and safety of the compound were evaluated. These patients were treated with $100-150mg/m^2$ nab-paclitaxel on days 1,8. The cycle was repeated every 3 weeks. Clinical efficacy was evaluated every two cycles. Results: Of the 29 patients, two persons interrupted treatment because of adverse reactions, failed to evaluate efficacy effect. The rest of 27 patients who could be evaluated for short-term response, 10 patients (37%) achieved partial response, 2 (7.4%) remained stable disease, and 15 (55.6%) had progressivedisease. The objective response rate was 37%, and the disease control rate was 44.4%.The median time to progression was 6.6 months.The major adverse reactions includedalopecia (62.07%), neutropenia (65.5%), gastrointestinalreaction (10.3%) andsensory neuropathy(6.8%). Conclusions: The albumin-bound paclitaxel-based chemotherapy is efficacy and safety in treatment for patients with advanced esophageal cancer who failed in first-line chemotherapy.

폐암 클리닉을 위한 공유 전자의무기록 (A Shared Electronic Medical Record for Lung Cancer Clinic)

  • 김규식;박은선;김승석;김형우;김영철;범희승;안성자;나국주;김윤현;김유일;임성철;문재동
    • Tuberculosis and Respiratory Diseases
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    • 제59권5호
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    • pp.480-486
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    • 2005
  • Since the year 2000, lung cancer has become the leading cause of cancer death in South Korea as in many other parts of the world. The current multidisciplinary approach for lung cancer includes a wide range of modalities, not only surgery, radiotherapy, medical drug therapy but also pain control, as well as social and psychological support. Therefore, thoracic surgeons, radiologists, nuclear medicine specialists, anesthetists, psychologist, nurses and social workers as well as medical doctors care for lung cancer patients. Sharing a common treatment protocol and optimal communication are vital aspects of shared care both from a medical and cost-effectiveness point of view. We developed a shared electronic medical record (SEMR) for treating patients with lung cancer in a university hospital to facilitate the sharing protocols and communications between doctors involved in a lung cancer clinic. A SEMR system was developed within a order communication system(OCS) for a lung cancer clinic. The records of radiological, laboratory and pathological studies as well as the records of surgery, chemotherapy, and radiotherapy were stored and presented to all doctors who treat the same patient. Every doctor was allowed to change his/her own records. They could review other doctor s records but could not alter them. With the SEMR, it was expected that the time to complete the medical records for one patient could be reduced because it was easy to review all the data from the other doctors who share the same patient. In addition, the confidence of the doctors who share a common treatment protocol would be higher. Therefore, a shared electronic medical record is expected to improve the quality of patient care.

Epidemiology of Esophageal Cancer in Kazakhstan

  • Igissinov, Saginbek;Igissinov, Nurbek;Moore, Malcolm A.;Kalieva, Zhansaya;Kozhakhmetov, Saken
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.833-836
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    • 2012
  • The incidence of esophageal cancer in Kazakhstan was analysed for the period of 1989-2010 years, with a focus on trends by age, gender and region. The highest rates of incidence were evident in the Western regions. The dynamics for cancer of the esophagus in the Republic demonstrated decrease, except in the Karaganda region, where a tendency for increase was noted. Considerable variation between regions pointed to differences in risk factor exposure which need to be targeted for future control efforts.