• Journal of Chest Surgery
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• 제33권9호
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• pp.734-737
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• 2000

Background: McKeown first described two autopsy cases of esophageal small cell carcinoma (SMC) in 1952; about 230 cases have since been reported in the literature. Small cell carcinoma has been reported to account for 0.4% to 7.6% of all esophageal malignancies. SMC of the esophagus as regarded as having a poor prognosis with frequent systemic dissemination. Choice of treatment remains controversial. Material and Method: From August 1987 to December 1998, a review of the records and histologic sections of 8 patients with primary small cell carcinoma of the esophagus seen in 11 years was undertaken. Result: Small cell carcinoma of the esophagus constituted 1.5% of all esophageal cancers. The median age was 61.5 years(range from 42 to 71 years). Seven patients were male, tumor was mainly located in the middle and lower thirds(6 cases) of the esophagus. Pure SMC is 5 cases, and mixed SMC is 3 cases. Operative procedure were as follow: transthoracic esophagectomy with thoracic or cervical reconstructon in 7 patients, transhiated esophagectomy with cervical reconstruction in one. The operative death was none. Adjuvant chemotherapy was performed in 7 patients except one who had poor general condition. Recurrence was observed in 4 patients(mediastinal LN, abdominal LN, SCN, bone). The overall median survival was 15.9 months. Only one patient survived for more than 5 years. Conclusion: We considered that esophageal SMC should be regarded as a systemic disease, and multimodality treatment including chemotherapy should be used. Surgery may be offered in selected patients to manage local disease as part of a chemotherapy based treatment program.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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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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• 제15권3호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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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.

• Journal of Chest Surgery
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• 제36권11호
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• pp.866-869
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• 2003

식도암 환자에서 동시에 일차성 폐암이 발견되는 빈도는 2% 미만에 불과하며, 특히 두 질환 모두 예후가 나쁨으로 인해서 환자들이 근치적 절제술을 받을 기회를 놓치게 되는 경우가 많다. 그러나 환자를 신중히 선택한다면 폐와 식도의 중복암을 동시에 절제함으로써 좋은 결과를 가져올 수 있다고 생각한다. 저자들은 최근 식도와 폐의 일차성 중복암 환자 1예를 경험하였고, 쌍폐엽절제술과 Ivor Lewis 술식으로 일차성 근치적 절제술을 시행하여 좋은 결과를 얻었기에 국내 문헌상으로는 최초로 이를 보고하는 바이다.

• BMB Reports
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• 제40권2호
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• pp.142-150
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• 2007

Epigenetic alterations, represented by aberrant DNA methylation, are deeply involved in human cancers. In gastric cancers, tumor-suppressor genes are inactivated more frequently by promoter methylation than by mutations. We recently showed that H. pylori infection, a potent gastric carcinogenic factor, induces methylation of specific genes in the gastric mucosae. When the methylation levels were analyzed in the gastric mucosae of healthy volunteers, cases with a single gastric cancer, and cases with multiple gastric cancers, who have increasing levels of risks for gastric cancers, there was a significant increasing trend in the methylation levels among the individuals without current H. pylori infection. This finding unequivocally showed the presence of an epigenetic field for cancerization. The degree of the field defect was measured more conveniently using methylation levels of marker genes than using those of tumor-suppressor genes. The presence of an epigenetic field for cancerization has been indicated for liver, colon, Barrett's esophageal, lung, breast, and renal cancers. Since decreased transcription is involved in the specificity of methylated genes, it is likely that specific genes are methylated according to carcinogenic factors. These findings emphasize the usefulness of DNA methylation as a marker for past exposure to carcinogens and future risk of cancer development.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9661-9666
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• 2014

Background: A number of studies have identified a shared susceptibility locus in phospholipase C epsilon 1 (PLCE1) for esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinomas (GCA). However, the results of PLCE1 expression in esophageal and gastric cancer remain inconsistent and controversial. Moreover, the effects on clinicopathological features remain undetermined. This study aimed to provide a precise quantification of the association between PLCE1 expression and the risk of ESCC and GCA through meta-analysis. Materials and Methods: Eligible studies were identified from PubMed, Wanfang Data, ISI Web of Science, and the Chinese National Knowledge Infrastructure databases. Using RevMan5.2 software, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were employed to assess the association of PLCE1 expression with clinicopathological features relative to ESCC or GCA. Results: Seven articles were identified, including 761 esophageal and gastric cancer cases and 457 controls. Overall, we determined that PLCE1 expression was associated with tumor progression in both esophageal cancers (pooled OR=5.93; 95%CI=3.86 to 9.11) and gastric cancers (pooled OR=9.73; 95%CI=6.46 to 14.7). Moreover, invasion depth (pooled OR=3.62; 95%CI=2.30 to 5.70) and lymph node metastasis (pooled OR=4.21; 95%CI=2.69 to 6.59) were linked with PLCE1 expression in gastric cancer. However, no significant associations were determined between PLCE1 overexpression and the histologic grade, invasion depth, and lymph node metastasis in esophageal cancer. Conclusions: Our metaanalysis results indicated that upregulated PLCE1 is significantly associated with an increased risk of tumor progression in ESCC and GCA. Therefore, PLCE1 expression can be appropriately regarded as a promising biomarker for ESCC and GCA patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1803-1806
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• 2013

Purpose: Carbohydrate antigen (CA) 242 is inversely related to prognosis in many cancers. However, few data regarding CA 242 in esophageal cancer (EC) are available. The aim of this study was to determine the prognostic value of CA 242 and propose an optimum cut-off point in predicting survival difference in patients with esophageal squamous cell carcinoma (ESCC). Methods: A retrospective analysis was conducted of 192 cases. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimum cuf-off point. Univariate and multivariate analyses were performed to evaluate prognostic parameters for survival. Results: The positive rate for CA 242 was 7.3% (14/192). The ROC curve for survival prediction gave an optimum cut-off of 2.15 (U/ml). Patients with CA 242 ${\leq}$ 2.15 U/ml had significantly better 5-year survival than patients with CA 242 >2.15 U/ml (45.4% versus 22.6%; P=0.003). Multivariate analysis showed that differentiation (P=0.033), CA 242 (P=0.017), T grade (P=0.004) and N staging (P<0.001) were independent prognostic factors. Conclusions: Preoperative CA 242 is a predictive factor for long-term survival in ESCC, especially in nodal-negative patients. We conclude that 2.15 U/ml may be the optimum cuf-off point for CA 242 in predicting survival in ESCC.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9831-9834
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• 2014

Background: The prevalence of esophageal cancer (EC) with second primary cancers (SPC) is increasing worldwide. This study was aimed to understand the clinical features of EC patients with SPC in the Taiwanese population. Materials and Methods: Clinical and laboratory data for 180 EC patients with or without SPC were collected between January 2009 and December 2013. Information on treatment approaches, location of SPCs and ABO blood type were also collected and stratified. Results: The most common SPC in EC patients was hypopharyngeal cancer, followed by laryngeal cancer and hepatocellular carcinoma in our study. Malignancies of colon, prostate and lung were also found. There was a significant higher portion of blood type A in the EC patients with SPC compared with those without (42.4% vs 19.5%, P=0.006). Conclusions: The frequency and SPC site distribution and blood type A should be considered in clinical evaluation of EC patients with a high risk of developing SPC in the Taiwanese population.