esophageal

摘要： Proteins are key players in various cellular processes.As the ultimate executors of cellular processes,they play essential roles in linking genotypes to phenotypes.Abnormalities in protein expression and post-translational modifications(PTMs)are closely associated with the initiation and development of cancer,and they carry biological information inaccessible to genomics and transcriptomics1.Proteomics complements genomic and transcriptomic data,thus enabling comprehensive analysis of cancer pathogenesis and accelerating biomedical research2.

摘要： Contents1.Overview 2.Guidelines for diagnosis of esophageal cancer 2.1 Signs and symptoms 2.1.1 Clinical symptoms 2.1.2 Signs 2.2 Examinations 2.2.1 Imaging 2.2.2 Endoscopy 2.2.3 Other tests 2.3 Clinical diagnosis 2.4 Screening of high-risk group of esophageal cancer 2.5 Classification and staging of esophageal cancer.

摘要： The prognostic value of estrogen and/or ER on female pa tients with esophageal squamous cell carcinoma(ESCC)is rarely reported.Current study was undertaken to elucidate the associations of serum estradiol level,tissue estrogen receptor alpha(ERa)and estrogen receptor beta(ERβ)expression with clinical response and reproductive factor changes in 387 female ESCC patients.A genome-wide association study on 3921 ESCC patients using 40 SNPs(P≤1×10^(-7))demonstrated that rsl SNP with AA,GG or GA genotype was significantly difference(X^(2)=12.258,8.399,6.671;P=0.002,0.015,0.036)on overall survival.

摘要： Purpose: This study aims to evaluate the treatment plans of Volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) techniques for cervical-thoracic esophageal cancers. Methods and Materials: Sixty patients were retrospectively identified. Several parameters were evaluated based on target conformity and dose-volume histograms of organs at risk (lung, spinal cord, and heart). A phantom for time comparison was also assessed for each plan. Results: The IMRT plans (5f-IMRT: V95% = 99.4 ± 0.3, 7f-IMRT: V95% = 99.8 ± 0.1) results in better PTV coverage than RA plans (Single-arc: V95% = 95.8 ± 3.2, Double-arc: V95% = 95.4 ± 2.3). The target dose conformity of the 5f-IMRT plan was inferior to all plans (CI = 70.4 ± 7.1). The Single-arc plan achieved the best conformity (CI = 72.5 ± 4.6), whereas the Double-arc plan (CI = 72.1 ± 5.1) was slightly inferior to the Single-arc plan but superior to the 7f-IMRT plan (CI = 71.7 ± 8.6). The total MU was reduced by 42.1% in VMAT plan. The average MU needed to deliver the dose of 60 Gy for Single-arc (423.5 ± 52.1 MU) was found to be the least. Similarly, the average MU for the 5f-IMRT, 7f-IMRT and Double-arc were 868.2 ± 182.0 MU, 870.0 ± 225.3 MU and 548.8 ± 47.2 MU, respectively. The delivery time in VMAT plans was reduced from 193.8 seconds to 99.2 seconds by around 48.8% compared to IMRT plans. Conclusion: For similar PTV parameters, VMAT delivers a lower dose to organs at risk than IMRT in a shorter time, and this has warranted clinical implementation.

摘要： Objective:To report and explain the significance of transesophageal echocardiography(TEE)in the observation of left atrium and left atrial appendage before radiofrequency ablation in patients with AF.Methods:25 patients with AF were selected as the review objects who received echocardiography in our hospital during June 2018 to June 2019.They had routinely received transthoracic echocardiography(TTE)before preparing for radiofrequency ablation.Then TEE was selected to observe and compare the effect of two detection methods on left atrial and left auricular thrombosis.Results:TEE examinations were given to patients with atrial fibrillation before radiofrequency ablation.Compared with TTE examinations,the detection rate of left atrium and left atrial appendage thrombosis was significantly improved.The two detection methods are different and comparable(P<0.05),which is of great significance in clinical application.Conclusion:The use of TEE has significantly improved the detection rate of left atrial and left atrial appendage thrombosis in patients with AF,and has become an important examination method before the implementation of radiofrequency ablation.

摘要： BACKGROUND Esophageal cancer is a common digestive tract tumor that is generally treated with radiotherapy.Poor responses to radiotherapy in most patients generally result in local radiotherapy failure,so it is essential to find new radiosensitizers that can enhance the response of cancer cells to radiotherapy and improve the survival of esophageal cancer patients with radiation resistance.The long noncoding RNA(lncRNA)Rpph1 is highly expressed in human gastric cancer tissues,and represses breast cancer cell proliferation and tumorigenesis.However,the expression of lncRNA Rpph1 in esophageal cancer and its relationship with radio-sensitivity has not been studied.AIM To explore the value of lncRNA Rpph1 in esophageal cancer and its effect on cancer cell sensitivity to radiotherapy.METHODS Eighty-three patients with esophageal cancer admitted to Qilu Hospital of Shandong University and 90 healthy participants who received physical examinations were collected as research participants.The expression of Rpph1 was determined by qRT-PCR.siRNA-NC and siRNA-Rpph1 were transfected into esophageal cancer cell lines,and cells without transfection were designated as the blank control group.Cell survival was tested by colony formation assays,and the levels of proteins related to apoptosis and epithelial-mesenchymal transitions were determined by Western blot assays.Cell proliferation was assessed by MTT assays,cell apoptosis by flow cytometry,and cell migration by wound-healing assays.Changes in cell cycle distribution were monitored.RESULTS Rpph1 was highly expressed in esophageal carcinoma,making it a promising marker for the diagnosis of esophageal cancer.Rpph1 could also be used to distinguish different short-term responses,T stages,N stages,and clinical stages of esophageal cancer patients.The results of 3-year overall survival favored patients with lower Rpph1 expression over patients with higher Rpph1 expression(P<0.05).In vitro and in vivo experiments showed that silencing Rpph1 expression led to higher sensitivity of esophageal cancer cells to radiotherapy,stronger apoptosis in esophageal cancer cells induced by radiotherapy,higher expression of Bax and caspase-3,and lower expression of Bcl-2(Bax,caspase-3,and Bcl-2 are apoptosis-related proteins).Additionally,silencing Rpph1 attenuated radiation-induced G2/M phase arrest,and significantly inhibited the expression of proteins involved in cell proliferation,migration,and epithelial-mesenchymal transition regulation in esophageal cancer cells.CONCLUSION Rpph1 is highly expressed in esophageal cancer.Silencing Rpph1 expression can promote cell apoptosis,inhibit cell proliferation and migration,and increase radio-sensitivity.

摘要： Esophageal squamous cell carcinoma(ESCC)is a common malignant tumor of the digestive system worldwide,especially in China.Due to the lack of effective early detection methods,ESCC patients often present at an advanced stage at the time of diagnosis,which seriously affects the prognosis of patients.At present,early detection of ESCC mainly depends on invasive and expensive endoscopy and histopathological biopsy.Therefore,there is an unmet need for a noninvasive method to detect ESCC in the early stages.With the emergence of a large class of non-invasive diagnostic tools,serum tumor markers have attracted much attention because of their potential for detection of early tumors.Therefore,the identification of serum tumor markers for early detection of ESCC is undoubtedly one of the most effective ways to achieve early diagnosis and treatment of ESCC.This article reviews the recent advances in the discovery of blood-based ESCC biomarkers,and discusses the origins,clinical applications,and technical challenges of clinical validation of various types of biomarkers.

摘要： BACKGROUND The first line treatment regimen for esophageal cancer is still surgical resection and the choice of surgical scheme depends on surgeon.Now the efficacy comparison of hybrid minimally invasive esophagectomy(HMIE)and open esophagectomy(OE)is still controversial.AIM To compare the perioperative and postoperative outcomes of HMIE and OE in patients with esophageal cancer.METHODS PubMed,EMBASE,and Cochrane Library databases were searched for related articles.The odds ratio(OR)or standard mean difference(SMD)with a 95%confidence interval(CI)was used to evaluate the effectiveness of HMIE and OE.RESULTS Seventeen studies including a total of 2397 patients were selected.HMIE was significantly associated with less blood loss(SMD=-0.43,95%CI:-0.66,-0.20;P=0.0002)and lower incidence of pulmonary complications(OR=0.72,95%CI:0.57,0.90;P=0.004).No significant differences were seen in the lymph node yield(SMD=0.11,95%CI:-0.08,0.30;P=0.26),operation time(SMD=0.24,95%CI:-0.14,0.61;P=0.22),total complications rate(OR=0.68,95%CI:0.46,0.99;P=0.05),cardiac complication rate(OR=0.91,95%CI:0.62,1.34;P=0.64),anastomotic leak rate(OR=0.95,95%CI:0.67,1.35;P=0.78),duration of intensive care unit stay(SMD=-0.01,95%CI:-0.21,0.19;P=0.93),duration of hospital stay(SMD=-0.13,95%CI:-0.28,0.01;P=0.08),and total mortality rates(OR=0.70,95%CI:0.47,1.06;P=0.09)between the two treatment groups.CONCLUSION Compared with the OE,HMIE shows less blood loss and pulmonary complications.However,further studies are necessary to evaluate the long-term oncologic outcomes of HMIE.

摘要： BACKGROUND After an esophagectomy, the stomach is most commonly used to restore continuity of the upper gastrointestinal tract. These esophago-gastric anastomoses are prone to serious complications such as leakage associated with high morbidity and mortality. Graft perfusion is considered to be an important predictor for anastomotic integrity. Based on the current literature we believe Indocyanine green fluorescence angiography(ICGA) is an easy assessment tool for gastric tube(GT) perfusion, and it might predict anastomotic leakage(AL).AIM To evaluate feasibility and effectiveness of ICGA in GT perfusion assessment and as a predictor of AL.METHODS This study was designed according to the PRISMA guidelines and registered in the PROSPERO database. PubMed and EMBASE were independently searched by 2 reviewers for studies presenting data on intraoperative ICGA GT perfusion assessment during esophago-gastric reconstruction after esophagectomy.Relevant outcomes such as feasibility, complications, intraoperative surgical changes based on ICGA findings, quantification attempts, anatomical data and the impact of ICGA on postoperative anastomotic complications, were collected by 2 independent researchers. The quality of the included articles was assessed based on the Methodological Index for Non-Randomized Studies. The 19 included studies presented data on 1192 esophagectomy patients, in 758 patients ICGA was used perioperative to guide esophageal reconstruction.RESULTS The 19 included studies for qualitative analyses all described ICGA as a safe and easy method to evaluate gastric graft perfusion. AL occurred in 13.8% of the entire cohort, 10% in the ICG guided group and 20.6% in the control group(P <0.001). When poorly perfused cases are excluded from the analyses, the difference in AL was even larger(AL well-perfused group 6.3% vs control group 20.5%, P <0.001). The AL rate in the group with an altered surgical plan based on the ICG image was 6.5%, similar to the well perfused group(6.3%) and significantly less than the poorly perfused group(47.8%)(P < 0.001), suggesting that the technique is able to identify and alter a potential bad outcome.CONCLUSION ICGA is a safe, feasible and promising method for perfusion assessment. The lower AL rate in the well perfused group suggest that a good fluorescent signal predicts a good outcome.

摘要： BACKGROUND Chronic liver disease and cirrhosis is the 12^(th) leading cause of death in the United States. Patients with decompensated-cirrhosis, especially with hepatic encephalopathy/coma(HC), have a higher rate of early readmission and contribute to higher healthcare cost.AIM To evaluate the national inpatient trends of discharges, mortalities and financial impacts associated with four common conditions of cirrhosis.METHODS The publicly available Healthcare Cost and Utilization Project National Inpatient Sample database was utilized to examine the temporal trends of total number of discharges, mortalities and inpatient costs related to hospitalization with a primary diagnosis of HC, transjugular intrahepatic portosystemic shunt(TIPS),esophageal varices with bleeding(EV) and spontaneous bacterial peritonitis(SBP) from 2005 to 2014. The ten-year temporal trends were assessed using simple linear regressions and multiple regression analysis. Two-sided P < 0.05 was considered statistically significant.RESULTS From 2005 to 2014, the total number of discharges with cirrhosis-associated complications trended up for HC, SBP and EV(HC by 70% increase, P < 0.0001;SBP by 819% increase, P = 0.0002; EV by 9% increase, P = 0.016), but not for TIPS(P = 0.90). HC related to viral hepatitis showed faster increase by 357%(P <0.0001) in comparison to HC not related to viral hepatitis by 33 %(P = 0.0006).Overall, in-hospital mortality rates for each condition decreased from 2005 to2014(HC by 29% reduction, P = 0.0024; SBP by 26% reduction, P = 0.0038; TIPS by 32% reduction, P = 0.021) except for EV(P = 0.34). After adjustment for inflation, aggregate cost of hospitalization for EV, HC, and SBP significantly increased by 20%, 86%, and 980%, respectively, from 2005 to 2014(all P < 0.02),while TIPS had trend toward decreasing cost by 3%(P = 0.95).CONCLUSION The number of hospitalizations and costs for some of the cirrhosis-associated conditions increased. However, the inpatient mortality rates for most of these conditions decreased.