Sample records for esophageal adenocarcinoma ea

  1. Microbiome in Reflux Disorders and Esophageal Adenocarcinoma

    PubMed Central

    Yang, Liying; Chaudhary, Noami; Baghdadi, Jonathan; Pei, Zhiheng

    2014-01-01

    The incidence of esophageal adenocarcinoma has increased dramatically in the United States and Europe since the 1970s without apparent cause. Although specific host factors can affect risk of disease, such a rapid increase in incidence must be predominantly environmental. In the stomach, infection with Helicobacter pylori has been linked to chronic atrophic gastritis, an inflammatory precursor of gastric adenocarcinoma. However, the role of H. pylori in the development of esophageal adenocarcinoma is not well established. Meanwhile, several studies have established that a complex microbiome in the distal esophagus might play a more direct role. Transformation of the microbiome in precursor states to esophageal adenocarcinoma—reflux esophagitis and Barrett’s metaplasia—from a predominance of gram-positive bacteria to mostly gram-negative bacteria raises the possibility that dysbiosis is contributing to pathogenesis. However, knowledge of the microbiome in esophageal adenocarcinoma itself is lacking. Microbiome studies open a new avenue to the understanding of the etiology and pathogenesis of reflux disorders. PMID:24855009

  2. FOLFOX-6 Induction Chemotherapy Followed by Esophagectomy and Post-operative Chemoradiotherapy in Patients With Esophageal Adenocarcinoma

    ClinicalTrials.gov

    2015-02-16

    Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Adenocarcinoma of the Gastric Cardia; Stage IIIA Esophageal Cancer; Stage IIIB Esophageal Cancer; Stage IIIC Esophageal Cancer

  3. NF-?B Activation in Esophageal Adenocarcinoma

    PubMed Central

    Abdel-Latif, Mohamed M. M.; O'Riordan, James; Windle, Henry J.; Carton, Eleanor; Ravi, Nagunivan; Kelleher, Dermot; Reynolds, John V.

    2004-01-01

    Objective: To examine the expression of the transcription factor nuclear factor kappa B (NF-?B) in Barrett's epithelium and adenocarcinoma and the impact of NF-?B expression on tumor stage and response to neoadjuvant chemotherapy and radiation therapy. Summary Background Data: Progression of Barrett's esophagus to adenocarcinoma is associated with a wide range of cellular and molecular abnormalities. Nuclear factor-kappa B (NF-?B) regulates several genes involved in inflammatory, immune and apoptotic responses, but its role in esophageal inflammation and tumorigenesis has not been reported. Methods: Mobility shift assay was used to measure NF-?B activity in nuclear extracts of fresh-frozen biopsies from tumor and uninvolved tissues (n = 30) and esophageal cell lines OE33, SKGT-4, and OE21. RelA expression was assessed by immunohistochemical staining (n = 97). The NF-?B/RelA and I?B protein expressions were also examined by Western blotting. Results: NF-?B was not expressed in normal esophageal squamous epithelium, in contrast to increased expression in 40% of patients with Barrett's epithelium. Sixty-one percent of resected tumors (n = 97) displayed NF-?B immunoreactivity, and 87.5% of the NF-?B- positive tumors were Stage IIb and III compared with only 12.5% of patients with Stage I and IIa disease (P < 0.05). The expression of NF-?B inversely correlated with major or complete pathologic responses to neoadjuvant chemotherapy and radiation therapy, with 15/20 (75%) responders in the NF-?B-negative group compared with 7/38 (18%) in the NF-?B-positive group (P < 0.00001). Moreover, incubation of esophageal cell lines OE33, SKGT-4, and OE21 with deoxycholic acid or low pH induced NF-?B expression. Conclusions: Bile acids and low pH induce NF-?B expression in esophageal cell lines. NF-?B activation is common in esophageal adenocarcinoma. In patients with Barrett's epithelium and an associated esophageal adenocarcinoma, there is a progressive expression of NF-?B through Barrett's tumorigenesis. The absence of NF-?B expression in esophageal adenocarcinoma correlates with response to neoadjuvant chemoradiotherapy and may be of value in predicting response to neoadjuvant therapy. PMID:15024310

  4. Esophagitis: Incidence and Risk of Esophageal Adenocarcinoma—A Population-Based Cohort Study

    Microsoft Academic Search

    Annmarie Lassen; Jesper Hallas; Ove B Schaffalitzky de Muckadell

    2006-01-01

    OBJECTIVES:Although symptoms of reflux are common, our knowledge of the epidemiology and natural history of gastroesophageal reflux disease is sparse. The risk of esophageal adenocarcinoma is increased among patients with acid reflux, but the contribution of Barrett's lesions is unknown.METHODS:With the aim to estimate the incidence of diagnosed endoscopic esophagitis lesions and the risk of esophageal adenocarcinoma among patients with

  5. Endoscopic assessment and management of early esophageal adenocarcinoma

    PubMed Central

    Hammoud, Ghassan M; Hammad, Hazem; Ibdah, Jamal A

    2014-01-01

    Esophageal carcinoma affects more than 450000 people worldwide and the incidence is rapidly increasing. In the United States and Europe, esophageal adenocarcinoma has superseded esophageal squamous cell carcinoma in its incidence. Esophageal cancer has a high mortality rates secondary to the late presentation of most patients at advanced stages. Endoscopic screening is recommended for patients with multiple risk factors for cancer in Barrett’s esophagus. These risk factors include chronic gastroesophageal reflux disease, hiatal hernia, advanced age, male sex, white race, cigarette smoking, and obesity. The annual risk of esophageal cancer is approximately 0.25% for patients without dysplasia and 6% for patients with high-grade dysplasia. Twenty percent of all esophageal adenocarcinoma in the United States is early stage with disease confined to the mucosa or submucosa. The significant morbidity and mortality of esophagectomy make endoscopic treatment an attractive option. The American Gastroenterological Association recommends endoscopic eradication therapy for patients with high-grade dysplasia. Endoscopic modalities for treatment of early esophageal adenocarcinoma include endoscopic resection techniques and endoscopic ablative techniques such as radiofrequency ablation, photodynamic therapy and cryoablation. Endoscopic therapy should be precluded to patients with no evidence of lymphovascular invasion. Local tumor recurrence is low after endoscopic therapy and is predicted by poor differentiation of tumor, positive lymph node and submucosal invasion. Surgical resection should be offered to patients with deep submucosal invasion. PMID:25132925

  6. A Large-scale genetic association study of esophageal adenocarcinoma risk

    PubMed Central

    Liu, Chen-yu; Wu, Michael C.; Chen, Feng; Ter-Minassian, Monica; Asomaning, Kofi; Zhai, Rihong; Wang, Zhaoxi; Su, Li; Heist, Rebecca S.; Kulke, Matthew H.; Lin, Xihong; Liu, Geoffrey; Christiani, David C.

    2010-01-01

    The incidence of esophageal adenocarcinoma (EA) has been increasing rapidly, particularly among white males, over the past few decades in the USA. However, the etiology of EA and the striking male predominance is not fully explained by known risk factors. To identify susceptible genes for EA risk, we conducted a pathway-based candidate gene association study on 335 Caucasian EA cases and 319 Caucasian controls. A total of 1330 single-nucleotide polymorphisms (SNPs) selected from 354 genes were analyzed using an Illumina GoldenGate assay. The genotyped common SNPs include missense and exonic SNPs, SNPs within untranslated regions and 2 kb 5? of the gene, and tagSNPs for genes with little functional information available. Logistic regression adjusted for potential confounders was used to assess the genetic effect of each SNP on EA risk. We also tested gene–gender interactions using the likelihood ratio tests. We found that the genetic variants in the apoptosis pathway were significantly associated with EA risk after correcting for multiple comparisons. SNPs of rs3127075 in Caspase-7 (CASP7) and rs4661636 in Caspase-9 (CASP9) genes that play a critical role in apoptosis were found to be associated with an increased risk of EA. A protective effect of SNP rs572483 in the progesterone receptor (PGR) gene was observed among women carrying the variant G allele [adjusted odds ratio (OR)?=?0.19; 95% confidence interval (CI)?= 0.08–0.46] but was not observed among men (adjusted OR?= 1.38; 95% CI?=?0.95–2.00). In conclusion, this study suggests that the genetic variants of CASP7 and CASP9 in the apoptosis pathway may be important predictive markers for EA susceptibility and that PGR in the sex hormone signaling pathway may be associated with the gender differences in EA risk. PMID:20453000

  7. Clinicopathologic Characteristics of Esophageal Cancer Patients in Northwest Iran - Very Low Incidence of Adenocarcinomas

    Microsoft Academic Search

    Yousef Bafandeh; Shahriar Hashemzadeh; Mohsen Sokouti; Heidar Esmaili

    2006-01-01

    Aims: Iran is one of the known countries with a high incidence of esophageal cancer in Asia .We have recently shown that the incidence of Barrett's esophagus , a precancerous lesion for esophageal adenocarcinoma (AC) is very low in the north -west of the country . Therefore, we hypothesized that esophageal AC would also be lower than in the Western

  8. Effect of Freeze-Dried Berries on the Development of Reflux-Induced Esophageal Adenocarcinoma

    Microsoft Academic Search

    Harini S. Aiyer; Yan Li; Jack N. Losso; Chenfei Gao; Suzanne C. Schiffman; Stephen P. Slone; Robert C. G. Martin

    2011-01-01

    The incidence of esophageal adenocarcinoma in humans is increasing more rapidly than any other malignancy in the United States. Animal studies have demonstrated the efficacy of freeze-dried berry supplementation on carcinogen-induced esophageal squamous cell carcinoma in rats; however, no such studies have been done in esophagoduodenal anastomosis (EDA), an animal model for reflux-induced esophageal adenocarcinoma (EAC) development. Eight-week-old male Sprague-Dawley

  9. Chromosomal instability and copy number alterations in Barrett's esophagus and esophageal adenocarcinoma

    PubMed Central

    Paulson, Thomas G.; Maley, Carlo C.; Li, Xiaohong; Li, Hongzhe; Sanchez, Carissa A.; Chao, Dennis L.; Odze, Robert D.; Vaughan, Thomas L.; Blount, Patricia L.; Reid, Brian J.

    2009-01-01

    Purpose Chromosomal instability, as assessed by many techniques, including DNA content aneuploidy, LOH, and comparative genomic hybridization, has consistently been reported to be common in cancer and rare in normal tissues. Recently, a panel of chromosome instability biomarkers, including LOH and DNA content, has been reported to identify patients at high and low risk of progression from Barrett's esophagus (BE) to esophageal adenocarcinoma (EA), but required multiple platforms for implementation. Although chromosomal instability involving amplifications and deletions of chromosome regions have been observed in nearly all cancers, copy number alterations (CNAs) in premalignant tissues have not been well characterized or evaluated in cohort studies as biomarkers of cancer risk. Experimental Design We examined CNAs in 98 patients having either BE or EA using BAC array CGH to characterize CNAs at different stages of progression ranging from early BE to advanced EA. Results CNAs were rare in early stages (EA), including high level amplifications. The number of CNAs correlated highly with DNA content aneuploidy. Patients whose biopsies contained CNAs involving more than 70 Mbp were at increased risk of progression to DNA content abnormalities or EA (HR=4.9, 95% CI 1.6-14.8, p=0.0047), and the risk increased as more of the genome was affected. Conclusions Genome wide analysis of CNAs provides a common platform for evaluation of chromosome instability for cancer risk assessment as well as identification of common regions of alteration that can be further studied for biomarker discovery. PMID:19417022

  10. Ion Mobility-Mass Spectrometry Analysis of Serum Nlinked Glycans from Esophageal Adenocarcinoma Phenotypes

    E-print Network

    Clemmer, David E.

    Ion Mobility-Mass Spectrometry Analysis of Serum Nlinked Glycans from Esophageal Adenocarcinoma) serum samples are examined using a combination of ion mobility spectrometry (IMS), mass spectrometry (MS: ion mobility, electrospray ionization mass spectrometry, glycans, cancer, genetic algorithm, principal

  11. Right atrial invasion by metastatic esophageal adenocarcinoma with direct connection to liver.

    PubMed

    Nomani, Ali Zohair; Toori, Kaleem Ullah

    2014-05-01

    Common causes of right sided intra-cardiac atrial masses include primary cardiac tumors (atrial myxoma), atrial thrombus, tumor thrombus with hepatocellular or other thoracoabdominal cancers and metastatic lesions. Invasion of atria by gastrointestinal tumors is rare and that with esophageal ones seldom observed. Esophageal cancers rather present with dysphagia, odynophagia or systemic symptoms. Due to the lack of a serosal layer, esophageal tumors usually spread early in their course. Typical sites of spread include liver, gut, mediastinum, lungs and draining lymph nodes. We report a case of metastatic esophageal adenocarcinoma presenting with direct extension of metastatic tumor thrombus from liver to right atrium via inferior vena cava. PMID:24906258

  12. MiRNA-Related SNPs and Risk of Esophageal Adenocarcinoma and Barrett’s Esophagus: Post Genome-Wide Association Analysis in the BEACON Consortium

    PubMed Central

    Buas, Matthew F.; Onstad, Lynn; Levine, David M.; Risch, Harvey A.; Chow, Wong-Ho; Liu, Geoffrey; Fitzgerald, Rebecca C.; Bernstein, Leslie; Ye, Weimin; Bird, Nigel C.; Romero, Yvonne; Casson, Alan G.; Corley, Douglas A.; Shaheen, Nicholas J.; Wu, Anna H.; Gammon, Marilie D.; Reid, Brian J.; Hardie, Laura J.; Peters, Ulrike; Whiteman, David C.; Vaughan, Thomas L.

    2015-01-01

    Incidence of esophageal adenocarcinoma (EA) has increased substantially in recent decades. Multiple risk factors have been identified for EA and its precursor, Barrett’s esophagus (BE), such as reflux, European ancestry, male sex, obesity, and tobacco smoking, and several germline genetic variants were recently associated with disease risk. Using data from the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON) genome-wide association study (GWAS) of 2,515 EA cases, 3,295 BE cases, and 3,207 controls, we examined single nucleotide polymorphisms (SNPs) that potentially affect the biogenesis or biological activity of microRNAs (miRNAs), small non-coding RNAs implicated in post-transcriptional gene regulation, and deregulated in many cancers, including EA. Polymorphisms in three classes of genes were examined for association with risk of EA or BE: miRNA biogenesis genes (157 SNPs, 21 genes); miRNA gene loci (234 SNPs, 210 genes); and miRNA-targeted mRNAs (177 SNPs, 158 genes). Nominal associations (P<0.05) of 29 SNPs with EA risk, and 25 SNPs with BE risk, were observed. None remained significant after correction for multiple comparisons (FDR q>0.50), and we did not find evidence for interactions between variants analyzed and two risk factors for EA/BE (smoking and obesity). This analysis provides the most extensive assessment to date of miRNA-related SNPs in relation to risk of EA and BE. While common genetic variants within components of the miRNA biogenesis core pathway appear unlikely to modulate susceptibility to EA or BE, further studies may be warranted to examine potential associations between unassessed variants in miRNA genes and targets with disease risk. PMID:26039359

  13. The Role of Tobacco, Alcohol, and Obesity in Neoplastic Progression to Esophageal Adenocarcinoma: A Prospective Study of Barrett's Esophagus

    PubMed Central

    Hardikar, Sheetal; Onstad, Lynn; Blount, Patricia L.; Odze, Robert D.; Reid, Brian J.; Vaughan, Thomas L.

    2013-01-01

    Background Esophageal adenocarcinoma (EA) incidence in many developed countries has increased dramatically over four decades, while survival remains poor. Persons with Barrett's esophagus (BE), who experience substantially elevated EA risk, are typically followed in surveillance involving periodic endoscopy with biopsies, although few progress to EA. No medical, surgical or lifestyle interventions have been proven to safely lower EA risk. Design We investigated whether smoking, obesity or alcohol could predict progression to EA in a prospective cohort of 411 BE patients. Data were collected during personal interview. Adjusted hazard ratios (HR) were estimated using Cox regression. Results 39% had body mass index (BMI) over 30 and 64% had smoked cigarettes. Main analyses focused on those with at least 5 months of follow-up (33,635 person-months), in whom 45 developed EA. Risk increased by 3% per year of age (trend p-value 0.02), with approximate doubling of risk among males. EA risk increased with smoking pack-years (trend p-value 0.04) and duration (p-value 0.05). Compared to never-smokers, the HR for those in the highest pack-year tertile was 2.29 (95%CI 1.04–5.07). No association was found with alcohol or BMI, whereas a suggestion of increased risk was observed in those with higher waist-hip ratio, especially among males. Conclusion EA risk significantly increased with increasing age and cigarette exposure. Abdominal obesity, but not BMI, was associated with a modest increased risk. Continued follow-up of this and other cohorts is needed to precisely define these relationships so as to inform risk stratification and preventive interventions. PMID:23300966

  14. Immunohistochemical assessment of NY-ESO-1 expression in esophageal adenocarcinoma resection specimens

    PubMed Central

    Hayes, Stephen J; Hng, Keng Ngee; Clark, Peter; Thistlethwaite, Fiona; Hawkins, Robert E; Ang, Yeng

    2014-01-01

    AIM: To assess NY-ESO-1 expression in a cohort of esophageal adenocarcinomas. METHODS: A retrospective search of our tissue archive for esophageal resection specimens containing esophageal adenocarcinoma was performed, for cases which had previously been reported for diagnostic purposes, using the systematised nomenclature of human and veterinary medicine coding system. Original haematoxylin and eosin stained sections were reviewed, using light microscopy, to confirm classification and tumour differentiation. A total of 27 adenocarcinoma resection specimens were then assessed using immunohistochemistry for NY-ESO-1 expression: 4 well differentiated, 14 moderately differentiated, 4 moderate-poorly differentiated, and 5 poorly differentiated. RESULTS: Four out of a total of 27 cases of esophageal adenocarcinoma examined (15%) displayed diffuse cytoplasmic and nuclear expression for NY-ESO-1. They displayed a heterogeneous and mosaic-type pattern of diffuse staining. Diffuse cytoplasmic staining was not identified in any of these structures: stroma, normal squamous epithelium, normal submucosal gland and duct, Barrett’s esophagus (goblet cell), Barrett’s esophagus (non-goblet cell) and high grade glandular dysplasia. All adenocarcinomas showed an unexpected dot-type pattern of staining at nuclear, paranuclear and cytoplasmic locations. Similar dot-type staining, with varying frequency and size of dots, was observed on examination of Barrett’s metaplasia, esophageal submucosal gland acini and the large bowel negative control, predominantly at the crypt base. Furthermore, a prominent pattern of apical (luminal) cytoplasmic dot-type staining was observed in some cases of Barrett’s metaplasia and also adenocarcinoma. A further morphological finding of interest was noted on examination of haematoxylin and eosin stained sections, as aggregates of lymphocytes were consistently noted to surround submucosal glands. CONCLUSION: We have demonstrated for the first time NY-ESO-1 expression by esophageal adenocarcinomas, Barrett’s metaplasia and normal tissues other than germ cells. PMID:24744590

  15. TGM2 A Cell Surface Marker in Esophageal Adenocarcinomas

    PubMed Central

    Leicht, Deborah T.; Kausar, Tasneem; Wang, Zhuwen; Ferrer-Torres, Daysha; Wang, Thomas D.; Thomas, Dafydd G.; Lin, Jules; Chang, Andrew C.; Lin, Lin; Beer, David G.

    2014-01-01

    Introduction Esophageal adenocarcinomas (EAC) are aggressive cancers that are increasing in incidence and associated with a poor prognosis. The identification of highly expressed genes in EAC relative to metaplastic Barrett’s esophagus (BE) may provide new targets for novel early cancer detection strategies using endoscopically administered, fluorescently labeled peptides. Methods Gene expression analysis of BE and EACs were used to identify the cell surface marker transglutaminase 2 (TGM2) as overexpressed in cancer. The expression of two major isoforms of TGM2 was determined by qRT-polymerase chain reaction in an independent cohort of 128 EACs. Protein expression was confirmed by tissue microarrays and immunoblot analysis of EAC cell lines. TGM2 DNA copy number was assessed using single nucleotide polymorphism microarrays and confirmed by qPCR. TGM2 expression in neoadjuvantly treated EACs and following small interfering RNA-mediated knockdown in cisplatin-treated EAC cells was used to determine its possible role in chemoresistance. Results TGM2 is overexpressed in 15 EACs relative to 26 BE samples. Overexpression of both TGM2 isoforms was confirmed in 128 EACs and associated with higher tumor stage, poor differentiation, and increased inflammatory and desmoplastic response. Tissue microarrays and immunohistochemistry confirmed elevated TGM2 protein expression in EAC. Single nucleotide polymorphism and qPCR analysis revealed increased TGM2 gene copy number as one mechanism underlying elevated TGM2 expression. TGM2 was highly expressed in resistant EAC after patient treatment with neoadjuvant chemotherapy/radiation suggesting a role for TGM2 in chemoresistance. Conclusion TGM2 may be a useful cell surface biomarker for early detection of EAC. PMID:24828664

  16. Radiation Therapy, Paclitaxel, and Carboplatin With or Without Trastuzumab in Treating Patients With Esophageal Cancer

    ClinicalTrials.gov

    2015-07-09

    Adenocarcinoma of the Gastroesophageal Junction; Esophageal Adenocarcinoma; Stage IB Esophageal Cancer; Stage IIA Esophageal Cancer; Stage IIB Esophageal Cancer; Stage IIIA Esophageal Cancer; Stage IIIB Esophageal Cancer

  17. Barrett's esophagus and esophageal adenocarcinoma: the scope of the problem

    Microsoft Academic Search

    M. S. Levine; J. B. Herman; E. E. Furth

    1995-01-01

    Conclusion  Barrett's esophagus is probably a more common condition than previously recognized. Although the classic radiologic findings of Barrett's esophagus are present in only a small percentage of patients, this condition should be suspected whenever reflux esophagitis or peptic strictures are demonstrated on double-contrast esophagography. Recent literature also suggests that Barrett's carcinomas comprise up to 50% of all esophageal cancers. Because

  18. An oncofetal protein IMP3: a new molecular marker for the detection of esophageal adenocarcinoma and high-grade dysplasia.

    PubMed

    Lu, Di; Vohra, Poonam; Chu, Peigou G; Woda, Bruce; Rock, Kenneth L; Jiang, Zhong

    2009-04-01

    Accurate diagnosis of dysplasia and adenocarcinoma in patients with Barrett esophagus is critical for clinical decision-making and patient management. IMP3 is an oncofetal protein and has been demonstrated to be associated with aggressive tumor behavior. The aim of this study was to establish the expression pattern and diagnostic value of IMP3 in Barrett esophagus, dysplasia, and carcinoma. A total of 217 cases (resection, n=56; biopsy, n=161) with 302 lesions (invasive esophageal adenocarcinoma, n=147; metastatic esophageal adenocarcinoma, n=14; high-grade dysplasia of the esophagus, n=52; low-grade dysplasia of the esophagus gland, n=21; and Barrett esophagus, n=68) were examined by immunohistochemistry for IMP3 expression. IMP3 showed strong cytoplasmic granular staining in 138 of 147 (94%) of invasive esophageal adenocarcinomas, 13 of 14 (93%) of metastatic esophageal adenocarcinomas, and 49 of 52 (94%) of high-grade dysplasias. In contrast, 3/21 (14%) of low-grade dysplasia and 5/68 (7%) Barrett esophagus were positive for IMP3. Expression of IMP3 was not found in adjacent benign squamous and glandular mucosa. Our findings indicate that IMP3 is a highly sensitive and specific biomarker for the diagnosis of invasive esophageal adenocarcinoma and high-grade dysplasia. The data also suggest that IMP3, an oncofetal protein, may play an important role in malignant transformation in esophageal adenocarcinoma. PMID:19047899

  19. Antidiabetic drug metformin inhibits esophageal adenocarcinoma cell proliferation in vitro and in vivo.

    PubMed

    Fujihara, Shintaro; Kato, Kiyohito; Morishita, Asahiro; Iwama, Hisakazu; Nishioka, Tomoko; Chiyo, Taiga; Nishiyama, Noriko; Miyoshi, Hisaaki; Kobayashi, Mitsuyoshi; Kobara, Hideki; Mori, Hirohito; Okano, Keiichi; Suzuki, Yasuyuki; Masaki, Tsutomu

    2015-05-01

    Esophageal carcinoma is the eighth most common cancer worldwide and the sixth leading cause of cancer-related deaths, with one of the worst prognoses of any form of cancer. Treatment with the anti-diabetic drug metformin has been associated with reduced cancer incidence in patients with type 2 diabetes. This study therefore evaluated the effects of metformin on the proliferation, in vitro and in vivo, of human esophageal adenocarcinoma cells, as well as the microRNAs associated with the antitumor effects of metformin. Metformin inhibited the proliferation of the esophageal adenocarcinoma cell lines OE19, OE33, SK-GT4 and OACM 5.1C, blocking the G0 to G1 transition in the cell cycle. This was accompanied by strong reductions in G1 cyclins, especially cyclin D1, cyclin-dependent kinase (Cdk)4, and Cdk6, and decreases in retinoblastoma protein phosphorylation. In addition, metformin reduced the phosphorylation of epidermal growth factor receptor and insulin-like growth factor and insulin-like growth factor-1 receptor, as well as angiogenesis-related proteins, such as vascular endothelial growth factor, tissue inhibitor of metalloproteinases (TIMP)-1, and TIMP-2. Metformin also markedly altered microRNA expression. Treatment with metformin of athymic nude mice bearing xenograft tumors reduced tumor proliferation. These findings suggest that metformin may have clinical use in the treatment of esophageal adenocarcinoma. PMID:25709052

  20. Esophageal Adenocarcinoma in Barrett's Esophagus After Endoscopic Ablative Therapy: A Meta-Analysis and Systematic Review

    Microsoft Academic Search

    Sachin Wani; Srinivas R Puli; Nicholas J Shaheen; Brenda Westhoff; Sanjeev Slehria; Ajay Bansal; Amit Rastogi; Hari Sayana; Prateek Sharma

    2009-01-01

    OBJECTIVES:The extent of reduction of esophageal adenocarcinoma (EAC) incidence in Barrett's esophagus (BE) patients after endoscopic ablation is not known. The objective of this study was to determine the cancer incidence in BE patients after ablative therapy and compare these rates to cohort studies of BE patients not undergoing ablation.METHODS:A MEDLINE search of the literature on the natural history and

  1. Infrared light-absorbing gold/gold sulfide nanoparticles induce cell death in esophageal adenocarcinoma

    PubMed Central

    Li, Yan; Gobin, Andre M; Dryden, Gerald W; Kang, Xinqin; Xiao, Deyi; Li, Su Ping; Zhang, Guandong; Martin, Robert CG

    2013-01-01

    Gold nanoparticles and near infrared-absorbing light are each innocuous to tissue but when combined can destroy malignant tissue while leaving healthy tissue unharmed. This study investigated the feasibility of photothermal ablation therapy for esophageal adenocarcinoma using chitosan-coated gold/gold sulfide (CS-GGS) nanoparticles. A rat esophagoduodenal anastomosis model was used for the in vivo ablation study, and three human esophageal cell lines were used to study the response of cancer cells and benign cells to near infrared light after treatment with CS-GGS. The results indicate that both cancerous tissue and cancer cells took up more gold nanoparticles and were completely ablated after exposure to near infrared light. The benign tissue and noncancerous cells showed less uptake of these nanoparticles, and remained viable after exposure to near infrared light. CS-GGS nanoparticles could provide an optimal endoluminal therapeutic option for near infrared light ablation of esophageal cancer. PMID:23818775

  2. Esophageal Adenocarcinoma in “Mice and Men”: Back to Basics!

    Microsoft Academic Search

    Stephen E. Attwood; Lea-Anne Harrison; Sean L. Preston; Janusz A. Jankowski

    2008-01-01

    Adenocarcinoma related to Barrett's esophagus (BE) is increasing in the West faster than any other cancer. There are many potential chemopreventive agents as well as predictive biomarkers of cancer progression, but what is required is a robust high-throughput model in which to test hypotheses preclinically. The pathophysiology of metaplasia and cancer has been studied in 10 animal species. Though they

  3. Inflammatory and microRNA Gene Expression as Prognostic Classifiers of Barrett's Associated Esophageal Adenocarcinoma

    PubMed Central

    Nguyen, Giang Huong; Schetter, Aaron J.; Chou, David B.; Bowman, Elise D.; Zhao, Ronghua; Hawkes, Jason E.; Mathe, Ewy A.; Kumamoto, Kensuke; Zhao, Yiqiang; Budhu, Anuradha; Hagiwara, Nobutoshi; Wang, Xin Wei; Miyashita, Masao; Casson, Alan G.; Harris, Curtis C.

    2010-01-01

    Purpose Esophageal cancer is one of the most aggressive and deadly forms of cancer; highlighting the need to identify biomarkers for early detection and prognostic classification. Our recent studies have identified inflammatory gene and microRNA signatures derived from tumor and nontumor tissues as prognostic biomarkers of hepatocellular, lung, and colorectal adenocarcinoma. Here, we examine the relationship between expression of these inflammatory genes and miRNA expression in esophageal adenocarcinoma and patient survival. Experimental Design We measured the expression of 23 inflammation-associated genes in tumors and adjacent normal tissues from 93 patients (58 Barrett's and 35 Sporadic adenocarcinomas) by quantitative reverse transcription-polymerase chain reaction. These data were used to build an inflammatory risk model, based on multivariate Cox regression, to predict survival in a training cohort (n=47). We then determined if this model could predict survival in a cohort of 46 patients. Expression data for miRNA-375 was available for these patients and was combined with inflammatory gene expression. Results IFN?, IL-1?, IL-8, IL-21, IL-23, and PRG expression in tumor and nontumor samples were each associated with poor prognosis based on Cox regression ([Z-score]>1.5) and therefore, were used to generate an inflammatory risk score (IRS). Patients with a high IRS had poor prognosis compared to those with a low IRS in the training (P=0.002) and test (P=0.012) cohorts. This association was stronger in the group with Barrett's history. When combining with miRNA-375, the combined IRS/miR signature was an improved prognostic classifier than either one alone. Conclusion Transcriptional profiling of inflammation-associated genes and miRNA expression in resected esophageal Barrett's associated adenocarcinoma tissues may have clinical utility as predictors of prognosis. PMID:20947516

  4. Esophageal adenocarcinoma with white opaque substance observed by magnifying endoscopy with narrow band imaging.

    PubMed

    Yoshii, Shunsuke; Kato, Motohiko; Honma, Keiichiro; Fujinaga, Tetsuji; Tsujii, Yoshiki; Maekawa, Akira; Inoue, Takuya; Hayashi, Yoshito; Akasaka, Tomofumi; Shinzaki, Shinichiro; Nishida, Tsutomu; Iijima, Hideki; Tsujii, Masahiko; Morii, Eiichi; Takehara, Tetsuo

    2015-03-01

    White opaque substance (WOS) is observed in the gastric neoplasia of 0-IIa type using magnifying endoscopy with narrow band imaging (NBI-ME). Colonic and duodenal neoplasms with WOS have also been reported. Immunohistochemical examination with adipophilin reveals WOS in gastric neoplasms as lipid droplets, and WOS is specific for neoplasm with intestinal or gastrointestinal phenotype. We herein report a case of adenocarcinoma of the esophagogastric junction with WOS. A male patient in his sixties was found by esophagogastroduodenoscopy to have an esophageal elevated lesion. NBI-ME showed whitish deposits that looked similar to WOS in gastric neoplasms. The patient underwent endoscopic submucosal dissection and the lesion was resected in a single piece. This tumor had diffuse positivity for adipophilin and gastrointestinal phenotype. PMID:25041337

  5. Radiation induced esophageal adenocarcinoma in a woman previously treated for breast cancer and renal cell carcinoma

    PubMed Central

    2012-01-01

    Background Secondary radiation-induced cancers are rare but well-documented as long-term side effects of radiation in large populations of breast cancer survivors. Multiple neoplasms are rare. We report a case of esophageal adenocarcinoma in a patient treated previously for breast cancer and clear cell carcinoma of the kidney. Case presentation A 56?year-old non smoking woman, with no alcohol intake and no familial history of cancer; followed in the National Institute of Oncology of Rabat Morocco since 1999 for breast carcinoma, presented on consultation on January 2011 with dysphagia. Breast cancer was treated with modified radical mastectomy, 6 courses of chemotherapy based on CMF regimen and radiotherapy to breast, inner mammary chain and to pelvis as castration. Less than a year later, a renal right mass was discovered incidentally. Enlarged nephrectomy realized and showed renal cell carcinoma. A local and metastatic breast cancer recurrence occurred in 2007. Patient had 2 lines of chemotherapy and 2 lines of hormonotherapy with Letrozole and Tamoxifen assuring a stable disease. On January 2011, the patient presented dysphagia. Oesogastric endoscopy showed middle esophagus stenosing mass. Biopsy revealed adenocarcinoma. No evidence of metastasis was noticed on computed tomography and breast disease was controlled. Palliative brachytherapy to esophagus was delivered. Patient presented dysphagia due to progressive disease 4?months later. Jejunostomy was proposed but the patient refused any treatment. She died on July 2011. Conclusion We present here a multiple neoplasm in a patient with no known family history of cancers. Esophageal carcinoma is most likely induced by radiation. However the presence of a third malignancy suggests the presence of genetic disorders. PMID:22873795

  6. Base Transitions at CpG Dinucleotides in the p53 Gene Are Common in Esophageal Adenocarcinoma1

    Microsoft Academic Search

    Catherine M. Gleeson; James M. Sloan; James A. McGuigan; Andrew J. Ritchie; S. E. Hilary Russell

    1995-01-01

    This study examined the association between 17p allelic loss and p53 gene mutation in a series of 16 esophageal adenocarcinomas arising on a background of Barrett's esophagus. Two highly polymorphic dinucleotide repeat polymorphisms mapping to 17pl3 were analyzed to assess the frequency of 17p allelic loss in these tumors. Mutations in the p53 gene were detected by direct DNA sequencing.

  7. Phase I/II study of trastuzumab, paclitaxel, cisplatin and radiation for locally advanced, HER2 overexpressing, esophageal adenocarcinoma

    SciTech Connect

    Safran, Howard [Brown University Oncology Group, Providence, RI (United States)]. E-mail: hsafran@lifespan.org; Di Petrillo, Thomas [Brown University Oncology Group, Providence, RI (United States); Akerman, Paul [Brown University Oncology Group, Providence, RI (United States); Ng, Thomas [Brown University Oncology Group, Providence, RI (United States); Evans, Devon [Brown University Oncology Group, Providence, RI (United States); Steinhoff, Margaret [Brown University Oncology Group, Providence, RI (United States); Benton, David [Brown University Oncology Group, Providence, RI (United States); Purviance, John [Brown University Oncology Group, Providence, RI (United States); Goldstein, Lisa [Brown University Oncology Group, Providence, RI (United States); Tantravahi, Umadevi [Brown University Oncology Group, Providence, RI (United States); Kennedy, Teresa R.N. [Brown University Oncology Group, Providence, RI (United States)

    2007-02-01

    Purpose: To determine the overall survival for patients with locally advanced, HER2 overexpressing, esophageal adenocarcinoma receiving trastuzumab, paclitaxel, cisplatin, and radiation on a Phase I-II study. Methods and Materials: Patients with adenocarcinoma of the esophagus without distant organ metastases and 2+/3+ HER2 overexpression by immunohistochemistry (IHC) were eligible. All patients received cisplatin 25 mg/m{sup 2} and paclitaxel 50 mg/m{sup 2} weekly for 6 weeks with radiation therapy (RT) 50.4 Gy. Patients received trastuzumab at dose levels of 1, 1.5, or 2 mg/kg weekly for 5 weeks after an initial bolus of 2, 3, or 4 mg/kg. Results: Nineteen patients were entered: 7 (37%) had celiac adenopathy, and 7 (37%) had retroperitoneal, portal adenopathy, or scalene adenopathy. Fourteen of 19 patients (74%) had either 3+ HER2 expression by immunohistochemistry, or an increase in HER2 gene copy number by HER2 gene amplification or high polysomy by fluorescence in situ hybridization. The median survival of all patients was 24 months and the 2-year survival was 50%. Conclusions: Assessment of the effect of trastuzumab in the treatment of patients with esophageal adenocarcinoma overexpressing HER2 is limited by the small number of patients in this study. Overall survival, however, was similar to prior studies without an increase in toxicity. Evaluation of HER2 status should be performed in future trials for patients with adenocarcinoma of the esophagus that investigate therapies targeting the HER family.

  8. The XPD 751Gln allele is associated with an increased risk for esophageal adenocarcinoma: a population-based case-control study in Sweden.

    PubMed

    Ye, Weimin; Kumar, Rajiv; Bacova, Gabriela; Lagergren, Jesper; Hemminki, Kari; Nyrén, Olof

    2006-09-01

    Mechanisms behind the strong associations of esophageal adenocarcinoma risk with gastroesophageal reflux (GOR) and body mass remain to be defined. In a nationwide population-based case-control study, we examined associations of polymorphisms in the DNA repair genes XPD, XPC, XRCC1 and XRCC3 with risk of esophageal adenocarcinoma, squamous-cell carcinoma (SCC) and gastric cardia adenocarcinoma, and paid special attention to possible interactions with symptomatic reflux or body mass. We collected blood samples from 96, 81 and 126 interviewed incident cases of esophageal adenocarcinoma, esophageal SCC and gastric cardia adenocarcinoma, respectively, and 472 randomly selected controls, frequency-matched with regard to age and sex. DNA was extracted and polymorphisms in XPD codon 751 (Lys-->Gln), codon 312 (Asp-->Asn), C insertion in intron 10 of XPD, XPC codon 939 (Lys-->Gln), XRCC1 codon 399 (Arg-->Gln) and XRCC3 codon 241 (Thr-->Met) were examined using PCR-RFLP. Odds ratios (ORs) derived from multivariate logistic regression with adjustments for potential confounding factors estimated relative risks. XPD codon 751 Lys/Gln and Gln/Gln genotypes, compared with Lys/Lys genotype, were both associated with a more than doubled risk for esophageal adenocarcinoma (OR=2.4; 95% CI=1.4-4.4; OR=2.7, 95% CI=1.3-5.9). The combined effects of these genotypes and symptomatic GOR or body mass showed borderline significant deviation from additivity. Excess risks for esophageal SCC were also noted for XPD 751Gln variant genotypes. Other studied variants were not found to be related to the three tumors. Our study suggests that XPD 751Gln allele is a potential genetic marker for susceptibility to esophageal adenocarcinoma. PMID:16571649

  9. Ion Mobility-Mass Spectrometry Analysis of Serum N-linked Glycans from Esophageal Adenocarcinoma Phenotypes

    PubMed Central

    Gaye, M. M.; Valentine, S. J.; Hu, Y.; Mirjankar, N.; Hammoud, Z. T.; Mechref, Y.; Lavine, B. K.; Clemmer, D. E.

    2012-01-01

    Three disease phenotypes, Barrett’s esophagus (BE), high-grade dysplasia (HGD), esophageal adenocarcinoma (EAC), and a set of normal control (NC) serum samples are examined using a combination of ion mobility spectrometry (IMS), mass spectrometry (MS) and principal component analysis (PCA) techniques. Samples from a total of 136 individuals were examined, including: 7 characterized as BE, 12 as HGD, 56 as EAC and 61 as NC. In typical datasets it was possible to assign ~20 to 30 glycan ions based on MS measurements. Ion mobility distributions for these ions show multiple features. In some cases, such as the [S1H5N4+3Na]3+ and [S1F1H5N4+3Na]3+ glycan ions, the ratio of intensities of high-mobility features to low-mobility features vary significantly for different groups. The degree to which such variations in mobility profiles can be used to distinguish phenotypes is evaluated for eleven N-linked glycan ions. An outlier analysis on each sample class followed by an unsupervised PCA using a genetic algorithm for pattern recognition reveals that EAC samples are separated from NC samples based on 46 features originating from the 11-glycan composite IMS distribution. PMID:23126309

  10. Esophageal adenocarcinoma and obesity: peritumoral adipose tissue plays a role in lymph node invasion

    PubMed Central

    Carraro, Amedeo; Lunardi, Francesca; Kotsafti, Andromachi; Porzionato, Andrea; Saadeh, Luca; Cagol, Matteo; Alfieri, Rita; Tedeschi, Umberto; Calabrese, Fiorella; Castoro, Carlo; Vettor, Roberto

    2015-01-01

    Obesity is associated with cancer risk in esophageal adenocarcinoma (EAC). Adipose tissue directly stimulates tumor progression independently from body mass index (BMI), but the mechanisms are not fully understood. We studied the morphological, histological and molecular characteristics of peritumoral and distal adipose tissue of 60 patients with EAC, to investigate whether depot-specific differences affect tumor behavior. We observed that increased adipocyte size (a hallmark of obesity) was directly associated with leptin expression, angiogenesis (CD31) and lymphangiogenesis (podoplanin); however, these parameters were associated with nodal metastasis only in peritumoral but not distal adipose tissue of patients. We treated OE33 cells with conditioned media (CM) collected from cultured biopsies of adipose tissue and we observed increased mRNA levels of leptin and adiponectin receptors, as well as two key regulator genes of epithelial-to-mesenchymal transition (EMT): alpha-smooth muscle actin (?-SMA) and E-cadherin. This effect was greater in cells treated with CM from peritumoral adipose tissue of patients with nodal metastasis and was partially blunted by a leptin antagonist. Therefore, peritumoral adipose tissue may exert a direct effect on the progression of EAC by secreting depot-specific paracrine factors, and leptin is a key player in this crosstalk. PMID:25857300

  11. Esophageal Carcinoma in African Americans: A Five-Decade Experience

    Microsoft Academic Search

    Hassan Ashktorab; Zahra Nouri; Mehdi Nouraie; Hadi Razjouyan; Edward E. Lee; Ehsan Dowlati; El-Waleed El-Seyed; Adeyinka Laiyemo; Hassan Brim; Duane T. Smoot

    Background  Esophageal cancer accounts for a considerable proportion of carcinomas of the upper gastrointestinal tract in African Americans.\\u000a Our aim was to describe the epidemiology of esophageal squamous cell cancer (ESCC) and esophageal adenocarcinoma (EA) among\\u000a African Americans in the last five decades.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 601 records of patients with documented esophageal cancer between 1959 and 2007 at Howard University

  12. Single nucleotide polymorphisms in CRTC1 and BARX1 are associated with esophageal adenocarcinoma

    PubMed Central

    van Nistelrooij, Anna M. J.; van der Korput, Hetty A. G. M.; Broer, Linda; van Marion, Ronald; van Berge Henegouwen, Mark I.; van Noesel, Carel J.; Biermann, Katharina; Spaander, Manon C. W.; Tilanus, Hugo W.; van Lanschot, J. Jan B.; Hofman, Albert; Uitterlinden, André G.; Wijnhoven, Bas P. L.; Dinjens, Winand N. M.

    2015-01-01

    Objective: Recently, single nucleotide polymorphisms (SNPs) associated with esophageal adenocarcinoma (EAC) and Barrett's esophagus (BE) were identified; rs10419226 (CRTC1), rs11789015 (BARX1), rs2687201 (FOXP1), rs2178146 (FOXF1), rs3111601 (FOXF1), and rs9936833 (FOXF1). These findings indicate that genetic susceptibility could play a role in the initiation of EAC in BE patients. The aim of this study was to validate the association between these previously identified SNPs and the risk of EAC in an independent and large case–control study. Design: Six SNPs found to be associated with EAC and BE were genotyped by a multiplex SNaPshot analysis in 1071 EAC patients diagnosed and treated in the Netherlands. Allele frequencies were compared to a control group derived from the Rotterdam Study, a population-based prospective cohort study (n = 6206). Logistic regression analysis and meta-analysis were performed to calculate odds ratios (OR). Results: Rs10419226 (CRTC1) showed a significantly increased EAC risk for the minor allele (OR = 1.17, P = 0.001), and rs11789015 (BARX1) showed a significantly decreased risk for the minor allele (OR = 0.85, P = 0.004) in the logistic regression analysis. The meta-analysis of the original GWAS and the current study revealed an improved level of significance for rs10419226 (CRTC1) (OR = 1.18, P = 6.66 × 10–10) and rs11789015 (BARX1) (OR = 0.83, P = 1.13 × 10–8). Conclusions: This independent and large Dutch case–control study confirms the association of rs10419226 (CRTC1) and rs11789015 (BARX1) with the risk of EAC. These findings suggest a contribution of the patient genetic make-up to the development of EAC and might contribute to gain more insight in the etiology of this cancer. PMID:26085818

  13. Prognostic Impact of Body Mass Index Stratified by Smoking Status in Patients With Esophageal Adenocarcinoma

    PubMed Central

    Yoon, Harry H.; Lewis, Mark A.; Shi, Qian; Khan, Maliha; Cassivi, Stephen D.; Diasio, Robert B.; Sinicrope, Frank A.

    2011-01-01

    Purpose Given that smoking affects body mass index (BMI) and survival, stratification by smoking status may be required to determine the true prognostic impact of BMI. Although obesity increases risk for developing esophageal adenocarcinoma (EAC), the prognostic influence of obesity and its potential modification by smoking status is unknown in this disease. Patients and Methods All patients (N = 778) underwent potentially curative esophagectomy. BMI was calculated using measured height and weight at surgery and categorized as obese (? 30 kg/m2), overweight (25 to 29.9 kg/m2), or normal (18.5 to 24.9 kg/m2). Cigarette smoking was categorized as never or ever. The association of BMI with disease-specific survival (DSS), disease-free survival (DFS), and overall survival (OS) was determined by Cox regression. Results Excess BMI was significantly associated with DSS in a manner that differed substantially by smoking status (P for interaction = .023). Among never smokers, obesity was significantly associated with adverse DSS (hazard ratio [HR] = 2.11; 95% CI, 1.31 to 3.43; P = .002), DFS (HR = 2.03; 95% CI, 1.30 to 3.18; P = .002), and OS (HR = 1.97; 95% CI, 1.24 to 3.14; P = .004), as compared with normal weight, after adjusting for covariates. By contrast, among ever smokers, obesity was not prognostic, and overweight status was significantly associated with favorable survival in univariate, but not multivariate, analysis. Conclusion Obesity among never smokers was independently associated with two-fold worsening of DSS, DFS, and OS after surgery for EAC, after adjusting for known prognostic factors. These data, in one of the largest reported resected EAC cohorts, are the first to show an adverse prognostic impact of obesity in EAC. PMID:21990414

  14. MiR-145 Expression Accelerates Esophageal Adenocarcinoma Progression by Enhancing Cell Invasion and Anoikis Resistance

    PubMed Central

    Derouet, Mathieu Francois; Liu, Geoffrey; Darling, Gail Elizabeth

    2014-01-01

    Background Carcinoma of the esophagus has a high case fatality ratio and is now the 6th most common cause of cancer deaths in the world. We previously conducted a study to profile the expression of miRNAs in esophageal adenocarcinoma (EAC) pre and post induction therapy. Of the miRNAs differentially expressed post induction chemoradiation, miR-145, a known tumor suppressor miRNA, was upregulated 8-fold following induction therapy, however, its expression was associated with shorter disease-free survival. This unexpected result was explored in this current study. Methods In order to study the role of miR-145 in EAC, miRNA-145 was overexpressed in 3 EAC cell lines (OE33, FLO-1, SK-GT-4) and one ESCC cell line (KYSE-410). After validation of the expression of miR-145, hallmarks of cancer such as cell proliferation, resistance to chemotherapy drugs or anoikis, and cell invasion were analyzed. Results There were no differences in cell proliferation and 5 FU resistance between miR145 cell lines and the control cell lines. miR-145 expression also had no effect on cisplatin resistance in two of three cell lines (OE33 and FLO-1), but miR-145 appeared to protect SK-GT-4 cells against cisplatin treatment. However, there was a significant difference in cell invasion, cell adhesion and resistance to anoikis. All three EAC miR-145 cell lines invaded more than their respective controls. Similarly, OE33 and SK-GT-4 miR-145 cell lines were able to survive longer in a suspension state. Discussion While expression of miR-145 in ESCC stopped proliferation and invasion, expression of miR-145 in EAC cells enhanced invasion and anoikis resistance. Although more work is required to understand how miR-145 conveys these effects, expression of miR-145 appears to promote EAC progression by enhancing invasion and protection against anoikis, which could in turn facilitate distant metastasis. PMID:25551563

  15. Whole Genome Expression Array Profiling Highlights Differences in Mucosal Defense Genes in Barrett's Esophagus and Esophageal Adenocarcinoma

    PubMed Central

    Nancarrow, Derek J.; Clouston, Andrew D.; Smithers, B. Mark; Gotley, David C.; Drew, Paul A.; Watson, David I.; Tyagi, Sonika; Hayward, Nicholas K.; Whiteman, David C.

    2011-01-01

    Esophageal adenocarcinoma (EAC) has become a major concern in Western countries due to rapid rises in incidence coupled with very poor survival rates. One of the key risk factors for the development of this cancer is the presence of Barrett's esophagus (BE), which is believed to form in response to repeated gastro-esophageal reflux. In this study we performed comparative, genome-wide expression profiling (using Illumina whole-genome Beadarrays) on total RNA extracted from esophageal biopsy tissues from individuals with EAC, BE (in the absence of EAC) and those with normal squamous epithelium. We combined these data with publically accessible raw data from three similar studies to investigate key gene and ontology differences between these three tissue states. The results support the deduction that BE is a tissue with enhanced glycoprotein synthesis machinery (DPP4, ATP2A3, AGR2) designed to provide strong mucosal defenses aimed at resisting gastro-esophageal reflux. EAC exhibits the enhanced extracellular matrix remodeling (collagens, IGFBP7, PLAU) effects expected in an aggressive form of cancer, as well as evidence of reduced expression of genes associated with mucosal (MUC6, CA2, TFF1) and xenobiotic (AKR1C2, AKR1B10) defenses. When our results are compared to previous whole-genome expression profiling studies keratin, mucin, annexin and trefoil factor gene groups are the most frequently represented differentially expressed gene families. Eleven genes identified here are also represented in at least 3 other profiling studies. We used these genes to discriminate between squamous epithelium, BE and EAC within the two largest cohorts using a support vector machine leave one out cross validation (LOOCV) analysis. While this method was satisfactory for discriminating squamous epithelium and BE, it demonstrates the need for more detailed investigations into profiling changes between BE and EAC. PMID:21829465

  16. Esophagitis

    MedlinePLUS

    ... following increase your risk of esophagitis: Alcohol use Cigarette smoking Surgery or radiation to the chest (for example, treatment for lung cancer) Taking certain medications without plenty of water, especially ...

  17. Expression of Bile Acid Transporting Proteins in Barrett’s Esophagus and Esophageal Adenocarcinoma

    PubMed Central

    Dvorak, Katerina; Watts, George S.; Ramsey, Lois; Holubec, Hana; Payne, Claire M.; Bernstein, Carol; Jenkins, Gareth J.; Sampliner, Richard E.; Prasad, Anil; Garewal, Harinder S.; Bernstein, Harris

    2015-01-01

    OBJECTIVES Barrett’s esophagus (BE) is a metaplastic lesion characterized by replacement of the normal squamous epithelium by columnar intestinal epithelium containing goblet cells. It is speculated that this process is an adaptation to protect cells from components of refluxate, such as gastric acid and bile acids. In contrast to the normal squamous epithelium, enterocytes of the distal ileum are adapted to transport bile acids from the intestinal lumen. Several bile acid transporters are utilized for effective removal of bile acids, including the apical sodium-dependent bile acid transporter (ASBT), the ileal bile acid-binding protein (IBABP), and the multidrug-resistant protein 3 (MRP3). We hypothesized that one of the possible functions of newly arising metaplastic epithelium, in the esophagus, is to transport bile acids. Our major goal was to evaluate the expression of bile acid transporters in normal squamous epithelium, BE with different grades of dysplasia, and esophageal adenocarcinoma (EAC). METHODS A total of 101 patients were included in this study. Immunohistochemistry (IHC) and reverse transcriptase (RT)–PCR were used to detect the expression of these transporters at the mRNA and protein levels. RESULTS Our immunohistochemical studies showed that all three bile acid transporters are expressed in BE glands, but not in squamous epithelium. ASBT was found in the apical border in BE biopsies. The highest frequency of ASBT expression was in patients with nondysplastic BE (9 of 15, 60%), and a progressive loss of ASBT was observed through the stages of dysplasia. ASBT was not detected in EAC (0 of 15). IBABP staining was observed in the cytoplasm of BE epithelial surface cells. Expression of IBABP was found in 100% of nondysplastic BE (14 of 14), in 93% of low-grade dysplasia (LGD, 15 of 16), in 73% of high-grade dysplasia (HGD, 10 of 14), and in 33% of EAC (5 of 15). MRP3 was expressed in the basolateral membrane in 93% of nondysplastic BE (13 of 14), in 60% of LGD (10 of 16), and in 86% of HGD (11 of 13). Only weak MRP3 staining was detected in EAC biopsies (5 of 15, 33%). In addition, RT–PCR studies showed increased expression of mRNA coding for ASBT (6.1×), IBABP (9.1×), and MRP3 (2.4×) in BE (N = 13) compared with normal squamous epithelium (N = 15). Significantly increased mRNA levels of IBABP (10.1×) and MRP3 (2.5×) were also detected in EAC (N = 21) compared with normal squamous epithelium. CONCLUSIONS We found that bile acid transporters expression is increased in BE tissue at the mRNA and protein levels and that expression of bile acid transporter proteins decreased with progression to cancer. PMID:19174784

  18. The impact of multimodality therapy of distal esophageal and gastroesophageal junction adenocarcinomas on treatment-related toxicity and complications.

    PubMed

    Monjazeb, Arta Monir; Blackstock, A William

    2013-01-01

    The benefit of multimodality therapy is clearly established for adenocarcinomas of the distal esophagus and gastroesophageal junction, but its impact on toxicity is not well defined. We reviewed data from prospective randomized trials to better define the risks of multimodality therapy. The rates of surgical mortality and complications range from 0% to 10% and 23% to 49%, respectively. Multimodality therapy increases acute toxicity. The rate of severe acute hematologic toxicity varies considerably between trials (3%-78%) and appears to be primarily attributable to chemotherapy. Common severe acute nonhematologic toxicities include esophagitis (16%-63%), infection (2%-30%), pain (3%-24%), and gastrointestinal (6%-60%) and cardiac (3%-19%) events. The individual contribution of each modality to nonhematologic toxicities is unclear, but toxicity is increased when adding radiosensitizing chemotherapy to radiotherapy. There is an acute decrease in quality of life with multimodality therapy; however, quality of life usually returns to, or exceeds, baseline by 12 months after therapy. Late toxicities are less well defined, but commonly include esophageal, pulmonary, and cardiac toxicities. PMID:23207048

  19. General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Steffen, Annika; Huerta, José-Maria; Weiderpass, Elisabete; Bueno-de-Mesquita, H B As; May, Anne M; Siersema, Peter D; Kaaks, Rudolf; Neamat-Allah, Jasmine; Pala, Valeria; Panico, Salvatore; Saieva, Calogero; Tumino, Rosario; Naccarati, Alessio; Dorronsoro, Miren; Sánchez-Cantalejo, Emilio; Ardanaz, Eva; Quirós, J Ramón; Ohlsson, Bodil; Johansson, Mattias; Wallner, Bengt; Overvad, Kim; Halkjaer, Jytte; Tjønneland, Anne; Fagherazzi, Guy; Racine, Antoine; Clavel-Chapelon, Françoise; Key, Tim J; Khaw, Kay-Tee; Wareham, Nick; Lagiou, Pagona; Bamia, Christina; Trichopoulou, Antonia; Ferrari, Pietro; Freisling, Heinz; Lu, Yunxia; Riboli, Elio; Cross, Amanda J; Gonzalez, Carlos A; Boeing, Heiner

    2015-08-01

    General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After mutual adjustment, BMI was unrelated to EAC, while WC showed a strong positive association (highest vs. lowest quintile HR?=?1.19; 95% CI, 0.63-2.22 and HR?=?3.76; 1.72-8.22, respectively). Hip circumference (HC) was inversely related to EAC after controlling for WC, while WC remained positively associated (HR?=?0.35; 0.18-0.68, and HR=4.10; 1.94-8.63, respectively). BMI was not associated with GCC or GNCC. WC was related to higher risks of GCC after adjustment for BMI and more strongly after adjustment for HC (highest vs. lowest quintile HR?=?1.91; 1.09-3.37, and HR?=?2.23; 1.28-3.90, respectively). Our study demonstrates that abdominal, rather than general, obesity is an indisputable risk factor for EAC and also provides evidence for a protective effect of gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further shows that general obesity is not a risk factor for GCC and GNCC, while the role of abdominal obesity in GCC needs further investigation. PMID:25598323

  20. Diet and esophageal disease.

    PubMed

    Dawsey, Sanford M; Fagundes, Renato B; Jacobson, Brian C; Kresty, Laura A; Mallery, Susan R; Paski, Shirley; van den Brandt, Piet A

    2014-09-01

    The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on macronutrients, dietary patterns, and risk of adenocarcinoma in Barrett's esophagus; micronutrients, trace elements, and risk of Barrett's esophagus and esophageal adenocarcinoma; the role of mate consumption in the development of squamous cell carcinoma; the relationship between energy excess and development of esophageal adenocarcinoma; and the nutritional management of the esophageal cancer patient. PMID:25266021

  1. A comprehensive survey of clonal diversity measures in Barrett’s esophagus as biomarkers of progression to esophageal adenocarcinoma

    PubMed Central

    Merlo, Lauren M.F.; Shah, Najaf A.; Li, Xiaohong; Blount, Patricia L.; Vaughan, Thomas L.; Reid, Brian J.; Maley, Carlo C.

    2010-01-01

    Neoplastic progression is an evolutionary process driven by the generation of clonal diversity and natural selection on that diversity within a neoplasm. We hypothesized that clonal diversity is associated with the risk of progression to cancer. We obtained molecular data from a cohort of 239 participants with Barrett’s esophagus (BE), including microsatellite shifts and loss of heterozygosity, DNA content tetraploidy and aneuploidy, methylation and sequence mutations. Using these data, we tested all major diversity measurement methods, including genetic divergence and entropy based measures, to determine which measures are correlated with risk of progression to esophageal adenocarcinoma. We also tested whether the use of different sets of loci and alterations to define clones (e.g. selectively advantageous vs. evolutionarily neutral) improved the predictive value of the diversity indices. All diversity measures were strong and highly significant predictors of progression (Cox proportional hazards model, p<0.001). The type of alterations evaluated had little effect on the predictive value of most of the diversity measures. In summary, diversity measures are robust predictors of progression to cancer in this cohort. PMID:20947487

  2. Esophageal Squamous Cell Carcinoma and Gastric Cardia Adenocarcinoma Shared Susceptibility Locus in C20orf54: Evidence from Published Studies

    PubMed Central

    Duan, Fujiao; Cui, Shuli; Song, Chunhua; Zhao, Xia; Dai, Liping; Shen, Yong

    2015-01-01

    This study aimed to determine whether C20orf54 rs13042395 polymorphism modify the risk of esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinomas (GCA) in common population. We conducted a systematic literature review and evaluated the quality of included studies based on Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) and corresponding 95% confidence intervals (95%CIs) were calculated to estimate the strengths of the associations. 9 articles (10 studies) were identified for synthesis analyses. Overall, the results indicated that the C20orf54 rs13042395 genotype was subtly decrease the risk of ESCC (T vs. C: OR?=?0.95; 95%CI?=?0.90–0.99; P?=?0.02) and the rs13042395 polymorphism was associated with a decreased risk of GCA (T vs. C: OR?=?0.95; 95%CI?=?0.91–0.98; P?

  3. Expression and prognostic significance of the polymeric immunoglobulin receptor in esophageal and gastric adenocarcinoma

    PubMed Central

    2014-01-01

    Introduction The polymeric immunoglobulin receptor (PIGR) has been proposed to be a candidate prognostic biomarker in a few cancer forms, and one previous study reported that reduced PIGR expression signifies more aggressive tumours of the distal esophagus and gastroesophageal junction (GEJ). In the present study, we examined the expression, clinicopathological correlates and prognostic significance of PIGR expression in an extended cohort of adenocarcinoma of the upper gastrointestinal tract. Materials and methods Immunohistochemical PIGR expression was examined in a consecutive cohort of patients with surgically resected, radio-chemonaive adenocarcinoma of the esophagus, GE-junction and stomach (n?=?173), including paired samples of benign-appearing squamous epithelium (n?=?51), gastric mucosa (n?=?114), Barrett’s esophagus (BE) or intestinal metaplasia (IM) (n?=?57) and lymph node metastases (n?=?75). Non-parametric tests were applied to explore associations between PIGR expression in primary tumours and clinicopathological characteristics. Classification and regression tree analysis was applied for selection of prognostic cut-off. The impact of PIGR expression on overall survival (OS) and recurrence-free survival (RFS) was assessed by Kaplan-Meier analysis and hazard ratios (HR) calculated by adjusted and unadjusted Cox proportional hazards modelling. Results PIGR expression was significantly higher in intestinal metaplasia (BE or gastric IM) compared to normal tissues and cancer (p?adenocarcinoma of the upper gastrointestinal tract. These findings are of potential clinical relevance and merit further validation. PMID:24694107

  4. C-Met Inhibitor AMG 337, Oxaliplatin, Leucovorin Calcium, and Fluorouracil in Treating Patients With Advanced Stomach or Esophageal Cancer

    ClinicalTrials.gov

    2015-01-16

    Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Diffuse Adenocarcinoma of the Stomach; Gastrointestinal Cancer; Intestinal Adenocarcinoma of the Stomach; Mixed Adenocarcinoma of the Stomach; Stage IIIA Esophageal Cancer; Stage IIIA Gastric Cancer; Stage IIIB Esophageal Cancer; Stage IIIB Gastric Cancer; Stage IIIC Esophageal Cancer; Stage IIIC Gastric Cancer; Stage IV Esophageal Cancer; Stage IV Gastric Cancer

  5. Statin use is associated with a reduction in the incidence of esophageal adenocarcinoma: a case control study.

    PubMed

    Beales, I L P; Vardi, I; Dearman, L; Broughton, T

    2013-01-01

    The incidence of esophageal adenocarcinoma (EAC) is increasing significantly throughout the developed world. As yet, there are no proven chemopreventive strategies. In laboratory studies, aspirin, non-steroidal anti-inflammatory drugs and statins have promising chemopreventive actions. Several observational studies support a protective effect of aspirin and non-steroidal anti-inflammatory drugs, but there are only limited clinical data exploring the potential protective effect of statins. We conducted a case-control study examining aspirin and statin use in patients with EAC. Cancer cases were compared against age-sex-matched controls attending for diagnostic upper gastrointestinal endoscopy. Risk factor and drug exposure were established using standardized interviews. Logistic regression was used to compare statin exposure and correct for confounding factors. A total of 112 cases and 448 controls were enrolled. Statin use was associated with a significantly lower incidence of EAC (odds ratio 0.52, 95% confidence interval 0.27-0.92). Aspirin use was also associated with apparent protection against EAC (odds ratio 0.68, 95% confidence interval 0.28-0.92), and a significantly greater effect was seen with the combination of statin plus aspirin (odds ratio 0.27, 95% confidence interval 0.05-0.67). There was a significant trend for greater risk reduction with longer duration and higher doses of statin use. Simvastatin comprised the majority of statin use, but similar effects were seen with simvastatin and non-simvastatin agents. In this observational study, patients regularly using statins or aspirin had a lower incidence of EAC. Statins may have clinically useful effects in preventing the development of EAC. PMID:22989236

  6. Pralatrexate and Oxaliplatin in Treating Patients With Unresectable or Metastatic Esophageal, Stomach, or Gastroesophageal Junction Cancer

    ClinicalTrials.gov

    2015-03-05

    Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Diffuse Adenocarcinoma of the Stomach; Intestinal Adenocarcinoma of the Stomach; Mixed Adenocarcinoma of the Stomach; Recurrent Esophageal Cancer; Recurrent Gastric Cancer; Squamous Cell Carcinoma of the Esophagus; Stage III Esophageal Cancer; Stage III Gastric Cancer; Stage IV Esophageal Cancer; Stage IV Gastric Cancer

  7. The Prognostic Value of Clinical and Pathologic Factors in Esophageal Adenocarcinoma: A Mayo Cohort of 796 Patients With Extended Follow-up After Surgical Resection

    PubMed Central

    Yoon, Harry H.; Khan, Maliha; Shi, Qian; Cassivi, Stephen D.; Wu, Tsung-Teh; Quevedo, J. Fernando; Burch, Patrick A.; Sinicrope, Frank A.; Diasio, Robert B.

    2010-01-01

    OBJECTIVE: To identify and describe clinicopathologic prognostic factors in patients with esophageal adenocarcinoma who underwent surgical resection with curative intent. PATIENTS AND METHODS: The study cohort consisted of 796 patients with adenocarcinoma of the esophagus, gastroesophageal junction, or gastric cardia who underwent complete tumor resection at Mayo Clinic from January 1, 1980, to December 31, 1997. We reviewed individual patient medical records and abstracted demographic, pathologic, perioperative, and cancer outcome data. Median follow-up for vital status and disease recurrence was 12.8 and 5.8 years, respectively. RESULTS: Univariate analysis revealed the following factors to be statistically associated with worse 5-year disease-specific survival: higher N and T status, higher tumor grade, age older than 76 years, and the presence of extracapsular lymph node extension and signet ring cells. The following factors remained significantly linked with worse 5-year disease-specific survival on multivariate analysis: higher N and T status, grade, and age and the absence of preoperative chemotherapy or radiotherapy. Anatomic location of tumor was not associated with differential prognosis. Lymph node metastases were found in 25 (27%) of 93 T1b tumors, 397 (85%) of 468 T3 tumors, and 22 (67%) of 33 T4a tumors. Disease-specific survival was better in T3-4N0 than in T1bN1-3 carcinomas (hazard ratio, 0.50; 95% confidence interval, 0.28-0.89, adjusted for grade and age; P=.02). CONCLUSION: Our results confirm the importance of T and N status and tumor grade and suggest that age may affect prognosis. In addition, we show that a significant proportion of superficial esophageal adenocarcinomas exhibit regional metastases and have worse prognosis than more invasive nonmetastatic tumors. PMID:21123634

  8. Bile Acid Exposure Up-regulates Tuberous Sclerosis Complex 1/Mammalian Target of Rapamycin Pathway in Barrett’s-Associated Esophageal Adenocarcinoma

    PubMed Central

    Yen, Chia-Jui; Izzo, Julie G.; Lee, Dung-Fang; Guha, Sushovan; Wei, Yongkun; Wu, Tsung-Teh; Chen, Chun-Te; Kuo, Hsu-Ping; Hsu, Jung-Mao; Sun, Hui-Lung; Chou, Chao-Kai; Buttar, Navtej S.; Wang, Kenneth K.; Huang, Peng; Ajani, Jaffer; Hung, Mien-Chie

    2008-01-01

    Barrett’s esophagus, a columnar metaplasia of the lower esophagus epithelium related to gastroesophageal reflux disease, is the strongest known risk factor for the development of esophageal adenocarcinoma (EAC). Understanding the signal transduction events involved in esophageal epithelium carcinogenesis may provide insights into the origins of EAC and may suggest new therapies. To elucidate the molecular pathways of bile acid–induced tumorigenesis, the newly identified inflammation-associated signaling pathway involving I?B kinases ? (IKK?), tuberous sclerosis complex 1 (TSC1), and mammalian target of rapamycin (mTOR) downstream effector S6 kinase (S6K1) was confirmed to be activated in immortalized Barrett’s CPC-A and CPC-C cells and esophageal cancer SEG-1 and BE3 cells. Phosphorylation of TSC1 and S6K1 was induced in response to bile acid stimulation. Treatment of these cells with the mTOR inhibitor rapamycin or the IKK? inhibitor Bay 11-7082 suppressed bile acid–induced cell proliferation and anchorage-independent growth. We next used an orthotopic rat model to evaluate the role of bile acid in the progression of Barrett’s esophagus to EAC. Of interest, we found high expression of phosphorylated IKK? (pIKK?) and phosphorylated S6K1 (pS6K1) in tumor tissues and the Barrett’s epithelium compared with normal epithelium. Furthermore, immunostaining of clinical EAC tissue specimens revealed that pIKK? expression was strongly correlated with pS6K1 level. Together, these results show that bile acid can deregulate TSC1/mTOR through IKK? signaling, which may play a critical role in EAC progression. In addition, Bay 11-7082 and rapamycin may potentially be chemopreventive drugs against Barrett’s esophagus–associated EAC. PMID:18413730

  9. Bevacizumab and Combination Chemotherapy Before Surgery in Treating Patients With Locally Advanced Esophageal or Stomach Cancer

    ClinicalTrials.gov

    2014-03-17

    Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Diffuse Adenocarcinoma of the Stomach; Intestinal Adenocarcinoma of the Stomach; Mixed Adenocarcinoma of the Stomach; Squamous Cell Carcinoma of the Esophagus; Stage IA Esophageal Cancer; Stage IA Gastric Cancer; Stage IB Esophageal Cancer; Stage IB Gastric Cancer; Stage IIA Esophageal Cancer; Stage IIA Gastric Cancer; Stage IIB Esophageal Cancer; Stage IIB Gastric Cancer; Stage IIIA Esophageal Cancer; Stage IIIA Gastric Cancer; Stage IIIB Esophageal Cancer; Stage IIIB Gastric Cancer; Stage IIIC Esophageal Cancer; Stage IIIC Gastric Cancer

  10. Metabolic risk factors for esophageal squamous cell carcinoma and adenocarcinoma: a prospective study of 580 000 subjects within the Me-Can project

    PubMed Central

    2014-01-01

    Background Obesity is associated with an increased risk of esophageal adenocarcinoma (EAC) and a decreased risk of esophageal squamous cell carcinoma (ESCC). However, little is known about the risk of EAC and ESCC related to other metabolic risk factors. We aimed to examine the risk of EAC and ESCC in relation to metabolic risk factors, separately and combined in a prospective cohort study. Methods The Metabolic Syndrome and Cancer cohort includes prospective cohorts in Austria, Norway and Sweden, with blood pressure, lipids, glucose and BMI available from 578 700 individuals. Relative risk (RR) for EAC and ESCC was calculated using Cox’s proportional hazards analysis for metabolic risk factors categorized into quintiles and transformed into z-scores. The standardized sum of all z-scores was used as a composite score for the metabolic syndrome (MetS). Results In total, 324 histologically verified cases of esophageal cancer were identified (114 EAC, 184 ESCC and 26 with other histology). BMI was associated with an increased risk of EAC (RR 7.34 (95% confidence interval, 2.88-18.7) top versus bottom quintile) and negatively associated with the risk of ESCC (RR 0.38 (0.23-0.62)). The mean value of systolic and diastolic blood pressure (mid blood pressure) was associated with the risk of ESCC (RR 1.77 (1.37-2.29)). The composite MetS score was associated with the risk of EAC (RR 1.56 (1.19-2.05) per one unit increase of z-score) but not ESCC. Conclusions In accordance with previous studies, high BMI was associated with an increased risk of EAC and a decreased risk of ESCC. An association between high blood pressure and risk of ESCC was observed but alcohol consumption is a potential confounding factor that we were not able to adjust for in the analysis. The MetS was associated with EAC but not ESCC. However this association was largely driven by the strong association between BMI and EAC. We hypothesize that this association is more likely to be explained by factors directly related to obesity than the metabolic state of the MetS, considering that no other metabolic factor than BMI was associated with EAC. PMID:24548688

  11. Comparative evaluation of serum C-reactive protein (CRP) levels in the different histological subtypes of esophageal cancer (squamous cell carcinoma and adenocarcinoma of esophagus).

    PubMed

    Lukaszewicz-Zaj?c, Marta; Mroczko, Barbara; Koz?owski, Miros?aw; Nikli?ski, Jacek; Lauda?ski, Jerzy; Siewko, Maria; Szmitkowski, Maciej

    2012-02-01

    Elevated C-reactive protein (CRP) levels have been found in patients with several malignancies. The aim of the present study was to analyze the diagnostic and prognostic values of CRP levels measurement in esophageal cancer (EC) patients in relation to its different histological subtypes (squamous cell carcinoma-ESCC and adenocarcinoma-AC of esophagus) and compared them with classic tumor markers-carcinoembryonic antigen (CEA) and squamous cell cancer antigen (SCC-Ag). The diagnostic sensitivity, specificity, and the areas under receiver operating characteristic curves (AUC) for all the proteins tested were defined. Serum CRP levels were statistically higher in EC, ESCC, and AC patients compared to healthy subjects and significantly increased in EC and ESCC patients with the presence of lymph node and distant metastases. The percentage of elevated CRP results in all the analyzed subgroups (EC, ESCC, and AC) was higher than CEA and SCC-Ag, similarly as AUC for CRP in comparison to SCC-Ag. Serum CRP level was a significant predictor of EC and ESCC patients' survival in univariate analysis. In conclusion, these results indicate that CRP can be used as an adjunct in evaluating the tumor markers-CEA and SCC-Ag and may improve the clinical diagnosis and follow-up of EC patients, especially for ESCC subgroup. PMID:22467322

  12. Hypertrophic pyloric stenosis following repair of esophageal atresia and tracheo-esophageal fistula.

    PubMed

    Seguier-Lipszyc, Emmanuelle; Klin, Baruch

    2014-01-01

    Two cases of hypertrophic pyloric stenosis (HPS) developed after a few weeks of repair of an esophageal atresia and tracheo-esophageal fistula (EA and TEF). Both cases were dealt successfully with laparoscopic pyloromyotomy. PMID:26023501

  13. The Changing Face of Esophageal Cancer

    PubMed Central

    Melhado, Rachel E.; Alderson, Derek; Tucker, Olga

    2010-01-01

    The two main histological esophageal cancer types, adenocarcinoma and squamous cell carcinoma, differ in incidence, geographic distribution, ethnic pattern and etiology. This article focuses on epidemiology with particular reference to geographic and temporal variations in incidence, along with a review of the evidence supporting environmental and genetic factors involved in esophageal carcinogenesis. Squamous cell carcinoma of the esophagus remains predominantly a disease of the developing world. In contrast, esophageal adenocarcinoma is mainly a disease of western developed societies, associated with obesity and gastro-esophageal reflux disease. There has been a dramatic increase in the incidence of adenocarcinoma in developed countries in parallel with migration of both esophageal and gastric adenocarcinomas towards the gastro-esophageal junction. PMID:24281163

  14. Nutrition and esophageal cancer

    Microsoft Academic Search

    K. K. Cheng; N. E. Day

    1996-01-01

    Epidemiologic evidence on the relation between nutrition and esophageal cancer is reviewed. Results from ecologic, case-control, cohort, and intervention studies are included. Most of the findings pertain more to squamous cell carcinoma than adenocarcinoma of the esophagus. The protective effect of fruit and vegetable consumption is supported by a large body of evidence, especially from case-control studies. The effects of

  15. Botulinum toxin use in pediatric esophageal achalasia: A case report

    Microsoft Academic Search

    J. M Walton; G Tougas

    1997-01-01

    Esophageal achalasia (EA) has been historically treated by esophageal dilatation or myotomy with or without fundoplication. Botulinum toxin (Botox-Allergan) use in pediatric EA has not been previously described. The authors' objective was to observe the efficacy of botulinum toxin injection into the lower esophageal sphincter (LES) for EA. An 11-year-old boy presented with a 9-month history of frequent pneumonia, productive

  16. Successful Use of Esophageal Stent Placement to Treat a Postoperative Esophageal Stricture in a Toddler

    PubMed Central

    Gebrail, Rami

    2014-01-01

    Esophageal atresia (EA) is the most common type of gastrointestinal atresia. The most common variant (type C) consists of a blind esophageal pouch with a fistula between the trachea and the distal esophagus. Surgical repair can be complicated by the development of benign stricture. Most strictures are amenable to dilation, but refractory strictures may require surgical intervention. A 24-month-old boy born with tracheoesophageal fistula and EA underwent surgical repair on day 1 of life. He developed esophageal stricture that responded to esophageal stent placement. Endoscopic biliary accessories can be safely used to dilate refractory esophageal strictures in children, and should be considered prior to seeking other complex alternatives.

  17. Physical Activity and Sedentary Behavior in Relation to Esophageal and Gastric Cancers in the NIH-AARP Cohort

    PubMed Central

    Cook, Michael B.; Matthews, Charles E.; Gunja, Munira Z.; Abid, Zaynah; Freedman, Neal D.; Abnet, Christian C.

    2013-01-01

    Introduction Body mass index is known to be positively associated with an increased risk of adenocarcinomas of the esophagus, yet there is there limited evidence on whether physical activity or sedentary behavior affects risk of histology- and site-specific upper gastrointestinal cancers. We used the NIH-AARP Diet and Health Study to assess these exposures in relation to esophageal adenocarcinoma (EA), esophageal squamous cell carcinoma (ESCC), gastric cardia adenocarcinoma (GCA), and gastric non-cardia adenocarcinoma (GNCA). Methods Self-administered questionnaires were used to elicit physical activity and sedentary behavior exposures at various age periods. Cohort members were followed via linkage to the US Postal Service National Change of Address database, the Social Security Administration Death Master File, and the National Death Index. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 percent confidence intervals (95%CI) Results During 4.8 million person years, there were a total of 215 incident ESCCs, 631 EAs, 453 GCAs, and 501 GNCAs for analysis. Strenuous physical activity in the last 12 months (HR>5 times/week vs. never=0.58, 95%CI: 0.39, 0.88) and typical physical activity and sports during ages 15–18 years (p for trend=0.01) were each inversely associated with GNCA risk. Increased sedentary behavior was inversely associated with EA (HR5–6 hrs/day vs. <1 hr=0.57, 95%CI: 0.36, 0.92). There was no evidence that BMI was a confounder or effect modifier of any relationship. After adjustment for multiple testing, none of these results were deemed to be statistically significant at p<0.05. Conclusions We find evidence for an inverse association between physical activity and GNCA risk. Associations between body mass index and adenocarcinomas of the esophagus do not appear to be related to physical activity and sedentary behavior. PMID:24367697

  18. Overexpression of interleukin-8 receptor 2 (IL-8R2) indicates better prognosis in esophageal adenocarcinoma and squamous cell carcinoma procession.

    PubMed

    Liang, Bing; Zhao, Hui; Che, Jian-Bo; Wang, Hao-Jie; Shi, Gong-Ning

    2014-08-01

    Researches have showed that interleukin family or receptors play a role in many human tumor progressions including esophageal carcinoma. In this study, we examined the expression of interleukin-8 receptor 2 (IL-8R2) and analyze the relationship between it and esophageal carcinoma clinical characteristics. IL-8R2 protein expression was confirmed by immunohistochemistry and immunofluorescence arrays and was analyzed further via Western blot and qRT-PCR analysis in frozen tissues. The correlation between their expression levels and clinical characteristics were evaluated by Mann-Whitney and Kruskal-Wallis test. Via Kaplan-Meier plots and Cox proportional hazard models, overall survival (OS) was analyzed. Compared with normal esophageal tissue, IL-8R2 protein was overexpressed significantly in esophageal cancer (p < 0.05) and was observed both in cytoplasm and nuclear. The lower expression of IL-8R2 protein was observed with higher p staging of esophageal cancer, and the significant association between them was confirmed (p = 0.000), and in advanced p T stage, the similar result was obtained (p = 0.015); however, compared with lymph node metastasis-negative group, it is no significant difference in positive group (p = 0.152). In a Kaplan-Meier analysis, compared with IL-8R2 low expression, IL-8R2 high expression identified a group of patients with the longest OS. Cox proportional hazard models revealed that IL-8R2 predicted long time to OS. The higher expression of IL-8R2 was found in early esophageal carcinoma, which may indicate that IL-8R2 plays an important role and is better prognostic factor in esophageal cancer development. PMID:24972913

  19. CISNET: Esophageal Cancer

    Cancer.gov

    The incidence of esophageal adenocarcinoma (EAC) has been rising at an alarming rate over the past four decades. Although the absolute number of EAC cases per year remains too low to screen the general population, targeted screening may be appropriate. Heartburn, the primary symptom of gastroesophageal reflux disease (GERD), affects 40-60 million Americans and can lead to Barrett's esophagus (BE), a premalignant condition associated with the greatest risk of developing EAC.

  20. Improved body weight and performance status and reduced serum PGE2 levels after nutritional intervention with a specific medical food in newly diagnosed patients with esophageal cancer or adenocarcinoma of the gastro-esophageal junction

    PubMed Central

    Faber, Joyce; Uitdehaag, Madeleen J; Spaander, Manon; van Steenbergen-Langeveld, Sabine; Vos, Paul; Berkhout, Marloes; Lamers, Cor; Rümke, Hans; Tilanus, Hugo; Siersema, Peter; van Helvoort, Ardy; van der Gaast, Ate

    2015-01-01

    Background The majority of cancer patients loses weight and becomes malnourished during the course of their disease. Metabolic alterations and reduced immune competence lead to wasting and an increased risk of infectious complications. In the present study, the effect of a nutritionally complete medical food, which is high in protein and leucine and enriched with fish oil and specific oligosaccharides, was investigated on immune function, nutritional status, and inflammation in patients with esophageal cancer and compared with routine care. Methods In this exploratory double-blind study, 64 newly diagnosed esophageal cancer patients were randomized. All patients received dietary counselling and dietary advice. In the Active group, all patients received the specific medical food for 4?weeks before the start of anticancer therapy. In the routine care control arm, patients with <5% weight loss received a non-caloric placebo product, and patients with weight loss ?5% received an iso-caloric control product to secure blinding of the study. The required study parameters of body weight and performance status were recorded at baseline and after 4?weeks of nutritional intervention, and patients were asked to complete quality of life questionnaires. In addition, blood samples were taken for the measurement of several immune, nutritional, and safety-parameters. Results No effect of the specific nutritional intervention could be detected on ex vivo stimulations of blood mononuclear cells. By contrast, body weight was significantly increased (P?esophageal cancer patients. This effect was accompanied by significantly reduced serum PGE2 levels.

  1. Helicobacter pylori Infection and Gastric Atrophy: Risk of Adenocarcinoma and Squamous-Cell Carcinoma of the Esophagus and Adenocarcinoma of the Gastric Cardia

    Microsoft Academic Search

    Weimin Ye; Maria Held; Jesper Lagergren; Lars Engstrand; William J. Blot; Joseph K. McLaughlin

    2004-01-01

    Background: An inverse association between Helicobacter pylori infection and esophageal adenocarcinoma has been reported that may be attributed to reduced acidity from inducing atrophic gastritis and from producing ammonia. We examined associations between H. pylori infection, gas- tric atrophy, and the risk of esophageal adenocarcinoma, esophageal squamous-cell carcinoma, and gastric cardia ad- enocarcinoma in a large population-based case-control study in

  2. No role for glutathione S-transferase genotypes in Caucasian esophageal squamous cell or adenocarcinoma etiology: an European case–control study

    PubMed Central

    2013-01-01

    Background Identifying and monitoring high-risk patients can aid the prevention of esophageal cancer (EC). The interaction of environmental risk factor exposure and genetic susceptibility may contribute to the etiology of EC. Biotransformation enzymes such as Glutathione S-Transferases (GSTs ) detoxify mutagenic and genotoxic compounds and therefore control the rate of detoxification of carcinogens. Functional polymorphisms in the genes coding for GSTs alter their enzyme activity in vitro, and were reported to modify EC risk in Asians. We hypothesized that altered enzyme activity GST genotypes influence the susceptibility for esophageal adeno- (EAC) and squamous cell carcinoma (ESCC) in Caucasians. Methods We performed a case–control study including 440 Caucasian patients with EC and 592 healthy Caucasian controls matched for age and sex. Functional polymorphisms were selected and genotypes were determined in GST classes Alpha, Mu, Theta and Pi by means of polymerase chain reaction. Genotypes were classified into predicted high, intermediate and low enzyme activity categories based on in vitro activity data. The distribution of the activity genotypes were compared between patients with EAC or ESCC, and controls. Odds ratios (OR) with 95% confidence intervals (CI) were calculated by logistic regression analyses. Gene-gene interactions were tested and for comparison purposes, the predicted low and intermediate activity genotypes were combined. Genotypes with similar risks for EAC or ESCC were combined and analyzed for multiplicative effects. Results Our analyses includes 327 patients with EAC and 106 patients with ESCC. Low or intermediate activity enzyme genotypes for GSTM1, GSTA1, GSTP1 I105V and A114V as well as for GSTT1, did not significantly modify the risk for ESCC or EAC in our Dutch population. Conclusion Functional genotypes in GST genes are not involved in EAC or ESCC susceptibility in Caucasians, in contrast to results on ESCC from Asia or Africa. PMID:23731957

  3. Esophageal spasm

    MedlinePLUS

    Diffuse esophageal spasm; Spasm of the esophagus; Distal esophageal spasm ... Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap ...

  4. Candida esophagitis

    Microsoft Academic Search

    Robert Mathieson; Sudhir K. Dutta

    1983-01-01

    Summary Candida esophagitis is being increasingly recognized in the practice of clinical gastroenterology. The widespread use of corticosteroids, immunosuppressive drugs, and cancer chemotherapy, combined with the frequent use of endoscopy for the evaluation of esophageal symptoms, often leads to the identification ofCandida infection in this part of the gastrointestinal tract. The salient clinical features ofCandida esophagitis include odynophagia and dysphagia,

  5. Use of anti-inflammatory drugs and lower esophageal sphincter relaxing drugs and risk of esophageal and gastric cancers

    PubMed Central

    Fortuny, Joan; Johnson, Christine; Bohlke, Kari; Chow, Wong-Ho; Hart, Gene; Kucera, Gena; Mujumdar, Urvi; Ownby, Dennis; Wells, Karen; Yood, Marianne Ulcickas; Engel, Lawrence S.

    2007-01-01

    Background and aims The incidence of esophageal and gastric cardia adenocarcinoma has increased in western countries in recent decades for largely unknown reasons. We investigated whether use of lower esophageal sphincter (LES) relaxing drugs was related to an increased risk of esophageal and gastric cardia adenocarcinoma, and whether use of non-steroidal anti-inflammatory drugs was related to a reduced risk of esophageal and gastric cancers. Methods We examined these associations using administrative databases in a case-control study in two integrated health care delivery systems. Cases were incident esophageal adenocarcinomas (n= 163) and squamous cell carcinomas (n= 114), and gastric cardia (n= 176) and non-cardia adenocarcinomas (n= 320), diagnosed between 1980 and 2002 in one health system and between 1993 and 2002 in the other. Matched controls (n= 3996) were selected. Complete prescription information was available for the study period. Results Prescription of corticosteroids was associated with a decreased risk of esophageal adenocarcinoma (OR= 0.6, 95% CI= 0.4-0.9), esophageal squamous cell carcinoma (OR= 0.4, 95% CI= 0.2-0.6) and gastric non-cardia carcinoma (OR= 0.4, 95% CI=0.3-0.6). Ever use of pharmacy-purchased aspirin was associated with 30-60% decreased risks of the studied cancers. As a group, LES-relaxing drugs showed little evidence of association with increased risk of any esophageal or gastric cancer. Conclusions Corticosteroid and aspirin use were associated with significantly decreased risks of esophageal and gastric cancer. Lower esophageal sphincter relaxing drugs as a group did not affect these risks, although we had limited power to assess individual drugs. The possibility that corticosteroids and aspirin may reduce esophageal cancer risk warrants further consideration. PMID:17644046

  6. Eosinophilic esophagitis in patients with esophageal atresia and chronic dysphagia.

    PubMed

    Kassabian, Sirvart; Baez-Socorro, Virginia; Sferra, Thomas; Garcia, Reinaldo

    2014-12-21

    Esophageal atresia (EA) is defined as a discontinuity of the lumen of the esophagus repaired soon after birth. Dysphagia is a common symptom in these patients, usually related to stricture, dysmotility or peptic esophagitis. We present 4 cases of patients with EA who complained of dysphagia and the diagnosis of Eosinophilic esophagitis (EoE) was made, ages ranging from 9 to 16 years. Although our patients were on acid suppression years after their EA repair, they presented with acute worsening of dysphagia. Esophogastroduodenoscopy and/or barium swallow did not show stricture and biopsies revealed elevated eosinophil counts consistent with EoE. Two of 4 patients improved symptomatically with the topical steroids. It is important to note that all our patients have asthma and 3 out of 4 have tested positive for food allergies. One of our patients developed recurrent anastomotic strictures that improved with the treatment of the EoE. A previous case report linked the recurrence of esophageal strictures in patients with EA repair with EoE. Once the EoE was treated the strictures resolved. On the other hand, based on our observation, EoE could be present in patients without recurrent anastomotic strictures. There appears to be a spectrum in the disease process. We are suggesting that EoE is a frequent concomitant problem in patients with history of congenital esophageal deformities, and for this reason any of these patients with refractory reflux symptoms or dysphagia (with or without anastomotic stricture) may benefit from an endoscopic evaluation with biopsies to rule out EoE. PMID:25548504

  7. Prostate Adenocarcinoma

    Cancer.gov

    Home Cancers Selected for Study Prostate Adenocarcinoma Prostate Adenocarcinoma Last Updated: April 01, 2013 What is prostate cancer? Prostate cancer is a disease of the prostate, a walnut-size gland in the male reproductive system.  Nearly all prostate

  8. Cyclooxygenase 2 expression in Barrett's esophagus and adenocarcinoma: Ex vivo induction by bile salts and acid exposure

    Microsoft Academic Search

    Vivian N. Shirvani; Rodica Ouatu-Lascar; Baljeet S. Kaur; M. Bishr Omary; George Triadafilopoulos

    2000-01-01

    Background & Aims: Barrett's esophagus (BE) results from chronic, severe gastroesophageal reflux and predisposes to esophageal adenocarcinoma. Cyclooxygenase (COX)-2 is involved in chronic inflammation and epithelial cell growth. We investigated COX-2 expression in BE and esophageal adenocarcinoma to explore a potential relation between COX-2 expression and metaplasia or carcinogenesis. Methods: Endoscopic mucosal biopsy specimens of Barrett's intestinal metaplasia (n =

  9. Herpetic esophagitis

    SciTech Connect

    Shortsleeve, M.J.; Gauvin, G.P.; Gardner, R.C.; Greenberg, M.S.

    1981-12-01

    Four patients with herpetic esophagitis were examined. In three of them, the presenting symptom was odynophagia. Early in the course of herpetic esophagitis, shallow round and oval ulcers were seen on barium esophagograms. Later, the ulcers filled with fibrinous exudate, forming nodular plaques that projected into the esophageal lumen. Although these findings are diagnostic of esophagitis, they are not specific for a herpes virus infection. The definitive diagnosis must be established by histologic examination, which demonstrates the cytopathic effect of the herpes virus infection within the squamous epithelium.

  10. Contractile profile of esophageal and gastric fundus strips in experimental doxorubicin-induced esophageal atresia

    PubMed Central

    Capeto, F.A.; Lima, F.J.B.; Okoba, W.; Ramos, F.L.; Messias, T.F.A.; Rigonatto, G.A.; Sbragia, L.; Magalhães, P.J.C.; Melo-Filho, A.A.

    2015-01-01

    Esophageal atresia (EA) is characterized by esophageal and gastric motility changes secondary to developmental and postsurgical damage. This study evaluated the in vitro contractile profile of the distal esophagus and gastric fundus in an experimental model of EA induced by doxorubicin (DOXO). Wistar pregnant rats received DOXO 2.2 mg/kg on the 8th and 9th gestational days. On day 21.5, fetuses were collected, sacrificed, and divided into groups: control, DOXO without EA (DOXO-EA), and DOXO with EA (DOXO+EA). Strips from the distal esophagus and gastric fundus were mounted on a wire myograph and isolated organ-bath system, respectively, and subjected to increasing concentrations of carbamylcholine chloride (carbachol, CCh). The isolated esophagus was also stimulated with increasing concentrations of KCl. In esophagus, the concentration-effect curves were reduced in response to CCh in the DOXO+EA and DOXO-EA groups compared to the control group (P<0.05). The maximum effect values (Emax) for DOXO+EA and DOXO-EA were significantly lower than control (P<0.05), but the half-maximal effective concentration (EC50) values were not significantly different when the three groups were compared (P>0.05). In response to KCl, the distal esophagus samples in the three groups were not statistically different with regard to Emax or EC50 values (P>0.05). No significant difference was noted for EC50 or Emax values in fundic strips stimulated with CCh (P>0.05). In conclusion, exposure of dams to DOXO during gestation inhibited the contractile behavior of esophageal strips from offspring in response to CCh but not KCl, regardless of EA induction. The gastric fundus of DOXO-exposed offspring did not have altered contractile responsiveness to cholinergic stimulation. PMID:25760030

  11. Esophageal actinomycosis

    Microsoft Academic Search

    Fu-Tsan Chou; Ken-Sheng Cheng; I-Ping Chiang

    2006-01-01

    Esophageal actinomycosis is uncommon and has been reported in immunocompetent and immunocompromised patients. A 41-y-old man\\u000a with a history of heavy alcohol use presented with progressively worsening odynophagia and dysphagia over a 2-wk period. Upper\\u000a gastrointestinal endoscopy and esophageal biopsy revealed ulceration withActinomyces and candidal infection. After therapy with intravenous penicillin G followed by oral amoxicillin that led to clinical

  12. Infectious esophagitis

    Microsoft Academic Search

    Brian P. Mulhall; Roy K. H. Wong

    2003-01-01

    Opinion statement  Infectious esophagitis can have significant implications in an impaired host. Described most commonly in immunocompromised\\u000a patients, infectious esophagitis can also occasionally be discovered in immunocompetent individuals in several unique clinical\\u000a settings. Evaluation of the typical presenting complaints, such as dysphagia or odynophagia, are especially important in immunocompetent\\u000a patients, and therapy should be directed at the appropriate predisposing condition and

  13. Esophageal and esophagogastric junction cancers, version 1.2015.

    PubMed

    Ajani, Jaffer A; D'Amico, Thomas A; Almhanna, Khaldoun; Bentrem, David J; Besh, Stephen; Chao, Joseph; Das, Prajnan; Denlinger, Crystal; Fanta, Paul; Fuchs, Charles S; Gerdes, Hans; Glasgow, Robert E; Hayman, James A; Hochwald, Steven; Hofstetter, Wayne L; Ilson, David H; Jaroszewski, Dawn; Jasperson, Kory; Keswani, Rajesh N; Kleinberg, Lawrence R; Korn, W Michael; Leong, Stephen; Lockhart, A Craig; Mulcahy, Mary F; Orringer, Mark B; Posey, James A; Poultsides, George A; Sasson, Aaron R; Scott, Walter J; Strong, Vivian E; Varghese, Thomas K; Washington, Mary Kay; Willett, Christopher G; Wright, Cameron D; Zelman, Debra; McMillian, Nicole; Sundar, Hema

    2015-02-01

    Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Adenocarcinoma is more common in North America and Western European countries, originating mostly in the lower third of the esophagus, which often involves the esophagogastric junction (EGJ). Recent randomized trials have shown that the addition of preoperative chemoradiation or perioperative chemotherapy to surgery significantly improves survival in patients with resectable cancer. Targeted therapies with trastuzumab and ramucirumab have produced encouraging results in the treatment of advanced or metastatic EGJ adenocarcinomas. Multidisciplinary team management is essential for patients with esophageal and EGJ cancers. This portion of the NCCN Guidelines for Esophageal and EGJ Cancers discusses management of locally advanced adenocarcinoma of the esophagus and EGJ. PMID:25691612

  14. Esophageal Microbiome in Eosinophilic Esophagitis

    PubMed Central

    Harris, J. Kirk; Fang, Rui; Wagner, Brandie D.; Choe, Ha Na; Kelly, Caleb J.; Schroeder, Shauna; Moore, Wendy; Stevens, Mark J.; Yeckes, Alyson; Amsden, Katie; Kagalwalla, Amir F.; Zalewski, Angelika; Hirano, Ikuo; Gonsalves, Nirmala; Henry, Lauren N.; Masterson, Joanne C.; Robertson, Charles E.; Leung, Donald Y.; Pace, Norman R.; Ackerman, Steven J.; Furuta, Glenn T.; Fillon, Sophie A.

    2015-01-01

    Objective The microbiome has been implicated in the pathogenesis of a number of allergic and inflammatory diseases. The mucosa affected by eosinophilic esophagitis (EoE) is composed of a stratified squamous epithelia and contains intraepithelial eosinophils. To date, no studies have identified the esophageal microbiome in patients with EoE or the impact of treatment on these organisms. The aim of this study was to identify the esophageal microbiome in EoE and determine whether treatments change this profile. We hypothesized that clinically relevant alterations in bacterial populations are present in different forms of esophagitis. Design In this prospective study, secretions from the esophageal mucosa were collected from children and adults with EoE, Gastroesophageal Reflux Disease (GERD) and normal mucosa using the Esophageal String Test (EST). Bacterial load was determined using quantitative PCR. Bacterial communities, determined by 16S rRNA gene amplification and 454 pyrosequencing, were compared between health and disease. Results Samples from a total of 70 children and adult subjects were examined. Bacterial load was increased in both EoE and GERD relative to normal subjects. In subjects with EoE, load was increased regardless of treatment status or degree of mucosal eosinophilia compared with normal. Haemophilus was significantly increased in untreated EoE subjects as compared with normal subjects. Streptococcus was decreased in GERD subjects on proton pump inhibition as compared with normal subjects. Conclusions Diseases associated with mucosal eosinophilia are characterized by a different microbiome from that found in the normal mucosa. Microbiota may contribute to esophageal inflammation in EoE and GERD. PMID:26020633

  15. [Eosinophilic esophagitis].

    PubMed

    Kusunose, Hiroaki; Ohara, Shuichi

    2015-07-01

    Eosinophilic esophagitis (EoE) is a clinicopathologic condition of increasing recognition and prevalence. Because of elevated total IgE levels and high rates of concurrent allergic diseases compared with the general population, EoE appears to be an antigen-driven immunologic process that caused by allergens like food or aeroallergens. EoE is a disease that features dense intraepithelial infiltration by eosinophils which cause excessive mucosal immunologic reactions which cause several symptoms that mostly involve dysphagia. For establishment of the diagnosis, infiltration of eosinophils (? 20 eosinophils/HPF) should be identified in an esophageal mucosal biopsy specimen. In treatment of patients have a possibility of EoE, proton-pump inhibitors(PPIs) must be tried as first choice. Other proved therapeutic options include topical or systemic corticosteroids, chronic dietary elimination, and esophageal dilation, but local administration of glucocorticoids has recently been reported as useful therapy for EoE. PMID:26165084

  16. Current status of esophageal cancer – West versus East: the European point of view

    Microsoft Academic Search

    J. Rüdiger Siewert; Burkhard H. A. von Rahden; Hubert J. Stein

    2004-01-01

    Esophageal cancer and its treatment differ largely between the West and the East because West and East are concerned – at least in part – with different diseases: squamous cell cancers are the prevailing tumor type in Japan and other parts of Asia whereas this entity is now clearly outnumbered in Europe and North America by esophageal adenocarcinoma. The latter

  17. Parathyroid adenocarcinoma.

    PubMed Central

    Nazem, A.; Anderson, B.; Leffal, L. D.; Reghini, M.; Brown, J.

    1989-01-01

    Parathyroid adenocarcinoma is a very rare carcinoma with an equal male-female incidence. The clinical picture that adenocarcinoma of the parathyroid presents is the same as that of hyperparathyroidism due to adenoma. Onset of parathyroid adenocarcinoma occurs primarily in the fourth decade of life. It is not incompatible with long-term survival provided that the entire gland is removed at the initial operation without rupture of the capsule. If the carcinoma recurs, it grows slowly and any spread tends to be local. Distant metastasis is rare. Calcium levels above 13 mg/100 mL should alert the clinician to the possibility of adenocarcinoma of the parathyroid. Increased mitotic figures, increased fibrosis of the gland, and invasion of the vessels and surrounding tissues are the features indicative of malignancy. A review of the literature reveals that fewer than 150 cases of this entity have been reported. The authors present two case reports and discuss the epidemiology, clinical picture, pathology, and therapy of parathyroid adenocarcinoma. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:2666678

  18. Molecular Pathways: Pathogenesis and clinical implications of microbiome alteration in esophagitis and Barrett’s esophagus

    PubMed Central

    Yang, Liying; Francois, Fritz; Pei, Zhiheng

    2013-01-01

    Esophageal adenocarcinoma is preceded by the development of reflux-related intestinal metaplasia or Barrett’s esophagus which is a response to inflammation of the esophageal squamous mucosa, reflux esophagitis. Gastroesophageal reflux impairs the mucosal barrier in the distal esophagus, allowing chronic exposure of the squamous epithelium to the diverse microbial ecosystem or microbiome, and inducing chronic inflammation. The esophageal microbiome is altered in both esophagitis and Barrett's esophagus, characterized by a significant decrease in Gram-positive bacteria and an increase in Gram-negative bacteria in esophagitis and Barrett's esophagus. Lipopolysaccharides (LPS), a major structure of the outer membrane in Gram-negative bacteria, can up-regulate gene expression of proinflammatory cytokines via activation of the TLR4 and NF-kB pathway. The potential impact of LPS on reflux esophagitis may be through relaxation of the lower esophageal sphincter via iNOS and by delaying gastric emptying via COX-2. Chronic inflammation may be play a critical role in the progression from benign to malignant esophageal disease. Therefore analysis of the pathways leading to chronic inflammation in the esophagus may help to identify biomarkers in Barrett's esophagus patients for neoplastic progression and provide insight into molecular events suitable for therapeutic intervention in prevention of esophageal adenocarcinoma development in patients with reflux esophagitis and Barrett's esophagus. PMID:22344232

  19. Amiloride and guggulsterone suppression of esophageal cancer cell growth in vitro and in nude mouse xenografts

    PubMed Central

    GUAN, Baoxiang; HOQUE, Ashraful; XU, Xiaochun

    2014-01-01

    Esophageal adenocarcinoma is increasing in the US and Western countries and frequent gastresophageal reflux or gastresophageal reflux disease carrying gastric acid and bile acid could contribute to esophageal adenocarcinogenesis. This study was designed to detect the expression of gastric acid-inducing gene Na + /H + exchanger-1 (NHE-1) ex vivo and then to explore targeting of NHE-1 expression or activity to control esophageal cancer cell viability in vitro and in nude mouse xenografts. The data showed that NHE-1 was highly expressed in esophageal adenocarcinoma tissues (66 of 101 cases [65.3%], but not in normal esophageal squamous cell epithelium (1 of 26 cases [3.8%]). Knockdown of NHE-1 expression using NHE-1 shRNA or inhibition of NHE-1 activity using the NHE-1 inhibitor amiloride suppressed viability and induced apoptosis in esophageal cancer cells. Molecularly, amiloride inhibited expression of cyclooxygenase-2 and matrix metallopeptidase-9 but not NHE-1 mRNA in esophageal cancer cells. A combination of amiloride and guggulsterone (a natural bile acid receptor inhibitor) showed more than additive effects in suppressing esophageal cancer cell growth in vitro and in nude mouse xenografts. This study suggests that inhibition of NHE-1 expression or activity or combination of amiloride and guggulsterone could be useful in control of esophageal adenocarcinoma. PMID:24999355

  20. Snapshot of Esophageal Cancer

    MedlinePLUS

    ... Discovery A Snapshot of Esophageal Cancer Incidence and Mortality Esophageal cancer consists of two primary cancer types, ... ethnic groups have higher esophageal cancer incidence and mortality rates than women. Historically, African American men have ...

  1. Preservation of Gastric Acid Secretion May Be Important for the Development of Gastroesophageal Junction Adenocarcinoma in Japanese People, Irrespective of the H. pylori Infection Status

    Microsoft Academic Search

    Yoshifumi Inomata; Tomoyuki Koike; Shuichi Ohara; Yasuhiko Abe; Hitoshi Sekine; Katsunori Iijima; Ken Ariizumi; Hatsushi Yamagishi; Yasushi Kitagawa; Akira Imatani; Tooru Shimosegawa

    2006-01-01

    BACKGROUND:We have previously reported that Helicobacter pylori infection prevents reflux esophagitis (RE) and Barrett's esophagus (BE) by decreasing gastric acid secretion. Gastroesophageal (GE) junction adenocarcinoma, including Barrett's adenocarcinoma, has been thought to be a complication of gastroesophageal reflux disease (GERD). However, the relationship between H. pylori infection, gastric acid secretion, and GE junction adenocarcinoma has not yet been investigated in

  2. Radiation esophagitis.

    PubMed

    Murro, Diana; Jakate, Shriram

    2015-06-01

    The esophagus is frequently exposed to radiation during treatment of advanced stages of common cancers such as lung, breast, and esophagus. However, symptomatic radiation esophagitis requiring endoscopic and histologic evaluation occurs quite rarely, affecting less than 1% of patients receiving radiation treatment. Symptoms occur acutely, generally within the first 2 months. Patients typically present with nonspecific symptoms such as dysphagia and odynophagia. Endoscopic changes such as erythema and ulceration are also nonspecific and nondiagnostic. Biopsies from affected areas show variable inflammatory changes and radiation-related atypia of endothelial and stromal cells. Such atypia mimics cytomegalovirus cytopathic changes, which are ruled out through absence of immunostaining. Radiation esophagitis is thus clinically unsuspected and endoscopically and histologically quite different from the more common and familiar radiation proctitis for which angioectasia is the predominant finding. PMID:26030254

  3. Androgens and esophageal cancer: What do we know?

    PubMed Central

    Sukocheva, Olga A; Li, Bin; Due, Steven L; Hussey, Damian J; Watson, David I

    2015-01-01

    Significant disparities exist between genders for the development and progression of several gastro-intestinal (GI) diseases including cancer. Differences in incidence between men vs women for colon, gastric and hepatocellular cancers suggest a role for steroid sex hormones in regulation of GI carcinogenesis. Involvement of intrinsic gender-linked mechanisms is also possible for esophageal adenocarcinoma as its incidence is disproportionally high among men. However, the cause of the observed gender differences and the potential role of androgens in esophageal carcinogenesis remains unclear, even though the cancer-promoting role of androgen receptors (AR) shown in other cancers such as prostate and bladder suggests this aspect warrants exploration. Several studies have demonstrated expression of ARs in esophageal cancer. However, only one study has suggested a potential link between AR signaling and outcome - poorer prognosis. Two groups have analyzed data from cohorts with prostate cancer and one of these found a decreased incidence of esophageal squamous and adenocarcinoma after androgen deprivation therapy. However, very limited information is available about the effects of androgen and AR-initiated signaling on esophageal cancer cell growth in vitro and in vivo. Possible mechanisms for androgens/AR involvement in the regulation of esophageal cancer growth are considered, and the potential use of AR as a prognostic factor and clinical target is highlighted, although insufficient evidence is available to support clinical trials of novel therapies. As esophageal adenocarcinoma is a gender linked cancer with a large male predominance further studies are warranted to clarify the role of androgens and ARs in shaping intracellular signaling and genomic responses in esophageal cancer. PMID:26034350

  4. Coincidence of Nutritional Habits and Esophageal Cancer in Germany

    Microsoft Academic Search

    E. Wolfgarten; U. Rosendahl; T. Nowroth; J. Leers; R. Metzger; A. H. Hölscher; E. Bollschweiler

    2001-01-01

    Summary Introduction: The incidence rates for adenocarcinoma (AC) of the esophagus have risen rapidly in Western nations, whereas the incidence rates for esophageal squamous cell carcinoma (SCC) have remained nearly stable. There are studies about body mass index, smoking, alcohol, and development of AC or SCC. The aim of this study was to evaluate differences in nutritional habits of patients

  5. [Long-term survival of a patient with esophageal metastasis from breast cancer treated with esophagectomy].

    PubMed

    Kawabata, Ryohei; Kimura, Yutaka; Kawase, Tomono; Kamigaki, Shunji; Yamamura, Jun; Nakamura, Yukio; Munakata, Satoru; Fukunaga, Mutsumi; Ohzato, Hiroki

    2014-11-01

    Esophageal metastasis from breast cancer is rarely observed. We encountered a case of long-term survival after esophageal metastasis from breast cancer that was treated with esophagectomy. A 79-year-old woman developed dysphagia 26 years after radical mastectomy. Endoscopic examination revealed stenosis at the mid-thoracic esophagus. An esophageal biopsy led to a diagnosis of undifferentiated cancer. A computed tomography (CT) scan revealed a massive tumor in the esophagus, but no distant metastases. Esophagectomy was performed with the suspicion of primary or metastatic esophageal cancer. Histopathologically, the excised tumor was an adenocarcinoma, which had histopathological features similar to that of the breast cancer. Accordingly, the adenocarcinoma was diagnosed as esophageal metastasis of the breast cancer. The patient is still alive 8 years after the esophagectomy. PMID:25731410

  6. Esophageal Cancer Staging

    PubMed Central

    Rice, Thomas W.

    2015-01-01

    Accurate staging of esophageal cancer is very important to achieving optimal treatment outcomes. The AJCC (American Joint Committee on Cancer) first published TNM esophageal cancer staging recommendations in the first edition of their staging manual in 1977. Thereafter, the staging of esophageal cancer was changed many times over the years. This article reviews the current status of staging of esophageal cancer. PMID:26078921

  7. Pancreatic Ductal Adenocarcinoma

    Cancer.gov

    Home Cancers Selected for Study Pancreatic Ductal Adenocarcinoma Pancreatic Ductal Adenocarcinoma Last Updated: May 15, 2013 What is pancreatic cancer?Pancreatic ductal adenocarcinoma is the most common form of pancreatic cancer, making up more than

  8. General Information about Esophageal Cancer

    MedlinePLUS

    ... Treatment (PDQ®) General Information About Esophageal Cancer Key Points Esophageal cancer is a disease in which malignant ( ... NCI Web site . Stages of Esophageal Cancer Key Points After esophageal cancer has been diagnosed, tests are ...

  9. Inhibition of Farnesoid X Receptor Controls Esophageal Cancer Cell Growth In Vitro and in Nude Mouse Xenografts

    PubMed Central

    Guan, Baoxiang; Li, Hao; Yang, Zhengduo; Hoque, Ashraful; Xu, Xiaochun

    2012-01-01

    BACKGROUND Gastroesophageal reflux is a risk factor for esophageal adenocarcinoma and bile acid and its farnesoid X receptor (FXR) have been implicated in esophageal tumorigenesis. We investigated the role of FXR expression and activity in esophageal cancer initiation and growth. METHODS FXR expression in esophageal adenocarcinoma tissues was assessed by immunohistochemistry. Knockdown of FXR expression in esophageal cancer cells in vitro and in nude mice xenografts was suppressed by FXR shRNA and guggulsterone (a natural FXR inhibitor). Esophageal cancer cells were treated with bile acids to show their effects on growth-promoting genes. RESULTS FXR was expressed in 48 of 59 esophageal adenocarcinoma tissues (81.3%), and this overexpression was associated with higher tumor grade, greater tumor size, and lymph node metastasis, but was inversely associated with RAR-?2 expression. Knockdown of FXR expression suppressed tumor cell growth in vitro and in nude mouse xenografts. Guggulsterone reduced viability of esophageal cancer cells in a time- and dose-dependent manner, whereas this effect was diminished after knockdown of FXR expression. Guggulsterone induced apoptosis through activation of caspases-8, -9, and -3 in tumor cells. FXR mediated bile acid–induced alterations of gene expression, e.g., RAR-?2 and COX-2. CONCLUSION Inhibition of FXR by FXR shRNA or guggulsterone suppressed tumor cell viability and induced apoptosis in vitro and reduced tumor formation and growth in nude mouse xenografts. FXR mediated bile acid–induced alterations of cell growth-related genes in esophageal cancer cells. PMID:23280144

  10. Current endoscopic methods of radical therapy in early esophageal cancer

    PubMed Central

    Mocanu, A; Bârla, R; Hoara, P; Constantinoiu, S

    2015-01-01

    During the last three decades, there has been an increasing incidence of the esophageal cancer at the global level, approx. 400,000 new esophageal cancers being currently diagnosed annually. This is the eighth leading cause of cancer incidence and the sixth leading cause of cancer death overall. If we refer to the countries of Western Europe and North America, we could see an increase in the esophageal adenocarcinoma in detriment of squamous cancer. As for the Asian region, referring in particular to China and Japan, 9 out of 10 esophageal cancers are squamous cell carcinomas. Considering that the incidence of gastric cancer in Japan is very high, the endoscopic screenings performed inevitably led to an increased rate of early detection of esophageal cancer, reaching approximately 20% of all esophageal cancers detected. This has led to the possibility of developing therapeutic endoscopic techniques with radical visa that we will describe while presenting comparative data from literature. Currently, however, there are not enough data on the effectiveness of these types of therapies, compared to surgery, in order to be transformed into standard therapeutic endoscopic treatment for early esophageal cancer. However, the combined therapy, resection/ endoscopic ablation + chemoradiotherapy, appears as an alternative to be taken into account. Abbreviations EEC = esophageal early cancer, BE = Barrett’s esophagus, HGD = High-grade dysphagia, EUS = Ultra sound endoscopy, CT = Computer tomograph, UGE = Upper gastro endoscopy, PET-CT = Positron Emission Tomography, FNAB = Fine needle aspiration biopsy, EMR = Esophageal mucosal resection, ESD = Esophageal submucosal dissection, SCC = Squamous cellular cancer, PCT = Poli-chemotherapy, RT- Radio-therapy. PMID:25866570

  11. Esophageal stricture - benign

    MedlinePLUS

    ... stricture can be caused by: Gastroesophageal reflux (GERD) Eosinophilic esophagitis Injuries caused by an endoscope Long-term use ... returning. Surgery is rarely needed. If you have eosinophilic esophagitis, you may need to take medicines or make ...

  12. Esophageal tuberculosis mimicking malignancy.

    PubMed

    Geusens, E; Verschakelen, J A; Flamaing, J; Bogaert, J; Ponette, E; Decramer, M; Baert, A L

    1996-01-01

    A case of pulmonary and esophageal tuberculosis in an 82-year-old female is presented. Esophageal tuberculosis is very rarely seen in Europe and the United States, but the disease is still endemic in India. The major differential diagnosis is esophageal malignancy. Findings that can suggest the diagnosis are tracheo-esophageal fistula formation, enlarged, centrally necrotizing lymph nodes, and a micronodular lung pattern. PMID:8797957

  13. Mesothelin is a specific biomarker of invasive cancer in the Barrett-associated adenocarcinoma progression model: translational implications for diagnosis and therapy

    Microsoft Academic Search

    Hector Alvarez; Pamela Leal Rojas; Ken-Tye Yong; Hong Ding; Gaixia Xu; Paras N. Prasad; Jean Wang; Marcia Canto; James R. Eshleman; Elizabeth A. Montgomery; Anirban Maitra

    2008-01-01

    Esophageal adenocarcinoma arises in the backdrop of Barrett metaplasia-dysplasia sequence, with the vast majority of patients presenting with late-stage malignancy. Mesothelin, a glycophosphatidylinositol-anchored protein, is aberrantly overexpressed on the surface of many solid cancers. Mesothelin expression was assessed in esophageal tissue microarrays encompassing the entire histological spectrum of Barrett-associated dysplasia and adenocarcinoma. Mesothelin expression was observed in 24\\/84 (29%) of

  14. Multiple esophageal rings: an association with eosinophilic esophagitis

    Microsoft Academic Search

    Constantinos G Siafakas; Charlotte K Ryan; Marilyn R Brown; Tracie L Miller

    2000-01-01

    Esophagitis may present endoscopically with erythema, edema, loss of vascular pattern, friability, and ulceration of the esophageal mucosa. Left untreated, chronic esophagitis may result in stricture formation. The presence of multiple concentric rings involving the entire esophagus has been cited as a chronic form of esophagitis. We present a case of an 8-yr-old boy with multiple concentric esophageal rings and

  15. High expression of RNA-binding motif protein 3 in esophageal and gastric adenocarcinoma correlates with intestinal metaplasia-associated tumours and independently predicts a reduced risk of recurrence and death

    PubMed Central

    2014-01-01

    Background High nuclear expression of the RNA-binding motif protein 3 (RBM3) has previously been found to correlate with favourable clinicopathological characteristics and a prolonged survival in several cancer forms. Here, we examined the clinicopathological correlates and prognostic significance of RBM3 expression in tumours from a consecutive cohort of upper gastrointestinal adenocarcinoma. Material and methods Immunohistochemical RBM3 expression was analysed in tissue microarrays with primary radiotherapy- and chemotherapy-naive adenocarcinoma of the esophagus, gastroesophageal junction and stomach (n?=?173). In addition paired samples of normal squamous epithelium (n?=?53), gastric mucosa (n?=?117), Barrett’s esophagus/gastric intestinal metaplasia (n?=?61) and lymph node metastases (n?=?71) were analysed. Kaplan-Meier analysis and Cox proportional hazards modelling was applied to assess the impact of RBM3 expression on overall survival (OS) and recurrence-free survival (RFS). Results RBM3 expression was similar in primary tumours and lymph node metastases, but significantly higher in primary tumours and metastases arising in a background of intestinal metaplasia compared with cases without intestinal metaplasia (p < 0.001). RBM3 expression was significantly reduced in more advanced tumour stages (p = 0.006). Low RBM3 expression was significantly associated with a shorter OS in cases with radically resected (R0) tumours (HR 2.19, 95% CI 1.33-3.61, p = 0.002) and RFS in curatively treated patients with R0 resection/distant metastasis-free disease (HR = 3.21, 95% CI 1.64-6.30, p = 0.001). These associations remained significant in adjusted analysis (HR = 1.95, 95% CI 1.17-3.25, p = 0.010 for OS and HR = 3.02, 95% CI 1.45-6.29, p = 0.003 for RFS). Conclusion High expression of RBM3 may signify a subset of upper gastrointestinal cancers arising in a background of intestinal metaplasia and independently predicts a reduced risk of recurrence and death in patients with these cancer forms. These findings are of potential clinical utility and merit further validation. PMID:24963396

  16. Helicobacter pylori Infection: A Protective Factor for Esophageal Squamous Cell Carcinoma in a Taiwanese Population

    Microsoft Academic Search

    Deng-Chyang Wu; I-Chen Wu; Jang-Ming Lee; Hon-Ki Hsu; Ein-Long Kao; Shah-Hwa Chou; Ming-Tsang Wu

    2005-01-01

    AIM:Many researchers have reported the inverse relationship between Helicobacter pylori (H. pylori) infection and esophageal adenocarcinoma risk, but very few studies have examined the association between H. pylori infection and the development of esophageal squamous-cell carcinoma (ESCC). Therefore, the aim of this study is to evaluate the relationship between H. pylori infection and ESCC risk.METHOD:Subjects were cancer cases, pathologically proven

  17. [Esophageal motility disorders].

    PubMed

    Müller, M; Gockel, I

    2015-06-01

    Esophageal motility disorders are a group of diseases that result in swallowing dysfunction due to changes in neuromuscular structures, which coordinate esophageal function. Besides achalasia, which is the best defined functional disturbance of the esophagus, there are other motility disorders, namely hypercontractile (diffuse esophageal spasm, nutcracker or jackhammer esophagus, hypertensive lower esophageal sphincter) and hypocontractile disorders, whose origins and disease mechanisms are not yet well understood. The main symptoms are dysphagia and thoracic pain. Diagnosis is usually made by means of esophageal manometry, while endoscopy and barium swallow are essential to exclude inflammatory or neoplastic changes. The introduction of high resolution manometry (HRM) with up to 36 pressure points that are simultaneously measured on the esophageal catheter has changed diagnosis and assessment, and has led-with the Chicago Classification-to a new functional classification of esophageal motility disorders. In the following review, the most important motility disorders of the esophagus are introduced. PMID:25940142

  18. Esophageal cancer in Germany is associated with Epstein-Barr-virus but not with papillomaviruses

    Microsoft Academic Search

    S. Awerkiew; E. Bollschweiler; R. Metzger; P. M. Schneider; A. H. Hölscher; H. Pfister

    2003-01-01

    Esophageal squamous cell carcinomas ( n=23) and adenocarcinomas ( n=14) from German patients were tested for the presence of human papillomavirus (HPV) and Epstein-Barr-Virus (EBV) DNA. No DNA for either genital HPV or epidermodysplasia verruciformis-associated HPV was detected in any tumor. In contrast, 35% of squamous cell carcinomas and 36% of adenocarcinomas were shown to contain EBV DNA by nested

  19. Esophageal duplication cyst.

    PubMed

    Bagheri, Reza; Asnaashari, Amir Mohammad Hashem; Afghani, Reza

    2015-03-01

    Esophageal duplication cyst is a rare congenital mediastinal cyst. Most of these cysts become symptomatic in childhood and only rare cases remain asymptomatic until adolescence. They may produce symptoms due to esophageal and respiratory system compression, rupture, and infection. A 25-year-old man presented with pulmonary infection and bronchiectasis that did not improve with medical treatment. A diagnosis of esophageal duplication cyst was made intraoperatively. PMID:24757179

  20. Esophageal lichen planus.

    PubMed

    Oliveira, Janine Pichler de; Uribe, Natalia Caballero; Abulafia, Luna Azulay; Quintella, Leonardo Pereira

    2015-01-01

    Lichen planus is a chronic inflammatory disease that affects the skin, mucous membranes, nails and scalp. Esophageal lichen planus is a rarely reported manifestation of lichen planus, presenting itself commonly in middle-aged women, with symptoms such as dysphagia. We report a case of esophageal lichen planus in a 54-year-old woman associated with oral, cutaneous and ungual lichen planus. Although lichen planus is a disorder well known by dermatologists, reports of esophageal lichen planus are rare in dermatologic literature. The esophageal lichen planus is little known and underdiagnosed, with a significant delay between the onset of symptoms and diagnosis. PMID:26131872

  1. Drug-induced esophagitis.

    PubMed

    Zografos, G N; Georgiadou, D; Thomas, D; Kaltsas, G; Digalakis, M

    2009-01-01

    Drug-induced esophagitis is being recognized increasingly in the past few years. Since 1970 more than 650 cases have been reported worldwide caused by 30 or more medications. We have reviewed these cases with a view to classifying this disease based on underlying pathological mechanism. Drug-induced esophageal injury tends to occur at the anatomical site of narrowing, with the middle third behind the left atrium predominating (75.6%). The disease is broadly classified into two groups. The first group being transient and self-limiting as exemplified by the tetracycline group induced injury (65.8%). The second is the persistent esophagitis group, often with stricture, with two distinct entities: (i) patients on nonsteroidal anti-inflammatory agents whose injury is aggravated by gastroesophageal reflux (21.8%) (reflux aggravated); and (ii) patients with potasium chloride and quinidine sulphate induced injury (12.4%) (persistent drug injury). Severe esophageal injury has been reported in some women taking biphosphonates as treatment for postmenopausal osteoporosis. Endoscopic findings in such patients with esophageal injury generally suggested a chemical esophagitis, with erosions or ulcerations and exudative inflammation accompanied by thickening of the esophageal wall. Most cases of medication-induced esophageal injury heal without intervention within a few days. Thus, the most important aspect of therapy is to make the correct diagnosis and then to avoid reinjury with the drug. When possible, potentially caustic oral medications should be discontinued. PMID:19392845

  2. Esophageal cancer in Iran

    Microsoft Academic Search

    A Ghavamzadeh; A Moussavi; M Jahani; M Rastegarpanah; M Iravani

    2001-01-01

    Esophageal cancer is among the 10 most frequent cancers in the world. Iran is one of the known areas with a high incidence of esophageal cancer. Most of the patients in Iran have been reported from the north and northeast regions of the country. In one survey by the Iran Cancer Institute, 9% of all cancers and 27% of gastrointestinal

  3. Esophageal pH monitoring

    MedlinePLUS

    pH monitoring - esophageal; Esophageal acidity test ... to stay in the hospital for the esophageal pH monitoring. ... Esophageal pH monitoring is used to check how much stomach acid is entering the esophagus. It also checks how ...

  4. Esophageal endosclerosis in children.

    PubMed

    Stellen, G P; Lilly, J R

    1985-11-01

    During the past 6 years, 25 consecutive patients with esophageal variceal hemorrhage were treated by esophageal endosclerosis (direct injection of varices with a sclerosing agent). The primary disease in the 25 children was portal vein thrombosis (11 patients), biliary atresia (nine patients), and hepatic cirrhosis from cystic fibrosis (three patients), alpha 1-antitrypsin deficiency (one patient), and neonatal hepatitis (one patient). Thirteen patients were treated during acute, major variceal hemorrhage. Esophageal endosclerosis was repeated at regular intervals until all esophageal varices were obliterated. Twenty-one patients completed therapy. Four patients died: one of a complication of therapy and three of the primary disease. Other than the one death, complications were minor. Recurrent esophageal variceal hemorrhage has not been encountered in follow-up from 9 months to 6 years after completion of therapy. PMID:3877348

  5. The Use of in vivo Real-Time Optical Imaging for Esophageal Neoplasia

    PubMed Central

    Vila, Peter M.; Thekkek, Nadhi; Richards-Kortum, Rebecca; Anandasabapathy, Sharmila

    2012-01-01

    Esophageal adenocarcinoma carries a poor prognosis, as it typically presents at a late stage. Thus, a major research priority is the development of novel diagnostic imaging strategies that can detect neoplastic lesions earlier and more accurately than current techniques. Advances in optical imaging allow clinicians to obtain real-time histopathologic information with instant visualization of cellular architecture and the potential to identify neoplastic tissue. The various endoscopic imaging modalities for esophageal neoplasia can be grouped into two major categories: (a) wide-field imaging, a comparatively lower-resolution view for imaging larger surface areas, and (b) high-resolution imaging, which allows individual cells to be visualized. This review will provide an overview of the various forms of real-time optical imaging in the diagnosis and management of Barrett's esophagus and esophageal adenocarcinoma. PMID:22069213

  6. Endoscopic palliation of advanced esophageal cancer

    PubMed Central

    Mocanu, A; Bârla, R; Hoara, P; Constantinoiu, S

    2015-01-01

    Esophageal cancer represents one of the most aggressive digestive tumors, with a survival rate at 5 years of only 10%. Globally, during the last three decades, there has been an increasing incidence of the esophageal cancer, approx. 400,000 new esophageal cancers being currently diagnosed annually. This represents the eighth leading cause of cancer incidence and the sixth leading cause of cancer death overall. Taking into account the population’s global aging and thus, the increase in the number of patients who will not bear surgery, PCT and radiation, or the fact that they do not want it especially because of deficiencies and associated pathology, the endoscopic ablative techniques with palliation purposes represent the alternative. If we refer to the Western Europe countries and North America, we notice an increase of esophageal adenocarcinoma rate versus squamous cancer. As for the Asian region, referring in particular to China and Japan, 9 out of 10 esophageal cancers are squamous cell carcinomas. For at least half of the patients with EC (esophageal cancer) there is no hope of healing because of the advanced regional malignant invasion (T3-4, N+, M+) with no chemo and radiotherapy response, poor preoperative patients’ conditions or systemic metastasis. The low life expectancy does not justify the risky medical procedures, the goal of the therapy consisting in the improvement of the quality of life by eliminating dysphagia (reestablishing oral feeding) which represents the most common complication of EC, the respiratory tract complication caused by eso-tracheal fistulas or by eliminating chest pain. To treat dysphagia, which is the main target of palliation, combined methods like endoscopic, chemo and radio-therapy, can be used, each one with indications, benefits and risks. Abbreviations: SEPS = self expanding plastic stent, SREMS = self expanding metal stent, EBRT = Endoscopic brachy radiotherapy, EUS = Ultra sound endoscopy, CT = Computer tomograph, UGE = Upper gastro endoscopy, PET-CT = Positron Emission Tomography, APC = argon plasma coagulation, PDT = photo dynamic therapy, PCT = Poli-chemotherapy, RT = Radio-therapy PMID:25866578

  7. Treatment Options by Stage (Esophageal Cancer)

    MedlinePLUS

    ... Treatment (PDQ®) General Information About Esophageal Cancer Key Points Esophageal cancer is a disease in which malignant ( ... NCI Web site . Stages of Esophageal Cancer Key Points After esophageal cancer has been diagnosed, tests are ...

  8. Mesothelin is a specific biomarker of invasive cancer in the Barrett-associated adenocarcinoma progression model: translational implications for diagnosis and therapy.

    PubMed

    Alvarez, Hector; Rojas, Pamela Leal; Yong, Ken-Tye; Ding, Hong; Xu, Gaixia; Prasad, Paras N; Wang, Jean; Canto, Marcia; Eshleman, James R; Montgomery, Elizabeth A; Maitra, Anirban

    2008-12-01

    Esophageal adenocarcinoma arises in the backdrop of Barrett metaplasia-dysplasia sequence, with the vast majority of patients presenting with late-stage malignancy. Mesothelin, a glycophosphatidylinositol-anchored protein, is aberrantly overexpressed on the surface of many solid cancers. Mesothelin expression was assessed in esophageal tissue microarrays encompassing the entire histological spectrum of Barrett-associated dysplasia and adenocarcinoma. Mesothelin expression was observed in 24/84 (29%) of invasive adenocarcinomas and in 5/34 (15%) lymph node metastases. In contrast, normal squamous and cardiac mucosa, as well as noninvasive Barrett lesions, failed to label with mesothelin. Mesothelin was expressed in the esophageal adenocarcinoma cell line JH-EsoAd1 but not in primary human esophageal epithelial cells. Anti-mesothelin antibody-conjugated CdSe/CDS/ZnS quantum rods were synthesized, and confocal bioimaging confirmed robust binding to JH-EsoAd1 cells. Anti-mesothelin antibody-conjugated nanoparticles can be useful for the diagnosis and therapy of mesothelin-overexpressing esophageal adenocarcinomas. PMID:18691948

  9. Neoadjuvant chemoradiotherapy for esophageal/gastroesophageal carcinoma

    PubMed Central

    Nurkin, Steven J.; Fong, Mei Ka; Groman, Adrienne; Flaherty, Leayn; Malhotra, Usha; LeVea, Charles M.; Yendamuri, Sai; Warren, Graham W.; Nava, Hector R.; May, Kilian S.

    2013-01-01

    Background Esophageal/gastroesophageal junction (GEJ) adenocarcinoma is increasingly treated with trimodality therapy. We present our experience using carboplatin/paclitaxel and radiotherapy followed by surgery. Methods Consecutive patients with distal esophageal/GEJ adenocarcinoma (?T2 or N+) treated from July 2010 to October 2011 were identified. Treatment included neoadjuvant carboplatin/paclitaxel with concurrent radiotherapy (CRT) to 50.4 Gy using an IMRT technique and then Ivor Lewis esophagogastrectomy (ILE). PET/CT was performed prior to and after CRT. Patient/treatment characteristics and tumor response were analyzed. Results Over this timeframe, 16 patients completed trimodality therapy. All were male, median age of 60 years (45-72 years). All tumors were grade 2-3 with mean tumor length of 4.4 cm (1-9 cm). A median of 6 cycles (5-9 cycles) neoadjuvant carboplatin/paclitaxel were administered. Average time from diagnosis to CRT completion was 76 days (44-141 days) and 60 days (35-92 days) from CRT end to surgery. Neoadjuvant CRT was well tolerated with mean weight loss of 3.9 kg. All pts had R0 resections. No anastomotic leaks or perioperative mortality occurred. Mean hospital stay was 13 days (8-28 days). Pathologic complete response (pCR) was seen in 38% of patients, microscopic residual disease (isolated tumor cells or <2 mm) in 31%, and macroscopic residual disease remained in 31%. Mean SUV reduction was 41% (0-100%). Of 11 patients with ?35% SUV decrease, 45% had pCR and 27% had microscopic residual disease. Three patients had signet ring features. Of these, 2 had no SUV reduction and all had gross residual disease, including the only patient with positive nodal disease. Conclusions Trimodality therapy utilizing concurrent carboplatin/paclitaxel and radiotherapy to 50.4 Gy followed by surgery was well tolerated and resulted in significant pathologic complete response or minimal residual disease. Further investigation of predictive factors for response is needed to best tailor therapy in the management of esophageal/GEJ adenocarcinoma. PMID:23730509

  10. Incidence and treatment of brain metastasis in patients with esophageal carcinoma

    PubMed Central

    Feng, Wei; Zhang, Peng; Zheng, Xiao; Chen, Ming; Mao, Wei-Min

    2015-01-01

    Brain metastasis from esophageal carcinoma (BMEC) is very rare, but its incidence has increased in the United States, Japan, China and other counties. Reports on BMEC have largely been focused on examining whether adjuvant therapy for esophageal cancer influences the survival duration of BMEC patients and on the imaging characteristics of BMEC determined using new medical equipment. The difference between different pathological types of esophageal cancer, especially adenocarcinoma and squamous cell carcinoma, is one important factor used to assess the influence of BMEC. Adjuvant therapy, including radiotherapy and chemotherapy, for esophageal cancer with different characteristics in different countries may affect BMEC treatment outcomes. The degree of popularization of advanced medical equipment is a major concern related to the prevalence of BMEC. Furthermore, targeted BMEC treatment is under development in developed countries. In this article, we reviewed the debate surrounding BMEC and analyzed BMEC studies from different perspectives. PMID:26019444

  11. Esophageal Rupture in a Patient With Idiopathic Eosinophilic Esophagitis

    Microsoft Academic Search

    Peter J Riou; Andrew G Nicholson; Ugo Pastorino

    1996-01-01

    Idiopathic eosinophilic esophagitis is an extremely rare condition with fewer than 20 cases described in the literature. We present a case presenting as an emergency with esophageal perforation that eventually required subtotal esophagectomy.

  12. Systemic treatment of gastric and esophageal adenocarcinoma in elderly patients

    PubMed Central

    2015-01-01

    This article explores the treatment of cancer of the stomach and of the lower esophagus in older individuals. The incidence of both malignancies increases with age and, at present, the biology of the diseases, including sensitivity to chemotherapy, does not seem to change with age. The treatment of these cancers in patients 70 and over includes assessment of life expectancy secondary to physiologic age and evaluation of the individual’s tolerance to stress. For this purpose a comprehensive geriatric assessment (CGA) is the best validated instrument. For individuals whose life expectancy without cancer exceeds that with cancer, the estimate of the risk of chemotherapy complications may reveal those patients in need of additional care and those patients in whom the risk of treatment may exceed the potential benefits. All older individuals receiving chemotherapy may need adjustment of the doses to the glomerular filtration rate, support with myelopoietic growth factors, and special care to prevent severe and irreversible neurotoxicity. PMID:25642340

  13. Oral microbiome in esophageal adenocarcinoma | Division of Cancer Prevention

    Cancer.gov

    Skip to main content Division of Cancer Prevention Search form Search Main menu Home Major Programs Research Networks Map Alliance of Glycobiologists for Detection of Cancer Barrett's Esophagus Translational Research Network (BETRNet) Cancer Prevention

  14. Association of Esophageal Inflammation, Obesity and Gastroesophageal Reflux Disease: From FDG PET/CT Perspective

    PubMed Central

    Lee, Yi-Chia; Wang, Shan-Ying; Chiu, Han-Mo; Tu, Chia-Hung; Wang, Hsiu-Po; Lin, Jaw-Town; Wu, Ming-Shiang; Yang, Wei-Shiung

    2014-01-01

    Objective Gastroesophageal reflux disease (GERD) is associated with bothersome symptoms and neoplastic progression into Barrett's esophagus and esophageal adenocarcinoma. We aim to determine the correlation between GERD, esophageal inflammation and obesity with 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Methods We studied 458 subjects who underwent a comprehensive health check-up, which included an upper gastrointestinal endoscopy, FDG PET/CT and complete anthropometric measures. GERD symptoms were evaluated with Reflux Disease Questionnaire. Endoscopically erosive esophagitis was scored using the Los Angeles classification system. Inflammatory activity, represented by standardized uptake values (SUVmax) of FDG at pre-determined locations of esophagus, stomach and duodenum, were compared. Association between erosive esophagitis, FDG activity and anthropometric evaluation, including body mass index (BMI), waist circumference, visceral and subcutaneous adipose tissue volumes were analyzed. Results Subjects with erosive esophagitis (n?=?178, 38.9%) had significantly higher SUVmax at middle esophagus (2.69±0.74 vs. 2.41±0.57, P<.001) and esophagogastric junction (3.10±0.89 vs. 2.38±0.57, P<.001), marginally higher at upper esophageal sphincter (2.29±0.42 vs. 2.21±0.48, P?=?.062), but not in stomach or duodenum. The severity of erosive esophagitis correlated with SUVmax and subjects with Barrett's esophagus had the highest SUVmax at middle esophagus and esophagogastric junction. Heartburn positively correlated with higher SUVmax at middle oesophagus (r?=?.262, P?=?.003). Using multivariate regression analyses, age (P?=?.027), total cholesterol level (P?=?.003), alcohol drinking (P?=?.03), subcutaneous adipose tissue (P<.001), BMI (P<.001) and waist circumference (P<.001) were independently associated with higher SUVmax at respective esophageal locations. Conclusions Esophageal inflammation demonstrated by FDG PET/CT correlates with endoscopic findings and symptomatology of GERD. Obesity markers, both visceral and general, are independent determinants of esophageal inflammation. PMID:24642729

  15. Urinary Bladder Adenocarcinoma

    MedlinePLUS

    ... bladder adenocarcinoma begins in the cells of glandular structures lining body organs and spreads to the bladder. After treatment, ... cancerous, or malignant, tumor originating in a glandular structure. ... the body. Pathologist: A physician who examines tissues and fluids ...

  16. Eosinophilic Esophagitis: Strictures, Impactions, Dysphagia

    Microsoft Academic Search

    Seema Khan; Susan R. Orenstein; Carlo Di Lorenzo; Samuel A. Kocoshis; Philip E. Putnam; Luther Sigurdsson; Theresa M. Shalaby

    2003-01-01

    Eosinophilic esophagitis, long known to be a feature of acid reflux, has recently been described in patients with food allergies and macroscopically furrowed esophagus. The pathophysiology and optimal management of patients with eosinophilic esophagitis is unclear. We describe our clinical experience related to eosinophilic esophagitis and obstructive symptoms in children and propose etiopathogenesis and management guidelines. Twelve children with obstructive

  17. Esophageal and Gastric Cardia Cancer Risk and Folate and Vitamin B12-related Polymorphisms in Linxian, China

    Microsoft Academic Search

    Rachael Z. Stolzenberg-Solomon; You-Lin Qiao; Christian C. Abnet; D. Luke Ratnasinghe; Sanford M. Dawsey; Zhi Wei Dong; Philip R. Taylor; Steven D. Mark

    2003-01-01

    Linxian, a rural county in North Central China, has among the highest rates of esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA) in the world. Its inhabitants have documented chronic nutritional inadequacies, including folate and vitamin B12 deficiencies. Using a cohort we have been studying in Linxian since 1985, we examined the relationship between incident ESCC and GCA

  18. Genetic landscape of esophageal squamous cell carcinoma.

    PubMed

    Gao, Yi-Bo; Chen, Zhao-Li; Li, Jia-Gen; Hu, Xue-Da; Shi, Xue-Jiao; Sun, Zeng-Miao; Zhang, Fan; Zhao, Zi-Ran; Li, Zi-Tong; Liu, Zi-Yuan; Zhao, Yu-Da; Sun, Jian; Zhou, Cheng-Cheng; Yao, Ran; Wang, Su-Ya; Wang, Pan; Sun, Nan; Zhang, Bai-Hua; Dong, Jing-Si; Yu, Yue; Luo, Mei; Feng, Xiao-Li; Shi, Su-Sheng; Zhou, Fang; Tan, Feng-Wei; Qiu, Bin; Li, Ning; Shao, Kang; Zhang, Li-Jian; Zhang, Lan-Jun; Xue, Qi; Gao, Shu-Geng; He, Jie

    2014-10-01

    Esophageal squamous cell carcinoma (ESCC) is one of the deadliest cancers. We performed exome sequencing on 113 tumor-normal pairs, yielding a mean of 82 non-silent mutations per tumor, and 8 cell lines. The mutational profile of ESCC closely resembles those of squamous cell carcinomas of other tissues but differs from that of esophageal adenocarcinoma. Genes involved in cell cycle and apoptosis regulation were mutated in 99% of cases by somatic alterations of TP53 (93%), CCND1 (33%), CDKN2A (20%), NFE2L2 (10%) and RB1 (9%). Histone modifier genes were frequently mutated, including KMT2D (also called MLL2; 19%), KMT2C (MLL3; 6%), KDM6A (7%), EP300 (10%) and CREBBP (6%). EP300 mutations were associated with poor survival. The Hippo and Notch pathways were dysregulated by mutations in FAT1, FAT2, FAT3 or FAT4 (27%) or AJUBA (JUB; 7%) and NOTCH1, NOTCH2 or NOTCH3 (22%) or FBXW7 (5%), respectively. These results define the mutational landscape of ESCC and highlight mutations in epigenetic modulators with prognostic and potentially therapeutic implications. PMID:25151357

  19. Thoracoscopic repair of esophageal atresia with a distal fistula – lessons from the first 10 operations

    PubMed Central

    Zaborowska, Kamila; Rogowski, B?a?ej; Kali?ska, Anita; Nosek, Marzena; Golonka, Anna; Lesiuk, Witold; Obel, Marcin

    2015-01-01

    Introduction Thoracoscopic esophageal atresia (EA) repair was first performed in 1999, but still the technique is treated as one of the most complex pediatric surgical procedures. Aim The study presents a single-center experience and learning curve of thoracoscopic repair of esophageal atresia and tracheo-esophageal (distal) fistula. Material and methods From 2012 to 2014, 10 consecutive patients with esophageal atresia and tracheo-esophageal fistula were treated thoracoscopically in our center. There were 8 girls and 2 boys. Mean gestational age was 36.5 weeks and mean weight was 2230 g. Four children had associated anomalies. The surgery was performed after stabilization of the patient between the first and fourth day after birth. Five patients required intubation before surgery for respiratory distress. Bronchoscopy was not performed before the operation. Results In 8 patients, the endoscopic approach was successfully used thoracoscopically, while in 2 patients conversion to an open thoracotomy was necessary. In all patients except 1, the anastomosis was patent, with no evidence of leak. One patient demonstrated a leak, which did not resolve spontaneously, necessitating surgical repair. In long-term follow-up, 1 patient required esophageal dilatation of the anastomosis. All patients are on full oral feeding. Conclusions The endoscopic approach is the method of choice for the treatment of esophageal atresia in our center because of excellent visualization and precise atraumatic preparation even in neonates below a weight of 2000 g. PMID:25960794

  20. Two cases of esophageal eosinophilia: eosinophilic esophagitis or gastro-esophageal reflux disease?

    PubMed

    Yilmaz, Ozlem; Karagol, Hacer Ilbilge Ertoy; Topal, Erdem; Unlusoy, Aysel Aksu; Egritas, Odul; Gonul, Ipek Isik; Bakirtas, Arzu

    2014-05-01

    Eosinophilic esophagitis (EoE) and gastroesophageal reflux disease are among the major causes of isolated esophageal eosinophilia. Isolated esophageal eosinophilia meeting criteria for EoE may respond to proton pump inhibitor (PPI) treatment. This entity is termed proton pumps inhibitor responsive esophageal eosinophilia (PPI-REE). Gastro-esophageal reflux is thought to comprise a subgroup of patients with PPI-REE. According to the latest guidelines, PPI responsiveness distinguishes people with PPI-REE from patients having EoE (non-responders). In this report, two unusual cases with findings belonging to both EoE and PPI-REE are discussed with known and unknown facts. PMID:24987510

  1. Evaluation of esophageal cytology using a neural net-based interactive scanning system (the PAPNET system): its possible role in screening for esophageal and gastric carcinoma.

    PubMed

    Koss, L G; Morgenstern, N; Tahir-Kheli, N; Suhrland, M; Schreiber, K; Greenebaum, E

    1998-05-01

    A neural net-based, semiautomated, interactive computerized cell analysis system (The PAPNET system, Neuromedical Systems, Suffern, NY) was used to examine cells from 138 esophageal smears obtained by lavage, brushings, or balloon from as many patients. From each smear, trained human observers examined 128 cell images selected by the machine. Abnormal cells were identified in all 35 patients with cancer, whether esophageal, gastric, oral, or metastatic. Further, in 11 smears, the displayed images allowed the recognition of effects of radiotherapy and, in 14 smears, the diagnosis of a specific tumor type, such as squamous cell carcinoma (8 patients) or adenocarcinoma (6 patients). In 3 additional cases, the diagnosis of "carcinoma, not further specified," was established. One case of esophageal carcinoma in situ, not previously recognized on a smear or in the biopsy specimen, and one case of gastric adenocarcinoma, not recognized in the smear, were identified in PAPNET-generated images. The possible application of the apparatus to the triage of smears and population screening for esophageal and gastric carcinoma precursors is discussed. PMID:9576572

  2. Can esophageal dilation be avoided in the treatment of severe esophageal stricture caused by eosinophilic esophagitis?

    PubMed

    Silva, D; Santos, F; Piedade, S; Morais-Almeida, M

    2015-07-01

    Eosinophilic esophagitis (EoE) is an inflammatory immune-mediated disease with predominant eosinophilic inflammation characterized by the presence of esophageal dysfunction symptoms. Treatment delay can be associated with disease complications, like esophageal strictures, that can justify the use of invasive procedures which are not deprived of side effects. We present a case report of a 14 year old child with severe esophageal stricture secondary to EoE, that was treated with topical and systemic corticosteroid before any invasive procedure was considered. After 26 weeks of medical treatment, significant improvement of esophageal dysfunction occurred with histological remission and stricture resolution. In patients with severe esophageal strictures secondary to EoE, the need for esophageal dilation procedures should be considered only after anti-inflammatory treatment. PMID:26159479

  3. Adenocarcinoma of the pancreas

    PubMed Central

    Hruban, Ralph H.; Klimstra, David S.

    2015-01-01

    Infiltrating ductal adenocarcinoma of the pancreas is a real enigma. On one hand, it is one of the most deadly of all of the solid malignancies. On the other hand, the neoplastic glands can be remarkably well-differentiated, and it can be difficult to distinguish between a reactive non-neoplastic gland and a gland of invasive adenocarcinoma. In this review, we will present diagnostic criteria that one can “hang your hat on” when establishing the diagnosis of infiltrating ductal adenocarcinoma of the pancreas. We will also review clinically important features of the disease, and, with the impending incorporation of molecular genetics into everyday practice, we will emphasize clinical applications of cancer genetics. PMID:25441308

  4. Adenocarcinoma of the pancreas.

    PubMed

    Hruban, Ralph H; Klimstra, David S

    2014-11-01

    Infiltrating ductal adenocarcinoma of the pancreas is a real enigma. On one hand, it is one of the most deadly of all of the solid malignancies. On the other hand, the neoplastic glands can be remarkably well-differentiated, and it can be difficult to distinguish between a reactive non-neoplastic gland and a gland of invasive adenocarcinoma. In this review, we will present diagnostic criteria that one can "hang your hat on" when establishing the diagnosis of infiltrating ductal adenocarcinoma of the pancreas. We will also review clinically important features of the disease, and, with the impending incorporation of molecular genetics into everyday practice, we will emphasize clinical applications of cancer genetics. PMID:25441308

  5. A Unique Case of a Patient with Rectal Cancer Who Developed Benign Esophageal Stenosis after Localized Rectal Radiation and Systemic Chemotherapy

    PubMed Central

    Chahla, Elie; Cheesman, Antonio; Hammami, Muhammad; Taylor, Jason R.; Poddar, Nishant; Garrett, Robert W.; Alkaade, Samer

    2015-01-01

    Acute esophagitis and esophageal strictures typically occur after local radiation therapy to the thoracic field. Toxicity is usually limited to the field of radiation and potentially augmented by concomitant use of chemotherapy, however esophageal stricturing due to chemotherapy alone is exceedingly rare. Gastrointestinal toxicity has been previously reported in the setting of 5-fluorouracil (5-FU)-based chemotherapy with abnormal thymidylate synthase or dihydropyrimidine dehydrogenase activities. We present a unique case of isolated chemotherapy-induced esophageal stricture in the setting of stage IIIa rectal adenocarcinoma which presented shortly after initiation of treatment with 5-FU-based chemotherapy in a patient with normal thymidylate synthase and dihydropyrimidine dehydrogenase assays. These findings prompt further investigation of pathways and potential risk factors leading to esophageal toxicity in patients treated with 5-FU-based chemotherapy. PMID:25802497

  6. Successful treatment of esophageal cancer with transhiatal esophagectomy after heart transplantation

    Microsoft Academic Search

    Dipin Gupta; Mahender Macha; Valentino Piacentino; Arun K Singhal; Harvey F Sasken; Satoshi Furukawa; Daniel T Dempsey

    2004-01-01

    A 55-year-old heart transplant recipient with reflux esophagitis presented for routine endoscopic surveillance of an area of Barrett's metaplasia initially seen 3 years previously. Esophagogastroduodenoscopy revealed adenocarcinoma at 33 cm from the incisors. The preoperative clinical stage was T1N0M0 by endoscopic ultrasound. Transhiatal esophagectomy was performed with R0 resection of the cancer, and the patient recovered uneventfully. Pathologic examination confirmed

  7. 21 CFR 876.5365 - Esophageal dilator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

  8. 21 CFR 876.5365 - Esophageal dilator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

  9. 21 CFR 876.5365 - Esophageal dilator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

  10. 21 CFR 876.5365 - Esophageal dilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

  11. 21 CFR 876.5365 - Esophageal dilator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

  12. Adenocarcinoma of the prostrate

    SciTech Connect

    Bruce, A.W.; Trachtenberg, J.

    1987-01-01

    This books contains 13 chapters. Some of the chapter titles are: Imaging Techniques in the Diagnosis and Pelvic Staging of Prostatic Cancer; Interstitial Radiotherapy; The Case for External Beam Radiotherapy of Certain Adenocarcinomas of the Prostate; and Chemotherapy of Prostatic Cancer.

  13. An Overview of Eosinophilic Esophagitis

    PubMed Central

    Park, Hyojin

    2014-01-01

    Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated esophageal disease affecting both children and adults. The condition is characterized by an eosinophilic infiltration of the esophageal epithelium. Symptoms of esophageal dysfunction include dysphagia, food impaction and symptoms mimicking gastroesophageal reflux disease. Endoscopic examination typically reveals mucosal fragility, ring or corrugated mucosa, longitudinal furrows, whitish plaques or a small caliber esophagus. Histologic findings of >15 eosinophils per high-power field is the diagnostic hallmark of EoE. An elimination diet, topical corticosteroids or endoscopic dilation for fibrostenotic disease serve as effective therapeutic option. PMID:25368745

  14. Targeted imaging of esophageal neoplasia with a fluorescently labeled peptide: First in-human results

    PubMed Central

    Sturm, Matthew B.; Joshi, Bishnu P.; Lu, Shaoying; Piraka, Cyrus; Khondee, Supang; Elmunzer, B. Joseph; Kwon, Richard S.; Beer, David G.; Appelman, Henry; Turgeon, D. Kim; Wang, Thomas D.

    2013-01-01

    Esophageal adenocarcinoma is rising rapidly in incidence, and usually develops from Barrett’s esophagus, a precursor condition commonly found in patients with chronic acid reflux. Pre-malignant lesions are challenging to detect on conventional screening endoscopy because of their flat appearance. Molecular changes can be used to improve detection of early neoplasia. We have developed a peptide that binds specifically to high-grade dysplasia and adenocarcinoma. We first applied the peptide ex vivo to esophageal specimens from 17 patients to validate specific binding. Next, we performed confocal endomicroscopy in vivo in 25 human subjects after topical peptide administration and found 3.8-fold greater fluorescence intensity for esophageal neoplasia compared with Barrett’s esophagus and squamous epithelium with 75% sensitivity and 97% specificity. No toxicity was attributed to the peptide in either animal or patient studies. Therefore, our first-in-humans results show that this targeted imaging agent is safe, and may be useful for guiding tissue biopsy and for early detection of esophageal neoplasia and potentially other cancers of epithelial origin, such as bladder, colon, lung, pancreas, and stomach. PMID:23658246

  15. [Eosinophilic esophagitis diagnostic features].

    PubMed

    2015-01-01

    Eosinophilic esophagitis (EoE) is a chronic inflammatory disease characterized by eosinophilic infiltration and inflammation of the gastrointestinal tract in the absence of other causes of tissue eosinophilia. The clinical course of EoE like gastroesophageal reflux disease with eosinophilic infiltration of the esophageal epithelium. EoE widely diagnosed abroad in children and adults, whereas in Russia the disease is almost never diagnosed. Upon detection of eosinophilia in the biopsy of the esophagus should exclude other causes. The correct clinical diagnosis in combination with the study of biopsy tissue of the esophagus and other laboratory methods (including allergic testing) is crucial in achieving the effectiveness of therapy EoE. PMID:25993874

  16. O-6-methylguanine-deoxyribonucleic acid methyltransferase methylation enhances response to temozolomide treatment in esophageal cancer

    PubMed Central

    Hasina, Rifat; Surati, Mosmi; Kawada, Ichiro; Arif, Qudsia; Carey, George B.; Kanteti, Rajani; Husain, Aliya N.; Ferguson, Mark K.; Vokes, Everett E.; Villaflor, Victoria M.; Salgia, Ravi

    2013-01-01

    Background: World-wide, esophageal cancer is a growing epidemic and patients frequently present with advanced disease that is surgically inoperable. Hence, chemotherapy is the predominate treatment. Cytotoxic platinum compounds are mostly used, but their efficacy is only moderate. Newer alkylating agents have shown promise in other tumor types, but little is known about their utility in esophageal cancer. Methods: We utilized archived human esophageal cancer samples and esophageal cancer cell lines to evaluate O-6-methylguanine-deoxyribonucleic acid methyltransferase (MGMT) hypermethylation status and determined sensitivity to the alkylating drug temozolomide (TMZ). Immunoblot analysis was performed to determine MGMT protein expression in cell lines. To assess and confirm the effect of TMZ treatment in a methylated esophageal cancer cell line in vivo, a mouse flank xenograft tumor model was utilized. Results: Nearly 71% (12/17) of adenocarcinoma and 38% (3/8) of squamous cell carcinoma (SCC) patient samples were MGMT hypermethylated. Out of four adenocarcinoma and nine SCC cell lines tested, one of each histology was hypermethylated. Immunoblot analyses confirmed that hypermethylated cell lines did not express the MGMT protein. In vitro cell viability assays showed the methylated Kyse-140 and FLO cells to be sensitive to TMZ at an IC50 of 52-420 ?M, whereas unmethylated cells Kyse-410 and SKGT-4 did not respond. In an in vivo xenograft tumor model with Kyse-140 cells, which are MGMT hypermethylated, TMZ treatment abrogated tumor growth by more than 60%. Conclusion: MGMT methylation may be an important biomarker in subsets of esophageal cancers and targeting by TMZ may be utilized to successfully treat these patients. PMID:24319345

  17. Hypnotherapy for Esophageal Disorders.

    PubMed

    Riehl, Megan E; Keefer, Laurie

    2015-01-01

    Hypnotherapy is an evidence based intervention for the treatment of functional bowel disorders, particularly irritable bowel syndrome. While similar in pathophysiology, less is known about the utility of hypnotherapy in the upper gastrointestinal tract. Esophageal disorders, most of which are functional in nature, cause painful and uncomfortable symptoms that impact patient quality of life and are difficult to treat from a medical perspective. After a thorough medical workup and a failed trial of proton pump inhibitor therapy, options for treatment are significantly limited. While the pathophysiology is likely multifactorial, two critical factors are believed to drive esophageal symptoms-visceral hypersensitivity and symptom hypervigilance. The goal of esophageal directed hypnotherapy is to promote a deep state of relaxation with focused attention allowing the patient to learn to modulate physiological sensations and symptoms that are not easily addressed with conventional medical intervention. Currently, the use of hypnosis is suitable for dysphagia, globus, functional chest pain/non-cardiac chest pain, dyspepsia, and functional heartburn. In this article the authors will provide a rationale for the use of hypnosis in these disorders, presenting the science whenever available, describing their approach with these patients, and sharing a case study representing a successful outcome. PMID:26046715

  18. Eosinophilic esophagitis in children.

    PubMed

    Trivedy, Prerna; Teitelbaum, Jonathan E

    2015-06-01

    Eosinophilic esophagitis (EoE) is a relatively common chronic immune-mediated disease of the esophagus characterized clinically by symptoms of esophageal dysfunction that vary by age. Histologically, EoE results in marked esophageal eosinophilia despite treatment with high-dose proton pump inhibition. The cornerstone of treatment is dietary restriction and/or pharmacologic therapy, mainly with topical steroids. This review briefly describes dietary therapy, but focuses on the various medical options in the treatment of EoE, with an emphasis on steroid-based therapy. Numerous landmark studies are reviewed describing the symptomatic and histologic endpoints as well as safety data. The literature strongly supports the use of topical steroid therapy as a means of significantly decreasing eosinophilic mucosal disease. Specifically, high-dose fluticasone propionate appears to be very effective, and has been shown to result in the resolution of mucosal eosinophilia in a large percentage of treated patients. Long-term studies over many years will need to determine whether mucosal healing will change the natural history of this stricture-causing disease. In addition to topical therapy, various other drug-based therapies are reported, including newer immune-based monoclonal antibodies. PMID:25792526

  19. Management of patients with combined tracheoesophageal fistula, esophageal atresia, and duodenal atresia

    PubMed Central

    Nabzdyk, Christoph S.; Chiu, Bill; Jackson, Carl-Christian; Chwals, Walter J.

    2014-01-01

    INTRODUCTION Patients with combined esophageal atresia (EA), tracheoesophageal fistula (TEF), and duodenal atresia (DA) pose a rare management challenge. PRESENTATION OF CASE Three patients with combined esophageal atresia (EA), tracheoesophageal fistula (TEF), and duodenal atresia safely underwent a staged approach inserting a gastrostomy tube and repairing the EA/TEF first followed by a duodenoduodenostomy within one week. None of the patients suffered significant pre- or post-operative complications and our follow-up data (between 12 and 24 months) suggest that all patients eventually outgrow their reflux and respiratory symptoms. DISCUSSION While some authors support repair of all defects in one surgery, we recommend a staged approach. A gastrostomy tube is placed first for gastric decompression before TEF ligation and EA repair can be safely undertaken. The repair of the DA can then be performed within 3–7 days under controlled circumstances. CONCLUSION A staged approach of inserting a gastrostomy tube and repairing the EA/TEF first followed by a duodenoduodenostomy within one week resulted in excellent outcomes. PMID:25460495

  20. Clinical and etiological heterogeneity in patients with tracheo-esophageal malformations and associated anomalies.

    PubMed

    Brosens, Erwin; Ploeg, Mirjam; van Bever, Yolande; Koopmans, Anna E; IJsselstijn, Hanneke; Rottier, Robbert J; Wijnen, Rene; Tibboel, Dick; de Klein, Annelies

    2014-08-01

    Esophageal Atresia (EA) is a severe developmental defect of the foregut that presents with or without a Tracheo-Esophageal Fistula (TEF). The prevalence of EA/TEF over time and around the world has been relatively stable. EA/TEF is manifested in a broad spectrum of anomalies: in some patients it manifests as an isolated atresia or fistula, but in over half it affects several organ systems. While the associated malformations are often those of the VACTERL spectrum (Vertebral, Anorectal, Cardiac, Tracheo-Esophageal, Renal and Limb), many patients are affected by other malformations, such as microcephaly, micrognathia, pyloric stenosis, duodenal atresia, a single umbilical artery, and anomalies of the genitourinary, respiratory and gastrointestinal systems. Though EA/TEF is a genetically heterogeneous condition, recurrent genes and loci are sometimes affected. Tracheo-Esophageal (TE) defects are in fact a variable feature in several known single gene disorders and in patients with specific recurrent Copy Number Variations and structural chromosomal aberrations. At present, a causal genetic aberration can be identified in 11-12% of patients. In most, EA/TEF is a sporadic finding; the familial recurrence rate is low (1%). As this suggests that epigenetic and environmental factors also contribute to the disease, non-syndromic EA/TEF is generally believed to be a multifactorial condition. Several population-based studies and case reports describe a wide range of associated risks, including age, diabetes, drug use, herbicides, smoking and fetal alcohol exposure. The phenotypical and genetic heterogeneity seen in EA/TEF patients indicates not one underlying cause, but several. Unraveling the complex multifactorial and heterogeneous etiology of EA/TEF and associated features will require large cohorts of patients. Combined statistical analysis of component findings, genome sequencing, and genome wide association studies will elucidate new causal genetic defects and predisposing loci in the etiology within specific sub-populations. Improved knowledge of environmental risk factors, genetic predisposition and causal genetic syndromes may improve prediction and parental counseling, and prevent co-morbidity. PMID:24931924

  1. Peptidomics-based Approach Reveals the Secretion of the 29Residue COOH- Terminal Fragment of the Putative Tumor Suppressor Protein DMBT1 from Pancreatic Adenocarcinoma Cell Lines1

    Microsoft Academic Search

    Kazuki Sasaki; Kae Sato; Yasuto Akiyama; Kazuyoshi Yanagihara; Masaaki Oka; Ken Yamaguchi

    2002-01-01

    Deleted in malignant brain tumors 1 is a putative tumor suppressor protein in brain, lung, esophageal, gastric, and colorectal cancer. Here we report the mass spectrometric identification of a 3335 Da peptide, which was found in serum-free conditioned medium from 5 of 15 pancreatic adenocarcinoma cell lines but not from 35 carcinoma cell lines and 2 nonmalignant pancreatic duct cell

  2. Characteristics of brain metastases from esophageal carcinoma

    PubMed Central

    Yamamoto, Takahiro; Kuroda, Jun-ichiro; Takezaki, Tatsuya; Shinojima, Naoki; Hide, Takuichiro; Makino, Keishi; Nakamura, Hideo; Yano, Shigetoshi; Nishi, Toru; Kuratsu, Jun-ichi

    2014-01-01

    Background: Esophageal carcinoma (EC) is a major malignancy with a poor prognosis. Although esophageal cancers rarely metastasize to the brain, the number of patients diagnosed with brain metastases (BM) from EC is steadily increasing. Therefore, the risk factors for BM from EC should be known. Here we reviewed our experiences and the previous literature regarding BM from EC. Methods: Between 2000 and 2013, we retrospectively reviewed the clinical features and neurological findings of 19 patients diagnosed with and treated for BM from EC to determine the clinical risk factors and features. Results: In all patients, the lesions were partially or completed located in the thoracic esophagus, and the average size of the EC lesion at diagnosis was 5.8 ± 2.9 cm, which was smaller than the previously reported size of EC lesions accompanied by BM. Patients without lung metastases were more common than those with lung metastases. The lesions in the 13 patients included squamous cell carcinoma (SqCC) in 9 (69.2%) and small cell carcinoma (SmCC) in 3 (23.0%). Six patients were not examined. Although there was no trend toward a higher incidence of BM in patients with adenocarcinoma and SqCC, this trend was observed in patients with SmCC. Excluding a single patient with SmCC, all patients had beyond stage III disease at EC diagnosis. Conclusions: Our study suggests that BM can occur in patients with EC lesions smaller than those previously reported; moreover, SmCC may be a risk factor for BM from EC. PMID:25317352

  3. Role of preoperative tracheobronchoscopy in newborns with esophageal atresia: A review.

    PubMed

    Parolini, Filippo; Boroni, Giovanni; Stefini, Stefania; Agapiti, Cristina; Bazzana, Tullia; Alberti, Daniele

    2014-10-16

    Preoperative tracheobronchoscopy (TBS) in the diagnostic assessment of newborns affected by esophageal atresia (EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included in the diagnostic and therapeutic assessment in many international pediatric surgery settings. Routine preoperative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualization of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fogarty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alternative diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound. PMID:25324919

  4. 21 CFR 868.1920 - Esophageal stethoscope with electrical conductors.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...false Esophageal stethoscope with electrical conductors. 868.1920 Section...1920 Esophageal stethoscope with electrical conductors. (a) Identification. An esophageal stethoscope with electrical conductors is a device...

  5. 21 CFR 868.1920 - Esophageal stethoscope with electrical conductors.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...false Esophageal stethoscope with electrical conductors. 868.1920 Section...1920 Esophageal stethoscope with electrical conductors. (a) Identification. An esophageal stethoscope with electrical conductors is a device...

  6. 21 CFR 868.1920 - Esophageal stethoscope with electrical conductors.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Esophageal stethoscope with electrical conductors. 868.1920 Section 868...Esophageal stethoscope with electrical conductors. (a) Identification. An esophageal stethoscope with electrical conductors is a device that is...

  7. 21 CFR 868.1920 - Esophageal stethoscope with electrical conductors.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Esophageal stethoscope with electrical conductors. 868.1920 Section 868...Esophageal stethoscope with electrical conductors. (a) Identification. An esophageal stethoscope with electrical conductors is a device that is...

  8. Esophageal metastasis from breast carcinoma.

    PubMed

    Vergote, G; Ponette, E; Verschakelen, J; Baert, A L; Rutgeerts, P; Moerman, P

    1994-12-01

    A case of esophageal metastasis from a breast carcinoma is presented. Location was, as usual, midesophageal. The interval of time between breast carcinoma and the onset of esophageal symptoms was rather long. Barium swallow examination enabled correct diagnosis, whereas several series of superficial endoscopical biopsies were negative. Diagnosis was confirmed by deep endoscopical biopsy. PMID:7829460

  9. Pill-induced esophageal injury

    Microsoft Academic Search

    James Walter Kikendall; Arnold C. Friedman; Morakinyo Anthony Oyewole; David Fleischer; Lawrence F. Johnson

    1983-01-01

    We report four cases of esophageal injury associated with the ingestion of commonly prescribed tablets or capsules. History and clinical characteristics of these cases suggest that the medications failed to transit the esophagus and acted locally to produce esophagitis. A search of English- and foreign-language medical journals documented 221 similar cases due to 26 different types of medication. While most

  10. Lichen Planus With Esophageal Involvement

    Microsoft Academic Search

    F. Valdés; A. Caparrini; J. M. Calzada

    2007-01-01

    Lichen planus is an inflammatory disease of unknown etiology which may affect the esophagus. Patients with esophageal lichen planus are usually elderly women. The most frequent symptoms are dysphagia and odynophagia. There is usually concomitant oral involvement in cases of esophageal lichen planus. Endoscopic findings include erosions, exudates and stenosis. Systemic steroids are the most effective therapy for these patients.

  11. Relationship of the notochord to foregut development in the fetal rat model of esophageal atresia

    Microsoft Academic Search

    Bao Quan Qi; Spencer W Beasley

    1999-01-01

    Background\\/Purpose: The notochord (Nt) is thought to act as a primary organizer for adjacent axial embryonic organs. The current study used the Adriamycin-induced fetal rat model of esophageal atresia and tracheoesophageal fistula (EA-TEF) to determine whether anomalies of the foregut (FG) were associated with an abnormal Nt.Methods: Eight experimental female Sprague-Dawley rats received intraperitoneal injection of Adriamycin (1.75 mg\\/kg) on

  12. Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities

    PubMed Central

    Napier, Kyle J; Scheerer, Mary; Misra, Subhasis

    2014-01-01

    Esophageal cancer is a serious malignancy with regards to mortality and prognosis. It is a growing health concern that is expected to increase in incidence over the next 10 years. Squamous cell carcinoma is the most common histological type of esophageal cancer worldwide, with a higher incidence in developing nations. With the increased prevalence of gastroesophageal reflux disease and obesity in developed nations, the incidence of esophageal adenocarcinoma has dramatically increased in the past 40 years. Esophageal cancer is staged according to the widely accepted TNM system. Staging plays an integral part in guiding stage specific treatment protocols and has a great impact on overall survival. Common imaging modalities used in staging include computed tomography, endoscopic ultrasound and positron emission tomography scans. Current treatment options include multimodality therapy mainstays of current treatment include surgery, radiation and chemotherapy. Tumor markers of esophageal cancer are an advancing area of research that could potentially lead to earlier diagnosis as well as playing a part in assessing tumor response to therapy. PMID:24834141

  13. Novel low-cost fiber optic colorimetric instrument to rapidly screen premalignant esophageal tissue

    NASA Astrophysics Data System (ADS)

    Dattamajumdar, Anupam K.; Myers, John A.; Proctor, Andrew H.; Levine, Douglas S.; Blount, Patricia L.; Reid, Brian J.; Martin, Roy W.

    1998-05-01

    A cost-efficient screening device is needed to detect patients who have Barrett's esophagus, a precursor to esophageal adenocarcinoma -- the most rapidly increasing cancer in the US. We have developed a prototype instrument based on colorimetric assessment of esophageal lumen. The system consists of a small diameter fiber-optic probe, interfacing electronics, a probe-head position sensor and a computer for display and analysis. The probe has a central plastic optical fiber through which white light is incident on the collapsed esophageal lumen via c conical mirror in the probe-head. A parabolic mirror in the probe-head focuses the reflected light is applied to a linear 520 X 3 RGB photo-diode array to generate proportional electrical signals. A position sensor tracks probe-head location as it is retracted, allowing generation of a 2D colormap of esophageal lumen. A color change from white to red indicates Barrett's esophagus. The system performed accurately in tests using models of esophageal lumen which simulate patterns observed in Barrett's esophagus.

  14. [Invaginated esophageal anastomosis].

    PubMed

    Petrov, V P; Mikhalkin, M P; Rozhkov, A G

    2002-01-01

    Extirpation of the stomach accounts for 55.5% of all radical surgery for gastric cancer. Five hundred and sixty-two operations with creation of invaginated esophageal-intestinal (gastric) anastomosis were performed. The surgical technique is presented, its positive points are demonstrated. Main advantages of the invaginated anastomosis are physiologic function in postoperative period and a decreased rate of sutures insufficiency. Complications after extirpation and proximal resection of the stomach were seen in 17.6% cases, 5.9% patients died. Insufficiency of anastomosis sutures was in 8 (14%) patients, 4 (0.7%) of them died. PMID:12449573

  15. Temporal evolution in caveolin 1 methylation levels during human esophageal carcinogenesis

    PubMed Central

    2014-01-01

    Background Esophageal cancer ranks eighth among frequent cancers worldwide. Our aim was to investigate whether and at which neoplastic stage promoter hypermethylation of CAV1 is involved in human esophageal carcinogenesis. Methods Using real-time quantitative methylation-specific PCR (qMSP), we examined CAV1 promoter hypermethylation in 260 human esophageal tissue specimens. Real-time RT-PCR and qMSP were also performed on OE33 esophageal cancer cells before and after treatment with the demethylating agent, 5-aza-2’-deoxycytidine (5-Aza-dC). Results CAV1 hypermethylation showed highly discriminative ROC curve profiles, clearly distinguishing esophageal adenocarcinomas (EAC) and esophageal squamous cell carcinomas (ESCC) from normal esophagus (NE) (EAC vs. NE, AUROC?=?0.839 and p?esophageal carcinomas and is associated with early neoplastic progression in Barrett’s esophagus. PMID:24885118

  16. Treatment of advanced esophageal cancer

    SciTech Connect

    Kelsen, D.

    1982-12-01

    When radiation therapy is used for palliation of obstruction in patients with advanced esophageal carcinoma, an improvement in dysphagia can be expected in approximately 50% of patients. Major objective responses have rarely been quantitied but, in one study, were seen in 33% patients. Recurrence of dysphagia is usually seen within 2-6 months of treatment. Radiation toxicities and complications, even when used with palliative intent, can be substantial and include esophagitis, tracheoesophageal or esophageal-aortic fistula, mediastinitis, hemorrhage, pneumonitis, and myelosuppression. (JMT)

  17. Pharmacologic treatments for esophageal disorders.

    PubMed

    Blackshaw, L Ashley; Bordin, Dmitry S; Brock, Christina; Brokjaer, Anne; Drewes, Asbjørn Mohr; Farmer, Adam D; Krarup, Anne Lund; Lottrup, Christian; Masharova, Antonina A; Moawad, Fouad J; Olesen, Anne Estrup

    2014-09-01

    The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role for ketamine and other alternative treatments in esophageal disorders; the use of linaclotide in the treatment of esophageal pain; the alginate test as a diagnostic criterion in gastroesophageal reflux disease (GERD); the use of baclofen in treatment of GERD; the effects of opioids on the esophagus; the use of antagonists on the receptor level in GERD; the effect of local formulation of drugs on the esophageal mucosa; and the use of electroencephalographic fingerprints to predict the effect of pharmacological treatment. PMID:25266012

  18. White specks in the esophageal mucosa: an endoscopic manifestation of non-reflux eosinophilic esophagitis in children

    Microsoft Academic Search

    Joel R Lim; Sandeep K Gupta; Joseph M Croffie; Marian D Pfefferkorn; Jean P Molleston; Mark R Corkins; Mary M Davis; Philip P Faught; Steven J Steiner; Joseph F Fitzgerald

    2004-01-01

    BackgroundWhite specks in the esophageal mucosa have been observed in children with eosinophilic esophagitis. The aim of this study was to determine the relationship between white specks in the esophageal mucosa and allergic (non-reflux) eosinophilic esophagitis.

  19. Endoscopic and clinicopathological patterns of esophageal cancer in Tanzania: experiences from two tertiary health institutions

    PubMed Central

    2013-01-01

    Background Esophageal cancer is one of the most serious gastrointestinal cancer worldwide, owing to its rapid development and fatal prognoses in most cases. There is a paucity of published data regarding esophageal cancer in Tanzania and the study area in particular. This study was conducted to describe the endoscopic and clinicopathological patterns of esophageal cancer in this part of the world. The study provides baseline local data for future comparison. Methods This was a retrospective study of histologically confirmed cases of esophageal cancer seen at Bugando Medical Center and Muhimbili National Hospital between March 2008 and February 2013. Data were retrieved from medical record computer database and analyzed using SPSS computer software version 17.0. Results A total of 328 esophageal cancer patients were enrolled in the study, representing 25.3% of all malignant gastrointestinal tract tumors. The male to female ratio was 2.2:1. The median age of patients at presentation was 47 years. The majority of patients (86.6%) were peasants coming from the rural areas. Smoking and alcohol consumption were documented in 74.7% and 61.6% of patients respectively. Family history of esophageal cancer was reported in 4.6% of cases. The majority of patients (81.7%) presented late with advanced stage of cancer. Progressive dysphagia and weight loss were the most common presenting symptoms occurring in all patients. The middle third esophagus (58.5%) was the most frequent anatomical site for esophageal cancer followed by lower third (27.4%) and upper third esophagus (10.4%). Squamous cell carcinoma (96.0%) was the most common histopathological type. Adenocarcinoma occurred in 13 (4.0%) patients. TNM staging was documented in only 104 (31.7%) patients. Of these, 102(98.1%) patients were diagnosed with advanced esophageal cancer (Stages III and IV). According to tumor grading, most of tumors were moderately differentiated accounting for 56.1% of cases. Distant metastasis was documented in 43.3% of patients. Conclusion Esophageal cancer is not uncommon in this region and shows a trend towards a relative young age at presentation and the majority of patients present late with advanced stage. There is a need for screening of high-risk populations and detecting esophageal cancer at an early stage in order to improve chances for successful treatment and survival. PMID:24094270

  20. Esophageal stenting in cancer therapy.

    PubMed

    Goenka, Mahesh Kumar; White, Russell E

    2014-09-01

    The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on nutritional support during chemoradiation, esophageal stents before surgery, and stenting the cervical esophagus. PMID:25266018

  1. Caustic ingestion and esophageal function

    SciTech Connect

    Cadranel, S.; Di Lorenzo, C.; Rodesch, P.; Piepsz, A.; Ham, H.R. (Children University Hospital, Brussels (Belgium))

    1990-02-01

    The aim of the present study was to investigate esophageal motor function by means of krypton-81m esophageal transit scintigraphy and to compare the results with the functional and morphological data obtained by means of triple lumen manometry and endoscopy. In acute and subacute stages of the disease, all clinical, anatomical, and functional parameters were in good agreement, revealing significant impairment. In chronic stages, the severity of the dysphagia was not correlated to the importance of the residual stenosis. Conversely, 81mKr esophageal transit and manometric's findings were in good agreement with the clinical symptoms, during the entire follow-up period ranging between 3 months to 7 years. The 81mKr test is undoubtedly the easiest and probably the most physiological technique currently available for long-term functional evaluation of caustic esophagitis.

  2. Drugs Approved for Esophageal Cancer

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for esophageal cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  3. Pancreatic adenocarcinoma: Outstanding problems.

    PubMed

    Zakharova, Olga P; Karmazanovsky, Grigory G; Egorov, Viacheslav I

    2012-05-27

    Pancreatic adenocarcinoma remains the fourth leading cause of cancer-related death and is one of the most aggressive malignant tumors with an overall 5-year survival rate of less than 4%. Surgical resection remains the only potentially curative treatment but is only possible for 15%-20% of patients with pancreatic adenocarcinoma. About 40% of patients have locally advanced nonresectable disease. In the past, determination of pancreatic cancer resectability was made at surgical exploration. The development of modern imaging techniques has allowed preoperative staging of patients. Institutions disagree about the criteria used to classify patients. Vascular invasion in pancreatic cancers plays a very important role in determining treatment and prognosis. There is no evidence-based consensus on the optimal preoperative imaging assessment of patients with suspected pancreatic cancer and a unified definition of borderline resectable pancreatic cancer is also lacking. Thus, there is much room for improvement in all aspects of treatment for pancreatic cancer. Multi-detector computed tomography has been widely accepted as the imaging technique of choice for diagnosing and staging pancreatic cancer. With improved surgical techniques and advanced perioperative management, vascular resection and reconstruction are performed more frequently; patients thought once to be unresectable are undergoing radical surgery. However, when attempting heroic surgery, a realistic approach concerning the patient's age and health status, probability of recovery after surgery, perioperative morbidity and mortality and life quality after tumor resection is necessary. PMID:22655124

  4. Drug-induced esophageal strictures.

    PubMed Central

    Bonavina, L; DeMeester, T R; McChesney, L; Schwizer, W; Albertucci, M; Bailey, R T

    1987-01-01

    A retrospective study of 55 patients with a benign esophageal stricture showed that in 11 patients (20%) the cause was a drug-induced lesion due to potassium chloride (3), tetracyclines (3), aspirin (2), vitamin C (1), phenytoin (1), and quinidine (1). Five of the 11 patients would have been diagnosed as having a reflux etiology of their stricture if 24-hour esophageal pH monitoring was not performed. Six patients responded to dilatation and five patients required resection or bypass. A prospective study of 18 asymptomatic volunteers showed a high incidence of esophageal lodgment of a radiolabeled medicinal capsule, with subsequent dissolution and release of the isotope. This occurred most frequently in elderly subjects and was reduced by increasing the volume of water chaser. The sites of lodgment correspond to the location of the observed strictures in the patient population. An in vitro study showed that, when the causative drugs were mixed with saliva, dissolution occurred within 60 minutes and was associated with significant changes in pH. These investigations show that drug-induced esophageal strictures are more common than previously appreciated, and can be confused with a reflux etiology. Diagnosis is suggested by a history of drug ingestion, location of the stricture, and a normal esophageal acid exposure on 24-hour pH monitoring. The severity of the esophageal injury is variable and requires dilatation to resection for therapy. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:3606243

  5. Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries

    PubMed Central

    Domper Arnal, María José; Ferrández Arenas, Ángel; Lanas Arbeloa, Ángel

    2015-01-01

    Esophageal cancer is one of the most unknown and deadliest cancers worldwide, mainly because of its extremely aggressive nature and poor survival rate. Esophageal cancer is the 6th leading cause of death from cancer and the 8th most common cancer in the world. The 5-year survival is around 15%-25%. There are clear differences between the risk factors of both histological types that affect their incidence and distribution worldwide. There are areas of high incidence of squamous cell carcinoma (some areas in China) that meet the requirements for cost-effectiveness of endoscopy for early diagnosis in the general population of those areas. In Europe and United States the predominant histologic subtype is adenocarcinoma. The role of early diagnosis of adenocarcinoma in Barrett’s esophagus remains controversial. The differences in the therapeutic management of early esophageal carcinoma (high-grade dysplasia, T1a, T1b, N0) between different parts of the world may be explained by the number of cancers diagnosed at an early stage. In areas where the incidence is high (China and Japan among others) early diagnoses is more frequent and has led to the development of endoscopic techniques for definitive treatment that achieve very effective results with a minimum number of complications and preserving the functionality of the esophagus. PMID:26185366

  6. Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries.

    PubMed

    Domper Arnal, María José; Ferrández Arenas, Ángel; Lanas Arbeloa, Ángel

    2015-07-14

    Esophageal cancer is one of the most unknown and deadliest cancers worldwide, mainly because of its extremely aggressive nature and poor survival rate. Esophageal cancer is the 6(th) leading cause of death from cancer and the 8(th) most common cancer in the world. The 5-year survival is around 15%-25%. There are clear differences between the risk factors of both histological types that affect their incidence and distribution worldwide. There are areas of high incidence of squamous cell carcinoma (some areas in China) that meet the requirements for cost-effectiveness of endoscopy for early diagnosis in the general population of those areas. In Europe and United States the predominant histologic subtype is adenocarcinoma. The role of early diagnosis of adenocarcinoma in Barrett's esophagus remains controversial. The differences in the therapeutic management of early esophageal carcinoma (high-grade dysplasia, T1a, T1b, N0) between different parts of the world may be explained by the number of cancers diagnosed at an early stage. In areas where the incidence is high (China and Japan among others) early diagnoses is more frequent and has led to the development of endoscopic techniques for definitive treatment that achieve very effective results with a minimum number of complications and preserving the functionality of the esophagus. PMID:26185366

  7. The Multifactorial Origin of Respiratory Morbidity in Patients Surviving Neonatal Repair of Esophageal Atresia

    PubMed Central

    Fragoso, Ana Catarina; Tovar, Juan A.

    2014-01-01

    Esophageal atresia with or without tracheoesophageal fistula (EA?±?TEF) occurs in 1 out of every 3000 births. Current survival approaches 95%, and research is therefore focused on morbidity and health-related quality of life issues. Up to 50% of neonates with EA?±?TEF have one or more additional malformations including those of the respiratory tract that occur in a relatively high proportion of them and particularly of those with vertebral, anal, cardiac, tracheoesophageal, renal, and limb association. Additionally, a significant proportion of survivors suffer abnormal pulmonary function and chronic respiratory tract disease. The present review summarizes the current knowledge about the nature of these symptoms in patients treated for EA?±?TEF, and explores the hypothesis that disturbed development and maturation of the respiratory tract could contribute to their pathogenesis. PMID:24829898

  8. Hyperthermochemoradiotherapy and esophageal carcinoma

    SciTech Connect

    Sugimachi, K.; Inokuchi, K.

    1986-01-01

    Cancer of the esophagus still poses considerable treatment problems, with a poor 5-year survival rate after surgery, an even worse outlook after radiation and surgery, and a not very satisfactory response to chemotherapy. After several years of continued research, in 1983 we developed a Radio Frequency System with endotract electrode and thermosensors for administering hyperthermochemoradiotherapy to patients with carcinoma of the esophagus. Results in 129 patients are discussed. Immediate improvement of subjective complaints and decrease or elimination of the cancer lesion are so distinct that this treatment, by means of an endotract antenna, shows promise as a modality for esophageal lesions and may find application in diseases such as colorectal cancer or carcinoma of the uterine cervix.

  9. Hyperthermochemoradiotherapy and esophageal carcinoma.

    PubMed

    Sugimachi, K; Inokuchi, K

    1986-01-01

    Cancer of the esophagus still poses considerable treatment problems, with a poor 5-year survival rate after surgery, an even worse outlook after radiation and surgery, and a not very satisfactory response to chemotherapy. After several years of continued research, in 1983 we developed a Radio Frequency System with endotract electrode and thermosensors for administering hyperthermochemoradiotherapy to patients with carcinoma of the esophagus. Results in 129 patients are discussed. Immediate improvement of subjective complaints and decrease or elimination of the cancer lesion are so distinct that this treatment, by means of an endotract antenna, shows promise as a modality for esophageal lesions and may find application in diseases such as colorectal cancer or carcinoma of the uterine cervix. PMID:2430326

  10. The MUC4 membrane-bound mucin regulates esophageal cancer cell proliferation and migration properties: Implication for S100A4 protein

    SciTech Connect

    Bruyere, Emilie; Jonckheere, Nicolas; Frenois, Frederic [Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 'Mucins, Epithelial Differentiation and Carcinogenesis', rue Polonovski, 59045 Lille Cedex (France) [Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 'Mucins, Epithelial Differentiation and Carcinogenesis', rue Polonovski, 59045 Lille Cedex (France); Universite Lille-Nord de France, 1 place de Verdun, 59045 Lille Cedex (France); Mariette, Christophe [Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 'Mucins, Epithelial Differentiation and Carcinogenesis', rue Polonovski, 59045 Lille Cedex (France) [Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 'Mucins, Epithelial Differentiation and Carcinogenesis', rue Polonovski, 59045 Lille Cedex (France); Universite Lille-Nord de France, 1 place de Verdun, 59045 Lille Cedex (France); Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, 1 place de Verdun, 59045 Lille Cedex (France); Van Seuningen, Isabelle, E-mail: isabelle.vanseuningen@inserm.fr [Inserm, UMR837, Jean-Pierre Aubert Research Center, Team 5 'Mucins, Epithelial Differentiation and Carcinogenesis', rue Polonovski, 59045 Lille Cedex (France); Universite Lille-Nord de France, 1 place de Verdun, 59045 Lille Cedex (France)

    2011-09-23

    Highlights: {yields} Loss of MUC4 reduces proliferation of esophageal cancer cells. {yields} MUC4 inhibition impairs migration of esophageal cancer cells but not their invasion. {yields} Loss of MUC4 significantly reduces in vivo tumor growth. {yields} Decrease of S100A4 induced by MUC4 inhibition impairs proliferation and migration. -- Abstract: MUC4 is a membrane-bound mucin known to participate in tumor progression. It has been shown that MUC4 pattern of expression is modified during esophageal carcinogenesis, with a progressive increase from metaplastic lesions to adenocarcinoma. The principal cause of development of esophageal adenocarcinoma is the gastro-esophageal reflux, and MUC4 was previously shown to be upregulated by several bile acids present in reflux. In this report, our aim was thus to determine whether MUC4 plays a role in biological properties of human esophageal cancer cells. For that stable MUC4-deficient cancer cell lines (shMUC4 cells) were established using a shRNA approach. In vitro (proliferation, migration and invasion) and in vivo (tumor growth following subcutaneous xenografts in SCID mice) biological properties of shMUC4 cells were analyzed. Our results show that shMUC4 cells were less proliferative, had decreased migration properties and did not express S100A4 protein when compared with MUC4 expressing cells. Absence of MUC4 did not impair shMUC4 invasiveness. Subcutaneous xenografts showed a significant decrease in tumor size when cells did not express MUC4. Altogether, these data indicate that MUC4 plays a key role in proliferative and migrating properties of esophageal cancer cells as well as is a tumor growth promoter. MUC4 mucin appears thus as a good therapeutic target to slow-down esophageal tumor progression.

  11. Prevalence of Esophageal Atresia among 18 International Birth Defects Surveillance Programs

    PubMed Central

    Nassar, Natasha; Leoncini, Emanuele; Amar, Emmanuelle; Arteaga-Vázquez, Jazmín; Bakker, Marian K.; Bower, Carol; Canfield, Mark A.; Castilla, Eduardo E.; Cocchi, Guido; Correa, Adolfo; Csáky-Szunyogh, Melinda; Feldkamp, Marcia L.; Khoshnood, Babak; Landau, Danielle; Lelong, Nathalie; López-Camelo, Jorge S.; Lowry, R. Brian; McDonnell, Robert; Merlob, Paul; Métneki, Julia; Morgan, Margery; Mutchinick, Osvaldo M.; Palmer, Miland N.; Rissmann, Anke; Siffel, Csaba; Sìpek, Antonin; Szabova, Elena; Tucker, David; Mastroiacovo, Pierpaolo

    2015-01-01

    BACKGROUND The prevalence of esophageal atresia (EA) has been shown to vary across different geographical settings. Investigation of geographical differences may provide an insight into the underlying etiology of EA. METHODS The study population comprised infants diagnosed with EA during 1998 to 2007 from 18 of the 46 birth defects surveillance programs, members of the International Clearinghouse for Birth Defects Surveillance and Research. Total prevalence per 10,000 births for EA was defined as the total number of cases in live births, stillbirths, and elective termination of pregnancy for fetal anomaly (ETOPFA) divided by the total number of all births in the population. RESULTS Among the participating programs, a total of 2943 cases of EA were diagnosed with an average prevalence of 2.44 (95% confidence interval [CI], 2.35–2.53) per 10,000 births, ranging between 1.77 and 3.68 per 10,000 births. Of all infants diagnosed with EA, 2761 (93.8%) were live births, 82 (2.8%) stillbirths, 89 (3.0%) ETOPFA, and 11 (0.4%) had unknown outcomes. The majority of cases (2020, 68.6%), had a reported EA with fistula, 749 (25.5%) were without fistula, and 174 (5.9%) were registered with an unspecified code. CONCLUSIONS On average, EA affected 1 in 4099 births (95% CI, 1 in 3954–4251 births) with prevalence varying across different geographical settings, but relatively consistent over time and comparable between surveillance programs. Findings suggest that differences in the prevalence observed among programs are likely to be attributable to variability in population ethnic compositions or issues in reporting or registration procedures of EA, rather than a real risk occurrence difference. PMID:22945024

  12. Eosinophilic esophagitis in adults: An emerging problem with unique esophageal features

    Microsoft Academic Search

    Jon W Potter; Kia Saeian; Benson T Massey; Richard A Komorowski; Reza Shaker; Walter J Hogan

    2004-01-01

    BackgroundEosinophilic esophagitis is an inflammatory condition in which there is dense eosinophilic infiltration of the surface lining of the esophagus. Reports of eosinophilic esophagitis pertain almost exclusively to pediatric populations. However, eosinophilic esophagitis is emerging as a clinical affliction of adults. This report describes the clinical and endoscopic findings of eosinophilic esophagitis in the largest cohort of adult patients reported

  13. SATB1 is an independent prognostic factor in radically resected upper gastrointestinal tract adenocarcinoma.

    PubMed

    Hedner, Charlotta; Gaber, Alexander; Korkocic, Dejan; Nodin, Björn; Uhlén, Mathias; Kuteeva, Eugenia; Johannesson, Henrik; Jirström, Karin; Eberhard, Jakob

    2014-12-01

    Gastric cancer is the second most common cause of cancer-related death worldwide, and the incidence of esophageal adenocarcinoma is rising. While some progress has been made in treatment strategies, overall survival remains very poor for patients with adenocarcinoma in the upper gastrointestinal tract. Special AT-rich sequence binding protein 1 (SATB1) is a global genome organizer that has been demonstrated to promote aggressive tumor behavior in several different types of cancer, including gastric cancer. The prognostic value of SATB1 expression in esophageal cancer has, however, not yet been described. In this study, expression of SATB1 was examined by immunohistochemistry on tissue microarrays prepared from tissue samples from 175 patients with adenocarcinoma of the esophagus, cardia, or stomach and containing normal tissue, intestinal metaplasia, primary tumors, and metastases. A well-validated antibody was used. We found SATB1 to be an independent prognostic factor in patients with a radically resected tumor, correlating with shorter overall survival as well as with shorter recurrence-free survival. SATB1 expression was also found to be significantly lower in primary tumors associated with intestinal metaplasia than those without intestinal metaplasia. This observation is of potential biological interest as it has been proposed that intestinal metaplasia-associated tumors constitute a less aggressive phenotype. PMID:25326863

  14. New and emerging combination therapies for esophageal cancer

    PubMed Central

    Wiedmann, Marcus W; Mössner, Joachim

    2013-01-01

    Esophageal cancer comprises two different histological forms – squamous cell carcinoma (SCC) and adenocarcinoma (AC). While the incidence of AC has increased steeply in Western countries during the last few years, the incidence of SCC is fairly stable. Both forms differ in pathogenesis and response to chemotherapy and radiation therapy. Plenty of studies have evaluated new chemotherapy combination regimens in the neoadjuvant, adjuvant, and palliative setting. In addition, new radiation and chemoradiation protocols have been investigated. Finally, molecular-targeted therapy has been included in several new randomized prospective trials. Therefore, this review presents new data on this topic and critically discusses promising approaches towards a more effective treatment in a disease with a grim prognosis. PMID:23869177

  15. Adenocarcinoma of the sphenoid sinus

    PubMed Central

    Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Nadour, Karim; Ammar, Haddou; Bouaity, Brahim

    2014-01-01

    Adenocarcinomas of the sphenoid sinus are exceptional. In this paper, we report a new case with a review of the literature. Our patient was a 45-year-old man who presented with isolated retro orbital headache. CT and MRI suspected a malignat tumor of the sphenoid sinus. The patient underwent a debulking surgery. The final pathology carried out the diagnosis of primary adenocarcinoma. The patient died several months later from radiotherapy complications. Even if adenocarcinomas of the sphenoid sinus are exceptional, they should be considered in the differential diagnosis of sphenoid sinus masses. The prognosis is poor. PMID:25469178

  16. Biological identification of ampullary adenocarcinomas.

    PubMed

    Relias, Valerie; Saif, Muhammad Wasif

    2014-07-01

    Ampullary adenocarcinomas have unique biologic and clinical features that result in its improved prognosis versus adenocarcinomas that arise from the distal bile ducts and pancreas. However the histological differentiation and identification of these tumors is not easily accomplished. Two abstracts at this year's ASCO Annual Meeting describe attempts to identify unique methods for distinguishing these tumors. Abstract #4141 described a 92 gene RT-PCR assay that was used for molecular classification of patients with ampullary adenocarcinomas while Abstract #e15175 looked at mutational status of K-ras in patients with these tumors. The results of their abstracts will be discussed. PMID:25076327

  17. Skip navigation Wireless System Tracks Esophageal Reflux

    E-print Network

    Chiao, Jung-Chih

    better testing than catheters now used MedlinePlus: Wireless System Tracks Esophageal Reflux URL: http://www.nlm.nih.gov Esophageal Reflux URL: http://www.nlm.nih.gov/medlineplus/news/fullstory_51164.html #12;

  18. [Epidemiology of pancreatic adenocarcinomas].

    PubMed

    Partensky, Christian

    2015-03-01

    Pancreatic cancer, mostly represented by pancreatic ductal adenocarcinoma, is a major public health burden in developed countries. More than half a million people are expected to die from pancreatic cancer, worldwide, in 2030. Age and tobacco are the main identified risk factors in sporadic cases, when many genetic syndromes increase the risk significantly. History of pancreatic cancer is a significant risk factor for pancreatic cancer for any first-degree related individual, known as familial pancreatic cancer. The genetic signature of this syndrome is probably due to a still not identified autosomal dominantly inherited gene with reduced penetrance. The risk increases with the number of first-degree relatives involved. Precursor lesions are known to give rise to invasive pancreatic cancer. These particular lesions are either macroscopic (intraductal papillary mucinous neoplasia and mucinous cystic neoplasms), or microscopic (pancreatic intraepithelial neoplasia). It is possible to identify a orouo of hig h-risk individuals who could be candidate for screening. PMID:26016196

  19. Esophageal perforation during or after conformal radiotherapy for esophageal carcinoma

    PubMed Central

    Chen, Hai-yan; Ma, Xiu-mei; Ye, Ming; Hou, Yan-li; Xie, Hua-Ying; Bai, Yong-rui

    2014-01-01

    The aim of this study was to analyze the risk factors and prognosis for patients with esophageal perforation occurring during or after radiotherapy for esophageal carcinoma. We retrospectively analyzed 322 patients with esophageal carcinoma. These patients received radiotherapy for unresectable esophageal tumors, residual tumors after operation, or local recurrence. Of these, 12 had radiotherapy to the esophagus before being admitted, 68 patients had concurrent chemoradiotherapy (CRT), and 18 patients had esophageal perforation after RT (5.8%). Covered self-expandable metallic stents were placed in 11 patients. Two patients continued RT after stenting and control of infection; one of these suffered a new perforation, and the other had a massive hemorrhage. The median overall survival was 2 months (0–3 months) compared with 17 months in the non-perforation group. In univariate analysis, the Karnofsky performance status (KPS) being ?70, age younger than 60, T4 stage, a second course of radiotherapy to the esophagus, extracapsular lymph nodes (LN) involving the esophagus, a total dose >100 Gy (biologically effective dose?10), and CRT were risk factors for perforation. In multivariate analysis, age younger than 60, extracapsular LN involving the esophagus, T4 stage, and a second course of radiotherapy to the esophagus were risk factors. In conclusion, patients with T4 stage, extracapsular LN involving the esophagus, and those receiving a second course of RT should be given particular care to avoid perforation. The prognosis after perforation was poor. PMID:24914102

  20. Pancreatic adenocarcinoma: epidemiology and genetics.

    PubMed Central

    Flanders, T Y; Foulkes, W D

    1996-01-01

    Pancreatic adenocarcinoma is an important cause of death from cancer throughout the developed world. There are few established environmental risk factors, but a previous history of pancreatitis and exposure to tobacco and salted food appear to be the most important. A family history of pancreatic adenocarcinoma is not common in patients with this disease, but recent research has shown that pancreatic adenocarcinoma can be a feature of cancer susceptibility syndromes associated with germline mutations in p16, BRCA1, BRCA2, and APC. This highlights the need for a full family history in apparently sporadic cases. Somatic mutations in p16, BRCA2, and APC have also been reported in pancreatic cancer; however, K-RAS mutations appear to be the commonest oncogenic alteration. Recent advances in our understanding of the basis of hereditary cancer syndromes may be applicable to the diagnosis, treatment, and possibly prevention of pancreatic adenocarcinoma in the future. PMID:8950667

  1. Sweat Gland Adenocarcinoma of Scalp

    PubMed Central

    Nair, Pragya A; Rathod, Kirti M; Chaudhary, Arvind H; Pilani, Abhishek P

    2013-01-01

    Sweat gland adenocarcinoma is a rare tumor particularly over scalp. They have potential to be benign as well as distant metastasis. Usually presents with papules or nodules. Ulcerative morphology is uncommon. Wide surigical excision with regional lymph not dissection is the treatment of choice. A 42-year-old female with sweat gland adenocarcinoma of scalp is reported with cervical lymph node involvement. PMID:24778534

  2. Reflux esophagitis triggered after Helicobacter pylori eradication: a noteworthy demerit of eradication therapy among the Japanese?

    PubMed Central

    Iijima, Katsunori; Koike, Tomoyuki; Shimosegawa, Tooru

    2015-01-01

    In the February 2013 Revision of Insured Medical Treatment, bacterial eradication for all Helicobacter pylori-positive individuals in Japan was covered under the insurance scheme. However, reflux esophagitis is believed to occur in approximately 10% of Japanese patients who undergo eradication therapy. Hence, the risk of reflux esophagitis among such cases should be carefully considered, particularly in the treatment for H. pylori-positive patients who are otherwise healthy. The eradication of H. pylori in cases of H. pylori-positive gastritis markedly suppresses gastric inflammation, and inhibits gastric mucosal atrophy and its progression to intestinal metaplasia. In a long-term follow-up study (10–20 years), eradication treatment was found to reduce the risk of subsequent gastric cancer. However, the fact that eradication-induced reflux esophagitis could increase the long-term risk of Barrett's esophagus and esophageal adenocarcinoma should also be considered in the Japanese population. Appropriate treatment with proton pump inhibitors should be taken into consideration for patients undergoing eradication therapy in clinical practice.

  3. Photodynamic therapy (PDT) with endoscopic ultrasound for the treatment of esophageal cancer

    NASA Astrophysics Data System (ADS)

    Woodward, Timothy A.; Wolfsen, Herbert C.

    2000-05-01

    In 1995, PDT was approved for palliative use in patients with esophageal cancer. We report our experience using PDT to treat esophageal cancer patients previously treated with combination chemotherapy and radiation therapy. In our series, nine patients referred for PDT with persistent esophageal cancer after chemo-radiation therapy. We found: (1) All patients were men with a mean age of 63 years and eight out of nine had adenocarcinoma with Barrett's esophagus; (2) All patients required endoscopic dilation after PDT; (3) At a mean follow up of 4 months, two T2N0 patients had no demonstrable tumor and all three T3N0 patients had greater than 50% tumor reduction (the partially responsive T3N0 patients will be offered repeat PDT); (4) Patients with metastatic disease (T3N1 or M1) had effective dysphagia palliation. Thus, PDT is safe and effective in ablating all or most tumor in patients with persistent esophageal cancer after chemotherapy and radiation therapy.

  4. The Pathophysiology of Eosinophilic Esophagitis

    PubMed Central

    Raheem, Mayumi; Leach, Steven T.; Day, Andrew S.; Lemberg, Daniel A.

    2014-01-01

    Eosinophilic esophagitis (EoE) is an emerging disease characterized by esophageal eosinophilia (>15eos/hpf), lack of responsiveness to acid-suppressive medication and is managed by allergen elimination and anti-allergy therapy. Although the pathophysiology of EoE is currently unsubstantiated, evidence implicates food and aeroallergen hypersensitivity in genetically predisposed individuals as contributory factors. Genome-wide expression analyses have isolated a remarkably conserved gene-expression profile irrespective of age and gender, suggesting a genetic contribution. EoE has characteristics of mainly TH2 type immune responses but also some TH1 cytokines, which appear to strongly contribute to tissue fibrosis, with esophageal epithelial cells providing a hospitable environment for this inflammatory process. Eosinophil-degranulation products appear to play a central role in tissue remodeling in EoE. This remodeling and dysregulation predisposes to fibrosis. Mast-cell-derived molecules such as histamine may have an effect on enteric nerves and may also act in concert with transforming growth factor-? to interfere with esophageal musculature. Additionally, the esophageal epithelium may facilitate the inflammatory process under pathogenic contexts such as in EoE. This article aims to discuss the contributory factors in the pathophysiology of EoE. PMID:24910846

  5. Risks of Esophageal Cancer Screening

    MedlinePLUS

    ... the type of cells that become malignant (cancerous): Squamous cell carcinoma : Cancer that begins in squamous cells , the thin, ... adenocarcinoma each year and fewer new cases of squamous cell carcinoma. Squamous cell carcinoma of the esophagus is found ...

  6. A Treatment Option for Esophageal Intramural Pseudodiverticulosis

    PubMed Central

    Jodorkovsky, Daniela

    2014-01-01

    Esophageal intramural pseudodiverticulosis (EIPD) is a rare condition often presenting with esophageal strictures. Treatment is often limited to endoscopic dilatation and treatment of the underlying esophageal pathology. We present a case of a patient with longstanding GERD on famotidine (she experienced anaphylaxis with proton pump inhibitors [PPIs]) who presented with dysphagia and weight loss. Work-up revealed a diagnosis of EIPD with a 5-mm mid-esophageal stricture. Therapy with dilatation was unsuccessful until the addition of sucralfate, after which dilatation was successful and symptoms resolved. In patients who are unable to take PPIs, the addition of sucralfate may enhance the success of dilatations of esophageal strictures and EIPD.

  7. Sloughing Esophagitis: A Not So Common Entity

    PubMed Central

    Akhondi, Hossein

    2014-01-01

    BACKGROUND: Sloughing esophagitis, also known as esophagitis dissecans superficialis, is a very rare and underdiagnosed entity with unknown incidence rate. It can be associated with bullous dermatoses and medications such as central nervous system depressants and those causing esophageal injury. CASE REPORT: A 55-years-old woman was recovering from renal failure due to rhabdomyolysis when she developed dysphagia and odynophagia. Esophagogastroduodenoscopy with biopsy was performed for suspected bullous pemphigus and confirmed sloughing esophagitis. She improved with intravenous steroids. CONCLUSIONS: Sloughing Esophagitis should enter our differential diagnosis more frequently. It is mostly a benign, self-limiting process but when associated with bullous dermatoses will require steroid treatment. PMID:25598761

  8. Photodynamic therapy for esophageal cancer.

    PubMed

    Yano, Tomonori; Hatogai, Ken; Morimoto, Hiroyuki; Yoda, Yusuke; Kaneko, Kazuhiro

    2014-03-01

    Photodynamic therapy (PDT) is a treatment that uses a photosensitizing drug that is administered to the patient, localized to a tumor, and then activated with a laser to induce a photochemical reaction to destroy the cell. PDT using porfimer sodium followed by excimer dye laser irradiation is approved as a curative treatment for superficial esophageal cancer in Japan. While endoscopic submucosal dissection (ESD) is currently more popular for esophageal cancer, there is evidence to support PDT as an alternative treatment and as a salvage treatment for local failure after chemoradiotherapy (CRT). A photosensitizing agent has also been developed that requires a shorter sun shade period after administration, and studies are currently underway to establish an esophageal cancer indication for this next-generation PDT in Japan. PMID:25333005

  9. Photodynamic therapy for esophageal cancer

    PubMed Central

    Hatogai, Ken; Morimoto, Hiroyuki; Yoda, Yusuke; Kaneko, Kazuhiro

    2014-01-01

    Photodynamic therapy (PDT) is a treatment that uses a photosensitizing drug that is administered to the patient, localized to a tumor, and then activated with a laser to induce a photochemical reaction to destroy the cell. PDT using porfimer sodium followed by excimer dye laser irradiation is approved as a curative treatment for superficial esophageal cancer in Japan. While endoscopic submucosal dissection (ESD) is currently more popular for esophageal cancer, there is evidence to support PDT as an alternative treatment and as a salvage treatment for local failure after chemoradiotherapy (CRT). A photosensitizing agent has also been developed that requires a shorter sun shade period after administration, and studies are currently underway to establish an esophageal cancer indication for this next-generation PDT in Japan. PMID:25333005

  10. Analysis of thermal effects in endoscopic nanocarriers-based photodynamic therapy applied to esophageal diseases

    NASA Astrophysics Data System (ADS)

    Salas-García, I.; Fanjul-Vélez, F.; Ortega-Quijano, N.; Wilfert, O.; Hudcova, L.; Poliak, J.; Barcik, P.; Arce-Diego, J. L.

    2014-02-01

    In this work we propose a predictive model that allows the study of thermal effects produced when the optical radiation interacts with an esophageal or stomach disease with gold nanoparticles embedded. The model takes into account light distribution in the tumor tissue by means of a Monte Carlo method. Mie theory is used to obtain the gold nanoparticles optical properties and the thermal model employed is based on the bio-heat equation. The complete model was applied to two types of tumoral tissue (squamous cell carcinoma located in the esophagus and adenocarcinoma in the stomach) in order to study the thermal effects induced by the inclusion of gold nanoparticles.

  11. Characterization of the autofluorescence of normal and tumoral esophageal epithelium cells

    NASA Astrophysics Data System (ADS)

    Villette, Sandrine; Bourg-Heckly, Genevieve; Pigaglio, Sophie; Validire, Pierre; Grichine, Alexei; Vever-Bizet, Christine

    2003-10-01

    The objectives of this study are to characterize the autofluorescence spectra of normal and tumoral esophageal epithelial cells and to link the cellular spectra with a data basis of in vivo tissular spectra. Our preliminary results show that no difference in spectral distribution can be observed between squamous cell carcinoma, adenocarcinoma and normal cells. A statistical significant difference is observed between the average intensity of the raw spectra of the different cell types. Nucleus autofluorescence presents the same spectral shape as cytoplasm, but with lower intensity.

  12. [Exfoliative esophagitis while taking dabigatran].

    PubMed

    Scheppach, Wolfgang; Meesmann, Malte

    2015-04-01

    History | A 77-year-old woman was admitted with severe chest pain, heartburn, dysphagia and odynophagia. She had been on dabigatran for 13 months due to atrial fibrillation and arterial hypertension. Investigations and findings | Endoscopy of the esophagus revealed sloughing of mucosal casts, predominantly in the upper half of the organ. Treatment and course | The patient was placed on pantoprazol, local anaesthetic antacid and i.?v. fluids. Dabigatran was discontinued. The symptoms disappeared within 3 days. Control endoscopy after 12 days showed complete healing of the esophageal mucosa. Conclusion | The intake of dabigatran was associated with exfoliative esophagitis, possibly due to caustic tissue damage by prolonged drug contact. PMID:25826037

  13. Thermal Neutrons in Eas: A New Dimension in Eas Study

    E-print Network

    Yuri V. Stenkin

    2007-02-27

    A new method to study Extensive Air Shower (EAS) hadronic component is proposed. It is shown that addition of specific detectors for thermal neutron detection to a standard array for EAS study can significantly improve its performance. Results of CORSIKA based Monte Carlo simulations as well as preliminary experimental data are presented. A proposal of novel type of EAS array is given.

  14. EA 125 Energy User's Guide

    E-print Network

    Gellman, Andrew J.

    -emission experiments, e.g. XPS, UPS, XPD, Auger and ions from ion-scattering spectroscopy (ISS) experiments. The EA 125 Package User's Guide ISS User's Guide for EA 125 XM 500 Monochromator User's Guide Table 1: Related

  15. Alternations in genes expression of pathway signaling in esophageal tissue with atresia: results of expression microarray profiling.

    PubMed

    Smigiel, R; Lebioda, A; Blaszczy?ski, M; Korecka, K; Czauderna, P; Korlacki, W; Jakubiak, A; Bednarczyk, D; Maciejewski, H; Wizinska, P; Sasiadek, M M; Patkowski, D

    2015-04-01

    Esophageal atresia (EA) is a congenital defect of the esophagus involving the interruption of the esophagus with or without connection to the trachea (tracheoesophageal fistula [TEF]). EA/TEF may occur as an isolated anomaly, may be part of a complex of congenital defects (syndromic), or may develop within the context of a known syndrome or association. The molecular mechanisms underlying the development of EA are poorly understood. It is supposed that a combination of multigenic factors and epigenetic modification of genes play a role in its etiology. The aim of our work was to assess the human gene expression microarray study in esophageal tissue samples. Total RNA was extracted from 26 lower pouches of esophageal tissue collected during thoracoscopic EA repair in neonates with the isolated (IEA) and the syndromic form (SEA). We identified 787 downregulated and 841 upregulated transcripts between SEA and controls, and about 817 downregulated and 765 upregulated probes between IEA and controls. Fifty percent of these genes showed differential expression specific for either IEA or SEA. Functional pathway analysis revealed substantial enrichment for Wnt and Sonic hedgehog, as well as cytokine and chemokine signaling pathways. Moreover, we performed reverse transcription polymerase chain reaction study in a group of SHH and Wnt pathways genes with differential expression in microarray profiling to confirm the microarray expression results. We verified the altered expression in SFRP2 gene from the Wnt pathway as well as SHH, GLI1, GLI2, and GLI3 from the Sonic hedgehog pathway. The results suggest an important role of these pathways and genes for EA/TEF etiology. PMID:24460849

  16. Esophageal manifestations of celiac disease.

    PubMed

    Lucendo, A J

    2011-09-01

    Celiac disease (CD) may often be associated with various motor disorders affecting the different segments of the digestive tract, including the esophagus. Although it has not been universally reported, some available evidences indicate that pediatric and adult celiac patients could manifest a higher frequency of esophagitis and gastroesophageal reflux disease-related symptoms compared to nonceliac patients. In addition, several published studies have consistently shown the efficacy of a gluten-free diet in rapidly controlling esophageal symptoms and in preventing their recurrence. Since the participation of gluten in the esophageal symptoms of CD seems clear, its intimate mechanisms have yet to be elucidated, and several hypothesis have been proposed, including the specific immune alterations characterizing CD, the reduction in nutrient absorption determining the arrival of intact gluten to distal gastrointestinal segments, and various dysregulations in the function of gastrointestinal hormones and peptides. Recent studies have suggested the existence of a possible relationship between CD and eosinophilic esophagitis, which should be more deeply investigated. PMID:21438963

  17. Surgical Management of Esophageal Carcinoma

    Microsoft Academic Search

    CAROLYN E. REED

    Surgical management of esophageal carcinoma is reviewed. The anatomy and biology are briefly mentioned, since these factors mitigate against the success of surgery. Staging, the key to proper treatment allocation and prog- nosis, is discussed, including the use of endoscopic ultra- sonography, positron emission tomography, and thoracoscopy\\/laparoscopy. Patient selection and preparation for surgery are important considerations. Surgical tech- niques are

  18. Role of proton pump inhibitor on esophageal carcinogenesis and pancreatic acinar cell metaplasia development: an experimental in vivo study.

    PubMed

    Dall'Olmo, Luigi; Fassan, Matteo; Dassie, Elisa; Scarpa, Marco; Realdon, Stefano; Cavallin, Francesco; Cagol, Matteo; Battaglia, Giorgio; Pizzi, Marco; Guzzardo, Vincenza; Franceschinis, Erica; Pasut, Gianfranco; Rugge, Massimo; Zaninotto, Giovanni; Realdon, Nicola; Castoro, Carlo

    2014-01-01

    Chronic gastro-duodenal reflux in the esophagus is a major risk for intestinal metaplasia and Barrett's adenocarcinoma. A role for chronic use of proton pump inhibitor (PPI) in the increased incidence of esophageal adenocarcinoma in Western countries has been previously suggested. The aim of this work was to study the effect of chronic administration of omeprazole (a proton pump inhibitor) per os in a model of reflux induced esophageal carcinogenesis. One week after esophago-gastro-jejunostomy, 115 Sprague-Dawley rats were randomized to receive 10 mg/Kg per day of omeprazole or placebo, 5 days per week. The esophago-gastric specimens were collected 28 ± 2 weeks after randomization and analyzed in a blinded fashion. Mortality and esophageal metaplasia rates did not differ between the two groups (p = 0.99 for mortality, p = 0.36 for intestinal metaplasia and p = 0.66 for multi-layered epithelium). Gastric pancreatic acinar cell metaplasia (PACM) was more frequently observed in PPI-treated rats (p = 0.003). Severe ulcer lesions significantly prevailed in the placebo group (p = 0.03). Locally invasive esophageal epithelial neoplasia were observed in 23/39 PPI-treated versus 14/42 placebo-animals (p = 0.03). In conclusion, chronic omeprazole treatment improved the healing of esophageal ulcerative lesions. Locally invasive neoplastic lesions and PACM prevailed among PPI-treated animals. However, neither an effect on the overall mortality nor on the incidence of pre-neoplastic lesions was observed in this work. PMID:25415190

  19. Appropriateness of Using Patient-Derived Xenograft Models for Pharmacologic Evaluation of Novel Therapies for Esophageal/Gastro-Esophageal Junction Cancers

    PubMed Central

    Dodbiba, Lorin; Teichman, Jennifer; Fleet, Andrew; Thai, Henry; Starmans, Maud H. W.; Navab, Roya; Chen, Zhuo; Girgis, Hala; Eng, Lawson; Espin-Garcia, Osvaldo; Shen, Xiaowei; Bandarchi, Bizhan; Schwock, Joerg; Tsao, Ming-Sound; El-Zimaity, Hala; Der, Sandy D.; Xu, Wei; Bristow, Robert G.; Darling, Gail E.; Boutros, Paul C.

    2015-01-01

    The high morbidity and mortality of patients with esophageal (E) and gastro-esophageal junction (GEJ) cancers, warrants new pre-clinical models for drug testing. The utility of primary tumor xenografts (PTXGs) as pre-clinical models was assessed. Clinicopathological, immunohistochemical markers (p53, p16, Ki-67, Her-2/neu and EGFR), and global mRNA abundance profiles were evaluated to determine selection biases of samples implanted or engrafted, compared with the underlying population. Nine primary E/GEJ adenocarcinoma xenograft lines were further characterized for the spectrum and stability of gene/protein expression over passages. Seven primary esophageal adenocarcinoma xenograft lines were treated with individual or combination chemotherapy. Tumors that were implanted (n=55) in NOD/SCID mice had features suggestive of more aggressive biology than tumors that were never implanted (n=32). Of those implanted, 21/55 engrafted; engraftment was associated with poorly differentiated tumors (p=0.04) and older patients (p=0.01). Expression of immunohistochemical markers were similar between patient sample and corresponding xenograft. mRNA differences observed between patient tumors and first passage xenografts were largely due to loss of human stroma in xenografts. mRNA patterns of early vs late passage xenografts and of small vs large tumors of the same passage were similar. Complete resistance was present in 2/7 xenografts while the remaining tumors showed varying degrees of sensitivity, that remained constant across passages. Because of their ability to recapitulate primary tumor characteristics during engraftment and across serial passaging, PTXGs can be useful clinical systems for assessment of drug sensitivity of human E/GEJ cancers. PMID:25826681

  20. Proton Beam Therapy and concurrent chemotherapy for esophageal cancer

    PubMed Central

    Lin, Steven H.; Komaki, Ritsuko; Liao, Zhongxing; Wei, Caimiao; Myles, Bevan; Guo, Xiaomao; Palmer, Matthew; Mohan, Radhe; Swisher, Stephen G.; Hofstetter, Wayne L.; Ajani, Jaffer A.; Cox, James D.

    2014-01-01

    Purpose/Objective Proton beam therapy (PBT) is a promising modality for the management of thoracic malignancies. We report our preliminary experience of treating esophageal cancer patients with concurrent chemotherapy (CChT) and PBT at MD Anderson Cancer Center. Materials/Methods This is an analysis of 62 esophageal cancer patients enrolled on a prospective study evaluating normal tissue toxicity from CChT/PBT from 2006 to 2010. Patients were treated with Passive Scattering PBT with 2 or 3 field beam arrangement using 180–250 MV protons. We used the method of Kaplan and Meier to assess time to event outcomes and compared the distributions between groups using the log-rank test. Results The median follow-up time was 20.1 months for survivors. The median age was 68 years (range 38–86). Most were males (82%), had adenocarcinomas (76%) and had stage II-III disease (84%). The median radiation dose was 50.4 Gray-Equivalence (Gy(RBE)) (range 36–57.6). The most common grade 2–3 acute toxicities from CChT/PBT were esophagitis (46.8%), fatigue (43.6%), nausea (33.9%), anorexia (30.1%), and radiation dermatitis (16.1%). There were two cases of grade 2 and 3 radiation pneumonitis and two grade 5 toxicities. A total of 29 patients (46.8%) received preoperative CChT/PBT with one postoperative death. The pathologic complete response (pCR) rate for the surgical cohort was 28%, and the pCR and near CR rate (0–1% residual cells) was 50%. While there were significantly fewer local-regional recurrences in the preoperative group (3/29) as compared to the definitive CChT/PBT group (16/33) (log-rank test p=0.005), there were no differences in DM free interval or OS between the two groups. Conclusions This is the first report of patients treated with PBT/CChT for esophageal cancer. Our data suggest that this modality is associated with a few severe toxicities but the pathologic response and clinical outcomes are encouraging. Prospective comparison with more traditional approach is warranted. PMID:22417808

  1. Gastric adenocarcinoma associated with isolated granulomatous gastritis

    Microsoft Academic Search

    Christopher Newton; Lucien Nochomovitz; Jonathan M. Sackier

    1998-01-01

    Background: Granulomatous gastritis is a rarely observed pathological diagnosis. This condition often mimics gastric adenocarcinoma clinically, resulting in gastric resection. However, granulomatous gastritis has long been viewed as a benign process not observed in association with adenocarcinoma of the stomach. This article describes a patient with granulomatous gastritis occurring in close proximity to an area of superficially invading gastric adenocarcinoma.

  2. Endoscopic Stenting and Clipping for Anastomotic Stricture and Persistent Tracheoesophageal Fistula after Surgical Repair of Esophageal Atresia in an Infant

    PubMed Central

    Benatta, Mohammed Amine; Benaired, Amine; Khelifaoui, Ahmed

    2014-01-01

    Anastomotic stricture (AS) and recurrent tracheoesophageal fistula (TEF) are two complications of surgical repair of esophageal atresia (EA). Therapeutic endoscopic modalities include stenting, tissue glue, and clipping for TEF and endoscopic balloon dilation bougienage and stenting for esophageal strictures. We report herein a two-month infant with both EA and TEF who benefited from a surgical repair for EA, at the third day of life. Two months later he experienced deglutition disorders and recurrent chest infections. The esophagogram showed an AS and a TEF confirmed with blue methylene test at bronchoscopy. A partially covered self-expanding metal type biliary was endoscopically placed. Ten weeks later the stent was removed. This allows for easy passage of the endoscope in the gastric cavity but a persistent recurrent fistula was noted. Instillation of contrast demonstrated a fully dilated stricture but with a persistent TEF. Then we proceeded to placement of several endoclips at the fistula site. The esophagogram confirmed the TEF was obliterated. At 12 months of follow-up, he was asymptomatic. Stenting was effective to alleviate the stricture but failed to treat the TEF. At our knowledge this is the second case of successful use of endoclips placement to obliterate recurrent TEF after surgical repair of EA in children. PMID:25580132

  3. The long non-coding RNA HNF1A-AS1 regulates proliferation and metastasis in lung adenocarcinoma

    PubMed Central

    Shi, Xuefei; Yao, Yanwen; Yang, Wen; Song, Yong

    2015-01-01

    Long noncoding RNAs (lncRNAs) have emerged as key regulators of tumor development and progression. The lncRNA HNF1A-antisense 1 (HNF1A-AS1) is a 2455-bp transcript on chromosome 12 with a potential oncogenic role in esophageal adenocarcinoma. Nevertheless, current understanding of the involvement of HNF1A-AS1 in lung adenocarcinoma tumorigenesis remains limited. In this study, we analyzed the roles of HNF1A-AS1 in 40 lung adenocarcinoma tissues and five lung cancer cell lines. Our results showed that HNF1A-AS1 was significantly up-regulated in lung adenocarcinoma tissues compared with corresponding non-tumor tissues, and its expression level was significantly correlated with TNM stage, tumor size, and lymph node metastasis. The UCSC Cancer Genomics Browser's Kaplan-Meier plot suggested that patients in the high HNF1A-AS1 expression subgroup experienced worse overall survival compared to the low expression subgroup. Moreover, HNF1A-AS1 was determined to promote tumor proliferation and metastasis, both in vitro and in vivo, by regulating cyclin D1, E-cadherin, N-cadherin and ?-catenin expression. In addition, the binding of HNF1A-AS1 to DNMT1 may explain its regulation of E-cadherin. In conclusions, we demonstrated that increased HNF1A-AS1 expression could regulate cell proliferation and metastasis and identified it as a poor prognostic biomarker in lung adenocarcinoma. PMID:25863539

  4. Fragility of the esophageal mucosa: A pathognomonic endoscopic sign of primary eosinophilic esophagitis?

    Microsoft Academic Search

    Alex Straumann; Livio Rossi; Hans-Uwe Simon; Pius Heer; Hans-Peter Spichtin; Christoph Beglinger

    2003-01-01

    Background: Primary eosinophilic esophagitis, a chronic inflammatory disorder of the esophagus, evokes recurrent dysphagia. Endoscopy is often unremarkable, and no consensus exists regarding management of resultant dysphagia. The response of a series of patients with primary eosinophilic esophagitis to dilation is reported together with a description of a possibly pathognomonic sign: fragile esophageal mucosa, for which the term “crêpe-paper” mucosa

  5. Barrett's Esophagus Translational Research Network Coordinating Center | Division of Cancer Prevention

    Cancer.gov

    The Barrett's Esophagus Translational Research Network (BETRNet) has been proposed to reduce the incidence, morbidity, and mortality of esophageal adenocarcinoma (EA), through answering key questions related to the progression of this disease, especially in the premalignant stage.

  6. Adenocarcinoma of the rete testis

    Microsoft Academic Search

    D. B. Glazier; T. S. Vates; K. B. Cummings; S. Antoun

    1996-01-01

    Adenocarcinoma of the rete testis is a rare tumor. Histologic diagnosis is difficult, and in the past the tumor may have been incorrectly identified in a number of cases, leading to misleading information on the nature and behavior of this neoplasm. We present the case of a 39-year-old man with a long history of a small left hydrocele, who was

  7. Corrosive Esophagitis Caused by Ingestion of Picosulfate

    PubMed Central

    Seo, Jae Yong; Kang, Ho Suk; Kim, Seong Eun; Park, Ji Won; Moon, Sung Hoon; Kim, Jong Hyeok; Park, Choong Kee

    2015-01-01

    Corrosive esophagitis is characterized by caustic injury due to the ingestion of chemical agents, mainly alkaline substances such as detergents. Esophageal bleeding, perforation, or stricture can be worsened by high-degree corrosive esophagitis. Picosulfate is a commonly used laxative frequently administered for bowel preparation before colonoscopy or colon surgery. Picosulfate powder should be completely dissolved in water before ingestion because the powder itself may cause chemical burning of the esophagus and stomach. Here, we report a case of corrosive esophagitis due to the ingestion of picosulfate powder that was not completely dissolved in water. PMID:25674529

  8. Esophageal Stenosis Associated With Tumor Regression in Radiotherapy for Esophageal Cancer: Frequency and Prediction

    SciTech Connect

    Atsumi, Kazushige [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Shioyama, Yoshiyuki, E-mail: shioyama@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Arimura, Hidetaka [Department of Health Sciences, Kyushu University, Fukuoka (Japan); Terashima, Kotaro [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Matsuki, Takaomi [Department of Health Sciences, Kyushu University, Fukuoka (Japan); Ohga, Saiji; Yoshitake, Tadamasa; Nonoshita, Takeshi; Tsurumaru, Daisuke; Ohnishi, Kayoko; Asai, Kaori; Matsumoto, Keiji [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Nakamura, Katsumasa [Department of Radiology, Kyushu University Hospital at Beppu, Oita (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)

    2012-04-01

    Purpose: To determine clinical factors for predicting the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer. Methods and Materials: The study group consisted of 109 patients with esophageal cancer of T1-4 and Stage I-III who were treated with definitive radiotherapy and achieved a complete response of their primary lesion at Kyushu University Hospital between January 1998 and December 2007. Esophageal stenosis was evaluated using esophagographic images within 3 months after completion of radiotherapy. We investigated the correlation between esophageal stenosis after radiotherapy and each of the clinical factors with regard to tumors and therapy. For validation of the correlative factors for esophageal stenosis, an artificial neural network was used to predict the esophageal stenotic ratio. Results: Esophageal stenosis tended to be more severe and more frequent in T3-4 cases than in T1-2 cases. Esophageal stenosis in cases with full circumference involvement tended to be more severe and more frequent than that in cases without full circumference involvement. Increases in wall thickness tended to be associated with increases in esophageal stenosis severity and frequency. In the multivariate analysis, T stage, extent of involved circumference, and wall thickness of the tumor region were significantly correlated to esophageal stenosis (p = 0.031, p < 0.0001, and p = 0.0011, respectively). The esophageal stenotic ratio predicted by the artificial neural network, which learned these three factors, was significantly correlated to the actual observed stenotic ratio, with a correlation coefficient of 0.864 (p < 0.001). Conclusion: Our study suggested that T stage, extent of involved circumference, and esophageal wall thickness of the tumor region were useful to predict the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer.

  9. Cell polarity protein Lgl2 is lost or aberrantly localized in gastric dysplasia and adenocarcinoma: an immunohistochemical study.

    PubMed

    Lisovsky, Mikhail; Dresser, Karen; Baker, Stephen; Fisher, Andrew; Woda, Bruce; Banner, Barbara; Lauwers, Gregory Y

    2009-07-01

    The diagnosis of gastric epithelial dysplasia, a precursor lesion of gastric adenocarcinoma, is hindered by interobserver variability and by its resemblance to regenerative changes. Loss of cell polarity, a histological feature of gastric epithelial dysplasia, may be difficult to ascertain, especially in the setting of inflammation or injury. A biomarker of cell polarity could be useful in diagnosis of dysplasia, but has not been reported. The Lethal giant larvae (lgl) gene controls apical-basal polarity of epithelial cells in Drosophila, and has properties of a tumor-suppressor gene. Two homologs, lgl1 and lgl2, are present in mammals and lgl2 mRNA is highly expressed in the stomach. The goal of our study was to test the hypothesis that Lgl2 protein expression and/or localization are disrupted in gastric epithelial dysplasia and adenocarcinoma. Routinely processed pathology specimens including 94 benign mucosae of digestive organs, in addition to 36 reactive gastropathy, 57 gastric epithelial dysplasia, and 77 gastric adenocarcinomas, were immunostained for Lgl2 protein. All normal, reactive, and chronically inflamed gastric epithelia showed basolateral Lgl2 staining. Normal esophageal, duodenal, colonic, biliary, and pancreatic duct mucosae, as well as gastric intestinal metaplasia, did not express Lgl2. All but one case each of gastric epithelial dysplasia and adenocarcinoma showed either complete loss of anti-Lgl2 immunoreactivity or diffuse, mostly weak, cytoplasmic staining. Complete loss of immunoreactivity was significantly more often observed in diffuse-type than in intestinal-type adenocarcinomas (79 vs 48%, respectively). Our data suggest that Lgl2 expression is either aberrantly localized or lost in gastric epithelial dysplasia and adenocarcinoma, whereas it is maintained in reactive gastric mucosa. We propose that Lgl2 may be a potential marker to rule out gastric epithelial dysplasia and adenocarcinoma in diagnostic specimens. However, the consistently negative anti-Lgl2 immunoreactivity seen in intestinal metaplasia does not allow differentiation of dysplasia from intestinal metaplasia with reactive change. PMID:19407852

  10. The 'skinny' on eosinophilic esophagitis.

    PubMed

    Katzka, David A

    2015-02-01

    Eosinophilic esophagitis--a disease that even most physicians know little about--is becoming increasingly common. Often starting in childhood with eating difficulties and symptoms of gastroesophageal reflux disease, it progresses with increasing inflammation, fibrosis, and strictures until the esophagus is visibly narrowed on radiography. Early recognition and treatment with an allergen-avoidance diet and steroids are critical to avoiding or postponing complications. PMID:25897596

  11. Esophageal metastasis of breast carcinoma

    Microsoft Academic Search

    Yasuo Wada; Nobuko Harada; Kazuhiro Ohara; Hironori Kawata; Hironori Iwasaki; Yuuichiro Kawamura; Takashi Gomi; Masahiro Ohtoshi; Yasuaki Nakashima

    2009-01-01

    Esophageal metastasis from primary breast cancer is an unusual manifestation. We recently treated a patient with dysphagia,\\u000a whose breast cancer had been treated in the distant past. A 70-year-old woman had been followed regularly in our outpatient\\u000a clinic for 14 years after her primary breast cancer treatment, with no apparent tumor recurrence. After 2 years absence, she\\u000a consulted our clinic with progressive

  12. The management of eosinophilic esophagitis.

    PubMed

    Greenhawt, Matthew; Aceves, Seema S; Spergel, Jonathan M; Rothenberg, Marc E

    2013-01-01

    Eosinophilic esophagitis (EoE) is a clinicopathologic, chronic esophageal inflammatory disease resistant to acid suppressive therapy and is associated with variable symptoms indicative of upper gastrointestinal dysfunction. Per current guidelines established by The International Group of Eosinophil Researchers (TIGERS), the diagnosis is made in symptomatic patients after a biopsy that confirms a peak eosinophil level of ?15 eosinophils/high-powered field (HPF). The esophagus is distinguished by pronounced tissue eosinophilia in which dietary antigens are key inciting factors for disease pathogenesis; EoE being reversed by elimination of triggering food allergens suggests that the disease is mediated in part by allergic sensitization to foods. Moreover, experimental EoE in mice can be induced not only via food exposure but also via aeroallergen exposure. Consistent with an allergic etiology rather than an acid-induced esophagitis, swallowed glucocorticoids are effective for the treatment of EoE. Evaluation by an allergist is a recommended part of the diagnostic workup, especially for management of allergic comorbidities. Clinical practice for the evaluation of patients with EoE mainly relies on prick skin tests due to the ease and validation of these tests in the context of immediate hypersensitivity. However, both atopy patch testing and serum IgE testing have been used in EoE. Herein, we reviewed the basic clinical features of EoE with a focus on the approach to diagnosing causative food allergens and to dietary therapy. PMID:24565538

  13. Reduction to homozygosity involving p53 in esophageal cancers demonstrated by the polymerase chain reaction.

    PubMed Central

    Meltzer, S J; Yin, J; Huang, Y; McDaniel, T K; Newkirk, C; Iseri, O; Vogelstein, B; Resau, J H

    1991-01-01

    Loss of heterozygosity affecting chromosome 17p has been detected at high frequencies in a variety of human tumors, including cancers of the colon, breast, lung, and brain. One presumed target of these losses is p53, a tumor suppressor gene located on 17p. To our knowledge, loss of heterozygosity has not yet been reported at any locus, including p53, in human esophageal cancer. Moreover, current methods of detecting loss of heterozygosity depend on the availability of large amounts of high molecular weight DNA, making the study of small biopsy specimens or paraffin-embedded tissues problematic. We examined 52 primary human esophageal neoplasms for loss of heterozygosity affecting the p53 gene by using the polymerase chain reaction. Loss of one allele was detected in 52% of informative cases and was more common in squamous carcinomas than in adenocarcinomas. Southern blot analysis was used to confirm polymerase chain reaction-derived data. The identification of allelic loss in approximately half of the tumors analyzed supports the hypothesis that inactivation of p53 is involved in the pathogenesis of esophageal cancer. Images PMID:2052580

  14. High-resolution EUS in children with eosinophilic “allergic” esophagitis

    Microsoft Academic Search

    Victor L. Fox; Samuel Nurko; Jonathan E. Teitelbaum; Kamran Badizadegan; Glenn T. Furuta

    2003-01-01

    Background: The pathophysiology of dysphagia associated with eosinophilic esophagitis is unknown. This study investigated possible anatomic alterations in children with eosinophilic esophagitis in comparison with healthy children by using high-resolution EUS to precisely measure individual tissue layers of the esophagus. Methods: Children with eosinophilic esophagitis (n = 11) and control children (n = 8) without esophagitis were prospectively evaluated by

  15. Esophagitis: old histologic concepts and new thoughts.

    PubMed

    Grin, Andrea; Streutker, Catherine J

    2015-06-01

    Context .- Inflammatory lesions of the esophagus are a diverse group, often with nonspecific histologic findings. These benign changes can produce diagnostic difficulties for pathologists. Objective .- To discuss the typical histologic findings of a variety of the most common causes of esophagitis (reflux, eosinophilic esophagitis, infections, medications) along with less common issues such as sloughing esophagitis and skin disorders involving the squamous mucosa. Data Sources .- The literature has been reviewed to discuss histologic definitions of current and developing issues in the area of esophagitis. Conclusions .- Histologic features are not entirely sensitive and specific for inflammatory esophageal disorders. Awareness of these problems is essential; clinical and endoscopic information can be very useful in distinguishing among the various lesions. PMID:26030241

  16. Cyclooxygenase-2 polymorphisms and susceptibility to esophageal cancer: a meta-analysis.

    PubMed

    Liang, Yuan; Liu, Jia-Li; Wu, Yan; Zhang, Zhen-Yong; Wu, Rong

    2011-01-01

    Esophageal cancer (EC) is one of the most common cancers worldwide with 5-year survival rate less than 10%. However, there is a lack of specific genetic markers that could help better understanding the mechanisms of esophageal carcinogenesis, improving the detection rate of EC, and distinguishing histological types. Cyclooxygenase-2 (COX-2) as an inducible enzyme in cancer development and progression is involved in esophageal carcinogenesis. A large number of studies have demonstrated a strong association between COX-2 polymorphisms and EC risk. However, the overall results are still controversial. This controversy may be partly due to the mix-up of esophageal squamous cell carcinoma (ESCC) and adenocarcinoma (EAC). The aim of this study was to investigate the association between COX-2 polymorphisms and susceptibility to ESCC or EAC by conducting a meta-analysis. Seven studies were retrieved reporting a total of 1450 ESCC patients, 523 EAC patients, and 2663 cancer-free control subjects. Five COX-2 polymorphisms were addressed, including -765G>C (rs20417), -1195G>A (rs689465), -1290A>G (rs689466), -8473T>C (rs5275) and -1759G>A (rs3218625). Meta-analysis results showed that the -765C allele is significantly associated with the susceptibility to both ESCC and EAC especially in Asian populations. In addition, there was a significant association between the -8473C allele and the susceptibility to EAC in Caucasian populations. In conclusion, our meta-analysis suggests that the -765C allele of the COX-2 gene might be a potential risk factor for both ESCC and EAC especially in Asian populations, while the -8473C allele might be a risk factor for EAC in Caucasian populations. PMID:21304218

  17. Carboplatin and paclitaxel as first-line treatment of unresectable or metastatic esophageal or gastric cancer.

    PubMed

    Prithviraj, G K; Baksh, K; Fulp, W; Meredith, K; Hoffe, S; Shridhar, R; Almhanna, K

    2014-08-25

    Survival in patients with metastatic esophageal and gastric cancer is dismal. No standard treatment has been established. Carboplatin/paclitaxel is active in both advanced gastric and esophageal cancer. Here we retrospectively present our single center experience. Between 1998 and 2013, a total of 134 patients with metastatic esophageal and gastric adenocarcinoma treated with carboplatin/paclitaxel (carboplatin predominantly area under the curve 5 and paclitaxel predominantly 175?mg/m(2) ) every 3 weeks as first-line therapy were identified. Baseline characteristics, response to therapy, toxicities, and survival in this patient population were evaluated. Overall survival was defined as date from diagnosis to death or last follow up, and progression-free survival was defined at time from cycle 1 to, progression or last follow up. Kaplan-Meier curves were fit to estimate overall and progression-free survival. Of the 134 patients evaluated, the median age at diagnosis was 65 years. Disease control rate was 62.6% (complete response: 11%, partial response: 28%, stable disease: 33%). Median overall survival from date of initial diagnosis was 15.5 months (95% confidence interval [CI] 1.06-1.5). Median progression-free survival from date of initiation of carboplatin and paclitaxel was 5.3 months (95% CI 0.34-0.5). Grade III or greater toxicity occurred in 26.1% of patients. The most common grade III toxicities were neutropenia and neuropathy, present in 14.2% and 3.7% of the total study population, respectively. In patients with metastatic or unresectable esophageal or gastric cancer, the combination of carboplatin and paclitaxel is well tolerated with comparable overall survival and progression-free survival to existing regimens in this population. PMID:25155802

  18. MicroRNAs and esophageal cancer--implications for pathogenesis and therapy.

    PubMed

    Mayne, George C; Hussey, Damian J; Watson, David I

    2013-01-01

    There are several microRNAs that have been consistently reported to be differentially expressed in esophageal squamous cell carcinoma vs. normal squamous tissue, with prognostic associations for miR-21 (invasion, positive nodes, decreased survival), miR-143 (disease recurrence, invasion depth), and miR-375 (inversely correlated with advanced stage, distant metastasis, poor overall survival, and disease-free survival). There is also evidence that miR-375 regulates gene expression associated with resistance to chemotherapy. Hence, microRNA expression assays have the potential to provide clinically relevant information about prognosis and potential response to chemotherapy in patients with esophageal squamous cell carcinoma. Results are inconsistent, however, for microRNAs across different studies for esophageal adenocarcinoma (EAC) vs. its precursor lesion Barrett's esophagus. These inconsistencies may partly result from pathological and/or molecular heterogeneity in both Barrett's esophagus and EAC, but may also result from differences in study designs or different choices of comparator tissues. Despite these inconsistencies, however, several mRNA/protein targets have been identified, the cancer related biology of some of these targets is well understood, and there are clinico-pathological associations for some of these mRNA targets. MicroRNAs also have potential for use in therapy for esophageal cancers. The development of new delivery methods, such as minicells and autologous microvesicles, and molecular modifications such as the addition of aromatic benzene pyridine analogs, have facilitated the exploration of the effects of therapeutic microRNAs in vivo. These approaches are producing encouraging results, with one technology in a phase I/IIa clinical trial. PMID:23092342

  19. DOE/EA-1570 ENVIRONMENTAL

    E-print Network

    Quigg, Chris

    DOE/EA-1570 FINAL ENVIRONMENTAL ASSESSMENT Environmental Assessment for Construction and Operation. Paul District St. Paul, MN June 2008 #12;(DOE/EA-1570) NOvA Environmental Assessment June 2008ii, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation

  20. Gastro-esophageal Reflux and Esophageal Motility Disorders in Morbidly Obese Patients

    Microsoft Academic Search

    M. Suter; G. Dorta; V. Giusti; J. M. Calmes

    2004-01-01

    Background: Morbid obesity has long been considered as a contributing factor to gastro-esophageal reflux, but the literature\\u000a contains conflicting data on the subject. The authors studied a large number of morbidly obese candidates for bariatric surgery\\u000a with objective means, in order to better define the incidence of gastro-esophageal reflux disease (GERD) and esophageal motility\\u000a disorders in this population. Methods: Morbidly

  1. Esophageal motility abnormalities in gastroesophageal reflux disease

    PubMed Central

    Martinucci, Irene; de Bortoli, Nicola; Giacchino, Maria; Bodini, Giorgia; Marabotto, Elisa; Marchi, Santino; Savarino, Vincenzo; Savarino, Edoardo

    2014-01-01

    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophageal motility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from non-erosive reflux disease to erosive reflux disease and Barrett’s esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted. PMID:24868489

  2. Severe Ulcerative Esophagitis Induced by Crizotinib Therapy

    PubMed Central

    Craig, Jamie; Bajaj, Rajesh; Spurling, Timothy

    2014-01-01

    Crizotinib is an oral tyrosine-kinase inhibitor that inhibits anaplastic lymphoma kinase (ALK) in gene-rearranged non-small cell lung cancer (NSCLC). In 2011, the Food and Drug Administration approved crizotinib for treatment of locally advanced or metastatic ALK-positive NSCLC. The crizotinib adverse events profile included esophageal disorders in 11% of patients treated during trial phases I, II, and III, but none of them had severe events. We describe the development of severe ulcerative esophagitis secondary to crizotinib therapy and the re-introduction of therapy at a lower dose without recurrence of esophageal symptoms.

  3. Resection of esophageal carcinoma during pregnancy.

    PubMed

    ?ahin, Murat; Kocaman, Gökhan; Özkan, Murat; Yüksel, Cabir; Enön, Serkan; Kutlay, Hakan

    2015-01-01

    Esophageal carcinoma diagnosed during pregnancy is a rare occurrence. A 26-year-old pregnant patient was referred to our hospital with dysphagia. A thorough examination showed a tumor in the esophagus. Laparotomy, thoracotomy, and cervical exploration were performed. There are only 2 cases reported in the literature about esophageal carcinoma diagnosed during pregnancy and treated surgically. However, ethical dilemmas arise in managing such situations. Here we report a case of esophageal squamous cell carcinoma diagnosed at 27 weeks of gestation in which surgical resection was performed successfully. PMID:25555961

  4. Esophageal melanocytosis in oral opium consumption.

    PubMed

    Geramizadeh, Bita; Asadian, Fatemeh; Taghavi, Alireza

    2014-01-01

    Esophageal melanocytosis is a rare and benign condition, characterized by melanocytic proliferation of the esophageal squamous epithelium with heavy melanin deposition. The etiology and pathogenesis has not been exactly known but it seems to be a chronic stimulus such as gastroesophageal reflux. This condition is very rare and about 35 cases have been reported so far, most of which have been from India and Japan. Herein, we present a case of esophageal melanocytosis in a patient with long history of oral opium consumption. To the best of our knowledge, such a history has not been reported. PMID:24719715

  5. Medical management of esophageal reflux.

    PubMed Central

    Hirschowitz, B. I.

    1994-01-01

    Gastroesophageal reflux of varying severity is a common disorder for which medical attention is sought at all levels, from pharmacists to specialist physicians and surgeons. This brief overview represents my current understanding of reflux, its effects on the esophagus and my personal approach to treatment of these disorders. Of necessity, because the literature is so extensive (a Medline search on reflux from 1966 to 1993 yielded over 1500 papers.), I have relied in places on the extensive review by Marks and Richter [1]. My paper emphasizes the evaluation and treatment of patients with symptomatic reflux, esophagitis and its complications. It describes why it is important to grade the disorders so that the treatment used is appropriate to the severity of the disease. The more severe the disease, the more specific the diagnostic information needed and the more exacting the treatment. Various treatments and outcomes of therapy are discussed, and a role for surgery is defined. The essence of effective medical treatment of esophagitis is to reduce acidity of the refluxate to a level outside the optimum proteolytic pH range of pepsin, i.e. greater than pH 3.5. PMID:7502531

  6. ?-fetoprotein produced by endometrioid adenocarcinoma of uterus.

    PubMed

    Akhavan, Ali; Karimi Zarchi, Mojgan; Akhavan Tafti, Mahmood; Navabii, Hossein

    2012-01-01

    ?-fetoprotein (AFP) producing adenocarcinoma of endometrium is a rare tumour. It is mostly high grade and has poor prognosis. Lung metastases are common. In this article, the authors present a case of a 57-year-old woman with AFP producing adenocarcinoma of endometrium and history of bilateral metachronous breast cancer, with lung, subcutaneous and brain metastases. PMID:22736779

  7. Obligate progression precedes lung adenocarcinoma dissemination

    PubMed Central

    Caswell, Deborah R.; Chuang, Chen-Hua; Yang, Dian; Chiou, Shin-Heng; Cheemalavagu, Shashank; Kim-Kiselak, Caroline; Connolly, Andrew; Winslow, Monte M.

    2014-01-01

    Despite its clinical importance, very little is known about the natural history and molecular underpinnings of lung cancer dissemination and metastasis. Here we employed a genetically-engineered mouse model of metastatic lung adenocarcinoma in which cancer cells are fluorescently marked to determine whether dissemination is an inherent ability or a major acquired phenotype during lung adenocarcinoma metastasis. We find very little evidence for dissemination from oncogenic Kras-driven hyperplasias or most adenocarcinomas. p53 loss is insufficient to drive dissemination but rather enables rare cancer cells in a small fraction of primary adenocarcinomas to gain alterations that drive dissemination. Molecular characterization of disseminated tumors cells indicates that down-regulation of the transcription factor Nkx2-1 precedes dissemination. Finally, we show that metastatic primary tumors possess a highly proliferative sub-population of cells with characteristics matching those of disseminating cells. We propose that dissemination is a major hurdle during the natural course of lung adenocarcinoma metastasis. PMID:24740995

  8. Esophageal cancer epidemiology in blacks and whites: racial and gender disparities in incidence, mortality, survival rates and histology.

    PubMed Central

    Baquet, Claudia R.; Commiskey, Patricia; Mack, Kelly; Meltzer, Stephen; Mishra, Shiraz I.

    2005-01-01

    BACKGROUND: Esophageal cancer rate disparities are pronounced for blacks and whites. This study presents black-white esophageal cancer incidence, mortality, relative survival rates, histology and trends for two five-year time periods--1991-1995 and 1996-2000--and for the time period 1991-2000. METHODS: The study used data from the National Cancer Institute's population-based Surveillance Epidemiology End Results (SEER) program with submission dates 1991-2000. Age-adjusted incidence, mortality, relative survival rates and histology for esophageal carcinoma were calculated for nine SEER cancer registries for 1991-2000. Rates were analyzed by race and gender for changes over specified time periods. RESULTS: Esophageal cancer age-adjusted incidence of blacks was about twice that of whites (8.63 vs. 4.39/100,000, p < 0.05). Age-adjusted mortality for blacks, although showing a declining trend, was nearly twice that of whites (7.79 vs. 3.96, p < 0.05). Although survival was poor for all groups, it was significantly poorer in blacks than in whites. Squamous cell carcinoma was more commonly diagnosed in blacks and white females, whereas adenocarcinoma was more common among white males (p < 0.001). CONCLUSIONS: Racial disparities in esophageal cancer incidence, mortality, survival and histology exist. Survival rates from this disease have not significantly improved over the decade. These data support the need for advances in prevention, early detection biomarker research and research on new, more effective treatment modalities for this disease. Images Figure 1 PMID:16334494

  9. Inhibition of Notch signaling enhances transdifferentiation of the esophageal squamous epithelium towards a Barrett's-like metaplasia via KLF4.

    PubMed

    Vega, Maria E; Giroux, Véronique; Natsuizaka, Mitsuteru; Liu, Mingen; Klein-Szanto, Andres J; Stairs, Douglas B; Nakagawa, Hiroshi; Wang, Kenneth K; Wang, Timothy C; Lynch, John P; Rustgi, Anil K

    2014-01-01

    Barrett's esophagus (BE) is defined as an incomplete intestinal metaplasia characterized generally by the presence of columnar and goblet cells in the formerly stratified squamous epithelium of the esophagus. BE is known as a precursor for esophageal adenocarcinoma. Currently, the cell of origin for human BE has yet to be clearly identified. Therefore, we investigated the role of Notch signaling in the initiation of BE metaplasia. Affymetrix gene expression microarray revealed that BE samples express decreased levels of Notch receptors (NOTCH2 and NOTCH3) and one of the the ligands (JAG1). Furthermore, BE tissue microarray showed decreased expression of NOTCH1 and its downstream target HES1. Therefore, Notch signaling was inhibited in human esophageal epithelial cells by expression of dominant-negative-Mastermind-like (dnMAML), in concert with MYC and CDX1 overexpression. Cell transdifferentiation was then assessed by 3D organotypic culture and evaluation of BE-lineage specific gene expression. Notch inhibition promoted transdifferentiation of esophageal epithelial cells toward columnar-like cells as demonstrated by increased expression of columnar keratins (K8, K18, K19, K20) and glandular mucins (MUC2, MUC3B, MUC5B, MUC17) and decreased expression of squamous keratins (K5, K13, K14). In 3D culture, elongated cells were observed in the basal layer of the epithelium with Notch inhibition. Furthermore, we observed increased expression of KLF4, a potential driver of the changes observed by Notch inhibition. Interestingly, knockdown of KLF4 reversed the effects of Notch inhibition on BE-like metaplasia. Overall, Notch signaling inhibition promotes transdifferentiation of esophageal cells toward BE-like metaplasia in part via upregulation of KLF4. These results support a novel mechanism through which esophageal epithelial transdifferentiation promotes the evolution of BE. PMID:25558829

  10. Esophageal papilloma: Flexible endoscopic ablation by radiofrequency.

    PubMed

    Del Genio, Gianmattia; Del Genio, Federica; Schettino, Pietro; Limongelli, Paolo; Tolone, Salvatore; Brusciano, Luigi; Avellino, Manuela; Vitiello, Chiara; Docimo, Giovanni; Pezzullo, Angelo; Docimo, Ludovico

    2015-03-16

    Squamous papilloma of the esophagus is a rare benign lesion of the esophagus. Radiofrequency ablation is an established endoscopic technique for the eradication of Barrett esophagus. No cases of endoscopic ablation of esophageal papilloma by radiofrequency ablation (RFA) have been reported. We report a case of esophageal papilloma successfully treated with a single session of radiofrequency ablation. Endoscopic ablation of the lesion was achieved by radiofrequency using a new catheter inserted through the working channel of endoscope. The esophageal ablated tissue was removed by a specifically designed cup. Complete ablation was confirmed at 3 mo by endoscopy with biopsies. This case supports feasibility and safety of as a new potential indication for Barrx(TM) RFA in patients with esophageal papilloma. PMID:25789102

  11. Eosinophilic Esophagitis (EE) or (EoE)

    MedlinePLUS

    ... These include asthma, allergic rhinitis, atopic dermatitis and food allergy. EoE has also been shown to occur in ... often part of the EoE evaluation. Eosinophilic Esophagitis: Food Allergies Adverse immune responses to food are the main ...

  12. Cervical esophageal hemangioma combined with thyroid cancer.

    PubMed

    Lee, Jong Cheol; Kim, Jeong Won; Lee, Yong Jik; Lee, Seong Rok; Park, Chang-Ryul; Jung, Jong-Pil

    2011-08-01

    Hemangiomas that arise in cervical esophagus are extremely rare, representing 3.3% of all benign esophageal tumors. Although endoscopic mucosal resection (EMR) and potassium titanyl phosphate/yttrium aluminum garnet (KTP/YAG) laser therapy have been used with success for small tumors, the safety and efficacy in the case of large tumors remains uncertain. We report the successful resection of cervical esophageal hemangioma through a cervical esophagotomy in a patient with thyroid cancer who needed a cervical collar incision. PMID:22263178

  13. MLN0264 in Previously Treated Asian Patients With Advanced Gastrointestinal Carcinoma or Metastatic or Recurrent Gastric or Gastroesophageal Junction Adenocarcinoma Expressing Guanylyl Cyclase C

    ClinicalTrials.gov

    2015-03-11

    Advanced Gastrointestinal Carcinoma; Gastroesophageal Junction Adenocarcinoma; Recurrent Gastric Adenocarcinoma; Recurrent Gastroesophageal Junction Adenocarcinoma; Metastatic Gastric Adenocarcinoma; Metastatic Gastroesophageal Junction Adenocarcinoma; Recurrent Gastrointestinal Carcinoma

  14. Effect of total laryngectomy on esophageal motility

    SciTech Connect

    Hanks, J.B.; Fisher, S.R.; Meyers, W.C.; Christian, K.C.; Postlethwait, R.W.; Jones, R.S.

    1981-01-01

    Total laryngectomy for cancer can result in dysphagia and altered esophageal motility. Manometric changes in the upper esophageal sphincter (UES), and in proximal and distal esophageal function have been reported. However, most studies have failed to take into account radiation therapy and appropriate controls. We selected ten male patients (54.3 +/- 1.9 yr) for longitudinal manometric evaluation prior to laryngectomy then at two weeks and again six months later. No patient received preoperative radiation therapy, had a previous history of esophageal surgery, or developed a postoperative wound infection or fistula. Seven of ten patients had positive nodes and received 6,000-6,600 rads postoperative radiation therapy. Preoperatively 4 of 10 patients complained of dysphagia which did not significantly change following surgery and radiation. Two of three patients who did not complain of dysphagia preoperatively and received radiation postoperatively developed dysphagia. No patient without dysphagia preoperatively who received no radiation therapy developed symptoms. Our studies show that laryngectomy causes alterations in the UES resting and peak pressures but not in the proximal or distal esophagus, or the lower esophageal sphincter. These data also imply radiation therapy may be associated with progressive alterations in motility and symptomatology. Further study regarding the effects of radiation on esophageal motility and function are urged.

  15. Management of refractory Eosinophilic Esophagitis

    PubMed Central

    Mukkada, Vincent A.; Furuta, Glenn T.

    2014-01-01

    Background/Aims Whereas most children and adults respond to traditional EoE treatments, such as exclusion of dietary allergens or the use of topical steroids, a small fraction may not. Methods Based on clinical experiences and review of the literature, the aim of this work is to provide practical advice to care for ‘refractory’ patients with EoE. Results The approach to this type of patient continues to evolve and decision-making should consider a number of issues including the patient's age, lack of complete understanding of the natural history of this disease, risks of monitoring and side effects of treatments. Next, one needs to define the term refractory, in that this can refer either to persistent symptoms, or to continued inflammation in the face of presumably effective drug or diet therapy. Before considering alternative treatments, it is important to rule out any other cause of persistent symptoms. For instance, could they be related to an occult esophageal narrowing not identified at the time of endoscopy? Esophagrams may be necessary to identify localized or longitudinal narrowing that could be amenable to dilation. If symptoms and inflammation are persistent and no narrowing is appreciated, an elemental diet can be considered but the long term use of this in older children and adults may be difficult. Prednisone or systemic steroids may be indicated to induce remission but side effects and complications associated with chronic use are limiting. Finally, the use of immunosuppression or biological agents has been reported in case reports and studies; use of these may be limited by side effects or the need to utilize compassionate use protocols. Conclusions As the scope of esophageal eosinophilia continues to evolve, the clinical and molecular characterization of new clinical phenotypes will be important so that new therapeutic targets can be identified. PMID:24603397

  16. EA Shuttle Document Retention Effort

    NASA Technical Reports Server (NTRS)

    Wagner, Howard A.

    2010-01-01

    This slide presentation reviews the effort of code EA at Johnson Space Center (JSC) to identify and acquire databases and documents from the space shuttle program that are adjudged important for retention after the retirement of the space shuttle.

  17. METABOLITE BIOIMARKERS IN THE DEVELOPMENT OF ESOPHAGEAL ADENOCARCINOMA | Division of Cancer Prevention

    Cancer.gov

    Skip to main content Division of Cancer Prevention Search form Search Main menu Home Major Programs Research Networks Map Alliance of Glycobiologists for Detection of Cancer Barrett's Esophagus Translational Research Network (BETRNet) Cancer Prevention

  18. GENETIC DETERMINANTS OF BARRETT'S ESOPHAGUS AND ESOPHAGEAL ADENOCARCINOMA | Division of Cancer Prevention

    Cancer.gov

    Skip to main content Division of Cancer Prevention Search form Search Main menu Home Major Programs Research Networks Map Alliance of Glycobiologists for Detection of Cancer Barrett's Esophagus Translational Research Network (BETRNet) Cancer Prevention

  19. Inhibition of Reflux-Induced Esophageal Adenocarcinoma by Proanthocyanidins | Division of Cancer Prevention

    Cancer.gov

    Skip to main content Division of Cancer Prevention Search form Search Main menu Home Major Programs Research Networks Map Alliance of Glycobiologists for Detection of Cancer Barrett's Esophagus Translational Research Network (BETRNet) Cancer Prevention

  20. Activation of GATA binding protein 6 (GATA6) sustains oncogenic lineage-survival in esophageal adenocarcinoma

    E-print Network

    Lin, Lin

    Gene amplification is a tumor-specific event during malignant transformation. Recent studies have proposed a lineage-dependency (addiction) model of human cancer whereby amplification of certain lineage transcription factors ...

  1. Colorectal adenocarcinoma in Crohn's disease.

    PubMed Central

    Ribeiro, M B; Greenstein, A J; Sachar, D B; Barth, J; Balasubramanian, S; Harpaz, N; Heimann, T M; Aufses, A H

    1996-01-01

    OBJECTIVE: The authors' aim was to review the clinical features and estimate the long-term survival of patients with colorectal carcinoma complicating Crohn's disease. SUMMARY BACKGROUND DATA: Recent studies have demonstrated a significantly increased risk of colorectal carcinoma in patients with Crohns disease. METHODS: The authors reviewed retrospectively the medical records of 30 patients with Crohn's disease admitted to The Mount Sinai Hospital between 1960 and 1989 in whom colorectal adenocarcinoma developed. All patients were operated on and follow-up was complete for all patients to 10 years after operation, to the time of death, or to the closing date of the study in December 1989. RESULTS: The 30 patients in the series had 33 colorectal adenocarcinomas; three patients (10%) presented with two synchronous cancers. The patients were relatively young (mean age, 53 years) and had long-standing Crohn's disease (duration >20 years in 87%). The 5-year actuarial survival was 44% for the overall series: 100% for stage A, 86% for stage B, 60% for stage C. All five patients with excluded bowel tumor died of large bowel cancer within 2.4 years; by contrast, the actuarial 5-year survival for patients with in-continuity tumors was 56%. CONCLUSIONS: The incidence, characteristics, and prognosis of colorectal carcinoma complicating Crohn's disease are similar to the features of cancer in ulcerative colitis, including young age, multiple neoplasms, long duration of disease, and greater than a 50% 5-year survival rate (without excluded loops). These observations suggest the advisability of surveillance programs for Crohn's disease of the colon similar to those for ulcerative colitis of comparable duration and extent. PMID:8597513

  2. External beam radiotherapy synergizes 188Re-liposome against human esophageal cancer xenograft and modulates 188Re-liposome pharmacokinetics

    PubMed Central

    Chang, Chih-Hsien; Liu, Shin-Yi; Chi, Chih-Wen; Yu, Hsiang-Lin; Chang, Tsui-Jung; Tsai, Tung-Hu; Lee, Te-Wei; Chen, Yu-Jen

    2015-01-01

    External beam radiotherapy (EBRT) treats gross tumors and local microscopic diseases. Radionuclide therapy by radioisotopes can eradicate tumors systemically. Rhenium 188 (188Re)-liposome, a nanoparticle undergoing clinical trials, emits gamma rays for imaging validation and beta rays for therapy, with biodistribution profiles preferential to tumors. We designed a combinatory treatment and examined its effects on human esophageal cancer xenografts, a malignancy with potential treatment resistance and poor prognosis. Human esophageal cancer cell lines BE-3 (adenocarcinoma) and CE81T/VGH (squamous cell carcinoma) were implanted and compared. The radiochemical purity of 188Re-liposome exceeded 95%. Molecular imaging by NanoSPECT/CT showed that BE-3, but not CE81T/VGH, xenografts could uptake the 188Re-liposome. The combination of EBRT and 188Re-liposome inhibited tumor regrowth greater than each treatment alone, as the tumor growth inhibition rate was 30% with EBRT, 25% with 188Re-liposome, and 53% with the combination treatment at 21 days postinjection. Combinatory treatment had no additive adverse effects and significant biological toxicities on white blood cell counts, body weight, or liver and renal functions. EBRT significantly enhanced the excretion of 188Re-liposome into feces and urine. In conclusion, the combination of EBRT with 188Re-liposome might be a potential treatment modality for esophageal cancer.

  3. External beam radiotherapy synergizes (188)Re-liposome against human esophageal cancer xenograft and modulates (188)Re-liposome pharmacokinetics.

    PubMed

    Chang, Chih-Hsien; Liu, Shin-Yi; Chi, Chih-Wen; Yu, Hsiang-Lin; Chang, Tsui-Jung; Tsai, Tung-Hu; Lee, Te-Wei; Chen, Yu-Jen

    2015-01-01

    External beam radiotherapy (EBRT) treats gross tumors and local microscopic diseases. Radionuclide therapy by radioisotopes can eradicate tumors systemically. Rhenium 188 ((188)Re)-liposome, a nanoparticle undergoing clinical trials, emits gamma rays for imaging validation and beta rays for therapy, with biodistribution profiles preferential to tumors. We designed a combinatory treatment and examined its effects on human esophageal cancer xenografts, a malignancy with potential treatment resistance and poor prognosis. Human esophageal cancer cell lines BE-3 (adenocarcinoma) and CE81T/VGH (squamous cell carcinoma) were implanted and compared. The radiochemical purity of (188)Re-liposome exceeded 95%. Molecular imaging by NanoSPECT/CT showed that BE-3, but not CE81T/VGH, xenografts could uptake the (188)Re-liposome. The combination of EBRT and (188)Re-liposome inhibited tumor regrowth greater than each treatment alone, as the tumor growth inhibition rate was 30% with EBRT, 25% with (188)Re-liposome, and 53% with the combination treatment at 21 days postinjection. Combinatory treatment had no additive adverse effects and significant biological toxicities on white blood cell counts, body weight, or liver and renal functions. EBRT significantly enhanced the excretion of (188)Re-liposome into feces and urine. In conclusion, the combination of EBRT with (188)Re-liposome might be a potential treatment modality for esophageal cancer. PMID:26056445

  4. Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study.

    PubMed

    Offermans, Nadine S M; Vermeulen, Roel; Burdorf, Alex; Goldbohm, R Alexandra; Keszei, András P; Peters, Susan; Kauppinen, Timo; Kromhout, Hans; van den Brandt, Piet A

    2014-10-15

    The evidence for an association between occupational asbestos exposure and esophageal, gastric and colorectal cancer is limited. We studied this association specifically addressing risk differences between relatively low and high exposure, risk associated with cancer subtypes, the influence of potential confounders and the interaction between asbestos and smoking in relation to cancer risk. Using the Netherlands Cohort Study (n = 58,279 men, aged 55-69 years at baseline), asbestos exposure was estimated by linkage to a job-exposure matrix. After 17.3 years of follow-up, 187 esophageal, 486 gastric and 1,724 colorectal cancer cases were available for analysis. The models adjusted for age and family history of cancer showed that mainly (prolonged) exposure to high levels of asbestos was statistically significantly associated with risk of esophageal adenocarcinoma (EAC), total and distal colon cancer and rectal cancer. For overall gastric cancer and gastric non-cardia adenocarcinoma (GNCA), also exposure to lower levels of asbestos was associated. Additional adjustment for lifestyle confounders, especially smoking status, yielded non-significant associations with overall gastric cancer and GNCA in the multivariable-adjusted model, except for the prolonged highly exposed subjects (tertile 3 vs. never: HR 2.67, 95% CI: 1.11-6.44 and HR 3.35, 95% CI: 1.33-8.44, respectively). No statistically significant additive or multiplicative interaction between asbestos and smoking was observed for any of the studied cancers. This prospective population-based study showed that (prolonged) high asbestos exposure was associated with overall gastric cancer, EAC, GNCA, total and distal colon cancer and rectal cancer. PMID:24585528

  5. Esophageal cancer as second primary tumor after breast cancer radiotherapy

    Microsoft Academic Search

    Beatrix Scholl; Ernane D Reis; Abderrahim Zouhair; Igor Chereshnev; Jean-Claude Givel; Michel Gillet

    2001-01-01

    Background: An increased risk of esophageal cancer has been reported in survivors of breast cancer treated with radiotherapy. This study further characterizes this association.Methods: Through hospital databases, 118 patients (109 men, 9 women) treated for esophageal cancer between 1985 and 1993 were identified, of whom 37 had 60 synchronous or metachronous cancers. 5 women had primary esophageal cancer after having

  6. Ultrasonic esophagoprobe for TNM staging of highly stenosing esophageal carcinoma

    Microsoft Academic Search

    Kenneth F. Binmoeller; Hans Seifert; Uwe Seitz; Jakob R. Izbicki; Mitsuhiro Kida; Nib Soehendra

    1995-01-01

    Background: Endosonographic staging of esophageal carcinoma may be limited in one third of cases by tumor stenoses that cannot be traversed with conventional echoendoscopes. We designed and evaluated a new endosonographic instrument (ultrasonic esophagoprobe) for TNM staging of highly stenosing esophageal carcinomas.Methods: Eighty-seven consecutive patients (64 men, mean age 61 years) with highly stenosing esophageal carcinomas were studied with the

  7. Molecular and cellular features of esophageal cancer cells

    Microsoft Academic Search

    Tetsuro Nishihira; Yu Hashimoto; Masafumi Katayama; Shozo Mori; Toshio Kuroki

    1993-01-01

    More than 70 cell lines were established from esophageal cancer, including 15 TE-series cell lines established by the authors. This article reviews molecular and cellular features of esophageal cancer cells from studies using these cell lines as well as primary tumors. The subjects reviewed include primary cultures of normal epithelium of the esophagus and of esophageal tumors, their growth and

  8. Relationship among esophageal dysfunction, diabetic gastroenteropathy, and peripheral neuropathy

    Microsoft Academic Search

    C. O. H. Russell; R. Gannan; J. Coatsworth; R. Neilsen; F. Allen; L. D. Hill; C. E. Pope

    1983-01-01

    Esophageal motor function was tested in 12 patients with a clinical diagnosis of diabetic gastroenteropathy by radionuclide transit (RT) studies. Other insulin-dependent diabetics with and without symptoms of peripheral neuropathy but with no symptoms of gastrointestinal disease were similarly studied. Eleven of the 12 patients with gastroenteropathy were found to have abnormal esophageal function, even though only five had esophageal

  9. Case Report Alendronate-induced Esophagitis in an Elderly Woman

    Microsoft Academic Search

    Victoria Gómez; Shu-Yuan Xiao

    Ingestion of alendronate sodium (Fosamax) had been reported to sometimes cause erosive or ulcerative esophagitis. Despite its widespread use and several case reports describing the clinical and endoscopic presentation, there has been limited discussion on the histologic appearances of the esophagitis caused by the medication. Here we describe one case of an elderly woman who presented with alendronate-induced esophagitis. The

  10. Comparative Genomic Hybridization of Esophageal Squamous Cell Carcinoma

    E-print Network

    Lin, Chi-Hung

    Comparative Genomic Hybridization of Esophageal Squamous Cell Carcinoma Correlations between aberrations of 46 samples of esophageal squamous cell carcinoma (EC-SCC) were analyzed by comparative genomic of the Department of Health, Taiwan, Re- public of China), and esophageal squamous cell carcinoma (EC

  11. 47 CFR 11.61 - Tests of EAS procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Telecommunication 1 2012-10-01 2012-10-01 false Tests of EAS procedures. 11.61 Section 11.61 ...COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Tests § 11.61 Tests of EAS procedures. (a) EAS Participants...

  12. 47 CFR 11.61 - Tests of EAS procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Telecommunication 1 2013-10-01 2013-10-01 false Tests of EAS procedures. 11.61 Section 11.61 ...COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Tests § 11.61 Tests of EAS procedures. (a) EAS Participants...

  13. 47 CFR 11.61 - Tests of EAS procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Telecommunication 1 2011-10-01 2011-10-01 false Tests of EAS procedures. 11.61 Section 11.61 ...COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Tests § 11.61 Tests of EAS procedures. (a) EAS Participants...

  14. 47 CFR 11.61 - Tests of EAS procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Telecommunication 1 2014-10-01 2014-10-01 false Tests of EAS procedures. 11.61 Section 11.61 ...COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Tests § 11.61 Tests of EAS procedures. (a) EAS Participants...

  15. 47 CFR 11.61 - Tests of EAS procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Telecommunication 1 2010-10-01 2010-10-01 false Tests of EAS procedures. 11.61 Section 11.61 ...COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Tests § 11.61 Tests of EAS procedures. (a) EAS Participants...

  16. Conservative surgical treatment of reflux esophagitis and esophageal stricture.

    PubMed Central

    Herrington, J L; Wright, R S; Edwards, W H; Sawyers, J L

    1975-01-01

    During a recent 3-year period, 17 consecutive patients were seen with advanced fibrotic esophageal strictures secondary to alkaline-acid-pepsin reflux. From detailed preoperative evaluations alone it was impossible to determine whether therapy should consist of excisional surgery, esophagogastroplasty or intra-operative dilatation with correction of reflux. Only at operation could the length, extent, degree and severity of the stricture be fully determined. Each of the 17 patients was treated by controlled dilatation, coupled with an antireflux procedure. This simplified approach proved successful on strictures thought preoperatively to be undilatable. It appears that this conservative approach is applicable to many advanced strictures and excisional and plastic procedures should be reserved for those cases that prove unyielding to intraoperative dilatation. The true appraisal of a reflux stricture and the choice of surgical procedure is best determined at the operating table. Images Fig. 5A. Fig. 5B. Fig. 6. Fig. 7. Fig. 8. Fig. 9. Fig. 10. Fig. 11. Fig. 12. Fig. 13. Fig. 14. Fig. 15. Fig. 16. Fig. 17. Fig. 18. Fig. 19. Fig. 20. Fig. 21. PMID:1130874

  17. Useful strategies to prevent severe stricture after endoscopic submucosal dissection for superficial esophageal neoplasm

    PubMed Central

    Uno, Kaname; Iijima, Katsunori; Koike, Tomoyuki; Shimosegawa, Tooru

    2015-01-01

    The minimal invasiveness of endoscopic submucosal dissection (ESD) prompted us to apply this technique to large-size early esophageal squamous cell carcinoma and Barrett’s adenocarcinoma, despite the limitations in the study population and surveillance duration. A post-ESD ulceration of greater than three-fourths of esophageal circumference was advocated as an important risk factor for refractory strictures that require several sessions of dilation therapy. Most of the preoperative conditions are asymptomatic, but dilatation treatment for dysphagia associated with the stricture has potential risks of severe complications and a worsening of quality of life. Possible mechanisms of dysphasia were demonstrated based on dysmotility and pathological abnormalities at the site: (1) delayed mucosal healing; (2) severe inflammation and disorganized fibrosis with abundant extracellular matrices in the submucosa; and (3) atrophy in the muscularis proper. However, reports on the administration of anti-scarring agents, preventive dilation therapies, and regenerative medicine demonstrated limited success in stricture prevention, and there were discrepancies in the study designs and protocols of these reports. The development and consequent long-term assessments of new prophylactic technologies on the promotion of wound healing and control of the inflammatory/tumor microenvironment will require collaboration among various research fields because of the limited accuracy of preoperative staging and high-risk of local recurrence.

  18. Eosinophilic esophagitis -- clinical manifestations, diagnosis, and treatment.

    PubMed

    Lucendo Villarín, A J

    2009-01-01

    Eosinophilic esophagitis (EE) is a chronic inflammatory, immunoallergic disease of the esophagus that represents the most common eosinophilic gut disease. Understanding and diagnosis regarding this condition have greatly increased in recent years, particularly in Europe and North America, in parallel with other allergic disorders. It consists of dense esophageal infiltration with eosinophils in the absence of gastro-esophageal reflux (GER). It involves individuals at all ages, and is particularly common in males during childhood and up to the 5th decade of life. It manifests with chronic, intermittent esophageal symptoms that predominantly include dysphagia, food impaction episodes, and GER-attributable complaints that do not respond to antisecretory therapy. Endoscopically, EE is a polymorphous disease that presents with various changes in esophageal caliber, and subtle changes in mucosal appearance, which lead to biopsy collection as a key procedure for diagnosis. Management must be multidisciplinary, including gastroenterologists, pathologists, allergologists, and also nutrition specialists in pediatric cases. Regarding therapy, dietary food restrictions are especially useful in the management of pediatric EE, but effectiveness is lower in the adult, maybe because of a greater involvement of air allergens. Drug use is standard, particularly involving topical steroids, which may revert manifestations and histological lesions, even though recurrence following discontinuation is common. PMID:19335033

  19. Fruit and vegetable intake and esophageal cancer in a large prospective cohort study.

    PubMed

    Freedman, Neal D; Park, Yikyung; Subar, Amy F; Hollenbeck, Albert R; Leitzmann, Michael F; Schatzkin, Arthur; Abnet, Christian C

    2007-12-15

    Changing patterns of esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) incidence worldwide suggest distinct etiologies. Although associations between fruit and vegetable intake and both ESCC and EAC have been found in multiple ecological and case-control studies, few prospective studies have investigated these associations. We prospectively examined these associations in 490,802 participants of the National Institutes of Health (NIH)-AARP Diet and Health Study using Cox models adjusted for age, alcohol intake, body mass index, cigarette smoking, education, physical activity and total energy intake. We present hazard ratios and 95% confidence intervals per serving per 1,000 calories. During 2,193,751 person years of follow-up, 103 participants were diagnosed with ESCC and 213 participants with EAC. We found a significant inverse association between total fruit and vegetable intake and ESCC risk (HR: 0.78, 95% CI: 0.67-0.91), but not EAC risk (0.98, 0.90-1.08). In models mutually adjusted for fruit and vegetable intake, the protective association with ESCC was stronger for fruits (0.73, 0.57-0.93) than for vegetables (0.84, 0.66-1.07). When we examined botanical subgroups, we observed significant protective associations for ESCC and intake of Rosacea (apples, peaches, nectarines, plums, pears and strawberries) and Rutaceae (citrus fruits). A significant inverse association between EAC and Chenopodiaceae (spinach) intake was observed. Results from our study suggest that the relation of fruit and vegetable intake and esophageal cancer risk may vary by histologic type. PMID:17691111

  20. Self-expanding plastic stent removed after radiochemotherapy for advanced esophageal cancer.

    PubMed

    Laquière, A; Grandval, P; Heresbach, D; Prat, F; Arpurt, J P; Bichard, P; D'Halluin, P-N; Berthillier, J; Boustière, C; Laugier, R

    2014-01-01

    Endoscopic evaluation after chemoradiotherapy (CR) is impossible with an esophageal stent in place. The main study objective was to evaluate self-expanding plastic stent (SEPS) removal post-CR. Secondary end-points were the improvement of dysphagia and patients' quality of life. From October 2008 to March 2011, 20 dysphagic patients who suffered from advanced esophageal cancer were enrolled in a multicenter, prospective study. SEPS was inserted prior to CR and then removed endoscopically. SEPS efficiency (dysphagia score) and tolerance, as well as the patients' quality of life (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire validated for the esophagus), were monitored. Continuous variables were compared using a paired t-test analysis for matched data. A P-value of less than 0.05 was considered statistically significant. Twenty patients (15 men and 5 women), aged 61.5 years (±9.88) (range 43-82 years), with adenocarcinoma (n = 12) and squamous cell carcinoma (n = 8), were enrolled. SEPS were successfully inserted in all patients (100%). There was one perforation and three episodes of migration. All of these complications were medically treated. The mean dysphagia score at the time of stent placement was 2.79 (0.6). Mean dysphagia scores obtained on day 1 and day 30 post-SEPS placement were 0.7 (0.9) (P < 0.0001) and 0.45 (0.8) (P < 0.0001), respectively. Quality of Life Questionnaire validated for the esophagus score showed an improvement in dysphagia (P = 0.01) and quality of oral feeding (P = 0.003). All SEPS were removed endoscopically without complications. In two patients, the stent was left in place due to metastatic disease. SEPS are extractable after CR of esophageal cancer. Early stenting by SEPS prior to and during CR may reduce dysphagia and improve quality of oral alimentation. PMID:23651038

  1. Deoxycholate induces COX-2 expression via Erk1/2-, p38-MAPK and AP-1-dependent mechanisms in esophageal cancer cells

    PubMed Central

    2009-01-01

    Background The progression from Barrett's metaplasia to adenocarcinoma is associated with the acquirement of an apoptosis-resistant phenotype. The bile acid deoxycholate (DCA) has been proposed to play an important role in the development of esophageal adenocarcinoma, but the precise molecular mechanisms remain undefined. The aim of this study was to investigate DCA-stimulated COX-2 signaling pathways and their possible contribution to deregulated cell survival and apoptosis in esophageal adenocarcinoma cells. Methods Following exposure of SKGT-4 cells to DCA, protein levels of COX-2, MAPK and PARP were examined by immunoblotting. AP-1 activity was assessed by mobility shift assay. DCA-induced toxicity was assessed by DNA fragmentation and MTT assay. Results DCA induced persistent activation of the AP-1 transcription factor with Fra-1 and JunB identified as the predominant components of the DCA-induced AP-1 complex. DCA activated Fra-1 via the Erk1/2- and p38 MAPK while Erk1/2 is upstream of JunB. Moreover, DCA stimulation mediated inhibition of proliferation with concomitant low levels of caspase-3-dependent PARP cleavage and DNA fragmentation. Induction of the anti-apoptotic protein COX-2 by DCA, via MAPK/AP-1 pathway appeared to balance the DCA mediated activation of pro-apoptotic markers such as PARP cleavage and DNA fragmentation. Both of these markers were increased upon COX-2 suppression by aspirin pretreatment prior to DCA exposure. Conclusion DCA regulates both apoptosis and COX-2-regulated cell survival in esophageal cells suggesting that the balance between these two opposing signals may determine the transformation potential of DCA as a component of the refluxate. PMID:19534809

  2. Herpetic esophagitis in immunocompetent medical student.

    PubMed

    Marinho, Andréia Vidica; Bonfim, Vinícius Mendes; de Alencar, Luciana Rodrigues; Pinto, Sebastião Alves; de Araújo Filho, João Alves

    2014-01-01

    Esophagitis caused by herpes simplex virus (HSV) is often documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV); it is rare in immunocompetent diagnosed patients. Case reports of herpetic esophagitis in students of health sciences are extremely rare. The disease presents with a clinical picture characterized by acute odynophagia and retrosternal pain without obvious causes and ulcers, evidenced endoscopically in the middistal esophagus. Diagnosis depends on endoscopy, biopsies for pathology studies, and immunohistochemistry techniques. The disease course is often benign; however, treatment with acyclovir speeds the disappearance of symptoms and limits the severity of infection. In this report, we present a case of herpetic esophagitis in an immunocompetent medical student, with reference to its clinical features, diagnosis, and treatment. The disease may have manifested as a result of emotional stress experienced by the patient. PMID:24707416

  3. Risk factors for esophageal and gastric cancers in Shanxi Province, China: A case-control study

    PubMed Central

    GAO, Ying; HU, Nan; HAN, Xiao You; DING, Ti; GIFFEN, Carol; GOLDSTEIN, Alisa M; TAYLOR, Philip R

    2011-01-01

    Objective Smoking and alcohol consumption explain little of the risk for upper-gastrointestinal (UGI) cancer in China, where over half of all cases in the world occur. Methods We evaluated questionnaire-based risk factors for UGI cancers in a case-control study from Shanxi Province, China, including 600 esophageal squamous cell carcinomas (ESCC), 599 gastric cardia adenocarcinomas (GCA), 316 gastric noncardia adenocarcinomas (GNCA), and 1514 age- and gender-matched controls. Results Ever smoking and ever use of any alcohol were not associated with risk of UGI cancer; only modest associations were observed between ESCC risk and highest cumulative smoking exposure, as well as GNCA risk and beer drinking. While several associations were noted for socioeconomic and some dietary variables with one or two UGI cancers, the strongest and most consistent relations for all three individual UGI cancers were observed for consumption of scalding hot foods (risk increased 150% to 219% for daily vs never users) and fresh vegetables and fruits (risk decreased 48% to 70% for vegetables and 46% to 68% for fruits, respectively, for high vs low quartiles). Conclusion This study confirms the minor role of tobacco and alcohol in UGI cancers in this region, and highlights thermal damage as a leading etiologic factor. PMID:21846596

  4. Advances in clinical management of eosinophilic esophagitis.

    PubMed

    Dellon, Evan S; Liacouras, Chris A

    2014-12-01

    Eosinophilic esophagitis (EoE) is a chronic immune/antigen-mediated clinicopathologic condition that has become an increasingly important cause of upper gastrointestinal morbidity in adults and children over the past 2 decades. It is diagnosed based on symptoms of esophageal dysfunction, the presence of at least 15 eosinophils/high-power field in esophageal biopsy specimens, and exclusion of competing causes of esophageal eosinophilia, including proton pump inhibitor-responsive esophageal eosinophilia. We review what we have recently learned about the clinical aspects of EoE, discussing the clinical, endoscopic, and histological features of EoE in adults and children. We explain the current diagnostic criteria and challenges to diagnosis, including the role of gastroesophageal reflux disease and proton pump inhibitor-responsive esophageal eosinophilia. It is also important to consider the epidemiology of EoE (with a current incidence of 1 new case per 10,000 per year and prevalence of 0.5 to 1 case per 1000 per year) and disease progression. We review the main treatment approaches and new treatment options; EoE can be treated with topical corticosteroids, such as fluticasone and budesonide, or dietary strategies, such as amino acid-based formulas, allergy test-directed elimination diets, and nondirected empiric elimination diets. Endoscopic dilation has also become an important tool for treatment of fibrostenotic complications of EoE. There are a number of unresolved issues in EoE, including phenotypes, optimal treatment end points, the role of maintenance therapy, and treatment of refractory EoE. The care of patients with EoE and the study of the disease span many disciplines; EoE is ideally managed by a multidisciplinary team of gastroenterologists, allergists, pathologists, and dieticians. PMID:25109885

  5. Lung adenocarcinoma and antiphospholipid antibodies.

    PubMed

    de Meis, Ernesto; Monteiro, Robson Q; Levy, Roger A

    2009-05-01

    Thrombosis is a frequent finding in cancer patients, being referred to as a poor prognostic factor. The mechanisms underlying the thrombophilic state in malignancy are not well elucidated but involve a complex interaction between tumor and host cells as well as the hemostatic system. A number of studies have demonstrated the presence of antiphospholipid antibodies (aPL) in cancer patients, suggesting a potential role in tumor-associated thrombosis. A prospective analysis has been performed in a group of lung adenocarcinoma patients in respect to the presence of aPL and thrombotic manifestations. Lupus anticoagulant (LAC) was identified in 61 out of 105 patients and it correlated highly with thrombosis (22/61, LAC positive vs 2/44, LAC negative RR=7.93; p<0.001). On the other hand, patients that displayed IgM anti-beta2-glycoprotein I (abeta2GPI) (22/80) showed an unexpected decrease in thrombosis risk (2/22, with IgM abeta2GPI vs 18/58, without IgM abeta2GPI RR=0.29; p=0.04). Considerations on the mechanisms that link cancer, thrombosis and aPL are discussed in this article. PMID:19185619

  6. Mimics of pancreatic ductal adenocarcinoma.

    PubMed

    Al-Hawary, Mahmoud M; Kaza, Ravi K; Azar, Shadi F; Ruma, Julie A; Francis, Isaac R

    2013-01-01

    Several uncommon primary pancreatic tumors, inflammatory conditions, metastasis to the pancreas and peripancreatic masses can mimic the appearance of pancreatic ductal adenocarcinoma (PDA). Differentiation between these lesions and PDA can be challenging, due to the overlap in imaging features; however, familiarity with their typical imaging features and clinical presentation may be helpful in their differentiation, as in some cases, invasive diagnostic tests or unnecessary surgery can be avoided. The different pathologies that can mimic PDA include inflammatory conditions such as the various forms of pancreatitis (chronic-focal mass-forming, autoimmune and groove pancreatitis), pancreatic neuroendocrine tumors, solid pseudopapillary tumors, metastasis (solid non-lymphomatous and hematologic), congenital variants (annular pancreas), as well as peripancreatic lesions (accessory spleen, adrenal masses, duodenal masses, lymph nodes and vascular lesions), and certain rare pancreatic tumors (e.g., acinar cell tumors, solid serous tumors, hamartoma and solitary fibrous tumors). The clinical presentation and imaging features of the most commonly encountered mimics of PDA are discussed in this presentation with representative illustrations. PMID:24060833

  7. EGFR, HER2 and HER3 dimerization patterns guide targeted inhibition in two histotypes of esophageal cancer.

    PubMed

    Fichter, Christiane Daniela; Timme, Sylvia; Braun, Julia Alexandra; Gudernatsch, Verena; Schöpflin, Anja; Bogatyreva, Lioudmilla; Geddert, Helene; Faller, Gerhard; Klimstra, David; Tang, Laura; Hauschke, Dieter; Werner, Martin; Lassmann, Silke

    2014-10-01

    Receptor tyrosine kinases (RTKs) are in the focus of targeted therapy for epithelial tumors. Our study addressed the role of EGFR, HER2 and HER3 expression and dimerization in esophageal cancers in situ and in vitro in the context of therapeutic EGFR and HER2 inhibitors. In archival pretreatment biopsies of esophageal carcinomas (n = 110), EGFR was preferentially expressed in esophageal squamous cell carcinomas (ESCCs) (22.4%; p = 0.088) and HER2 (34.4%; p < 0.001) with HER3 (91.5%; p < 0.001) in esophageal (Barrett's) adenocarcinomas (EACs). In situ proximity ligation assays revealed mainly EGFR and HER2 homodimers in ESCC and EAC cases, respectively. However, EAC cases also exhibited HER2/HER3 heterodimers. In vitro ESCC (OE21) cells displayed a significant response to erlotinib, gefitinib and lapatinib, with loss of AKT phosphorylation, G0/G1 cell cycle arrest and induction of apoptosis. In EAC cells (OE19, OE33 and SK-GT-4), lapatinib was similarly effective in strongly HER2-positive (mainly HER2 homodimers and some HER2/EGFR heterodimers) OE19 and OE33 cells. The HER2-targeting antibodies (trastuzumab and pertuzumab) given alone were largely ineffective in ESCC and EAC cells. However, both antibodies significantly induced antibody-dependent cellular cytotoxicity in EAC (OE19 and OE33) cells upon co-culture with peripheral blood mononuclear cells. The study reveals that overexpression of EGFR and HER2 predominantly results in homodimers in ESCCs and EACs, respectively. Still, some EACs also show HER2 dimerization plasticity, e.g., with HER3. Such RTK dimerization patterns affect responses to EGFR and HER2 targeting inhibitors in ESCC and EAC cells in vitro and hence may influence future prediction for particularly HER2-targeting inhibitors in EACs. PMID:24510732

  8. Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients

    Microsoft Academic Search

    Jeremy R Parfitt; James C Gregor; Neville G Suskin; Hani A Jawa; David K Driman

    2006-01-01

    Eosinophilic esophagitis in adults is a recently described entity occurring in young males with dysphagia, in whom esophageal biopsies show eosinophilic infiltration. This study defines the clinical and histological features of patients with eosinophilic esophagitis, distinguishing it from gastroesophageal reflux disease. Esophageal biopsies from patients with dysphagia or esophagitis were reviewed blindly, and assessed for: epithelial eosinophil counts, presence of

  9. Frequency of eosinophilic esophagitis in patients with esophageal symptoms: a single-center Turkish experience.

    PubMed

    Altun, R; Akbas, E; Y?ld?r?m, A E; Öcal, S; Korkmaz, M; Selcuk, H

    2013-01-01

    Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated esophageal disease characterized with symptoms related to esophageal dysfunction and eosinophil-predominant inflammation. There has been a dramatic increase in the diagnosis of this disease in recent years. The primary objective of this study was to determine the frequency of EoE in adult patients who were evaluated by gastroenterologists in our clinic with esophageal symptoms. Between November 2010 and May 2011, 311 adult patients who were evaluated in our clinic with esophageal symptoms were enrolled prospectively. All patients underwent endoscopy and had biopsies taken. Gastroesophageal reflux disease was excluded by either proton pump inhibitory treatment or 24-hour ambulatory pH monitorization. The diagnosis was confirmed by one independent pathologist. Frequency of EoE in patients with esophageal symptoms was 2.6% (n = 8; four men and four women). Mean age at diagnosis was 40.2 ± 8 years. Heartburn was the predominant symptom in patients (75% of the patients), and 87.5% (n = 7) of patients had more than one symptom at diagnosis. Nearly 38% of the patients (n = 3) had a history of allergic disease. Endoscopic findings were as follows: transient/fixed esophageal rings (25%), white exudates (25%), and normal appearance (50%). Median number of circulating eosinophils was 208 (93-659)/mm(3) . Median number of intraepithelial eosinophils in proximal-middle 1/3 part and distal 1/3 part of esophagus were 0 (0-50)/hpf and 37 (16-50)/hpf, respectively. In conclusion, EoE is not rare in Turkey, and it should be considered in the differential diagnosis of patients with esophageal symptoms. PMID:22925366

  10. IgG4-Related Esophageal Disease Presenting as Esophagitis Dissecans Superficialis With Chronic Strictures.

    PubMed

    Dumas-Campagna, Myriam; Bouchard, Simon; Soucy, Genevieve; Bouin, Mickael

    2014-08-01

    IgG4-related disease is a recently recognized autoimmune systemic disorder that has been described in various organs. The disease is characterized histologically by a dense lymphoplasmocytic infiltrate of IgG4-positive cells, storiform fibrosis and can be associated with tumefactive lesions. IgG4-related disease involving the upper gastrointestinal tract is rare and only two previous case reports have reported IgG4-related esophageal disease. We report the case of a 63-year-old female patient with a long-standing history of severe dysphagia and odynophagia with an initial diagnosis of reflux esophagitis. Symptoms persisted despite anti-acid therapy and control esophagogastroduodenoscopy (EGD) revealed endoscopic images consistent with esophagitis dissecans superficialis (sloughing esophagitis). An underlying autoimmune process was suspected and immunosuppressant agents were tried to control her disease. The patient eventually developed disabling dysphagia secondary to multiple chronic esophageal strictures. A diagnosis of IgG4-related disease was eventually made after reviewing esophageal biopsies and performing an immunohistochemical study with an anti-IgG4 antibody. Treatment attempts with corticosteroids and rituximab was not associated with a significant improvement of the symptoms of dysphagia and odynophagia, possibly because of the chronic nature of the disease associated with a high fibrotic component. Our case report describes this unique case of IgG4-related esophageal disease presenting as chronic esophagitis dissecans with strictures. We also briefly review the main histopathological features and treatment options in IgG4-related disease. PMID:24883156

  11. Clinical features of eosinophilic esophagitis.

    PubMed

    Miehlke, Stephan

    2014-01-01

    Eosinophilic esophagitis (EoE) may affect individuals at any age with a predominance for Caucasian males. The clinical manifestation of EoE is strongly age dependent. While dysphagia and food impaction are typical lead symptoms in adults and adolescents, infants often present with unspecific symptoms such as feeding problems, abdominal pain and vomiting. Some EoE patients may also experience heartburn. Therefore, EoE should always be considered in cases of heartburn refractory to antireflux therapy. Concomitant allergic diseases such as asthma, rhinitis and eczema are prevalent. Peripheral eosinophilia and elevated total serum IgE values are found in up to 50 and 70% of cases, respectively. Endoscopic features of EoE are variable and none of them is pathognomonic. Frequent findings are mucosal edema, furrows, exudates and corrugated rings. These endoscopic abnormalities have high specificities (90-95%), but low sensitivities (15-48%). A novel grading and classification system for the endoscopic assessment of EoE has been proposed which includes fixed rings, exudates, furrows and edema as major features. This classification system demonstrated good interobserver agreement among pediatric and adult gastroenterologists, and presents a useful tool to standardize endoscopic assessments and to further investigate the relation between endoscopic manifestation, clinical activity and response to treatment in EoE. Long-term follow-up studies have shown that EoE is a chronic disease causing recurrent dysphagia in the majority of cases. The prevalence of strictures significantly increases with the duration of disease, which stresses the importance of early diagnosis and consequent treatment of EoE. PMID:24603382

  12. Combined Modality Therapy of cT2N0M0 Esophageal Cancer: UT M. D. Anderson Cancer Center Experience

    PubMed Central

    Kountourakis, P.; Correa, A. M.; Hofstetter, W. L.; Lee, J. H.; Bhutani, M. S.; Rice, D. C.; Komaki, R.; Maru, D. M.; Ross, W. A.; Vaporciyan, A.; Swisher, S. G.; Ajani, J. A.

    2010-01-01

    Background Treatment strategy for patients with adequately staged cT2N0M0 carcinoma of the thoracic esophagus is a subject of debate. We analyzed the largest series of consecutive cT2N0M0 esophageal cancer patients treated with preoperative chemoradiotherapy. Methods All patients with cT2N0M0 (assessment included endoscopic ultrasonography and computed tomography of the chest and abdomen) thoracic esophageal cancer treated with preoperative chemoradiation between 1997 and 2009 were analyzed. We used the Cox regression model and Kaplan-Meier plots to analyze the data. Results Forty-nine patients were analyzed. The median follow-up was 28.46 months. Men and adenocarcinoma histology predominated. Pathologic complete response was observed 19 (39%) patients. Ten-year actuarial overall survival (OS) for adenocarcinoma patients was >60%. In the univariate analysis for OS, squamous histology (p=0.006), smoking (p=0.015), and alcohol consumption (p=0.032) were associated with poor OS. In the univariate analysis for disease-free survival (DFS), squamous histology (p=0.009) and smoking (p=0.014) were associated with poor DFS. In the multivariate analysis for OS, smoking was an independent prognosticator (p=0.02). In the multivariate analysis for DFS, advanced yp stage (p=0.05) and nodal metastases (p=0.006) were independent prognosticators. Patients with adenocarcinoma (p=0.002) and those with ypN0 had better OS and DFS. Upward stage migration occurred in only 10% of patients. Conclusions Our data suggest that smoking and alcohol influence the long-term outcome of cT2N0M0 patients. Adenocarcinoma patients treated with trimodality therapy had an excellent actuarial 10-year OS and a high rate of pathologic complete response. Trimodality therapy should be prospectively compared with primary surgery in these patients. PMID:20960497

  13. Risk factors for adenocarcinoma of the lung

    SciTech Connect

    Brownson, R.C.; Reif, J.S.; Keefe, T.J.; Ferguson, S.W.; Pritzl, J.A.

    1987-01-01

    The relation between various risk factors and adenocarcinoma of the lung was evaluated in a case-control study. Subjects were selected from the Colorado Central Cancer Registry from 1979-1982 in the Denver metropolitan area. A total of 102 (50 males and 52 females) adenocarcinoma case interviews and 131 (65 males and 66 females) control interviews were completed. The control group consisted of persons with cancers of the colon and bone marrow. The risk estimates associated with cigarette smoking were significantly elevated among males (odds ratio (OR) = 4.49) and females (OR = 3.95) and were found to increase significantly (p less than 0.01) with increasing levels of cigarette smoking for both males and females. For adenocarcinoma in females, the age- and smoking-adjusted odds ratios at different levels of passive smoke exposure followed an increasing overall trend (p = 0.05). After additional adjustment for potential confounders, prior cigarette use remained the most significant predictor of risk of adenocarcinoma among males and females. Analysis restricted to nonsmoking females revealed a risk of adenocarcinoma of 1.68 (95% confidence interval (Cl) = 0.39-2.97) for passive smoke exposure of four or more hours per day. Neither sex showed significantly elevated risk for occupational exposures, although males bordered on significance (OR = 2.23, 95% Cl = 0.97-5.12). The results suggest the need to develop cell type-specific etiologic hypotheses.

  14. Chromatin patterns associated with lung adenocarcinoma progression

    PubMed Central

    Druliner, Brooke R.; Fincher, Justin A.; Sexton, Brittany S.; Vera, Daniel L.; Roche, Michael; Lyle, Stephen; Dennis, Jonathan H.

    2013-01-01

    The development and progression of lung adenocarcinoma, one of the most common cancers, is driven by the interplay of genetic and epigenetic changes and the role of chromatin structure in malignant transformation remains poorly understood. We used systematic nucleosome distribution and chromatin accessibility microarray mapping platforms to analyze the genome-wide chromatin structure from normal tissues and from primary lung adenocarcinoma of different grades and stages. We identified chromatin-based patterns across different patients with lung adenocarcinoma of different cancer grade and stage. Low-grade cancers had nucleosome distributions very different compared with the corresponding normal tissue but had nearly identical chromatin accessibility. Conversely, nucleosome distributions of high-grade cancers showed few differences. Substantial disruptions in chromosomal accessibility were seen in a patient with a high-grade and high-stage tumor. These data imply that chromatin structure changes during the progression of lung adenocarcinoma. We have therefore developed a model in which low-grade lung adenocarcinomas are linked to changes in nucleosome distributions, whereas higher-grade tumors are linked to large-scale chromosomal changes. These results provide a foundation for the development of a comprehensive framework linking the general and locus-specific roles of chromatin structure to lung cancer progression. We propose that this strategy has the potential to identify a new class of chromatin-based diagnostic, prognostic and therapeutic markers in cancer progression. PMID:23598721

  15. Mapping the Hallmarks of Lung Adenocarcinoma with Massively Parallel Sequencing

    E-print Network

    Lander, Eric S.

    Lung adenocarcinoma, the most common subtype of non-small cell lung cancer, is responsible for more than 500,000 deaths per year worldwide. Here, we report exome and genome sequences of 183 lung adenocarcinoma tumor/normal ...

  16. Eosinophilic Esophagitis: Interactions with Gastroesophageal Reflux Disease

    PubMed Central

    Cheng, Edaire; Souza, Rhonda F.; Spechler, Stuart Jon

    2014-01-01

    Synopsis Early authorities on eosinophilic esophagitis (EoE) deemed it crucial to distinguish this disorder from gastroesophageal reflux disease (GERD). However, it has become clear that GERD and EoE are not mutually exclusive disorders, and that their interactions can be complex. The notion that GERD and EoE can be distinguished by the response to PPI treatment is based on the assumption that gastric acid suppression is the only important therapeutic effect of PPIs, and therefore only GERD can respond to PPIs. This assumption appears to be incorrect for two major reasons. First, there are multiple mechanisms whereby PPI-induced acid reduction might benefit patients with EoE. Second, PPIs have acid-independent, anti-inflammatory effects that might be beneficial both for GERD and for EoE. Since the PPIs have multiple effects that might benefit both diseases, for patients who have esophageal symptoms and esophageal eosinophilia, we feel that a clinical and/or histological response to PPIs does not rule in GERD, and does not rule out EoE. However, we do recommend a trial of PPI therapy for patients with symptomatic esophageal eosinophilia, even if the diagnosis of EoE seems clear-cut. PMID:24813513

  17. Esophageal cancer revealing a tracheal diverticulum

    PubMed Central

    Zhang, Miao; Wang, Heng; Wu, Wen-Bin

    2015-01-01

    Tracheal diverticulum is a benign entity characterized by single or multiple invaginations of the tracheal wall, and is rarely encountered in clinical practice but frequently in postmortem examination as an incidental finding. Its combination with esophageal cancer is extremely rare. In this case report, we present a patient with these two lesions and analyze their correlation. PMID:25973258

  18. Esophageal function testing: beyond manometry and impedance.

    PubMed

    Mittal, Ravinder K

    2014-10-01

    Manometry and impedance provide only surrogate information regarding longitudinal wall function and are focused on contractile amplitude and lumen content. Ultrasound imaging provides a unique perspective of esophageal function by providing important information regarding longitudinal muscle contraction. Laser Doppler assessment of perfusion may be an important complementary tool to assess abnormal wall blood perfusion as a possible mechanism of pain. PMID:25216911

  19. Eosinophilic esophagitis: asthma of the esophagus?

    Microsoft Academic Search

    AMINDRA S. ARORA; Kiyoshi Yamazaki

    2004-01-01

    Eosinophilic esophagitis (EE) is rapidly emerging as a distinct disease entity in both pediatric and adult gastroenterology. The typical clinical presentation includes solid food dysphagia in young men who have an atopic predisposition. Food impaction necessitating endoscopic intervention is common. EE should be suspected, in particular, in patients with unexplained dysphagia or those with no response to antacid or anti-acid

  20. Histomorphological and Immunophenotypic Features of Pill-Induced Esophagitis

    PubMed Central

    Kim, Su Hwan; Kim, Won; Lee, Kook Lae; Byeon, Sun-ju; Choi, Euno; Chang, Mee Soo

    2015-01-01

    The aim of this study was to investigate histomorphological and immunophenotypic features in pill-induced esophagitis. We comparatively evaluated the histomorphological, immunophenotypic features of pill-induced esophagitis vs. reflux esophagitis, as well as clinical information and endoscopic findings. Fifty-two tissue pieces from 22 cases of pill-induced esophagitis, 46 pieces from 20 reflux esophagitis, and 16 pieces from 14 control samples were subjected to immunohistochemistry for inflammatory infiltrates (CD3 for T lymphocyte, CD20 for B lymphocyte, CD56 for NK cell, CD68 for macrophage, CD117 for mast cell) and eosinophil chemotaxis-associated proteins (Erk, leptin, leptin receptor, pSTAT3, phospho-mTOR). As a result, Histomorphology showed that a diffuse pattern of dilated intercellular spaces was more frequently observed in pill-induced esophagitis, while reactive atypia and subepithelial papillary elongation were more often found in reflux esophagitis (P < 0.05, respectively). Interestingly, intraepithelial eosinophilic microabscess, intraepithelial pustule and diffuse pattern of dilated intercellular spaces were observed in 14% (3 cases), 9% (2 cases) and 32% (7 cases) of pill-induced esophagitis, respectively, but in no cases of reflux esophagitis. Regarding intraepithelial inflammatory infiltrates in pill-induced esophagitis, T lymphocytes were the most common cells, followed by eosinophil; 11 and 7 in one x400 power field, respectively. Intraepithelial pSTAT3-positive pattern was more frequently observed in pill-induced esophagitis than in reflux esophagitis, at 45% (10 cases) versus 10% (2 cases), respectively (P < 0.05). Considering the distal esophageal lesion only, intraepithelial pustule, diffuse dilated intercellular spaces and stromal macrophages were more frequently found in distal pill-induced esophagitis, whereas reactive atypia and intraepithelial mast cells in reflux esophagitis (P < 0.05, respectively). In conclusion, diffuse dilated intercellular spaces, intraepithelial eosinophil microabscess, pustule, T lymphocytes, eosinophils, and pSTAT3 positivity can be added to histopathological features of pill-induced esophagitis, other than non-specific ulcer. Besides, distal pill-induced esophagitis may be histopathologically differentiated from reflux esophagitis. PMID:26047496

  1. Serum Leptin and Adiponectin Levels and Risk of Barrett's Esophagus and Intestinal Metaplasia of the Gastroesophageal Junction

    Microsoft Academic Search

    Olivia M. Thompson; Shirley A. A. Beresford; Elizabeth A. Kirk; Mary P. Bronner; Thomas L. Vaughan

    2010-01-01

    Persons diagnosed with Barrett's esophagus (BE) are at increased risk of developing esophageal adenocarcinoma (EA). Obesity is a major risk factor for both BE and EA. The primary purposes of this study were to determine whether circulating levels of leptin and adiponectin, both of which are deregulated in obese states, predict risk of specialized intestinal metaplasia (SIM) occurring in the

  2. Bladder metastasis from lung adenocarcinoma: a difficult differential diagnosis with primary bladder adenocarcinoma

    PubMed Central

    2014-01-01

    Background Bladder metastases from lung adenocarcinoma are extremely rare; in the seven previously reported cases, the finding of an intact epithelium overlying the bladder tumour was considered suggestive of a secondary lesion. We describe the first case of bladder metastasis from lung adenocarcinoma whereby endoscopic appearance was strongly consistent with primary bladder cancer, thus complicating the differential diagnosis with primary bladder adenocarcinoma. Case report A 65-year-old woman with a 13-year history of clean intermittent catheterization was diagnosed with a right lung adenocarcinoma metastatic to mediastinal and right supraclavicular nodes, as well as to the left lung, and treated with six cycles of cisplatin/pemetrexed, followed by six cycles of pemetrexed only. The 18-month follow-up computed tomography revealed several solid lesions of the bladder wall and she was scheduled for transurethral resection of bladder tumours. Endoscopic appearance was strongly consistent with primary bladder cancer but a thorough pathologic evaluation allowed the diagnosis of bladder metastasis from lung adenocarcinoma. Conclusions Differentiating primary bladder adenocarcinoma from metastatic adenocarcinoma lesions can be difficult. An endoscopic appearance consistent with primary bladder cancer further complicates the differential diagnosis, which heavily relies on pathologic evaluation and specific immunohistochemical staining. PMID:24716732

  3. Does surgery correct esophageal motor dysfunction in gastroesophageal reflux

    SciTech Connect

    Russell, C.O.; Pope, C.E.; Gannan, R.M.; Allen, F.D.; Velasco, N.; Hill, L.D.

    1981-09-01

    The high incidence of dysphagia in patients with symptomatic gastroesophageal reflux (GER) but no evidence of peptic stricture suggests esophageal motor dysfunction. Conventional methods for detecting dysfunction (radiologic and manometric examinations) often fail to detect abnormality in these patients. Radionuclide transit (RT), a new method for detecting esophageal motor dysfunction, was used to prospectively assess function in 29 patients with symptomatic GER uncomplicated by stricture before and three months after antireflux surgery (HILL). The preoperative incidence of dysphagia and esophageal dysfunction was 73% and 52%, respectively. During operation (Hill repair), intraoperative measurement of the lower esophageal sphincter pressure was performed and the LESP raised to levels between 45 and 55 mmHg. The preoperative lower esophageal sphincter pressure was raised from a mean of 8.6 mmHg, to mean of 18.5 mmHg after operation. No patient has free reflux after operation. Postoperative studies on 20 patients demonstrated persistence of all preoperative esophageal dysfunction despite loss of dysphagia. RT has demonstrated a disorder of esophageal motor function in 52% of patients with symptomatic GER that may be responsible for impaired esophageal clearance. This abnormality is not contraindication to surgery. The results indicate that construction of an effective barrier to reflex corrects symptoms of reflux, even in the presence of impaired esophageal transit. Radionuclide transit is a safe noninvasive test for assessment of esophageal function.

  4. Prostatic adenocarcinoma presenting as isolated inguinal lymphadenopathy.

    PubMed

    Doreswamy, Kanakaiah; Karthikeyan, Vilvapathy Senguttuvan; Nagabhushana, Mahadevappa; Shankaranand, Bharatnur

    2015-01-01

    Prostatic adenocarcinoma (CaP) is the most common cancer in males and approximately 50% of patients have metastases at presentation, most commonly spreading to the bones and regional lymph nodes. CaP metastasising to inguinal lymph nodes in the absence of pelvic lymphadenopathy or other metastases is very uncommon. A 66-year-old man presented with isolated left inguinal lymphadenopathy of 3?months duration and a history of lower urinary tract symptoms for 1?year. He had prostatic cancer extending into the bladder base and seminal vesicles on contrast-enhanced CT of the pelvis, and asymptomatic vertebral secondaries on skeletal scintigraphy. Transrectal ultrasound biopsy revealed adenocarcinoma (Gleason score 3+4=7), and inguinal lymph node biopsy showed metastatic adenocarcinoma positive for prostate-specific antigen (PSA). As inguinal lymphadenopathy may also be due to other causes, biopsy is useful and meticulous clinical examination is a must in these patients. PMID:26153290

  5. Non-invasive Predictors of Esophageal Varices

    PubMed Central

    Cherian, Jijo V.; Deepak, Nandan; Ponnusamy, Rajesh Prabhu; Somasundaram, Aravindh; Jayanthi, V.

    2011-01-01

    Background/Aim: Current guidelines recommend screening cirrhotic patients with an endoscopy to detect esophageal varices and to institute prophylactic measures in patients with large esophageal varices. In this study, we aimed at identifying non-endoscopic parameters that could predict the presence and grades of esophageal varices. Patients and Methods: In a prospective study, 229 newly diagnosed patients with liver cirrhosis, without a history of variceal bleeding, were included. Demographic, clinical, biochemical and ultrasonographic parameters were recorded. Esophageal varices were classified as small and large, at endoscopy. Univariate analysis and multivariate logistic regression analysis were done to identify independent predictors for the presence and grades of varices. Results: Of the 229 patients (141 males; median age 42 years; range 17-73 years) with liver cirrhosis, 97 (42.3%) had small and 81 (35.4%) had large varices. On multivariate analysis, low platelet count (Odd’s Ratio [OR], 4.3; 95% confidence interval [CI], 1.2-14.9), Child Pugh class B/C (OR, 3.3; 95% CI, 1.8-6.3), spleen diameter (OR, 4.3; 95% CI, 1.6-11.9) and portal vein diameter (OR, 2.4; 95% CI, 1.1-5.3) were independent predictors for the presence of varices. Likewise, for the presence of large esophageal varices, low platelet count (OR, 2.7; 95% CI, 1.4-5.2), Child Pugh class B/C (OR, 3.8; 95% CI, 2.3-6.5) and spleen diameter (OR, 3.1; 95% CI, 1.6-6.0) were the independent risk factors. Conclusion: The presence and higher grades of varices can be predicted by a low platelet count, Child-Pugh class B/C and spleen diameter. These may be considered as non-endoscopic predictors for the diagnosis and management of large grade varices. PMID:21196656

  6. Obesity, alcohol, and tobacco as risk factors for cancers of the esophagus and gastric cardia: adenocarcinoma versus squamous cell carcinoma.

    PubMed

    Vaughan, T L; Davis, S; Kristal, A; Thomas, D B

    1995-03-01

    Adenocarcinomas of the esophagus and gastric cardia were once rare. However, for unknown reasons, their incidence has been increasing rapidly over the past 15 years in the United States and parts of Western Europe. In contrast, the incidence of esophageal squamous cell carcinomas has remained relatively constant. To investigate possible reasons for these diverging incidence rates we analyzed data from two population-based case-control studies of cancers of the esophagus and gastric cardia that were conducted among male and female residents of western Washington between 1983 and 1990. Information on body mass index, cigarette use, alcohol intake, and other possible risk factors was collected via personal interviews with 404 cases or their next of kin (including 298 adenocarcinomas and 106 squamous cell carcinomas) and 724 controls identified by random digit dialing. Use of alcohol and cigarettes were significant risk factors for both histological types. The increase in risk for current smokers of 80 or more pack-years compared to nonsmokers was substantially higher for squamous cell cancer [odds ratio (OR) = 16.9; 95% confidence interval (CI) = 4.1-69.1] than for adenocarcinoma (OR = 3.4; 95% CI = 1.4-8.0), as was the increase for persons who typically drank 21 or more drinks/week compared to those who drank <7/week (OR = 9.5; 95% CI = 4.1-22.3 versus OR = 1.8; 95% CI = 1.1-3.1). For squamous cell carcinoma, body mass index was inversely associated with risk, whereas for adenocarcinoma, the highest risk was observed among persons who were in the highest decile of body mass index (OR = 1.9; 95% CI = 1.1-3.2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7742727

  7. Esophageal atresia associated with anorectal malformation: Is the outcome better after surgery in two stages in a limited resources scenario?

    PubMed Central

    Singh, Sunita; Wakhlu, Ashish; Pandey, Anand; Singh, Anita; Kureel, Shiv N.; Rawat, Jiledar; Srivastava, Payal Mishra

    2012-01-01

    Aims: To analyze whether outcome of neonates having esophageal atresia with or without tracheoesophageal fistula (EA±TEF) associated with anorectal malformation (ARM) can be improved by doing surgery in 2 stages. Materials and Methods: A prospective study of neonates having both EA±TEF and ARM from 2004 to 2011. The patients with favorable parameters were operated in a single stage, whereas others underwent first-stage decompression surgery for ARM. Thereafter, once septicemia was under control and ventilator care available, second-stage surgery for EA±TEF was performed. Results: Total 70 neonates (single stage = 20, 2 stages = 30, expired after colostomy = 9, only EA±TEF repair needed = 11) were enrolled. The admission rate for this association was 1 per 290. Forty-one percent (24/70) neonates had VACTERL association and 8.6% (6/70) neonates had multiple gastrointestinal atresias. Sepsis screen was positive in 71.4% (50/70). The survival was 45% (9/20) in neonates operated in a single stage and 53.3% (16/30) when operated in 2 stages (P = 0.04). Data analysis of 50 patients revealed that the survived neonates had significantly better birth weight, better gestational age, negative sepsis screen, no cardiac diseases, no pneumonia, and 2-stage surgery (P value 0.002, 0.003, 0.02, 0.02, 0.04, and 0.04, respectively). The day of presentation and abdominal distension had no significant effect (P value 0.06 and 0.06, respectively). This was further supported by stepwise logistic regression analysis. Conclusions: In a limited resources scenario, the survival rate of babies with this association can be improved by treating ARM first and then for EA±TEF in second stage, once mechanical ventilator care became available and sepsis was under control. PMID:22869975

  8. Lung adenocarcinoma metastasizing into a renal angiomyolipoma.

    PubMed

    Wu, Pao-Shu; Pan, Chin-Chen

    2015-05-01

    Tumor-to-tumor metastasis is a very rare phenomenon. The most common donor and recipient of tumor-to-tumor metastasis are carcinomas of lung and renal cell carcinoma, respectively. We report a case of primary lung adenocarcinoma that metastasized into a renal angiomyolipoma 9 years after the resection of primary lung tumor. Comparisons in morphology, immunohistochemical profiles, and genetic mutations indicate that the tumor metastasizing into angiomyolipoma originated from the same clone of previous lung adenocarcinoma. Albeit rare, pathologists should be aware of the possibility of tumor-to-tumor metastasis when confronting a neoplasm exhibiting 2 distinct morphological features. PMID:25691390

  9. Mucinous adenocarcinoma arising from chronic perianal fistula.

    PubMed

    Hisham, Raja B; Sabariah, A R; Yunus, A G

    2006-03-01

    Perianal mucinous adenocarcinoma is a rare tumor which may be associated with long-standing chronic perianal sepsis. Early diagnosis is challenging and is based on a high index of clinical suspicion and specific histological features. Definitive treatment is surgical, in the form of an abdomino-perineal resection. We hereby describe a case of a perianal mucinous adenocarcinoma arising from long-standing recurrent perianal fistula and complement this with a brief review of the literature pertaining in particular to the management of this condition. PMID:16708740

  10. Genetic Features of Metachronous Esophageal Cancer Developed in Hodgkin’s Lymphoma or Breast Cancer Long-Term Survivors: An Exploratory Study

    PubMed Central

    Boldrin, Elisa; Rumiato, Enrica; Fassan, Matteo; Cappellesso, Rocco; Rugge, Massimo; Chiarion-Sileni, Vanna; Ruol, Alberto; Alfieri, Rita; Cagol, Matteo; Castoro, Carlo; Amadori, Alberto; Saggioro, Daniela

    2015-01-01

    Background Development of novel therapeutic drugs and regimens for cancer treatment has led to improvements in patient long-term survival. This success has, however, been accompanied by the increased occurrence of second primary cancers. Indeed, patients who received regional radiotherapy for Hodgkin’s Lymphoma (HL) or breast cancer may develop, many years later, a solid metachronous tumor in the irradiated field. Despite extensive epidemiological studies, little information is available on the genetic changes involved in the pathogenesis of these solid therapy-related neoplasms. Methods Using microsatellite markers located in 7 chromosomal regions frequently deleted in sporadic esophageal cancer, we investigated loss of heterozygosity (LOH) and microsatellite instability (MSI) in 46 paired (normal and tumor) samples. Twenty samples were of esophageal carcinoma developed in HL or breast cancer long-term survivors: 14 squamous cell carcinomas (ESCC) and 6 adenocarcinomas (EADC), while 26 samples, used as control, were of sporadic esophageal cancer (15 ESCC and 11 EADC). Results We found that, though the overall LOH frequency at the studied chromosomal regions was similar among metachronous and sporadic tumors, the latter exhibited a statistically different higher LOH frequency at 17q21.31 (p = 0.018). By stratifying for tumor histotype we observed that LOH at 3p24.1, 5q11.2 and 9p21.3 were more frequent in ESCC than in EADC suggesting a different role of the genetic determinants located nearby these regions in the development of the two esophageal cancer histotypes. Conclusions Altogether, our results strengthen the genetic diversity among ESCC and EADC whether they occurred spontaneously or after therapeutic treatments. The presence of histotype-specific alterations in esophageal carcinoma arisen in HL or breast cancer long-term survivors suggests that their transformation process, though the putative different etiological origin, may retrace sporadic ESCC and EADC carcinogenesis. PMID:25611972

  11. Diffuse esophageal intramural pseudodiverticulosis and nutcracker esophagus in a 54-year-old man.

    PubMed

    Walker, S; Hippéli, R; Goës, R

    1990-02-01

    Esophageal intramural pseudodiverticulosis, which was first described by Mendl et al. in 1960, is characterized by multiple small flask-shaped outpouchings in the esophageal wall. The pseudodiverticula represent dilated excretory ducts of deep mucous glands in the esophagus. The etiology of this rare condition is unknown. Hiatal hernias, gastroesophageal reflux, esophageal strictures, candida esophagitis, herpes esophagitis, diabetes mellitus, and chronic alcoholism have been found associated with intramural pseudodiverticulosis. We report the second case of esophageal hypermotility in intramural pseudodiverticulosis. PMID:2107356

  12. Genes Regulating Epithelial Polarity Are Critical Suppressors of Esophageal Oncogenesis

    PubMed Central

    Li, Xiu-Min; Wang, Hui; Zhu, Li-Li; Zhao, Run-Zhen; Ji, Hong-Long

    2015-01-01

    Esophageal cancer is an aggressive disease featured by early lymphatic and hematogenous dissemination, and is the sixth leading cause of cancer-related deaths worldwide. The proper formation of apicobasal polarity is essential for normal epithelium physiology and tissue homeostasis, while loss of polarity is a hallmark of cancer development including esophageal oncogenesis. In this review, we summarized the stages of esophageal cancer development associated with the loss or deregulation of epithelial cell apicobasal polarity. Loss of epithelial apicobasal polarity exerts an indispensable role in the initiation of esophageal oncogenesis, tumor progression, and the advancement of tumors from benign to malignant. In particular, we reviewed the involvement of several critical genes, including Lkb1, claudin-4, claudin-7, Par3, Lgl1, E-cadherin, and the Scnn1 gene family. Understanding the role of apicobasal regulators may lead to new paradigms for treatment of esophageal tumors, including improvement of prognostication, early diagnosis, and individually tailored therapeutic interventions in esophageal oncology. PMID:26185530

  13. Robot assisted thoracoscopic resection of giant esophageal leiomyoma

    PubMed Central

    Compean, Steven D.; Gaur, Puja; Kim, Min P.

    2014-01-01

    INTRODUCTION Esophageal leiomyoma represents the most common benign esophageal tumor. Robot-assisted thoracoscopic surgery has provided ability to remove it successfully using a minimally invasive approach. PRESENTATION OF CASE A 63-year old female with history of chronic chest pain presented with an esophageal mass on chest CT and endoscopic ultrasound. Robot-assisted surgery was performed using three robot arms, a camera and an assistant port. A 10 cm leiomyoma was enucleated and removed through a 2 cm myotomy. Completion endoscopy confirmed integrity of the esophagus. Patient's chest pain resolved postoperatively, and she was discharged on postoperative day 3. DISCUSSION Our case describes successful removal of the giant esophageal leiomyoma (10 cm) by robot assisted minimally invasive resection through a 2 cm myotomy. CONCLUSION Use of robot allows for removal of large esophageal leiomyoma. The improved dexterity and patient outcome offered by robot suggests its potential as the mainstay technique for giant esophageal leiomyoma removal. PMID:25460487

  14. Esophageal perforation. An unusual presentation with a benign clinical course.

    PubMed

    DeLuca, R F; Tedesco, F J; Ballan, K; Wortzel, E; Rogers, A I

    1977-04-01

    A case of esophageal perforation occurring in a 75-year-old man is presented. The clinical presentation was benign and the diagnosis of esophageal perforation was made incidental to an upper gastrointestinal barium examination. Conservative management consisting of nasogastric suctioning, antibiotics and antacids was effective in minimizing the clinical course. This represents a rare instance of a successful nonsurgical approach to esophageal perforation. PMID:879153

  15. Ambulatory 24-hour esophageal pH monitoring

    Microsoft Academic Search

    G. J. Wiener; T. M. Morgan; J. B. Copper; D. O. Castell; J. W. Sinclair; J. E. Richter

    1988-01-01

    If 24-hour esophageal pH monitoring is to be a useful diagnostic tool, it must reliably discriminate gastroesophageal reflux patients despite daily variations in distal esophageal acid exposure. To address this issue, we studied 53 subjects (14 healthy normals, 14 esophagitis patients, and 25 patients with atypical symptoms) with two ambulatory pH tests performed within 10 days of each other. Intrasubject

  16. Expression of cyclooxygenase-2 in human esophageal squamous cell carcinomas

    Microsoft Academic Search

    Jian-Gang Jiang; Jiang-Bo Tang; Chun-Lian Chen; Bao-Xing Liu; Xiang-Ning Fu; Zhi-Hui Zhu; Wei Qu; Katherine Cianflone; Michael P. Waalkes; Dao-Wen Wang

    2004-01-01

    AIM: To determine whether cyclooxygenase-2 (COX-2) was expressed in human esophageal squamous cell carcinoma. METHODS: Quantitative reverse transcription-polymerase chain reaction (RT-PCR), western blotting, immunohistoc- hemistry and immunofluorescence were used to assess the expression level of COX-2 in esophageal tissue. RESULTS: COX-2 mRNA levels were increased by >80-fold in esophageal squamous cell carcinoma when compared to adjacent noncancerous tissue. COX-2 protein

  17. Altered esophageal pain threshold in irritable bowel syndrome

    Microsoft Academic Search

    Mario Costantini; Giacomo Carlo Sturniolo; Giovanni Zaninotto; Renata D'Incà; Rita Polo; Remo Naccarato; Ermanno Ancona

    1993-01-01

    Gut motility disorders and altered pain perception were reported in patients with irritable bowel syndrome (IBS). To verify foregut involvement in IBS, we studied 30 patients using esophageal manometry and 24-hr pH monitoring of the distal esophagus. Two subgroups of patients underwent esophageal provocative tests (bethanechol 50 µg\\/kg subcutaneously and esophageal balloon distension test). Twelve healthy volunteers formed a control

  18. Esophageal motility impairment in plummer-vinson syndrome

    Microsoft Academic Search

    Roberto O. Dantas; Marcia G. Villanova

    1993-01-01

    Summary We report the case of a 41-year-old woman with Plummer-Vinson syndrome and an esophageal motility disorder. She complained of dysphagia and odynophagia and had cheilitis, glossitis, and hypochromic anemia. An esophageal motility study showed low amplitude of contraction and high intrabolus pressure in the esophageal body. After iron replacement, the patient was free from symptoms, and a new motility

  19. Molecular factors related to metastasis of esophageal squamous cell carcinoma

    Microsoft Academic Search

    Yutaka Shimada; Fumiaki Sato

    2007-01-01

    The aggressive behavior of esophageal cancer leads to a low survival rate for patients with this disease. Isolated esophageal\\u000a cancer cells seem to have the potential for regrowth and metastasis. To control the metastasis of esophageal carcinoma, detailed\\u000a analysis of various molecular and biological factors should be done in each patient. Recent progress in molecular biology\\u000a has revealed that oncogenes,

  20. Gastroesophageal scintigraphy and endoscopy in the diagnosis of esophageal reflux and esophagitis

    SciTech Connect

    Fung, W.P.; Van der Schaaf, A.; Grieve, J.C.

    1985-04-01

    The value of gastroesophageal (G/E) scintigraphy in the diagnosis of gastroesophageal reflux was assessed in 51 subjects, who presented with heartburn and had endoscopic evidence of reflux esophagitis. G/E scintigraphy was done using /sup 99m/Tc sulfur-colloid in acidified orange juice. The G/E reflux index was calculated according to previous reports. The mean (+/- SD) G/E reflux index in 18 patients with severe esophagitis and 30 patients with moderate esophagitis were 1.6% (+/- 1.5) and 3.2% (+/- 5.0), respectively. The mean G/E reflux index in 14 control subjects was 2.4% (+/- 1.1). There was no significant difference between the esophagitis and control groups. Furthermore, if 4% was taken as upper limit of normal, this will include almost all the esophagitis patients and controls. It is concluded that the G/E reflux index based on G/E scintigraphy is of little value in the diagnosis of G/E reflux.

  1. Esophageal Motor Disorders in Terms of High-Resolution Esophageal Pressure Topography: What Has Changed?

    PubMed Central

    Kahrilas, Peter J.

    2010-01-01

    The concept of high-resolution manometry (HRM) is to use sufficient pressure sensors such that intraluminal pressure can be monitored as a continuum along luminal length much as time is viewed as a continuum in conventional manometry. When HRM is coupled with pressure topography plots, pressure amplitude is transformed into spectral colors with isobaric conditions indicated by same-colored regions on the display. Together, these technologies are called high-resolution esophageal pressure topography (HREPT). HREPT has several advantages compared with conventional manometry, the technology that it was designed to replace. (i) The contractility of the entire esophagus can be viewed simultaneously in a uniform format, (ii) standardized objective metrics can be systematically applied for interpretation, and (iii) topographic patterns of contractility are more easily recognized and have greater reproducibility than with conventional manometry. Compared with conventional manometry, HREPT has improved sensitivity for detecting achalasia, largely due to the objectivity and accuracy with which it identifies impaired esophagogastric junction (EGJ) relaxation. In addition, it has led to the subcategorization of achalasia into three clinically relevant subtypes based on the contractile function of the esophageal body: classic achalasia, achalasia with esophageal compression, and spastic achalasia. Headway has also been made in understanding hypercontractile conditions, including diffuse esophageal spasm and a newly described entity, spastic nutcracker. Ultimately, clinical experience will be the judge, but it seems likely that HREPT data, along with its well-defined functional implications, will improve the clinical management of esophageal motility disorders. PMID:20179690

  2. Pancreatic ductal adenocarcinoma screening: New perspectives

    PubMed Central

    Pezzilli, Raffaele; Fabbri, Dario; Imbrogno, Andrea

    2012-01-01

    Pancreatic ductal adenocarcinoma accounts for more than 90% of all pancreatic cancers and its incidence has increased significantly worldwide. Patients with pancreatic ductal adenocarcinoma have a poor outcome and more than 95% of the people affected die from the disease within 12 mo after diagnosis. Surgery is the first-line treatment in the case of resectable neoplasm, but only 20% of patients are candidates for this approach. One of the reasons there are few candidates for surgery is that, during the early phases of the disease, the symptoms are poor or non-specific. Early diagnosis is of crucial importance to improve patient outcome; therefore, we are looking for a good screening test. The screening test must identify the disease in an early stage in order to be effective; having said this, a need exists to introduce the concept of “early” ductal adenocarcinoma. It has been reported that at least five additional years after the occurrence of the initiating mutation are required for the acquisition of metastatic ability of pancreatic adenocarcinoma and patients die an average of two years thereafter. We have reviewed the most recent literature in order to evaluate the present and future perspectives of screening programs of this deadly disease. PMID:23049204

  3. Reflux, Barrett's oesophagus and adenocarcinoma: burning questions

    Microsoft Academic Search

    Laura J. Hardie; Christopher P. Wild

    2003-01-01

    The incidence of oesophageal adenocarcinoma is increasing rapidly in Western populations. Gastro-oesophageal reflux disease is a strong risk factor for both this tumour and the pre-cancerous lesion Barrett's oesophagus, but the underlying disease mechanisms remain unclear. Developing a better understanding of the aetiology and pathogenesis of Barrett's oesophagus, including the induction of DNA damage and genetic alterations, might provide opportunities

  4. Eosinophilic esophagitis as paraneoplastic syndrome in a patient with ganglioneuroblastoma.

    PubMed

    Prader, S; Spalinger, J; Caduff, J; Hürlimann, S; Rischewski, J

    2015-05-01

    A 16-month-old boy presented with failure to thrive despite sufficient caloric intake, hypersalivation, abdominal pain, chronic diarrhea and blepharitis. An eosinophilic esophagitis (EoE) was diagnosed by esophageal biopsy. Dietary restrictions and topical steroid treatment lead to no improvement. Further diagnostic work-up revealed an intrathoracal, paraspinal ganglioneuroblastoma. After operative extirpation of the tumour, all initial symptoms resolved. An esophageal control biopsy 4 weeks after tumour resection was normal. This is the first report of eosinophilic esophagitis as part of a paraneoplastic syndrome in a patient with a malignant disease other than a carcinoma. PMID:25985452

  5. Investigation of intra-esophageal air kinetics and esophageal sphincters in patients with total laryngectomy during esophageal speech.

    PubMed

    Bozan, Aykut; Vardar, Rukiye; Akyildiz, Serdar; Kirazli, Tayfun; Ogut, Fatih; Yildirim, Esra; Bor, Serhat

    2015-08-01

    The purpose of this study was to evaluate the air kinetics of well- and poor-speaking patients and their upper (UES) and lower (LES) esophageal sphincter pressures . The esophageal speech capability of 23 total laryngectomy patients was assessed with the Wepman scale. LES and UES points and pressures were measured, and air kinetics were compared. All patients were male, with an average age of 58 years. Both the LES and UES pressures were not statistically different between good-speaking and poor-speaking patients (p > 0.05). The ability to speak was estimated only by looking at tracings. Good speakers are able to retain air successfully and on a long-term basis between the upper and lower esophageal sphincters. During short and/or rapid speech, these patients are able to rapidly suck and then expel the air from their upper esophagus. During long speeches, after sucking the air into their distal esophagus, they used the air in the upper part of the esophagus during the speech, only later seeming to fill the lower esophagus with the air as a possible reserve in the stomach. It has been shown that the basic requirement for speaking is the capacity to suck and store the air within the esophagus. For successful speech, the air should be stored inside the esophagus. MII technology contributes to our understanding of speech kinetics and occupies an important place in patient training as a biofeedback technique. PMID:25763572

  6. Eosinophils in the Esophagus—Peptic or Allergic Eosinophilic Esophagitis? Case Series of Three Patients with Esophageal Eosinophilia

    Microsoft Academic Search

    Peter Ngo; Glenn T. Furuta; Donald A. Antonioli; Victor L. Fox

    2006-01-01

    OBJECTIVES:Scattered eosinophils in the distal esophagus traditionally provide the hallmark for peptic esophagitis, but the upper limit of eosinophils and the longitudinal extent of peptic inflammation along the esophagus are unknown. Recently, adults and children with upper intestinal symptoms and >20 eosinophils\\/high-power field (eos\\/HPF) have been given the diagnosis of allergic esophagitis. Standardized diagnostic criteria for allergic esophagitis are lacking

  7. Eosinophilic Esophagitis in Brazilian Pediatric Patients

    PubMed Central

    Pinheiro, Mayra Isabel Correia; de Góes Cavalcanti, Luciano Pamplona; Honório, Rodrigo Schuler; de Alencar Moreno, Luís Hélder; Fortes, Mayara Carvalho; da Silva, Carlos Antônio Bruno

    2013-01-01

    We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils. PMID:24106430

  8. Esophageal perforation in a sword swallower.

    PubMed

    Scheinin, S A; Wells, P R

    2001-01-01

    We present the case of a 59-year-old man who sustained an esophageal perforation as a result of sword swallowing. An esophagogram established the diagnosis, and surgical repair was attempted. However, 19 days later, a persistent leak and deterioration of the patient's condition necessitated a transhiatal esophagectomy with a left cervical esophagogastrostomy. The patient recovered and has resumed his daily activities at the circus, with the exception of sword swallowing. This case report presents an unusual mechanism for a potentially lethal injury. Our search of the English-language medical literature revealed no other report of esophageal perforation resulting from sword swallowing. Management of such an injury is often difficult, and a favorable outcome is dependent on prompt diagnosis and treatment. PMID:11330747

  9. Esophageal Perforation in a Sword Swallower

    PubMed Central

    Scheinin, Scott A.; Wells, Patrick R.

    2001-01-01

    We present the case of a 59-year-old man who sustained an esophageal perforation as a result of sword swallowing. An esophagogram established the diagnosis, and surgical repair was attempted. However, 19 days later, a persistent leak and deterioration of the patient's condition necessitated a transhiatal esophagectomy with a left cervical esophagogastrostomy. The patient recovered and has resumed his daily activities at the circus, with the exception of sword swallowing. This case report presents an unusual mechanism for a potentially lethal injury. Our search of the English-language medical literature revealed no other report of esophageal perforation resulting from sword swallowing. Management of such an injury is often difficult, and a favorable outcome is dependent on prompt diagnosis and treatment. PMID:11330747

  10. Peroral endoscopic myotomy for esophageal achalasia

    PubMed Central

    Inoue, Haruhiro; Ikeda, Haruo; Sato, Hiroki; Sato, Chiaki; Hokierti, Chananya

    2014-01-01

    Peroral endoscopic myotomy (POEM) is one of the alternative treatment for achalasia. Due to concept of natural orifice transluminal endoscopic surgery (NOTES), it becomes popular and widely accepted. With the endoluminal technique, submucosal tunnel was created followed by endoscopic myotomy. POEM is not only indicated in classical achalasia but also other abnormal esophageal motility disorders. Moreover, failures of endoscopic treatment or surgical attempted cases are not contraindicated for POEM. The second attempted POEM is also safe and technically feasible. Even though the legend of success of POEM is fruitful, the possible complications are very frightened. Good training and delicate practice will reduce rate of complications. This review provides a summary of current state-of-the-art of POEM, including indication equipments, technique and complications. This perfect procedure may become the treatment of choice of achalasia and some esophageal motility disorders in the near future. PMID:25333007

  11. Successful tubes treatment of esophageal fistula

    PubMed Central

    Zhou, Ning; Chen, Wei-xing; Li, You-ming; Xiang, Zhun; Gao, Ping; Fang, Ying

    2007-01-01

    Aim: To discuss the merits of “tubes treatment” for esophageal fistula (EF). Methods: A 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful “three tubes treatment” (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nutritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He too was treated conservatively with the three tubes strategy as mentioned above towards a favorable outcome. Results: The two patients recovered with the tubes treatment, felt well and became able to eat and drink, presenting no complaint. Conclusion: Tubes treatment is an effective basic way for EF. It may be an alternative treatment option. PMID:17910112

  12. Medical management of iatrogenic esophageal perforations

    Microsoft Academic Search

    Ryan D. Madanick

    2008-01-01

    Opinion statement  Esophageal perforation is an uncommon, potentially disastrous occurrence with high mortality rates even when managed with\\u000a surgery. Over the past few decades, several case series have shown that nonoperative management is a feasible option in some\\u000a patients, although the criteria for selecting such patients are neither firmly established nor accepted by all those who manage\\u000a these critical patients. The

  13. Significance of feeding dysfunction in eosinophilic esophagitis

    PubMed Central

    Menard-Katcher, Calies; Henry, Michelle; Furuta, Glenn T; Atkins, Dan; Maune, Nancy Creskoff; Haas, Angela M

    2014-01-01

    Feeding dysfunction is a frequent presenting symptom of eosinophilic esophagitis (EoE). Here we present 3 children of various ages whose manifestations of EoE associated feeding dysfunction led to significant and life altering impact on their growth and development. Early identification of presenting symptoms of EoE will allow for prompt diagnosis and initiation of appropriate treatments. Recognition of salient features of dysfunction and treatment by feeding therapists and nutritionists led to symptom resolution and growth. PMID:25152606

  14. Ambulatory esophageal pH testing

    Microsoft Academic Search

    J. Patrick Shoenut; Clifford S. Yaffe

    1996-01-01

    Over a 30-month period, 867 esophageal pH studies were conducted in a Canadian teaching hospital; of these, 315 tests were recorded in patients who were first-time referrals having no chest or upper gastrointestinal surgery and taking no medication that would affect the results. Patients were referred by gastroenterologists, general surgeons, ENT surgeons, thoracic surgeons, and a miscellaneous group. Patients were

  15. Total Thoracic Esophagectomy for Esophageal Cancer

    Microsoft Academic Search

    Vladimir A Anikin; Kieran G McManus; Alastair N Graham; James A McGuigan

    1997-01-01

    Background: Many current methods of esophageal resection have drawbacks that result in inadequate proximal resection, inadequate lymphadenectomy, and difficult gastric and splenic access. We describe a technique that allows reliable and safe access to the chest, abdomen, and neck.Study Design: From 1988 to 1995, 113 patients (82 men; mean age 65.3 ± 4.5 years) with carcinoma of the esophagus or

  16. Esophageal squamous cell carcinoma: Pathology and prognosis

    Microsoft Academic Search

    Hiroko Ide; Tsutomu Nakamura; Kazuhiko Hayashi; Takeshi Endo; Ataru Kobayashi; Reiki Eguchi; Fujio Hanyu

    1994-01-01

    Between 1985 and 1992 a total of 403 patients with resected thoracic esophageal squamous cell carcinoma were evaluated histopathologically, and various pathologic findings related to survival were examined. Concerning depth of tumor invasion, 8 (2%) cases were pTis, 110 (27%) were pT1, 48 (12%) were pT2, 202 (50%) were pT3, and 35 (9%) were pT4. Lymphatic invasion was detected in

  17. Eosinophilic Esophagitis in Infants and Toddlers

    Microsoft Academic Search

    Scott P. Pentiuk; Claire Kane Miller; Ajay Kaul

    2007-01-01

    Feeding refusal is often described in conjunction with the diagnosis of eosinophilic esophagitis (EE) in pediatric patients;\\u000a however, there are little data regarding the specific clinical manifestations and effective management of this condition in\\u000a very young children. The aim of this study was to evaluate the presentation of EE in infants and toddlers referred to the\\u000a Interdisciplinary Feeding Team Clinic

  18. EAS selection in the EMMA underground array

    NASA Astrophysics Data System (ADS)

    Sarkamo, J.; Bezrukov, L.; Enqvist, T.; Fynbo, H.; Inzhechik, L.; Joutsenvaara, J.; Kalliokoski, T.; Kuusiniemi, P.; Loo, K.; Lubsandorzhiev, B.; Monto, T.; Petkov, V.; Räihä, T.; Slupecki, M.; Trzaska, W. H.; Virkajärvi, A.

    2013-02-01

    The first measurements of the Experiment with MultiMuon Array (EMMA) have been analyzed for the selection of the Extensive Air Showers (EAS). Test data were recorded with an underground muon tracking station and a satellite station separated laterally by 10 metres. Events with tracks distributed over all of the tracking detector area and even extending over to the satellite station are identified as EAS. The recorded multiplicity spectrum of the events is in general agreement with CORSIKA EAS simulation and demonstrates the array's capability of EAS detection.

  19. HER2-positive, trastuzumab-resistant metastatic esophageal cancer presenting with brain metastasis after durable response to dual HER2 blockade: a case report

    PubMed Central

    Gelbspan, Deborah; Weitz, David; Markman, Maurie; Quan, Walter

    2014-01-01

    We here report a case of a patient diagnosed with human epithelial growth factor receptor 2 (HER2)-amplified esophageal adenocarcinoma. The patient responded well to trastuzumab-based chemotherapy initially, but progressed with liver metastases. Her treatment was then switched to dual HER2 blockade with both trastuzumab and lapatinib in combination with capecitabine. She tolerated therapy and responded remarkably well with radiographic resolution of liver metastases. Unfortunately, she developed multiple brain metastases in the absence of extracranial progression. Discordant negative expression of HER2 and subclonal mutations in brain lesions were discovered, which, at least in part, explained her brain metastases in the presence of capecitabine and lapatinib, as both agents are known to be able to cross the blood brain barrier. The potential mechanism for dual HER2 blockade is discussed in the context of HER2-positive, trastuzumab-resistant, advanced esophageal cancer. The incidence of brain metastasis in advanced gastro-esophageal cancer has been reported to be extremely low, but is expected to increase with more effective systemic therapy. The intratumoral heterogeneity between the metastases, local recurrences and the primary tumor is definitely noteworthy. PMID:25436131

  20. HER2-positive, trastuzumab-resistant metastatic esophageal cancer presenting with brain metastasis after durable response to dual HER2 blockade: a case report.

    PubMed

    Niu, Jiaxin; Gelbspan, Deborah; Weitz, David; Markman, Maurie; Quan, Walter

    2014-12-01

    We here report a case of a patient diagnosed with human epithelial growth factor receptor 2 (HER2)-amplified esophageal adenocarcinoma. The patient responded well to trastuzumab-based chemotherapy initially, but progressed with liver metastases. Her treatment was then switched to dual HER2 blockade with both trastuzumab and lapatinib in combination with capecitabine. She tolerated therapy and responded remarkably well with radiographic resolution of liver metastases. Unfortunately, she developed multiple brain metastases in the absence of extracranial progression. Discordant negative expression of HER2 and subclonal mutations in brain lesions were discovered, which, at least in part, explained her brain metastases in the presence of capecitabine and lapatinib, as both agents are known to be able to cross the blood brain barrier. The potential mechanism for dual HER2 blockade is discussed in the context of HER2-positive, trastuzumab-resistant, advanced esophageal cancer. The incidence of brain metastasis in advanced gastro-esophageal cancer has been reported to be extremely low, but is expected to increase with more effective systemic therapy. The intratumoral heterogeneity between the metastases, local recurrences and the primary tumor is definitely noteworthy. PMID:25436131

  1. Distinct clinicopathologic characteristics of lung mucinous adenocarcinoma with KRAS mutation.

    PubMed

    Ichinokawa, Hideomi; Ishii, Genichiro; Nagai, Kanji; Kawase, Akikazu; Yoshida, Junji; Nishimura, Mitsuyo; Hishida, Tomoyuki; Ogasawara, Naomi; Tsuchihara, Katsuya; Ochiai, Atsushi

    2013-12-01

    Primary mucinous adenocarcinomas are uncommon, and their pathogenesis remains unclear. We recently reported the clinicopathologic characteristics of surgically resected mucinous adenocarcinoma, including the frequent involvement of the left and lower lung and absence of central fibrosis. The present study attempted to clarify the pathogenesis of mucinous adenocarcinoma based on KRAS mutation status. We selected 45 mucinous adenocarcinoma cases from among 2474 surgically resected primary lung adenocarcinomas. Of these, 22 had a KRAS mutation (48.9%), whereas only 7 (15.6%) had an epidermal growth factor receptor mutation, and 2 cases had both mutations. The mucinous adenocarcinomas with KRAS mutations were located in the lower lung lobe significantly more often (P < .05) than were tumors without KRAS mutation. The mucinous adenocarcinoma cases with KRAS mutations also had a significantly lower frequency of nuclear atypia (P < .05). We compared the degree of immunostaining for matrix metalloproteinase-7 (MMP-7), laminin-5, and geminin in the mucinous adenocarcinoma with and without KRAS mutation. The proportion of geminin-positive cells was lower among the cases with a mutation than among those without (0.7% versus 2.1%; P < .05). No significant differences in the extent of staining of the other markers were observed between the groups. The current study clearly demonstrated that mucinous adenocarcinomas with KRAS mutations have clinicopathologic characteristics different from those of mucinous adenocarcinoma without such mutations. PMID:24119562

  2. Increasing toxicity during neoadjuvant radiochemotherapy as positive prognostic factor for patients with esophageal carcinoma.

    PubMed

    Hennies, S; Hermann, R M; Gaedcke, J; Grade, M; Hess, C F; Christiansen, H; Wolff, H A

    2014-01-01

    The aim of this study was to correlate acute organ toxicity during preoperative radiochemotherapy with overall survival and tumor regression for patients with primarily operable esophageal carcinoma. From 1995 to 2002, 60 patients with primarily operable esophageal carcinoma were treated in a preoperative setting at our department. Thirty-three percent of the patients had International Union against Cancer (UICC)-stage II tumors, 62% had UICC-stage III tumors, and 5% had UICC-stage IVA tumors. All patients received irradiation (40?Gy at 2?Gy/fraction). Chemotherapy for all patients with adenocarcinoma and, from 2001, also for patients with squamous cell carcinoma consisted of two cycles, 5-fluorouracil and cisplatinum; between 1995 and 2001, patients with squamous cell carcinoma received three courses of chemotherapy (folinic acid, etoposide, 5-fluorouracil, and cisplatinum every 3 weeks) before and further cisplatinum and etoposide during radiotherapy. We found a significant correlation between acute organ toxicity and histopathological tumor regression, as well as overall survival. The probability to achieve tumor regression grade 1 after radiochemotherapy was nearly four times higher for patients with worsening of odynophagia than for those without an increase (odds ratio: 3.97). Patients with worsening of odynophagia had a 5-year overall-survival rate of 66% compared with 39% in patients without (P = 0.048). Our data indicate that normal tissue and tumor tissue may behave similar with respect to treatment response, as acute organ toxicity showed to be an independent prognostic marker in our patient population. The hypothesis should be further analyzed on biomolecular and clinical level in future clinical trials. PMID:23574528

  3. A novel approach to cancer staging: application to esophageal cancer

    PubMed Central

    Blackstone, Eugene H.; Apperson-Hansen, Carolyn; Rice, Thomas W.

    2009-01-01

    A novel 3-step random forests methodology involving survival data (survival forests), ordinal data (multiclass forests), and continuous data (regression forests) is introduced for cancer staging. The methodology is illustrated for esophageal cancer using worldwide esophageal cancer collaboration data involving 4627 patients. PMID:19502615

  4. Evolving Options in the Management of Esophageal Perforation

    Microsoft Academic Search

    Clayton J. Brinster; Sunil Singhal; Lawrence Lee; M. Blair Marshall; Larry R. Kaiser; John C. Kucharczuk

    2004-01-01

    Esophageal perforation remains a devastating event that is difficult to diagnose and manage. The majority of injuries are iatrogenic and the increasing use of endo- scopic procedures can be expected to lead to an even higher incidence of esophageal perforation in coming years. Accurate diagnosis and effective treatment depend on early recognition of clinical features and accurate interpretation of diagnostic

  5. Photodynamic Therapy for Barrett's Esophagus and Esophageal Carcinoma.

    PubMed

    Qumseya, Bashar J; David, Waseem; Wolfsen, Herbert C

    2013-01-01

    This paper reviews the use of photodynamic therapy (PDT) in patients with Barrett's esophagus and esophageal carcinoma. We describe the history of PDT, mechanics, photosensitizers for PDT in patients with esophageal disease. Finally, we discuss its utility and limitations in this setting. PMID:23423151

  6. Vitamin supplement use and risk for oral and esophageal cancer

    Microsoft Academic Search

    Jeanine Barone; Emanuela Taioli; James R. Hebert; Ernst L. Wynder

    1992-01-01

    In a hospital?based case?control study, 290 oral cancer cases and 133 esophageal cancer cases were queried as to smoking status, alcohol consumption, and dietary exposures, including vitamin supplement history. Among oral cancer cases, vitamin E use appeared to exert a protective effect. Vitamins C and E had protective effects among esophageal cancer cases. When stratified by smoking status, the protective

  7. Eosinophilic Esophagitis: Red on Microscopy, White on Endoscopy

    Microsoft Academic Search

    Alex Straumann; Hans-Peter Spichtin; Kathleen A. Bucher; Pius Heer; Hans-Uwe Simon

    2004-01-01

    Background\\/Aims: The presenting symptom of eosinophilic esophagitis, a chronic TH2-type inflammatory disease, is uniform dysphagia attacks. Histology reveals a dense mucosal infiltration with eosinophils. Unfortunately, endoscopic findings are often unremarkable or misleading. This study characterizes the endoscopic manifestations of eosinophilic esophagitis and analyzes the nature and clinical features of the frequently observed white alterations. Methods: Thirty adult patients (22 males,

  8. Clinical and Endoscopic Features of Eosinophilic Esophagitis in Adults

    Microsoft Academic Search

    John Croese; Stephen K. Fairley; John W. Masson; André K. H. Chong; David A. Whitaker; Peter A. Kanowski; Neal I. Walker

    2003-01-01

    BackgroundEosinophilic esophagitis in adults is regarded as unusual, being diagnosed mostly in young men presenting with dysphagia. Mucosal furrows are a sentinel endoscopic feature. This study examined the demographic and clinical profile of adults with eosinophilic esophagitis seen from 1981 to 2002.

  9. Tea and coffee consumption and risk of esophageal cancer: the European prospective investigation into cancer and nutrition study.

    PubMed

    Zamora-Ros, Raul; Luján-Barroso, Leila; Bueno-de-Mesquita, H Bas; Dik, Vincent K; Boeing, Heiner; Steffen, Annika; Tjønneland, Anne; Olsen, Anja; Bech, Bodil Hammer; Overvad, Kim; Boutron-Ruault, Marie-Christine; Racine, Antoine; Fagherazzi, Guy; Kuhn, Tilman; Katzke, Verena; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Tumino, Rosario; Panico, Salvatore; Vineis, Paolo; Grioni, Sara; Palli, Domenico; Weiderpass, Elisabete; Skeie, Guri; Huerta, José María; Sánchez, María-José; Argüelles, Marcial; Amiano, Pilar; Ardanaz, Eva; Nilsson, Lena; Wallner, Bengt; Lindkvist, Björn; Wallström, Peter; Peeters, Petra H M; Key, Timothy J; Khaw, Kay-Thee; Wareham, Nicholas J; Freisling, Heinz; Stepien, Magdalena; Ferrari, Pietro; Gunter, Marc J; Murphy, Neil; Riboli, Elio; González, Carlos A

    2014-09-15

    Epidemiological data regarding tea and coffee consumption and risk of esophageal cancer (EC) is still inconclusive. We examined the association of tea and coffee consumption with EC risk among 442,143 men and women without cancer at baseline from 9 countries of the European Prospective Investigation into Cancer and Nutrition. Tea and coffee intakes were recorded using country-specific validated dietary questionnaires. Cox regression models were used to analyze the relationships between tea and coffee intake and EC risk. During a mean follow-up of 11.1 years, 339 participants developed EC, of which 142 were esophageal adenocarcinoma (EAC) and 174 were esophageal squamous cell carcinoma (ESCC). In the multivariable models, no significant associations between tea (mostly black tea), and coffee intake and risk of EC, EAC and ESCC were observed. In stratified analyses, among men coffee consumption was inversely related to ESCC (HR for comparison of extreme tertiles 0.42, 95% CI 0.20-0.88; p-trend=0.022), but not among women. In current smokers, a significant and inverse association was observed between ESCC risk and tea (HR 0.46, 95% CI 0.23-0.93; p-trend=0.053) and coffee consumption (HR 0.37, 95% CI 0.19-0.73; p-trend=0.011). However, no statistically significant findings were observed using the continuous variable (per 100 mL/d). These data did not show a significant association between tea and coffee consumption and EC, EAC and ESCC, although a decreased risk of ESCC among men and current smokers is suggested, but need to be confirmed in further prospective studies including more cases. PMID:24535727

  10. Cox2 and ?-Catenin/T-cell Factor Signaling Intestinalize Human Esophageal Keratinocytes When Cultured under Organotypic Conditions12

    PubMed Central

    Kong, Jianping; Crissey, Mary Ann S; Stairs, Douglas B; Sepulveda, Antonia R; Lynch, John P

    2011-01-01

    The incidence of esophageal adenocarcinoma (EAC) is rising in the United States. An important risk factor for EAC is the presence of Barrett esophagus (BE). BE is the replacement of normal squamous esophageal epithelium with a specialized columnar epithelium in response to chronic acid and bile reflux. However, the emergence of BE from squamous keratinocytes has not yet been demonstrated. Our research has focused on this. Wnt and cyclooxygenase 2 (Cox2) are two pathways whose activation has been associated with BE and progression to EAC, but their role has not been tested experimentally. To explore their contribution, we engineered a human esophageal keratinocyte cell line to express either a dominant-active Wnt effector CatCLef or a Cox2 complementary DNA. In a two-dimensional culture environment, Cox2 expression increases cell proliferation and migration, but neither transgene induces known BE markers. In contrast, when these cells were placed into three-dimensional organotypic culture conditions, we observed more profound effects. CatCLef-expressing cells were more proliferative, developed a thicker epithelium, and upregulated Notch signaling and several BE markers including NHE2. Cox2 expression also increased cell proliferation and induced a thicker epithelium. More importantly, we observed cysts form within the epithelium, filled with intestinal mucins including Muc5B and Muc17. This suggests that Cox2 expression in a three-dimensional culture environment induces a lineage of mucin-secreting cells and supports an important causal role for Cox2 in BE pathogenesis. We conclude that in vitro modeling of BE pathogenesis can be improved by enhancing Wnt signaling and Cox2 activity and using three-dimensional organotypic culture conditions. PMID:21969813

  11. Sarcoidosis of the pancreas mimicking adenocarcinoma

    PubMed Central

    Mayne, Alistair Ivan William; Ahmad, Jawad; Loughrey, Maurice; Taylor, Mark A

    2013-01-01

    Primary sarcoidosis of the pancreas is extremely rare. Clinical presentation is often identical to that of pancreatic adenocarcinoma. Preoperative diagnosis of primary pancreatic sarcoidosis is always challenging. We present a 52-year-old man who developed weight loss and obstructive jaundice. Abdomino-pelvic CT scan showed a mass in the pancreatic head. After  hepatopancreaticobiliary MDT discussion, a Whipple's procedure was attempted but the mass was deemed unresectable due to invasion of the superior mesenteric vein. Upon completion of palliative chemotherapy, repeat imaging showed significant mass shrinkage. A reattempt Whipple's procedure was successfully undertaken. Histology showed changes of chronic pancreatitis and peripancreatic granulomatous inflammation with no evidence of malignancy and a diagnosis of sarcoidosis was made. Owing to the devastating nature of pancreatic adenocarcinoma, any mass in the pancreas must be thoroughly investigated before a definitive diagnosis is made. PMID:23784760

  12. Promising new therapies in advanced pancreatic adenocarcinomas.

    PubMed

    Kundranda, Madappa; Kachaamy, Toufic

    2014-12-01

    Pancreatic ductal adenocarcinoma is a lethal disease due to late diagnosis, early metastasis and the lack of effective therapies. In patients with metastatic disease, 1-year survival ranges from 17 to 23% and 5-year survival is less than 5%. This necessitates an urgent need for developing more effective therapies. Targeting the neoplastic cells has been largely ineffective due to the dense stroma, which is a physical barrier for effective drug delivery and also a source for different factors that promote tumor progression and immunosuppression. In this review, we focus on understanding the complex biology of this tumor as it relates to the evaluation of previously failed molecularly targeted trials and review potential new therapies that are emerging in the treatment of metastatic pancreatic ductal adenocarcinoma. PMID:25531049

  13. Adenocarcinoma associated with tail gut cyst

    PubMed Central

    Wise, Susannah; Maloney-Patel, Nell; Rezac, Craig; Poplin, Elizabeth

    2013-01-01

    Primary adenocarcinomas of the presacral (retrorectal) space are rare. The diagnosis is usually delayed because of non-specific symptoms, and is made after a biopsy or surgery. These carcinomas arise from cystic lesions developing from remnants of the embryological postanal gut containing mucous-secreting epithelium, known as tail gut cysts. The potential for infection, perianal fistulas and most importantly, malignant change warrants an early complete surgical resection. From an oncologist’s perspective, the management of these carcinomas has varied, and has included adjuvant chemotherapy and/or radiation therapy. We describe here a rare case of adenocarcinoma associated with a tail gut cyst that was discovered incidentally and resected by a posterior approach (Kraske procedure). The patient has had clinical and periodic radiologic surveillance without any evidence of cancer recurrence for over a year and a half. PMID:23450681

  14. Proton pump inhibitor responsive esophageal eosinophilia, a distinct disease entity?

    PubMed Central

    Munday, William; Zhang, Xuchen

    2014-01-01

    Recent studies have suggested the existence of a patient population with esophageal eosinophilia that responds to proton pump inhibitor therapy. These patients are being referred to as having proton pump inhibitor responsive esophageal eosinophilia (PPI-REE), which is currently classified as a distinct and separate disease entity from both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE). The therapeutic effect of proton pump inhibitor (PPI) on PPI-REE is thought to act directly at the level of the esophageal mucosa with an anti-inflammatory capacity, and completely independent of gastric acid suppression. The purpose of this manuscript is to review the mechanistic data of the proposed immune modulation/anti-inflammatory role of the PPI at the esophageal mucosa, and the existence of PPI-REE as a distinct disease entity from GERD and EoE. PMID:25132757

  15. HELICOBACTER PYLORI AND GASTROINTESTINAL TRACT ADENOCARCINOMAS

    Microsoft Academic Search

    Richard M. Peek Jr; Martin J. Blaser

    Although gastric adenocarcinoma is associated with the presence of Helicobacter pylori in the stomach, only a small fraction of colonized individuals develop this common malignancy. H. pylori strain and host genotypes probably influence the risk of carcinogenesis by differentially affecting host inflammatory responses and epithelial-cell physiology. Understanding the host-microbial interactions that lead to neoplasia will improve cancer-targeted therapeutics and diagnostics,

  16. Optimal management of resectable gastric adenocarcinoma.

    PubMed

    Buscariollo, Daniela L; Mamon, Harvey J

    2015-08-01

    The worldwide incidence of gastric adenocarcinoma has rapidly declined in the past century, but gastric cancer remains the fifth most common malignancy in the world. Approximately half of all cases of gastric cancer are diagnosed in Eastern Asia. In this review, we provide an overview of the landmark studies investigating neoadjuvant and adjuvant therapies in resectable gastric cancer and highlight ongoing efforts to define optimal population-adapted management strategies. PMID:26165449

  17. Helicobacter pylori and gastrointestinal tract adenocarcinomas

    Microsoft Academic Search

    Martin J. Blaser; Richard M. Peek

    2002-01-01

    Although gastric adenocarcinoma is associated with the presence of Helicobacter pylori in the stomach, only a small fraction of colonized individuals develop this common malignancy. H. pylori strain and host genotypes probably influence the risk of carcinogenesis by differentially affecting host inflammatory responses and epithelial-cell physiology. Understanding the host–microbial interactions that lead to neoplasia will improve cancer-targeted therapeutics and diagnostics,

  18. Understanding EA Dynamics via Population Fitness Distributions

    E-print Network

    George Mason University

    Understanding EA Dynamics via Population Fitness Distributions Elena Popovici epopovic Abstract. It is clear from the study of complex non-linear systems in general, and evolutionary algorithms of understanding how the fitness distribution of an EA population changes over time. 1 Introduction and Background

  19. Advanced esophageal cancer with tracheobronchial fistula successfully treated by?esophageal bypass surgery

    PubMed Central

    Kimura, Masahiro; Ishiguro, Hideyuki; Tanaka, Tatsuya; Takeyama, Hiromitsu

    2015-01-01

    Introduction When esophageal cancer infiltrates the respiratory tract and forms a fistula, a patient’s quality of life falls remarkably. Abstinence from oral feeding is necessary to prevent respiratory complications including pneumonia. Surgery is sometimes necessary to maintain quality of life. The aim of this study was to examine clinical outcomes of esophageal cancer complicated by tracheobronchial fistula. Presentation of case Twelve patients who underwent esophageal bypass between 2006 and 2011 in our hospital were studied. Patient characteristics, therapeutic course, outcome, and operation type were compared. Six patients among 8 who could not tolerate oral feeding could do so after bypass surgery. Ten patients were able to enjoy oral intake up until the last few days of life. Three patients survived for more than 10 months. In spite of undergoing an operation, 1 patient survived for only 2 months and another for 4 months. The only complication was postoperative delirium in 1 patient. Discussion While surgical bypass is more invasive than procedures such as endoscopic stenting, we had few complications after operative intervention and were able to maintain quality of life in our patients. Conclusion This bypass procedure is a treatment option for patients with tracheobronchial fistula from advanced esophageal cancer. PMID:25765740

  20. High Intraepithelial Eosinophil Counts in Esophageal Squamous Epithelium Are Not Specific for Eosinophilic Esophagitis in Adults

    Microsoft Academic Search

    Sonali Rodrigo; Gebran Abboud; Daniel Oh; Steven R. DeMeester; Jeffrey Hagen; John Lipham; Tom R. DeMeester; Parakrama Chandrasoma

    2008-01-01

    OBJECTIVESThe histologic criterion of >20 eosinophils per high power field (hpf) is presently believed to establish the diagnosis of idiopathic eosinophilic esophagitis (IEE). This is based on data that the number of intraepithelial eosinophils in gastroesophageal reflux disease (GERD) is less than 20\\/hpf. This study tests this belief.METHODSPathology records were searched for patients who had an eosinophil count >20\\/hpf in

  1. Reflux Esophagitis: Sequelae and Differential Diagnosis in Infants and Children Including Eosinophilic Esophagitis

    Microsoft Academic Search

    Beverly Barrett Dahms

    2004-01-01

    Gastroesophageal reflux disease (GERD) is a common condition in infants and children and has many clinical mimics. Most pediatric pathology departments process many mucosal biopsies from the proximal gastrointestinal tract to evaluate the presence or absence of reflux esophagitis. Since this subject was last reviewed in the 1997 edition of Perspectives in Pediatric Pathology devoted to gastrointestinal diseases in children

  2. Comprehensive molecular profiling of lung adenocarcinoma

    PubMed Central

    2014-01-01

    Adenocarcinoma of the lung is the leading cause of cancer death worldwide. Here we report molecular profiling of 230 resected lung adenocarcinomas using messenger RNA, microRNA and DNA sequencing integrated with copy number, methylation and proteomic analyses. High rates of somatic mutation were seen (mean 8.9 mutations per megabase). Eighteen genes were statistically significantly mutated, including RIT1 activating mutations and newly described loss-of-function MGA mutations which are mutually exclusive with focal MYC amplification. EGFR mutations were more frequent in female patients, whereas mutations in RBM10 were more common in males. Aberrations in NF1, MET, ERBB2 and RIT1 occurred in 13% of cases and were enriched in samples otherwise lacking an activated oncogene, suggesting a driver role for these events in certain tumours. DNA and mRNA sequence from the same tumour highlighted splicing alterations driven by somatic genomic changes, including exon 14 skipping in MET mRNA in 4% of cases. MAPK and PI(3)K pathway activity, when measured at the protein level, was explained by known mutations in only a fraction of cases, suggesting additional, unexplained mechanisms of pathway activation. These data establish a foundation for classification and further investigations of lung adenocarcinoma molecular pathogenesis. PMID:25079552

  3. Comprehensive molecular profiling of lung adenocarcinoma.

    PubMed

    2014-07-31

    Adenocarcinoma of the lung is the leading cause of cancer death worldwide. Here we report molecular profiling of 230 resected lung adenocarcinomas using messenger RNA, microRNA and DNA sequencing integrated with copy number, methylation and proteomic analyses. High rates of somatic mutation were seen (mean 8.9 mutations per megabase). Eighteen genes were statistically significantly mutated, including RIT1 activating mutations and newly described loss-of-function MGA mutations which are mutually exclusive with focal MYC amplification. EGFR mutations were more frequent in female patients, whereas mutations in RBM10 were more common in males. Aberrations in NF1, MET, ERBB2 and RIT1 occurred in 13% of cases and were enriched in samples otherwise lacking an activated oncogene, suggesting a driver role for these events in certain tumours. DNA and mRNA sequence from the same tumour highlighted splicing alterations driven by somatic genomic changes, including exon 14 skipping in MET mRNA in 4% of cases. MAPK and PI(3)K pathway activity, when measured at the protein level, was explained by known mutations in only a fraction of cases, suggesting additional, unexplained mechanisms of pathway activation. These data establish a foundation for classification and further investigations of lung adenocarcinoma molecular pathogenesis. PMID:25079552

  4. Gene expression profiling in sinonasal adenocarcinoma

    PubMed Central

    2009-01-01

    Background Sinonasal adenocarcinomas are uncommon tumors which develop in the ethmoid sinus after exposure to wood dust. Although the etiology of these tumors is well defined, very little is known about their molecular basis and no diagnostic tool exists for their early detection in high-risk workers. Methods To identify genes involved in this disease, we performed gene expression profiling using cancer-dedicated microarrays, on nine matched samples of sinonasal adenocarcinomas and non-tumor sinusal tissue. Microarray results were validated by quantitative RT-PCR and immunohistochemistry on two additional sets of tumors. Results Among the genes with significant differential expression we selected LGALS4, ACS5, CLU, SRI and CCT5 for further exploration. The overexpression of LGALS4, ACS5, SRI, CCT5 and the downregulation of CLU were confirmed by quantitative RT-PCR. Immunohistochemistry was performed for LGALS4 (Galectin 4), ACS5 (Acyl-CoA synthetase) and CLU (Clusterin) proteins: LGALS4 was highly up-regulated, particularly in the most differentiated tumors, while CLU was lost in all tumors. The expression of ACS5, was more heterogeneous and no correlation was observed with the tumor type. Conclusion Within our microarray study in sinonasal adenocarcinoma we identified two proteins, LGALS4 and CLU, that were significantly differentially expressed in tumors compared to normal tissue. A further evaluation on a new set of tissues, including precancerous stages and low grade tumors, is necessary to evaluate the possibility of using them as diagnostic markers. PMID:19903339

  5. Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma

    PubMed Central

    Gharaibeh, Kamel A.; Yousuf, Tauqeer

    2014-01-01

    Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations. PMID:25309762

  6. Expression of galectin-3 in gastric adenocarcinoma

    PubMed Central

    Gomes, Thiago Simão; Oshima, Celina Tizuko Fujiyama; Forones, Nora Manoukian; De Oliveira Lima, Flávio; Ribeiro, Daniel Araki

    2014-01-01

    Background & objectives: Galectin-3 a member of the galectin family is an endogenous ?-galactoside binding lectin. It has been found to be associated with cell adhesion, recognition, proliferation, differentiation, immunomodulation, angiogenesis, apoptosis and can be a reliable marker for cancer aggressiveness. The aim of this study was to verify protein expression in gastric adenocarcinoma tissues and correlate the results with the clinical aspects in the study population. Methods: Galectin-3 expression was examined by immunohistochemistry in 57 samples of gastric adenocarcinomas tissues. Galectin-3 protein expression was observed in the cytoplasm and the nucleus of examined tissues. Results: Thirty one (54.4%) samples had strong or moderate staining and 26 (45.6%) tumours had negative or weak staining. The galectin-3 did not show association with the sex (P=0.347), age (P=0.999), Lauren's classification (P=0.731) and TNM stage (P=0.222). Regarding the TNM stage, 66.7 per cent of stage I tumours had strong or moderate staining; with tumours stage IV this percentage was 33.3 per cent. Interpretation & conclusion: Our results suggest that gal-3 is not a reliable biomarker for prognosis of the gastric adenocarcinoma by immunohistochemistry. Further studies need to be done on a large sample of tumour tissues in different clinical staging. PMID:25222780

  7. Expression, Tissue Distribution and Function of miR-21 in Esophageal Squamous Cell Carcinoma

    PubMed Central

    Nouraee, Nazila; Van Roosbroeck, Katrien; Vasei, Mohammad; Semnani, Shahriar; Samaei, Nader Mansour; Naghshvar, Farshad; Omidi, Abbas Ali; Calin, George A.; Mowla, Seyed Javad

    2013-01-01

    Objective MiR-21 is an oncomir expressed by malignant cells and/or tumor microenvironment components. In this study we focused on understanding the effects of stromal miR-21 on esophageal malignant cells. Design MiR-21 expression was evaluated in formalin-fixed paraffin-embedded samples from patients with esophageal squamous-cell carcinoma (SCC) by quantitative RT-PCR. MiR-21 tissue distribution was visualized with in situ hybridization. A co-culture system of normal fibroblasts and esophageal cancer cells was used to determine the effects of fibroblasts on miR-21 expression levels, and on SCC cell migration and invasion. Results MiR-21 was overexpressed in SCCs, when compared to the adjacent non-tumor tissues (P?=?0.0007), and was mainly localized in the cytoplasm of stromal cells adjacent to malignant cells. Accordingly, miR-21 expression was increased in tumors with high versus low stromal content (P?=?0.04). When co-cultured with normal fibroblasts, miR-21 expression was elevated in SCC cells (KYSE-30), while its expression was restricted to fibroblasts when co-cultured with adenocarcinoma cells (OE-33 and FLO-1). MiR-21 was detected in conditioned media of cancer cell lines, illustrating the release of this miRNA into the environment. Co-culturing with normal fibroblasts or addition of fibroblast conditioned media caused a significant increase in cell migration and invasion potency of KYSE-30 cells (P<0.0001). In addition, co-culturing cancer cells with fibroblasts and expression of miR-21 induced the expression of the cancer associated fibroblast (CAF) marker S100A4. Conclusions MiR-21 expression is mostly confined to the SCC stroma and its release from fibroblasts influences the migration and invasion capacity of SCC cells. Moreover, miR-21 may be an important factor in “activating” fibroblasts to CAFs. These findings provide new insights into the role of CAFs and the extracellular matrix in tumor microenvironment formation and in tumor cell maintenance, and suggest miR-21 may contribute to cellular crosstalk in the tumor microenvironment. PMID:24039846

  8. EUS, PET, and CT scanning for evaluation of pancreatic adenocarcinoma

    Microsoft Academic Search

    Howard R. Mertz; Panos Sechopoulos; Dominique Delbeke; Steven D. Leach

    2000-01-01

    Background: Preoperative diagnosis of pancreatic adenocarcinoma can be difficult. Computed tomography (CT) is the standard, noninvasive imaging method for evaluation of suspected pancreatic adenocarcinoma, but it has limited sensitivity for diagnosis, local staging, and metastases. Endoscopic ultrasound (EUS) and fluoro-deoxyglucose\\/positron emission tomography (FDG-PET) are imaging methods that may improve diagnostic accuracy. Methods: Thirty-five patients with presumed resectable pancreatic adenocarcinoma were

  9. Circumferential intramural esophageal dissection successfully treated by endoscopic procedure and metal stent insertion

    Microsoft Academic Search

    Seong Hun Kim; Seung-Ok Lee

    2005-01-01

    Spontaneous intramural esophageal dissection is a rare disorder characterized by a lengthy laceration between the mucosal\\u000a and submucosal layers of the esophageal wall, without perforation. The majority of previously reported cases of spontaneous\\u000a intramural esophageal dissection were partial, and the circumferential type of intramural esophageal dissection has not been\\u000a reported previously. Most spontaneous intramural esophageal dissection responds to conservative management,

  10. High dose intravenous methylprednisolone resolves esophageal stricture resistant to balloon dilatation with intralesional injection of dexamethasone

    Microsoft Academic Search

    Nobuyuki Morikawa; Toshiro Honna; Tatsuo Kuroda; Koji Watanabe; Hideaki Tanaka; Hajime Takayasu; Akihiro Fujino; Hiroko Tanemura; Makoto Matsukubo

    2008-01-01

    One of the most serious problems in patients with long-gap esophageal atresia or corrosive esophagitis is esophageal stricture,\\u000a which may require esophageal resection and replacement. We describe two cases with persistent esophageal stricture successfully\\u000a managed by high dose intravenous methylprednisolone following balloon dilatation. High-dose methylprednisolone with gradual\\u000a tapering (daily 25, 15, 10, 5, 2 mg\\/kg for 4 days each) plus cimetidine and

  11. A Phase Ib Study of Safety and Pharmacokinetics of Ramucirumab in Combination With Paclitaxel in Patients With Advanced Gastric Adenocarcinomas

    PubMed Central

    Ueda, Shinya; Gotoh, Masahiro; Gao, Ling; Doi, Toshihiko

    2015-01-01

    Lessons Learned The pharmacokinetic results of this phase Ib study of ramucirumab combined with paclitaxel as second-line therapy in Japanese patients with metastatic gastric or gastro-esophageal junction adenocarcinoma are in line with previous ramucirumab studies. This combination at the doses and schedule given did not result in any dose-limiting toxicities and appeared to be safe and well tolerated. Background. This phase Ib study evaluated the tolerability and pharmacokinetics of ramucirumab, an anti-VEGFR-2 antibody, combined with paclitaxel as second-line therapy in Japanese patients with metastatic gastric or gastroesophageal junction adenocarcinoma after first-line therapy with fluoropyrimidines and/or platinum. Methods. Patients received ramucirumab 8 mg/kg on days 1 and 15 and paclitaxel 80 mg/m2 on days 1, 8, and 15 of a 28-day cycle. Safety analyses included all patients (n = 6). Results. No dose-limiting toxicities occurred in the first cycle. All patients experienced ?1 treatment-emergent adverse event (TEAE); 5 patients experienced grade ?3 TEAEs. There were two deaths caused by disease progression. The best overall responses were stable disease (n = 5) and partial response (n = 1). Patients received ramucirumab and paclitaxel for a median of 12.5 weeks (range: 11.4–42.7 weeks) and 12.2 weeks (range: 11.0–41.0 weeks), respectively. Following a single dose of ramucirumab IV infusion 8 mg/kg, clearance was ?0.017 L/hour, half-life (t1/2) was 138 to 225 hours, and steady-state volume of distribution (Vss) was ?3 L. Conclusion. The ramucirumab/paclitaxel combination appears to be well-tolerated in Japanese patients with advanced gastric adenocarcinomas. These results are in line with previous ramucirumab pharmacokinetic studies as anticipated. PMID:25888272

  12. Emerging Therapeutic Options for Eosinophilic Esophagitis

    PubMed Central

    Dougherty, Timothy; Stephen, Sindu; Borum, Marie L.

    2014-01-01

    Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the esophagus that often occurs in atopic persons. Management strategies include pharmacotherapy, dietary modification, and endoscopic therapy, although patients will often have a relapsing and remitting course. Currently, the primary pharmacotherapy for EoE consists of corticosteroids. Immuno-modulators, leukotriene antagonists, biologies, and monoclonal antibodies are currently under study for treatment of EoE. The role of immunoglobulin E-mediated allergic reactions has been well documented and may provide insight into the etiology and effective therapy of EoE. PMID:24803874

  13. Cell sheets engineering for esophageal regenerative medicine

    PubMed Central

    Kanai, Nobuo; Yamato, Masayuki

    2014-01-01

    Recently, cell-based therapies, regenerative medicine, and tissue engineering have been progressing rapidly. We have developed a novel strategy for regenerative medicine to recover tissue functions using temperature-responsive cell culture surfaces. To overcome of conventional methods such as the usage of single-cell suspension injection, we have applied transplantable cell sheets fabricated with temperature-responsive culture surfaces for cell delivery. In the field of gastroenterology, transplantable cell sheets from autologous oral mucosal epithelial cells can prevent esophageal stricture following extensive endoscopic mucosal resection. PMID:25333004

  14. Esophageal hypomotility and spastic motor disorders: current diagnosis and treatment.

    PubMed

    Valdovinos, Miguel A; Zavala-Solares, Monica R; Coss-Adame, Enrique

    2014-11-01

    Esophageal hypomotility (EH) is characterized by abnormal esophageal peristalsis, either from a reduction or absence of contractions, whereas spastic motor disorders (SMD) are characterized by an increase in the vigor and/or propagation velocity of esophageal body contractions. Their pathophysiology is not clearly known. The reduced excitation of the smooth muscle contraction mediated by cholinergic neurons and the impairment of inhibitory ganglion neuronal function mediated by nitric oxide are likely mechanisms of the peristaltic abnormalities seen in EH and SMD, respectively. Dysphagia and chest pain are the most frequent clinical manifestations for both of these dysfunctions, and gastroesophageal reflux disease (GERD) is commonly associated with these motor disorders. The introduction of high-resolution manometry (HRM) and esophageal pressure topography (EPT) has significantly enhanced the ability to diagnose EH and SMD. Novel EPT metrics in particular the development of the Chicago Classification of esophageal motor disorders has enabled improved characterization of these abnormalities. The first step in the management of EH and SMD is to treat GERD, especially when esophageal testing shows pathologic reflux. Smooth muscle relaxants (nitrates, calcium channel blockers, 5-phosphodiesterase inhibitors) and pain modulators may be useful in the management of dysphagia or pain in SMD. Endoscopic Botox injection and pneumatic dilation are the second-line therapies. Extended myotomy of the esophageal body or peroral endoscopic myotomy (POEM) may be considered in highly selected cases but lack evidence. PMID:25376746

  15. Evaluation of human tissue kallikrein-related peptidases 6 and 10 expression in early gastroesophageal adenocarcinoma.

    PubMed

    Grin, Andrea; Samaan, Sara; Tripathi, Monika; Rotondo, Fabio; Kovacs, Kalman; Bassily, Mena N; Yousef, George M

    2015-04-01

    Kallikreins are a family of serine proteases that are linked to malignancy of different body organs with potential clinical utility as tumor markers. In this study, we investigated kallikrein-related peptidase 6 (KLK6) and KLK10 expression in early gastroesophageal junction adenocarcinoma and Barrett esophagus (BE) with and without dysplasia. Immunohistochemistry revealed significantly increased KLK6 expression in early invasive cancer compared with dysplastic (P = .009) and nondysplastic BE (P = .0002). There was a stepwise expression increase from metaplasia to dysplasia and invasive tumors. Significantly higher KLK10 was seen in dysplastic lesions compared with metaplasia but not between dysplastic lesions and invasive cancers. KLK6 staining intensity was increased at the invasive front (P = .006), suggesting its role in tumor invasiveness. Neither KLK6 nor KLK10 was significantly associated with other prognostic markers, including depth of invasion, indicating their potential as independent biomarkers. Our results should be interpreted with caution due to limited sample size. There was a significant correlation between KLK6 and KLK10 expression both at the invasive front and within the main tumor, indicating a collaborative effect. We then compared KLK6 and KLK10 messenger RNA expression between metaplastic and cancerous tissues in an independent data set of esophageal carcinoma from The Cancer Genome Atlas. KLK6 and KLK10 may be useful markers and potential therapeutic targets in gastroesophageal junction tumors. PMID:25649006

  16. Treatment of head and neck and esophageal xenografts employing Alimta and concurrent ionizing radiation.

    PubMed

    Mauceri, H J; Seetharam, S; Salloum, R M; Vokes, E E; Weichselbaum, R R

    2001-10-01

    We examined the interaction between Alimta and ionizing radiation (IR) as a potential strategy to enhance the therapeutic ratio of combined-modality cancer treatment. Mice bearing human esophageal adenocarcinoma xenografts (Seg-1) or squamous cell carcinoma xenografts (SQ-20B) were treated with Alimta and IR employing a fractionated treatment schedule. Treatment with Alimta alone slowed the growth of Seg-1 but not SQ-20B tumors compared with control tumors. In Seg-1 xenografts combined treatment with Alimta and IR produced significant tumor growth inhibition compared with Alimta alone or IR alone. In SQ-20B xenografts, treatment with Alimta did not enhance IR-mediated tumor growth inhibition suggesting that sensitivity to Alimta is necessary for an interactive cytotoxic effect with IR. The present data suggest the potential clinical efficacy of combining Alimta administration with radiotherapy for Alimta-sensitive cells and indicate that further testing needs to be conducted to optimize the dosing schedule to enhance the interaction between the therapeutic agents. PMID:11562763

  17. Benign Esophageal Stricture in a Tropical African Population

    PubMed Central

    Ajao, Oluwole G.; Solanke, Toriola F.

    1978-01-01

    In North America, the most common causes of benign esophageal stricture are hiatal hernia and reflux esophagitis. These are localized to the lower end of the esophagus. At the University College Hospital, Ibadan, Nigeria, the most common cause of benign esophageal stricture is ingestion of corrosives. The ingestion is accidental, suicidal, or for medicinal purposes. This stricture is long, narrow, and irregular. Most extend from the cervical esophagus to the cardioesophageal junction. A surgical procedure that has given good results is the use of left colon pedicled on the left colic artery for retrosternal isoperistaltic esophagocoloplasty. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:702578

  18. Intensity-Modulated Radiotherapy for Pancreatic Adenocarcinoma

    SciTech Connect

    Abelson, Jonathan A.; Murphy, James D.; Minn, Ann Yuriko; Chung, Melody [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Fisher, George A.; Ford, James M.; Kunz, Pamela [Department of Medical Oncology, Stanford University, Stanford, CA (United States); Norton, Jeffrey A.; Visser, Brendan C.; Poultsides, George A. [Department of Surgical Oncology, Stanford University, Stanford, CA (United States); Koong, Albert C. [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Chang, Daniel T., E-mail: dtchang@stanford.edu [Department of Radiation Oncology, Stanford University, Stanford, CA (United States)

    2012-03-15

    Purpose: To report the outcomes and toxicities in patients treated with intensity-modulated radiotherapy (IMRT) for pancreatic adenocarcinoma. Methods and Materials: Forty-seven patients with pancreatic adenocarcinoma were treated with IMRT between 2003 and 2008. Of these 47 patients, 29 were treated adjuvantly and 18 definitively. All received concurrent 5-fluorouracil chemotherapy. The treatment plans were optimized such that 95% of the planning target volume received the prescription dose. The median delivered dose for the adjuvant and definitive patients was 50.4 and 54.0 Gy, respectively. Results: The median age at diagnosis was 63.9 years. For adjuvant patients, the 1- and 2-year overall survival rate was 79% and 40%, respectively. The 1- and 2-year recurrence-free survival rate was 58% and 17%, respectively. The local-regional control rate at 1 and 2 years was 92% and 80%, respectively. For definitive patients, the 1-year overall survival, recurrence-free survival, and local-regional control rate was 24%, 16%, and 64%, respectively. Four patients developed Grade 3 or greater acute toxicity (9%) and four developed Grade 3 late toxicity (9%). Conclusions: Survival for patients with pancreatic cancer remains poor. A small percentage of adjuvant patients have durable disease control, and with improved therapies, this proportion will increase. Systemic therapy offers the greatest opportunity. The present results have demonstrated that IMRT is well tolerated. Compared with those who received three-dimensional conformal radiotherapy in previously reported prospective clinical trials, patients with pancreatic adenocarcinoma treated with IMRT in our series had improved acute toxicity.

  19. Esophageal cancer risk by type of alcohol drinking and smoking: a case-control study in Spain

    PubMed Central

    Vioque, Jesus; Barber, Xavier; Bolumar, Francisco; Porta, Miquel; Santibáñez, Miguel; de la Hera, Manuela García; Moreno-Osset, Eduardo

    2008-01-01

    Background The effect of tobacco smoking and alcohol drinking on esophageal cancer (EC) has never been explored in Spain where black tobacco and wine consumptions are quite prevalent. We estimated the independent effect of different alcoholic beverages and type of tobacco smoking on the risk of EC and its main histological cell type (squamous cell carcinoma) in a hospital-based case-control study in a Mediterranean area of Spain. Methods We only included incident cases with histologically confirmed EC (n = 202). Controls were frequency-matched to cases by age, sex and province (n = 455). Information on risk factors was elicited by trained interviewers using structured questionnaires. Multiple logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals (CI). Results Alcohol drinking and tobacco smoking were strong and independent risk factors for esophageal cancer. Alcohol was a potent risk factor with a clear dose-response relationship, particularly for esophageal squamous-cell cancer. Compared to never-drinkers, the risk for heaviest drinkers (? 75 g/day of pure ethanol) was 7.65 (95%CI, 3.16–18.49); and compared with never-smokers, the risk for heaviest smokers (? 30 cigarettes/day) was 5.07 (95%CI, 2.06–12.47). A low consumption of only wine and/or beer (1–24 g/d) did not increase the risk whereas a strong positive trend was observed for all types of alcoholic beverages that included any combination of hard liquors with beer and/or wine (p-trend<0.00001). A significant increase in EC risk was only observed for black-tobacco smoking (2.5-fold increase), not for blond tobacco. The effects for alcohol drinking were much stronger when the analysis was limited to the esophageal squamous cell carcinoma (n = 160), whereas a lack of effect for adenocarcinoma was evidenced. Smoking cessation showed a beneficial effect within ten years whereas drinking cessation did not. Conclusion Our study shows that the risk of EC, and particularly the squamous cell type, is strongly associated with alcohol drinking. The consumption of any combination of hard liquors seems to be harmful whereas a low consumption of only wine may not. This may relates to the presence of certain antioxidant compounds found in wine but practically lacking in liquors. Tobacco smoking is also a clear risk factor, black more than blond. PMID:18673563

  20. Pathology Case Study: History of Colonic Adenocarcinoma

    NSDL National Science Digital Library

    Grant, Maurice R.

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 69-year-old man with a history of colonic adenocarcinoma has metastasis to the liver, bladder and rectum. Visitors are given the gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gastrointestinal pathology.

  1. [Acute appendicitis masking adenocarcinoma of the cecum].

    PubMed

    Santorek-Strumi??o, Edyta; Brocki, Marian

    2015-01-01

    Acute appendicitis can be the first symptom of the malignant tumour of the cecum. In the article we described case of 76 years old patient who came to the hospital on account pain in the right iliac hole, occurrent for 4 days with nausea and vomiting. Primarily patient classified to the appendectomy. The ultrasound examination showed the pathological mass in projection ileocecal valve and appendicitis. The computer tomography of the abdomen confirmed this diagnosis. The patient became classified to the right-sides hemicolectomy. The result of histopathological examination is adenocarcinoma of the ileocaecal valve and the appendicitis phlegmonous. Patient became classified to the adiuvant chemotherapy in the regional oncological centre. PMID:25763585

  2. Characterization and Properties of Nine Human Ovarian Adenocarcinoma Cell Lines

    Microsoft Academic Search

    Simon P. Langdon; Sandra S. Lawrie; Frances G. Hay; Mary M. Hawkes; Amanda McDonald; Ian P. Hayward; Dick J. Schol; Jo Hilgers; Robert C. F. Leonard; John F. Smyth

    Four series of cell lines have been derived from patients with ovarian adenocarcinoma. Nine cell lines have been established at different stages of treatment: eight from malignant effusions and one from a solid metas tasis. Six lines were derived from the ascites or pleural effusion of patients with poorly differentiated adenocarcinoma: PEO1, PEO4, and PEO6 from one patient, PEA1 and

  3. Adenocarcinoma in Situ of the Cervix: Management and Outcome

    Microsoft Academic Search

    Masoud Azodi; Setsuko K. Chambers; Thomas J. Rutherford; Ernest I. Kohorn; Peter E. Schwartz; Joseph T. Chambers

    1999-01-01

    Objective. The aim of this study was to review the management and outcome of patients with adenocarcinoma in situ of the cervix and to evaluate the significance of endocervical cone margin status in these patients.Methods. A retrospective review of records between January 1988 and December 1996 identified 40 patients with adenocarcinoma in situ on cone biopsy for whom complete information

  4. [Esophageal diseases: gastroesophageal reflux disease, Barrett's esophagus, achalasia and eosinophilic esophagitis].

    PubMed

    Calvet, Xavier; Villoria, Albert

    2013-10-01

    Important new advances were presented in esophageal disease in Digestive Disease Week 2013. A highlight was confirmation of the high efficacy of weight loss to treat symptoms of reflux and an interesting pilot study suggesting that a simple ligature with supra- and infracardial bands could be an effective technique in esophageal reflux. If the excellent results and safety and efficacy of this technique are confirmed in the long term, it could revolutionize the management of gastroesophageal reflux disease. Also of note this year was the presentation of multiple studies validating a new technique, peroral endoscopic myotomy (POEM) for the endoscopic treatment of achalasia. This technique seems to have excellent efficacy and safety. PMID:24160952

  5. Genomic aberrations in cervical adenocarcinomas in Hong Kong Chinese women.

    PubMed

    Chung, Tony K H; Van Hummelen, Paul; Chan, Paul K S; Cheung, Tak Hong; Yim, So Fan; Yu, Mei Y; Ducar, Matthew D; Thorner, Aaron R; MacConaill, Laura E; Doran, Graeme; Pedamallu, Chandra Sekhar; Ojesina, Akinyemi I; Wong, Raymond R Y; Wang, Vivian W; Freeman, Samuel S; Lau, Tat San; Kwong, Joseph; Chan, Loucia K Y; Fromer, Menachem; May, Taymaa; Worley, Michael J; Esselen, Katharine M; Elias, Kevin M; Lawrence, Michael; Getz, Gad; Smith, David I; Crum, Christopher P; Meyerson, Matthew; Berkowitz, Ross S; Wong, Yick Fu

    2015-08-15

    Although the rates of cervical squamous cell carcinoma have been declining, the rates of cervical adenocarcinoma are increasing in some countries. Outcomes for advanced cervical adenocarcinoma remain poor. Precision mapping of genetic alterations in cervical adenocarcinoma may enable better selection of therapies and deliver improved outcomes when combined with new sequencing diagnostics. We present whole-exome sequencing results from 15 cervical adenocarcinomas and paired normal samples from Hong Kong Chinese women. These data revealed a heterogeneous mutation spectrum and identified several frequently altered genes including FAT1, ARID1A, ERBB2 and PIK3CA. Exome sequencing identified human papillomavirus (HPV) sequences in 13 tumors in which the HPV genome might have integrated into and hence disrupted the functions of certain exons, raising the possibility that HPV integration can alter pathways other than p53 and pRb. Together, these provisionary data suggest the potential for individualized therapies for cervical adenocarcinoma based on genomic information. PMID:25626421

  6. Metallothionein in human oesophagus, Barrett's epithelium and adenocarcinoma

    PubMed Central

    Coyle, P; Mathew, G; Game, P A; Myers, J C; Philcox, J C; Rofe, A M; Jamieson, G G

    2002-01-01

    The potential of the metal-binding protein, metallothionein, in assessing the progression of normal oesophagus through Barrett's to adenocarcinoma was investigated. Metallothionein was quantitatively determined in resected tissues from patients undergoing oesophagectomy for high grade dysplasia/adenocarcinoma and in biopsies from patients with Barrett's syndrome. In 10 cancer patients, metallothionein concentrations in adenocarcinoma were not significantly different from normal oesophagus, although six had elevated metallothionein concentrations in the metaplastic tissue bordering the adenocarcinoma. In 17 out of 20 non-cancer patients with Barrett's epithelium, metallothionein was significantly increased by 108% (P<0.004). There was no association between the metallothionein levels in Barrett's epithelium and the presence of inflammatory cells, metaplasia or dysplasia. Metallothionein is a marker of progression from normal to Barrett's epithelium but is not increased in oesophageal adenocarcinoma. British Journal of Cancer (2002) 87, 533–536. doi:10.1038/sj.bjc.6600473 www.bjcancer.com © 2002 Cancer Research UK PMID:12189552

  7. Berberine protects against esophageal mucosal damage in reflux esophagitis by suppressing proinflammatory cytokines

    PubMed Central

    CHOO, BYUNG KIL; ROH, SEONG-SOO

    2013-01-01

    This study was performed to investigate the effects of berberine (BB) in a rat model of gastroesophageal reflux disease (GERD), induced by pylorus and forestomach ligation. We evaluated cytotoxicity and proinflammatory biomarkers (nitric oxide, interleukin (IL)-1? and prostaglandin E2) in RAW 264.7 cells in vitro and anti-inflammatory effects in vivo. A total of 54 Sprague Dawley rats were divided into six groups: intact control rats; reflux esophagitis (RE) control rats; RE rats treated with 20 mg/kg omeprazole and RE rats treated with BB at doses of 20, 40 and 60 mg/kg, respectively. All rats were fasted. RE was induced by pylorus and forestomach ligation one hour subsequent to the oral treatment. Six hours subsequent to the surgery, the rats were sacrificed, blood was collected from the abdominal vein and the esophagus and stomach were dissected. The gastric volume and the pH of the gastric juice were evaluated, prior to the esophagus being cut longitudinally and an inner mucosal area being imaged, to analyze mucosal damage indices. Proinflammatory biomarkers in the serum, including tumor necrosis factor (TNF)-?, IL-1?, IL-6 and monocyte chemoattractant protein (MCP)-1 were analyzed using an enzyme-linked immunosorbent assay (ELISA) kit, while the mRNA expression of TNF-?, IL-1?, IL-6 and plasminogen activator inhibitor (PAI)-1 was analyzed using a quantitative polymerase chain reaction (qPCR). Esophagic tissue damage in the BB groups was dose-dependently decreased compared with that in the RE control group. This result was consistent with significant reductions in the levels of proinflammatory biomarkers in the serum and in the expression of proinflammatory mRNA, specifically, TNF-?, IL-1?, IL-6 and PAI-1. The results suggest that the anti-inflammatory and protective effects of BB may attenuate the severity of RE and prevent esophageal mucosal damage, in addition to validating the use of BB as a pharmacological treatment for esophageal reflux disease. PMID:24137243

  8. Multiple Rapid Swallow Responses During Esophageal High-Resolution Manometry Reflect Esophageal Body Peristaltic Reserve

    PubMed Central

    Shaker, Anisa; Stoikes, Nathaniel; Drapekin, Jesse; Kushnir, Vladimir; Brunt, L. Michael; Gyawali, C. Prakash

    2014-01-01

    OBJECTIVES Dysphagia may develop following antireflux surgery as a consequence of poor esophageal peristaltic reserve. We hypothesized that suboptimal contraction response following multiple rapid swallows (MRS) could be associated with chronic transit symptoms following antireflux surgery. METHODS Wet swallow and MRS responses on esophageal high-resolution manometry (HRM) were characterized collectively in the esophageal body (distal contractile integral (DCI)), and individually in each smooth muscle contraction segment (S2 and S3 amplitudes) in 63 patients undergoing antireflux surgery and in 18 healthy controls. Dysphagia was assessed using symptom questionnaires. The MRS/wet swallow ratios were calculated for S2 and S3 peak amplitudes and DCI. MRS responses were compared in patients with and without late postoperative dysphagia following antireflux surgery. RESULTS Augmentation of smooth muscle contraction (MRS/wet swallow ratios > 1.0) as measured collectively by DCI was seen in only 11.1% with late postoperative dysphagia, compared with 63.6% in those with no dysphagia and 78.1% in controls (P?0.02 for each comparison). Similar results were seen with S3 but not S2 peak amplitude ratios. Receiver operating characteristics identified a DCI MRS/wet swallow ratio threshold of 0.85 in segregating patients with late postoperative dysphagia from those with no postoperative dysphagia with a sensitivity of 0.67 and specificity of 0.64. CONCLUSIONS Lack of augmentation of smooth muscle contraction following MRS is associated with late postoperative dysphagia following antireflux surgery, suggesting that MRS responses could assess esophageal smooth muscle peristaltic reserve. Further research is warranted to determine if antireflux surgery needs to be tailored to the MRS response. PMID:24019081

  9. Bullous systemic lupus erythematosus associated with esophagitis dissecans superficialis.

    PubMed

    Yogarajah, Meera; Sivasambu, Bhradeev; Jaffe, Eric A

    2015-01-01

    Bullous systemic lupus erythematosus is one of the rare autoantibody mediated skin manifestation of systemic lupus erythematosus (SLE) demonstrating subepidermal blistering with neutrophilic infiltrate histologically. We present a case of a 40-year-old Hispanic female who presented with a several months' history of multiple blistering pruritic skin lesions involving the face and trunk, a photosensitive rash over the face and neck, swelling of the right neck lymph node, and joint pain involving her elbows and wrist. Her malady was diagnosed as bullous systemic lupus erythematosus based on the immunological workup and biopsy of her skin lesions. The patient also complained of odynophagia and endoscopy revealed esophagitis dissecans superficialis which is a rare endoscopic finding characterized by sloughing of the esophageal mucosa. The bullous disorders typically associated with esophagitis dissecans superficialis are pemphigus and rarely bullous pemphigoid. However, this is the first reported case of bullous systemic lupus erythematosus associated with esophagitis dissecans superficialis. PMID:25821624

  10. Bullous Systemic Lupus Erythematosus Associated with Esophagitis Dissecans Superficialis

    PubMed Central

    Jaffe, Eric A.

    2015-01-01

    Bullous systemic lupus erythematosus is one of the rare autoantibody mediated skin manifestation of systemic lupus erythematosus (SLE) demonstrating subepidermal blistering with neutrophilic infiltrate histologically. We present a case of a 40-year-old Hispanic female who presented with a several months' history of multiple blistering pruritic skin lesions involving the face and trunk, a photosensitive rash over the face and neck, swelling of the right neck lymph node, and joint pain involving her elbows and wrist. Her malady was diagnosed as bullous systemic lupus erythematosus based on the immunological workup and biopsy of her skin lesions. The patient also complained of odynophagia and endoscopy revealed esophagitis dissecans superficialis which is a rare endoscopic finding characterized by sloughing of the esophageal mucosa. The bullous disorders typically associated with esophagitis dissecans superficialis are pemphigus and rarely bullous pemphigoid. However, this is the first reported case of bullous systemic lupus erythematosus associated with esophagitis dissecans superficialis. PMID:25821624

  11. Esophageal involvement of pemphigus vulgaris associated with upper gastrointestinal bleeding.

    PubMed

    Chang, Sooyun; Park, Soo Jung; Kim, Sun Wook; Jin, Moo-Nyun; Lee, Jung-Hee; Kim, Hyun Ju; Hong, Sung Pil; Kim, Tae Il

    2014-09-01

    Esophageal involvement of pemphigus vulgaris is rare, and when present, the most common presenting symptoms reported in the medical literature are odynophagia and dysphagia. Here, we present two cases of pemphigus vulgaris presenting with upper gastrointestinal hemorrhage because of esophageal involvement of the disease. In case 1, a 41-year-old female patient with a prior diagnosis of pemphigus vulgaris presented with hematemesis. Esophagogastroduodenoscopy showed diffuse mucosal exfoliation and oozing bleeding of the oropharynx and esophagus. The patient recovered after the administration of high-dose corticosteroids and immunosuppressants. In case 2, a 30-year-old female patient with known pemphigus vulgaris also presented with hematemesis, showing similar endoscopic findings to the first case. She also responded to the same treatment. Esophageal involvement of pemphigus vulgaris responds to high-dose corticosteroids and immunosuppressants. Thus, in patients with pemphigus vulgaris with signs or symptoms of upper gastrointestinal bleeding, an early endoscopy for the evaluation of esophageal involvement is beneficial. PMID:25325007

  12. Esophageal cancer presenting as a brain metastasis: A case report

    PubMed Central

    SPALLONE, ALDO; IZZO, CHIARA

    2013-01-01

    Carcinoma of unknown primary origin (CUP) is defined as the histological diagnosis of metastasis without the detection of a primary tumor. The incidence of CUP in all patients with a malignant disease has been reported to be between 3 and 15%. Esophageal cancer is the third most common type of cancer of the digestive tract and the seventh most common cause of cancer-related mortality worldwide. The overall incidence of the disease is highest in males >50 years old. Brain metastases have been reported in only 1.7–3.6% of all patients with different types of esophageal cancer. Brain metastasis as the presenting form of esophageal carcinoma is highly uncommon. The present study reports the case of a patient with an unknown primary tumor who presented with a cerebral metastasis, without extra-neurological symptoms. The CUP was subsequently diagnosed as an esophageal carcinoma. PMID:24137398

  13. [Management of the esophageal candidiasis by the primary care physician].

    PubMed

    Behrens, Garance; Bocherens, Astrid; Senn, Nicolas

    2014-05-14

    Esophageal candidiasis is one of the most common opportunistic infections in patients infected by human immunodeficiency virus (HIV). This pathology is also found in patients without overt immunodeficiency. Other risk factors are known to be associated with this disease like inhaled or systemic corticosteroid treatment or proton-pump inhibitors and H2 receptor antagonists. In the absence of identified risk factors, a primary immune deficiency should be sought. Prevention of esophageal candidiasis is based primarily on the identification of risk factors, and a better control of them. This article presents a review of the physiopathology, clinical presentation and management of esophageal candidiasis by primary care physicians. We will also discuss ways of preventing esophageal candidiasis when necessary. PMID:24930154

  14. Buspirone, a new drug for the management of patients with ineffective esophageal motility?

    PubMed

    Scheerens, Charlotte; Tack, Jan; Rommel, Nathalie

    2015-06-01

    Ineffective esophageal motility (IEM) is the most frequently encountered esophageal motility disorder. Patients may present with a variety of symptoms, such as dysphagia, heartburn, odynophagia, and regurgitation. Over the past years, the landscape of esophageal motility testing has been revolutionized; however, our current treatment options for IEM still remain limited. Previous studies have suggested that buspirone, a serotonin receptor agonist, enhances esophageal peristalsis and lower esophageal sphincter (LES) function. Recent work provides the first evidence that buspirone may influence LES resting pressure in patients with systemic sclerosis. Future research should evaluate whether the beneficial effects of buspirone also apply to the broad clinical entity of esophageal dysphagia patients with IEM. PMID:26137300

  15. Buspirone, a new drug for the management of patients with ineffective esophageal motility?

    PubMed Central

    Scheerens, Charlotte; Tack, Jan

    2015-01-01

    Ineffective esophageal motility (IEM) is the most frequently encountered esophageal motility disorder. Patients may present with a variety of symptoms, such as dysphagia, heartburn, odynophagia, and regurgitation. Over the past years, the landscape of esophageal motility testing has been revolutionized; however, our current treatment options for IEM still remain limited. Previous studies have suggested that buspirone, a serotonin receptor agonist, enhances esophageal peristalsis and lower esophageal sphincter (LES) function. Recent work provides the first evidence that buspirone may influence LES resting pressure in patients with systemic sclerosis. Future research should evaluate whether the beneficial effects of buspirone also apply to the broad clinical entity of esophageal dysphagia patients with IEM. PMID:26137300

  16. Successful treatment with alectinib after crizotinib-induced esophageal ulceration.

    PubMed

    Yoneshima, Yasuto; Okamoto, Isamu; Takano, Tomotsugu; Enokizu, Aimi; Iwama, Eiji; Harada, Taishi; Takayama, Koichi; Nakanishi, Yoichi

    2015-06-01

    Crizotinib was the first clinically available inhibitor of the tyrosine kinase ALK, and next-generation ALK inhibitors, such as alectinib, are now under development. Although crizotinib is generally well tolerated, severe esophageal injury has been reported as a rare but serious adverse event of crizotinib therapy. We now describe the successful treatment with alectinib of a patient who developed crizotinib-induced esophageal ulceration. PMID:25837798

  17. Paraneoplastic cutaneous lupus secondary to esophageal squamous cell carcinoma.

    PubMed

    Koritala, Thoyaja; Tworek, Joseph; Schapiro, Brian; Zolotarevsky, Eugene

    2015-06-01

    Sporadic subacute cutaneous lupus erythematosus (SCLE) in an elderly man does not fit a typical demographic for the disease process. Using the McLean's criteria we were able to establish a temporal relationship between the patient's diagnosis of esophageal squamous cell carcinoma (SCC) and his dermatosis, both of which responded to cytotoxic chemotherapy. The clinical presentation and progression of the clinical illness is supportive of a very unusual and not previously reported paraneoplastic SCLE secondary to esophageal SCC. PMID:26029469

  18. Esophageal ruptures: triage using the systemic inflammatory response syndrome score

    Microsoft Academic Search

    Kouichi Furugaki; Junichi Yoshida; Koji Hokazono; Takuya Emoto; Jo Nakashima; Mayumi Ohyama; Toshiyuki Ishimitsu; Masahiro Shinohara; Kenichi Matsuo

    2011-01-01

    Esophageal rupture is a rare entity. Delay in the diagnosis and treatment may threaten the patient’s life. The decision for\\u000a surgical or nonsurgical treatment, however, remains controversial because advocates of both treatments have reported comparable\\u000a results. To quantify the decision making, we suggest the systemic inflammatory response syndrome (SIRS) score for triage of\\u000a an esophageal rupture. Using this criterion for

  19. Helicobacter pylori infection inhibits reflux esophagitis by inducing atrophic gastritis

    Microsoft Academic Search

    Tomoyuki Koike; Shuichi Ohara; Hitoshi Sekine; Katsunori Iijima; Katsuaki Kato; Tooru Shimosegawa; Takayoshi Toyota

    1999-01-01

    OBJECTIVE:Although it is widely accepted that Helicobacter pylori (H. pylori) infection is an important cause of atrophic gastritis, few studies have examined the relationship between H. pylori-induced atrophic gastritis and the occurrence of reflux esophagitis. The present study was aimed to examine the relationship between H. pylori infection, atrophic gastritis, and reflux esophagitis in Japan.METHODS:A total of 175 patients with

  20. Esophageal manometrics in patients with angina-like chest pain

    Microsoft Academic Search

    Douglas L. Brand; Doris Martin; Charles E. Pope

    1977-01-01

    Fifty-eight patients with angina-like chest pain had esophageal manometric testing. Forty-three had no evidence of coronary artery disease at the time of referral or at subsequent contact; 15 patients were proven to have coronary artery disease. High-amplitude contraction waves were the most frequently found manometric abnormality (15 patients). Less frequent were increased duration of contractions, achalasia, and diffuse esophageal spasm;

  1. Beneficial Effects of Immediate Enteral Nutrition After Esophageal Cancer Surgery

    Microsoft Academic Search

    Satoshi Aiko; Yutaka Yoshizumi; Yoshiaki Sugiura; Tomokazu Matsuyama; Yoshihisa Naito; Junichi Matsuzaki; Tadaaki Maehara

    2001-01-01

    This study was conducted to determine the effects of immediate enteral nutrition (EN) on nutritional status, immunological\\u000a competence, and the suppression of excessive inflammatory responses in patients following esophageal cancer surgery. Twenty-four\\u000a patients who underwent the same elective operation for thoracic esophageal carcinoma were randomized into an immediate enteral\\u000a nutrition (IEN) group who received EN from postoperative day (POD) 1

  2. Esophageal cancer: staging system and guidelines for staging and treatment

    PubMed Central

    2014-01-01

    Survival of esophageal cancer is improving but remains poor. Esophageal cancer stage is based on depth of tumor invasion, involvement of regional lymph nodes, and the presence or absence of metastatic disease. Appropriate work-up is critical to identify accurate pre-treatment staging so that both under-treatment and unnecessary treatment is avoided. Treatment strategy should follow guideline recommendations, and generally should be developed after multidisciplinary evaluation. PMID:24876933

  3. Usefulness of intralesional triamcinolone in treatment of benign esophageal strictures

    Microsoft Academic Search

    Rakesh Kochhar; Govind K. Makharia

    2002-01-01

    Introduction: The cornerstone treatment for benign esophageal strictures is endoscopic dilation. There are reports suggesting that intralesional corticosteroid injection decreases the frequency of endoscopic dilation. Methods: Seventy-one patients (mean age 42.39 [17.52] years; range, 13-78 years) with benign esophageal strictures (corrosive 29, peptic 14, anastomotic 19, radiation-induced 9) were recruited for this study. All were being managed with a program

  4. Variability in Diagnostic Criteria for Eosinophilic Esophagitis: A Systematic Review

    Microsoft Academic Search

    Evan S. Dellon; Ademola Aderoju; John T. Woosley; Robert S. Sandler; Nicholas J. Shaheen

    2007-01-01

    BACKGROUND:Eosinophilic esophagitis (EoE) is an emerging clinicopathologic entity defined by abnormal esophageal eosinophilic infiltration. Our understanding of this disease is hampered by the lack of a uniform diagnostic standard. The aim of this systematic review was to determine the range of diagnostic strategies and histologic criteria in the EoE literature.METHODS:The MEDLINE-indexed literature from 1950 through December 31, 2006 was independently

  5. Viewpoints on Acid-Induced Inflammatory Mediators in Esophageal Mucosa

    PubMed Central

    Harnett, Karen M; Rieder, Florian; Behar, Jose

    2010-01-01

    We have focused on understanding the onset of gastroesophageal reflux disease by examining the mucosal response to the presence of acid in the esophageal lumen. Upon exposure to HCl, inflammation of the esophagus begins with activation of the transient receptor potential channel vanilloid subfamily member-1 (TRPV1) in the mucosa, and production of IL-8, substance P (SP), calcitonin gene related peptide (CGRP) and platelet activating factor (PAF). Production of SP and CGRP, but not PAF, is abolished by the neural blocker tetrodotoxin suggesting that SP and CGRP are neurally released and that PAF arises from non neural pathways. Epithelial cells contain TRPV1 receptor mRNA and protein and respond to HCl and to the TRPV1 agonist capsaicin with production of PAF. PAF, SP and IL-8 act as chemokines, inducing migration of peripheral blood leukocytes. PAF and SP activate peripheral blood leukocytes inducing the production of H2O2. In circular muscle, PAF causes production of IL-6, and IL-6 causes production of additional H2O2, through activation of reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidases. Among these, NADPH oxidase 5 cDNA is significantly up-regulated by exposure to PAF; H2O2 content of esophageal and lower esophageal sphincter circular muscle is elevated in human esophagitis, causing dysfunction of esophageal circular muscle contraction and reduction in esophageal sphincter tone. Thus esophageal keratinocytes, that constitute the first barrier to the refluxate, may also serve as the initiating cell type in esophageal inflammation, secreting inflammatory mediators and pro-inflammatory cytokines and affecting leukocyte recruitment and activity. PMID:21103419

  6. Reconstruction techniques for hypopharyngeal and cervical esophageal carcinoma

    PubMed Central

    Jiang, Ming; He, Xiaotian; Wu, Duoguang; Han, Yuanyuan

    2015-01-01

    Objective To investigate the incidence of perioperative complications in patients with hypopharyngeal and cervical esophageal carcinoma who underwent three types of esophageal defect reconstruction procedures. Methods Clinical data from 105 patients with hypopharyngeal and cervical esophageal carcinoma who were treated at SUN YAT-SEN Memorial Hospital from January 2003 to February 2013 were retrospectively analyzed. Among these patients, 45 underwent a pectoral major muscle skin flap reconstruction following carcinoma resection (group A); 32 patients were treated with stomach replacement of the esophagus (group B), and 28 patients were treated with tube stomach replacement of the esophagus (group C). The incidences of perioperative complications were compared among these three groups. Results The incidences of anastomotic leakage, neck swelling, and incision infection were significantly lower in group C than in group A (P<0.05). The incidences of anastomotic leakage, reflux esophagitis, and thoracic stomach syndrome were significantly lower in group C than in group B (P<0.05). Conclusions Tube stomach replacement of the esophagus in the setting of hypopharyngeal and cervical esophageal carcinoma reduced the incidence of complications; therefore, it is a reasonable procedure for the management of esophageal defects. PMID:25922724

  7. Gastro-esophageal Reflux Disease (GERD)

    NSDL National Science Digital Library

    Patient Education Institute

    This patient education program discusses Gastro-Esophageal Reflux Disease, or GERD, including the anatomy of the digestive system, causes and effects, signs and symptoms, possible complications, and treatment options for GERD with their benefits and side effects. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

  8. Mucinous bronchioloalveolar carcinomas display a specific pattern of mucin gene expression among primary lung adenocarcinomas

    Microsoft Academic Search

    Marie-Christine Copin; Marie-Pierre Buisine; Emmanuelle Leteurtre; Charles Hugo Marquette; Henri Porte; Jean-Pierre Aubert; Bernard Gosselin; Nicole Porchet

    2001-01-01

    Lung adenocarcinomas are heterogeneous clinically and histologically. Expression of the mucin genes was analyzed as a molecular marker of glandular cytodifferentiation in primary lung adenocarcinomas. Expression was correlated with histopathologic subtypes of World Health Organization classification with the aim of investigating the histogenesis of primary lung adenocarcinomas. Thirty-four primary lung adenocarcinomas were examined by in situ hybridization for mucin gene

  9. Lymph node staging in esophageal adenocarcinoma with PET-CT based on a visual analysis and based on metabolic parameters

    Microsoft Academic Search

    Johannes B. Roedl; Michael A. Blake; Nagaraj S. Holalkere; Peter R. Mueller; Rivka R. Colen; Mukesh G. Harisinghani

    2009-01-01

    Background  In order to investigate the value of FDG positron emission tomography-computed tomography (PET-CT), FDG PET (reviewed side-by-side\\u000a with CT), and metabolic parameters in the assessment of lymph node status and prognosis.\\u000a \\u000a \\u000a \\u000a Methods  Fifty-five subjects with lymph node positive (N1) and 26 subjects with lymph node negative (N0) disease were included. In\\u000a the slice with the maximum FDG uptake of the tumor,

  10. Duodenal adenocarcinoma presenting as a mass with aneurismal dilatation.

    PubMed

    Mama, Nadia; Ben Slama, Aïda; Arifa, Nadia; Kadri, Khaled; Sriha, Badreddine; Ksiaa, Mehdi; Jemni, Hela; Tlili-Graiess, Kalthoum

    2014-01-01

    Duodenal adenocarcinoma is frequent. Aneurysmal dilatation of the small bowel is reported to be a lymphoma characteristic imaging finding. A 57-year-old male was found to have a duodenal adenocarcinoma with aneurismal dilatation on imaging which is an exceptional feature. On laparotomy, the wall thickening of the dilated duodenum extended to the first jejunal loop, with multiple mesenteric lymph nodes and ascites. Segmental palliative resection with gastro-entero-anastomosis was done. Histopathology revealed a moderately differentiated adenocarcinoma with neuro-endocrine differentiation foci. Wide areas of necrosis and vascular emboli were responsible for the radiological feature of the dilated duodenum with wall thickening. PMID:24411203

  11. Clinical esophageal pH recording: A technical review for practice guideline development

    Microsoft Academic Search

    Peter J Kahrilas; Eamonn M. M Quigley

    1996-01-01

    Our present concept of peptic esophagitis dates back to 1935, when Winkelstein suggested that gastric secretions were the cause of mucosal damage observed in peptic esophagitis.1GASTROENTEROLOGY 1996;110-1982-1996

  12. TGF? signaling in pancreatic ductal adenocarcinoma.

    PubMed

    Zhang, Hui; Liu, Chengli; Kong, Yalin; Huang, Hui; Wang, Cheng; Zhang, Hongyi

    2015-03-01

    Transforming growth factor ? (TGF?) receptor signaling plays a paradoxical effect in the tumorigenesis of pancreatic ductal adenocarcinoma (PDAC), in which its tumor-inhibitory role at early stages turns into a tumor-promoting role at later stages. The underlying mechanism remains far from clear. Here we provide strong evidence that the activation of TGF? receptor signaling in PDAC cells increased SMAD3 phosphorylation and nuclear translocation to inhibit cell growth. Meanwhile, it also activated SMAD7 to induce nuclear translocation and retention of ?-catenin, which not only attenuated the inhibition of cell growth by nuclear SMAD3 but also activated vascular endothelial growth factor A (VEGF-A) to promote vascularization. Our data thus support a model involving crosstalk of the TGF? and Wnt signaling pathways, for regulating the complicated effect of TGF? signaling on the tumorigenesis of PDAC. PMID:25355597

  13. Coexisting Mantle Cell Lymphoma and Prostate Adenocarcinoma

    PubMed Central

    Rajput, Ashish B.; Burns, Bruce; Gerridzen, Ronald; van der Jagt, Richard

    2014-01-01

    Prostatic mantle cell lymphoma (MCL) is a very rare entity with only 5 reported cases in the literature. We report a case of coexisting MCL and prostate adenocarcinoma (PCa) in an elderly male and review the morphologic features of classic and rare prostatic MCL subtypes. Careful morphologic evaluation and immunohistochemical findings of positive CD5, CD20, and cyclin D1 and negative CD23 and CD3 can guide us to the diagnosis of MCL. Given the fact that transurethral resection of prostate is done quite routinely, this paper draws attention to the manner in which long standing bladder outlet obstruction and postbiopsy prostate specimens with dense lymphoid infiltration can masquerade as lymphoma. It highlights the importance of exercising care while reviewing prostate specimens with evidence of chronic prostatitis so as not to miss this rare neoplasm. PMID:25386194

  14. Molecular Characteristics of Pancreatic Ductal Adenocarcinoma

    PubMed Central

    Ottenhof, Niki A.; de Wilde, Roeland F.; Maitra, Anirban; Hruban, Ralph H.; Offerhaus, G. Johan A.

    2011-01-01

    Pancreatic cancer is an almost universally lethal disease and despite extensive research over the last decades, this has not changed significantly. Nevertheless, much progress has been made in understanding the pathogenesis of pancreatic ductal adenocarcinoma (PDAC) suggesting that different therapeutic strategies based on these new insights are forthcoming. Increasing focus exists on designing the so-called targeted treatment strategies in which the genetic characteristics of a tumor guide therapy. In the past, the focus of research was on identifying the most frequently affected genes in PDAC, but with the complete sequencing of the pancreatic cancer genome the focus has shifted to defining the biological function that the altered genes play. In this paper we aimed to put the genetic alterations present in pancreatic cancer in the context of their role in signaling pathways. In addition, this paper provides an update of the recent advances made in the development of the targeted treatment approach in PDAC. PMID:21512581

  15. Laparoscopic distal pancreatosplenectomy for pancreatic ductal adenocarcinoma.

    PubMed

    Kuroki, Tamotsu; Eguchi, Susumu

    2014-08-26

    Laparoscopic distal pancreatectomy (LDP) including laparoscopic distal pancreatosplenectomy has rapidly developed as a minimally invasive surgery. LDP is mainly indicated for benign disease and low-grade malignancy during the initial period. In recent years, an increasing number of LDPs for pancreatic ductal adenocarcinoma (PDAC) have been reported. However, the benefits of LPD for PDAC, especially in view of the oncological benefits, are unclear and remain controversial. In this review of the literature, we note that LDP has been found to be a technically feasible and safe surgical procedure in selected patients and that LDP has the advantages expected of a minimally invasive surgery. In addition, LDP has oncological feasibility for PDAC in light of its favorable rate of R0 resection and lymph node harvest compared to conventional laparotomy. Large randomized and controlled prospective studies are needed to determine the clinical advantages of LDP for left-sided PDAC. PMID:25156008

  16. [Radiotherapy for adenocarcinoma of the uterine cervix].

    PubMed

    Okamoto, Y; Hirota, S; Soejima, T; Maeda, H; Takada, Y; Hasegawa, K; Hishikawa, Y

    1997-12-01

    One hundred three patients with adenocarcinoma of the uterine cervix treated with radiotherapy between 1975 and 1992 were evaluated. The results for 24 patients treated with radiotherapy alone were as follows: The overall 5-year survival rates for Stages I + II (N = 12) and III + IV (N = 12) were 52% and 16%, respectively, lower than those for squamous cell carcinoma (stage I: 89%, II: 54%, III: 44%, IV: 19%). The overall response rate was 79.1%, and the recurrence rate was 54.2% (local recurrence: 29.2%, distant metastasis: 33.3%). In Stage I + II patients with an intracavitary irradiation dose of 40 Gy (LDR) or more, there was no local recurrence. In stage III + IV patients, local recurrence was recognized in spite of the high dosage of intracavitary irradiation. The results for 79 patients treated with combined irradiation and operation were as follows: The overall 5-year survival rates for Stages I, II, III and IV were 76%, 60%, 57%, and 0%, respectively. The incidence of lymph node metastasis was 30.4%, and for Stages I, II, III and IV was 26.7%, 34.6%, 28.6%, and 100%, respectively. This showed that adenocarcinoma had a higher incidence of lymph node metastasis after the early stage. The recurrence rate for patients with lymph node metastasis was 75.0%, significantly higher than 25.4% for patients without lymph node metastasis (p < 0.001). To improve prognosis, 40 Gy or more of intracavitary irradiation dose (LDR) and systemic chemotherapy to prevent distant metastasis are recommended for stage I and II cases. For stage III and IV cases, it was thought to be difficult to control local disease with radiation alone. Additional treatment should be used for these cases, i.e. intraarterial infusion, chemotherapy, hyperthermia and so on. PMID:9483941

  17. The Function and Interaction of Genes Related to Esophageal Squamous Cell Cancer

    Microsoft Academic Search

    Yu Long Chen; Su Gai Yin; Yao Song Wu

    2011-01-01

    Objective: To study the function and interaction of genes related to esophageal squamous cell cancer and discuss esophageal cancer molecular mechanism.Methods: The gene microarray date set of esophageal was downloaded from the GEO BRB-ArrayTools and online tool was used to analysis the difference expression genes between esophageal squamous cell cancer and normal tissue, and analysis the functional and interaction of

  18. Does Dysphagia Indicate Recurrence of Benign Esophageal Strictures?

    PubMed Central

    Borgström, Anders; Fork, Frans-Thomas; Lövdahl, Eje

    1995-01-01

    Esophageal dilatation in dysphagic patients with benign strictures is usually considered successful if the patients' dysphagia is alleviated. However, the relation between dysphagia and the diameter of a stricture is not well understood. Moreover, the dysphagia may also be caused by an underlying esophageal motor disorder. In order to compare symptoms and objective measurements of esophageal stricture, 28 patients were studied with interview and a radiologic esophagram. The latter included swallowing of a solid bolus. All patients underwent successful balloon dilatation at least one month prior to this study. Recurrence of a stricture with a diameter of less than 13 mm was diagnosed by the barium swallow in 21 patients. Recurrence of dysphagia was seen in 15 patients. Thirteen patients denied any swallowing symptoms. Chest pain was present in 9 patients. Of 15 patients with dysphagia 2 (13%) had no narrowing but severe esophageal dysmotility. Of 13 patients without dysphagia 9 (69%) had a stricture with a diameter of 13 mm or less. Of 21 patients with a stricture of 13 mm or less 14 (67%) were symptomatic while 7 (33%) were asymptomatic. Four of 11 patients with retrosternal pain had a stricture of less than 10 mm. Three patients with retrosternal pain and obstruction had severe esophageal dysmotility. Whether or not the patients have dysphagia may be more related to diet and eating habits than to the true diameter of their esophageal narrowing. We conclude that the clinical history is non-reliable for evaluating the results of esophageal stricture dilatation. In order to get an objective measurement of therapeutic outcome, barium swallow including a solid bolus is recommended. PMID:18493375

  19. Mast Cells Density Positive to Tryptase Correlates with Angiogenesis in Pancreatic Ductal Adenocarcinoma Patients Having Undergone Surgery

    PubMed Central

    Sacco, Rosario; Sammarco, Giuseppe; Donato, Giuseppe; Zuccalà, Valeria; Luposella, Maria; Patruno, Rosa; Marech, Ilaria; Montemurro, Severino; Zizzo, Nicola; Gadaleta, Cosmo Damiano

    2014-01-01

    Background. Literature data suggest that cells such as mast cells (MCs), are involved in angiogenesis. MCs can stimulate angiogenesis by releasing of several proangiogenic cytokines stored in their cytoplasm. In particular MCs can release tryptase, a potent in vivo and in vitro proangiogenic factor. Nevertheless few data are available concerning the role of MCs positive to tryptase in primary pancreatic cancer angiogenesis. This study analyzed MCs and angiogenesis in primary tumour tissue from patients affected by pancreatic ductal adenocarcinoma (PDAC). Method. A series of 31 PDAC patients with stage T2-3N0-1M0 (by AJCC for Pancreas Cancer Staging 7th Edition) was selected and then underwent surgery. Tumour tissue samples were evaluated by means of immunohistochemistry and image analysis methods in terms of number of MCs positive to tryptase (MCDPT), area occupied by MCs positive to tryptase (MCAPT), microvascular density (MVD), and endothelial area (EA). The above parameters were related to each other and to the main clinicopathological features. Results. A significant correlation between MCDPT, MCAPT, MVD, and EA group was found by Pearson's t-test analysis (r ranged from 0.69 to 0.81; P value ranged from 0.001 to 0.003). No other significant correlation was found. Conclusion. Our pilot data suggest that MCs positive to tryptase may play a role in PDAC angiogenesis and they could be further evaluated as a novel tumour biomarker and as a target of antiangiogenic therapy. PMID:24995015

  20. Esophageal reflexes modulate frontoparietal response in neonates: Novel application of concurrent NIRS and provocative esophageal manometry

    PubMed Central

    Pakiraih, Joanna F.; Hasenstab, Kathryn A.; Dar, Irfaan; Gao, Xiaoyu; Bates, D. Gregory; Kashou, Nasser H.

    2014-01-01

    Central and peripheral neural regulation of swallowing and aerodigestive reflexes is unclear in human neonates. Functional near infrared spectroscopy (NIRS) is a noninvasive method to measure changes in oxyhemoglobin (HbO) and deoxyhemoglobin (HbD). Pharyngoesophageal manometry permits evaluation of aerodigestive reflexes. Modalities were combined to investigate feasibility and to test neonatal frontoparietal cortical changes during pharyngoesophageal (visceral) stimulation and/or swallowing. Ten neonates (45.6 ± 3.0 wk postmenstrual age, 4.1 ± 0.5 kg) underwent novel pharyngoesophageal manometry concurrent with NIRS. To examine esophagus-brain interactions, we analyzed cortical hemodynamic response (HDR) latency and durations during aerodigestive provocation and esophageal reflexes. Data are presented as means ± SE or percent. HDR rates were 8.84 times more likely with basal spontaneous deglutition compared with sham stimuli (P = 0.004). Of 182 visceral stimuli, 95% were analyzable for esophageal responses, 38% for HDR, and 36% for both. Of analyzable HDR (n = 70): 1) HbO concentration (?mol/l) baseline 1.5 ± 0.7 vs. 3.7 ± 0.7 poststimulus was significant (P = 0.02), 2) HbD concentration (?mol/l) between baseline 0.1 ± 0.4 vs. poststimulus ?0.5 ± 0.4 was not significant (P = 0.73), and 3) hemispheric lateralization was 21% left only, 29% right only, and 50% bilateral. During concurrent esophageal and NIRS responses (n = 66): 1) peristaltic reflexes were present in 74% and HDR in 61% and 2) HDR was 4.75 times more likely with deglutition reflex vs. secondary peristaltic reflex (P = 0.016). Concurrent NIRS with visceral stimulation is feasible in neonates, and frontoparietal cortical activation is recognized. Deglutition contrasting with secondary peristalsis is related to cortical activation, thus implicating higher hierarchical aerodigestive protective functional neural networks. PMID:24789204

  1. Esophageal reflexes modulate frontoparietal response in neonates: Novel application of concurrent NIRS and provocative esophageal manometry.

    PubMed

    Jadcherla, Sudarshan R; Pakiraih, Joanna F; Hasenstab, Kathryn A; Dar, Irfaan; Gao, Xiaoyu; Bates, D Gregory; Kashou, Nasser H

    2014-07-01

    Central and peripheral neural regulation of swallowing and aerodigestive reflexes is unclear in human neonates. Functional near infrared spectroscopy (NIRS) is a noninvasive method to measure changes in oxyhemoglobin (HbO) and deoxyhemoglobin (HbD). Pharyngoesophageal manometry permits evaluation of aerodigestive reflexes. Modalities were combined to investigate feasibility and to test neonatal frontoparietal cortical changes during pharyngoesophageal (visceral) stimulation and/or swallowing. Ten neonates (45.6 ± 3.0 wk postmenstrual age, 4.1 ± 0.5 kg) underwent novel pharyngoesophageal manometry concurrent with NIRS. To examine esophagus-brain interactions, we analyzed cortical hemodynamic response (HDR) latency and durations during aerodigestive provocation and esophageal reflexes. Data are presented as means ± SE or percent. HDR rates were 8.84 times more likely with basal spontaneous deglutition compared with sham stimuli (P = 0.004). Of 182 visceral stimuli, 95% were analyzable for esophageal responses, 38% for HDR, and 36% for both. Of analyzable HDR (n = 70): 1) HbO concentration (?mol/l) baseline 1.5 ± 0.7 vs. 3.7 ± 0.7 poststimulus was significant (P = 0.02), 2) HbD concentration (?mol/l) between baseline 0.1 ± 0.4 vs. poststimulus -0.5 ± 0.4 was not significant (P = 0.73), and 3) hemispheric lateralization was 21% left only, 29% right only, and 50% bilateral. During concurrent esophageal and NIRS responses (n = 66): 1) peristaltic reflexes were present in 74% and HDR in 61% and 2) HDR was 4.75 times more likely with deglutition reflex vs. secondary peristaltic reflex (P = 0.016). Concurrent NIRS with visceral stimulation is feasible in neonates, and frontoparietal cortical activation is recognized. Deglutition contrasting with secondary peristalsis is related to cortical activation, thus implicating higher hierarchical aerodigestive protective functional neural networks. PMID:24789204

  2. 47 CFR 101.1327 - Renewal expectancy for EA licensees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 2010-10-01 2010-10-01 false Renewal expectancy for EA licensees. 101.1327...Systems System Requirements § 101.1327 Renewal expectancy for EA licensees. (a) A renewal applicant shall receive a renewal...

  3. Clinical Symptoms in Endoscopic Reflux Esophagitis: Evaluation in 8031 Adult Subjects

    Microsoft Academic Search

    Kazuyo Okamoto; Ryuichi Iwakiri; Mitsuru Mori; Megumi Hara; Kayoko Oda; Akiko Danjo; Akifumi Ootani; Hiroyuki Sakata; Kazuma Fujimoto

    2003-01-01

    This study aimed to evaluate the correlation between symptoms and endoscopic findings in reflux esophagitis. Subjects, 8031 persons without medication for gastrointestinal disease, were briefly asked about the presence of heartburn, dysphagia, odynophagia, and acid regurgitation by associated medical staff before endoscopy for assessment of esophagitis utilizing the Los Angeles Classification. Endoscopically, 1199 (14.9%) were classified as positive reflux esophagitis,

  4. Thoughts on the Complex Relationship Between Gastroesophageal Reflux Disease and Eosinophilic Esophagitis

    Microsoft Academic Search

    Stuart Jon Spechler; Robert M. Genta; Rhonda F. Souza

    2007-01-01

    Recent data suggest that the interaction between gastroesophageal reflux disease (GERD) and eosinophilic esophagitis can be complex, and that the notion of establishing a clear distinction between the two disorders may be too simplistic. There are at least four situations in which GERD might be associated with esophageal eosinophils: (a) GERD causes esophageal injury that results in a mild eosinophilic

  5. Failed Nissen fundoplication in two patients who had persistent vomiting and eosinophilic esophagitis

    Microsoft Academic Search

    Chris A Liacouras

    1997-01-01

    The following report describes two patients who had chronic symptoms of gastroesophageal reflux and persistent histological esophagitis, despite aggressive medical antireflux therapy, who continued to have esophagitis and remained symptomatic post antireflux surgery (Nissen fundoplication). Both patients demonstrated a severe eosinophilic esophagitis with normal gastric and duodenal histology before and after surgery. Postoperatively, each received the diagnosis of allergic enteritis

  6. Quantifying the Interfractional Displacement of the Gastroesophageal Junction During Radiation Therapy for Esophageal Cancer

    SciTech Connect

    Wang Jingya [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lin, Steven H., E-mail: shlin@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dong Lei; Balter, Peter; Mohan, Radhe [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Komaki, Ritsuko; Cox, James D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Starkschall, George [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-06-01

    Purpose: Accounting for interfractional changes in tumor location improves the accuracy of radiation treatment delivery. The purpose of this study was to quantify the interfractional displacement of the gastroesophageal junction (GEJ) based on standard treatment setup in patients with esophageal cancer undergoing radiation therapy. Methods and Materials: Free-breathing four-dimensional computed tomography (4D-CT) datasets were acquired weekly from 22 patients during treatment for esophageal adenocarcinoma. Scans were registered to baseline (simulation) 4D-CT scans by using bony landmarks. The distance between the center of the GEJ contour on the simulation scan and the mean location of GEJ centers on subsequent scans was used to assess changes in GEJ location between fractions; displacement was also correlated with clinical and respiratory variables. Results: The mean absolute random error was 1.69 mm (range, 0.11-4.11 mm) in the lateral direction, 1.87 mm (range, 0.51-4.09 mm) in the anterior-posterior (AP) direction, and 3.09 mm (range, 0.99-6.16 mm) in the superior-inferior (SI) direction. The mean absolute systemic GEJ displacement between fractions was 2.88 mm lateral ({>=}5 mm in 14%), mostly leftward; 2.90 mm ({>=}5 mm in 14%) AP, mostly anterior; and 6.77 mm ({>=}1 cm in 18%) SI, mostly inferior. Variations in tidal volume and diaphragmatic excursion during treatment correlated strongly with systematic SI GEJ displacement (r = 0.964, p < 0.0001; and r = 0.944, p < 0.0001, respectively) and moderately with systematic AP GEJ displacement (r = 0.678, p = 0.0005; r = 0.758, p < 0.0001, respectively). Systematic displacement in the inferior direction resulted in higher-than-intended doses ({>=}60 Gy) to the GEJ, with increased hot-spot to the adjacent stomach and lung base. Conclusion: We found large (>1-cm) interfractional displacements in the GEJ in the SI (especially inferior) direction that was not accounted for when skeletal alignment alone was used for patient positioning. Because systematic displacement in the SI direction had dosimetric impact and correlated with tidal volume, better accounting for depth of breathing is needed to reduce interfractional variability.

  7. F-prostanoid receptor regulation of inflammation in endometrial adenocarcinoma 

    E-print Network

    Wallace, Alison E.

    2010-01-01

    Endometrial adenocarcinoma is the most common gynaecological malignancy in Western countries, affecting mainly post-menopausal women with a frequency of 15-20 per 100 000 women per year. Over-expression of the cyclooxygenase ...

  8. Neurofibromatosis and small bowel adenocarcinoma: an unrecognised association.

    PubMed Central

    Jones, T J; Marshall, T L

    1987-01-01

    We present a review of the reported cases and describe a fifth of neurofibromatosis with small bowel adenocarcinoma and concurrent leiomyomas, indicating a previously unrecognised association. Images Fig. 1 Fig. 2 Fig. 3 PMID:3119436

  9. Effects of chemotherapy on ultrastructure of oesophageal adenocarcinoma.

    PubMed Central

    Darnton, S. J.; Antonakopoulos, G. N.; Newman, J.; Matthews, H. R.

    1992-01-01

    AIMS: To compare and contrast the ultrastructural appearance of resected oesophageal adenocarcinomas treated with preoperative chemotherapy with that of non-treated resected controls; and to determine the usefulness of this method in the assessment of the effectiveness of the chemotherapeutic regimen. METHODS: Ten resected oesophageal adenocarcinomas treated with preoperative chemotherapy--mitomycin-C, ifosfamide, and cisplatin (MIC)--were examined by transmission electron microscopy and their appearance compared with that of 13 concurrent untreated resected oesophageal adenocarcinomas. RESULTS: The treated adenocarcinomas showed cytotoxic damage although complete tumour eradication was not achieved. In all 10 treated cases a variable proportion of the neoplastic cells showed unusual degenerative and necrotic changes not seen in untreated cases. In the most affected carcinomas the stroma contained increased numbers of inflammatory cells. CONCLUSIONS: This ultrastructural method is useful for the assessment of the in vivo effect of MIC. Images PMID:1452793

  10. Discovery of New Molecular Subtypes in Oesophageal Adenocarcinoma

    PubMed Central

    Langer, Rupert; Schuster, Tibor; Feith, Marcus; Slotta-Huspenina, Julia; Malinowsky, Katharina; Becker, Karl-Friedrich

    2011-01-01

    A large number of patients suffering from oesophageal adenocarcinomas do not respond to conventional chemotherapy; therefore, it is necessary to identify new predictive biomarkers and patient signatures to improve patient outcomes and therapy selections. We analysed 87 formalin-fixed and paraffin-embedded (FFPE) oesophageal adenocarcinoma tissue samples with a reverse phase protein array (RPPA) to examine the expression of 17 cancer-related signalling molecules. Protein expression levels were analysed by unsupervised hierarchical clustering and correlated with clinicopathological parameters and overall patient survival. Proteomic analyses revealed a new, very promising molecular subtype of oesophageal adenocarcinoma patients characterised by low levels of the HSP27 family proteins and high expression of those of the HER family with positive lymph nodes, distant metastases and short overall survival. After confirmation in other independent studies, our results could be the foundation for the development of a Her2-targeted treatment option for this new patient subgroup of oesophageal adenocarcinoma. PMID:21966358

  11. Strategies to identify novel therapeutic targets for oesophageal adenocarcinoma 

    E-print Network

    O'Neill, John Robert

    2014-11-28

    Oesophageal adenocarcinoma (OAC) is a leading cause of cancer death in the UK and current systemic therapies are ineffective for the majority of patients. The central aim of this work was to explore strategies to identify ...

  12. Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy.

    PubMed

    Haefner, Matthias F; Lang, Kristin; Krug, David; Koerber, Stefan A; Uhlmann, Lorenz; Kieser, Meinhard; Debus, Juergen; Sterzing, Florian

    2015-07-01

    The aim of this study was to evaluate the effectiveness and tolerability of definitive chemo-radiation or radiotherapy alone in patients with esophageal cancer. We retrospectively analyzed the medical records of n = 238 patients with squamous cell carcinoma or adenocarcinoma of the esophagus treated with definitive radiotherapy with or without concomitant chemotherapy at our institution between 2000 and 2012. Patients of all stages were included to represent actual clinical routine. We performed univariate and multivariate analysis to identify prognostic factors for overall survival (OS) and progression-free survival (PFS). Moreover, treatment-related toxicity and patterns of recurrence were assessed. Patients recieved either chemo-radiation (64%), radiotherapy plus cetuximab (10%) or radiotherapy alone (26%). In 69%, a boost was applied, resulting in a median cumulative dose of 55.8 Gy; the remaining 31% received a median total dose of 50 Gy. For the entire cohort, the median OS and PFS were 15.0 and 11.0 months, respectively. In multivariate analysis, important prognostic factors for OS and PFS were T stage (OS: P = 0.005; PFS: P = 0.006), M stage (OS: P = 0.015; PFS: P = 0.003), concomitant chemotherapy (P < 0.001) and radiation doses of >55 Gy (OS: P = 0.019; PFS: P = 0.022). Recurrences occurred predominantly as local in-field relapse or distant metastases. Toxicity was dominated by nutritional impairment (12.6% with G3/4 dysphagia) and chemo-associated side effects. Definitive chemo-radiation in patients with esophageal cancer results in survival rates comparable with surgical treatment approaches. However, local and distant recurrence considerably restrict prognosis. Further advances in radio-oncological treatment strategies are necessary for improving outcome. PMID:25907360

  13. Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy

    PubMed Central

    Haefner, Matthias F.; Lang, Kristin; Krug, David; Koerber, Stefan A.; Uhlmann, Lorenz; Kieser, Meinhard; Debus, Juergen; Sterzing, Florian

    2015-01-01

    The aim of this study was to evaluate the effectiveness and tolerability of definitive chemo-radiation or radiotherapy alone in patients with esophageal cancer. We retrospectively analyzed the medical records of n = 238 patients with squamous cell carcinoma or adenocarcinoma of the esophagus treated with definitive radiotherapy with or without concomitant chemotherapy at our institution between 2000 and 2012. Patients of all stages were included to represent actual clinical routine. We performed univariate and multivariate analysis to identify prognostic factors for overall survival (OS) and progression-free survival (PFS). Moreover, treatment-related toxicity and patterns of recurrence were assessed. Patients recieved either chemo-radiation (64%), radiotherapy plus cetuximab (10%) or radiotherapy alone (26%). In 69%, a boost was applied, resulting in a median cumulative dose of 55.8 Gy; the remaining 31% received a median total dose of 50 Gy. For the entire cohort, the median OS and PFS were 15.0 and 11.0 months, respectively. In multivariate analysis, important prognostic factors for OS and PFS were T stage (OS: P = 0.005; PFS: P = 0.006), M stage (OS: P = 0.015; PFS: P = 0.003), concomitant chemotherapy (P < 0.001) and radiation doses of >55 Gy (OS: P = 0.019; PFS: P = 0.022). Recurrences occurred predominantly as local in-field relapse or distant metastases. Toxicity was dominated by nutritional impairment (12.6% with G3/4 dysphagia) and chemo-associated side effects. Definitive chemo-radiation in patients with esophageal cancer results in survival rates comparable with surgical treatment approaches. However, local and distant recurrence considerably restrict prognosis. Further advances in radio-oncological treatment strategies are necessary for improving outcome. PMID:25907360

  14. Metformin sensitizes chemotherapy by targeting cancer stem cells and the mTOR pathway in esophageal cancer.

    PubMed

    Honjo, Soichiro; Ajani, Jaffer A; Scott, Ailing W; Chen, Qiongrong; Skinner, Heath D; Stroehlein, John; Johnson, Randy L; Song, Shumei

    2014-08-01

    Our clinical study indicates esophageal adenocarcinoma patients on metformin had a better treatment response than those without metformin. However, the effects of metformin and the mechanisms of its action in esophageal cancer (EC) are unclear. EC cell lines were used to assess the effects of metformin alone or in combination with 5-fluorouracil on survival and apoptosis. RPPA proteomic array and immunoblots were used to identify signaling affected by metformin. Standard descriptive statistical methods were used. Reduction in cell survival and induction of apoptosis by metformin were observed in several EC cell lines. The use of metformin in combination with 5-FU significantly sensitized EC cells to the cytotoxic effect of 5-FU. RPPA array demonstrated that metformin decreased various oncogenes including PI3K/mTORsignaling and survival/cancer stem cell-related genes in cells treated with metformin compared with its control. Immunoblots and transcriptional analyses further confirm that metformin downregulated these CSC-related genes and the components of the mTOR pathway in a dose?dependent manner. Sorted ALDH-1+ cell tumor sphere forming capacity was preferentially reduced by metformin. Finally, metformin reduced tumor growth in vivo and when combined with FU, there was synergistic reduction in tumor growth. Metformin inhibits EC cell growth and sensitizes EC cells to 5-FU cytotoxic effects by targeting CSCs and the components of mTOR. The present study supports our previous clinical observations that the use of metformin is beneficial to EC patients. Metformin can complement other therapeutic combinations to effectively treat EC patients. PMID:24859412

  15. Hypersensitivity to acid is associated with impaired esophageal mucosal integrity in patients with gastroesophageal reflux disease with and without esophagitis.

    PubMed

    Weijenborg, Pim W; Smout, André J P M; Verseijden, Caroline; van Veen, Henk A; Verheij, Joanne; de Jonge, Wouter J; Bredenoord, Albert J

    2014-08-01

    Increased esophageal sensitivity and impaired mucosal integrity have both been described in patients with gastroesophageal reflux disease, but the relationship between hypersensitivity and mucosal integrity is unclear. The aim of the present study was to investigate acid sensitivity in patients with erosive and nonerosive reflux disease and control subjects to determine the relation with functional esophageal mucosal integrity changes as well as to investigate cellular mechanisms of impaired mucosal integrity in these patients. In this prospective experimental study, 12 patients with nonerosive reflux disease, 12 patients with esophagitis grade A or B, and 11 healthy control subjects underwent an acid perfusion test and upper endoscopy. Mucosal integrity was measured during endoscopy by electrical tissue impedance spectroscopy and biopsy specimens were analyzed in Ussing chambers for transepithelial electrical resistance, transepithelial permeability and gene expression of tight junction proteins and filaggrin. Patients with nonerosive reflux disease and esophagitis were more sensitive to acid perfusion compared with control subjects, having a shorter time to perception of heartburn and higher perceived intensity of heartburn. In reflux patients, enhanced acid sensitivity was associated with impairment of in vivo and vitro esophageal mucosal integrity. Mucosal integrity was significantly impaired in patients with esophagitis, displaying higher transepithelial permeability and lower extracellular impedance. Although no significant differences in the expression of tight junction proteins were found in biopsies among patient groups, mucosal integrity parameters in reflux patients correlated negatively with the expression of filaggrin. In conclusion, sensitivity to acid is enhanced in patients with gastroesophageal reflux disease, irrespective of the presence of erosions, and is associated with impaired esophageal mucosal integrity. Mucosal integrity of the esophagus is associated with the expression of filaggrin. PMID:24924748

  16. A phase II study of biweekly pralatrexate and docetaxel in patients with advanced esophageal and gastroesophageal carcinoma that have failed first-line platinum-based therapy

    PubMed Central

    Petullo, Brian; Wei, Lai; Yereb, Melissa; Neal, Alison; Rose, Jeffrey; Bekaii-Saab, Tanios

    2015-01-01

    Background The appropriate second-line therapy for patients with advanced gastroesophageal (GE) or esophageal (E) cancer after failure of first-line platinum-based therapy is unclear. Pralatrexate and docetaxel have independently been shown to have efficacy in the treatment of these cancers. Thus, we performed a clinical trial examining the efficacy of the combination of these agents in the treatment of GE and E cancer. Methods A Fleming phase II design with a single stage of 32 patients was planned. Pralatrexate 120 mg/m2 and docetaxel 35 mg/m2 were administered on day 1 of 14-day cycles. The primary end-point was to evaluate the overall response rate by Response Evaluation Criteria in Solid Tumors (RECIST) criteria, and secondary end-points were to evaluate for progression-free survival (PFS) and overall survival (OS). Results The study was halted prematurely due to loss of funding after the accrual of six patients. Two patients had stable disease (SD) and four patients had disease progression per RECIST. When applying PERCIST criteria in four evaluable patients, two had a partial response (PR) and two had SD. Median PFS was 1.9 months (95% CI, 0.8-7.2) and median OS was 5.5 (0.8-11.7) months. Conclusions Pralatrexate and docetaxel as therapy in refractory esophageal and GE adenocarcinoma did not demonstrate meaningful preliminary activity. PERCIST may prove to better assess the meaningfulness of anatomic SD. PMID:26029462

  17. The Samarkand EAS installation and experimental results

    NASA Astrophysics Data System (ADS)

    Makhmudov, B. M.; Sirodzhev, N. S.; Alimov, T. A.; Aliev, N. A.; Kakhkharov, M. K.; Khamikov, N. Kh.; Vernov, S. N.; Khristiansen, G. B.

    1982-09-01

    The Samarkand University extensive-air-shower installation is briefly described, and experimental results obtained at this installation are discussed. It is shown that the spatial distribution of EAS Cerenkov emission at distances of 10-100 m from the EAS axis with respect to shape and absolute value given a purely protonic composition of the primary radiation can be made compatible with the scaling model only under the assumption of an anomalously sharp increase with energy of the cross section of the inelastic interactions of hadrons with atomic air nuclei. In addition, it is shown that the Xmax(E0) relationship (Xmax is the position of the maximum of an individual EAS) obtained at E0 exceeding 10 to the 17th eV on the basis of Yakutsk data does not contradict Samarkand data at E0 = 10 to the 16th eV.

  18. Early cervical adenocarcinoma: selection criteria for radical surgery

    Microsoft Academic Search

    John O. Schorge; Kenneth R. Lee; Sandra J. Lee; Cynthia E. Flynn; Annekathryn Goodman; Ellen E. Sheets

    1999-01-01

    Objective: To identify selection criteria for radical surgery in early cervical adenocarcinoma based on pretreatment clinical stage and correlation with high-risk surgical-pathologic factors.Methods: One hundred seventy-five women with International Federation of Gynecology and Obstetrics (FIGO) clinical stage IB1 (n = 132) and IB2-IIA (n = 43) cervical adenocarcinoma were treated primarily at our institutions from 1982 to 1996. Histopathologic sections

  19. Effects of chemotherapy on ultrastructure of oesophageal adenocarcinoma

    Microsoft Academic Search

    S J Darnton; G N Antonakopoulos; J Newman; H R Matthews

    1992-01-01

    AIMS: To compare and contrast the ultrastructural appearance of resected oesophageal adenocarcinomas treated with preoperative chemotherapy with that of non-treated resected controls; and to determine the usefulness of this method in the assessment of the effectiveness of the chemotherapeutic regimen. METHODS: Ten resected oesophageal adenocarcinomas treated with preoperative chemotherapy--mitomycin-C, ifosfamide, and cisplatin (MIC)--were examined by transmission electron microscopy and their

  20. Unusual prostatic adenocarcinoma with endocrine basophilic FSH-immunoreactive cells

    Microsoft Academic Search

    Giovanni Serio; Clementina Zampatti; Guido Rindi

    2000-01-01

    We report an unusual variant of prostatic adenocarcinoma with marked endocrine differentiation (mixed endocrine-exocrine adenocarcinoma).\\u000a Endocrine cells accounted for 60% of the tumour cells, were positive with silver impregnation and for chromogranin A, synaptophysin,\\u000a and neuron-specific enolase, and coexpressed the exocrine antigens prostatic acid phosphatase and prostatic-specific antigen.\\u000a Most of the endocrine cells were basophilic with haematoxylin-eosin and proved immunoreactive

  1. Bilateral Endobronchial Metastasis in Postoperative Stage I Pulmonary Adenocarcinoma

    PubMed Central

    Onuki, Takamasa; Tatebayashi, Takayuki; Oyama, Kunihiro; Murasugi, Masahide; Nitta, Sumio

    2000-01-01

    We reported a case of bilateral endobronchial metastasis in postoperative synchronous adenocarcinoma. Twenty months ago, a 63-year-old man underwent combined operation. Biopsy was performed, histological diagnosis of pulmonary adenocarcinoma. When surgery is not indicated because the patient has decreased pulmonary function and contralateral metastatic lesions, the Nd–YAG laser has been used to treat focal malignancy of the trachea and mainstem bronchi, and the laser has been effective, especially in patients with inoperable lesions. PMID:18493517

  2. A case of periampullary adenocarcinoma in neurofibromatosis type 1

    PubMed Central

    Kistler, C. Andrew; Johnson, Jennifer M.; Winter, Jordan M.; Baliff, Jeffrey P.; Siddiqui, Ali A.

    2014-01-01

    Neurofibromatosis type 1 (NF-1) is an autosomal dominant genetic disorder with a known predisposition to gastrointestinal neoplasms such as stromal tumors and carcinoids. Adenocarcinomas (ACs) of the gastrointestinal tract are relatively rare in patients with NF-1, especially those found in the periampullary region. We present a case report of periampullary adenocarcinoma in a 56-year-old woman with NF-1 who presented with abdominal pain and obstructive jaundice. PMID:25436139

  3. Primary adenocarcinoma of the jejunum--a case report.

    PubMed

    Rózy?o-Kalinowska, I; Karski, J; Wo?nica, J; Z?omaniec, J

    2001-01-01

    A case of adenocarcinoma of jejunum is reported. Although survival figures in adenocarcinoma of the small bowel appear to correlate with early presentation, due to poor specificity of the symptoms a preoperative diagnosis is very seldom. Therefore, in order to improve the treatment outcome, the diagnosis must be done at an early stage. Thus there are discussed imaging modalities applied in diagnostics of this rare pathology. PMID:11977319

  4. Lymph Node Metastasis In Small Peripheral Adenocarcinoma Of The Lung

    Microsoft Academic Search

    Tsuneyo Takizawa; Masanori Terashima; Teruaki Koike; Takehiro Watanabe; Yuzo Kurita; Akira Yokoyama; Keiichi Honma

    1998-01-01

    Objective: Our aim in this study is to clarify the clinical and pathologic features of small peripheral adenocarcinoma of the lung with special emphasis on intraoperative identification of lymph node metastasis. Patients and methods: Between 1980 and 1996, 157 patients underwent lobectomy and complete hilar\\/mediastinal lymphadenectomy for small (1.1 to 2.0 cm in diameter) peripheral adenocarcinoma of the lung. The

  5. Stage IA 1 cervical adenocarcinoma: definition and treatment

    Microsoft Academic Search

    John O. Schorge; Kenneth R. Lee; Cynthia E. Flynn; Annekathryn Goodman; Ellen E. Sheets

    1999-01-01

    Objective: To propose a definition for stage IA1 cervical adenocarcinoma, based on the International Federation of Gynecology and Obstetrics (FIGO) staging system, and to determine if patients meeting criteria might be candidates for conservative surgery.Methods: Two hundred women were diagnosed with early-stage cervical adenocarcinoma from 1982 to 1996. Histopathologic sections were reviewed by a gynecologic pathologist. Medical records were reviewed,

  6. Volumetric modulated arc radiotherapy for esophageal cancer

    SciTech Connect

    Vivekanandan, Nagarajan, E-mail: viveknaren@hotmail.com [Department of Medical Physics, Cancer Institute, Chennai (India); Sriram, Padmanaban; Syam Kumar, S.A.; Bhuvaneswari, Narayanan; Saranya, Kamalakannan [Department of Medical Physics, Cancer Institute, Chennai (India)

    2012-04-01

    A treatment planning study was performed to evaluate the performance of volumetric arc modulation with RapidArc (RA) against 3D conformal radiation therapy (3D-CRT) and conventional intensity-modulated radiation therapy (IMRT) techniques for esophageal cancer. Computed tomgraphy scans of 10 patients were included in the study. 3D-CRT, 4-field IMRT, and single-arc and double-arc RA plans were generated with the aim to spare organs at risk (OAR) and healthy tissue while enforcing highly conformal target coverage. The planning objective was to deliver 54 Gy to the planning target volume (PTV) in 30 fractions. Plans were evaluated based on target conformity and dose-volume histograms of organs at risk (lung, spinal cord, and heart). The monitor unit (MU) and treatment delivery time were also evaluated to measure the treatment efficiency. The IMRT plan improves target conformity and spares OAR when compared with 3D-CRT. Target conformity improved with RA plans compared with IMRT. The mean lung dose was similar in all techniques. However, RA plans showed a reduction in the volume of the lung irradiated at V{sub 20Gy} and V{sub 30Gy} dose levels (range, 4.62-17.98%) compared with IMRT plans. The mean dose and D{sub 35%} of heart for the RA plans were better than the IMRT by 0.5-5.8%. Mean V{sub 10Gy} and integral dose to healthy tissue were almost similar in all techniques. But RA plans resulted in a reduced low-level dose bath (15-20 Gy) in the range of 14-16% compared with IMRT plans. The average MU needed to deliver the prescribed dose by RA technique was reduced by 20-25% compared with IMRT technique. The preliminary study on RA for esophageal cancers showed improvements in sparing OAR and healthy tissue with reduced beam-on time, whereas only double-arc RA offered improved target coverage compared with IMRT and 3D-CRT plans.

  7. Conventional X-ray examination in esophageal cancer: an opinion.

    PubMed

    Ponette, E; Dekeyzer, M; Van Steen, A; Lerut, T; Broeckaert, L; Geboes, K

    1991-01-01

    Double contrast is the best radiological technique for the detection of small esophageal cancer. Gastrografin is indicated when a blind mediastinal fistula is suspected; in cases of choking or suspicion of a fistula with the airways, a low osmotic hydrosoluble Iodium compound must be used. Conventional radiology and endoscopy are complementary techniques for the detection of esophageal cancer, as some lesions may be missed or misinterpreted by both. The need for endoscopic biopsy being incontestable for diagnostic confirmation and characterization, radiology presents some advantages over classic esophagoscopy for preoperative and the general pretherapeutic staging of esophageal carcinoma: assessment of topographical relation with the surrounding organs is possible and with the upper esophageal sphincter is easier; appreciation of tumoral extension along the longitudinal axis (tumor length, gastric invasion) remains mostly possible even in cases of severe stenosis; tumoral extension along the transverse axis (kinking, fistula) may be evaluated; detection of a second tumor or concomitant pathology distally from a stenosing tumor is mostly possible; moreover radiology is important before starting radiotherapy; and finally, previous radiology may reduce the (small) risk of endoscopic perforation. Radiology is indispensable or indicated in the posttherapeutic follow-up of esophageal carcinoma, as well after surgery as after endoscopic interventions, radiotherapy or chemotherapy. PMID:1797799

  8. Free radical scavengers prevent reflux esophagitis in rats.

    PubMed

    Wetscher, G J; Hinder, P R; Bagchi, D; Perdikis, G; Redmond, E J; Glaser, K; Adrian, T E; Hinder, R A

    1995-06-01

    Free radical damage in reflux esophagitis of rats induced by 24-hr duodenojejunal ligation was studied. Oxygen free radicals were selectively blocked. Groups were: sham operation, reflux, reflux + superoxide dismutase (SOD), catalase, dimethylthiourea, allopurinol, and inactivated SOD or inactivated catalase alone or in the combination SOD + catalase or SOD + catalase + dimethylthiourea + allopurinol. Macroscopic esophagitis was inhibited only by SOD, alone or in combination with other agents. Esophageal mucosal lipid peroxidation was 10-fold increased in the reflux group compared to the sham group (P < 0.05). This response was damped by SOD > catalase (P < 0.05) but not by the inactivated enzymes, dimethylthiourea or allopurinol. SOD + catalase showed no significant improvement on SOD alone. Total inhibition of lipid peroxidation was achieved by combining all scavengers. Total glutathione (GSH) in the esophageal mucosa was stimulated by reflux. This response was inhibited by scavengers equivalent to their efficacy in preventing lipid peroxidation. It is concluded that reflux esophagitis is associated with free radical release with O2- being the main source. Free radicals appear to stimulate GSH production in this prolonged oxidative stress. PMID:7781450

  9. Do We Know What Causes Eosinophilic Esophagitis? A Mechanistic Update.

    PubMed

    Runge, Thomas M; Dellon, Evan S

    2015-09-01

    The mechanisms underlying eosinophilic esophagitis (EoE) have been intensely investigated, and significant advances have been made in understanding the pathogenesis of EoE. EoE is defined as a chronic immune/antigen-mediated disease, characterized clinically by symptoms of esophageal dysfunction and histologically by an esophageal eosinophilic infiltrate. In this paper, we will review the current knowledge of EoE pathophysiology based on both animal and human data and discuss possible etiologic mechanisms from the genetic and environmental perspectives. EoE is a Th2-predominant inflammatory process triggered by allergens. Proinflammatory cytokines and chemokines recruit eosinophils and other effector cells, such as mast cells, into the esophageal epithelium, where they cause direct damage and promote esophageal remodeling. The genetic expression profile of EoE has been described, and several single nucleotide polymorphisms have been identified and associated with EoE. While this genetic contribution is important, it is difficult to postulate that EoE is primarily a genetic disease. Given the rapid epidemiologic changes in the incidence and prevalence of EoE over the past two decades, environmental factors may be the driving force. While it is not known what causes EoE in an individual patient at a specific time, the current hypothesis is that there is a complex interaction between genetic factors and environmental exposures that remains to be elucidated. PMID:26205715

  10. Endometrial Metastasis of Lung Adenocarcinoma: A Report of Two Cases

    PubMed Central

    Ahmad, Zeeshan; Raza, Ahmad; Patel, Manish R.

    2015-01-01

    Case series Patient: Female, 55 • Female, 51 Final Diagnosis: Metastatic lung adenocarcinoma Symptoms: Neck swelling Medication: Erlotinib Clinical Procedure: Lymph node biopsy Specialty: Oncology Objective: Unusual clinical course Background: The female genital tract is an uncommon site of involvement for extragenital malignancies. Ovarian, vaginal, and cervical metastasis has been described in the literature. Uterine corpus and, particularly, endometrial involvement are exceedingly rare. As the incidence of lung cancer is rising in the female population, metastatic uterine involvement by lung cancer is also being reported in the medical literature. Here, we report two cases of endometrial metastasis from primary lung adenocarcinoma. Case Report: The first case is a 55-year-old woman diagnosed with stage III lung adenocarcinoma who received initial treatment with sequential chemotherapy and radiotherapy, which resulted in complete response to treatment. However, patient was found to have recurrence soon after completion of initial treatment. Biopsy of a hypermetabolic lesion confirmed endometrial metastasis. The second case is a 51-year-old woman who presented with stage IV lung adenocarcinoma with metastasis to the uterus. EGFR mutation analysis of the lung mass and endometrial biopsy revealed epidermal growth factor receptor L858R mutation in exon 21. She had a positive response to EGFR-directed treatment of all areas of disease, including the uterus. Conclusions: Uterine metastasis from lung adenocarcinoma is uncommon and difficult to differentiate from primary uterine cancer. The possibility of lung cancer metastasis should be considered in patients who have adenocarcinoma on biopsy of uterine lesions. PMID:25981989

  11. [Low-grade adenocarcinoma of nasal cavities: a case report].

    PubMed

    Achour, I; Chakroun, A; Daoud, J; Hammami, B; Ghorbel, A

    2014-11-01

    Low-grade sinonasal adenocarcinomas are uncommon and recently described entities. Its histologic diagnosis is challenging. This tumour is characterized by a tendency to local invasion, and rare distant metastases. Well treated, the prognosis is excellent. We describe a case of low-grade nasal cavity adenocarcinoma and discuss the anatomoclinical, therapeutic and evolutionary characteristics of this malignant tumour. A 54-year-old female patient presented with a 10 years history of right-sided nasal obstruction and recurrent epistaxis. On examination the patient had a large, firm mass in the right nasal cavity. Endoscopic sinonasal surgery was performed. The lesion was found to originate from the posteriolateral wall of the right nasal cavity. Histopathology analysis identified a low-grade sinonasal adenocarcinoma. Upon follow-up 4 years after surgery, the patient exhibited no clinical evidence of recurrence. Low-grade sinonasal adenocarcinomas are poorly defined neoplasms, accounting for 4 to 20% of all sinonasal malignancies. The nasal cavity is the most frequently involved site. Low-grade sinonasal adenocarcinomas pose a diagnostic challenge for the pathologist because they must be distinguished from benign tumours, especially adenomas. The primary treatment of sinonasal adenocarcinoma is complete surgical excision. PMID:25284635

  12. Synchronous mucinous colonic adenocarcinoma and multiple small intestinal adenocarcinomas: report of a case and review of literature.

    PubMed

    Corvino, Antonio; Corvino, Fabio; Radice, Leonardo; Catalano, Orlando

    2015-01-01

    With the wide use of diagnostic imaging modalities, multiple primary malignancies frequently occur; different associations of malignancies have been reported. We describe the case of a primary mucinous adenocarcinoma of large bowel synchronous with three primary poorly differentiated adenocarcinomas of ileum. This type of association has not been described yet; since computed tomography increasingly is proving to be highly accurate in detection of colon cancer, this technique is recommended in such patients. PMID:25744428

  13. Barrett's Esophagus Translational Research Network (BETRNet) | Division of Cancer Prevention

    Cancer.gov

    BETRNet, a multi-disciplinary, multi-institutional collaboration co-sponsored by NCI's Division of Cancer Prevention and Division of Cancer Biology, was established to centralize and enhance efforts to understand Barrett's esophagus (BE) and to prevent esophageal adenocarcinoma (EA).

  14. Radionuclide transit: a sensitive screening test for esophageal dysfunction

    SciTech Connect

    Russell, C.O.; Hill, L.D.; Holmes, E.R. III; Hull, D.A.; Gannon, R.; Pope, C.E. II

    1981-05-01

    The purpose of this study was to extend existing nuclear medicine techniques for the diagnosis of esophageal motor disorders. A standard homogeneous bolus of 99mtechnetium sulfur colloid in water was swallowed in the supine position under the collimator of a gamma camera linked to a microprocessor. Bolus transit was recorded at 0.4-s intervals, and the movie obtained was used to analyze transit in an objective manner. Ten normal volunteers and 30 subjects with dysphagia not related to mechanical obstruction were studied with this technique. Radionuclide transit studies detected a higher incidence of esophageal motor abnormality than manometry or radiology in the dysphagia group. In addition a definitive description of the functional problem was possible in most cases. Radionuclide transit is a safe noninvasive test and suitable as a screening test for esophageal motor disorders.

  15. Abnormalities of esophageal and gastric emptying in progressive systemic sclerosis

    SciTech Connect

    Maddern, G.J.; Horowitz, M.; Jamieson, G.G.; Chatterton, B.E.; Collins, P.J.; Roberts-Thomson, P.

    1984-10-01

    Gastric and esophageal emptying were assessed using scintigraphic techniques in 12 patients with progressive systemic sclerosis and 22 normal volunteers. Esophageal emptying was significantly delayed in the patient group, with 7 of the 12 patients beyond the normal range. Gastric emptying was slower in patients than in controls, with 9 patients being outside the normal range for solid emptying and 7 patients outside the normal range for liquid emptying. Findings from gastric and esophageal emptying tests generally correlated well with symptoms of dysphagia and gastroesophageal reflux. However, 2 patients with normal emptying studies had symptomatic heartburn, and 2 patients with delay of both solid and liquid gastric emptying gave no history of gastroesophageal reflux. Delayed gastric emptying may be an important factor in the development of upper gastrointestinal symptoms in patients with progressive systemic sclerosis.

  16. An etiological role for aeroallergens and eosinophils in experimental esophagitis

    PubMed Central

    Mishra, Anil; Hogan, Simon P.; Brandt, Eric B.; Rothenberg, Marc E.

    2001-01-01

    Eosinophil infiltration into the esophagus is observed in diverse diseases including gastroesophageal reflux and allergic gastroenteritis, but the processes involved are largely unknown. We now report an original model of experimental esophagitis induced by exposure of mice to respiratory allergen. Allergen-challenged mice develop marked levels of esophageal eosinophils, free eosinophil granules, and epithelial cell hyperplasia, features that mimic the human disorders. Interestingly, exposure of mice to oral or intragastric allergen does not promote eosinophilic esophagitis, indicating that hypersensitivity in the esophagus occurs with simultaneous development of pulmonary inflammation. Furthermore, in the absence of eotaxin, eosinophil recruitment is attenuated, whereas in the absence of IL-5, eosinophil accumulation and epithelial hyperplasia are ablated. These results establish a pathophysiological connection between allergic hypersensitivity responses in the lung and esophagus and demonstrate an etiologic role for inhaled allergens and eosinophils in gastrointestinal inflammation. PMID:11134183

  17. An Update on Modern Approaches to Localized Esophageal Cancer

    PubMed Central

    Welsh, James; Amini, Arya; Likhacheva, Anna; Erasmus, Jeremy; Gomez, Daniel; Davila, Marta; Mehran, Reza J; Komaki, Ritsuko; Liao, Zhongxing; Hofstetter, Wayne L; Bhutani, Manoop; Ajani, Jaffer A

    2014-01-01

    Esophageal cancer treatment continues to be a topic of wide debate. Based on improvements in chemotherapy drugs, surgical techniques, and radiotherapy advances, esophageal cancer treatment approaches are becoming more specific to the stage of the tumor and the overall performance status of the patient. While surgery continues to be the standard treatment option for localized disease, the current direction favors multimodality treatment including both radiation and chemotherapy with surgery. In the next few years, we will continue to see improvements in radiation techniques and proton treatment, with more minimally invasive surgical approaches minimizing postoperative side effects, and the discovery of molecular biomarkers to help deliver more specifically targeted medication to treat esophageal cancers. PMID:21365188

  18. [Rubber-band ligation of esophageal and cardiac varices].

    PubMed

    Arnon, R; Zimmerman, J; Keret, D; Lysy, J; Wengrower, D; Fich, A; Goldin, E

    1993-01-15

    Esophageal sclerotherapy was the treatment of choice for bleeding esophageal varices in the past decade. It is effective for treating acute variceal bleeding, as well as eradicating esophageal varices for secondary prevention of bleeding. However, in more than 20% of patients sclerotherapy involves complications, some of which are serious. The high complication rate suggested the development of a new method that should be at least as effective and as easy to perform as sclerotherapy, but with fewer complications and side-effects. Endoscopic variceal ligation was developed at the University of Colorado and described in 1986. It is reported to control active variceal bleeding in about 90% of patients, and to eradicate varices in about 80% of surviving patients. Complications are rare. We have adapted the method in our unit and here describe out preliminary experience in 11 patients. PMID:8436323

  19. [Esophageal toxicity of radiation therapy: clinical risk factors and management].

    PubMed

    Challand, T; Thureau, S; Dubray, B; Giraud, P

    2012-09-01

    Acute radiation-induced esophagitis includes all clinical symptoms (odynophagia, dysphagia) occurring within 90 days after thoracic irradiation start. Its severity can be graded using RTOG and CTCAE scales. The clinical risk factors are: age, female gender, initial performance status, pre-therapeutic body mass index, pre-therapeutic dysphagia, tumoral and nodal stage, delivered dose, accelerated hyperfractionned radiotherapy, concomitant association of chemotherapy to radiotherapy and response to the treatment. The dosimetric parameters predictive of esophagitis are: mean dose, V(20Gy), V(30Gy), V(40Gy), V(45Gy) and V(50Gy). Amifostine is the only drug to have a proven radioprotective efficacy (evidence level C, ESMO recommendation grade III). The medical management of esophagitis associates a diet excluding irritant food, medication against gastroesophageal reflux, analgesic treatment according to the WHO scale and management of dehydration and denutrition by enteral feeding. PMID:22925486

  20. Eosinophilic esophagitis: a practical approach to diagnosis and management.

    PubMed

    Molina-Infante, Javier; Lucendo, Alfredo J

    2014-11-01

    Eosinophilic esophagitis (EoE) has emerged as a common cause of dysphagia and food impaction in children and adults. A trial of proton pump inhibitor (PPI) therapy is a mandatory diagnostic first step, given that at least one third of patients with suspected EoE will have PPI-responsive esophageal eosinophilia. Once EoE is diagnosed, short-and long-term therapeutic decision making may rely on patient symptoms, phenotype (inflammatory vs fibrostenotic) and preferences. Currently, the most reliable therapeutic targets are mucosal healing and caliber abnormalities resolution. Topical steroids followed by endoscopic dilation are recommended in symptomatic narrow caliber esophagus/strictures, whereas either topical steroids or dietary therapy are good short-term options for mucosal inflammation. Maintenance anti-inflammatory therapy is necessary to prevent esophageal fibrotic remodeling and stricture formation. PMID:24830679

  1. Expression and Diagnostic Value of HE4 in Pancreatic Adenocarcinoma

    PubMed Central

    Huang, Tianhe; Jiang, Shi-Wen; Qin, Liangyi; Senkowski, Christopher; Lyle, Christian; Terry, Karen; Brower, Steven; Chen, Haibin; Glasgow, Wayne; Wei, Yongchang; Li, Jinping

    2015-01-01

    Human epididymis protein 4 (HE4) is a recognized biomarker in ovarian and endometrial cancer and over-expressed in pancreatic adenocarcinoma. The diagnostic value of HE4 in pancreatic adenocarcinoma remains unknown. Here we elucidate mRNA, protein and serum level of HE4 in pancreatic adenocarcinoma. HE4 mRNA level in tumor adjacent tissues and pancreatic adenocarcinoma tissues were tested by real time-PCR. Tissue microarray containing normal, adenocarcinoma, and adjacent pancreatic tissue was tested by immunohistochemistry (IHC). Serum level of HE4, carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3) and carbohydrate antigen 125 (CA125) were detected by ELISA assay in control and tumor patients. Further we compared the sensitivity and specificity of determining HE4, CA19-9, CA15-3, and CA125 for diagnosis of pancreatic adenocarcinoma and assessed the complementary diagnostic value of HE4, CA19-9, CA15-3 and CA125. Real time PCR showed significantly increased HE4 mRNA level in pancreatic adenocarcinoma compared with control. Result of IHC showed that HE4 significantly higher expressed in the human pancreatic carcinoma tissues than in both normal and adjacent non-tumorous pancreatic tissues, and the staining intensity is inversely correlated with the clinical stage. HE4 was highly expressed in early stage of pancreatic adenocarcinoma. Serum HE4 level is higher in cases with pancreatic adenocarcinoma than in the controls. Serum HE4 levels could research to a sensitivity of 45.83% and specificity of 93.75% when the Cutoff was set at 4.59 ng/mL. The Combined HE4 and CA19-9 increased the sensitivity to 83.33%; and interestingly, the combination of HE4 with CA15-3 led to the most powerful sensitivity of 87.5%. Combined with CA19-9 and CA15-3, HE4 could be a potential biomarker to improve the diagnostic power for pancreatic adenocarcinoma. PMID:25642754

  2. Esophagitis in Sprague-Dawley rats is mediated by free radicals.

    PubMed

    Wetscher, G J; Perdikis, G; Kretchmar, D H; Stinson, R G; Bagchi, D; Redmond, E J; Adrian, T E; Hinder, R A

    1995-06-01

    Free radical-mediated esophagitis was studied during duodenogastroesophageal reflux (mixed reflux) or acid reflux in rats. The influence of reflux on esophageal glutathione levels was also examined. Mixed reflux caused more gross mucosal injury than acid reflux. Gross mucosal injury occurred in the mid-esophagus. Total glutathione (GSH) in the esophageal mucosa of control rats was highest in the distal esophagus. The time course of esophageal GSH in rats treated by mixed reflux showed a significant decrease 4 hr after initiation of reflux, followed by a significant increase from the 12th hour on. Mucosal GSH was increased in both reflux groups after 24 hr but significantly more so in the mixed than in the acid reflux group. The free radical scavenger superoxide dismutase (SOD) prevented esophagitis and was associated with decreased GSH levels. GSH depletion by buthionine sulfoximine (BSO) prevented esophagitis and stimulated SOD production in the esophageal mucosa. It is concluded that gastroesophageal reflux is associated with oxidative stress in the esophageal mucosa. The lower GSH levels in the mid-esophagus may predispose to damage in this area. Duodenogastroesophageal reflux causes more damage than pure acid reflux. Oxidative stress leads to GSH depletion of the esophageal mucosa in the first few hours following damage but then stimulates GSH production. GSH depletion by BSO does not worsen esophagitis since it increases the esophageal SOD concentration. PMID:7781451

  3. Endoscopic mucosal resection of duodenal bulb adenocarcinoma with neuroendocrine features: An extremely rare case report

    PubMed Central

    Wen, Ming-Yao; Wang, Yu; Meng, Xiao-Yan; Xie, Hua-Ping

    2015-01-01

    Duodenal adenocarcinoma, especially duodenal bulb with neuroendocrine features (NEF), is extremely rare. Here, we report one such case of duodenal bulb adenocarcinoma with neuroendocrine features. A 63-year-old Han Chinese woman was admitted to our department with the diagnosis of a duodenal bulb polyp and underwent an endoscopic mucosal resection. The pathological findings confirmed it as duodenal bulb adenocarcinoma with NEF. The patient remains curative after one and half a years of follow-up. Duodenal adenocarcinoma with NEF might be a low malignant neuroendocrine tumor rather than a conventional adenocarcinoma. Endoscopic treatment, including endoscopic mucosal resection, might be an ideal option for the adenocarcinomas with NEF.

  4. A Novel Approach to Management of Esophageal Pill Impaction

    PubMed Central

    Caufield, Sean; Lavery, Eric; Partridge, Brett

    2014-01-01

    A 26-year-old male presented with symptoms of acute esophageal obstruction immediately after swallowing an 800-mg ibuprofen tablet. Multiple attempts to extract the pill with a variety of traditional endoscopic retrieval devices were unsuccessful. We successfully destroyed the pill using a threaded-tip biliary stent retrieval device to drill a hole in the center of the pill, which allowed us to use a rat-tooth forceps to crush the pill. This case report demonstrates a novel use of this device in a challenging esophageal pill extraction.

  5. Paraneoplastic cutaneous lupus secondary to esophageal squamous cell carcinoma

    PubMed Central

    Tworek, Joseph; Schapiro, Brian; Zolotarevsky, Eugene

    2015-01-01

    Sporadic subacute cutaneous lupus erythematosus (SCLE) in an elderly man does not fit a typical demographic for the disease process. Using the McLean’s criteria we were able to establish a temporal relationship between the patient’s diagnosis of esophageal squamous cell carcinoma (SCC) and his dermatosis, both of which responded to cytotoxic chemotherapy. The clinical presentation and progression of the clinical illness is supportive of a very unusual and not previously reported paraneoplastic SCLE secondary to esophageal SCC. PMID:26029469

  6. Recent advances in the recognition and management of eosinophilic esophagitis.

    PubMed

    Eustace, Gregory; Gui, Xianyong; Iacucci, Marietta

    2015-01-01

    The incidence and recognition of eosinophilic esophagitis is increasing. Pathophysiological understanding of eosinophilic esophagitis is improving and an immunological reaction to ingested food is likely to play a significant role. Patients present with dysphagia and food bolus obstruction. Both histological and endoscopic criteria have been developed and validated. Dietary therapy, topical steroid therapy, proton pump inhibitors and endoscopic dilation are the main approaches to therapy; however, novel targeted therapies are being developed. Among the food items commonly implicated are wheat, dairy, nuts, soy, shellfish and eggs. A multidisciplinary approach to management in dedicated clinics may yield the best results. PMID:26076223

  7. A case of eosinophilic esophagitis caused by a cedar ball.

    PubMed

    Fukuoka, Keiko; Izumi, Toshinobu; Yaku, Hiroaki; Okada, Hirokazu; Tsubosaka, Mako; Okada, Yuki; Ikemura, Takahiro; Kawase, Yoshito

    2015-01-01

    A 65-year-old woman presented to our hospital with chief complaints of a strange sensation in her pharynx, dysphagia, and odynophagia. Upper gastrointestinal endoscopy showed multiple aphthae in the esophagus and she was diagnosed with eosinophilic esophagitis based on the results of biopsy. Swallowing therapy with fluticasone was scheduled; however, she subsequently developed urticaria. She was treated with systemic steroid therapy at another hospital, which improved her symptoms and endoscopic images. A detailed history revealed that she had experienced significant facial edema after making a cedar ball. It was considered that the eosinophilic esophagitis was possibly caused by cedar pollen. PMID:26050724

  8. Esophageal perforation after radiofrequency ablation for atrial fibrillation.

    PubMed

    Manouchehri, Namdar; Turner, Simon R; Lockwood, Evan; Sterns, Laurence D; Bédard, Eric Lr

    2014-11-01

    A 69-year-old man underwent left atrial radiofrequency ablation for atrial fibrillation. After 10 minutes, the procedure was terminated due to pericardial tamponade secondary to perforation during mapping. Pericardiocentesis resolved the tamponade. Ablation was completed one week later, and the patient was discharged. Two days later, he presented with odynophagia. Computed tomography demonstrated small bilateral pleural effusions. He was judged to be stable and was discharged again, but returned 2 days later with chest pain. He was found to have esophageal perforation with empyema, which was repaired using a muscle patch and esophageal stenting, successfully treating the lesion with minimal morbidity. PMID:24887888

  9. Understanding EA Dynamics via Population Fitness Distributions

    E-print Network

    George Mason University

    Understanding EA Dynamics via Population Fitness Distributions Elena Popovici and Kenneth De Jong population fitness distribution rather than just "best-so-far" curves. But characterizing how repeated fitness landscapes. Our approach is to study empirically derived fitness distributions, both qual

  10. TRANSPORT PROPERTY MEASUREMENTS OF HFC-236EA

    EPA Science Inventory

    The report gives results of an evaluation of transport properties of 1,1,1,2,3,3,-hexafluoropropane (HFC-236ea), with liquid viscosity and thermal conductivity being the two main transport properties of interest. In addition, the specific heat and density of refrigerant/lubrican...

  11. TRANSPORT PROPERTY MEASUREMENTS OF HFC-236EA

    EPA Science Inventory

    The report gives results of an evaluation of transport properties of 1, 1, 1, 2, 3, 3-hexafluoropropane (HFC-236ea), with liquid viscosity and thermal conductivity being the two main transport properties of interest. In addition, the specific heat and density of refrigerant/lubri...

  12. Comprehensive molecular characterization of gastric adenocarcinoma

    PubMed Central

    Bass, Adam J.; Thorsson, Vesteinn; Shmulevich, Ilya; Reynolds, Sheila M.; Miller, Michael; Bernard, Brady; Hinoue, Toshinori; Laird, Peter W.; Curtis, Christina; Shen, Hui; Weisenberger, Daniel J.; Schultz, Nikolaus; Shen, Ronglai; Weinhold, Nils; Kelsen, David P.; Bowlby, Reanne; Chu, Andy; Kasaian, Katayoon; Mungall, Andrew J.; Robertson, A. Gordon; Sipahimalani, Payal; Cherniack, Andrew; Getz, Gad; Liu, Yingchun; Noble, Michael S.; Pedamallu, Chandra; Sougnez, Carrie; Taylor-Weiner, Amaro; Akbani, Rehan; Lee, Ju-Seog; Liu, Wenbin; Mills, Gordon B.; Yang, Da; Zhang, Wei; Pantazi, Angeliki; Parfenov, Michael; Gulley, Margaret; Piazuelo, M. Blanca; Schneider, Barbara G.; Kim, Jihun; Boussioutas, Alex; Sheth, Margi; Demchok, John A.; Rabkin, Charles S.; Willis, Joseph E.; Ng, Sam; Garman, Katherine; Beer, David G.; Pennathur, Arjun; Raphael, Benjamin J.; Wu, Hsin-Ta; Odze, Robert; Kim, Hark K.; Bowen, Jay; Leraas, Kristen M.; Lichtenberg, Tara M.; Weaver, Stephanie; McLellan, Michael; Wiznerowicz, Maciej; Sakai, Ryo; Getz, Gad; Sougnez, Carrie; Lawrence, Michael S.; Cibulskis, Kristian; Lichtenstein, Lee; Fisher, Sheila; Gabriel, Stacey B.; Lander, Eric S.; Ding, Li; Niu, Beifang; Ally, Adrian; Balasundaram, Miruna; Birol, Inanc; Bowlby, Reanne; Brooks, Denise; Butterfield, Yaron S. N.; Carlsen, Rebecca; Chu, Andy; Chu, Justin; Chuah, Eric; Chun, Hye-Jung E.; Clarke, Amanda; Dhalla, Noreen; Guin, Ranabir; Holt, Robert A.; Jones, Steven J.M.; Kasaian, Katayoon; Lee, Darlene; Li, Haiyan A.; Lim, Emilia; Ma, Yussanne; Marra, Marco A.; Mayo, Michael; Moore, Richard A.; Mungall, Andrew J.; Mungall, Karen L.; Nip, Ka Ming; Robertson, A. Gordon; Schein, Jacqueline E.; Sipahimalani, Payal; Tam, Angela; Thiessen, Nina; Beroukhim, Rameen; Carter, Scott L.; Cherniack, Andrew D.; Cho, Juok; Cibulskis, Kristian; DiCara, Daniel; Frazer, Scott; Fisher, Sheila; Gabriel, Stacey B.; Gehlenborg, Nils; Heiman, David I.; Jung, Joonil; Kim, Jaegil; Lander, Eric S.; Lawrence, Michael S.; Lichtenstein, Lee; Lin, Pei; Meyerson, Matthew; Ojesina, Akinyemi I.; Pedamallu, Chandra Sekhar; Saksena, Gordon; Schumacher, Steven E.; Sougnez, Carrie; Stojanov, Petar; Tabak, Barbara; Taylor-Weiner, Amaro; Voet, Doug; Rosenberg, Mara; Zack, Travis I.; Zhang, Hailei; Zou, Lihua; Protopopov, Alexei; Santoso, Netty; Parfenov, Michael; Lee, Semin; Zhang, Jianhua; Mahadeshwar, Harshad S.; Tang, Jiabin; Ren, Xiaojia; Seth, Sahil; Yang, Lixing; Xu, Andrew W.; Song, Xingzhi; Pantazi, Angeliki; Xi, Ruibin; Bristow, Christopher A.; Hadjipanayis, Angela; Seidman, Jonathan; Chin, Lynda; Park, Peter J.; Kucherlapati, Raju; Akbani, Rehan; Ling, Shiyun; Liu, Wenbin; Rao, Arvind; Weinstein, John N.; Kim, Sang-Bae; Lee, Ju-Seog; Lu, Yiling; Mills, Gordon; Laird, Peter W.; Hinoue, Toshinori; Weisenberger, Daniel J.; Bootwalla, Moiz S.; Lai, Phillip H.; Shen, Hui; Triche, Timothy; Van Den Berg, David J.; Baylin, Stephen B.; Herman, James G.; Getz, Gad; Chin, Lynda; Liu, Yingchun; Murray, Bradley A.; Noble, Michael S.; Askoy, B. Arman; Ciriello, Giovanni; Dresdner, Gideon; Gao, Jianjiong; Gross, Benjamin; Jacobsen, Anders; Lee, William; Ramirez, Ricardo; Sander, Chris; Schultz, Nikolaus; Senbabaoglu, Yasin; Sinha, Rileen; Sumer, S. Onur; Sun, Yichao; Weinhold, Nils; Thorsson, Vésteinn; Bernard, Brady; Iype, Lisa; Kramer, Roger W.; Kreisberg, Richard; Miller, Michael; Reynolds, Sheila M.; Rovira, Hector; Tasman, Natalie; Shmulevich, Ilya; Ng, Santa Cruz Sam; Haussler, David; Stuart, Josh M.; Akbani, Rehan; Ling, Shiyun; Liu, Wenbin; Rao, Arvind; Weinstein, John N.; Verhaak, Roeland G.W.; Mills, Gordon B.; Leiserson, Mark D. M.; Raphael, Benjamin J.; Wu, Hsin-Ta; Taylor, Barry S.; Black, Aaron D.; Bowen, Jay; Carney, Julie Ann; Gastier-Foster, Julie M.; Helsel, Carmen; Leraas, Kristen M.; Lichtenberg, Tara M.; McAllister, Cynthia; Ramirez, Nilsa C.; Tabler, Teresa R.; Wise, Lisa; Zmuda, Erik; Penny, Robert; Crain, Daniel; Gardner, Johanna; Lau, Kevin; Curely, Erin; Mallery, David; Morris, Scott; Paulauskis, Joseph; Shelton, Troy; Shelton, Candace; Sherman, Mark; Benz, Christopher; Lee, Jae-Hyuk; Fedosenko, Konstantin; Manikhas, Georgy; Potapova, Olga; Voronina, Olga; Belyaev, Smitry; Dolzhansky, Oleg; Rathmell, W. Kimryn; Brzezinski, Jakub; Ibbs, Matthew; Korski, Konstanty; Kycler, Witold; ?aŸniak, Radoslaw; Leporowska, Ewa; Mackiewicz, Andrzej; Murawa, Dawid; Murawa, Pawel; Spycha?a, Arkadiusz; Suchorska, Wiktoria M.; Tatka, Honorata; Teresiak, Marek; Wiznerowicz, Maciej; Abdel-Misih, Raafat; Bennett, Joseph; Brown, Jennifer; Iacocca, Mary; Rabeno, Brenda; Kwon, Sun-Young

    2014-01-01

    Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein–Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also knownasPD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies. PMID:25079317

  13. Systemic therapy for metastatic pancreatic adenocarcinoma

    PubMed Central

    Lawrence, Ben; Findlay, Michael

    2010-01-01

    Systemic treatment of metastatic pancreatic adenocarcinoma achieves only modest benefits, with evidence indicating a survival advantage with 5-fluorouracil (5-FU) over best supportive care alone, and further advantage of single-agent gemcitabine over 5-FU. There are very few regimens better than single-agent gemcitabine despite multiple trials of cytotoxic and targeted agents. The addition of a platinum agent has improved response rate but not survival. The addition of erlotinib has improved survival but only by a small margin. The use of gemcitabine in multidrug regimens containing one or more of: a platinum agent; fluoropyrimidine; anthracycline; and taxane has demonstrated advantages in response rate, progression-free survival and, in one randomized study, overall survival. After gemcitabine failure, second-line therapy with oxaliplatin and 5-FU provides a further survival advantage. Further advances depend upon the current and future clinical trials investigating enhanced delivery of current agents, new agents and novel modalities, improved supportive care, and treatment more tailored to the individual patient and tumour. PMID:21789129

  14. Management of stage II endometrial adenocarcinoma

    SciTech Connect

    Trimble, E.L.; Jones, H.W. III

    1988-03-01

    Charts of 36 patients with clinical stage II endometrial adenocarcinoma over ten years were reviewed. All were staged before any treatment, in accordance with International Federation of Gynecology and Obstetrics (FIGO) guidelines. Although details of treatment varied, two main protocols were used. Fourteen patients were treated with the standard protocol involving external whole-pelvis radiation, followed by intracavitary cesium and then hysterectomy. In 1981, a modified protocol was introduced, which called for a hysterectomy immediately following intrauterine and vaginal cesium. External radiation therapy was given only to those patients found to have deep myometrial invasion or cervical involvement. Of 14 patients treated by this protocol, seven had no surgical indication for postoperative external radiation. There was no increase in recurrence in these patients, and the five-year survival rate was 76% for patients treated with the modified protocol compared with 65% for those who had standard therapy. Morbidity related to external radiation therapy occurred in two patients with the standard protocol and one patient who received pelvic radiation on the modified protocol.

  15. Comprehensive molecular characterization of gastric adenocarcinoma.

    PubMed

    2014-09-11

    Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein-Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also known as PD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies. PMID:25079317

  16. Adenocarcinoma of the parotid gland with calcification.

    PubMed

    Song, H-U; Kwon, K-J; Koh, K-J

    2003-03-01

    A 78-year-old Korean woman was referred to Chonbuk National University Dental Hospital complaining of facial palsy and palpable mass in the right parotid gland area for 4 years. Clinical examination showed an asymmetrical facial appearance due to a 4 cmx5 cm hard, fixed, non-tender mass in the right parotid gland area, incomplete eye closure and a slight tremor at the corner of the mouth. A panoramic radiograph showed an amorphous calcified mass on the posterior mandibular ramus with thinning of the cortical plate adjacent to the mass. A sialogram showed constriction of the main duct and no further filling of striated, intercalated ducts and parenchymal areas. CT indicated an expansile mass with slight contrast enhancement involving the right parotid gland. The large mass showed necrotic areas and calcifications. A bone scan showed marked accumulation of (99)Tc(m)-methylene diphosphonate on the right posterior maxilla. Microscopic findings revealed minimal morphological alterations and rare mitotic figures within tumour cells, and the lesion was diagnosed as adenocarcinoma not otherwise specified (NOS, grade II). PMID:12775669

  17. Ovarian clear cell adenocarcinoma: a continuing enigma.

    PubMed

    Tan, David S P; Kaye, Stan

    2007-04-01

    Ovarian clear cell adenocarcinomas (OCCAs) account for <5% of all ovarian malignancies. Compared to other epithelial ovarian cancer (EOC) subtypes, when at an advanced stage, they are associated with a poorer prognosis and are relatively resistant to conventional platinum-based chemotherapy. By contrast, early-stage clear cell ovarian cancer carries a relatively good prognosis. Hence, there is a need to improve our understanding of its pathobiology in order to optimise currently available treatments and develop new therapeutic strategies. This review summarises the currently available literature regarding the pathogenesis of OCCA, its molecular genetic features and postulated molecular mechanisms that underlie its chemoresistant phenotype. Marked similarities with clear cell carcinomas of the kidney and endometrium have been noted by some investigators, raising interesting possibilities regarding novel therapeutic approaches. Unfortunately, most studies on OCCA have hitherto been hampered by insufficient sample sizes, leaving many key issues unresolved. It is envisaged that in the future, high-resolution genomic and gene-expression microarray studies incorporating larger sample sizes will lead to the characterisation of the key molecular players in OCCA biology, which may potentially lead to the identification of novel targets for therapeutic development. PMID:17018684

  18. Syringetin suppresses osteoclastogenesis mediated by osteoblasts in human lung adenocarcinoma.

    PubMed

    Tsai, Ying-Ming; Chong, Inn-Wen; Hung, Jen-Yu; Chang, Wei-An; Kuo, Po-Lin; Tsai, Ming-Ju; Hsu, Ya-Ling

    2015-08-01

    Bone metastasis in lung cancer results in an unfavorable outcome for patients by not only impairing the quality of life, yet also increasing the cancer-related death rates. In the present study, we discuss a novel treatment strategy that may benefit these patients. Human CD14+ monocytes treated with macrophage-colony stimulating factor (M-CSF)/receptor activator of nuclear factor ?B ligand (RANKL) differentiated into osteoclasts, whereas syringetin (SGN), a flavonoid derivative found in both grapes and wine, suppressed the osteoclastogenesis in vitro in a dose?dependent manner. In addition, SGN inhibited osteoclast formation induced by human lung adenocarcinoma A549 and CL1-5 cells. The associated signaling transduction pathway in osteoclastogenesis and SGN inhibition was found to be via the AKT/mammalian target of rapamycin (mTOR) signaling pathway. Blocking AKT and mTOR by respective inhibitors significantly decreased lung adenocarcinoma-mediated osteoclastogenesis. Moreover, SGN regulated the lung adenocarcinoma-mediated interaction between osteoblasts and osteoclasts by suppressing the stimulatory effect of lung adenocarcinoma on M-CSF and RANKL production in osteoblasts, and reversing the inhibitory effect of the lung adenocarcinoma on OPG production in osteoblasts. The present study has two novel findings. It is the first to illustrate lung adenocarcinoma-mediated interaction between osteoblasts and osteoclasts, leading to osteolytic bone metastasis. It also reveals that SGN, a flavonoid derivative, directly inhibits osteoclastogenesis and reverses lung adenocarcinoma?mediated osteoclastogenesis. In conclusion, the present study suggests that SGN, a natural compound, prevents and treats bone metastasis in patients with lung cancer. PMID:26044862

  19. LAMC2 enhances the metastatic potential of lung adenocarcinoma.

    PubMed

    Moon, Y W; Rao, G; Kim, J J; Shim, H-S; Park, K-S; An, S S; Kim, B; Steeg, P S; Sarfaraz, S; Changwoo Lee, L; Voeller, Donna; Choi, E Y; Luo, Ji; Palmieri, D; Chung, H C; Kim, J-H; Wang, Y; Giaccone, G

    2015-08-01

    Lung cancer is the number one cancer killer, and metastasis is the main cause of high mortality in lung cancer patients. However, mechanisms underlying the development of lung cancer metastasis remain unknown. Using genome-wide transcriptional analysis in an experimental metastasis model, we identified laminin ?2 (LAMC2), an epithelial basement membrane protein, to be significantly upregulated in lung adenocarcinoma metastatic cells. Elevated LAMC2 increased traction force, migration, and invasion of lung adenocarcinoma cells accompanied by the induction of epithelial-mesenchymal transition (EMT). LAMC2 knockdown decreased traction force, migration, and invasion accompanied by EMT reduction in vitro, and attenuated metastasis in mice. LAMC2 promoted migration and invasion via EMT that was integrin ?1- and ZEB1-dependent. High LAMC2 was significantly correlated with the mesenchymal marker vimentin expression in lung adenocarcinomas, and with higher risk of recurrence or death in patients with lung adenocarcinoma. We suggest that LAMC2 promotes metastasis in lung adenocarcinoma via EMT and may be a potential therapeutic target. PMID:25591736

  20. Primary adenocarcinoma of the nasal cavity and paranasal sinuses.

    PubMed

    Moran, C A; Wenig, B M; Mullick, F G

    1991-12-01

    Eight cases of primary adenocarcinoma of the nasal cavity associated with wood dust exposure are reported. The patients include seven men and one woman between the ages of 31 and 81 years. All the patients had a history of wood dust exposure. Carpentry was the occupation in four patients; inspector for railroad boxcars in one; teacher in a wood-work shop in another and worker in a desk factory in the other. The only female patient was a school teacher whose husband had a wood-work shop at home. Clinically, epistaxis and/or nasal obstruction were the most common symptoms. The histology of the tumors varied and consisted of well differentiated adenocarcinoma, clear cell adenocarcinoma, papillary-mucinous adenocarcinoma, and "colonic-type" adenocarcinoma. Follow-up data showed that three patients were alive of whom two had either recurrent or metastatic disease at one and three years following the initial diagnosis, respectively. The third patient was alive and well four years after initial diagnosis. Three other patients died but a direct cause of death was not identified. The remaining two patients were lost to follow-up. PMID:1819530

  1. Early diagnosis of esophageal cancer. Analysis of 11 cases of esophageal mucosal cancer.

    PubMed Central

    Misumi, A; Harada, K; Murakami, A; Arima, K; Kondo, H; Akagi, M; Yagi, Y; Ikeda, T; Kobori, Y; Matsukane, H

    1989-01-01

    We reviewed 11 patients with esophageal mucosal carcinoma in various aspects to improve the early diagnosis of the disease. Eighteen lesions measuring 0.5 to 5.0 cm were confirmed histologically in the 11 cases. Histologically 10 of the 18 lesions were carcinomas in situ (ep cancer), and the other 8 lesions were carcinomas confined to the mucosa other than ep cancer (mm cancer); all 18 lesions were squamous cell carcinomas. Six (85.7%) of the seven mm cancers showed abnormal radiographic findings regardless of the size. Similarly these findings were noted on four of five (80%) ep carcinomas 2 cm or larger in size. All 15 lesions diagnosed before operation showed abnormal findings on conventional endoscopy regardless of the size and depth of transmural invasion. Morphologic change was observed in 9 lesions (53.3%), while 13 (86.7%) showed color change; most of the lesions (80%) were manifested as redness. Dyeing of the resected specimen with Lugol solution (Katayama Chemical Industries, Osaka, Japan) showed all 18 cancerous lesions as unstained areas. Among the 18 lesions, two lesions were unstained areas, which agreed with the areas determined histologically. An additional lesion was visible with dye endoscopy as an unstained area but it was not visible with radiography or conventional endoscopy. Dye endoscopy using Lugol solution is very important because it allows detection and evaluation of the extent of esophageal mucosal cancer. Images Figs. 3A and B. Fig. 4. Figs. 5A and B. Figs. 6A and B. Figs. 7A and B. Figs. 8A and B. Figs. 9A and B. Fig. 10. PMID:2589886

  2. Genetics Home Reference: Esophageal atresia/tracheoesophageal fistula

    MedlinePLUS

    ... Patients and Families Resources for Health Professionals What glossary definitions help with understanding EA/TEF? atresia ; cardiac ; ... many other terms in the Genetics Home Reference Glossary . See also Understanding Medical Terminology . References (10 links) ...

  3. Microsatellite instability in adenocarcinoma of the prostrate

    SciTech Connect

    Terrell, R.B.; Willie, A.H.; Cheville, J.C. [Univ. of Iowa, Iowa City, IA (United States)] [and others

    1994-09-01

    Instability of tandem repeat sequences (microsatellites) has been reported to play a major etiologic role in familial colon cancer, as well as a potential role in the carcinogenesis of other sporadic neoplasms. These replication errors are the result of faulty DNA excision/repair function controlled at the gene level. In order to examine this phenomenon in prostate cancer, we screened 40 tumors with di-, tri- and tetranucleotide markers spanning eleven chromosomal loci. Microsatellite instability was observed overall in 3 of the 40 cases (7.5%). All changes were identified solely in tetranucleotide sequences (3 of 11 total markers analyzed). One tumor demonstrated repeat length expansions at two loci, while the other tumors did so at a single locus. Both Type 1 (>4 base pairs) and Type II (4 base pairs) mutations were identified. One of these cases also included metastatic nodal disease. Analysis of the metastatic tumor tissue revealed allelic patterns identical to the normal tissue control. A secondary screening of the mutated tumors demonstrated no repeat length alterations in 16 additional markers. A CAG repeat in the androgen receptor (AR) gene was also studied and demonstrated that 3 of 40 (7.5%) tumors contained mutations within this repeat. We concluded that microsatellite instability is uncommon in prostate adenocarcinoma appearing to occur more often in tetranucleotide repeat sequences and in an AR gene repeat. Additionally, these findings suggest that dysfunctional DNA excision/repair mechanisms, as evidenced by the low frequency of replication errors, are unlikely to play a major role in the natural history of prostate cancer.

  4. Comprehensive Analysis of Lung Adenocarcinoma - Matthew Meyerson, TCGA Scientific Symposium 2012

    Cancer.gov

    Home News and Events Multimedia Library Videos Comprehensive Analysis of Lung Adenocarcinoma - Matthew Meyerson Comprehensive Analysis of Lung Adenocarcinoma - Matthew Meyerson, TCGA Scientific Symposium 2012 You will need Adobe Flash Player 8 or

  5. Comprehensive Molecular Characterization of Gastric Adenocarcinoma - Adam Bass, TCGA Scientific Symposium 2014

    Cancer.gov

    Home News and Events Multimedia Library Videos Comprehensive Molecular Characterization of Gastric Adenocarcinoma - Adam Bass Comprehensive Molecular Characterization of Gastric Adenocarcinoma - Adam Bass, TCGA Scientific Symposium 2014 You will

  6. High-Grade Serous Ovarian Adenocarcinoma Transcriptome Sequencing - Andrew Mungall, TCGA Scientific Symposium 2012

    Cancer.gov

    Home News and Events Multimedia Library Videos High-Grade Serous Ovarian Adenocarcinoma Transcriptome Sequencing - Andrew Mungall High-Grade Serous Ovarian Adenocarcinoma Transcriptome Sequencing - Andrew Mungall, TCGA Scientific Symposium 2012 You

  7. Diagnosis and surgical treatment of esophageal gastrointestinal stromal tumors

    PubMed Central

    Zhang, Fang-Biao; Shi, Hong-Can; Shu, Yu-Sheng; Shi, Wei-Ping; Lu, Shi-Chun; Zhang, Xiang-Yan; Tu, Shao-Song

    2015-01-01

    AIM: To retrospectively evaluate our experience with the diagnosis and surgical resection of esophageal gastrointestinal stromal tumors (GISTs). METHODS: Between January 2003 and August 2014, five esophageal GIST cases were admitted to our hospital. In this study, the hospital records, surgery outcomes, tumor recurrence and survival of these patients were retrospectively reviewed. RESULTS: The median age of the patients was 45.6 years (range: 12-62 years). Three patients presented with dysphagia, and one patient presented with chest discomfort. The remaining patient was asymptomatic. Four patients were diagnosed with esophageal GISTs by a preoperative endoscopic biopsy. Three patients underwent esophagectomy, and two patients underwent video-assisted thoracoscopic surgery. The mean operating time was 116 min (range: 95-148 min), and the mean blood loss was 176 mL (range: 30-300 mL). All tumors were completely resected. The mean length of postoperative hospital stay was 8.4 d (range: 6-12 d). All patients recovered and were discharged successfully. The median postoperative follow-up duration was 48 mo (range: 29-72 mo). One patient was diagnosed with recurrence, one patient was lost to follow-up, and three patients were asymptomatic and are currently being managed with close radiologic and clinical follow-up. CONCLUSION: Surgery is the standard, effective and successful treatment for esophageal GISTs. Long-term follow-up is required to monitor recurrence and metastasis. PMID:25987788

  8. Emerging management concepts for eosinophilic esophagitis in children.

    PubMed

    Heine, Ralf G; Nethercote, Mark; Rosenbaum, Jeremy; Allen, Katrina J

    2011-07-01

    Eosinophilic esophagitis (EoE) is a newly recognized condition that appears to be increasing in incidence for as yet unknown reasons. It can occur at any age and presents both to gastroenterologists and allergists. Clinical manifestations range from gastrointestinal symptoms (vomiting, feeding difficulties, dysphagia or food bolus impaction) to co-existing atopic conditions (asthma, allergic rhinitis or eczema). The diagnosis requires demonstration of at least 15 eosinophils per high power field on esophageal histology, usually in the context of resistance to proton pump inhibitor treatment or a normal 24-h esophageal pH monitoring study. The differential diagnosis between EoE and gastroesophageal reflux disease (GERD) can be problematic as there is significant clinical overlap between both conditions. Although difficult-to-manage esophageal strictures are well recognized in patients with long-standing EoE, little is known about risk factors for the development of this complication. There is a paucity of data on both the natural history and optimal long-term management of EoE. Current treatment options include food allergen elimination diets, use of topical aerosolized corticosteroids, or a combination of the two. Pediatric case studies have been provided to illustrate the complexity of decision points that often arise in the management of these patients. This paper aims to discuss the various strategies currently available to clinicians in the management of EoE and highlights gaps in the current evidence base that urgently require further research. PMID:21545525

  9. Intrathoracic esophageal perforation: The merit of primary repair

    Microsoft Academic Search

    Richard I. Whyte; Mark D. Iannettoni; Mark B. Orringer

    1995-01-01

    Between 1976 and 1993, 22 patients with intrathoracic esophageal perforations, none associated with carcinoma, underwent primary repair regardless of the interval between perforation and the time of repair. Eighteen perforations were iatrogenic and four were spontaneous. The interval from perforation to operation was less than 12 hours in 10 patients, 12 to 24 hours in 3, and more than 24

  10. Nitinol Esophageal Stents: New Designs and Clinical Indications

    SciTech Connect

    Strecker, Ernst-Peter; Boos, Irene; Vetter, Sylvia; Strohm, Michael; Domschke, Sigurd [Department of Radiology and Nuclear Medicine, Diakonissen-Krankenhaus, Diakonissenstr. 28, D-76191 Karlsruhe (Germany)

    1996-11-15

    Purpose: To evaluate the clinical use of covered and noncovered, knitted nitinol stents in patients presenting new stent indications. Methods: Self-expandable, knitted nitinol stents were implanted in four patients for treatment of dysphagia. In two patients who had malignant strictures and had esophago-respiratory fistulae and in one patient with an esophagocutaneous fistula, polytetrafluoroethylene (PTFE)-covered stents were implanted. One patient received a noncovered stent, but a retrograde approach through a percutaneous endoscopic gastrostomy (PEG) fistula had to be chosen for recanalization of an esophageal occlusion. Two patients received stents for treatment of benign strictures. Results: Recanalization of the stricture and stent implantation were performed under fluoroscopic control without any procedure-related morbidity or mortality. Dysphagia improved in all patients and the esophageal fistulae could be sealed off by covered stents. During a maximum follow-up of 18 months, there was no stent migration or esophageal perforation. Complications observed were stent stenosis due to food impaction (1/4) and benign stent stenosis (2/2). Most complications could be treated by the interventional radiologist. Conclusion: Self-expandable, covered Nitinol stents provide an option for the treatment of dysphagia combined with esophageal fistulae. In combination with interventional radiology techniques, even complex strictures are accessible. For benign strictures, the value of stent treatment has not yet been proven.

  11. Ambulatory esophageal pH monitoring using a wireless system

    Microsoft Academic Search

    John E Pandolfino; Joel E Richter; Tina Ours; Jason M Guardino; Jennifer Chapman; Peter J Kahrilas

    2003-01-01

    ObjectivesLimitations of catheter-based esophageal pH monitoring are discomfort, inconvenience, and interference with normal activity. An alternative to conventional pH monitoring is the wireless Medtronic Bravo pH System. The aim of this study was to evaluate the safety, performance, and tolerability of this system.

  12. Etiology and chemoprevention of esophageal squamous cell carcinoma

    Microsoft Academic Search

    Gary D. Stoner; Ashok Gupta

    Squamous cell carcinoma (SCC) of the human esophagus has a multifactorial etiology involving several environ- mental and\\/or genetic factors. Current modalities of therapy for this disease offer poor survival and cure rates. Although a number of approaches could be undertaken to reduce the occurrence of esophageal SCC, including changes in lifestyle and improved nutrition, such approaches are not easily implemented.

  13. Esophageal atresia with tracheoesophageal fistula associated with situs inversus totalis.

    PubMed

    Barman, Shibsankar; Mandal, Kartik Chandra; Shukla, Ram Mohan; Mukhopadhyay, Biswanath

    2014-06-01

    Esophageal atresia with tracheoesophageal fistula with situs inversus totalis is an extremely rare association. We are presenting a case of a preterm neonate suffering from similar condition. Fistula ligation with primary repair was done via left thoracotomy to avoid technical difficulties. Preoperative echocardiography should be done to confirm dextrocardia and disposition of the aortic arch. PMID:25177126

  14. Preparation and characterization of a biologic scaffold from esophageal mucosa.

    PubMed

    Keane, Timothy J; Londono, Ricardo; Carey, Ryan M; Carruthers, Christopher A; Reing, Janet E; Dearth, Christopher L; D'Amore, Antonio; Medberry, Christopher J; Badylak, Stephen F

    2013-09-01

    Biologic scaffolds composed of extracellular matrix (ECM) are commonly used to facilitate a constructive remodeling response in several types of tissue, including the esophagus. Surgical manipulation of the esophagus is often complicated by stricture, but preclinical and clinical studies have shown that the use of an ECM scaffold can mitigate stricture and promote a constructive outcome after resection of full circumference esophageal mucosa. Recognizing the potential benefits of ECM derived from homologous tissue (i.e., site-specific ECM), the objective of the present study was to prepare, characterize, and assess the in-vivo remodeling properties of ECM from porcine esophageal mucosa. The developed protocol for esophageal ECM preparation is compliant with previously established criteria of decellularization and results in a scaffold that maintains important biologic components and an ultrastructure consistent with a basement membrane complex. Perivascular stem cells remained viable when seeded upon the esophageal ECM scaffold in-vitro, and the in-vivo host response showed a pattern of constructive remodeling when implanted in soft tissue. PMID:23777917

  15. Cyclosporine in the management of esophageal lichen planus

    PubMed Central

    Chaklader, M; Morris-Larkin, C; Gulliver, W; McGrath, J

    2009-01-01

    Lichen planus (LP) is an uncommon disorder of unknown etiology, mostly affecting patients in their fifth and sixth decade of life. It is believed to be an autoimmune process involving T cells directed against basal keratinocytes. It affects the skin, nails, oral pharynx and genitals. Esophageal involvement is quite rare and can cause strictures, ulcerations and squamous cell cancer. The present article describes the case of a 54-year-old woman who was referred for assessment of dysphagia that initially occurred with solids, which then progressed to soft foods but spared liquids. The patient reported a weight loss of 9.1 kg. An esophagogastroduodenoscopy was performed and she was subsequently diagnosed with pill esophagitis. At the same time, she was also diagnosed with oral LP, with no involvement of the esophagus. She was treated with a proton pump inhibitor that resolved her gastrointestinal symptoms. The symptoms returned one year later and a repeat esophagogastroduodenoscopy revealed white plaques due to LP. She was treated with intermittent glucocorticoids. Diagnosis of esophageal LP is crucial for the proper treatment. Some patients may require systemic immunosuppression and mechanical dilation to prevent weight loss. Surveillance endoscopies should be performed to monitor for squamous cell cancer. Cyclosporine has been used for genital and oral LP, but the present case is the first in which it has been used successfully to treat esophageal LP. PMID:19826643

  16. Preparation and Characterization of a Biologic Scaffold from Esophageal Mucosa

    PubMed Central

    Keane, Timothy J.; Londono, Ricardo; Carey, Ryan M.; Carruthers, Christopher A.; Reing, Janet E.; Dearth, Christopher L.; D’Amore, Antonio; Medberry, Christopher J.; Badylak, Stephen F.

    2013-01-01

    Biologic scaffolds composed of extracellular matrix (ECM) are commonly used to facilitate a constructive remodeling response in several types of tissue, including the esophagus. Surgical manipulation of the esophagus is often complicated by stricture, but preclinical and clinical studies have shown that the use of an ECM scaffold can mitigate stricture and promote a constructive outcome after resection of full circumference esophageal mucosa. Recognizing the potential benefits of ECM derived from homologous tissue (i.e., site-specific ECM), the objective of the present study was to prepare, characterize, and assess the in-vivo remodeling properties of ECM from porcine esophageal mucosa. The developed protocol for esophageal ECM preparation is compliant with previously established criteria of decellularization and results in a scaffold that maintains important biologic components and an ultrastructure consistent with a basement membrane complex. Perivascular stem cells remained viable when seeded upon the esophageal ECM scaffold in vitro, and the in-vivo host response showed a pattern of constructive remodeling when implanted in soft tissue. PMID:23777917

  17. Palliative Chemotherapy Does Not Improve Survival in Metastatic Esophageal Cancer

    Microsoft Academic Search

    Antoine Adenis; Nicolas Penel; Samy Horn; Sophie Dominguez; Marie Vanhuyse; Xavier Mirabel

    2010-01-01

    Background: The role of chemotherapy in metastatic esophageal carcinoma (MEC) remains a matter of debate. The aim of this retrospective study was to analyze the survival impact of chemotherapy after stratification for prognostic factors. Methods: Consecutive patients with MEC (1995 to 2008) were randomly assigned to a development (n = 171) and a validation cohort (n = 113). We had

  18. Esophageal foreign body in a 2-day-old calf

    PubMed Central

    Haas, Jackie

    2010-01-01

    A 2-day-old male Charolais crossbred calf presented with a section of an esophageal feeding tube partially obstructing his esophagus. External palpation of the neck confirmed the location of the obstruction to be within the cervical esophagus. A rumenotomy was performed and the foreign body was successfully removed. PMID:20592832

  19. [Tracheoesophageal fistula after the removal of esophageal foreign body].

    PubMed

    Szmeja, Z; Kruk-Zagajewska, A; Wa?niewska, E

    1999-01-01

    A case of 18 years old male with tracheoesophageal fistula as a result of esophageal foreign body (chestnut) is described. Foreign body was removed using esophagoscopy. Bronchofiberoscopy performed because of difficulties with swallowing and frequent airway infections revealed tracheoesophageal fistula. Fistula was closed from intratracheal access. Symptoms of dysfagia disappeared after surgery. PMID:10689920

  20. Polycyclic aromatic hydrocarbons and esophageal squamous cell carcinoma.

    PubMed

    Roshandel, Gholamreza; Semnani, Shahryar; Malekzadeh, Reza; Dawsey, Sanford M

    2012-11-01

    Esophageal cancer (EC) is the 8th most common cancer and the 6th most frequent cause of cancer mortality worldwide. Esophageal squamous cell carcinoma (ESCC) is the most common type of EC. Exposure to polycyclic aromatic hydrocarbons (PAHs) has been suggested as a risk factor for developing ESCC. In this paper we will review different aspects of the relationship between PAH exposure and ESCC. PAHs are a group of compounds that are formed by incomplete combustion of organic matter. Studies in humans have shown an association between PAH exposure and development of ESCC in many populations. The results of a recent case-control study in a high risk population in northeastern Iran showed a dramatic dose-response relationship between PAH content in non-tumor esophageal tissue (the target tissue for esophageal carcinogenesis) and ESCC case status, consistent with a causal role for PAH exposure in the pathogenesis of ESCC.  Identifying the main sources of exposure to PAHs may be the first and most important step in designing appropriate PAH-reduction interventions for controlling ESCC, especially in high risk areas. Coal smoke and drinking mate have been suggested as important modifiable sources of PAH exposure in China and Brazil, respectively. But the primary source of exposure to PAHs in other high risk areas for ESCC, such as northeastern Iran, has not yet been identified. Thus, environmental studies to determining important sources of PAH exposure should be considered as a high priority in future research projects in these areas. PMID:23102250

  1. Doctors, Engineers Develop New Wireless System To Detect Esophageal Reflux

    E-print Network

    Chiao, Jung-Chih

    that takes photos as it goes through the digestive tract, and Bravo capsule, another wireless systemDoctors, Engineers Develop New Wireless System To Detect Esophageal Reflux Science Daily -- UT Southwestern Medical Center doctors and UT Arlington engineers have developed a wireless monitoring system

  2. Clinical and immunopathologic effects of swallowed fluticasone for eosinophilic esophagitis

    Microsoft Academic Search

    Richard J Noel; Philip E Putnam; Margaret H Collins; Amal H Assa’ad; Jesus R Guajardo; Sean C Jameson; Marc E Rothenberg

    2004-01-01

    Background & Aims: Eosinophilic esophagitis (EE) is a recently recognized clinical disorder that is understood poorly. We aimed to determine the efficacy of swallowed fluticasone propionate on the immunopathologic features associated with EE. Methods: A retrospective analysis was performed on 20 pediatric patients with EE. Inclusion criteria specified a peak eosinophil density of ?24 cells per 400× field in the

  3. Endoscopy in eosinophilic esophagitis: “feline” esophagus and perforation risk

    Microsoft Academic Search

    Mitchell Kaplan; Ece A. Mutlu; Shriram Jakate; Keith Bruninga; John Losurdo; Joseph Losurdo; Ali Keshavarzian

    2003-01-01

    Background & Aims: Idiopathic eosinophilic esophagitis is an underdiagnosed disease with typical endoscopic findings, which have not been well described. Methods: Charts and pathology reports at two tertiary care centers from June 1993 to April 2002 were reviewed to describe the endoscopic findings of this disease and to correlate them with clinical characteristics. Eight patients were identified as having eosinophilic

  4. An Audit of Endoscopic Complications in Adult Eosinophilic Esophagitis

    Microsoft Academic Search

    Matthew S. Cohen; Adam B. Kaufman; Juan P. Palazzo; Daniel Nevin; Anthony J. DiMarino; Sidney Cohen

    2007-01-01

    Background & Aims: Eosinophilic esophagitis (EoE) in adults, characterized by the triad of dysphagia, a ringed esophagus, and mucosal eosinophilic infiltration, has asso- ciated complications that include vertical mucosal lacera- tions, instrumental perforation, and emesis-induced rup- ture. The aim of this study was to determine whether clinical, endoscopic, and histologic features can be used to predict the risk for development

  5. Biopsy-negative malignant esophageal stricture: diagnosis by endoscopic ultrasound

    Microsoft Academic Search

    Douglas O. Faigel; Clifford Deveney; Daniel Phillips; M. Brian Fennerty

    1998-01-01

    Endoscopic ultrasound (EUS) of the esophagus has been used primarily in staging biopsy-proven cancers. Its use as a primary diagnostic modality for esophageal malignancy has not been previously described. We report our recent experience in four patients with dysphagia and endoscopic biopsies negative for malignancy, including one patient with clinical and manometric features suggestive of achalasia. In all cases, EUS

  6. Molecular, genetic, and cellular bases for treating eosinophilic esophagitis.

    PubMed

    Rothenberg, Marc E

    2015-05-01

    Eosinophilic esophagitis (EoE) was historically distinguished from gastroesophageal reflux disease on the basis of histology and lack of responsiveness to acid suppressive therapy, but it is now appreciated that esophageal eosinophilia can respond to proton pump inhibitors. Genetic and environmental factors contribute to risk for EoE, particularly early-life events. Disease pathogenesis involves activation of epithelial inflammatory pathways (production of eotaxin-3 [encoded by CCL26]), impaired barrier function (mediated by loss of desmoglein-1), increased production and/or activity of transforming growth factor-?, and induction of allergic inflammation by eosinophils and mast cells. Susceptibility has been associated with variants at 5q22 (TSLP) and 2p23 (CAPN14), indicating roles for allergic sensitization and esophageal specific protease pathways. We propose that EoE is a unique disease characterized by food hypersensitivity; strong hereditability influenced by early-life exposures and esophageal-specific genetic risk variants; and allergic inflammation and that the disease is remitted by disrupting inflammatory and T-helper type 2 cytokine-mediated responses and through dietary elimination therapy. PMID:25666870

  7. Endoscopic evaluation of gastro-esophageal reflux disease.

    PubMed Central

    Armstrong, D.

    1999-01-01

    Endoscopy is, currently, the initial investigation of choice for the investigation of gastroesophageal reflux disease (GERD) in clinical practice and clinical research. Erosion severity is predictive of a patient's response to therapy and of the likelihood of relapse after therapy. It is, therefore, important to grade the severity of erosive reflux esophagitis, particularly in the context of clinical trials. The Savary-Miller endoscopic classification system is used widely but usage and interpretation are very variable. The "MUSE" (metaplasia [M], ulceration [U], stricturing [S] and erosions [E]) classification provides clear definitions of the relevant endoscopic features, and it is based on a standardized report form, which allows the endoscopist to make a clear record of esophagitis severity. Recent studies confirm that endoscopists can identify erosions or mucosal breaks, ulcers, strictures, and metaplasia reproducibly. The "L.A." (Los Angeles) classification describes four grades of esophagitis severity (A to D), based on the extent of esophageal lesions known as "mucosal breaks," but it does not record the presence or severity of other GERD lesions. Thus, for patients with "complicated" reflux disease, the "MUSE" classification offers a more comprehensive description of esophagitis severity. Endoscopy is not universally applicable: 40 to 60 percent of patients with typical reflux symptoms do not have esophageal erosions and are now considered to have "endoscopy negative reflux disease" (ENRD). Thus, endoscopy is not the final arbiter as to a diagnosis of reflux disease, and it is not, therefore, a necessary prerequisite to therapy. Endoscopy is indicated at first presentation for patients with alarm symptoms referable to the upper gastrointestinal tract. It has also been proposed that all patients with chronic GERD should have a "once-in-a-lifetime" endoscopy; in the absence of Barrett's esophagus or other complications, no follow-up is required unless the patient's symptoms change significantly. A surveillance program with multiple biopsies should be instituted if there is evidence of Barrett's esophagus. Endoscopic evaluation should document the presence and extent of esophageal erosions using the L.A. or MUSE classification systems; complications should also be documented and may be recorded using the MUSE classification. Non-erosive changes such as erythema may be ignored on the basis of present evidence, and there are no clear data to support the use of endoscopic biopsies for the diagnosis of GERD. PMID:10780570

  8. Adenocarcinoma Involving the Tongue and the Epiglottis in a Horse

    PubMed Central

    LAUS, Fulvio; ROSSI, Giacomo; PAGGI, Emanuele; BORDICCHIA, Matteo; FRATINI, Margherita; TESEI, Beniamino

    2013-01-01

    ABSTRACT Tumors involving the oral cavity of the horse are uncommon. No cases of equine adenocarcinoma on the dorsum of the tongue have been reported in the literature. We report a case of adenocarcinoma located on the dorsum of the posterior one-third of the tongue in a 29-year-old gelding with severe dysphagia. Endoscopy revealed an epiglottis involvement, and histology was consistent with adenocarcinoma arising from minor salivary glands, which was associated with a severe fungal colonization of affected tissues. The goals of this report are to present an uncommon case of dorsum of the tongue-associated neoplasia and to highlight the association with atypical fungal colonization, to review the literature and to discuss possible clinical approach and prognosis. PMID:24284972

  9. Small bowel adenocarcinoma: epidemiology, risk factors, diagnosis and treatment.

    PubMed

    Aparicio, Thomas; Zaanan, Aziz; Svrcek, Magali; Laurent-Puig, Pierre; Carrere, Nicolas; Manfredi, Sylvain; Locher, Christophe; Afchain, Pauline

    2014-02-01

    Small bowel adenocarcinomas are rare tumours, but their incidence is increasing. Their most common primary location is the duodenum. The few studies that have collected data regarding small bowel adenocarcinoma are not homogeneous and are widely spread over time. Even though these tumours are most often sporadic, some predisposing diseases have been identified, among which Crohn's disease and genetic syndromes. Early diagnosis of small bowel adenocarcinoma remains difficult despite significant radiological and endoscopic progress. After surgical resection the main prognostic factor is node invasion; in this case, adjuvant chemotherapy can be expected to be beneficial, although this has not been established by randomised trials. For metastatic disease, platinum-based chemotherapy seems to be the most effective treatment. Targeted therapies have not yet been evaluated in this type of cancer. PMID:23796552

  10. Esophageal Motion During Radiotherapy: Quantification and Margin Implications

    PubMed Central

    Cohen, Randi J.; Paskalev, Kamen; Litwin, Samuel; Price, Robert; Feigenberg, Steven J.; Konski, Andre

    2010-01-01

    Purpose To evaluate inter- and intra-fraction esophageal motion in the right-left (RL) and anterior-posterior (AP) directions using computed tomography (CT) in esophageal cancer patients. Methods and Materials Eight patients underwent CT simulation and CT-on-rails imaging before and after radiotherapy. Inter-fraction displacement was defined as differences between pre-treatment and simulation images. Intra-fraction displacement was defined as differences between pre- and post-treatment images. Images were fused using bone registries, adjusted to the carina. The mean, average of the absolute, and range of esophageal motion were calculated in RL and AP directions, above and below the carina. Results Thirty-one CT image sets were obtained. The incidence of esophageal inter-fraction motion ?5 was 24% and ?10 mm was 3%; intra-fraction motion ? 5mm was 13% and ?10 mm was 4%. The average RL motion was 1.8±5.1 mm, favoring leftward movement, and the average AP motion was 0.6±4.8 mm, favoring posterior movement. Average absolute motion was 4.2 mm or less in RL and AP directions. Motion was greatest in the RL direction above the carina. Coverage of 95% of esophageal mobility requires 12mm left, 8mm right, 10mm posterior, and 9mm anterior margins. Conclusion In all directions, the average of the absolute inter-fraction and intra-fraction displacement was 4.2 mm or less. These results support a 12 mm left, 8 mm right, 10 mm posterior, and 9 mm anterior margin for ITV and can guide margins for future IMRT trials to account for organ motion and set up error in 3-dimesional planning. PMID:20095993

  11. Comparison of air-coupled balloon esophageal and anorectal manometry catheters with solid-state esophageal manometry and water-perfused anorectal manometry catheters.

    PubMed

    Fang, John C; Hilden, Kristen; Tuteja, Ashok K; Peterson, Kathryn A

    2004-10-01

    Clinical gastrointestinal manometry studies are currently performed with multilumen water-perfused polyvinyl or strain gauge sensor solid-state catheters. A disposable catheter incorporating air-filled balloons has been developed with performance characteristics suitable for esophageal and anorectal manometry studies. Our aim was to compare esophageal and anorectal pressure measurements using this newly developed catheter with measurements obtained using standard solid-state or water-perfused catheters. Measurements of resting LES pressure, esophageal contraction amplitudes, and anorectal rest and squeeze pressures were obtained in 10 healthy volunteers using a solid-state esophageal catheter, a water-perfused anorectal catheter, and air-filled balloon esophageal and anorectal catheters. Correlation coefficient analysis demonstrated that LES pressures, esophageal contraction amplitudes, and anorectal resting and squeeze pressures were not significantly among between the different catheters. We conclude that recently developed air-filled balloon esophageal and anorectal manometry catheters provide very similar measurements of LES, esophageal body, and anorectal sphincter pressures compared to presently used manometry catheters. PMID:15573923

  12. Mucinous adenocarcinoma of the rectum with breast and ocular metastases.

    PubMed

    Hisham, Raja B; Thuaibah, Hashim; Gul, Yunus A

    2006-04-01

    We present the case of a 32-year-old woman who, 10 months after abdominoperineal resection and total mesorectal excision for a locally advanced mucinous adenocarcinoma of the rectum, presented with local recurrence and metastases to the breast, spine, the left eye and orbit. Following surgery, due to the patient's personal reasons, adjuvant chemoradiation was not given. The patient died 2 months later, with disseminated cancer. To the best of our knowledge, breast as well as ocular metastasis in a patient with mucinous adenocarcinoma of the rectum has never been reported and, therefore, needs to be documented. PMID:16644510

  13. [How to treat a thyroid adenocarcinoma inside a branchial cyst].

    PubMed

    Ljunggren, M P; Ebbo, D; Koubbi, G; Barrault, S; Vuong, N

    2002-02-01

    The authors reported three cases of branchial cycts containing a thyroid adenocarcinoma. This rare condition imposed a search for the primary tumor. All complementary investigations remained negative as in the few cases reported in the medical literature. A loboisthmectomy for one and a total thyroidectomy for the two others, with cervical recurential neck dissection for all was carried out. Histological examination of the operative specimen after total blocking in paraffin helped discover microscopic foci of papillary carcinoma in the thyroid gland. These data justified this therapeutic attitude because the nature of the adenocarcinoma found in the branchial cyst is likely to be metastatic. PMID:11965107

  14. Relationships Between Eosinophilic Inflammation, Tissue Remodeling and Fibrosis in Eosinophilic Esophagitis*

    PubMed Central

    Aceves, Seema S.; Ackerman, Steven J.

    2009-01-01

    SYNOPSIS The clinical and pathologic features of Eosinophilic Esophagitis (EE) include extensive tissue remodeling. Increasing evidence supports a key role for the eosinophil in multiple aspects of the esophageal remodeling and fibrosis seen in this allergic disease, including epithelial hyperplasia, subepithelial fibrosis, smooth muscle hyperplasia, and angiogenesis. These structural changes contribute to the endoscopic findings of esophageal thickening, luminal narrowing, furrowing, transient and fixed rings (trachealization) and stricture, as well as the clinical features of dysmotility, dysphagia and food impactions in pediatric and adult EE. This chapter reviews the clinical implications of esophageal remodeling and fibrosis in EE and discusses the possible pathogenic mechanisms inducing and regulating these responses. We focus specifically on eosinophil and cytokine interactions with the esophageal epithelium, vascular endothelium, resident fibroblasts, and smooth muscle. Current and potential therapeutic interventions are discussed that may impact the development or resolution of chronic esophageal remodeling and fibrosis in EE. PMID:19141355

  15. Various Upper Endoscopic Findings of Acute Esophageal Thermal Injury Induced by Diverse Food: A Case Series

    PubMed Central

    Lee, Yu Mi; Kim, Ji Young; Song, Hyun Jung; Koo, Hoon Sup; Song, Kyung Ho; Kim, Yong Seok; Huh, Kyu Chan

    2014-01-01

    Esophageal thermal injury caused by food has been reported to occur mostly after drinking hot liquid food, and is known to produce alternating white and red linear mucosal bands. In addition, thermal injury caused by ingestion of hot solid foods is documented to be a cause of esophageal ulcers or pseudomembranes. From January 2006 to August 2012, five patients with suspected esophageal thermal injury underwent esophagogastroduodenoscopy with biopsy. A "candy-cane" appearance was observed in one case, pseudomembrane was observed in two cases, an esophageal ulcer was observed in one case, and a friable and edematous mucosa was noted in one case. We believe that the endoscopic findings of esophageal thermal injury depend on the following factors: causative materials, amount of food consumed, exposure period, and time to endoscopy after the incident. Therefore, physicians who encounter patients with suspected esophageal thermal injury should carefully take the patient's history considering these factors. PMID:25325006

  16. Recurrent cervical esophageal stenosis after colon conduit failure: use of myocutaneous flap.

    PubMed

    Sa, Young Jo; Kim, Young Du; Kim, Chi Kyung; Park, Jong Kyung; Moon, Seok Whan

    2013-01-14

    A 53-year-old male developed cervical esophageal stenosis after esophageal bypass surgery using a right colon conduit. The esophageal bypass surgery was performed to treat multiple esophageal strictures resulting from corrosive ingestion three years prior to presentation. Although the patient underwent several endoscopic stricture dilatations after surgery, he continued to suffer from recurrent esophageal stenosis. We planned cervical patch esophagoplasty with a pedicled skin flap of sternocleidomastoid (SCM) muscle. Postoperative recovery was successful, and the patient could eat a solid meal without difficulty and has been well for 18 mo. SCM flap esophagoplasty is an easier and safer method of managing complicated and recurrent cervical esophageal strictures than other operations. PMID:23345956

  17. Esophageal blood flow in the cat. Normal distribution and effects of acid perfusion

    SciTech Connect

    Hollwarth, M.E.; Smith, M.; Kvietys, P.R.; Granger, D.N.

    1986-03-01

    The radioactive microsphere technique was used to estimate blood flow to different regions of the esophagus and to adjacent regions of the stomach before and after perfusion of the esophagus with hydrochloric acid (pH 1.5) for 5 min. Under resting conditions total blood flow, as well as blood flow to the mucosal-submucosal layer and the muscular layer, to both sphincters was significantly higher than to the esophageal body. Blood flow to the adjacent regions of the stomach was significantly higher than esophageal blood flow. Acid perfusion resulted in a large increase in total blood flow in both sphincters and the lower esophageal body. Gastric blood flow was not altered by acid perfusion. The esophageal hyperemia resulted primarily from an increase in blood flow to the muscular layer; mucosal-submucosal blood flow was increased only in the lower esophageal sphincter. The present study indicates that short periods (5 min) of gastroesophageal reflux may increase esophageal blood flow.

  18. 36 CFR 1010.6 - Determination of requirement for EA or EIS.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Determination of requirement for EA or EIS. 1010.6 Section 1010.6 Parks... Determination of requirement for EA or EIS. In deciding whether to require the preparation of an EA or an EIS, the NEPA Compliance Coordinator...

  19. 36 CFR 1010.6 - Determination of requirement for EA or EIS.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Determination of requirement for EA or EIS. 1010.6 Section 1010.6 Parks... Determination of requirement for EA or EIS. In deciding whether to require the preparation of an EA or an EIS, the NEPA Compliance Coordinator...

  20. 36 CFR 1010.6 - Determination of requirement for EA or EIS.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Determination of requirement for EA or EIS. 1010.6 Section 1010.6 Parks... Determination of requirement for EA or EIS. In deciding whether to require the preparation of an EA or an EIS, the NEPA Compliance Coordinator...