These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

Chemoprevention of Esophageal Adenocarcinoma  

PubMed Central

The incidence of esophageal adenocarcinoma (EAC) is rising rapidly in Western countries, and effective chemoprevention for this malignancy is lacking. Endoscopic surveillance of patients with Barrett's esophagus is currently employed to diagnose EAC at earlier stages, but this strategy has several limitations. Non-steroidal anti-inflammatory drugs and proton pump inhibitors are the most promising agents for prevention of EAC, and a randomized controlled trial of aspirin and esomeprazole is ongoing. Other agents under investigation include green tea, berries, and antioxidants. Cost-effectiveness analyses have shown that chemopreventive agents need to be highly effective at preventing EAC in order to have benefit beyond endoscopic surveillance. PMID:21180511

2008-01-01

2

Barrett’s and Esophageal Adenocarcinoma Consortium  

Cancer.gov

An international consortium with epidemiologic studies of Barrett's Esophagus and esophageal adenocarcinoma. Analyses so far have included alcohol consumption, anthropometry, cigarette smoking, excess risk models, gastroesophageal reflux disease, non-steroidal anti-inflammatory drugs, reproductive factors, and genome-wide studies to identify susceptibility loci associated with Barrett’s esophagus and/or adenocarcinomas of the esophagus.

3

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

ClinicalTrials.gov

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

2014-07-21

4

Advances in Barrett's esophagus and esophageal adenocarcinoma.  

PubMed

Despite advances in diagnosis and therapy, esophageal adenocarcinoma remains an aggressive and usually lethal tumor. This review focuses on the epidemiology of esophageal adenocarcinoma and its presumed precursor lesion, Barrett's esophagus; the pathogenesis of the cancer; advances in treatment of adenocarcinoma and Barrett's esophagus; and strategies for cancer prevention. Emphasis is placed on recent literature. Although the absolute number of cases of adenocarcinoma in the United States is still small, the incidence of this cancer has increased dramatically in the last 40 years, and adenocarcinoma is now the predominant form of esophageal cancer in this country. Recent evidence suggests that Barrett's esophagus is more prevalent in asymptomatic individuals than previously appreciated. The pathogenesis of Barrett's esophagus is poorly understood. Given that some subjects will have repeated bouts of severe erosive esophagitis and never develop Barrett's esophagus, host factors must play an important role. The utility of neoadjuvant radiation and chemotherapy in those with adenocarcinoma, although they are widely practiced, is not of clear benefit, and some authorities recommend against it. Ablative therapies, as well as endoscopic mucosal resection, hold promise for those with superficial cancer or high-grade dysplasia. Most series using these modalities feature relatively short follow-up, and longer-term data will be necessary to better describe the effects of these therapies. The value of chemoprevention in subjects with dysplastic Barrett's esophagus by use of cyclooxygenase 2 inhibitors, nonsteroidal anti-inflammatory drugs, or proton pump inhibitors is unknown. Similarly, although endoscopic screening is widely practiced, its value in patients with chronic gastroesophageal reflux disease symptoms is of unproven value, and recommending bodies are divided as to its practice. PMID:15887151

Shaheen, Nicholas J

2005-05-01

5

HER2 amplification, overexpression and score criteria in esophageal adenocarcinoma  

PubMed Central

The HER2 oncogene was recently reported to be amplified and overexpressed in esophageal adenocarcinoma. However, the relationship of HER2 amplification in esophageal adenocarcinoma with prognosis has not been well defined. The scoring systems for clinically evaluating HER2 in esophageal adenocarcinoma are not established. The aims of the study were to establish a HER2 scoring system and comprehensively investigate HER2 amplification and overexpression in esophageal adenocarcinoma and its precursor lesion. Using a tissue microarray, containing 116 cases of esophageal adenocarcinoma, 34 cases of BE, 18 cases of low grade dysplasia and 15 cases of high grade dysplasia, HER2 amplification and overexpression were analyzed by HercepTest and CISH methods. The amplification frequency in an independent series of 116 esophageal adenocarcinoma samples was also analyzed using Affymetrix SNP 6.0 microarrays. In our studies, we have found that HER2 amplification does not associate with poor prognosis in total 232 esophageal adenocarcinoma patients by CISH and high density microarrays. We further confirm the similar frequency of HER2 amplification by CISH (18.10%; 21/116) and SNP 6.0 microarrays (16.4%, 19/116) in esophageal adenocarcinoma. HER2 protein overexpression was observed in 12.1 % (14/116) of esophageal adenocarcinoma and 6.67% (1/15) of HGD. No HER2 amplification or overexpression was identified in BE or LGD. All HER2 protein overexpression cases showed HER2 gene amplification. Gene amplification was found to be more frequent by CISH than protein overexpression in esophageal adenocarcinoma (18.10% vs 12.9%). A modified two-step model for esophageal adenocarcinoma HER-2 testing is recommend for clinical esophageal adenocarcinoma HER-2 trial. PMID:21460800

Hu, Yingchuan; Bandla, Santhoshi; Godfrey, Tony E.; Tan, Dongfeng; Luketich, James D.; Pennathur, Arjun; Qiu, Xing; Hicks, David G.; Peters, Jeffrey; Zhou, Zhongren

2011-01-01

6

Association Between Markers of Obesity and Progression From Barrett's Esophagus to Esophageal Adenocarcinoma Adenocarcinoma  

PubMed Central

BACKGROUND & AIMS Individuals with Barrett’s esophagus (BE) have an increased risk of developing esophageal adenocarcinoma (EA). Obesity contributes to development of BE and its progression to cancer. We investigated the roles of obesity-induced hyperinsulinemia and dysregulation of adipokines in these processes. METHODS We measured fasting levels of glucose, insulin, leptin, and adiponectin in 392 patients enrolled in the Seattle BE Study. We calculated homeostatic model assessment (HOMA) scores (a measure of insulin sensitivity) and identified subjects with metabolic syndrome. We evaluated the association between these measures and risk of EA using Cox regression models adjusted for known risk factors. RESULTS Increasing HOMA scores were associated with increasing risk for EA; the strongest association was observed within the first 3 years after participants entered the study (hazard ratio (HR)=2.45; 95% confidence interval [CI], 1.43–4.1; Ptrend=.001). Leptin level was also significantly associated with increased risk of EA within 3 y (HR=2.51; 95% CI 1.09–5.81; Ptrend =0.03) and 6 y (HR=2.07; 95% CI 1.01–4.26; Ptrend=0.048) of baseline. The level of high molecular weight adiponectin had a non-linear inverse association with risk of EA; the strongest associations were observed in the second tertile (HR=0.34; 95% CI, 0.14–0.82). Metabolic syndrome was not associated with risk of EA. CONCLUSIONS Among patients with BE, increased levels of leptin and insulin resistance are associated with increased risk for EA, whereas increased level of high molecular weight adiponectin is inversely associated with EA. These biomarkers might be used to determine cancer risk among patients with BE. PMID:23466711

Duggan, Catherine; Onstad, Lynn; Hardikar, Sheetal; Blount, Patricia L; Reid, Brian J; Vaughan, Thomas L

2013-01-01

7

Notch signaling drives stemness and tumorigenicity of esophageal adenocarcinoma.  

PubMed

Esophageal adenocarcinoma ranks sixth in cancer mortality in the world and its incidence has risen dramatically in the Western population over the last decades. Data presented herein strongly suggest that Notch signaling is critical for esophageal adenocarcinoma and underlies resistance to chemotherapy. We present evidence that Notch signaling drives a cancer stem cell phenotype by regulating genes that establish stemness. Using patient-derived xenograft models, we demonstrate that inhibition of Notch by gamma-secretase inhibitors (GSI) is efficacious in downsizing tumor growth. Moreover, we demonstrate that Notch activity in a patient's ultrasound-assisted endoscopic-derived biopsy might predict outcome to chemotherapy. Therefore, this study provides a proof of concept that inhibition of Notch activity will have efficacy in treating esophageal adenocarcinoma, offering a rationale to lay the foundation for a clinical trial to evaluate the efficacy of GSI in esophageal adenocarcinoma treatment. Cancer Res; 74(21); 6364-74. ©2014 AACR. PMID:25164006

Wang, Zhiqiang; Da Silva, Thiago G; Jin, Ke; Han, Xiaoqing; Ranganathan, Prathibha; Zhu, Xiaoxia; Sanchez-Mejias, Avencia; Bai, Feng; Li, Bin; Fei, Dennis Liang; Weaver, Kelly; Carpio, Rodrigo Vasquez-Del; Moscowitz, Anna E; Koshenkov, Vadim P; Sanchez, Lilly; Sparling, Lynne; Pei, Xin-Hai; Franceschi, Dido; Ribeiro, Afonso; Robbins, David J; Livingstone, Alan S; Capobianco, Anthony J

2014-11-01

8

Radiation and chemoradiation therapy for esophageal adenocarcinoma.  

PubMed

The aims of preoperative chemoradiation therapy (preop-CRT) for esophageal adenocarcinoma are to reduce incomplete local resection (R1,R2), local and systemic recurrences that are reported in up to 30% of patients who undergo surgery alone. Phase II studies of preop-CRT, with radiation doses in the 40-50 Gy range, and concurrent chemotherapy with 5-fluorouracil (5-FU)-cisplatin +/- paclitaxel, or cisplatin-paclitaxel, have reported subsequent RO resection rates of 80%-100%, with tumor sterilization achieved in 8%-49% of cases, and consequently improved local control. New chemotherapy regimens omitting 5-FU have reduced the incidence of severe esophagitis, unplanned hospitalization, with comparable efficacy. Among three randomised trials that compared preop-CRT to surgery alone, one shown a debatable survival advantage. Reducing local recurrence rates lead to a switch to more distant failures, and increasing the radiation dose beyond 45 Gy appears to be of little value. However, it should be remembered that preop-CRT has associated toxicity, and may increase postoperative mortality. Novel strategies, which include induction with chemotherapy followed by preop-CRT, and for radiation therapy, three dimensional conformation techniques, image fusioning, and improved definition of treatment volumes, are still considered experimental and should be tested in specialized centers. PMID:16299784

Bosset, Jean-François; Lorchel, F; Mantion, G; Buffet, J; Créhange, G; Bosset, M; Chaigneau, L; Servagi, S

2005-12-01

9

Pathophysiological mechanisms linking obesity and esophageal adenocarcinoma.  

PubMed

In recent decades there has been a dramatic rise in the incidence of esophageal adenocarcinoma (EAC) in the developed world. Over approximately the same period there has also been an increase in the prevalence of obesity. Obesity, especially visceral obesity, is an important independent risk factor for the development of gastro-esophageal reflux disease, Barrett's esophagus and EAC. Although the simplest explanation is that this mediated by the mechanical effects of abdominal obesity promoting gastro-esophageal reflux, the epidemiological data suggest that the EAC-promoting effects are independent of reflux. Several, not mutually exclusive, mechanisms have been implicated, which may have different effects at various points along the reflux-Barrett's-cancer pathway. These mechanisms include a reduction in the prevalence of Helicobacter pylori infection enhancing gastric acidity and possibly appetite by increasing gastric ghrelin secretion, induction of both low-grade systemic inflammation by factors secreted by adipose tissue and the metabolic syndrome with insulin-resistance. Obesity is associated with enhanced secretion of leptin and decreased secretion of adiponectin from adipose tissue and both increased leptin and decreased adiponectin have been shown to be independent risk factors for progression to EAC. Leptin and adiponectin have a set of mutually antagonistic actions on Barrett's cells which appear to influence the progression of malignant behaviour. At present no drugs are of proven benefit to prevent obesity associated EAC. Roux-en-Y reconstruction is the preferred bariatric surgical option for weight loss in patients with reflux. Statins and aspirin may have chemopreventative effects and are indicated for their circulatory benefits. PMID:25400997

Alexandre, Leo; Long, Elizabeth; Beales, Ian Lp

2014-11-15

10

Pathophysiological mechanisms linking obesity and esophageal adenocarcinoma  

PubMed Central

In recent decades there has been a dramatic rise in the incidence of esophageal adenocarcinoma (EAC) in the developed world. Over approximately the same period there has also been an increase in the prevalence of obesity. Obesity, especially visceral obesity, is an important independent risk factor for the development of gastro-esophageal reflux disease, Barrett’s esophagus and EAC. Although the simplest explanation is that this mediated by the mechanical effects of abdominal obesity promoting gastro-esophageal reflux, the epidemiological data suggest that the EAC-promoting effects are independent of reflux. Several, not mutually exclusive, mechanisms have been implicated, which may have different effects at various points along the reflux-Barrett’s-cancer pathway. These mechanisms include a reduction in the prevalence of Helicobacter pylori infection enhancing gastric acidity and possibly appetite by increasing gastric ghrelin secretion, induction of both low-grade systemic inflammation by factors secreted by adipose tissue and the metabolic syndrome with insulin-resistance. Obesity is associated with enhanced secretion of leptin and decreased secretion of adiponectin from adipose tissue and both increased leptin and decreased adiponectin have been shown to be independent risk factors for progression to EAC. Leptin and adiponectin have a set of mutually antagonistic actions on Barrett’s cells which appear to influence the progression of malignant behaviour. At present no drugs are of proven benefit to prevent obesity associated EAC. Roux-en-Y reconstruction is the preferred bariatric surgical option for weight loss in patients with reflux. Statins and aspirin may have chemopreventative effects and are indicated for their circulatory benefits.

Alexandre, Leo; Long, Elizabeth; Beales, Ian LP

2014-01-01

11

Gastroesophageal Reflux in Relation to Adenocarcinomas of the Esophagus: A Pooled Analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON)  

PubMed Central

Background Previous studies have evidenced an association between gastroesophageal reflux and esophageal adenocarcinoma (EA). It is unknown to what extent these associations vary by population, age, sex, body mass index, and cigarette smoking, or whether duration and frequency of symptoms interact in predicting risk. The Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON) allowed an in-depth assessment of these issues. Methods Detailed information on heartburn and regurgitation symptoms and covariates were available from five BEACON case-control studies of EA and esophagogastric junction adenocarcinoma (EGJA). We conducted single-study multivariable logistic regressions followed by random-effects meta-analysis. Stratified analyses, meta-regressions, and sensitivity analyses were also conducted. Results Five studies provided 1,128 EA cases, 1,229 EGJA cases, and 4,057 controls for analysis. All summary estimates indicated positive, significant associations between heartburn/regurgitation symptoms and EA. Increasing heartburn duration was associated with increasing EA risk; odds ratios were 2.80, 3.85, and 6.24 for symptom durations of <10 years, 10 to <20 years, and ?20 years. Associations with EGJA were slighter weaker, but still statistically significant for those with the highest exposure. Both frequency and duration of heartburn/regurgitation symptoms were independently associated with higher risk. We observed similar strengths of associations when stratified by age, sex, cigarette smoking, and body mass index. Conclusions This analysis indicates that the association between heartburn/regurgitation symptoms and EA is strong, increases with increased duration and/or frequency, and is consistent across major risk factors. Weaker associations for EGJA suggest that this cancer site has a dissimilar pathogenesis or represents a mixed population of patients. PMID:25075959

Cook, Michael B.; Corley, Douglas A.; Murray, Liam J.; Liao, Linda M.; Kamangar, Farin; Ye, Weimin; Gammon, Marilie D.; Risch, Harvey A.; Casson, Alan G.; Freedman, Neal D.; Chow, Wong-Ho; Wu, Anna H.; Bernstein, Leslie; Nyren, Olof; Pandeya, Nirmala; Whiteman, David C.; Vaughan, Thomas L.

2014-01-01

12

Endoscopic assessment and management of early esophageal adenocarcinoma.  

PubMed

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

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

2014-08-15

13

Lifetime risk of esophageal adenocarcinoma in patients with Barrett's esophagus  

PubMed Central

AIM: To investigate the lifetime risk of development of esophageal adenocarcinoma and/or high-grade dysplasia in patients diagnosed with Barrett’s esophagus. METHODS: Data were extracted from the United Kingdom National Barrett’s Oesophagus Registry on date of diagnosis, patient age and gender of 7877 patients from who had been registered from 35 United Kingdom centers. Life expectancy was evaluated from United Kingdom National Statistics data based upon gender and age at year at diagnosis. These data were then used with published estimates of annual adenocarcinoma and high-grade dysplasia incidences from meta-analyses and large population-based studies to estimate overall lifetime risk of development of these study endpoints. RESULTS: The mean age at diagnosis of Barrett’s esophagus was 61.6 years in males and 67.3 years in females. The mean life expectancy at diagnosis was 23.1 years in males, 20.7 years in females and 22.2 years overall. Using data from published meta-analyses, the lifetime risk of development of adenocarcinoma was between 1 in 8 and 1 in 14 and the lifetime risk of high-grade dysplasia or adenocarcinoma was 1 in 5 to 1 in 6. Using data from 3 large recent population-based cohort studies the lifetime risk of adenocarcinoma was between 1 in 10 and 1 in 37 and of the combined end-point of high-grade dysplasia and adenocarcinoma was between 1 in 8 and 1 in 20. Age at Barrett’s esophagus diagnosis is reducing and life expectancy is increasing, which will partially counter-balance lower annual cancer incidence. CONCLUSION: There is a significant lifetime risk of development of high-grade dysplasia and adenocarcinoma in Barrett’s esophagus. PMID:25071359

Gatenby, Piers; Caygill, Christine; Wall, Christine; Bhatacharjee, Santanu; Ramus, James; Watson, Anthony; Winslet, Marc

2014-01-01

14

Dietary supplement use and risk of neoplastic progression in esophageal adenocarcinoma: a prospective study.  

PubMed

The incidence of esophageal adenocarcinoma (EA) and its precursor condition, Barrett's esophagus, has risen rapidly in the United States for reasons that are not fully understood. Therefore, we evaluated the association between use of supplemental vitamins and minerals and risk of neoplastic progression of Barrett's esophagus and EA. The Seattle Barrett's Esophagus Program is a prospective study based on 339 men and women with histologically confirmed Barrett's esophagus. Participants underwent baseline and periodic follow-up exams, which included endoscopy and self-administered questionnaires on diet, supplement use, and lifestyle characteristics. Use of multivitamins and 4 individual supplements was calculated using time-weighted averages of reported use over the observational period. Cox proportional-hazards models were used to calculate hazard ratios (HR) for each endpoint: EA, tetraploidy, and aneuploidy. During a mean follow-up of 5 yr, there were 37 cases of EA, 42 cases of tetraploidy, and 34 cases of aneuploidy. After controlling for multiple covariates including diet, nonsteroidal anti-inflammatory drug use, obesity, and smoking, participants who took 1 or more multivitamin pills/day had a significantly decreased risk of tetraploidy [HR = 0.19; 95% confidence interval (CI) = 0.08-0.47) and EA (HR = 0.38; 95% CI = 0.15-0.99] compared to those not taking multivitamins. Significant inverse associations were also observed between risk of EA and supplemental vitamin C (> or = 250 mg vs. none: HR = 0.25; 95% CI = 0.11-0.58) and vitamin E (> or = 180 mg vs. none: HR = 0.25; 95% CI = 0.10-0.60). In this cohort study, use of multivitamins and single antioxidant supplements was associated with a significantly reduced risk of EA and markers of neoplastic progression among individuals with Barrett's esophagus. PMID:18444134

Dong, Linda M; Kristal, Alan R; Peters, Ulrike; Schenk, Jeannette M; Sanchez, Carissa A; Rabinovitch, Peter S; Blount, Patricia L; Odze, Robert D; Ayub, Kamran; Reid, Brian J; Vaughan, Thomas L

2008-01-01

15

Comparative genomic analysis of esophageal adenocarcinoma and squamous cell carcinoma.  

PubMed

Esophageal cancer ranks sixth in cancer death. To explore its genetic origins, we conducted exomic sequencing on 11 esophageal adenocarcinomas (EAC) and 12 esophageal squamous cell carcinomas (ESCC) from the United States. Interestingly, inactivating mutations of NOTCH1 were identified in 21% of ESCCs but not in EACs. There was a substantial disparity in the spectrum of mutations, with more indels in ESCCs, A:T>C:G transversions in EACs, and C:G>G:C transversions in ESCCs (P < 0.0001). Notably, NOTCH1 mutations were more frequent in North American ESCCs (11 of 53 cases) than in ESCCs from China (1 of 48 cases). A parallel analysis found that most mutations in EACs were already present in matched Barrett esophagus. These discoveries highlight key genetic differences between EACs and ESCCs and between American and Chinese ESCCs, and suggest that NOTCH1 is a tumor suppressor gene in the esophagus. Finally, we provide a genetic basis for the evolution of EACs from Barrett esophagus. PMID:22877736

Agrawal, Nishant; Jiao, Yuchen; Bettegowda, Chetan; Hutfless, Susan M; Wang, Yuxuan; David, Stefan; Cheng, Yulan; Twaddell, William S; Latt, Nyan L; Shin, Eun J; Wang, Li-Dong; Wang, Liang; Yang, Wancai; Velculescu, Victor E; Vogelstein, Bert; Papadopoulos, Nickolas; Kinzler, Kenneth W; Meltzer, Stephen J

2012-10-01

16

Exome and whole-genome sequencing of esophageal adenocarcinoma identifies recurrent driver events and mutational complexity  

E-print Network

The incidence of esophageal adenocarcinoma (EAC) has risen 600% over the last 30 years. With a 5-year survival rate of ~15%, the identification of new therapeutic targets for EAC is greatly important. We analyze the mutation ...

Lander, Eric S.

17

Tumor-specific apoptotic gene targeting overcomes radiation resistance in esophageal adenocarcinoma  

Microsoft Academic Search

Purpose: To overcome radiation resistance in esophageal adenocarcinoma by tumor-specific apoptotic gene targeting using tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Methods and Materials: Adenoviral vector Ad\\/TRAIL-F\\/RGD with a tumor-specific human telomerase reverse transcription promoter was used to transfer TRAIL gene to human esophageal adenocarcinoma and normal human lung fibroblastic cells (NHLF). Activation of apoptosis was analyzed by Western blot, fluorescent

Joe Y.. Chang; Zhang Xiaochun; Ritsuko Komaki; Rex Cheung; Fang Bingliang

2006-01-01

18

Comparative genomic analysis of esophageal adenocarcinoma and squamous cell carcinoma  

PubMed Central

Esophageal cancer (EC) ranks sixth in cancer death. To explore its genetic origins, we performed exomic sequencing on 11 adenocarcinomas (EAC) and 12 squamous cell carcinomas (ESCCs) from the United States. Interestingly, inactivating mutations of NOTCH1 were identified in 21% of ESCCs but not in EACs. There was a substantial disparity in the spectrum of mutations, with more indels in ESCCs, A:T>C:G transversions in EACs, and C:G>G:C transversions in ESCCs (p<0.0001). Notably, NOTCH1 mutations were more frequent in North American ESCCs (11 of 53 cases) than in ESCCs from China (1 of 48 cases). A parallel analysis found that most mutations in EACs were already present in matched Barrett’s esophagus (BE). These discoveries highlight key genetic differences between EAC and ESCC, American and Chinese ESCC, and suggest that NOTCH1 is a tumor suppressor gene in the esophagus. Finally, we provide a genetic basis for the evolution of EACs from BE. PMID:22877736

Agrawal, Nishant; Jiao, Yuchen; Bettegowda, Chetan; Hutfless, Susan M.; Wang, Yuxuan; David, Stefan; Cheng, Yulan; Twaddell, William S.; Latt, Nyan L.; Shin, Eun J.; Wang, Li-Dong; Wang, Liang; Yang, Wancai; Velculescu, Victor E.; Vogelstein, Bert; Papadopoulos, Nickolas; Kinzler, Kenneth W.; Meltzer, Stephen J.

2012-01-01

19

Inflammation-Related Carcinogenesis and Prevention in Esophageal Adenocarcinoma Using Rat Duodenoesophageal Reflux Models  

PubMed Central

Development from chronic inflammation to Barrett's adenocarcinoma is known as one of the inflammation-related carcinogenesis routes. Gastroesophageal reflux disease induces regurgitant esophagitis, and esophageal mucosa is usually regenerated by squamous epithelium, but sometimes and somewhere replaced with metaplastic columnar epithelium. Specialized columnar epithelium, so-called Barrett's epithelium (BE), is a risk factor for dysplasia and adenocarcinoma in esophagus. Several experiments using rodent model inducing duodenogastroesophageal reflux or duodenoesophageal reflux revealed that columnar epithelium, first emerging at the proliferative zone, progresses to dysplasia and finally adenocarcinoma, and exogenous carcinogen is not necessary for cancer development. It is demonstrated that duodenal juice rather than gastric juice is essential to develop esophageal adenocarcinoma in not only rodent experiments, but also clinical studies. Antireflux surgery and chemoprevention by proton pump inhibitors, nonsteroidal anti-inflammatory drugs, selective cyclooxygenase-2 inhibitors, green tea, retinoic acid and thioproline showed preventive effects on the development of Barrett's adenocarcinoma in rodent models, but it remains controversial whether antireflux surgery could regress BE and prevent esophageal cancer in clinical observation. The Chemoprevention for Barrett's Esophagus Trial (CBET), a phase IIb, multicenter, randomized, double-masked study using celecoxib in patients with Barrett's dysplasia failed to prove to prevent progression of dysplasia to cancer. The AspECT (Aspirin Esomeprazole Chemoprevention Trial), a large multicenter phase III randomized trial to evaluate the effects of esomeprazole and/or aspirin on the rate of progression to high-grade dysplasia or adenocarcinoma in patients with BE is now ongoing. PMID:24212953

Fujimura, Takashi; Oyama, Katsunobu; Sasaki, Shozo; Nishijima, Koji; Miyashita, Tomoharu; Ohta, Tetsuo; Koichi, Miwa; Takanori, Hattori

2011-01-01

20

Inflammation-related carcinogenesis and prevention in esophageal adenocarcinoma using rat duodenoesophageal reflux models.  

PubMed

Development from chronic inflammation to Barrett's adenocarcinoma is known as one of the inflammation-related carcinogenesis routes. Gastroesophageal reflux disease induces regurgitant esophagitis, and esophageal mucosa is usually regenerated by squamous epithelium, but sometimes and somewhere replaced with metaplastic columnar epithelium. Specialized columnar epithelium, so-called Barrett's epithelium (BE), is a risk factor for dysplasia and adenocarcinoma in esophagus. Several experiments using rodent model inducing duodenogastroesophageal reflux or duodenoesophageal reflux revealed that columnar epithelium, first emerging at the proliferative zone, progresses to dysplasia and finally adenocarcinoma, and exogenous carcinogen is not necessary for cancer development. It is demonstrated that duodenal juice rather than gastric juice is essential to develop esophageal adenocarcinoma in not only rodent experiments, but also clinical studies. Antireflux surgery and chemoprevention by proton pump inhibitors, nonsteroidal anti-inflammatory drugs, selective cyclooxygenase-2 inhibitors, green tea, retinoic acid and thioproline showed preventive effects on the development of Barrett's adenocarcinoma in rodent models, but it remains controversial whether antireflux surgery could regress BE and prevent esophageal cancer in clinical observation. The Chemoprevention for Barrett's Esophagus Trial (CBET), a phase IIb, multicenter, randomized, double-masked study using celecoxib in patients with Barrett's dysplasia failed to prove to prevent progression of dysplasia to cancer. The AspECT (Aspirin Esomeprazole Chemoprevention Trial), a large multicenter phase III randomized trial to evaluate the effects of esomeprazole and/or aspirin on the rate of progression to high-grade dysplasia or adenocarcinoma in patients with BE is now ongoing. PMID:24212953

Fujimura, Takashi; Oyama, Katsunobu; Sasaki, Shozo; Nishijima, Koji; Miyashita, Tomoharu; Ohta, Tetsuo; Miwa, Koichi; Hattori, Takanori

2011-01-01

21

Overexpression of Slug is associated with malignant progression of esophageal adenocarcinoma  

PubMed Central

AIM: To characterise expression of known E-cadherin repressors; Snail, Slug and Twist in the development of esophageal adenocarcinoma. METHODS: E-cadherin, Slug, Snail and Twist mRNA expression in Barrett's metaplasia and esophageal adenocarcinoma specimens was examined by real-time reverse transcription-polymerase chain reaction (RT-PCR). Semi-quantitative immunohistochemistry was used to examine cellular localization and protein levels. The effect of Slug on epithelial mesenchymal transition (EMT) markers was examined by transfection of Slug into an adenocarcinoma line OE33. RESULTS: Cellular localization of Slug in Barrett’s metaplasia was largely cytoplasmic whilst in adenocarcinoma it was nuclear. Semi-quantitative analysis indicated that Slug was more abundant in adenocarcinoma compared to matched Barrett's metaplastic specimens. Snail and Twist were expressed in adenocarcinoma but were cytoplasmic in location and not induced compared to Barrett's mucosa. These observations were supported by mRNA studies where only Slug mRNA was shown to be over-expressed in adenocarcinoma and inversely correlated to E-cadherin expression. Overexpression of Slug in OE33 mediated E-cadherin repression and induced the mesenchymal markers vimentin and fibronectin. CONCLUSION: Progression to adenocarcinoma is associated with increased Slug expression and this may represent a mechanism of E-cadherin silencing. PMID:18286686

Jethwa, Paras; Naqvi, Mushal; Hardy, Robert G; Hotchin, Neil A; Roberts, Sally; Spychal, Robert; Tselepis, Chris

2008-01-01

22

Physical activity is associated with reduced risk of esophageal cancer, particularly esophageal adenocarcinoma: a systematic review and meta-analysis  

PubMed Central

Background Physical activity has been inversely associated with risk of several cancers. We performed a systematic review and meta-analysis to evaluate the association between physical activity and risk of esophageal cancer (esophageal adenocarcinoma [EAC] and/or esophageal squamous cell carcinoma [ESCC]). Methods We conducted a comprehensive search of bibliographic databases and conference proceedings from inception through February 2013 for observational studies that examined associations between recreational and/or occupational physical activity and esophageal cancer risk. Summary adjusted odds ratio (OR) estimates with 95% confidence intervals (CI) were estimated using the random-effects model. Results The analysis included 9 studies (4 cohort, 5 case–control) reporting 1,871 cases of esophageal cancer among 1,381,844 patients. Meta-analysis demonstrated that the risk of esophageal cancer was 29% lower among the most physically active compared to the least physically active subjects (OR, 0.71; 95% CI, 0.57-0.89), with moderate heterogeneity (I2?=?47%). On histology-specific analysis, physical activity was associated with a 32% decreased risk of EAC (4 studies, 503 cases of EAC; OR, 0.68; 95% CI, 0.55-0.85) with minimal heterogeneity (I2?=?0%). There were only 3 studies reporting the association between physical activity and risk of ESCC with conflicting results, and the meta-analysis demonstrated a null association (OR, 1.10; 95% CI, 0.21-5.64). The results were consistent across study design, geographic location and study quality, with a non-significant trend towards a dose–response relationship. Conclusions Meta-analysis of published observational studies indicates that physical activity may be associated with reduced risk of esophageal adenocarcinoma. Lifestyle interventions focusing on increasing physical activity may decrease the global burden of EAC. PMID:24886123

2014-01-01

23

Similarity of aberrant DNA methylation in Barrett's esophagus and esophageal adenocarcinoma  

Microsoft Academic Search

BACKGROUND: Barrett's esophagus (BE) is the metaplastic replacement of squamous with columnar epithelium in the esophagus, as a result of reflux. It is the major risk factor for the development of esophageal adenocarcinoma (EAC). Methylation of CpG dinucleotides of normally unmethylated genes is associated with silencing of their expression, and is common in EAC. This study was designed to determine

Eric Smith; Neville J De Young; Sandra J Pavey; Nicholas K Hayward; Derek J Nancarrow; David C Whiteman; B Mark Smithers; Andrew R Ruszkiewicz; Andrew D Clouston; David C Gotley; Peter G Devitt; Glyn G Jamieson; Paul A Drew

2008-01-01

24

Infectivity-Enhanced Cyclooxygenase2Based Conditionally Replicative Adenoviruses for Esophageal Adenocarcinoma Treatment  

Microsoft Academic Search

The employment of conditionally replicative adenoviruses (CRAd) con- stitutes a promising alternative for cancer treatment; however, in the case of esophageal adenocarcinoma (EAC) the lack of an appropriate tumor- specific promoter and relative resistance to adenovirus infection have hampered the construction of CRAds with clinically applicable specificity and efficacy. By combining transcriptional targeting with infectivity en- hancement for CRAds, we

Julia Davydova; Tatyana Gavrikova; Minghui Wang; Victor Krasnykh; Masato Yamamoto

2004-01-01

25

Biomarkers may help predict progression of Barrett's esophagus to esophageal adenocarcinoma  

Cancer.gov

A series of microRNA expression signatures that may help to define progression of the precancerous condition Barrett's esophagus into esophageal adenocarcinoma was reported recently in Cancer Prevention Research, a journal of the American Association for Cancer Research. The study was conducted by researchers at the University of Texas MD Anderson Cancer Center, in Houston.

26

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

E-print Network

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 cirrhosis, and control groups could be delineated by analyzing serum N-linked glycans by a combination

Clemmer, David E.

27

Slug regulates proliferation and invasiveness of esophageal adenocarcinoma cells in vitro and in vivo.  

PubMed

Slug is a transcription factor and E-cadherin repressor, which has recently been demonstrated to be important for cancer cells to down-regulate epithelial markers and up-regulate mesenchymal markers in order to become motile and invasive. In the present study, we assessed the relevance of Slug for invasion and growth potential of esophageal adenocarcinoma (EA) cells in vitro and in vivo. Slug expression was detected in nine human esophageal cancer cell lines. OE33 cell line was infected with Slug siRNA to knockdown of Slug; TE7 cell line was infected with full Slug cDNA to increase Slug expression. Then, Bcl-2 and E-cadherin expression and Caspase-3 activity were analyzed. MTT assay was applied to detect growth curve. The flow cytometric and Hoechst33258 staining was performed to detect apoptosis. The cells invasion in vitro was detected with a Boyden chamber. A pseudometastatic model of OE33 and TE7 in immunodeficient mice was used to assess the effects of knockdown of Slug and Slug overexpression on metastasis development. A subcutaneously nude mice xenograft model of OE33 and TE7 was used to assess the effects of knockdown of Slug and Slug overexpression on tumor growth. Immunohistochemical staining was used to analyze the expression of Slug, bcl-2 and E-cadherin, and TUNEL was used to detected apoptosis in vivo. Western blotting and RT-PCR showed that Slug expression was detectable in 7 of 9 human esophageal cancer cell lines. Bcl-2 was down-regulated and E-cadherin was up-regulated significantly in Slug siRNA-infected OE33 cell line (P<0.01). Bcl-2 was upregulated and E-cadherin was downregulated significantly in Slug cDNA-infected TE7 cells (P<0.05). OE33 cells with Slug knockdown were shown to possess markedly decreased invasiveness (P<0.05) and markedly increased apoptosis (P<0.05). Slug cDNA-infected TE7 cells were shown only to possess markedly increased invasiveness (P<0.05). There was significant relationship between Slug knockdown or Slug overexpression and cells proliferation (respectively, P<0.05). Animals injected with Slug-silenced OE33 cells had fewer seeded tumor (P<0.01), more apoptosis cells (P<0.05) and significantly xenograft tumor growth regression (P<0.05). But in Slug cDNA-infected TE7 cells, more seeded tumor number and significantly xenograft tumor growth were found in xenograft tumor (respectively, P<0.05). It was showed in the subcutaneously nude mice xenograft model tumor tissue, bcl-2 expression was reduced followed by the decrease of Slug expression in Slug-silenced tumor, and bcl-2 expression was increased followed by the increase of Slug expression. In pseudometastatic model, E-cadherin overexpression was found in Slug siRNA tumor tissue, but less E-cadherin expression was found in Slug cDNA tissue. Slug is an important modulator of apoptosis, growth and invasion in EA in vitro and in vivo. Slug inhibition may represent a novel strategy for treatment of EA. PMID:20730573

Zhang, Kejun; Zhang, Shaoyan; Jiao, Xuelong; Wang, Haibo; Zhang, Dianliang; Niu, Zhaojian; Shen, Yi; Lv, Liang; Zhou, Yanbing

2011-12-01

28

Esophageal Adenocarcinoma and Its Rare Association with Barrett's Esophagus in Henan, China  

PubMed Central

Incidence of esophageal adenocarcinoma (EAC) has increased sharply in Western Europe and United States over the past three decades. Nearly all cases of EAC in the west are thought to be associated with Barrett’s esophagus (BE) at the time of diagnosis. Regions in the Henan province of China have one of world’s highest incidences of esophageal cancer, yet recent temporal trends in the relative rates of EAC with respect to esophageal squamous-cell carcinoma (ESCC), as well as its association with Barrett’s esophagus (BE), have not been reported. In this report, we present large-scale longitudinal clinical and histological data on 5401 esophageal cancers (EC) patients diagnosed during the recent 10-year period (2002–2011) at Henan Cancer Hospital, China. All 217 esophageal adenocarcinoma (EAC) patients from these 5401 EC patients were examined to better understand the relationship between Barrett’s esophagus (BE) and EAC. We found that EAC was relatively rare and accounted for approximately 5% of all esophageal cancers each year during 2002–2011. There is no evidence of significant temporal trends in the rate of EAC relative to ESCC. Only 10 out of 217 (4.6%) EAC cases were detected to have any evidence of Barrett’s esophagus. This result raises the possibility of a different etiological basis for EAC in China motivating more detailed epidemiological, clinical and molecular characterization of EAC in China in order to better understand the neoplastic development of EAC. PMID:25333822

Yao, Lena; Li, Xiaohong; Reid, Brian; Self, Steve; Ma, Jie; Chang, Yuxi; Feng, Shixian; de Dieu Tapsoba, Jean; Sun, Xin; Sun, Xibin

2014-01-01

29

Integrative post-genome-wide association analysis of CDKN2A and TP53 SNPs and risk of esophageal adenocarcinoma.  

PubMed

Incidence of esophageal adenocarcinoma (EA) in Western countries has increased markedly in recent decades. Although several risk factors have been identified for EA and its precursor, Barrett's esophagus (BE), including reflux, Caucasian race, male gender, obesity, and smoking, less is known about the role of inherited genetic variation. Frequent somatic mutations in the tumor suppressor genes CDKN2A and TP53 were recently reported in EA tumors, while somatic alterations at 9p (CDKN2A) and 17p (TP53) have been implicated as predictors of progression from BE to EA. Motivated by these findings, we used data from a genome-wide association study of 2515 EA cases and 3207 controls to analyze 37 germline single nucleotide polymorphisms at the CDKN2A and TP53 loci. Three CDKN2A polymorphisms were nominally associated (P < 0.05) with reduced risk of EA: rs2518720 C>T [intronic, odds ratio 0.90, P = 0.0121, q = 0.3059], rs3088440 G>A (3'UTR, odds ratio 0.84, P = 0.0186, q = 0.3059), and rs4074785 C>T (intronic, odds ratio 0.85, P = 0.0248, q = 0.3059). None of the TP53 single nucleotide polymorphisms reached nominal significance. Two of the CDKN2A variants identified were also associated with reduced risk of progression from BE to EA, when assessed in a prospective cohort of 408 BE patients: rs2518720 (hazard ratio 0.57, P = 0.0095, q = 0.0285) and rs3088440 (hazard ratio 0.34, P = 0.0368, q = 0.0552). In vitro functional studies of rs3088440, a single nucleotide polymorphism located in the seed sequence of a predicted miR-663b binding site, suggested a mechanism whereby the G>A substitution may attenuate miR-663b-mediated repression of the CDKN2A transcript. This study provides the first evidence that germline variation at the CDKN2A locus may influence EA susceptibility. PMID:25280564

Buas, Matthew F; Levine, David M; Makar, Karen W; Utsugi, Heidi; Onstad, Lynn; Li, Xiaohong; Galipeau, Patricia C; Shaheen, Nicholas J; Hardie, Laura J; Romero, Yvonne; Bernstein, Leslie; Gammon, Marilie D; Casson, Alan G; Bird, Nigel C; Risch, Harvey A; Ye, Weimin; Liu, Geoffrey; Corley, Douglas A; Blount, Patricia L; Fitzgerald, Rebecca C; Whiteman, David C; Wu, Anna H; Reid, Brian J; Vaughan, Thomas L

2014-12-01

30

Gastric juice protects against the development of esophageal adenocarcinoma in the rat.  

PubMed Central

OBJECTIVE: The authors investigate the effects of gastric juice on tumorigenesis in a rat model of esophageal adenocarcinoma. SUMMARY BACKGROUND DATA: In rats treated with the carcinogen methyl-n-amyl nitrosamine, squamous cancer of the esophagus develops in a time- and dose-dependent manner. When methyl-n-amyl nitrosamine treatment is preceded by an operation to induce reflux of duodenal and gastric juice into the esophagus, there is an increased yield of esophageal tumors, many of which are adenocarcinomas. When only gastric juice refluxes into the esophagus, the tumor yield is less and adenocarcinomas are not found. METHODS: Two hundred seventy 8-week old Sprague-Dawley rats were studied. Twenty unoperated rats served as controls. The remaining rats underwent the following operations: esophagoduodenostomy with gastric and vagal preservation to induce duodenogastroesophageal reflux (n = 48); esophagoduodenostomy with antrectomy and Billroth 1 reconstruction to produce reflux of duodenogastric juice with the exclusion of the antrum (n = 53); esophagoduodenostomy with proximal gastrectomy to induce hypergastrinemia and reflux of duodenogastric juice with exclusion of the body and forestomach (n = 51); esophagoduodenostomy plus total gastrectomy to produce reflux of duodenal juice alone (n = 50); and esophagoduodenostomy with vagal and gastric preservation but with division of the duodenum just beyond the pylorus and reimplantation into the jejunum, 13 cm distal to the esophagoduodenostomy. This produced reflux of duodenal juice with gastric juice diverted downstream, (n = 48). At 10 weeks of age, all rats were given 4 weekly doses of carcinogen (methyl-n-amyl nitrosamine, 25 mg/kg intraperitoneally), and survivors were killed at 36 weeks of age. RESULTS: The prevalence rate of esophageal adenocarcinoma was 30% in rats with duodenogastroesophageal reflux and 87% in rats with reflux of duodenal juice alone. Fifty-six percent of rats with reflux of duodenogastric juice with exclusion of the antrum and 72% of rats with reflux of duodenogastric juice with the exclusion of the body and forestomach developed adenocarcinoma, showing a progression increase in the prevalence of adenocarcinoma as less gastric juice was permitted to reflux with duodenal juice into the esophagus. CONCLUSION: In this rat model, the presence of gastric juice in refluxed duodenal juice against the development of esophageal adenocarcinoma. The protective effect appears to be due to acid secretion from the stomach. Continuous profound acid suppression therapy may be detrimental by encouraging esophageal metaplasia and tumorigenesis in patients with duodenogastroesophageal reflux. Images Figure 1. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. Figure 9. Figure 10. Figure 11. Figure 12. PMID:8813264

Ireland, A P; Peters, J H; Smyrk, T C; DeMeester, T R; Clark, G W; Mirvish, S S; Adrian, T E

1996-01-01

31

Esophageal adenocarcinoma arising in cervical inlet patch with synchronous Barrett's esophagus-related dysplasia.  

PubMed

Esophageal adenocarcinomas usually develop in Barrett's esophagus, typically through the metaplasia-dysplasia-carcinoma sequence, but adenocarcinomas can occur from heterotopic gastric mucosa in cervical esophagus (inlet patch). This report describes the first case of synchronous presentation of adenocarcinoma arising from cervical inlet patch and Barrett's esophagus-related dysplasia in a 76-year-old man. Surveillance CT detected a 3-cm polypoid mass in the cervical esophagus. Endoscopic biopsies confirmed a diagnosis of adenocarcinoma of the cervical esophagus. Barrett's esophagus was present also in the lower esophagus. Histologic examination of the surgically resected specimen revealed the polypoid mass as composed of tubular adenocarcinoma, and was associated with non-neoplastic columnar mucosa representing pre-existing inlet patch. Another isolated cervical inlet patch with intestinal metaplasia was also recognized. In the lower esophagus, high-grade dysplasia was noted within the Barrett's esophagus. Immunohistochemically, the adenocarcinoma associated with inlet patch had intestinal immunophenotype (CDX2-, CD10- and MUC2-positive), whereas the Barrett's esophagus-related high-grade dysplasia showed mixed immunophenotype (MUC5AC- and MUC6-positive, with scattered MUC2-positive goblet cells). Previous studies and our findings suggest that intestinal metaplasia might predispose to the development of adenocarcinoma in the inlet patch. Therefore, endoscopists and pathologists should be aware of rare malignant transformation of inlet patches, especially those with intestinal metaplasia. PMID:25143128

Tanaka, Mariko; Ushiku, Tetsuo; Ikemura, Masako; Shibahara, Junji; Seto, Yasuyuki; Fukayama, Masashi

2014-08-01

32

Impact of Endoscopic Surveillance on Mortality From Barrett's Esophagus-Associated Esophageal Adenocarcinomas  

PubMed Central

Background & Aims Although patients with Barrett's esophagus commonly undergo endoscopic surveillance, its effectiveness in reducing mortality from esophageal/gastroesophageal junction adenocarcinomas has not been evaluated rigorously. Methods We performed a case-control study in a community-based setting. Among 8272 members with Barrett's esophagus, we identified 351 esophageal adenocarcinoma: 70 in persons who had a prior diagnosis of Barrett's esophagus (who were eligible for surveillance); 51 of these patients died, 38 as a result of the cancers (cases). Surveillance histories were contrasted with a sample of 101 living persons with Barrett's esophagus (controls), matched for age, sex, and duration of follow-up evaluation. Results Surveillancei within 3 years was not associated with a decreased risk of death from esophageal adenocarcinoma (adjusted odds ratio, 0.99; 95% confidence interval, 0.36–2.75). Fatal cases were nearly as likely to have received surveillance (55.3%) as were controls (60.4%). A Barrett's esophagus length longer than 3 cm and prior dysplasia each were associated with subsequent mortality, but adjustment for these did not change the main findings. Although all patients should be included in evaluations of effectiveness, excluding deaths related to cancer treatment and patients who failed to complete treatment, changed the magnitude, but not the significance, of the association (odds ratio, 0.46; 95% confidence interval, 0.13–1.64). Conclusions Endoscopic surveillance of patients with Barrett's esophagus was not associated with a substantially decreased risk of death from esophageal adenocarcinoma. The results do not exclude a small to moderate benefit. However, if such a benefit exists, our findings indicate that it is substantially smaller than currently estimated. The effectiveness of surveillance was influenced partially by the acceptability of existing treatments and the occurrence of treatment-associated mortality. PMID:23673354

Corley, Douglas A.; Mehtani, Kunal; Quesenberry, Charles; Zhao, Wei; De Boer, Jolanda; Weiss, Noel S.

2013-01-01

33

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

PubMed Central

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

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

34

Genomic catastrophes frequently arise in esophageal adenocarcinoma and drive tumorigenesis.  

PubMed

Oesophageal adenocarcinoma (EAC) incidence is rapidly increasing in Western countries. A better understanding of EAC underpins efforts to improve early detection and treatment outcomes. While large EAC exome sequencing efforts to date have found recurrent loss-of-function mutations, oncogenic driving events have been underrepresented. Here we use a combination of whole-genome sequencing (WGS) and single-nucleotide polymorphism-array profiling to show that genomic catastrophes are frequent in EAC, with almost a third (32%, n=40/123) undergoing chromothriptic events. WGS of 22 EAC cases show that catastrophes may lead to oncogene amplification through chromothripsis-derived double-minute chromosome formation (MYC and MDM2) or breakage-fusion-bridge (KRAS, MDM2 and RFC3). Telomere shortening is more prominent in EACs bearing localized complex rearrangements. Mutational signature analysis also confirms that extreme genomic instability in EAC can be driven by somatic BRCA2 mutations. These findings suggest that genomic catastrophes have a significant role in the malignant transformation of EAC. PMID:25351503

Nones, Katia; Waddell, Nicola; Wayte, Nicci; Patch, Ann-Marie; Bailey, Peter; Newell, Felicity; Holmes, Oliver; Fink, J Lynn; Quinn, Michael C J; Tang, Yue Hang; Lampe, Guy; Quek, Kelly; Loffler, Kelly A; Manning, Suzanne; Idrisoglu, Senel; Miller, David; Xu, Qinying; Waddell, Nick; Wilson, Peter J; Bruxner, Timothy J C; Christ, Angelika N; Harliwong, Ivon; Nourse, Craig; Nourbakhsh, Ehsan; Anderson, Matthew; Kazakoff, Stephen; Leonard, Conrad; Wood, Scott; Simpson, Peter T; Reid, Lynne E; Krause, Lutz; Hussey, Damian J; Watson, David I; Lord, Reginald V; Nancarrow, Derek; Phillips, Wayne A; Gotley, David; Smithers, B Mark; Whiteman, David C; Hayward, Nicholas K; Campbell, Peter J; Pearson, John V; Grimmond, Sean M; Barbour, Andrew P

2014-01-01

35

STMN-1 is a potential marker of lymph node metastasis in distal esophageal adenocarcinomas and silencing its expression can reverse malignant phenotype of tumor cells  

PubMed Central

Background Distal esophageal adenocarcinoma is a highly aggressive neoplasm. Despite advances in diagnosis and therapy, the prognosis is still poor. Stathmin (STMN-1) is a ubiquitously expressed microtubule destabilizing phosphoprotein. It promotes the disassembly of microtubules and prevents assembly. STMN-1 can cause uncontrolled cell proliferation when mutated and not functioning properly. Recently, found to be overexpressed in many types of human cancers. However, its clinical significance remains elusive in distal esophageal adenocarcinoma. Here, we reported for the first time that STMN-1 is highly overexpressed in adenocarcinomas of the distal esophagus and strongly associated with lymph node metastasis. Methods STMN-1 expression in 63 cases of distal esophageal adenocarcinoma was analyzed by immunoblotting, while expression in esophageal adenocarcinoma cells was determined by immunocytochemistry, immunofluorescence, qRT-PCR and western blotting. Lentivirus-mediated RNAi was employed to knock-down STMN-1 expression in Human esophageal adenocarcinoma cells. The relationship between STMN-1 expression and lymph node metastasis in distal esophageal adenocarcinoma was determined by univariate and multivariate analyses. Results STMN-1 was detected in 31 (49.21%) of the 63 cases. STMN-1 was highly overexpressed in specimens with lymph node metastasis pN (+), but its expression was almost undetected in pN (?) status. Multivarian regression analysis demonstrated that STMN-1 overexpression is an independent factor for lymph node metastasis in distal esophageal adenocarcinoma. STMN-1 shRNA effectively reduced STMN-1 expression in esophageal adenocarcinoma cells (P?esophageal adenocarcinoma cells in vitro. To verify the in vitro data, we conducted in vivo tumor xenograft studies. Esophageal adenocarcinoma cells stably transfected with STMN-1 shRNA significantly reduced tumor xenografts volume in vivo. Conclusions STMN-1 overexpression is associated with lymph node metastasis and increase malignancy in distal esophageal adenocarcinoma. In vivo and in vitro laboratory findings, suggests that STMN-1 may be a suitable target for future therapeutic strategies in distal esophageal adenocarcinoma. PMID:24433541

2014-01-01

36

Age and sex differences in the incidence of esophageal adenocarcinoma: results from the Surveillance, Epidemiology, and End Results (SEER) Registry (1973-2008).  

PubMed

Risk factors driving sex disparity in esophageal cancer are unclear. Recent molecular evidence suggests hormonal factors. We conducted a national descriptive epidemiological study to assess the hypothesis that estrogen exposure could explain the male predominance in observed esophageal adenocarcinoma incidence. We analyzed the esophageal cancer incidence trends by histology and sex from 1973 to 2008 in nine population-based cancer registries of the Surveillance, Epidemiology, and End Results (SEER) 9 Registry Database. We used age as a proxy for estrogen exposure in females. The collective age groups annual percentage change in esophageal adenocarcinoma for females is positive (0.03%; 95% confidence interval: 0.02, 0.03%) during the study period. Interestingly, the esophageal adenocarcinoma annual percentage change in incidence rates for females during the same time period is significantly negative from ages 50-54 to ages 60-64. Even though the incidence of esophageal adenocarcinoma rises in both males and females, the male-to-female ratio across age peaks in the 50-54 years then decreases. Furthermore, the esophageal adenocarcinoma age-adjusted incidence rate in postmenopausal females age 80 and above increases with age unlike their male counterparts. Taken together, these data support the hypothesis that the endocrine milieu in pre- and perimenopausal females serves as a protective factor against esophageal adenocarcinoma, and with loss of estrogen or because of the increasing time period away from estrogen exposure, the rate of esophageal adenocarcinoma incidence increases in the older postmenopausal female. Because females comprise the largest portion of the elderly population with esophageal adenocarcinoma, these findings are significant. PMID:24118313

Mathieu, L N; Kanarek, N F; Tsai, H-L; Rudin, C M; Brock, M V

2014-11-01

37

Vitamin D receptor is highly expressed in precancerous lesions and esophageal adenocarcinoma with significant sex difference.  

PubMed

Bile acid reflux into the esophagus is important in the development of esophageal adenocarcinoma (EAC). Recently, vitamin D receptor (VDR) was recognized as a bile acid receptor as well as a vitamin receptor. Expression of VDR is reported to influence the development of various types of cancer, such as those of the breast, liver, and colon. However, little is known about the role of VDR in esophageal neoplasms. We investigated the clinicopathological role of VDR in esophageal tumors. We analyzed genomic DNA from 116 EACs for copy number aberrations. The VDR locus was amplified in 7% of EACs. Expression of the VDR protein was also detected by immunohistochemistry from tissue microarrays created from tissues of Barrett esophagus (BE), low-grade (LGD) and high-grade dysplasia (HGD), columnar cell metaplasia (CCM), squamous epithelium (SE), EAC, and esophageal squamous cell carcinoma (ESCC). The protein was highly expressed in 88% of CCM (58/66), 95% of BE (35/37), 100% of the 19 LGD, 94% of HGD (15/16), and 79% of EAC (86/109), but expression in SE and ESCC was rare. Female patients with EAC and CCM were significantly less likely to have high VDR expression than male patients. The overall survival rate was significantly different for patients with tumors exhibiting VDR amplification versus nonamplification. Our findings suggest that VDR plays a role in the early development of EAC through a bile acid ligand. The sex difference in VDR expression may help to explain why men have a high incidence of EAC. PMID:24951052

Zhou, Zhongren; Xia, Yinglin; Bandla, Santhoshi; Zakharov, Vladislav; Wu, Shaoping; Peters, Jeffery; Godfrey, Tony E; Sun, Jun

2014-08-01

38

MicroRNAs, development of Barrett's esophagus, and progression to esophageal adenocarcinoma  

PubMed Central

Barrett’s esophagus is a premalignant condition caused by gastroesophageal reflux. Once developed, it can progress through varying grades of dysplasia to esophageal adenocarcinoma. Whilst it is well accepted that Barrett’s esophagus is caused by gastroesophageal reflux, the molecular mechanisms of its pathogenesis and progression to cancer remain unclear. MicroRNAs (miRNAs) are short segments of RNA that have been shown to control the expression of many human genes. They have been implicated in most cellular processes, and the role of miRNAs in disease development is becoming increasingly evident. Understanding altered miRNA expression is likely to help unravel the molecular mechanisms that underpin the development of Barrett’s esophagus and its progression to cancer. PMID:20128019

Smith, Cameron M; Watson, David I; Michael, Michael Z; Hussey, Damian J

2010-01-01

39

DNA methylation profiling in Barrett's esophagus and esophageal adenocarcinoma reveals unique methylation signatures and molecular subclasses.  

PubMed

Barrett's esophagus (BE) is a metaplastic process whereby the normal stratified, squamous esophageal epithelium is replaced by specialized intestinal epithelium. Barrett's is the only accepted precursor lesion for esophageal adenocarcinoma (EAC), a solid tumor that is rapidly increasing in incidence in western countries. BE evolves into EAC through intermediate steps that involve increasing degrees of dysplasia. Current histologic criteria are quite subjective and the clinical behavior of BE is highly variable and difficult to predict using these standards. It is widely believed that molecular alterations present in BE and EAC will provide more precise prognostic and predictive markers for these conditions than the current clinical and histologic features in use. In order to further define molecular alterations that can classify unique groups of BE and EAC, we utilized methylation microarrays to compare the global gene methylation status of a collection of normal squamous, BE, BE + high-grade dysplasia (HGD), and EAC cases. We found distinct global methylation signatures, as well as differential methylation of specific genes, that discriminated these histological groups. We also noted high and low methylation epigenotypes among the BE and EAC cases. Additional validation of those CpG sites that distinguished BE from BE + HGD and EAC may lead to the discovery of useful biomarkers with potential clinical applications in the diagnosis and prognosis of BE and EAC. PMID:22139570

Kaz, Andrew M; Wong, Chao-Jen; Luo, Yanxin; Virgin, Jeffrey B; Washington, M Kay; Willis, Joseph E; Leidner, Rom S; Chak, Amitabh; Grady, William M

2011-12-01

40

Thioproline inhibits development of esophageal adenocarcinoma induced by gastroduodenal reflux in rats.  

PubMed

Several epidemiological cohort studies have suggested that duodeno-gastroesophageal reflux per se induces Barrett's esophagus leading to increased risk of the development of esophageal adenocarcinoma (EAC). However, the exact causative factors behind EAC remain unclear. Recently, we designed a new duodenal contents reflux model which retained normal stomach function. In this model, duodenal contents flowed back into the esophagus and stomach resulting in repeated re-entry into the esophagus through the site of esophagojejunostomy. To elucidate the factors underlying the development of EAC, thiazolidine-4-carboxylic acid (thioproline, TPRO) was applied to the new reflux models as a nitrite scavenger and as a probe to detect reactive nitrogen species (RNS). Post-operatively, 31 animals were divided into two groups according to diet. Animals belonging to the control group were given normal diet (n = 18), while the TPRO group was given food containing 0.5% TPRO (n = 13). All esophageal sections in both groups were examined using hematoxylin and eosin staining and immunohistochemical analysis of inducible nitric oxide synthase (iNOS). EACs developed in 7 of 18 rats (38.9%) of the control group, whereas no EACs were detected in the TPRO group (Fisher's exact test, P < 0.05). Conversely, esophageal squamous cell carcinoma (ESCC) was detected in 1 of 18 rats (5.6%) of the control group and in 1 of 13 rats (7.7%) of the TPRO group. The incidence of ESCC was not significantly different between the two groups (P = 0.671). iNOS protein was overexpressed in Barrett's esophagus of both groups. The present results suggest that RNS such as nitric oxide and peroxynitrite and nitroso compounds derived from reflux of duodenal contents play an important role in the development of EAC, and that the primary causes of ESCC and EAC may differ. PMID:14754873

Kumagai, Hitomi; Mukaisho, Ken-ichi; Sugihara, Hiroyuki; Miwa, Koichi; Yamamoto, Gaku; Hattori, Takanori

2004-05-01

41

Genome-wide methylation analysis shows similar patterns in Barrett's esophagus and esophageal adenocarcinoma.  

PubMed

Barrett's esophagus (BE) is a precursor of esophageal adenocarcinoma (EAC). To identify novel tumor suppressors involved in esophageal carcinogenesis and potential biomarkers for the malignant progression of BE, we performed a genome-wide methylation profiling of BE and EAC tissues. Using Illumina's Infinium HumanMethylation27 BeadChip microarray, we examined the methylation status of 27 578 CpG sites in 94 normal esophageal (NE), 77 BE and 117 EAC tissue samples. The overall methylation of CpG sites within the CpG islands was higher, but outside of the CpG islands was lower in BE and EAC tissues than in NE tissues. Hierarchical clustering analysis showed an excellent separation of NE tissues from BE and EAC tissues; however, the clustering of BE and EAC tissues was less clear, suggesting that methylation occurs early during the progression of EAC. We confirmed many previously reported hypermethylated genes and identified a large number of novel hypermethylated genes in BE and EAC tissues, particularly genes encoding ADAM (A Disintegrin And Metalloproteinase) peptidase proteins, cadherins and protocadherins, and potassium voltage-gated channels. Pathway analysis showed that a number of channel and transporter activities were enriched for hypermethylated genes. We used pyrosequencing to validate selected candidate genes and found high correlations between the array and pyrosequencing data (rho > 0.8 for each validated gene). The differentially methylated genes and pathways may provide biological insights into the development and progression of BE and become potential biomarkers for the prediction and early detection of EAC. PMID:23996928

Xu, Enping; Gu, Jian; Hawk, Ernest T; Wang, Kenneth K; Lai, Maode; Huang, Maosheng; Ajani, Jaffer; Wu, Xifeng

2013-12-01

42

Frequent Loss of TIMP-3 Expression in Progression of Esophageal and Gastric Adenocarcinomas1  

PubMed Central

Tissue inhibitor of metalloproteinase 3 (TIMP-3) promoter methylation has been linked to loss of TIMP-3 expression in various cancers. In this study, we analyzed TIMP-3 gene methylation using MethyLight assay and TIMP-3 mRNA expression using reverse transcription-polymerase chain reaction analysis in 22 esophageal cancers, 27 gastric carcinomas, and 7 cancer cell lines. We also analyzed TIMP-3 protein expression by immunohistochemistry and its association with clinicopathological characteristics in two cohorts of gastric cancer comprising a total of 347 patients. The TIMP-3 gene was more commonly methylated in adenocarcinomas of the esophagus (9/13) and stomach (9/15) than in the corresponding nonneoplastic mucosa of the esophagus (1/8; P = .024) and stomach (2/14; P = .021). In gastric cancer patients, TIMP-3 was decreased in a diffuse-type gastric cancer and in cancers with poor differentiation and was associated with poor survival (P = .04). In summary, we observed frequent TIMP-3 promoter methylation in adenocarcinomas of the esophagus and stomach and the loss of TIMP-3 expression seems to be of clinical and prognostic relevance in these cancers. PMID:18516293

Gu, Ping; Xing, Xiangbin; Tanzer, Marc; Rocken, Christoph; Weichert, Wilko; Ivanauskas, Audrius; Pross, Matthias; Peitz, Ulrich; Malfertheiner, Peter; Schmid, Roland M; Ebert, Matthias P A

2008-01-01

43

Esophageal cancer  

MedlinePLUS

... There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope. Squamous cell esophageal cancer is linked to smoking and ...

44

Regulation of Desmocollin3 Expression by Promoter Hypermethylation is Associated with Advanced Esophageal Adenocarcinomas  

PubMed Central

BACKGROUND: Desmocollin3 (DSC3) is a member of the cadherin superfamily of calcium-dependent cell adhesion molecules and plays an important role in tumor invasion and metastasis. In this study, we investigated the epigenetic mechanism that regulates DSC3 expression in esophageal adenocarcinomas (EACs). METHODS: Expression of DSC3 was analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). The promoter DNA methylation level of DSC3 was examined using quantitative bisulfite pyrosequencing. RESULTS: The qRT-PCR analysis demonstrated significant down-regulation of the DSC3 mRNA levels in human EAC cell lines and tissue samples (P<.001). In addition, the EAC cell lines and tumor samples have aberrant promoter hypermethylation as compared to normal esophageal samples (P<.001). DSC3 promoter hypermethylation (>10% methylation level) was detected in 97.5% (39/40) of EAC samples whereas none of the normal tissue samples showed hypermethylation (P<.0001). There was a significant inverse correlation between promoter DNA methylation levels and mRNA expression folds for DSC3 (coefficient r=-0.685, P<.0001). Treatment of FLO-1 and SKGT4 EAC cells with 5-Aza-deoxytidine led to a significant reduction in the promoter DNA methylation levels with restoration of the DSC3 expression, suggesting that promoter DNA methylation is a key epigenetic mechanism regulating DSC3 expression. High DSC3 promoter DNA methylation levels were significantly correlated with advanced tumor stage (P<.001) and lymph node metastasis (P<.001). CONCLUSION: Taken together, our results demonstrate that epigenetic silencing of DSC3 is a frequent finding in EAC that is possibly associated with advanced stages. PMID:24847386

Wang, Qinggang; Peng, DunFa; Zhu, Shoumin; Chen, Zheng; Hu, TianLing; Soutto, Mohammed; Saad, Rama; Zhang, Shutian; EI-Rifai, Wael

2014-01-01

45

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

SciTech Connect

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.

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

46

Regulation of arachidonic acid in esophageal adenocarcinoma cells and tumor-infiltrating lymphocytes  

PubMed Central

The generation and development of esophageal adenocarcinoma (EAC) are correlated with neuroimmunological factors. The aim of this study was to observe the effectiveness of the neurotransmitter arachidonic acid (AA) on two EAC cell lines, OE19 and SK-GT-4, as well as three isolated tumor-infiltrating lymphocytes (TIL1, 2 and 3). C-X-C chemokine receptor type 4 (CXCR-4) and tumor necrosis factor receptor 1 (TNFR1) expression, cell migration, necrosis, cytokine secretion and cytotoxicity of TILs were investigated. AA dose-dependently increased the migration of all cells. However, AA did not increase the percentage of cell death of the three TILs in the presence of a necrosis-inducing agent. AA dose-dependently increased the cytotoxicity of the three ??T cell-enriched TILs compared with the OE19 and SK-GT-4 cell lines. AA also dose-dependently increased the secretion of interferon-? (IFN-?) and TNF-? in TIL1 and 2. However, the cytokine secretion and cytotoxicity activity of TIL3 and ??T cell-enriched TIL3 were the lowest. Furthermore, the percentage of CD4+forkhead box p3 (Foxp3)+ regulatory T cells in TIL3 was the highest. The effect of AA on tumor cells and TILs is different. The degree of malignancy of the tumor and the ratio of regulatory T cells may be the main factors determining the function of AA. PMID:23833663

SONG, WEI; JIANG, RUI; ZHAO, CHUNMING

2013-01-01

47

Curcumin promotes apoptosis, increases chemosensitivity, and inhibits nuclear factor kappaB in esophageal adenocarcinoma.  

PubMed

The transcription factor, nuclear factor kappaB (NF-kappaB), plays a central role as a key mediator of cell survival and proliferation, and its activation may confer increased tumor chemoresistance. Curcumin, an orally available naturally occurring compound, has been shown to inhibit NF-kappaB and has a potential role in cancer chemoprevention. We investigated the effects of curcumin on NF-kappaB activity, on cell viability, and as a chemosensitizing agent with 5-fluorouracil (5-FU) or cisplatin (CDDP) in esophageal adenocarcinoma (EAC). Oligonucleotide microarray analysis of 46 cases, consisting of Barrett metaplasia, low-grade dysplasia, high-grade dysplasia and EAC, showed increased expression of NF-kappaB and IkappaB kinase subunits and decreased effector caspase expression in EAC compared with Barrett metaplasia. Stromal expression of both IkappaB and phospho-IkappaB was detected in several EAC samples by tissue microarray analysis. Curcumin alone inhibited NF-kappaB activity and induced apoptosis in both Flo-1 and OE33 EAC cell lines as determined by Western blot analysis, NF-kappaB reporter assays, and Caspase-Glo 3/7 assays. It also increased 5-FU- and CDDP-induced apoptosis in both cell lines. These data suggest that activation of NF-kappaB and inhibition of apoptosis may play a role in the progression from Barrett metaplasia to EAC. In addition, curcumin, a well-known inhibitor of NF-kappaB activity, was shown to increase apoptosis and enhance both 5-FU- and CDDP-mediated chemosensitivity, suggesting that it may have potential application in the therapy of patients with EAC. PMID:20360934

Hartojo, Wibisono; Silvers, Amy L; Thomas, Dafydd G; Seder, Christopher W; Lin, Lin; Rao, Hyma; Wang, Zhuwen; Greenson, Joel K; Giordano, Thomas J; Orringer, Mark B; Rehemtulla, Alnawaz; Bhojani, Mahaveer S; Beer, David G; Chang, Andrew C

2010-04-01

48

Polymorphisms in MGMT and DNA repair genes and the risk of esophageal adenocarcinoma.  

PubMed

Rates of adenocarcinoma of the esophagus (EAC) and esophago-gastric junction (EGJAC) have increased rapidly in recent decades. The primary risk factors, gastro-esophageal acid reflux and smoking, are potentially genotoxic through the generation of N-nitroso compounds. The DNA repair protein O(6)-methylguanine-DNA methyltransferase (MGMT) is the major cellular defense against alkylating DNA damage. We compared patients with EAC (n = 263) or EGJAC (n = 303) with matched population controls (n = 1,337) for the frequency of 5 MGMT single nucleotide polymorphisms (SNPs) (rs12269324, rs12268840, L84F, I143V, K178R), as well as SNPs in DNA repair genes ERCC1 (N118N), XRCC1 (Q399R) and XPD (K751Q). Relative risks were estimated using multivariable logistic regression. Potential biological interaction was assessed through the synergy index S. Each MGMT SNP conferred increased risks of EAC but not EGJAC; strongest associations were found for the 2 variant MGMT alleles rs12268840 and I143V (p = 0.005 and p < 0.001, respectively). Homozygous carriers of MGMT rs12268840 with frequent acid reflux had significantly higher risks of EAC (OR 15.5, 95% CI 5.8-42) than expected under an additive model, consistent with biological interaction (S = 3.3, 95% CI 1.1-10). Modest, nonsignificant interactions with smoking were also observed. Homozygous variant ERCC1 genotype was associated with reduced risks of EAC (OR 0.6, 95% CI 0.4-1.1), while the homozygous variant XRCC1 genotype conferred higher risks of EGJAC (OR 1.6, 95% CI 1.1-2.4). No associations with EAC or EGJAC were observed with XPD (rs13181). In summary, MGMT SNPs are associated with increased risks of EAC. Exposure to acid reflux, and possibly smoking, confer markedly higher risks among homozygous variant genotype carriers. PMID:18386788

Doecke, James; Zhao, Zhen Zhen; Pandeya, Nirmala; Sadeghi, Shahram; Stark, Mitchell; Green, Adèle C; Hayward, Nicholas K; Webb, Penelope M; Whiteman, David C

2008-07-01

49

Endoscopic and Surgical Treatment of Mucosal (T1a) Esophageal Adenocarcinoma in Barrett's Esophagus  

PubMed Central

Background and Aims Endoscopic therapy is emerging as an alternative to surgical therapy in patients with mucosal (T1a) esophageal adenocarcinoma (EAC) given the low likelihood of lymph node metastases. Long term outcomes of patients treated endoscopically and surgically for mucosal EAC are unknown. We compared long term outcomes of patients with mucosal EAC treated endoscopically and surgically. Methods Patients treated for mucosal EAC between 1998 and 2007 were included. Patients were divided into an ENDO group (treated endoscopically) and a SURG group (treated surgically). Vital status information was queried using an institutionally approved internet research and location service. Statistical analysis was performed using Kaplan Meier curves and Cox proportional hazards ratios. Results 176 patients were included of which 132 (74 %) were in the ENDO group and 46 (26 %) were in the SURG group. Mean follow up was 64 months (SEM 4.8) in the SURG group and 43 months (SEM 2.8) in the ENDO group. Cumulative mortality in the ENDO group (17%) was comparable to the SURG group (20 %) (p=0.75). Overall survival was also comparable using the Kaplan Meier method. Treatment modality was not a significant predictor of survival on multivariable analysis. Recurrent carcinoma was detected in 12% of patients in the ENDO group, all successfully re-treated without impact on overall survival. Conclusions Overall survival in patients with mucosal EAC when treated endoscopically appears to be comparable to that of patients treated surgically. Recurrent carcinoma occurs in a limited proportion of patients, but can be managed endoscopically. PMID:19524578

Prasad, Ganapathy A.; Wu, T. T.; Wigle, Dennis A.; Buttar, Navtej S.; Wongkeesong, Louis-Michel; Dunagan, Kelly T.; Lutzke, Lori S.; Borkenhagen, Lynn S.; Wang, Kenneth K.

2013-01-01

50

MicroRNA Prognostic Signature for Nodal Metastases and Survival in Esophageal Adenocarcinoma  

PubMed Central

Background The incidence of esophageal adenocarcinoma is rapidly increasing and is now one of the leading causes of cancer death in the western world. MicroRNAs (miRNAs) are small non-coding RNAs which regulate the expression of protein-encoding genes and are involved in the development, progression and prognosis of other malignancies. We hypothesized that global miRNA expression would predict survival and lymph node involvement in a cohort of surgically resected esophagus cancer patients. Methods miRNA analysis was performed using a custom Affymetrix microarray with probes for 462 known human, 2102 predicted human, 357 mouse and 238 rat miRNAs. miRNA expression was evaluated in 45 primary tumors, and the association of miRNA expression with patient survival and lymph node metastasis was assessed. The prognostic impact of identified unique miRNAs was verified with quantitative RT-PCR. Results Our data indicate that the expression of individual human miRNA species is significantly associated with post-resection patient survival. Using data from five unique miRNAs, we were further able to generate a combined miRNA expression signature that is associated with patient survival (p=0.005; HR = 3.6) independent of node involvement and overall stage. The expression of three miRNAs (miR-99b, miR-199a_3p and _5p) was also associated with the presence of lymph node metastasis. Conclusions These results suggest miRNA expression profiling could provide prognostic utility in staging esophagus cancer patients and treatment planning with endoscopic and neoadjuvant therapies. The alterations of specific miRNAs may further elucidate steps in the metastatic pathway and allow for development of targeted therapy. PMID:21420070

Feber, Andrew; Xi, Liqiang; Pennathur, Arjun; Gooding, William E; Bandla, Santhoshi; Wu, Maoxin; Luketich, James D.; Godfrey, Tony E.; Litle, Virginia R.

2012-01-01

51

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

ClinicalTrials.gov

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

2014-10-30

52

Endothelial-mesenchymal transition in normal human esophageal endothelial cells cocultured with esophageal adenocarcinoma cells: role of IL-1? and TGF-?2.  

PubMed

Endothelial-mesenchymal transition (EndoMT) has been recognized as a key determinant of tumor microenvironment in cancer progression and metastasis. Endothelial cells undergoing EndoMT lose their endothelial markers, acquire the mesenchymal phenotype, and become more invasive with increased migratory abilities. Early stages of esophageal adenocarcinoma (EAC) are characterized by strong microvasculature whose impact in tumor progression remains undefined. Our aim was to determine the role of EndoMT in EAC by investigating the impact of tumor cells on normal primary human esophageal microvascular endothelial cells (HEMEC). HEMEC were either cocultured with OE33 adenocarcinoma cells or treated with IL-1? and transforming growth factor-?2 (TGF-?2) for indicated periods and analyzed for EndoMT-associated changes by real-time PCR, Western blotting, immunofluorescence staining, and functional assays. Additionally, human EAC tissues were investigated for detection of EndoMT-like cells. Our results demonstrate an increased expression of mesenchymal markers [fibroblast-specific protein 1 (FSP1), collagen1?2, vimentin, ?-smooth muscle actin (?-SMA), and Snail], decreased expression of endothelial markers [CD31, von Willebrand factor VIII (vWF), and VE-cadherin], and elevated migration ability in HEMEC following coculture with OE33 cells. The EndoMT-related changes were inhibited by IL-1? and TGF-?2 gene silencing in OE33 cells. Recombinant IL-1? and TGF-?2 induced EndoMT in HEMEC. Although the level of VEGF expression was elevated in EndoMT cells, the angiogenic property of these cells was diminished. In vivo, by immunostaining EndoMT-like cells were detected at the invasive front of EAC. Our findings underscore a significant role for EndoMT in EAC and provide new insights into the mechanisms and significance of EndoMT in the context of tumor progression. PMID:25163519

Nie, Linghui; Lyros, Orestis; Medda, Rituparna; Jovanovic, Nebojsa; Schmidt, Jamie L; Otterson, Mary F; Johnson, Christopher P; Behmaram, Behnaz; Shaker, Reza; Rafiee, Parvaneh

2014-11-01

53

Everolimus and Combination Chemotherapy in Treating Patients With Metastatic Stomach or Esophageal Cancer  

ClinicalTrials.gov

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; Stage IV Esophageal Cancer; Stage IV Gastric Cancer

2014-08-15

54

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

PubMed Central

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

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

55

Assessment of tumor regression of esophageal adenocarcinomas after neoadjuvant chemotherapy: comparison of 2 commonly used scoring approaches.  

PubMed

Histopathologic determination of tumor regression provides important prognostic information for locally advanced gastroesophageal carcinomas after neoadjuvant treatment. Regression grading systems mostly refer to the amount of therapy-induced fibrosis in relation to residual tumor or the estimated percentage of residual tumor in relation to the former tumor site. Although these methods are generally accepted, currently there is no common standard for reporting tumor regression in gastroesophageal cancers. We compared the application of these 2 major principles for assessment of tumor regression: hematoxylin and eosin-stained slides from 89 resection specimens of esophageal adenocarcinomas following neoadjuvant chemotherapy were independently reviewed by 3 pathologists from different institutions. Tumor regression was determined by the 5-tiered Mandard system (fibrosis/tumor relation) and the 4-tiered Becker system (residual tumor in %). Interobserver agreement for the Becker system showed better weighted ? values compared with the Mandard system (0.78 vs. 0.62). Evaluation of the whole embedded tumor site showed improved results (Becker: 0.83; Mandard: 0.73) as compared with only 1 representative slide (Becker: 0.68; Mandard: 0.71). Modification into simplified 3-tiered systems showed comparable interobserver agreement but better prognostic stratification for both systems (log rank Becker: P=0.015; Mandard P=0.03), with independent prognostic impact for overall survival (modified Becker: P=0.011, hazard ratio=3.07; modified Mandard: P=0.023, hazard ratio=2.72). In conclusion, both systems provide substantial to excellent interobserver agreement for estimation of tumor regression after neoadjuvant chemotherapy in esophageal adenocarcinomas. A simple 3-tiered system with the estimation of residual tumor in % (complete regression/1% to 50% residual tumor/>50% residual tumor) maintains the highest reproducibility and prognostic value. PMID:25140894

Karamitopoulou, Eva; Thies, Svenja; Zlobec, Inti; Ott, Katja; Feith, Marcus; Slotta-Huspenina, Julia; Lordick, Florian; Becker, Karen; Langer, Rupert

2014-11-01

56

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

PubMed

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

Monjazeb, Arta Monir; Blackstock, A William

2013-01-01

57

MicroRNA alterations in Barrett's esophagus, esophageal adenocarcinoma, and esophageal adenocarcinoma cell lines following cranberry extract treatment: Insights for chemoprevention  

PubMed Central

Background: Aberrant expression of small noncoding endogenous RNA molecules known as microRNAs (miRNAs) is documented to occur in multiple cancer types including esophageal adencarcinoma (EAC) and its only known precursor, Barrett's esophagus (BE). Recent studies have linked dysregulation of specific miRNAs to histological grade, neoplastic progression and metastatic potential. Materials and Methods: Herein, we present a summary of previously reported dysregulated miRNAs in BE and EAC tissues as well as EAC cell lines and evaluate a cranberry proanthocyanidin rich extract's (C-PAC) ability to modulate miRNA expression patterns of three human EAC cell lines (JHEso-Ad-1, OE33 and OE19). Results: A review of 13 published studies revealed dysregulation of 87 miRNAs in BE and EAC tissues, whereas 52 miRNAs have been reported to be altered in BE or EAC cell lines, with 48% overlap with miRNA changes reported in tissues. We report for the first time C-PAC–induced modulation of five miRNAs in three EAC cell lines resulting in 26 validated gene targets and identification of key signaling pathways including p53, angiogenesis, T-cell activation and apoptosis. Additionally, mutiple cancer related networks were ideintified as modulated by C-PAC utilizing Kyoto Encyclopedia of Genes and Genomes (KEGG), Protein Analysis Through Evolutionary Relationships (PANTHER), and MetaCore analysis tools. Conclusions: Study results support the cancer inhibitory potential of C-PAC is in part attributable to C-PAC's ability to modify miRNA profiles within EAC cells. A number of C-PAC–modulated miRNAs have been been identified as dysregulated in BE and EAC. Further insights into miRNA dysregulation and modulation by select cancer preventive agents will support improved targeted interventions in high-risk cohorts. PMID:22279419

Kresty, Laura A.; Clarke, Jennifer; Ezell, Kristin; Exum, Amy; Howell, Amy B.; Guettouche, Toumy

2011-01-01

58

Snapshot of Esophageal Cancer  

MedlinePLUS

... NCI Budget (Billions of $) NCI Esophageal Cancer Research Investment Source: NCI Office of Budget and Finance. If ... which include the Asian Barrett’s Consortium and the International Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON), were formed ...

59

Prognostic Value and Targeted Inhibition of Survivin Expression in Esophageal Adenocarcinoma and Cancer-Adjacent Squamous Epithelium  

PubMed Central

Background Survivin is an inhibitor of apoptosis and its over expression is associated with poor prognosis in several malignancies. While several studies have analyzed survivin expression in esophageal squamous cell carcinoma, few have focused on esophageal adenocarcinoma (EAC) and/or cancer-adjacent squamous epithelium (CASE). The purpose of this study was 1) to determine the degree of survivin up regulation in samples of EAC and CASE, 2) to evaluate if survivin expression in EAC and CASE correlates with recurrence and/or death, and 3) to examine the effect of survivin inhibition on apoptosis in EAC cells. Methods Fresh frozen samples of EAC and CASE from the same patient were used for qRT-PCR and Western blot analysis, and formalin-fixed, paraffin-embedded tissue was used for immunohistochemistry. EAC cell lines, OE19 and OE33, were transfected with small interfering RNAs (siRNAs) to knockdown survivin expression. This was confirmed by qRT-PCR for survivin expression and Western blot analysis of cleaved PARP, cleaved caspase 3 and survivin. Survivin expression data was correlated with clinical outcome. Results Survivin expression was significantly higher in EAC tumor samples compared to the CASE from the same patient. Patients with high expression of survivin in EAC tumor had an increased risk of death. Survivin expression was also noted in CASE and correlated with increased risk of distant recurrence. Cell line evaluation demonstrated that inhibition of survivin resulted in an increase in apoptosis. Conclusion Higher expression of survivin in tumor tissue was associated with increased risk of death; while survivin expression in CASE was a superior predictor of recurrence. Inhibition of survivin in EAC cell lines further showed increased apoptosis, supporting the potential benefits of therapeutic strategies targeted to this marker. PMID:24223792

Malhotra, Usha; Zaidi, Ali H.; Kosovec, Juliann E.; Kasi, Pashtoon M.; Komatsu, Yoshihiro; Rotoloni, Christina L.; Davison, Jon M.; R, Clint; Irvin; Hoppo, Toshitaka; Nason, Katie S.; Kelly, Lori A.; Gibson, Michael K.; Jobe, Blair A.

2013-01-01

60

Nano-Curcumin Inhibits Proliferation of Esophageal Adenocarcinoma Cells and Enhances the T Cell Mediated Immune Response  

PubMed Central

In Western countries the incidence of the esophageal adenocarcinoma (EAC) has risen at a more rapid rate than that of any other malignancy. Despite intensive therapies this cancer is associated with extreme high morbidity and mortality. For this reason, novel effective therapeutic strategies are urgently required. Dendritic Cell (DC)-based immunotherapy is a promising novel treatment strategy, which combined with other anti-cancer strategies has been proven to be beneficial for cancer patients. Curcumin (diferuloylmethane), is a natural polyphenol that is known for its anti-cancer effects however, in it’s free form, curcumin has poor bioavailability. The aim of this study was to investigate whether using a highly absorptive form of curcumin, dispersed with colloidal nano-particles, named Theracurmin would be more effective against EAC cells and to analyze if this new compound affects DC-induced T cell response. As a result, we show efficient uptake of nano-curcumin by the EAC cell lines, OE33, and OE19. Moreover, nano-curcumin significantly decreased the proliferation of the EAC cells, while did not affect the normal esophageal cell line HET-1A. We also found that nano-curcumin significantly up-regulated the expression of the co-stimulatory molecule CD86 in DCs and significantly decreased the secretion of pro-inflammatory cytokines from in vitro activated T cells. When we combined T cells with nano-curcumin treatment in OE19 and OE33, we found that the basic levels of T cell induced cytotoxicity of 6.4 and 4.1%, increased to 15 and 13%, respectively. In conclusion, we found that nano-curcumin is effective against EAC, sensitizes EAC cells to T cell induced cytotoxicity and decreases the pro-inflammatory signals from T cells. Combining DC immunotherapy with nano-curcumin is potentially a promising approach for future treatment of EAC. PMID:23755374

Milano, Francesca; Mari, Luigi; van de Luijtgaarden, Wendy; Parikh, Kaushal; Calpe, Silvia; Krishnadath, Kausilia K.

2013-01-01

61

Central Adiposity Is Associated With Increased Risk of Esophageal Inflammation, Metaplasia, and Adenocarcinoma: A Systematic Review and Meta-analysis  

PubMed Central

BACKGROUND & AIMS Central adiposity has been implicated as a risk factor for Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC), possibly promoting the progression from inflammation to metaplasia and neoplasia. We performed a systematic review and meta-analysis of studies to evaluate the association between central adiposity and erosive esophagitis (EE), BE, and EAC, specifically exploring body mass index (BMI)–independent and gastroesophageal reflux (GERD)–independent effects of central adiposity on the risk of these outcomes. METHODS We performed a systematic search of multiple databases through March 2013. Studies were included if they reported effect of central adiposity (visceral adipose tissue area, waist-hip ratio, and/or waist circumference) on the risk of EE, BE, and EAC. Summary adjusted odds ratio (aOR) estimates with 95% confidence intervals (CIs), comparing highest category of adiposity with the lowest category of adiposity, were calculated by using randomeffects model. RESULTS Forty relevant articles were identified. Compared with patients with normal body habitus, patients with central adiposity had a higher risk of EE (19 studies; aOR, 1.87; 95% CI, 1.51–2.31) and BE (17 studies; aOR, 1.98; 95% CI, 1.52–2.57). The association between central adiposity and BE persisted after adjusting for BMI (5 studies; aOR, 1.88; 95% CI, 1.20–2.95). Refluxindependent association of central adiposity and BE was observed in studies that used GERD patients as controls or adjusted for GERD symptoms (11 studies; aOR, 2.04; 95% CI, 1.44–2.90). In 6 studies, central adiposity was associated with higher risk of EAC (aOR, 2.51; 95% CI, 1.54–4.06), compared with normal body habitus. CONCLUSIONS On the basis of a meta-analysis, central adiposity, independent of BMI, is associated with esophageal inflammation (EE), metaplasia (BE), and neoplasia (EAC). Its effects are mediated by reflux-dependent and reflux-independent mechanisms. PMID:23707461

Singh, Siddharth; Sharma, Anamay N.; Murad, Mohammad Hassan; Buttar, Navtej S.; El-Serag, Hashem B.; Katzka, David A.; Iyer, Prasad G.

2013-01-01

62

STAT3 expression, activity and functional consequences of STAT3 inhibition in esophageal squamous cell carcinomas and Barrett's adenocarcinomas.  

PubMed

Signal transducer and activator of transcription 3 (STAT3) is altered in several epithelial cancers and represents a potential therapeutic target. Here, STAT3 expression, activity and cellular functions were examined in two main histotypes of esophageal carcinomas. In situ, immunohistochemistry for STAT3 and STAT3-Tyr705 phosphorylation (P-STAT3) in esophageal squamous cell carcinomas (ESCC, n=49) and Barrett's adenocarcinomas (BAC, n=61) revealed similar STAT3 expression in ESCCs and BACs (P=0.109), but preferentially activated P-STAT3 in ESCCs (P=0.013). In vitro, strong STAT3 activation was seen by epidermal growth factor (EGF) stimulation in OE21 (ESCC) cells, whereas OE33 (BAC) cells showed constitutive weak STAT3 activation. STAT3 knockdown significantly reduced cell proliferation of OE21 (P=0.0148) and OE33 (P=0.0243) cells. Importantly, STAT3 knockdown reduced cell migration of OE33 cells by 2.5-fold in two types of migration assays (P=0.073, P=0.015), but not in OE21 cells (P=0.1079, P=0.386). Investigation of transcriptome analysis of STAT3 knockdown revealed a reduced STAT3 level associated with significant downregulation of cell cycle genes in both OE21 (P<0.0001) and OE33 (P=0.01) cells. In contrast, genes promoting cell migration (CTHRC1) were markedly upregulated in OE21 cells, whereas a gene linked to tight-junction stabilization and restricted cell motility (SHROOM2) was downregulated in OE21 but upregulated in OE33 cells. This study shows frequent, but distinct, patterns of STAT3 expression and activation in ESCCs and BACs. STAT3 knockdown reduces cell proliferation in ESCC and BAC cells, inhibits migration of BAC cells and may support cell migration of ESCC cells. Thereby, novel STAT3-regulated genes involved in ESCC and BAC cell proliferation and cell migration were identified. Thus, STAT3 may be further exploited as a potential novel therapeutic target, however, by careful distinction between the two histotypes of esophageal cancers. PMID:23912451

Timme, S; Ihde, S; Fichter, C D; Waehle, V; Bogatyreva, L; Atanasov, K; Kohler, I; Schöpflin, A; Geddert, H; Faller, G; Klimstra, D; Tang, L; Reinheckel, T; Hauschke, D; Busch, H; Boerries, M; Werner, M; Lassmann, S

2014-06-19

63

Elevated Tumor Expression of PAI-1 and SNAI2 in Obese Esophageal Adenocarcinoma Patients and Impact on Prognosis  

PubMed Central

OBJECTIVES: Obesity is linked to increased mortality from many cancer types, and esophageal adenocarcinoma (EAC) displays one of the strongest epidemiological associations. The aims of this study are to dissect molecular pathways linking obesity with EAC and to determine if obesity is linked to increased aggressiveness of this disease. METHODS: Affymetrix microarrays identified altered signaling pathways in an EAC cell line following coculture with visceral adipose tissue or isolated adipocytes from viscerally obese EAC patients (n=6). Differentially expressed genes were subsequently investigated in patient tumor biopsies by quantitative reverse transcriptase PCR and examined with respect to obesity status, tumor biology, and patient survival. RESULTS: Visceral adipose tissue induced expression of genes involved in epithelial mesenchymal transition (EMT), plasminogen activator inhibitor (PAI)-1, and transcription factor SNAI2, in an EAC cell line. In EAC patient tumor biopsies from obese patients, we noted elevated expression of these genes, together with reduced expression of epithelial marker E-cadherin. SNAI2 was associated with EAC prognosis. CONCLUSIONS: Expression of EMT genes, PAI-1 and SNAI2, was elevated in tumors of obese EAC patients, and SNAI2 was associated with poor survival. Genes deregulated in obesity and associated with prognosis may represent potential targets for treatment stratification of obese EAC patients. PMID:23238211

Allott, Emma H; Morine, Melissa J; Lysaght, Joanne; McGarrigle, Sarah A; Donohoe, Claire L; Reynolds, John V; Roche, Helen M; Pidgeon, Graham P

2012-01-01

64

Early Involvement of Death-Associated Protein Kinase Promoter Hypermethylation in the Carcinogenesis of Barrett's Esophageal Adenocarcinoma and Its Association with Clinical Progression1  

PubMed Central

Esophageal Barrett's adenocarcinoma (BA) develops through a multistage process, which is associated with the transcriptional silencing of tumor-suppressor genes by promoter CpG island hypermethylation. In this study, we explored the promoter hypermethylation and protein expression of proapoptotic deathassociated protein kinase (DAPK) during the multistep Barrett's carcinogenesis cascade. Early BA and paired samples of premalignant lesions of 61 patients were analyzed by methylation-specific polymerase chain reaction and immunohistochemistry. For the association of clinicopathological markers and protein expression, an immunohistochemical tissue microarray analysis of 66 additional BAs of advanced tumor stages was performed. Hypermethylation of DAPK promoter was detected in 20% of normal mucosa, 50% of Barrett's metaplasia, 53% of dysplasia, and 60% of adenocarcinomas, and resulted in a marked decrease in DAPK protein expression (P < .01). The loss of DAPK protein was significantly associated with advanced depth of tumor invasion and advanced tumor stages (P < .001). Moreover, the severity of reflux esophagitis correlated significantly with the hypermethylation rate of the DAPK promoter (P < .003). Thus, we consider DAPK inactivation by promoter hypermethylation as an early event in Barrett's carcinogenesis and suggest that a decreased protein expression of DAPK likely plays a role in the development and progression of BA. PMID:17401463

Kuester, Doerthe; Dar, Altaf A; Moskaluk,, Christopher C; Krueger, Sabine; Meyer, Frank; Hartig, Roland; Stolte, Manfred; Malfertheiner, Peter; Lippert, Hans; Roessner, Albert; El-Rifai, Wael; Schneider-Stock, Regine

2007-01-01

65

Hypomethylation of Noncoding DNA Regions and Overexpression of the Long Noncoding RNA, AFAP1-AS1, in Barrett's Esophagus and Esophageal Adenocarcinoma  

PubMed Central

BACKGROUND & AIMS Alterations in methylation of protein-coding genes are associated with Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC). Dys-regulation of noncoding RNAs occurs during carcinogen-esis but has never been studied in BE or EAC. We applied high-resolution methylome analysis to identify changes at genomic regions that encode noncoding RNAs in BE and EAC. METHODS We analyzed methylation of 1.8 million CpG sites using massively parallel sequencing-based HELP tagging in matched EAC, BE, and normal esophageal tissues. We also analyzed human EAC (OE33, SKGT4, and FLO-1) and normal (HEEpic) esophageal cells. RESULTS BE and EAC exhibited genome-wide hypomethylation, significantly affecting intragenic and repetitive genomic elements as well as noncoding regions. These methylation changes targeted small and long noncoding regions, discriminating normal from matched BE or EAC tissues. One long noncoding RNA, AFAP1-AS1, was extremely hypomethylated and overexpressed in BE and EAC tissues and EAC cells. Its silencing by small interfering RNA inhibited proliferation and colony-forming ability, induced apoptosis, and reduced EAC cell migration and invasion without altering the expression of its protein-coding counterpart, AFAP1. CONCLUSIONS BE and EAC exhibit reduced methylation that includes noncoding regions. Methylation of the long noncoding RNA AFAP1-AS1 is reduced in BE and EAC, and its expression inhibits cancer-related biologic functions of EAC cells. PMID:23333711

Wu, Wenjing; Bhagat, Tushar D.; Yang, Xue; Song, Jee Hoon; Cheng, Yulan; Agarwal, Rachana; Abraham, John M.; Ibrahim, Sariat; Bartenstein, Matthias; Hussain, Zulfiqar; Suzuki, Masako; Yu, Yiting; Chen, Wei; Eng, Charis; Greally, John; Verma, Amit; Meltzer, Stephen J.

2013-01-01

66

Germline Mutations in MSR1, ASCC1, and CTHRC1 in Patients With Barrett Esophagus and Esophageal Adenocarcinoma  

PubMed Central

Context Barrett esophagus (BE) occurs in 1% to 10% of the general population and is believed to be the precursor of esophageal adenocarcinoma (EAC). The incidence of EAC has increased 350% in the last 3 decades without clear etiology. Finding predisposition genes may improve premorbid risk assessment, genetic counseling, and management. Genome-wide multiplatform approaches may lead to the identification of genes important in BE/EAC development. Objective To identify risk alleles or mutated genes associated with BE/EAC. Design, Setting, and Patients Model-free linkage analyses of 21 concordant-affected sibling pairs with BE/EAC and 11 discordant sibling pairs (2005–2006). Significant germline genomic regions in independent prospectively accrued series of 176 white patients with BE/EAC and 200 ancestry-matched controls (2007–2010) were validated and fine mapped. Integrating data from these significant genomic regions with somatic gene expression data from 19 BE/EAC tissues yielded 12 “priority” candidate genes for mutation analysis (2010). Genes that showed mutations in cases but not in controls were further screened in an independent prospectively accrued validation series of 58 cases (2010). Main Outcome Measures Identification of germline mutations in genes associated with BE/EAC cases. Functional interrogation of the most commonly mutated gene. Results Three major genes, MSR1, ASCC1, and CTHRC1 were associated with BE/EAC (all P<.001). In addition, 13 patients (11.2%) with BE/EAC carried germline mutations in MSR1, ASCC1, or CTHRC1. MSR1 was the most frequently mutated, with 8 of 116 (proportion, 0.069; 95% confidence interval [CI], 0.030–0.130; P<.001) cases with c.877C>T (p.R293X). An independent validation series confirmed germline MSR1 mutations in 2 of 58 cases (proportion, 0.035; 95% CI, 0.004–0.120; P=.09). MSR1 mutation resulted in CCND1 up-regulation in peripheral-protein lysate. Immunohistochemistry of BE tissues in MSR1-mutation carriers showed increased nuclear expression of CCND1. Conclusion MSR1 was significantly associated with the presence of BE/EAC in derivation and validation samples, although it was only present in a small percentage of the cases. PMID:21791690

Orloff, Mohammed; Peterson, Charissa; He, Xin; Heald, Shireen Ganapathi Brandie; Yang, Yi-ran; Bebek, Gurkan; Romigh, Todd; Song, Mess Jee Hoon; Wu, Mess Wenjing; David, Stefan; Cheng, Yulan; Meltzer, Stephen J.; Eng, Charis

2013-01-01

67

Study of FoxA Pioneer Factor at Silent Genes Reveals Rfx-Repressed Enhancer at Cdx2 and a Potential Indicator of Esophageal Adenocarcinoma Development  

PubMed Central

Understanding how silent genes can be competent for activation provides insight into development as well as cellular reprogramming and pathogenesis. We performed genomic location analysis of the pioneer transcription factor FoxA in the adult mouse liver and found that about one-third of the FoxA bound sites are near silent genes, including genes without detectable RNA polymerase II. Virtually all of the FoxA-bound silent sites are within conserved sequences, suggesting possible function. Such sites are enriched in motifs for transcriptional repressors, including for Rfx1 and type II nuclear hormone receptors. We found one such target site at a cryptic “shadow” enhancer 7 kilobases (kb) downstream of the Cdx2 gene, where Rfx1 restricts transcriptional activation by FoxA. The Cdx2 shadow enhancer exhibits a subset of regulatory properties of the upstream Cdx2 promoter region. While Cdx2 is ectopically induced in the early metaplastic condition of Barrett's esophagus, its expression is not necessarily present in progressive Barrett's with dysplasia or adenocarcinoma. By contrast, we find that Rfx1 expression in the esophageal epithelium becomes gradually extinguished during progression to cancer, i.e, expression of Rfx1 decreased markedly in dysplasia and adenocarcinoma. We propose that this decreased expression of Rfx1 could be an indicator of progression from Barrett's esophagus to adenocarcinoma and that similar analyses of other transcription factors bound to silent genes can reveal unanticipated regulatory insights into oncogenic progression and cellular reprogramming. PMID:21935353

Watts, Jason A.; Zhang, Chaolin; Klein-Szanto, Andres J.; Kormish, Jay D.; Fu, Jian; Zhang, Michael Q.; Zaret, Kenneth S.

2011-01-01

68

Hypermethylation of the nel-like 1 gene is a common and early event and is associated with poor prognosis in early-stage esophageal adenocarcinoma.  

PubMed

The nel-like1 (NELL1) gene maps to chromosome 11p15, which frequently undergoes loss of heterozygosity in esophageal adenocarcinoma (EAC). NELL1 promoter hypermethylation was examined by real-time methylation-specific polymerase chain reaction in 259 human esophageal tissues. Hypermethylation of this promoter showed highly discriminative receiver-operator characteristic curve profiles, clearly distinguishing esophageal squamous cell carcinoma (ESCC) and EAC from normal esophagus (NE) (P<0.001). NELL1 normalized methylation values were significantly higher in Barrett's metaplasia (BE), dysplastic Barrett's (D) and EAC than in NE (P<0.0000001). NELL1 hypermethylation frequency was zero in NE but increased early during neoplastic progression, to 41.7% in BE from patients with Barrett's alone, 52.5% in D and 47.8% in EAC. There was a significant correlation between NELL1 hypermethylation and BE segment length. Three (11.5%) of 26 ESCCs exhibited NELL1 hypermethylation. Survival correlated inversely with NELL1 hypermethylation in patients with stages I-II (P=0.0264) but not in stages III-IV (P=0.68) EAC. Treatment of KYSE220 ESCC and BIC EAC cells with 5-aza-2'-deoxycytidine reduced NELL1 methylation and increased NELL1 mRNA expression. NELL1 mRNA levels in EACs with an unmethylated NELL1 promoter were significantly higher than those in EACs with a methylated promoter (P=0.02). Promoter hypermethylation of NELL1 is a common, tissue-specific event in human EAC, occurs early during Barrett's-associated esophageal neoplastic progression, and is a potential biomarker of poor prognosis in early-stage EAC. PMID:17452981

Jin, Z; Mori, Y; Yang, J; Sato, F; Ito, T; Cheng, Y; Paun, B; Hamilton, J P; Kan, T; Olaru, A; David, S; Agarwal, R; Abraham, J M; Beer, D; Montgomery, E; Meltzer, S J

2007-09-20

69

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

ClinicalTrials.gov

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

2014-03-17

70

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

PubMed Central

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

2014-01-01

71

Epidermal growth factor receptor (EGFR) is an independent adverse prognostic factor in esophageal adenocarcinoma patients treated with cisplatin-based neoadjuvant chemotherapy  

PubMed Central

Neoadjuvant platin-based therapy is accepted as a standard therapy for advanced esophageal adenocarcinoma (EAC). Patients who respond have a better survival prognosis, but still a significant number of responder patients die from tumor recurrence. Molecular markers for prognosis in neoadjuvantly treated EAC patients have not been identified yet. We investigated the epidermal growth factor receptor (EGFR) in prognosis and chemotherapy resistance in these patients. Two EAC patient cohorts, either treated by neoadjuvant cisplatin-based chemotherapy followed by surgery (n=86) or by surgical resection (n=46) were analyzed for EGFR protein expression and gene copy number. Data were correlated with clinical and histopathological response, disease-free and overall survival. In case of EGFR overexpression, the prognosis for neoadjuvant chemotherapy responders was poor as in non-responders. Responders had a significantly better disease-free survival than non-responders only if EGFR expression level (p=0.0152) or copy number (p=0.0050) was low. Comparing neoadjuvantly treated patients and primary resection patients, tumors of non-responder patients more frequently exhibited EGFR overexpression, providing evidence that EGFR is a factor for indicating chemotherapy resistance. EGFR overexpression and gene copy number are independent adverse prognostic factors for neoadjuvant chemotherapy-treated EAC patients, particularly for responders. Furthermore, EGFR overexpression is involved in resistance to cisplatin-based neoadjuvant chemotherapy. PMID:25216514

Aichler, Michaela; Motschmann, Martin; Jutting, Uta; Luber, Birgit; Becker, Karen; Ott, Katja; Lordick, Florian; Langer, Rupert; Feith, Marcus; Siewert, Jorg Rudiger; Walch, Axel

2014-01-01

72

Esophageal Cancer  

MedlinePLUS

Español Esophageal Cancer Definition Cancer that forms in tissues lining the esophagus (the muscular tube through which food passes from ... the upper digestive system. Prevention and Screening Esophageal Cancer Prevention (PDQ®) Esophageal Cancer Screening (PDQ®) Diagnosis and Treatment Esophageal Cancer ...

73

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

PubMed Central

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

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

2013-01-01

74

Adenocarcinoma of the esophagus and Barrett's esophagus: a population-based study  

Microsoft Academic Search

Objective: We described incidence rates of esophageal adenocarcinoma in Denmark in a 20-yr period and determined the proportion of patients diagnosed with esophageal adenocarcinoma who had a previous diagnosis of Barrett's esophagus, making them potential candidates for endoscopic surveillance. Methods: Rates of esophageal and gastric cancers were collected from the Danish Cancer registry for the period 1970–1991. The registry was

Peter Bytzer; Peer Brehm Christensen; Per Damkier; Kirsten Vinding; Niels Seersholm

1999-01-01

75

Long-term evaluation of esophageal function in patients treated at birth for esophageal atresia  

Microsoft Academic Search

Dysphagia, gastroesophageal reflux (GER) and esophageal metaplasia are reported with various incidence in the long term follow-up of patients treated at birth for esophageal atresia (EA). To evaluate the long term outcomes 26 patients treated at birth for EA with Tracheo Esophageal Fistula (TEF) were examined 8-28 (mean 15.8) years later by clinical evaluation, including barium meal, fiberoptic upper GI

V. Tomaselli; M. Volpi; M. Bini; A. Rossi; A. Indriolo

2003-01-01

76

Epigenetics in esophageal cancers.  

PubMed

Esophageal cancers are a challenging upper gastrointestinal tract tumor entity for interdisciplinary oncology. For the two main histotypes, namely esophageal squamous cell carcinomas and Barrett's adenocarcinomas, several genetic aberrations have been shown to contribute to carcinogenesis and progression as well as to represent potential novel targets for therapeutic intervention. This is paralleled by growing insight into epigenetic alterations of esophageal cancers. Studies involving the analyses of human tissue specimens predominantly describe altered patterns of miRNA expression, DNA methylation patterns, and histone marks levels. This review provides a critical update on this increasing knowledge of epigenetic alteration in esophageal cancers by specifically focusing on the translational aspects of epigenetic analyses from human tissue specimens. PMID:24816987

Ahrens, Theresa D; Werner, Martin; Lassmann, Silke

2014-06-01

77

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

PubMed

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

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

2014-08-01

78

Upper esophageal and pharyngeal cancers.  

PubMed

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on laryngopharyngeal reflux as a risk factor for laryngeal cancer; the role of pepsin in laryngopharyngeal neoplasia; natural fruit and vegetable compounds for the prevention and treatment of pharyngeal and esophageal cancers; and evaluation of cranberry constituents as inhibitors of esophageal adenocarcinoma utilizing in vitro assay and in vivo models. PMID:25266014

Bock, Jonathan M; Howell, Amy B; Johnston, Nikki; Kresty, Laura A; Lew, Daniel

2014-09-01

79

Current knowledge on esophageal atresia  

PubMed Central

Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. The improvement of survival observed over the previous two decades is multifactorial and largely attributable to advances in neonatal intensive care, neonatal anesthesia, ventilatory and nutritional support, antibiotics, early surgical intervention, surgical materials and techniques. Indeed, mortality is currently limited to those cases with coexisting severe life-threatening anomalies. The diagnosis of EA is most commonly made during the first 24 h of life but may occur either antenatally or may be delayed. The primary surgical correction for EA and TEF is the best option in the absence of severe malformations. There is no ideal replacement for the esophagus and the optimal surgical treatment for patients with long-gap EA is still controversial. The primary complications during the postoperative period are leak and stenosis of the anastomosis, gastro-esophageal reflux, esophageal dysmotility, fistula recurrence, respiratory disorders and deformities of the thoracic wall. Data regarding long-term outcomes and follow-ups are limited for patients following EA/TEF repair. The determination of the risk factors for the complicated evolution following EA/TEF repair may positively impact long-term prognoses. Much remains to be studied regarding this condition. This manuscript provides a literature review of the current knowledge regarding EA. PMID:22851858

Pinheiro, Paulo Fernando Martins; Simoes e Silva, Ana Cristina; Pereira, Regina Maria

2012-01-01

80

Epidemiology of esophageal cancer  

PubMed Central

Esophageal cancer (EsC) is one of the least studied and deadliest cancers worldwide because of its extremely aggressive nature and poor survival rate. It ranks sixth among all cancers in mortality. In retrospective studies of EsC, smoking, hot tea drinking, red meat consumption, poor oral health, low intake of fresh fruit and vegetables, and low socioeconomic status have been associated with a higher risk of esophageal squamous cell carcinoma. Barrett’s esophagus is clearly recognized as a risk factor for EsC, and dysplasia remains the only factor useful for identifying patients at increased risk, for the development of esophageal adenocarcinoma in clinical practice. Here, we investigated the epidemiologic patterns and causes of EsC. Using population based cancer data from the Surveillance, Epidemiology and End Results Program of the United States; we generated the most up-to-date stage distribution and 5-year relative survival by stage at diagnosis for 1998-2009. Special note should be given to the fact that esophageal cancer, mainly adenocarcinoma, is one of the very few cancers that is contributing to increasing death rates (20%) among males in the United States. To further explore the mechanism of development of EsC will hopefully decrease the incidence of EsC and improve outcomes. PMID:24039351

Zhang, Yuwei

2013-01-01

81

Genetic variants in DNA repair pathway genes and risk of esophageal squamous cell carcinoma and gastric adenocarcinoma in a Chinese population.  

PubMed

The DNA repair pathways help to maintain genomic integrity and therefore genetic variation in the pathways could affect the propensity to develop cancer. Selected germline single nucleotide polymorphisms (SNPs) in the pathways have been associated with esophageal cancer and gastric cancer (GC) but few studies have comprehensively examined the pathway genes. We aimed to investigate associations between DNA repair pathway genes and risk of esophageal squamous cell carcinoma (ESCC) and GC, using data from a genome-wide association study in a Han Chinese population where ESCC and GC are the predominant cancers. In sum, 1942 ESCC cases, 1758 GC cases and 2111 controls from the Shanxi Upper Gastrointestinal Cancer Genetics Project (discovery set) and the Linxian Nutrition Intervention Trials (replication set) were genotyped for 1675 SNPs in 170 DNA repair-related genes. Logistic regression models were applied to evaluate SNP-level associations. Gene- and pathway-level associations were determined using the resampling-based adaptive rank-truncated product approach. The DNA repair pathways overall were significantly associated with risk of ESCC (P = 6.37 × 10(-4)), but not with GC (P = 0.20). The most significant gene in ESCC was CHEK2 (P = 2.00 × 10(-6)) and in GC was CLK2 (P = 3.02 × 10(-4)). We observed several other genes significantly associated with either ESCC (SMUG1, TDG, TP53, GTF2H3, FEN1, POLQ, HEL308, RAD54B, MPG, FANCE and BRCA1) or GC risk (MRE11A, RAD54L and POLE) (P < 0.05). We provide evidence for an association between specific genes in the DNA repair pathways and the risk of ESCC and GC. Further studies are warranted to validate these associations and to investigate underlying mechanisms. PMID:23504502

Li, Wen-Qing; Hu, Nan; Hyland, Paula L; Gao, Ying; Wang, Zhao-Ming; Yu, Kai; Su, Hua; Wang, Chao-Yu; Wang, Le-Min; Chanock, Stephen J; Burdett, Laurie; Ding, Ti; Qiao, You-Lin; Fan, Jin-Hu; Wang, Yuan; Xu, Yi; Shi, Jian-Xin; Gu, Fangyi; Wheeler, William; Xiong, Xiao-Qin; Giffen, Carol; Tucker, Margaret A; Dawsey, Sanford M; Freedman, Neal D; Abnet, Christian C; Goldstein, Alisa M; Taylor, Philip R

2013-07-01

82

Tobacco, Alcohol, and Socioeconomic Status and Adenocarcinomas of the Esophagus and Gastric Cardia  

Microsoft Academic Search

Background: Incidence rates for adenocarcinomas of the esophagus and gastric cardia have risen steeply over the last few decades. To determine risk factors for these tumors, we conducted a multicenter, population-based, case-control study. Methods: The study included 554 subjects newly di- agnosed with esophageal or gastric cardia adenocarcinomas, 589 subjects newly diagnosed with esophageal squamous cell carcinoma or other gastric

Marilie D. Gammon; Janet B. Schoenberg; Habibul Ahsan; Harvey A. Risch; Thomas L. Vaughan; Wong-Ho Chow; Heidi Rotterdam; A. Brian West; Robert Dubrow; Janet L. Stanford; Susan T. Mayne; Diana C. Farrow; William J. Blot; Joseph F. Fraumeni

83

Tobacco, Alcohol, and Socioeconomic Status and Adenocarcinomas of the Esophagus and Gastric Cardia  

Microsoft Academic Search

Background: Incidence rates for adenocarcinomas of the esophagus and gastric cardia have risen steeply over the last few decades. To determine risk factors for these tumors, we conducted a multicenter, population-based, case-control study. Methods: The study included 554 subjects newly di- agnosed with esophageal or gastric cardia adenocarcinomas, 589 subjects newly diagnosed with esophageal squamous cell carcinoma or other gastric

Marilie D. Gammon; Janet B. Schoenberg; Habibul Ahsan; Harvey A. Risch; Thomas L. Vaughan; Wong-Ho Chow; Heidi Rotterdam; A. Brian West; Robert Dubrow; Janet L. Stanford; Susan T. Mayne; Diana C. Farrow; Shelley Niwa; William J. Blot; Joseph F. Fraumeni

1997-01-01

84

Esophageal Cancer  

MedlinePLUS

... from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may ... You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid ...

85

Genome-wide association studies of gastric adenocarcinoma and esophageal squamous cell carcinoma identify a shared susceptibility locus in PLCE1 at 10q23  

PubMed Central

We conducted a genome-wide association study of gastric cancer (GC) and esophageal squamous cell carcinoma (ESCC) in ethnic Chinese subjects in which we genotyped 551,152 single nucleotide polymorphisms (SNPs). We report a combined analysis of 2,240 GC cases, 2,115 ESCC cases, and 3,302 controls drawn from five studies. In logistic regression models adjusted for age, sex, and study, multiple variants at 10q23 had genome-wide significance for GC and ESCC independently. A notable signal was rs2274223, a nonsynonymous SNP located in PLCE1, for GC (P=8.40×1010; per allele odds ratio (OR) = 1.31) and ESCC (P=3.85×10?9; OR = 1.34). The association with GC differed by anatomic subsite. For tumors located in the cardia the association was stronger (P=4.19 × 10?15; OR= 1.57) and for those located in the noncardia stomach it was absent (P=0.44; OR=1.05). Our findings at 10q23 could provide insight into the high incidence rates of both cancers in China. PMID:22960999

Abnet, Christian C; Freedman, Neal D; Hu, Nan; Wang, Zhaoming; Yu, Kai; Shu, Xiao-Ou; Yuan, Jian-Min; Zheng, Wei; Dawsey, Sanford M; Dong, Linda M; Lee, Maxwell P; Ding, Ti; Qiao, You-Lin; Gao, Yu-Tang; Koh, Woon-Puay; Xiang, Yong-Bing; Tang, Ze-Zhong; Fan, Jin-Hu; Wang, Chaoyu; Wheeler, William; Gail, Mitchell H; Yeager, Meredith; Yuenger, Jeff; Hutchinson, Amy; Jacobs, Kevin B; Giffen, Carol A; Burdett, Laurie; Fraumeni, Joseph F; Tucker, Margaret A; Chow, Wong-Ho; Goldstein, Alisa M; Chanock, Stephen J; Taylor, Philip R

2012-01-01

86

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

87

Herpetic esophagitis  

SciTech Connect

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.

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

1981-12-01

88

Esophageal perforation.  

PubMed

Esophageal perforation is uncommon but carries a high morbidity and mortality, particularly if the injury is not detected early before the onset of systemic signs of sepsis. The fact that it is an uncommon problem and it produces symptoms that can mimic other serious thoracic conditions, such as myocardial infarction, contributes to the delay in diagnosis. Patients at risk for iatrogenic perforations (esophageal malignancy) frequently have comorbidities that increase their perioperative morbidity and mortality. The optimal treatment of esophageal perforation varies with respect to the time of presentation, the extent of the perforation, and the underlying esophageal pathologic conditions. PMID:24267495

Nirula, Raminder

2014-02-01

89

Food group intake and risk of subtypes of esophageal and gastric cancer  

PubMed Central

Incidence rates for adenocarcinomas of the esophagus and gastric cardia have been increasing rapidly, while rates for non-cardia gastric adenocarcinoma and esophageal squamous cell carcinoma have declined. We examined food group intake as a risk factor for subtypes of esophageal and gastric cancers in a multi-center, population-based case-control study in Connecticut, New Jersey, and western Washington state. Associations between food groups and risk were estimated using adjusted odds ratios (OR), based on increasing intake of one serving per day. Total vegetable intake was associated with decreased risk of esophageal adenocarcinoma (OR = 0.85, 95% CI = 0.75, 0.96). Conversely, total meat intake was associated with increased risk of esophageal adenocarcinoma (OR = 1.43, 95% CI = 1.11, 1.83), gastric cardia adenocarcinoma (OR = 1.37, 95% CI = 1.08, 1.73), and non-cardia gastric adenocarcinoma (OR = 1.39, 95% CI = 1.12, 1.71), with red meat most strongly associated with esophageal adenocarcinoma risk (OR = 2.49, 95% CI = 1.39, 4.46). Poultry was most strongly associated with gastric cardia adenocarcinoma (OR = 1.89, 95% CI = 1.15, 3.11) and non-cardia gastric adenocarcinoma (OR = 1.90, 95% CI = 1.19, 3.03). High-fat dairy was associated with increased risk of both esophageal and gastric cardia adenocarcinoma. Higher intake of meats, particularly red meats, and lower intake of vegetables were associated with an increased risk of esophageal adenocarcinoma, while higher intake of meats, particularly poultry, and high-fat dairy was associated with increased risk of gastric cardia adenocarcinoma. PMID:18537156

SA, Navarro Silvera; ST, Mayne; H, Risch; MD, Gammon; T, Vaughan; W-H, Chow; R, Dubrow; J, Schoenberg; JL, Stanford; AB, West; H, Rotterdam; WJ, Blot; JF, Fraumeni

2010-01-01

90

Small adenocarcinomas of the esophagogastric junction: association with intestinal metaplasia and dysplasia  

Microsoft Academic Search

OBJECTIVES:Intestinal metaplasia in Barrett's esophagus predisposes to esophageal adenocarcinoma. Intestinal metaplasia of the cardia is a common finding in persons without cancer. Many adenocarcinomas of the esophagogastric junction are large enough to obliterate any underlying intestinal metaplasia. To estimate how often adenocarcinoma of the esophagogastric junction arises in intestinal metaplasia, we studied small adenocarcinomas of the esophagogastric junction.METHODS:Resection patients had

Alan J. Cameron; Enrico O. Souto; Thomas C. Smyrk

2002-01-01

91

Eosinophilic esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is an atopic condition of the esophagus that has become increasingly recognized over the last decade. Diagnosis of the disorder is dependent on the patient’s clinical manifestations and histologic findings on esophageal mucosal biopsies. Patients with eosinophilic esophagitis should be referred to both an allergist and gastroenterologist for optimal management, which may include dietary modifications, pharmacologic agents such as corticosteroids, leukotriene modifiers and biologics as well as mechanical dilatation of the esophagus. The epidemiology, pathophysiology, diagnosis, treatment, and prognosis of EoE are discussed in this review. PMID:22165816

2011-01-01

92

Adenocarcinoma of the upper esophagus arising in heterotopic gastric mucosa: common pathogenesis with Barrett's adenocarcinoma?  

Microsoft Academic Search

Adenocarcinoma of the upper esophagus arising in heterotopic gastric mucosa is a rare tumor, with only 15 cases reported to date. We report a case in a 61-year-old man complaining of dysphagia. The upper endoscopy revealed that the tumor measured 3 cm and was 22 cm distant from the incisivors. A hiatal hernia with erosive esophagitis of the distal esophagus

Denis Chatelain; Anne-Sophie de Lajarte-Thirouard; Emmanuel Tiret; Jean-François Flejou

2002-01-01

93

Eosinophilic esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition where infiltration of eosinophils into the esophageal mucosa leads to symptoms of esophageal dysfunction. It has rapidly emerged as an important cause of upper GI morbidity in patients of all ages and is encountered in a substantial proportion of patients undergoing diagnostic upper endoscopy. This review discusses the clinical, endoscopic, and histologic features of EoE and presents the most recent guidelines for diagnosis of EoE. It describes selected diagnostic dilemmas including distinguishing EoE from gastroesophageal reflux disease and addressing the newly recognized clinical entity of proton pump inhibitor responsive esophageal eosinophilia. It also highlights evidence to support both pharmacologic and non-pharmacologic treatments, including topical corticosteroids, dietary elimination therapy, and endoscopic dilation. PMID:23452635

Dellon, Evan S.

2012-01-01

94

Esophageal cancer  

SciTech Connect

This book contains the proceedings on esophageal cancer. Topics covered include: Scope of the problem, Diagnostic considerations: Methods of early diagnosis, Staging criteria, Elective surgical management, and Postoperative complications.

Delarue, N.C. (Univ. of Toronto, Toronto (CA)); Wilkins, E.W. Jr. (Harvard Medical School, MA (US)); Wong, J. (Dept. of Surgery, Univ. of Hong Kong (HK))

1988-01-01

95

Eosinophilic Esophagitis  

Microsoft Academic Search

Eosinophilic esophagitis is a chronic inflammatory disorder characterized by dense eosinophilic infiltration of the esophageal\\u000a mucosa. The pathogenesis is incompletely understood and food allergies and aeroallergens have been implicated. The most common\\u000a clinical presentation in adults is dysphagia to solids. Its associated endoscopic findings are distinct and include concentric\\u000a rings and longitudinal furrows, although endoscopy may be unremarkable in a

Fouad J. Moawad; Ganesh R. Veerappan; Roy K. Wong

2009-01-01

96

Colon Adenocarcinoma  

MedlinePLUS

... tests include colonoscopy, flexible sigmoidoscopy, or double-contrast barium enema. How does a pathologist diagnose colon adenocarcinoma? ... of these treatment options? • What are the side effects? • Should I receive a second opinion? • Is your ...

97

[Urachal adenocarcinoma].  

PubMed

Cancer of the urachus is very unusual. The lesion is a mucosecretory adenocarcinoma. The diagnosis is usually established late, and has a serious prognosis because of a long clinical latency. We report a case of metastatic adenocarcinoma of the urachus revealed by hematuria. A review of the literature allows us to demonstrate the rarity of this tumour and to demonstrate its various clinical, histological, radiological and therapeutical aspects. PMID:11761694

Dakir, M; Dahami, Z; Sarf, I; Tahri, A; Elmrini, M; Benjelloun, S

2001-09-01

98

Neoadjuvant therapy for esophageal cancer  

PubMed Central

Esophageal cancer is increasing in incidence more than any other visceral malignancy in North America. Adenocarcinoma has become the most common cell type. Surgery remains the primary treatment modality for locoregional disease. Overall survival with surgery alone has been dismal, with metastatic disease the primary mode of treatment failure after an R0 surgical resection. Cure rates with chemotherapy or radiation therapy alone have been disappointing as well. For these reasons, over the last decade multi-modality treatment has gained increasing acceptance as the standard of care. This review examines the present data and role of neoadjuvant treatment using chemotherapy and radiation therapy followed by surgery for the treatment of esophageal cancer. PMID:25320656

Shah, Rachit D; Cassano, Anthony D; Neifeld, James P

2014-01-01

99

Esophageal trauma.  

PubMed

The anatomy of the esophagus is unique in that it traverses the neck, chest, and abdomen. As a result, surgeons need to be familiar with the anatomy of all three of these areas to be facile and comfortable in performing esophageal surgery. Traumatic injuries to the esophagus encompass a heterogeneous group of injuries that can be iatrogenic, external, or from physiologic forces. Primary repair of traumatic injuries is preferred when possible; however, if systemic sepsis is present and esophageal resection becomes necessary due to extensive injury or inflammation, immediate reconstruction should be delayed in most cases. Successful management of traumatic esophageal injuries requires prompt and accurate diagnosis and treatment tailored specifically to both the type of injury as well as to the patient's overall clinical condition. PMID:18420126

Johnson, Scott B

2008-01-01

100

Esophageal Surgery for Malignant Disease in the Elderly  

Microsoft Academic Search

\\u000a Neoplasms of the esophagus and gastroesophageal junction are aggressive tumors that often present at an advanced stage, and\\u000a that historically have been associated with poor survival despite therapy. 16,470 Americans are diagnosed with and 14,280\\u000a die of esophageal cancer annually, and the incidence is increasing. In fact, the incidence of esophageal adenocarcinoma (EAC)\\u000a has increased in the last 25 years,

Philip A. Rascoe; John C. Kucharczuk

101

Esophageal Helicobacter pylori colonization aggravates esophageal injury caused by reflux  

PubMed Central

AIM: To investigate esophageal Helicobacter pylori (H. pylori) colonization on esophageal injury caused by reflux and the related mechanisms. METHODS: An esophagitis model, with acid and bile reflux, was surgically produced in male rats. The rats were randomly divided into either: (1) an esophagogastroduodenal anastomosis (EGDA) group; (2) an EGDA with H. pylori infection group; (3) a pseudo-operation with H. pylori infection group; or (4) a pseudo-operation group. All rats were kept for 36 wk. Based on the location of H. pylori colonization, the EGDA rats with H. pylori infection were subdivided into those with concomitant esophageal H. pylori colonization or those with only gastric H. pylori colonization. The esophageal injuries were evaluated grossly and microscopically. The expressions of CDX2 and MUC2 were determined by real-time polymerase chain reaction (RT-PCR) and immunohistochemistry. Ki-67 antigen expression was determined by immunohistochemistry. The mRNA levels of cyclin D1, c-Myc, Bax and Bcl-2 were determined by RT-PCR. Cell apoptosis was evaluated using the TdT-mediated dUTP nick-end labeling method. RESULTS: Esophagitis, Barrett’s esophagus (BE), and esophageal adenocarcinoma (EAC) developed in rats that underwent EGDA. When comparing rats with EGDA and concomitant esophageal H. pylori colonization to EGDA-only rats, the severity of injury (87.9 ± 5.2 vs 77.2 ± 8.6, macroscopically, 92.5 ± 8.0 vs 83.8 ± 5.5, microscopically, both P < 0.05) and the incidences of BE (80.0% vs 33.3%, P = 0.055) and EAC (60.0% vs 11.1%, P < 0.05) were increased. These increases were associated with upregulation of CDX2 and MUC2 mRNA (10.1 ± 5.4 vs 3.0 ± 2.9, 8.4 ± 4.6 vs 2.0 ± 3.2, respectively, Ps < 0.01) and protein (8.1 ± 2.3 vs 3.3 ± 3.1, 7.3 ± 4.0 vs 1.8 ± 2.7, respectively, all P < 0.05). The expression of Ki-67 (8.9 ± 0.7 vs 6.0 ± 1.7, P < 0.01) and the presence of apoptotic cells (8.3 ± 1.1 vs 5.3 ± 1.7, P < 0.01) were also increased significantly in rats with EGDA and concomitant esophageal H. pylori colonization compared with rats with EGDA only. The mRNA levels of cyclin D1 (5.8 ± 1.9 vs 3.4 ± 1.3, P < 0.01), c-Myc (6.4 ± 1.7 vs 3.7 ± 1.2, P < 0.01), and Bax (8.6 ± 1.6 vs 5.1 ± 1.3, P < 0.01) were significantly increased, whereas the mRNA level of Bcl-2 (0.6 ± 0.3 vs 0.8 ± 0.3, P < 0.01) was significantly reduced in rats with EGDA and concomitant esophageal H. pylori colonization compared with rats with EGDA only. CONCLUSION: Esophageal H. pylori colonization increases esophagitis severity, and facilitates the development of BE and EAC with the augmentation of cell proliferation and apoptosis in esophageal mucosa.

Chu, Yun-Xiang; Wang, Wei-Hong; Dai, Yun; Teng, Gui-Gen; Wang, Shu-Jun

2014-01-01

102

T1 esophageal cancer, request an endoscopic mucosal resection (EMR) for in-depth review  

PubMed Central

Endoscopic management of superficial esophageal adenocarcinoma has gained wider acceptance with the growing literature on its efficacy. Patient selection is critical in deciding who should be a candidate for surgery or endoscopy in the management of T1 esophageal cancer. This article discusses the key role EMR plays in the diagnostic evaluation. PMID:23825773

2013-01-01

103

Palliation of Malignant Dysphagia in Esophageal Cancer: A Literature-Based Review  

Microsoft Academic Search

Esophageal cancer is a lethal malignancy and adenocarcinoma of the esophagus is increasing in incidence. Most patients present with lo- cally advanced, unresectable or metastatic disease. The 5-year survival rate of patients with esophageal cancer is < 20%. Dysphagia is the most com- mon presenting symptom of this disease and leads to nutritional compro- mise, pain, and deterioration of quality

Milind Javle; Sikander Ailawadhi; Gary Y. Yang; Chukwumere E. Nwogu; Michael D. Schiff; Hector R. Nava

104

The Miscellaneous Mystery of Esophageal Cancer: New pathogenetic and clinical insights  

Microsoft Academic Search

Esophageal cancer is the 8th most common type of malignancy and the 6th most\\u000acommon cause of cancer mortality in the world. Worldwide more than 400,000\\u000apatients are newly diagnosed with esophageal cancer each year. The majority of\\u000apatients (>90%) is diagnosed with the two most common histological subtypes:\\u000asquamous cell carcinoma or adenocarcinoma of the esophagus. Esophageal squamous\\u000acell

B. A. Grotenhuis

2010-01-01

105

[Esophageal diverticula].  

PubMed

Esophageal diverticula are classified by location-phrenoesophageal (Zenker's diverticulum-70%), thoracic and mediastinal (10%), and epiphrenic (20%). Almost all esophageal diverticula are acquired pulsion diverticula. The most common symptoms are dysphagia, regurgitation, thoracic pain, and pulmonary manifestations related to aspiration. Barium swallow and upper endoscopy will help to establish the diagnosis while esophageal manometry may reveal underlying dysmotility. Diverticula should not be treated unless they are symptomatic. The treatment of Zenker's diverticulum is surgical and consists of either diverticulectomy or diverticular suspension with a myotomy of the cricopharyngeus muscle via cervical approach. Transoral endoscopic stapled diverticulostomy is a new and simple approach which may become the treatment of choice, particularly in elderly and high-risk patients. Treatment of diverticula of the mid and low esophagus must take into account any motor anomalies or associated lesions. Diverticulectomy with esophageal myotomy and an anti-reflux procedure through a left thoracotomy is the standard approach, but endoscopic approaches seem feasible, particularly for epiphrenic diverticula, and may become the norm in years to come. PMID:15133431

Carrère, N; Pradère, B

2004-03-01

106

Adenocarcinomas arising in tongues or short segments of Barrett's esophagus  

Microsoft Academic Search

Summary The diagnosis of Barrett's esophagus is established when the esophageal mucosa is lined by 2–3 cm of columnar epithelium or when specialized (intestinal type) columnar epithelium of any length is present. Emphasis is frequently placed on long segments of Barrett's because these patients reportedly are at higher risk of developing adenocarcinoma than patients with shorter segments. We present four

Thomas G. Schnell; Stephen J. Sontag; Gregorio Chejfec

1992-01-01

107

Esophageal Cancer  

Microsoft Academic Search

\\u000a Treatment of esophageal cancer by surgery alone, radiotherapy alone, or chemotherapy alone has not given satisfactory results.\\u000a In recent years integrated treatment schedules have been studied including first using intra-arterial chemotherapy as induction\\u000a treatment delivered in greater concentration and more directly to the cancer region. \\u000a Combined simultaneous chemo-radiation achieved a significantly higher rate of complete pCRs in comparison to chemotherapy

Tetsuo Taguchi

108

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

109

Esophageal atresia with tracheoesophageal fistula: Suggested mechanism in faulty organogenesis  

Microsoft Academic Search

Background\\/Purpose: The organogenesis of esophageal atresia with tracheoesophageal fistula (EA-TEF) is unknown. Using an established model for EA-TEF in rats, the authors proposed to study this aberrancy of development in the hope of gaining insight into its mechanism of formation.Methods: Pregnant Sprague-Dawley rats were injected with 2.2 mg\\/kg of Adriamycin intraperitoneally on days 6 through 9 of gestation. Using microdissection,

Christopher A Crisera; Patrick R Connelly; Alexander R Marmureanu; Kari L Colen; Michael I Rose; Min Li; Michael T Longaker; George K Gittes

1999-01-01

110

Metastatic esophageal carcinoma masquerading as inflammatory breast carcinoma.  

PubMed

A 50-year-old Caucasian woman with a history of esophageal adenocarcinoma presented with a 3-week history of right breast swelling and progressive erythema. Twenty-two months prior to presentation, she had been diagnosed with adenocarcinoma of the esophagus (T3,N1,M1a) and underwent neoadjuvant chemoradiotherapy followed by surgical resection. On physical examination, the right breast was red, swollen (40% larger than the contralateral breast), tender to palpation, and warm to the touch (Fig. 1). No mass was palpable. On the basis of the clinical findings, inflammatory breast carcinoma was suspected. A punch biopsy revealed a poorly differentiated adenocarcinoma with extensive involvement of dermal lymphatics (Fig. 2). The clinical and histologic differential diagnosis included inflammatory breast carcinoma vs. metastatic esophageal adenocarcinoma to the skin of the breast. To resolve this question, immunohistochemical stains for estrogen and progesterone receptors and CDX-2 (BioGenex, San Ramon, CA, USA) were performed. CDX-2 is an intestinal homeobox gene expressed in gastrointestinal epithelium and gastrointestinal tumors. The tumor nuclei were positive for CDX-2 but negative for both steroid receptors (Fig. 3), confirming the diagnosis of metastatic esophageal adenocarcinoma. PMID:17343591

Nebesio, Christy L; Goulet, Robert J; Helft, Paul R; Billings, Steven D

2007-03-01

111

Metastases of esophageal carcinoma to skeletal muscle: Single center experience  

PubMed Central

Metastases of esophageal carcinoma to the skeletal muscle are rare, but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT). A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases. Four patients had skeletal muscle metastases of esophageal carcinoma, including two patients with squamous cell carcinoma. In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases, muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma. In all cases, skeletal muscle metastases were the first manifestation of systemic disease. In three patients palliation was obtained with the combination of external beam radiation therapy, systemic chemotherapy or surgical resection. Skeletal muscle metastases are a rare complication of esophageal carcinoma. PMID:23002370

Cincibuch, Jan; Myslivecek, Miroslav; Melichar, Bohuslav; Neoral, Cestmir; Metelkova, Iva; Zezulova, Michaela; Prochazkova-Studentova, Hana; Flodr, Patrik; Zlevorova, Miloslava; Aujesky, Rene; Cwiertka, Karel

2012-01-01

112

Metastases of esophageal carcinoma to skeletal muscle: single center experience.  

PubMed

Metastases of esophageal carcinoma to the skeletal muscle are rare, but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT). A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases. Four patients had skeletal muscle metastases of esophageal carcinoma, including two patients with squamous cell carcinoma. In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases, muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma. In all cases, skeletal muscle metastases were the first manifestation of systemic disease. In three patients palliation was obtained with the combination of external beam radiation therapy, systemic chemotherapy or surgical resection. Skeletal muscle metastases are a rare complication of esophageal carcinoma. PMID:23002370

Cincibuch, Jan; Myslive?ek, Miroslav; Melichar, Bohuslav; Neoral, Cestmír; Metelková, Iva; Zezulová, Michaela; Procházková-Študentová, Hana; Flodr, Patrik; Zlevorová, Miloslava; Aujeský, René; Cwiertka, Karel

2012-09-21

113

Current treatment options for the management of esophageal cancer  

PubMed Central

In recent years, esophageal cancer characteristics and management options have evolved significantly. There has been a sharp increase in the frequency of esophageal adenocarcinoma and a decline in the frequency of squamous cell carcinoma. A more comprehensive understanding of prognostic factors influencing outcome has also been developed. This has led to more management options for esophageal cancer at all stages than ever before. A multidisciplinary, team approach to management in a high volume center is the preferred approach. Each patient should be individually assessed based on type of cancer, local or regional involvement, and his or her own functional status to determine an appropriate treatment regimen. This review will discuss management of esophageal cancer relative to disease progression and patient functional status. PMID:23152702

Mawhinney, Mark R; Glasgow, Robert E

2012-01-01

114

Impact of preoperative diagnosis of congenital heart disease on the treatment of esophageal atresia  

Microsoft Academic Search

Congenital heart disease (CHD) has a major impact on the survival of babies with esophageal atresia (EA). The present study\\u000a assesses whether early diagnosis influences the management strategies in a large series of EA. Cases of EA treated between\\u000a 1982 and 2002 were retrospectively divided into groups according to the presence or absence of CHD and to whether this was

J. L. Encinas; A. L. Luis; L. F. Avila; L. Martinez; L. Guereta; L. Lassaletta; Juan A. Tovar

2006-01-01

115

Abnormal enteric nerve morphology in atretic esophagus of fetal rats with adriamycin-induced esophageal atresia  

Microsoft Academic Search

Gastroesophageal reflux is common in children after successful repair of esophageal atresia (EA), and may be related to a\\u000a congenital neuronal abnormality of the esophagus. This study employed a fetal rat model of adriamycin-induced EA to investigate\\u000a whether the innervation of the esophagus is abnormal in EA. The fetal rats were divided into four groups: (1) normal controls;\\u000a (2) a

W. Cheng; A. E. Bishop; L. Spitz; J. M. Polak

1999-01-01

116

Esophageal cancer in Canada: Trends according to morphology and anatomical location  

PubMed Central

BACKGROUND: Esophageal adenocarcinoma has one of the fastest rising incidence rates and one of the lowest survival rates of any cancer type in the Western world. However, in many countries, trends in esophageal cancer differ according to tumour morphology and anatomical location. In Canada, incidence and survival trends for esophageal cancer subtypes are poorly known. METHODS: Cancer incidence and mortality rates were obtained from the Canadian Cancer Registry, the National Cancer Incidence Reporting System and the Canadian Vital Statistics Death databases for the period from 1986 to 2006. Observed trends (annual per cent change) and five-year relative survival ratios were estimated separately for esophageal adenocarcinoma and squamous cell carcinoma, and according to location (upper, middle, or lower one-third of the esophagus). Incidence rates were projected up to the year 2026. RESULTS: Annual age-standardized incidence rates for esophageal cancer in 2004 to 2006 were 6.1 and 1.7 per 100,000 for males and females, respectively. Esophageal adenocarcinoma incidence rose by 3.9% (males) and 3.6% (females) per year for the period 1986 to 2006, with the steepest increase in the lower one-third of the esophagus (4.8% and 5.0% per year among males and females, respectively). In contrast, squamous cell carcinoma incidence declined by 3.3% (males) and 3.2% (females) per year since the early 1990s. The five-year relative survival ratio for esophageal cancer was 13% between 2004 and 2006, approximately a 3% increase since the period from 1992 to 1994. Projected incidence rates showed increases of 40% to 50% for esophageal adenocarcinoma and decreases of 30% for squamous cell carcinoma by 2026. DISCUSSION: Although esophageal cancer is rare in Canada, the incidence of esophageal adenocarcinoma has doubled in the past 20 years, which may reflect the increasing prevalence of obesity and gastroesophageal reflux disease. Declines in squamous cell carcinoma may be the result of the decreases in the prevalence of smoking in Canada. Given the low survival rates and the potential for further increases in incidence, esophageal adenocarcinoma warrants close attention. PMID:23061066

Otterstatter, Michael C; Brierley, James D; De, Prithwish; Ellison, Larry F; MacIntyre, Maureen; Marrett, Loraine D; Semenciw, Robert; Weir, Hannah K

2012-01-01

117

The MUC1 mucin regulates the tumorigenic properties of human esophageal adenocarcinomatous cells.  

PubMed

MUC1 is a membrane-bound mucin known to participate in tumor proliferation. It has been shown that MUC1 pattern of expression is modified during esophageal carcinogenesis, with a progressive increase from metaplasia to adenocarcinoma. The principal cause of development of esophageal adenocarcinoma is gastro-esophageal reflux and MUC1 was previously shown to be up-regulated by several bile acids present in reflux. In this report, our aim was thus to determine whether MUC1 plays a role in biological properties of human esophageal cancer cells. For that, a stable MUC1-deficient esophageal cancer cell line was 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 MUC1-deficient cells were analyzed. Our results show that esophageal cancer cells lacking MUC1 were less proliferative and had decreased migration and invasion properties. These alterations were accompanied by a decreased activity of NFKB p65, Akt and MAPK (p44/42, JNK and p38) pathways. MCM6 and TSG101 tumor-associated markers were also decreased. Subcutaneous xenografts showed a significant decrease in tumor size when cells did not express MUC1. Altogether, the data indicate that MUC1 plays a key role in proliferative, migrating and invasive properties of esophageal cancer cells as well as in tumor growth promotion. MUC1 mucin appears thus as a good therapeutic target to slow down esophageal tumor progression. PMID:25003315

Gronnier, Caroline; Bruyère, Emilie; Lahdaoui, Fatima; Jonckheere, Nicolas; Perrais, Michaël; Leteurtre, Emmanuelle; Piessen, Guillaume; Mariette, Christophe; Van Seuningen, Isabelle

2014-11-01

118

Robotic benign esophageal procedures.  

PubMed

Robotic master-slave devices can assist surgeons to perform minimally invasive esophageal operations with approaches that have already been demonstrated using laparoscopy and thoracoscopy. Robotic-assisted surgery for benign esophageal disease is described for the treatment of achalasia, epiphrenic diverticula, refractory reflux, paraesophageal hernias, duplication cysts, and benign esophageal masses, such as leiomyomas. Indications and contraindications for robotic surgery in benign esophageal disease should closely approximate the indications for laparoscopic and thoracoscopic procedures. Given the early application of the technology and paucity of clinical evidence, there are currently no procedures for which robotic esophageal surgery is the clinically proven preferred approach. PMID:24780427

Hanna, Jennifer M; Onaitis, Mark W

2014-05-01

119

Neoadjuvant and adjuvant chemotherapy without radiation for esophageal cancer  

Microsoft Academic Search

We performed a Phase II trial to evaluate the use neoadjuvant (NAD) and adjuvant (AD) combination chemotherapy (CT) without radiation therapy (RT), for advanced esophageal adenocarcinoma. The eligibility criteria include T3 disease, by Computed Tomography and\\/or endoscopic ultrasounds, and ECOG performance 0–1. The CT cycles were as follow: Cisplatin 100 mg\\/m2 on day one, Taxol 125 mg\\/m2 on day 28,

S. A. Spector; A. S. Livingstone; D. Franceschi; A. C. Burnett; P. Ganjei-Azar; M. Lima; L. Sparling; B. Ardalan

2003-01-01

120

The diagnosis of fetal esophageal atresia and its implications on perinatal outcome.  

PubMed

The current diagnostic accuracy and perinatal outcome of fetuses with esophageal atresia (EA) continues to be debated. In this review, we report on our experience at a tertiary care fetal center with the prenatal ultrasound diagnosis of EA. Enrollment criteria included a small/absent stomach bubble with a normal or elevated amniotic fluid index between 2005 and 2013. Perinatal outcomes were analyzed and compared to postnatally diagnosed EA cases. Of the 22 fetuses evaluated, polyhydramnios occurred in 73 %. Three (14 %) died in utero or shortly after birth, but none had EA. In the presence of an absent/small stomach and polyhydramnios, the positive predictive value for EA was 67 %. In fetal EA cases confirmed postnatally (group 1, n = 11), there were no differences in gestational age, birthweight, or mortality when compared to postnatally diagnosed infants (group 2, n = 59). Group 1 was associated with long-gap EA, need for esophageal replacement, and increased hospital length of stay. When taken in context with the current literature, we conclude that ultrasound findings suggestive of EA continue to be associated with a relatively high rate of false positives. However, among postnatally confirmed cases, there is an increased risk for long-gap EA and prolonged hospitalization. PMID:25056797

Kunisaki, Shaun M; Bruch, Steven W; Hirschl, Ronald B; Mychaliska, George B; Treadwell, Marjorie C; Coran, Arnold G

2014-10-01

121

Gene expression changes associated with Barrett's esophagus and Barrett's-associated adenocarcinoma cell lines after acid or bile salt exposure  

PubMed Central

Background Esophageal reflux and Barrett's esophagus represent two major risk factors for the development of esophageal adenocarcinoma. Previous studies have shown that brief exposure of the Barrett's-associated adenocarcinoma cell line, SEG-1, or primary cultures of Barrett's esophageal tissues to acid or bile results in changes consistent with cell proliferation. In this study, we determined whether similar exposure to acid or bile salts results in gene expression changes that provide insights into malignant transformation. Methods Using previously published methods, Barrett's-associated esophageal adenocarcinoma cell lines and primary cultures of Barrett's esophageal tissue were exposed to short pulses of acid or bile salts followed by incubation in culture media at pH 7.4. A genome-wide assessment of gene expression was then determined for the samples using cDNA microarrays. Subsequent analysis evaluated for statistical differences in gene expression with and without treatment. Results The SEG-1 cell line showed changes in gene expression that was dependent on the length of exposure to pH 3.5. Further analysis using the Gene Ontology, however, showed that representation by genes associated with cell proliferation is not enhanced by acid exposure. The changes in gene expression also did not involve genes known to be differentially expressed in esophageal adenocarcinoma. Similar experiments using short-term primary cultures of Barrett's esophagus also did not result in detectable changes in gene expression with either acid or bile salt exposure. Conclusion Short-term exposure of esophageal adenocarcinoma SEG-1 cells or primary cultures of Barrett's esophagus does not result in gene expression changes that are consistent with enhanced cell proliferation. Thus other model systems are needed that may reflect the impact of acid and bile salt exposure on the esophagus in vivo. PMID:17597535

Hao, Ying; Sood, Sumita; Triadafilopoulos, George; Kim, Jong Hyeok; Wang, Zheng; Sahbaie, Peyman; Omary, M Bishr; Lowe, Anson W

2007-01-01

122

Esophageal cancer staging: improved accuracy by endoscopic ultrasound of celiac lymph nodes  

Microsoft Academic Search

Background. Clinical staging of esophageal cancer is required for optimal therapy but remains imprecise. Pathologic verification of involved lymph nodes could potentially direct treatment allocation. With the rising incidence of distal and gastroesophageal junction adenocarcinomas, assessment of the celiac axis lymph nodes (CLNs) becomes important because it is a common nodal drainage basin. Endoscopic ultrasound (EUS) permits evaluation of CLNs

Carolyn E Reed; Girish Mishra; Anand V Sahai; Brenda J Hoffman; Robert H Hawes

1999-01-01

123

Hypericin activated by an incoherent light source has photodynamic effects on esophageal cancer cells  

Microsoft Academic Search

Background and aims. Photodynamic therapy (PDT) is a new treatment modality for early esophageal neoplasia. With two absorption maxima in the visible light range (550 and 588 nm) hypericin is a very promising photosensitizer for PDT with incoherent light sources. We studied the effects of photosensitizing hypericin in both primary cell cultures and cell lines (squamous: Kyse-140 and adenocarcinoma: OE-33)

M. Höpfner; K. Maaser; A. Theiss; M. Lenz; A. P. Sutter; H. Kashtan; B. von Lampe; E. Riecken; M. Zeitz; H. Scherübl

2003-01-01

124

Stomach-Esophageal Cancer  

Cancer.gov

Stomach and esophageal cancers are close in anatomical location and have been combined into one project within TCGA. Although they are two separate cancer types, TCGA is collecting samples from various anatomic subsites along the esophageal and gastric tracts for analysis.

125

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

PubMed Central

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

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

2012-01-01

126

Adenocarcinoma villoglandular de cérvix  

Microsoft Academic Search

Villoglandular adenocarcinoma of the uterine cervix is a rare neoplasm, with histological and clinical features that distinguish it from other types of cervical adenocarcinomas. Until 1994, this entity was not included with the cervical carcinoma classification of the World Health Organization. The prognosis of this tumor is favorable and consequently treatment should be conservative as far as possible if the

Sonia M. García Rodríguez; Rosa Rodríguez Rodríguez; Nazaret Villalba Martín; José Luis Trujillo Carrillo; Javier De La Torre Fdez De Vega

2011-01-01

127

Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma  

SciTech Connect

Purpose: To clarify the radiotherapy clinical target volume (CTV) margin needed for esophageal squamous-cell carcinoma (SCC) and gastroesophageal junction (GEJ) adenocarcinoma. Methods and Materials: Surgical specimens of esophageal SCC (n = 34) and GEJ adenocarcinoma (n = 32) were prospectively collected and analyzed for microscopic spread along the esophagus and GEJ both proximally and distally from gross tumor and for lymph node (LN) metastasis. Results: For SCC, the mean microscopic spread beyond the gross tumor was 10.5 {+-} 13.5 mm proximally (<30 mm in 32 of 34 cases) and 10.6 {+-} 8.1 mm distally (<30 mm in 33 of 34 cases). For GEJ adenocarcinoma, the spread was 10.3 {+-} 7.2 mm proximally (<30 mm in 29 of 29 cases) and 18.3 {+-} 16.3 mm distally (<30 mm in 27 of 32 cases). The extent of microscopic spread of cancer was significantly associated with pathologic T stage (p = 0.012). LN metastases were observed in 12 (35%) of 34 patients with middle and lower esophageal SCC and 15 (47%) of 32 patients with GEJ adenocarcinoma. Conclusions: The extent of microscopic spread within esophagus (recommended CTV margin) was <30 mm in about 94% of cases of esophageal cancer, except for distal microscopic spread in GEJ adenocarcinoma, in which 50 mm was needed to cover about 94% of cases.

Gao Xianshu [Department of Radiation Oncology, Beijing University First Hospital, Beijing (China); Department of Radiation Oncology, Hebei Medical University Fourth Hospital, Shijiazhuang (China); Qiao Xueying [Department of Radiation Oncology, Hebei Medical University Fourth Hospital, Shijiazhuang (China); Wu Fengpeng [Department of Radiation Oncology, Hebei Medical University Fourth Hospital, Shijiazhuang (China); Cao Li [Department of Radiation Oncology, Hebei Medical University Fourth Hospital, Shijiazhuang (China); Meng Xianli [Department of Thoracic Surgery, Hebei Medical University Fourth Hospital, Shijiazhuang (China); Dong Zhiming [Department of Pathology, Hebei Medical University Fourth Hospital, Shijiazhuang (China); Wang Xiaoling [Department of Pathology, Hebei Medical University Fourth Hospital, Shijiazhuang (China); Gao Guodong [Department of Pathology, Hebei Medical University Fourth Hospital, Shijiazhuang (China); Wu, T.-T. [Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Chang, Joe Y. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: jychang@mdanderson.org

2007-02-01

128

Esophageal motility disorders.  

PubMed

Esophageal motility disorders consist of a complex array of disturbances in normal esophageal function associated with dysphagia, gastroesophageal reflux, and noncardiac chest pain. A thorough knowledge of normal esophageal anatomy and physiology is important to a full understanding of these motility derangements. Through a complicated interaction of neuromuscular and hormonal influences, the voluntary act of swallowing transforms into an automated sequence of peristaltic waves propelling food and liquids into the stomach in concert with coordinated relaxation of the sphincters. Anatomic and physiologic barriers exist within the esophagus protecting against gastroesophageal reflux and aspiration. With improvements in diagnostic tools such as barium contrast radiography, scintigraphy, pH measurements, and esophageal manometrics with provocative testing, motility disorders have become better defined and understood. Primary motility disorders consist of achalasia, diffuse esophageal spasm (DES), "nutcracker esophagus," hypertensive lower esophageal sphincter, and nonspecific esophageal motility dysfunction (NEMD). A host of secondary and miscellaneous motility disorders also affect the esophagus, including scleroderma and other connective tissue diseases, diabetes mellitus, Chagas' disease, chronic idiopathic intestinal pseudo-obstruction, and neuromuscular disorders of striated muscle. Gastroesophageal reflux disease (GERD) may also be promoted by associated motility disturbances. Treatment modalities include surgical myotomy; dilatation; and pharmacologic manipulations, including use of nitrates, calcium-channel blockers, H2-blockers, and psychotropic drugs where appropriate. PMID:3292177

Nelson, J B; Castell, D O

1988-06-01

129

Treatment-related esophagitis.  

PubMed

Current therapeutic approaches for lung cancer favor treatment intensification, with the presumption that dose-intense chemotherapy regimens and/or higher radiation therapy (RT) doses or novel fractionation schemes will result in increased patient survival. Also, the trend for non-operative therapy has favored concurrent over sequential regimens. The incidence of severe acute esophagitis in patients treated for lung cancer with standard (once daily) RT alone is 1.3%, and induction chemotherapy increases the risk of severe acute esophagitis slightly over that of standard RT alone. In contrast, a strong radiosensitizing effect of chemotherapy given concurrently with standard thoracic RT (chemoRT) is associated with an incidence of severe esophagitis of 14% to 49%. Acute esophagitis may be severe and disabling, and result in hospitalization, placement of a feeding tube in the stomach or intravenous feedings, and steady supportive care. Also, RT may need to be halted temporarily to allow for healing of the esophageal lining; treatment breaks in turn decrease survival of patients with unresectable lung cancer. Therefore, esophagitis as a dose-limiting toxicity of chemoRT may have a direct impact on tumor control and survival. Aggressive types of RT fractionation have also been associated with worsening esophagitis grades and duration. Moreover, it is commonly assumed in the radiation oncology clinic that the longer the length of the esophagus segment included in the RT field the higher the probability of esophageal toxicity, although differing opinions are commonly expressed. Recent advances in 3-dimensional conformal RT allow a unique chance to gain volumetric data pertaining to organ damage rather than rely on older estimates based on organ length (eg, esophagus) or portion (ie, lung, spinal cord). The Radiation Therapy Oncology Group (RTOG) conducted a large phase III, randomized study RTOG 98-01 examining chemoRT with or without the amifostine (Ethyol; MedImmune, Inc, Gaithersburg, MD), a cyto- and radioprotectant in locally advanced non-small cell lung cancer (n = 243). While amifostine did not significantly reduce severe esophagitis based on National Cancer Institute Common Toxicity Criteria and weekly physician dysphagia logs, swallowing dysfunction over time (based on patient diaries, the equivalent of Esophagitis Index) was significantly lower in the amifostine arm ( P = .03). Therefore, significant progress has been accomplished in our understanding of the basis of esophageal injury resulting from thoracic RT, and future effort may find other effective strategies to either minimize or eliminate esophagitis. PMID:16015537

Werner-Wasik, Maria

2005-04-01

130

Esophageal Cancer Prevention  

MedlinePLUS

... the type of cells that become malignant (cancerous): Squamous cell carcinoma : Cancer that begins in squamous cells , the thin, ... chance of developing esophageal cancer increases with age. Squamous cell carcinoma of the esophagus is more common in blacks ...

131

Urinary Bladder Adenocarcinoma  

MedlinePLUS

... channels. Healing begins with the pathologist’s diagnosis. Pathologists are core members of your patient care team. (continued from ... oncologists, radiologists and others. What kinds of treatments are ... most common treatment for urinary bladder adenocarcinoma is surgery, which ...

132

In Vivo Cancer Biomarkers of Esophageal Neoplasia  

PubMed Central

Summary The emergence of in vivo cancer biomarkers is promising tool for early detection, risk stratification, and therapeutic intervention in the esophagus, where adenocarcinoma is increasing at a rate that is faster than any other in industrialized nations. Exciting advances in target identification, probe development, and optical instrumentation are creating tremendous new opportunities for advancing techniques of molecular imaging. Progress in these areas is being made with small animal models of esophageal cancer using surgical approaches to induce reflux of acid and bile, and these findings are beginning to be evaluated in the clinic. Further identification of relevant targets, characterization of specific probes, and development of endoscopic imaging technologies are needed to further this direction in the field of molecular medicine. In the future, new methods that use in vivo cancer biomarkers for the early detection of neoplastic changes in the setting of Barrett's esophagus will become available. PMID:19126962

Lu, Shaoying; Wang, Thomas D

2011-01-01

133

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

PubMed Central

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

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

134

Staged esophageal lengthening with internal and subsequent external traction sutures leads to primary repair of an ultralong gap esophageal atresia with upper pouch tracheoesophagel fistula.  

PubMed

Primary repair of very long gap esophageal atresia (EA) with almost complete absence of thoracic esophagus has usually been thought impossible. Thus, esophageal replacement with colon or gastric interposition seemed inevitable. In contrast, J. Foker described a technique of lengthening the pouches with traction sutures and making primary repair possible. To contribute clinical experience to this discussion, we report about esophageal elongation in a child with long gap EA and an upper pouch tracheoesophageal fistula (TEF). The patient presented as a preterm baby with a long gap EA of almost 9 vertebral bodies (7 cm) and additionally TEF on the upper pouch. Initially, he was treated with a gastrostomy and replogle suction of the upper pouch. Tracheoesophageal fistula was repaired, and the upper pouch brought from the neck into the thoracic inlet. At the same time thoracotomy was performed, and the lower esophageal segment mobilized and fixed to the prevertebral fascia under moderate tension. The tension reduced the gap between both pouches to about 3.5 cm. After 4 weeks, both pouches were mobilized further. However, the remaining gap did not allow primary anastomosis at that time, so the traction sutures were reconfigured and brought out externally through the skin above and below the incision. Daily increases in tension resulted in the ends virtually touching within 10 days. Now a contrast study showed the two lumens within 5 mm of each other, and primary anastomosis was completed without difficulty. Postoperative diagnosed gastroesophageal reflux and anastomotic stricture were controlled by a Thal hemifundoplication and dilatations. In conclusion, staged esophageal lengthening may be considered for a primary repair of EA even in cases with ultralong gap and TEF. PMID:18558163

Till, Holger; Muensterer, Oliver J; Rolle, Udo; Foker, John

2008-06-01

135

A Phase I study of capecitabine, carboplatin, and paclitaxel with external beam radiation therapy for esophageal carcinoma  

Microsoft Academic Search

Purpose: Concurrent chemotherapy and radiation therapy (RT) are used to treat patients with esophageal cancer. The optimal combination of chemotherapeutic agents with RT is undefined. We evaluated a combination of capecitabine, carboplatin, and paclitaxel with RT in a phase I study. Methods and Materials: Patients with squamous cell carcinoma or adenocarcinoma of the esophagus initially received capecitabine, carboplatin, and paclitaxel

Brian G.. Czito; Chris R. Kelsey; Herbert I. Hurwitz; Chris G. Willett; Michael A. Morse; Gerard C. Blobe; Nishan H. Fernando; Thomas A. D’Amico; David H. Harpole; Wanda R. N. Honeycutt; Daohai Yu; Johanna C. Bendell

2007-01-01

136

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 ...

137

Genetic landscape of esophageal squamous cell carcinoma.  

PubMed

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

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

138

Esophageal tissue engineering.  

PubMed

Esophageal tissue engineering is still in an early state, and ideal methods have not been developed. Since the beginning of the 20th century, advances have been made in the materials that can be used to produce an esophageal substitute. Three approaches to scaffold-based tissue engineering have yielded good results. The first development concerned non-absorbable constructs based on silicone and collagen. The need to remove the silicone tube is the main disadvantage of this material. Polymeric absorbable scaffolds have been used since the 1990s. The main polymeric material used is poly (glycolic) acid combined with collagen. The problem of stenosis remains prevalent in most studies using an absorbable construct. Finally, decellularized scaffolds have been used since 2000. The promises of this new approach are unfulfilled. Indeed, stenosis occurs when the esophageal defect is circumferential regardless of the scaffold materials. Cell supplementation can decrease the rate of stenosis, but the type(s) of cells and their roles have not been defined. Finally, esophageal tissue engineering cannot provide a functional esophageal substitute, and further development is necessary prior to conducting human clinical studies. PMID:24387697

Luc, Guillaume; Durand, Marlène; Collet, Denis; Guillemot, Fabien; Bordenave, Laurence

2014-03-01

139

Functional esophageal disorders.  

PubMed

Functional esophageal disorders represent processes accompanied by typical esophageal symptoms (heartburn, chest pain, dysphagia, globus) that are not explained by structural disorders, histopathology-based motor disturbances, or gastroesophageal reflux disease. Gastroesophageal reflux disease is the preferred diagnosis when reflux esophagitis or excessive esophageal acid exposure is present or when symptoms are closely related to acid reflux events or respond to antireflux therapy. A singular, well-defined pathogenetic mechanism is unavailable for any of these disorders; combinations of sensory and motor abnormalities involving both central and peripheral neural dysfunction have been invoked for some. Treatments remain empirical, although the efficacy of several interventions has been established in the case of functional chest pain. Management approaches that modulate central symptom perception or amplification often are required once local provoking factors (eg, noxious esophageal stimuli) have been eliminated. Future research directions include further determination of fundamental mechanisms responsible for symptoms, development of novel management strategies, and definition of the most cost-effective diagnostic and treatment approaches. PMID:16678559

Galmiche, Jean Paul; Clouse, Ray E; Bálint, András; Cook, Ian J; Kahrilas, Peter J; Paterson, William G; Smout, Andre J P M

2006-04-01

140

Clinical Value of Esophageal Motility Testing  

Microsoft Academic Search

Esophageal motility testing is the method of choice in evaluating esophageal motor disorders. Some physicians, however, question the clinical utility of esophageal motility testing, since the results are often normal in symptomatic patients. The clinical utility of esophageal motility testing is reviewed for patients with a complaint of noncardiac chest pain, dysphagia or symptoms of gastroesophageal reflux disease. Esophageal motility

Melvin L. Allen; Richard B. Lynn; Saeed Zamani

1998-01-01

141

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

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

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

1998-05-01

142

Prostatic adenocarcinoma with glomeruloid features  

Microsoft Academic Search

A wide variety of architectural patterns of adenocarcinoma may be seen in the prostate. We have recently encountered a hithertoundescribed pattern of growth characterized by intraluminal ball-like clusters of cancer cells reminiscent of renal glomeruli, which we refer to as prostatic adenocarcinoma with glomeruloid features. To define the architectural features, frequency, and distribution of prostatic adenocarcinoma with glomeruloid features, we

Anna Pacelli; Antonio Lopez-Beltran; A. J. Matthew Egan; David G Bostwick

1998-01-01

143

Deoxycholate induces COX2 expression via Erk1\\/2-, p38MAPK and AP1-dependent mechanisms in esophageal cancer cells  

Microsoft Academic Search

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

Eileen Looby; Mohamed MM Abdel-Latif; Veronica Athié-Morales; Shane Duggan; Aideen Long; Dermot Kelleher

2009-01-01

144

Pancreatic Ductal Adenocarcinoma  

Cancer.gov

Because pancreatic cancer is often diagnosed at a late stage, surgical removal of the tumor or the organ is often difficult, if not impossible. Pancreatic ductal adenocarcinoma, or PDAC, is by far the most common type of pancreatic malignancy. PDAC is distinct from other cancers due to the biological barrier the tumor builds around itself.

145

Reduced esophageal cancer incidence in statin users, particularly with cyclo-oxygenase inhibition  

PubMed Central

AIM: To examine the association between statin use and the development of esophageal cancer METHODS: We performed a systematic review and meta-analysis. Multiple databases (Pubmed, EMBASE, Cochrane Library, Web of Science, Wiley Interscience and Google Scholar) were systematically searched for studies reporting the association of statin use and the development of esophageal cancer. Literature searching and data abstraction were performed independently by two separate researchers. The quality of studies reviewed was evaluated using the Newcastle-Ottawa Quality assessment scale. Meta-analysis on the relationship between statin use and cancer incidence was performed. The effect of the combination of statin plus a cyclo-oxygenase inhibitor was also examined. RESULTS: Eleven studies met eligibility criteria, 9 high and 2 medium quality. All were observational studies. Studies examining adenocarcinoma development in Barrett’s esophagus included 317 cancers and 1999 controls, population-based studies examining all esophageal cancers included 371203 cancers and 6083150 controls. In the Barrett’s population the use of statins (OR = 0.57; 95%CI: 0.43-0.75) and cyclo-oxygenase inhibitors (OR = 0.59; 95%CI: 0.45-0.77) were independently associated with a reduced incidence of adenocarcinoma. Combined use of a statin plus cyclo-oxygenase inhibitor was associated with an even lower adenocarcinoma incidence (OR = 0.26; 95%CI: 0.1-0.68). There was more heterogeneity in the population-based studies but pooled adjusted data showed that statin use was associated with a lower incidence of all combined esophageal cancers (OR = 0.81; 95%CI: 0.75-0.88). CONCLUSION: Statin use in patients with Barrett’s oesophagus is associated with a significantly lower incidence of adenocarcinoma. The chemopreventive actions of statins, especially combined with cyclo-oxygenase inhibitors deserve further exploration. PMID:23919219

Beales, Ian Leonard Phillip; Hensley, Abigail; Loke, Yoon

2013-01-01

146

Tracheo-esophageal fistula: Successful palliation after failed esophageal stent  

PubMed Central

The incidence of tracheo-esophageal (TO) fistula is on the rise, especially after palliative management for esophageal malignancies. We report a case of cancer of esophagus who after chemotherapy and radiotherapy developed TO fistula. Placement of an esophageal stent helped him in taking food orally, but his cough and dyspnoea continued to worsen. Fibreoptic bronchoscopy demonstrated a severely compressed trachea secondary to protrusion of esophageal stent which responded very well to an Ultraflex-covered tracheal stent and the patient achieved relief from cough and dyspnoea. PMID:22919174

Chawla, Rakesh K.; Madan, Arun; Chawla, Kiran

2012-01-01

147

Practical management of eosinophilic esophagitis.  

PubMed

CME EDUCATIONAL OBJECTIVES 1. Determine the clinical presentation and diagnostic criteria for eosinophilic esophagitis in children. 2. Discuss the three major treatment strategies for eosinophilic esophagitis. 3. Provide key strategies for practical identification and management of eosinophilic esophagitis in children and adolescents. Eosinophilic esophagitis (EoE) is a recently discovered disease that affects patients worldwide. The conceptual definition of EoE is a chronic, immune/antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. As a chronic, antigen-mediated disease causing eosinophilic inflammation in the esophagus, EoE symptoms are similar to gastroesophageal reflux disease (GERD) and it results in significant morbidity. PMID:23805960

Davis, Carla M

2013-07-01

148

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2011 CFR

...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...

2011-04-01

149

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2013 CFR

...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...

2013-04-01

150

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2012 CFR

...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...

2012-04-01

151

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2010 CFR

...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...

2010-04-01

152

21 CFR 876.5365 - Esophageal dilator.  

...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...

2014-04-01

153

Delayed diagnosis of high proximal tracheoesophageal fistula in esophageal atresia and a novel approach to the treatment of tracheomalacia by submanubrial tracheopexy.  

PubMed

An infant with esophageal atresia (EA) had delayed diagnosis of proximal tracheoesophageal fistula (TEF) and severe tracheomalacia. We recommend bronchoscopy via laryngeal mask or rigid bronchoscopy to rule out associated TEF in infants diagnosed with esophageal atresia, as flexible bronchoscopy via endotracheal tube may not provide complete visualization of the trachea. We also describe a novel cervical approach to tracheopexy via neck incision for treatment of associated severe tracheomalacia in this infant. PMID:24634808

Bjornson, Candice; Brindle, Mary; Bailey, Ja Michelle; Mitchell, Ian; Soles, Melissa

2014-01-01

154

Prognostic significance of differentially expressed miRNAs in esophageal cancer  

PubMed Central

Altered microRNA (miRNA) expression has been found to promote carcinogenesis, but little is known about the role of miRNAs in esophageal cancer. In this study, we selected 10 miRNAs and analyzed their expression in 10 esophageal cancer cell lines and 158 tissue specimens using Northern blotting and in situ hybridization, respectively. We found that Let-7g, miR-21, and miR-195p were expressed in all 10 cell lines, miR-9 and miR-20a were not expressed in any of the cell lines, and miR-16-2, miR-30e, miR-34a, miR-126, and miR-200a were expressed in some of the cell lines but not others. In addition, transient transfection of miR-34a inhibited c-Met and cyclin D1 expression and esophageal cancer cell proliferation, whereas miR-16-2 suppressed RAR-?2 expression and increased tumor cell proliferation. Furthermore, we found that miR-126 expression was associated with tumor cell de-differentiation and lymph node metastasis, miR-16-2 was associated with lymph node metastasis, and miR-195p was associated with higher pathologic disease stages in patients with esophageal adenocarcinoma. Kaplan-Meier analysis showed that miR-16-2 expression and miR-30e expression were associated with shorter overall and disease-free survival in all esophageal cancer patients. In addition, miR-16-2, miR-30e, and miR-200a expression were associated with shorter overall and disease-free survival in esophageal adenocarcinoma patients; however, miR-16-2, miR-30e, and miR-200a expression was not associated with overall or disease-free survival in squamous cell carcinoma patients. Our data indicate that further evaluation of miR-30e and miR-16-2 as prognostic biomarkers is warranted in patients with esophageal adenocarcinoma. In addition, the role of miR-34a in esophageal cancer also warrants further study. PMID:20309880

Hu, Yuxin; Correa, Arlene M.; Hoque, Ashraful; Guan, Baoxiang; Ye, Fei; Huang, Jie; Swisher, Stephen G.; Wu, Tsung Teh; Ajani, Jaffer A.; Xu, Xiao-chun

2010-01-01

155

Moscatilin Induces Apoptosis and Mitotic Catastrophe in Human Esophageal Cancer Cells  

PubMed Central

Abstract Moscatilin, a bibenzyl derivative from the orchid Dendrobium loddigesii, has been shown to possess anticancer activity. We examined the effect of moscatilin on human esophageal cancer cells, including squamous cell carcinoma (SCC) and adenocarcinoma (ADC) cells and its possible mechanisms. Moscatilin suppressed the growth of both the histological cell lines in a dose- and time-dependent manner. Morphological changes indicative of apoptosis and mitotic catastrophe were observed following moscatilin treatment. The population of cells in the sub-G1 phase and polyploidy phase significantly increased after treatment. Immunofluorescence revealed multipolar mitosis and subsequent multinucleation in moscatilin-treated cells, indicating the development of mitotic catastrophe. Western blot showed a marked increase in expressions of polo-like kinase 1 and cyclin B1 after exposure to moscatilin. In conclusion, moscatilin inhibits growth and induces apoptosis and mitotic catastrophe in human esophageal SCC- and ADC-derived cell lines, indicating that moscatilin has broad potential against esophageal cancer. PMID:24074296

Chen, Chien-An; Chen, Chien-Chih; Shen, Chien-Chang

2013-01-01

156

Moscatilin induces apoptosis and mitotic catastrophe in human esophageal cancer cells.  

PubMed

Moscatilin, a bibenzyl derivative from the orchid Dendrobium loddigesii, has been shown to possess anticancer activity. We examined the effect of moscatilin on human esophageal cancer cells, including squamous cell carcinoma (SCC) and adenocarcinoma (ADC) cells and its possible mechanisms. Moscatilin suppressed the growth of both the histological cell lines in a dose- and time-dependent manner. Morphological changes indicative of apoptosis and mitotic catastrophe were observed following moscatilin treatment. The population of cells in the sub-G1 phase and polyploidy phase significantly increased after treatment. Immunofluorescence revealed multipolar mitosis and subsequent multinucleation in moscatilin-treated cells, indicating the development of mitotic catastrophe. Western blot showed a marked increase in expressions of polo-like kinase 1 and cyclin B1 after exposure to moscatilin. In conclusion, moscatilin inhibits growth and induces apoptosis and mitotic catastrophe in human esophageal SCC- and ADC-derived cell lines, indicating that moscatilin has broad potential against esophageal cancer. PMID:24074296

Chen, Chien-An; Chen, Chien-Chih; Shen, Chien-Chang; Chang, Hen-Hong; Chen, Yu-Jen

2013-10-01

157

Laser-induced fluorescence in the detection of esophageal carcinoma  

NASA Astrophysics Data System (ADS)

Laser induced fluorescence (LIF) is a technique which can perform an 'optical biopsy' of gastrointestinal mucosa. LIF was performed in resected specimens using a pulsed N2-laser coupled fiberoptically to a probe. Fluorescence was measured using a 0.2 meter spectroscope with an intensified photodiode array. Measurements were made on fresh (<30 minutes after resection) esophageal specimens containing normal mucosa, Barrett's esophagus, and adenocarcinoma. Each tissue section was examined using an optical probe consisting of a central fiber for delivering the excitation energy and a 6 fiber bundle surrounding the central fiber for detection of the fluorescence. An excitation wavelength of 337 nm was used which generated 3-ns pulses while fluorescence intensities were acquired from 300-800 nm. Spectra were obtained from each section in a standardized fashion and background spectra subtracted. Fluorescence readings were taken from 54 normal esophageal sections and 32 sections of adenocarcinoma. A fluorescence index obtained from the tumor sections was 0.68+/- 0.01 compared with 0.51+/- 0.01 for the normal sections (p<0.001). Using a discriminant value of 0.65, this technique had a sensitivity of 81% and a specificity of 100% for detection of malignant tissue. The positive predictive value was 100% and the negative predictive value was 90% for an overall accuracy of 93%. LIF is a promising technique which has the capability of distinguishing normal versus malignant tissue in the esophagus with good accuracy.

Wang, Kenneth K.; Gutta, Kumar; Laukka, Mark A.; Densmore, John

1995-01-01

158

An Overview of Eosinophilic Esophagitis  

PubMed Central

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

Park, Hyojin

2014-01-01

159

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

PubMed Central

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

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

160

Src Mutation Induces Acquired Lapatinib Resistance in ERBB2-Amplified Human Gastroesophageal Adenocarcinoma Models  

PubMed Central

ERBB2-directed therapy is now a routine component of therapy for ERBB2-amplified metastatic gastroesophageal adenocarcinomas. However, there is little knowledge of the mechanisms by which these tumors develop acquired resistance to ERBB2 inhibition. To investigate this question we sought to characterize cell line models of ERBB2-amplified gastroesophageal adenocarcinoma with acquired resistance to ERBB2 inhibition. We generated lapatinib-resistant (LR) subclones from an initially lapatinib-sensitive ERBB2-amplified esophageal adenocarcinoma cell line, OE19. We subsequently performed genomic characterization and functional analyses of resistant subclones with acquired lapatinib resistance. We identified a novel, acquired SrcE527K mutation in a subset of LR OE19 subclones. Cells with this mutant allele harbour increased Src phosphorylation. Genetic and pharmacologic inhibition of Src resensitized these subclones to lapatinib. Biochemically, Src mutations could activate both the phosphatidylinositol 3-kinase and mitogen activated protein kinase pathways in the lapatinib-treated LR OE19 cells. Ectopic expression of Src E527K mutation also was sufficient to induce lapatinib resistance in drug-naïve cells. These results indicate that pathologic activation of Src is a potential mechanism of acquired resistance to ERBB2 inhibition in ERBB2-amplified gastroesophageal cancer. Although Src mutation has not been described in primary tumor samples, we propose that the Src hyperactivation should be investigated in the settings of acquired resistance to ERBB2 inhibition in esophageal and gastric adenocarcinoma. PMID:25350844

Hong, Yong Sang; Kim, Jihun; Pectasides, Eirini; Fox, Cameron; Hong, Seung-Woo; Ma, Qiuping; Wong, Gabrielle S.; Peng, Shouyong; Stachler, Matthew D.; Thorner, Aaron R.; Van Hummelen, Paul; Bass, Adam J.

2014-01-01

161

Radiochemotherapy of esophageal cancer.  

PubMed

Cancer of the esophagus continues to be a threat to public health. The common practice is esophagectomy for surgically resectable tumors and radiochemotherapy for locally advanced, unresectable tumors. However, local regional tumor control and overall survival of esophageal cancer patients after the standard therapies remain poor, approximately 30% of patients treated with surgery only will develop local recurrence, and 50% to 60% patients treated with radiochemotherapy only fail local regionally due to persistent disease or local recurrence. Esophagectomy after radiochemotherapy or preoperative radiochemotherapy has increased the complete surgical resection rate and local regional control without a significant survival benefit. Induction chemotherapy followed by preoperative radiochemotherapy has produced encouraging results. In addition to patient-, tumor-, and treatment-related factors, involvement of celiac axis nodes, number of positive lymph nodes after preoperative radiochemotherapy, incomplete pathologic response, high metabolic activity on positron emission tomography scan after radiochemotherapy, and incomplete surgical resection are factors associated with a poor outcome. Radiochemotherapy followed by surgery is associated with significant adverse effects, including treatment-related pneumonitis, postoperative pulmonary complications, esophagitis and pericarditis. The incidence and severity of the adverse effects are associated with chemotherapy and radiotherapy dosimetric factors. Innovative treatment strategies including physically and biologically molecular targeted therapy is needed to improve the treatment outcome of patients with esophageal cancer. PMID:17545853

Liao, Zhongxing; Cox, James D; Komaki, Ritsuko

2007-06-01

162

The role of neoadjuvant and adjuvant treatment for adenocarcinoma of the upper gastrointestinal tract  

PubMed Central

Both locally advanced adenocarcinoma of the stomach and gastro-esophageal junction are associated with poor prognosis due to the lack of effective treatment. Recently multimodal treatment consisting of neoadjuvant chemotherapy in combination with radiotherapy is reported to improve survival when compared to surgery alone. Neoadjuvant therapy in these locally advanced tumors allows for early tumor responses and the extent of tumor regression that can be achieved is considered a significant prognostic factor. This, in turn, increases the resectability of these tumors. Also due to the high frequency of lymph node metastasis, patients with locally advanced adenocarcinoma should undergo a D2 lymphadenectomy. Postoperative chemoradiation and perioperative chemotherapy have been studied in gastric adenocarcinomas and showed a survival benefit. However, the surgical techniques used in these trials are no longer considered to be standard by today's surgical practice. In addition, there are no standard recommendations for adjuvant chemotherapy or chemoradiation after R0 resection and adequate lymph node dissection. PMID:21810561

2011-01-01

163

Characteristics of brain metastases from esophageal carcinoma  

PubMed Central

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.

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

164

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

PubMed Central

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.

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

2014-01-01

165

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

PubMed

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

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

2014-10-16

166

Preoperative chemotherapy in esophageal carcinoma  

Microsoft Academic Search

Preoperative chemotherapy for localized esophageal cancer is an area of increasing interest because neither surgery nor radiation has had a major impact on disease-free or overall survival. This is probably because, as several autopsy series have demonstrated, esophageal cancer is a systemic disease. Preoperative chemotherapy thus, in theory, allows a simultaneous attack on both the primary and metastatic disease. A

D. P. Kelsen

1987-01-01

167

Comparison of outcomes according to the operation for type A esophageal atresia  

PubMed Central

Purpose The purpose was to evaluate outcomes according to different operative strategies of type A esophageal atresia (EA). Methods All patients who underwent surgery for type A EA between 1980 and 2011 were included. Patients were divided into 2 groups: E-E group included patients who received esophageal end-to-end anastomosis, whereas E-G group included patients who received esophago-gastric tube anastomosis. Results Twenty-two patients were included. The median gestational age was 37.5 weeks. The median birth weight was 2.5 kg. Twenty-one patients underwent gastrostomy as initial procedures, and one patient underwent primary esophageal end-to-end anastomosis. The median gap between both esophageal ends was six vertebral distance (VD). Seven patients underwent primary anastomosis of the esophagus, and 14 patients underwent gastric replacement. Three patients (13.6%) had anastomotic leakage and 10 patients (45.5%) had anastomotic stenosis. Most of the patients (90.9%) had gastroesophageal reflux, but only two patients required antireflux surgery. The median VD was significantly shorter in E-E group than in E-G group (3 VD vs. 6 VD). Stenosis was significantly more often in E-E group, but there was no significant difference in leakage and reflux symptoms. Conclusion The treatment for type A EA can include E-E anastomosis or E-G anastomosis, depending on the length of the end-to-end interval after performing gastrostomy. Appropriate tension and blood flow in the anastomosis site are essential for preventing postoperative stenosis and leakage, and esophageal replacement with gastric tube is believed to be feasible and safe in cases where excessive tension is present. PMID:24761413

Huh, Yeon-Ju; Kim, Hyun-Young; Lee, Seong-Cheol; Park, Kwi-Won

2014-01-01

168

[Computerized analysis of esophageal manometry].  

PubMed

Computerized analysis of esophageal manometry should consider the following objectives: a) objectivation of data acquisition; b) precision in calculating the various parameters; c) speed of analysis; d) an easy-to-read and promptly understandable graphic display of the manometric data; e) computation of new parameters capable of defining normal and pathologic function. It is with these objectives in mind that we launched our research project. Five normal subjects and 10 patients, of whom 5 presented esophageal achalasia and 5 gastroesophageal reflux disease, underwent computerized esophageal manometry and were evaluated on the basis of both traditional and innovative parameters, of our own inception. Among the various indexes tested, the "Esophageal transport" parameter, calculated as the ratio of momentum (dp*dT) over speed of propagation of the esophageal contractions, gave rise to particular interest. In our opinion, this parameter can be used as an index of the dynamic function of the organ. PMID:2067691

Spigno, L; Pandolfo, N; Guiddo, G; Calci, G; Mattioli, G; De Salvo, L

1991-04-15

169

Prognostic Value of Metabolic Tumor Volume Measured by 18 F-Fluorodeoxyglucose Positron Emission Tomography in Patients with Esophageal Carcinoma  

Microsoft Academic Search

Purpose  The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in patients with esophageal carcinoma.\\u000a \\u000a \\u000a \\u000a Methods  We retrospectively reviewed 151 patients with pathologically proven esophageal carcinoma (146 squamous cell carcinomas and\\u000a 5 adenocarcinomas) who underwent pretreatment 18F-FDG PET. MTV and maximum standardized uptake value (SUVmax) for the

Seung Hyup Hyun; Joon Young Choi; Young Mog Shim; Kwhanmien Kim; Su Jin Lee; Young Seok Cho; Ji Young Lee; Kyung-Han Lee; Byung-Tae Kim

2010-01-01

170

Glossopexy as an alternative to aortopexy in infants with repaired esophageal atresia and upper airway obstruction  

Microsoft Academic Search

Background\\/Purpose: Clinical manifestations of airway obstruction in infants with repaired esophageal atresia or tracheoesophageal fistula (EA\\/TEF) are attributed conventionally to tracheomalacia. In the current study, the authors tested the hypothesis that a retrodisplacement of the tongue (glossoptosis), by causing a functional upper airway obstruction (obstructive apnea\\/hypopnea), may play a role in the pathogenesis of the respiratory problems. Methods: The records

Francesco Cozzi; Francesco Morini; Alessandra Casati; Daniela Camanni; Augusto Zani; Denis A. Cozzi

2002-01-01

171

Primary Repair of Esophageal Atresia in Extremely Low Birth Weight Infants: A Single-Center Experience and Review of the Literature  

Microsoft Academic Search

Background: Advances in neonatal intensive care have led to an increased survival of very low birth weight (VLBW, <1,500 g) and extremely low birth weight infants (ELBW, <1,000 g). Several abnormalities may occur in these children, e.g. esophageal atresia (EA), imperforate anus or abdominal wall defects. Correction of EA is often performed as a staged procedure in this group of

Guido Seitz; Steven W. Warmann; Juergen Schaefer; Christian F. Poets; Joerg Fuchs

2006-01-01

172

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

PubMed

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

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

2014-05-15

173

Esophageal cancer management controversies: Radiation oncology point of view  

PubMed Central

Esophageal cancer treatment has evolved from single modality to trimodality therapy. There are some controversies of the role, target volumes and dose of radiotherapy (RT) in the literature over decades. The present review focuses primarily on RT as part of the treatment modalities, and highlight on the RT volume and its dose in the management of esophageal cancer. The randomized adjuvant chemoradiation (CRT) trial, intergroup trial (INT 0116) enrolled 559 patients with resected adenocarcinoma of the stomach or gastroesophageal junction. They were randomly assigned to surgery plus postoperative CRT or surgery alone. Analyses show robust treatment benefit of adjuvant CRT in most subsets for postoperative CRT. The Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS) used a lower RT dose of 41.4 Gray in 23 fractions with newer chemotherapeutic agents carboplatin and paclitaxel to achieve an excellent result. Target volume of external beam radiation therapy and its coverage have been in debate for years among radiation oncologists. Pre-operative and post-operative target volumes are designed to optimize for disease control. Esophageal brachytherapy is effective in the palliation of dysphagia, but should not be given concomitantly with chemotherapy or external beam RT. The role of brachytherapy in multimodality management requires further investigation. On-going studies of multidisciplinary treatment in locally advanced cancer include: ZTOG1201 trial (a phase II trial of neoadjuvant and adjuvant CRT) and QUINTETT (a phase III trial of neoadjuvant vs adjuvant therapy with quality of life analysis). These trials hopefully will shed more light on the future management of esophageal cancer. PMID:25132924

Tai, Patricia; Yu, Edward

2014-01-01

174

Extra-ampullary Duodenal Adenocarcinoma.  

PubMed

Extra-ampullary duodenal adenocarcinomas are rare, and when studied, frequently have been grouped with jejunoileal adenocarcinomas. Nevertheless, anecdotal experiences suggest that these neoplasms may present 2 or more distinct phenotypes. To better characterize these neoplasms, we performed a retrospective review of 38 cases with a special focus on the morphologic and immunophenotypic characteristics and their clinicopathologic significance. Our cohort of extra-ampullary duodenal adenocarcinomas was classified on the basis of the morphologic features into gastric type (n=19, 50%), intestinal type (n=14, 37%), pancreaticobiliary type (n=2, 5%), and others (n=3, 8%). Most gastric-type adenocarcinomas (n=18, 95%) developed in the proximal duodenum, whereas the other types were located equally in the proximal and distal duodenum. Intestinal-type dysplasia was present at the periphery of 8 (57%) intestinal-type adenocarcinomas, and 8 (42%) gastric-type adenocarcinoma were associated with gastric-type dysplasia. Gastric foveolar metaplasia (n=12) and Brunner gland hyperplasia (n=10) were exclusively recognized adjacent to gastric-type adenocarcinomas. Notably, intestinal-type histology and the absence of lymph node metastasis were significantly associated with favorable disease-free survival in univariate and multivariate analyses. In summary, this study demonstrated that 2 major subsets of extra-ampullary duodenal adenocarcinoma, intestinal type and gastric type, are associated with distinct histopathologic features and clinical behavior. PMID:25310836

Ushiku, Tetsuo; Arnason, Thomas; Fukayama, Masashi; Lauwers, Gregory Y

2014-11-01

175

[Esophageal scintigraphy during endoscopic treatment of reflux esophagitis].  

PubMed

The paper is concerned with analysis of a method of dynamic esophageal scintigraphy modified by the authors for diagnosis and control of therapy of reflux esophagitis combined with duodenal ulcer in 33 patients aged 17 to 72. The proposed method is technically simple, highly effective and can be recommended for use in hospitals equipped with computer-assisted gamma-cameras. Indices of radionuclide clearance of the esophagus reflect its function of self-purification and well correlate with a degree of inflammatory changes of esophageal mucosa. They disappear more rapidly in patients receiving multimodality therapy including selective drug denervation of the stomach than in patients on conservative therapy alone. PMID:3262191

Glazov, A V; Zubovski?, L G; Sineev, Iu V; Kerin, V V; Rodchenko, Z P

1988-09-01

176

The simultaneous expression of both ephrin B3 receptor and E-cadherin in Barrett`s adenocarcinoma is associated with favorable clinical staging  

PubMed Central

Background In intestinal epithelium, tyrosine kinase receptor Ephrin B3 (Eph B3) maintains the architecture of the crypt-villus axis by repulsive interaction with its ligand ephrin-B1. While loss of Eph B3 is linked to colorectal cancer initiation, overexpression of Eph B3 in cancer cell lines inhibits growth and induces functional changes with decreased mesenchymal and increased epithelial markers. In order to study this tumor suppressor activity of Eph B3 in esophageal adenocarcinoma we analyzed the simultaneous expression of Eph B3 and E-cadherin in both the healthy esophagus and in Barrett’s carcinoma. Methods Simultaneous expression of Eph B3 and E-cadherin was investigated in samples from 141 patients with Barrett’s carcinoma and from 20 healthy esophagi using immunhistology and quantitative PCR. Results from healthy squamous epithelium, Barrett’s metaplasia and staging-specific esophageal adenocarcinoma were correlated. Results A significantly reduced E-cadherin mRNA expression could be detected in adenocarcinoma compared to dysplasia. The immunhistological activity of E-cadherin and Eph B3 was reduced in adenocarcinoma compared to dysplasia or healthy esophageal mucosa. The intracellular E-cadherin distribution changed significantly from the cytoplasm to the membrane, when the Eph receptor was simultaneously expressed. Simultaneous expression of E-cadherin and Eph B3 showed a significant inverse correlation to tumor stage. Conclusions We present novel evidence of the tumor suppressor activity of Eph B3 in esophageal adenocarcinoma possibly due to the impact on redistribution of cellular E-cadherin to the membrane. Our results suggest that this effect might play a role in the dysplasia-adenocarcinoma sequence, the infiltrative growth pattern and the development of lymph node metastases. PMID:22583970

2012-01-01

177

Temporal evolution in caveolin 1 methylation levels during human esophageal carcinogenesis  

PubMed Central

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

2014-01-01

178

Hypermethylation of the AKAP12 promoter is a biomarker of Barrett's-associated esophageal neoplastic progression.  

PubMed

The A-kinase anchoring protein 12 (AKAP12) is a kinase scaffold protein with known tumor suppressor activity. Recently, AKAP12 promoter hypermethylation was reported in gastric and colorectal cancers. We examined AKAP12 promoter hypermethylation using real-time methylation-specific PCR in 259 human esophageal tissues. AKAP12 hypermethylation showed highly discriminative receiver-operator characteristic (ROC) curve profiles, clearly distinguishing esophageal adenocarcinoma (EAC) from esophageal squamous cell carcinoma and normal esophagus (P < 0.0001). AKAP12-normalized methylation values were significantly higher in Barrett's metaplasia (BE), dysplastic Barrett's, and EAC than in normal esophagus (P < 0.0000001). AKAP12 hypermethylation frequency was zero in normal esophagus but increased early during neoplastic progression, to 38.9% in BE from patients with Barrett's alone, 52.5% in dysplastic Barrett's metaplasia, and 52.2% in EAC. AKAP12 hypermethylation levels were significantly higher in normal esophageal epithelia from patients with EAC (mean = 0.00082) than in normal esophagi from patients without Barrett's or esophageal cancer (mean = 0.00007; P = 0.006). There was a significant correlation between AKAP12 hypermethylation and BE segment length, a known clinical neoplastic progression risk factor. In contrast, only 2 (7.7%) of 26 esophageal squamous cell carcinomas exhibited AKAP12 hypermethylation. Treatment of BIC and OE33 EAC cells with 5-aza-2'-deoxycytidine reduced AKAP12 methylation and increased AKAP12 mRNA expression. AKAP12 mRNA levels in EACs with unmethylated AKAP12 (mean = 0.1663) were higher than in EACs with methylated AKAP12 (mean = 0.0668). We conclude that promoter hypermethylation of AKAP12 is a common, tissue-specific event in human EAC, occurs early during Barrett's-associated esophageal neoplastic progression, and is a potential biomarker for the early detection of EAC. PMID:18199717

Jin, Zhe; Hamilton, James P; Yang, Jian; Mori, Yuriko; Olaru, Alexandru; Sato, Fumiaki; Ito, Tetsuo; Kan, Takatsugu; Cheng, Yulan; Paun, Bogdan; David, Stefan; Beer, David G; Agarwal, Rachana; Abraham, John M; Meltzer, Stephen J

2008-01-01

179

Pharmacologic treatments for esophageal disorders.  

PubMed

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

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

180

Esophageal Lipoma: A Rare Tumor  

PubMed Central

Esophageal lipomas are rare tumors, making up 0.4% of all digestive tract benign neoplasms. Most of these lesions are clinically silent as a result of their small size, however, the majority of lesions over 4 cm have been reported to cause dysphagia, regurgitation and/or epigastralgia. We report a case of a 53 year-old African American female who presented with dysphagia. Computed tomography of the chest and esophagram confirmed esophageal lipoma as the cause of the patient’s symptoms. Accurately diagnosing an esophageal lipoma is crucial in order to rule out potential malignant lesions, relieve patient symptoms and plan the appropriate treatment. PMID:23365708

Feldman, Jeremy; Tejerina, Manfred; Hallowell, Michael

2012-01-01

181

Treatment of advanced esophageal cancer  

SciTech Connect

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)

Kelsen, D.

1982-12-01

182

47 CFR 11.18 - EAS Designations.  

Code of Federal Regulations, 2012 CFR

...EAS Designations. 11.18 Section 11.18 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.18 EAS Designations. (a) National Primary (NP) is a source of EAS Presidential...

2012-10-01

183

47 CFR 11.32 - EAS Encoder.  

Code of Federal Regulations, 2013 CFR

...false EAS Encoder. 11.32 Section 11.32 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11.32 EAS Encoder. (a) EAS Encoders must at a minimum be capable...

2013-10-01

184

47 CFR 11.32 - EAS Encoder.  

Code of Federal Regulations, 2012 CFR

...false EAS Encoder. 11.32 Section 11.32 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11.32 EAS Encoder. (a) EAS Encoders must at a minimum be capable...

2012-10-01

185

47 CFR 11.18 - EAS Designations.  

Code of Federal Regulations, 2011 CFR

...EAS Designations. 11.18 Section 11.18 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.18 EAS Designations. (a) National Primary (NP) is a source of EAS Presidential...

2011-10-01

186

47 CFR 11.33 - EAS Decoder.  

Code of Federal Regulations, 2013 CFR

...COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements...CAP)-formatted EAS messages into EAS alert messages that comply with the EAS...Display and logging. For received alert messages formatted in both the...

2013-10-01

187

47 CFR 11.33 - EAS Decoder.  

Code of Federal Regulations, 2012 CFR

...COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements...CAP)-formatted EAS messages into EAS alert messages that comply with the EAS...Display and logging. For received alert messages formatted in both the...

2012-10-01

188

47 CFR 11.33 - EAS Decoder.  

Code of Federal Regulations, 2010 CFR

...false EAS Decoder. 11.33 Section 11.33 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11.33 EAS Decoder. (a) An EAS Decoder must at a minimum be...

2010-10-01

189

47 CFR 11.32 - EAS Encoder.  

Code of Federal Regulations, 2011 CFR

...false EAS Encoder. 11.32 Section 11.32 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11.32 EAS Encoder. (a) EAS Encoders must at a minimum be capable...

2011-10-01

190

47 CFR 11.18 - EAS Designations.  

Code of Federal Regulations, 2010 CFR

...EAS Designations. 11.18 Section 11.18 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.18 EAS Designations. (a) National Primary (NP) is a source of EAS Presidential...

2010-10-01

191

47 CFR 11.33 - EAS Decoder.  

Code of Federal Regulations, 2011 CFR

...false EAS Decoder. 11.33 Section 11.33 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11.33 EAS Decoder. (a) An EAS Decoder must at a minimum be...

2011-10-01

192

47 CFR 11.32 - EAS Encoder.  

Code of Federal Regulations, 2010 CFR

...false EAS Encoder. 11.32 Section 11.32 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11.32 EAS Encoder. (a) EAS Encoders must at a minimum be capable...

2010-10-01

193

47 CFR 11.18 - EAS Designations.  

Code of Federal Regulations, 2013 CFR

...EAS Designations. 11.18 Section 11.18 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.18 EAS Designations. (a) National Primary (NP) is a source of EAS Presidential...

2013-10-01

194

Evaluation of Esophageal Contractile Propagation using Esophageal Pressure Topography  

PubMed Central

Background High-resolution manometry and esophageal pressure topography have ienhanced our ability to analyze esophageal motor disturbances by improving the detail and accuracy of measurements of peristaltic activity. This has been extremely helpful in the evaluation of disorders of rapid propagation as the technique is able to define important time points and physiologic landmarks that are crucial in defining peristaltic velocity and latency intervals. Purpose The goal of the current review will be to assess how esophageal pressure topography has impacted our ability to define important phenotypes of rapid propagation. Additionally, this review will also be utilized to complement the description of the Chicago Classification of Esophageal Motor Disorders, which is presented in this supplement issue. PMID:22248104

Pandolfino, J.E.; Sifrim, D.

2013-01-01

195

Esophageal tissue engineering: a new approach for esophageal replacement.  

PubMed

A number of congenital and acquired disorders require esophageal tissue replacement. Various surgical techniques, such as gastric and colonic interposition, are standards of treatment, but frequently complicated by stenosis and other problems. Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function. We review the literature of esophageal tissue engineering, discuss its implications, compare the methodologies that have been employed and suggest possible directions for the future. Medline, Embase, the Cochrane Library, National Research Register and ClinicalTrials.gov databases were searched with the following search terms: stem cell and esophagus, esophageal replacement, esophageal tissue engineering, esophageal substitution. Reference lists of papers identified were also examined and experts in this field contacted for further information. All full-text articles in English of all potentially relevant abstracts were reviewed. Tissue engineering has involved acellular scaffolds that were either transplanted with the aim of being repopulated by host cells or seeded prior to transplantation. When acellular scaffolds were used to replace patch and short tubular defects they allowed epithelial and partial muscular migration whereas when employed for long tubular defects the results were poor leading to an increased rate of stenosis and mortality. Stenting has been shown as an effective means to reduce stenotic changes and promote cell migration, whilst omental wrapping to induce vascularization of the construct has an uncertain benefit. Decellularized matrices have been recently suggested as the optimal choice for scaffolds, but smart polymers that will incorporate signalling to promote cell-scaffold interaction may provide a more reproducible and available solution. Results in animal models that have used seeded scaffolds strongly suggest that seeding of both muscle and epithelial cells on scaffolds prior to implantation is a prerequisite for complete esophageal replacement. Novel approaches need to be designed to allow for peristalsis and vascularization in the engineered esophagus. Although esophageal tissue engineering potentially offers a real alternative to conventional treatments for severe esophageal disease, important barriers remain that need to be addressed. PMID:23322987

Totonelli, Giorgia; Maghsoudlou, Panagiotis; Fishman, Jonathan M; Orlando, Giuseppe; Ansari, Tahera; Sibbons, Paul; Birchall, Martin A; Pierro, Agostino; Eaton, Simon; De Coppi, Paolo

2012-12-21

196

Villoglandular papillary adenocarcinoma of the cervix  

Microsoft Academic Search

Villoglandular papillary adenocarcinoma of the cervix is a well differentiated form of cervical adenocarcinoma with a favourable prognosis and a conservative procedure is suggested. We present three cases of villoglandular papillary adenocarcinoma of the cervix. Histological examination of a biopsy of each cervix showed well differentiated villoglandular papillary adenocarcinoma, stage Ib according to FIGO classification. In all cases the disease

Annechien Bouman; G. Jurjen E. Oosterhuis; Gijs A. van Doorn

1999-01-01

197

A Stakeholder Based Approach to EA Engineering  

Microsoft Academic Search

Enterprise Architecture (EA) is a complex system that addresses the concerns of a large and diverse group of stakeholders. These concerns must be reflected in the models which are created and used in the EA management process. Current EA engineering practice positions EA primarily is a tool for IT architects. However, experience from visionary EA programs has shown, that EA

Stephan Aier

198

Esophageal Cancer - Featured Clinical Trials  

Cancer.gov

Esophageal Cancer - Featured Clinical Trials The following list shows Featured Clinical Trials for a specific type of cancer. You may also want to view: Multiple Cancer Types - Featured Clinical Trials Supportive Care - Featured Clinical Trials

199

Esophageal stenting in cancer therapy.  

PubMed

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

Goenka, Mahesh Kumar; White, Russell E

2014-09-01

200

Biological identification of ampullary adenocarcinomas.  

PubMed

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

Relias, Valerie; Saif, Muhammad Wasif

2014-07-01

201

CT evaluation of thickened esophageal walls  

SciTech Connect

A study of 200 consecutive chest computed tomographic (CT) examinations revealed thickened esophageal walls (over 3 mm) in 35%. While this is the earliest finding of carcinoma of the esophagus on CT, only half of the cases of thickened walls were due to esophageal carcinoma. Other mediastinal malignancies as well as benign inflammatory, vascular, and fibrotic conditions such as reflux and monilial esophagitis, esophageal varices, and postirradiation scarring were found to cause thickened esophageal walls. Distension with air and intravenous enhancement aid in the optimal evaluation of the esophagus by CT. The thickened esophageal wall is always abnormal, but it is nonspecific, seen in both malignant and nonmalignant conditions.

Reinig, J.W.; Stanley, J.H.; Schabel, S.I.

1983-05-01

202

Uses of esophageal function testing: dysphagia.  

PubMed

Esophageal function testing should be used for differential diagnosis of dysphagia. Dysphagia can be the consequence of hypermotility or hypomotility of the muscles of the esophagus. Decreased esophageal or esophagogastric junction distensibility can provoke dysphagia. The most well established esophageal dysmotility is achalasia. Other motility disorders can also cause dysphagia. High-resolution manometry (HRM) is the gold standard investigation for esophageal motility disorders. Simultaneous measurement of HRM and intraluminal impedance can be useful to assess motility and bolus transit. Impedance planimetry measures distensibility of the esophageal body and gastroesophageal junction in patients with achalasia and eosinophilic esophagitis. PMID:25216909

Yazaki, Etsuro; Woodland, Philip; Sifrim, Daniel

2014-10-01

203

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

PubMed Central

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

Fragoso, Ana Catarina; Tovar, Juan A.

2014-01-01

204

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

SciTech Connect

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.

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

205

Pancreatic adenocarcinoma: epidemiology and genetics.  

PubMed Central

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

Flanders, T Y; Foulkes, W D

1996-01-01

206

New and emerging combination therapies for esophageal cancer  

PubMed Central

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

Wiedmann, Marcus W; Mossner, Joachim

2013-01-01

207

Villoglandular Adenocarcinoma of the Vulva  

Microsoft Academic Search

Background. Only two previous cases of villoglandular adenocarcinoma of the vulva, an entity morphologically similar to tumors found in the uterine cervix and colorectum, have been reported. This paper communicates the first complete immunohistochemical study in villoglandular adenocarcinoma in order to determine its phenotype and histogenesis.Case. A 69-year-old woman had a 1.5-cm nodule in the right labium majus. Histologically, it

Antonio Rodriguez; Mar??a Alejandra Isaac; Esther Hidalgo; Bélgica Márquez; Francisco F. Nogales

2001-01-01

208

Repair of complete longitudinal esophageal rupture with preservation of esophageal motility.  

PubMed

There is no consensus on the ideal treatment for esophageal perforation and on the maximal extent of esophageal disruption amenable to primary repair. The effect of extensive esophageal injury on postoperative esophageal motility is also unknown. We report the case of a longitudinal iatrogenic esophageal laceration extending from the hypopharynx to the cardia in a morbidly obese patient treated with primary repair. The patient exhibited no postoperative esophageal leak or stricture and maintained a preserved esophageal peristalsis on manometry at 3 months. An extensively lacerated esophagus can be repaired primarily while maintaining a normal postoperative function. PMID:25282231

Frechette, Eric; Bolca, Ciprian; Lebel, Stefane

2014-10-01

209

NQO1 C609T polymorphism and esophageal cancer risk: a HuGE review and meta-analysis  

PubMed Central

Background Many studies have been carried out to test the hypothesis that the NQO1 C609T polymorphism might be associated with the risk of esophageal cancer. However, the results are poorly consistent, partly due to genetic or other sources of heterogeneity. To investigate the association between this polymorphism and the risk of esophageal cancer, a meta-analysis was performed. Methods We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of association. The frequency of the putative risk allele in the controls was estimated by the inverse-variance method. Cochran’s Q statistic and the inconsistency index (I2) were used to check heterogeneity. Egger’s test and an inverted funnel plot were used to assess the publication bias. Results Our study included eight published case-control studies about the NQO1 C609T polymorphism and esophageal cancer, including a total of 1,217 esophageal cancer patients and 1,560 controls. Overall, a significant association was found between the NQO1 C609T variant and esophageal cancer under a recessive model (OR?=?1.647; 95% CI?=?1.233-2.200). Regarding histological type, more significant evidence was found for esophageal squamous cell carcinoma (ESCC) (OR?=?2.03; 95% CI?=?1.29-3.19) than esophageal adenocarcinoma (EAC) (OR?=?1.61; 95% CI?=?1.01-2.56) under a recessive model. Conclusions The meta-analysis suggests that the NQO1 C609T polymorphism considerably increases the risk of esophageal cancer. PMID:23497461

2013-01-01

210

Primary esophageal adenosquamous carcinoma: a retrospective analysis of 24 cases.  

PubMed

Primary adenosquamous carcinoma (ASC) of the esophagus is a rare kind of malignancy characterized by mixed glandular and squamous differentiation as well as a propensity for aggressive clinical behavior. Data on the evaluation of the clinicopathological features and the prognosis of patients suffering from this malignancy are few because of the rarity of this disease. We conducted a retrospective review of 24 patients with primary esophageal ASC among 6546 esophageal cancer patients who underwent transthoracic esophagectomy in our hospital. The clinicopathological presentation, diagnosis, treatment, and prognostic factors of the patients were respectively investigated. The Kaplan-Meier method and the log rank test were used to calculate and compare overall survival (OS). The Cox proportional hazards model was employed to identify independent prognostic factors. There were 18 males and 6 females with a median age of 60 years (range: 40-78 years). The clinical symptoms, macroscopic type, as well as the radiological and endoscopic features of esophageal ASC were similar to those of esophageal squamous cell carcinoma. Sixteen (88.9%) of the 18 cases who underwent preoperative esophagoscopic biopsy were misdiagnosed as adenocarcinoma or squamous cell carcinoma. The overall median follow-up period was 36 months, and the median survival time was 32 months. The 1, 3, 5-year OS rates were 75.0%, 48.5%, and 19.4%, respectively. Univariate analysis showed that gender (P = 0.047), lymph node metastasis (P = 0.007), and TNM stage (P = 0.037) were important factors associated with OS of the 22 patients who underwent radical resection. Multivariate analysis showed that the pathological N stage was the only independent prognostic factor (P = 0.031, hazard ratio [HR], 5.369, 95% confidence interval [CI], 1.167-24.700). These results suggest that esophageal ASC is an uncommon disease prone to be misdiagnosed by endoscopic biopsy. Surgical resection is the primary treatment, but the prognosis of ASC is usually poorer than conventional squamous cell carcinoma. Lymph node metastasis is an independent prognostic factor after radical resection. PMID:24127755

Zhang, H D; Chen, C G; Gao, Y Y; Ma, Z; Tang, P; Duan, X F; Ren, P; Yue, J; Yu, Z T

2014-11-01

211

Esophageal perforation during or after conformal radiotherapy for esophageal carcinoma  

PubMed Central

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

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

2014-01-01

212

Prevention and Treatment of Esophageal Stenosis after Endoscopic Submucosal Dissection for Early Esophageal Cancer  

PubMed Central

Endoscopic submucosal dissection (ESD) for the treatment of esophageal mucosal lesions is associated with a risk of esophageal stenosis, especially for near-circumferential or circumferential esophageal mucosal defects. Here, we review historic and modern studies on the prevention and treatment of esophageal stenosis after ESD. These methods include prevention via pharmacological treatment, endoscopic autologous cell transplantation, endoscopic esophageal dilatation, and stent placement. This short review will focus on direct prevention and treatment, which may help guide the way forward. PMID:25386186

Wen, Jing; Lu, Zhongsheng; Liu, Qingsen

2014-01-01

213

Radiation-induced esophageal injury: A spectrum from esophagitis to cancer  

SciTech Connect

Radiation esophagitis is a common but frequently unrecognized complication of therapeutic radiation to the neck, chest, or mediastinum. The spectrum of injury ranges from acute self-limited esophagitis to life-threatening esophageal perforation. Complications such as stricture or primary esophageal cancer may occur many years after irradiation, and their linkage to radiation may not be considered. Five cases of radiation-induced injury are described, and the spectrum of radiation-induced esophageal injury is reviewed.

Vanagunas, A.; Jacob, P.; Olinger, E. (Northwestern Univ. Medical School, Chicago, IL (USA))

1990-07-01

214

A Comprehensive Review of Esophageal Stents  

PubMed Central

Esophageal stents are important tools for palliative treatment of inoperable esophageal malignancies. With the development of multiple self-expandable stents, there are now several therapeutic options for managing benign and malignant esophageal diseases. This paper discusses the various types of esophageal stents currently available, indications for their placement, challenges and complications that gastroenterologists face when placing these stents, and some of the innovations that will become available in the near future. PMID:23293566

Hong, Jinwha; Lam-Tsai, Yvette; Gress, Frank

2012-01-01

215

Heat Shock Protein 90 (HSP90) and Her2 in Adenocarcinomas of the Esophagus  

PubMed Central

Her2 overexpression and amplification can be found in a significant subset of esophageal adenocarcinomas. The activity of Her2 has been shown to be modulated by molecular chaperones such as HSP90. We analyzed expression/amplification data for HSP90 and Her2 on 127 primary resected esophageal adenocarcinomas in order to evaluate a possible relationship between these two molecules. HSP90 expression determined by immunohistochemistry was observed in various levels. Thirty nine (39) tumors (30.7%) were classified as Her2-positive according to their immunoreactivity and amplification status. There was a significant correlation between HSP90 expression and Her2-status (p = 0.008). This could also be demonstrated by quantitative protein expression analysis with reverse phase protein arrays (r = 0.9; p < 0.001). Her2-status was associated withpT-category (p = 0.041), lymph node metastases (p = 0.049) and tumor differentiation (p = 0.036) with a higher percentage of cases with negative Her2 status in lower tumor stagesA negative Her2-status was also associated with better survival in univariate and multivariate analysis (p = 0.001 and p = 0.014). For HSP90, no associations between clinical and pathological parameters were found. The observed association between HSP90 expression and Her2 suggests a co-regulation of these molecules in at least a subset of esophageal adenocarcinomas. Anti-HSP90 drugs, which recently have been introduced in cancer treatment, may also be an option for these tumors by targeting HSP90 alone or in combination with Her2. PMID:24978439

Slotta-Huspenina, Julia; Becker, Karl-Friedrich; Feith, Marcus; Walch, Axel; Langer, Rupert

2014-01-01

216

Esophageal pathology: a brief guide and atlas.  

PubMed

This article contains a brief atlas for esophageal dysphagia, with an emphasis on endoscopic evaluation. Dysphagia refers to an abnormality with food propulsion, and it may be caused by oropharyngeal or esophageal disorders. Radiological modalities, endoscopy, and manometry play an important role in both the diagnosis and management of esophageal disorders. PMID:24262958

Chokhavatia, Sita; Alli-Akintade, Latifat; Harpaz, Noam; Stern, Richard

2013-12-01

217

Esophageal motor function: technical aspects of manometry.  

PubMed

High-resolution manometry (HRM) has advanced the understanding of esophageal peristaltic mechanisms and has simplified esophageal motor testing. In this article the technical aspects of HRM are addressed, focusing on test protocols, in addition to concerns and pitfalls in performing esophageal motor studies. Specifically, catheter positioning, equipment-related artifacts, basal data acquisition, adequate swallows, and provocative maneuvers are discussed. PMID:25216901

Gyawali, C Prakash; Patel, Amit

2014-10-01

218

Pancreatic ductal adenocarcinoma staging  

PubMed Central

Abstract In addition to clinical history and evaluations, the results of laboratory tests and imaging studies help clinicians in determining treatment strategies. Imaging plays a central role in the management of oncology patients including the initial diagnosis, staging, and follow-up to assess treatment response. Historically, radiologists have relied on free-style dictations to convey the results of imaging findings in radiology reports to referring clinicians. These unstructured free-style dictations can potentially be a source of frustration as the pertinent information needed to guide treatment may be omitted or difficult to extract from the report, thereby limiting its completeness and usefulness. These limitations can be overcome by adopting a structured and reproducible form of reporting imaging studies to help clinicians in deciding the best treatment strategy for each patient. There is a growing need to establish standardized radiology reporting templates for specific disease processes. One such example involves patients with pancreatic ductal adenocarcinoma, as imaging findings determine the treatment arm to which the patient is assigned. In this presentation, we outline a list of essential features that need to be included in a structured report and highlight this with illustrative case examples. PMID:24060977

Francis, Isaac R.

2013-01-01

219

New TNM Staging System for Esophageal Cancer: What Chest Radiologists Need to Know.  

PubMed

Esophageal cancer is a leading cause of cancer-related deaths worldwide, and the 5-year relative survival rate remains less than 20% in the United States. The treatment of esophageal cancer should be stage specific for better clinical outcomes. Recent treatment paradigms tend to involve a multimodality approach to management, which includes surgical resection and preoperative or definitive chemoradiation therapy. Accurate pretreatment staging of esophageal cancer is integral for assessing operability and determining a suitable treatment plan. The American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) have published the seventh edition of the staging manual for cancer in the esophagus and esophagogastric junction. Unlike the sixth edition, the revised staging manual is data driven and harmonized with the staging of stomach cancer. Improvements include new definitions for the anatomic classifications Tis, T4, regional lymph node, N, and M and the addition of nonanatomic cancer characteristics (histopathologic cell type, histologic grade, and cancer location). Given the recent increase in the incidence of adenocarcinoma of the distal esophagus, esophagogastric junction, and gastric cardia, the staging of tumors in the esophagogastric junction has been addressed. Radiologists must understand the details of the seventh edition of the AJCC-UICC staging system for esophageal cancer and use appropriate imaging modalities, such as computed tomography (CT), endoscopic ultrasonography, and positron emission tomography/CT, for initial staging. ©RSNA, 2014. PMID:25310426

Hong, Su Jin; Kim, Tae Jung; Nam, Kyung Bum; Lee, In Sun; Yang, Hee Chul; Cho, Sukki; Kim, Kwhanmien; Jheon, Sanghoon; Lee, Kyung Won

2014-10-01

220

Therapeutic and radiosensitizing effects of armillaridin on human esophageal cancer cells.  

PubMed

Background. Armillaridin (AM) is isolated from Armillaria mellea. We examined the anticancer activity and radiosensitizing effect on human esophageal cancer cells. Methods. Human squamous cell carcinoma (CE81T/VGH and TE-2) and adenocarcinoma (BE-3 and SKGT-4) cell lines were cultured. The MTT assay was used for cell viability. The cell cycle was analyzed using propidium iodide staining. Mitochondrial transmembrane potential was measured by DiOC6(3) staining. The colony formation assay was performed for estimation of the radiation surviving fraction. Human CE81T/VGH xenografts were established for evaluation of therapeutic activity in vivo. Results. AM inhibited the viability of four human esophageal cancer cell lines with an estimated concentration of 50% inhibition (IC50) which was 3.4-6.9??M. AM induced a hypoploid cell population and morphological alterations typical of apoptosis in cells. This apoptosis induction was accompanied by a reduction of mitochondrial transmembrane potential. AM accumulated cell cycle at G2/M phase and enhanced the radiosensitivity in CE81T/VGH cells. In vivo, AM inhibited the growth of CE81T/VGH xenografts without significant impact on body weight and white blood cell counts. Conclusion. Armillaridin could inhibit growth and enhance radiosensitivity of human esophageal cancer cells. There might be potential to integrate AM with radiotherapy for esophageal cancer treatment. PMID:23864890

Chi, Chih-Wen; Chen, Chien-Chih; Chen, Yu-Jen

2013-01-01

221

Therapeutic and Radiosensitizing Effects of Armillaridin on Human Esophageal Cancer Cells  

PubMed Central

Background. Armillaridin (AM) is isolated from Armillaria mellea. We examined the anticancer activity and radiosensitizing effect on human esophageal cancer cells. Methods. Human squamous cell carcinoma (CE81T/VGH and TE-2) and adenocarcinoma (BE-3 and SKGT-4) cell lines were cultured. The MTT assay was used for cell viability. The cell cycle was analyzed using propidium iodide staining. Mitochondrial transmembrane potential was measured by DiOC6(3) staining. The colony formation assay was performed for estimation of the radiation surviving fraction. Human CE81T/VGH xenografts were established for evaluation of therapeutic activity in vivo. Results. AM inhibited the viability of four human esophageal cancer cell lines with an estimated concentration of 50% inhibition (IC50) which was 3.4–6.9??M. AM induced a hypoploid cell population and morphological alterations typical of apoptosis in cells. This apoptosis induction was accompanied by a reduction of mitochondrial transmembrane potential. AM accumulated cell cycle at G2/M phase and enhanced the radiosensitivity in CE81T/VGH cells. In vivo, AM inhibited the growth of CE81T/VGH xenografts without significant impact on body weight and white blood cell counts. Conclusion. Armillaridin could inhibit growth and enhance radiosensitivity of human esophageal cancer cells. There might be potential to integrate AM with radiotherapy for esophageal cancer treatment. PMID:23864890

Chi, Chih-Wen; Chen, Chien-Chih; Chen, Yu-Jen

2013-01-01

222

Outcome for esophageal cancer following treatment with chemotherapy and radiotherapy but not esophagectomy: Nonsurgical treatment of esophageal cancer  

PubMed Central

Background: More than 50% of patients with esophageal cancer are not suitable for surgery. The aim of this study was to analyze the outcome of patients undergoing standard nonsurgical treatment. Methods: Data of all patients undergoing nonsurgical treatment for esophageal cancer were identified from a prospective database. Results: Seventy-five patients were treated for localized disease, and 52 for metastatic disease at diagnosis. Except for age, which was higher in patients without metastases, there were no significant differences between the patients with vs. without metastatic disease. Kaplan–Meier analysis showed a median survival of 10.8 months for all patients. There was a significant difference in survival (p < 0.001) between the groups with versus without metastases, with median survival in the patients without metastases 13.6 months versus 6.5 months in patients with metastases. Patients undergoing nonsurgical treatment for localized disease had a five-year survival of 12%. No significant difference between adenocarcinoma and squamous cell carcinoma was identified. Subanalysis of patients who received chemoradiotherapy revealed similar results to the overall group of patients. Conclusion: In patients with localized disease at diagnosis, long-term survival can be achieved in some patients, whereas five-year survival is rare in patients who present with metastatic disease. PMID:21694830

Zingg, Urs; DiValentino, Dennis; McQuinn, Alexander; Mardzuki, Ahmad; Thompson, Sarah K; Karapetis, Christos S; Watson, David I

2009-01-01

223

Eosinophilic esophagitis and allergy.  

PubMed

Eosinophilic esophagitis (EoE) has been associated with allergic diseases of the airways and skin. Here, we review the current literature on the sensitization pattern of adult EoE patients and critically discuss the diagnostic and therapeutic tools available. Most EoE patients have elevated total IgE levels in serum and are sensitized to aero- and food allergens as assessed by measuring specific IgE levels and/or the skin prick test. Whereas in children with EoE sensitization to food allergens predominate, in adults EoE symptoms do not correlate with IgE sensitization to specific food allergens. However, in two thirds of adult EoE patients, sensitization to cross-reactive plant allergen components have been be detected, mainly to profilins and PR10 proteins. So far, food triggering EoE can only be identified by an elimination diet and following reintroduction controlled by endoscopy and histology. Further research is required to elucidate the role of allergens in the pathogenesis of EoE and develop appropriate tools for diagnostic and specific treatment. PMID:24603377

Simon, Dagmar; Straumann, Alex; Simon, Hans-Uwe

2014-01-01

224

Surgical treatments for esophageal cancers.  

PubMed

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy. PMID:25266029

Allum, William H; Bonavina, Luigi; Cassivi, Stephen D; Cuesta, Miguel A; Dong, Zhao Ming; Felix, Valter Nilton; Figueredo, Edgar; Gatenby, Piers A C; Haverkamp, Leonie; Ibraev, Maksat A; Krasna, Mark J; Lambert, René; Langer, Rupert; Lewis, Michael P N; Nason, Katie S; Parry, Kevin; Preston, Shaun R; Ruurda, Jelle P; Schaheen, Lara W; Tatum, Roger P; Turkin, Igor N; van der Horst, Sylvia; van der Peet, Donald L; van der Sluis, Peter C; van Hillegersberg, Richard; Wormald, Justin C R; Wu, Peter C; Zonderhuis, Barbara M

2014-09-01

225

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

NASA Astrophysics Data System (ADS)

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.

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

2014-02-01

226

Characterization of the autofluorescence of normal and tumoral esophageal epithelium cells  

NASA Astrophysics Data System (ADS)

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.

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

2003-10-01

227

Study finds molecular 'signature' for rapidly increasing form of esophageal cancer  

Cancer.gov

During the past 30 years, the number of patients with cancers that originate near the junction of the esophagus and stomach has increased approximately 600 percent in the United States. The first extensive probe of the DNA of these esophageal adenocarcinomas (EACs) has revealed that many share a distinctive mix-up of letters of the genetic code, and found more than 20 mutated genes that had not previously been linked to the disease. The research, led by scientists at Dana-Farber Cancer Institute, the Broad Institute, and other research centers, may offer clues to why EAC rates have risen so sharply.

228

Surgical Treatment of Synchronous Gastric and Esophageal Carcinoma: Case Report and Review of Literature  

PubMed Central

A 65-year-old man was admitted to our hospital because of advanced esophageal squamous cell carcinoma located on the left posterior wall of the lower thoracic esophagus and gastric adenocarcinoma in the antrum. Esophagectomy and distal gastrectomy with two-field lymph node dissection (mediastinum and abdomen) were performed via a left-sided abdominothoracic incision. The remnant gastric was pulled up successfully with the blood supply maintained by the left gastric vessel. He was discharged on the 13th postoperative day without any complications. PMID:25360410

Xie, Songping; Huang, Jie; Kang, Ganjun; Fan, Guohua; Wang, Wei

2013-01-01

229

Esophageal combined carcinomas: Immunohoistochemical and molecular genetic studies  

PubMed Central

Primary esophageal combined carcinoma is very rare. The authors herein report 2 cases. Case 1 was a combined squamous cell carcinoma and small cell carcinoma, and case 2 was a combined squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. Case 1 was a 67-year-old man with complaints of dysphagia. Endoscopic examination revealed an ulcerated tumor in the middle esophagus, and 6 biopsies were obtained. All 6 biopsies revealed a mixture of squamous cell carcinoma and small cell carcinoma. Both elements were positive for cytokeratin, epithelial membrane antigen, and p53 protein, and had high Ki-67 labeling. The small cell carcinoma element was positive for synaptophysin, CD56, KIT, and platelet-derived growth factor-? (PDGFRA), while the squamous cell carcinoma element was not. Genetically, no mutations of KIT and PDGFRA were recognized. The patient died of systemic carcinomatosis 15 mo after presentation. Case 2 was a 74-year-old man presenting with dysplasia. Endoscopy revealed a polypoid tumor in the distal esophagus. Seven biopsies were taken, and 6 showed a mixture of squamous cell carcinoma, small cell carcinoma, and adenocarcinoma. The 3 elements were positive for cytokeratins, epithelial membrane antigen, and p53 protein, and had high Ki-67 labeling. The adenocarcinoma element was positive for mucins. The small cell carcinoma element was positive for CD56, synaptophysin, KIT, and PDGFRA, but the other elements were not. Mutations of KIT and PDGFRA were not recognized. The patient died of systemic carcinomatosis 7 mo after presentation. These combined carcinomas may arise from enterochromaffin cells or totipotential stem cell in the esophagus or transdifferentiation of one element to another. A review of the literature was performed. PMID:22509088

Terada, Tadashi; Maruo, Hirotoshi

2012-01-01

230

47 CFR 11.31 - EAS protocol.  

Code of Federal Regulations, 2011 CFR

...COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements ...indicates the geographic area affected by the EAS alert. There may be 31 Location codes in an EAS alert. The Location code uses the...

2011-10-01

231

47 CFR 11.31 - EAS protocol.  

Code of Federal Regulations, 2010 CFR

...COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements ...indicates the geographic area affected by the EAS alert. There may be 31 Location codes in an EAS alert. The Location code uses the...

2010-10-01

232

47 CFR 11.31 - EAS protocol.  

Code of Federal Regulations, 2013 CFR

...COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements ...indicates the geographic area affected by the EAS alert. There may be 31 Location codes in an EAS alert. The Location code uses the codes...

2013-10-01

233

47 CFR 11.31 - EAS protocol.  

Code of Federal Regulations, 2012 CFR

...COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements ...indicates the geographic area affected by the EAS alert. There may be 31 Location codes in an EAS alert. The Location code uses the codes...

2012-10-01

234

Efficacy of Intensity Modulated Radiation Therapy After Surgery in Early Stage of Esophageal Carcinoma;  

ClinicalTrials.gov

Esophageal Neoplasm; Esophageal Cancer TNM Staging Primary Tumor (T) T2; Esophageal Cancer TNM Staging Primary Tumor (T) T3; Esophageal Cancer TNM Staging Regional Lymph Nodes (N) N0; Esophageal Cancer TNM Staging Distal Metastasis (M) M0

2012-12-28

235

Feeding difficulties in children with esophageal atresia: treatment by a multidisciplinary team.  

PubMed

Esophageal atresia (EA) is one of the congenital neonatal anomalies whose immediate consequence for the newborn is the inability to feed. Most centers strive to minimize the effects of surgeries and subsequent postoperative complications such as esophageal strictures, respiratory problems, and gastrointestinal reflux on the child's ability or motivation to feed. Feeding difficulties in early infancy may not only interrupt maternal expectations of becoming providers of nutrition to their infants but may also influence the infant's development of sensory motor skills and parent-child relationships. Early involvement by a multidisciplinary team consisting of occupational therapist, nutritionist, and psychologist is an important addition to the surgical and medical team. The team assists in preparing mothers for feeding-related difficulties, providing anticipatory guidance to improve feeding abilities and relationships, especially for children with multiple surgical involvements and prolonged periods of non-oral feeding. PMID:23679033

Ramsay, M; Birnbaum, R

2013-01-01

236

Physiology of Normal Esophageal Motility  

PubMed Central

The esophagus consists of two different parts. In humans, the cervical esophagus is composed of striated muscles and the thoracic esophagus is composed of phasic smooth muscles. The striated muscle esophagus is innervated by the lower motor neurons and peristalsis in this segment is due to sequential activation of the motor neurons in the nucleus ambiguus. Both primary and secondary peristaltic contractions are centrally mediated. The smooth muscle of esophagus is phasic in nature and is innervated by intramural inhibitory (nitric oxide releasing) and excitatory (acetylcholine releasing) neurons that receive inputs from separate sets of preganglionic neurons located in the dorsal motor nucleus of vagus. The primary peristalsis in this segment involves both central and peripheral mechanisms. The primary peristalsis consist of inhibition (called deglutitive inhibition) followed by excitation. The secondary peristalsis is entirely due to peripheral mechanisms and also involves inhibition followed by excitation. The lower esophageal sphincter (LES) is characterized by tonic muscle that is different from the muscle of the esophageal body. The LES, like the esophageal body smooth muscle, is also innervated by the inhibitory and excitatory neurons. The LES maintains tonic closure due to its myogenic property. The LES tone is modulated by the inhibitory and the excitatory nerves. Inhibitory nerves mediate LES relaxation and the excitatory nerves mediate reflex contraction or rebound contraction of the LES. Clinical disorders of esophageal motility can be classified on the basis of disorders of the inhibitory and excitatory innervations and the smooth muscles. PMID:18364578

Goyal, Raj K; Chaudhury, Arun

2009-01-01

237

Pathological characteristics of esophageal cancer  

PubMed Central

The pathological characteristics of esophageal squamous cell carcinoma, which include regularly occurring multiple carcinogenic lesions (MLs), severe dysplasia (SD) and direct intramural infiltration (DI), were investigated using large pathological sections. A total of 52 esophageal cancer patients underwent surgical resection and were diagnosed with esophageal squamous cell carcinoma. Large sections of the surgical resection specimens were then made for pathological examination. The actual length of the carcinoma was calculated during surgery from the length determined microscopically. ML, SD and DI were identified during pathological examination of the large sections by microscope and were statistically analyzed. The lesion lengths obtained by the various inspection methods differed from each other. ML, SD and DI were identified in 15, 28 and 41 patients, respectively. Furthermore, a higher incidence of DI was observed in patients with lymphatic infiltration or those with a later stage of disease. ML, SD and DI were identified as characteristics of esophageal squamous cell carcinoma, and ML and DI were found to correlate with lymphatic infiltration. PMID:25013466

SHI, HONG-YUN; ZHU, SHU-CHAI; SHEN, WEN-BIN; LIU, MIAO-LING

2014-01-01

238

Surgical Management of Esophageal Carcinoma  

Microsoft Academic Search

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

CAROLYN E. REED

239

Treatment of localized esophageal cancer  

Microsoft Academic Search

The treatment of localized esophageal cancer (LEC) is controversial. The approaches that are used in daily practice include surgery or radiation alone, preoperative or postoperative radiation, preoperative or postoperative chemotherapy, and definitive or preoperative chemoradiation. The varied modalities used to treat LEC reflect both the lack of randomized trial data and the suboptimal results with current therapy. Nonetheless, the available

Baruch Brenner; David H. Ilson; Bruce D. Minsky

2004-01-01

240

[Acute necrotizing esophagitis. Case report].  

PubMed

Acute necrotizing esophagitis, also known as black esophagus, represents an extremely rare clinical entity, defined by the black pigmentation of the esophagus, secondary to necrosis of the mucosa and detected at endoscopy. We present a clinical case of this rare disease, with its manifestation, diagnosis, treatment, and we perform a review of the literature. PMID:23940914

Pierini, Angel; Imhof, Hugo; Burlando, Eduardo; Gianinetti, Leonardo; Pierini, Leandro

2013-06-01

241

Role of Proton Pump Inhibitor on Esophageal Carcinogenesis and Pancreatic Acinar Cell Metaplasia Development: An Experimental In Vivo Study  

PubMed Central

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

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

242

Proton Beam Therapy and concurrent chemotherapy for esophageal cancer  

PubMed Central

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

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

243

Expression and clinical significance of Glucose Regulated Proteins GRP78 (BiP) and GRP94 (GP96) in human adenocarcinomas of the esophagus  

Microsoft Academic Search

BACKGROUND: Glucose regulated proteins (GRPs) are main regulators of cellular homeostasis due to their role as molecular chaperones. Moreover, the functions of GRPs suggest that they also may play important roles in cancer biology. In this study we investigated the glucose regulated proteins GRP78 (BiP) and GRP94 (GP96) in a series of human esophageal adenocarcinomas to determine their implications in

Rupert Langer; Marcus Feith; Joerg-Ruediger Siewert; Hans-Juergen Wester; Heinz Hoefler

2008-01-01

244

Mechanics and hemodynamics of esophageal varices during peristaltic contraction  

E-print Network

Mechanics and hemodynamics of esophageal varices during peristaltic contraction Larry S. Miller,1 Ahmed, and James G. Brasseur. Mechanics and hemodynamics of esophageal varices dur- ing peristaltic hypothesis states that variceal pressure and wall tension increase dramatically during esophageal peristaltic

Brasseur, James G.

245

Plasmacytoid adenocarcinoma of the lung.  

PubMed

Plasmacytoid adenocarcinoma of the lung has not been reported. Herein reported is the first case of plasmacytoid adenocarcinoma of the lung. A 68-year-old man presented with cough and sputum. X-P and CT demonstrated a large tumor (10 x 10 x 9 cm) in the right upper lobe. CT-guided needle biopsy was performed. The biopsy showed plasmacytoid malignant cells. The malignant cells were small, had eccentrically located nuclei, perinuclear halo, and basophilic cytoplasm. No mucins were observed by mucins stains. Immunohistochemical study showed that the tumor cells were positive for pancytokeratin AE1/3, pancytokeratin CAM5.2, TTF-1, Ki-67 (labeling 70%), CA19-9, and p53. They were negative for neuron specific enolase, CEA, CD45, CD68, chromogranin, synaptophysin, surfactant apoprotein A, CDX-2, ?-chain, ?-chain, KIT, and PDGFRA. Since epithelial markers and adenocarcinoma markers were positive, the pathological diagnosis was plasmacytoid adenocarcinoma of lung. The patient is now treated with chemotherapy. PMID:22670180

Terada, Tadashi

2012-01-01

246

Obesity and outcomes in patients treated with chemoradiotherapy for esophageal carcinoma.  

PubMed

Body mass index (BMI) is a risk factor for comorbid illnesses and cancer development. It was hypothesized that obesity status affects disease outcomes and treatment-related toxicities in esophageal cancer patients treated with chemoradiotherapy (CRT). From March 2002 to April 2010, 405 patients with non-metastatic esophageal carcinoma at MD Anderson Cancer Center treated with either definitive or neoadjuvant CRT were retrospectively analyzed. Patients were categorized as either obese (BMI ? 25?kg/m(2) ) or nonobese (BMI < 25?kg/m(2) ). Progression-free survival and overall survival times were examined using the Kaplan-Meier method and Cox proportional hazards regression analysis. One hundred fifteen (28.4%) patients were classified as nonobese and 290 (71.6%) as obese. Obese patients were more likely than others to have several comorbid diseases (P < 0.001), adenocarcinoma located distally (P < 0.001), and have undergone surgery (P = 0.004). Obesity was not associated with either worse operative morbidity/mortality (P > 0.05) or worse positron emission tomography tumor response (P = 0.46) on univariate analysis, nor with worse pathologic complete response (P = 0.98) on multivariate analysis. There was also no difference in overall survival, locoregional control, or metastasis-free survival between obese and nonobese patients (P = 0.86). However, higher BMI was associated with reduced risk of chemoradiation-induced high-grade esophagitis (P = 0.021), esophageal stricture (P < 0.001), and high-grade hematologic toxicity (P < 0.001). In esophageal cancer patients treated with CRT, obesity is not predictive of poorer disease outcomes or operative morbidities; instead, data suggest it may be associated with decreased risk of acute chemotherapy- and radiotherapy-related treatment toxicities. PMID:23621168

Wang, J; Myles, B; Wei, C; Chang, J Y; Hofstetter, W L; Ajani, J A; Swisher, S G; Cox, J D; Komaki, R; Liao, Z; Lin, S H

2014-01-01

247

Radiation-induced esophageal injury: A spectrum from esophagitis to cancer  

Microsoft Academic Search

Radiation esophagitis is a common but frequently unrecognized complication of therapeutic radiation to the neck, chest, or mediastinum. The spectrum of injury ranges from acute self-limited esophagitis to life-threatening esophageal perforation. Complications such as stricture or primary esophageal cancer may occur many years after irradiation, and their linkage to radiation may not be considered. Five cases of radiation-induced injury are

A. Vanagunas; P. Jacob; E. Olinger

1990-01-01

248

Esophageal wall blood perfusion during contraction and transient lower esophageal sphincter relaxation in humans  

PubMed Central

We recently reported that esophageal contraction reduces esophageal wall perfusion in an animal study. Our aim was to determine esophageal wall blood perfusion (EWBP) during esophageal contraction and transient lower esophageal sphincter relaxations (TLESRs) in humans. We studied 12 healthy volunteers. A custom-designed laser Doppler probe was anchored to the esophageal wall, 4–6 cm above the LES, by use of the Bravo pH system so that the laser light beam stay directed toward the esophageal mucosa. A high-resolution manometry equipped with impedance electrodes recorded esophageal pressures and reflux events. Synchronized pressure, impedance, pH, and EWBP recordings were obtained during dry and wet swallows and following a meal. Stable recordings of laser Doppler EWBP were only recorded when the laser Doppler probe was firmly anchored to the esophageal wall. Esophageal contractions induced by dry and wet swallows resulted in 46 ± 9% and 60 ± 10% reduction in the EWBP, respectively (compared to baseline). Reduction in EWBP was directly related to the amplitude (curvilinear fit) and duration of esophageal contraction. Atropine reduced the esophageal contraction amplitude and decreased the EWBP reduction associated with esophageal contraction. TLESRs were also associated with reduction in the EWBP, albeit of smaller amplitude (29 ± 3%) but longer duration (19 ± 2 s) compared with swallow-induced esophageal contractions. We report 1) an innovative technique to record EWBP for extended time periods in humans and 2) contraction of circular and longitudinal muscle during peristalsis and selective longitudinal muscle contraction during TLESR causes reduction in the EWBP; 3) using our innovative technique, future studies may determine whether esophageal wall ischemia is the cause of esophageal pain/heartburn. PMID:22790599

Jiang, Yanfen; Bhargava, Valmik; Kim, Young Sun

2012-01-01

249

Pneumatic dilatation in patients with symptomatic diffuse esophageal spasm and lower esophageal sphincter dysfunction  

Microsoft Academic Search

Nine patients with severe symptoms of diffuse esophageal spasm and lower esophageal sphincter dysfunction who were unresponsive to medical therapy and bougienage dilatation were treated by forceful pneumatic dilatation. Treatment with pneumatic dilatation in eight of the nine patients produced a marked improvement in dysphagia and regurgitation (average follow-up of 37.4 months). Esophageal motility performed up to three years (average

E. C. Ebert; A. Ouyang; S. H. Wright; S. Cohen; W. H. Lipshutz

1983-01-01

250

Current Management of Cervical Esophageal Cancer  

Microsoft Academic Search

Background  Pharyngo-laryngo-esophagectomy (PLE) has been regarded as a standard treatment for cervical esophageal cancer, but the morbidity\\u000a and mortality rates associated with PLE are substantial. Chemoradiation (CTRT) is widely used to treat esophageal cancer;\\u000a however, its role in managing cervical esophageal cancer has not been fully elucidated. It was hypothesized that up-front\\u000a CTRT could be an effective alternative treatment option to

Daniel King Hung Tong; Simon Law; Dora Lai Wan Kwong; William I. Wei; Raymond Wai Man Ng; Kam Ho Wong

2011-01-01

251

Esophageal leiomyoma detected by transesophageal contrast echocardiography.  

PubMed

Transesophageal echocardiography (TEE) provides valuable information in the evaluation of intra- and extracardiac masses. There is no report demonstrating its usefulness in identifying esophageal mass lesions. This is because generally it is contraindicated in patients with esophageal diseases. However, endoscopic ultrasound is used in the evaluation of gastrointestinal pathology. We report a case of an esophageal tumor detected by TEE and the value of contrast echocardiography in further definition of the tumor. PMID:18177392

Meng, Hong; Lee, Pui Wai; Mathieu, Bernier; Chandrasekaran, Krishnaswamy

2008-03-01

252

Radiation esophagitis: Predictive factors and preventive strategies.  

PubMed

Radiation esophagitis remains the primary dose-limiting acute toxicity in the radiotherapeutic management of thoracic neoplasms. Improved understanding of this toxicity will facilitate dose escalation and enhancement of the therapeutic ratio. This article reviews the predictive factors and preventive strategies for radiation esophagitis. In particular, clinical and dosimetric studies predicting the risk of radiation esophagitis are analyzed. The critical impact of chemotherapy on radiation esophagitis is characterized. Preventive strategies to minimize this toxicity also are explored. Overall, this article reviews the current understanding of radiation toxicity for the esophagus. PMID:15558501

Bradley, Jeffrey; Movsas, Benjamin

2004-10-01

253

Brain abscess after esophageal dilatation: case report.  

PubMed

Brain abscess formation is a serious disease often seen as a complication to other diseases and to procedures. A rare predisposing condition is dilatation therapy of esophageal strictures. A case of brain abscess formation after esophageal dilatations is presented. A 59-year-old woman was admitted with malaise, progressive lethargy, fever, aphasia and hemiparesis. Six days before she had been treated with esophageal dilatation for a stricture caused by accidental ingestion of caustic soda. The brain abscess was treated with surgery and antibiotics. She recovered completely. This clinical case illustrates the possible association between therapeutic esophageal dilatation and the risk of brain abscess formation. PMID:17710371

Gaïni, S; Grand, M; Michelsen, J

2008-02-01

254

Pathophysiology of Portal Hypertension and Esophageal Varices  

PubMed Central

Esophageal varices are the major complication of portal hypertension. It is detected in about 50% of cirrhosis patients, and approximately 5–15% of cirrhosis patients show newly formed varices or worsening of varices each year. The major therapeutic strategy of esophageal varices consists of primary prevention, treatment for bleeding varices, and secondary prevention, which are provided by pharmacological, endoscopic, interventional and surgical treatments. Optimal management of esophageal varices requires a clear understanding of the pathophysiology and natural history. In this paper, we outline the current knowledge and future prospect in the pathophysiology of esophageal varices and portal hypertension. PMID:22666604

Maruyama, Hitoshi; Yokosuka, Osamu

2012-01-01

255

Esophageal motility abnormalities in gastroesophageal reflux disease.  

PubMed

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

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

2014-05-01

256

The use of neural networks in identifying risk factors for lymph node metastasis and recommending management of t1b esophageal cancer.  

PubMed

The objective of this study was to establish a prediction model of lymph node status in T1b esophageal carcinoma and define the best squamous and adenocarcinoma predictors. The literature lacks a satisfactory level of evidence of T1b esophageal cancer management. We performed an analysis pooling the effects of outcomes of 2098 patients enrolled into 37 retrospective studies using "neural networks" as data mining techniques. The percentages for lymph node, lymphatic (L+), and vascular (V+) invasion in Sm1 esophageal cancers were 24, 46, and 20 per cent, respectively. The same parameters apply to Sm2 with 34, 63, and 38 per cent as opposed to Sm3 with 51, 69, and 47 per cent. The respective number of patients with well, moderate, and poor histologic differentiation totaled 267, 752, and 582. The rank order of the predictors of lymph node positivity was, respectively: Grade III, (L+), (V+), Sm3 invasion, Sm2 invasion, and Sm1 invasion. Histologic-type squamous and adenocarcinoma (ADC/SCC) was not included in the model. The best predictors for SCC lymph node positivity were sm3 invasion and (V+). As concerns ADC, the most important predictor was (L+). Submucosal esophageal cancer should be managed with surgical resection. However, this is subject to the histologic type and presence of specific predictors that could well alter the perspective of multimodality management. PMID:22369829

Sgourakis, George; Gockel, Ines; Lyros, Orestis; Lanitis, Sophocles; Dedemadi, Georgia; Polotzek, Ursula; Karaliotas, Constantine; Lang, Hauke

2012-02-01

257

Management of Esophageal Variceal Bleeding  

Microsoft Academic Search

\\u000a Esophageal variceal bleeding is a potentially life-threatening complication of portal hypertension. One-third of cirrhotic\\u000a patients with documented varices bleed within 2 years from the time of initial diagnosis. Mortality rates from an initial\\u000a episode of bleeding are 20–35% and approximately 30% with each additional episode of bleeding. Risk factors for acute bleeding\\u000a episodes include advanced cirrhosis, large or proximal extension

Keki Balsara; Lisa Pickett

258

Radiation-induced esophageal carcinoma  

Microsoft Academic Search

Radiation-induced carcinoma of the esophagus is rare and only 8 cases have been reported since 1957. This article presents 2 additional patients in whom esophageal carcinoma developed in segments previously exposed to large therapeutic doses of irradiation. The first patient had received 5,000 rads to her mediastinum and the second patient 3,200 rads to her neck region. The latent intervals

Elizabeth W. O'Connell; William B. Seaman; Gary G. Ghahremani

1984-01-01

259

Esophageal schwannoma: a case report  

PubMed Central

Most tumorous lesions of the esophagus are esophageal cancers. Benign primary tumors of the esophagus are uncommon, and account for approximately 2% of all esophageal tumors. More than 80% of benign esophageal tumors are leiomyomas, with schwannomas being rare. A 55-year-old woman visited our internal medicine department with complaints of palpitations and discomfort during swallowing. A chest computed tomography scan showed a lobulated tumor (75 × 57 × 80 mm) in the upper to middle mediastinum, with homogenous inner opacity, compressing the esophagus. Upper gastrointestinal endoscopy revealed a smooth-surfaced elevated lesion covered with normal mucosa, and a schwannoma was diagnosed based on the biopsy result. The tumor was large. It was thus considered to be difficult to repair the esophagus by direct anastomosis after tumor resection. Therefore, subtotal esophagectomy and esophagogastrostomy in the right thorax were performed. Histopathological examination revealed spindle-shaped cells in a fasciculated and disarrayed architecture and nuclei in a palisading pattern. Immunohistochemical studies revealed S100 protein positivity and the absence of staining for ? smooth muscle actin (?SMA), CD34 and CD117, thereby establishing the diagnosis of benign schwannoma. Her postoperative course was uneventful and there has been no evidence of recurrence to date. PMID:24088647

2013-01-01

260

Pharmacologic influence on esophageal varices  

SciTech Connect

Selective catherization of the left gastric vein was performed after percutaneous transhepatic portography (PTP) in patients with portal hypertension and esophageal varices. Following the hypothesis that drugs increasing the lower esophageal sphincter (LES) pressure may obstruct the variceal blood flow throught the lower esophagus, the effect of different drugs (i.e., intravenous injection of vasopressin, pentagastrin, domperidone and somatostatin and subcutaneous injection of metacholine) on the variceal blood flow was examined. Vasopressin did not change the variceal blood flow; pentagastrine, with its known effect of increasing the LES pressure produced a total interruption of the flow in four of eight patients; domperiodone, also known to increase the LES pressure obstructed the variceal blood flow in the only patient examined with this drug; somatostatin has no reported action on the LES but blocked the flow in one of two patients; and metacholine, reported to increase the LES pressure did not produce any change in the flow in the three patients examined. LES pressure was recorded before and during vasopressin infusion in seven patients with portal hypertension and esophageal varices. No reaction on the pressure was found. The patient number in the study is small and the results are nonuniform but still they suggest that drugs increasing the LES tonus might be useful to control variceal blood flow.

Lunderquist, A.; Owman, T.; Alwmark, A.; Gullstrand, P.; Hall-Angeras, M.; Joelsson, B.; Tranberg, K.G.; Pettersson, K.I.

1983-06-01

261

Endotracheal metastases from colon adenocarcinoma  

Microsoft Academic Search

Endotracheal metastases (ETM) from non-lung cancer are seldom seen. Their main clinical symptoms are cough, haemoptysis and\\u000a dyspnoea, although occasionally an incidental finding is made during a bronchoscopy. Breast, colon and kidney adenocarcinoma\\u000a might be associated with ETM, lung cancer being the most frequent cause. Its finding is associated with advanced disease but\\u000a survival will depend on the primary origin,

José M. Galbis Caravajal; Jesús G. Sales Badía; Carlos Trescolí Serrano; Pedro Cordero Rodríguez; Carlos Jordá Aragón; Elsa Naval Sendra

2008-01-01

262

De Novo Deletion of Chromosome 20q13.33 in a Patient with Tracheo-esophageal Fistula, Cardiac Defects and Genitourinary Anomalies Implicates GTPBP5 as a Candidate Gene  

PubMed Central

BACKGROUND Tracheo-esophageal fistula (TEF) with/or without esophageal atresia (EA) is a common congenital malformation that is often accompanied by other anomalies. The causes of this condition are thought to be heterogeneous but are overall not well understood. CASE REPORT We identified a patient with a TEF/EA, as well as cardiac and genitourinary anomalies, who was found to have a 0.7 Mb de novo deletion of chromosome 20q13.33. One gene within the deleted interval, GTPBP5, is of particular interest as a candidate gene. CONCLUSIONS GTPBP5 bears further study as a cause of TEF/EA accompanied by other malformations. Birth Defects Research (Part A) 2011. © 2011 Wiley-Liss, Inc. PMID:21608104

Solomon, Benjamin D; Pineda-Alvarez, Daniel E; Hadley, Donald W; Keaton, Amelia A; Agochukwu, Nneamaka B; Raam, Manu S; Carlson-Donohoe, Hannah E; Kamat, Aparna; Chandrasekharappa, Settara C

2011-01-01

263

Epidemiological studies of esophageal cancer in the era of genome-wide association studies  

PubMed Central

Esophageal cancer (EC) caused about 395000 deaths in 2010. China has the most cases of EC and EC is the fourth leading cause of cancer death in China. Esophageal squamous cell carcinoma (ESCC) is the predominant histologic type (90%-95%), while the incidence of esophageal adenocarcinoma (EAC) remains extremely low in China. Traditional epidemiological studies have revealed that environmental carcinogens are risk factors for EC. Molecular epidemiological studies revealed that susceptibility to EC is influenced by both environmental and genetic risk factors. Of all the risk factors for EC, some are associated with the risk of ESCC and others with the risk of EAC. However, the details and mechanisms of risk factors involved in the process for EC are unclear. The advanced methods and techniques used in human genome studies bring a great opportunity for researchers to explore and identify the details of those risk factors or susceptibility genes involved in the process of EC. Human genome epidemiology is a new branch of epidemiology, which leads the epidemiology study from the molecular epidemiology era to the era of genome wide association studies (GWAS). Here we review the epidemiological studies of EC (especially ESCC) in the era of GWAS, and provide an overview of the general risk factors and those genomic variants (genes, SNPs, miRNAs, proteins) involved in the process of ESCC. PMID:25133033

Wang, An-Hui; Liu, Yuan; Wang, Bo; He, Yi-Xuan; Fang, Ye-Xian; Yan, Yong-Ping

2014-01-01

264

Baseline nutritional status is prognostic factor after definitive radiochemotherapy for esophageal cancer.  

PubMed

Identify prognostic factors for survival and patterns of treatment failure after definitive radiochemotherapy for esophageal cancer. Between 2003 and 2006, 143 patients with squamous cell carcinoma and adenocarcinoma of the esophagus were retrospectively reviewed. Median age was 65 years (42-81). Median radiation dose was 62.5?Gy (38-72) with 1.8-2?Gy fraction. Median follow-up was 20.8 months (2.8-92.4). Three and 5-year local recurrence-free survival rates were 58.3% and 50.9%. In univariate analysis, traversable esophageal stricture was a prognostic factor. Three, 5-year locoregional recurrence-free survival rates were 42.4% and 34.9%. In multivariate analysis, traversable esophageal stricture and stage < IIB were independent prognostic factors. Three and 5-year disease-free survival rates were 30.5% and 25.9%. In multivariate analysis, Nutritional Risk Index (NRI) ? 97.5 and performance status (PS) = 0 were independent prognostic factors. Median, 3, and 5-year overall survival rates were 22.1 months, 34.4%, and 19.8%. In multivariate analysis, independent prognostic factors were NRI ? 97.5 and PS = 0. Median survival times for the NRI classes (no denutrition, moderate and severe denutrition) were 29.5, 19.7, and 12 months (P = 0.0004), respectively. A major impact of baseline NRI was found in terms of survival; it should be included in future prospective trials. PMID:23106980

Clavier, J-B; Antoni, D; Atlani, D; Ben Abdelghani, M; Schumacher, C; Dufour, P; Kurtz, J-E; Noel, G

2014-08-01

265

Ingestion of thioproline suppresses rat esophageal adenocarcinogenesis caused by duodenogastroesophageal reflux.  

PubMed

Duodenogastroesophageal reflux causes esophageal adenocarcinoma in rats without the use of a carcinogen. This etiology is unclear, but may be associated with endogenous nitrosation in the gastrointestinal tract. Thioproline (TPRO) is an effective nitrite-trapping agent and blocks endogenous nitrosation. We investigated how ingested TPRO affected esophageal adenocarcinogenesis in rats with duodenogastroesophageal reflux (DGER) or gastroesophageal reflux (GER). A series of 200 male Fischer 344 rats received surgery to induce reflux of duodenogastric contents or gastric contents alone into the esophagus. The rats were separated into two divisions according to the surgical procedure employed (DGER or GER), and each division was further subdivided into two groups: one group was fed a special diet (CRF-1 containing 0.5% of TPRO); the other group was fed a standard diet (CRF-1). The rats were given no carcinogen and sacrificed at ten-week intervals from the 25th to the 45th week after surgery. Pathological examination was carried out using hematoxylin-eosin or immunohistochemical staining. Erosion, regenerative thickening, basal cell hyperplasia and columnar-lined epithelium (CLE) were found in both groups of the DGER rats. Adenocarcinoma (AC) appeared only in the DGER rats sacrificed at 35 and 45 weeks following surgery. The incidence of AC at the 45th week was significantly lower in the group of rats fed the diet containing TPRO, as compared to those fed the standard diet, whereas the incidences of CLE were the same for both groups. iNOS protein and nitrotyrosine protein were identified in the CLE and macrophages of the DGER group using immunohistochemical staining. There were no remarkable pathological changes in the esophagi of the rats which underwent the GER procedure. In conclustion, TPRO has an inhibitory effect on esophageal reflux-induced adenocarcinogenesis in rats in that it prevents the progression from CLE to AC. PMID:17982628

Sasaki, Shozo; Miwa, Koichi; Fujimura, Takashi; Oba, Masaru; Miyashita, Tomoharu; Kinami, Shinichi

2007-12-01

266

Expression of COX2 and p53 in Rat Esophageal Cancer Induced by Reflux of Duodenal Contents  

PubMed Central

Aim. Reflux of duodenal contents can induce mucosal injury, stimulate cell proliferation, and promote tumorigenesis. We examined the expression of COX2 and p53 in rat esophageal lesions induced by duodenal content reflux. Methods. Thirty 8-week-old male Wistar rats were exposed to duodenal content esophageal reflux. All animals underwent an esophagoduodenal anastomosis (EDA) with total gastrectomy in order to produce chronic esophagitis. Ten rats were the sham. Control. They were sacrificed at the 40th week. Their esophagi were examined for HE, COX2, p53, and proliferating cell nuclear antigen (PCNA). Results. After 40 weeks of reflux, dysplasia, squamous cell carcinoma (SCC), and adenocarcinoma (ADC) were found. PCNA labeling index was higher in dysplastic and cancer tissue than that in normal. Overexpression of COX2 was shown in ADC and SCC. Wild-type p53 accumulation was found in ADC, and not in SCC. Conclusion. Reflux of duodenal contents into the esophagus led to ADC and SCC in rats. COX2 may play an important role in esophageal cancer by duodenal content reflux. Our present results suggest an association between wild-type p53 accumulation and COX2 expression in ADC, with no such relation seen in SCC. PMID:22272378

Hashimoto, Naoki

2012-01-01

267

Videoendoscopic diagnosis of esophageal motility disorders  

Microsoft Academic Search

Background: Esophageal motility disorders are usually diagnosed by manometry. We evaluated videoendoscopy as a diagnostic test. Methods: In this study, 20 patients with achalasia, 13 with scleroderma, and 33 control subjects had a standard endoscopic examination followed by protocol videotaping of swallows to observe contractions in the esophagus and in the lower esophageal sphincter. Tapes were later reviewed by 2

Alan J. Cameron; Allison Malcolm; Charlene M. Prather; Sidney F. Phillips

1999-01-01

268

CONCURRENT CHEMORADIATION FOR ESOPHAGEAL CARCINOMA: PRELIMINARY RESULTS  

Microsoft Academic Search

Despite all advances, treatment of esophageal carcinoma is still unsatisfactory. Currently the standard non-surgical treatment of esophageal cancer is concurrent chemotherapy and radiotherapy (chemoradiation), with results comparable to best surgical series. A few years ago, we started a chemoradiation protocol for the cancer of esophagus as a curative treatment, of which we present the preliminary results here. Files of all

P. Haddad; F. Amouzgar-Hashemi

269

Esophageal Cancer: A Review and Update  

Microsoft Academic Search

Although significant advancements have been made in the treatment of esophageal cancer, this aggressive malignancy commonly presents as locally advanced disease with a poor prognosis. Despite improvements in the detection of premalignant pathology, newer preventative strate- gies, and the development of more effective combination therapies, the overall incidence of esophageal carcinomas has risen. A clear association has been established between

JOHN C. LAYKE; DeWitt Daughtry

2006-01-01

270

Exclusively Endoscopic Resection of Nasopharyngeal Adenocarcinoma  

PubMed Central

We reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach. Case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma. The tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary. The two patients were followed up for 26 and 18 months respectively, and no recurrence was noted without postoperative chemotherapy or radiotherapy. To the best of our knowledge, this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma. Our experience revealed that not only for the early recurrent nasopharyngeal carcinoma, the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma. PMID:24353869

Lai, Yu-Shih

2013-01-01

271

Survival Effect of Neoadjuvant Radiotherapy Before Esophagectomy for Patients With Esophageal Cancer: A Surveillance, Epidemiology, and End-Results Study  

SciTech Connect

Purpose: The role of neoadjuvant radiotherapy (NeoRT) before definitive surgery for esophageal cancer remains controversial. This study used a large population-based database to assess the effect of NeoRT on survival for patients treated with definitive surgery. Methods and Materials: The overall survival (OS) and cause-specific survival for patients with Stage T2-T4, any N, M0 (cT2-T4M0) esophageal cancer who had undergone definitive surgery between 1998 and 2004 were analyzed by querying the Surveillance, Epidemiology, and End-Results database. Kaplan-Meier survival curves were generated and univariate comparisons were made using the log-rank test. Cox proportional hazards survival regression multivariate analysis was performed with NeoRT, T stage (T2 vs. T3-T4), pathologic nodal status (pN0 vs. pN1), number of nodes dissected (>10 vs. {<=}10), histologic type (adenocarcinoma vs. squamous cell carcinoma), age (<65 vs. {>=}65 years), and gender as covariates. Results: A total of 1,033 patients were identified. Of these, 441 patients received NeoRT and 592 underwent esophagectomy alone; 77% were men, 67% had adenocarcinoma, and 72% had Stage T3-T4 disease. The median OS and cause-specific survival were both significantly greater for patients who received NeoRT compared with esophagectomy alone (27 vs. 18 months and 35 vs. 21 months, respectively, p <0.0001). The 3-year OS rate was also significantly greater in the NeoRT group (43% vs. 30%). On multivariate analysis, NeoRT, age <65 years, adenocarcinoma histologic type, female gender, pN0 status, >10 nodes dissected, and Stage T2 disease were all independently correlated with increased OS. Conclusion: These results support the use of NeoRT for patients with esophageal cancer. Prospective studies are needed to confirm these results.

Schwer, Amanda L. [Department of Radiation Oncology, University of Colorado Health Sciences Center, Aurora, Colorado (United States)], E-mail: amanda.schwer@uchsc.edu; Ballonoff, Ari; McCammon, Robert; Rusthoven, Kyle [Department of Radiation Oncology, University of Colorado Health Sciences Center, Aurora, Colorado (United States); D'Agostino, Ralph B. [Department of Biostatistical Science, Wake Forest University School of Medicine, Winston-Salem, NC (United States); Schefter, Tracey E. [Department of Radiation Oncology, University of Colorado Health Sciences Center, Aurora, Colorado (United States)

2009-02-01

272

Association of esophageal candidiasis and squamous cell carcinoma  

PubMed Central

Chronic esophageal candidiasis is an infection that is mostly seen in immunocompromised conditions, among which is chronic mucocutaneous candidiasis (CMC). Recently an association between CMC and esophageal carcinoma has been reported. Here we present two patients with chronic esophageal candidiasis who developed esophageal squamous cell carcinoma and we discuss the etiologic role of Candida-induced nitrosamine production, the loss of STAT1 function and impaired tumor surveillance and T-lymphocyte function in the development of esophageal carcinoma. PMID:24371724

Delsing, C.E.; Bleeker-Rovers, C.P.; van de Veerdonk, F.L.; Tol, J.; van der Meer, J.W.M.; Kullberg, B.J.; Netea, M.G.

2012-01-01

273

[Non-neoplastic esophageal stenosis: not always so benign].  

PubMed

Esophageal intramural pseudodiverticulosis is a rare pathology whose etiology is unknown, but which is frequently associated with three highly prevalent entities: esophageal reflux disease, esophageal candidosis and alcoholic esophagitis. With conservative treatment the course of these pathologies is usually benign. However, some severe cases are resistant to conservative treatment and may require more aggressive management. We here present the case of patient suffering from a severe esophagitis complicated by chronic mediastinitis with life-threatening repercussions, requiring esophagectomy as treatment. PMID:24088236

Lorenz, Julie; Vollenweider, Peter; Vuilleumier, Henri; Schwab, Marcos

2013-10-01

274

Thoracoscopic elongation of the esophagus in long gap esophageal atresia.  

PubMed

Long gap esophageal atresia in which a primary anastomosis cannot be achieved remains a challenge. Elongation of the esophagus by traction on the 2 ends has been previously described. With the advent of thoracoscopic repair of esophageal atresia, there have thus far been no reports of thoracoscopic repair of long gap esophageal atresia. This paper describes the first successful repair of long gap esophageal atresia by thoracoscopic traction of the 2 esophageal ends and delayed thoracoscopic anastomosis. PMID:17923217

van der Zee, David C; Vieirra-Travassos, Daisy; Kramer, William L M; Tytgat, Stefaan H A J

2007-10-01

275

Endoglin Promoter Hypermethylation Identifies a Field Defect in Human Primary Esophageal Cancer  

PubMed Central

Endoglin (ENG) is a 180-kDa transmembrane glycoprotein that functions as a component of the transforming growth factor-? receptor complex. Recently, ENG promoter hypermethylation was reported in several human cancers. We examined ENG promoter hypermethylation using real-time quantitative methylation-specific PCR in 260 human esophageal tissues. ENG hypermethylation showed highly discriminative receiver-operator characteristic curve profiles, clearly distinguishing esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) from normal esophagus (N) (p<0.01). Interestingly, ENG normalized methylation values were significantly higher in ESCC than in N (p<0.01) or EAC (p<0.01). ENG hypermethylation frequency was 46.2% in ESCC and 11.9% in N, but increased early and sequentially during EAC-associated neoplastic progression, to 13.3% in Barrett’s metaplasia (BE), 25% in dysplastic BE (D), and 26.9% in frank EAC. ENG hypermethylation was significantly higher in N from ESCC patients (mean = 0.0186) than in N from EAC patients (mean = 0.0117; p < 0.05). Treatment of KYSE220 ESCC cells with the demethylating agent, 5-aza-2?-deoxycytidine, reversed ENG methylation and reactivated ENG mRNA expression. We conclude that promoter hypermethylation of ENG is a frequent, tissue-specific event in human ESCC and exhibits a field defect with promising biomarker potential for the early detection of ESCC. In addition, ENG hypermethylation occurs in a subset of human EAC, and early during BE-associated esophageal neoplastic progression. PMID:23893879

Jin, Zhe; Zhao, Zhenfu; Cheng, Yulan; Dong, Ming; Zhang, Xiaojing; Wang, Liang; Fan, Xinmin; Feng, Xianling; Mori, Yuriko; Meltzer, Stephen J

2013-01-01

276

Chemotherapy-induced modification of microRNA expression in esophageal cancer.  

PubMed

Neoadjuvant chemotherapy is often used in the treatment of advanced esophageal cancer. In this study, we determined the impact of chemotherapy on microRNA (miRNA) expression in esophageal cancer cells, and whether identified changes might have biological relevance. Two esophageal carcinoma cell lines (one adenocarcinoma and one squamous cell carcinoma) were treated with cisplatin or 5-fluorouracil for 24 or 72 h. RNA was extracted from cells following 24-h treatment, and used for microarray studies. Promising miRNA candidates were selected for RT-PCR validation. Target prediction using TargetScan, combined with bioinformatic analysis (Ingenuity Pathway Analysis, IPA), was performed to evaluate the implications of the altered miRNA expression. Thirteen miRNAs (miR-199a-5p, miR-302f, miR-320a, miR-342-3p, miR-425, miR-455-3p, miR-486-3p, miR-519c-5p, miR-548d-5p, miR-617, miR-758, miR-766, miR-1286) were deregulated after 24- and/or 72-h treatment in both cell lines, and most miRNAs presented similar expression changes after short- or long-term exposure. IPA revealed that the major networks which incorporate the predicted targets, include functions such as 'Cell death', 'Cell cycle', 'Cellular growth and proliferation', 'DNA replication, recombination, and repair' and 'Drug metabolism'. Cisplatin or 5-fluorouracil alter miRNA expression in esophageal cancer cells. IPA suggests that these miRNAs may target molecular pathways involved in cell survival after chemotherapy. PMID:21743970

Hummel, Richard; Wang, Tingting; Watson, David I; Michael, Michael Z; Van der Hoek, Mark; Haier, Joerg; Hussey, Damian J

2011-10-01

277

[Multimodal treatment of esophageal carcinoma].  

PubMed

Despite major progress in clinical diagnostics and therapy, esophageal carcinoma represents a tumor entity with limited prognosis. In case of carcinoma restricted to mucosa endoscopic resection has developed into an important therapeutic method. Surgical resection represents the standard procedure for patients with locally limited (cT1/T2, N0) and advanced carcinoma (cT3, T4, Nx). In multimodal therapy neoadjuvant treatment concepts with chemotherapy or radiochemotherapy for patients with locally advanced tumors are well established. In case of metastatic disease palliative radio- and chemotherapy represent a treatment concept, however therapy efficiency is very limited. This review reflects the current status of multimodal therapy. PMID:25289924

Graf, D; Vallböhmer, D; Knoefel, W T; Budach, W; Häussinger, D

2014-10-01

278

Gestational lung adenocarcinoma: case report.  

PubMed

Gestational cancer is a dramatic situation, with a deep impact on the patient and family, with an overall incidence of 1 per 100 pregnancies. Lung cancers are extremely rare during pregnancy but have become more frequent in past years, as the mean age of pregnancy has increased. The purpose of this case report is to present a gestational lung adenocarcinoma, with metastasis in the liver and ovaries, diagnosed in the third trimester, with a fatal outcome in days after birth through cesarean section. PMID:24771256

Ceau?u, Mihai; Hostiuc, Sorin; Sajin, Maria; Roman, Gheorghe; Nicodin, Ovidiu; Dermengiu, Dan

2014-10-01

279

Villoglandular papillary adenocarcinoma of the uterine cervix  

Microsoft Academic Search

Villoglandular papillary adenocarcinoma of the uterine cervix was recently (1989) described by three main histological features: exophytic proliferation, papillary architecture and mild to moderate cellular atypicality. The authors report a case of villoglandular papillary adenocarcinoma, clinical stage IB, which was peculiar because of its association with a co-existing and simultaneously discovered invasive squamous cell carcinoma. These two patterns were juxtaposed

Pierre Collinet; Jean-François Prolongeau; Sylvie Vaneecloo

1999-01-01

280

47 CFR 11.41 - Participation in EAS.  

Code of Federal Regulations, 2013 CFR

...Participation in EAS. 11.41 Section 11.41 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Organization § 11.41 Participation in EAS. All EAS Participants specified in § 11.11 are...

2013-10-01

281

47 CFR 11.41 - Participation in EAS.  

Code of Federal Regulations, 2012 CFR

...Participation in EAS. 11.41 Section 11.41 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Organization § 11.41 Participation in EAS. All EAS Participants specified in § 11.11 are...

2012-10-01

282

47 CFR 11.41 - Participation in EAS.  

Code of Federal Regulations, 2010 CFR

...Participation in EAS. 11.41 Section 11.41 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Organization § 11.41 Participation in EAS. (a) All EAS Participants specified in § 11.11...

2010-10-01

283

47 CFR 11.41 - Participation in EAS.  

Code of Federal Regulations, 2011 CFR

...Participation in EAS. 11.41 Section 11.41 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Organization § 11.41 Participation in EAS. (a) All EAS Participants specified in § 11.11...

2011-10-01

284

Esophageal motility abnormalities in gastroesophageal reflux disease  

PubMed Central

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

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

2014-01-01

285

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

Microsoft Academic Search

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

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

2004-01-01

286

[A case of Barrett's esophageal carcinoma treated with combined therapy].  

PubMed

During a routine health examination, a 50-year-old man was found to have an elevated lesion at the esophagogastric junction. Poorly differentiated adenocarcinoma was diagnosed from the biopsy findings. Computed tomography showed metastases in the mediastinal, intra-abdominal, and paraaortic lymph nodes. The clinical stage diagnosis was cT2, cN4, cM0, cStage IVa. Combination chemotherapy with docetaxel, CDDP, and 5-FU (DCF) was started initially. After 2 courses of DCF, the primary lesion and mediastinal lymph nodes had decreased in size, but the intra-abdominal lymph node had grown. A curative operation with paraaortic lymph node dissection was considered possible; thus, video-assisted thoracoscopic surgery of the esophagus with 3-field lymph node dissection was performed. The final findings revealed Barrett's esophageal carcinoma, EG, 0-III,23×18 mm, mod-por, CT-pT1b (sm3) pN4, sM0, fStage IV. Histologically, the mediastinal lymph node metastases disappeared with chemotherapy, but no reduction was observed in the abdominal lymph nodes. After surgery, 2 courses of combination adjuvant chemotherapy with CDDP and 5-FU were administered along with 50 Gy of radiotherapy. Subsequently, the treatment was changed to tegafur-gimeracil-oteracil potassium alone on an outpatient basis. The patient remains recurrence free 22 months postsurgery. PMID:23267993

Suto, Yujin; Tomizawa, Naoki; Andoh, Tatsumasa; Arakawa, Kazuhisa; Kobayashi, Katsumi; Sato, Hiroaki; Sakamoto, Kazuha; Itoh, Hideaki; Sunose, Yutaka; Takeyoshi, Izumi

2012-11-01

287

Ordering of mutations in preinvasive disease stages of esophageal carcinogenesis.  

PubMed

Cancer genome sequencing studies have identified numerous driver genes, but the relative timing of mutations in carcinogenesis remains unclear. The gradual progression from premalignant Barrett's esophagus to esophageal adenocarcinoma (EAC) provides an ideal model to study the ordering of somatic mutations. We identified recurrently mutated genes and assessed clonal structure using whole-genome sequencing and amplicon resequencing of 112 EACs. We next screened a cohort of 109 biopsies from 2 key transition points in the development of malignancy: benign metaplastic never-dysplastic Barrett's esophagus (NDBE; n=66) and high-grade dysplasia (HGD; n=43). Unexpectedly, the majority of recurrently mutated genes in EAC were also mutated in NDBE. Only TP53 and SMAD4 mutations occurred in a stage-specific manner, confined to HGD and EAC, respectively. Finally, we applied this knowledge to identify high-risk Barrett's esophagus in a new non-endoscopic test. In conclusion, mutations in EAC driver genes generally occur exceptionally early in disease development with profound implications for diagnostic and therapeutic strategies. PMID:24952744

Weaver, Jamie M J; Ross-Innes, Caryn S; Shannon, Nicholas; Lynch, Andy G; Forshew, Tim; Barbera, Mariagnese; Murtaza, Muhammed; Ong, Chin-Ann J; Lao-Sirieix, Pierre; Dunning, Mark J; Smith, Laura; Smith, Mike L; Anderson, Charlotte L; Carvalho, Benilton; O'Donovan, Maria; Underwood, Timothy J; May, Andrew P; Grehan, Nicola; Hardwick, Richard; Davies, Jim; Oloumi, Arusha; Aparicio, Sam; Caldas, Carlos; Eldridge, Matthew D; Edwards, Paul A W; Rosenfeld, Nitzan; Tavaré, Simon; Fitzgerald, Rebecca C

2014-08-01

288

[Infectious complications after esophageal surgery].  

PubMed

The incidence of wound infection, which is an intrasurgical field infection, is lower than the incidence of pneumonia, which is an extrasurgical field infection, after esophageal cancer surgery. Several trials predicting postoperative infectious complications have been reported. One measured the phytohemagglutinin- and concanavalin A-induced proliferation of peripheral blood mononuclear cells in patients; one measured the white blood cell (WBC) count 2 h after surgery and the decrease in WBC count on first postoperative day; and another showed that the decrease in serum IgG2 level can predict the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) infections. Useful strategies for managing infectious complications have also been reported. Applying mupirocin calcium hydrate ointment to the nasal cavity decreases the incidence of MRSA infections. Autologous blood collection reduces the need for allogeneic transfusion in patients undergoing resection of esophageal cancer, and avoidance of allogeneic transfusion may reduce the risk of postoperative infection. The total exposure to preoperative chemoradiotherapy should be limited to 40 Gy or less to prevent postoperative pneumonia. PMID:12599924

Ozawa, Soji; Kitagawa, Yuko; Okamoto, Nobuhiko; Shimizu, Yoshimasa; Kitajima, Masaki

2002-12-01

289

Colonic interposition and supercharge for esophageal reconstruction  

Microsoft Academic Search

Aims  We evaluated the techniques of colonic interposition and supercharge for esophageal reconstruction and discussed the main\\u000a considerations related to these procedures.\\u000a \\u000a \\u000a \\u000a Patients and methods  In this study, we performed 51 esophageal reconstructions using colonic interposition. Twenty-eight of the 51 patients had\\u000a synchronous or allochronic gastric malignancy. We selected colonic interposition for high anastomosis in 11 patients and also\\u000a for esophageal bypass

Yasuhiro Shirakawa; Yoshio Naomoto; Kazuhiro Noma; Kazufumi Sakurama; Toshio Nishikawa; Tetsuji Nobuhisa; Masahiko Kobayashi; Takaomi Okawa; Shinya Asami; Tomoki Yamatsuji; Minoru Haisa; Junji Matsuoka; Motohiko Hanazaki; Kiyoshi Morita; Takao Hiraki; Noriaki Tanaka

2006-01-01

290

Esophageal schwannoma: report of a case.  

PubMed

We report a case of esophageal schwannoma in a 46-year-old woman who presented with rapidly progressive dyspnea and dysphagia. Chest computed tomography showed a large mediastinal mass, which was extrinsically compressing the trachea, widely adjacent to the upper thoracic esophagus. We performed an axillary right thoracotomy to enucleate the tumor, which was located in the esophageal muscle layer. A definite diagnosis of esophageal schwannoma was made from the pathologic findings, which included positive immunohistochemical staining for S-100 protein and negative staining for c-kit and CD34. PMID:17522770

Tokunaga, Toshiteru; Takeda, Shin-ichi; Sumimura, Jun-ichi; Maeda, Hajime

2007-01-01

291

Esophageal Melanocytosis in Oral Opium Consumption  

PubMed Central

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

Geramizadeh, Bita; Asadian, Fatemeh; Taghavi, Alireza

2014-01-01

292

Esophageal ulceration induced by intracavitary irradiation for esophageal carcinoma  

SciTech Connect

Twenty-two patients with esophageal carcinoma had no local recurrence after external and intracavitary radiation treatment, but all developed ulcers in the field of intracavitary irradiation. Ten were linear ulcers that appeared 3-12 months after radiation treatment (mean, 5.3 months); the other 12 were the long circumferential type and appeared 1-8 months after irradiation (mean, 3.7 months). Esophagobronchial fistulae developed in two cases in which deep ulcer had been found between the completion of external irradiation and the beginning of intracavitary irradiation. In these cases with deep ulcer, intracavitary irradiation should not be done. For patients receiving intracavitary radiation, the total dosage should be less than 20 Gy.

Hishikawa, Y.; Tanaka, S.; Miura, T.

1984-08-01

293

Establishing Magnetic Resonance Imaging as an Accurate and Reliable Tool to Diagnose and Monitor Esophageal Cancer in a Rat Model  

PubMed Central

Objective To assess the reliability of magnetic resonance imaging (MRI) for detection of esophageal cancer in the Levrat model of end-to-side esophagojejunostomy. Background The Levrat model has proven utility in terms of its ability to replicate Barrett’s carcinogenesis by inducing gastroduodenoesophageal reflux (GDER). Due to lack of data on the utility of non-invasive methods for detection of esophageal cancer, treatment efficacy studies have been limited, as adenocarcinoma histology has only been validated post-mortem. It would therefore be of great value if the validity and reliability of MRI could be established in this setting. Methods Chronic GDER reflux was induced in 19 male Sprague-Dawley rats using the modified Levrat model. At 40 weeks post-surgery, all animals underwent endoscopy, MRI scanning, and post-mortem histological analysis of the esophagus and anastomosis. With post-mortem histology serving as the gold standard, assessment of presence of esophageal cancer was made by five esophageal specialists and five radiologists on endoscopy and MRI, respectively. Results The accuracy of MRI and endoscopic analysis to correctly identify cancer vs. no cancer was 85.3% and 50.5%, respectively. ROC curves demonstrated that MRI rating had an AUC of 0.966 (p<0.001) and endoscopy rating had an AUC of 0.534 (p?=?0.804). The sensitivity and specificity of MRI for identifying cancer vs. no-cancer was 89.1% and 80% respectively, as compared to 45.5% and 57.5% for endoscopy. False positive rates of MRI and endoscopy were 20% and 42.5%, respectively. Conclusions MRI is a more reliable diagnostic method than endoscopy in the Levrat model. The non-invasiveness of the tool and its potential to volumetrically quantify the size and number of tumors likely makes it even more useful in evaluating novel agents and their efficacy in treatment studies of esophageal cancer. PMID:24705451

Kosovec, Juliann E.; Zaidi, Ali H.; Komatsu, Yoshihiro; Kasi, Pashtoon M.; Cothron, Kyle; Thompson, Diane V.; Lynch, Edward; Jobe, Blair A.

2014-01-01

294

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

PubMed Central

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

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

2005-01-01

295

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2013 CFR

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2013-04-01

296

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2012 CFR

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2012-04-01

297

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2011 CFR

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2011-04-01

298

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2010 CFR

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2010-04-01

299

21 CFR 868.1910 - Esophageal stethoscope.  

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2014-04-01

300

21 CFR 878.3610 - Esophageal prosthesis.  

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2014-04-01

301

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2012 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2012-04-01

302

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2011 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2011-04-01

303

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2013 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2013-04-01

304

Multimodality Therapy of Nonmetastatic Esophageal Cancer  

Microsoft Academic Search

SummaryEsophageal cancer is a highly aggressive malignancy with an exceedingly poor prognosis. Despite improved surgical techniques over the past decades, which increased the rate of complete tumor resection, improved the perioperative management and reduced the perioperative morbidity and mortality,still less than 10% of patients in the Western World with esophageal cancer will survive more than 5 years. Similar unsatisfactory results

M. Schmücking; T. G. Wendt

1998-01-01

305

Bleeding esophageal ulcers caused by NSAIDs  

Microsoft Academic Search

.   This report describes four patients with NSAID-induced esophageal ulcers documented by endoscopy. The cause of injury was\\u000a ibuprofen alone in two patients, aspirin in one patient, and a combination of aspirin and ibuprofen in one patient. The most\\u000a common findings were anemia, retrosternal pain, and dysphagia. Three patients had bleeding esophageal ulcers requiring blood\\u000a transfusions. One patient had massive

C. Sugawa; Y. Takekuma; C. E. Lucas; H. Amamoto

1997-01-01

306

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

E-print Network

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 ...

Lin, Lin

307

[Clinicopathological study of acute esophageal mucosal lesion].  

PubMed

Acute esophageal mucosal lesion (AEML) is a comprehensive disease that includes necrotizing esophagitis and acute erosive esophagitis, which result in upper gastrointestinal bleeding. However, little is known about AEML. We examined the clinicopathological features of 57 AEML cases. AEML presented as acute diffuse esophagitis showing an endoscopically erosive mucosa. The disease did not include corrosive injury, radiation-induced damage, infectious esophagitis, or acute exacerbation of chronic gastroesophageal reflux disease. AEML predominantly affected elderly men, and upper gastrointestinal bleeding was the frequent presenting symptom. Severe underlying diseases such as cranial nerve disease or pneumonia were observed in 98% of the patients. Esophageal sliding hernia and gastroduodenal ulcers were endoscopically observed in 67% and 63% of the patients, respectively. Deaths due to exacerbation of the underlying diseases accounted for 16%. Most cases rapidly improved with conservative management using a proton pump inhibitor or an H2 blocker. Therefore, AEML should be considered a disease having characteristics different from those of common gastroesophageal reflux disease. PMID:23831655

Kawauchi, Hirohito; Ohta, Tomoyuki; Matsubara, Yu; Yoshizaki, Koji; Sakamoto, Jun; Amitsuka, Hisato; Kimura, Keisuke; Maemoto, Atsuo; Orii, Fumika; Ashida, Toshifumi

2013-07-01

308

Genetic and Cellular Mechanisms Regulating Anterior Foregut and Esophageal Development  

PubMed Central

Separation of the single anterior foregut tube into the esophagus and trachea involves cell proliferation and differentiation, as well as dynamic changes in cell-cell adhesion and migration. These biological processes are regulated and coordinated at multiple levels through the interplay of the epithelium and mesenchyme. Genetic studies and in vitro modeling have shed light on relevant regulatory networks that include a number of transcription factors and signaling pathways. These signaling molecules exhibit unique expression patterns and play specific functions in their respective territories before the separation process occurs. Disruption of regulatory networks inevitably leads to defective separation and malformation of the trachea and esophagus and results in the formation of a relatively common birth defect, esophageal atresia with or without tracheoesophageal fistula (EA/TEF). Significantly, some of the signaling pathways and transcription factors involved in anterior foregut separation continue to play important roles in the morphogenesis of the individual organs. In this review, we will focus on new findings related to these different developmental processes and discuss them in the context of developmental disorders (or birth defects) commonly seen in clinics. PMID:22750256

Jacobs, Ian J.; Ku, Wei-Yao; Que, Jianwen

2012-01-01

309

Pharyngo-Enteral Anastomosis for Esophageal Reconstruction in Diffuse Corrosive Esophageal Stricture  

Microsoft Academic Search

Background. Diseases involving the entire esophagus usually require extensive surgical procedures to accom- plish functional reconstruction. These procedures are extremely stressful for undernourished patients. We have utilized a simpler procedure for total esophageal reconstruction. Methods. This retrospective report reviews the experi- ence in 8 patients who underwent esophageal reconstruc- tion by pharyngo-colo-gastrostomy or jejunostomy with- out any resection of bony

Jae K. Park; Sung B. Sim; Sun H. Lee; Hae M. Jeon; Moon S. Kwack

310

Catumaxomab for Treatment of Peritoneal Carcinomatosis in Patients With Gastric Adenocarcinomas  

ClinicalTrials.gov

Gastric Adenocarcinoma With Peritoneal Carcinomatosis; Siewert Type II Adenocarcinoma of Esophagogastric Junction With Peritoneal Carcinomatosis; Siewert Type III Adenocarcinoma of Esophagogastric Junction With Peritoneal Carcinomatosis

2014-04-08

311

Chronic xerostomia increases esophageal acid exposure and is associated with esophageal injury  

SciTech Connect

OBJECTIVES: To assess the effects of chronic xerostomia on parameters of gastroesophageal reflux and esophagitis. DESIGN: Observational study of a cohort of male patients with xerostomia and age-matched control subjects. SETTING: Tertiary-care Veterans Affairs Medical Center. SUBJECTS: Sixteen male patients with chronic xerostomia secondary to radiation for head and neck cancers or medications. Nineteen age-matched male control subjects with comparable alcohol and smoking histories. MEASUREMENTS AND MAIN RESULTS: Esophageal motility was similar in patients with xerostomia and controls. Clearance of acid from the esophagus and 24-hour intraesophageal pH were markedly abnormal in patients with xerostomia. Symptoms and signs of esophagitis were significantly more frequent in subjects with xerostomia. CONCLUSIONS: Chronic xerostomia may predispose to esophageal injury, at least in part, by decreasing the clearance of acid from the esophagus and altering 24-hour intraesophageal pH. Esophageal injury is a previously unreported complication of long-term salivary deficiency.

Korsten, M.A.; Rosman, A.S.; Fishbein, S.; Shlein, R.D.; Goldberg, H.E.; Biener, A. (Gastrointestinal Section, Veterans Affairs Medical Center, Bronx, New York (USA))

1991-06-01

312

Esophageal varix predictive performance of lower esophageal Doppler signals during the swallowing process.  

PubMed

The objective of this study was to assess whether the swallowing action can improve the display of lower esophageal Doppler signals (LEDS) during transabdominal ultrasound (TUS). Eighty-four patients with cirrhosis underwent both TUS and endoscopic examination for esophageal varices (EVs). LEDS were assessed under the esophageal resting state and during the swallowing process. Univariate analysis indicated that spleen diameter, spleen vein diameter, portal vein diameter, LEDS and left gastric vein hepatofugal flow were significantly associated with the presence of EVs. No LEDS were detected in patients without EVs at rest or during swallowing. Of the 69 patients with EVs, LEDS could be detected in 21 cases (30.4%) in the esophageal resting state and in 58 cases (84.1%) during the swallowing process. Compared with the esophageal resting state, the swallowing action can significantly improve display of LEDS during TUS (p = 0.000), which may be beneficial for TUS detection of EVs. PMID:24951299

Zhang, Chao-Xue; Xu, Xiao-Yong; Wang, Ling; Huang, Meng; Li, Liang

2014-09-01

313

Villoglandular papillary adenocarcinoma of the uterine cervix.  

PubMed

Villoglandular papillary adenocarcinoma of the uterine cervix was recently (1989) described by three main histological features: exophytic proliferation, papillary architecture and mild to moderate cellular atypicality. The authors report a case of villoglandular papillary adenocarcinoma, clinical stage IB, which was peculiar because of its association with a co-existing and simultaneously discovered invasive squamous cell carcinoma. These two patterns were juxtaposed and not intermingled. The patient was treated with radical hysterectomy followed by vaginal radiation therapy. She remains without evidence of recurrence after 12 months of follow-up. Five main clinicopathological features of the villoglandular papillary adenocarcinoma could be stressed: rare histological variant (72 described cases), young age of patients (25-45 years old), superficial stromal invasion, usual association with other tumoral patterns (in situ or invasive adenocarcinoma as well as in situ or invasive squamous cell carcinoma) and excellent prognosis. For selected cases, a conservative surgical approach (cervical conization) was possible. PMID:10471150

Collinet, P; Prolongeau, J F; Vaneecloo, S

1999-09-01

314

Blunt traumatic esophageal injury: Unusual presentation and approach?  

PubMed Central

INTRODUCTION Blunt esophageal injury is extremely rare event. However, it is a potential morbid injury unless managed early. PRESENTATION OF CASE We report a rare case of blunt esophageal injury for a 28-year old male who presented with history of fall of heavy object over the right side of the chest. Diagnostic work up including chest X-ray, computerized tomography scans and gastrografin esophagogram revealed lower esophageal rupture. Right mini-thoracotomy with esophageal repair was performed. Postoperative course was uneventful. DISCUSSION The exact mechanism of blunt esophageal injury remains uncertain. This report described a unique location of esophageal rupture after blunt trauma that happened on the right side. Diagnosis of esophageal injury needs high index of suspicion and accurate diagnostic workup. CONCLUSION Prompt diagnosis and management are the key for better prognosis in patients with blunt esophageal injury. PMID:24394856

Abdulrahman, Husham; Ajaj, Ahmad; Shunni, Adam; El-Menyar, Ayman; Chaikhouni, Amer; Al-Thani, Hassan; Latifi, Rifat

2013-01-01

315

Evaluation of Esophageal Motor Function With High-resolution Manometry  

PubMed Central

For several decades esophageal manometry has been the test of choice to evaluate disorders of esophageal motor function. The recent introduction of high-resolution manometry for the study of esophageal motor function simplified performance of esophageal manometry, and revealed previously unidentified patterns of normal and abnormal esophageal motor function. Presentation of pressure data as color contour plots or esophageal pressure topography led to the development of new tools for analyzing and classifying esophageal motor patterns. The current standard and still developing approach to do this is the Chicago classification. While this methodical approach is improving our diagnosis of esophageal motor disorders, it currently does not address all motor abnormalities. We will explore the Chicago classification and disorders that it does not address. PMID:23875094

2013-01-01

316

Pulmonary adenocarcinoma: A renewed entity in 2011  

PubMed Central

Lung cancer, of which non-small-cell lung cancer comprises the majority, is the leading cause of cancer-related deaths in the United States and worldwide. Lung adenocarcinomas are a major subtype of non-small-cell lung cancers, are increasing in incidence globally in both males and females and in smokers and non-smokers, and are the cause for almost 50% of deaths attributable to lung cancer. Lung adenocarcinoma is a tumour with complex biology that we have recently started to understand with the advent of various histological, transcriptomic, genomic and proteomic technologies. However, the histological and molecular pathogenesis of this malignancy is still largely unknown. This review will describe advances in the molecular pathology of lung adenocarcinoma with emphasis on genomics and DNA alterations of this disease. Moreover, the review will discuss recognized lung adenocarcinoma preneoplastic lesions and current concepts of the early pathogenesis and progression of the disease. We will also portray the field cancerization phenomenon and lineage-specific oncogene expression pattern in lung cancer and how both remerging concepts can be exploited to increase our understanding of lung adenocarcinoma pathogenesis for subsequent development of biomarkers for early detection of adenocarcinomas and possibly personalized prevention. PMID:22040022

Kadara, Humam; Kabbout, Mohamed; Wistuba, Ignacio I.

2014-01-01

317

Increased Risk of Stomach and Esophageal Malignancies in People With AIDS  

PubMed Central

BACKGROUND & AIMS People infected with human immunodeficiency virus (HIV) have an increased risk of some malignancies, but little is known about the effects of infection on risk of cancers of the upper gastrointestinal tract. We evaluated the risks of different histologic and anatomic subtypes of carcinomas and non-Hodgkin lymphomas (NHLs) of the stomach and esophagus in people with acquired immunodeficiency syndrome (AIDS). METHODS We analyzed data from the HIV/AIDS Cancer Match Study, which links data collected from 1980 to 2007 for 16 US population-based HIV and AIDS and cancer registries. We compared risks of stomach and esophageal malignancies in people with AIDS (N = 596,955) with those of the general population using standardized incidence ratios (SIRs). We assessed calendar trends using Poisson regression. RESULTS People with AIDS had increased risks of carcinomas of the esophagus (SIR, 1.69; 95% confidence interval [CI], 1.37–2.07; n = 95) and stomach (SIR, 1.44; 95% CI, 1.17–1.76; n = 96). Risk was increased for esophageal adenocarcinoma (SIR, 1.91; 95% CI, 1.31–2.70) and squamous cell carcinoma (SIR, 1.47; 95% CI, 1.10 –1.92). People with AIDS had greater risks of carcinomas of the gastric cardia (SIR, 1.36; 95% CI, 0.83–2.11) and noncardia (SIR, 1.53; 95% CI, 1.12–2.05) than the general population. Although most stomach and esophageal NHLs that developed in people with AIDS were diffuse large B-cell lymphomas, these individuals also had an increased risk of stomach mucosa–associated lymphoid tissue lymphoma (SIR, 5.99; 95% CI, 3.19 –10.2; n = 13). The incidence of carcinomas remained fairly constant over time, but rates of NHL decreased from 1980 to 2007 (Ptrend < .0001). CONCLUSIONS People with AIDS are at increased risk for developing esophageal and stomach carcinomas and NHLs. Although the incidence of NHL decreased from 1980 to 2007 as treatments for HIV infection improved, HIV-infected individuals face continued risks of esophageal and stomach carcinomas. PMID:22796240

Persson, E. Christina; Shiels, Meredith S.; Dawsey, Sanford M.; Bhatia, Kishor; Anderson, Lesley A.; Engels, Eric A.

2013-01-01

318

Inconsistent association of esophageal symptoms, psychometric abnormalities and dysmotility  

Microsoft Academic Search

OBJECTIVES:The aim of this study was to characterize the psychometric profiles of symptomatic patients with abnormal esophageal motility and symptomatic patients with normal manometric findings compared to asymptomatic controls.METHODS:A total of 113 patients with abnormal esophageal motility (7 achalasia, 8 diffuse esophageal spasm, 27 nutcracker esophagus, 37 hypertensive lower esophageal sphincter, 21 hypotensive peristalsis, 13 failed peristalsis), 23 symptomatic controls

Chi W. Song; Seong J. Lee; Yoon T. Jeen; Hoon J. Chun; Soon H. Um; Chang D. Kim; Ho S. Ryu; Jin H. Hyun; Min S. Lee; Peter J. Kahrilas

2001-01-01

319

Secondary esophageal contractions are abnormal in chronic alcoholics  

Microsoft Academic Search

It is known that primary (swallow-induced) esophageal contractions are abnormal in alcoholics. Data concerning acid-induced esophageal contractions, which appear to be important in cleansing refluxed acid from the esophagus, are lacking. To determine whether acid-induced esophageal contractions are also affected by chronic ethanol exposure, we studied secondary (acid or saline-induced) esophageal motor events in 19 male alcoholics [6 actively drinking

A. Keshavarzian; C. Polepalle; F. L. Iber; M. Durkin

1992-01-01

320

Broken Esophageal Stent Successfully Treated by Interventional Radiology Technique  

SciTech Connect

Esophageal stent fractures occur quite rarely. A 61-year-old male patient was previously treated for rupture of benign stenosis, occurring after dilatation, by implanting an esophageal stent. However, a year after implantation, the patient suffered from dysphagia caused by the broken esophageal stent. He was treated with the interventional radiology technique, whereby a second implantation of the esophageal stent was carried out quite successfully.

Zelenak, Kamil, E-mail: zelenak@mfn.s [University Hospital, Department of Radiology (Slovakia); Mistuna, Dusan; Lucan, Jaroslav [University Hospital, Department of Surgery (Slovakia); Polacek, Hubert [University Hospital, Department of Radiology (Slovakia)

2010-06-15

321

MAL hypermethylation is a tissue-specific event that correlates with MAL mRNA expression in esophageal carcinoma  

PubMed Central

MAL promoter hypermethylation was examined in 260 human esophageal specimens using real-time quantitative methylation-specific PCR (qMSP). MAL hypermethylation showed highly discriminative ROC curve profiles which clearly distinguished esophageal adenocarcinomas (EAC) from both esophageal squamous cell carcinomas (ESCC) and normal esophagus (NE). Both MAL methylation frequency and normalized methylation value (NMV) were significantly higher in Barrett's esophagus (BE), dysplastic BE, and EAC than in ESCC or in NE. Among matched NE and EAC samples, MAL NMVs in EAC were significantly higher than in corresponding NE. There was a significant correlation between MAL hypermethylation and BE segment length. Treatment with 5-aza-2?-deoxycytidine reversed MAL methylation and reactivated MAL mRNA expression in OE33 EAC cells. MAL mRNA levels in EACs with unmethylated MAL were significantly higher than in EACs with methylated MAL. MAL hypermethylation is a common, tissue-specific event in human EAC and correlates with clinical neoplastic progression risk factors. PMID:24088706

Jin, Zhe; Cheng, Yulan; Gao, Yan; Feng, Xianling; Dong, Ming; Cao, Ziyi; Chen, Si; Yu, Huimin; Zhao, Zhenfu; Zhang, Xiaojing; Liu, Jie; Mori, Yuriko; Fan, Xinmin; Meltzer, Stephen J.

2013-01-01

322

Interobserver Reproducibility of Diffusion-Weighted MRI in Monitoring Tumor Response to Neoadjuvant Therapy in Esophageal Cancer  

PubMed Central

Objective To investigate the reproducibility of diffusion-weighted magnetic resonance imaging (DW-MRI) in assessing tumor response early in the course of neoadjuvant chemoradiotherapy in patients with operable esophageal cancer. Methods Eleven male patients (mean age 54.8 years) with newly diagnosed esophageal cancer underwent DW-MRI before and 10 days after start of chemoradiotherapy. Reproducibility of apparent diffusion coefficient (ADC) measurements by manual (freehand) and semi-automated volumetric methods was assessed. Results Interobserver reproducibility for the assessment of mean tumor ADC by the manual measurement method was good, with an ICC of 0.69 (95% CI, 0.36 to 0.85; P?=?0.001). Interobserver reproducibility for the assessment of mean tumor ADC by the semi-automated volumetric measurement method was very good, with an ICC of 0.96 (95% CI, 0.91 to 0.98; P<0.001). Conclusion Semi-automated volumetric ADC measurements have higher reproducibility than manual ADC measurements in assessing tumor response to chemoradiotherapy in patients with esophageal adenocarcinoma. PMID:24704912

Kwee, Robert M.; Dik, Alexander K.; Sosef, Meindert N.; Berendsen, Ralph C. M.; Sassen, Sander; Lammering, Guido; Clarijs, Ruud; Oostenbrug, Liekele E.; Blom, Rachel L. G. M.; Vliegen, Roy F. A.

2014-01-01

323

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

PubMed

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

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

324

Allelic imbalance of 14q32 in esophageal carcinoma  

Microsoft Academic Search

It has been demonstrated that the accumulation of alterations in several oncogenes and tumor suppressor genes plays a role in the initiation and progression of esophageal carcinoma. However, to our knowledge, very few studies have described the molecular genetic changes of chromosome arm 14q in esophageal carcinoma. In this study, we examined 35 primary esophageal carcinomas for allelic imbalance on

Yuji Ihara; Yuji Kato; Tadashi Bando; Fuminori Yamagishi; Tetsuji Minamimura; Takashi Sakamoto; Kazuhiro Tsukada; Masaharu Isobe

2002-01-01

325

Molecular and cellular features of esophageal cancer cells  

Microsoft Academic Search

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

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

1993-01-01

326

ESOPHAGEAL LICHEN PLANUS: A CASE REPORT AND REVIEW OF LITERATURE  

PubMed Central

Lichen planus is a rare cause of esophagitis and esophageal stricture. It is invariably associated with oral mucosal involvement and the diagnosis has to be considered in these patients who present with dysphagia. We present a case of esophageal stricture secondary to lichen planus. PMID:19967015

Madhusudhan, K S; Sharma, Raju

2008-01-01

327

Corrosive esophageal strictures: Predictors of response to endoscopic dilation  

Microsoft Academic Search

Twenty-one patients with corrosive esophageal strictures underwent contrast-enhanced CT of the chest to determine (1) the esophageal wall thickness at the stricture site and (2) its correlation with number of sessions required for adequate dilation. Average esophageal wall thickness was defined as the mean thickness of all four walls at the site of the stricture, whereas the size of the

Deepak Lahoti; Sohan L. Broor; Partha P. Basu; Ajay Gupta; Rajesh Sharma; Chandra S. Pant

1995-01-01

328

Esophageal motor abnormalities in scleroderma and related diseases  

Microsoft Academic Search

Esophageal motor activity was measured by intra-esophageal pressure recordings in 53 patients with scleroderma and 29 patients with other collagen diseases. The purpose of the study was to determine the relationship of motor abnormalities to esophageal symptoms, to compare the abnormalities in scleroderma with those in other collagen diseases, and to try to increase understanding of the responsible mechanism. Methacholine

Thomas A. Saladin; Arthur B. French; Chris J. D. Zarafonetis; H. Marvin Pollard

1966-01-01

329

A Phase II Study of Capecitabine, Oxaliplatin, and Bevacizumab in the Treatment of Metastatic Esophagogastric Adenocarcinomas  

PubMed Central

Background. Esophageal and gastric cancers often present at an advanced stage. Systemic chemotherapy is the mainstay of treatment, but survival with current regimens remains poor. We evaluated the safety, tolerability, and efficacy of the combination capecitabine, oxaliplatin, and bevacizumab in the treatment of metastatic esophagogastric adenocarcinomas. Methods. Thirty-seven patients with metastatic or unresectable gastric/gastroesophageal junction tumors were enrolled and treated with capecitabine 850 mg/m2 BID on days 1–14, and oxaliplatin 130 mg/m2 with bevacizumab 15 mg/kg on day 1 of a 21-day cycle. The primary endpoint was progression-free survival (PFS). Secondary endpoints included response rate (RR) and overall survival (OS). Neuropilin-1 (NRP1) and -2 (NRP2) mRNA expression was evaluated in archived tumor. Results. Thirty-five patients were evaluable for efficacy. Median PFS was 7.2 months; median OS was 10.8 months. RR was estimated at 51.4%. The regimen was tolerable with expected drug class-related toxicities. NRP2 mRNA levels significantly correlated with PFS (p = 0.042) and showed a trend toward significance with OS (p = 0.051). Nonsignificant trends for NRP1 were noted for higher expression levels and worse outcome. Conclusions. Bevacizumab can be given safely with chemotherapy in patients with metastatic esophagogastric adenocarcinomas. The combination of capecitabine, oxaliplatin, plus bevacizumab has activity comparable to other bevacizumab-containing regimens in metastatic gastroesophageal cancer. PMID:23485624

Uronis, Hope E.; Bendell, Johanna C.; Altomare, Ivy; Blobe, Gerard C.; Hsu, S. David; Morse, Michael A.; Pang, Herbert; Zafar, S. Yousuf; Conkling, Paul; Favaro, Justin; Arrowood, Christy C.; Cushman, Stephanie M.; Meadows, Kellen L.; Brady, John C.; Nixon, Andrew B.

2013-01-01

330

Esophageal Bezoar in a Patient with Achalasia: Case Report and Literature Review  

PubMed Central

Esophageal bezoars are rare, but are recognized as a distinct clinical entity. They are known to occur in patients with esophageal structural and functional abnormalities, but only a few cases of the development of esophageal bezoars in patients with esophageal motility disorders have only been described. We report a rare case of an esophageal bezoar that developed in a patient with achalasia, and review the literature concerning esophageal bezoars associated with esophageal motility disorders. PMID:20479921

Kim, Ki Hoon; Seo, Geom Seog; Kim, Yong Sung; Choi, Chang Soo; Im, Chong Ju

2010-01-01

331

Pharmacological Management of Esophageal Food Bolus Impaction  

PubMed Central

Background. Soft esophageal bolus impaction is an emergency that requires skilled endoscopic removal if persistent obstructive symptoms do not resolve spontaneously after careful observation. Expedited care of these patients is crucial to avoid respiratory and mechanical complications. Other possible options for management include medical agents used to manage it prior to performing endoscopy if access to endoscopy was not available or declined by the patient. Aim. To review the available pharmacological and other nonmedicinal options and their mechanism of relief for soft esophageal impaction. Method. Pubmed, Medline and Ovid were used for search of MESH terms pertinent including “foreign body, esophageal, esophageal bolus and medical” for pharmacological and non medicinial agents used for management of esophageal soft bolus impaction as well as manual review of the cross-references. Results. Several agents were identified including Buscopan, Glucagon, nitrates, calcium channel blockers, and papaveretum. Non medicinal agents are water, effervescent agents, and papain. No evidence was found to suggest preference or effectiveness of use of a certain pharmacological agent compared to others. Buscopan, Glucagon, benzodiazepines, and nitrates were studied extensively and may be used in selected patients with caution. Use of papain is obsolete in management of soft bolus impaction. PMID:23738071

Khayyat, Yasir Mohammed

2013-01-01

332

Multidisciplinary approach for patients with esophageal cancer  

PubMed Central

Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced. There are no screening recommendations for patients unless they have Barrett’s esophagitis or a significant family history of this disease. Often, esophageal cancer is not diagnosed until patients present with dysphagia, odynophagia, anemia or weight loss. When symptoms occur, the stage is often stage III or greater. Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection. The treatment of patients who have locally advanced esophageal cancer is more complex and controversial. Despite multiple trials, treatment recommendations are still unclear due to conflicting data. Sadly, much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically. Additionally, studies have been underpowered or stopped early due to poor accrual. In the United States, concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient. Patients who have metastatic disease are treated palliatively. The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer, and to review the literature which guides our treatment recommendations. PMID:23239911

Villaflor, Victoria M; Allaix, Marco E; Minsky, Bruce; Herbella, Fernando A; Patti, Marco G

2012-01-01

333

Mimics of pancreatic ductal adenocarcinoma  

PubMed Central

Abstract 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

Kaza, Ravi K.; Azar, Shadi F.; Ruma, Julie A.; Francis, Isaac R.

2013-01-01

334

Multiple lung adenocarcinomas associated with von hippel-lindau disease.  

PubMed

Lung adenocarcinoma has never before been reported to be associated with von Hippel-Lindau (VHL) disease. Here, we report a case of VHL disease in a patient who had metachronous multiple lung adenocarcinomas. The patient is a 64-year-old-woman with VHL disease. She underwent surgical resection of one adenocarcinoma and one atypical adenomatous hyperplasia. A second lung adenocarcinoma developed metachronously. A point mutation in the VHL gene was confirmed in DNA from a blood sample, and loss of heterozygosity at the VHL locus was detected in the lung adenocarcinoma. The VHL dysfunction may have a role in the development of multiple lung adenocarcinomas. PMID:25282218

Ikeda, Koei; Osumi, Hironobu; Matsuishi, Kentaro; Matsubara, Eri; Fujino, Kousuke; Shibata, Hidekatsu; Yoshimoto, Kentaro; Shiraishi, Kenji; Mori, Takeshi; Suzuki, Makoto

2014-10-01

335

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

PubMed Central

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

2009-01-01

336

2011 update on esophageal achalasia  

PubMed Central

There have been some breakthroughs in the diagnosis and treatment of esophageal achalasia in the past few years. First, the introduction of high-resolution manometry with pressure topography plotting as a new diagnostic tool has made it possible to classify achalasia into three subtypes. The most favorable outcome is predicted for patients receiving treatment for type II achalasia (achalasia with compression). Patients with typeI(classic achalasia) and type III achalasia (spastic achalasia) experience a less favorable outcome. Second, the first multicenter randomized controlled trial published by the European Achalasia Trial group reported 2-year follow-up results indicating that laparoscopic Heller myotomy was not superior to endoscopic pneumatic dilation (PD). Although the follow-up period was not long enough to reach a convincing conclusion, it merits the continued use of PD as a generally available technique in gastroenterology. Third, the novel endoscopic technique peroral endoscopic myotomy is a promising option for treating achalasia, but it requires increased experience and cautious evaluation. Despite all this good news, the bottom line is a real breakthrough from the basic studies to identify the actual cause of achalasia that may impede treatment success is still anticipated. PMID:22529685

Chuah, Seng-Kee; Hsu, Pin-I; Wu, Keng-Liang; Wu, Deng-Chyang; Tai, Wei-Chen; Changchien, Chi-Sin

2012-01-01

337

HER2 status in Barrett's esophagus & esophageal cancer: a meta analysis  

PubMed Central

Background The oncogenic potential of the Human Epidermal Growth Factor Receptor 2 (HER2) is well known in the context of breast cancer however; its relationship with the development of Barrett’s Esophagus (BE) and Esophageal Cancer (EC) is unclear. The aim of this meta-analysis was to determine the overall prevalence and survival of HER2+ in BE & EC. Patients and methods Several databases were searched including article reference lists. Inclusion criteria required that studies measured HER2 positivity in subjects with BE or EC. Results 33 studies were included in the meta-analysis (10 BE & 23 EC studies). The prevalence of HER2+ was found to be 24% (95% CI: 15-36%) in BE and 26% (95% CI: 19-34%) in EC. Squamous cell carcinoma (SCC) had a higher ER of 32% (95% CI: 20-48%) in comparison with adenocarcinoma (ADC) with an ER of 21% (95% CI: 14-32%). Sub group analyses showed a high geographical variance, Asia was found to be the highest prevalent area with an ER 42% (95% CI: 22-64%). The difference in survival rate between groups HER2- & HER2+ was found to be 7 months. Conclusions Our results highlight a high prevalence of HER2+ in subjects with adenocarcinoma. HER2+ appears to decrease the survival time of EC patients. PMID:24490040

Gowryshankar, Ashwini; Nagaraja, Vinayak

2014-01-01

338

Congenital esophageal stenosis owing to tracheobronchial remnants  

PubMed Central

OBJECTIVE To emphasize the need of an accurate diagnosis of congenital esophageal stenosis due to tracheobronchial remnants, since its treatment differs from other types of congenital narrowing. CASE DESCRIPTION Four cases of lower congenital esophageal stenosis due to tracheobronchial remnants, whose definitive diagnosis was made by histopathology. Except for the last case, in which a concomitant anti-reflux surgery was not performed, all had a favorable outcome after resection and anastomosis of the esophagus. COMMENTS The congenital esophageal stenosis is an intrinsic narrowing of the organâ€(tm)s wall associated with its structural malformation. The condition can be caused by tracheobronchial remnants, fibromuscular stenosis or membranous diaphragm and the first symptom is dysphagia after the introduction of solid food in the diet. The first-choice treatment to tracheobronchial remnants cases is the surgical resection and end-to-end anastomosis of the esophagus. PMID:24142326

Rebelo, Priscila Guyt; Ormonde, Joao Victor C.; Ormonde, Joao Baptista C.

2013-01-01

339

Early esophageal carcinoma treated with intracavitary irradiation  

SciTech Connect

Five patients with early esophageal carcinoma were treated by 6-12 Gy of intracavitary irradiation following 50-60 Gy of external irradiation as a boost therapy. Surgery was not performed in these cases. None of the patients had local recurrence after radiation therapy, as demonstrated by esophagography and endoscopy. Three patients have been alive for 1-3 years 10 months. Esophageal ulceration induced by intracavitary irradiation has occurred in three of the five patients; however, intracavitary irradiation is still a beneficial treatment because of its efficacy in controlling local lesions and because radiation ulceration can eventually be cured. Intracavitary irradiation is recommended to follow external irradiation as a boost therapy for the treatment of early esophageal carcinoma.

Hishikawa, Y.; Tanaka, S.; Miura, T.

1985-08-01

340

MicroRNA involvement in esophageal carcinogenesis.  

PubMed

MicroRNAs (miRs) have recently emerged as a novel class of gene expression regulators. The number of studies documenting an altered miR expression pattern in cancer continues to expand rapidly. Critical information is continuously gained regarding how aberrantly expressed miRs contribute to carcinogenesis. Current studies provide evidence that analyses of miR expression patterns have potential clinical applications toward developing tumor biomarkers to identify the presence and dissemination of esophageal cancer, as well as to assess tumor chemosensitivity or radiosensitivity. The incidence of esophageal cancer is on the rise, and this disease continues to portend a poor prognosis. The current review addresses ways in which altered miR expression contributes to esophageal carcinogenesis, along with how recent discoveries may be applied clinically. PMID:21992930

David, Stefan; Meltzer, Stephen J

2011-12-01

341

Herpetic Esophagitis in Immunocompetent Medical Student  

PubMed Central

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

Marinho, Andreia Vidica; Bonfim, Vinicius Mendes; de Alencar, Luciana Rodrigues; Pinto, Sebastiao Alves; de Araujo Filho, Joao Alves

2014-01-01

342

Cineradiography identifies esophageal candidiasis in progressive systemic sclerosis.  

PubMed

Cineradiography of the esophagus showed signs of esophageal candidiasis in 11 out of 71 patients with progressive systemic sclerosis (PSS) - both in diffuse scleroderma and the CREST syndrome. Culture of esophageal brushings confirmed the presence of Candida albicans in eight of these 11 patients. Antimycotic treatment decreased the cineradiographic signs of candidiasis and the degree of dysphagia. Since impaired esophageal motility and treatment with immunosuppressive drugs may predispose to candida esophagitis, and since dysphagia will decrease after antimycotic treatment esophageal mycosis should always be sought in patients with PSS. PMID:2706818

Geirsson, A J; Akesson, A; Gustafson, T; Elner, A; Wollheim, F A

1989-01-01

343

Transhiatal Esophageal Resection for Corrosive Injury  

PubMed Central

Objectives: To analyze the feasibility and safety of transhiatal approach for resection of corrosively scarred esophagus. Background Summary Data: The unrelenting corrosive strictures of esophagus merit esophageal substitution. Because of the risk of complications in the retained esophagus, such as malignancy, mucocele, gastroesophageal reflux, and bleeding, esophageal resection is deemed necessary. Transthoracic approach for esophageal resection is considered safe. The safety and feasibility of transhiatal resection of the esophagus is not established in corrosive injury of the esophagus. Patients and Methods: Transhiatal approach was used for resection of the scarred esophagus for all patients between January 1986 and December 2001. The intraoperative complications, indications for adding thoracotomy, and postoperative outcome were studied in 51 patients. Follow-up period varied from minimum of 6 months to 15 years. Results: Esophageal resection was achieved in 49 of 51 patients whereas thoracotomy was added in 2 patients. In 1 of the patients tracheal injury occurred whereas in other patient there were dense adhesions between tracheal membrane and esophagus. Gastric tube was used for esophageal substitution in 40 (78.4%) patients whereas colon was transplanted in 11 (21.6%) patients. Colon was used only when stomach was not available. One patient (1.9%) had tracheal membrane injury whereas 4 patients (7.8%) had recurrent laryngeal nerve palsy. One patient each had thoracic duct injury and intrathoracic gastric tube leak. There was no operative mortality. Anastomotic complications like leak were present in 19.6% and stricture in 58.8% patients. All the patients were able to resume their normal duties and swallow normal food within 6 months of the surgery. Conclusion: One-stage transhiatal esophageal resection and reconstruction could be safely used for the extirpation of scarred esophagus. Use of gastric conduit was technically simple, quicker, and offered good functional outcome. Postoperative anastomotic stricture amenable to dilatations was the commonest complication. PMID:15075652

Gupta, Narendar Mohan; Gupta, Rajesh

2004-01-01

344

Case of mucinous adenocarcinoma with porcelain gallbladder.  

PubMed

Histologically, the majority of gallbladder cancers are adenocarcinomas. Among the adenocarcinomas, the mucinous adenocarcinoma is relatively uncommon. Porcelain gallbladder is a rare finding and the risk of gallbladder cancer is significantly increased in porcelain gallbladder. We describe a rare case of mucinous adenocarcinoma with porcelain gallbladder. A 46-year-old man was admitted to Chonnam National University Hospital with a 2-week history of right upper quadrant pain. Three and 2 years previously, he had two episodes of cholecystitis with gallstones. An abdominal computed tomography revealed a contracted gallbladder with circumferential mural calcification, and the possibility of gallbladder cancer and porcelain gallbladder were considered. At laparotomy, cholecystectomy, liver wedge resection, and radical lymph node dissection were performed. The resected gallbladder showed thickened wall, luminal narrowing and mucosal irregularity. A histological examination of the resected gallbladder showed a mucinous adenocarcinoma composed of poorly differentiated glandular cells with mucin lakes. Porcelain gallbladder may be an end result of a chronic inflammatory reaction, and this change is associated with the development of gallbladder cancer. PMID:12859733

Joo, Young-Eun; Kim, Hyun-Soo; Choi, Sung-Kyu; Rew, Jong-Sun; Kim, Hyun-Jong; Kang, Heoung-Keun; Juhng, Sang-Woo; Kim, Sei-Jong

2003-08-01

345

Etiology, diagnosis and treatment of infectious esophagitis.  

PubMed

Infectious esophagitis may be caused by fungal, viral, bacterial or even parasitic agents. Risk factors include antibiotics and steroids use, chemotherapy and/or radiation therapy, malignancies and immunodeficiency syndromes including acquired immunodeficiency syndrome. Acute onset of symptoms such as dysphagia and odynophagia is typical. It can coexist with heartburn, retrosternal discomfort, nausea and vomiting. Abdominal pain, anorexia, weight loss and even cough are present sometimes. Infectious esophagitis is predominantly caused by Candida species. Other important causes include cytomegalovirus and herpes simplex virus infection. PMID:24868280

Roso?owski, Mariusz; Kierzkiewicz, Maciej

2013-01-01

346

Technological advances in radiotherapy for esophageal cancer  

PubMed Central

Radiotherapy with concurrent chemotherapy and surgery represent the main treatment modalities in esophageal cancer. The goal of modern radiotherapy approaches, based on recent technological advances, is to minimize post-treatment complications by improving the gross tumor volume definition (positron emission tomography-based planning), reducing interfraction motion (image-guided radiotherapy) and intrafraction motion (respiratory-gated radiotherapy), and by better dose delivery to the precisely defined planning target volume (intensity-modulated radiotherapy and proton therapy). Reduction of radiotherapy-related toxicity is fundamental to the improvement of clinical results in esophageal cancer, although the dose escalation concept is controversial. PMID:21105188

Vosmik, Milan; Petera, Jiri; Sirak, Igor; Hodek, Miroslav; Paluska, Petr; Dolezal, Jiri; Kopacova, Marcela

2010-01-01

347

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

PubMed

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

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

348

Promoter hypermethylation of CDH13 is a common, early event in human esophageal adenocarcinogenesis and correlates with clinical risk factors.  

PubMed

Although the CDH13 gene has been shown to undergo epigenetic silencing by promoter methylation in many types of tumors, hypermethylation of this gene in Barrett's-associated esophageal adenocarcinogenesis has not been studied. Two hundred fifty-nine human esophageal tissues were therefore examined for CDH13 promoter hypermethylation by real-time methylation-specific PCR. CDH13 hypermethylation showed discriminative receiver-operator characteristic curve profiles, sharply demarcating esophageal adenocarcinoma (EAC) from esophageal squamous cell carcinoma (ESCC) and normal esophagus (NE) (p < 0.0001). CDH13 normalized methylation values (NMV) were significantly higher in Barrett's esophagus (BE), dysplastic BE (D) and EAC than in NE (p < 0.0000001). CDH13 hypermethylation frequency was 0% in NE but increased early during neoplastic progression, rising to 70% in BE, 77.5% in D and 76.1% in EAC. Both CDH13 hypermethylation frequency and its mean NMV were significantly higher in BE with than without accompanying EAC. In contrast, only 5 (19.2%) of 26 ESCCs exhibited CDH13 hypermethylation. Furthermore, both CDH13 hypermethylation frequency and its mean NMV were significantly higher in EAC than in ESCC, as well as in BE or D vs. ESCC. Interestingly, mean CDH13 NMV was significantly lower in short-segment than in long-segment BE, a known clinical risk factor for neoplastic progression. Similarly, BE segment length was significantly lower in specimens with unmethylated than with methylated CDH13 promoters. 5-aza-2'-deoxycytidine treatment of OE33 EAC and KYSE220 ESCC cells reduced CDH13 methylation and increased CDH13 mRNA expression. These findings suggest that hypermethylation of CDH13 is a common, tissue-specific event in human EAC, occurs early during BE-associated neoplastic progression, and correlates with known clinical neoplastic progression risk factors. PMID:18729198

Jin, Zhe; Cheng, Yulan; Olaru, Alexandru; Kan, Takatsugu; Yang, Jian; Paun, Bogdan; Ito, Tetsuo; Hamilton, James P; David, Stefan; Agarwal, Rachana; Selaru, Florin M; Sato, Fumiaki; Abraham, John M; Beer, David G; Mori, Yuriko; Shimada, Yutaka; Meltzer, Stephen J

2008-11-15

349

A Phase I study of capecitabine, carboplatin, and paclitaxel with external beam radiation therapy for esophageal carcinoma  

SciTech Connect

Purpose: Concurrent chemotherapy and radiation therapy (RT) are used to treat patients with esophageal cancer. The optimal combination of chemotherapeutic agents with RT is undefined. We evaluated a combination of capecitabine, carboplatin, and paclitaxel with RT in a phase I study. Methods and Materials: Patients with squamous cell carcinoma or adenocarcinoma of the esophagus initially received capecitabine, carboplatin, and paclitaxel with RT (1.8 Gy daily to 50.4 Gy). After completion, patients were restaged and evaluated for surgery. Primary endpoints included determination of dose-limiting toxicities (DLT) and a recommended phase II dose, non-DLT, and preliminary radiographic and pathologic response rates. Results: Thirteen patients were enrolled (10 men, 3 women). All were evaluable for toxicity and efficacy. Two of 3 patients at dose level 1 (capecitabine 825 mg/m{sup 2} twice daily on RT days, carboplatin area under the curve (AUC) 2 weekly, paclitaxel 60 mg/m{sup 2} weekly) had DLT (both Grade 4 esophagitis). Of these 3, 2 underwent esophagectomy and had pathologic complete response (pCR). Ten patients were then enrolled at dose level -1 (capecitabine 600 mg/m{sup 2} twice daily, carboplatin AUC 1.5, paclitaxel 45 mg/m{sup 2}). Overall, 3 of 10 patients at dose level -1 developed DLT (2 Grade 3 esophagitis, 1 Grade 3 hypotension). Esophagectomy was performed in 6 of 10 patients. All patients had pathologic downstaging and 2 of 6 had pCR. Conclusions: The maximally tolerated/recommended phase II doses were capecitabine 600 mg/m{sup 2} twice daily, carboplatin AUC 1.5 weekly, and paclitaxel 45 mg/m{sup 2} weekly with RT to 50.4 Gy. In our small study, this regimen appears active but is accompanied by significant toxicities, primarily esophagitis.

Czito, Brian G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)]. E-mail: czito@radonc.duke.edu; Kelsey, Chris R. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Hurwitz, Herbert I. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); Willett, Chris G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Morse, Michael A. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); Blobe, Gerard C. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); Fernando, Nishan H. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); D'Amico, Thomas A. [Department of General Surgery, Duke University Medical Center, Durham, NC (United States); Harpole, David H. [Department of General Surgery, Duke University Medical Center, Durham, NC (United States); Honeycutt, Wanda R.N. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); Yu Daohai [Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC (United States); Bendell, Johanna C. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States)

2007-03-15

350

Mapping the Hallmarks of Lung Adenocarcinoma with Massively Parallel Sequencing  

E-print Network

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 ...

Lander, Eric S.

351

47 CFR 11.44 - EAS message priorities.  

Code of Federal Regulations, 2011 CFR

...message priorities. 11.44 Section 11.44 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Organization § 11.44 EAS message priorities. (a) A national activation of the EAS for a...

2011-10-01

352

47 CFR 11.44 - EAS message priorities.  

Code of Federal Regulations, 2010 CFR

...message priorities. 11.44 Section 11.44 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Organization § 11.44 EAS message priorities. (a) A national activation of the EAS for a...

2010-10-01

353

Short-term neurodevelopmental outcome of babies operated on for low-risk esophageal atresia: a pilot study.  

PubMed

Data on the neurodevelopmental outcome of esophageal atresia (EA) survivors are scarce, controversial, and based on small samples. This is an observational prospective longitudinal study on a selected cohort of low-risk EA survivors. We considered a low-risk EA survivor a patient with the following characteristics: gestational age >32 weeks, no long gap, no genetic or chromosomic anomaly associated with neurodevelopmental delay, and no further major surgical congenital anomalies. Infants were evaluated with scales derived from the Bayley Scales of Infant and Toddler Development - 3rd Edition at 6 and 12 months, with a score of 100 considered normal for each scale. Analysis of variance was used to assess differences of cognitive and motor development. Linear regression was used to assess the impact of the following clinical and sociodemographic variables: gender, birthweight, gestational age, length of hospital stay, number of surgeries and number of esophageal dilatations during first hospitalization, days of mechanical ventilation, weight at follow up, number of surgeries and esophageal dilatations at follow up, parental age, educational level, and socioeconomic status. Thirty children form the object of the study. The mean (standard deviation [SD]) cognitive scale's score was 93.7 (7.5) and 98.2 (9.6) at 6 and 12 months, respectively (P < 0.05). The mean (SD) motor scale's score was 97.6 (9.3) and 98.0 (12.1) at 6 and 12 months, respectively (P = n.s.). Children with a body weight <5° percentile at 12 months showed a mean (SD) cognitive score significantly lower when compared with those with a body weight >5° percentile: 88.8 (6.3) and 100.5 (8.9), respectively. At 12 months, children with unemployed mothers had a mean (SD) motor score significantly lower when compared with those in the other socioeconomic classes: 87.7 (9.8) and 100.6 (12.4), respectively. In conclusion, parents of babies operated on for low-risk EA can be reassured about neurodevelopmental outcome at least up to 1 year of age. When offering a multidisciplinary follow-up program, underweight patients should deserve particular attention to promote their quality of life and support their global development. PMID:23980587

Aite, L; Bevilacqua, F; Zaccara, A; Ravà, L; Valfrè, L; Conforti, A; Braguglia, A; Bagolan, P

2014-01-01

354

Pathologic classification of adenocarcinoma of lung.  

PubMed

Recently, the 1999/2004 World Health Organization (WHO) classification of adenocarcinoma became less useful from a clinical standpoint as most adenocarcinomas belonged to the mixed subtype and the term bronchioloalveolar carcinoma (BAC) gave rise to much confusion among clinicians. For these reasons a new adenocarcinoma classification was introduced in 2011 by a joint working group of the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS), and European Respiratory Society (ERS). This represents an international, multidisciplinary effort joining pathologists, molecular biologists, pulmonary physicians, thoracic oncologists, radiologists, and thoracic surgeons. Currently, a distinction is made between pre-invasive lesions, minimally invasive and invasive lesions. The confusing term BAC is not used anymore and new subcategories include adenocarcinoma in situ and minimally invasive adenocarcinoma. Several aspects of this classification are discussed with main emphasis on its correlation with imaging techniques and its impact on diagnosis, treatment and prognosis. On chest computed tomography (CT) a distinction is made between solid and subsolid nodules, the latter comprising ground glass opacities (GGO), and partly solid lesions. Several studies incorporating CT and positron emission tomographic (PET) data show a good imaging-pathologic correlation. With the implementation of screening programs early lung cancer has become a hotly debated topic and sublobar resection is currently reconsidered for early lesions without lymph node involvement. This new classification will also have an impact on the TNM classification. Thoracic surgeons will continue to play a major role in the application, evaluation and further refinement of this new adenocarcinoma classification. PMID:24006216

Van Schil, Paul E; Sihoe, Alan D L; Travis, William D

2013-10-01

355

Detection of Early-Stage Pancreatic Adenocarcinoma  

PubMed Central

Background Pancreatic adenocarcinoma is an almost universally lethal disease, in large part, due to our inability to detect early-stage disease. Monoclonal antibody PAM4 is reactive with a unique biomarker expressed by greater than 85% of pancreatic adenocarcinomas. In this report, we examined the ability of a PAM4-based immunoassay to detect early-stage disease. Methods The PAM4-based immunoassay was used to quantitate antigen in the serum of healthy volunteers (N=19), patients with known pancreatic adenocarcinoma (N=68), and patients with a primary diagnosis of chronic pancreatitis (N=29). Results Sensitivity for detection of pancreatic adenocarcinoma was 82%, with a false-positive rate of 5% for healthy controls. Patients with advanced disease had significantly higher antigen levels than those with early-stage disease (P<0.01), with a diagnostic sensitivity of 91%, 86%, and 62% for stage 3/4 advanced disease, stage-2, and stage-1, respectively. We also evaluated chronic pancreatitis sera, finding 38% positive for antigen; however, this was discordant with immunohistochemical findings that suggest the PAM4-antigen is not produced by inflamed pancreatic tissue. Furthermore, several of the serum-positive pancreatitis patients, for whom tissue specimens were available for pathological interpretation, had evidence of neoplastic precursor lesions. Conclusions These results suggest the use of the PAM4-serum assay to detect early-stage pancreatic adenocarcinoma, and that positive levels of PAM4-antigen are not derived from inflamed pancreatic tissues, but rather may provide evidence of subclinical pancreatic neoplasia. Impact The ability to detect pancreatic adenocarcinoma at an early stage could provide for early therapeutic intervention with potentially improved patient outcomes. PMID:20810605

Gold, David V.; Goggins, Michael; Modrak, David E.; Newsome, Guy; Liu, Mengling; Shi, Chanjuan; Hruban, Ralph H.; Goldenberg, David M.

2010-01-01

356

Primary appendicular adenocarcinoma presenting as haematuria.  

PubMed

Adenocarcinoma of the vermiform appendix is a rare malignant neoplasm of the gastrointestinal tract encountered rarely within general surgical practice. We present the case of a 49-year-old man who, while undergoing investigations for haematuria, was diagnosed with an appendicular adenocarcinoma following bladder biopsy. Consequently he underwent right hemicolectomy and partial cystectomy followed by adjuvant chemotherapy. By discussing this case we hope to raise awareness within the medical profession of this rare presentation so that it may be considered within clinicians' differential diagnoses. PMID:25358831

Amr, Bassem; Santana-Vaz, Natasha; Munir, Komal

2014-01-01

357

Telecommunications Emergency Alert System (EAS) Radio  

E-print Network

Telecommunications Emergency Alert System (EAS) Radio 1. Send completed form to Mail Stop; Emergency Alert System Radio Instructions The EAS radio operates in a similar fashion as weather radios Maroon Alert (Red LED flashing) or the weekly test (Amber light solid) move switch to reset and then back

358

An overview of esophageal sensory receptors  

Microsoft Academic Search

The neurophysiological basis of esophageal pain and discomfort is not well known. Functional disorder, such as noncardiac chest pain, is thought to be associated with hypersensitivity of primary afferents innervating the esophagus and\\/or sensitization of spinal dorsal horn cells receiving input from the organ. Although we have accumulated a large body of information about the morphologic structure and neuropeptide contents

J. N Sengupta

2000-01-01

359

Protection by Indomethacin against Acute Radiation Esophagitis  

Microsoft Academic Search

The mechanism of radiation induced damage to the mucosal lining of the gastrointestinal tract, as well as mucositis, is not fully characterized. Prostaglandins may partially mediate the inflammatory response to radiation damage. The effect of the prostaglandin synthetase inhibitor indomethacin on radiation induced esophagitis, pneumonitis, and tumor response was evaluated in the C3H mouse. The effects of indomethacin on radiation

Zelig Tochner; Margaret Barnes; James B. Mitchell; Kathy Orr; Eli Glatstein; Angelo Russo

1990-01-01

360

Combined modality therapy for esophageal cancer  

Microsoft Academic Search

Treatment approaches for esophageal cancer include primary treatment (surgical or nonsurgical) or adjuvant treatment (preoperative or postoperative). Primary treatments include surgery alone, radiation therapy alone, and radiation therapy plus chemotherapy (combined modality therapy). Adjuvant therapies include preoperative or postoperative radiation therapy, preoperative chemotherapy, and preoperative combined modality therapy. There is considerable controversy as to the ideal therapeutic approach. This review

Bruce D Minsky

2003-01-01

361

Pharmacokinetics and pharmacogenomics in esophageal cancer chemoradiotherapy  

Microsoft Academic Search

Esophageal cancer is one of the most lethal malignancies. Surgical resection of the tumor from the primary site has been the standard treatment, especially for localized squamous cell carcinoma, but considerable clinical efforts during the last decade have resulted in novel courses of treatment. These options include chemoradiotherapy, consisting of a continuous infusion of 5-fluorouracil (5-FU), cisplatin (CDDP), and concurrent

Toshiyuki Sakaeda; Motohiro Yamamori; Akiko Kuwahara; Kohshi Nishiguchi

2009-01-01

362

Thoracoscopic treatment of benign esophageal tumors  

PubMed Central

Introduction Gastrointestinal stromal tumors are among the most frequent mesenchymal tumors of the gastrointestinal tract; the incidence of these tumors in the esophagus is less than 5%. Prognosis depends on localization, size, mitotic activity and possible invasion of surrounding structures. Minimally invasive surgery may be maximally utilized for removal of these tumors from the esophageal wall. This operation is usually performed thoracoscopically or laparoscopically and using the “rendez-vous” method – with endoscopic navigation. Aim To evaluate a set of patients with benign tumor of the esophagus who were operated on at the First Department of Surgery from 2006 to 2011. Material and methods In the years 2006-2011 a total of 11 patients with benign tumors of the esophagus underwent operation. Results Of the 11 patients with esophageal tumor, 5 were diagnosed with gastrointestinal stromal tumor, 5 with leiomyoma and in one patient the lesion was described as heterotopy of the pancreas. We used the minimally invasive rendez-vous method with endoscopic navigation in 9 cases. All patients healed primarily and were released from hospital on the 4th-7th day. These patients are being followed up as outpatients and recurrence of the tumor has not been observed in any of them. Conclusions Minimally invasive treatment of benign tumors of the esophageal wall is considered to the method of choice. Due to possible complications and the need for subsequent therapy in some patients, these procedures should be centralized to departments with experience in esophageal, thoracic and minimally invasive surgery. PMID:23362430

Neoral, Cestmir; Aujesky, Rene; Skarda, Jozef; Vrba, Radek; Chudacek, Josef; Vomackova, Katherine

2012-01-01

363

Genomics and pharmacogenomics of pancreatic adenocarcinoma  

Microsoft Academic Search

The last decade has brought significant advances in the development of molecularly targeted therapies for treatment of a variety of human malignancies. In contrast to other solid tumors, however, the impact of novel therapeutic strategies on clinical outcomes in patients with pancreas adenocarcinoma (PAC) has been limited to date. Gemcitabine was established as a standard of care for treatment of

M A Lowery; E M O'Reilly

2012-01-01

364

Primary retroperitoneal Müllerian adenocarcinoma arising from endometriosis.  

PubMed

Primary retroperitoneal Müllerian adenocarcinoma (PRMA) is an extremely rare tumor and the cause remains unknown. We report a case of PRMA arising from endometriosis. A 52-year-old woman with a history of malignant lymphoma underwent a follow-up computed tomography scan, which revealed a retroperitoneal tumor. Immunohistochemical analysis of tumor resected during laparoscopic surgery showed adenocarcinoma positive for cytokeratin 7 and negative for cytokeratin 20. The patient had undergone hysterectomy and bilateral salpingo-oophorectomy 14 years ago for myoma uteri and endometrial cysts and was treated with estrogen-replacement therapy. The size of the tumor increased and laparotomy was performed. Histopathological examination showed adenocarcinoma resembling endometrial adenocarcinoma, which stained positive for cancer antigen 125, cancer antigen 19-9, estrogen receptor, and progesterone receptor immunohistochemically. The focus of the endometriosis was found at the edge of the tumor, and the stromal cells around the tumor cells were CD10 positive. The patient was diagnosed as having PRMA arising from endometriosis, and treated with adjuvant chemotherapy. PMID:24888958

Tanaka, Kei; Kobayashi, Yoichi; Shibuya, Hiromi; Nishigaya, Yoshiko; Momomura, Mai; Matsumoto, Hironori; Iwashita, Mitsutoshi

2014-06-01

365

Rare coexistence of sarcoidosis and lung adenocarcinoma  

PubMed Central

Case An eighty year old African-American female was evaluated for cough, chest pain, asymptomatic anemia and 21 pound weight loss over a six month period. Computerized tomography (CT) revealed a spiculated 2.8 cm right upper lobe lung nodule, other smaller nodules and lymphadenopathy. Gallium scan revealed abnormal uptake of radiotracer in lacrimal, hilar and mediastinal glands. Broncho-alveolar lavage showed CD4/CD8 ratio of 2:1 with 15% lymphocytes. Biopsy of right upper lobe lesion and mediastinoscopic lymph node biopsy showed numerous matured uniform non-caseating granulomatous inflammation, however stains and culture for Acid fast bacilli (AFB)/fungal organisms were negative. Patient improved on oral steroids. Six months later she returned with worsening dyspnea and chest X-ray showed bilateral pleural effusions. Thoracocentesis revealed Thyroid transcription factor 1 (TTF1) positive adenocarcinoma cells and Video assisted thoracic surgery (VATS) procedure revealed numerous pleural, pericardial, diaphragmatic metastasis. Biopsy also was positive for TTF1 adenocarcinoma and positive for Epidermal Growth Factor receptor (EGFR) mutation, however negative for Anaplastic Lymphoma Kinase (ALK). Talc pleurodesis was performed. She was treated with erlotinib while steroid was kept on hold. Initial tumor burden decreased but follow-up PET scan six months later showed progression of tumor with lymphadenopathy. After discussion with patient and family, patient opted for hospice care. Discussion Oncocentric theory postulates sarcoidosis as an immunological reaction to dispersal of tumor antigen. Sarcocentric theory postulates that cell-mediated immune abnormalities induced by sarcoidosis in CD4 and CD8 cells is involved in the onset of lung cancer. Thus considerable controversy exists regarding sarcoidosis and malignancy. In our case, TTF1 adenocarcinoma cells from thoracocentesis suggest peripheral nodules in right upper lobe and lingula were likely metastatic, presenting as malignant pleural effusions. However if noncaseating granulomatous inflammation is expected as an immunological reaction to tumor antigen, it is very interesting to observe that initial tissue biopsy of primary right upper lobe mass and mediastinal lymph nodes showed matured uniform non-caseating granulomatous inflammation and no evidence of adenocarcinoma. This being said, it would be highly unlikely for sarcoidosis to progress to lung adenocarcinoma within six months. This adds further controversy to whether granulomatous inflammation is a precursor to future malignancy or whether this elderly African-American female was predisposed to develop granulomatous inflammation in presence of a tumor antigen. One can also speculate whether repeat tissue sampling from right upper lobe mass would have shown granulomatous inflammation or TTF1 adenocarcinoma. Conclusion While evidence is still lacking regarding association between sarcoidosis and lung adenocarcinoma, it is important for clinicians to exclude metastatic malignancy in patients exhibiting clinical and radiographic findings consistent with sarcoidosis.

Kachalia, Amit Girish; Ochieng, Pius; Kachalia, Kinjal; Rahman, Habibur

2014-01-01

366

Esophageal perforation post pneumatic dilatation for achalasia managed by esophageal stenting  

PubMed Central

Patient: Female, 82 Final Diagnosis: Achalasia Symptoms: Nocturnal regurgtation • weight loss Medication: — Clinical Procedure: Esophageal stenting Specialty: Gastroenterology • Hepatology Objective: Unusual or unexpected effect of treatment Background: Pneumatic dilatation is one of the most effective methods for treating achalasia. Esophageal perforation is the most serious complication after pneumatic dilatation and has been reported to occur in the range of 1 to 4.3%. The appropriate management of esophageal perforation can range from conservative medical treatment to surgical intervention. Case Report: We report a case of an 82-year-old male who had an 8 month history of dysphagia for solid and liquids, a 10 lb weight loss and nocturnal regurgitation. The diagnosis of achalasia was established by endoscopic; barium and manometric criteria. He underwent a pneumatic dilation with a 30 mm Rigiflex balloon. A confined or limited esophageal perforation projecting into the mediastinum and located 1–2 cm above the diaphragm was confirmed by a gastrografin swallow study performed immediately after the procedure. There was some accompanying epigastric abdominal pain. Patient was treated later that day by placing a fully covered metallic esophageal stent in addition to antibiotics, proton pump inhibitor, and fasting. Patient was discharged home 3 days later able to eat liquid-soft foods. Follow up endoscopy 2 weeks later and a gastrografin swallow showed a completely healed perforation and the stent was removed. Symptomatically he has done well, with no dysphagia or heartburn at six and twelve months follow up. Conclusions: Early esophageal stenting for esophageal perforation after pneumatic dilation for achalasia is a treatment option which accelerates healing shortens recovery period, as well as decreasing hospital stay and costs. PMID:24349606

Elhanafi, Sherif; Othman, Mohamed; Sunny, Joseph; Said, Sarmad; Cooper, Chad J.; Alkhateeb, Haider; Quansah, Raphael; McCallum, Richard

2013-01-01

367

Detection of esophageal ulcerations with technetium-99m albumin sucralfate  

SciTech Connect

Technetium-99m albumin-sucralfate ((/sup 99m/Tc)Su) can be used to demonstrate peptic ulcer disease in man and animals. We evaluated the usefulness of (/sup 99m/Tc)Su for detecting various grades of esophagitis. (/sup 99m/Tc)Su adhered to the distal esophagus for up to 3 hr in five of six patients with esophageal ulcers but adhered to only two of nine with lesser degrees of esophagitis. No adherence was seen in five patients without esophagitis. Thus, (/sup 99m/Tc)Su may not be useful for detecting any but the most severe grade of esophagitis. Based on these results, we speculate that the previously documented beneficial effects of sucralfate on mild to moderate esophagitis may be due to other mechanisms besides adherence to the ulcerated mucosa.

Goff, J.S.; Adcock, K.A.; Schmelter, R.

1986-07-01

368

Mechanism of enhancement of esophageal tumorigenesis by 6-phenylhexyl isothiocyanate  

Microsoft Academic Search

6-Phenylhexyl isothiocyanate (PHITC) enhances esophageal tumorigenesis induced by the carcinogen N-nitrosomethylben-zylamine (NMBA) in rats while its shorter chain analog, phenethyl isothiocyanate (PEITC), inhibits NMBA-induced esophageal tumorigenesis. A significant increase in O6-methylguanine levels in esophageal DNA at 72 h after NMBA administration to rats pretreated with PHITC suggested that PHITC might enhance NMBA metabolic activation or inhibit DNA repair. To test

Mark A. Morse; Jerry Lu; Rajaram Gopalakrishnan; Lisa A. Peterson; Gulzar Wani; Gary D. Stoner

1997-01-01

369

Barrett's esophagus and reflux esophagitis: is there a missing link?  

Microsoft Academic Search

OBJECTIVES:Barrett's esophagus (BE) is associated with esophageal reflux. The development stage of BE is not well described. Epidemiological evidence indicates that the columnar epithelium in BE is acquired and reaches its full length rapidly. We tested the hypothesis that BE might result from direct replacement of erosions in reflux esophagitis (RE).METHODS:At endoscopy, we compared the length and distribution of esophageal

Alan J. Cameron; Amindra S. Arora

2002-01-01

370

Role of Positron Emission Tomography in Staging Esophageal Cancer  

Microsoft Academic Search

Background. Conventional noninvasive staging of esophageal cancer is inaccurate. This study investigated the role of positron emission tomography (PET) in staging esophageal cancer.Methods. Patients with potentially resectable esophageal cancer were included. A whole-body PET scan was acquired after injection of 18F-fluorodeoxyglucose and was evaluated for areas of increased focal uptake. Accuracy was determined by comparing PET with surgical staging.Results. Potentially

James D Luketich; Philip R Schauer; Carolyn Cidis Meltzer; Rodney J Landreneau; G. Kathleen Urso; David W Townsend; Peter F Ferson; Robert J Keenan; Chandra P Belani

1997-01-01

371

Dosimetric and clinical predictors for radiation-induced esophageal injury  

Microsoft Academic Search

Purpose: To evaluate the clinical and three-dimensional dosimetric parameters associated with esophageal injury after radiotherapy (RT) for non-small-cell lung cancer. Methods and materials: The records of 254 patients treated for non-small-cell lung cancer between 1992 and 2001 were reviewed. A variety of metrics describing the esophageal dose were extracted. The Radiation Therapy Oncology Group toxicity criteria for grading of esophageal

Sung-Ja Ahn; Daniel Kahn; Sumin Zhou; Xiaoli Yu; Donna M. S. Hollis; Timothy D. Shafman; Lawrence B.. Marks

2005-01-01

372

Radiation-induced esophageal strictures in children with cancer  

Microsoft Academic Search

.   The purpose of this study was to determine the long-term esophageal side effects of irradiation and (doxorubicin) chemotherapy\\u000a given to children with cancer. Barium esophagograms and medical records of 18 patients with esophagitis who received between\\u000a 1200 and 5580 cGy to the chest and chemotherapy were reviewed. The age range was 3–14 years. Esophageal strictures occuring\\u000a 1–10 years after

S. Mahboubi; J. H. Silber

1997-01-01

373

Desmoglein-1 regulates esophageal epithelial barrier function and immune responses in eosinophilic esophagitis.  

PubMed

The desmosomal cadherin desmoglein-1 (DSG1) is an essential intercellular adhesion molecule that is altered in various human cutaneous disorders; however, its regulation and function in allergic disease remains unexplored. Herein, we demonstrate a specific reduction in DSG1 in esophageal biopsies from patients with eosinophilic esophagitis (EoE), an emerging allergic disorder characterized by chronic inflammation within the esophageal mucosa. Further, we show that DSG1 gene silencing weakens esophageal epithelial integrity, and induces cell separation and impaired barrier function (IBF) despite high levels of desmoglein-3. Moreover, DSG1 deficiency induces transcriptional changes that partially overlap with the transcriptome of inflamed esophageal mucosa; notably, periostin (POSTN), a multipotent pro-inflammatory extracellular matrix molecule, is the top induced overlapping gene. We further demonstrate that IBF is a pathological feature in EoE, which can be partially induced through the downregulation of DSG1 by interleukin-13 (IL-13). Taken together, these data identify a functional role for DSG1 and its dysregulation by IL-13 in the pathophysiology of EoE and suggest that the loss of DSG1 may potentiate allergic inflammation through the induction of pro-inflammatory mediators such as POSTN. PMID:24220297

Sherrill, J D; Kc, K; Wu, D; Djukic, Z; Caldwell, J M; Stucke, E M; Kemme, K A; Costello, M S; Mingler, M K; Blanchard, C; Collins, M H; Abonia, J P; Putnam, P E; Dellon, E S; Orlando, R C; Hogan, S P; Rothenberg, M E

2014-05-01

374

EA Planning, Development and Management Process for Agile Enterprise Development  

Microsoft Academic Search

In this study, we suggest an enterprise architecture (EA) development process model suitable for EA projects limited in scope and time. Several EA process models have been put forward, which have in common the idea of comprehensive EA management and development that is generic, cyclic and ongoing in a user organization. The suggested models are of varying level of abstraction.

Mirja Pulkkinen; Ari P. Hirvonen

2005-01-01

375

Innovative techniques in evaluating the esophagus; imaging of esophageal morphology and function; and drugs for esophageal disease.  

PubMed

This paper reporting on techniques for esophageal evaluation and imaging and drugs for esophageal disease includes commentaries on endoscopy techniques including dye-based high-resolution and dye-less high-definition endoscopy; the shift from CT to MRI guidance in tumor delineation for radiation therapy; the role of functional lumen imaging in measuring esophageal distensibility; electrical stimulation of the lower esophageal sphincter (LES) as an alternative to fundoduplication for treatment of gastroesophageal reflux disease (GERD); the morphological findings of reflux esophagitis and esophageal dysmotility on double-contrast esophagography; the value of videofluoroscopy in assessing protecting mechanisms in patients with chronic reflux or swallowing disorders; targeting visceral hypersensitivity in the treatment of refractory GERD; and the symptoms and treatments of nighttime reflux and nocturnal acid breakthrough (NAB). PMID:24117631

Neumann, Helmut; Neurath, Markus F; Vieth, Michael; Lever, Frederiek M; Meijer, Gert J; Lips, Irene M; McMahon, Barry P; Ruurda, J P; van Hillegersberg, R; Siersema, P; Levine, Marc S; Scharitzer, Martina; Pokieser, Peter; Zerbib, Frank; Savarino, Vincenzo; Zentilin, Patrizia; Savarino, Edoardo; Chan, Walter W

2013-10-01

376

Esophageal cancer: Recent advances in screening, targeted therapy, and management  

PubMed Central

The incidence of esophageal cancer remains on the rise worldwide and despite aggressive research in the field of gastrointestinal oncology, the survival remains poor. Much remains to be defined in esophageal cancer, including the development of an effective screening tool, identifying a good tumor marker for surveillance purposes, ways to target esophageal cancer stem cells as well as circulating tumor cells, and developing minimally invasive protocols to treat early-stage disease. The goal of this chapter is to highlight some of the recent advances and ongoing research in the field of esophageal cancer.

Gaur, Puja; Kim, Min P.; Dunkin, Brian J.

2014-01-01

377

A Case of Esophageal Squamous Cell Carcinoma with Pancreatic Metastasis  

PubMed Central

Solitary pancreatic metastasis of esophageal cancer is extremely rare. We report the case of a 58-year-old male admitted with esophageal cancer. Additional asymptomatic solitary hepatic and pancreatic masses were observed in the staging work-up for esophageal cancer. The hepatic mass was confirmed as a primary hepatocellular carcinoma with an ultrasound-guided needle biopsy. An esophagectomy with a distal pancreatectomy and radiofrequency ablation for hepatocellular carcinoma were performed. Histologically, the pancreatic mass was confirmed to be a metastasis from the esophageal cancer. The patient has been followed up with chemotherapy. PMID:23614134

Park, Choulki; Kim, Youn Hwa; Hwang, Eun Jung; Na, Ki Yong; Kim, Kyung-Yup; Park, Jae Hyun; Chang, Young Woon

2013-01-01

378

Intramural esophagic hematoma secondary to coumarinic anticoagulation: a case report  

PubMed Central

Esophagic Intramural Hematoma is an uncommon clinical condition, with a prognosis which is essentially benign. On most cases, a predisposing or precipitating factor may be seen, with the most common ones being the history of esophagic instrumentation, food impactations and thrombocytopenia. In the following manuscript, the authors present the case of a 54-years-old male with history of valve replacement surgery, who was treated at the Clinica Cardiovascular (Medellin, Colombia), with a clinical case of Intramural Esophagic Hematoma that was later confirmed to be due to a Coumarinic overanticoagulation. On this case, it is evidenced that Intramural Esophagic Hematoma is an unrecognized complication of Courmarinic anticoagulation therapy. PMID:20069068

2009-01-01

379

Limited resection for early esophageal cancer?  

Microsoft Academic Search

Background. Early squamous cell carcinoma (SCC) and early adenocarcinoma (AC) of the esophagus are potentially curable diseases. The crucial point in treatment is that the depth of tumor infiltration into the mucosal and submucosal layers is correlated with the rate of nodal metastases and therefore with long-term prognosis. Methods and focus. In submucosal SCC with a high rate of nodal

W. Schröder; C. A. Gutschow; A. H. Hölscher

2003-01-01

380

A Sequence Variant in the Phospholipase C Epsilon C2 Domain Is Associated With Esophageal Carcinoma and Esophagitis  

PubMed Central

A single-nucleotide polymorphism (rs2274223: A5780G:His1927Arg) in the phospholipase C epsilon gene (PLC?) was recently identified as a susceptibility locus for esophageal cancer in Chinese subjects. To determine the underlying mechanisms of PLC? and this SNP in esophageal carcinogenesis, we analyzed PLC? genotypes, expression, and their correlation in esophageal cancer cell lines, non-transformed esophageal cells, 58 esophageal squamous cell carcinomas and 10,614 non-cancer subjects from China. We found that the G allele (AG or GG) was associated with increased PLC? mRNA and protein expression in esophageal cancer tissues and in esophageal cancer cell lines. G allele was also associated with higher enzyme activity, which might be associated with increased protein expression. Quantitative analysis of the C2 domain sequences revealed that A:G allelic imbalance was strongly linked to esophageal malignancy. Moreover, the analysis of 10,614 non-cancer subjects demonstrated that the G allele was strongly associated with moderate to severe esophagitis in the subjects from the high-incidence areas of China (OR 6.03, 95% CI 1.59–22.9 in high-incidence area vs. OR 0.74, 95% CI 0.33–1.64 in low-incidence area; P = 0.008). In conclusion, the PLC? gene, particularly the 5780G allele, might play a pivotal role in esophageal carcinogenesis via upregulating PLC? mRNA, protein, and enzyme activity, and augmenting inflammatory process in esophageal epithelium. Thus, 5780G allele may constitute a promising biomarker for esophageal squamous cell carcinoma risk stratification, early detection, and progression prediction. PMID:23390063

Wang, Li-Dong; Bi, Xiuli; Song, Xin; Pohl, Nicole M.; Cheng, Yulan; Zhou, Yixing; Shears, Stephen; Ansong, Emmanuel; Xing, Mengtao; Wang, Shaomeng; Xu, Xiao-Chun; Huang, Peng; Xu, Liyan; Wang, Liang; Fan, Zongmin; Zhao, Xueke; Dong, Huali; Meltzer, Stephen J.; Ding, Ivan; Yang, Wancai

2014-01-01

381

Current strategies in chemoradiation for esophageal cancer  

PubMed Central

Chemoradiotherapy (CRT) has an important role in the treatment of esophageal cancer in both the inoperable and the pre-operative settings. Pre-operative chemoradiation therapy is generally given to 41.4-50.4 Gy with platinum or paclitaxel based chemotherapy. The most common definitive dose in the U.S. is 50-50.4 Gy. New advances in CRT for esophageal cancer have come from looking for ways to minimize toxicity and maximize efficacy. Recent investigations for minimizing toxicity have focused advanced radiation techniques such as IMRT and proton therapy, have sought to further define normal tissue tolerances, and have examined the use of tighter fields with less elective clinical target volume coverage. Efforts to maximize efficacy have included the use of early positron emission tomography (PET) response directed therapy, molecularly targeted therapies, and the use of tumor markers that predict response. PMID:24982764

Lloyd, Shane

2014-01-01

382

Radiation-Induced Esophagitis Exacerbated by Everolimus  

PubMed Central

Background Everolimus, a potent mammalian target of rapamycin (mTOR) inhibitor, has shown anticancer activity against various types of cancer, including renal cell carcinoma (RCC); however, little information is available on the efficacy and safety of the combination of everolimus and radiotherapy. We report a case of radiation-induced esophagitis that might have been exacerbated by the sequential administration of everolimus. Case Presentation A 63-year-old Japanese man with RCC complained of back pain, and magnetic resonance imaging revealed vertebral metastases. He received radiotherapy (30 Gy/10 fractions) to the T6–10 vertebrae. Everolimus was administered immediately after the completion of radiotherapy. One week later, he complained of dysphagia, nausea and vomiting. An endoscopic examination of the esophagus showed erosive esophagitis in the middle to lower portions of his thoracic esophagus, corresponding to the irradiation field. Conclusion Clinicians should be aware that everolimus might lead to the unexpected exacerbation of radiation toxicities. PMID:23898276

Miura, Yuji; Suyama, Koichi; Shimomura, Akihiko; Miyakawa, Jimpei; Kobayashi, Hiroki; Uki, Akiyoshi; Okaneya, Toshikazu; Takano, Toshimi

2013-01-01

383

Esophageal disruption: evaluation with iohexol esophagography.  

PubMed

Twenty-six patients with possible esophageal disruption who were also at risk for aspiration or direct communication of the esophagus with the tracheobronchial tree were examined with iohexol esophagography. Fifteen patients had normal studies confirmed by findings at a barium examination performed immediately after. In 11 patients abnormalities were diagnosed on the basis of iohexol esophagograms; the abnormalities included extraluminal extravasation of contrast material (n = 7), aspiration (n = 1), esophageal stricture with intramural diverticulosis (n = 1), edema of the gastroesophageal junction (n = 1), and epiphrenic diverticulum (n = 1). Eight of these patients were immediately reexamined with barium esophagography, which yielded no additional information. Low-osmolality, water-soluble contrast agents are a safe alternative for patients in whom barium esophagography poses a risk of mediastinitis and esophagography with diatrizoate meglumine and diatrizoate sodium (Gastrografin) poses a risk of pulmonary edema. PMID:3420250

Brick, S H; Caroline, D F; Lev-Toaff, A S; Friedman, A C; Grumbach, K; Radecki, P D

1988-10-01

384

Peroral endoscopic myotomy for esophageal achalasia  

PubMed Central

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

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

2014-01-01

385

Follistatin Is a Novel Biomarker for Lung Adenocarcinoma in Humans  

PubMed Central

Background Follistatin (FST), a single chain glycoprotein, is originally isolated from follicular fluid of ovary. Previous studies have revealed that serum FST served as a biomarker for pregnancy and ovarian mucinous tumor. However, whether FST can serve as a biomarker for diagnosis in lung adenocarcinoma of humans remains unclear. Methods and Results The study population consisted of 80 patients with lung adenocarcinoma, 40 patients with ovarian adenocarcinoma and 80 healthy subjects. Serum FST levels in patients and healthy subjects were measured using ELISA. The results showed that the positive ratio of serum FST levels was 51.3% (41/80), which was comparable to the sensitivity of FST in 40 patients with ovarian adenocarcinoma (60%, 24/40) using the 95th confidence interval for the healthy subject group as the cut-off value. FST expressions in lung adenocarcinoma were examined by immunohistochemical staining, we found that lung adenocarcinoma could produce FST and there was positive correlation between the level of FST expression and the differential degree of lung adenocarcinoma. Furthermore, the results showed that primary cultured lung adenocarcinoma cells could secrete FST, while cells derived from non-tumor lung tissues almost did not produce FST. In addition, the results of CCK8 assay and flow cytometry showed that using anti-FST monoclonal antibody to neutralize endogenous FST significantly augmented activin A-induced lung adenocarcinoma cells apoptosis. Conclusions These data indicate that lung adenocarcinoma cells can secret FST into serum, which may be beneficial to the survival of adenocarcinoma cells by neutralizing activin A action. Thus, FST can serve as a promising biomarker for diagnosis of lung adenocarcinoma and a useful biotherapy target for lung adenocarcinoma. PMID:25347573

Feng, Ye; Liu, Haiyan; Sun, Yang; Liu, Zhonghui; Ge, Jingyan; Cui, Xueling

2014-01-01

386

Reversal of lower esophageal sphincter hypotension and esophageal aperistalsis after treatment for hypothyroidism  

SciTech Connect

A 65-year-old woman suffered from both chronic gastroesophageal reflux, which was complicated by columnar metaplasia (Barrett's epithelium), and profound hypothyroidism. An esophageal motility tracing showed absence of peristalsis in the lower esophagus and the lower esophageal sphincter (LES) could not be identified. Thyroid replacement therapy, in conjunction with antacid and cimetidine treatment, was associated not only with improvement in the gastroesophageal reflux symptoms, but also with a return of esophageal peristalsis and LES pressure to normal. To support our clinical observations, we rendered four cats hypothyroid with /sup 131/I and documented a fall in LES pressure. We propose that abnormal smooth-muscle function of the esophagus may be another manifestation of the gastrointestinal motility disturbances which are associated with hypothyroidism.

Eastwood, G.L.; Braverman, L.E.; White, E.M.; Vander Salm, T.J.

1982-08-01

387

Eosinophilic Esophagitis: update on treatment approaches  

PubMed Central

?osinophilic esophagitis (EoE) is a clinical entity with continuously increasing incidence in children and adults. Diet therapy and corticosteroids are the most important therapeutic interventions currently used, while new therapies are being developed, based on the research of the disease mechanisms. In this review we assess the results of the latest clinical trials on management of patients with EoE, and the advances in the development of novel drug therapies. Hippokratia 2012; 16 (3): 200-204 PMID:23935283

Fotis, L; Xatzipsalti, M; Papadopoulou, A

2012-01-01

388

Dietary freeze dried black raspberry’s effect on cellular antioxidant status during reflux-induced esophagitis in rats  

PubMed Central

Introduction Esophageal cancer consists of two distinct types –esophageal adenocarcinoma (EAC) and squamous cell carcinoma (SCC), both of which differ significantly in their etiology. Freeze dried black raspberry (BRB) has been consistent in its ability to modulate the biomarkers and reduce the incidence of carcinogen-induced SCC in rats. In our previous studies in the esophagoduodenal anastomosis (EDA) model, we have shown that the early modulation of Manganese Superoxide dismutase (MnSOD) significantly correlates with the development of reflux-induced EAC in rats. In this study we looked at the short-term effects of a BRB supplemented diet on the modulation of antioxidant enzymes in reflux-induced esophagitis. Methods Male SD rats (8 wo; n=3–5) were randomized into 3 groups- sham-operated, fed control AIN-93M diet (SH-CD), EDA operated and fed either control diet (EDA-CD) or 2.5% (w/w) BRB diet (EDA-BRB). The effect of both reflux and dietary supplementation was analyzed 2 and 4 weeks after EDA surgery. Results Animals in EDA groups had significantly lower weight gain and diet intake compared to SH-CD (p<0.05). The sham operated animals, received an average esophagitis score of 0.1 ± 0.1, this increased significantly in EDA –CD animals to 1.8 ± 0.14 (p< 0.001 vs SH-CD) and in EDA-BRB group to 1.7 ± 0.06 (p< 0.001 vs SH-CD), with BE changes also present. However, dietary supplementation of BRB did not alter or ameliorate the grade of esophagitis or the induction of BE. BRB diet caused a 43% increase in MnSOD levels compared to EDA-CD (0.73 ± 0.16; p=0.09), however, this effect was not statistically significant and at 4 weeks, EDA-CD (0.58 ±0.12) showed an increase in MnSOD expression compared to SH-CD (0.34 ± 0.01). Conclusions In conclusion, our data suggests that dietary BRB does not increase the levels of cellular antioxidant enzymes or reduce the levels of lipid peroxidation compared to a control diet, in a short-term study of gastroesophageal reflux induction in the EDA animal model. However, it remains to be tested whether this is indicative of its ineffectiveness to inhibit reflux-induced EAC incidence over long-term. PMID:20538426

Aiyer, Harini S; Li, Yan; Liu, Qiao Hong; Reuter, Nathaniel; Martin, Robert C.G.

2010-01-01

389

Diagnostic and therapeutic strategies for eosinophilic esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is a recently recognized allergic disorder, characterized by eosophageal dysfunction, accumulation of ?15 eosinophils/high-powered field, eosinophil microabssess, basal cell hyperplasia, extracellular eosinophilic granules in the esophageal epithelial mucosal biopsy and a lack of response to a 8-week proton pump inhibitor treatment. Despite the increased incidences and considerable progress made in understanding EoE pathogenesis, there are limited diagnostic and therapeutic options available for EoE. Currently, the only criterion for diagnosing EoE is repetitive esophageal endoscopic biopsies and histopathological evaluation. Antigen elimination or corticosteroid therapies are effective therapies for EoE but are expensive and have limitations, if continued in the long term. Hence, there is a great necessity for novel noninvasive diagnostic biomarkers that can easily diagnose EoE and assess effectiveness of therapy. Herein, we have provided an update on key molecules involved in the disease initiation, and progression and proposed novel noninvasive diagnostic molecules and strategies for EoE therapy.

Zaidi, Asifa K; Mussarat, Ahad; Mishra, Anil

2014-01-01

390

Treatment of early and delayed esophageal perforation.  

PubMed

Esophageal perforations are life threatening emergencies associated with high morbidity and mortality. We report on 22 consecutive patients (age 20-86; 13 female and 9 male) with an oesophageal perforation treated at the university hospital Duesseldorf. The patients' charts were reviewed and follow-up was completed for all patients until demission, healed reconstruction or death. Patients' history, clinical presentation, time interval to surgical presentation, and treatment modality were recorded and correlated with patients' outcome. Six esophageal perforations were due to a Boerhaave-syndrome, eleven caused by endoscopic perforation, two after osteosynthesis of the cervical spine and three foreign body induced. In 7 patients a primary local suture was performed, in 4 cases a supplemental muscle flap was interposed, and 7 patients underwent an oesophageal resection. Four patients were treated without surgery (three esophageal stent implantations, one conservative treatment). Eleven patients (50 %) were presented within 24 h of perforation, and 11 patients (50 %) afterwards. Time delay correlates with survival. In 17 (80.9 %) cases a surgical sufficient reconstruction could be achieved. One (4.7 %) patient is waiting for reconstruction after esophagectomy. Four (18.2 %) patients died. A small subset of patients can be treated conservatively by stenting of the Esophagus, if the patient presents early. In the majority of patients a primary repair (muscle flap etc.) can be performed with good prognosis. If the patient presents delayed with extensive necrosis or mediastinitis, oesophagectomy and secondary repair is the only treatment option with high mortality. PMID:24465104

Kroepil, F; Schauer, M; Raffel, A M; Kröpil, P; Eisenberger, C F; Knoefel, W T

2013-12-01

391

EAS Longitudinal Development and the Knee  

E-print Network

It is shown that Extensive Air Shower (EAS) longitudinal development has a critical point where an equilibrium between the main hadronic component and the secondary electromagnetic one exhibits a brake. This results in a change of slope in quasi-power law function $N_{e}(Eo)$. The latter leads to a knee in the EAS size spectrum at primary energy of about 100 TeV/nucleon. Many ``strange'' experimental results can be successfully explained in the frames of current approach.

Yuri V. Stenkin

2007-07-15

392

Adenocarcinoma associated with tail gut cyst  

PubMed Central

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

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

2013-01-01

393

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

PubMed Central

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.

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

2014-01-01

394

Characterizing the cancer genome in lung adenocarcinoma  

Microsoft Academic Search

Somatic alterations in cellular DNA underlie almost all human cancers1. The prospect of targeted therapies2 and the development of high-resolution, genome-wide approaches3-8 are now spurring systematic efforts to characterize cancer genomes. Here we report a large-scale project to characterize copy-number alterations in primary lung adenocarcinomas. By analysis of a large collection oftumours(n 5371)usingdensesinglenucleotidepolymorphism arrays, we identify a total of 57

Barbara A. Weir; Michele S. Woo; Gad Getz; Sven Perner; Li Ding; Rameen Beroukhim; William M. Lin; Michael A. Province; Aldi Kraja; Laura A. Johnson; Kinjal Shah; Mitsuo Sato; Roman K. Thomas; Justine A. Barletta; Ingrid B. Borecki; Stephen Broderick; Andrew C. Chang; Derek Y. Chiang; Lucian R. Chirieac; Jeonghee Cho; Yoshitaka Fujii; Adi F. Gazdar; Thomas Giordano; Heidi Greulich; Megan Hanna; Bruce E. Johnson; Mark G. Kris; Alex Lash; Ling Lin; Neal Lindeman; Elaine R. Mardis; John D. McPherson; John D. Minna; Margaret B. Morgan; Mark Nadel; Mark B. Orringer; John R. Osborne; Brad Ozenberger; Alex H. Ramos; James Robinson; Jack A. Roth; Valerie Rusch; Hidefumi Sasaki; Frances Shepherd; Carrie Sougnez; Margaret R. Spitz; Ming-Sound Tsao; David Twomey; Roel G. W. Verhaak; George M. Weinstock; David A. Wheeler; Wendy Winckler; Akihiko Yoshizawa; Soyoung Yu; Maureen F. Zakowski; Qunyuan Zhang; David G. Beer; Ignacio I. Wistuba; Mark A. Watson; Levi A. Garraway; Marc Ladanyi; William D. Travis; William Pao; Mark A. Rubin; Stacey B. Gabriel; Richard A. Gibbs; Harold E. Varmus; Richard K. Wilson; Eric S. Lander; Matthew Meyerson

2007-01-01

395

Isolated sphenoid sinus adenocarcinoma: a case report  

Microsoft Academic Search

While solitary sphenoid sinus disease is uncommon, primary isolated sphenoid sinus carcinoma is extremely rare. We describe a case of isolated sphenoid sinus adenocarcinoma in a 68-year-old man. The patient presented with a persistent headache and with diplopia secondary to complete ophthalmoplegia. Paranasal sinus tomography showed a soft-tissue mass obliterating the sphenoid sinus and infiltrating the cavernous sinuses. The histological

Ozcan Cakmak; Tan N. Ergin; Volkan M. Aydin

2002-01-01

396

Helicobacter pylori and gastrointestinal tract adenocarcinomas  

Microsoft Academic Search

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,

Martin J. Blaser; Richard M. Peek

2002-01-01

397

HELICOBACTER PYLORI AND GASTROINTESTINAL TRACT ADENOCARCINOMAS  

Microsoft Academic Search

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,

Richard M. Peek Jr; Martin J. Blaser

398

Genetics Home Reference: Esophageal atresia/tracheoesophageal fistula  

MedlinePLUS

... trachea (EA with a distal TEF). Other possible configurations include having the upper section of the malformed ... Where can I find information about diagnosis or management of EA/TEF? These resources address the diagnosis ...

399

An incidentally diagnosed prostatic ductal adenocarcinoma  

PubMed Central

Ductal adenocarcinoma of the prostate was initially described in 1967 by Melicow and Patcher. It was given the erroneous name endometrioid carcinoma, however, further studies confirmed the prostatic origin of this tumor. Currently DAP is classified as a histological variant of prostatic carcinoma. Compared with “classic” acinar carcinoma of the prostate, DAP is a rare histological finding. It's prevalence in prostatectomy and biopsy specimens varies from less than 1% for pure ductal adenocarcinoma up to 5% for mixed DAP. Because of its typical periurethral location, the tumor usually manifests itself clinically with urinary obstruction, urinary urgency, urinary frequency and hematuria. DAP is associated with more aggressive natural history and worse prognosis than pure AA – patients presented at more advanced stage, with poorly differentiated and distant disease. DAP has a tendency to spread to regional lymph nodes, axial skeleton, and visceral organs. We report a case of a 90–year old man who presented to our clinic with acute urinary retention and gross hematuria. He underwent suprapubic transvesical adenomectomy to diminish the urinary obstruction. The pathological examination of the specimens revealed a dominant focus of DAP, which was located near the intraprostatic urethra and a coexisting, smaller component of “classic” acinar adenocarcinoma. PMID:24579020

Kalinowski, Tomasz; Ligaj, Marcin; Demkow, Tomasz

2013-01-01

400

Characterizing the cancer genome in lung adenocarcinoma  

PubMed Central

Somatic alterations in cellular DNA underlie almost all human cancers1. The prospect of targeted therapies2 and the development of high-resolution, genome-wide approaches3–8 are now spurring systematic efforts to characterize cancer genomes. Here we report a large-scale project to characterize copy-number alterations in primary lung adenocarcinomas. By analysis of a large collection of tumors (n = 371) using dense single nucleotide polymorphism arrays, we identify a total of 57 significantly recurrent events. We find that 26 of 39 autosomal chromosome arms show consistent large-scale copy-number gain or loss, of which only a handful have been linked to a specific gene. We also identify 31 recurrent focal events, including 24 amplifications and 7 homozygous deletions. Only six of these focal events are currently associated with known mutations in lung carcinomas. The most common event, amplification of chromosome 14q13.3, is found in ~12% of samples. On the basis of genomic and functional analyses, we identify NKX2-1 (NK2 homeobox 1, also called TITF1), which lies in the minimal 14q13.3 amplification interval and encodes a lineage-specific transcription factor, as a novel candidate proto-oncogene involved in a significant fraction of lung adenocarcinomas. More generally, our results indicate that many of the genes that are involved in lung adenocarcinoma remain to be discovered. PMID:17982442

Weir, Barbara A.; Woo, Michele S.; Getz, Gad; Perner, Sven; Ding, Li; Beroukhim, Rameen; Lin, William M.; Province, Michael A.; Kraja, Aldi; Johnson, Laura A.; Shah, Kinjal; Sato, Mitsuo; Thomas, Roman K.; Barletta, Justine A.; Borecki, Ingrid B.; Broderick, Stephen; Chang, Andrew C.; Chiang, Derek Y.; Chirieac, Lucian R.; Cho, Jeonghee; Fujii, Yoshitaka; Gazdar, Adi F.; Giordano, Thomas; Greulich, Heidi; Hanna, Megan; Johnson, Bruce E.; Kris, Mark G.; Lash, Alex; Lin, Ling; Lindeman, Neal; Mardis, Elaine R.; McPherson, John D.; Minna, John D.; Morgan, Margaret B.; Nadel, Mark; Orringer, Mark B.; Osborne, John R.; Ozenberger, Brad; Ramos, Alex H.; Robinson, James; Roth, Jack A.; Rusch, Valerie; Sasaki, Hidefumi; Shepherd, Frances; Sougnez, Carrie; Spitz, Margaret R.; Tsao, Ming-Sound; Twomey, David; Verhaak, Roel G. W.; Weinstock, George M.; Wheeler, David A.; Winckler, Wendy; Yoshizawa, Akihiko; Yu, Soyoung; Zakowski, Maureen F.; Zhang, Qunyuan; Beer, David G.; Wistuba, Ignacio I.; Watson, Mark A.; Garraway, Levi A.; Ladanyi, Marc; Travis, William D.; Pao, William; Rubin, Mark A.; Gabriel, Stacey B.; Gibbs, Richard A.; Varmus, Harold E.; Wilson, Richard K.; Lander, Eric S.; Meyerson, Matthew

2008-01-01

401

Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma  

PubMed Central

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

Gharaibeh, Kamel A.; Yousuf, Tauqeer

2014-01-01

402

Expression of galectin-3 in gastric adenocarcinoma  

PubMed Central

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

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

2014-01-01

403

Comprehensive molecular profiling of lung adenocarcinoma  

PubMed Central

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

2014-01-01

404

Gene expression profiling in sinonasal adenocarcinoma  

PubMed Central

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

2009-01-01

405

Psoas muscle infiltration masquerading distant adenocarcinoma.  

PubMed

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

Gharaibeh, Kamel A; Lopez-Ruiz, Arnaldo; Yousuf, Tauqeer

2014-01-01

406

Irinotecan, cisplatin, and radiation in esophageal cancer.  

PubMed

The limited effectiveness of currently available chemotherapy in the treatment of advanced esophageal cancer, and the poor survival achieved in locally advanced disease with combined chemoradiotherapy with or without surgery, have prompted the evaluation of new agents. Irinotecan (CPT-11, Camptosar) has promising single-agent activity in gastrointestinal cancers. In phase II evaluation of weekly irinotecan plus cisplatin, response rates have exceeded 30% in esophageal and gastric cancers. Irinotecan is an active radiosensitizer in preclinical studies and clinical trials in lung cancer. We performed a phase I trial of weekly irinotecan, cisplatin, and concurrent radiotherapy in locally advanced esophageal cancer. Induction chemotherapy with irinotecan and cisplatin was given prior to radiotherapy, over 6 weeks, cycled on a 2-week-on, 1-week-off schedule to relieve dysphagia. Radiotherapy was given subsequently in 180-cGy daily fractions to a total dose of 5,040 cGy. Doses of chemotherapy, when given with concurrent radiotherapy, were cisplatin at 30 mg/m2 followed by irinotecan at escalated doses (40, 50, 65, and 80 mg/m2), on days 1, 8, 22, and 29. Among 18 patients entered in the trial, minimal toxicity has been observed, with no grade 3/4 esophagitis or diarrhea. Hematologic toxicity has been minimal. Dose-limiting toxicity (ie, requiring more than a 2-week delay in radiotherapy) has been seen in one of three patients at the 80-mg/M2 irinotecan dose level, and accrual continues at this dose level. Among 13 evaluable patients, five complete responses have been seen (38%), including three pathologic complete responses in 10 patients undergoing surgery (30%). Asymptomatic pulmonary emboli were noted on the posttreatment computed tomography scan in 3 of 15 patients, prompting the addition of warfarin sodium (Coumadin) prophylaxis on protocol. Full doses of weekly irinotecan (65 mg/ m2) and cisplatin (30 mg/m2) can be combined safely with concurrent radiotherapy in patients with locally advanced esophageal cancer. PMID:12109799

Ilson, David H; Minsky, Bruce; Kelsen, David

2002-05-01

407

PET/CT planning during chemoradiotherapy for esophageal cancer  

PubMed Central

Purpose To evaluate the usefulness of positron emission tomography/computed tomography (PET/CT) for field modification during radiotherapy in esophageal cancer. Materials and Methods We conducted a retrospective study on 33 patients that underwent chemoradiotherapy (CRT). Pathologic findings were squamous cell carcinoma in 32 patients and adenocarcinoma in 1 patient. All patients underwent PET/CT scans before and during CRT (after receiving 40 Gy and before a 20 Gy boost dose). Response evaluation was determined by PET/CT using metabolic tumor volume (MTV), total glycolytic activity (TGA), MTV ratio (rMTV) and TGA ratio (rTGA), or determined by CT. rMTV and rTGA were reduction ratio of MTV and TGA between before and during CRT, respectively. Results Significant decreases in MTV (MTV2.5: mean 70.09%, p < 0.001) and TGA (TGA2.5: mean 79.08%, p<0.001) were found between before and during CRT. Median rMTV2.5 was 0.299 (range, 0 to 0.98) and median rTGA2.5 was 0.209 (range, 0 to 0.92). During CRT, PET/CT detected newly developed distant metastasis in 1 patient, and this resulted in a treatment strategy change. At a median 4 months (range, 0 to 12 months) after completion of CRT, 8 patients (24.2%) achieved clinically complete response, 11 (33.3%) partial response, 5 (15.2%) stable disease, and 9 (27.3%) disease progression. SUVmax (p = 0.029), rMTV50% (p = 0.016), rMTV75% (p = 0.023) on intra-treatment PET were found to correlate with complete clinical response. Conclusion PET/CT during CRT can provide additional information useful for radiotherapy planning and offer the potential for tumor response evaluation during CRT. rMTV50% during CRT was found to be a useful predictor of clinical response. PMID:24724049

Seol, Ki Ho

2014-01-01

408

Case report: differential diagnosis between primary cutaneous apocrine adenocarcinoma versus extramammary or metastatic breast adenocarcinoma.  

PubMed

: Cutaneous apocrine adenocarcinoma (CAA) is a rare adnexal neoplasm that histologically can mimic breast carcinoma metastatic to the skin or apocrine carcinoma arising in ectopic breast tissue. It can present with a wide range of clinical modalities and can often simulate many benign processes, which delays its diagnosis and hinders its prognosis. We describe a case of a 33-year-old man who had a short-evolution small nodule in the right axilla with local lymph node metastases. The immunohistochemical characterization was closer to that of breast adenocarcinoma than to an adnexal neoplasm. This was established as the main differential diagnosis. Diagnosis of cutaneous apocrine adenocarcinoma may be difficult and immunomarkers are not specific. The anatomical criteria and systemic investigation are mandatory to establish the correct diagnosis. PMID:23863550

Toledo-Pastrana, Tomás; Llombart-Cussac, Beatriz; Traves-Zapata, Victor; Requena-Caballero, Celia; Sanmartín-Jimenez, Onofre; Angeles-Sales, María; Cabezas, María; Guillén-Barona, Carlos

2014-10-01

409

Complications following Video-Assisted Transhiatal Esophagectomy for Esophageal Cancer  

Microsoft Academic Search

Background: The aim of the study was to evaluate the clinical safety and usefulness of esophageal dissection under laparoscopic monitoring during transhiatal esophagectomy for esophageal cancer. Patients and Methods: The study group of 115 patients included 102 men and 13 women. The mean age was 57 (range 32-79) years. Tumor histology showed a squamous cell carcinoma in 75% and an

Pawel Lampe; Marek Olakowski; Andrzej Wojtyczka; Andrzej Lekstan; Alex Alli-Balogun

2005-01-01

410

Blood Supply Routes of Recurrent Esophageal Varices following Endoscopic Embolization  

Microsoft Academic Search

Background\\/Aim: The blood supply routes of recurrent esophageal varices following complete endoscopic embolization (EE) are not yet known. The purpose of this study is to identify these blood supply routes by comparing endoscopic varicography and percutaneous transhepatic portography (PTP). Methods: Eleven cases of recurrent esophageal varices following EE are included in this study. The blood supply routes of primary and

Fumio Chikamori; Sadao Nishio; Nobutoshi Kuniyoshi; Susumu Shibuya; Yasuhiro Takase

2000-01-01

411

Proposed Revision Of The Staging Classification For Esophageal Cancer  

Microsoft Academic Search

Objectives: This study analyzed survival with respect to lymph node involvement to develop a new staging system for patients with esophageal cancer that accurately reflects prognosis. Methods: The records of patients undergoing resection of primary esophageal cancer from 1989 to 1993 were reviewed. The data collected included patient age and sex, tumor histologic characteristics and location, the use of preoperative

Robert J. Korst; Valerie W. Rusch; Ennapadam Venkatraman; Manjit S. Bains; Michael E. Burt; Robert J. Downey; Robert J. Ginsberg

1998-01-01

412

Peptidergic and nitrinergic denervation in congenital esophageal stenosis  

Microsoft Academic Search

Congenital esophageal stenosis (CES) is a rare disorder with narrowed esophageal lumen that presents as dysphagia from childhood and that is often associated with tracheobronchial remnants or webs. The pathogenesis of CES is unknown. The aim of this study was to examine the histological and immunohistochemical features of CES. Esophagi from 2 young adults with CES and 3 controls with

Chandar Singaram; Mark A. Sweet; Eric A. Gaumnitz; Alan J. Cameron; Michael Camilleri

1995-01-01

413

Long-term survival after photodynamic therapy for esophageal cancer  

Microsoft Academic Search

Background\\/Aims: Photodynamic therapy (PDT) has been adapted to the endoscopic treatment of digestive cancer, but its indications and efficacy remain uncertain. The aim of this study was to assess its feasibility in the curative treatment of small esophageal tumors. Methods: From 1983 to 1991, PDT was used to treat 123 patients with esophageal cancer who were recommended for nonsurgical treatment

Alain Sibille; René Lambert; Jean-Christophe Souquet; Ghislaine Sabben; Françoise Descos

1995-01-01

414

Enucleation of a giant esophageal gastrointestinal stromal tumor.  

PubMed

Despite development of novel chemotherapy for gastrointestinal stromal tumors (GISTs), complete resection remains the gold standard treatment. Because of the small number of reported esophageal gastrointestinal stromal tumors, the optimal extent of resection is not well defined. We present a case of an 82-year-old man with an 11-cm esophageal gastrointestinal stromal tumor who was successfully treated with enucleation. PMID:19379921

Milman, Steven; Kim, Anthony W; Farlow, Erin; Liptay, Michael J

2009-05-01

415

Concurrent Chemoradiotherapy for Esophageal Cancer With Malignant Fistula  

Microsoft Academic Search

Background: We reviewed clinical results of chemoradiotherapy (CRT) in the treatment of patients with advanced esophageal cancer with fistulae that developed before or during CRT. Methods and Materials: The study group included 16 patients with fistulous esophageal cancer treated by means of CRT between 1999 and 2006. Nine patients had fistulae before CRT, whereas 7 developed fistulae during CRT. The

Ryuta Koike; Yasumasa Nishimura; Kiyoshi Nakamatsu; Shuichi Kanamori; Toru Shibata

2008-01-01

416

Esophageal Carcinoma with Celiac Nodal Metastases; Curative or Palliative?  

Microsoft Academic Search

Introduction: To determine the prognostic value of celiac lymph- adenopathy for patients with esophageal or gastroesophageal junc- tion carcinomas treated with neoadjuvant or definitive chemoradio- therapy. Methods: The records of patients undergoing chemoradiation ther- apy for esophageal cancer, who received a dose of at least 45 Gy, were retrospectively reviewed. Results: One hundred forty-four patients were eligible for this retrospective

Marco Trovo; Jeffrey Bradley; Issam El Naqa; Ethan Foster; Bryan Meyers; Ramaswamy Govindan; Alexander Patterson

2008-01-01