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1.
Susumu Saigusa Yasuhiko Mohri Koji Tanaka Masaki Ohi Tadanobu Shimura Takahito Kitajima Yoshito Ishino Hiromi Yasuda Yoshinaga Okugawa Yuji Toiyama Yasuhiro Inoue Keiichi Uchida Masato Kusunoki 《Esophagus》2014,11(2):108-116
Background
Neoadjuvant therapy followed by surgery can improve long-term survival and reduce local recurrence in patients with esophageal squamous cell carcinoma (ESCC). Extracapsular lymph node involvement (ECLNI) reflects tumor progression in gastrointestinal malignancies. The aim of this study was to clarify the correlation between ECLNI and clinical outcome in ESCC following neoadjuvant therapy.Methods
A total of 36 patients with ESCC who underwent neoadjuvant therapy followed by surgery were enrolled in this study (CT: n = 16; CRT: n = 20). The correlation between ECLNI and clinicopathological variables was investigated. In addition, we also evaluated whether differences in pathological response existed between primary tumors and metastatic lymph nodes (LNs), and whether chemotherapy (CT) and chemoradiotherapy (CRT) had different effects on LNs.Results
Of 36 patients, 22.2 % had detectable ECLNI. ECLNI was significantly correlated with tumor size (>40 mm), LN density (≧20 %), advanced stage, lymphatic invasion, non-R0 resection, and poor pathological response. Patients with ECLNI had a significantly poorer prognosis than those without ECLNI (P = 0.0040). No differences in pathological response were observed between primary tumors and metastatic LNs for each type of therapy. The median number of dissected LNs was 21, 45, and 14 in the surgery alone (n = 22), CT, and CRT groups, respectively (P < 0.05). More severe morphologic changes in LNs appeared to be induced by CRT than by CT.Conclusion
ECLNI was correlated with poor prognosis in patients with ESCC after neoadjuvant therapy. CT and CRT had different effects on LNs. 相似文献2.
Youichi Kumagai Jun Sobajima Morihiro Higashi Toru Ishiguro Minoru Fukuchi Kei-ichiro Ishibashi Erito Mochiki Koji Yakabi Tatsuyuki Kawano Jun-ichi Tamaru Hideyuki Ishida 《Esophagus》2016,13(3):245-253
Background
The association between angiogenesis and tumor-associated macrophages (TAMs) is unclear. Mononuclear cell infiltration was reported to induce angiogenesis in early stage esophageal squamous cell carcinoma (ESCC).Methods
The study materials included 14 samples of normal squamous epithelium, 11 samples of low-grade intraepithelial neoplasia, and 64 samples of superficial esophageal cancer (M1 and M2 cancer 27; M3 or deeper cancer 37). We assessed microvessel density (MVD) using CD34 and CD105 immunostaining and monocyte count (MC) using CD68 and CD163 immunostaining in relation to the histological type or grade of mononuclear cell infiltration, as well as the correlation between MVD and MC.Results
MVD and MC increased in accordance with histological type, and the differences were significant (P < 0.001). MVD and MC were significantly higher in M1 and M2 lesions than in normal squamous epithelium (P < 0.05). MVD (CD34 and CD105) and MC (CD68 and CD163) were significantly correlated with the degree of mononuclear cell infiltration (P < 0.001), and there was a strong correlation between MC assessed using CD68 and MC assessed using CD163 (rS = 0.93, P < 0.001). The CD163/CD68 ratio did not differ significantly according to histological type. There was a significant correlation between MVD assessed using CD105 and MC assessed using CD68 (rS = 0.69, P < 0.001) and CD163 (rS = 0.67, P < 0.001). MVD assessed using CD34 was also significantly correlated with MC assessed using both CD68 (rS = 0.59, P < 0.001) and CD163 (rS = 0.57, P < 0.001).Conclusion
The number of TAMs is significantly associated with the development of neovasculature in the early stage of ESCC progression.3.
Maria Luisa Torre Giuseppina T. Russo Marta Ragonese Annalisa Giandalia Ernesto De Menis Giorgio Arnaldi Angela Alibrandi Carmelo Buda Giovanni Romanello Elisabetta L. Romeo Domenico Cucinotta Francesco Trimarchi Salvatore Cannavo 《Pituitary》2014,17(3):257-266
Background
Acromegalic patients have a higher risk of developing colorectal tumours (CRT). The common C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR) gene is a well-documented CRT risk factor in the general population, but its role in acromegaly has never been examined.Purpose
We investigated the influence of MTHFR C677T polymorphism, folate status and other lifestyle, nutritional and disease-specific variables on CRT risk in acromegaly.Methods
Clinical data were collected from 115 acromegalic patients (25 with active disease) who underwent a complete colonoscopy. C677T MTHFR genotype, homocysteine, vitamin B12, insulin growth factor and insulin levels, as well as metabolic variables were evaluated.Results
Colorectal tumours were identified in 51 patients (3 adenocarcinomas). MTHFR C677T distribution was in the Hardy–Weinberg equilibrium and similar in patients with or without CRT. There was a correlation between patients with TT genotype and CRT occurrence (Spearman’s test: P = 0.03), with an Odds Ratio (OR) of 1.32 (95 % CI 0.522–3.362, P NS). A folate–MTHFR genotype interaction on CRT risk was found (P = 0.037): in the lower folate subgroup, TT patients showed a 2.4 higher OR for CRT (95 % CI 0.484–11.891; P NS) than C-allele carriers. Smoking (P = 0.007), increased HbA1c levels (P = 0.021), dyslipidaemia (P = 0.049), acromegaly control (P = 0.057), and folate–MTHFR genotype interaction (P = 0.088) were associated with CRT at multivariate analysis.Conclusions
In this cohort of acromegalic patients, CRT risk is increased in 677TT MTHFR patients with low plasma folate levels. Smoking, high HbA1c levels, dyslipidaemia and disease activity were also associated with increased CRT risk. 相似文献4.
Song T Shen YG Jiao NN Li XH Hu HT Qu JR Chen XJ Feng W Zhang X Li HL 《Digestive diseases and sciences》2012,57(8):2195-2202
Objectives
The purpose of this study was to investigate the correlation between multi-slice computed tomographic perfusion imaging (CTPI) parameters and immunohistologic markers of angiogenesis in esophageal squamous cell carcinoma (ESCC).Methods
Fifty patients with histologically proven esophageal squamous cell carcinoma were enrolled in this study. All subjects underwent multi-slice CT perfusion scan. The hemodynamic parameters of vascular tumor, including blood volume (BV), blood flow (BF), mean transit time (MTT) and permeability surface (PS) were generated. All the ESCC specimens were stained immunohistochemically to identify CD31 for quantification of microvessel density (MVD). CTPI parameters were correlated with MVD by using Pearson correlation analysis.Results
The value of CT perfusion parameters of ESCC were as follows: BF 116.71 ± 47.59 ml/100 g/min, BV 6.74 ± 2.70 ml/100 g, MTT 6.42 ± 2.84 s, PS 13.82 ± 6.25 ml/100 g/min. The mean MVD of all 50 tumor specimens was 34.44 ± 19.75. The PS values were significantly higher in ESCC patients with involvement of lymph node than those without involvement of lymph node (p < 0.01). Blood volume and permeability surface were positively correlated with MVD (p < 0.01), whereas no significant correlation was observed between MVD and BF or between MVD and MTT.Conclusions
Blood volume and permeability surface were positively correlated with MVD. CTPI could reflect the angiogenesis in ESCC. 相似文献5.
Beata Biesaga Joanna Niemiec Marek Ziobro 《Journal of cancer research and clinical oncology》2014,140(12):2009-2019
Purpose
The aim of this retrospective study was to investigate the effect of B cell lymphoma 2 (BCL-2) expression on disease-free survival (DFS) in 172 early breast cancer (BC) patients treated with anthracycline-based adjuvant chemotherapy. We have reanalysed follow-up data in these patient groups, and therefore, the relation between DFS and other tumour biological features [expression of oestrogen (ER) and progesterone (PgR) receptors, cytokeratin 5/6 (CK5/6), HER2, topoisomerase IIα (TOPOIIα), Ki-67, P53 and microvessel density (MVD)] studied previously (Biesaga et al. in Breast 20(4):338–350, 2011, doi:10.1016/j.breast.2011.03.002, Pathol Oncol Res 18(4): 949–960, 2012, doi:10.1007/s12253-012-9525-9) was also investigated.Method
Tumour biological features were assessed immunohistochemically on paraffin-embedded sections obtained before treatment from 172 women with BC in stage T1–T2, N1–N2, M0.Results
In univariate analysis, longer DFS was found for patients having tumours with BCL-2 positivity (P = 0.005), low grade (P = 0.001), ER (P = 0.017) and PgR (P = 0.045) positivity, CK5/6 negativity (P = 0.021), low TOPOIIα expression (P = 0.003) and high MVD (P = 0.000). In multivariate analysis, BCL-2, TOPOIIα and MVD were independent parameters indicating patient prognosis. All patients (n = 18) characterized by tumour BCL-2 positivity, low TOPOIIα expression and high MVD survived 80 months without any evidence of cancer disease, whereas DFS for all other patients was significantly (P = 0.022) lower (76.5 %).Conclusion
Combination of three parameters: BCL-2 positivity, low topoisomerase IIα expression and high MVD, allows to identify subgroup of BC patients with very good prognosis after adjuvant anthracycline-based chemotherapy. 相似文献6.
Ligang Xing Yemin Liang Jiandong Zhang Peipei Wu Deguo Xu Fengjun Liu Xinshuang Yu Zhongmin Jiang Xiaoming Song Qi Zang Wei Wang 《Journal of cancer research and clinical oncology》2014,140(5):867-872
Purpose
The aim of this retrospective study is to evaluate the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) or sequential chemoradiotherapy (SCRT) with capecitabine and cisplatin for elderly patients with locally advanced esophageal squamous cell carcinoma (ESCC).Methods
A total of 75 patients elder than 65 years with histologically proven stage II–III ESCC were enrolled, in whom 40 patients were treated with CCRT consisted of two cycles of intravenous cisplatin and oral capecitabine during and after radiotherapy and 35 patients were treated with SCRT as two cycles of capecitabine plus cisplatin before and after radiotherapy. Response rate, overall survival, progression-free survival and toxicity were compared.Results
The overall response rate (CR + PR) in the CCRT group (91.6 %) was significantly higher than that in the SCRT group (67.7 %), P = 0.023. The median PFS and median OS were significantly higher in CCRT group (19.7 and 33.6 months) than those in SCRT group (11.6 and 15.7 months), P < 0.05. The acute toxic effect was more severe in the CCRT group than in the SCRT group, but the grade 3–4 acute toxicities were similar in two groups.Conclusions
It suggested that both CCRT and SCRT with capecitabine and cisplatin are tolerable and effective for elderly patients with locally advanced ESCC. Concurrent CRT might be superior to SCRT. 相似文献7.
R. O. Perez A. Habr-Gama G. P. São Julião P. B. Lynn C. Sabbagh I. Proscurshim F. G. Campos J. Gama-Rodrigues S. C. Nahas C. A. Buchpiguel 《Techniques in coloproctology》2014,18(8):699-708
Background
Molecular imaging using positron emission tomography/computerized tomography (PET/CT) may add relevant incremental diagnostic information to standard structural cross-sectional imaging. Such information may allow identification of patients with rectal cancer that are more likely to develop complete tumor regression after neoadjuvant chemoradiation therapy (CRT). The objective of this report was to identify PET/CT features that are associated with a complete response after CRT.Methods
99 cT2-4N0-2M0 distal rectal cancer patients (≤7 cm from anal verge) were included in this prospective single center trial (NCT 00254683). Patients underwent baseline PET/CT followed by 54 Gy and 5-fluorouracil-based neoadjuvant CRT. After completion of therapy, patients underwent 6- and 12-week PET/CT. Clinical assessment of tumor response was performed at 12 weeks and was blinded to radiological information. Patients were treated according to clinical assessment.Results
There were seven patients with a complete pathological response (pCR) and 16 with a complete clinical response (cCR) (23 complete responders). Comparison of pCR exclusively and non-pCR revealed that only baseline primary tumor standard uptake value (SUV) was a significant predictor of response. Comparison of complete responders (pCR or cCR) and non-complete responders showed that depth of rectal wall uptake at baseline PET/CT (p = 0.002) and variation between baseline and 12-week maximum standard uptake value (SUVmax) of primary tumor (p = 0.001) were independent predictors for complete response at multivariate analysis. A decrease >67 % between baseline and 6-week or 76 % between baseline and 12-week SUVmax were associated with complete response (pCR or cCR; p = 0.02 and p < 0.001, respectively).Conclusions
Positron emission tomography/computerized tomography at baseline, 6 and 12 weeks, may provide information regarding patients with a higher likelihood of developing complete tumor regression following neoadjuvant CRT. 相似文献8.
Yohei Ozawa Yasuhiro Nakamura Fumiyoshi Fujishima Saulo J. A. Felizola Kenichiro Takeda Ken Ito Hiroshi Okamoto Takashi Kamei Go Miyata Noriaki Ohuchi Hironobu Sasano 《Esophagus》2014,11(4):223-230
Background
Esophageal squamous cell carcinoma (ESCC) is a highly malignant disease because of its aggressive biological behavior and metastatic potential. Although several molecular markers have been identified as prognostic factors and/or clinicopathological correlation for the patients of ESCC, it has not been established as the effective new treatment for ESCC patients yet. Hepatocyte growth factor (HGF) is a biomarker as known to promote cell proliferation, motility, and invasion in various human malignancies. But the correlation with cytoplasmic HGF and ESCC has been unclear in details.Methods
We studied the correlation of HGF expression in ESCC tumor cells from 83 ESCC patients who were operated in our hospital using immunohistochemistry.Results
High cytoplasmic HGF expression was detected in 50.6 % (42/83) of ESCC cases examined. HGF immunoreactivity was also focally detected in some cancer-associated fibroblasts. High HGF expression group was significantly correlated with lymph node metastasis (P = 0.029) and tumor differentiation (P = 0.018). Increased HGF immunoreactivity was also correlated with clinicopathological features associated with invasiveness of carcinoma cells (lymphatic invasion, venous invasion, distant metastasis, and pathological stage) but not with actual clinical outcome of the patients.Conclusions
Results of our present study indicated that HGF cytoplasmic expression in ESCC was associated with increased potential for lymph node metastasis and carcinoma differentiation. These findings indicated that endogenous HGF did play an important role in progression and invasion of ESCC via c-Met/HGF autocrine loop together with HGF paracrine mechanisms. 相似文献9.
Youichi Kumagai Tetsuhiko Tachikawa Morihiro Higashi Jun Sobajima Akemi Takahashi Kunihiko Amano Minoru Fukuchi Kei-ichiro Ishibashi Erito Mochiki Koji Yakabi Jun-ichi Tamaru Hideyuki Ishida 《Esophagus》2018,15(1):19-26
Background
The relationship between thymidine phosphorylase (TP) and angiogenesis at the early stage of esophageal squamous cell carcinoma has been unclear.Methods
Using 14 samples of normal squamous epithelium, 11 samples of low-grade intraepithelial neoplasia, and 64 samples of superficial esophageal cancer, microvessel density (MVD) was estimated using immunostaining for CD34 and CD105. TP expression was also evaluated in both cancer cells and stromal monocytic cells (SMCs). We then investigated the correlation between MVD and TP expression in both cancer cells and SMCs.Results
On the basis of the above parameters, MVD was significantly higher in cancerous lesions than in normal squamous epithelium. In terms of CD34 and CD105 expression, MVD showed a gradual increase from normal squamous epithelium, to low-grade intraepithelial neoplasia, and then to M1 and M2 cancer, and M3 or deeper cancer. M1 and M2 cancer showed overexpression of TP in both cancer cells and SMCs. There was no significant correlation between TP expression in cancer cells and MVD estimated from CD34 (rS = 0.16, P = 0.21) or CD105 (rS = 0.05, P = 0.68) expression. Significant correlations were found between TP expression in SMCs and CD34-related (rS = 0.46, P < 0.001) and CD105-related (rS = 0.34, P < 0.01) MVD. In M3 or deeper cancers, there were no significant correlations between TP expression in cancer cells or SMCs and venous invasion, lymphatic invasion, and lymph node metastasis.Conclusion
TP expression is activated in both cancer cells and stromal monocytic cells at the very early stage of ESCC progression. TP expression in SMCs, rather than in cancer cells, is significantly correlated with angiogenesis.10.
Keinchi Koushi Yuji Nishizawa Motohiro Kojima Satoshi Fujii Norio Saito Ryuichi Hayashi Atsushi Ochiai Masaaki Ito 《International journal of colorectal disease》2016,31(12):1845-1852
Purpose
Neoadjuvant chemoradiotherapy (CRT) for rectal cancer improves local control but also induces severe postoperative anal dysfunction that may be related to neural degeneration. The aims of the study were to identify pathological features of neural degeneration caused by neoadjuvant CRT or neoadjuvant chemotherapy (NAC) and to evaluate the association between neural degeneration and anal function.Methods
A retrospective study using chronologically different groups was performed in 95 patients with rectal cancer treated with curative resection with neoadjuvant CRT (n = 47), NAC (n = 27), or surgery alone (no neoadjuvant therapy) (n = 21) at National Cancer Center Hospital East from 2001 to 2014. Peripheral nerve degeneration was evaluated histopathologically using H&E stained sections, based on karyopyknosis, vacuolar or acidophilic degeneration, denucleation, adventitial neuron change, and fibrosis. Morphological analysis of peripheral nerves was compared among the three groups. The association between pathological features and anal function (Wexner Score) was evaluated.Results
After CRT, the degree of fibrosis around the tumor was severe, and neural degeneration was found in peripheral neurons. With NAC and surgery alone, there was little fibrosis and neural degeneration. Pathological changes after CRT were more pronounced than those after NAC, indicating greater tissue degeneration due to CRT. There was an association between anal function and degeneration score in the CRT group, but not in the other groups.Conclusions
Peripheral nerves in patients who received neoadjuvant CRT showed characteristic pathological features indicating greater degeneration, compared with patients who received NAC. Neural degeneration is associated with anal function and several pathological factors after CRT.11.
Takeshi Nishino Takahiro Yoshida Seiya Inoue Satoshi Fujiwara Masakazu Goto Takuya Minato Yoshihito Furukita Yota Yamamoto Yasuhiro Yuasa Hiromichi Yamai Hirokazu Takechi Hiroaki Toba Hiromitsu Takizawa Mitsuteru Yoshida Junichi Seike Takanori Miyoshi Akira Tangoku 《Esophagus》2017,14(2):122-130
Background
Esophageal squamous cell carcinoma (ESCC) is more frequent in male, and female ESCC patients have better prognosis and tend to diagnose at an earlier stage than male. Regarding these female advantages, gender differences of immunological reaction and sex hormone relations were investigated previously. However, the gender differences of clinicopathological features and prognostic factors of ESCC remain well unknown.Methods
A total of consecutive 170 Japanese patients, including 28 females with ESCC who newly diagnosed and underwent esophagectomy between January 2004 and March 2013 in our institute, were examined. Clinicopathological features and p53 expression, a potent biomarker reflecting chemoresistance and prognosis, were compared. Prognostic factors were analyzed using a multivariate analysis.Results
The rates of current drinking, flusher, smoking habits, and Brinkman index in female were lower than those in male (p < 0.001). Tumor location, tumor differentiation, T factor, N factor, clinical stage, and contents of initial treatment had no gender differences. Especially, in the population that received neoadjuvant chemotherapy, excellent pathological effectiveness (>Grade2) was seen much more in female significantly (36.1:66.7 %, p = 0.048). Immunohistostaining revealed positive rates of p53 expression were significantly high in male (50.4:30.5 %, p = 0.007). Postoperative complication occurred more frequently in male than female (52.8:28.6 %, p = 0.024). Estimated 5-year disease-specific survivals by Kaplan–Meier method were worse in male than female at rates of 46.2 and 76.7 %, respectively (p = 0.045). Multivariate analysis by Cox’s proportional hazards model showed that female gender (HR: 0.508, p = 0.023) and tumor depth (HR: 0.572, p = 0.018) were independent prognostic factors of ESCC after resection.Conclusions
Female ESCC showed prefer prognosis to male ESCC. Low p53 imunohistochemical expression in the female ESCC patients might be related with higher sensitivity to neoadjuvant chemotherapy.12.
Ming-Huang Chen Yi-Chen Yeh Yi-Ming Shyr Yi-Hua Jan Yee Chao Chung-Pin Li Shin-E Wang Cheng-Hwai Tzeng Peter Mu-Hsin Chang Chun-Yu Liu Ming-Han Chen Michael Hsiao Chi-Ying F. Huang 《Journal of gastroenterology》2013,48(1):101-108
Background
Gremlin 1 (GREM1) is a bone morphogenetic protein antagonist and a novel proangiogenic factor. Our aim was to evaluate the prognostic value of GREM1 expression and GREM1-related factors in tumor-associated angiogenesis in pancreatic neuroendocrine tumors (NETs).Methods
The immunohistochemical expression of GREM1 and microvessel density (MVD) were examined in 35 patients with pancreatic NETs and then compared with other clinicopathologic characteristics, including the World Health Organization classification.Results
The presence of expression of GREM1 (p = 0.016) and high MVD (p = 0.020) were significant and favorable prognostic factors. Moreover, GREM1 expression was significantly associated with high MVD (p = 0.011). MVD was significantly higher in well-differentiated NETs than in well-differentiated or poorly differentiated neuroendocrine carcinomas (p < 0.001).Conclusions
GREM1 expression was correlated with tumor-associated angiogenesis and was found to be a novel prognostic marker in pancreatic NETS. Our data support a tumor suppressor role of GREM1 in pancreatic NETs. 相似文献13.
Mizuki Aimoto Hideo Koh Takako Katayama Hiroshi Okamura Takuro Yoshimura Shiro Koh Satoru Nanno Mitsutaka Nishimoto Asao Hirose Mika Nakamae Takahiko Nakane Hirohisa Nakamae Hiroshi Kakeya Masayuki Hino 《Infection》2014,42(6):971-979
Purpose
Although a few prospective studies have addressed the question as to which biomarker of infection in adult patients with febrile neutropenia (FN) is superior, procalcitonin (PCT) or C-reactive protein (CRP), the results have been inconsistent and inconclusive. This was possibly due to the poor sensitivity of previous PCT tests that have a functional sensitivity of 0.5 ng/ml.Methods
Between November 2010 and February 2012, we prospectively compared the diagnostic utility of serum high-sensitivity (hs) PCT (lower limit of detection, 0.02 ng/ml) and CRP levels for detecting bacterial infection in patients with FN. Serum was collected within 72 h after the onset of FN in patients with hematological disorders.Results
Seventy-five febrile episodes were evaluable. The areas under the receiver operating characteristic curves for life-threatening infection defined as septic shock and bacteremia caused by non-coagulase negative staphylococcus were 0.824 (95 % CI 0.711–0.937; P = 0.001) for hsPCT and 0.673 (0.505–0.842; P = 0.068) for CRP, respectively. In contrast, CRP, but not hsPCT, tended to increase significantly with the clinical severity, as indicated by the diagnostic classification (P = 0.002 for trend).Conclusions
The serum hsPCT test may be more useful than the serum CRP test in the detection of life-threatening infection at an early phase after the onset of FN. In contrast, the serum CRP test may be more useful in diagnosing the severity of infection. However, neither of these tests was able to differentiate the cause of FN with a low probability of fatal outcome. 相似文献14.
Background
The aim of the study was to assess serum C-reactive protein (CRP) level immediately after minimally invasive esophagectomy (MIE) as a surrogate of surgical invasiveness in patients who underwent esophagectomy.Methods
In total, 104 patients were enrolled in the study: 37 patients underwent MIE in the left lateral decubitus position (MIE-LP) and 67 patients underwent MIE in the prone position (MIE-PP). Serum CRP levels were assessed on POD 1, 3, 5, and 7 after MIE, and were compared with surgical outcomes and duration of systemic inflammatory response syndrome (SIRS) to investigate less invasiveness of the MIE.Results
Reduced serum CRP level on POD 1 was associated with PP during MIE (P < 0.001) and decreased blood loss (P = 0.03). MIE-PP was identified as a significant independent predictor of reduced CRP level on POD 1 (odds ratio 3.65, P = 0.042). CRP level on POD 7 was associated with gender (P = 0.02), position of MIE (P = 0.011), blood loss (P = 0.02), and respiratory complications and/or anastomotic leakage (P < 0.001). Postoperative respiratory and/or anastomotic complication was identified as a significant predictor of elevated serum CRP level on POD 7 (odds ratio 3.44, P = 0.048). Shorter duration of SIRS was shown in the patients with reduced serum CRP level on POD 1 and 7 (P = 0.03 and P < 0.001, respectively).Conclusion
Serial assessments of serum CRP level immediately after MIE may be a possible indicator that can reflect surgical invasiveness and postoperative complications.15.
Hironori Sakita Hiroshi Okumura Sumiya Ishigami Masataka Matsumoto Yasuto Uchikado Tetsuro Setoyama Takaaki Arigami Yoshikazu Uenosono Yuko Kijima Tetsuhiro Owaki Hiroyuki Shinchi Shinichi Ueno Shoji Natsugoe 《Esophagus》2013,10(3):129-134
Background
The clinical and biological characteristics of metachronous esophageal squamous cell cancer (ESCC) after gastrectomy for gastric cancer have yet to be sufficiently elucidated. The aim of the present study was to examine carcinogenesis in such patients.Methods
Subjects comprised 11 patients with metachronous carcinoma in whom ESCC occurred after gastric cancer (metachronous ESCC), 9 patients with simultaneously occurring gastric cancer and ESCC (simultaneous ESCC) and 52 patients with ESCC alone. We investigated the clinicopathological findings and biological properties using p53, p21 and cyclin D1 expression.Results
The positive rate for the intraepithelial spread of tumor was higher for metachronous ESCC than for simultaneous ESCC (p < 0.05). The number of dysplastic lesions in metachronous ESCC, simultaneous ESCC and ESCC alone was 56, 41 and 44, respectively. The rate of positive p53 expression in dysplasia was significantly higher for metachronous ESCC than for ESCC alone (p = 0.03).Conclusions
Positive expression of p53 was found in not only the primary tumor, but also intraepithelial neoplasia around the tumor in metachronous ESCC. Chronic gastroesophageal reflux due to gastrectomy may be involved in the process of carcinogenesis in addition to environmental and genetic factors for metachronous ESCC. Further studies of a larger number of patients with metachronous ESCC and a history of gastrectomy are warranted. 相似文献16.
Pietro Contin Yakup Kulu Thomas Bruckner Martin Sturm Thilo Welsch Beat P. Müller-Stich Johannes Huber Markus W. Büchler Alexis Ulrich 《International journal of colorectal disease》2014,29(2):165-175
Purpose
This study evaluates the anorectal and genitourinary function of patients treated by preoperative short-term radiotherapy (RT) or chemoradiotherapy (CRT) followed by surgery and surgery alone for rectal cancer.Methods
For this study, a total of 613 patients, who were identified from a prospective rectal cancer database, underwent anterior resection of the rectum between October 2001 and December 2007. Standardized questionnaires were used to determine fecal incontinence, urinary, and sexual function. Relevant clinical variables were evaluated using univariate and multivariate analyses. Independent predictors of functional outcome were identified by a binary logistic regression analysis.Results
The data of 263 (43 %) patients were available for analysis. On multivariate analysis, neoadjuvant RT (P?<?0.01) and low anterior resection (LAR) (P?=?0.049) were associated with fecal incontinence. In univariate analysis, fecal incontinence was linked to preoperative neoadjuvant treatment (RT and/or CRT vs. LAR) (P?<?0.01). The hazard ratio for developing fecal incontinence was 3.3 (1.6–6.8) for patients who received RT. One hundred twenty-five patients (51.2 %) experienced urinary incontinence following surgery, the majority of whom were female (P?<?0.01). On univariate analysis, male sexual function was associated with age (P?<?0.01), ASA class (P?=?0.01) and LAR (P?=?0.01).Conclusion
Multimodal therapy of low rectal cancer increases the incidence of fecal incontinence and negatively affects sexual function. The potential benefits of RT or CRT need to be balanced against the risk of increased bowel dysfunction when determining the appropriate treatment for individual patients with rectal cancer. 相似文献17.
Shuhei Komatsu Daisuke Ichikawa Shoji Hirajima Hiroki Takeshita Atsushi Shiozaki Hitoshi Fujiwara Tsutomu Kawaguchi Mahito Miyamae Hirotaka Konishi Takeshi Kubota Kazuma Okamoto Nobuaki Yagi Eigo Otsuji 《Digestive diseases and sciences》2014,59(6):1152-1159
Background
This study was designed to evaluate the clinical benefit of predicting the cyclin D1 (CCND1) status using cell-free plasma DNA in superficial esophageal squamous cell carcinoma (ESCC) patients.Methods
The ratio of the CCND1 (11q13) dosage to the DRD2 (11q22–23) dosage (C/D ratio) as the CCND1 copy number was evaluated. This study was divided into three steps: (1) demonstration of the feasibility, (2) evaluation of whether the plasma C/D ratio assay could monitor tumor dynamics, and (3) a validation study in 63 consecutive superficial ESCC (pTis-T1) patients and 40 healthy volunteers.Results
(1) The plasma C/D ratio was significantly higher (p = 0.0369) in superficial ESCC patients than in the controls in a preliminary test. (2) The high plasma C/D ratio appeared to reflect the tumor levels of the CCND1 status and was reduced in postoperative plasma samples (p = 0.1154) and samples following endoscopic resection (p = 0.0845). (3) Validation analysis revealed that the plasma C/D ratio was significantly higher in superficial ESCC patients than in controls (p < 0.0001). The frequency of recurrence was significantly higher (p = 0.0198), and recurrence-free survival was significantly shorter (p = 0.0075) in patients with a high plasma C/D ratio. Moreover, a high C/D ratio was shown to be an independent risk factor for recurrence on multivariate analysis [p = 0.0334; odds ratio 10.58 (range 1.203–93.23)].Conclusion
The prediction of CCND1 amplification by plasma DNA may be a new complementary clinical biomarker for recurrence in patients with superficial ESCC. 相似文献18.
Clara Natoli Patrizia Vici Isabella Sperduti Antonino Grassadonia Giancarlo Bisagni Nicola Tinari Andrea Michelotti Germano Zampa Stefania Gori Luca Moscetti Michele De Tursi Michele Panebianco Maria Mauri Ilaria Ferrarini Laura Pizzuti Corrado Ficorella Riccardo Samaritani Lucia Mentuccia Stefano Iacobelli Teresa Gamucci 《Journal of cancer research and clinical oncology》2013,139(7):1229-1240
Purpose
Trastuzumab and chemotherapy is the current standard of care in HER2+ early or locally advanced breast cancer, but there are scanty literature data of its real world effectiveness.Methods
We retrospectively reviewed 205 patients with HER2+ breast cancer diagnosed in 10 Italian Medical Oncology Units between July 2003 and October 2011. All patients received neoadjuvant systemic therapy (NST) with trastuzumab in association with chemotherapy. Many different chemotherapy regimens were used, even if 90 % of patients received schemes including anthracyclines and 99 % received taxanes. NST was administered for more than 21 weeks (median: 24) in 130/205 (63.4 %) patients, while trastuzumab was given for more than 12 weeks (median: 12 weeks) in 101/205 (49.3 %) patients. pCR/0 was defined as ypT0+ypN0, and pCR/is as ypT0/is+ypN0.Results
pCR/0 was obtained in 24.8 % and pCR/is in 46.8 % of the patients. At multivariate logistic regression, nonluminal/HER2+ tumors (P < 0.0001) and more than 12 weeks of neoadjuvant trastuzumab treatment (P = 0.03) were independent predictors of pCR/0. Median disease-free survival (DFS) and cancer-specific survival (CSS) have not been reached at the time of analysis. At multivariate analysis, nonluminal/HER2+ subclass (DFS: P = 0.01 and CSS: P = 0.01) and pathological stage II–III at surgery (DFS: P < 0.0001 and CSS: P = 0.001) were the only variables significantly associated with a worse long-term outcome.Conclusions
Our data set the relevance of molecular subclasses and residual tumor burden after neoadjuvant as the most relevant prognostic factors for survival in this cohort of patients. 相似文献19.
Qingxu Song Hong Liu Jianbo Wang Yibin Jia Yuan Liu Nana Wang Bingxu Tan Shanghui Guan Dianzheng An Yufeng Cheng 《Journal of cancer research and clinical oncology》2014,140(5):817-821
Purpose
Esophageal squamous cell carcinoma (ESCC) remains a significant cause of morbidity and mortality worldwide. The aim of the study was to investigate the effects of shorter dinner-to-bed time and post-dinner walk on ESCC risk.Methods
A matched case–control study with 232 ESCC patients and 286 age- and gender-matched healthy controls enrolled was conducted. Conditional logistic regression was used to calculated odds ratio (OR) and 95 % confidence intervals (95 % CI).Results
The adjusted ORs of ESCC for subjects with shorter dinner-to-bed time (<3 h) were 2.84 (95 % CI 1.64–4.29), relative to those with longer dinner-to-bed time (≥4 h). While post-dinner walk was associated with a decreased ESCC risk (adjusted OR 0.64; 95 % CI 0.41–0.89). What’s more, when reflux symptom was added into the multivariate models, risk estimate for shorter dinner-to-bed time still remained statistically significant (p = 0.003), and risk estimate for post-dinner walk changed slightly. In the subgroup analysis stratified by post-dinner walk, subjects with shorter dinner-to-bed time experienced similar risk (adjusted ORs 2.71 vs. 2.82).Conclusions
Shorter dinner-to-bed time is a potential risk factor for ESCC and post-dinner walk is a protective factor, providing evidence for the effect of lifestyle factors on ESCC risk. 相似文献20.
Thomas Mücke David A. Mitchell Andrea Tannapfel Klaus-Dietrich Wolff Denys John Loeffelbein Anastasios Kanatas 《Journal of cancer research and clinical oncology》2014,140(1):127-131