《中国肿瘤临床》文章荐读:食管癌发病水平及变化趋势北大核心CSCD

食管癌的组织学类型主要分为食管鳞癌和食管腺癌,从上世纪70代开始许多西方国家的食管鳞癌发病率呈下降趋势,与此相反食管腺癌的发病率迅速增加,成为增长速度最快的恶性肿瘤之一。中国人群食管癌的病理类型以鳞状上皮细胞癌为主,该组织学类型占我国食管癌的90%以上。我国食管癌发病率呈明显的地区差异,食管鳞癌和食管腺癌的发病水平、地理分布、时间变化趋势及发病危险因素存在较大差别。《中国肿瘤临床》2016     

食管癌药物治疗的前景困难及对策

我国是世界上食管癌发病率和死亡率最高的国家之一,食管癌患者数量约占全球的50%.在消化道恶性肿瘤中,食管癌比较独特,有两种不同的组织学类型--鳞癌(占90%)和腺癌(占3.8%～8.8%).目前,我国基本上查清了食管癌的发病、死亡及分布状况,并长期坚持在食管癌高发现场开展流行病学、病因学、发病学的多学科研究及预防实践,取得了一系列成果,特别是在早期诊断与治疗方面居国际领先地位.     

食管癌化学治疗现状

1 概述 食管癌是常见的恶性肿瘤之一,在世界范围内发病率呈上升的趋势,特别是在西方国家,食管腺癌(食管-胃结合部癌,以往称贲门癌)的发病率上升更明显,病理类型由原来的食管鳞癌高发转向腺癌高发,占食管癌的60%～70%[1,2].     

食管癌基因方面的新知识

食管癌发病有明显地域性，全球75%的患者在亚洲。据WHO公布的2012年全球癌症数据，食管癌死亡率最高区域为东亚。食管癌主要包括鳞癌和腺癌，鳞癌是亚洲国家尤其是中国、韩国、日本等东亚国家的主要病理类型，发病率明显高于西方国家，而腺癌则只占1%～4%。     

食管癌术后辅助治疗现状

<正>食管癌在发展中国家发病率较高,死亡率居高不下。在国内,鳞癌是最主要的组织学类型。而在欧美等发达国家,随着胃食管反流病和肥胖发生率的增加,腺癌发生率已超过鳞癌。由于两种组织学类型的预后和侵袭模式不同,目前,美国癌症联合委员会(AJCC)已将两种不同的组织学类型分     

食管癌放化疗相关进展

2008年全球新诊断食管癌约482 300例,死亡约406 800例[1]。我国食管癌发病率居世界之首,欧美等西方国家食管癌患者中腺癌发病率逐年升高,而在我国等东方国家食管鳞癌为主要病理类型,占90%以上。目前手术仍然是食管癌的主要治疗手段,但ⅡA~Ⅲ期食管鳞癌单纯手术的5年生存率仅为20.6%~34.0%。对临床分期较晚的食管癌,目前推荐采用手术、放疗、化疗相结合的综合治疗模式。     

食管癌淋巴结转移特点及化疗研究进展

<正>食管癌是常见的消化道恶性肿瘤之一,全世界每年约30万人死于食管癌,其发病率和死亡率各国及各地区差异极大,其中欧美国家食管癌病理类型主要为腺癌,而我国90%以上食管癌病理类型为鳞癌。我国是食管癌发病大国,是食管癌发病率和死亡率最高的国家,平均每年约15万人死于食管癌。2015年全国肿瘤登记中心收集汇总了我国2012年恶性肿瘤情况显示,食管癌的发病率和死亡率分别位于各类恶性肿瘤的第五位和第四位[1],     

体重指数与食营贲门腺癌

为什么某些消化系统癌症的发病率增长迅速（如食管腺癌，其次是贲门腺癌），而食管鳞癌发病率保持稳定，非资门部胃腺癌甚至稳中有降。美国国立癌症研究所的佩呷．HoCltow等对一以人群为基础的食管癌和胃癌病例对照研究进行了人体测量学危险因素测定，对照组（朋5人）和食管鳞癌、非贲门部腺癌组（589人）按年龄、性别和种族与食管资门、腺癌组（554人）进行匹配。按原发部位肿瘤大小和组织学类型对病例进行分类。通过测算体重指数（BMI），用比值比（OR）来反映肥胖与本研究的关系。对OR按地理区域、年龄、性别、种族、吸烟等进行调整…     

中国专家首次破解亚裔人种食管鳞癌高发密码

<正>中国是食管癌高发国家,病例数占全球50%,且九成患者病理类型为鳞癌;而美国食管癌发病率则很低,且病理类型以腺癌为主。复旦大学附属肿瘤医院放射治疗中心课题组找到了中国食管鳞癌患者的基因特点和遗传学背景,并首次发现了导致中国等亚裔人种食管鳞癌发病风险高的重要原因——NFE2L2基因的"胚系突变"发生风险较其他人种更高。课题组分析人体细胞内的遗传物质DNA,挖掘不同人种食管癌的基因差别,"绘制"出中国食管鳞癌基因图谱,将该图谱与美     

晚期肺腺癌的内科治疗策略

肺癌是我国最常见的恶性肿瘤,肺癌的发病率和死亡率占我国恶性肿瘤的第1位。非小细胞肺癌（non-small-cell lung cancer,NSCLC）约占所有肺癌的85%,主要的病理组织学亚型为腺癌、鳞状细胞癌和大细胞癌。30年前,鳞癌最为多见,但近年来腺癌的发病率呈进行性上升,是目前肺癌中最多见的类型,约占所有肺癌的40%～60%。     

Trends in esophageal cancer incidence by histology, United States, 1998-2003

Esophageal adenocarcinoma rates may be increasing, whereas, squamous cell carcinoma rates appear to be decreasing in the United States. Previous population-based research on esophageal cancer has only covered up to 68% of the country. Additional, updated research on a larger percentage of the country is needed to describe racial, ethnic and regional trends in histologic subtypes of esophageal cancer. Invasive esophageal cancer cases diagnosed between 1998 and 2003 (n = 65,926), collected by the National Program of Cancer Registries or the Surveillance, Epidemiology, and End Results program, were included. These data cover 83% of the US population. Esophageal squamous cell carcinoma incidence fell by 3.6%/year, whereas esophageal adenocarcinoma increased by 2.1%/year. Squamous cell carcinoma rates decreased among both sexes in most racial or ethnic groups, whereas adenocarcinoma rates increased primarily among white or non-Hispanic men. Except for white or non-Hispanic men, squamous cell carcinoma rates were similar to, or greater than, adenocarcinoma rates for men and women of all other races and ethnicities. The largest decrease in squamous cell carcinoma rates occurred in the West census region, which also exhibited no increase in adenocarcinoma rates. The rate of regional and distant-staged adenocarcinomas increased, while rates for local-staged adenocarcinoma remained stable. This is the first article to characterize esophageal cancer trends using data covering the majority of the US. Substantial racial, ethnic and regional variation in esophageal cancer is present in the US. Our work may inform interventions related to tobacco and alcohol use, and overweight/obesity prevention, and provide avenues for further research.     

基于基因芯片技术新疆汉族食管鳞癌差异表达mRNA的筛选

目的 食管癌是全球常见的的恶性肿瘤,新疆为发病率较高的地区之一.本研究旨在完善新疆汉族食管鳞癌(esophageal squamous cell carcinoma,ESCC)基因表达谱,进一步了解ESCC的发生、发展机制,提供与ESCC的预防、诊断及治疗相关的新的生物标志.方法 收集2014-11-03-2015-09-25新疆石河子大学医学院第一附属医院兵团内镜中心6例汉族中分化ESCC患者的癌组织和癌旁正常组织(距癌组织＞5 cm).利用基因芯片技术检测新疆汉族ESCC的差异表达基因.结果 共筛选出汉族ESCC差异表达的mRNAs 335个,其中有138个表达上调的mRNAs和197个表达下调的mRNAs,差异倍数(fold change,FC)≥2且P＜0.01,这些基因涉及多种生物学功能及通路.结论 利用基因芯片技术基于人类全基因谱筛选了新疆汉族ESCC差异表达基因,完善了新疆汉族ESCC基因谱,为ESCC的诊断及预后的进一步研究打下基础.     

VEGF-C与食管鳞癌淋巴管生成的研究进展

食管鳞癌是我国常见的消化道恶性肿瘤之一,淋巴结转移是食管鳞癌最常见的转移途径,也是影响食管鳞癌预后的重要因素。既往研究已证实,食管鳞癌的淋巴道转移与肿瘤淋巴管生成调节因子的表达有密切关系,其中血管内皮生长因子-C（vascular endothelial growth factor-C,VEGF-C) 在恶性肿瘤的淋巴管生成及淋巴结转移中发挥着重要作用。本文就VEGF-C与食管鳞癌淋巴管生成的研究进展作一综述,探讨食管鳞癌淋巴管生成的分子机制,尽可能为食管鳞癌的治疗提供新的理论依据。     

食管鳞癌新辅助放化疗疗效相关生物标志物的研究进展

食管鳞癌是我国最常见的恶性肿瘤之一。新辅助放化疗联合手术明显提高了局部晚期可手术食管鳞癌患者的生存率,但约有一半患者疗效不佳或无效。为精准预测食管癌患者新辅助放化疗的疗效,筛选新辅助放化疗的优势人群,在生物标志物方面已进行多项研究,这在一定程度上促进了食管鳞癌新辅助治疗的进展。本文就生物标志物预测食管鳞癌新辅助放化疗疗效的研究进行综述。     

食管鳞癌新辅助放化疗疗效相关生物标志物的研究进展

食管鳞癌是我国最常见的恶性肿瘤之一。新辅助放化疗联合手术明显提高了局部晚期可手术食管鳞癌患者的生存率,但约有一半患者疗效不佳或无效。为精准预测食管癌患者新辅助放化疗的疗效,筛选新辅助放化疗的优势人群,在生物标志物方面已进行多项研究,这在一定程度上促进了食管鳞癌新辅助治疗的进展。本文就生物标志物预测食管鳞癌新辅助放化疗疗效的研究进行综述。     

RICTOR expression in esophageal squamous cell carcinoma and its clinical significance

Esophageal cancer is one of the most common malignant tumors in the world, and its incidence is the eighth highest; meanwhile, its fatality rate is the sixth highest. The PI3K/Akt/mTOR signaling pathway plays a required role in human cancer, including cell survival, metabolism and migration. As a kind of important scaffold protein in mTORC2, RICTOR has showed over-expression in several malignancies like melanoma and endometrial cancer. In this research, we selected 201 cases of paraffin specimens from patients diagnosed as esophageal squamous cell carcinoma after surgical treatment and then estimated the RICTOR expression in each esophageal squamous cell carcinoma tissue by using the immunohistochemical streptavidin–peroxidase technique. Then, we analyzed the association among the clinicopathological parameters, the prognosis and the expression of RICTOR. Eventually, we found that the percentage of RICTOR-positive expression in 201 ESCC samples is 70.6% (142/201) and the figure for RICTOR-negative or RICTOR-doubtful-positive expression is 29.4% (59/201). RICTOR expression positively correlated with ESCC patients’ AJCC stage (P = 0.011) and showed an opposite trend with survival (P = 0.007). Based on univariate and multivariate Cox proportional hazards regression analysis, RICTOR-positive expression, AJCC staging III or IV and nodal metastasis are prognostic factors and the former two are independent risk factors for ESCC. In conclusion, our study showed potential that targeting RICTOR may represent new effective inhibitors for treating ESCC.     

食管鳞状细胞癌免疫治疗的现状与展望

食管鳞状细胞癌是我国食管癌患者主要的病理类型,目前针对食管鳞癌的免疫治疗显示出新的曙光。免疫抑制剂的疗效令人鼓舞,过继性T细胞疗法和肿瘤疫苗在食管鳞癌方面取得了巨大进步;溶瘤病毒也在针对食管鳞癌方面取得进展;免疫检查点抑制剂与放化疗联合治疗正在积极的试验中。肿瘤免疫治疗因其突出的有效性和安全性,为食管鳞癌患者制定个性化治疗方案提供有意义的指导。     

Molecular and biologic basis of upper gastrointestinal malignancy--esophageal carcinoma

Esophageal cancer is one of the most deadly forms of gastrointestinal cancer. Even though the incidence of esophageal adenocarcinoma has been rising in Western populations over the past two decades, esophageal squamous cell carcinoma remains the predominant type of esophageal malignancy in the remainder of the world. With the recent advances in molecular biology, high-output genome wide screening has provided comprehensive profiles of molecular alterations in human esophageal carcinomas. The elucidation of the basic mechanisms of esophageal carcinogenesis brings with it the promise of developing treatment and preventive strategies that are based on the molecular biology of these tumors. The genetic alterations discussed in this article are not unique to the formation of esophageal carcinomas and represent only a fraction of the molecular changes found in these tumors. The goal of this article is to provide the clinician with a useful conceptual basis for evaluating studies on the molecular mechanisms underlying the development of esophageal carcinomas.     

Expression of PGDH Correlates with Cell Growth in Both Esophageal Squamous Cell Carcinoma and Adenocarcinoma

Esophageal cancer represents the fourth most common gastrointestinal cancer and generally confers a poorprognosis. Prostaglandin-producing cyclo-oxygenase has been implicated in the pathogenesis of esophageal cancergrowth. Here we report that prostaglandin dehydrogenase, the major enzyme responsible for prostaglandindegradation, is significantly reduced in expression in esophageal cancer in comparison to normal esophagealtissue. Reconstitution of PGDH expression in esophageal cancer cells suppresses cancer cell growth, at least inpart through preventing cell proliferation and promoting cell apoptosis. The tumor suppressive role of PGDHapplies equally to both squamous cell carcinoma and adenocarcinoma, which enriches our understanding of thepathogenesis of esophageal cancer and may provide an important therapeutic target.     

The Therapeutic and Preventive Efficacy of Curcumin and Its Derivatives in Esophageal Cancer

Esophageal cancer is the eighth most common occurring cancer type worldwide and 6th most common amongthe cancer related deaths of which the most common type is squamous cell carcinoma which comprise about 90%of esophageal cancer cases. The standard of care for esophageal cancer is neoadjuvant concurrent chemotherapy andradiation (NACRT) followed by surgery however the prognosis remains dismal with 5 year survival a meager 10-15%.The treatment modalities for esophageal cancer is associated with both long term and short term toxicities. Curcuminhas been explored as a therapeutic modality as a chemo adjuvant in different cancers due to its low toxicity profile andpotent anticancer effect however despite lot of promising preclinical data it has not progressed from bench side to bedside. The primary reason that has obstructed its application in clinic has been its low bioavailability which was seenin different clinical trials but there has been tremendous progress in developing formulations of curcumin which havesignificantly increased its bioavailability and are being tested in clinical trials. Esophageal cancer is associated withinflammation that’s why curcumin being a natural antioxidant offer a potential avenue to reduce toxicity of currenttherapeutic modalities in a chemo adjuvant setting while simultaneously targeting different pro oncogenic pathways.The present review tries to cover in depth different aspects of curcumin application in treatment of esophageal cancerand progress of this potent anticancer agent in its treatment and prevention.