Esophageal Neoplasms/diagnostic imaging* ; Humans ; Laryngeal Neoplasms/diagnostic imaging* ; Laryngoscopes ; Narrow Band Imaging ; Neoplasms, Multiple Primary

Esophageal Neoplasms ; surgery ; Esophagectomy ; adverse effects ; Humans ; Mediastinum ; diagnostic imaging ; Surgical Wound Infection ; diagnostic imaging ; etiology

Objective: To construct the diagnostic model of superficial esophageal squamous cell carcinoma (ESCC) and precancerous lesions in endoscopic images based on the YOLOv5l model by using deep learning method of artificial intelligence to improve the diagnosis of early ESCC and precancerous lesions under endoscopy. Methods: 13, 009 endoscopic esophageal images of white light imaging (WLI), narrow band imaging (NBI) and lugol chromoendoscopy (LCE) were collected from June 2019 to July 2021 from 1, 126 patients at the Cancer Hospital, Chinese Academy of Medical Sciences, including low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia, ESCC limited to the mucosal layer, benign esophageal lesions and normal esophagus. By computerized random function method, the images were divided into a training set (11, 547 images from 1, 025 patients) and a validation set (1, 462 images from 101 patients). The YOLOv5l model was trained and constructed with the training set, and the model was validated with the validation set, while the validation set was diagnosed by two senior and two junior endoscopists, respectively, to compare the diagnostic results of YOLOv5l model and those of the endoscopists. Results: In the validation set, the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the YOLOv5l model in diagnosing early ESCC and precancerous lesions in the WLI, NBI and LCE modes were 96.9%, 87.9%, 98.3%, 88.8%, 98.1%, and 98.6%, 89.3%, 99.5%, 94.4%, 98.2%, and 93.0%, 77.5%, 98.0%, 92.6%, 93.1%, respectively. The accuracy in the NBI model was higher than that in the WLI model (P<0.05) and lower than that in the LCE model (P<0.05). The diagnostic accuracies of YOLOv5l model in the WLI, NBI and LCE modes for the early ESCC and precancerous lesions were similar to those of the 2 senior endoscopists (96.9%, 98.8%, 94.3%, and 97.5%, 99.6%, 91.9%, respectively; P>0.05), but significantly higher than those of the 2 junior endoscopists (84.7%, 92.9%, 81.6% and 88.3%, 91.9%, 81.2%, respectively; P<0.05). Conclusion: The constructed YOLOv5l model has high accuracy in diagnosing early ESCC and precancerous lesions in endoscopic WLI, NBI and LCE modes, which can assist junior endoscopists to improve diagnosis and reduce missed diagnoses.
Artificial Intelligence ; Endoscopy/methods* ; Esophageal Neoplasms/pathology* ; Esophageal Squamous Cell Carcinoma/diagnostic imaging* ; Humans ; Narrow Band Imaging ; Precancerous Conditions/diagnostic imaging* ; Sensitivity and Specificity

OBJECTIVETo summarize the experience of diagnosis and treatment of esophageal leiomyoma.

METHODSClinical data of 52 patients with esophageal leiomyoma were analyzed from 1993 to 2002.

RESULTSAbout 54% patients in this group had difficulty of food intake. The diagnostic accuracy of gastrointestinal barium meal series, computed tomography, gastric endoscope and endoscopic ultrasonography (EUS) for esophageal leiomyoma was 64% 44% 27% and 90% respectively. All patients received operation, resection of esophageal leiomyoma by videothoracoscopy (VAS) and endoscope were performed in 6, 9 patients respectively. The remaining 37 patients received regular open operation,in whom 32 cases received enucleation of esophageal leiomyoma, 5 cases received partial esophageal resection and esophageal-gastric anastomosis. No serious complications occurred except only one case needed operation again because of bleeding.

CONCLUSIONEUS is an effective method for diagnosing esophageal leiomyoma. VAS and endoscopic treatment should be considered for suitable cases in order to reduce the trauma.

Esophageal Neoplasms ; diagnostic imaging ; surgery ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Thoracoscopy ; Ultrasonography

OBJECTIVETo study the cancer stem cell populations in esophageal cancer cell lines KYSE150 and TE1 and identify whether resulting stem-like cell spheres display radiation resistance characteristics.

METHODSSerum-free medium (SFM) suspension was used to culture the esophageal cancer stem cell lines and enrich the esophageal stem-like cell spheres. RT-PCR assay was used to detect the stem cell gene expression in the sphere cells. Radiosensitivity of the sphere cells and parental cells were evaluated by clone formation assay. Different cells after irradiation at different doses were tested to evaluate the changes of sphere formation, and cell cycle and CD44(+)CD271(+) expression of the sphere cells were also analyzed by flow cytometry before and after irradiation.

RESULTSCancer stem-like cell spheres were generated from KYSE150 and TE1 cells and enriched by culture in serum-free medium, and the number of spheres was increasing alone with the increase of cell passages. The numbers of spheres formed from the 1st, 2nd and 3rd generations of KYSE150 cells were 25 ± 2, 37 ± 2 and 47 ± 3, respectively. The numbers of spheres formed from the 1st, 2nd and 3rd generations of TE1 cells were 15 ± 3, 24 ± 3 and 36 ± 4, respectively. Certain doses of radiation increased the sphere formation rate. The average survival fraction (SF2) of the suspension-cultured KYSE150 stem-like cell spheres after 2 Gy irradiation were 0.81 ± 0.03 and 0.69 ± 0.04, while that of TE1 parental cells were 0.87 ± 0.01 and 0.80 ± 0.03 (P < 0.05 for all). In the esophageal parental KYSE150 and TE1 cells, arrest at G2 phase was induced after irradiation. After the same dose of irradiation, the inhibition of proliferation of the cancer stem cells was lower than that of the parent cells (P < 0.05). After 0, 4 and 8 Gy irradiation, the CD44(+)CD271(+) cell percentage of KYSE150 parental cells were (1.08 ± 0.03)%, (1.29 ± 0.07)% and (1.11 ± 0.09)%; the CD44(+)CD271(+) cell percentage of TE1 parental cells were (1.16 ± 0.11)%, (0.97 ± 0.08)% and (1.45 ± 0.35)% (P > 0.05 for all). After 0, 4 and 8 Gy irradiation, the percentage of CD44(+)CD271(+) cells of KYSE150 stem cell-like spheres were (35.83 ± 1.23)%, (44.90 ± 1.67)% and (57.77 ± 1.88)%, and that of TE1 stem cell-like spheres were (16.07 ± 0.91)%, (22.67 ± 1.12)% and (33.27 ± 1.07)%. Compared the 4 Gy and 8 Gy irradiated KYSE150 and TE1 stem-like cell spheres with the 0 Gy irradiated spheres, the differences were statistically significant (P < 0.05 for all).

CONCLUSIONSThe cancer stem cells in KYSE150 and TE1 spheres are more radio-resistant than their parental cells. It may suggest that cancer stem cell populations in the esophageal cancer cells are related to the mechanism of occurrence of radioresistance.

Cell Cycle ; Cell Line, Tumor ; diagnostic imaging ; Clone Cells ; Esophageal Neoplasms ; diagnostic imaging ; Flow Cytometry ; Humans ; Neoplastic Stem Cells ; diagnostic imaging ; Radiation Tolerance ; Radiography

Esophageal Neoplasms ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Subclavian Artery ; abnormalities ; diagnostic imaging ; surgery

The accurate judgement of the upper and lower borders of the adenocarcinoma of esophagogastric junction (AEG) by radiology can facilitate the decisions on surgical approach and staging criteria. X-ray double contrast radiography, CT and MRI are the common modalities. The accuracy of X-ray double contrast radiography in determining the invasion length of esophagus and the central point of gastric infiltration can be improved by standardized pretreatment, combination of multiple contrast methods such as double contrast and flow-coating procedure, and combination of multi-angle observations such as conventional frontal, left /right anterior oblique and supine right posterior oblique position. Abdominal enhanced CT is the imaging method recommended by clinical guidelines for the radiological examination of AEG. The relative position of the central point of the tumor from 2 cm line can be determined through the combination of measurement and formula calculation on multi-planar reconstructed CT images. The "three-layer four-type" classification can provide reference for the selection of abdominothoracic incision. The direct demonstration of the tumor extension can be achieved through the CT curved planar reconstruction by drawing lines along esophagus to stomach. The combination of multiple sequences of MRI is helpful to determine the extension of the lesions. In the future, more radiological studies are needed to establish criteria with high accuracy, repeatability and convenient operation,and to assist clinical evaluation of AEG invasion.
Adenocarcinoma ; classification ; diagnostic imaging ; pathology ; surgery ; Contrast Media ; Esophageal Neoplasms ; classification ; diagnostic imaging ; pathology ; surgery ; Esophagogastric Junction ; diagnostic imaging ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Neoplasm Invasiveness ; Neoplasm Staging ; Stomach Neoplasms ; classification ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

The occurrence of double primary cancer of the esophagus and duodenum is considered to be very rare. Moreover, it is difficult to manage this type of double cancer because esophageal cancer has a biologic tendency towards early metastasis. Yet the development of endoscopy such as endoscopic ultrasonography (EUS), the new diagnostic imaging modalities such as PET/CT and advanced pathologic interpretation can lead to an early diagnosis of these multiple primary neoplasms. Appropriate intervention with various therapeutic tools then becomes possible, so these multiple primary neoplasms are not currently obstinate problems. We experienced one patient with double primary cancer; we simultaneously found esophageal cancer and duodenal cancer via endoscopy, and we wanted to treat them with chemo- radiation therapy and endoscopic submucosal dissection, but we failed to persuade the patient to accept the treatment.
Diagnostic Imaging ; Duodenal Neoplasms ; Duodenum ; Early Diagnosis ; Endoscopy ; Endosonography ; Esophageal Neoplasms ; Hematemesis ; Humans ; Neoplasm Metastasis ; Neoplasms, Multiple Primary

Esophageal cancer is one of frequent malignant tumors worldwide. As a noninvasive technique, computed tomography (CT) perfusion imaging could be valuable to assess the microcirculation of esophageal cancer in vivo. Recently, multidetector row CT (MDCT) perfusion imaging has sparked new interest in the assessment of the microcirculation of esophageal cancer, and therapeutic effects of chemoradiotherapy on this tumor. In this paper, we reviewed the status quo of perfusion imaging with MDCT on esophageal cancer.
Esophageal Neoplasms ; blood supply ; diagnostic imaging ; Humans ; Models, Theoretical ; Multidetector Computed Tomography ; methods ; Perfusion Imaging ; methods ; Regional Blood Flow

The 18F 2-fluoro-2-deoxyglucose (FDG) PET/CT scan is an imaging modality used in the management of patients with various types of malignancies. 18F-FDG PET/CT has demonstrated significant efficacy in the staging and detection of metastatic disease in malignancies of the gastrointestinal tract. The assessment of the metabolic response to chemotherapy and improvements of overall survivals in malignancies of esophagus and stomach has been demonstrated in several studies. This review focuses on the role of 18F-FDG PET/CT scan in staging, metastasis, predict of recurrence and assessment of metabolic response in malignancies of the upper gastrointestinal tract.
Esophageal Neoplasms/pathology/*radionuclide imaging ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Lymphatic Metastasis ; Neoplasm Metastasis ; Neoplasm Staging ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Recurrence ; Stomach Neoplasms/pathology/*radionuclide imaging