6.Optimization of perioperative treatment strategies for locally advanced esophageal squamous cell carcinoma from the perspective of tumor heterogeneity.
Xiao Zheng KANG ; Rui Xiang ZHANG ; Zhen WANG ; Xian Kai CHEN ; Jian Jun QIN ; Yin LI ; Qi XUE ; Jie HE
Chinese Journal of Gastrointestinal Surgery 2023;26(4):334-338
Recent advances in multimodality treatment offer excellent opportunities to rethink the paradigm of perioperative management for locally advanced esophageal squamous cell carcinoma. One treatment clearly doesn't fit all in terms of a broad disease spectrum. Individualized treatment of local control of bulky primary tumor burden (advanced T stage) or systemic control of nodal metastatic tumor burden (advanced N stage) is essential. Given that clinically applicable predictive biomarkers are still awaited, therapy selection guided by diverse phenotypes of tumor burden (T vs. N) is promising. Potential challenges regarding the use of immunotherapy may also boost this novel strategy in the future.
Humans
;
Esophageal Squamous Cell Carcinoma/surgery*
;
Carcinoma, Squamous Cell/pathology*
;
Esophageal Neoplasms/pathology*
;
Combined Modality Therapy
;
Immunotherapy
7.Analysis of risk factors for depth of invasion and angiolymphatic invasion for circumferential superficial esophageal squamous cell carcinoma and precancerous lesion.
Yi LIU ; Li Zhou DOU ; Xue Min XUE ; Yong LIU ; Shun HE ; Yue Ming ZHANG ; Yan KE ; Xu Dong LIU ; Chang Yuan GUO ; Li Yan XUE ; Gui Qi WANG
Chinese Journal of Oncology 2023;45(2):153-159
Objective: To analyze clinicopathological features of circumferential superficial esophageal squamous cell carcinoma and precancerous lesions and investigate the risk factors for deep submucosal invasion and angiolymphatic invasion retrospectively. Methods: A total of 116 cases of esophageal squamous epithelial high-grade intraepithelial neoplasia or squamous cell carcinoma diagnosed by gastroscopy, biopsy pathology and endoscopic resection pathology during November 2013 to October 2021 were collected, and their clinicopathological features were analyzed. The independent risk factors of deep submucosal invasion and angiolymphatic invasion were analyzed by logistic regression model. Results: The multivariate logistic regression analysis showed that drinking history (OR=3.090, 95% CI: 1.165-8.200; P<0.05), The AB type of intrapapillary capillary loop (IPCL) (OR=11.215, 95% CI: 3.955-31.797; P<0.05) were the independent risk factors for the depth of invasion. The smoking history (OR=5.824, 95% CI: 1.704-19.899; P<0.05), the presence of avascular area (AVA) (OR=3.393, 95% CI: 1.285-12.072; P<0.05) were the independent factors for the angiolymphatic invasion. Conclusions: The risk of deep submucosal infiltration is greater for circumferential superficial esophageal squamous cell carcinoma patients with drinking history and IPCL type B2-B3 observed by magnifying endoscopy, while the risk of angiolymphatic invasion should be vigilant for circumferential superficial esophageal squamous cell carcinoma patients with smoking history and the presence of AVA observed by magnifying endoscopy. Ultrasound endoscopy combined with narrowband imagingand magnification endoscopy can improve the accuracy of preoperative assessment of the depth of infiltration of superficial squamous cell carcinoma and precancerous lesions and angiolymphaticinvasion in the whole perimeter of the esophagus, and help endoscopists to reasonably grasp the indications for endoscopic treatment.
Humans
;
Esophageal Squamous Cell Carcinoma/pathology*
;
Esophageal Neoplasms/pathology*
;
Retrospective Studies
;
Esophagoscopy
;
Carcinoma, Squamous Cell/pathology*
;
Precancerous Conditions/surgery*
;
Margins of Excision
;
Risk Factors
10.Application of novel non-endoscopic device in the screening and early diagnosis of esophageal cancer.
Zhi Yuan FAN ; Ru CHEN ; Wen qiang WEI
Chinese Journal of Oncology 2023;45(8):637-641
Esophageal cancer (EC) is a dreadful disease with a poor prognosis and poses heavy health burden worldwide. Developing effective methods to identify high-risk individuals is urgently needed for preliminary screening before endoscopy. The novel non-endoscopic device has the potential advantages of low cost, simple operation, and minimal invasiveness. Approximately 90% of participants can swallow the device successfully with high safety profiles, and sufficient esophageal exfoliated cells can be collected for cytological examination and biomarker detection. Cytological examination based on the device combined with trefoil factor 3 (TFF3) protein or DNA methylation examinations could effectively screen Barrett's esophagus-associated dysplasia and early esophageal adenocarcinoma, but large prospective studies are needed to further validate the diagnostic value of this device to improve the quality of evidence. Although the device-based cytological examination in combination with biomarker detection holds promise in the early screening of esophageal squamous dysplasia and early esophageal squamous cell carcinoma, related research is still in its infancy, and there is still a lack of sufficient evidence for population screening in China. Active research into the application of this novel non-endoscopic device in EC screening and early diagnosis is of great significance for optimizing EC screening strategies and improving the early diagnosis of EC.
Humans
;
Esophageal Neoplasms/pathology*
;
Early Detection of Cancer
;
Esophageal Squamous Cell Carcinoma
;
Barrett Esophagus/pathology*
;
Biomarkers/analysis*
;
Esophagoscopy
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