Esophageal squamous cell carcinoma (ESCC) poses a significant global health challenge, necessitating early detection, timely diagnosis, and prompt treatment to improve patient outcomes. Endoscopic examination plays a pivotal role in this regard. However, despite the availability of various endoscopic techniques, certain limitations can result in missed or misdiagnosed ESCCs. Currently, artificial intelligence (AI)-assisted endoscopic diagnosis has made significant strides in addressing these limitations and improving the diagnosis of ESCC and precancerous lesions. In this review, we provide an overview of the current state of AI applications for endoscopic diagnosis of ESCC and precancerous lesions in aspects including lesion characterization, margin delineation, invasion depth estimation, and microvascular subtype classification. Furthermore, we offer insights into the future direction of this field, highlighting potential advancements that can lead to more accurate diagnoses and ultimately better prognoses for patients.
Humans ; Artificial Intelligence ; Esophageal Squamous Cell Carcinoma/diagnosis* ; Esophageal Neoplasms/diagnosis* ; Precancerous Conditions/diagnosis*

The early diagnosis and precise treatment of esophageal squamous cell carcinoma (ESCC) hold significant clinical value in improving patient survival rate. Current diagnostic methods for early-stage ESCC primarily rely on invasive procedures and endoscopy, which can cause discomfort and financial burden for patients. Therefore, non-invasive biomarkers with high sensitivity and specificity present a more suitable alternative for early tumor diagnosis. Tumor associated autoantibodies (TAAb), identified as potential biomarkers, have considerable clinical implications for the early diagnosis, treatment monitoring, and prognosis assessment of ESCC. Here in we aim to summarize recent research on ESCC-related autoantibodies, including their background, types and development, analyze the potential of those autoantibodies in clinical diagnosis, treatment monitoring, and prognosis assessment, and also discuss the limitations of existing research and future directions. The goal is to provide a theoretical foundation for the early diagnosis and personalized treatment of ESCC.
Humans ; Autoantibodies/immunology* ; Esophageal Neoplasms/therapy* ; Esophageal Squamous Cell Carcinoma/immunology* ; Biomarkers, Tumor/immunology* ; Prognosis ; Carcinoma, Squamous Cell/diagnosis* ; Animals

Humans ; Esophageal Squamous Cell Carcinoma/pathology* ; Esophageal Neoplasms/pathology* ; Carcinoma, Squamous Cell/pathology* ; Precancerous Conditions/pathology* ; Early Diagnosis

Early detection of esophageal cancer can provide a good prognosis and a possibility of achieving a cure through endoscopic treatment. Owing to the high risk of lymph node metastasis, the prognosis of esophageal cancer is poorer than that of gastric cancer. Therefore, detection of esophageal cancer at an early stage by endoscopic examination is important. The esophagus is not simply the area through which the endoscope passes. To avoid missing esophageal lesions, knowledge of the normal mucosal findings is important to detect minute changes in the esophagus. If suspicious lesions are found, endoscopists should describe the location and characteristics of the lesion in detail, and perform accurate biopsy. If a suspicious part is found, chromoendoscopy using Lugol's solution or image-enhanced endoscopy, such as narrow-band imaging, can help in the decision for further examinations. Biopsy should be performed to confirm the lesion.
Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Endoscopes ; Endoscopy ; Esophageal Neoplasms ; Esophagus ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms

Esophageal cancer is an aggressive malignant tumor with a poor prognosis because of its typically advanced stage at diagnosis and treatment-related morbidity and mortality. Of the two major subtypes, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma, ESCC is prevalent in more than 90 percent of esophageal cancer patients in Korea. Both the incidence and mortality of esophageal cancer are declining, and the relative survival rate of patients with esophageal cancer has improved. These epidemiological changes are attributed to increase in the detection rate of esophageal cancer at localized and regional stages before distant spread of the disease. And the most well-known risk factors for esophageal adenocarcinoma are obesity and gastro-esophageal reflux disease. The carcinogenesis of ESCC is associated with chronic irritation caused by smoking, heavy alcohol use, drinking very hot beverages, and a low socioeconomic status. Understanding the risk factors for esophageal cancer can lead to the identification of preventative strategies to reduce the risk of developing esophageal cancer or to improve the long-term prognosis.
Adenocarcinoma ; Beverages ; Carcinogenesis ; Carcinoma, Squamous Cell ; Diagnosis ; Drinking ; Epidemiology ; Esophageal Neoplasms ; Gastroesophageal Reflux ; Humans ; Incidence ; Korea ; Mortality ; Obesity ; Prognosis ; Risk Factors ; Smoke ; Smoking ; Social Class ; Survival Rate

A subepithelial tumor-like esophageal carcinoma is rare. We report a case of an esophageal squamous cell carcinoma with lymph node metastasis presenting as a small subepithelial tumor. A 68-year-old man presented to our hospital complaining of hoarseness since last three months. Endoscopic examination revealed a 1 cm hard and fixed subepithelial tumor with surface erosion in the lower esophagus. A biopsy specimen was obtained using conventional forceps, and histopathological evaluation revealed few atypical squamous epithelial cells. Subsequent EUS demonstrated a homogeneous hypoechoic lesion in the deep mucosal layer. A CT scan of the chest showed a 3 cm mass in the right upper paratracheal area. EUS-guided fine needle biopsy of the lesion led to the diagnosis of squamous cell carcinoma with lymph node metastasis.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell ; Diagnosis ; Endosonography ; Epithelial Cells ; Esophageal Neoplasms ; Esophagus ; Hoarseness ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Surgical Instruments ; Thorax ; Tomography, X-Ray Computed

To explore the changes of serum microRNA-183 levels in patients with esophageal squamous cell carcinoma (ESCC) and its clinical significance.
 Methods: Fifty-one patients with ESCC and 55 healthy subjects from Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South Unicersity were selected for this study. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to determine the level of miRNA-183 in serum samples. Chi-square test and correlation analysis were used to investigate the relationship between serum miRNA-183 level and clinical and pathological parameters of ESCC. Diagnostic efficiency of miRNA-183 and combined carcinoembryonic antigen (CEA) examination for ESCC was analyzed by receiver operating characteristic (ROC) curve.
 Results: 1) The levels of miR-183 in the patients with ESCC (4.47±1.54) were elevated compared with that in the healthy subjects (2.03±0.96), with significant difference (t=9.700, P<0.01). 2) The levels of serum miR-183 in ESCC patients were significantly different among patients with different TNM stages (χ2=4.049, P<0.01), which was not affected by gender, age, smoking, drinking, tumor location, tumor diameter, lymph node metastasis, depth of invasion and differentiation (all P>0.05). The levels of miR-183 were not associated with the serum CEA levels (P>0.05). 3) When the ROC curve analysis was used to diagnose ESCC with the optimal cutoff value of 4.502 for miR-183, the sensitivity, the specificity, the area under the curve (AUC) and 95% confidence interval was 78.9%, 76.2%, 0.762 and 0.830-0.922, respectively. When combined detection of serum miR-183 and CEA was used to diagnose ESCC, the sensitivity, specificity, AUC and 95% confidence interval was 82.3%, 92.6%, 0.877 and 0.814-0.935, respectively.
 Conclusion: Serum miRNA-183 levels in ESCC patients may be increased, which can improve the diagnostic efficiency of ESCC when combined with CEA. Serum miRNA-183 levels is related with tumor TNM stage, which contributes to the judgment of tumor progression and efficacy prediction.
Biomarkers, Tumor ; blood ; Carcinoembryonic Antigen ; blood ; Esophageal Neoplasms ; blood ; diagnosis ; Esophageal Squamous Cell Carcinoma ; blood ; diagnosis ; Humans ; MicroRNAs ; blood ; Predictive Value of Tests ; Prognosis

BACKGROUND/AIMS: Esophageal squamous cell carcinoma (ESCC) and colorectal neoplasms (CRNs) share risk factors. We aimed to investigate whether the CRN risk is increased in ESCC patients. METHODS: ESCC patients who underwent a colonoscopy within 1 year of diagnosis were retrospectively analyzed. Patients were matched 1:3 by age, gender, and body mass index to asymptomatic controls. CRN was defined as the histological confirmation of adenoma or adenocarcinoma. Advanced CRN was defined as any of the following: > or =3 adenomas, high-grade dysplasia, villous features, tumor > or =1 cm, or adenocarcinoma. The risk factors for both CRN and advanced CRN were evaluated by univariate and multivariate analyses. RESULTS: Sixty ESCC patients were compared with 180 controls. The ESCC group had significantly higher numbers of CRNs (odds ratio [OR], 2.311; 95% confidence interval [CI], 1.265 to 4.220; p=0.006) and advanced CRNs (OR, 2.317; 95% CI, 1.185 to 4.530; p=0.013). Significant risk factors for both CRN and advanced CRN by multivariate analysis included ESCC (OR, 2.157, 95% CI, 1.106 to 4.070, p=0.024; and OR, 2.157, 95% CI, 1.045 to 4.454, p=0.038, respectively) and older age (OR, 1.068, 95% CI, 1.032 to 1.106, p<0.001; and OR, 1.065, 95% CI, 1.024 to 1.109, p=0.002, respectively). CONCLUSIONS: The rates of CRN and advanced CRN are significantly increased in ESCC. Colonos-copy should be considered at ESCC diagnosis.
Adenocarcinoma/diagnosis/*etiology ; Adenoma/diagnosis/*etiology ; Aged ; Carcinoma, Squamous Cell/diagnosis/*etiology ; Case-Control Studies ; Colonoscopy ; Colorectal Neoplasms/diagnosis/*etiology ; Esophageal Neoplasms/diagnosis/*etiology ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis/*etiology ; Odds Ratio ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: In head and neck squamous cell carcinoma, second primary gastrointestinal tumors are not uncommon. However, it is unclear whether a screening endoscopy is needed for detecting gastrointestinal neoplasm in patients with head and neck cancer. Therefore, we analyzed the prevalence and independent risk factors for second primary gastrointestinal neoplasm in head and neck squamous cell carcinoma. METHODS: A consecutive series of 328 patients with primary head and neck squamous cell carcinoma that underwent esophagogastroduodenoscopy or colonoscopy were included using our registry. An age- and sex-matched group of 328 control subjects was enrolled. We assessed risk factors of synchronous gastrointestinal cancer. RESULTS: The prevalence of esophageal cancer with head and neck squamous cell carcinoma was significantly higher than that of the control group (1.5% vs. 0.0%, p=0.011). An age of 54 years or more (OR, 1.033; 95% CI, 1.008-1.059; p=0.009) and male gender (OR, 4.974; 95% CI, 1.648-15.013; p=0.004) were risk factors for concomitant colorectal cancer or adenomas in the head and neck squamous cell carcinoma patients. CONCLUSIONS: Preoperative colonoscopy can be recommended for detecting synchronous second primary colorectal lesions in head and neck squamous cell carcinoma patients with male sex regardless of age, and esophagogastroduodenoscopy is necessary in all head and neck squamous cell carcinoma patients for detecting esophageal cancer.
Adenoma ; Carcinoma, Squamous Cell ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis ; Endoscopy ; Endoscopy, Digestive System ; Endoscopy, Gastrointestinal* ; Esophageal Neoplasms ; Gastrointestinal Neoplasms ; Head and Neck Neoplasms* ; Head* ; Humans ; Male ; Mass Screening ; Neck ; Neoplasms, Second Primary* ; Prevalence ; Risk Factors

OBJECTIVETo explore the correlation of c-met protein with the clinical staging and cell differentiation of esophageal squamous cell carcinoma (ESCC).

METHODSA total of 100 patients with ESCC were enrolled were examined for expression of c-met protein using immunohistochemistry, and the patients in negative and positive c-met expression groups were compared for clinicopathological characteristics and overall survival.

RESULTSs The 100 ESCC patients included 67 male and 33 female patients with a median age of 59 years; 49 of the patients were negative and 51 were positive for c-met expression. Positive c-met expression was significantly correlated with advanced TMN stages and lower tumor differentiation. Kaplan-Meier survival curve showed that the median survival time of c-met-positive patients was significantly reduced compared with that of c-met-negative patients (30.9 vs 48.2 months, P<0.05). COX regression analysis showed that c-met was a independent risk factor for the overall survival of the patients (HR: 2.34, 95% CI: 1.63-4.54, P<0.05).

CONCLUSIONA positive expression of c-met protein is significantly correlated with an advanced TMN stage, lower tumor differentiation and a poor prognosis, and may serve as a indicator for predicting the prognosis of ESCC.

Carcinoma, Squamous Cell ; diagnosis ; metabolism ; Esophageal Neoplasms ; diagnosis ; metabolism ; Female ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Proto-Oncogene Proteins c-met ; metabolism ; Risk Factors