Objective To explore the comprehensive treatment of synchronous double cancers of the esophagus and stomach. Methods The treatment procedures of 8 patients with synchronous double cancers of the esophagus andstomach admitted in the Department of Digestive Tumor Surgery of The Hospital of Traditional Chinese Medicine of Jiangsu Province between Oct. 2006 to Feb. 2013 were analyzed. Some experience of comprehensive treatment of synch-ronous double cancers of the esophagus and stomach was explored. Results Eight cases of synchronous double cancers of the esophagus and stomach were all diagnosed by endoscopic biopsy. According to the results of CT and endoscopic ultrasonography assessment， lesions which were staged earlier than T1a were cured by endoscopic mucosal resection（6 cases， including 4 cases of esophagus cancer and 2 cases of gastric cancer）， and resection operation （1 cases of esop-hagus cancer）. The lesions staged later than T2 were treated by preoperative neoadjuvant chemoradiation， surgery， and adjuvant chemoradiation after operation （8 cases， including 2 cases of esophagus cancer and 6 cases of gastric cancer）， and simple operation （1 case）. Eight patients had been followed-up for 10-76 months （averaged 41.3 months）. Six patients survived without recurrence and metastasis during the followed-up， 1 patient died in 7 months after operation， and 1 patient relapsed in 20 months after operation. Conclusions Individually designed comprehensive treatment using neo-chemotherapy， intervention chemotherapy， radio-chemotherapy， radical resction surgery， adjuvant chemotherapy， and endoscopic mucosal resection can treat synchronous double cancers of the esophagus and stomach effectively. Impr-actical pursuit for radical surgery will not result in good prognosis
ObjectiveTo detect human papilloma virus (HPV)infection with fluorescent quantitative real-time polymerase chain reaction (FQ-PCR)in Minnan population, and explore the correlation between HPV infection and carcinogenesis of esophageal carcinoma (EC)of Minnan patients. MethodsFQ-PCR was performed to examine HPV-6, HPV-11, HPV-16 and HPV-18 in 100 healthy Minnan people (healthy group, 66 males and 34 females with their age of 52.35±6.72 years)and 100 Minnan patients with squamous EC (EC group and tumor-adjacent normal tissue group, 64 males and 36 females with their age of 51.62±6.37 years)between October 2009 and December 2012. ResultsThe incidences of HPV infection in 100 EC tissues, 100 tumor-adjacent normal tissues and 100 esophageal mucosa tissues of healthy people were 22/100, 8/100 and 6/100 respectively, which were statistically different (χ2=10.63, P < 0.01). Positive infection of HPV-6, HPV-11, HPV-16 and HPV-18 was observed in 11 cases, 11 cases, 14 cases and 15 cases in EC group respectively, 5 cases, 6 cases, 7 cases and 8 cases in tumor-adjacent normal tissue group respectively, and 5 cases, 5 cases, 6 cases and 6 cases in the healthy group respectively (P > 0.05). Positive HPV infection was observed in 1 patients with well differentiated squamous EC, 21 patients with moderately differentiated squamous EC and 5 patients with poorly differentiated squamous EC (P > 0.05). ConclusionHPV infection may exist in tumor tissue of Minnan patients with squamous EC, and may be correlated with carcinogenesis and development of squamous EC.
Objective To discuss the applycation possibility of themicroscopic stripping technique used in the primary culture of human embryonicesophagus squamous epithelial cells, and of the methodds for the isolation, depuration and subculture of the esophagus epithelial cells in vitro. Methods The squamous epithelial cells wereobtained from the esophagus mucous membrane of the 20-week abortion fetus through the microscopic stripping technique, and were digested with trypsin. Then, the morphological, immunohistochemical observation and the growth curve of the isolated cells were studied. Results The isolated cells were spherical in the cell suspension and spherical-like or polygon-like after attachment to the culture flask.The squamous epithelial specialized cytokeratin staining was bly positive. And the morphological studies by the transmission electron microscopy indicated that the cultured cells were squamous epithelial cells. The squamous epithelial cells reached the peak level 3-4 days after the transfer of the culture. The absorbanceat 3 and 4 days was significantly higher than that at 1,2,5 and 6 days (P＜0.05). Conclusion A large mumber of squamous epithelial cells can be available with the microscopic stripping technique and the digestion method. Thecultured squamous epithelial cells can be proliferated quickly, and fit for the tissue engineering study.
Esophageal cancer is one of the common malignant tumors with high incidence and poor prognosis. Angiogenesis-related pathways play an important role in the occurrence and development of esophageal cancer. Vascular endothelial growth factor (VEGF) is the main mediator of angiogenesis. In addition to promoting angiogenesis and maintaining the survival of neovascularization, VEGF can also directly act on esophageal cancer cells and promote the occurrence and development of tumors. This article reviews the biology of VEGF and its effect on blood vessels, the expression of VEGF in esophageal cancer cells and its influencing factors, the role of VEGF in esophageal cancer cells, the immunomodulatory activity of VEGF and the clinical study of VEGF inhibitors. The purpose of this study is to provide a basis for more rational use of VEGF inhibitors in the treatment of esophageal cancer.
Objectives To evaluate the effect of preoperative body mass index (BMI) on the perioperative and long-term results in esophageal squamous cell cancer patients. Method We retrospectively analyzed the clinical data of 503 patients with esophageal cancer between January 2001 and December 2009. There were 268 males and 235 females with the median age of 57 years ranging from 32-88 years. The associations between preoperative BMI and clinic patholo-gical characteristics were assessed by using the χ2 or Fisher's exact test. Survival analysis was performed by Kaplan-Meier curves with log-rank tests. ResultsThe 1-year, 3-year, 5-year, and 10-year overall survival rate for the entire cohort of patients was 64.0%, 49.0%, 43.0%, and 41.0% respectively. The occurance rates of weight loss, lymph node metastases, and poorly differentiated tumorigenesis represented statistically higher in patients with BMI≤18.5 kg/m2 than those in the patients with BMI>18.5 kg/m2 (P=0.026, P=0.006, P=0.048). For the cohort, the Kaplan-Meier survival analysis showed a significant trend toward a decreased survival in esophageal cancer patients with underweight (P=0.001). No statistical difference in overall complication, anastomotic leakage, and pulmonary complication rate was detected among the different BMI classes(P=0.162, P=0.590, P=0.376). Univariate and multivariate analysis showed that the drinking status, pathological stage, and underweight were the independent prognostic factors. ConclusionsAfter esophagectomy, BMI is not associated with the incidence of postoperative complications in patients. Patients with underweight are usually diagnosed with advanced stage, therefore tend to have poorer survivals than those with normal or over-weight.
ObjectiveTo evaluate the effect on complication after esophagectomy by comparing the different methods of anastomosis (cervical versus thoracic anastomosis). MethodsWe searched the following databases including PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang database to identify randomized controlled trials (RCTs) of cervical versus thoracic anastomosis for esophagectomy patients from establishment of each database to October 30, 2014. Quality of the included RCT was evaluated. Meta-analysis was conducted by using RevMan 5.2 software. ResultsWe finally identified 4 RCTs involving 267 patients. In terms of the postoperative complication, the incidence of anastomotic leakage (RR=3.83, 95%CI 1.70 to 8.63, P=0.001) with cervical anastomosis was significantly higher than that of the patients with thoracic anastomosis. However, there was no statistical difference in incidence of anastomotic stricture (RR=1.04, 95%CI 0.62 to 1.76, P=0.87), pulmonary complication (RR=0.73, 95%CI 0.27 to 1.91, P=0.52), and mortality (RR=0.89, 95%CI 0.40 to 1.97, P=0.77) between cervical and thoracic anastomosis. ConclusionCompared with thoracic anastomosis, the method of cervical anastomosis is associated with a higher incidence of anastomotic leakage. But there are many unclear factors about anastomotic stricture, pulmonary complication and mortality, further measurement should be taken.