Table of Contents
1
UI - 21274266
AU - Gupta NM; Jindal R; Prakash O; Gupta R; Bhasin DK
TI -
Comparison of the clinical profile and outcome for squamous cell
carcinoma and adenocarcinoma of the distal esophagus and cardia in
India.
SO - Surg Today 2001;31(5):400-4
AD - Department of Surgery, Postgraduate Institute of Medical Education and
Research, Chandigarh 160012, India.
This retrospective review aimed to assess the clinical profile and
outcome of squamous cell carcinoma as compared with adenocarcinoma of
the lower third of esophagus and cardia following a transhiatal
esophagectomy. A total of 169 patients were analyzed retrospectively in
this series from 1989 to 1994. There were 100 patients with squamous
cell carcinoma (SCC) and 69 patients with adenocarcinoma (ADC). All
tumors were assessed by an esophagogram, upper gastrointestinal
endoscopy, and abdominal ultrasonography. The surgical procedure
performed in all cases was a transhiatal esophagectomy (THE). The mean
age of the patients with SCC and ADC was comparable (48 +/- 14 vs 54 +/-
12 years). Male/female ratio was 1.0:1.4 in the SCC group while in the
ADC group it was 8.8:1.0. The main symptom in both the groups was grade
II dysphagia (62% in SCC and 60% in ADC). The mean length of the tumor
was 6.6 +/- 4.5 cm in the SCC group and 4.2 +/- 3.3 cm in the ADC group.
The resectability rate of the SCC group was significantly higher (76%)
than in the ADC group (55%). The 6-month and 1-year survival for the SCC
patients was not significantly different from the ADC patients (83.7%
and 49.3% vs 85.0% and 54.0%). The 5-year survival achieved in SCC was
higher than in the ADC group (11.6% vs 7.2%) but the difference was not
statistically significant. Adenocarcinoma arising from the distal
esophagus and cardia was more common in males, and also occurred in a
higher age group and had a lower resectability rate than squamous cell
carcinoma. No case of Barrett's esophagus was encountered. The short-
and long-term survival in both tumors were similar.
2
UI - 21315867
AU - Kim YT; Sung SW; Kim JH
TI -
Is it necessary to resect the diseased esophagus in performing
reconstruction for corrosive esophageal stricture?
SO - Eur J Cardiothorac Surg 2001 Jul;20(1):1-6
AD - Department of Thoracic and Cardiovascular Surgery, Seoul National
University Hospital, Cancer Research Institute, Seoul National
University College of Medicine, Seoul, South Korea.
OBJECTIVE: The incidence of carcinoma of the esophagus among patients
with chronic esophageal stricture caused by ingestion of corrosive
agents is reported to be significantly higher than that of the general
population. The question of whether or not a resection of the diseased
esophagus should be included in the surgical reconstruction procedure of
the undilatable esophageal stricture continues to be a controversial.
METHODS: During the 12 year period from 1988 to 1999, a total of 54
consecutive patients with caustic stricture of the esophagus were
treated in our department. We retrospectively reviewed these cases and
analyzed the incidence of cicatrical carcinoma among the patients and
the risk of esophagectomy according to the procedures performed.
RESULTS: We found seven cases of esophageal cancer among these patients.
There was no significant increase in mortality or morbidity related to
esophagectomy. CONCLUSIONS: Considering the high incidence of cicatrical
carcinoma from the stricture sites as well as the possible chance of
hidden malignancy, we concluded that the simultaneous resection of the
esophagus with reconstruction for patients with chronic intractable
caustic stricture would give the patients a better probability of being
completely cured of the disease.
3
UI - 21340690
AU - Bollschweiler E; Holscher AH
TI -
[Carcinoma of the esophagus--actual epidemiology in Germany]
SO - Onkologie 2001 Apr;24(2):180-4
AD - Klinik und Poliklinik fur Visceral- und Gefasschirurgie der Universitat
zu Koln. Elfriede.Bollschweiler@medizin.uni-koeln.de
Over the last years the incidence of esophageal cancer in Germany has
been rising. One of the reasons of this rise is the increase of
adenocarcinoma (AC) of the esophagus, a nearly unknown diagnosis 30
years ago. The incidence of squamous cell carcinoma (SCC) is rising,
too. The main risk factors for the development of SCC as well as for AC
are heavy smoking and alcohol. Barrett's esophagus is predominantly
developing in men after a longer lasting gastroesophageal reflux. In
consequence, AC of the esophagus will be observed mostly in men.
Patients with AC differ from patients with SCC by a smaller number of
concomitant diseases, which are often caused by obesity of patients with
AC. The preoperative risk factors of patients with SCC are caused by
tobacco and alcohol. Only patients with early cancer (pT1) of the
esophagus have a good prognosis with a 5-year survival rate of 83% for
AC and 63% for SCC. Copyright 2001 S. Karger GmbH, Freiburg
4
UI - 21356556
AU - Davydov M; Stilidi I; Bokhyan V; Arzykulov G
TI -
Surgical treatment of esophageal carcinoma complicated by fistulas.
SO - Eur J Cardiothorac Surg 2001 Aug;20(2):405-8
AD - Surgical Department of Thoracoabdominal Oncology, Russian Cancer
Research Centre, Kashirsskoe s. 24, Moscow 115478, Russia.
OBJECTIVES: The locally advanced esophageal carcinoma can be complicated
by fistulas. According to published data, the incidence rate of
malignant esophageal fistulas is about 13%. The range of treatment
modalities proposed by different authors varies from palliation to
active and, if possible, radical surgical interventions. In the present
study, we investigated combined esophagectomies as a radical treatment
of the malignant esophageal fistulas. METHODS: Thirty-five patients
(aged 28--67) with malignant esophageal fistulas of different
localizations were operated over a period from 1990 to 2000. The tumor
was located in the upper, middle and lower thoracic esophagus in four,
20 and 11 cases, respectively. The malignant fistula with the
mediastinum, pleural cavity, lungs, bronchi and trachea was observed in
21, two, five, four and three cases, respectively. Subtotal
esophagectomy and esophagogastroplasty were performed in 18 patients;
subtotal esophagectomy with intrapleural coloesophagoplasty was
performed in one case; proximal gastric and lower thoracic esophageal
resection from the left-side abdominothoracic approach was performed in
three cases. Esophagogastric bypass anastomoses were formed in ten
patients. Gastrostomy was performed in three patients. RESULTS: The
complication rate was 40% (14 out of 35); the postoperative mortality
was 14.3% (five out of 35). In patients after esophageal resection, the
mortality rate was 13.6% (three out of 22). With a median survival of 13
months (range, 3--31), the 2-year survival rate was 21% after combined
esophagectomies. CONCLUSIONS: The goal of surgery for esophageal cancer
with various fistulas is to completely resect the primary tumor and
involved adjacent structures with clear surgical margins and extended
two-field lymphadenectomy. The importance of performing a complete
resection is stressed by the absence of 1-year survivors among patients
who underwent bypass surgery or gastrostomy. We consider that en-bloc
combined resection of esophageal cancer complicated by fistula can be
done with a low mortality.
5
UI - 21367951
AU - Kumimoto H; Hamajima N; Nishizawa K; Nishimoto Y; Matsuo K; Harada H;
TI -
Shinoda M; Hatooka S; Ishizaki K
Different susceptibility of each L-myc genotype to esophageal cancer
risk factors.
SO - Jpn J Cancer Res 2001 Jul;92(7):735-9
AD - Central Laboratory and Radiation Biology, Aichi Cancer Center Research
Institute, Chikusa-ku, Nagoya, Aichi 464-8681, Japan.
hkumimot@aichi-cc.pref.aichi.jp
To understand the relationship between the L-myc genotypes and
esophageal cancer risk, a polymerase chain reaction-based restriction
fragment length polymorphism analysis was performed on 91 Japanese
patients with esophageal cancer and 241 non-cancer outpatients. No
significant difference in the distribution of genotypes was observed
between patients and controls; 18.7% LL genotype, 56.0% LS and 25.3% SS
among patients, and 24.5%, 55.6% and 19.9%, respectively, among
controls. Frequency of the s-allele in patients (0.533) was slightly
higher than in controls (0.477), but the difference was not
statistically significant. However, the odds ratios (ORs) for smoking or
heavy drinking were markedly higher in SS and LS genotypes than in LL
genotype; age-sex-adjusted ORs for smoking was 7.57 in the SS genotype,
6.40 in the LS genotype and 1.77 in the LL genotype. Age-sex-adjusted
ORs for heavy drinking were 19.78, 18.20 and 7.40, respectively. The
age-sex-adjusted ORs for both factors combined were 12.77, 18.45 and
1.44, respectively. These results suggested that the L-myc polymorphism
might modify the effects of lifestyle factors on esophageal cancer risk.
6
UI - 21385132
AU - Takashima T; Fujiwara Y; Higuchi K; Arakawa T; Yano Y; Hasuma T; Otani S
TI -
PPAR-gamma ligands inhibit growth of human esophageal adenocarcinoma
cells through induction of apoptosis, cell cycle arrest and reduction of
ornithine decarboxylase activity.
SO - Int J Oncol 2001 Sep;19(3):465-71
AD - Department of Biochemistry, Osaka City University Medical School, 1-4-3
Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
d98m011@medsv2.med.osaka-cu.ac.jp
Peroxisome proliferator-activated receptor gamma (PPAR-gamma), a member
of the nuclear hormone receptor superfamily, is involved in suppression
of growth of several types of tumors such as liposarcoma, breast cancer,
prostate cancer, and colon cancer, possibly through induction of cell
cycle arrest and/or apoptosis. In this study, we demonstrated expression
of PPAR-gamma mRNA and protein in human esophageal carcinoma cells.
Expression of PPAR-gamma protein was higher in an adenocarcinoma cell
line (TE-7 cells) than in a squamous cell carcinoma cell line (TE-1
cells). PPAR-gamma ligands such as 15-deoxy-Delta12,14-prostaglandin J2
and troglitazone significantly inhibited the growth of TE-7 cells but
had less or no effect on growth of TE-1 cells. 15d-PGJ2 and troglitazone
induced apoptosis in TE-7 cells but not in TE-1 cells. Troglitazone
caused G1 cell cycle arrest and reduced ornithine decarboxylase activity
(ODC) in TE-7 cells but not in TE-1 cells. Inhibition by PPAR-gamma
ligands of growth of esophageal adenocarcinoma cells may thus be due to
induction of apoptosis, G1 cell cycle arrest and reduction of ODC
activity.
7
UI - 21396157
AU - Martins AS
TI -
Neck and mediastinal node dissection in pharyngolaryngoesophageal
tumors.
SO - Head Neck 2001 Sep;23(9):772-9
AD - Head and Neck Service, Department of Surgery, Faculty of Medical
Sciences, State University Of Campinas (Unicamp), Rua Roxo Moreira, No.
1234, Cidade Universitaria, 13083-591, Campinas, Sao Paulo, Brazil.
asmartin@mpc.com.br
BACKGROUND: Specific reports about neck node metastasis in cervical
esophageal tumors and mediastinal node metastasis in patients with
pharyngolaryngoesophageal tumors are lacking. This study was undertaken
to evaluate the need for neck and mediastinal lymph node dissection when
dealing with carcinomas of this region. METHODS: A retrospective review
of the records of 34 patients who underwent total
pharyngolaryngoesophagectomy and gastric transposition (TPLEGT) for
squamous cell carcinoma of the pharyngoesophageal junction was done.
Sixteen patients had esophageal carcinomas, 14 had hypopharyngeal
carcinomas, and 4 had laryngeal carcinomas. The mediastinal dissection
was designed to remove mainly the paratracheal and paraesophageal lymph
nodes down to the aortic arch, without thoracotomy. Neck and mediastinal
lymph node metastases were studied with specific reference to main
primary site, and comparison with the literature was undertaken.
RESULTS: Twenty-five neck dissections were performed in 19 patients and
yielded positive nodes in 16 patients (47% of all patients). The neck
nodes were positive in 75%, 64.2%, and 18.7% of the patients with
laryngeal, hypopharyngeal, and esophageal carcinomas, respectively.
Mediastinal dissection data were available on 27 patients, and 16
(59.2%) had mediastinal node metastasis. These mediastinal nodes were
positive in 0%, 72.7%, and 61.5% of the patients with laryngeal,
hypopharyngeal, and esophageal carcinomas, respectively. CONCLUSIONS:
There is little controversy about neck dissections in tumors of the
larynx and hypopharynx when a TPLEGT is contemplated. A similar
situation applies to mediastinal dissections for cervical esophageal
carcinomas. Although we observed a low incidence of positive neck nodes
(18.7%) in patients with cervical esophageal carcinomas, there is a need
for a larger prospective series. Our finding of 72.7% positive
mediastinal nodes in hypopharyngeal carcinomas is high enough to deserve
further study. Laryngeal carcinomas showed no positive mediastinal nodes
in this series. Copyright 2001 John Wiley & Sons, Inc.
8
UI - 21439127
AU - Corn PG; Heath EI; Heitmiller R; Fogt F; Forastiere AA; Herman JG; Wu TT
TI -
Frequent hypermethylation of the 5' CpG island of E-cadherin in
esophageal adenocarcinoma.
SO - Clin Cancer Res 2001 Sep;7(9):2765-9
AD - University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
19104, USA. pcorn@mail.med.upenn.edu
PURPOSE: E-cadherin, a M(r) 120,000 transmembrane glycoprotein, mediates
calcium-dependent intercellular adhesion that is essential for normal
tissue homeostasis. Loss of E-cadherin occurs in a variety of epithelial
tumors and is correlated with invasion and metastasis. In esophageal
adenocarcinoma, reduction of E-cadherin expression has been demonstrated
previously, but mutations of the gene (CDH1) are rare. EXPERIMENTAL
DESIGN: In this study, we used a nested PCR approach to examine the
methylation status of the 5' CpG island of E-cadherin in esophageal
specimens obtained from individuals with and without a history of
esophageal cancer. RESULTS: In four individuals without esophageal
cancer, E-cadherin was completely unmethylated in normal squamous
cell-lined esophageal mucosa. In contrast, in patients with esophageal
adenocarcinoma, E-cadherin was methylated in 26 of 31 (84%) tumor
specimens. In the majority of cases, matched normal tissue (esophagus or
stomach) from each patient was completely unmethylated. By
immunostaining, methylated tumor samples demonstrated heterogeneously
decreased membranous E-cadherin staining. CONCLUSIONS: These data
suggest that epigenetic silencing via aberrant methylation of the
E-cadherin promoter is a common cause of inactivation of this gene in
esophageal adenocarcinoma.
9
UI - 21449347
AU - Aloia TA; Harpole DH Jr; Reed CE; Allegra C; Moore MB; Herndon JE 2nd;
TI -
D'Amico TA
Tumor marker expression is predictive of survival in patients with
esophageal cancer.
SO - Ann Thorac Surg 2001 Sep;72(3):859-66
AD - Division of Cardiothoracic Surgery, Duke University Medical Center,
Durham, North Carolina 27710, USA.
BACKGROUND: This study was designed to determine the prognostic value of
immunohistochemical tumor marker expression in a population of patients
with node-negative esophageal cancer treated with complete resection
alone. METHODS: Resection specimens were collected from 61 patients with
node-negative T1 (n = 31), T2 (n = 14), and T3 (n = 16) esophageal
cancer. A panel of 10 tumor markers was chosen for immunohistochemical
analysis, based on associations with differing oncologic mechanisms:
apoptosis (p53), growth regulation (transforming growth factor-alpha,
epidermal growth factor receptor, and Her2-neu), angiogenesis (factor
VIII), metastatic potential (CD44), platinum resistance (p-glycoprotein
and metallothionein), 5-fluorouracil resistance (thymidylate
synthetase), and carcinogenic detoxification (glutathione
S-transferase-pi). RESULTS: Complete resection was performed in all
patients (44 adenocarcinoma, 17 squamous cell carcinoma), with no
operative deaths. Multivariable analysis demonstrated a significant
relationship between cancer-specific death and the following variables:
low-level P-gp expression (p = 0.004), high-level expression of p53 (p =
0.04), and low-level expression of transforming growth factor-alpha (p =
0.03). In addition, the number of involved tumor markers present was
strongly predictive of negative outcome (p = 0.0001). CONCLUSIONS: This
study supports the prognostic value of immunohistochemical tumor
markers, specifically the expression pattern of P-gp, p53, and
transforming growth factor-alpha, in patients with esophageal carcinoma
treated with complete resection alone.
10
UI - 21449348
AU - Fang W; Igaki H; Tachimori Y; Sato H; Daiko H; Kato H
TI -
Three-field lymph node dissection for esophageal cancer in elderly
patients over 70 years of age.
SO - Ann Thorac Surg 2001 Sep;72(3):867-71
AD - Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
BACKGROUND: The risk and benefit of esophagectomy with three-field lymph
node dissection has not been well defined in elderly esophageal cancer
patients. METHODS: A total of 441 patients underwent three-field lymph
node dissection from 1986 to 1998. Patients were divided into two age
groups: group 1 consisted of 79 patients aged 70 years or over, and
group 2 consisted of 362 patients under 70 years of age. Patients'
characteristics and surgical outcomes were compared between groups. Risk
factors for morbidity, mortality, and survival of patients in group 1
were further studied by multivariate analysis. RESULTS: Significantly
more patients had multiorgan dysfunction preoperatively in group 1 (24;
30.4%) than in group 2 (34; 9.4%, p < 0.001). The overall (65.8% vs
61.6%, p = 0.483) and surgically related complication rates (41.8% vs
52.2%, p = 0.093) were similar, but significantly more organ failure
(11.4% vs 5.0%, p = 0.031) and infection (22.8% vs 13.8%, p = 0.045),
defined as medical complications, occurred in group 1. There was no
significant difference in 30-day (3.8% vs 0.8%, p = 0.074) or
in-hospital mortality (7.6% vs 3.3%, p = 0.082) between groups. The
overall (40.9% vs 48.1%, p = 0.235) and cause-specific 5-year survivals
(55.4% vs 59.1%, p = 0.688) were comparably good in both groups, but the
risk of death due to causes other than esophageal cancer was much higher
in the elderly (p = 0.028). Multiorgan dysfunction was an independent
predictive factor in elderly patients for overall and medical morbidity,
overall survival, and risk of death from causes other than esophageal
cancer. CONCLUSIONS: Esophagectomy with three-field lymph node
dissection could be carried out safely in patients over 70 years of age
with satisfactory long-term results. For elderly patients with
multiorgan dysfunction, however, less invasive procedures might be more
appropriate.
11
UI - 21455256
AU - Billingsley KG; Maynard C; Schwartz DL; Dominitz JA
TI -
The use of trimodality therapy for the treatment of operable esophageal
carcinoma in the veteran population: patient survival and outcome
analysis.
SO - Cancer 2001 Sep 1;92(5):1272-80
AD - Department of Surgery, University of Washington School of Medicine and
Veterans Affairs Puget Sound Health Care System, Seattle, Washington
98108, USA. kevinb@u.washington.edu
BACKGROUND: In an effort to improve the cure rates associated with
surgical therapy, neoadjuvant chemoradiotherapy is being used with
increasing frequency before resection (trimodality therapy). A variety
of clinical trials have reviewed this approach, but only one study to
the authors' knowledge has shown a survival benefit for trimodality
therapy. The extent to which trimodality therapy has gained acceptance
in general practice is not clear. The objective of the current study was
to determine the extent to which both surgery and trimodality therapy
are used for the management of esophageal carcinoma within a large,
national health care system and to determine the outcome of patients
treated with these treatment approaches. METHODS: The current study was
a retrospective cohort study. The study population was comprised of all
veterans who underwent either surgery alone or trimodality therapy for
operable esophageal carcinoma between the fiscal years of 1993 and 1997.
Data were obtained from the Veterans Administration Patient Treatment
File, Outpatient Clinic File, and the Beneficiary Identification Record
Locator System. The main outcome measures were perioperative mortality
and patient survival. RESULTS: During the study period, 695 patients
underwent either surgery alone or trimodality therapy for esophageal
carcinoma. Five hundred thirty-four (77%) patients were treated with
surgery only. One hundred sixty-one (23%) patients underwent surgery
after induction chemoradiotherapy (trimodality therapy). Patients
selected for trimodality therapy were younger (mean age, 60.8 years vs.
65.6 years), had fewer comorbidities, and were more likely to have a
midesophageal tumor. The median survival for all patients was 15.2
months. The type of treatment had no apparent effect on survival.
Favorable prognostic factors included younger age, a distal esophageal
tumor, and the absence of metastases. The overall perioperative
mortality was 13.7 %. The use of trimodality therapy did not increase
perioperative mortality. CONCLUSIONS: Trimodality therapy is commonly
used within the VA system. The nonrandomized nature of this study does
not allow comparison of trimodality therapy to surgery alone, but the
overall survival was limited for all patients. The predictors of
survival are related to the biology of the disease, and they include
patient age, tumor location, and stage at diagnosis. Copyright 2001
American Cancer Society.
12
UI - 21423009
AU - Wu MT; Lee YC; Chen CJ; Yang PW; Lee CJ; Wu DC; Hsu HK; Ho CK; Kao EL;
TI -
Lee JM
Risk of betel chewing for oesophageal cancer in Taiwan.
SO - Br J Cancer 2001 Sep 1;85(5):658-60
AD - Division of Environmental Health and Occupational Medicine, National
Health Research Institutes, Kaohsiung, Taiwan. mingtsangwu@yahoo.com
Among 104 cases of squamous-cell oesophageal carcinoma patients and 277
controls in Taiwan, after adjusting for cigarette smoking, alcohol
consumption, and other confounders, we found that subjects who chewed
from 1 to 495 betel-year and more than 495 betel-years (about 20 betel
quid per day for 20 years) had 3.6-fold (95% Cl = 1.3-10.1) and 9.2-fold
risk (95% Cl = 1.8-46.7), respectively, of developing oesophageal
cancer, compared to those who did not chew betel. Copyright 2001 Cancer
Research Campaign.
13
UI - 21423010
AU - Phukan RK; Ali MS; Chetia CK; Mahanta J
TI -
Betel nut and tobacco chewing; potential risk factors of cancer of
oesophagus in Assam, India.
SO - Br J Cancer 2001 Sep 1;85(5):661-7
AD - Regional Medical Research Centre, Indian Council of Medical Research,
North East Region, Assam, Dibrugarh, India.
Cancer of the oesophagus is the most commonly diagnosed cancer in males
in Assam, in north-eastern India, and ranks second for females. The
chewing of betel nut, with or without tobacco and prepared in various
ways, is a common practice in the region and a case-control study has
been designed to study the pattern of risk associated with different
ways of preparing and chewing the nuts. 358 newly diagnosed male
patients and 144 female have been interviewed together with 2 control
subjects for each case chosen at random from among the attendants who
accompanied patients to hospital. There were significant trends in risk
ratios associated with the frequency of chewing each day, with the
duration of chewing in years and with the age at which the habit was
started that were apparent for both males and females and which remained
significant after allowance was made for other known risk factors,
notably tobacco smoking and alcohol consumption. The adjusted ratios, in
comparison with non-chewers, were 13.3 M and 5.7 F for chewing more than
20 times a day, 10.6 M and 7.2 F for persons who had chewed for more
than 20 years and 10.3 M and 5.3 F for those who had started before the
age of 20. Among the different combinations of ingredients that were
chewed the adjusted odds ratios were highest for those who had been
using fermented betel nut with any form of tobacco (7.1 M and 3.6 F).
The risk associated with tobacco smoking and alcohol consumption, which
are high in some parts of the world, were less in Assam than those
associated with the chewing of betel nut. Copyright 2001 Cancer Research
Campaign.
14
UI - 21423019
AU - Mashino K; Sadanaga N; Tanaka F; Yamaguchi H; Nagashima H; Inoue H;
TI -
Sugimachi K; Mori M
Expression of multiple cancer-testis antigen genes in gastrointestinal
and breast carcinomas.
SO - Br J Cancer 2001 Sep 1;85(5):713-20
AD - Department of Surgery, Medical Institute of Bioregulation, Kyushu
University, 4546 Tsurumibaru, Beppu, Japan.
Cancer-testis antigens (CTAs) such as MAGE are selectively expressed in
various types of human neoplasms but not in normal tissues other than
testis. This characteristic feature of CTAs makes them promising
antigens for cancer-specific immunotherapy. A critical requirement for
this therapy is identification of promising antigens. In this study, we
investigated the expression of 6 genes recently identified by
serological analysis of antigens by recombinant expression (SEREX)
libraries: NY-ESO-1, LAGE-1, SCP-1, SSX-1, SSX-2, and SSX-4, in many
surgical samples of gastrointestinal and breast carcinomas using reverse
transcription-polymerase chain reaction. We found relatively high
expression of SCP-1 (23.5%) and SSX-4 (20.6%) in gastric carcinoma,
LAGE-1 (39.1%) and NY-ESO-1 (23.9%) in oesophageal carcinoma, and SCP-1
(34.1%) in breast carcinoma. We also found frequent synchronous
expression with MAGE, including LAGE-1 (46.2%) in oesophageal carcinoma,
SSX-4 (46.7%) in gastric carcinoma, and SCP-1 (38.3%) in breast
carcinoma. Immunohistochemical analysis of the tumour samples expressing
both MAGE-4 and NY-ESO-1 genes demonstrated differences in distribution
between MAGE-4 and NY-ESO-1 in serial sections. We concluded that
NY-ESO-1, LAGE-1, SCP-1 and SSX-4 genes may be promising candidates for
cancer-specific immunotherapy in addition to MAGE, and that polyvalent
cancer vaccines may be useful in cases of heterogeneous expressions of
CTA genes in gastrointestinal and breast carcinomas. Copyright 2001
Cancer Research Campaign.
15
UI - 21423020
AU - Taniere P; Martel-Planche G; Saurin JC; Lombard-Bohas C; Berger F;
TI -
Scoazec JY; Hainaut P
TP53 mutations, amplification of P63 and expression of cell cycle
proteins in squamous cell carcinoma of the oesophagus from a low
incidence area in Western Europe.
SO - Br J Cancer 2001 Sep 1;85(5):721-6
AD - Molecular Carcinogenesis, International Agency for Research on Cancer,
150 cours Albert Thomas, Lyon cedex, 69372 08, France.
In Europe, high incidence rates of oesophageal squamous cell carcinoma
(SCCE) are observed in western France (Normandy and Brittany) and in
north-eastern Italy. Analysis of TP53 mutations in tumours from these
regions has shown a high prevalence of mutations at A:T basepairs that
may result from DNA damage caused by specific mutagens. However, the
spectrum of TP53 mutations in regions of low incidence is unknown. We
report here TP53 mutation analysis in 33 SCCE collected in Lyon, an area
of low incidence. These tumours were also examined for MDM2 and P63
amplification, and for expression of p16(INK4a/CDKN2a), cyclin E,
p27(Kipl)and Cox2. TP53 mutations were detected in 36% of the cases
(12/33). In contrast with regions of high incidence, the mutation
spectrum did not show a high prevalence of mutations at A:T base pairs.
P63 was amplified in 5/32 cases tested (15.5%). No amplification of MDM2
was found. Expression studies revealed frequent loss of
p16(INK4a/CDKN2a)(46%) and p27(Kipl)(25%) expression, and frequent
overexpression of Cyclin E (70%) and Cox2 (42%). Overall, these results
indicate that in Europe, SCCE from areas of high and low incidence
present a similar pattern of molecular alterations but differ by the
type of TP53 mutations. Copyright 2001 Cancer Research Campaign.
16
UI - 21190897
AU - Hibi K; Nakayama H; Taguchi M; Kasai Y; Ito K; Akiyama S; Nakao A
TI -
AIS overexpression in advanced esophageal cancer.
SO - Clin Cancer Res 2001 Mar;7(3):469-72
AD - Second Department of Surgery, Nagoya University School of Medicine,
Japan. khibi@tsuru.med.nagoya-u.ac.jp
We examined AIS status in digestive tract cancers and found that all
eight esophageal cancer cell lines (100%) showed AIS/TA-AIS gene
overexpression, whereas 1 of 12 (8%) gastric cancer and 0 of 14 (0%)
colon cancer cell lines showed AIS/TA-AIS gene expression. We then
confirmed that the AIS gene, not the TA-AIS gene, was dominantly
expressed in esophageal cancers by reverse transcription-PCR. AIS
protein was also expressed in AIS gene-positive cell lines.
Subsequently, we tested AIS gene expression in paired esophageal normal
tissues and cancers. Twenty-five of 39 (64%) primary esophageal cancers
demonstrated an obviously higher expression of AIS gene compared to
paired normal tissues. Moreover, high AIS gene expression was
significantly associated with lymph node metastases in esophageal cancer
(P = 0.0271). These results suggested that AIS may be useful as a marker
for advanced esophageal cancer.
17
UI - 21190911
AU - Harpole DH Jr; Moore MB; Herndon JE 2nd; Aloia T; D'Amico TA; Sporn T;
TI -
Parr A; Linoila I; Allegra C
The prognostic value of molecular marker analysis in patients treated
with trimodality therapy for esophageal cancer.
SO - Clin Cancer Res 2001 Mar;7(3):562-9
AD - Thoracic Oncology Program, Duke University Medical Center, Durham, North
Carolina 27710, USA. harpo002@mc.duke.edu
The purpose of this study was to define the prognostic value of a group
of molecular tumor markers in a well-staged population of patients
treated with trimodality therapy for esophageal cancer. The original
pretreatment paraffin-embedded endoscopic esophageal tumor biopsy
material was obtained from 118 patients treated with concurrent
cisplatin + 5-fluorouracil (5-FU) + 45 Gy radiation followed by
resection from 1986 until 1997 at the Duke University Comprehensive
Cancer Center. Three markers of possible platinum chemotherapy
association [metallothionein (MT), glutathione S-transferase-pi
(GST-pi), P-glycoprotein (P-gp or multidrug resistance)] and one marker
of possible 5-FU association [thymidylate synthase (TS)] were measured
using immunohistochemistry. The median cancer-free survival was 25.0
months, with a significantly improved survival for the 38 patients who
had a complete response (P < 0.001). High-level expression of GST-pi,
P-gp, and TS were associated with a decreased survival. MT was not
significant in this population. Multivariate analysis identified
high-level expression in two of the platinum markers (GST-pi and P-gp)
and the 5-FU marker TS as independent predictors of early recurrence and
death. In conclusion, this investigation measured three possible markers
associated with platinum and one possible marker associated with 5-FU in
a cohort of esophageal cancer patients. Independent prognostic
significance was observed, which suggests that it may be possible to
predict which patients may benefit most from trimodality therapy. These
data need to be reproduced in a prospective investigation.
18
UI - 21190917
AU - Okuda E; Osugi H; Morimura K; Takada N; Takemura M; Fukushima S;
TI -
Higashino M; Kinoshita H
Detection of p53 gene mutations in human esophageal squamous cell
carcinomas using a p53 yeast functional assay: possible difference in
esophageal carcinogenesis between the young and the elderly group.
SO - Clin Cancer Res 2001 Mar;7(3):600-6
AD - Second Department of Surgery, Osaka City University Medical School,
Osaka, Japan. m5144423@msic.med.osaka-cu.ac.jp
A p53 yeast functional assay, which cannot only detect p53 gene
mutations but also can assess p53 gene function, was used to screen for
p53 gene dysfunction in human esophageal squamous cell carcinomas.
Surgically resected frozen tissues of esophageal squamous cell
carcinomas from 57 patients were examined for p53 gene mutation. Because
the mean age of the patients diagnosed with esophageal squamous cell
carcinoma was 64 years, we classified those who were <65 years of age as
the Young Group and classified the others as the Elderly Group. The
incidence of p53 gene mutations was 43 of 57 (75%). The incidence of p53
gene mutations observed in the Young Group was significantly higher than
in the Elderly Group (P = 0.0007). Alcohol and smoking status did not
relate to p53 gene mutation expression. Survival rate after surgery was
not significantly associated with the presence of p53 gene mutation.
However, in the Young Group with p53 gene mutation, those who had null
mutations had a significantly shorter survival than those without null
mutations (P = 0.0455). No other clinicopathological factors were
associated with p53 gene mutations. Possibly, there may be a difference
in esophageal carcinogenesis between the Young and the Elderly groups,
because the incidence of p53 gene mutations is different between the two
groups. In the Young Group, p53 gene mutation may cause esophageal
carcinogenesis, and null mutation for p53 gene is a significant
prognostic factor.
19
UI - 21262955
AU - Blewett CJ; Miller JD; Ramlawi B; Young JE; BennettWF; Urschel JD
TI -
Local recurrence after total or subtotal esophagectomy for esophageal
cancer.
SO - J Exp Clin Cancer Res 2001 Mar;20(1):17-9
AD - Dept. of Surgery, McMaster University, Hamilton, Ontario, Canada.
Cancer recurrence is a common problem after esophagectomy for esophageal
cancer. Local recurrence is especially problematic because it often
negates the palliative benefit of esophagectomy. We conducted a
retrospective review to assess the effect of extent of esophageal
resection (subtotal or total esophagectomy) on local cancer recurrence.
Seventy-four consecutive patients with esophageal cancer underwent
esophagectomy at our institution over a four-year period. Their charts
were reviewed retrospectively and data was collected on age, gender,
histology, stage, tumor location, operation, resection margin status,
anastomotic leaks, operative mortality, adjuvant therapy, cancer
survival, and local recurrence. Total esophagectomy was done in 19
patients (transhiatal - 3; McKeown - 16) and subtotal esophagectomy was
done in the other 55 patients (Lewis - 25; left thoracoabdominal - 30).
The two groups were similar with respect to age, gender, histology,
stage, anastomotic leaks, operative mortality, adjuvant therapy, and
overall survival. Resection margins were positive for residual tumor in
2 out of 19 (11%) total esophagectomies and 9 out of 55 (16%) subtotal
esophagectomies (p=0.42). Local recurrence occurred in 3 of 19 (16%)
patients treated with total esophagectomy and 23 out of 55 (42%)
patients treated with subtotal esophagectomy (p=0.04). We conclude that
total esophagectomy is associated with fewer local cancer recurrences
than subtotal esophagectomy. We, therefore, recommend total
esophagectomy for the surgical treatment of esophageal cancer.
20
UI - 21271479
AU - Takeo Y; Yoshida T; Shigemitu T; Yanai H; Hayashi N; Okita K
TI -
Endoscopic mucosal resection for early esophageal cancer and esophageal
dysplasia.
SO - Hepatogastroenterology 2001 Mar-Apr;48(38):453-7
AD - First Department of Internal Medicine, Yamaguchi University School of
Medicine, 1-1-1, Minami-Kogushi, Ube-City, Yamaguchi-Ken, Japan.
BACKGROUND/AIMS: Advances in diagnostic technology have led to increased
detection of early esophageal cancer, which is suitable for endoscopic
treatment. We performed endoscopic esophageal mucosal resection of such
cancer and dysplasia using the endoscopic esophageal mucosal resection
tube and evaluated the clinical benefit of this technique. METHODOLOGY:
Twenty-nine patients with esophageal mucosal cancer (27 cases with 33
lesions) or dysplasia (2 cases with 2 lesions) diagnosed between
and extent of invasion by double staining with toluidine blue and
iodine. Endoscopic ultrasonography was also performed to assess the
depth of invasion in 22 cases with 22 lesions. RESULTS: The 35
esophageal lesions comprised 27 esophageal carcinomas and 8 areas of
dysplasia. Twenty of the 35 lesions were resected en bloc and 15 were
resected piecemeal. Subsequent surgery was performed for 5 cases with 7
lesions out of 10 cases with 15 lesions that were histopathologically
diagnosed as m3 or more invasive. No recurrence has been detected in 24
evaluable cases (including 1 who died of another disease, 2 in whom
surgery could not be performed due to complications, and 3 who refused
subsequent surgery). No patients died of esophageal cancer after a mean
follow-up period of 30.9 +/- 18.9 months. The 4-year survival rate was
100% in the m2 or less invasive group of 19 cases with 20 lesions, 75%
in the m3 or higher invasive group of 5 cases with 8 lesions and 100% in
the surgery group of 5 cases with 7 lesions (NS). No serious
complications occurred except for 1 patient. Circumferential mucosal
resection was done in this patient, resulting in esophageal stenosis,
which responded to esophageal dilation. CONCLUSIONS: Esophageal mucosal
resection using the endoscopic esophageal mucosal resection tube is safe
and beneficial for early esophageal cancer and dysplasia.
21
UI - 21271480
AU - Kuwano H; Sumiyoshi K; Sonoda K; Kitamura K; Toh Y; Nakashima H;
TI -
Sugimachi K
Pathogenesis of esophageal squamous cell carcinoma with lymphoid stroma.
SO - Hepatogastroenterology 2001 Mar-Apr;48(38):458-61
AD - Department of Surgery I, Faculty of Medicine, Gunma University, 3-39-22,
Showa-machi, Maebashi 371-8511, Japan.
BACKGROUND/AIMS: Lymphocyte infiltration in esophageal cancer,
especially when beneath intraepithelial carcinoma, is frequently seen.
However, cases of esophageal cancer with a dense stromal infiltration of
lymphocytes are rare and the pathogenesis of such cases has yet to be
clearly demonstrated. The objective of this study is to clarify its
pathogenesis. METHODOLOGY: Four cases of esophageal squamous cell
carcinoma with lymphoid stroma were investigated by immunohistochemical
staining for the detection of Epstein-Barr virus, human papillomavirus,
human leukocyte antigen-DR, as well as T and B cells in cancer tissue.
RESULTS: In these four cases, neither positive staining of Epstein-Barr
virus nor human papillomavirus infection was detected. On the other
hand, the expression of human leukocyte antigen-DR antigen was evident
in all cases with dense T-cell infiltration in the tumor tissue and
moderate B-cell infiltration around the tumor. CONCLUSIONS: The
expression of human leukocyte antigen-DR antigen without Epstein-Barr
virus or human papillomavirus infection could thus be one possible
pathogenesis of patients demonstrating esophageal squamous cell
carcinoma with a lymphoid stroma.
22
UI - 21271483
AU - Saito S; Kasai Y; Nomoto S; Fujiwara M; Akiyama S; Ito K; Nakao A
TI -
Polymorphism of tumor necrosis factor in esophageal, gastric or
colorectal carcinoma.
SO - Hepatogastroenterology 2001 Mar-Apr;48(38):468-70
AD - Department of Surgery II, School of Medicine, Nagoya University, 65
Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan.
BACKGROUND/AIMS: Several microsatellite polymorphisms located in the
tumor necrosis factor locus on the chromosomal region 6p21.3 in the
major histocompatibility complex region have been associated with
malignant neoplasms and autoimmune diseases. In this study, we focused
on the polymorphisms of tumor necrosis factor a and d from
gastrointestinal carcinoma patients to ascertain whether they can be
useful to predict these neoplasms. METHODOLOGY: We examined esophageal,
gastric, and colorectal cancers (47, 53, 77 patients, respectively), and
213 normal controls. To compare the microsatellite polymorphisms of
tumor necrosis factor a, d in Japanese individuals, dioxyribonucleic
acids were extracted from normal mucosa (cancer patients) and from
peripheral blood monocytes (the normal controls) by polymerase chain
reaction. RESULTS: The frequency of tumor necrosis factor a3 allele was
significantly higher in gastric cancer (P = 0.012) and that of tumor
necrosis factor d7 allele was significantly higher in the colorectal
cancer than the normal controls (P = 0.037). That of tumor necrosis
factor a10 was significantly lower in the gastric cancer than the normal
controls (P = 0.008). CONCLUSIONS: Microsatellite polymorphisms of tumor
necrosis factor a and d might be significantly correlated with
carcinogenesis of specific neoplasms, and may be useful for predicting
these cancers.
23
UI - 21369700
AU - Stocks SC; Pratt N; Sales M; Johnston DA; Thompson AM; Carey FA;
TI -
Kernohan NM
Chromosomal imbalances in gastric and esophageal adenocarcinoma:
specific comparative genomic hybridization-detected abnormalities
segregate with junctional adenocarcinomas.
SO - Genes Chromosomes Cancer 2001 Sep;32(1):50-8
AD - Department of Molecular and Cellular Pathology, University of Dundee,
Tayside University Hospitals Trust, Dundee, United Kingdom.
The incidence of adenocarcinoma arising at the esophagogastric junction
(EGJ) is increasing at a rate greater than that for any other form of
solid malignancy. Commensurate with this, the incidence of
histologically similar tumors arising in the gastric body and antral
mucosa is declining. The increased incidence of the proximal group of
tumors may reflect, in part, the higher prevalence of Barrett esophagus.
These epidemiological features suggest that histologically similar
tumors arising at the EGJ and from the distal stomach are different,
which may be reflected in the genetic abnormalities that characterize
the two groups of tumors. The purpose of this study was to screen
genomic DNA from adenocarcinomas of the esophagus and stomach for
regions of chromosomal imbalance, using comparative genomic
hybridization to determine whether tumors at the EGJ (junctional tumors)
have a different profile compared with tumors of the distal stomach.
Tumor samples were derived from a series of 48 gastroesophageal
adenocarcinomas (20 junctional and 28 distal) that were acquired
prospectively from patients undergoing esophagogastrectomy. These tumors
are characterized by several regions of chromosomal imbalance with no
obvious correlation between most regions of abnormal copy number and
tumor type. However, our study shows for the first time cytogenetic
abnormalities (5p+ and 18q-) that identify statistically significant
differences (P < 0.02 and < 0.05, respectively) between junctional and
distal gastric tumors. These differences are gain of 5p (55% [11/20] of
junctional tumors vs. 21% [6/28] of distal gastric tumors) and loss of
18q (25% [5/20] cases of junctional tumors vs. 4% [1/28] of distal
tumors) segregating with tumors of the EGJ. These abnormalities may
distinguish distinct tumor subtypes that are recognized in
epidemiological and clinical studies but that are otherwise
histologically identical. Copyright 2001 Wiley-Liss, Inc.
24
UI - 21433408
AU - McKeeby JL; Li X; Zhuang Z; Vortmeyer AO; Huang S; Pirner M; Skarulis
TI -
MC; James-Newton L; Marx SJ; Lubensky IA
Multiple leiomyomas of the esophagus, lung, and uterus in multiple
endocrine neoplasia type 1.
SO - Am J Pathol 2001 Sep;159(3):1121-7
AD - Pediatric and Reproductive Endocrinology Branch, National Institutes of
Health, Bethesda, Maryland 20892-1414, USA.
Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant
hereditary disorder characterized by multiple parathyroid, pancreatic,
duodenal, and pituitary neuroendocrine tumors. Nonendocrine mesenchymal
tumors, such as lipomas, collagenomas, and angiofibromas have also been
reported. MEN1-associated neuroendocrine and some mesenchymal tumors
have documented MEN1 gene alterations on chromosome 11q13. To test
whether the MEN1 gene is involved in the pathogenesis of multiple smooth
muscle tumors, we examined the 11q13 loss of heterozygosity (LOH) and
clonality patterns in 15 leiomyomata of the esophagus, lung, and uterus
from five patients with MEN1. Forty sporadic uterine leiomyomata were
also studied for 11q13 LOH. LOH analysis was performed using four
polymorphic DNA markers at the MEN1 gene locus; D11S480, PYGM, D11S449,
and INT-2. 11q13 LOH was detected in 10 of 12 (83%) MEN1-associated
esophageal and uterine smooth muscle tumors. In contrast, LOH at the
MEN1 gene locus was
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