• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5073-5076
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• 2013

Objective: This study aimed to investigate whether the miR-198 expression level is related to clinicopathological factors and prognosis of esophageal cancer. Methods: MicroRNA was extracted from esophageal cancer patients who underwent surgery for assessment using the Taqman@ MicroRNA assay. The correlation between miR-198 expression and clinicopathological features was analyzed, and the significance of miR-198 as a prognostic factor and its relationship with survival was determined. Results: MicroRNA-198 (miR-198) expression was higher in patients with poor prognosis than those with good prognosis (P<0.05). Kaplan-Meier analysis results showed that the miR-198 expression level had a significant correlation with survival time (P=0.030) and that patients with a higher expression of miR-198 had a shorter survival time. Cox multi-factor model analysis showed that patient prognosis (P=0.014), tumor length (P=0.040) and expression (P=0.012), and survival time had a significant correlation; the corresponding risks were 7.268, 1.246, and 3.524, respectively. Conclusion: miR-198 overexpression is involved in the poor prognosis of esophageal cancer and can be used as a biomarker for selection of cases requiring especial attention.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4187-4193
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• 2013

Background: Evaluation of Human papilloma virus (HPV) and its association with promoter methylation of candidate genes, p53 and Aurora A in esophageal cancer. Materials and Methods: One hundred forty-one esophageal tissue samples from different pathologies were evaluated for HPV infection by PCR, while the promoter methylation status of p53 and Aurora A was assessed by methylation-specific restriction based PCR assay. Statistical analyses were performed with MedCalc and MDR software. Results: Based on endoscopy and histopathology, samples were categorized: cancers (n=56), precancers (n=7), esophagitis (n=19) and normals (n=59). HPV infection was found to be less common in cancers (19.6%), whereas its prevalence was relatively high in precancers (71.4%), esophagitis (57.8%) and normals (45.7%). p53 promoter methylation did not show any significant difference between cancer and normal tissues, whereas Aurora A promoter methylation demonstrated significant association with disease (p=0.00016, OR:5.6452, 95%CI:2.18 to 14.6) when compared to normals. Aurora A methylation and HPV infection was found in a higher percentages of precancer (66.6%), esophagitis (54.5%) and normal (45.2%) when compared to cancers (14.2%). Conclusions: Aurora A promoter methylation is significantly associated with esophageal cancer, but the effect of HPV infection on this epigenetic alteration is not significant. However MDR analysis showed that the hypostatic effect of HPV was nullified when the cases had Aurora methylation and tobacco exposure. Further HPV sub-typing may give an insight into its reduced prevalence in esophageal cancer verses normal tissue. However, with the present data it is difficult to assign any significant role to HPV in the etiopathology of esophageal cancer.

• 대한기관식도과학회지
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• 제17권1호
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• pp.19-22
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• 2011

내시경 초음파검사는 식도벽의 조직학적 층구조를 가장 유사하게 반영하는 검사법으로 식도 병변의 진단과 치료전략에 필수검사이다. 표재성 식도암에서 고주파 미세탐촉자를 이용한 EUS는 내시경 절제 같은 국소치료가 가능한 환자들을 선별하는 데 중요한 역할을 한다.

• Tuberculosis and Respiratory Diseases
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• 제45권6호
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• pp.1305-1309
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• 1998

심막기종은 드문 질병이고 성인에서는 대부분 그 원인이 외상성으로 알려져 있으나, 저자들은 최근 식도 편평상피암에 동반된 전형적인 심막기종을 경험하였기에 문헌 고찰과 함께 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제39권3호
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• pp.255-259
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• 2006

식도암의 수술은 일반적으로 개흉술과 개복술이 동시에 시행되며 경우에 따라 경부절개까지 추가되므로 다른 수술에 비해 이환율과 사망률이 상대적으로 높다. 수술에 따른 합병증을 최소화하고 빠른 회복을 유도하기 위하여 최근에는 양성 질환뿐만 아니라 악성 종양의 수술에도 저 침습적인 방법이 많이 시행되고 있으나, 식도암에는 적극적으로 적용되고 있지는 않으며 아직 국내보고도 없다. 최근 저자들은 8예의 식도암 환자에게 저 침습 수술을 적용하였기에 수술 기법을 중심으로 보고하는 바이다.

• Journal of Chest Surgery
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• 제56권6호
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• pp.403-411
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• 2023

Background: The concept of oligo-recurrence has not been generally applied in esophageal cancer. This study aimed to determine the prognostic significance of the number of recurrences in esophageal cancer. Methods: Patients with squamous cell carcinoma who underwent curative esophagectomy with R0 or R1 resection and who experienced a confirmed recurrence were included. The study included 321 eligible participants from March 2001 to December 2019. The relationship between the number of recurrences and post-recurrence survival was investigated. Results: The mean age was 63.8±8.1 years, and the majority of the participants (97.5%) were men. The median time to recurrence was 10.7 months, and the median survival time after recurrence was 8.8 months. Multiple recurrences with simultaneous local, regional, and distant locations were common (38%). In terms of the number of recurrences, single recurrences were the most common (38.3%) and had the best post-recurrence survival rate (median, 17.1 months; p<0.001). Patients with 2 or 3 recurrences showed equivalent survival to each other and longer survival than those with 4 or more (median, 9.4 months; p<0.001). In the multivariable analysis, the significant predictors of post-recurrence survival were body mass index, minimally invasive esophagectomy, N stage, R0 resection, post-recurrence treatment, and the number of recurrences (p<0.05). Conclusion: After esophagectomy, the number of recurrences was the most significant risk factor influencing post-recurrence survival in patients with esophageal cancer. In esophageal cancer, oligo-recurrence can be defined as a recurrence with three or fewer metastases. More intensive treatment might be recommended if oligo-recurrence occurs.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1463-1469
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• 2015

Background: To evaluate the safety and efficacy of combined chemoradiotherapy or radiotherapy alone in elderly patients with esophageal carcinoma to identify the best method of treatment. Materials and Methods: One hundred and sixteen patients with esophageal carcinoma aged 70 and older who received definitive radiotherapy or chemoradiotherapy entered the study. Overall survival (OS), disease-free survival (DFS) and treatment-related toxicities were assessed. Results: The median OS of the overall population was 17.9 months. For patients treated with cCRT, sCRT and radiotherapy alone, the median OS was 22.3 months, 18.0 months and 12.4 months respectively(P=0.044). Median OS for patients treated with radiotherapy dose ${\geq}60Gy$ and <60Gy was 20.2 months and 10.9 months respectively (p=0.017). By univariate analysis, Chemoradiotherapy (include cCRT and sCRT) and radiotherapy dose ${\geq}60Gy$ were found to achieve higher survival rates compared with radiotherapy alone and radiotherapy dose <60Gy (P=0.015, P=0.017). By multivariate analysis, chemoradiotherapy (HR=1.645, P=0.022) and radiotherapy dose ${\geq}60Gy$ (HR=1.642, P=0.025) were identified as independent prognostic factors of OS. Conclusions: Definitive concurrent chemoradiotherapy could be considered as a feasible and effective treatment in esophageal carcinoma patients aged 70 and older. Radiotherapy dose 60Gy is an effective treatment option compared with standard dose radiotherapy, while higher doses are not beneficial to improve survival.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10299-10306
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• 2015

The esophageal squamous cell carcinoma (ESCC) is thought to develop through a multi-stage process. Epigenetic gene silencing constitutes an alternative or complementary mechanism to mutational events in tumorigenesis. Posttranscriptional regulation of human leukocyte antigen class I (HLA-I) and antigen processing machinery (APM) proteins expression may be associated with novel epigenetic modifications in cancer development. In the present study, we determined the expression levels of HLA-I antigen and APM components by immunohistochemistry. Then by a bisulfite-sequencing PCR (BSP) approach, we identified target CpG islands methylated at the gene promoter region of APM family genes in a ESCC cell line (ECa109), and further quantitative analysis of CpG site specific methylation of these genes in cases of Kazakh primary ESCCs with corresponding non-cancerous esophageal tissues using the Sequenom MassARRAY platform. Here we showed that the development of ESCCs was accompanied by partial or total loss of protein expression of HLA-B, TAP2, LMP7, tapasin and ERp57. The results demonstrated that although no statistical significance was found of global target CpG fragment methylation level sof HLA-B, TAP2, tapasin and ERp57 genes between ESCC and corresponding non-cancerous esophageal tissues, there was significant differences in the methylation level of several single sites between the two groups. Of thesse only the global methylation level of LMP7 gene target fragments was statistically higher ($0.0517{\pm}0.0357$) in Kazakh esophageal cancer than in neighboring normal tissues ($0.0380{\pm}0.0214$, p<0.05). Our results suggest that multiple CpG sites, but not methylation of every site leads to down regulation or deletion of gene expression. Only some of them result in genetic transcription, and silencing of HLA-B, ERp57, and LMP7 expression through hypermethylation of the promoters or other mechanisms may contribute to mechanisms of tumor escape from immune surveillance in Kazakh esophageal carcinogenesis.

• 대한기관식도과학회지
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• 제17권1호
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• pp.23-28
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• 2011

Diagnosis of early esophageal cancer has become more frequent as a result of improved endoscopic technology, surveillance programmes, and increasing experience and awareness on the part of endoscopists. In early esophageal cancer, squamous cell carcinoma and early adenocarcinoma must be managed differently because they have different origins, pathogenesis. and clinical characteristics. The current treatment options vary widely, from extended resection with lymphadenectomy to endoscopic mucosal resection (EMR) or ablation. None of these treatment options can be recommended universally. Instead, an individualized strategy should be based on the depth of tumor infiltration into the mucosa or submucosa, the presence or absence of lymph node metastases, the multicentricity of tumor growth, the length of the segment of intestinal metaplasia, and comorbidities of the patient. EMR has become increasingly important, both as a diagnostic tool for the staging of esophageal carcinomas and as a method of carrying out definitive treatment when the cancer meets certain criteria in which the risk of lymph-node metastasis is negligible. EMR may be sufficient in a subset of patients who have m1 or m2 squamous cell carcinoma and in patients who have isolated foci of high-grade intraepithelial neoplasia or mucosal cancer.

• Journal of Chest Surgery
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• 제37권8호
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• pp.665-671
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• 2004

배경: 흉부 식도암에서의 림프절 전이는 식도암이 점막하층에만 국한된 경우라도 흔하게 발견된다고 보고되고 있다. 림프절 전이가 수술 후의 예후에 큰 영향을 주고 있음에도 불구하고 조기식도암의 림프절 전이 양상은 완전히 조사되어 있지 않으며 림프절 절제술의 역할에 대해서도 여전히 의견이 분분하다. 대상 및 방법: 저자는 1995년 12월부터 2001년 8월까지 수술한 표층부(T1)식도암 환자 44예를 대상으로 림프절 전이의 양상을 후향적으로 연구하였다. 결과: 총 44예의 환자 중에서 림프절 전이는 총 10예(22.7%)에서 있었다. 식도암의 침윤 정도에 따라 볼 때 상피성 점막층에 국한된 경우 3예 중 0예, 점막고유 점막층까지 침윤된 경우 4예 중 0예, 근육성 점막층까지 침윤된 경우 4예 중 2예, 그리고 점막하층까지 침윤된 경우 33예 중 8예에서 림프절 전이가 발견되었다. 반회후두신경 림프절 전이는 5예, 복강내 림프절 전이가 8예에서 있어 흉부내 림프절 전이 3예보다 흔히 있었다. 수술사망은 없었고 병원사망이 점막고유층 환자에서 1예, 만기사망이 점막하식도암 환자에서 1예 있었다. 병원사망을 제외한 3년 생존율은 점막식도암이 100%, 점막하식도암은 97.0% (32/33예)였다(p＞0.05). 림프절 전이가 없는 환자들의 3년 생존율은 100%, 림프절 전이가 있는 환자들은 90.0% (9/10예)였다(p＞0.05). 결론: 표층부(T1) 식도암은 수술적 절제 후 생존율이 우수하다. 그러나 표층부(T1) 식도암에서 근육성 점막층 이상의 침윤이 있는 암에서는 림프절전이가 있을 수 있으며 특히 반회후두신경 림프절과 복강내 림프절 등 원격 림프절에도 빈번한 전이가 관찰되므로 광범위한 림프절 절제술이 필요하다고 생각된다.