جستجوی مقالات مرتبط با کلیدواژه « Esophageal carcinoma » در نشریات گروه « پزشکی »

Esophageal cancer, a highly aggressive and often fatal gastrointestinal disease, frequently reaches advanced unresectable stages. The standard treatment involves definitive chemoradiation due to concerns about regional failure. To address this, intensified radiation dosages and advanced techniques like Intensity-Modulated Radiation Therapy (IMRT) and Three-Dimensional Conformal Radiation Therapy (3D-CRT) are being explored. This study aimed to compare dosimetric factors in patients with esophageal carcinoma undergoing IMRT versus 3D-CRT treatments.

Twenty patients were alternately assigned to receive either treatment. Each patient’s alternate virtual plan resulted in a total of forty plans. Dosimetric evaluations included coverage of the Planning Target Volume (PTV) and dose-volumes of lungs, heart, and spinal cord. Treatment consisted of 50.4 Gy radiation with concurrent weekly paclitaxel and carboplatin chemotherapy. Statistical analysis was conducted using the two-tailed Paired t-Test.

Dosimetric evaluations revealed no significant distinctions in PTV parameters such as maximum dose, minimum dose, mean dose, D2%, D50%, and V95% between IMRT and 3D-CRT plans. However, IMRT exhibited improvements in D98% and Homogeneity Index. While Conformity Index did not differ significantly, IMRT displayed reduced lung irradiation in various aspects such as Dmean, V20, and V30, while 3D-CRT showed lower irradiation in V5 and V10. IMRT effectively spared the heart with lowered heart irradiation in V30. Spinal cord Dmax remained consistent across both techniques.

IMRT demonstrated better dose homogeneity and superior lung and heart sparing capabilities compared to 3D-CRT in treating esophageal carcinoma. While both techniques had similar dose conformity, IMRT’s potential to reduce longterm radiation-induced lung and heart complications through improved sparing of these organs is noteworthy.

Esophageal carcinoma (ESCA) is one of the most common types of cancer. ESCA accounted for the sixth leading cause of cancer-related deaths globally. Most patients are diagnosed at late stages of ESCA, with distance metastasis or chemoresistance, which leads to a poor prognosis. Previous studies demonstrated lncRNA presentation and roles in ESCA cells and patients' tissue. It has been proposed that lncRNAs can be considered a new prognostic and diagnostic biomarker in ESCA. In this study, we comprehensively explored the interaction of lncRNAs with miRNAs and mRNAs of the TCGA database and proposed a novel promising biomarker with good diagnostic and prognostic values.

The public data of RNA-seq, miR-seq, and related clinical data were downloaded from the TCGA database. Differential expression analysis was conducted by “limma” in R. GO, and KEGG signaling pathways were used for enrichments. STRING database was used for PPI analysis. CE-network was constructed by the STAR database in R. Kaplan-Meier survival analysis (log-rank test), and ROC curve analysis was used to indicate the diagnostic and prognostic values of the biomarkers.

Differentially expressed data illustrated that 45.8% of the total mRNAs in the data related to ESCA patients showed increased expression and 54.2% decreased expression. The GO and KEGG pathway analysis showed that the differentially expressed mRNAs were enriched in critical biological processes. Important protein-protein interaction hubs were identified. The ceRNA network data demonstrated critical lncRNAs essential in ESCA development, including TMEM16B-AS1, AC093010.3, SNHG3, and PVT1. The data revealed that the lncRNA WDFY3-AS2, AC108449.2, DLEU2, AC007128.1, and AP003356.1 are potential diagnostic and prognostic biomarkers in ESCA patients.

Altogether, this study demonstrates lncRNA, miRNA, and mRNA interaction and mentions regulatory networks which can be considered as a therapeutic option in ESCA. In addition, we proposed potential diagnostic and prognostic biomarkers for ESCA patients.

Due to the delay in esophageal cancer until the late stages, its mortality rate is relatively high. One of the most common presentations of advanced esophageal cancer is dysphagia. Esophageal stenting is a palliative treatment modality to resolve dysphagia and restore oral intake. Despite this advantage, stenting has various complications.

We reported a case of active bleeding after esophageal stenting.

A case of a complication caused by an esophageal stent placement for carcinoma is presented. The placement of the stent was difficult under fluoroscopic control, which led tosome pushing, resulting in a wound in the pharynx with active bleeding without perforation. The bleeding was successfully controlled by the surgeon. Therefore, the patient was postponed a few days later and we preferred this time to put a stent through the scope without complications.

Active bleeding is one of the esophageal stenting complications. In this article, we reported a middle-aged woman with advanced esophageal cancer who underwent esophageal stenting. Afterward, she developed activebleeding, which was successfully managed.

The aim of this study was to compare the post-operation analgesic effects of patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients who were undergoing esophageal cancer surgery. This was a randomized clinical trial. 80 patients undergone esophagostomy were randomly divided into two groups: 40 patients in the epidural PCA and 40 patients in the intravenous PCA group were evaluated. Post-operation pain score was assessed using the universal pain assessment tool (UPAT) in both groups at 24 and 48 hours after surgery. Secondary outcomes included AKI, MI, CVA, pulmonary complications, ICU stay and three months survival. Mean pain scores were similar in the two groups (P>0.05). There was no significant difference between the two groups for rescue treatment, three months’ survival, CVA, MI and AKI. However, ICU stay (P=0.008) and pulmonary complications (P=0.05) were greater in PCIA group. The results indicate that none of the PCEA and PCIA methods have any superiority in terms of pain control and the incidence of analgesic-related side effect complications after surgery in patients undergoing esophagostomy and confirm sufficient analgesia by both.

Given the fact that viral infections play an important role, either directly or indirectly, in around 20 percent of human cancers, this study aimed at investigating the potential association of Epstein–Barr virus (EBV) and cytomegalovirus (CMV) infections in esophageal cancer that is the sixth most common cause of cancer-related deaths.

In this case-control study, a total of 200 paraffin-embedded biopsies of cancerous and benign esophageal tissues were gathered from the biopsy bank of Imam Reza Hospital, Tabriz, Iran in 2017. All samples were first deparaffinized, and then subjected to commercial DNA extraction. The quality of extracted DNA was evaluated by amplification of the beta globulin gene. Identification of EBV and CMV DNA was performed using primers designed for the EBER region of EBV and the immediate early (IE) region of the CMV genome, respectively.

The mean age of the subjects in the test and control groups was 52.2 (17.1) and 59.9 (18.9), respectively. The distribution of gender (male/female) in patient and control groups was 54/46 and 53/47, respectively. Our results showed that the frequency of EBV (P < 0.001) and CMV (P < 0.001) in cancerous samples was statistically higher than control group. Moreover, in the cancerous group the rate of EBV was significantly higher in the esophageal adenocarcinomas (EAC) sample (12 out of 70) than esophageal squamous cell carcinomas (ESCC) (0 out of 30) (P = 0.016) but, in the ESCC group, 17 out of 30 subjects were positive for CMV which was significantly higher in comparison with EAC patients (1 out of 70) (P < 0.001).

Findings indicated that EBV and CMV might be contributed to the pathogenesis of EAC and ESCC types of esophageal carcinoma, respectively, although further studies are warranted.

Both mitochondrial dysfunction and aerobic glycolysis are signs of growing aggressive cancer. If altered metabolism of cancer cell is intended, using the glycolysis inhibitor (2-deoxyglucose (2DG)) would be a viable therapeutic method. The AMP-activated protein kinase (AMPK), as a metabolic sensor, could be activated with metformin and it can also launch a p53-dependent metabolic checkpoint and might inhibit cancer cell growth. After treatment with 5 mM metformin and/or 500 µM 2DG, the TE1, TE8, and TE11 cellular viability and apoptosis were assessed by MTT, TUNEL, and ELISA methods. The changes in p53 and Bcl-2 genes expression levels were examined using real-time PCR method. Data were analyzed by Kruskal-Wallis test using the SPSS 17.0 software. Metformin and 2DG, alone and in combination, induced apoptosis in the cell lines. Real-time PCR revealed that metformin induced apoptosis in TE8 and TE11 cells by activating p53, down-regulating Bcl-2 expression. The induced apoptosis by 2DG raised by metformin and the combination modulated the expression of Bcl-2 protein in all cell lines and it was more effective in TE11 cell line. Metformin induced apoptosis in ESCC by down-regulating Bcl-2 expression, and up-regulating p53 and induced apoptosis increased by 2-deoxy-d-glucose. Thus, the combination therapy is an effective therapeutic strategy for esophageal squamous cell carcinoma.

Cigarette smoking and alcohol consumption have a well-known effect on the development of upper aerodigestive tract carcinomas, but such a role for opium is questionable. This study was designed to assess the correlation between opium inhalation and cancer of the larynx and upper esophagus.
Fifty eight patients with laryngeal cancer, ninety eight patients with upper esophageal cancer and twenty seven healthy individuals with no evidence of head and neck or esophageal malignancies were selected from Otolaryngology and Radiation Oncology Department of Mashhad University of Medical Sciences. Duration and amount of cigarette smoking and opium consumption were recorded through comprehensive interviews.
The crude odds ratio for laryngeal cancer was 5.58 (95% CI 2.05-15.15, P=0.000) in cigarette smokers relative to non-smokers and 9.09 (95% CI 3.21-25.64, P=0.000) in opium users relative to non-users. The crude odds ratio for esophageal cancer was 0.44 (95% CI 0.18-1.09, P=0.07) in cigarette smokers relative to non-smokers and 1.44 (95% CI 0.57-3.62, P=0.43) in opium users relative to non-users. After adjusting for smoking, the odds ratio for laryngeal cancer in opium users relative to non-users was 6.06 (95% CI 1.10-33.23, P=0.05). Laryngeal cancer was detected at a significantly lower age in opium users (54.54±10.93 vs 62.92±10.10 years, P=0.02) than in smokers. This effect was not observed in esophageal cancer. Although the duration (year 17.50±14.84 vs 21.91±14.03; P=0.34) and amount (pack/day 0.625 vs 0.978; P=0.06) of smoking were higher among those who were opium dependent, these differences were not statistically significant (P=0.34 and P=0.06, respectively).
Opium addiction by snuffing is an independent risk factor for the development laryngeal cancer but not esophageal cancer. Cigarette smoking increases this risk. Opium dependency increases the likelihood of developing laryngeal cancer at a younger age.

Esophageal carcinoma is a common malignancy in the North East of Iran. Combined modality treatments have been adopted to improve survival in patients with esophageal carcinoma. In this trial, we evaluated the effi cacy and toxicity of a preoperative concurrent chemoradiotherapy protocol in the patients with locally advanced esophageal carcinoma. Between 2006 and 2011, eligible patients with locally advanced esophageal carcinoma underwent concurrent radiotherapy and chemotherapy and 3-4 weeks later, esophagectomy. Pathologic response, overall survival rate, toxicity, and feasibility were evaluated. One hundred ninety-seven patients with a median age of 59 (range: 27-70) entered the protocol. One hundred ninety-four cases (98.5%) had esophageal squamous cell carcinoma. Grades 3-4 of toxicity in patients undergoing neoadjuvant chemoradotherapy were as follows: Neutropenia in 21% and esophagitis in 2.5% of cases. Th ere were 11 (5.6%) early death probably due to the treatment-related toxicities. One hundred twenty-seven patients underwent surgery with postsurgical mortality of 11%. In these cases, the complete pathological response was shown in 38 cases (29.9%) with a 5-year overall survival rates of 48.2% and median overall survival of 44 months (95% confi dence interval, 24.46-63.54). Th e pathological response rate and the overall survival rate are promising in patients who completed the protocol as receiving at least one cycle of chemotherapy. However, the treatment toxicities were relatively high.