ABSTRACT
Resumen Introducción: Los schwannomas esofágicos son tumores de elementos perineurales de la vaina nerviosa de la célula de Schwann en los nervios periféricos y representan el 2 % de los tumores primarios de esófago. Su difícil diagnóstico está dado por la baja incidencia que este presenta; sin embargo, es una etiología que debe considerarse debido a que su comportamiento clínico e imagenológico es rápidamente progresivo e inusual, comparado con otros tumores benignos de esófago. Caso clínico: Paciente femenina de 38 años con cuadro clínico de disfagia de 1 año de evolución, con endoscopia de vías digestivas altas y tomografía axial computarizada (TAC) de tórax contrastada que evidencian una masa a nivel del esófago cervical y torácico transmural, que obstruye la luz y ejerce el efecto de masa sobre la tráquea. Se realizó una biopsia que reportó un tumor fusocelular con inmunohistoquímica positiva para el marcador S100, por lo que se diagnosticó un schwannoma esofágico. En la actualidad, la paciente se encuentra en controles periódicos y en espera del concepto por oncología clínica para proponer tratamiento no quirúrgico dado el compromiso adyacente. Conclusión: Ante la sospecha de tumor primario de esófago, la primera impresión diagnóstica según la incidencia será un leiomioma, pero con nuestro reporte de caso de schwannoma esofágico, se resalta que, en un cuadro clínico no usual, este es un diagnóstico diferencial que requiere atención precoz para evitar complicaciones y secuelas en los pacientes.
Abstract Introduction: Esophageal schwannomas are tumors of the perineural components of the Schwann cell nerve sheath in peripheral nerves and account for 2% of primary esophageal tumors. Its low incidence makes diagnosis challenging; however, this etiology should be considered because its clinical and imaging behavior is rapidly progressive and unusual compared to other benign esophageal tumors. Case study: A 38-year-old female patient with a 1-year history of dysphagia underwent upper digestive tract endoscopy and contrast chest CT showing a mass at the cervical and transmural thoracic esophagus level, obstructing the lumen and exerting a mass effect on the trachea. A biopsy revealed a spindle cell tumor with positive immunohistochemistry for the S100 marker, leading to the diagnosis of esophageal Schwannoma. The patient is currently undergoing regular check-ups and is awaiting the advice of a clinical oncologist to recommend non-surgical treatment options due to the involvement of adjacent structures. Conclusion: The first diagnostic impression in the case of a suspected primary esophageal tumor would be a leiomyoma based on its incidence. The present case report of an esophageal schwannoma emphasizes that this is a differential diagnosis that requires timely treatment to avoid complications and sequelae in patients.
Subject(s)
Humans , Female , Adult , Esophageal Neoplasms , Neurilemmoma , Therapeutics , EndoscopyABSTRACT
Objective To study the relationship between the ratio of target volume to lung volume and the prescription dose in intensity modulated radiation therapy (IMRT) for esophageal cancer, so as to help clinicians to choose the appropriate prescription dose according to the target situation. Methods 80 patients with esophageal cancer were randomly selected. The lesion range included all types of esophageal cancer, and the target area was outlined according to ICRU (International Commission Radiological Units) 50 and ICRU62. Set statistical parameters and plan objectives. Statistical analysis was performed according to the statistical results of the parameters. The critical value of volume ratio is obtained by fitting calculation. Results there was a positive linear correlation between volume ratio and lung V5, V20, V30 and average lung dose. The critical value of volume ratio is 10% for 60 Gy and 13% for 50 Gy. Conclusion according to the research results, it can be predicted that when the ratio of target volume to lung volume is more than 10%, the prescribed dose should not be higher than 60 Gy; when the ratio of target volume to lung volume is more than 13%, the prescribed dose should be selected cautiously, meanwhile in the condition of whose target volume exceeds lung segment the prescribed dose. This provides a reference for clinicians when choose the prescription dose and target range while making the target delineation.
ABSTRACT
Objective@#To study the related factors of radiation induced lung injury(RILI) after three-dimensional conformal radiotherapy(3D-CRT) in the elderly patients with advance esophageal cancer, thus to provide reference for radiotherapy planning.@*Methods@#The clinical data and physical parameters of 72 elderly patients with advance esophageal cancer were analyzed, including gender, age, performance status scoring, smoking history, tumor location, T staging, underlying disease of the lung, radiation dose, the whole lung accepted 5 Gy exposure volume(V5), V10, V15, V20, V25, V30, V40 and mean lung dose(MLD).@*Results@#Among 72 patients, 15 cases developed RILI.It was revealed by univariate analysis that there were statistically significant differences in advanced age, underlying disease of the lung, V5, V10, V15, V20, V25, MLD with RILI(χ2=5.098, P=0.026; χ2=3.598, P=0.030; t=3.854, P=0.034; t=4.901, P=0.022, t=4.638, P=0.029, t=5.122, P=0.015, t=3.652, P=0.041, t=5.760, P=0.010).@*Conclusion@#It should be payed more attention to factors such as advanced age, underlying disease of the lung, V5, V10, V15, V20, V25 and MLD when elderly patients with advance esophageal cancer patients were treated with 3D-CRT in order to prevent and decrease the risks of RILI.
ABSTRACT
Fibrovascular polyps are rare benign intraluminal tumors that usually arise from the cervical esophagus. These often present as very large sized pedunculated polyps and cause symptoms including dysphagia and respiratory distress. Generally, large polyps are surgically excised, while endoscopic resection is limited to smaller polyps. Herein, we present a giant fibrovascular polyp of the esophagus treated successfully by endoscopic resection.
Subject(s)
Deglutition Disorders , Esophagus , PolypsABSTRACT
Objective To evaluate the application of tubular stomach gastroesophagostomy on the life quality after esophagectomy surgery.Methods From March 2011 to September 2011,66 cases of esophageal cancer patients were divided in two groups in randomized principles.Tirty-four cases in group of tubiform gastro surgery whose the stomach was cut into tubiform stomach in width of 4 cm.And 32 cases of conventional group and whose surgery method was adopted to maintain whole stomach but cut the cardia.And then,using statistical methods,life quality after esophagectomy (treatment related symptoms,general symptoms,daily life,social life,emotional activities) and the perioperative complications were evaluated in 3,6,12,24 months in comparison and analysis.Results Sixty-six surgeries of both group patients were successfully performed,tumor resection rate was 100％,and there was no intraoperative accident also no perioperative death.There was no statistical significance of perioperative complications of 2 groups (P ＞ 0.05).Life quality of tubiform gastro group had improved apparently more than conventional group at the 3rd,6th,12th and 24th month after surgery(78.68 ±2.23 vs 65.94± 4.13,83.79 ± 2.40 vs 66.84 ± 5.86,86.41 ± 1.94 vs 67.09 ± 4.43,89.02 ± 1.71 vs 68.88 ±3.53,P＜0.05).At each time point,there were statistically significant differences between tubiform gastro group and conventional group on treatment related symptoms,general symptoms,daily life,emotion activities (P ＜0.05).At the 3rd,6th month after surgery,tubiform gastro group and the conventional group had no statistically significant difference in the aspect of social life (P＞0.05).In the conventional group,the evaluation of quality of life at each time point after surgery and before a point in time in the same group showed no statistical significance (P＞0.05).Conclusion Tubiform gastro esophagectomy has a positive influence on life quality of patients of esophageal cancer after surgery prospectively.
ABSTRACT
Background and purpose:Endoscopic treatment is a promising therapeutic option for superifcial lesions throughout the gastrointestinal tract, this study was aimed to evaluate the efficacy of endoscopic resection (ER) using the new Duette multiband mucosectomy kit (DT-6) on treating esophageal disease. Methods:Since Jun. 2011, ER using DT-6 has been performed on 100 patients in a tertiary medical center. Data from those who have been followed up for over 6 months was analyzed. ER and esophagectomy were compared on treating high grade dysplasia (HGD) lesions and early esophageal cancer. Results:From Jun. 2011 to Jan. 2012, a total of 32 patients with esophageal lesions underwent 34 ER using DT-6 (22 male and 10 female, mean age 59.0 years, range 25 to 83 years). There were (3.4±1.0) specimen resected per operation, and the average greatest diameter was (11.8±2.7)mm. Intraoperative blood loss was (5.45±1.47)mL. The median follow-up period was 8.2 months with a 100%half-year-follow-up rate. Except one pneumothorax occurred during one endoscopic submucosal dissection (ESD), no other complications happened. When Comparing ER and esophagectomy on treating HGD and early esophageal cancer, ER showed advantages in terms of operation time, intraoperative blood loss, hospital stay and complications. Conclusion:ER using DT-6 is safe, simple, minimally invasive and effective for esophageal disease. Prospective study and long follow-up are needed to compare endoscopic resection and esophagectomy for HGD and early esophagus cancer.
ABSTRACT
ObjectiveTo investigate the biological significance and mechanism of VEGF-C in esophageal tumor development,and correlation of CNTN-1 level with VEGF-C.MethodsThe expression of VEGF-C and its receptors in esophageal squamous cancer cell (ESCC) and in corresponding noncancerous esophageal tissue specimens were detected by real-tithe PCR.Esophageal squamous cancer cell line TE-1 was transinfected by VEGF-C overexpression and gene silencing vectors,respectively,and the relative amount of C/EBP bound to CNTN-1 promoter was determined by quantitative ChIP,to explore the possibility that VEGF-C was involved in development of esophageal cancer through mediating transcription of CNTN-1.ResultsThe mRNA levels of VEGF-C was significantly higher in ESCC than in normal esophageal tissues.VEGF-C expression was significantly increased in VEGF-C-overexpressing TE-1 cells compared to untransfected cells (mock).Cells transfected with either of the VEGF-C targeting shRNA vectors,shRNA-1 and shRNA-2,showed reduced VEGF-C transcripts (P ＜ 0.01 ).Expression levels of VEGF-C and CNTN-1 mRNA correlated significantly with each other.The binding site of C/EBP in CNTN-1 was detected by ChIP,and the relative amount of C/EBP binding to CNTN-1 promoter was significantly increased in TE-1 after transfecting by VEGF-C overexpression vector ( P ＜ 0.05).ConclusionVEGF-C and its receptor are highly expressed in esophageal cancer tissues,which may be associated with ESCC carcinogenesis and development.VEGF-C may influence on growth and migration in TE-1 cells through CNTN-1.
ABSTRACT
Objective To study the expression of early growth response gene-1(Egr-1)in esophageal carcinoma tissue,and to explore the relationship between Egr-1 and the survival time of the patients with esophageal carcinoma.Methods RT-PCR was performed to detect the expression of Egr-1 mRNA in68 cases of esophageal carcinoma.The relationship between survival time and prognosis was analyzed.Results The expression of Egr-1 mRNA was the lowest(0.567±0.404),(0.945±0.336)and(1.201±0.347)in esophageal carcinoma tissue,para-cancerous tissue and normal esophageal mucosa tissue,respectively(F=12.709,P＜0.05,P＜0.00).21 cases showed the positive expression of Egr-1 mRNA of both the esophageal carcinoma tissue and the para-cancerous tissue.21 cases showed the positive expression of Egr-1 mRNA in a single esophageal carcinoma tissue or the para-cancerous tissue.26 cases showed the negative expression of Egr-1 mRNA both in the esophageal carcinoma tissue and the paracancerous tissue.The positive rate of Egr-1mRNA expression was 65.71%and 30.00%in the groups of the survival time for three years and the groups of the survival time for one year(P＜0.05).The survival rates in the two groups with positive expression of Egr-1 mRNA were 94.44%and 86.96%,respectively(P＞0.05).Conclusion Decreased level of EGR1 expression may be related to esophageal carcinogenesis.The expression level of Egr-1 mRNA might be associated with the survival time of the patients with esophageal carcinoma.Egr-1 expression in esophageal carcinoma tissue may be of great value for determining prognosis of esophageal carcinoma.
ABSTRACT
Objective:To evaluate the effectiveness of endoscopic minimally invasive treatment for submucosal tumors of the esophagus.Methods:Included in the study were 33 patients with esophageal submucosal tumors,male 23 and female 10 cases,aged 34-85 years(average 51.2).The lesions were removed by means of endoscopic mucosal resection(EMR),or stripping-resection method,i.e.,first stripped by a needle knife and followed by "injection and cut".Results:All the lesions were resected completely by endoscopic minimally invasive methods.Of 33 lesions,15 cases were undertook EMR,and 18 cases were treated by stripping-resection method.Except 5 cases of treatable bleeding,and 6 cases of post-operative substernal pain,no other complications were found.Pathological exam and immunohistochemical study showed that 25 cases were esophageal leiomyoma,3 cases of stromal tumor,2 cases of lipoma,2 cases of haemangioma and 1 case of submucoal cyst.No recurrence was found during the follow-up of 2-30 months. Conclusion:Endoscopic minimally invasive therapy is effective and safe for the treatment of esophageal submucosal tumors.
ABSTRACT
Purpose:To evaluate radiotherapy after operation of esophageal carcinoma. Methods:A comparative study was done between the group of 80 patients treated by postoperative radiotherapy and the group of 80 patients by operation only from January 1989 to June 1994. The radiation dose was 40—50 Gy. Results:The 1 ,3 ,and 5 year survival rates of operative group were 76.3%, 37.5%, 22.5%, and those of postoperative radiotherapy were 77.5 %,56.3 %,32.5 %. There was significant difference between the 3 year survival rates of the two groups ( P
ABSTRACT
Objective To study the relationship between expression of EGFR and E- cadherin and metastasis of esophageal cancer. Methods The expression of EGFR and E- cadherin in esophageal cancer tissues of 47 patients by LSAB immunohistochemistry method was studied. Results The positive rates of EGFR in distant metastasis group and local lymph node metastasis group were 47.62 % and 56.52 % respectively. They were higher than individual corresponding control groups(27.08 % and 26.32 %)(P
ABSTRACT
Aim To investigate the inhibitory effect of paeonol (Pae) on the human esophageal cancer cell line Eca-109 in vitro and in vivo and its effect on apoptosis.Methods Cytotoxic effect of Pae on Eca-109 cells cultured in vitro was measured by MTT assay.Anti-tumor activity was performed on BALB/c nude mice xenografts model.The morphologic changes of tumor tissue were observed under light microscope and transmission electron microscope.The apoptosis index was assessed by TUNEL.Results Pae had significant in- hibitory effect on the proliferation of Eca-109 cells,and the IC50 value was 0.342 mmol?L-1.In the model of human esophageal cancer xenografts in BALB/c nude mice,the inhibitory rates of Pae group (25、50、100、200 mg?kg-1) were 10.67%、23.54%、27.91% and 34.46% respectively.In vivo administration of Pae 100 mg?kg-1 combined with cisplatin 5 mg?kg-1 resulted in a significant inhibition of Eca-109 tumor growth with the inhibitory rate of 77.91%,compared with cisplatin used alone (58.71%).The more apoptotic tumor cells could be seen under light microscope in every theraperutic groups than those in control.Changes of ultrastructure of tumor cells including concentration and side accumulation of the nuclear chromatin,and the fragmentation of the nuclear was observed under transmission electronic microscope.Apoptosis body was also found.The apoptosis indexes of every theraperutic groups were significantly different from the control.Conclusion Pae can inhibit the cell growth and induce apoptosis in human esophageal cancer cell line Eca-109 in vitro and in vivo.