Incidence of venous thromboembolism in esophageal cancer: a real-world study of 8 458 cases / 中华消化外科杂志

Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.

COVID-19 infection after minimally invasive esophagectomy: Two cases report / 中国胸心血管外科临床杂志

@#Two male patients (75 years and 51 years, respectively) suffered infection of novel coronavirus after minimally invasive surgery for esophageal squamous cell carcinoma in Sichuan Cancer Hospital since December 2022. Both patients developed severe hypoxemia after surgery, and were treated with advanced oxygen therapy, antiviral therapy, hormone shock therapy, antibiotic anti-infection and nutritional support. The two patients stayed in the intensive care unit for 6 days and 8 days respectively. They were transferred to the general ward for symptomatic treatment and were discharged successfully. Both patients required low-flow oxygen maintenance after discharge. On the 20th day of follow-up after discharge, patient 1 still needed low-flow oxygen, his oxygen saturation could be maintained above 97%, but intermittent deoxygenation could be performed for half an hour. Patient 2 was in good condition on 35 days after discharge.

Surgical treatment and prognosis analysis of thoracic esophageal squamous cell carcinoma: a report of 2 766 cases / 中华消化外科杂志

Objective:To investigate the surgical treatment and prognosis of thoracic esophageal squamous cell carcinoma (ESCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 2 766 patients with thoracic ESCC who were admitted to Sichuan Cancer Hospital & Institute from January 2010 to December 2017 were collected. There were 2 256 males and 510 females, aged (62±8)years. All patients underwent surgical treatment. Observation indicators: (1) treatment; (2) postoperative complications; (3) postoperative survival. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absolute numbers or percentages. The Kaplan-Meier method was used to draw survival curve and calculate survival rate, and the Log-Rank test was used for survival analysis. Result:(1) Treatment. Fifty-two of the 2 766 patients underwent neoadjuvant therapy. There were 1 444 patients undergoing open surgery, including 44 cases conversion to thoracotomy, and there were 1 322 patients undergoing minimally invasive esophagectomy. There were 1 991, 729 and 46 cases with McKeown, Ivor-Lewis and Sweet esophagectomy, respectively. One thousand two hundred and seventy-one of the 2 766 patients underwent postoperative adjuvant therapy. The number of lymph node metastases, the number of lymph node dissected, rate of R 0 resection, operation time of 2 766 patients were 2.1(0,3.0), 22±12, 94.722%(2 620/2 766), (237±66)minutes. (2) Postoperative complications. The overall incidence of postoperative complications was 25.850%(715/2 766). The top two postoperative complications were pneumonia and anastomotic fistula, with incidence rates of 8.604%(238/2766) and 7.484%(207/2766), respectively. One patient may have more than two kinds of postoperative complications. (3) Postoperative survival. The 1-, 3-and 5-year overall survival rates of 2 766 patients were 86.2%, 57.5% and 46.8%, respectively. Further analysis indicated that the 5-year overall survival rates of 510 female patients and 2 256 male patients were 62.0% and 43.3%, respectively, showing a significant difference between them ( χ2=48.94, P<0.05). The 5-year overall survival rates of 693 cases with upper thoracic ESCC, 1 479 cases with middle thoracic ESCC and 594 cases with lower thoracic ESCC were 49.5%, 46.7% and 44.1%, respectively, showing no significant difference among them ( χ2=3.21, P>0.05). The 5-year overall survival rates of 68 cases with stage 0 thoracic ESCC, 259 cases with stage Ⅰ esophageal ESCC, 885 cases with stage Ⅱ thoracic ESCC, 1 222 cases with stage Ⅲ thoracic ESCC, and 332 cases with stage Ⅳ thoracic ESCC were 95.6%, 76.4%, 61.4%, 35.6%, and 14.5%, respectively, showing a significant difference among them ( χ2=500.40, P<0.05). The 5-year overall survival rates of 1 444 patients undergoing open esophagectomy and 1 322 patients undergoing minimally invasive esophagectomy were 42.5% and 51.8%, respectively, showing a significant difference between them ( χ2=31.29, P<0.05). The 5-year overall survival rates of 1 991 cases undergoing McKeown esophagectomy, 729 cases undergoing Ivor-Lewis esophagectomy, and 46 cases undergoing Sweet esophagectomy were 49.5%, 41.2%, and 32.3%, respectively, showing a significant difference among them ( χ2=19.19, P<0.05). Conclusions:Compared with open esophagectomy, minimally invasive esophagectomy brings survival benefits to patients with thoracic esophageal ESCC. Among different esophagectomy methods, the McKeown esophagectomy has also brought survival benefits to patients with esophageal ESCC compared to the Ivor-Lewis esophagectomy and the Sweet esophagectomy.

Brief introduction of surgical development of esophageal cancer in Japan / 中华外科杂志

Esophageal cancer surgery originated in the early 20th century. However, the true meaning of trans-thoracic esophagectomy and digestive tract reconstruction began in the 1930s. Almost at the same time, Japan and Western countries began the surgical exploration of esophageal cancer. Based on the pathological type of esophageal cancer in Asia, squamous cell carcinoma is the majority, and its biological characteristics and treatment strategies are different from those of European and American patients. After more than eighty years of development, the surgical treatment of esophageal cancer in Japan has been developed from the initial attempt, deep cultivation practice to the pursuit of excellence, and explored a set of more advanced surgical techniques and diagnostic strategies, which is unique in the world. On the basis of the establishment of the Japanese Society of Esophagus, Japanese scholars have developed and irregularly updated the Japanese Classification of Esophageal Cancer and published the professional academic journal Esophagus. The Japanese Clinical Oncology Group organized a number of phase Ⅲ clinical studies on esophageal cancer, providing strong evidence for the diagnosis and treatment of esophageal squamous carcinoma. Focused on the origin, development, current situation and future of esophageal cancer surgery in Japan, this paper summarized the development of esophageal cancer surgery in Japan through literature review, interviews with senior experts and Hot topics of esophageal cancer surgery-questionnaire survey of Japanese experts.

Progress of clinical trials for immunotherapy drugs in advanced esophageal cancer / 中国胸心血管外科临床杂志

@#Early and mid-stage esophageal cancer can achieve a particular effect through surgeries or comprehensive treatment based on surgery. Once the esophageal cancer progresses to the advanced stage, it is still lack of effective remedy for the disease, and the patient's prognosis is poor. Immunotherapy has developed rapidly in recent years, bringing dawn to patients with advanced esophageal cancer. On July 31, 2019, the US Food and Drug Administration (FDA) approved KEYTRUDA (Merck) for the treatment of esophageal squamous cell carcinoma, and it became the first milestone drug for esophageal squamous cell carcinoma. In the paper, we will review the progress of immunotherapy in the treatment of advanced esophageal cancer on the basis of current clinical researches, which might provide ideas for further studies in the immunotherapy for esophageal cancer.

Molecular Mechanism of Different Signaling Pathways in Regulating PD-L1 Expression in EGFR Mutated Lung Adenocarcinoma / 中国肺癌杂志

The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and programmed death receptor 1 (PD-1)/programmed death ligand 1 (PD-L1) immune checkpoint inhibitors were landmarks in the treatment of non-small cell lung cancer (NSCLC). However, the regulation mechanisms of PD-L1 expression were not fully clear in NSCLC patients with EGFR mutations. Multiple signaling pathways may be involved in the tumorigenesis regulation. This paper summarized and reviewed the potential EGFR mutations impacting on PD-L1 expression with aims to the development of strategies on immunochemical therapy for NSCLC.
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RBP2 induces stem-like cancer cells by promoting EMT and is a prognostic marker for renal cell carcinoma

Renal cell carcinoma (RCC), one of the most common kidney cancers, has a poor prognosis. Epithelial to mesenchymal transition (EMT) is a hallmark of carcinoma invasion and metastasis. Several studies have examined the molecular regulation of EMT, but the relationship between histone demethylases and EMT is little understood. In this study, we investigated the role of retinoblastoma-binding protein-2 (RBP2), a histone demethylase that is highly expressed in RCC and is positively correlated with poor RCC prognosis in the regulation of EMT. We found that ectopic overexpression of RBP2 can induce cancer stem cell-like (CSC) phenotypes through EMT in RCC cells by converting them to a more mesenchymal phenotype. This results in increased resistance to apoptosis, which leads to enhanced tumor growth in xenograft models. Together, our data show that RBP2 is an epigenetic regulator that has an important role in the initiation of CSC phenotypes through EMT, leading to tumor progression. RBP2 is also a novel biomolecule for RCC diagnosis, and prognosis and may be a therapeutic target.

DNA Extraction of Cast-off Cells of Fingerprints from 502 Glue Fumigated Con-tact Samples / 法医学杂志

Objective To establish a method of fingerprint position, sample transfer and fingerprint DNA extraction in contact samples. Methods Sixty-six cases were visualized by 502 glue fingerprint fumiga-tion. Two methods, ordinary wipe and acetone wipe, were used to transfer cast-off cells of fingerprints fromtesting samples, respectively. DNA was extracted and purified by ultramicro magnetic bead kit. The data was resolved on genetic analysis after amplification. Results In 33 samples, 30 samples got better STR analysis by acetone wipe method. The peak range was 1 000-4 000 R FU and peak shapes were equable. It was hard to get ideal STR typing by ordinary wipe method. Conclusion The samples are visualized by 502 glue fingerprint fumigation and the case-off cells are transferred by acetone wipe method. The method shows better STR analysis result, which might be a better method for forensic sci-ence practice.

Analysis of ERCC1 mRNA expression to predict prognosis in patients with non-small cell lung cancer who received adjuvant chemotherapy / 重庆医学

Objective To discover the excision repair cross-complementing 1 (ERCC1) expression in non-small cell lung cancer (NSCLC) patients and explore the prognostic value of ERCC1 .Methods The ERCC1 mRNA expressions in NSCLC was tested from 85 tumor tissues and 34 adjacent tissue samples from patients who were after the surgery were used by semi-quantitative RT-PCR .The data of clinical features and progression-free survival (PFS) and overall survival (OS) were linked to ERCC1 expression by retrospective analysis .Results In 85 patients ,the ERCC1 negative ones had a significantly longer survival than the ERCC1 posi-tive expression ones (PFS ,P=0 .001;OS ,P=0 .001) .During the multivariate analysis ,ERCC1was found to be a significant factor in PFS and OS (P=0 .018 and P=0 .027) .Conclusion NSCLC patients who were undertaken platinum-based adjuvant chemother-apy after surgery could use the detection of ERCC1 mRNA as a determinant factor for the prognosis predicting of individualized treatment .