Expression of CXCL12 and its receptor CXCR4 in esophageal squamous cell carcinoma.

The chemokine CXCL12, also known as stromal cell-derived factor-1 and its receptor CXCR4 have been shown to play prominent roles in regulating the directional migration and proliferation of various types of cancer cells during the metastatic process. However, few researchers have examined the expression of CXCL12 and CXCR4 and their prognostic value in patients with esophageal squamous cell carcinoma (ESCC). We investigated immunohistochemically the relationship between CXCL12 and CXCR4 expression and clinicopathological factors including prognosis in surgical specimens of primary tumors in 214 patients with ESCC. The positive expression rate of CXCL12 was 53.7% and that of CXCR4 was 84.6%. Positive CXCL12 expression was significantly correlated with lymph node metastasis, tumor stage, gender and lymphatic invasion. The overall and disease-free survival rate was significantly lower in patients with positive CXCL12 expression than in those with negative CXCL12 expression. The expression of CXCR4 had no correlation with clinicopathological variables and prognosis. We showed that positive CXCL12 expression was related to a greater degree to tumor development, compared with CXCR4 expression. Evaluation of CXCL12 expression is useful for determining tumor properties, including nodal metastasis and prognosis in patients with ESCC.

[An effective treatment by chemoradiation therapy after stent insertion for advanced esophageal cancer with esophago-pulmonary fistula--report of a case].

We report the case of a 56-year-old male who was diagnosed as advanced esophageal cancer with esophago-pulmonary fistula and lung abscess. He received radiation therapy in combination with chemotherapy using cisplatin and 5-FU after insertion of a self-expanding metallic stent. He had sufficient food intake during the chemoradiotherapy (CRT). CRT was very effective for not only primary tumor but also lymph node metastasis, with resulting partial response. We could not detect any relapses and metastases for 8 months after CRT. The CRT after insertion of self-expanding metallic stent is one of the useful and palliative treatments for advance esophageal cancer with esophago-pulmonary fistula.

Distribution of p53 mutations in esophageal and gastric carcinomas and the relationship with p53 expression.

Mutations of p53, a tumor suppressor gene, are known to be involved in the pathogenesis of a number of neoplasms. This study investigated the distribution of p53 mutations within both esophageal and gastric adenocarcinomas. The correlation between p53 mutations and an overexpression of p53, which has been reported by other researchers, was also explored. Samples were taken from 17 patients following a surgical resection of the tumor. The patients included 8 cases of adenocarcinoma from the cardia (esophagogastric junction) and 9 cases of gastric carcinoma. Two or three samples were taken from each tumor, plus samples of normal tissue from the patient. Denaturing high pressure liquid chromatography (DHPLC) was employed to detect p53 mutations, and samples found to have mutations were then sequenced. The expression of p53 was determined by immunohistochemistry. DHPLC demonstrated that 37.5% (3/8) of esophageal carcinomas and 44.4% (4/9) of gastric carcinomas have p53 mutations. DNA sequencing showed the same mutation to be present in all of the samples from each tumor, while the corresponding normal tissue was free from mutations (except for 2 cases of polymorphism). The results of immunohistochemistry did not demonstrate a relationship between p53 mutations and the expression of p53 protein, and only 4 of the 7 tumors with p53 mutations showed a positive result. These findings support the hypothesis that p53 mutations are homogeneous throughout a tumor and may thus be a more useful diagnostic and prognostic indicator than the expression of p53, which does not reliably correlate with p53 mutations.

Esophageal cancer associated with the right aortic arch: a case study.

A case of esophageal cancer associated with the right aortic arch in a 62-year-old Japanese male is described herein. Endoscopy performed after an initial complaint of dysphagia revealed cancer at the upper third of the esophagus. The right aortic arch was located by routine chest X-ray and an irregularly-shaped tumor defect and a shadow defect due to right aortic arch were detected on the right side of the thoracic esophagus by barium study. Computed tomography and magnetic resonance imaging offered useful information for surgical procedure. The patient underwent a subtotal esophagectomy and regional lymphadenectomy though a left thoracotomy. The clinical features of cases previously reported in Japan are reviewed following the presentation of this case.