The prognostic value of 11th Japanese classification and 8th AJCC staging systems in Chinese patients with esophageal squamous cell carcinoma.

BACKGROUND: Two staging systems, the 8th staging system by the American Joint Committee on Cancer (AJCC) and the 11th Japanese classification by Japan Esophageal Society (JES), are currently applied in the clinic for predicting the prognosis of patients with esophageal squamous cell carcinoma (ESCC). The differences between the two staging systems have been widely researched. However, little studies focus on the differences in specific staging between the two systems. Therefore, we aimed to compare the performance of different staging in predicting overall survival (OS) of Chinese patients with ESCC. METHODS: This retrospective study included 268 patients who underwent radical esophagectomy and mediastinal lymph node dissection for ESCC between January 2008 and December 2013. Patients were staged by the 8th AJCC and 11th JES staging systems. OS was estimated using the Kaplan-Meier method and compared between N stages and between stage groupings using the log-rank test. Cox proportional hazards regression analysis was performed to identify factors independently related to outcome. Further, we compared the concordance indexes (C-indexes) of the two staging systems. RESULTS: The mean age was 61.25 ± 7.056 years, median follow-up was 44.82 months, and 5-year OS rate was 47%. The OS was well predicted by the 8th AJCC N staging (P < 0.001) and the 11th JES N staging (P < 0.001), with a c-index of 0.638 (95% CI: 0.592-0.683) for AJCC N staging and 0.627 (95% CI: 0.583-0.670) for JES N staging (P = 0.13). In addition, the OS was also well predicted by stage groupings of the 8th AJCC (P < 0.001) and the 11th JES systems (P < 0.001), with a c-index of 0.658 (95% CI: 0.616-0.699) for 8th AJCC stage grouping and 0.629 (95% CI: 0.589-0.668) for the11th JES stage grouping (P = 0.211). CONCLUSIONS: The prognostic effect of 11th JES staging system is comparable with that of AJCC 8th staging system for patients with ESCC. Therefore, both systems are applicable to clinical practice.

Effectiveness of extracorporeal shock-wave therapy for frozen shoulder: A protocol for a systematic review of randomized controlled trial.

BACKGROUND: This systematic review aims to explore the effectiveness and safety of extracorporeal shock-wave therapy (ESWT) for patients with frozen shoulder. METHODS: The sources of Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and Websites of Clinical Trials Registry will be searched. All databases and other sources will be searched from inception to the date of the search will be run. Only randomized controlled trials of ESWT for frozen shoulder will be considered for inclusion in this systematic review. Two authors independently screen the studies, extract the data, and evaluate the methodology quality for included trials. If sufficient trials will be included with fair heterogeneity, the data will be pooled, and the meta-analysis will be performed by using RevMan 5.3 software. RESULTS: This systematic review will assess the effectiveness and safety of ESWT for frozen shoulder. The primary outcome includes pain intensity. The secondary outcomes consist of shoulder function, quality of life, and also the adverse events. CONCLUSION: Its findings may provide latest evidence of ESWT for the treatment of frozen shoulder. ETHICS AND DISSEMINATION: No research ethics approval is required in this study, because it is a systematic review and will not use individual data. The results of this study are expected to publish at peer-reviewed journals.

[Isolation and characterization of dendritic cells from normal human esophageal mucosa].

AIM: To investigate the characteristics of dendritic cells (DCs) from normal human esophageal mucosa. METHODS: We collected normal esophageal mucosa samples from healthy individuals using endoscope and isolated mononuclear cells from the samples using Ficoll-Hypaque density gradient centrifugation. DCs were further separated by magnetic-activated cell sorting (MACS) to analyze DCs subsets by flow cytometry. RESULTS: Three mononuclear cell populations were detected in normal human esophageal mucosa: HLA-DR(high)/CD13(low);, HLA-DR(med)/CD13(+); and HLA-DR(-)/CD13(+). HLA-DR(high)/CD13(low); cells expressed the DCs-associated molecules and were referred to as esophageal mucosal DCs. The DCs were immature since they expressed low levels of CD80, CD83 and CD86. CONCLUSION: HLA-DR(high)/CD13(low); cells isolated from the normal human esophageal mucosa were proved to be DCs. DCs can be successfully isolated from esophageal mucosa.