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Arora J, Nassar M, Baraka B. Unravelling the potential of plasma DNA methylation in the detection and surveillance of esophageal cancer. World J Gastrointest Oncol 2025; 17:103333. [DOI: 10.4251/wjgo.v17.i6.103333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 02/09/2025] [Accepted: 02/19/2025] [Indexed: 06/13/2025] Open
Abstract
Esophageal cancer (EC) continues to pose a significant clinical challenge due to the absence of a reliable early detection method, leading to late-stage diagnoses and poor patient outcomes. The recent study by Liu et al presents a promising breakthrough, demonstrating that plasma DNA methylation markers-SHOX2, SEPTIN9, EPO, and RNF180-offer a non-invasive approach for early EC detection with 76.19% sensitivity and 86.27% specificity. Given the urgent need for effective screening strategies, the potential integration of this assay into clinical practice could significantly enhance early diagnosis, patient monitoring, and overall survival rates. While further validation is necessary, this advancement marks an important step toward improving EC detection and management.
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Affiliation(s)
- Jitesh Arora
- Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, United Kingdom
| | - Mahmoud Nassar
- Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York, NY 14203, United States
| | - Bahaaeldin Baraka
- Department of Oncology, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, United Kingdom
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Lin A, Song L, Wang Y, Yan K, Tang H. Future prospects of deep learning in esophageal cancer diagnosis and clinical decision support (Review). Oncol Lett 2025; 29:293. [PMID: 40271007 PMCID: PMC12016012 DOI: 10.3892/ol.2025.15039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Accepted: 03/18/2025] [Indexed: 04/25/2025] Open
Abstract
Esophageal cancer (EC) is one of the leading causes of cancer-related mortality worldwide, still faces significant challenges in early diagnosis and prognosis. Early EC lesions often present subtle symptoms and current diagnostic methods are limited in accuracy due to tumor heterogeneity, lesion morphology and variable image quality. These limitations are particularly prominent in the early detection of precancerous lesions such as Barrett's esophagus. Traditional diagnostic approaches, such as endoscopic examination, pathological analysis and computed tomography, require improvements in diagnostic precision and staging accuracy. Deep learning (DL), a key branch of artificial intelligence, shows great promise in improving the detection of early EC lesions, distinguishing benign from malignant lesions and aiding cancer staging and prognosis. However, challenges remain, including image quality variability, insufficient data annotation and limited generalization. The present review summarized recent advances in the application of DL to medical images obtained through various imaging techniques for the diagnosis of EC at different stages. It assesses the role of DL in tumor pathology, prognosis prediction and clinical decision support, highlighting its advantages in EC diagnosis and prognosis evaluation. Finally, it provided an objective analysis of the challenges currently facing the field and prospects for future applications.
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Affiliation(s)
- Aiting Lin
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P.R. China
- Department of Thoracic Surgery, The Second Affiliated Hospital of Naval Medical University, Shanghai 200003, P.R. China
| | - Lirong Song
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P.R. China
| | - Ying Wang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P.R. China
| | - Kai Yan
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, P.R. China
| | - Hua Tang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Naval Medical University, Shanghai 200003, P.R. China
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Chen J, Fan X, Chen QL, Ren W, Li Q, Wang D, He J. Research status and progress of deep learning in automatic esophageal cancer detection. World J Gastrointest Oncol 2025; 17:104410. [DOI: 10.4251/wjgo.v17.i5.104410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2024] [Revised: 02/28/2025] [Accepted: 03/24/2025] [Indexed: 05/15/2025] Open
Abstract
Esophageal cancer (EC), a common malignant tumor of the digestive tract, requires early diagnosis and timely treatment to improve patient prognosis. Automated detection of EC using medical imaging has the potential to increase screening efficiency and diagnostic accuracy, thereby significantly improving long-term survival rates and the quality of life of patients. Recent advances in deep learning (DL), particularly convolutional neural networks, have demonstrated remarkable performance in medical imaging analysis. These techniques have shown significant progress in the automated identification of malignant tumors, quantitative analysis of lesions, and improvement in diagnostic accuracy and efficiency. This article comprehensively examines the research progress of DL in medical imaging for EC, covering various imaging modalities such as digital pathology, endoscopy, computed tomography, etc. It explores the clinical value and application prospects of DL in EC screening and diagnosis. Additionally, the article addresses several critical challenges that must be overcome for the clinical translation of DL techniques, including constructing high-quality datasets, promoting multimodal feature fusion, and optimizing artificial intelligence-clinical workflow integration. By providing a detailed overview of the current state of DL in EC imaging and highlighting the key challenges and future directions, this article aims to guide future research and facilitate the clinical implementation of DL technologies in EC management, ultimately contributing to better patient outcomes.
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Affiliation(s)
- Jing Chen
- Department of Nuclear Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Xin Fan
- Department of Nuclear Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Qiao-Liang Chen
- Department of Nuclear Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Wei Ren
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Qi Li
- Department of Pathology, Nanjing Drum Tower Hospital, Nanjing 210008, Jiangsu Province, China
| | - Dong Wang
- Nanjing Center for Applied Mathematics, Nanjing 211135, Jiangsu Province, China
| | - Jian He
- Department of Nuclear Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
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Kim JS, Nam H, Kim EC, Jeong HJ, Lee SJ. Bioengineered Approaches for Esophageal Regeneration: Advancing Esophageal Cancer Therapy. Bioengineering (Basel) 2025; 12:479. [PMID: 40428100 PMCID: PMC12109178 DOI: 10.3390/bioengineering12050479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2025] [Revised: 04/24/2025] [Accepted: 04/29/2025] [Indexed: 05/29/2025] Open
Abstract
Esophageal cancer (EC) is the eighth leading cause of cancer-related deaths globally, largely due to its late-stage diagnosis and aggressive progression. Esophagectomy remains the primary treatment, typically requiring organ-based reconstruction techniques such as gastric pull-up or colonic interposition. However, these reconstruction methods often lead to severe complications, significantly reducing the quality of life of patients. To address these limitations, tissue engineering has emerged as a promising alternative, offering bioengineered patch-type and tubular-type scaffolds designed to restore both structural integrity and functional regeneration. Recent advancements in three-dimensional (3D) biofabrication-including 3D bioprinting, electrospinning, and other cutting-edge techniques-have facilitated the development of patient-specific constructs with improved biocompatibility. Despite significant advancements, critical challenges persist in achieving mechanical durability, multilayered cellular organization, and physiological resilience post-transplantation. Ongoing research continues to address these limitations and enhance clinical applicability. Therefore, this review aims to examine recent advancements in esophageal tissue engineering, with a focus on key biofabrication techniques, preclinical animal models, and the major translational challenges that must be addressed for successful clinical application.
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Affiliation(s)
- Jae-Seok Kim
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Republic of Korea; (J.-S.K.); (E.C.K.)
| | - Hyoryung Nam
- Department of Biomedical Engineering, School of Medicine, Daegu Catholic University, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Republic of Korea;
| | - Eun Chae Kim
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Republic of Korea; (J.-S.K.); (E.C.K.)
| | - Hun-Jin Jeong
- College of Dental Medicine, Columbia University Irving Medical Center, 630 W. 168th St., VC12-212A, New York, NY 10032, USA
| | - Seung-Jae Lee
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Republic of Korea; (J.-S.K.); (E.C.K.)
- Division of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Republic of Korea
- MECHABIO Group, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Republic of Korea
- Advanced Bio-Convergence Research Center, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Republic of Korea
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Li R, Yang Y, Gao Y, Lv J, Dai C, Zhai Y, Mao C, Jiang J, Fan J, Yu Y, Wu L, Lin Z. Knowledge map of programmed cell death in esophageal cancer: a bibliometric analysis. Discov Oncol 2025; 16:609. [PMID: 40274628 PMCID: PMC12022209 DOI: 10.1007/s12672-025-02376-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2025] [Accepted: 04/11/2025] [Indexed: 04/26/2025] Open
Abstract
OBJECTIVES This study aimed to delineate the evolving knowledge structure of programmed cell death in esophageal cancer and identify key thematic trends, influential collaborations, and emerging areas for future research. METHODS A bibliometric approach was applied to 2677 publications retrieved from the Web of Science Core Collection (2000-2024). Three complementary tools-CiteSpace, VOSviewer, and bibliometrix-were employed to visualize co-citation networks, detect citation bursts, and map collaborative patterns among authors, institutions, and countries. Inclusion criteria focused on articles and reviews that addressed esophageal cancer in conjunction with apoptosis, necroptosis, pyroptosis, ferroptosis, autophagy, or related pathways. RESULTS Publication outputs grew markedly, reflecting a shift from early investigations of basic apoptotic mechanisms to broader explorations of necroptosis, pyroptosis, and ferroptosis. China led in publication volume and citations, driven by substantial governmental funding and large clinical cohorts. The United States and Japan also contributed significantly, forming international research networks that spanned Asia and Europe. Leading institutions, particularly Zhengzhou University, demonstrated extensive collaborations. Journals such as Oncology Letters and Oncology Reports were prominent outlets for new findings, while highly cited references highlighted hypoxia, immune checkpoint blockade, and emerging gene-editing strategies. Keyword analyses revealed the ascendance of immuno-oncology, network pharmacology, and translational applications targeting multiple regulated cell death pathways. CONCLUSION Bibliometric evidence underscores a rapid expansion of multidisciplinary research that integrates diverse cell death pathways in esophageal cancer. Continued international collaborations, leveraging advanced genomics and immunologic strategies, are poised to accelerate translational breakthroughs and enable more personalized, effective therapies.
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Affiliation(s)
- Rulin Li
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China
| | - Yanchun Yang
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China
| | - Yang Gao
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China
| | - Jing Lv
- Department of Orthopedics, Ziyang Central Hospital, Ziyang, 641300, China
| | - Chuanqiang Dai
- Department of Orthopedics, Ziyang Central Hospital, Ziyang, 641300, China
| | - Yuanwei Zhai
- Department of Medical Imaging, Ziyang Central Hospital, Ziyang, 641300, China
| | - Chirong Mao
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China
| | - Jiudong Jiang
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China
| | - Jiangang Fan
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China
| | - Yang Yu
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China
| | - Liang Wu
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China
| | - Zhiwu Lin
- Department of Thoracic Surgery, Ziyang Central Hospital, Ziyang, 641300, China.
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Ren Y, Wang F, Zhu Z, Luo R, Lv G, Cui H. Breath biomarkers for esophageal cancer: identification, quantification, and diagnostic modeling. ANAL SCI 2025:10.1007/s44211-025-00769-x. [PMID: 40232623 DOI: 10.1007/s44211-025-00769-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2025] [Accepted: 04/01/2025] [Indexed: 04/16/2025]
Abstract
Esophageal cancer is a major global health issue with a high mortality rate. Early diagnosis is crucial for improving patient outcomes, but traditional diagnostic methods are often invasive and costly. This study explores the potential of exhaled volatile organic compounds (VOCs) as a non-invasive diagnostic tool for esophageal cancer. Using gas chromatography-mass spectrometry (GC-MS), we analyzed the breath samples of 80 esophageal cancer patients and 60 healthy controls, identifying and quantifying over 100 VOCs. The results revealed significant differences in the concentrations of VOCs such as acetone, ethanol, and isoprene between the two groups. A multi-parameter regression diagnostic model based on a neural network algorithm achieved an accuracy of 90.3% in distinguishing esophageal cancer patients from healthy individuals. Further optimization incorporating physiological factors, including smoking, drinking, and dietary habits, improved the model's accuracy to 92.4%, with a specificity of 93.1%, representing a significant improvement over previous studies. These results suggest that VOCs analysis in exhaled breath holds great promise as a non-invasive, cost-effective, and accurate method for early detection of esophageal cancer.
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Affiliation(s)
- Yuke Ren
- Key Laboratory of Clean Energy and Carbon Neutrality of Zhejiang Province, State Key Laboratory of Clean Energy Utilization (Zhejiang University), Hangzhou, 310027, China
| | - Fei Wang
- Key Laboratory of Clean Energy and Carbon Neutrality of Zhejiang Province, State Key Laboratory of Clean Energy Utilization (Zhejiang University), Hangzhou, 310027, China.
| | - Ziyi Zhu
- Department of Thoracic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China
| | - Raojun Luo
- Department of Thoracic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China
| | - Guojun Lv
- Key Laboratory of Clean Energy and Carbon Neutrality of Zhejiang Province, State Key Laboratory of Clean Energy Utilization (Zhejiang University), Hangzhou, 310027, China
| | - Haibin Cui
- Key Laboratory of Clean Energy and Carbon Neutrality of Zhejiang Province, State Key Laboratory of Clean Energy Utilization (Zhejiang University), Hangzhou, 310027, China
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Tian F, He X, Wang S, Liang Y, Wang Z, Hu M, Gao Y. Integrating single-cell sequencing and machine learning to uncover the role of mitophagy in subtyping and prognosis of esophageal cancer. Apoptosis 2025; 30:1021-1041. [PMID: 39948301 DOI: 10.1007/s10495-024-02061-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2024] [Indexed: 03/27/2025]
Abstract
Globally, esophageal cancer stands as a prominent contributor to cancer-related fatalities, distinguished by its poor prognosis. Mitophagy has a significant impact on the process of cancer progression. This study investigated the prognostic significance of mitophagy-related genes (MRGs) in esophageal carcinoma (ESCA) to elucidate molecular subtypes. By analyzing RNA-seq data from The Cancer Genome Atlas (TCGA), 6451 differentially expressed genes (DEGs) were identified. Cox regression analysis narrowed this list to 14 MRGs with potential prognostic implications. ESCA patients were classified into two distinct subtypes (C1 and C2) based on these genes. Furthermore, leveraging the differentially expressed genes between Cluster 1 and Cluster 2, ESCA patients were classified into two novel subtypes (CA and CB). Importantly, patients in C2 and CA subtypes exhibited inferior prognosis compared to those in C1 and CB (p < 0.05). Functional enrichments and immune microenvironments varied significantly among these subtypes, with C1 and CB demonstrating higher immune checkpoint expression levels. Employing machine learning algorithms like LASSO regression, Random Forest and XGBoost, alongside multivariate COX regression analysis, two core genes: HSPD1 and MAP1LC3B were identified. A prognostic model based on these genes was developed and validated in two external cohorts. Additionally, single-cell sequencing analysis provided novel insights into esophageal cancer microenvironment heterogeneity. Through Coremine database screening, Icaritin emerged as a potential therapeutic candidate to potentially improve esophageal cancer prognosis. Molecular docking results indicated favorable binding efficacies of Icaritin with HSPD1 and MAP1LC3B, contributing to the understanding of the underlying molecular mechanisms of esophageal cancer and offering therapeutic avenues.
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Affiliation(s)
- Feng Tian
- Clinical College of Chengde Medical University, Chengde, 067000, China
| | - Xinyang He
- Nursing College of Chengde Medical University, Chengde, 067000, China
| | - Saiwei Wang
- Nursing College of Chengde Medical University, Chengde, 067000, China
| | - Yiwei Liang
- Nursing College of Chengde Medical University, Chengde, 067000, China
| | - Zijie Wang
- Nursing College of Chengde Medical University, Chengde, 067000, China
| | - Minxuan Hu
- Clinical College of Chengde Medical University, Chengde, 067000, China
| | - Yaxian Gao
- Department of Immunology, Basic Medical Institute, Chengde Medical University, Anyuan Road, Shuangqiao District, Chengde, 067000, Hebei, China.
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Cevik AB, Yıldız H, Sert H. Preventive Behaviors, Knowledge of Esophageal Cancer and Relationships Socio-Demographic Characteristics Among Older Adults: A Cross Sectional Study. Am J Health Promot 2025:8901171251326322. [PMID: 40156548 DOI: 10.1177/08901171251326322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2025]
Abstract
PurposeThis study aimed to investigate the risks of esophageal cancer (EC), protective behaviors, and risk awareness among Turkish adults aged 50 years and older, as well as their relationships with sociodemographic characteristics.DesignCross-sectional. Recruitment took place between February-April 2022, via online google forms and WhatsApp.SettingParticipants completed the survey online throught WhatsApp.SampleAnalyses included 214 participants (≥50 years from three provinces of Turkey); 73.8% female (n:158), 62.6% between 50-60 years (n:134 ), 55.6% had a university education (n:47).MeasuresStudy-specific survey items included questions about demographics, risky conditions and diseases, preventive health behaviors and Esophageal Cancer Knowledge Test (ECRKT).AnalysesFrequency or Mean, Percentage, Independent Samples t-Test, one-way analysis of variance (ANOVA), post hoc analysis (Tukey, LSD), and Cohen's effect size and linear regression analysis.ResultsThe participants had low ECRKT scores (x:13.50 ± 9.33, Min:0, Max:31) and reported the most consumed hot beverages (36.9%) among negative EC preventive behaviors. Male gender, not working, not having previously received training on EC, low education and income status cause low knowledge and awareness about EC (P < 0.05). Most of the participants had oral herpes (54.7%), vitamin deficiency (49.1%), and obesity (47.2%) in the past or now. Regarding the participants' EC risk knowledge and, female gender, being between 50-60 years old, and being employed had a weak effect (η2<0.01), while having previous EC training had a moderate effect (η2 = 0.006), and having university or higher education had a large positive effect (η2 = 0.14) (P < 0.05). Participants' level of education and previous educational experiences contribute significantly to esophageal cancer risk knowledge (P < 0.01).ConclusionThese findings highlight adults aged ≥50 years are exposed to significant EC risks, and have poor knowledge of EC risks. These results highlight the urgent need for educational campaigns to improve EC awareness.
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Affiliation(s)
| | - Hicran Yıldız
- Nursing Department, Uludag University Health Science Faculty, Bursa, Turkey
| | - Havva Sert
- Nursing Department, Sakarya University Health Science Faculty, Sakarya, Turkey
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Xi M, Luo X, Chen F, Wang Z, Xiao X, Luo B, Chen M, Gan T, Yang J, Deng K. Iodine Staining With Distance Countdown Improving the Safety for Reduction of Adverse Events: A Randomized Controlled Trial. Clin Transl Gastroenterol 2025; 16:e00822. [PMID: 39836052 PMCID: PMC11932585 DOI: 10.14309/ctg.0000000000000822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 01/03/2025] [Indexed: 01/22/2025] Open
Abstract
INTRODUCTION Lugol chromoendoscopy (LCE) is valuable, cost-effective, and widely used in early esophageal cancer screening, yet it suffers from low compliance because of adverse events after LCE. In addition, the reflux of iodine during iodine staining in the upper esophagus brings the risk of bucking and aspiration. We introduced a new model called distance countdown (DC) aimed to reduce reflux during iodine staining in upper esophageal LCE. METHODS In this randomized controlled trial, 204 patients were randomized into the DC and No-DC groups. The primary end point was the difference in the incidence of positive starch reagent reaction (iodine solution reflux) between the 2 groups. The secondary end points were the comparisons of the incidence of other adverse events after LCE between the 2 groups. RESULTS The rate of iodine solution reflux was 1.0% in the DC group and 26.5% in the No-DC group ( P < 0.001). Furthermore, the incidences of bucking between the 2 groups were 1.0% and 9.8% ( P = 0.005). LCE satisfaction rates were 78.4% and 76.5% in the DC and No-DC groups ( P = 0.363), respectively. Concerning symptoms after LCE, incidences of sore throat, pharyngeal discomfort or odor, bitter taste, and heartburn were also reduced in the DC group (all P < 0.05). DISCUSSION Adding DC as an auxiliary effect during LCE would reduce the risk of iodine solution reflux, as well as other adverse events after LCE. Implementing this measure could be beneficial in improving the safety of LCE in early esophageal cancer screening.
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Affiliation(s)
- Mingjia Xi
- Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinyue Luo
- Department of Gastroenterology & Hepatology, The First People's Hospital of Longquanyi District, Chengdu, Sichuan, China
| | - Feifan Chen
- Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhu Wang
- Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xue Xiao
- Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Binyang Luo
- Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mo Chen
- Department of Gerontology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
- Department of Gerontology, Tibetan Chengdu Branch Hospital of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tao Gan
- Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinlin Yang
- Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Deng
- Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Zhang X, Li Z, Wang T. Etomidate suppresses proliferation, migration, invasion, and glycolysis in esophageal cancer cells via PI3K/AKT pathway inhibition. Cytotechnology 2025; 77:4. [PMID: 39583284 PMCID: PMC11579264 DOI: 10.1007/s10616-024-00661-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 10/26/2024] [Indexed: 11/26/2024] Open
Abstract
Esophageal cancer remains a formidable challenge in oncology, characterized by its poor prognosis and limited therapeutic options. Recent investigations have unveiled the potential of repurposing existing drugs for cancer treatment. Notably, etomidate, an anesthetic agent traditionally used for inducing general anesthesia, has emerged as a promising candidate demonstrating significant anticancer properties across various tumor types. The present study aims to investigate the effects of etomidate on esophageal carcinoma cells, with a specific focus on its ability to modulate the PI3K/AKT signaling pathway and inhibit tumor proliferation. This study employed both in vitro and in vivo methodologies to assess the effects of etomidate on esophageal cancer cells. In vitro experiments evaluated the effects of etomidate on cell proliferation, migration, invasion, and glycolytic processes. An in vivo xenograft mouse model was established to investigate the therapeutic potential of etomidate on tumor growth and assess its impact on the PI3K/AKT signaling pathway in a physiologically relevant context. Etomidate demonstrated a significant inhibitory effect on the proliferation, migration, invasion, and glycolytic capacity of esophageal cancer cells. This multifaceted suppression of tumorigenic properties was closely associated with the inhibition of the PI3K/AKT pathway, as evidenced by reduced phosphorylation levels of PI3K and AKT. In vivo studies using a murine model of esophageal cancer corroborated these findings. Etomidate administration resulted in a substantial reduction in tumor volume and mass, accompanied by increased apoptotic activity and the inhibition of the PI3K/AKT pathway within the tumor tissue. This study demonstrates etomidate's potent inhibition of esophageal cancer progression through suppression of the PI3K/AKT pathway. These promising results warrant further clinical investigation of etomidate as a potential therapeutic strategy for esophageal cancer. Supplementary Information The online version contains supplementary material available at 10.1007/s10616-024-00661-y.
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Affiliation(s)
- Xiangchao Zhang
- Department of Anesthesiology, Shenyang Chest Hospital, No. 11 Beihai Street, Dadong District, Shenyang City, 110044 Liaoning China
| | - Zhengjun Li
- Department of Thoracic Surgery, Shenyang Chest Hospital, No. 11 Beihai Street, Dadong District, Shenyang City, 110044 Liaoning China
| | - Tao Wang
- Department of Anesthesiology, Shenyang Chest Hospital, No. 11 Beihai Street, Dadong District, Shenyang City, 110044 Liaoning China
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Ilic I, Zivanovic Macuzic I, Ravic-Nikolic A, Ilic M, Milicic V. Global Burden of Esophageal Cancer and Its Risk Factors: A Systematic Analysis of the Global Burden of Disease Study 2019. Life (Basel) 2024; 15:24. [PMID: 39859964 PMCID: PMC11767048 DOI: 10.3390/life15010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 12/20/2024] [Accepted: 12/26/2024] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND Esophageal cancer is a major public health issue, yet risk factors for its occurrence are still insufficiently known. This study aimed to estimate the global burden of esophageal cancer and its risk factors. METHODS This ecological study presented the incidence, mortality, and Disability-Adjusted Life Years (DALYs) of esophageal cancer in the world. This study collected the Global Burden of Disease study data from 1990 to 2019. Trends in esophageal cancer burden were assessed using the joinpoint regression analysis and calculating the average annual percent change (AAPC). RESULTS Globally, in 2019, in both sexes and all ages, the ASR for the incidence of esophageal cancer was 6.5 per 100,000 and for mortality, 6.1 per 100,000. The global proportion of DALYs for esophageal cancer attributable to selected behavioral, metabolic, and dietary risk factors was similar in males and females: chewing tobacco (3.8% vs. 5.1%), diet low in fruits (10.1% vs. 12.6%), diet low in vegetables (3.3% vs. 4.6%), and high body mass index (18.8% vs. 19.3%). However, the proportion of DALYs for esophageal cancer attributable to smoking and alcohol use was 4-5 times higher in males than in females (50.1% vs. 11.3%, and 29.6% vs. 5.1%, respectively). From 1990 to 2019, a significant decrease in global trends in rates of DALYs for esophageal cancer attributable to smoking (AAPC = -1.6%), chewing tobacco (AAPC = -0.5%), alcohol use (AAPC = -1.0%), a diet low in fruits (AAPC = -3.1%), and a diet low in vegetables (AAPC = -3.6%) was observed, while a significant increase in trends was observed in DALYs rates for esophageal cancer attributable to a high body mass index (AAPC = +0.4%). CONCLUSIONS More epidemiological research is needed to elucidate the relationship between esophageal cancer and certain risk factors and guide prevention efforts.
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Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Ivana Zivanovic Macuzic
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Ana Ravic-Nikolic
- Department of Dermatovenerology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Vesna Milicic
- Department of Dermatovenerology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
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12
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Vissapragada R, Bulamu NB, Yazbeck R, Karnon J, Watson DI. A Markov cohort model for Endoscopic surveillance and management of Barrett’s esophagus. HEALTHCARE ANALYTICS 2024; 6:100360. [DOI: 10.1016/j.health.2024.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2025]
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13
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Chen HY, Por CR, Hong YK, Kong EQZ, Subramaniyan V. Molecular mechanisms underlying oesophageal cancer development triggered by chronic alcohol consumption. CLINICAL AND TRANSLATIONAL DISCOVERY 2024; 4. [DOI: 10.1002/ctd2.70021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 11/24/2024] [Indexed: 12/27/2024]
Abstract
AbstractThis review explores the mechanisms underlying alcohol‐induced oesophageal carcinogenesis, including DNA damage, oxidative stress, and nutritional deficiencies. Alcohol metabolism primarily involves alcohol dehydrogenase (ADH) converting ethanol to acetaldehyde, which can cause DNA damage, inhibit repair mechanisms, and form DNA adducts thus inhibiting DNA replication. Plus, it delves into the epidemiological evidence, genetic susceptibility, epigenetic modifications, biomarkers, and preventive strategies associated with alcohol‐related oesophageal cancers. Consumption of alcohol increases the risk of gastroesophageal reflux disease thus compromising mucosal integrity of the oesophagus as dysregulation of cytokines such as IL‐18, TNFA, GATA3, TLR4, and CD68 expands the intercellular spaces of epithelial cells. Genetic variants, such as ADH1B rs1229984 and ALDH2 rs671, significantly influence susceptibility to alcohol‐related oesophageal cancers, with these variations affecting acetaldehyde metabolism and cancer risk. Understanding these factors is crucial for early detection, effective treatment, and the development of targeted prevention strategies. Biomarkers, such as miRNA and metabolite markers, offer non‐invasive methods for early detection, while advanced endoscopic techniques provide better diagnostic accuracy. Pharmacological interventions, such as statins and proton pump inhibitors, also show potential for reducing cancer progression in high‐risk individuals. Despite advances, late‐stage oesophageal cancer diagnoses are still common, highlighting the need for better screening and prevention. Further research, including this study, should aim to improve early detection, personalise prevention, and explore new treatments to reduce cases and enhance outcomes in alcohol‐related oesophageal cancers.
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Affiliation(s)
- Huai Yi Chen
- Jeffrey Cheah School of Medicine and Health Sciences Monash University Jalan Lagoon Selatan Bandar Sunway Subang Jaya Malaysia
| | - Chia Rou Por
- Jeffrey Cheah School of Medicine and Health Sciences Monash University Jalan Lagoon Selatan Bandar Sunway Subang Jaya Malaysia
| | - Yong Kai Hong
- Jeffrey Cheah School of Medicine and Health Sciences Monash University Jalan Lagoon Selatan Bandar Sunway Subang Jaya Malaysia
| | - Eason Qi Zheng Kong
- Jeffrey Cheah School of Medicine and Health Sciences Monash University Jalan Lagoon Selatan Bandar Sunway Subang Jaya Malaysia
| | - Vetriselvan Subramaniyan
- Jeffrey Cheah School of Medicine and Health Sciences Monash University Jalan Lagoon Selatan Bandar Sunway Subang Jaya Malaysia
- School of Medical and Life Sciences Sunway University Jalan Lagoon Selatan Bandar Sunway Petaling Jaya Malaysia
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14
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Ohta R, Sano C. Aspiration as an Initial Symptom of Early-Stage Esophageal Cancer: A Case Report. Cureus 2024; 16:e69758. [PMID: 39429380 PMCID: PMC11490588 DOI: 10.7759/cureus.69758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2024] [Indexed: 10/22/2024] Open
Abstract
This case report discusses a rare presentation of esophageal adenocarcinoma located in the upper part of the esophagus in a 74-year-old male, where the sole initial symptom was silent aspiration. The absence of typical symptoms such as dysphagia or respiratory issues delayed the diagnosis of esophageal cancer. However, subsequent investigations, including endoscopy, revealed adenocarcinoma in the upper esophagus. This case underscores the importance of considering esophageal cancer in differential diagnoses when unexplained aspiration occurs, even in the absence of common symptoms, and highlights the critical need for early detection to improve patient outcomes.
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Affiliation(s)
| | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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15
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Ono T. Importance of early detection of esophageal cancer before the tumor progresses too much for effective treatment. World J Gastrointest Oncol 2024; 16:3382-3385. [PMID: 39171185 PMCID: PMC11334036 DOI: 10.4251/wjgo.v16.i8.3382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/02/2024] [Accepted: 05/17/2024] [Indexed: 08/07/2024] Open
Abstract
This editorial comments on an article by Qu et al published in the World Journal of Gastrointestinal Oncology. It focuses on the importance of early detection of esophageal cancer, including recurrence or secondary malignancy after chemoradiotherapy (CRT). Endoscopic resection is the first choice for treatment for esophageal cancer remaining within the mucous membrane, while surgery or radical CRT are treatment options for advanced stages depending on the patient's general condition and desire. Although these treatments are potentially curative, they are more invasive than endoscopic resection. Early-stage esophageal cancer is often asymptomatic and difficult to detect. Uniform periodic endoscopy is unrealistic. Although less burdensome tests exist, including liquid biopsy and urinary biomarkers, these have not yet been widely used in clinical practice. Early detection is important after radical CRT because the local recurrence rate is higher than that after surgery. However, endoscopic resection or photodynamic therapy is indicated if detected in the early stages, and positive results have been reported. Early detection of esophageal cancer is crucial. Endoscopy is the main diagnostic method; however, new and less burdensome methods should be established to ensure early treatment for patients with esophageal cancer.
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Affiliation(s)
- Takashi Ono
- Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
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16
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Pubu S, Zhang JW, Yang J. Early diagnosis of esophageal cancer: How to put "early detection" into effect? World J Gastrointest Oncol 2024; 16:3386-3392. [PMID: 39171169 PMCID: PMC11334019 DOI: 10.4251/wjgo.v16.i8.3386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/04/2024] [Accepted: 05/20/2024] [Indexed: 08/07/2024] Open
Abstract
This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology, focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achieving "early detection". The five-year age-standardized net survival for esophageal cancer patients falls short of expectations. Early detection and accurate diagnosis are critical strategies for improving the treatment outcomes of esophageal cancer. While advancements in endoscopic technology have been significant, there seems to be an excessive emphasis on the latest high-end endoscopic devices and various endoscopic resection techniques. Therefore, it is imperative to redirect focus towards proactive early detection strategies for esophageal cancer, investigate the most cost-effective screening methods suitable for different regions, and persistently explore practical solutions to improve the five-year survival rate of patients with esophageal cancer.
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Affiliation(s)
- Suolang Pubu
- Department of Gastroenterology, Changdu People’s Hospital of Xizang, Changdu 854000, Tibet Autonomous Region, China
| | - Jun-Wen Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jian Yang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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17
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Pubu S, Zhang JW, Yang J. Early diagnosis of esophageal cancer: How to put "early detection" into effect? World J Gastrointest Oncol 2024; 16:3386-3392. [PMID: 39171169 DOI: 10.4251/wjgo.v16.i8.3386if:] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/04/2024] [Accepted: 05/20/2024] [Indexed: 03/07/2025] Open
Abstract
This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology, focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achieving "early detection". The five-year age-standardized net survival for esophageal cancer patients falls short of expectations. Early detection and accurate diagnosis are critical strategies for improving the treatment outcomes of esophageal cancer. While advancements in endoscopic technology have been significant, there seems to be an excessive emphasis on the latest high-end endoscopic devices and various endoscopic resection techniques. Therefore, it is imperative to redirect focus towards proactive early detection strategies for esophageal cancer, investigate the most cost-effective screening methods suitable for different regions, and persistently explore practical solutions to improve the five-year survival rate of patients with esophageal cancer.
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Affiliation(s)
- Suolang Pubu
- Department of Gastroenterology, Changdu People's Hospital of Xizang, Changdu 854000, Tibet Autonomous Region, China
| | - Jun-Wen Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jian Yang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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18
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Liu S, Chen LX, Ye LS, Hu B. Challenges in early detection and endoscopic resection of esophageal cancer: There is a long way to go. World J Gastrointest Oncol 2024; 16:3364-3367. [PMID: 39072158 PMCID: PMC11271785 DOI: 10.4251/wjgo.v16.i7.3364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/13/2024] [Accepted: 06/03/2024] [Indexed: 07/12/2024] Open
Abstract
The publication by Qu et al provided a comprehensive discussion about the epidemiology, etiology, histopathology, early detection, and endoscopic treatment of esophageal carcinoma (EC) and summarized the progress in the advanced technologies for screening and endoscopic resection for EC. In this editorial, we will provide deeper insight into the challenges that hinder practical application of these advanced technologies along with the role of these technologies in upper endoscopy quality. More efforts need to be made to overcome the challenges and add the value of these technologies in upper endoscopy quality. Clinical outcomes of management strategies after noncurative endoscopic dissection for early EC patients need further investigation. The experiences with noncurative endoscopic resection of other organs may have certain implications for noncurative resection of early EC.
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Affiliation(s)
- Shuang Liu
- Department of Gastroenterology and Hepatology/Medical Engineering Integration Laboratory of Digestive Endoscopy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Liu-Xiang Chen
- Department of Gastroenterology and Hepatology/Medical Engineering Integration Laboratory of Digestive Endoscopy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology and Hepatology/Medical Engineering Integration Laboratory of Digestive Endoscopy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology and Hepatology/Medical Engineering Integration Laboratory of Digestive Endoscopy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Cheng CY, Hao WR, Cheng TH. Esophageal cancer: A global challenge requiring tailored strategies. World J Gastrointest Oncol 2024; 16:2881-2883. [PMID: 39072159 PMCID: PMC11271769 DOI: 10.4251/wjgo.v16.i7.2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/25/2024] [Accepted: 05/14/2024] [Indexed: 07/12/2024] Open
Abstract
In this editorial we comment on the article published in a recent issue of the World Journal of Gastrointestinal Oncology. Characterized by high mortality rates and geographical variations in its incidence, esophageal cancer poses a major global health challenge. This editorial article synthesizes insights from the review of esophageal cancer conducted by Qu et al, which highlights the importance of tailored screening and treatment strategies. Key themes include the effect of regional disparities on screening protocols, advancements in early detection methodologies, and therapeutic management disparities between different regions. By embracing personalized approaches grounded in regional nuances and technological innovation, the article advocates for comprehensive and collaborative efforts to improve patient outcomes in esophageal cancer care.
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Affiliation(s)
- Chun-Yao Cheng
- Department of Medical Education, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Wen-Rui Hao
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Ministry of Health and Welfare, Taipei Medical University, New Taipei 23561, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11002, Taiwan
| | - Tzu-Hurng Cheng
- Department of Biochemistry, School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
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