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World Journal of Gastroenterology 2020年第12期26卷 1262-1272页

作者： Isabelle Traini Jessica Menzies Jennifer Hughes Steven Thomas Leach Usha Krishnan School of Women’s and Children’s Health University of New South WalesSydneyNSW 2052Australia Department of Nutrition and Dietetics Sydney Children’s HospitalRandwickNSW 2031Australia Department of Speech Pathology Sydney Children’s HospitalRandwickNSW 2031Australia Department of Paediatric Gastroenterology Sydney Children’s HospitalRandwickNSW 2031Australia

Poor growth is an under-recognised yet significant long-term sequelae of oesophageal atresia(OA)*** studies have specifically explored the reasons for growth impairment in this complex *** association between poor growth with younger age and fundoplication appears to have the strongest supportive evidence,highlighting the need for early involvement of a dietitian and speech pathologist,and consideration of optimal medical reflux management prior to referring for anti-reflux ***,it remains difficult to reach conclusions regarding other factors which may negatively influence growth,due to conflicting findings,inconsistent definitions and lack of validated tool *** swallowing and feeding difficulties are particularly frequent in younger children,their relationship with growth remains *** is possible that these morbidities impact on the diet of children with OA,but detailed analysis of dietary composition and quality,and its relationship with these complications and growth,has not yet been *** potential area of research in OA is the role of the microbiota in growth and *** the microbiota has been linked to growth impairment in other paediatric conditions,it is yet to be investigated in *** research is needed to identify the most important contributory factors to poor growth,the role of the intestinal microbiota,and effective interventions to maximise growth and nutritional outcomes in this cohort.

关键词： oesophageal atresia Growth Malnutrition Feeding difficulty Dysphagia Microbiota

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Radiofrequency ablation for early oesophageal squamous neoplasia:Outcomes form United Kingdom registry

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World Journal of Gastroenterology 2013年第36期19卷 6011-6019页

作者： Rehan J Haidry Mohammed A Butt Jason Dunn Matthew Banks Abhinav Gupta Howard Smart Pradeep Bhandari Lesley Ann Smith Robert Willert Grant Fullarton Morris John Massimo Di Pietro Ian Penman Marco Novelli Laurence B Lovat Department of Surgery and Interventional Science National Medical Laser Centre UCL Department Gastroenterology University College Hospital NHS Foundation Trust Department Gastroenterology Guy’s and St Thomas’ Hospitals NHS Trust Institute for Medical Informatics Oslo University Hospital Department Gastroenterology Royal Liverpool University Hospital Merseyside Department Gastroenterology Princess Alexandra Hospital Cosham Department Gastroenterology Bradford Royal Infirmary Bradford Department Gastroenterology Central Manchester University Hospital Department Gastroenterology Glasgow Royal Infirmary Department Gastroenterology Addenbrooke’s Hospital Royal Infirmary Edinburgh

AIM:To report outcomes on patients undergoing radiofrequency ablation(RFA)for early oesophageal squamous neoplasia from a National ***:A Prospective cohort study from 8 tertiary referral centres in the United *** with squamous high grade dysplasia(HGD)and early squamous cell carcinoma(ESCC)confined to the mucosa were *** lesions were removed by endoscopic mucosal resection(EMR)before *** initial RFA treatment,patients were followed up *** flat dysplasia was treated with RFA until complete reversal dysplasia(CR-D)was achieved or progression to invasive Squamous cell cancer defined as infiltration into the submucosa layer or *** main outcome measures were CR-D at 12 mo from start of treatment,long term durability,progression to cancer and adverse ***:Twenty patients with squamous HGD/ESCC completed treatment *** patients(25%)had EMR before starting RFA ***-D was 50%at12 mo with a median of 1 RFA treatment,mean 1.5(range 1-3).Two further patients achieved CR-D with repeat RFA after this *** per cent with CR-D remain dysplasia free at latest biopsy,with median follow up 24 mo(IQR 17-54).Six of 20 patients(30%)progressed to invasive cancer at 1 *** patients(20%)required endoscopic dilatations for symptomatic structuring after *** of these patients have required serial dilatations thereafter for symptomatic dysphagia with a median of 4 dilatations per *** other 2 patients required only a single dilatation to achieve an adequate symptomatic *** patient developed cancer during follow up after end of treatment ***:The role of RFA in these patients re-mains *** our series 50%patients responded at12 *** figures are lower than limited published data.

关键词： Squamous neoplasia oesophageal cancer Endoscopic mucosal resection High-grade dysplasia Radiofrequency ablation

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Construction of an oesophageal cancer-specific ceRNA network based on miRNA, lncRNA, and mRNA expression data

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World Journal of Gastroenterology 2018年第1期24卷 23-34页

作者： Wen-Hua Xue Zhi-Rui Fan Li-Feng Li Jing-Li Lu Bing-Jun Ma Quan-Cheng Kan Jie Zhao Department of Pharmacy the First Affiliated Hospital of Zhengzhou University Cancer Centre the First Affiliated Hospital of Zhengzhou University

AIM To explore the expression profiles of microRNAs(miRNAs), long non-coding RNAs(lncRNAs), and mRNAs in oesophageal squamous cell carcinoma(ESCC) in order to construct an oesophageal cancer-specific competing endogenous RNA(ceRNA) *** In this work, the expression data of miRNAs, lncRNAs, and mRNAs in ESCC were obtained. An oesophageal cancer-specific ceRNA network was then constructed and *** CeRNAs have the ability to reduce the targeting activityof miRNAs, leading to the de-repression of specific mRNAs with common miRNA response elements. CeRNA interactions have a critical effect in gene regulation and cancer *** This study suggests a novel perspective on potential oesophageal cancer mechanisms as well as novel pathways for modulating ceRNA networks for treating cancers.

关键词： Competing endogenous RNA MicroRNA Long non-coding RNA mRNA oesophageal squamous cell carcinoma

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Detection and management of oligometastatic disease in oesophageal cancer and identification of prognostic factors: A systematic review

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World Journal of Gastrointestinal Oncology 2019年第9期11卷 741-749页

作者： Sara Jamel Karina Tukanova Sheraz Markar Department Surgery and Cancer Imperial College London

BACKGROUND oesophageal cancer is the eighth most common cancer *** prognosis of oesophageal cancer patients still remains *** 5-year survival rate rarely exceeds 5%in case of metastatic *** patients may however present with oligometastasis which can be treated with loco-regional *** To assess the current practice regarding the management of patients with oligometastatic oesophageal cancer and identify prognostic factors affecting survival following treatment for *** A systematic search of the literature was performed in Cochrance Library,MEDLINE and EMBASE databases from September 1950 to January *** electronic databases were searched for studies assessing the clinical outcome of *** A total of 14 publications were included,of which 12 studies assessing metachronous oligometastasis and 2 on synchronous *** included articles evaluated the specific outcomes of metastasis,management modality and survival *** majority of the patients presented with oesophageal squamous cell *** median disease free interval(time to recurrence)in patients was 19.6 mo and the overall survival reached 30.8 *** prognostic factors were assessed in eight studies and included time to recurrence20 mm),disease free interval(DFI)oesophageal cancer in selected patients is amenable to locoregional treatment,and the overall survival of this patient cohort may be improved with patient and tumour-specific treatments.

关键词： Oligometastasis oesophageal cancer Neoplasm Liver Pulmonary

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Risk of lymph node metastases in patients with T1b oesophageal adenocarcinoma: A retrospective single centre experience

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World Journal of Gastroenterology 2018年第41期24卷 4698-4707页

作者： David Graham Nejc Sever Cormac Magee William Waddingham Matthew Banks Rami Sweis Hannah Al-Yousuf Miriam Mitchison Durayd Alzoubaidi Manuel Rodriguez-Justo Laurence Lovat Marco Novelli Marnix Jansen Rehan Haidry GI Services University College London Hospital Division of Surgery and Science University College London Gastroenterology Department University Medical Center Ljubljana Department of Metabolism and Experimental Therapeutics University College London

AIM To assess clinical outcomes for submucosal (T1b) oesophageal adenocarcinoma (OAC) patients managed with either surgery or endoscopic eradication *** Patients found to have T1b OAC following endoscopic resection between January 2008 to February 2016 at University College London Hospital were retrospectively analysed. Patients were split into low-risk and high-risk groups according to established histopathological criteria and were then further categorised according to whether they underwent surgical resection or conservative management. Study outcomes include the presence of lymphnode metastases, disease-specific mortality and overall survival. RESULTS A total of 60 patients were included; 22 patients were surgically managed (1 low-risk and 21 high-risk patients) whilst 38 patients were treated conservatively (12 low-risk and 26 high-risk). Overall, lymph node metastases (LNM) were detected in 10 patients (17%); six of these patients had undergone conservative management and LNM were detected at a median of 4 mo after endoscopic mucosal resection (EMR). All LNM occurred in patients with highrisk lesions and this represented 21% of the total high-risk lesions. Importantly, there was no statistically significant difference in tumor-related deaths between those treated surgically or conservatively (P = 0.636) and disease-specific survival time was also comparable between the two treatment strategies (P = 0.376).CONCLUSION T1b tumours without histopathological high-risk markers of LNM can be treated endoscopically with good outcomes. In selected patients, endoscopic therapy may be appropriate for high-risk lesions.

关键词： oesophageal adenocarcinoma Submucosal invasion T1b Lymph node metastasis Risk prediction Endoscopy

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Histopathological changes in the oesophageal mucosa in Egyptian children with corrosive strictures: A single-centre vast experience

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World Journal of Gastroenterology 2019年第7期25卷 870-879页

作者： Ayman EskANDer Carolyne Ghobrial Nabil A Mohsen Bahaa Mounir Dalia Abd EL-Kareem Sara Tarek Mortada HF El-Shabrawi Department of Paediatrics Kasr Alainy School of Medicine Cairo University Department of Pathology Kasr Alainy School of Medicine Cairo University

BACKGROUND The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patients suffered from corrosive induced oesophageal strictures have more than a 1000-fold risk of developing carcinoma of the *** To determine the possibility of oesophageal mucosal dysplasia after prolonged dilatation in post corrosive *** This observational study was conducted at the Paediatric Endoscopy Unit in Cairo University Children's Hospital. It included children of both sexes older than 2 years of age who had an established diagnosis of post-corrosive oesophageal stricture and repeated endoscopic dilatation sessions for more than 6 mo. All patients were biopsied at the stricture site after 6 mo of endoscopic dilatation. A histopathological examination of an oesophageal mucosal biopsy was performed for the detection of chronic oesophagitis, inflammatory cellular infiltration and *** The mean age of the enrolled children was 5.9 ± 2.6 years; 90% of the patients had ingested an alkaline corrosive substance(potash). The total number of endoscopic dilatation sessions were ranging from 16 to 100 with mean number of sessionswas 37.2 ± 14.9. Histopathological examination of the specimens showed that 85%of patients had evidence of chronic oesophagitis(group A) in the form of basal cell hyperplasia, hyperkeratosis and subepithelial fibrosis. Thirteen percent of the patients had evidence of reactive atypia(group B) in the form of severe neutrophilic intraepithelial inflammatory cellular infiltration, and 2 patients(2%)had mild squamous dysplasia(group C); we rebiopsied these two patients 6 mo after the initial pathological assessment, guided by chromoendoscopy by Lugol's *** The histopathology of oesophageal mucosal biopsies in post-corrosive patients demonstrates evidence of chronic oesophagitis, intraepi

关键词： Children Endoscopic dilatation Dysplasia oesophageal strictures Postcorrosive

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Double-layered covered stent for the treatment of malignant oesophageal obstructions: Systematic review and meta-analysis

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World Journal of Gastroenterology 2016年第34期22卷 7841-7850页

作者： Zeiad Hussain Athanasios Diamantopoulos Miltiadis Krokidis Konstantinos Katsanos Department of Interventional Radiology Guy’s and St.Thomas’ HospitalsNHS Foundation Trust Department of Interventional Radiology Addenbrooke’s HospitalCambridge University Hospitals NHS Foundation Trust

AIM To investigate the efficacy of double-layered covered stent in the treatment of malignant oesophageal *** A systematic review and meta-analysis was performed following the PRISMA process. Pub Med(Medline),EMBASE(Excerpta Medical Database),AMED(Allied and Complementary medicine Database),Scopus and online content,were searched for studies reporting on the Ni Ti-S polyurethane-covered double oesophageal stent for the treatment of malignant dysphagia. Weighted pooled outcomes were synthesized with a random effects model to account for clinical heterogeneity. All studies reporting the outcome of palliative management of dysphagia due to histologically confirmed malignant oesophageal obstruction using double-layered covered nitinol stent were included. The level of statistical significance was set at α = *** Six clinical studies comprising 250 patients in total were identified. Pooled technical success of stent insertion was 97.2%(95%CI: 94.8%-98.9%; I2 = 5.8%). Pooled complication rate was 27.6%(95%CI: 20.7%-35.2%; I2 = 41.9%). Weighted improvement of dysphagia on a scale of 0-5 scoring system was-2.00 [95%CI:-2.29%-(-1.72%); I2 = 87%]. Distal stent migration was documented in 10 out of the 250 cases *** stent migration rate was 4.7%(95%CI: 2.5%-7.7%; I2 = 0%). Finally,tumour overgrowth was reported in 34 out of the 250 cases with pooled rate of tumour overgrowth of 11.2%(95%CI: 3.7%-22.1%; I2 = 82.2%). No funnel plot asymmetry to suggest publication bias(bias = 0.39,P = 0.78). In the sensitivity analysis all results were largely similar between the fixed and random effects *** The double-layered nitinol stent provides immediate relief of malignant dysphagia with low rates of stent migration and tumour

关键词： Double-layered covered stent Malignant oesophageal obstructions Dysphagia Double-layered nitinol stent

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Impact of regular enteral feeding via jejunostomy during neo-adjuvant chemotherapy on body composition in patients with oesophageal cancer

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World Journal of Gastrointestinal Oncology 2019年第12期11卷 1182-1192页

作者： Imran M Mohamed John Whiting Benjamin HL Tan Department of Upper Gastrointestinal Surgery Queen Elizabeth Hospital

BACKGROUND Malnourishment and sarcopenia are well documented phenomena in oesophageal *** undergoing neo-adjuvant chemotherapy prior to oesophagectomy have complex nutritional *** To examine the effect of regular nutritional support via feeding jejunostomy on overall body composition in patients undergoing neo-adjuvant chemotherapy prior to oesophagectomy for oesophageal *** Retrospective data were collected for 15 patients before and after neo-adjuvant *** patients had feeding jejunostomies inserted at staging laparoscopy prior to neo-adjuvant chemotherapy and underwent regular jejunostomy *** in body composition were determined by analysis of computed tomography *** Patient age was 61.3±12.8 years,and 73%of patients were *** time between start of chemotherapy and surgery was 107±21.6 *** was no change in weight(74.5±14.1 kg to 74.8±13.1 kg)and body mass index(26.0±3.8 kg/m^2 to 26.1±3.4 kg/m^2).Body composition analysis revealed a statistically significant decrease in lumbar skeletal muscle index despite regular feeding(45.8±8.0 cm^2/m^2 to 43.5±7.3 cm^2/m^2;P=0.045).The proportion of sarcopenic patients increased(33.3% to 60%).Six patients(40%)experienced dose-limiting toxicity during *** Regular jejunostomy feeding during neo-adjuvant chemotherapy can maintain weight and adipose *** alone is not sufficient to maintain muscle *** insight into the underlying processes causing reduced muscle mass in cancer patients may help to provide targeted interventions.

关键词： Body composition Neo-adjuvant therapy oesophageal cancer Enteral feeding

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Impact of postoperative TNM stages after neoadjuvant therapy on prognosis of adenocarcinoma of the gastro-oesophageal junction tumours

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World Journal of Gastroenterology 2018年第13期24卷 1429-1439页

作者： Michael Thomaschewski Richard Hummel Ekaterina Petrova Juliana Knief Ulrich Friedrich Wellner Tobias Keck Dirk Bausch Department of Surgery University Medical Center Schleswig-Holstein Campus Lübeck Department of Pathology University Medical Center Schleswig-Holstein Campus Lübeck

AIM To compare prognostic relevance of postoperative tumour/node/metastasis(TMN) stages between patients with and without neoadjuvant treatment. METHODS Data from patients with adenocarcinoma of the gastrooesophageal junction(AEG) who had undergone surgical resection at a single German university centre were retrospectively analysed. Patients with or without neoadjuvant preoperative treatment were selected by exact matching based on preoperative staging. Standard assessment of preoperative(c)TNM stage was based on endoscopic ultrasound and computed tomography of the thorax and abdomen, according to the American Joint Committee on Cancer/Union for International Cancer Control classification system. Patients with cT1cN0cM0 and cT2cN0cM0 stages were excluded from the study, as these patients are generally not recommended for pretreatment. Longterm survival among the various postoperative TNM stages was compared between the groups of patients with or without neoadjuvant treatment. For statistical assessments, a P-value of ≤ 0.05 was considered *** The study included a total of 174 patients. The group of patients who had received preoperative neoadjuvant treatment included more cases of AEG(Siewert) type 1 carcinoma(P < 0.001), and consequently oesophagectomy was performed more frequently among these patients(P < 0.001). The two groups(with or without preoperative neoadjuvant treatment) had comparable preoperative T stages, but the group of patients with preoperative neoadjuvant treatment presented a higher rate of preoperative N-positive disease(P = 0.020). Overall long-term survival was not different between the two groups of patients according to tumours of different AEG classifications, receipt of oesophagectomy or gastrectomy, nor between patients with similar postoperative TNM stage, resection margin and grading. However, an improvement of long-term survival was found for patients with nodal down-staging after neoadjuvant therapy(P = 0.053).CONCLUSI

关键词： Adenocarcinoma of the gastro-oesophageal junction American Joint Committee on Cancer/Union for International Cancer Control TNM system Neoadjuvant therapy oesophageal cancer

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Psychosocial factors and their association with reflux oesophagitis,Barrett's oesophagus and oesophageal adenocarcinoma

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World Journal of Gastroenterology 2013年第11期19卷 1770-1777页

作者： Paul Denver Michael Donnelly Liam J Murray Lesley A Anderson Centre for Public Health Queen's University BelfastBelfast BT12 6BJNorthern IrelandUnited Kingdom

AIM:To investigate the role of psychological characteristics as risk factors for oesophageal adenocarcinoma(OAC),as well as the reflux-mediated precursor ***:An all-Ireland population-based case-control study recruited 230 reflux oesophagitis(RO),224 Barrett's oesophagus(BO) and 227 OAC patients and 260 *** case/control group completed measures of stress,depression,self-efficacy,self-esteem,repression and social support.A comparative analysis was undertaken using polytomous logistic regression adjusted for potential ***:Compared to controls,OAC patients were almost half as likely to report high stress levels over their lifetime(P = 0.010,OR 0.51;95%CI:0.29-0.90)and 36% less likely to report having experienced depression(OR 0.64;95%CI:0.42-0.98).RO patients reported significantly higher stress than controls particularly during middle-and senior-years(P for trends < 0.001).RO patients were 37% less likely to report having been highly emotionally repressed(OR 0.63;95%CI:0.41-0.95).All case groups(OAC,RO and BO) were more likely than controls to report having had substantial amounts of social support(OR 2.84;95%CI:1.63-4.97;OR 1.97;95%CI:1.13-3.44 and OR 1.83;95%CI:1.03-3.24,respectively).CONCLUSION:The improved psychological profile of OAC patients may be explained by response *** role of psychological factors in the development of OAC requires further investigation.

关键词： Reflux oesophagitis Barrett’s oesophagus oesophageal adenocarcinoma Adjustment Psychological Psychosocial factors

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