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Query: UMLS:C0546837 (esophageal cancer)
 8,907 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A high incidence of pathology in the esophagus was established in patients with chronic, particularly atrophic, gastritis (esophagitis, leukoplakia, dysplasia, fibrosis of submucosa, early forms of cancer, etc.). Most patients with chronic gastritis revealed esophagitis (71%) with concomitant leukoplakia (70.6%) or dysplasia (49%) which can be identified as precancer. Therefore, patients suffering from severe chronic gastritis, involving lesions of glands and atrophy of mucosa, living in areas with highly-endemic esophageal cancer should be referred to those at high risk for cancer of the esophagus. Timely examination for and therapy of chronic esophagitis in patients with a long history of severe chronic gastritis should be indispensable to prevent esophageal cancer.
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PMID:[Esophageal and stomach pathology of residents in areas characterized by a high incidence of esophageal cancer morbidity]. 621 29

Carcinoma of the esophagus is the most common malignancy in many parts of China. In an attempt to control it by early diagnosis, the balloon sampling technique was developed approximately 20 years ago. This technique is now widely used in China and is accepted as a diagnostic method by WHO. Up to 1979, more than 500,000 people were examined in China. It is routinely used for differentiation between benign and malignant lesions in the esophagus, with an accuracy in the range of 90%. In mass surveys, 73.8% of the cancers detected have been carcinoma in situ and minimally invasive carcinomas. Dysplasias have been shown to progress to invasion by cytologic studies. The utilization of this technique has made possible epidemiologic studies and, thereby, coordination of etiologic research in esophageal cancer. Detection rates of early esophageal cancer by cytologic studies are more accurate than are those with either endoscopic or radiologic methods. The instruments and technique for balloon sampling of esophageal lesions are described, as are the cellular cytomorphology and the diagnostic cytologic criteria applicable to the samples obtained.
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PMID:Cytopathology of the esophagus. An overview of esophageal cytopathology in China. 657 34

In geographic areas where there is a high risk of esophageal cancer, analysis of cells obtained from the esophagus has been used effectively to detect early lesions. This has been demonstrated on a large scale in studies from China. Using abrasive balloon cytology techniques, 75% of the cancers detected were early lesions, where the 5-year survival after resection was in the range of 90%. Endoscopic followup studies indicate that dysplastic changes in the esophageal mucosa are a common precursor to malignancy. In many cases, the time course from dysplasia to carcinoma in situ to early invasive cancer may take place over many years, allowing a reasonable amount of time for screening. In low-incidence areas, such as the United States, most esophageal cancers are related to the excessive use of tobacco and alcohol. These factors are too common and the incidence of the disease too low, however, to justify screening on this basis. There are smaller groups at higher risk where selective screening by endoscopy with cytology and biopsy is recommended, usually every 1 to 3 years. These include patients with longstanding achalasia, lye strictures, and Plummer- Vinson syndrome. Patients with cancers of the head and neck region and patients with celiac disease may also be considered to be at increased risk. Tylosis is a rare inherited disease with a very high risk of esophageal cancer. There is an increased incidence of adenocarcinoma of the esophagus with Barrett's epithelium, and once identified such patients should be kept under endoscopic surveillance. The finding of severe dysplasia in any of these groups would indicate a shorter screening interval. Most patients with symptoms referable to the esophagus are first tested by barium esophagram. If negative, with persistent symptoms or if a suspicious lesion is identified, endoscopy with cytology and biopsy is recommended. Staging of the cancer is based on the size of the cancer both longitudinally and circumferentially and the presence of extraesophageal spread. At the present time, CT is the best noninvasive method for judging the extent of the cancer. Performance and nutritional status are also determinants of prognosis and should be considered in planning treatment.
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PMID:Screening diagnosis and staging of esophageal cancer. 672 90

A high prevalence of a chronic form of esophagitis was found during two endoscopic surveys carried out in high-incidence areas of esophageal cancer in 430 subjects from Iran, and in 527 individuals from Linxian, Peoples Republic of China, selected from the general population. This high prevalence was present even in the younger age groups. The lesion does not seem to be related to gastro-histological correlation, available for all cases examined, confirmed the chronic nature of the lesion. dysplasia was found in 3 to 8 per cent of the cases. Overall, 21 esophageal cancers were diagnosed, most in a very early phase, and some only at histology. A follow-up of 20 cases after one year, showed the progression of this chronic lesion to cancer in 4 cases. The data available suggest the precancerous nature of the lesion in these high-risk populations.
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PMID:Endoscopic features of suspected precancerous lesions in high-risk areas for esophageal cancer. 673 38

In an area with high incidence of esophageal cancer, Linxian, staple food is heavily contaminated by fungi of the Fusarium genus. We have found that T-2 toxin produced by Fusarium has both direct cytotoxic and proliferative effects on fetal esophageal epithelium. At higher dosage of T-2 toxin (4 ng/ml for 6 days) the cultured epithelium became necrotic. At a lower dosage range of 0.2-1.2 ng/ml, T-2 toxin caused mitogenic effects including focal basal cell hyperplasia, dysplasia, and increased number of mitoses. Atypical mitoses were also seen. These changes are very similar to the premalignant lesions seen in epithelium adjacent to human esophageal carcinoma. These observations suggest that Fusarium mycotoxin can have a role in human esophageal carcinogenesis and should be further investigated.
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PMID:Proliferative and cytotoxic effects of Fusarium T2 toxin on cultured human fetal esophagus. 688 33

The results presented here concern the study of in situ cancer and marked dysplasia revealed during the pathological study of 39 specimens removed during esophagogastrectomy for invasive carcinoma of the esophagus. In 12 cases, macroscopic study made it possible to define precisely the macroscopic features of in situ canccer; in one case, however, the mucous membrane at the site of the in situ cancer was macroscopically normal. The iodine test performed in 37 cases showed that the normal esophageal mucosa is iodine-positive and that in situ and invasive squamous cell carcinoma are always represented by sharply defined iodine-negative zones: in the case in which it was sufficiently extensive, marked dysplasia presented the same iodine-negative character. The possibilities for applying these results to early endoscopic diagnosis of esophageal cancer are presented.
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PMID:In situ carcinoma of the esophagus. Macroscopic study with particular reference to the Lugol test. 698 10

Chinese historical records of about 2,000 years ago noted several unique epidemiological features and possible risk factors of esophageal cancer in this country. This paper presents selected recent findings on the epidemiology of esophageal cancer in China with special attention directed to geographical distribution, risk factors, and preventive measures. Some of the major characteristics of this disease in China include: 1) an unusually high mortality, the highest in the world; 2) wide geographical differences in mortality; 3) an irregular concentric belt area of elevated mortality; 4) stability of rates over the years; 5) variations in rate by sex; 6) great ethnic differences in mortality; 7) gullet cancer in chickens comparable to the human disease; and 8) associations with high prevalence of epithelial dysplasia of the esophagus. It has been hypothesized that the prevalence of esophageal cancer in high-risk areas may be associated with fermented and moldy foodstuffs, nitrosamines, deficiencies of molybdenum, nutritional deficiencies, specific living habits, and poor oral hygiene. Accordingly, comprehensive studies are being conducted in Lin County and other areas with elevated risk of this diseases so that the possible function of fungi and nitrosamines in the carcinogenesis of esophageal cancer can be determined.
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PMID:Epidemiology of esophageal cancer in China. 716 71

Histological changes occurring in the esophageal mucosa of 110 C57b1 mice, after protracted topical treatment with diethylnitrosamine, were compared to those present in human esophagus in three patients operated for early esophageal cancer. Both in mice and in human material, the histological changes were classified into slight, moderate or severe dysplasia, carcinoma in situ, questionable invasive carcinoma and invasive carcinoma. Starting from moderate dysplasia, the epithelial-stroma border became irregular with bud formation bulging into the stroma. The findings strongly suggest an association between the degree of cellular atypia, the formation of epithelial buds, and progression towards invasive carcinoma.
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PMID:Comparative studies on the histogenesis of squamous carcinoma of esophagus in mice and in human subjects. 716 51

Two randomized nutrition intervention trials were conducted in Linxian, an area of north central China with some of the world's highest rates of esophageal and stomach cancer and a population with a chronically low intake of several nutrients. One trial used a factorial design that allowed us to assess the effects in nearly 30,000 participants of daily supplementation with four nutrient combinations: retinol and zinc; riboflavin and niacin; vitamin C and molybdenum; and beta-carotene, alpha-tocopherol, and selenium. The second trial provided daily multiple vitamin-mineral supplementation or placebo in 3318 persons with esophageal dysplasia, a precursor to esophageal cancer. After supplements were given for 5.25 y in the general population trial, small but significant reductions in total [relative risk (RR) = 0.91] and cancer (RR = 0.87) mortality were observed in subjects receiving beta-carotene, alpha-tocopherol, and selenium but not the other nutrients. The reductions were greater in women than men, and in those under compared with over the age of 55; however, differences by sex or age were not significant. After multiple vitamin and mineral supplements were given for 6 y in the smaller dysplasia trial, reductions in total (RR = 0.93) and cancer (RR = 0.96) mortality were observed but these were not significant. The largest reductions were for cerebrovascular disease mortality, but the effects differed by sex: a significant reduction was observed in men (RR = 0.45) but not women (RR = 0.90). Restoring adequate intake of certain nutrients may help to lower the risk of cancer and other diseases in this high-risk population.
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PMID:The Linxian trials: mortality rates by vitamin-mineral intervention group. 749 42

The people of Linxian County, China have one of the world's highest rates of esophageal cancer. Two intervention trials were conducted to determine whether supplementation with specific vitamins and minerals could lower mortality from or incidence of cancer in this population and whether supplementation with multiple vitamins and minerals would reduce esophageal and gastric cardia cancer in persons with esophageal dysplasia. About 30,000 general population (GP) subjects in the GP trial were randomly assigned to one of eight intervention groups according to a one-half replicate of a 2(4) factorial experimental design and were supplemented for 5.25 y with four combinations of micronutrients at doses from one to two times the US recommended dietary allowance (RDA). About 3000 subjects in whom dysplasia was diagnosed in the dysplasia trial were randomly assigned to groups receiving daily supplementation with 14 vitamins and 12 minerals at two to three times the US RDA or placebo for 6 y. Results of the dysplasia trial indicate that in individuals with esophageal dysplasia, micronutrient supplementation had little effect on T lymphocyte responses. In contrast, male participants in the GP trial who were supplemented with beta-carotene, vitamin E, and selenium showed significantly (P < 0.05) higher mitogenic responsiveness of T lymphocytes in vitro than those not receiving these micronutrients.
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PMID:Possible immunologic involvement of antioxidants in cancer prevention. 749 48


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