Pathogenesis, diagnosis and therapeutic possibilities of esophageal cancer

Quercetin Antagonizes Esophagus Cancer by Modulating miR-1-3p/TAGLN2 Pathway-Dependent Growth and Metastasis

The progression of esophagus cancer (EC) is associated with the alterative expressions of multiple microRNAs (miRs). MiR-1-3p is reported to inhibit the development of EC by targeting TAGLN2. Quercetin (Que) is a natural compound capable of antagonizing esophagus carcinoma (EC). In the current study, the role of miR-1-3p/TAGLN2 axis in the anti-EC function of Que was explored. Human EC cell lines KYSE-510 and TE-7 were treated with Que. Then the effects of Que on the growth and metastasis of EC cells, and on the activity of miR-1-3p/TAGLN2 axis were detected. The interaction between Que and miR-1-3p axis was further assessed by inhibiting miR-1-3p level in EC cells. The results showed that the treatment of Que impaired the growth and induced cell apoptosis in EC cells. The invasive ability of EC cells was also suppressed by Que. At molecular level, the expression of miR-1-3p was induced, while the expression of TAGLN2 was suppressed by Que. Moreover, the anti-EC effects of Que were blocked by miR-1-3p inhibition, which was represented by the restored growth and invasion of EC cells. Collectively, the current study demonstrated that Que exerted inhibitory effects on EC cells by inducing miR-1-3p.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1972125.

Molecular mechanisms of Barrett's esophagus

Barrett's esophagus (BE) is defined as the metaplastic conversion of esophageal squamous epithelium to intestinalized columnar epithelium. As a premalignant lesion of esophageal adenocarcinoma (EAC), BE develops as a result of chronic gastroesophageal reflux disease (GERD). Many studies have been conducted to understand the molecular mechanisms of this disease. This review summarizes recent results involving squamous and intestinal transcription factors, signaling pathways, stromal factors, microRNAs, and other factors in the development of BE. A conceptual framework is proposed to guide future studies. We expect elucidation of the molecular mechanisms of BE to help in the development of improved management of GERD, BE, and EAC.

Therapy-related leukemia following chemoradiotherapy for esophageal cancer

Chemoradiotherapy has improved the outcome of patients with esophageal cancer. Although a sufficiently long-time survival has resulted in the increase of several treatment-related late toxicities, little is still known about the incidence of secondary malignancies. In our hospital, 348 patients with esophageal cancer received chemotherapy consisting of nedaplatin and 5-fluorouracil and concurrent irradiation. Median and average follow-up durations were 8 and 21 months (1-92), respectively. Four patients developed leukemia after 19-48 months of follow-up. Two patients were diagnosed with overt leukemia from myelodysplastic syndrome presenting a complex karyotype, including the deletion of chromosome 5 or 7. Notably, one patient showed an additional chromosomal abnormality with t(9;22)(q34;q11). Other patients developed acute myeloid leukemia with t(9;22)(q34;q11) and Burkitt leukemia with t(8;14)(q24;q32). All patients eventually succumbed to leukemia. Platinum and fluorouracil have shown relatively lower risks for secondary malignancies in comparison with alkylating agents and topoisomerase II inhibitors. Especially, nedaplatin has never been described to introduce secondary neoplasms. Our report supports the idea that the concurrent administration of radiotherapy with these agents affects the risk of leukemia. Interestingly, rare balanced chromosomal abnormalities were observed in the present cases, thus providing new insights into the leukemogenesis of therapy-related leukemia.

Advances in gene chip technique in Barrett's metaplasia and adenocarcinoma

Gene chip methods are applied to the study of gene expression. The differentially expressed genes in different specimens may be detected with parallel analysis by gene chip, which has greatly improved the traditional experiments in that only a single or several gene expressions need to be observed for each test, thereby speeding up the identification of differentially expressed genes and the construction of differential expression profiles. Many studies have applied this technology for Barrett's metaplasia and adenocarcinoma, and identified a number of candidate genes useful as biomarkers in cancer staging, prediction of recurrence, prognosis and treatment selection. This review described the gene expression profile and molecular changes related to Barrett's metaplasia and adenocarcinoma of the esophagus, with emphasis on its prognostic value and possibilities for targeted therapy in a clinical setting.

In vivo and in vitro anti-tumor effects of β-elemene liposome

AIM: To investigate the inhibitory effects of β-elemene liposome on digestive tumors in vitro and in vivo.

METHODS: Five digestive tumor cell lines and one human lung embryonic fibroblast cell line were used to test the IC₅₀ values of β-elemene liposome in vitro by cell culture. H22-bearing Kunming mice were treated with injection of β-elemene liposome through the tail vein at 20, 40 or 80 mg/kg to establish solid and ascites tumor models. Mice treated with glucose or elemene emulsion served as negative or positive controls, respectively. The anti-tumor effects, survival and side effects of β-elemene liposome observed and compared between different groups.

RESULTS: IC₅₀ values of β-elemene liposome and elemene emulsion for the five digestive tumor cell lines were from 34.1 ± 4.5 to 51.4 ± 4.2 mg/L and 41.5 ± 4.7 mg/L to 82.3 ± 8.8 mg/L, respectively, and IC₅₀ of the former was half of the later. In solid tumor models, the inhibitory rates of 80-, 40- or 20-mg/kg β-elemene liposome and elemene emulsion were 47.4%-50.8%, 38.2%-45.0%, 23.2%-28.2% and 21.8%-43.0%, respectively, and the average tumor weights were lower than those in the glucose control group (t > 4.09, P < 0.05). In ascites tumor models, the survival time was 51.3%-153.0% longer in β-elemene liposome or emulsion group than that in the glucose control group (t > 7.92, P < 0.05). Furthermore, the survival time in 80- or 40-mg/kg β-elemene liposome group was longer than that in elemene emulsion group (t > 4.64, P < 0.05). The stimulating symptoms and phlebitis of tail vein generated by injection of β-elemene liposome were slighter than those by elemene emulsion.

CONCLUSION: β-elemene liposome has greater ability to inhibit tumor growth and relieve side effects than elemene emulsion.

Palliation of thoracic malignancies

The sequelae of advanced malignancies of the chest, whether primary or metastatic, can be severely debilitating. In this review, we discuss the advances in palliative treatment for several intrathoracic complications of malignancy. The treatment of malignant pleural and pericardial effusions now includes a range of chemical sclerosants and percutaneous or surgical interventions. A new generation of promising stent and ablation technologies allows for the treatment of intrinsic or extrinsic airway obstruction. Similar techniques are being explored for esophageal obstruction, while the possible benefit of palliative radiation and chemotherapy continues to be investigated. Although their symptoms are often severe, patients with advanced thoracic malignancies have a growing number and variety of palliative treatment options to improve their quality of life.