Relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China

ABO genotypes and the risk of esophageal and gastric cancers

BACKGROUND

Blood type has been associated with the risk of gastric cancer, but few studies have examined the association with esophageal squamous cell carcinoma (ESCC).

METHODS

We conducted a case-control study using genotyping data of Chinese individuals, including cases of 2022 ESCC, 1189 gastric cardia adenocarcinoma, 1161 gastric noncardia adenocarcinoma, and 2696 controls. Genetic blood type was imputed using three single nucleotide polymorphisms. We used logistic regression to examine the association between blood type and the risk of each cancer.

RESULTS

Compared to blood type O, the risk of ESCC was significantly elevated for blood type B and AB, with the highest risk for type AB (OR, 95%CI: 1.34, 1.07-1.67). Analysis of genotype suggested that the association of ESCC was from carrying the B allele. Similarly, blood type was significantly associated with gastric noncardia adenocarcinoma (P < 0.001) with risk significantly elevated in type A (1.37, 1.14-1.65) and AB (1.44, 1.10-1.89) compared to type O. Blood type was not associated with gastric cardia adenocarcinoma (P = 0.13).

CONCLUSIONS

This study provides novel insights into the association between blood type and the risk of ESCC and restricted previously observed association to only gastric noncardia cancer, providing important evidence to clarify the pattern of association and suggesting mechanisms of action.

Prognostic Role of ABO Blood Type in Operable Esophageal Cancer: Analysis of 2179 Southern Chinese Patients

Background

The prognostic value of ABO blood types is not well clarified for esophageal carcinoma (EC). This study attempted to elucidate the associations between different ABO blood types and disease-free survival (DFS) and overall survival (OS) of EC.

Methods

This study was a retrospective review of the records of 2179 patients with EC who received surgery from December 2000 to December 2008. The prognostic impact of ABO blood group on DFS and OS were estimated using the Kaplan-Meier method and cox proportional hazard models.

Results

Univariate analyses found significant differences in DFS and OS among the four blood types. Multivariate analyses showed ABO blood type independently predicted DFS (P=0.001) and OS (P=0.002). Furthermore, patients with non-B blood types had a significantly shorter DFS (HR=1.22, 95%CI:1.07–1.38, P=0.002) and OS (HR=1.22, 95%CI:1.07–1.38, P=0.003) than patients with blood type B, and patients with non-O blood types had a significantly better DFS (HR=0.86, 95%CI:0.77–0.96, P=0.006) and OS (HR=0.86, 95%CI:0.77–0.96, P=0.007) than patients with blood type O. Subgroup analyses found that blood type B had a better DFS and OS than non-B in patients who were male, younger, early pathological stages and had squamous-cell carcinomas (ESCC). Blood type O had a worse DFS and OS than non-O in patients who were male, younger, and had ESCC (P<0.05).

Conclusions

The results demonstrate that ABO blood group is an independent prognostic factor of survival, and that type B predicts a favorable prognosis, whereas type O predicts an unfavorable prognosis for survival in patients with EC, especially those with ESCC.

The association between ABO blood group distribution and peptic ulcer disease: a cross-sectional study from Ethiopia

BACKGROUND

Studies have shown that ABO blood group antigens are associated with peptic ulcer disease (PUD). There are limited sources regarding the association of blood groups with PUD patients in Ethiopia. The aim of this study was to assess the association between ABO blood group distribution, non-steroidal anti-inflammatory drugs (NSAIDs), smoking, alcohol, coffee, and PUD at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

METHODS

A cross-sectional study was undertaken, and a total of 63 endoscopically confirmed PUD patients and 63 healthy controls were screened for ABO blood grouping using the standard slide agglutination reaction. Stool antigens were checked to determine Helicobacter pylori status of PUD patients. Chi-square and logistic regression were used for statistical analysis.

RESULTS

The ABO blood group distribution of PUD patients was 19.04% (12/63), 19.04% (12/63), 11.11% (7/63), 50.79% (32/63) for blood group A, B, AB, and O, respectively, while among control groups it was 25.39% (16/63), 23.80% (15/63), 12.69% (8/63), and 38.09% (24/63) for blood group A, B, AB, and O, respectively. 34.1% (22/63) of PUD patients had gastric ulcer and 65.9% (41/63) had duodenal ulcer. There was statistically a significant association between sex (p=0.001), use of NSAIDs (p=0.001), smoking cigarette (p=0.014), alcohol consumption (p=0.028), and PUD.

CONCLUSION

Although PUD trended as more prevalent among patients with blood group O than other blood group types their association was not statistically significant.

Blood groups A and AB are associated with increased gastric cancer risk: evidence from a large genetic study and systematic review

Background

The association of ABO blood groups with gastric cancer risk was proposed decades ago, but the results have been inconsistent.

Methods

We used two single nucleotide polymorphisms to determine ABO genotype in 4932 gastric cancer cases and 6158 controls of Chinese descent, and evaluated the associations of ABO blood groups and genotypes with risk of gastric cancer using multivariable logistic regression models. We also systematically reviewed published literature and performed a meta-analysis of all relevant studies.

Results

In the case-control study, compared with blood group O, both blood group A and AB were associated with increased gastric cancer risk (for group A, odds ratio (OR) = 1.13, 95% confidence interval (CI): 1.02–1.24; for group AB, OR = 1.18, 95% CI: 1.02–1.36, respectively). Analyses of ABO genotypes revealed associations of AO and AB with risk of gastric cancer compared with OO genotype. Consistent with the case-control study, meta-analysis of 40 studies including 33,613 cases and 2,431,327 controls demonstrated that blood group A (OR = 1.19, 95% CI: 1.13–1.25) and AB (OR = 1.09, 95% CI: 1.03–1.16) were associated with increased risk of gastric cancer.

Conclusions

Our analyses validated the association of blood group A with risk of gastric cancer, and suggested that blood group AB was also associated with gastric cancer risk. Functional investigations are warranted to elucidate the exact mechanism of ABO blood groups in gastric carcinogenesis.

Electronic supplementary material

The online version of this article (10.1186/s12885-019-5355-4) contains supplementary material, which is available to authorized users.

Blood type B antigen is associated with worse New York Heart Association classification in male patients with hypertrophic cardiomyopathy

OBJECTIVE

ABO blood type is associated with cardiovascular diseases. Several studies have suggested sex-related differences in both hypertrophic cardiomyopathy (HCM) clinical features and ABO blood type. However, few data are available regarding the relationship between ABO blood type and HCM clinical features. We aimed to analyze the relationship between ABO blood type and HCM clinical features, and the potential effects of sex on these relationship.

METHODS

A total of 549 patients with HCM were enrolled consecutively. Left ventricular outflow tract gradients at rest (LOVTG-R) were measured by echocardiography. Left ventricular end-diastolic dimension, interventricular septum, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular mass (LVM) were assessed using cardiovascular magnetic resonance imaging.

RESULTS

Compared with the non-B antigen group, patients with B antigen had significantly higher LOVTG-R and LVEF values, worse New York Heart Association (NYHA) classification, lower left ventricular volume index values, as well as no difference in LVM index values. After adjustments for sex, male patients with B antigen still had higher LOVTG-R values and frequency of NYHA classification III/IV as well as lower LVEDV and LVESV index values. These differences were not present in female patients. Additionally, patients with NYHA classification III/IV had lower LVEDV index values.

CONCLUSION

In males, not females, patients with HCM with blood type B antigens exhibited worse cardiac functional capacity, higher LOVTG-R values, and lower left ventricular volume index values. These relationships are a potential indicator for clinical prevention. We speculate that rehydration is more efficient in relieving symptoms in male patients with HCM with B antigens.

Genetic and Environmental Dispositions for Cardiovascular Variability: A Pilot Study

BACKGROUND

The aim of our study was to evaluate the degree of genetic homozygosity in the group of patients with coronary artery disease (CAD), as well as to evaluate morphogenetic variability in CAD patients regarding the presence of investigated risk factors (RF) compared to a control sample of individuals. Additionally, we aimed to evaluate the distribution of ABO blood type frequencies between tested samples of individuals.

METHODS

This study analyzed individual phenotype and morphogenetic variability of 17 homozygously-recessive characteristics (HRC), by using HRC test in a sample of 148 individuals in CAD patients group and 156 individuals in the control group. The following RF were analyzed: hypertension, diabetes mellitus, hyperlipidemia, and smoking.

RESULTS

The mean value of HRC in CAD patients is significantly higher, while variability decreases compared to the control sample (CAD patients: 4.24 ± 1.59, control sample: 3.75 ± 1.69; V_CAD-patients = 37.50%, V_C = 45.07%). There is a significant difference in individual variations of 17 HRC between control sample and CAD patients (χ² = 169.144; p < 0.01), which points out to different variability for tested genes. Mean values of HRC significantly differed in CAD patients in regard to the number of RF present. A blood type (OR = 1.75) is significant predictor for CAD, while O blood type (OR = 0.43) was significantly associated with controls.

CONCLUSION

There is a higher degree of recessive homozygosity in CAD patients versus individuals in the control sample, and the presence of significant variations in the degree of recessive homozygosity as the number of tested RF increases.

ABO blood groups as a prognostic factor for recurrence in ovarian and vulvar cancer

The relationship between ABO blood groups (BG) and risk of incidence in cancers including gynecological cancers has been widely studied, showing increased incidence risk for BG A patients. As available data are inconsistent we investigated whether BG and their anti-glycan antibodies (anti-A and anti-B) have prognostic values in gynecological cancers. We retrospectively evaluated 974 patients with gynecological cancers in three cancer centers (Switzerland and Australia) between 1974 and 2014 regarding the relationships between clinico-pathological findings and the BG. Time to disease recurrence was significantly influenced by BG in patients with ovarian (n = 282) and vulvar (n = 67) cancer. BG O or B patients showed a significantly increased risk for ovarian cancer relapse compared to A, 59% and 82%, respectively (p = 0.045; HR O vs A = 1.59 (CI 1.01-2.51) and (p = 0.036; HR A vs B = 0.55 (CI 0.32-0.96). Median time to relapse for advanced stage (n = 126) ovarian cancer patients was 18.2 months for BG O and 32.2 for A (p = 0.031; HR O vs A = 2.07 (CI 1.07-4.02)). BG also significantly influenced relapse-free survival in patients with vulvar cancer (p = 0.002), with BG O tending to have increased relapse risk compared to A (p = 0.089). Blood groups hence associate with recurrence in ovarian and vulvar cancer: women with BG O seem to have a lower ovarian cancer incidence, however are more likely to relapse earlier. The significance of the BG status as a prognostic value is evident and may be helpful to oncologists in prognosticating disease outcome and selecting the appropriate therapy.

ABO blood type and the risk of cancer - Findings from the Shanghai Cohort Study

ABO blood type is an inherited characteristic. The associations between ABO blood type and risk of all cancer and specific cancers were examined in a prospective cohort study of 18,244 Chinese men enrolled in 1986. During the 25 years of follow-up, 3,973 men developed cancer including 964 lung cancers, 624 colorectal cancers, 560 gastric cancers, 353 liver cancers, and 172 urinary bladder cancers. Hazard ratios (HR) for all cancer and specific cancers by ABO blood type were calculated using Cox proportional hazards models. Compared with blood type A, blood type B was associated with statistically significant reduced risk of all cancers (HR, 0.91, 95% CI:0.84, 0.99). Both blood types B and AB were associated with significantly lower risk of gastrointestinal cancer and colorectal cancer, respectively. Blood type B was also associated with significantly lower risk of stomach cancer and bladder cancer, while blood type AB was associated with significantly increased risk of liver cancer. By histological type, blood types B and AB were associated with lower risk of epidermoid carcinoma and adenocarcinoma, but were not associated with risk of sarcoma, lymphoma, leukemia or other cell types of cancer. The findings of this study support a role of genetic traits related to ABO blood type in the development of cancers in the gastrointestinal and urinary tracts.

Aspartic acid racemization in dentin of the third molar for age estimation of the Chaoshan population in South China

Aspartic acid racemization in teeth has been increasingly used to estimate chronological age with a considerably high accuracy in forensic practice. The Chaoshan population in South China is relatively isolated in geography, and has specific lifestyle and dietary inhibits. It is still unknown whether this method is suitable for this population. The aim of this study was to analyze the relationship between chronological age and the d/l aspartic acid ratio in dentin in the third molar tooth of the Chaoshan population. Fifty-eight non-carious third molar teeth (31 mandibles and 27 maxillae), from 58 living individuals of known age (24 males and 34 females), were retrieved. Dentin was extracted from these teeth. The d- and l-aspartic acids in dentins were separated and detected by high performance liquid chromatography (HPLC). Linear regression was performed between the d/l aspartic acid ratio of dentins and chronological age. Results showed that the correlation coefficient (r) was 0.969, and the mean absolute error (MAE) was 2.19 years, its standard deviation (SD) was ±1.53 years, indicating excellent correlation. There was no significant difference in racemization rates of dentin between sexes (P=0.113, F=2.6), or between mandibles and maxillae (P=0.964, F=0.000). Results indicate that the ratio of the d and l forms of aspartic acid of dentins, in the third molar, is closely correlated with chronological age, special lifestyle do no obviously affect the accuracy of the age estimations by aspartic acid racemization of the dentin in the third molar and that aspartic acid racemization in the third molar dentin can be used as an accurate method to estimate chronological age in the Chaoshan population in South China.

ABO blood groups in relation to breast carcinoma incidence and associated prognostic factors in Moroccan women

The association between blood groups ABO and different types of diseases was established in several previous studies. Our aim was to seek the possible association between the ABO blood group and breast cancer-associated prognostic factors. The Chi-squared analytic test was used to compare phenotypic ABO distribution among Moroccan blood donors and 442 cases of women suffering from breast carcinoma with archived files in Maternity Ward of University Hospital C.H.U Ibn Rochd between 2008 and 2011. High incidence of breast carcinoma was observed in blood type B patients (p < 0.05). Blood type B was associated with breast carcinomas overexpressing human epidermal growth factor receptor HER2 (p < 0.05) and high risk of cancer at age over 70 years (p < 0.001). Blood type A was associated with high risk of cancer among women younger than 35 years old. Blood type A and AB were associated with high incidence of lymph node metastasis (p < 0.05). Multivariate analysis has shown correlation between O blood type and estrogen receptor-positive tumor. Patients with blood group A, B, and AB were more likely to develop aggressive breast carcinoma. Further follow-up studies are necessary to clarify the role of ABH antigens in the progression of breast carcinoma.

Effect of blood type on survival of Chinese patients with esophageal squamous cell carcinoma

BACKGROUND

The aim of this study was to evaluate the prognostic value of ABO blood group in Chinese patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy.

METHODS

This study was a retrospective review of the records of 548 patients with ESCC who received cytoreductive surgery between October 2002 and March 2007. The prognostic impact of ABO blood group on overall survival (OS) was analyzed.

RESULTS

The median follow-up time was 37 months, and the 5-year OS was 43.3%. The overall 5-year OS was 41.2%, 49.7%, 44.0%, and 29.8% for the A, B, O, and AB groups, respectively (P=0.038). Among patients with negative lymph nodes (LNs), the 5-year OS was 59.0%, 68.2%, 57.9%, and 28.6% for the A, B, O, and AB groups, respectively (P<0.001), but blood type had no value in predicting the OS of patients with positive LNs (P=0.524). In multivariate Cox regression analysis of all patients, ABO blood group was not an independent prognostic factor of OS. However, in patients with negative LNs, blood type was an independent prognostic factor of OS, and the higher risk of death for patients of type AB versus non-AB significant in multivariate analyses (hazard ratio [HR], 2.576; 95% confidence interval [CI], 1.349-4.919; P=0.004).

CONCLUSION

ABO blood group is associated with survival in Chinese patients with ESCC. Patients with blood type AB had a significantly worse OS than patients with non-AB type, especially in patients with negative LNs.

ABO blood groups and risk of cancer: a systematic review and meta-analysis

BACKGROUND

For decades, studies have been performed to evaluate the association between ABO blood groups and risk of cancer. However, whether ABO blood groups are associated with overall cancer risk remains unclear. We therefore conducted a meta-analysis of observational studies to assess this association.

MATERIALS AND METHODS

A search of Pubmed, Embase, ScienceDirect, Wiley, and Web of Knowledge databases (to May 2013) was supplemented by manual searches of bibliographies of key retrieved articles and relevant reviews. We included case-control studies and cohort studies with more than 100 cancer cases.

RESULTS

The search yielded 89 eligible studies that reported 100,554 cases at 30 cancer sites. For overall cancer risk, the pooled OR was 1.12 (95%CI: 1.09-1.16) for A vs. non- A groups, and 0.84 (95%CI: 0.80-0.88) for O vs. non-O groups. For individual cancer sites, blood group A was found to confer increased risk of gastric cancer (OR=1.18; 95%CI: 1.13-1.24), pancreatic cancer (OR=1.23; 95%CI: 1.15-1.32), breast cancer (OR=1.12; 95%CI: 1.01-1.24), ovarian cancer (OR=1.16; 95%CI: 1.04-1.27), and nasopharyngeal cancer (OR=1.17; 95%CI: 1.00-1.33). Blood group O was found to be linked to decreased risk of gastric cancer (OR=0.84; 95%CI: 0.80-0.88), pancreatic cancer (OR=0.75; 95%CI: 0.70-0.80), breast cancer (OR=0.90; 95%CI: 0.85-0.95), colorectal cancer (OR=0.89; 95%CI: 0.81-0.96), ovarian cancer (OR=0.76; 95%CI: 0.53-1.00), esophagus cancer (OR=0.94; 95%CI: 0.89-1.00), and nasopharyngeal cancer (OR=0.81; 95%CI: 0.70-0.91).

CONCLUSIONS

Blood group A is associated with increased risk of cancer, and blood group O is associated with decreased risk of cancer.

Is there an association between ABO blood group and overall survival in patients with esophageal squamous cell carcinoma?

BACKGROUND

The relationship between ABO blood group and clinical characteristics had been studied in several cancers. However, its role in esophageal cancer (EC) is unclear. The aim of this study was to determine whether ABO blood group is associated with overall survival in patients with esophageal squamous cell carcinoma (ESCC).

METHODS

From 2005 to 2008, a retrospective analysis of 496 consecutive patients with ESCC was conducted. The relationship between ABO blood group and clinicopathologic features of ESCC was analyzed. Prognostic factors for overall survival of ESCC were also analyzed.

RESULTS

The 5-year overall survival of ESCC patients with blood group A, B, AB and O were 47.8%, 44.1%, 43.2%, and 38.4%, respectively (P = 0.165). However, patients with blood group non-O have a better 5-year overall survival than patients with blood group O (45.7% vs. 38.4%; P = 0.043). Multivariate analyses showed ABO blood group (O vs. non-O; P = 0.034) is an independent prognostic factors.

CONCLUSIONS

ABO blood group is associated with overall survival in patients with ESCC. We concluded that patients with blood group O have a significantly worse overall survival than non-O blood groups.

Allele frequency of ABO blood group antigen and the risk of esophageal cancer

BACKGROUND

ABO blood group and risk of squamous cell carcinoma of esophagus have been reported by many studies, but there is no discipline that had provided association with the genotype and gene frequency by population statics.

METHODS

We conducted a case-control study on 480 patients with squamous cell carcinoma of the esophagus and 480 noncancer patients. ABO blood group was determined by presence of antigen with the help of monoclonal antibody. Chi-square test and odds ratio (OR) with 95% confidence intervals (CIs) were calculated by statistical methods, and gene frequencies were calculated by Hardy-Weinberg model.

RESULTS

We observed significant associations between ABO genotype and squamous cell carcinoma of esophagus. OR (95% CIs) was 1.69 (1.31-2.19) for presence of B antigen allele relative to its absence (P < 0.0001); in female subgroup OR (95% CIs) observed at 1.84 (1.27-2.65) was statistically significant (P = 0.001). SCC of esophagus shows significant difference in comparison to general population; blood group B is found to be higher in incidence (P = 0.0001). Increased risk of cancer was observed with absence of Rh antigen (P = 0.0001). Relatively increased gene frequency of q[B] allele is observed more significantly in female cancer patients (P = 0.003).

CONCLUSION

Statistically significant association between squamous cell carcinoma of the esophagus and ABO and Rh genotype is identified by this study. Sex and anatomical site of cancer also present with statistically significant relative association. However, larger randomised trials are required to establish the hypothesis.

The ABO blood group predicts survival in esophageal squamous cell carcinoma in patients who ever smoked: a retrospective study from China

The association between clinical characteristics, prognosis, and the ABO blood group of esophageal squamous cell carcinoma (ESCC) is rarely discussed. The aims of the current study were to investigate the correlation of the ABO blood group with the clinicopathological characteristics in a consecutive cohort of patients with ESCC and to assess whether the ABO blood group was associated with prognosis. A total of 511 patients with locoregional ESCC who underwent curative treatment were retrospectively analyzed at a single institution between January 2007 and December 2008. The relationship between the ABO blood group and clinicopathological variables was assessed by chi-squared analysis. The Kaplan-Meier method was used to estimate the 5-year overall survival (OS). The Cox proportional hazards model was used in univariate and multivariate analyses of OS. There were no significant differences in the clinicopathological characteristics among patients with different ABO blood groups. The 5-year OS rates were 50.0 % for patients with blood type A, 45.4 % for type B, 50.8 % for type O, and 60.7 % for type AB. In a subgroup analysis of 321 patients who ever smoked, the B/O group had a poorer OS compared with the A/AB group (p = 0.0245). Multivariate analysis revealed an unfavorable and independent impact of the B/O group on patient survival with ESCC who ever smoked (p = 0.011). Findings suggest the B/O blood type as a predictor of mortality in ESCC patients who ever smoked. Future studies conducted prospectively are warranted to confirm this work and to better understand the underlying biological mechanisms.

A novel staging model to classify oesophageal squamous cell carcinoma patients in China

BACKGROUND

Oesophageal squamous cell carcinoma (ESCC) is the predominant subtype of oesophageal carcinoma in China, with the overall 5-year survival rate of <10%. The current tumour-node-metastasis (TNM) staging system has become so complex that it is not easy to use in the life expectancy assessment. We aim to combine clinical variables and biomarkers to develop and validate a relative simple and reliable model, named the FENSAM, for ESCC prognosis.

METHODS

To build the FENSAM, we analysed 22 potential prognostic factors from 461 patients, including 9 biomarkers (Ezrin, Fascin, desmocollin 2 (DSC2), pFascin, activating transcription factor 3 (ATF3), connective-tissue growth factor (CTGF), neutrophil gelatinase-associated lipocalin (NGAL), NGAL receptor (NGALR), and cysteine-rich angiogenic protein 61 (CYR61)) and other 13 clinical variables. We selected significant factors associated with survival of ESCC patients, and used them to build our FENSAM model. We then obtained the hazard risk score of the model to classify ESCC patients. In addition, we validated the model in an independent cohort of 290 patients from the same hospital. The predictive performance of the model was assessed by the Area under the Receiver Operating Characteristic Curve (AUC) and Kaplan-Meier survival analysis.

RESULTS

We found six markers significantly associated with survival of ESCC patients (Ezrin, Fascin, ATF3, surgery extent, N-stage, and M-stage). They were combined to create a novel four-stage FENSAM model for patients' classification. FENSAM possessed a high classification precision similar to the TNM staging system, but with a much simpler model. The efficiency of FENSAM was evaluated by different quantiles of AUC and the results of survival analysis. The validation result demonstrated the potential of the FENSAM model to improve classification accuracy for ESCC patients.

CONCLUSIONS

FENSAM provides an alternative classifier for ESCC patients with a high classification precision using a simple model.

Relationships between skin cancers and blood groups--link between non-melanomas and ABO/Rh factors

BACKGROUND

This investigation focused on possible relationships between skin cancers and ABO/Rh blood groups.

MATERIALS AND METHODS

Between January 2005 and December 2012, medical data of 255 patients with skin cancers who were admitted to Kayseri Training and Research Hospital, Radiation Oncology and Plastic Surgery Outpatient Clinics were retrospectively analyzed. Blood groups of these patients were recorded. The control group consisted of 25701 healthy volunteers who were admitted to Kayseri Training and Research Hospital, Blood Donation Center between January 2010 and December 2011. The distribution of the blood groups of the patients with skin cancers was compared to the distribution of ABO/Rh blood groups of healthy controls. The association of the histopathological subtypes of skin cancer with the blood groups was also investigated.

RESULTS

Of the patients, 50.2% had A type, 26.3% had O type, 16.1% had B type, and 7.5% had AB blood group with a positive Rh (+) in 77.3%. Of the controls, 44.3% had A type, 31.5% had 0 type, 16.1% had B type, and 8.1% had AB blood group with a positive Rh (+) in 87.8%. There was a statistically significant difference in the distribution of blood groups and Rh factors (A Rh (-) and 0 Rh positive) between the patients and controls. A total of 36.8% and 20.4% of the patients with basal cell carcinoma (BCC) had A Rh (+) and B Rh (+), respectively, while 39.2% and 27.6% of the controls had A Rh (+) and B Rh (+), respectively. A significant relationship was observed between the patients with BCC and controls in terms of A Rh (-) (p=0.001).

CONCLUSION

Our study results demonstrated that there is a significant relationship between non-melanoma skin cancer and ABO/Rh factors.

Risk factors for anaplastic thyroid cancer

Background. Anaplastic thyroid cancer (ATC) is a form of thyroid cancer with very poor prognosis, but is fortunately quite rare. Its aetiology is unknown and not well researched. Aim. The aim of this study was to identify potential risk factors for ATC. Material and Method. Case-control study of 126 ATC patients (77 females and 49 males) and 252 controls individually matched by gender, age, and place of abode. In statistical analysis we used a Cox regression model. Results. Univariate logistic regression showed that the risk factors for ATC are low education level, type B blood group, goitre, other nonthyroid malignancies, diabetes, late menarche, and an early first pregnancy. Multivariate logistic regression analysis showed that independent risk factors for ATC are low education level (OR = 1.42, 95% CI = 1.09-1.86), type B blood group (OR = 2.41, 95% CI = 1.03-5.66), and goitre (OR = 25-33, 95% CI = 5.66-126.65). Conclusion. Independent risk factors for ATC are: low education level, type B blood group, and goitre.

ABO and Rh blood groups in relation to ovarian, endometrial and cervical cancer risk among the population of South-East Siberia

BACKGROUND

There is a large amount of evidence that the ABO blood group system may play a role in disease etiology. A relationship between ABO and Rhesus blood groups and cancer risk has been demonstrated in a number of studies. However, in relation to gynecological malignancies, these findings are inconsistent and contradictory.

AIM

To perform a case-control study for analysis of the distribution of ABO and Rh blood antigens among women from South-East Siberia who suffered from ovarian, endometrial and cervical cancer, and to assess the potential role of these antigens in carcinogenesis.

DESIGN, SUBJECTS AND METHODS

A total of 1,163 cases with ovarian cancer (n=551), endometrial cancer (n=440) and cervical cancer (n=172) were involved in the study. The control group was formed from 22,581 female blood donors. Blood groups were determined through patients medical records and blood donor records. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. The blood group O was defined as the referent group, as it has the greatest frequency in the populations of Southern Siberia. P values less than 0.05 were regarded as statistically significant.

RESULTS

We found that carriage of non-O blood types increased the risk of ovarian cancer by 40-60%, and the magnitude of this relationship was strongest in women with the AB (IV) blood group. Carriage of the A (II) blood group strongly correlated with an increased risk of ovarian cancer in premenopausal, but not in postmenopausal women. No statistically significant correlations were obtained for endometrial cancer and cervical cancer. Additionally, we did not observe a relationship between Rhesus factor and cancer risk.

CONCLUSION

We suggest that carriage of non-O blood groups may elevate risk of ovarian cancer and can play a role in its development.

Sex-specific differences in the association between ABO genotype and gastric cancer risk in a Korean population

BACKGROUND

Although previous studies have demonstrated an association between ABO blood group and the risk of gastric cancer (GC), only one study has identified these associations using the ABO genotype; however, that study did not evaluate sex differences in this association. The aim of the present study was to investigate whether there are sex-specific differences in the ABO genotype-associated risk of GC. In addition, we explored the association of the ABO genotype and the clinicopathologic characteristics of GC in a Korean population.

METHODS

We conducted a large-scale case-control study of 3245 GC patients (2204 males, 1041 females) and 1700 controls (821 males, 879 females). The ABO genotype was determined by multicolor real-time polymerase chain reaction (PCR) using displacing probes.

RESULTS

As compared with genotype OO, genotypes AA and AO in females, but not in males, were associated with a significantly increased risk of GC (odds ratio [OR] 1.56 and 95 % confidence interval [CI] 1.08-2.26 for AA; OR 1.57 and 95 % CI 1.21-2.03 for AO). In a subgroup analysis, blood group A had a significantly increased risk of diffuse-type GC (OR 2.00, 95 % CI 1.43-2.78), but not of intestinal-type (OR 1.31, 95 % CI 0.96-1.79) or mixed-type GC (OR 1.43, 95 % CI 0.92-2.24).

CONCLUSION

The ABO genotypes AA and AO were significantly associated with GC only in females and only for diffuse-type GC. These data suggest that the association between ABO blood group and GC risk may differ according to sex and histological type.

ABO blood type, diabetes and risk of gastrointestinal cancer in northern China

AIM: To explore the potential risk factors related to gastrointestinal cancer in northern China.

METHODS: A total of 3314 cases of gastrointestinal cancer (esophageal, gastric, pancreatic and biliary) and 2223 controls (including healthy individuals, glioma and thyroid cancer) were analyzed by case-control study. Multivariable logistic regression analysis was applied to evaluate the association between different cancers and hepatitis B surface antigen, sex, age, blood type, diabetes, or family history of cancer.

RESULTS: Type 2 diabetes was significantly associated with gastric, biliary and pancreatic cancer with an OR of 2.0-3.0. Blood type B was significantly associated with esophageal cancer [odd ratio (OR) = 1.53, 95% confidence interval (CI) = 1.10-2.14] and biliary cancer (OR = 1.49, 95% CI = 1.09-2.05). The prevalence of type 2 diabetes was significantly higher in gastric, biliary and pancreatic cancers compared with other groups, with ORs ranging between 2.0 and 3.0. Family history of cancer was strongly associated with gastrointestinal compared with other cancers.

CONCLUSION: Blood type B individuals are susceptible to esophageal and biliary cancer. Type 2 diabetes is significantly associated with gastric, biliary and especially pancreatic cancer.

Are laryngeal squamous cell carcinoma incidence and patient mortality a function of ABO blood grouping? A retrospective study

OBJECTIVE

Few studies have examined the association between ABO blood grouping and head and neck cancer. This retrospective review examined the association between blood group and laryngeal cancer incidence and patient mortality.

METHODS

Of 271 patients treated for squamous cell laryngeal carcinoma (1997-2002), 143 patients with supraglottic, glottic and subglottic tumours were included; 128 patients were excluded. The blood group characteristics of patients and healthy blood donors were compared.

RESULTS

There was no significant correlation between blood type and laryngeal carcinoma incidence or mortality. Type A blood was commoner in African Americans with laryngeal cancer than Caucasian patients, but not significantly so. As expected, five-year survival rates were lower in patients with more advanced stage cancer (p < 0.0001).

CONCLUSION

Although our findings show no association between blood group and five-year survival, these results are inconclusive, and warrant further study of the association between blood type and laryngeal (and other) head and neck cancers.

Elevated expression of Rad51 is correlated with decreased survival in resectable esophageal squamous cell carcinoma

BACKGROUND

Rad51 plays a critical role in homologous recombination and correlates with many human malignancies. However, its role and clinical significance in esophageal squamous cell carcinoma (ESCC) has not been clarified. The purpose of this study was to explore the clinicopathological correlation and prognostic significance of Rad51 expression in a group of ESCC patients.

METHODS

We evaluated Rad51 expression in 230 surgically resected ESCC specimens by immunochemistry using tissue microarray and correlated with clinicopathological features including post-operation survival.

RESULTS

There was no significant correlation between Rad51 expression and clinicopathological characteristics in terms of age, sex, tumor location, histologic grade, T, N categories, and TNM stage. The Kaplan-Meier survival analysis showed that high expression of Rad51 indicated a poorer disease free survival (DFS) of ESCC patients compared with the patients with low expression of Rad51 (P = 0.031), similar result also shown in overall survival (OS) analysis (P = 0.034). Furthermore, Rad51 expression could stratify node positive patients in DFS (P = 0.021) and OS (P = 0.035). Multivariate analysis confirmed the Rad51 expression was an independent prognostic factor for DFS (HR = 1.603, P = 0.013) and OS (HR = 1.555, P = 0.021) of ESCC patients.

CONCLUSIONS

Elevated expression of Rad51 is associated with poor prognosis for resectable ESCC patients.

Association of mitochondrial haplogroup D and risk of esophageal cancer in Taihang Mountain and Chaoshan areas in China

Both the Taihang Mountain area in north-central China and Chaoshan area in the southeastern littoral of China are areas with high risk of esophageal cancer (EC). Our previous study confirmed that populations from the two areas might share similar matrilineal backgrounds and found that mitochondrial DNA (mtDNA) haplogroup D, especially subhaplogroups D4a and D5a, might be genetic background markers of EC in Chaoshan area. Here, to further determine whether D4a, D5a, and D might be susceptibility markers for EC in the two high-risk areas, we performed a case-control study with larger samples and analyzed the distributions of these three haplogroups in subjects (controls [n = 898] and patients [n = 768]) from the two areas. D4a haplogroup was significantly associated with increased risk of EC in Taihang Mountain subjects, especially women. D5 haplogroup was associated with EC at the general population level in the Taihang Mountain area and in subjects ≤ 60 years, especially women ≤ 60 years, in the Chaoshan area. D haplogroup was associated with EC only in subjects ≤ 60 years, especially men ≤ 60 years, in the Chaoshan area. D4a and D5 showing positive association with EC in the Taihang Mountain area became the predominant subhaplogroups of D in Chaoshan controls. In conclusion, D, D4a, and D5 haplogroups might be susceptibility markers for EC in the two high-risk areas in China, particularly D4a and D5 for the Taihang Mountain area and D and D5 for the Chaoshan area.

Risk of gastric cancer and peptic ulcers in relation to ABO blood type: a cohort study

Blood group A was found to be associated with gastric cancer in the 1950s. Strikingly, for peptic ulcers an increased risk has been shown for blood group O. However, previous investigations have generally been poorly conducted and have failed to take a unifying approach to these observations. Using the Scandinavian Donations and Transfusions (referred to as "SCANDAT") database, the authors established a cohort of Swedish and Danish blood donors with known blood type and followed these for the occurrence of gastric cancer and peptic ulcers through December 31, 2002. Cases were ascertained by using nationwide cancer and hospital registers. Altogether, 1,089,022 donors were followed for up to 35 years, during which 688 gastric cancer cases and 5,667 peptic ulcer cases accrued. Poisson regression analyses confirmed an increased risk of gastric cancer among individuals with blood group A (incidence rate ratio = 1.20, 95% confidence interval: 1.02, 1.42) and conversely that peptic ulcer risk was instead highest among those with blood group O. In this large, population-based cohort study, the authors have confirmed the association between blood group A and gastric cancer. In addition, they give further support to the notion that individuals with blood group O have a higher risk of peptic ulcers than those with other blood groups.

Degree of genetic homozygosity and distribution of AB0 blood types among patients with spina bifida occulta and spina bifida aperta

INTRODUCTION

Assuming that spina bifida (SB) is a genetically controlled disease, the aim of our study was to evaluate the degree of genetic homozygosity and the distribution of AB0 blood types among patients with SB occulta and SB aperta by the homozygously recessive characteristics (HRC) test.

MATERIAL AND METHODS

Our study included an analysis of the presence, distribution and individual combination of 15 selected genetically controlled morpho-physiological traits in a sample of 100 patients with SB (SB occulta N = 50 and SB aperta N = 50) and a control group of individuals (N = 100).

RESULTS

We found a statistically significant difference between the mean values for genetic homozygosity (SB 4.5 ±0.3; control 3.0 ±0.2, p < 0.001) and also differences in the presence of certain individual combinations of such traits. In 12 (80.0%) of the 15 observed characteristics, recessive homozygosity was expressed to a greater degree among the group of SB patients, while for 9 (60.0%) of the traits this level of difference was statistically significant (Σ(χ) (2) = 266.3, p < 0.001). There was no difference in average homozygosity of such genetic markers between groups of SB occulta and SB aperta patients, but the type of individual variation in the two studied groups significantly differed. In the group of patients with SB the frequency of 0 blood group was significantly increased while B blood group was significantly decreased.

CONCLUSIONS

Our results clearly show that there is a populational genetic difference in the degree of genetic homozygosity and variability between the group of patients with SB and individuals without clinical manifestations, indicating a possible genetic component in the aetiopathogenesis of spina bifida.

Prognostic relevance of β-catenin expression in T2-3N0M0 esophageal squamous cell carcinoma

AIM: To study the expression of β-catenin in esophageal squamous cell carcinoma (ESCC) at stage T2-3N0M0 and its relation with the prognosis of ESCC patients.

METHODS: Expression of β-catenin in 227 ESCC specimens was detected by immunohistochemistry (IHC). A reproducible semi-quantitative method which takes both staining percentage and intensity into account was applied in IHC scoring, and receiver operating characteristic curve analysis was used to select the cut-off score for high or low IHC reactivity. Then, correlation of β-catenin expression with clinicopathological features and prognosis of ESCC patients was determined.

RESULTS: No significant correlation was observed between β-catenin expression and clinicopathological parameters in terms of gender, age, tumor size, tumor grade, tumor location, depth of invasion and pathological stage. The Kaplan-Meier survival curve showed that the up-regulated expression of β-catenin indicated a poorer post-operative survival rate of ESCC patients at stage T2-3N0M0 (P = 0.004), especially of those with T3 lesions (P = 0.014) or with stage IIB diseases (P = 0.007). Multivariate analysis also confirmed that β-catenin was an independent prognostic factor for the overall survival rate of ESCC patients at stage T2-3N0M0 (relative risk = 1.642, 95% CI: 1.159-2.327, P = 0.005).

CONCLUSION: Elevated β-catenin expression level may be an adverse indicator for the prognosis of ESCC patients at stage T2-3N0M0, especially for those with T3 lesions or stage IIB diseases.

Polymorphisms of Lewis and Secretor genes are related to breast cancer and metastasis in axillary lymph nodes

ABH and Lewis antigen expression has been associated with cancer development and prognosis, tumor differentiation, and metastasis. Considering that invasive ductal breast carcinoma (IDC) presents multiple molecular alterations, the aim of the present study was to determine whether the polymorphism of ABO, Lewis, and Secretor genes, as well as ABO phenotyping, could be associated with tumor differentiation and lymph nodes metastasis. Seventy-six women with IDC and 78 healthy female blood donors were submitted to ABO phenotyping/genotyping and Lewis and Secretor genotyping. Phenotyping was performed by hemagglutination and genotyping by the polymerase chain reaction with sequence-specific primers. ABO, Lewis, and Secretor genes were classified by individual single nucleotide polymorphism at sites 59, 1067, 202, and 314 of the Lewis gene, 428 of the Secretor gene, and 261 (O1 allele), 526 (O2 and B allele), and 703 (B allele). No association was found between breast cancer and ABO antigen expression (P = 0.9323) or genotype (P = 0.9356). Lewis-negative genotype was associated with IDC (P = 0.0126) but not with anatomoclinical parameters. Nonsecretor genotype was associated with axillary lymph node metastasis (P = 0.0149). In conclusion, Lewis and Secretor genotyping could be useful to predict respectively breast cancer susceptibility and axillary lymph nodes metastasis.

CYFRA21-1 and CEA are useful markers for predicting the sensitivity to chemoradiotherapy of esophageal squamous cell carcinoma

BACKGROUND

Chemoradiotherapy (CRT) is currently performed for patients with advanced esophageal carcinoma. Sensitivity of tumours to CRT differs from one case to another and may be influenced by the expression of biological molecules. The aim of this study was to identify biological markers which could predict sensitivities of esophageal squamous cell carcinoma (ESCC) to CRT.

METHODS

A total of 84 patients with stage I-IV ESCC were evaluated. The cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and carcinoembryonic antigen (CEA) levels were measured before CRT by enzyme-linked immunosorbent assays in patients with primary ESCCs using 3.4 ng ml(-1) and 3.3 ng ml(-1), respectively, as cut-off values. The relationships between pretreatment expression of CYFRA 21-1 and CEA and the effectiveness of CRT were analysed.

RESULTS

The complete response (CR) rates of the primary tumours estimated by computed tomography in patients with high levels of CYFRA21-1 and CEA were 10% (3/30) and 4.2% (1/24), while in cases with low CYFRA21-1 and CEA the CR rates were 50% (27/54) and 48.3% (29/60), respectively (p = 0.002 and 0.003). The effective rates (CR+PR) in CYFRA21-1 high and low groups were 60% (18/30) and 96.3% (52/54), while in CEA high and low groups they were 58.3% (14/24) and 93.3% (56/60), respectively (p = 0.013 and 0.013).

CONCLUSION

CYFRA21-1 and CEA may be helpful in predicting the responsiveness in ESCC of primary lesions to CRT, although the results should be confirmed in larger, more homogeneous studies.

Morphogenetic variability during selection of elite water polo players

In this population-genetic study, we compared morphological and genetic variability of a control group of individuals with that of developing and elite water polo players from Serbia, using a test of determination of homozygously recessive characteristics in humans (HRC-test). Comparisons of the frequencies of ABO and Rh blood types were also made for the groups examined. The degree of genetic homozygosity showed not only statistically significant differences in the mean values obtained for the studied samples (control group 5.1 +/- 0.2; emerging water polo players 3.5 +/- 0.1; elite water polo players 1.9 +/- 0.3 HRCs, out of 20 analysed characteristics), but also differences in the type of distribution, as well as the presence of specific combinations of such traits. During identification of swimming talents, the degree of genetic homozygosity showed a significant decrease, from 4.8 +/- 0.3 in the group of pre-competitive young boys, to 2.7 +/- 0.3 in selected adult team members, to only 1.9 +/- 0.3 in elite water polo players. In the group of pre-competitive young individuals, all characteristics tested also had homo-recessive combinations, while in the group of elite water polo players only 8 of 20 traits were expressed as homozygously recessive. In the group of elite water polo players, who were World and European champions as well as Olympic champions, the frequencies of the A and B blood types were low, AB was absent, and the frequency of the O blood type was high at 72.2% (i.e., almost twice the expected percentage).

AB0 system and D(Rh o) antigen frequencies in left ventricular hypertrabeculation/noncompaction in relation to cardiac and neuromuscular findings

BACKGROUND

Left ventricular hypertrabeculation/noncompaction (LVHT) is a cardiac abnormality with suspected genetic background, characterized by trabeculations and intertrabecular recesses. Aim of the study in LVHT patients was to assess the AB0 system and D(Rh(o)) antigen frequencies, to look for an association between the prevalence of cardiac and neuromuscular abnormalities and to compare distribution of the AB0 system and D(Rh(o)) antigen frequencies with the Austrian general population.

METHODS AND RESULTS

In 77/102 LVHT patients (75%) information about blood group could be obtained. There were no differences in the prevalence of clinical, electrocardiographic and echocardiographic findings and neuromuscular disorders between the AB0 blood groups. When comparing 67 LVHT patients who were D(Rh(o)) antigen positive with 10 patients who were D(Rh(o)) antigen negative, no differences could be found. Among LVHT patients, 0 D(Rh(o)) antigen positive was the most frequent (39%) followed by A D(Rh(o)) antigen positive (34%). In the Austrian general population A D(Rh(o)) antigen positive was the most frequent (33%) followed by 0 D(Rh(o)) antigen positive (30%).

CONCLUSION

This study shows that LVHT patients do not differ according the blood groups, and that the distribution of blood groups is only minimally different between LVHT patients and the general Austrian population.

Case-control study of anaplastic thyroid cancer: goiter patients as controls

Anaplastic thyroid cancer is very serious disease with bad prognosis and unknown etiology. The aim of the study was to test some hypotheses about other factors in addition to goiter related to anaplastic thyroid cancer occurrence. A case-control study was performed during the period 1993-2005. The case group comprised 126 patients with newly diagnosed anaplastic thyroid cancer. The control group comprised 252 patients who had for the first time goiter operation, and had no malignancy of thyroid gland. Cases and controls were individually matched by age, sex and place of residence (urban/rural). According to conditional multivariate logistic regression analysis, anaplastic thyroid cancer was significantly related to lower education (odds ratio=1.85, 95% confidence interval=1.21-2.82), other malignant tumors in personal history (odds ratio=4.37, 95% confidence interval=1.11-17.31), blood group B (odds ratio=3.69, 95% confidence interval=1.10-12.49), menarche at >or=15 years of age (odds ratio=2.63, 95% confidence interval=1.15-5.88), and first full-term pregnancy before 19 years of age (odds ratio=2.96, 95% confidence interval=1.26-6.96). On the basis of the results obtained, risk factors for anaplastic thyroid cancer are similar to risk factors for differentiated thyroid cancers.

mtDNA evidence: genetic background associated with related populations at high risk for esophageal cancer between Chaoshan and Taihang Mountain areas in China

There are three major geographic regions in China known for their high incidences of esophageal cancer (EC): the Taihang Mountain range of north-central China, the Minnan area of Fujian province, and the Chaoshan plain of Guangdong province. Historically, waves of great population migrations from north-central China through coastal Fujian to the Chaoshan plain were recorded. To study the genetic relationship among the related EC high-risk populations, we analyzed mitochondrial DNA (mtDNA) haplogroups based on 30 EC patients from Chaoshan and used control samples from the high-risk populations, including 48, 73, and 89 subjects from the Taihang, Fujian, and Chaoshan areas, respectively. The principal component of all haplogroups, correlation analysis of haplogroup frequency distributions between populations, and haplogroup D network analysis showed that compared with other Chinese populations, populations in the three studied areas are genetically related. The highest haplogroup frequency shared by all studied populations was haplogroup D, with much higher frequency in the Chaoshan area EC patients. The majority of haplogroup D individuals among the Chaoshan area EC patients belonged to subhaplogroups D4a and D5a, with the total frequency of these two haplogroups significantly higher than that in the high-risk population in the same area (chi(2)=9.017, p<0.01). In conclusion, EC high-risk populations in these three areas share a similar matrilineal genetic background, and D4a and D5a might be candidate genetic markers for screening populations susceptible to EC in the Chaoshan area. Ours is the first report to show the association between mtDNA haplogroups (D4a and D5a) and esophageal cancer.

Temporal trends of esophageal cancer during 1995-2004 in Nanao Island, an extremely high-risk area in China

The purpose of our study was to investigate the temporal malignant tumor incidence rates among the 70,000 residents at the relatively isolated Nanao Island in South China Sea. The data on all malignant tumor cases from Nanao Cancer Registry during 1995-2004 were coded, computerized, and analyzed using the software SPSS10.0. The tumor incident cases, crude incident rate, age-standardized incidence rate, their sex distribution and temporal trend were assessed. A total of 1450 new cancer cases (990 males and 460 females) were identified. The annual average age-standardized incidence rate (ASR) of malignant tumors was 208.18/100,000. The age-standardized incidence rate of the ten leading cancers in both sexes combined per 100,000 population were 74.47 for esophageal cancer (EC), 34.81 for cardiac cancer (CC), 25.66 for liver cancer, 26.01 for lung cancer, 18.52 for stomach cancer, 4.45 for nasopharyngeal cancer, 3.91 for breast cancer, 2.53 for colon/rectum cancer, 2.45 for bladder cancer and 1.92 for pancreatic cancer. These ten types of cancers make up to 93% of all cancer cases, with EC and CC being the most prevalent and making up 52% of the total cases. The incidence rates of esophagus, liver, lung, breast, nasopharyngeal, and colon/rectum cancers showed increasing trends during the period from 1995 to 2004 in Nanao Island. Astounding the EC ASR were 72-150/100,000 among male and 26-64/100,000 among female in Nanao Island during 1995-2004. The EC incidence rate in Nanao population is among the highest across the world, which suggests that there are potential genetic and/or environmental factors affecting this particular population.

Overexpression of Ets-like protein 1 in human esophageal squamous cell carcinoma

AIM: To study the expression pattern of Ets-like protein 1 (Elk-1) in human esophageal squamous cell carcinoma (ESCC) and to analyze its relationship with clinicopathologic parameters.

METHODS: The expression of Elk-1 in fresh esophageal cancer tissues and their corresponding normal mucosae was detected immunohistochemically (IHC) by means of tissue microarray (TMA). Its correlation with clinical characteristics was evaluated and analyzed by univariate analysis. All statistical analyses were performed by SPSS version 13.0.

RESULTS: Expression level of transcription factor Elk-1 increased in 78.5% (84/107) ESCC tissues compared with their matched normal esophageal epithelium. However, the expression of Elk-1 did not show any obvious correlation with degree of differentiation of esophageal carcinoma (in well-differentiated, moderately-differentiated and poorly-differentiated tumors, the increased expression was 7/8, 60/74, and 19/25, respectively, P > 0.05). Moreover, no obvious correlation was found with lymph node metastasis and depth of invasion.

CONCLUSION: Increased expression of transcription factor Elk-1 may play an important role in esophageal carcinogenesis.

Mutation screening of mismatch repair gene Mlh3 in familial esophageal cancer

AIM: To shed light on the possible role of mismatch repair gene Mlh3 in familial esophageal cancer (FEC).

METHODS: A total of 66 members from 10 families suggestive of a genetic predisposition to hereditary esophageal cancer were screened for germline mutations in Mlh3 with denaturing high performance liquid chromatography (DHPLC), a newly developed method of comparative sequencing based on heteroduplex detection. For all samples exhibiting abnormal DHPLC profiles, sequence changes were evaluated by cycle sequencing. For any mutation in family members, we conducted a segregation study to compare its prevalence in sporadic esophageal cancer patients and normal controls.

RESULTS: Exons of Mlh3 in all samples were successfully examined. Overall, 4 missense mutations and 3 polymorphisms were identified in 4 families. Mlh3 missense mutations in families 9 and 10 might be pathogenic, but had a reduced penetrance. While in families 1 and 7, there was no sufficient evidence supporting the monogenic explanations of esophageal cancers in families. The mutations were found in 33% of high-risk families and 50% of low-risk families.

CONCLUSION: Mlh3 is a high risk gene with a reduced penetrance in some families. However, it acts as a low risk gene for esophageal cancer in most families. Mutations of Mlh3 may work together with other genes in an accumulated manner and result in an increased risk of esophageal tumor. DHPLC is a robust and sensitive technique for screening gene mutations.

Expression of Egr-1 gene and its correlation with the oncogene proteins in non-irradiated and irradiated esophageal squamous cell carcinoma

We study the expression of early growth response gene-1 (Egr-1 gene) in non-irradiated and irradiated human esophageal cancer tissues, and its relationship with the expression of C-fos, C-jun onco-proteins as well as Egr-1 target gene proteins P53, Rb and Bax expression. In situ hybridization (ISH) and immunohistochemistry (IHC) were used respectively to detect Egr-1 mRNA, Egr-1, C-fos, C-jun, P53, Rb and Bax proteins in 80 surgically resected non-irradiated and irradiated tumor specimens of esophageal squamous cell carcinoma. Egr-1 gene mRNA and Bax protein were located in the cytoplasm, whereas Egr-1, C-fos, C-jun, P53, Rb proteins were located in the nuclei. Egr-1 was expressed in nine out of 40 cases (22.5%) of non-irradiated and 23 of 40 cases (57.5%) of irradiated tumor specimens. No correlation was found between Egr-1 gene expression and C-fos, C-jun onco-proteins expression, neither was any correlation disclosed between Egr-1 gene expression with its target gene protein expression. Patients who underwent radiotherapy with Egr-1 overexpressed in their cancer tissue had better prognosis. Radiotherapy up-regulates Egr-1 expression in esophageal carcinoma. Egr-1 overexpression may be a potential radiation response gene marker and may play an important role in prognosis of esophageal squamous cell carcinoma.

Hereditary risk factors for the development of gastric cancer in younger patients

BACKGROUND

It is believed that the development of gastric cancer (GC) before the age of 50 has a hereditary basis. Blood group A and history of gastric cancer in first-degree relatives have been shown to be risk factors for GC.

METHODS

In this case-control study, we enrolled patients with GC who were diagnosed before the age of 50. Patients who were diagnosed as having GC were selected. A total of 534 cases were found; of these, 44 diagnosed before the age of 50 were included in the case group. For the control group, 22 males and 22 females were randomly selected from the remaining subjects, who had diagnoses of GC after the age of 50. All the surviving patients and family members of the dead patients were interviewed about the history of cancer in the family and the age at which other family members developed cancer. The blood group of each subject was also obtained.

RESULTS

forty-four cases under 50 years old (mean age: 36.2 years) and forty-four controls (mean age: 67.1 years) were enrolled in the study. At the time of the study, 59.1% of the study group and 50% of the control group were alive (P value = NS). In the study group, 68.1%, 13.6%, 13.6% and 4.5% had blood groups O, A, B and AB, respectively. In the control group the corresponding figures were 27.7%, 63.6%, 6.8% and 4.5%. First or second-degree relatives with cancer, including gastric (the most frequent), breast, lung, gynecological and hematological malignancies, were noted in 54.5% of the cases and 11.4% of the controls (p < 0.01). Family histories of cancer were accepted as valid provided that they were based on valid medical documents.

CONCLUSIONS

It seems that the development of GC before the age of 50 is likely to be accompanied by familial susceptibility. Interestingly, our study showed a significant correlation between blood group O and the development of gastric cancer under the age of 50.

Correlation of ABO blood group with clinicopathologic characteristics of patients with esophageal squamous cell carcinoma

The aim of the current study was to determine the nvolvement of ABO blood group in clinicopathologic features in squamous cell carcinoma (SCC) of the esophagus, that has not previously been studied fully. Two hundred and eighty four consecutive patients with esophageal SCC were enrolled for the study. The relationship between patients' ABO blood group and the clinicopathologic features was analyzed. The proportion of poorly differentiated SCC among patients with blood group O was significantly lower than in those patients with other blood types (P = 0.001). The mean size of the tumors in patients with blood group AB was significantly larger than those in patients with other blood groups. The proportion of tumors associated with venous invasion was significantly higher in patients with blood type A than those of tumors in other blood types (P = 0.007). The TNM stages of tumors in blood group AB were found to be significantly more advanced (P = 0.036) than other groups. The functional significance of ABO blood group distribution might be associated with biological behavior of SCCs. However, it was found not to be a clinical predictor for the prognosis of the patients with esophageal SCC.

Separation and identification of differentially expressed nuclear matrix proteins between human esophageal immortalized and carcinomatous cell lines

AIM: To separate and identify differentially expressed nuclear matrix proteins (NMPs) between the immortalized human esophageal epithelial cell line (SHEE) and the malignantly transformed esophageal carcinoma cell line (SHEEC), and to provide new ways for finding specific markers and the pathogenesis of esophageal carcinoma.

METHODS: SHEE and SHEEC cell lines were used to extract NMPs. The quality of NMPs was monitored by Western blot analysis including DNA topoisomerase IIα, proliferation cell nuclear antigen (PCNA) and histone. NMPs of SHEE and SHEEC were analyzed by two-dimensional electrophoresis (2-DE), silver staining and PDQuest6.2 image analysis software. Three spots in which the differentially expressed NMPs were more obvious, were selected and analyzed with matrix-assisted laser desorption/ionization time of flying mass spectrometry (MALDI-TOF-MS) and database search.

RESULTS: Western blot analysis revealed that DNA topoisomerase IIα and PCNA were detected, and the majority of histones were deleted in NMPs of SHEE and SHEEC. After 2-DE image analysis by PDQuest6.2 software, the 2-DE maps were detected with an average of 106 ± 7.1 spots in SHEE and 132 ± 5.0 spots in SHEEC. Most of them were matched one another (r = 0.72), only 16 protein spots were found differing in intensity. Three NMPs including cytoskeletal tropomyosin, FK506-binding protein 6, similar to retinoblastoma binding protein 8 were preliminarily identified by MALDI- TOF-MS.

CONCLUSION: These differentially expressed NMPs may play an important role during malignant transformation from SHEE to SHEEC. Their separation and identification will contribute to searching for specific markers and probing into the pathogenesis of esophageal carcinoma.

Epidemiology of alcoholic liver diseases in Xi'an

AIM

To investigate the characteristics of ethanol consumption in Xi'an area, and to explore the prevalence of alcoholic liver disease and the correlation of the quantity of ethanol consumed with the development of alcoholic liver disease.

METHODS

By random cluster sampling, 9 professional groups of people were chosen in the city and the rural areas as subjects. Questionaire was taken and the data collected and analyzed by specialists.

RESULTS

During April to June 2000, 3 613 persons were investigated. Among them 1270 were drinkers, in which 90.1% were males and only 126 females. 78 persons were alcoholic fatty liver patients (6.1%). The prevalence rate was 2.2% in all subjects. Only one female patient with alcoholic liver disease (0.3%), and 5 cases of alcoholic cirrhosis (0.1%) were found. Alcoholic fatty liver patients consumed the equivalent of 31.3+24.2 g absolute ethanol with a mean duration of 14.0+7.4 years. With increase of alcoholic consumption the serum levels of ALT and AST increased. The prevalence rate of alcoholic fatty liver is higher in city than that in rural area.

CONCLUSION

Alcohol drinkers in Xi'an are very popular. Males are the major population. Alcoholic fatty liver is the most common type of ALD with prevalence rate of 2.2%. The equivalent of 30 g ethanol consumed in more than 14 years may result in alcoholic fatty liver. The alterations of liver function are parallel to the consumption of alcohol.

Expression of estrogen receptor and estrogen receptor messenger RNA in gastric carcinoma tissues

AIM: To study estrogen receptor (ER) and estrogen receptor messenger RNA (ERmRNA) expression in gastric carcinoma tissues and to investigate their association with the pathologic types of gastric carcinoma.

METHODS: The expression of ER and ERmRNA in gastric carcinoma tissues (15 males and 15 females, 42-70 years old) was detected by immunohistochemistry and in situ hybridization, respectively.

RESULTS: The positive rate of ER (immunohistochemistry) was 33.3% in males and 46.7% in females. In Borrmann IV gastric carcinoma ER positive rate was greater than that in other pathologic types, and in poorly differentiated adenocarcinoma and signet ring cell carcinoma the positive rates were greater than those in other histological types of both males and females (P < 0.05). The ER was more highly expressed in diffused gastric carcinoma than in non-diffused gastric carcinoma (P < 0.05). The ER positive rate was also related to regional lymph nodes metastases (P < 0.05), and was significantly higher in females above 55 years old, and higher in males under 55 years old (P < 0.05). The ERmRNA (in situ hybridization) positive rate was 73.3% in males and 86.7% in females. The ERmRNA positive rates were almost the same in Borrmann I, II, III and IV gastric carcinoma (P > 0.05). ERmRNA was expressed in all tubular adenocarcinoma, poorly differentiated adenocarcinoma and signet ring cell carcinoma (P < 0.05). The ERmRNA positive rate was related to both regional lymph nodes metastases and gastric carcinoma growth patterns, and was higher in both sexes above 55 years old but without statistical significance (P > 0.05). The positive rate of ERmRNA expression by in situ hybridization was higher than that of ER expression by immunohistochemistry (P < 0.05).

CONCLUSION: ERmRNA expression is related to the pathological behaviors of gastric carcinoma, which might help to predict the prognosis and predict the effectiveness of endocrine therapy for gastric carcinoma.

An analysis of esophageal cancer incidence in Cixian county from 1974 to 1996

AIM: To describe the incidence of esophageal cancer (EC) in Cixian, a county of Hebei province during 1974-1996. We analyzed the sex and age characteristics as well as the geographic distribution of EC, in order to determine the impact so that methods of preventing and controlling EC in Cixian can be put in place.

METHODS: Since the early 1970s, the cancer registry system has been established, which collects the cancer incidence in Cixian county. The malignant tumors were coded according to International Classification of Disease IX (ICD-9). All the data were checked and analyzed using EPIINFO.

RESULTS: The trend of the incidence rate of EC from 1974 to 1996 had declined, (229.9/100000 vs 178.5/100000, Odds ratio = 1.47, 95% CI:1.32~1.63, χ² = 52.89. trend χ² = 26.54, P < 0.001). The incidence rate of males declined significantly (281.81/100000 vs 157.96/100000, Odds ratio = 1.61, 95% CI: 1.41~1.84, χ² = 47.85. Trend χ² = 44.86, P < 0.001), whereas, the females remained steady (157.96/100000 vs 133.41/100000, odds ratio = 1.28, 95% CI:1.17~1.49, χ² = 9.26. trend χ² = 2.69, P > 0.05). Male average annual incidence rate was 142.80/100000 and the female's was 95.18/100000. The sex ratio (males to females) was 1.50:1. The incidence rate was increasing along with the age. As to the geographic distribution, the incidence rate in mountainous areas and hilly areas showed a significantly declining trend (mountainous areas, trend χ² = 149.93, P < 0.001; hilly areas, trend χ² = 42.70, P < 0.001). The incidence rate of EC in plain areas had increased (trend χ² = 22.39, P < 0.001).

CONCLUSION: The incidence rate of EC in Cixian county shows a trend and has declined after two decades, especially in mountainous area. But compared to other regions in the world, Cixian county still had a high incidence rate of EC.

Relationship between Egr-1 gene expression and apoptosis in esophageal carcinoma and precancerous lesions

AIM: To study the expression of early growth response gene-1 (Egr-1 gene) and Bcl-X/_L protein and its relationship with the cell apoptosis in human esophageal carcinoma(EC) and precancerous lesions.

METHODS: In situ hybridization(ISH), immunohistochemistry (IHC) and TUNEL method were used respectively to detect Egr-1mRNA,Egr-1 protein, apoptosis related-protein Bcl-X/_L and cell apoptosis in situ from 66 cases of esophageal squamous cell carcinoma and their upper cut edge and paracancerous mucosa.

RESULTS: Egr-1 gene in situ hybridization, Bcl-X/_L immunohistochemistry positive products were located in the cytoplasm, while Egr-1 immunohistochemistry and TUNEL positive signal were located in the nuclei. The apoptosis index(AI) and the frequency of apoptosis occurrence were increased gradually from precancerous lesion to cancer (P < 0.01) and the expression of Egr-1mRNA and Egr-1 protein in dysplasia was the highest among all specimens (P < 0.01). The AI of Egr-1 positive cancer tissues was much higher than that of Egr-1 negative cancer tissues (P < 0.01), while the AI of Bcl-X/_L positive cancer tissues was much lower than that of Bcl-X/_L negative cancer tissues (P < 0.01). The AI and Egr-1 expression were not correlated with invasiveness and lymphatic metastasis in EC.

CONCLUSION: Cell apoptosis was present through esophageal carcinogenesis. The expression of Egr-1 mRNA and Egr-1 protein were high in precancerous lesion of esophagus. The AI was increased significantly in Egr-1 positive squamous cell carcinoma. Egr-1 might promote apoptotic effect. Egr-1 expression and cell apoptosis may have an important biological significance in esophageal carcinogenesis.

Expression of histo-blood group A antigen increases resistance to apoptosis and facilitates escape from immune control of rat colon carcinoma cells

A and B histo-blood group antigens are present on carcinoma cells at the early stages of cancerogenesis and tend to disappear at later stages, but it is not yet clear whether they take part to the process of tumor progression. To gain some insight into this issue, we used a rat colon carcinoma experimental model. To obtain expression of the A antigen, REG cells were cotransfected with the rat A enzyme cDNA and a rat alpha1,2fucosyltransferase cDNA, either FTA or FTB, whereas PRO cells that spontaneously have alpha1,2fucosyltransferase activity were only transfected with the A enzyme cDNA. All A antigen-expressing transfected cells derived from either REG FTA, REG FTB, or PRO parental cells were more resistant to apoptosis induced by either serum deprivation or heat shock than were their respective controls. When injected to syngeneic immunocompetent rats, A enzyme-transfected PRO cells formed tumors that grew faster than those formed by mock-transfected PRO cells. However, in immunodeficient SCID mice, no difference in growth could be observed between the two types of tumors, indicating that the faster tumor growth of the A antigen-positive cells in immunocompetent animals was due to their higher ability to escape immune control and that this was associated with their higher degree of resistance to apoptosis. These results might explain the slightly augmented incidence of carcinomas observed in A and B blood group individuals compared to O individuals.

Identification of differentially expressed proteins between human esophageal immortalized and carcinomatous cell lines by two-dimensional electrophoresis and MALDI-TOF-mass spectrometry

AIM: To identify the differentially expressed proteins between the human immortalized esophageal epithelial cell line (SHEE) and the malignant transformed esophageal carcinoma cell line (SHEEC), and to explore new ways for studying esophageal carcinoma associated genes.

METHODS: SHEE and SHEEC cell lines were used to separate differentially expressed proteins by two-dimensional electrophoresis. The silver-stained 2-D gels was scanned with EDAS290 digital camera system and analyzed with the PDQuest 6.2 Software. Six spots in which the differentially expressed protein was more obvious were selected and analyzed with matrix-assisted laser desorption/ionization time of flying mass spectrometry (MALDI-TOF-MS).

RESULTS: There were 107±4.58 and 115±9.91 protein spots observed in SHEE and SHEEC respectively, and the majority of these spots between the two cell lines matched each other (r = 0.772), only a few were expressed differentially. After analyzed by MALDI-TOF-MS and database search for the six differentially expressed proteins, One new protein as well as other five sequence-known proteins including RNPEP-like protein, human rRNA gene upstream sequence binding transcription factor, uracil DNA glycosylase, Annexin A2 and p300/CBP-associated factor were preliminarily identified.

CONCLUSION: These differentially expressed proteins might play an importance role during malignant transformation of SHEEC from SHEE. The identification of these proteins may serve as a new way for studying esophageal carcinoma associated genes.

Four case reports of families with esophageal cancer in a high-risk region on the Guangdong Chaoshan coast of China

Four families with a history of esophageal cancer were studied and their family trees analyzed. All the families had lived in Chaoshan for about 20 generations, speak Chanshan dialect, and generally have a predilection for drinking scalding Gong Fu tea and eating pickled Chinese cabbage. The majority of the esophageal cancer patients of the first generation were diagnosed 40 or 50 years ago after presenting with the typical symptom of dysphagia, whereas patients of the second and third generations were diagnosed mainly by means of radiography and pathology. The ratio of male to female patients was 14:5, which corresponds to that in the general population. The average age at occurrence of esophageal carcinoma in the patients studied was lower than in the general population and had progressively decreased from generation to generation.