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Hoang AT, Vizio B, Chiusa L, Cimino A, Solerio D, Do NH, Pileci S, Camandona M, Bellone G. Impact of Tissue Enolase 1 Protein Overexpression in Esophageal Cancer Progression. Int J Med Sci 2021; 18:1406-1414. [PMID: 33628097 PMCID: PMC7893569 DOI: 10.7150/ijms.52688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/18/2020] [Indexed: 12/31/2022] Open
Abstract
Enolase (ENO) 1 is a key glycolytic enzyme and important player in tumorigenesis. ENO1 overexpression has been correlated with tumor progression and/or worse prognosis in several solid malignancies. However, data concerning the impact of ENO1 in cancer conflict. The study correlated local and circulating ENO1 protein levels in esophageal cancer (EC) with clinicopathological data, to assess its potential clinical value. ENO1 expression was analyzed by immunohistochemistry in paired tumor and non-tumor tissue samples from 40 EC cases and mucosal biopsies from 45 Barrett's esophagus (BE) cases, plus in plasma from these patients and 25 matched healthy controls. ENO1 was abnormally elevated in cancer-cell cytoplasm in both EC types, in esophageal squamous cell carcinoma and in adenocarcinoma (EAC), increasing significantly with tumor stage progression and the transition from BE to EAC. EAC patients exhibited significantly lower ENO1 plasma concentrations than normal subjects. Neither local nor systemic ENO1 expression levels were significantly associated with overall survival. These results indicate ENO1 as potential biomarker, delineating a population of patients with Barrett's esophagus at high risk of cancer, and as new therapeutic opportunity in EC patient management. However, further confirmation might be necessary.
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Affiliation(s)
- Anh Tuan Hoang
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Barbara Vizio
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Luigi Chiusa
- Pathology Unit, AOU City of Health and Science of Turin, 10126 Turin, Italy
| | - Antonio Cimino
- Pathology Unit, AOU City of Health and Science of Turin, 10126 Turin, Italy
| | - Dino Solerio
- Department of Surgical Sciences, University of Turin, Unit of Digestive and Oncological Surgery 1U, AOU City of Health and Science of Turin, 10126 Turin, Italy
| | - Nhu Hon Do
- Vietnam National Institute of Ophthalmology, Hanoi, Vietnam
| | - Stefano Pileci
- Department of Surgical Sciences, University of Turin, Unit of Digestive and Oncological Surgery 1U, AOU City of Health and Science of Turin, 10126 Turin, Italy
| | - Michele Camandona
- Department of Surgical Sciences, University of Turin, Unit of Digestive and Oncological Surgery 1U, AOU City of Health and Science of Turin, 10126 Turin, Italy
| | - Graziella Bellone
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
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2
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Mashimo H, Gordon SR, Singh SK. Advanced endoscopic imaging for detecting and guiding therapy of early neoplasias of the esophagus. Ann N Y Acad Sci 2020; 1482:61-76. [PMID: 33184872 DOI: 10.1111/nyas.14523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 12/16/2022]
Abstract
Esophageal cancers, largely adenocarcinoma in Western countries and squamous cell cancer in Asia, present a significant burden of disease and remain one of the most lethal of cancers. Key to improving survival is the development and adoption of new imaging modalities to identify early neoplastic lesions, which may be small, multifocal, subsurface, and difficult to detect by standard endoscopy. Such advanced imaging is particularly relevant with the emergence of ablative techniques that often require multiple endoscopic sessions and may be complicated by bleeding, pain, strictures, and recurrences. Assessing the specific location, depth of involvement, and features correlated with neoplastic progression or incomplete treatment may optimize treatments. While not comprehensive of all endoscopic imaging modalities, we review here some of the recent advances in endoscopic luminal imaging, particularly with surface contrast enhancement using virtual chromoendoscopy, highly magnified subsurface imaging with confocal endomicroscopy, optical coherence tomography, elastic scattering spectroscopy, angle-resolved low-coherence interferometry, and light scattering spectroscopy. While there is no single ideal imaging modality, various multimodal instruments are also being investigated. The future of combining computer-aided assessments, molecular markers, and improved imaging technologies to help localize and ablate early neoplastic lesions shed hope for improved disease outcome.
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Affiliation(s)
- Hiroshi Mashimo
- VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Stuart R Gordon
- Dartmouth-Hitchcock Medical Center, Dartmouth University, Lebanon, New Hampshire
| | - Satish K Singh
- VA Boston Healthcare System, Boston, Massachusetts.,Boston University School of Medicine, Boston, Massachusetts
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3
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Abstract
PURPOSE OF REVIEW Esophageal adenocarcinoma bears one of the fastest rising incidence of any cancers and generally arises in the setting of gastroesophageal reflux and Barrett's esophagus. However, early detection of neoplasia can be challenging since most patients are asymptomatic until they progress to more advanced and less curable stages, and early dysplastic lesions can be small, multifocal, and difficult to detect. Clearly, new imaging tools are needed in light of sampling error associated with random biopsies, the current standard of practice. RECENT FINDINGS Advances in endoscopic imaging including virtual chromoendoscopy, confocal laser endomicroscopy, and subsurface imaging with optical coherence tomography have ushered in a new era for detecting subtle neoplastic lesions. Moreover, in light of esophagus-sparing treatments for neoplastic lesions, such tools are likely to guide ablation and follow-up management. While there is no ideal single imaging modality to facilitate improved detection, staging, ablation, and follow-up of patients with dysplastic Barrett's esophagus, new advances in available technology, the potential for multimodal imaging, and the use of computer-aided diagnosis and biomarkers all hold great promise for improving detection and treatment.
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Affiliation(s)
- Mansoureh Mkarimi
- VA Boston Healthcare, Harvard Medical School, 1400 VFW Parkway, West Roxbury, MA, 02132, USA
| | - Hiroshi Mashimo
- VA Boston Healthcare, Harvard Medical School, 1400 VFW Parkway, West Roxbury, MA, 02132, USA.
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4
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Lastraioli E, Lottini T, Iorio J, Freschi G, Fazi M, Duranti C, Carraresi L, Messerini L, Taddei A, Ringressi MN, Salemme M, Villanacci V, Vindigni C, Tomezzoli A, La Mendola R, Bencivenga M, Compagnoni B, Chiudinelli M, Saragoni L, Manzi I, De Manzoni G, Bechi P, Boni L, Arcangeli A. hERG1 behaves as biomarker of progression to adenocarcinoma in Barrett's esophagus and can be exploited for a novel endoscopic surveillance. Oncotarget 2018; 7:59535-59547. [PMID: 27517748 PMCID: PMC5312329 DOI: 10.18632/oncotarget.11149] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 07/09/2016] [Indexed: 12/21/2022] Open
Abstract
Barrett's esophagus (BE) is the only well-known precursor lesion of esophageal adenocarcinoma (EA). The exact estimates of the annual progression rate from BE to EA vary from 0.07% to 3.6%. The identification of BE patients at higher risk to progress to EA is hence mandatory, although difficult to accomplish. In search of novel BE biomarkers we analyzed the efficacy of hERG1 potassium channels in predicting BE progression to EA. Once tested by immunohistochemistry (IHC) on bioptic samples, hERG1 was expressed in BE, and its expression levels increased during progression from BE to esophageal dysplasia (ED) and EA. hERG1 was also over-expressed in the metaplastic cells arising in BE lesions obtained in different BE mouse models, induced either surgically or chemically. Furthermore, transgenic mice which over express hERG1 in the whole gastrointestinal tract, developed BE lesions after an esophago-jejunal anastomosis more frequently, compared to controls. A case-control study was performed on 104 bioptic samples from newly diagnosed BE patients further followed up for at least 10 years. It emerged a statistically significant association between hERG1 expression status and risk of progression to EA. Finally, a novel fluorophore- conjugated recombinant single chain variable fragment antibody (scFv-hERG1-Alexa488) was tested on freshly collected live BE biopsies: it could recognize hERG1 positive samples, perfectly matching IHC data.Overall, hERG1 can be considered a novel BE biomarker to be exploited for a novel endoscopic surveillance protocol, either in biopsies or through endoscopy, to identify those BE patients with higher risk to progress to EA.
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Affiliation(s)
- Elena Lastraioli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Tiziano Lottini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Jessica Iorio
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Giancarlo Freschi
- Department of Surgery and Translational Medicine, University of Florence, 50134 Florence, Italy
| | - Marilena Fazi
- Department of Surgery and Translational Medicine, University of Florence, 50134 Florence, Italy
| | - Claudia Duranti
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | | | - Luca Messerini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Antonio Taddei
- Department of Surgery and Translational Medicine, University of Florence, 50134 Florence, Italy
| | - Maria Novella Ringressi
- Department of Surgery and Translational Medicine, University of Florence, 50134 Florence, Italy
| | | | | | - Carla Vindigni
- Pathology Division, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy
| | - Anna Tomezzoli
- Pathology Division, Borgo Trento Hospital, 37134 Verona, Italy
| | | | | | - Bruno Compagnoni
- Surgery Division, Esine Hospital, ASL Vallecamonica Sebino, 25040 Esine (BS), Italy
| | - Mariella Chiudinelli
- Pathology Division, Esine Hospital, ASL Vallecamonica Sebino, 25040 Esine (BS), Italy
| | - Luca Saragoni
- Pathology Division, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy
| | - Ilaria Manzi
- Gastroenterology and Endoscopy Unit, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy
| | | | - Paolo Bechi
- Department of Surgery and Translational Medicine, University of Florence, 50134 Florence, Italy
| | - Luca Boni
- Clinical Trials Coordinating Center, Azienda Ospedaliero-Universitaria Careggi/Istituto Toscano Tumori, 50134 Florence, Italy
| | - Annarosa Arcangeli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
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Fukui S, Watari J, Tomita T, Yamasaki T, Okugawa T, Kondo T, Kono T, Tozawa K, Ikehara H, Ohda Y, Oshima T, Fukui H, Das KM, Miwa H. Localization of specialized intestinal metaplasia and the molecular alterations in Barrett esophagus in a Japanese population: an analysis of biopsy samples based on the "Seattle" biopsy protocol. Hum Pathol 2016; 51:32-40. [PMID: 27067780 DOI: 10.1016/j.humpath.2015.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 12/11/2015] [Accepted: 12/16/2015] [Indexed: 02/07/2023]
Abstract
It remains unclear why Barrett esophagus (BE)-associated adenocarcinoma (EAC) frequently occurs in the 0 to 3 o'clock area of the BE. The aims of this study were to clarify the localization of specialized intestinal metaplasia (SIM) as a precancerous lesion and of molecular alterations among different locations using 4-quadrant biopsies based on the "Seattle" protocol. We prospectively evaluated microsatellite instability; methylation status at the APC, CDKN2A, hMLH1, RUNX3, and MGMT genes; the immunoreactivity of the monoclonal antibody Das-1 for the colonic phenotype; and Ki-67 staining in 10 early EACs and 128 biopsy samples from 32 BE patients. Among the molecular changes, only APC gene hypermethylation was an independent predictive marker of EAC (odds ratio, 24.4; P = .01). SIM was more frequently identified in the 0 to 3 o'clock quadrant than in the 6 to 9 o'clock quadrant (P = .08). The Ki-67 index was higher in SIM than in the columnar-lined epithelium (CLE) without goblet cells (P < .0001) and in both SIM and CLE with Das-1 reactivity than in those without (P = .04 and P = .06, respectively). Furthermore, the index was relatively higher in the 0 to 3 o'clock quadrant than in the 6 to 9 o'clock quadrant in cases with Das-1 reactivity. RUNX3 methylation was more frequently found in SIM than in CLE (P = .04), whereas the incidence of the other biomarkers did not show a significant difference between the 0 to 3 o'clock and 6 to 9 o'clock areas, nor between SIM and CLE. SIM with Das-1 reactivity, but not molecular alterations, in the 0 to 3 o'clock quadrant may have higher proliferative activity compared to the other areas of the BE.
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Abstract
In-depth molecular characterization of esophageal oncogenesis has improved over the recent years. Advancement in molecular biology and bioinformatics has led to better understanding of its genomic landscape. More specifically, analysis of its pathogenesis at the genetic level has uncovered the involvement of a number of tumor suppressor genes, cell cycle regulators, and receptor tyrosine kinases. Due to its poor prognosis, the development of clinically applicable biomarkers for diagnosis, progression, and treatment has been the focus of many research studies concentrating on upper gastrointestinal malignancies. As in other cancers, early detection and subsequent intervention of the preneoplastic condition significantly improves patient outcomes. Currently, clinically approved surveillance practices heavily depend on expensive, invasive, and sampling-error-prone endoscopic procedures. There is, therefore, a great demand to establish clearly reliable biomarkers that could identify those patients at higher risk of neoplastic progression and hence would greatly benefit from further monitoring and/or intervention. This chapter will present the most recent advances in the analysis of the esophageal cancer genome serving as basis for biomarker development.
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Affiliation(s)
- Mark Pusung
- MRC Cancer Unit, University of Cambridge, Cambridge, UK
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7
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Dassie E, Arcidiacono D, Wasiak I, Damiano N, Dall'Olmo L, Giacometti C, Facchin S, Cassaro M, Guido E, De Lazzari F, Marin O, Ciach T, Fery-Forgues S, Alberti A, Battaglia G, Realdon S. Detection of fluorescent organic nanoparticles by confocal laser endomicroscopy in a rat model of Barrett's esophageal adenocarcinoma. Int J Nanomedicine 2015; 10:6811-23. [PMID: 26586943 PMCID: PMC4636176 DOI: 10.2147/ijn.s86640] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
For many years, novel strategies for cancer detection and treatment using nanoparticles (NPs) have been developed. Esophageal adenocarcinoma is the sixth leading cause of cancer-related deaths in Western countries, and despite recent advances in early detection and treatment, its prognosis is still very poor. This study investigated the use of fluorescent organic NPs as potential diagnostic tool in an experimental in vivo model of Barrett’s esophageal adenocarcinoma. NPs were made of modified polysaccharides loaded with [4-(dicyanomethylene)-2-methyl-6-(4-dimethylaminostyryl)-4H-pyran] (DCM), a well-known fluorescent dye. The NP periphery might or might not be decorated with ASYNYDA peptide that has an affinity for esophageal cancer cells. Non-operated and operated rats in which gastroesophageal reflux was surgically induced received both types of NPs (NP-DCM and NP-DCM-ASYNYDA) by intravenous route. Localization of mucosal NPs was assessed in vivo by confocal laser endomicroscopy, a technique which enables a “real time” and in situ visualization of the tissue at a cellular level. After injection of NP-DCM and NP-DCM-ASYNYDA, fluorescence was observed in rats affected by esophageal cancer, whereas no signal was observed in control non-operated rats, or in rats with simple esophagitis or Barrett’s esophagus mucosa. Fluorescence was observable in vivo 30 minutes after the administration of NPs. Interestingly, NP-DCM-ASYNYDA induced strong fluorescence intensity 24 hours after administration. These observations suggested that NPs could reach the tumor cells, likely by enhanced permeability and retention effect, and the peptide ASYNYDA gave them high specificity for esophageal cancer cells. Thus, the combination of NP platform and confocal laser endomicroscopy could play an important role for highlighting esophageal cancer conditions. This result supports the potential of this strategy as a targeted carrier for photoactive and bioactive molecules in esophageal cancer diagnosis and treatment.
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Affiliation(s)
- Elisa Dassie
- Department of Molecular Medicine, University of Padua, Padua, Italy ; Venetian Institute of Molecular Medicine, University of Padua, Padua, Italy
| | - Diletta Arcidiacono
- Venetian Institute of Molecular Medicine, University of Padua, Padua, Italy ; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Iga Wasiak
- Faculty of Chemical and Process Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Nunzio Damiano
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Luigi Dall'Olmo
- Department of Emergency Medicine, "Santi Giovanni e Paolo" Hospital, Venice, University of Padua, Italy
| | - Cinzia Giacometti
- Anatomic Pathology Unit, ULSS 15, Alta Padovana, Camposampiero, University of Padua, Italy
| | - Sonia Facchin
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Mauro Cassaro
- Anatomic Pathology Unit, ULSS 15, Alta Padovana, Camposampiero, University of Padua, Italy
| | - Ennio Guido
- Gastroenterology Unit, Sant'Antonio Hospital, University of Padua, Italy
| | - Franca De Lazzari
- Gastroenterology Unit, Sant'Antonio Hospital, University of Padua, Italy
| | - Oriano Marin
- Interdepartmental Research Centre for Innovative Biotechnologies (CRIBI), University of Padua, Italy ; Proteomics Facility, Azienda Ospedaliera di Padova, Padua, Italy
| | - Tomasz Ciach
- Faculty of Chemical and Process Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Suzanne Fery-Forgues
- CNRS, ITAV-USR 3505, Toulouse, France ; Université de Toulouse, ITAV-USR 3505, Toulouse, France
| | - Alfredo Alberti
- Department of Molecular Medicine, University of Padua, Padua, Italy ; Venetian Institute of Molecular Medicine, University of Padua, Padua, Italy
| | - Giorgio Battaglia
- Endoscopy Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Stefano Realdon
- Endoscopy Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
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Krishnamoorthi R, Iyer PG. Molecular biomarkers added to image-enhanced endoscopic imaging: will they further improve diagnostic accuracy? Best Pract Res Clin Gastroenterol 2015; 29:561-73. [PMID: 26381302 DOI: 10.1016/j.bpg.2015.05.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 05/20/2015] [Indexed: 02/07/2023]
Abstract
Barrett's esophagus (BE) is a premalignant condition for esophageal adenocarcinoma (EAC) which has dismal prognosis. The risk of progression from BE to EAC increases with dysplasia grade. The purpose of surveillance exams in BE is to detect dysplasia at an early stage and intervene before development of EAC. However, the current surveillance practices have not been effective in reducing EAC incidence. Major limitations of this strategy include challenges in identifying dysplasia during endoscopic surveillance, which leads to sampling error and subjectivity in the histological diagnosis of dysplasia due to interobserver variation amongst pathologists. Advanced imaging techniques may allow targeted biopsy of suspicious foci with incremental yield in dysplasia detection and reduce sampling error. Molecular biomarker panels have the potential to objectively assess progression risk without the subjectivity associated with histology. Combining molecular markers with advanced imaging appears to be a promising strategy to further improve risk stratification and reduce EAC incidence and mortality. Few studies have investigated this strategy so far and the results are promising. Further research on different permutations between the available biomarkers and imaging techniques will help us determine the best possible combination that detects dysplasia with high sensitivity and specificity. Further research is needed to establish the combined strategy's cost effectiveness and feasibility.
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Affiliation(s)
- Rajesh Krishnamoorthi
- Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
| | - Prasad G Iyer
- Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States.
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