Guangdong Esophageal Cancer Research Institute

Guangzhou, China

Guangdong Esophageal Cancer Research Institute

Guangzhou, China
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Wang G.,Sun Yat Sen University | Wang G.,Guangdong Esophageal Cancer Research Institute | Tang J.,Sun Yat Sen University | Tang J.,Jiangxi Cancer Hospital | And 8 more authors.
Theranostics | Year: 2017

The poor clinical outcome and prognosis of esophageal squamous cell carcinoma (ESCC) is mainly attributed to its highly invasive and metastatic nature, making it urgent to further elicit the molecular mechanisms of the metastasis of ESCC. The function of each polycomb chromobox (CBX) protein in cancer is cell-type-dependent. Although CBX8 has been reported to promote the esophageal squamous cell carcinoma (ESCC) tumorigenesis, its role in ESCC metastasis has not been explored yet. In this study, we report that the inhibition of cell migration, invasion, and metastasis in ESCC requires CBX8-mediated repression of Snail, a key transcription factor that induces epithelial-to-mesenchymal transition (EMT), and that CBX8 inversely correlated with Snail in the ESCC tissues. Moreover, this novel function of CBX8 is dependent on its binding with the Snail promoter, which in turn suppresses the transcription of Snail. Collectively, CBX8 may play paradoxical roles in ESCC, inhibiting metastasis while promoting cell proliferation. © Ivyspring International Publisher.


Li X.-H.,Sun Yat Sen University | Gu W.-S.,Sun Yat Sen University | Wang X.-P.,Sun Yat Sen University | Lin J.-H.,Sun Yat Sen University | And 6 more authors.
Journal of Cancer | Year: 2017

Background: Although various inflammation-based indexes in esophageal carcinoma have been documented, but the prognostic value of the albumin-to-globulin ratio(AGR) and its correlation with fibrinogen in resectable ESCC remain unknown. Methods: The levels of pre-treatment serum common acute phase proteins (including CRP, albumin and fribrinogen) were retrospectively analyzed in 447 patients with ESCC who underwent surgical resection at our department. The prognostic value was explored by univariate and multivariate cox hazard analysis. The correlation between AGR and acute phase proteins were also analyzed. Results: Patients with decreased levels of AGR and increased CRP had significantly lower 5-year survival rates than those with higher AGR, not only in the whole ESCC cohort but also in the subgroups stratified according to the disease T, N classifications, and metastasis, whereas the other acute phase proteins were not independent prognostic factors for ESCC. In addition, a lower AGR level was observed more often in patients with a high fibrinogen level than in those with a low fibrinogen level. Spearman's rank correlation analysis revealed that the AGR level presented a negative correlation with the fibrinogen level (r =-0.317, p<0.001). Conclusions: The 5-year survival was shorter in resectable ESCC patients exhibiting decreased pre-treatment AGR and increased CRP. Thus, the serum AGR and CRP may be a clinical prognostic factor for resectable ESCC patients. In addition, a negative correlation was present between the levels of AGR and fibrinogen, the common indexes of acute phase reactants. © 2017 Ivyspring International Publisher.


He Z.,Sun Yat Sen University | He Z.,Guangdong Esophageal Cancer Research Institute | Wu S.,Xiamen University | Li Q.,Sun Yat Sen University | And 4 more authors.
PLoS ONE | Year: 2013

Objectives:The objective of this study was to investigate the number of metastatic lymph nodes (pN) and the metastatic lymph node ratio (MLR) on the post-surgical prognosis of Chinese patients with esophageal cancer (EC) and lymph node metastasis.Methods:We enrolled 353 patients who received primary curative resection for EC from 1990 to 2003. The association of pN and MLR with 5-year overall survival (OS) was examined by receiver operating characteristic (ROC) and area under the curve (AUC) analysis. The Kaplan-Meier method was used to calculate survival rates, and survival curves were compared with the log-rank test. The Cox model was employed for univariate and multivariate analyses of factors associated with 5-year OS.Results:The median follow-up time was 41 months, and the 1-, 3- and 5-year OS rates were 71.2%, 30.4%, and 19.5%, respectively. Univariate analysis showed that age, pN stage, and the MLR were prognostic factors for OS. Patients with MLRs less than 0.15, MLRs of 0.15-0.30, and MLRs greater than 0.30 had 5-year OS rates of 30.1%, 17.8%, and 9.5%, respectively (p < 0.001). Patients classified as pN1, pN2, and pN3 had 5-year OS rates of 23.7%, 11.4%, and 9.9%, respectively (p < 0.001). Multivariate analysis indicated that a high MLR and advanced age were significant and independent risk factors for poor OS. Patients classified as pN2 had significantly worse OS than those classified as pN1 (p = 0.022), but those classified as pN3 had similar OS as those classified as pN1 (p = 0.166). ROC analysis indicated that MLR (AUC = 0.585, p = 0.016) had better predictive value than pN (AUC = 0.565, p = 0.068).Conclusions:The integrated use of MLR and pN may be suitable for evaluation of OS in Chinese patients with EC and positive nodal metastasis after curative resection. © 2013 He et al.


Zhang S.-S.,Sun Yat Sen University | Zhang S.-S.,Guangdong Esophageal Cancer Research Institute | Huang Q.-Y.,Sun Yat Sen University | Huang Q.-Y.,Guangdong Esophageal Cancer Research Institute | And 15 more authors.
Annals of Surgical Oncology | Year: 2013

Background: The value of p53 status for predicting response to chemotherapy-based treatment in patients with esophageal cancer has been controversial. We conducted a meta-analysis to elucidate the correlation of p53 status with the response to chemotherapy-based treatment. Methods: Studies were searched in PubMed, Embase, and Web of Science (up to September 2012). The p53 status and response to therapy were defined and standardized. Subgroup analyses based on the treatment and histopathology were performed to explore the usefulness of p53 status for predicting response to therapy in esophageal cancer. Sensitivity analyses were conducted by removing specific studies to assess the effects of study quality. Results: We included 28 studies with 1497 cases in our meta-analysis. Wild-type form of p53 status (low expression of p53 protein and/or wild-type p53 gene) was associated with high response to chemotherapy-based treatment in esophageal cancer (total major response [MR]: risk ratio [RR] = 1.09, 95 % CI = 1.03-1.16, P =.003; pathological MR: RR = 1.15, 95 % CI = 1.06-1.25, P =.001; total complete response [CR]: RR = 1.08, 95 % CI = 1.00-1.17, P =.040). The similar correlation between the wild-type form p53 and response to therapy were also detected in subgroup analyses (total MR, pathological MR, and total CR in chemoradiotherapy subgroup; total MR in chemotherapy subgroup; total MR and pathological CR in esophageal squamous cell carcinoma [ESCC]). Additionally, patients with wild-type form p53 status had high pathological complete response rate to neoadjuvant chemoradiotherapy in ESCC. Conclusions: The current meta-analysis suggested that p53 status might be a predictive biomarker for response to chemotherapy-based treatment in esophageal cancer. © 2013 Society of Surgical Oncology.


Zhang S.S.,Sun Yat Sen University | Zhang S.S.,Guangdong Esophageal Cancer Research Institute | Yang H.,Sun Yat Sen University | Yang H.,Guangdong Esophageal Cancer Research Institute | And 23 more authors.
British Journal of Cancer | Year: 2013

Background: Body mass index (BMI) has been associated with the risk of oesophageal cancer. But the influence of BMI on postoperative complication and prognosis has always been controversial. Methods: In total, 2031 consecutive patients who underwent oesophagectomy between 1998 and 2008 were classified according to Asian-specific BMI (kg m -2) cutoff values. The impact of BMI on overall survival (OS) was estimated using the Kaplan-Meier method and Cox proportional hazard models. We performed a meta-analysis to examine the association of BMI with OS and postoperative complication. Results: Patients with higher BMI had more postoperative complication (P = 0.002), such as anastomotic leakage (P = 0.016) and cardiovascular diseases (P < 0.001), but less incidence of chylous leakage (P = 0.010). Logistic regression analysis showed that BMI (P = 0.005) was a confounding factor associated with postoperative complication. Multivariate analysis showed that overweight and obese patients had a more favourable survival than normal weight patients (HR (hazard ratio) = 0.80, 95% CI (confidence interval): 0.70-0.92, P = 0.001). Subgroup analysis showed that the association with higher BMI and increased OS was observed in patients with oesophageal squamous cell carcinoma (ESCC) (P < 0.001), oesophageal adenocarcinoma (EA) (P = 0.034), never-smoking (P = 0.035), ever-smoking (P = 0.035), never alcohol consumption (P = 0.005), weight loss (P = 0.003) and advanced pathological stage (P < 0.001). The meta-analysis further corroborated that higher BMI was associated with increased complication of anastomotic leakage (RR (risk ratio) = 1.04, 95% CI: 1.02-1.06, P = 0.001), wound infection (RR = 1.03, 95% CI: 1.00-1.05, P = 0.031) and cardiovascular diseases (RR = 1.02, 95% CI: 1.00-1.05, P = 0.039), but decreased incidence of chylous leakage (RR = 0.98, 95% CI: 0.96-0.99, P < 0.001). In addition, high BMI could significantly improved OS (HR = 0.78, 95% CI: 0.71-0.85, P < 0.001). Conclusion: Preoperative BMI was an independent prognostic factor for survival, and strongly associated with postoperative complications in oesophageal cancer. Copyright © 2013 Cancer Research UK.


Xie X.,Sun Yat Sen University | Xie X.,Guangdong Esophageal Cancer Research Institute | Zhang S.-S.,Sun Yat Sen University | Zhang S.-S.,Guangdong Esophageal Cancer Research Institute | And 12 more authors.
Biomarkers | Year: 2013

Objective: This study was to determine the role of HOXB7 in predicting outcomes of patients with oesophageal squamous cell cancer (OSCC). Methods: Samples were collected from 179 OSCC patients. HOXB7 mRNA expression was measured by quantitative real-time polymerase chain reaction. Results: HOXB7 mRNA expression was up-regulated in 85.1% of OSCC tumorous tissues, and correlated with age, pathological T and N category, as well as cancer-specific survival (CSS). However, subgroup analysis revealed its discernibility on CSS was only pronounced in early stage. Conclusions: HOXB7 mRNA expression might serve as a novel prognostic biomarker for resected OSCC patients in early stage. © 2013 Informa UK Ltd.


Zhu Y.,Sun Yat Sen University | Zhu Y.,Guangdong Esophageal Cancer Research Institute | Qiu B.,Sun Yat Sen University | Qiu B.,Guangdong Esophageal Cancer Research Institute | And 10 more authors.
Diseases of the Esophagus | Year: 2014

Summary: Primary small cell carcinoma of esophagus (SCCE) is a rare disease with poor prognosis. The aims of this study are to review the clinical characteristics, treatment modalities, and outcomes of SCCE and to investigate the prognostic factors and optimal treatment options. Sixty-four patients diagnosed as SCCE in Sun Yat-sen University Cancer Center from 1990 to 2011 were retrospectively reviewed. There were 46 patients with limited disease (LD) and 18 with extensive disease. The median survival time (MST) and overall survival rate were calculated and compared by the Kaplan-Meier method and log-rank test, respectively. The prognostic factors were calculated by Cox hazards regression model. With a median follow up of 11.6 months, the MST of all the 64 patients was 12.6 months, 16.5 months for LD and 9.0 months for extensive disease. The 1-, 3-, and 5-year overall survivals were 52.5%, 20.9%, and 7.5%, respectively. In univariate analysis, patients with ECOG performance score <2 (P = 0.009), lesion length ≤5cm (P = 0.009), T stage ≤2 (P = 0.004), LD (P = 0.000), and multimodality treatment (P = 0.016) had significant associations with MST. Multivariate analysis showed that ECOG performance score (P = 0.001), T stage (P = 0.023), limited-extensive stage (P = 0.007), and treatment modality (P = 0.008) were independent prognostic factors. Locoregional treatment combined with chemotherapy had a trend to increase MST from 15.3 to 20.0 months in LD patients (P = 0.126), while combined chemotherapy had a significant impact on MST in extensive disease patients (P = 0.000). SCCE is a highly malignant disease with poor prognosis. Patients might obtain survival benefit from the combination of locoregional treatment and systemic therapy. Prospective studies are needed to validate these factors. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

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