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The free generalized endoscopic screening for diagnosis of early esophageal cancer and precancerous lesion could not be satisfactorily implemented in China. At present, the decision to accept endoscopic screening at their own expense may largely depend on the public awareness. This study was aimed to investigate the awareness and other influencing factors associated with the accompanying children of esophageal cancer patients after their hospitalization. In this cross-sectional study, from April to June 2016, 233 children of accompanying patients, who were admitted within the last 1 year due to esophageal cancer in three affiliated hospitals of Zhengzhou University and Anyang Tumor Hospital, were enrolled. In addition, telephone surveys were conducted to investigate their awareness about endoscopic screening. One child was corresponded to an esophageal cancer patient. About half (47.6%, 111/233) of the children were unaware that endoscopic screening could detect early esophageal cancer and precancerous lesion. There was no significant difference in their awareness rates between hospitals with different administration levels. Besides, the males who had a lower family income and lower education level showed a poor awareness rate (P < 0.05). The overall awareness rate among the accompanying children of patients on endoscopic screening was rather low in Henan province (China). Hence, the health education and awareness on the importance of endoscopic screening for early detection of esophageal cancer should be promoted among children accompanying the patients. More attention should be focused towards the subject group, particularly among those male children with lower educational level and family income.

The aim of this study was to evaluate the diagnostic values by detecting sera autoantibodies to eight tumor-associated antigens (TAAs) of P53, IMP1, P16, cyclin B1, P62, C-myc, Survivn and Koc full-length recombinant proteins for the screening of high-risk subjects and early detection of esophageal squamous cell carcinoma (ESCC). Enzyme-linked immunosorbent assay was used to detect autoantibodies against the eight selected TAAs in 567 sera samples from four groups, including 200 individuals with normal esophageal epithelia (NOR), 214 patients with esophageal basal cell hyperplasia (BCH), 65 patients with esophageal dysplasia (DYS), and 88 patients with ESCC. In addition, the expression of the eight antigens in esophageal tissues was analyzed by immunohistochemistry. Statistically significant distribution differences were identified among the four groups for each of the individual autoantibodies to six TAAs (P53, IMP1, P16, cyclin B1, P62, and C-myc); the detection rates of antoantibodies were positively correlated with the progression of ESCC. When autoantibody assay successively accumulated to six TAAs (P53, IMP1, P16, cyclin B1, P62, and C-myc), a stepwise increased detection frequency of autoantibodies was found in the four sera groups (6% in NOR, 18% in BCH, 38% in DYS, and 64% in ESCC, respectively), the risks to BHC, DYS, and ESCC steadily increased about 3-, 9-, and 27-folds. The sensitivity and the specificity for autoantibodies against the six TAAs in diagnosing ESCC reached up to 64% and 94%, respectively. The area under the receiver operating characteristic curve for the six anti-TAA autoantibodies was 0.78 (95% confidence interval 0.74-0.83). No more increasing in sensitivity was found with the addition of new anti-TAA autoantibodies. A combination detection of autoantibodies to TAAs might distinguish ESCC patients from normal individuals and the patients with esophageal precancerous lesions.

The lymph node metastasis (LNM) has been well recognized as one of the major risk factors affecting the survival of the patients with esophageal squamous cell carcinoma (ESCC). However, it is a dilemma to determine the LNM status before surgery. The invasive depth (T stage) of ESCC could be determined either with computed tomography or ultrasound endoscopy and may reflect the severity of LNM. Thus, the present study was designed to determine the impact of tumor invasive depth on LNM status and survival in ESCC patients with T1-4N0M0. The enrolled 30,514 ESCC patients in this study were from the ESCC database in Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University. Of the patients, there were 18346 males with an mean age of 59.2±8.9, and 12168 females with an mean age of 59.7±8.7. All the patients had been performed radical esophagectomy without radiotherapy and chemotherapy before surgery, and the invasive depth records were retrieved from the medical records in hospitals after surgical resection. Based on the 6th version of UICC criteria, the invasive depth (T) was classified as Tis, and T1-4. Of the 30,514 ESCC patients, 20,288 cases were successfully followed until the end of 2015. The Logistic regression method were used to determine the correlation between T stage and LNM status. The Kaplan-Meier method was applied to analyze the survival in different groups. The results showed that, of the 30,514 ESCC patients, there were 3324 (10.9%) patients with Tis+T1, 9616 (31.5%) with T2, 17249 (56.5%) with T3 and 325 (1.1%) with T4. Accordingly, from Tis&T1 to T4, the number of the patients with positive LNM were 554 (16.7%), 3392 (35.3%), 7737 (44.9%) and 205 (63.1%), respectively. Logistic regression analysis indicated the risk of LNM was dramatically increased from 2- to 8-folds with the T stages from Tis&T1 to T4, with OR values of 2.725 (T2: 95%CI: 2.465-3.013), 4.067 (T3: 95%CI: 3.695-4.477) and 8.542 (T4: 95%CI: 6.699-10.892), respectively. Interestingly, seventeen percent of the patients with Tis&T1 stages had occurred positive LNM, indicating that LNM may occur in very early stage of ESCC. Kaplan-Meier analysis showed that T staging was obviously associated with the survival in ESCC patients with negative LNM (P value < 0.05). Overall, the present results indicated a strong correlation between invasive depth and LNM status, suggesting that the invasion depth may be one of crucial markers to reflect the LNM in ESCC. The invasive depth could be used as an promising indicator for LNM status judgment in clinical TNM staging and prognosis for ESCC. [Supported by the Joint Funds of the National Natural Science Foundation of China (U1301227), the General Program of National Natural Science Foundation of China (81472323) and Correspondence to: Li Dong Wang, Email: ldwang2007@126.com] Note: This abstract was not presented at the meeting. Citation Format: Xin Song, Fu You Zhou, Hai Jun Yang, Xue Na Han, Tang Juan Zhang, Lian Qun Zhang, Ning Liu, Jing Li Ren, Zhi Wei Chang, Xin Tian, Hai Ling Wang, Hui Fang Tan, Li Dong Wang. Impact of the invasive depth on lymph node metastasis and survival in Chinese patients with esophageal squamous cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3293. doi:10.1158/1538-7445.AM2017-3293

Object To explore the clinical feasibility of employing occlusion to treat basilar artery dissecting aneurysm. Methods One patient, male and 46 years old, suffered transient numbness and weakness on the right limbs. Cerebral angiography indicated basilar artery dissecting aneurysm. The patient underwent the stent-assisted coil embolization of aneurysm and the result is satisfactory. Digital subtraction angiography (DSA) reviews were performed at 1 month and 4.5 months, respectively after the operation and indicate that the basilar artery is unobstructed and there was no recurrence of the aneurysm. DSA review 1 year after the first treatment indicates the aneurysm recurrence, stent-assisted coils dense embolization of aneurysm was performed again and the result was satisfactory. Ten months after the second operation, DSA review found the basilar artery aneurysm recurrence again and occlusion of the basilar artery was performed. Results The basilar artery occlusion was effective. The bilateral posterior inferior cerebellar arteries and the bilateral posterior cerebral arteries are unobstructed. Five months of follow-up found that the patient recovered well. DSA reviews performed 5 months after occlusion indicate no recurrence of the aneurysm. Conclusions Occlusion to treat basilar artery dissecting aneurysm is clinically feasible, but surgical indications should be considered strictly.