Esophageal Squamous Cell Carcinoma Precursor Study

Esophageal cancer is the sixth most common cause of cancer death in the world. High-risk areas occur across central Asia and from eastern to southern Africa, and in these populations, nearly all of the cases are esophageal squamous cell carcinoma (ESCC). ESCC has a dismal prognosis, largely because symptoms usually appear late in the course of the disease, when the tumors are incurable. Early detection and treatment of curable precursor lesions and early invasive ESCC in asymptomatic high-risk adults offers the potential for long-term survival and reduced mortality from this disease. Previous studies have shown that routine cytology of non-endoscopically collected esophageal cell samples is not sensitive and specific enough to be clinically useful, so we are now looking for molecular markers of high-grade esophageal squamous dysplasia (HGD), the proven clinically important precursor lesion of ESCC, that can be used to increase the accuracy and utility of this initial screening exam. National Cancer Institute (NCI) and Cancer Institute and Hospital, Chinese Academy of Medical Sciences (CAMS) began collaborative studies of ESCC since the mid-1980s in China. The present proposal is designed to characterize the type and prevalence of DNA mutations in tissue samples of HGD and to establish biologic and questionnaire resources for further study. The proposed study has two components, a field study to obtain questionnaire data and biological samples, and a genomic analysis to perform sequencing of the biological samples and bioinformatics analysis of the sequencing. ]]>
Participants were recruited by the department of endoscopy in Cancer Institute and Hospital, Chinese Academy of Medical Sciences (CAMS) among asymptomatic patients identified in the National Early Detection and Early Treatment of Esophageal Cancer (EDETEC) screening program who had been found to have a most extreme histologic diagnosis of high-grade (moderate or severe) esophageal squamous dysplasia (HGD). Questionnaire, blood collection, and endoscopic biopsies collection were obtained during clinical visits for the treatment of their HGD after written informed consent. Other eligibility criteria included age 21-79 years and no contraindications to endoscopy examination. Exclusion criteria included previous history of esophageal cancer, uncontrolled congestive heart failure, unstable angina, uncontrolled coagulopathy, severe pulmonary disease, cirrhosis, esophageal varices, or hypersensitivity to lidocaine or iodine.]]>