Zaidi Neeha, Kelly Ronan J
Upper Aerodigestive Malignancies Division, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Chin Clin Oncol. 2017 Oct;6(5):46. doi: 10.21037/cco.2017.07.07.
Esophageal cancer remains a significant cause of cancer-related mortality worldwide and carries a poor prognosis both in the locally advanced and metastatic setting. Esophageal squamous cell carcinoma (ESCC) accounts for the majority of esophageal cancers globally, while esophageal adenocarcinoma (EAC) now predominates in the Western world. Historically, clinical trials have not separated the two histologic subtypes, with similar regimens being used for both. This, however, is changing with the recent publication by the Cancer Genome Atlas Research Group confirming that comprehensive analysis reveals ESCC demonstrates frequent genomic amplifications of CCND1 and SOX2 and/or TP63 and biologically are more like head and neck squamous cell carcinomas, whereas EACs strongly resemble the chromosomally unstable variant of gastric cancer. With a lack of viable targets in squamous cell carcinoma, immunotherapeutic approaches are now being investigated in both early stage and metastatic ESCC with promising results being reported in the preliminary data published to date.
食管癌仍然是全球癌症相关死亡的一个重要原因，在局部晚期和转移情况下预后都很差。食管鳞状细胞癌（ESCC）在全球食管癌中占大多数，而食管腺癌（EAC）目前在西方世界占主导地位。从历史上看，临床试验并未区分这两种组织学亚型，两种亚型都使用相似的治疗方案。然而，随着癌症基因组图谱研究小组最近发表的文章，这种情况正在发生变化，该文章证实全面分析显示ESCC表现出CCND1和SOX2和/或TP63的频繁基因组扩增，并且在生物学上更类似于头颈部鳞状细胞癌，而EACs与染色体不稳定的胃癌变体非常相似。由于鳞状细胞癌缺乏可行的靶点，目前正在对早期和转移性ESCC进行免疫治疗方法的研究，迄今为止公布的初步数据报告了有希望的结果。
