Methods in molecular biology
-
Pathological assessment of frozen sections of tissues is important in the clinical management (intraoperative consultation) and research in patients with esophageal squamous cell carcinoma. Frozen sections may be used in the assessment of status of resection margins, extent of cancer metastasis (pathological staging), confirmation of the pathology, and increased volume of cancer cells for tissue banking. However, the applications of frozen sections have many technical limitations. Thus, interpretation of frozen sections needs expertise, collaborations, and attention to proper technical skills in the sectioning.
-
While surgery plays a major role in the treatment and potential cure of esophageal cancers, esophagectomy remains a high-risk operation with significant perioperative morbidity and mortality compared to other oncosurgical procedures. Perioperative management for esophagectomy is complex, and close attention to detail in various areas of anesthetic and perioperative management is crucial to improve postoperative outcomes. Patients undergoing esophagectomy should be offered an evidence-based risk assessment for their postoperative outcomes to allow active participation and informed, shared-decision making. ⋯ Furthermore, anesthetic practice and perioperative anesthetic drug usage can potentially affect cancer progression and recurrence. This chapter reviews current evidence for various factors that contribute to the improvement of perioperative outcomes, including prehabilitation, preoperative optimization of anemia, thoracic epidural analgesia, intraoperative protective ventilatory strategies, goal-directed fluid therapy, as well as special attention to other perioperative issues that potentially reduce anastomotic and cardiopulmonary complications. In summary, it is difficult to show a measurable benefit from any one single intervention, and a multidisciplinary approach that encompasses multiple aspects of perioperative care is necessary to improve outcomes after esophagectomy.
-
Circulating tumor cells (CTC) harvested in the blood of patients with esophageal squamous cell carcinoma (ESCC) are associated with certain clinical pathological parameters as well as patients' prognosis and response to chemoradiation. They are the source of distant metastases and their mechanisms of pathogenesis is complex. ⋯ The most commonly used is detection by immunomagnetic method. Although all these methods have limitations, they are helpful for understanding the pathogenesis of CTCs with potential applications in clinical managements in patients with ESCC.
-
The simple applicability and facile target programming of the CRISPR/Cas9-system abolish the major boundaries of previous genome editing tools, making it the tool of choice for generating site-specific genome alterations. Its versatility and efficacy have been demonstrated in various organisms; however, accurately predicting guide RNA efficiencies remains an organism-independent challenge. Thus, designing optimal guide RNAs is essential to maximize the experimental outcome. Here, we summarize the current knowledge for guide RNA design and highlight discrepancies between different experimental systems.
-
Surgery is the mainstay treatment for esophageal squamous cell carcinoma (ESCC). A major development in surgical therapy for esophageal cancer in the past two or three decades has been the marked reduction in surgical mortality rates as a result of improvement in staging technologies, patient selection, perioperative support systems, and surgical experience. Minimally invasive techniques are also becoming widely adopted. Protocol for surgical management of squamous cell cancer of the esophagus is described herein.