| Background Upper digestive tract tumors mainly include esophageal cancer,cardiac cancer,gastric cancer and so on.In 2020,more than one-tenth of all cancer deaths are due to upper gastrointestinal tumors,which pose a significant threat to human health worldwide.Although there are many reports on the clinical features and prognosis of upper gastrointestinal cancer,the comparative analysis of esophageal cancer,cardiac cancer and gastric cancer among upper gastrointestinal cancer is still lacking.Objective At present,there is a lack of data to compare the clinical factors of esophageal cancer,cardiac cancer and gastric cancer in upper gastrointestinal cancer.The aim of this study was to elucidate the clinical data distribution of esophageal cancer,cardiac cancer and gastric cancer,and to compare the prognostic factors of esophageal cancer,cardiac cancer and gastric cancer,the similarities and differences between esophageal carcinoma,cardiac carcinoma and gastric carcinoma were elucidated.Methods Included in the population with a confirmed upper gastrointestinal tumor from 1January 2007 to 31 December 2017 at Xinxiang Medical University and Xinxiang Medical University.Demographic information,clinical pathology and other relevant variables were collected to describe the relevant factors in esophageal cancer,cardiac cancer and gastric cancer respectively,in addition,Univariate Cox survival analysis was performed for esophageal cancer,cardiac cancer and gastric cancer.Univariate Cox survival analysis included multivariate Cox survival analysis,in which the P value was less than 0.05,to explore the prognostic factors of esophageal cancer,cardiac cancer and gastric cancer.The survival time of esophageal carcinoma,cardiac carcinoma and gastric carcinoma were compared by K-M survival analysis.Results A total of 1883 patients were divided into 3 groups according to the tumor location: 1205 cases（64.0%）in esophageal cancer group,301 cases（16.0%）in cardiac cancer group and 377 cases（20.0%）in gastric cancer group.After describing the three groups of variables,the data of the three groups were compared,sex,age,history of digestive tract inflammation,lymph node metastasis,distant metastasis,stage,differentiation and treatment were different among the three groups.In esophageal cancer,Cox survival analysis indicated that age,history of digestive tract inflammation,lymph node metastasis,distant metastasis,tumor stage,tumor differentiation and treatment were independent prognostic factors.Cox survival analysis indicated that age,tumor stage and treatment were independent prognostic factors in cardiac cancer.Cox survival analysis in gastric cancer suggested that age,distant metastasis,tumor stage and treatment were independent prognostic factors.The median survival time of esophageal,cardiac and gastric cancer was 35.3,39.8 and41.9 months,respectively.The P value of log-rank test was 0.139.Conclusion Sex,age,history of digestive tract inflammation,lymph node metastasis,distant metastasis,stage,differentiation and treatment were different among the three groups.Univariate and multivariate Cox survival analysis suggested that the prognostic factors were not all the same in the three groups.Age,tumor stage and treatment are the independent prognostic factors of esophageal cancer,cardiac cancer and gastric cancer,and distant metastasis is the independent prognostic factor of esophageal cancer and gastric cancer,the history of digestive tract inflammation,lymph node metastasis and tumor differentiation were the independent prognostic factors.K-M survival analysis showed that there was no significant difference in survival time between esophageal,cardiac and gastric cancer.Background Mutant L Homologue 1（MLH1）is a DNA mismatch repair gene,it is also reported to be involved in ATM signaling for DNA damage repair.MLH1 is found frequently mutanted and methylated in colorectal and other cancers.While the methylation status of MLH1 is still vacant in large scale of esophageal cancer（EC）.Objective This study is to investigate the methylation status of MLH1 in large esophageal cancer samples and the association of MLH1 methylation and clinical factors for the application of “synthetic lethality” strategy.Methods DNA extraction and methylation-specific PCR（MSP）were performed in 589 cases of primary esophageal carcinoma and 5 cases of normal esophageal mucosa,to analyze the methylation status of MLH1 gene in esophageal carcinoma.The clinical and pathological data of 589 patients with esophageal carcinoma were included,and the methylation status of MLH1 in esophageal carcinoma tissues was statistically analyzed,the association of 15 variables,including methylation status of MLH1 gene,with clinical prognosis was analyzed.Results MLH1 is methylated in 3.57%（21/589）of esophageal cancer.The methylation status of MLH1 gene was associated to gender and smoking.No association was found between MLH1 methylation and survival.The multivariate Cox analysis showed that age≥60 years,tumor size≥5cm,lymph node metastasis are independent risk factors of poor prognosis in esophageal cancer patients.Conclusion MLH1 is methylated in 3.57%（21/589）of esophageal cancer.The methylation status of MLH1 gene was associated to gender and smoking.The multivariate Cox analysis showed that age≥60 years,tumor size≥5cm,lymph node metastasis are independent risk factors of poor prognosis in esophageal cancer patients. |
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