Development and validation of a model to determine the risk of esophageal strictures after endoscopic submucosal dissection for esophageal neoplasms

Xia, Si-Yuan; Lü, Qing; Wang, Zijing; Gan, Tao; Yang, Jin-Lin; Wang, Zhu

doi:10.1007/s00464-022-09729-2

Cited by 2 publications

(4 citation statements)

References 20 publications

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“…Nowadays, more and more studies focused on the risk factors of esophageal stricture after ESD and the conditions of patients, lesions and surgery all influence the incidence of stricture [5,14,15]. Moreover, as the extensive use of narrow-band imaging, our knowledge of lesions’ endoscopic manifestations has become much more profound.…”

Section: Discussionmentioning

confidence: 99%

“…We believe that the estimation of esophageal stricture after ESD would be very helpful for guiding precautionary medical intervention in the clinical setting, which may decrease the incidence of stricture. Nowadays, more and more studies focused on the risk factors of esophageal stricture after ESD and the conditions of patients, lesions and surgery all influence the incidence of stricture [5,14,15]. Moreover, as the extensive use of narrow-band imaging, our knowledge of lesions' endoscopic manifestations has become much more profound.…”

Section: Discussionmentioning

confidence: 99%

“…So far, researches have focused on identifying the risk factors of esophageal stricture after ESD, and several highrisk factors have been recognized including circumferential extension, histological depth, and longitudinal resection length [5][6][7]. However, there is only two clinical prediction model for postoperative esophageal stricture thus far, and they did not take longitudinal resection length into account and only based on data from a single center [8]. In addition, it only divided patients into three groups, rather than provide the probability for every patient.…”

Section: Introductionmentioning

confidence: 99%

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A novel risk score model of esophageal stricture for patients undergoing endoscopic submucosal dissection

Yan,

Yang,

Gao

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Background and purpose Endoscopic submucosal dissection (ESD) is a promising technique for superficial esophageal lesions. However, stricture is a frequent adverse complication. This study was performed to develop a precise and convenient score prediction model for esophageal strictures after ESD, and compare its efficacy with a previously published predictive model. Methods This study enrolled clinical data of patients who underwent esophageal ESD for superficial esophageal lesions. Possible risk factors for esophageal stricture were identified by univariate and multivariate logistic regression analysis. Then we developed a prediction model according to the Framingham system for the first time and presented a convenient table containing the risk probability for each patient. In addition, we validated our score model and the previously published model in our center. Results A total of 838 patients were enrolled in this study and 6 variables, including age, surgery time, location of the lesion, circumference of the lesion, longitudinal resection length, and depth of infiltration were comprised in the score model. The total score ranged from 0 to 16 points and the risk probability was presented in one concise table for each patient. Areas under receiver-operator characteristic curves for the prediction model were 0.715 in derivation group and 0.804 in validation group. Conclusion We designed and validated a prediction score model for esophageal stricture after ESD, which can be applied conveniently to stratify the stricture risk after esophageal ESD and may facilitate appropriate clinical decision-making for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A novel risk score model of esophageal stricture for patients undergoing endoscopic submucosal dissection

Yan,

Yang,

Gao

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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“…The clinic treatments for esophageal strictures include physical dilatation through esophagoscopy together with local injections or/and oral therapy with glucocorticoid medicines like triamcinolone acetonide (TA) (Nagami et al , 2018; Kato et al , 2018; Oyama, 2015; Shibagaki et al , 2018). However, many patients are insensitive or ineffective to glucocorticoids due to individual differences (Horváth et al , 2023; Xia et al , 2023; Khlevner et al , 2023). Repeated physical expansion is not able to cure the stricture.…”

Section: Introductionmentioning

confidence: 99%

CSTA: A Biomarker Regulating Esophageal Stricture Epithelial Barrier, Potential Medication Target

Yang,

Hu,

Shi

et al. 2023

Preprint

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Esophageal strictures resulting from ESD/EMR in the esophagus are distressing, with uncertain causes and treatments due to epithelial barrier dysfunction. We explored cystatin A (CSTA) as a novel biomarker for the esophageal epithelial barrier. CSTA regulates the barrier and is influenced by tacrolimus (FK506). Analyzing biopsy samples by proteomics, we identified CSTA as an esophageal epithelial biomarker. Knocking down CSTA reduced responsiveness to triamcinolone acetonide (TA) and lowered expression of proteins related to cell-cell junctions and barrier function during inflammation. These findings suggest that down-regulate CSTA weakens tight junctions and the esophageal barrier, leading to strictures. Notably, FK506 showed promise in rescuing CSTA-knockdown cells by increasing the expression of proteins related to cell-cell junctions and barrier function. This highlights FK506 as a potential therapy for esophageal strictures in patients with CSTA mutations.

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Development and validation of a model to determine the risk of esophageal strictures after endoscopic submucosal dissection for esophageal neoplasms

Cited by 2 publications

References 20 publications

A novel risk score model of esophageal stricture for patients undergoing endoscopic submucosal dissection

A novel risk score model of esophageal stricture for patients undergoing endoscopic submucosal dissection

CSTA: A Biomarker Regulating Esophageal Stricture Epithelial Barrier, Potential Medication Target

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