Breast cancer(BC)remains the most frequently diagnosed malignancy worldwide,with an estimated 2.3 million new cases and approximately 685,000 deaths reported in 2020.Forecasts suggest a substantial rise in global inci...Breast cancer(BC)remains the most frequently diagnosed malignancy worldwide,with an estimated 2.3 million new cases and approximately 685,000 deaths reported in 2020.Forecasts suggest a substantial rise in global incidence,with new annual cases projected to reach 3.2 million by 2050,representing a 39%increase.Additionally,BC is expected to account for approximately 7.7%of the anticipated$25.2 trillion global economic burden associated with cancer by 2050.These trends underscore an urgent need for affordable,widely accessible and effective therapeutic strategies,particularly in low-and middle-income countries.Statins,commonly prescribed for the treatment of hypercholesterolaemia via inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A(HMG-CoA)reductase,have garnered increasing interest for their potential anticancer properties.This review focuses on the mechanistic underpinnings and therapeutic implications of statin use,particularly simvastatin,in the context of BC.Statins exert their primary effect through inhibition of the mevalonate pathway,which is crucial for cholesterol and isoprenoid biosynthesis.Disruption of this pathway impairs the prenylation of key signalling proteins,including members of the Ras and Rho GTPase families,which are essential for cancer cell proliferation,survival and metastasis.Preclinical evidence has demonstrated that simvastatin can induce tumour cell apoptosis,arrest cell-cycle progression and inhibit oncogenic signalling pathways.These effects have been particularly pronounced in hormone receptor-negative and triple-negative breast cancer(TNBC)subtypes,which are often associated with poor prognosis and limited treatment options.Epidemiological and observational studies further support a potential association between statin use and reduced BC recurrence and mortality.Nevertheless,robust evidence from randomised controlled trials remains limited,and further investigation is required to establish causality and define optimal therapeutic regimens.Given their well-established safety profile,global accessibility and pleiotropic effects,statins,especially simvastatin,represent a promising class of repurposed drugs in the adjuvant treatment of BC.This review synthesises evidence from the past two decades,highlighting the need for continued clinical research to validate and optimise the use of statins as adjunctive agents in BC therapy.展开更多
The convergence of artificial intelligence(AI)and big data is reshaping contemporary oncology by enabling the integration of multimodal information across imaging,pathology,genomics,and clinical records.From a physici...The convergence of artificial intelligence(AI)and big data is reshaping contemporary oncology by enabling the integration of multimodal information across imaging,pathology,genomics,and clinical records.From a physician-centered perspective,these technologies can potentially be used to improve diagnostic precision,support individualized treatment planning,enhance longitudinal patient management,and accelerate both clinical and translational research.In this review,we synthesize the core AI methodologies most relevant to oncology-machine learning,deep learning,and large language models-and examine how they interact with established and emerging oncology data platforms.We further highlight practical use cases in clinical workflows and research pipelines,emphasizing opportunities for advancing precision cancer care while also addressing challenges associated with data heterogeneity,model generalizability,privacy protection,and real-world implementation.By underscoring the synergistic value of AI and big data,this review aims to inform the development of clinically meaningful,context-adapted strategies that promote translational innovation in both global and locally resourced healthcare environments.展开更多
Background:Gastric cancer(GC)continues to pose a significant global health challenge due to its high rates of incidence and mortality,with the majority of cases identified at advanced stages.Immunotherapy,particularly...Background:Gastric cancer(GC)continues to pose a significant global health challenge due to its high rates of incidence and mortality,with the majority of cases identified at advanced stages.Immunotherapy,particularly immune checkpoint blockades(ICBs),has demonstrated considerable therapeutic potential;however,many patients do not exhibit a favorable response.As a result,constructing a predictive model to assess ICBs'responsiveness is essential for enhancing treatment outcomes.Methods:Using consensus clustering based on anoikis-related gene expression,GC patients were stratified into two subclusters.Differences in tumor immune microenvironment,ICB resistance,genomic alterations,methylation profiles,and transcriptional networks were analyzed.A machine learning-based strategy was employed to develop a consensus anoikis-related gene signature(ARGS).Potential therapeutic targets were identified through single-cell RNA sequencing(scRNA-seq),and validation was conducted using multiplex immunofluorescence and immunohistochemistry in an in-house cohort(n=28),including 14 ICB responders and 14 nonresponders.Results:The anoikis-resistant cluster(Cluster A)was associated with poorer survival,immunosuppressive infiltration,lower tumor mutation burden,and ICB resistance.ScRNA-seq revealed high fibroblast and endothelial infiltration,with GLI3+cancer-associated fibroblasts suggesting Hedgehog pathway involvement.The ARGS model effectively stratified patients,with elevated scores associ-ated with immunotherapy resistance,enhanced AR characteristics,and poorer clinical outcomes.展开更多
Background:Sclerosing adenosis(SA)and breast cancer(BC)often exhibit overlapping clinical,imaging,and pathological characteristics,making them difficult to differentiate.SA may also coexist with BC(SA+BC),including du...Background:Sclerosing adenosis(SA)and breast cancer(BC)often exhibit overlapping clinical,imaging,and pathological characteristics,making them difficult to differentiate.SA may also coexist with BC(SA+BC),including ductal carcinoma in situ(SA-DCIS)and invasive breast cancer(SA-IBC),which complicates diagnosis even when core-needle biopsy(CNB)suggests SA.This study aimed to develop interpretable AI-based binary and ternary classification models that leverage clinical and imaging features to distinguish SA-only from SA+BC and to further differentiate among SA-only,SA-DCIS,and SA-IBC.Methods:We retrospectively analyzed a cohort of 726 patients with SA(January 2006 to December 2021),comprising 537 SA-only and 189 SA+BC cases(90 SA-DCIS,99 SA-IBC).Multiple machine learning algorithms-logistic regression,support vector machine,decision tree,XGBoost,and random forest-were compared using AUC,accuracy,F1-score,and C-index.Model interpretability was assessed with SHAP to elucidate feature contributions and identify key predictors.Additionally,we incorporated an independent external validation cohort consisting of 113 patients to verify the model's effectiveness.展开更多
Background:Immune-mediated inflammatory disease(IMID)and cancer share underlying mechanisms.We aimed to comprehensively evaluate the associations between IMIDs and cancers from global,population and genetic perspectiv...Background:Immune-mediated inflammatory disease(IMID)and cancer share underlying mechanisms.We aimed to comprehensively evaluate the associations between IMIDs and cancers from global,population and genetic perspectives.Methods:A triangulation framework was employed to assess the association between IMIDs and cancers,using the Global Burden of Disease Study(2012-2021)to analyse six IMIDs and 33 cancers.The UK Biobank(UKBB)prospective cohort was subsequently used to validate these associations,with hazard ratios(HRs)and 95%confidence intervals(CIs)estimated by Cox proportional hazards models.Causal inference based on genetic instruments was performed in the FinnGen and UKBB to assess the potential causal effects between IMIDs and cancers.Results:IMIDs were positively associated with the occurrence of cancers from a global perspective.Moreover,170 specific IMID-cancer pairs revealed statistically significant associations.A total of 20 pairs of specific IMID-cancer associations were further confirmed in the UKBB cohort.Among these,the five most pronounced associations included atopic dermatitis with Hodgkin lymphoma(HR=12.56,95%CI:1.76-89.59),with ovarian cancer(HR=5.65,95%CI:1.41-22.65)and with non-Hodgkin lymphoma(HR=5.11,95%CI:1.91-13.63);rheumatoid arthritis with Hodgkin lymphoma(HR=3.85,95%CI:1.11-13.32);and psoriasis with Hodgkin lymphoma(HR=3.43,95%CI:1.69-6.96).Additionally,a positive causal association between rheumatoid arthritis and Hodgkin lymphoma(inverse variance weighted OR=1.31,95%CI:1.10-1.57)was observed.Conclusions:This study provides comprehensive evidence of the relationships between IMIDs and cancers from global,population and genetic perspectives and identifies 20 pairs of specific IMID-cancer associations,thereby contributing to advancements in cancer prevention and control.展开更多
In recent years,multidisciplinary treatment strategies have profoundly improved drug responses and survival outcomes of breast cancer(BC)patients.However,there is an urgent need for novel therapies for BC patients who...In recent years,multidisciplinary treatment strategies have profoundly improved drug responses and survival outcomes of breast cancer(BC)patients.However,there is an urgent need for novel therapies for BC patients who are heavily treated or develop resistance to conventional treatment regimens.Radionuclide therapy(RT)and targeted radionuclide therapy(TRT)have emerged as paradigm-shifting therapeutic approaches for BC,which enable functions of both imaging and localised treatment.They utilise radionuclides that can selectively bind to biomarkers overexpressing on BC cells,allowing precise delivery and localised tumour irradiation.Moreover,several types of radionuclides possess‘cross-fire’effects that result in the eradication of neighbouring tumour cells lacking the biomarker expression.In the current review,we summarise the potential biomarkers for the development of RT and TRT that can be employed in the treatment of BC,including receptor markers of ER,PR and HER2,together with other markers of Trop2,PD-1,EGFR,GRPR and PSMA.展开更多
Background:The phosphoinositide 3-kinase(PI3K)/protein kinase B(PKB or AKT)/mammalian target of rapamycin(mTOR)signaling pathway(PAM pathway)plays a critical role in breast cancer pathogenesis and progression,and is c...Background:The phosphoinositide 3-kinase(PI3K)/protein kinase B(PKB or AKT)/mammalian target of rapamycin(mTOR)signaling pathway(PAM pathway)plays a critical role in breast cancer pathogenesis and progression,and is closely linked with resistance to endocrine therapy in advanced breast cancer.Randomized clinical trials have shown that PI3K/AKT/mTOR inhibitors deliver significant clinical benefits,particularly for patients with advanced hormone receptor(HR)-positive,human epidermal growth factor receptor 2(HER2)-negative breast cancer.Methods:In 2022,the Breast Cancer Expert Committee of the National Cancer Quality Control Center convened specialists in related fields to draft the“Expert Consensus on the Clinical Application of PI3K/AKT/mTOR Inhibitors in the Treatment of Advanced Breast Cancer.”This consensus raised awareness of these inhibitors among oncologists in China and improved the precision of clinical decision-making.In recent years,growing evidence has emphasized the importance of targeting the PAM pathway,reflected in the approval of several innovative agents.This consensus is an updated 2025 edition that retains the foundational structure of the 2022 edition while incorporating notable updates.Results:Updates to the consensus include the introduction of newly approved PAM pathway inhibitors,updated data from recent clinical trials,and expanded therapeutic applications.The revised guidance also offers updated recommendations for genetic testing to detect alterations in relevant pathways.The section on managing drug-related adverse events has been significantly expanded,providing detailed insights into different types of adverse events and their management.These updates aim to enhance the clinical application of PAM pathway inhibitors,promote precision medicine,and ultimately,improve survival outcomes for patients with breast cancer.展开更多
Background:Ovarian cancer patients with elevated serum CA125 levels after operation have a high incidence of relapse or metastasis.^(18)F-FDG PET/CT is an effective imaging method for identifying recurrent or metastat...Background:Ovarian cancer patients with elevated serum CA125 levels after operation have a high incidence of relapse or metastasis.^(18)F-FDG PET/CT is an effective imaging method for identifying recurrent or metastatic lesions.This study systematically investigated the diagnostic value of^(18)F-FDG PET/CT in this patient population.Methods:A systematic search of PubMed,Embase,Cochrane Library(Central),Web of Science(SCI-Expanded),and Chinese databases(CNKI,VIP database,Wan Fang Data,CBM)was performed.Studies that evaluated the diagnostic value of^(18)F-FDG PET/CT for relapse or dissemination in postoperative ovarian cancer patients with elevated serum CA125 levels were included.The methodological quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 tool.Data were analyzed for heterogeneity using Meta-Disc 1.4 software.Sensitivity analysis and release bias evaluation were conducted using STATA 14.0 software.Thirteen studies(including 421 female patients)qualified for the meta-analysis.The pooled sensitivity and specificity of 18 F-FDG PET/CT were 0.94(95%CI:0.91-0.97)and 0.83(95%CI:0.71-0.91),respectively.The pooled positive likelihood proportion was 4.59(95%CI:2.81-7.51),the pooled negative likelihood proportion was 0.09(95%CI:0.05-0.15),and the pooled diagnostic odds ratio was 64.22(95%CI:27.21-151.57).The area under the curve was 0.9379.A sensitivity analysis and publication bias test indicated that the outcomes were steady,and there was no reporting bias.Conclusions:^(18)F-FDG PET/CT has high diagnostic veracity for identifying recurrence or metastasis in ovarian cancer cases with increased serum CA125 levels after surgery.It can accurately detect recurrent or metastatic lesions,providing valuable information for clinical decision-making.展开更多
Background:The predictive value of the neutrophil-to-lymphocyte ratio(NLR)for immune checkpoint inhibitors(ICIs)in various tumors remains uncertain despite its use in forecasting the effectiveness of immunotherapy.The...Background:The predictive value of the neutrophil-to-lymphocyte ratio(NLR)for immune checkpoint inhibitors(ICIs)in various tumors remains uncertain despite its use in forecasting the effectiveness of immunotherapy.The purpose of our research was to determine the prognostic significance of NLR for immune checkpoint inhibitor-related myocarditis in non-small-cell lung cancer(NSCLC)patients.Methods:We enrolled and monitored patients with NSCLC who received ICI therapy at the Fifth Medical Center of Chinese PLA General Hospital between January 1,2018,and February 20,2021.NLR was determined before and soon after each cycle of ICIs.All participants in this study were periodically examined for troponin and brain natriuretic peptide(BNP),and an electrocardiogram(ECG)and echocardiography were done.Cox's proportional hazards regression model and receiver operating characteristic(ROC)were used to assess the predictive value for ICI-related myocarditis.Results:A total of 146 patients received ICI treatment and completed a follow-up.Of these,17 patients(11.64%)developed ICIrelated myocarditis that met the diagnostic criteria.The initial cycle revealed that the NLR was a reliable predictor of potential myocarditis related to ICIs,with an area under the curve(AUC)of 0.833 and a 95% confidence interval(CI)of 0.721-0.945.Following the initial round of ICI treatment,an NLR elevation(NLR≥3.25)appeared to be the most significant standalone indicator of ICI-related myocarditis(HR:11.094;95%CI:3.186-38.631;p<0.001).Conclusions:Our study confirmed that NLR elevation in the early phase after ICI treatment of NSCLC is a reliable predictive factor of ICI-related myocarditis.Regular and frequent cardiac monitoring may help to avoid the occurrence of severe and fatal cases.展开更多
Background:Treatment of osteosarcoma in children remains difficult.The combination of chemotherapy and surgery is the classic treatment for osteosarcoma.With the development of medicine,chemotherapy has also improved ...Background:Treatment of osteosarcoma in children remains difficult.The combination of chemotherapy and surgery is the classic treatment for osteosarcoma.With the development of medicine,chemotherapy has also improved greatly.This study aimed to explore the short-term efficacy and safety of neoadjuvant chemotherapy(NAC)with a protocol of pegylated liposomal doxorubicin(PLD),high-dose methotrexate,and ifosfamide(PLDMI)in pediatric patients with osteosarcoma.Methods:Between May 1,2018 and May 1,2021,25 pediatric patients with osteosarcoma were included in this retrospective,observational study.All patients received PLDMI including PLD,high-dose methotrexate,and ifosfamide,followed by surgery and postoperative chemotherapy.Tumor parameters at the time of preoperative chemotherapy were evaluated by the investigator using MRI,and the response to preoperative chemotherapy was scored according to the Huvos grading system.Shortterm survival was analyzed by a Cox proportional hazard model.Safety was assessed as adverse events(AEs)by the Common Terminology Criteria for AEs version 5.0.Results:MRI showed that preoperative chemotherapy significantly decreased the coronal tumor width,sagittal anteroposterior diameter,and tumor volume(all p<0.05),while no significant change was found in tumor length(p>0.05).More than 90% of tumor necrosis was achieved in 13(61.9%,13/21)patients.The 2-year overall survival and disease-free survival rates were 92% and 76%,respectively.Cox regression analysis identified pathological type and imaging at the time of completion of treatment as independent prognostic factors for children with osteosarcoma.Grade 3-4 AEs included febrile neutropenia(25/25,100%),secondary anemia(18/25,72%),secondary thrombocytopenia(20/25,80%),and mucositis with local infection(3/25,12%),which were resolved with symptomatic treatment.Conclusions:PLDMI was an effective protocol for children with osteosarcoma and could effectively reduce the tumor burden in the primary site and augment surgical treatment,although with a high incidence of AEs.展开更多
Background: Although there have been significant advancements in the treatment modalities for gastric cancer (GC) inrecent years, the overall prognosis remains poor, particularly for individuals in advanced stages. Th...Background: Although there have been significant advancements in the treatment modalities for gastric cancer (GC) inrecent years, the overall prognosis remains poor, particularly for individuals in advanced stages. The absence of a sensitivetumor marker in GC is a crucial factor contributing to this challenge.Methods: Our study focused on investigating a newly discovered long noncoding RNA (lncRNA) known as TCONS_00251376,which has been confirmed to exhibit differential expression in GC compared to adjacent tissues. To further validate theseexpression differences, we collected 22 pairs of GC and adjacent noncancerous tissues. Subsequent cell function experimentsand animal studies were conducted to elucidate the role and underlying mechanisms of lncRNA TCONS_00251376 in thedevelopment of GC.Results: The study revealed a significant upregulation of lncRNA TCONS_00251376 in cancer tissues (p < 0.01) and a consistent upregulation in GC cell lines (AGS, MKN45, BGC-823, and MGC-803). Furthermore, it was observed that lncRNATCONS_00251376 played a promotive role in the proliferation, migration, and invasion of GC cells. Subsequent analysisindicated that lncRNA TCONS_00251376 could upregulate the expression of ETV1, a factor associated with the prognosis of GC.Conclusions: Therefore, our findings suggest that lncRNA TCONS_00251376 functions as an oncogenic lncRNA, promotingtumorigenesis and progression by regulating the expression of ETV1 gene. This highlights its potential as an effective target fortreating GC.展开更多
1|Introduction.Cancer remains a predominant cause of morbidity and mortality in contemporary society globally.Whilst therapeutic advancements such as chemotherapy,radiotherapy,immunotherapy,have substantially improved...1|Introduction.Cancer remains a predominant cause of morbidity and mortality in contemporary society globally.Whilst therapeutic advancements such as chemotherapy,radiotherapy,immunotherapy,have substantially improved survival outcomes in cancer patients,these interventions are frequently associated with cardiotoxic effects[1-3].Notably,the incidence of cardiotoxicity among cancer patients exhibits substantial heterogeneity across studies,with documented rates between 3.8% and 37.5%[4].展开更多
Background:Conducting a systematic review(SR)is a time-intensive process and represents the first phase in developing a clinical practice guideline(CPG).Completing a CPG through the Program in Evidence-Based Care(PEBC...Background:Conducting a systematic review(SR)is a time-intensive process and represents the first phase in developing a clinical practice guideline(CPG).Completing a CPG through the Program in Evidence-Based Care(PEBC),a globally acknowledged guideline program supported by Ontario Health(Cancer Care Ontario),typically takes about 2 years.Thus,expediting an SR can significantly reduce the overall time required to complete a CPG.Our recently published review identified two artificial intelligence(AI)tools,DistillerSR and EPPI-Reviewer that reduced time in the title and abstract screening in an SR process when developing a CPG.However,the consistency and generalizability of these tools remain unclear within or across different SRs related to cancer.This study protocol aims to evaluate and compare the performance of DistillerSR and EPPI-Reviewer against human reviewers for title and abstract screening(Stage I screening)in cancer CPG development.Methods:We will conduct a retrospective simulation study to evaluate and compare the performance of DistillerSR and EPPI-Reviewer across 10 previously published CPGs by PEBC.These CPGs include the five cancer types with the highest incidence(lung,breast,prostate,colorectal,and bladder).We will run 30 simulation trials for one CPG per AI tool.Primary outcomes are workload savings and time savings in Stage I screening.The secondary outcome is the percentage of missing articles among the final included articles.This informs the accuracy and comprehensiveness of the AI tools.Descriptive and inferential statistical analysis will be conducted to evaluate the outcomes.Results:This is a study protocol.The data presented in the tables are illustrative examples rather than actual study results,in accordance with the journal’s standard structure.All data included in the final study will be thoroughly validated.Discussion:This will be the first study to investigate and compare the performance of DistillerSR and EPPI-Reviewer in Stage I screening of SRs in CPGs across different cancer types.These findings will inform the reliable use of AI tools in future cancer-related CPGs.The results from this retrospective study will need to be confirmed by prospective studies.展开更多
Breast cancer is one of the most common malignant tumors among women in China,with approximately 306,000 new cases reported in 2016.Notably,around 33%(100,400)of these cases occurred in rural areas.County-level hospit...Breast cancer is one of the most common malignant tumors among women in China,with approximately 306,000 new cases reported in 2016.Notably,around 33%(100,400)of these cases occurred in rural areas.County-level hospitals,encompassing counties and county-level cities,serve as the primary diagnostic units for the majority of rural breast cancer patients.These hospitals are integral to cancer prevention,screening,maintenance treatment,rehabilitation,follow-up,and referral processes.However,economic and geographical constraints result in county-level hospitals being relatively deficient in medical equipment,health human resources,and drug accessibility.Consequently,there is a critical need for breast cancer prevention and management guidelines that are tailored to the specific conditions of China's counties.In response to this need,and within the policy framework of hierarchical diagnosis and treatment,a Chinese expert group has developed the Guideline for the Management Pathway and Quality Control of Breast Cancer Prevention and Treatment in China's Counties(2023 Edition).This guideline aims to expand the availability of quality medical resources,ensure better distribution of these resources across regions,and enhance the capacity for breast cancer prevention and treatment.Ultimately,the goal is to improve the prognosis and quality of life for breast cancer patients in China's counties.This guideline includes clear and concise path diagrams that are easy to implement in clinical practice,serving as a valuable reference for clinicians in countylevel hospitals.展开更多
1|The Evolution of Lung Cancer Screening Despite the paradigm shift in treatment modalities driven by immunology,mortality from lung cancer remains the highest of all cancers[1],rendering it an unrelenting and formida...1|The Evolution of Lung Cancer Screening Despite the paradigm shift in treatment modalities driven by immunology,mortality from lung cancer remains the highest of all cancers[1],rendering it an unrelenting and formidable public health threat.Fortunately,coordinated global efforts have been made,both in the United States and internationally to reduce lung cancer mortality via primary and secondary screening measures,that is,smoking cessation and population screening[2].展开更多
Background: The incidence of alcohol-associated cancers is higher within Asian populations having an increased prevalence ofan inactivating mutation in aldehyde dehydrogenase 2 (ALDH2), a mitochondrial enzyme required...Background: The incidence of alcohol-associated cancers is higher within Asian populations having an increased prevalence ofan inactivating mutation in aldehyde dehydrogenase 2 (ALDH2), a mitochondrial enzyme required for the clearance of acetaldehyde, a cytotoxic metabolite of ethanol. The role of alcohol consumption in promoting lung cancer is controversial, andlittle attention has been paid to the association between alcohol drinking and pulmonary ALDH2 expression.Methods: We performed a comprehensive bioinformatic analysis of multi-omics data available in public databases to elucidatethe role of ALDH2 in lung adenocarcinoma (LUAD).Results: Transcriptional and proteomic data indicate a substantial pulmonary expression of ALDH2, which is functional for themetabolism of alcohol diffused from the bronchial circulation. ALDH2 expression is higher in healthy lung tissue than in LUADand inhibits cell cycle, apoptosis, and epithelial–mesenchymal transition pathways. Moreover, low ALDH2 mRNA levels predictpoor prognosis and low overall survival in LUAD patients. Interestingly, ALDH2 expression correlates with immune infiltrationin LUAD.Conclusions: A better understanding of the role of ALDH2 in lung tumor progression and immune infiltration might supportits potential use as a prognostic marker and therapeutic target for improving immunotherapeutic response.展开更多
The paper“Challenges in Immune System:Mesoscale and mesoregime complexity”by Ren et al.[1]represents more than an important advance in immunology;it offers a growing recognition of mesoscience as a unifying scientif...The paper“Challenges in Immune System:Mesoscale and mesoregime complexity”by Ren et al.[1]represents more than an important advance in immunology;it offers a growing recognition of mesoscience as a unifying scientific framework for understanding complexity.展开更多
Background:Breast cancer(BC)remains a significant global public health challenge,and its incidence and mortality rates among adolescents and young adults(AYAs)aged 15-39 years are increasing.Compared with older adults...Background:Breast cancer(BC)remains a significant global public health challenge,and its incidence and mortality rates among adolescents and young adults(AYAs)aged 15-39 years are increasing.Compared with older adults,AYAs often face poorer prognoses and a higher disease burden.Understanding the trends and determinants of BC burden in AYAs is crucial for guiding preventive measures,early detection programs,and treatment strategies.The aim of this study is to systematically investigate the trends and distribution of the BC burden among AYAs aged 15-39 years across regions and countries and identify the contributing risk factors and disparities in incidence,mortality,and disability-adjusted life years(DALYs).Methods:Data on BC were collected from the Global Burden of Disease(GBD)2021 database.The number of cases,age-standardized rates,mortality,and DALYs for BC were assessed for 204 countries and territories from 1990 to 2021.Joinpoint regression analysis was used to calculate the average annual percentage changes(AAPCs)in incidence,mortality,and DALYs.Risk factors that contribute to the BC burden were also evaluated.Results:According to GBD 2021 estimates,180,791 new BC cases and 42,055 related deaths were observed among AYAs globally.Between 1990 and 2021,the global incidence rate increased by 33.4%,with the highest incidence observed in regions with a high sociodemographic index(SDI)and the highest mortality rates in low-SDI regions.Incidence rates in women showed a significant upward trend(AAPC,3.03)and peaked in North Africa and the Middle East,whereas the most rapid increase in incidence in men was noted in East Asia(AAPC,4.87).Projections indicated a decline in age-standardized incidence rates across most European countries by 2050,in contrast to rising trends in Asia and Africa.Risk factor analysis identified dietary risks(10.5%),tobacco smoking(2%),and high fasting plasma glucose(1.6%)as major contributors to DALYs.展开更多
Tryptophan(Trp)is an essential amino acid that serves as a precursor for the synthesis of several important bioactive compounds.Trp is involved in a variety of pathophysiological processes,including neuronal function,...Tryptophan(Trp)is an essential amino acid that serves as a precursor for the synthesis of several important bioactive compounds.Trp is involved in a variety of pathophysiological processes,including neuronal function,metabolism,inflammatory responses,oxidative stress,immune regulation,and intestinal homeostasis.The role of Trp metabolism in tumorigenesis and cancer progression is of particular significance.The influence of Trp and its metabolites on tumor growth and metastasis is mediated through various mechanisms,such as immune evasion,promotion of angiogenesis,and increased resistance to therapeutic agents.This review presents the physiological pathways involved in Trp metabolism and its implications for various malignancies.We also highlight the latest clinical research targeting Trp metabolic pathways in oncology,in addition to exploring future directions for therapeutic advancements aimed at modulating Trp metabolism to enhance cancer treatment outcomes.展开更多
Gastrointestinal stromal tumors(GISTs),the most prevalent mesenchymal neoplasms of the gastrointestinal tract,frequently metastasize to the liver.Despite this clinical reality,there is a lack of standardized therapeut...Gastrointestinal stromal tumors(GISTs),the most prevalent mesenchymal neoplasms of the gastrointestinal tract,frequently metastasize to the liver.Despite this clinical reality,there is a lack of standardized therapeutic protocols for GIST liver metastases(GISTLM).Here we present the first case of a GISTLM patient treated with Yttrium‐90(Y90)resin microsphere selective internal radiation therapy(SIRT)in China.We further reviewed the current challenges in GISTLM management and highlighted the emerging role of SIRT.By integrating case‐specific insights with broader therapeutic paradigms,we aim to develop safe and effective individualized treatment strategies for GIST patients.展开更多
基金supported by Rural Health Research Institute,Charles Sturt University.
文摘Breast cancer(BC)remains the most frequently diagnosed malignancy worldwide,with an estimated 2.3 million new cases and approximately 685,000 deaths reported in 2020.Forecasts suggest a substantial rise in global incidence,with new annual cases projected to reach 3.2 million by 2050,representing a 39%increase.Additionally,BC is expected to account for approximately 7.7%of the anticipated$25.2 trillion global economic burden associated with cancer by 2050.These trends underscore an urgent need for affordable,widely accessible and effective therapeutic strategies,particularly in low-and middle-income countries.Statins,commonly prescribed for the treatment of hypercholesterolaemia via inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A(HMG-CoA)reductase,have garnered increasing interest for their potential anticancer properties.This review focuses on the mechanistic underpinnings and therapeutic implications of statin use,particularly simvastatin,in the context of BC.Statins exert their primary effect through inhibition of the mevalonate pathway,which is crucial for cholesterol and isoprenoid biosynthesis.Disruption of this pathway impairs the prenylation of key signalling proteins,including members of the Ras and Rho GTPase families,which are essential for cancer cell proliferation,survival and metastasis.Preclinical evidence has demonstrated that simvastatin can induce tumour cell apoptosis,arrest cell-cycle progression and inhibit oncogenic signalling pathways.These effects have been particularly pronounced in hormone receptor-negative and triple-negative breast cancer(TNBC)subtypes,which are often associated with poor prognosis and limited treatment options.Epidemiological and observational studies further support a potential association between statin use and reduced BC recurrence and mortality.Nevertheless,robust evidence from randomised controlled trials remains limited,and further investigation is required to establish causality and define optimal therapeutic regimens.Given their well-established safety profile,global accessibility and pleiotropic effects,statins,especially simvastatin,represent a promising class of repurposed drugs in the adjuvant treatment of BC.This review synthesises evidence from the past two decades,highlighting the need for continued clinical research to validate and optimise the use of statins as adjunctive agents in BC therapy.
基金Hunan Provincial Natural Science Foundation of China,Grant/Award Numbers:2024JJ6289,2023JJ60464,2023JJ60334Changsha City Technology Program,Grant/Award Number:kq2403120+1 种基金Climb Plan of Hunan Cancer Hospital,Grant/Award Numbers:ZX2021005,QH2023006High-Level Talent Support Program of Hunan Cancer Hospital,Grant/Award Number:20250731-1050。
文摘The convergence of artificial intelligence(AI)and big data is reshaping contemporary oncology by enabling the integration of multimodal information across imaging,pathology,genomics,and clinical records.From a physician-centered perspective,these technologies can potentially be used to improve diagnostic precision,support individualized treatment planning,enhance longitudinal patient management,and accelerate both clinical and translational research.In this review,we synthesize the core AI methodologies most relevant to oncology-machine learning,deep learning,and large language models-and examine how they interact with established and emerging oncology data platforms.We further highlight practical use cases in clinical workflows and research pipelines,emphasizing opportunities for advancing precision cancer care while also addressing challenges associated with data heterogeneity,model generalizability,privacy protection,and real-world implementation.By underscoring the synergistic value of AI and big data,this review aims to inform the development of clinically meaningful,context-adapted strategies that promote translational innovation in both global and locally resourced healthcare environments.
基金National Science and Technology Major Project,Grant/Award Number:2024ZD0533300Excellent Doctor Program of Zhongnan Hospital of Wuhan University,Grant/Award Number:ZNYB2021009。
文摘Background:Gastric cancer(GC)continues to pose a significant global health challenge due to its high rates of incidence and mortality,with the majority of cases identified at advanced stages.Immunotherapy,particularly immune checkpoint blockades(ICBs),has demonstrated considerable therapeutic potential;however,many patients do not exhibit a favorable response.As a result,constructing a predictive model to assess ICBs'responsiveness is essential for enhancing treatment outcomes.Methods:Using consensus clustering based on anoikis-related gene expression,GC patients were stratified into two subclusters.Differences in tumor immune microenvironment,ICB resistance,genomic alterations,methylation profiles,and transcriptional networks were analyzed.A machine learning-based strategy was employed to develop a consensus anoikis-related gene signature(ARGS).Potential therapeutic targets were identified through single-cell RNA sequencing(scRNA-seq),and validation was conducted using multiplex immunofluorescence and immunohistochemistry in an in-house cohort(n=28),including 14 ICB responders and 14 nonresponders.Results:The anoikis-resistant cluster(Cluster A)was associated with poorer survival,immunosuppressive infiltration,lower tumor mutation burden,and ICB resistance.ScRNA-seq revealed high fibroblast and endothelial infiltration,with GLI3+cancer-associated fibroblasts suggesting Hedgehog pathway involvement.The ARGS model effectively stratified patients,with elevated scores associ-ated with immunotherapy resistance,enhanced AR characteristics,and poorer clinical outcomes.
基金National High Level Hospital Clinical Research Funding,Grant/Award Numbers:2025-PUMCH-A-147,2022-PUMCH-B-039Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFM),Grant/Award Number:2021-I2M-1-014。
文摘Background:Sclerosing adenosis(SA)and breast cancer(BC)often exhibit overlapping clinical,imaging,and pathological characteristics,making them difficult to differentiate.SA may also coexist with BC(SA+BC),including ductal carcinoma in situ(SA-DCIS)and invasive breast cancer(SA-IBC),which complicates diagnosis even when core-needle biopsy(CNB)suggests SA.This study aimed to develop interpretable AI-based binary and ternary classification models that leverage clinical and imaging features to distinguish SA-only from SA+BC and to further differentiate among SA-only,SA-DCIS,and SA-IBC.Methods:We retrospectively analyzed a cohort of 726 patients with SA(January 2006 to December 2021),comprising 537 SA-only and 189 SA+BC cases(90 SA-DCIS,99 SA-IBC).Multiple machine learning algorithms-logistic regression,support vector machine,decision tree,XGBoost,and random forest-were compared using AUC,accuracy,F1-score,and C-index.Model interpretability was assessed with SHAP to elucidate feature contributions and identify key predictors.Additionally,we incorporated an independent external validation cohort consisting of 113 patients to verify the model's effectiveness.
基金National Natural Science Foundation of China,Grant/Award Numbers:82404340,82273722,82373685,82204143CAMS Innovation Fund for Medical Science,Grant/Award Number:2021-I2M-1-067Open Research Fund Programme of Changzhou Institute for Advanced Study of Public Health,Nanjing Medical University,Grant/Award Number:CPHM202301。
文摘Background:Immune-mediated inflammatory disease(IMID)and cancer share underlying mechanisms.We aimed to comprehensively evaluate the associations between IMIDs and cancers from global,population and genetic perspectives.Methods:A triangulation framework was employed to assess the association between IMIDs and cancers,using the Global Burden of Disease Study(2012-2021)to analyse six IMIDs and 33 cancers.The UK Biobank(UKBB)prospective cohort was subsequently used to validate these associations,with hazard ratios(HRs)and 95%confidence intervals(CIs)estimated by Cox proportional hazards models.Causal inference based on genetic instruments was performed in the FinnGen and UKBB to assess the potential causal effects between IMIDs and cancers.Results:IMIDs were positively associated with the occurrence of cancers from a global perspective.Moreover,170 specific IMID-cancer pairs revealed statistically significant associations.A total of 20 pairs of specific IMID-cancer associations were further confirmed in the UKBB cohort.Among these,the five most pronounced associations included atopic dermatitis with Hodgkin lymphoma(HR=12.56,95%CI:1.76-89.59),with ovarian cancer(HR=5.65,95%CI:1.41-22.65)and with non-Hodgkin lymphoma(HR=5.11,95%CI:1.91-13.63);rheumatoid arthritis with Hodgkin lymphoma(HR=3.85,95%CI:1.11-13.32);and psoriasis with Hodgkin lymphoma(HR=3.43,95%CI:1.69-6.96).Additionally,a positive causal association between rheumatoid arthritis and Hodgkin lymphoma(inverse variance weighted OR=1.31,95%CI:1.10-1.57)was observed.Conclusions:This study provides comprehensive evidence of the relationships between IMIDs and cancers from global,population and genetic perspectives and identifies 20 pairs of specific IMID-cancer associations,thereby contributing to advancements in cancer prevention and control.
基金Noncommunicable Chronic Diseases-National Science and Technology Major Project,Grant/Award Number:2023ZD0502200National Natural Science Foundation of China,Grant/Award Number:82103010+2 种基金Cultivation Project of Medical Oncology Key Foundation of Cancer HospitalChinese Academy of Medical Sciences,Grant/Award Number:CICAMS-MOCP2022004Joint Innovative Fund of Beijing Natural Science Foundation and Changping District,Grant/Award Number:L234004。
文摘In recent years,multidisciplinary treatment strategies have profoundly improved drug responses and survival outcomes of breast cancer(BC)patients.However,there is an urgent need for novel therapies for BC patients who are heavily treated or develop resistance to conventional treatment regimens.Radionuclide therapy(RT)and targeted radionuclide therapy(TRT)have emerged as paradigm-shifting therapeutic approaches for BC,which enable functions of both imaging and localised treatment.They utilise radionuclides that can selectively bind to biomarkers overexpressing on BC cells,allowing precise delivery and localised tumour irradiation.Moreover,several types of radionuclides possess‘cross-fire’effects that result in the eradication of neighbouring tumour cells lacking the biomarker expression.In the current review,we summarise the potential biomarkers for the development of RT and TRT that can be employed in the treatment of BC,including receptor markers of ER,PR and HER2,together with other markers of Trop2,PD-1,EGFR,GRPR and PSMA.
基金the Major Collaborative Innovation Project,Medical and Health Science and Technology Innovation Initiative,Chinese Academy of Medical Sciences(Project No.2021‐I2M‐1‐014).
文摘Background:The phosphoinositide 3-kinase(PI3K)/protein kinase B(PKB or AKT)/mammalian target of rapamycin(mTOR)signaling pathway(PAM pathway)plays a critical role in breast cancer pathogenesis and progression,and is closely linked with resistance to endocrine therapy in advanced breast cancer.Randomized clinical trials have shown that PI3K/AKT/mTOR inhibitors deliver significant clinical benefits,particularly for patients with advanced hormone receptor(HR)-positive,human epidermal growth factor receptor 2(HER2)-negative breast cancer.Methods:In 2022,the Breast Cancer Expert Committee of the National Cancer Quality Control Center convened specialists in related fields to draft the“Expert Consensus on the Clinical Application of PI3K/AKT/mTOR Inhibitors in the Treatment of Advanced Breast Cancer.”This consensus raised awareness of these inhibitors among oncologists in China and improved the precision of clinical decision-making.In recent years,growing evidence has emphasized the importance of targeting the PAM pathway,reflected in the approval of several innovative agents.This consensus is an updated 2025 edition that retains the foundational structure of the 2022 edition while incorporating notable updates.Results:Updates to the consensus include the introduction of newly approved PAM pathway inhibitors,updated data from recent clinical trials,and expanded therapeutic applications.The revised guidance also offers updated recommendations for genetic testing to detect alterations in relevant pathways.The section on managing drug-related adverse events has been significantly expanded,providing detailed insights into different types of adverse events and their management.These updates aim to enhance the clinical application of PAM pathway inhibitors,promote precision medicine,and ultimately,improve survival outcomes for patients with breast cancer.
基金supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(grant no.2021-I2M-C&T-B-063)Collaborative Education Program between the Ministry of Education and Industry of China(grant no.230805236315631)National Key Research and Development Program of China(grant no.2020AAA0109500).
文摘Background:Ovarian cancer patients with elevated serum CA125 levels after operation have a high incidence of relapse or metastasis.^(18)F-FDG PET/CT is an effective imaging method for identifying recurrent or metastatic lesions.This study systematically investigated the diagnostic value of^(18)F-FDG PET/CT in this patient population.Methods:A systematic search of PubMed,Embase,Cochrane Library(Central),Web of Science(SCI-Expanded),and Chinese databases(CNKI,VIP database,Wan Fang Data,CBM)was performed.Studies that evaluated the diagnostic value of^(18)F-FDG PET/CT for relapse or dissemination in postoperative ovarian cancer patients with elevated serum CA125 levels were included.The methodological quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 tool.Data were analyzed for heterogeneity using Meta-Disc 1.4 software.Sensitivity analysis and release bias evaluation were conducted using STATA 14.0 software.Thirteen studies(including 421 female patients)qualified for the meta-analysis.The pooled sensitivity and specificity of 18 F-FDG PET/CT were 0.94(95%CI:0.91-0.97)and 0.83(95%CI:0.71-0.91),respectively.The pooled positive likelihood proportion was 4.59(95%CI:2.81-7.51),the pooled negative likelihood proportion was 0.09(95%CI:0.05-0.15),and the pooled diagnostic odds ratio was 64.22(95%CI:27.21-151.57).The area under the curve was 0.9379.A sensitivity analysis and publication bias test indicated that the outcomes were steady,and there was no reporting bias.Conclusions:^(18)F-FDG PET/CT has high diagnostic veracity for identifying recurrence or metastasis in ovarian cancer cases with increased serum CA125 levels after surgery.It can accurately detect recurrent or metastatic lesions,providing valuable information for clinical decision-making.
基金supported by the Young Talent Project of Chinese PLA General Hospital(20230433).
文摘Background:The predictive value of the neutrophil-to-lymphocyte ratio(NLR)for immune checkpoint inhibitors(ICIs)in various tumors remains uncertain despite its use in forecasting the effectiveness of immunotherapy.The purpose of our research was to determine the prognostic significance of NLR for immune checkpoint inhibitor-related myocarditis in non-small-cell lung cancer(NSCLC)patients.Methods:We enrolled and monitored patients with NSCLC who received ICI therapy at the Fifth Medical Center of Chinese PLA General Hospital between January 1,2018,and February 20,2021.NLR was determined before and soon after each cycle of ICIs.All participants in this study were periodically examined for troponin and brain natriuretic peptide(BNP),and an electrocardiogram(ECG)and echocardiography were done.Cox's proportional hazards regression model and receiver operating characteristic(ROC)were used to assess the predictive value for ICI-related myocarditis.Results:A total of 146 patients received ICI treatment and completed a follow-up.Of these,17 patients(11.64%)developed ICIrelated myocarditis that met the diagnostic criteria.The initial cycle revealed that the NLR was a reliable predictor of potential myocarditis related to ICIs,with an area under the curve(AUC)of 0.833 and a 95% confidence interval(CI)of 0.721-0.945.Following the initial round of ICI treatment,an NLR elevation(NLR≥3.25)appeared to be the most significant standalone indicator of ICI-related myocarditis(HR:11.094;95%CI:3.186-38.631;p<0.001).Conclusions:Our study confirmed that NLR elevation in the early phase after ICI treatment of NSCLC is a reliable predictive factor of ICI-related myocarditis.Regular and frequent cardiac monitoring may help to avoid the occurrence of severe and fatal cases.
基金Tianjin Applied Basic Research Multi-Input Foundation(Tianjin Natural Science Foundation)(Grant No.:21JCQNJC01360).
文摘Background:Treatment of osteosarcoma in children remains difficult.The combination of chemotherapy and surgery is the classic treatment for osteosarcoma.With the development of medicine,chemotherapy has also improved greatly.This study aimed to explore the short-term efficacy and safety of neoadjuvant chemotherapy(NAC)with a protocol of pegylated liposomal doxorubicin(PLD),high-dose methotrexate,and ifosfamide(PLDMI)in pediatric patients with osteosarcoma.Methods:Between May 1,2018 and May 1,2021,25 pediatric patients with osteosarcoma were included in this retrospective,observational study.All patients received PLDMI including PLD,high-dose methotrexate,and ifosfamide,followed by surgery and postoperative chemotherapy.Tumor parameters at the time of preoperative chemotherapy were evaluated by the investigator using MRI,and the response to preoperative chemotherapy was scored according to the Huvos grading system.Shortterm survival was analyzed by a Cox proportional hazard model.Safety was assessed as adverse events(AEs)by the Common Terminology Criteria for AEs version 5.0.Results:MRI showed that preoperative chemotherapy significantly decreased the coronal tumor width,sagittal anteroposterior diameter,and tumor volume(all p<0.05),while no significant change was found in tumor length(p>0.05).More than 90% of tumor necrosis was achieved in 13(61.9%,13/21)patients.The 2-year overall survival and disease-free survival rates were 92% and 76%,respectively.Cox regression analysis identified pathological type and imaging at the time of completion of treatment as independent prognostic factors for children with osteosarcoma.Grade 3-4 AEs included febrile neutropenia(25/25,100%),secondary anemia(18/25,72%),secondary thrombocytopenia(20/25,80%),and mucositis with local infection(3/25,12%),which were resolved with symptomatic treatment.Conclusions:PLDMI was an effective protocol for children with osteosarcoma and could effectively reduce the tumor burden in the primary site and augment surgical treatment,although with a high incidence of AEs.
基金Young and Middle-aged Scientific Research Project of Affiliated Hospital of Qinghai University(Grant:ASRF-2020-YB-01)Project of Basic Research for Application of Science and Technology Department of Qinghai Province(Grant:2019-ZJ-7003)。
文摘Background: Although there have been significant advancements in the treatment modalities for gastric cancer (GC) inrecent years, the overall prognosis remains poor, particularly for individuals in advanced stages. The absence of a sensitivetumor marker in GC is a crucial factor contributing to this challenge.Methods: Our study focused on investigating a newly discovered long noncoding RNA (lncRNA) known as TCONS_00251376,which has been confirmed to exhibit differential expression in GC compared to adjacent tissues. To further validate theseexpression differences, we collected 22 pairs of GC and adjacent noncancerous tissues. Subsequent cell function experimentsand animal studies were conducted to elucidate the role and underlying mechanisms of lncRNA TCONS_00251376 in thedevelopment of GC.Results: The study revealed a significant upregulation of lncRNA TCONS_00251376 in cancer tissues (p < 0.01) and a consistent upregulation in GC cell lines (AGS, MKN45, BGC-823, and MGC-803). Furthermore, it was observed that lncRNATCONS_00251376 played a promotive role in the proliferation, migration, and invasion of GC cells. Subsequent analysisindicated that lncRNA TCONS_00251376 could upregulate the expression of ETV1, a factor associated with the prognosis of GC.Conclusions: Therefore, our findings suggest that lncRNA TCONS_00251376 functions as an oncogenic lncRNA, promotingtumorigenesis and progression by regulating the expression of ETV1 gene. This highlights its potential as an effective target fortreating GC.
基金National Natural Science Foundation of China,Grant/Award Numbers:82170327,82370332Tianjin Key Medical Discipline Construction Project,Grant/Award Number:TJYXZDXK-3-006B。
文摘1|Introduction.Cancer remains a predominant cause of morbidity and mortality in contemporary society globally.Whilst therapeutic advancements such as chemotherapy,radiotherapy,immunotherapy,have substantially improved survival outcomes in cancer patients,these interventions are frequently associated with cardiotoxic effects[1-3].Notably,the incidence of cardiotoxicity among cancer patients exhibits substantial heterogeneity across studies,with documented rates between 3.8% and 37.5%[4].
基金supported by the Hamilton Health Sciences Foundation(RD-241).
文摘Background:Conducting a systematic review(SR)is a time-intensive process and represents the first phase in developing a clinical practice guideline(CPG).Completing a CPG through the Program in Evidence-Based Care(PEBC),a globally acknowledged guideline program supported by Ontario Health(Cancer Care Ontario),typically takes about 2 years.Thus,expediting an SR can significantly reduce the overall time required to complete a CPG.Our recently published review identified two artificial intelligence(AI)tools,DistillerSR and EPPI-Reviewer that reduced time in the title and abstract screening in an SR process when developing a CPG.However,the consistency and generalizability of these tools remain unclear within or across different SRs related to cancer.This study protocol aims to evaluate and compare the performance of DistillerSR and EPPI-Reviewer against human reviewers for title and abstract screening(Stage I screening)in cancer CPG development.Methods:We will conduct a retrospective simulation study to evaluate and compare the performance of DistillerSR and EPPI-Reviewer across 10 previously published CPGs by PEBC.These CPGs include the five cancer types with the highest incidence(lung,breast,prostate,colorectal,and bladder).We will run 30 simulation trials for one CPG per AI tool.Primary outcomes are workload savings and time savings in Stage I screening.The secondary outcome is the percentage of missing articles among the final included articles.This informs the accuracy and comprehensiveness of the AI tools.Descriptive and inferential statistical analysis will be conducted to evaluate the outcomes.Results:This is a study protocol.The data presented in the tables are illustrative examples rather than actual study results,in accordance with the journal’s standard structure.All data included in the final study will be thoroughly validated.Discussion:This will be the first study to investigate and compare the performance of DistillerSR and EPPI-Reviewer in Stage I screening of SRs in CPGs across different cancer types.These findings will inform the reliable use of AI tools in future cancer-related CPGs.The results from this retrospective study will need to be confirmed by prospective studies.
文摘Breast cancer is one of the most common malignant tumors among women in China,with approximately 306,000 new cases reported in 2016.Notably,around 33%(100,400)of these cases occurred in rural areas.County-level hospitals,encompassing counties and county-level cities,serve as the primary diagnostic units for the majority of rural breast cancer patients.These hospitals are integral to cancer prevention,screening,maintenance treatment,rehabilitation,follow-up,and referral processes.However,economic and geographical constraints result in county-level hospitals being relatively deficient in medical equipment,health human resources,and drug accessibility.Consequently,there is a critical need for breast cancer prevention and management guidelines that are tailored to the specific conditions of China's counties.In response to this need,and within the policy framework of hierarchical diagnosis and treatment,a Chinese expert group has developed the Guideline for the Management Pathway and Quality Control of Breast Cancer Prevention and Treatment in China's Counties(2023 Edition).This guideline aims to expand the availability of quality medical resources,ensure better distribution of these resources across regions,and enhance the capacity for breast cancer prevention and treatment.Ultimately,the goal is to improve the prognosis and quality of life for breast cancer patients in China's counties.This guideline includes clear and concise path diagrams that are easy to implement in clinical practice,serving as a valuable reference for clinicians in countylevel hospitals.
文摘1|The Evolution of Lung Cancer Screening Despite the paradigm shift in treatment modalities driven by immunology,mortality from lung cancer remains the highest of all cancers[1],rendering it an unrelenting and formidable public health threat.Fortunately,coordinated global efforts have been made,both in the United States and internationally to reduce lung cancer mortality via primary and secondary screening measures,that is,smoking cessation and population screening[2].
基金uropean Foundation for Alcohol Research(Grant:EA 1719)。
文摘Background: The incidence of alcohol-associated cancers is higher within Asian populations having an increased prevalence ofan inactivating mutation in aldehyde dehydrogenase 2 (ALDH2), a mitochondrial enzyme required for the clearance of acetaldehyde, a cytotoxic metabolite of ethanol. The role of alcohol consumption in promoting lung cancer is controversial, andlittle attention has been paid to the association between alcohol drinking and pulmonary ALDH2 expression.Methods: We performed a comprehensive bioinformatic analysis of multi-omics data available in public databases to elucidatethe role of ALDH2 in lung adenocarcinoma (LUAD).Results: Transcriptional and proteomic data indicate a substantial pulmonary expression of ALDH2, which is functional for themetabolism of alcohol diffused from the bronchial circulation. ALDH2 expression is higher in healthy lung tissue than in LUADand inhibits cell cycle, apoptosis, and epithelial–mesenchymal transition pathways. Moreover, low ALDH2 mRNA levels predictpoor prognosis and low overall survival in LUAD patients. Interestingly, ALDH2 expression correlates with immune infiltrationin LUAD.Conclusions: A better understanding of the role of ALDH2 in lung tumor progression and immune infiltration might supportits potential use as a prognostic marker and therapeutic target for improving immunotherapeutic response.
文摘The paper“Challenges in Immune System:Mesoscale and mesoregime complexity”by Ren et al.[1]represents more than an important advance in immunology;it offers a growing recognition of mesoscience as a unifying scientific framework for understanding complexity.
基金supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0502602)the CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2024-I2M-C&T-B-057)+1 种基金Natural Science Foundation of China(Nos.82072940,82173328)Beijing Hope Run Special Fund of Cancer Foundation of China(No.LC2019L07).
文摘Background:Breast cancer(BC)remains a significant global public health challenge,and its incidence and mortality rates among adolescents and young adults(AYAs)aged 15-39 years are increasing.Compared with older adults,AYAs often face poorer prognoses and a higher disease burden.Understanding the trends and determinants of BC burden in AYAs is crucial for guiding preventive measures,early detection programs,and treatment strategies.The aim of this study is to systematically investigate the trends and distribution of the BC burden among AYAs aged 15-39 years across regions and countries and identify the contributing risk factors and disparities in incidence,mortality,and disability-adjusted life years(DALYs).Methods:Data on BC were collected from the Global Burden of Disease(GBD)2021 database.The number of cases,age-standardized rates,mortality,and DALYs for BC were assessed for 204 countries and territories from 1990 to 2021.Joinpoint regression analysis was used to calculate the average annual percentage changes(AAPCs)in incidence,mortality,and DALYs.Risk factors that contribute to the BC burden were also evaluated.Results:According to GBD 2021 estimates,180,791 new BC cases and 42,055 related deaths were observed among AYAs globally.Between 1990 and 2021,the global incidence rate increased by 33.4%,with the highest incidence observed in regions with a high sociodemographic index(SDI)and the highest mortality rates in low-SDI regions.Incidence rates in women showed a significant upward trend(AAPC,3.03)and peaked in North Africa and the Middle East,whereas the most rapid increase in incidence in men was noted in East Asia(AAPC,4.87).Projections indicated a decline in age-standardized incidence rates across most European countries by 2050,in contrast to rising trends in Asia and Africa.Risk factor analysis identified dietary risks(10.5%),tobacco smoking(2%),and high fasting plasma glucose(1.6%)as major contributors to DALYs.
基金supported by The First Affiliated Hospital of the Army Military Medical University Series Cultivation Fund Project-Youqing Top Fund(No.2024YQBJ-4)Chongqing Outstanding Youth Natural Science Foundation,Chongqing Municipal Bureau of Science and Technology(No.CSTB2023NSCQ-JQX0012).
文摘Tryptophan(Trp)is an essential amino acid that serves as a precursor for the synthesis of several important bioactive compounds.Trp is involved in a variety of pathophysiological processes,including neuronal function,metabolism,inflammatory responses,oxidative stress,immune regulation,and intestinal homeostasis.The role of Trp metabolism in tumorigenesis and cancer progression is of particular significance.The influence of Trp and its metabolites on tumor growth and metastasis is mediated through various mechanisms,such as immune evasion,promotion of angiogenesis,and increased resistance to therapeutic agents.This review presents the physiological pathways involved in Trp metabolism and its implications for various malignancies.We also highlight the latest clinical research targeting Trp metabolic pathways in oncology,in addition to exploring future directions for therapeutic advancements aimed at modulating Trp metabolism to enhance cancer treatment outcomes.
文摘Gastrointestinal stromal tumors(GISTs),the most prevalent mesenchymal neoplasms of the gastrointestinal tract,frequently metastasize to the liver.Despite this clinical reality,there is a lack of standardized therapeutic protocols for GIST liver metastases(GISTLM).Here we present the first case of a GISTLM patient treated with Yttrium‐90(Y90)resin microsphere selective internal radiation therapy(SIRT)in China.We further reviewed the current challenges in GISTLM management and highlighted the emerging role of SIRT.By integrating case‐specific insights with broader therapeutic paradigms,we aim to develop safe and effective individualized treatment strategies for GIST patients.
