Hematologic malignancies,including leukemia,lymphoma,and multiple myeloma,are hazardous diseases characterized by the uncontrolled proliferation of cancer cells.Dysregulated cell cycle resulting from genetic and epige...Hematologic malignancies,including leukemia,lymphoma,and multiple myeloma,are hazardous diseases characterized by the uncontrolled proliferation of cancer cells.Dysregulated cell cycle resulting from genetic and epigenetic abnormalities constitutes one of the central events.Importantly,cyclin-dependent kinases(CDKs),complexed with their functional partner cyclins,play dominating roles in cell cycle control.Yet,efforts in translating CDK inhibitors into clinical benefits have demonstrated disappointing outcomes.Recently,mounting evidence highlights the emerging significance of WEE1 G2 checkpoint kinase(WEE1)to modulate CDK activity,and correspondingly,a variety of therapeutic inhibitors have been developed to achieve clinical benefits.Thus,WEE1 may become a promising target to modulate the abnormal cell cycle.However,its function in hematologic diseases remains poorly elucidated.In this review,focusing on hematologic malignancies,we describe the biological structure of WEE1,emphasize the latest reported function of WEE1 in the carcinogenesis,progression,as well as prognosis,and finally summarize the therapeutic strategies by targeting WEE1.展开更多
Immuno-positron emission tomography(immuno-PET)is an innovative medical imaging technique that combines antibodies(Abs)or other immune-targeting molecules with positron-emitting radionuclides.By targeting antigens tha...Immuno-positron emission tomography(immuno-PET)is an innovative medical imaging technique that combines antibodies(Abs)or other immune-targeting molecules with positron-emitting radionuclides.By targeting antigens that are highly expressed in hematologic malignancies,immuno-PET has transformed diagnostic capabilities and enables precise monitoring of therapeutic responses through highly sensitive and specific tumor cell detection.Additionally,it plays a critical role in advancing therapeutic approaches by seamlessly linking diagnostic imaging with personalized treatment strategies.Its non-invasive nature and ability to provide whole-body imaging offer significant advantages over traditional diagnostic methods,especially for detecting minimal residual disease and guiding adaptive therapeutic interventions.In Ab-based immuno-PET,positronemitting radionuclides must have a half-life sufficient for slower pharmacokinetics and blood clearance of Abs.Recent studies have highlighted the advantages of long-lived radionuclides,such as 89Zr,which exhibit low positron energy and enable high sensitivity and resolution,making them particularly effective for tumor visualization and characterization.This review explores the current applications,recent advancements,and potential of immuno-PET for hematologic malignancies,emphasizing its pivotal role in improving patient outcomes and advancing precision medicine.展开更多
BACKGROUND Hepatobiliary and pancreatic malignancies,with their aggressiveness and poor prognosis,often trigger anxiety and depression in patients,but the roles of disease stage and psychosocial factors in this remain...BACKGROUND Hepatobiliary and pancreatic malignancies,with their aggressiveness and poor prognosis,often trigger anxiety and depression in patients,but the roles of disease stage and psychosocial factors in this remain unclear.AIM To explore the clinical characteristics and factors influencing comorbid anxiety and depression in patients with malignant liver,gallbladder,and pancreatic tumors.METHODS This study enrolled 150 participants,including 48 patients with early stage(IA-IB)hepatobiliary and pancreatic malignancies(Control Group 1),52 patients with middle-stage(IIA-IIIA)tumors(Observation Group),and 50 healthy individuals undergoing physical examination(Control Group 2).Anxiety and depression detection rates,and scores on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),and Life Event Scale were compared across groups.The factors influencing emotion of each patient were collected and analyzed by group.RESULTS Anxiety and depression detection rates were significantly higher in the Observation Group(82.69%and 92.31%,respectively;P<0.05)than those in Control Groups 1(62.50%and 66.67%,respectively)and 2(10.00%and 8.00%,respectively).SAS and SDS scores showed similar trends.Life event stress scores and the presence of influencing factors,such as treatment side effects,pain,and economic burden,were also significantly elevated in the Observation Group.These findings suggest that psychological distress worsens as the disease progresses.CONCLUSION Patients with hepatobiliary and pancreatic malignancies are prone to comorbid anxiety and depression,with increasing severity in the later disease stages.Despite the relatively small sample size,our findings suggest the need for psychological assessments and interventions in comprehensive cancer care.Future studies should consider expanding the sample size to enhance generalizability.Strengthening psychosocial support may improve patient outcomes and quality of life.展开更多
Objective To evaluate the clinical efficacy of Traditional Chinese Medicine(TCM)hot-pack therapy in treating postoperative gastrointestinal dysfunction in patients undergoing surgery for gastrointestinal malignancies....Objective To evaluate the clinical efficacy of Traditional Chinese Medicine(TCM)hot-pack therapy in treating postoperative gastrointestinal dysfunction in patients undergoing surgery for gastrointestinal malignancies.Method 60 postoperative patients with gastrointestinal malignancies were randomized into a treatment group(n=30)and a control group(n=30).Both groups received standard postoperative supportive care,including oral mosapride citrate(5 mg,three times daily,starting 6 h post-op,for 3 days).The treatment group additionally received external abdominal application of a TCM hot-pack twice daily(20-30 min each)for 3 days.Primary endpoints were time to first flatus,first defecation,and first oral intake.Secondary endpoints included numeric scores for abdominal pain and distension at 24 h and 72 h post-op,and overall clinical efficacy.Result Compared with controls,the treatment group showed significantly faster recovery:time to first flatus(50.3±7.8 h vs.62.5±9.4 h),first defecation(72.1±11.3 h vs.85.2±13.6 h),and first oral intake(48.0±9.5 h vs.62.5±12.4 h)(all P<0.01).At 24 h and 72 h,the treatment group reported lower abdominal pain and distension scores(24 h pain 5.1±1.3 vs.6.0±1.4,distension 2.3±0.5 vs.2.8±0.6;72 h pain 3.9±0.8 vs.4.7±0.9,distension 1.9±0.5 vs.2.3±0.6;P<0.05 to P<0.01).Total effective rate was higher in the treatment group(96.7%vs.90.0%,χ^(2)=6.96,P=0.031).Conclusion TCM hot-pack therapy combined with routine care significantly accelerates recovery of gastrointestinal function,shortens duration of postoperative dysfunction,and alleviates abdominal pain and distension in patients after gastrointestinal malignancy surgery,demonstrating notable clinical benefit.展开更多
Background:Patients with hemato-oncological malignancies may respond insufficiently to vaccination,especially in terms of antibody titer.The antibody response depends on the type of malignancy as well as the type and ...Background:Patients with hemato-oncological malignancies may respond insufficiently to vaccination,especially in terms of antibody titer.The antibody response depends on the type of malignancy as well as the type and timing of treatment.We intended to evaluate this using real-world data from patients of our regional hospital.This study also considers the role of immune status,including T-cell activation markers,in predicting vaccination success.Methods:Seventeen patients of our hospital having a hematological malignancy were included in this study,including myeloma,lymphoma,as well as acute myeloid leukemia(AML)and chronic lymphoid leukemia(CLL).All patients were vaccinated against Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2)using Tozinameran following current recommendations.Circulating antibodies directed against the spike protein of SARS-CoV-2 were determined by a commercial immune assay.Immune status was determined from peripheral blood by flow cytometry.Both parameters were followed in fifteen patients who provided sufficient follow-up data for up to one year.Patients were categorized as responders or non-responders,and differences in diagnosis,treatment,and immune status were analyzed.Results:Antibody response depended on both diagnosis and treatment.Active treatment directed against B-cells,such as anti-Cluster of Differentiation 20(CD20)therapy,was associated with weak seroconversion.For CD38-as well as proteasome-directed therapies,the data suggest that responders as well as non-responders exist.Notably,low peripheral B-cell numbers and high CD3+HLADR+cell counts correlated withweak seroconversion upon vaccination.Conclusions:We suggest that peripheral immune status can be applied as a predictive biomarker for seroconversion upon vaccinations.展开更多
Since 1968 when the first successful hematopoietic stem cell transplantation(HSCT) was performed, transplant technique has developed rapidly for more than 50 years. In the past 20 years, the significant breakthroughs ...Since 1968 when the first successful hematopoietic stem cell transplantation(HSCT) was performed, transplant technique has developed rapidly for more than 50 years. In the past 20 years, the significant breakthroughs and widely use of haploidentical-related donor HSCT(e.g. Beijing Protocol) make everyone can have a donor(1), and the novel, reduced-toxicity transplant regimens help elderly patients receive HSCT safely(2).展开更多
Circular RNAs(circRNAs)are formed by splicing of precursor RNAs and covalently linked at the 5′and 3′ends.Dysregulated circRNAs are closely related to the epithelial-mesenchymal transition(EMT)of gastrointestinal ma...Circular RNAs(circRNAs)are formed by splicing of precursor RNAs and covalently linked at the 5′and 3′ends.Dysregulated circRNAs are closely related to the epithelial-mesenchymal transition(EMT)of gastrointestinal malignancies.CircRNAs,including circRNA_0008717,circGOT1,circ-DOCK5,circVPS33B,circPVT1,circMET,circ-OXCT1,circ_67835,circRTN4,circ_0087502,circFNDC38,circ_PTEN1,circPGPEP1,and circ-E-Cad are involved in the EMT process of gastrointestinal malignancies through a variety of mechanisms,such as regulating EMT-inducing transcription factors,signaling pathways,and tumor microenvironments.Gastrointestinal(GI)malignancies are common malignant tumors worldwide,and the heterogeneity and easy metastasis of gastrointestinal malignancies limit the effectiveness of medical treatments.Therefore,investigating the molecular mechanisms involved in the pathogenesis of gastrointestinal malignancies is essential for clinical treatment.This article summarizes the biological roles and molecular mechanism of circRNAs in EMT of gastrointestinal malignancies,providing a theoretical basis for applying EMT-related circRNAs in targeted therapy.展开更多
BACKGROUND Resilience is an individual’s ability and psychological rebound capacity to adapt well after experiencing adversity,trauma,etc.Patients with strong resilience can face illnesses actively.AIM To determine t...BACKGROUND Resilience is an individual’s ability and psychological rebound capacity to adapt well after experiencing adversity,trauma,etc.Patients with strong resilience can face illnesses actively.AIM To determine the association of resilience with coping styles and quality of life in patients with malignancies.METHODS This study included patients with malignant tumors who were hospitalized at Fuyang Hospital Affiliated to Anhui Medical University from March 2022 to March 2024.The Connor-Davidson Resilience Scale,Medical Coping Modes Questionnaire,Social Support Rating Scale,and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were utilized to assess patients’resilience,coping styles,social support,and quality of life,respectively.Pearson correlation analysis was conducted to assess the correlations.RESULTS A total of 175 patients with malignant tumors demonstrated no marked difference in terms of age,education level,employment status,monthly household income,and disease staging(P<0.05).Further,patients with malignancies demonstrated scores of 17.49±1.20,17.27±1.46,and 11.19±1.29 points in terms of coping styles in confrontation,avoidance,and resignation dimensions,respectively.Subjective support,objective support,and support utilization scores in terms of social support were 10.67±1.80,11.26±2.08,and 9.24±1.14 points,respectively.The total resilience score and tenacity,self-improvement,and optimism dimension scores were positively correlatedwith the confrontation coping style score,whereas the total resilience score and tenacity and self-improvementscores were negatively associated with avoidance and resignation coping style scores(P<0.05).The total resiliencescore and the tenacity dimension score were positively associated with physical,role,cognitive,emotional,andsocial functions,as well as global health status(P<0.05),and were inversely related to fatigue,insomnia,andeconomic difficulties(P<0.05).CONCLUSIONThe resilience of patients with malignancies is positively associated with the confrontation dimension in the copingstyle,the total and various social support domain scores,and the overall quality of life.Clinical medical staff needto pay attention to the effect of medical coping styles and social support on the resilience level of patients withmalignancies to further improve their quality of life.展开更多
In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin famil...In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin family member 14(KIF14),a critical kinesin,is pivotal in the proliferation,migration,and invasion of tumor cells.It has emerged as a focal point in recent studies of malignant tumors in the digestive tract.This article reviews the current research on KIF14 within these tumors and details its significant role in tumor cell behaviors,including proliferation,apo-ptosis,migration,invasion,and angiogenesis,alongside the regulatory mechanisms of the associated intracellular signaling pathways.Additionally,it explores the clinical value of KIF14 as a potential biomarker for early diagnosis,disease monitoring,and prognostic evaluation in malignant tumors of the digestive tract.The article concludes by introducing the potential regulatory role of traditional Chinese medicine,aiming to combine the strengths of both modern and traditional medical approaches to enhance treatment outcomes and prognosis for patients with these tumors.展开更多
Objective:To explore the epidemiological trends and clinical presentations of brucellosis in patients diagnosed with different types of cancer.Methods:A systematic review was performed utilizing PubMed,Embase,Scopus,W...Objective:To explore the epidemiological trends and clinical presentations of brucellosis in patients diagnosed with different types of cancer.Methods:A systematic review was performed utilizing PubMed,Embase,Scopus,Web of Science,and Google Scholar following PRISMA guidelines until September 2022.An update in December 2023 was conducted to ensure thorough coverage of the literature.Results:A total of 28 articles met the eligibility criteria,reporting 38 cases of brucellosis in patients with cancer.Among these cases,hematological cancers were the most common,comprising 66%of the cases,and B.melitensis was identified as the predominant species.The primary clinical manifestations of brucellosis infection included constitutional symptoms in a notable 60.5%of cases and febrile neutropenia in 21%.Additionally,six cases(15.8%)experienced relapse or recurrence of brucellosis,all of which were managed using a combination therapy of rifampin and doxycycline.While 28 patients successfully achieved remission from both brucellosis and their underlying neoplastic conditions,unfortunately,nine cases resulted in mortality attributed to septic shock,progressive liver failure,and massive embolism;no deaths directly related to brucellosis were reported.Among the non-surviving cases,hematologic malignancies were the most prevalent neoplastic conditions(77.7%).Conclusions:Brucellosis-cancer co-occurrence is rare but is not related to increasing mortality.The risk of relapse is higher in cancer patients,especially with hematologic malignancies.Screening,monitoring,and judicious antibiotic use can mitigate brucellosis risks in neoplastic patients.展开更多
Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the per...Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the perioperative and nutritional management of patients with gynecologic malignancy.Methods:This study included 77 patients with gynecologic malignancies confirmed by surgical pathology between December 2021 and January 2023.Preoperative body composition data were obtained using bioelectrical impedance analysis.Nutritional risk screening and assessment were performed.Differences in body composition by age,nutritional status,International Federation of Gynecology and Obstetrics(FIGO)stage,systemic inflammatory response,and type of gynecologic malignancy were compared.Results:The extracellular water ratio was significantly higher in patients with a high FIGO stage than in those with a low FIGO stage(t=4.047,P<0.001).Other body composition parameters were lower in patients with a high FIGO stage than in those with a low FIGO stage(P<0.05).Regarding the NLR,the extracellular water ratio was significantly higher in patients with a high NLR than in those with a low NLR(t=2.929,P=0.005).As the nutritional condition worsened,the extracellular water ratio increased(H=12.291,P=0.002),with no significant difference in other body composition parameters between patients with different nutritional conditions(H=5.118,P=0.077).Other body composition parameters decreased with the nutritional condition,which was statistically significant(P<0.05).Conclusions:Bioelectrical impedance analysis is an easy-to-perform,noninvasive,and reproducible measurement technique that can assess changes in body composition.Body composition analysis can effectively determine an individual’s nutritional and metabolic status,providing a reference for the management of patients with gynecologic malignancy,and potentially providing predictive biomarkers to stratify these patients.展开更多
Liver transplantation(LT)is the definitive treatment for end-stage liver disease,acute liver failure,and liver cancer.Although advancements in surgical techniques,postoperative care,and immunosuppressive therapies hav...Liver transplantation(LT)is the definitive treatment for end-stage liver disease,acute liver failure,and liver cancer.Although advancements in surgical techniques,postoperative care,and immunosuppressive therapies have significantly improved outcomes,the long-term use of immunosuppression has increased the risk of complications,including infections,cardiovascular disease,and cancer.Among these,de novo malignancies(DNMs)are a major concern,accounting for 20%-25%of deaths in LT recipients surviving beyond the early post-transplant period.Non-melanoma skin cancers,particularly squamous cell carcinoma are the most prevalent DNMs.Other significant malignancies include Kaposi's sarcoma,post-transplant lymphoproliferative disorders,and various solid organ cancers,including head and neck cancers.Compared to the general population,LT patients face a twofold increase in solid organ malignancies and a 30-fold increase in lymphoproliferative disorders.Risk factors for DNM include chronic immunosuppression,alcohol or tobacco use,viral infections,and underlying liver disease.Emerging evidence emphasizes the importance of tailored cancer screening and prevention strategies,including regular dermatological examinations,targeted screenings for high-risk cancers,and patient education on lifestyle modifications.Early detection through enhanced surveillance protocols has been shown to improve outcomes.Management of DNMs involves a combination of standard oncological therapies and adjustments to immunosuppressive regimens,with promising results from the use of mTOR inhibitors in select patients.The review highlights the critical need for ongoing research to refine risk stratification,optimize screening protocols,and improve treatment approaches to mitigate the burden of DNMs in LT recipients.By implementing personalized preventive and therapeutic strategies,we can enhance long-term outcomes and quality of life for this vulnerable population.展开更多
Immunoglobulin G4‐related disease(IgG4‐RD)is a systemic fibroinflammatory disease characterized by tumefactive lesions.Beyond the role of the disease as a cancer mimic,studies over the past decade have demonstrated ...Immunoglobulin G4‐related disease(IgG4‐RD)is a systemic fibroinflammatory disease characterized by tumefactive lesions.Beyond the role of the disease as a cancer mimic,studies over the past decade have demonstrated that IgG4‐RD is associated with increased cancer risk.A search of articles,case reports,and reviews concerning malignancies in patients with IgG4‐RD was conducted on PubMed,Web of Science,and Google Scholar.The site of cancer development is not always affected by IgG4‐RD.The prevalence of solid cancers varies among populations.Moreover,B‐cell neoplasms constitute a proportion of the malignancies linked to this disease.The precise mechanism of oncogenesis in IgG4‐RD is ambiguous.Several mechanisms may be relevant to the increased cancer risk in patients with IgG4‐RD,including chronic inflammation,IgG4‐positive plasma cell infiltration,and the involvement of follicular helper T cells,macrophages,and plasmacytoid dendritic cells in tumor immunity.The risk factors include male sex,older age,smoking status,occupational exposure,disease recurrence,and involvement of specific organs.Malignancies in patients with IgG4‐RD are associated with a poor prognosis,underscoring the importance of cancer risk management and regular screening during follow‐up.The precise mechanisms linking IgG4‐RD to malignancy remain unclear and warrant further research.Regular cancer screening should be prioritized during follow‐up to facilitate early detection of malignancies.展开更多
E2F family of transcription factors regulates various cellular functions related to cell cycle and apoptosis. Its individual members have traditionally been classified into activators and repressors, based on in vitro...E2F family of transcription factors regulates various cellular functions related to cell cycle and apoptosis. Its individual members have traditionally been classified into activators and repressors, based on in vitro studies. However their contribution in human cancer is more complicated and difficult to predict. We review current knowledge on the expression of E2Fs in digestive system malignancies and its clinical implications for patient prognosis and treatment. E2F1, the most extensively studied member and the only one with prognostic value, exhibits a tumor-suppressing activity in esophageal, gastric and colorectal adenocarcinoma, and in hepatocellular carcinoma (HCC), whereas in pancreatic ductal adenocarcinoma and esophageal squamous cell carcinoma may function as a tumorpromoter. In the latter malignancies, E2F1 immunohistochemical expression has been correlated with higher tumor grade and worse patient survival, whereas in esophageal, gastric and colorectal adenocarcinomas is a marker of increased patient survival. E2F2 has only been studied in colorectal cancer, where its role is not considered significant. E2F4's role in colorectal, gastric and hepatic carcinogenesis is tumor-promoting. E2F8 is strongly upregulated in human HCC, thus possibly contributing to hepatocarcinogenesis. Adenoviral transfer of E2F as gene therapy to sensitize pancreatic cancer cells for chemotherapeutic agents has been used in experimental studies. Other therapeutic strategies are yet to be developed, but it appears that targeted approaches using E2F-agonists or antagonists should take into account the tissue-dependent function of each E2F member. Further understanding of E2Fs' contribution in cellular functions in vivo would help clarify their role in carcinogenesis.展开更多
Hepatitis due to hepatitis B virus(HBV) reactivation can be severe and potentially fatal, but is preventable. HBV reactivation is most commonly reported in patients receiving cancer chemotherapy, especially rituximabc...Hepatitis due to hepatitis B virus(HBV) reactivation can be severe and potentially fatal, but is preventable. HBV reactivation is most commonly reported in patients receiving cancer chemotherapy, especially rituximabcontaining therapy for hematological malignancies and those receiving stem cell transplantation. All patients with hematological malignancies receiving anticancer therapy should be screened for active or resolved HBV infection by blood tests for hepatitis B surface antigen(HBs Ag) and antibody to hepatitis B core antigen(antiHBc). Patients found to be positive for HBs Ag should be given prophylactic antiviral therapy to prevent HBV reactivation. For patients with resolved HBV infection, no standard strategy has yet been established to prevent HBV reactivation. There are usually two options. One is pre-emptive therapy guided by serial HBV DNA monitoring, whereby antiviral therapy is given as soon as HBV DNA becomes detectable. However, there is little evidence regarding the optimal interval and period of monitoring. An alternative approach is prophylactic antiviral therapy, especially for patients receiving highrisk therapy such as rituximab, newer generation of anti-CD20 monoclonal antibody, obinutuzumab or hematopoietic stem cell transplantation. This strategy may effectively prevent HBV reactivation and avoid the inconvenience of repeated HBV DNA monitoring. Entecavir or tenofovir are preferred over lamivudine as prophylactic therapy. Although there is no well-defined guideline on the optimal duration of prophylactic therapy, there is growing evidence to recommend continuing prophylactic antiviral therapy for at least 12 mo after cessation of chemotherapy, and even longer for those who receive rituximab or who had high serum HBV DNA levels before the start of immunosuppressive therapy. Many novel agents have recently become available for the treatment of hematological malignancies, and these agents may be associated with HBV reactivation. Although there is currently limited evidence to guide the optimal preventive measures, we recommend antiviral prophylaxis in HBs Ag-positive patients receiving novel treatments, especially the Bruton tyrosine kinase inhibitors and the phosphatidylinositol 3-kinase inhibitors, which are B-cell receptor signaling modulators and reduce proliferation of malignant B-cells. Further studies are needed to clarify the risk of HBV reactivation with these agents and the best prophylactic strategy in the era of targeted therapy for hematological malignancies.展开更多
BACKGROUND Immunosuppression has undoubtedly raised the overall positive outcomes in the post-operative management of solid organ transplantation. However, long-term exposure to immunosuppression is associated with cr...BACKGROUND Immunosuppression has undoubtedly raised the overall positive outcomes in the post-operative management of solid organ transplantation. However, long-term exposure to immunosuppression is associated with critical systemic morbidities. De novo malignancies following orthotopic liver transplants (OLTs) are a serious threat in pediatric and adult transplant individuals. Data from different experiences were reported and compared to assess the connection between immunosuppression and de novo malignancies in liver transplant patients. AIM To study the role of immunosuppression on the incidence of de novo malignancies in liver transplant recipients. METHODS A systematic literature examination about de novo malignancies and immunosuppression weaning in adult and pediatric OLT recipients was described in the present review. Worldwide data were collected from highly qualified institutions performing OLTs. Patient follow-up, immunosuppression discontinuation and incidence of de novo malignancies were reported. Likewise, the review assesses the differences in adult and pediatric recipients by describing the adopted immunosuppression regimens and the different type of diagnosed solid and blood malignancy.RESULTS Emerging evidence suggests that the liver is an immunologically privileged organ able to support immunosuppression discontinuation in carefully selected recipients. Malignancies are often detected in liver transplant patients undergoing daily immunosuppression regimens. Post-transplant lymphoproliferative diseases and skin tumors are the most detected de novo malignancies in the pediatric and adult OLT population, respectively. To date, immunosuppression withdrawal has been achieved in up to 40% and 60% of well-selected adult and pediatric recipients, respectively. In both populations, a clear benefit of immunosuppression weaning protocols on de novo malignancies is difficult to ascertain because data have not been specified in most of the clinical experiences. CONCLUSION The selected populations of tolerant pediatric and adult liver transplant recipients greatly benefit from immunosuppression weaning. There is still no strong clinical evidence on the usefulness of immunosuppression withdrawal in OLT recipients on malignancies. An interesting focus is represented by the complete reconstitution of the immunological pathways that could help in decreasing the incidence of de novo malignancies and may also help in treating liver transplant patients suffering from cancer.展开更多
In this study,we used plasma factor V activity and parameters of the thrombin generation test to discuss their diagnostic and prognostic value for disseminated intravascular coagulation (DIC) in patients with hematolo...In this study,we used plasma factor V activity and parameters of the thrombin generation test to discuss their diagnostic and prognostic value for disseminated intravascular coagulation (DIC) in patients with hematological malignancies.A total of 164 patients who were diagnosed with hematological malignancies in the Department of Hematology,Union Hospital,between Apr 2014 and Dec.2014 were enrolled in this study.There were 131 patients in the study group and 33 patients in the control group in terms of the laboratory results for DIC.The patients in the study group were divided into a DIC subgroup (n=59) and a non-DIC subgroup (n=72) based on the International Society of Thrombosis and Hemostasis (ISTH) Integral System,and they were divided into four subgroups [score ≤3 (n=35),score=4 (n=37),score=5 (n=47),and score >6 (n=12)] according to ISTH scores.Using 28-day mortality as the endpoint,the patients in the study group were divided into a survival subgroup (n=111) and a non-survival subgroup (n=20).The results showed that the plasma factor V activity was significantly weaker,and lag time and time to peak were significantly shorter in the study group than in the control group (P<0.01).The factor V activity,peak and endogenous thrombin potential (ETP) were significantly decreased in the DIC subgroup as compared with those in the non-DIC subgroup (P<0.01).Among factor V activity,lag time,peak,ETP,and ttPeak,only the factor V activity was significantly decreased in the nonsurvival subgroup compared with the survival subgroup (P<0.01).With the increase in ISTH score,the ETP and peak decreased gradually.The binary logistic regression analysis revealed that PLT,D-dimer,factor V activity and ETP had linear relationship with DIC diagnosed by ISTH Integral System.Using DIC diagnosed by ISTH Integral System as the endpoint,the area under curve (AUC) of factor V activity was found to be similar to that of blood platelet count (PLT) and prothrombin time (PT).In conclusion,factor V activity,ETP and peak had diagnostic value for DIC in patients with hematological malignancies,and only factor V activity had limited prognostic value.展开更多
AIM： To analyze the characteristics of multiple primary malignancies （MPMs） of digestive system; including incidence, types of tumor combinations, time intervals between development of multiple tumors, clinical cou...AIM： To analyze the characteristics of multiple primary malignancies （MPMs） of digestive system; including incidence, types of tumor combinations, time intervals between development of multiple tumors, clinical course,and prognostic factors affecting survival and mortality.METHODS： Data from a total of 129 patients treated from January 1991 to December 2000 for pathologically proved MPMs, including at least one originating from the digestive system, were reviewed retrospectively.RESULTS： Among 129 patients, 120 （93.02%） had two primary cancers and 9 （6.98%） had three primary cancers. The major sites of MPMs of the digestive system were large intestine, stomach, and liver. Associated nondigestive cancers included 40 cases of gynecological cancers, of which 31 were carcinoma of cervix and 10 cases of genitourinary cancers, of which 5 were bladder cancers. Other cancers originated from the lung, breast,nasopharynx, larynx, thyroid, brain, muscle, and skin.Reproductive tract cancers, especially cervical, ovarian,bladder, and prostate cancers were the most commonlyassociated non-G! cancers, followed by cancer of the lung and breasts. Forty-three cases were synchronous, while the rest （86 cases） were metachronous cancers. Staging of MPMs and treatment regimes correlated with the prognosis between survival and non-survival groups.CONCLUSION： As advances in cancer therapy bring about a progressively larger percentage of long-term survivors, the proportion of patients with subsequent primary lesions will increase. Early diagnosis of these lesions, based on an awareness of the possibility of second and third cancers, and multidiscipiinary treatment strategies will substantially increase the survival of these patients.展开更多
TMTP1, a 5-amino acid peptide NVVRQ, obtained by using the flagella peptide library screening in our previous studies, can be used for the labeling of malignant in situ and metastatic lesions, and even micro-metastase...TMTP1, a 5-amino acid peptide NVVRQ, obtained by using the flagella peptide library screening in our previous studies, can be used for the labeling of malignant in situ and metastatic lesions, and even micro-metastases. In this study, TMTP1 was assessed for its ability to specifically target the malignant hematopoietic cells and metastatic lesions of hematological malignancies. FITC-TMTP1 was chemically synthesized. Immunofluorescence assay and competitive test were carried out to determine the specific binding capacity of TMTPl to hematological malignant cell lines, including HL60, k562, SHI-1, Jurkat, Raji, El-4 and umbilical cord blood mononuclear cells. Mononuclear cells were isolated from the bone marrow of healthy subjects and patients with chronic myeloid leukemia. Then the cells were co-clutured with TMTP1 or scrambled peptides and the binding and affinity of TMTP1 peptide to the primary cells of hematological malignancies were flow cytometrically analyzed. The binding speci-ficity of TMTP1 to target hematological malignancies was measured in vivo by intravenous injection of FITC-conjugated TMTP1 into El-4 lymphoma-bearing mice. The results showed that TMTP1 specifi-cally bound to the cells of a series of hematological malignancies, including HL60, k562, Jurkat, Raji , El-4 and chronic myeloid leukemia primary cells but not to bone marrow mononuclear cells from healthy subjects. By contrast, TMTP1 could bind to the metastatic foci of lymphoma originating from the EL-4 cell line while the scrambled peptide failed to do so. Moreover, the occult metastases could be identified, with high specificity, by detecting FITC-TMTP1. We are led to conclude that TMTP1, as a novel tumor-homing peptide, can serve as a marker for primary malignant and metastatic lesions for the early diagnosis of hematological malignances and a carrier of anticancer drugs for cancer treatment.展开更多
Hepatectomy is still the major curative treatment for patients with liver malignancies.However,it is still a big challenge to remove the tumors in the central posterior area,especially if their location involves the r...Hepatectomy is still the major curative treatment for patients with liver malignancies.However,it is still a big challenge to remove the tumors in the central posterior area,especially if their location involves the retrohepatic inferior vena cava and hepatic veins.Ex vivo liver resection and auto-transplantation(ELRA),a hybrid technique of the traditional liver resection and transplantation,has brought new hope to these patients and therefore becomes a valid alternative to liver transplantation.Due to its technical difficulty,ELRA is still concentrated in a few hepatobiliary centers that have experienced surgeons in both liver resection and liver transplantation.The efficacy and safety of this technique has already been demonstrated in the treatment of benign liver diseases,especially in the advanced alveolar echinococcosis.Recently,the application of ELRA for liver malignances has gained more attention.However,standardization of clinical practice norms and international consensus are still lacking.The prognostic impact in these oncologic patients also needs further evaluation.In this review,we summarized the principles and recent progresses on ELRA.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81920108004,82270127,82203880)the Hunan Provincial Natural Science Foundation of China(No.2023JJ30928,2024JJ3037)+2 种基金the Changsha Municipal Natural Sci-Science Foundation(No.kq2208382)the Fellowship of the China Postdoctoral Science Foundation(No.2023T160740)the Hunan Province Clinical Medical Technology Innovation Guidance Project(No.2021SK50917,2023SK4056)。
文摘Hematologic malignancies,including leukemia,lymphoma,and multiple myeloma,are hazardous diseases characterized by the uncontrolled proliferation of cancer cells.Dysregulated cell cycle resulting from genetic and epigenetic abnormalities constitutes one of the central events.Importantly,cyclin-dependent kinases(CDKs),complexed with their functional partner cyclins,play dominating roles in cell cycle control.Yet,efforts in translating CDK inhibitors into clinical benefits have demonstrated disappointing outcomes.Recently,mounting evidence highlights the emerging significance of WEE1 G2 checkpoint kinase(WEE1)to modulate CDK activity,and correspondingly,a variety of therapeutic inhibitors have been developed to achieve clinical benefits.Thus,WEE1 may become a promising target to modulate the abnormal cell cycle.However,its function in hematologic diseases remains poorly elucidated.In this review,focusing on hematologic malignancies,we describe the biological structure of WEE1,emphasize the latest reported function of WEE1 in the carcinogenesis,progression,as well as prognosis,and finally summarize the therapeutic strategies by targeting WEE1.
文摘Immuno-positron emission tomography(immuno-PET)is an innovative medical imaging technique that combines antibodies(Abs)or other immune-targeting molecules with positron-emitting radionuclides.By targeting antigens that are highly expressed in hematologic malignancies,immuno-PET has transformed diagnostic capabilities and enables precise monitoring of therapeutic responses through highly sensitive and specific tumor cell detection.Additionally,it plays a critical role in advancing therapeutic approaches by seamlessly linking diagnostic imaging with personalized treatment strategies.Its non-invasive nature and ability to provide whole-body imaging offer significant advantages over traditional diagnostic methods,especially for detecting minimal residual disease and guiding adaptive therapeutic interventions.In Ab-based immuno-PET,positronemitting radionuclides must have a half-life sufficient for slower pharmacokinetics and blood clearance of Abs.Recent studies have highlighted the advantages of long-lived radionuclides,such as 89Zr,which exhibit low positron energy and enable high sensitivity and resolution,making them particularly effective for tumor visualization and characterization.This review explores the current applications,recent advancements,and potential of immuno-PET for hematologic malignancies,emphasizing its pivotal role in improving patient outcomes and advancing precision medicine.
文摘BACKGROUND Hepatobiliary and pancreatic malignancies,with their aggressiveness and poor prognosis,often trigger anxiety and depression in patients,but the roles of disease stage and psychosocial factors in this remain unclear.AIM To explore the clinical characteristics and factors influencing comorbid anxiety and depression in patients with malignant liver,gallbladder,and pancreatic tumors.METHODS This study enrolled 150 participants,including 48 patients with early stage(IA-IB)hepatobiliary and pancreatic malignancies(Control Group 1),52 patients with middle-stage(IIA-IIIA)tumors(Observation Group),and 50 healthy individuals undergoing physical examination(Control Group 2).Anxiety and depression detection rates,and scores on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),and Life Event Scale were compared across groups.The factors influencing emotion of each patient were collected and analyzed by group.RESULTS Anxiety and depression detection rates were significantly higher in the Observation Group(82.69%and 92.31%,respectively;P<0.05)than those in Control Groups 1(62.50%and 66.67%,respectively)and 2(10.00%and 8.00%,respectively).SAS and SDS scores showed similar trends.Life event stress scores and the presence of influencing factors,such as treatment side effects,pain,and economic burden,were also significantly elevated in the Observation Group.These findings suggest that psychological distress worsens as the disease progresses.CONCLUSION Patients with hepatobiliary and pancreatic malignancies are prone to comorbid anxiety and depression,with increasing severity in the later disease stages.Despite the relatively small sample size,our findings suggest the need for psychological assessments and interventions in comprehensive cancer care.Future studies should consider expanding the sample size to enhance generalizability.Strengthening psychosocial support may improve patient outcomes and quality of life.
基金2024 Technological Innovation Project of Shapingba District,Chongqing(2024174)。
文摘Objective To evaluate the clinical efficacy of Traditional Chinese Medicine(TCM)hot-pack therapy in treating postoperative gastrointestinal dysfunction in patients undergoing surgery for gastrointestinal malignancies.Method 60 postoperative patients with gastrointestinal malignancies were randomized into a treatment group(n=30)and a control group(n=30).Both groups received standard postoperative supportive care,including oral mosapride citrate(5 mg,three times daily,starting 6 h post-op,for 3 days).The treatment group additionally received external abdominal application of a TCM hot-pack twice daily(20-30 min each)for 3 days.Primary endpoints were time to first flatus,first defecation,and first oral intake.Secondary endpoints included numeric scores for abdominal pain and distension at 24 h and 72 h post-op,and overall clinical efficacy.Result Compared with controls,the treatment group showed significantly faster recovery:time to first flatus(50.3±7.8 h vs.62.5±9.4 h),first defecation(72.1±11.3 h vs.85.2±13.6 h),and first oral intake(48.0±9.5 h vs.62.5±12.4 h)(all P<0.01).At 24 h and 72 h,the treatment group reported lower abdominal pain and distension scores(24 h pain 5.1±1.3 vs.6.0±1.4,distension 2.3±0.5 vs.2.8±0.6;72 h pain 3.9±0.8 vs.4.7±0.9,distension 1.9±0.5 vs.2.3±0.6;P<0.05 to P<0.01).Total effective rate was higher in the treatment group(96.7%vs.90.0%,χ^(2)=6.96,P=0.031).Conclusion TCM hot-pack therapy combined with routine care significantly accelerates recovery of gastrointestinal function,shortens duration of postoperative dysfunction,and alleviates abdominal pain and distension in patients after gastrointestinal malignancy surgery,demonstrating notable clinical benefit.
基金supported by a grant of the Deutsche Forschungsgemeinschaft(DFG)to G.B.(#405833349).
文摘Background:Patients with hemato-oncological malignancies may respond insufficiently to vaccination,especially in terms of antibody titer.The antibody response depends on the type of malignancy as well as the type and timing of treatment.We intended to evaluate this using real-world data from patients of our regional hospital.This study also considers the role of immune status,including T-cell activation markers,in predicting vaccination success.Methods:Seventeen patients of our hospital having a hematological malignancy were included in this study,including myeloma,lymphoma,as well as acute myeloid leukemia(AML)and chronic lymphoid leukemia(CLL).All patients were vaccinated against Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2)using Tozinameran following current recommendations.Circulating antibodies directed against the spike protein of SARS-CoV-2 were determined by a commercial immune assay.Immune status was determined from peripheral blood by flow cytometry.Both parameters were followed in fifteen patients who provided sufficient follow-up data for up to one year.Patients were categorized as responders or non-responders,and differences in diagnosis,treatment,and immune status were analyzed.Results:Antibody response depended on both diagnosis and treatment.Active treatment directed against B-cells,such as anti-Cluster of Differentiation 20(CD20)therapy,was associated with weak seroconversion.For CD38-as well as proteasome-directed therapies,the data suggest that responders as well as non-responders exist.Notably,low peripheral B-cell numbers and high CD3+HLADR+cell counts correlated withweak seroconversion upon vaccination.Conclusions:We suggest that peripheral immune status can be applied as a predictive biomarker for seroconversion upon vaccinations.
文摘Since 1968 when the first successful hematopoietic stem cell transplantation(HSCT) was performed, transplant technique has developed rapidly for more than 50 years. In the past 20 years, the significant breakthroughs and widely use of haploidentical-related donor HSCT(e.g. Beijing Protocol) make everyone can have a donor(1), and the novel, reduced-toxicity transplant regimens help elderly patients receive HSCT safely(2).
基金supported by grants from the Key Scientific and Technological Projects of Ningbo(No.2021Z133)Ningbo Top Medical and Health Research Program(No.2023020612)+2 种基金National Natural Science Foundation of China(No.81702367)the Medical and Health Research Project of Zhejiang Province(No.2024KY319)the Youth Medical Backbone Talents Training Program of Ningbo.
文摘Circular RNAs(circRNAs)are formed by splicing of precursor RNAs and covalently linked at the 5′and 3′ends.Dysregulated circRNAs are closely related to the epithelial-mesenchymal transition(EMT)of gastrointestinal malignancies.CircRNAs,including circRNA_0008717,circGOT1,circ-DOCK5,circVPS33B,circPVT1,circMET,circ-OXCT1,circ_67835,circRTN4,circ_0087502,circFNDC38,circ_PTEN1,circPGPEP1,and circ-E-Cad are involved in the EMT process of gastrointestinal malignancies through a variety of mechanisms,such as regulating EMT-inducing transcription factors,signaling pathways,and tumor microenvironments.Gastrointestinal(GI)malignancies are common malignant tumors worldwide,and the heterogeneity and easy metastasis of gastrointestinal malignancies limit the effectiveness of medical treatments.Therefore,investigating the molecular mechanisms involved in the pathogenesis of gastrointestinal malignancies is essential for clinical treatment.This article summarizes the biological roles and molecular mechanism of circRNAs in EMT of gastrointestinal malignancies,providing a theoretical basis for applying EMT-related circRNAs in targeted therapy.
文摘BACKGROUND Resilience is an individual’s ability and psychological rebound capacity to adapt well after experiencing adversity,trauma,etc.Patients with strong resilience can face illnesses actively.AIM To determine the association of resilience with coping styles and quality of life in patients with malignancies.METHODS This study included patients with malignant tumors who were hospitalized at Fuyang Hospital Affiliated to Anhui Medical University from March 2022 to March 2024.The Connor-Davidson Resilience Scale,Medical Coping Modes Questionnaire,Social Support Rating Scale,and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were utilized to assess patients’resilience,coping styles,social support,and quality of life,respectively.Pearson correlation analysis was conducted to assess the correlations.RESULTS A total of 175 patients with malignant tumors demonstrated no marked difference in terms of age,education level,employment status,monthly household income,and disease staging(P<0.05).Further,patients with malignancies demonstrated scores of 17.49±1.20,17.27±1.46,and 11.19±1.29 points in terms of coping styles in confrontation,avoidance,and resignation dimensions,respectively.Subjective support,objective support,and support utilization scores in terms of social support were 10.67±1.80,11.26±2.08,and 9.24±1.14 points,respectively.The total resilience score and tenacity,self-improvement,and optimism dimension scores were positively correlatedwith the confrontation coping style score,whereas the total resilience score and tenacity and self-improvementscores were negatively associated with avoidance and resignation coping style scores(P<0.05).The total resiliencescore and the tenacity dimension score were positively associated with physical,role,cognitive,emotional,andsocial functions,as well as global health status(P<0.05),and were inversely related to fatigue,insomnia,andeconomic difficulties(P<0.05).CONCLUSIONThe resilience of patients with malignancies is positively associated with the confrontation dimension in the copingstyle,the total and various social support domain scores,and the overall quality of life.Clinical medical staff needto pay attention to the effect of medical coping styles and social support on the resilience level of patients withmalignancies to further improve their quality of life.
基金Supported by the 2023 Government-funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731D+1 种基金Natural Science Foundation of Hebei Province,No.H202423105Hebei Provincial Administration of Traditional Chinese Medicine,Scientific Research Project,No.2020014.
文摘In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin family member 14(KIF14),a critical kinesin,is pivotal in the proliferation,migration,and invasion of tumor cells.It has emerged as a focal point in recent studies of malignant tumors in the digestive tract.This article reviews the current research on KIF14 within these tumors and details its significant role in tumor cell behaviors,including proliferation,apo-ptosis,migration,invasion,and angiogenesis,alongside the regulatory mechanisms of the associated intracellular signaling pathways.Additionally,it explores the clinical value of KIF14 as a potential biomarker for early diagnosis,disease monitoring,and prognostic evaluation in malignant tumors of the digestive tract.The article concludes by introducing the potential regulatory role of traditional Chinese medicine,aiming to combine the strengths of both modern and traditional medical approaches to enhance treatment outcomes and prognosis for patients with these tumors.
文摘Objective:To explore the epidemiological trends and clinical presentations of brucellosis in patients diagnosed with different types of cancer.Methods:A systematic review was performed utilizing PubMed,Embase,Scopus,Web of Science,and Google Scholar following PRISMA guidelines until September 2022.An update in December 2023 was conducted to ensure thorough coverage of the literature.Results:A total of 28 articles met the eligibility criteria,reporting 38 cases of brucellosis in patients with cancer.Among these cases,hematological cancers were the most common,comprising 66%of the cases,and B.melitensis was identified as the predominant species.The primary clinical manifestations of brucellosis infection included constitutional symptoms in a notable 60.5%of cases and febrile neutropenia in 21%.Additionally,six cases(15.8%)experienced relapse or recurrence of brucellosis,all of which were managed using a combination therapy of rifampin and doxycycline.While 28 patients successfully achieved remission from both brucellosis and their underlying neoplastic conditions,unfortunately,nine cases resulted in mortality attributed to septic shock,progressive liver failure,and massive embolism;no deaths directly related to brucellosis were reported.Among the non-surviving cases,hematologic malignancies were the most prevalent neoplastic conditions(77.7%).Conclusions:Brucellosis-cancer co-occurrence is rare but is not related to increasing mortality.The risk of relapse is higher in cancer patients,especially with hematologic malignancies.Screening,monitoring,and judicious antibiotic use can mitigate brucellosis risks in neoplastic patients.
基金funded by the Jiangsu Graduate Student Practice and Innovation Program(No.SJCX23_0665).
文摘Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the perioperative and nutritional management of patients with gynecologic malignancy.Methods:This study included 77 patients with gynecologic malignancies confirmed by surgical pathology between December 2021 and January 2023.Preoperative body composition data were obtained using bioelectrical impedance analysis.Nutritional risk screening and assessment were performed.Differences in body composition by age,nutritional status,International Federation of Gynecology and Obstetrics(FIGO)stage,systemic inflammatory response,and type of gynecologic malignancy were compared.Results:The extracellular water ratio was significantly higher in patients with a high FIGO stage than in those with a low FIGO stage(t=4.047,P<0.001).Other body composition parameters were lower in patients with a high FIGO stage than in those with a low FIGO stage(P<0.05).Regarding the NLR,the extracellular water ratio was significantly higher in patients with a high NLR than in those with a low NLR(t=2.929,P=0.005).As the nutritional condition worsened,the extracellular water ratio increased(H=12.291,P=0.002),with no significant difference in other body composition parameters between patients with different nutritional conditions(H=5.118,P=0.077).Other body composition parameters decreased with the nutritional condition,which was statistically significant(P<0.05).Conclusions:Bioelectrical impedance analysis is an easy-to-perform,noninvasive,and reproducible measurement technique that can assess changes in body composition.Body composition analysis can effectively determine an individual’s nutritional and metabolic status,providing a reference for the management of patients with gynecologic malignancy,and potentially providing predictive biomarkers to stratify these patients.
文摘Liver transplantation(LT)is the definitive treatment for end-stage liver disease,acute liver failure,and liver cancer.Although advancements in surgical techniques,postoperative care,and immunosuppressive therapies have significantly improved outcomes,the long-term use of immunosuppression has increased the risk of complications,including infections,cardiovascular disease,and cancer.Among these,de novo malignancies(DNMs)are a major concern,accounting for 20%-25%of deaths in LT recipients surviving beyond the early post-transplant period.Non-melanoma skin cancers,particularly squamous cell carcinoma are the most prevalent DNMs.Other significant malignancies include Kaposi's sarcoma,post-transplant lymphoproliferative disorders,and various solid organ cancers,including head and neck cancers.Compared to the general population,LT patients face a twofold increase in solid organ malignancies and a 30-fold increase in lymphoproliferative disorders.Risk factors for DNM include chronic immunosuppression,alcohol or tobacco use,viral infections,and underlying liver disease.Emerging evidence emphasizes the importance of tailored cancer screening and prevention strategies,including regular dermatological examinations,targeted screenings for high-risk cancers,and patient education on lifestyle modifications.Early detection through enhanced surveillance protocols has been shown to improve outcomes.Management of DNMs involves a combination of standard oncological therapies and adjustments to immunosuppressive regimens,with promising results from the use of mTOR inhibitors in select patients.The review highlights the critical need for ongoing research to refine risk stratification,optimize screening protocols,and improve treatment approaches to mitigate the burden of DNMs in LT recipients.By implementing personalized preventive and therapeutic strategies,we can enhance long-term outcomes and quality of life for this vulnerable population.
基金National High Level Hospital Clinical Research Funding,Grant/Award Number:2022‐PUMCHC‐006Chinese National Key Technology R&D Program,Grant/Award Number:2022YFC2703103Beijing Natural Science Foundation,Grant/Award Number:7232113。
文摘Immunoglobulin G4‐related disease(IgG4‐RD)is a systemic fibroinflammatory disease characterized by tumefactive lesions.Beyond the role of the disease as a cancer mimic,studies over the past decade have demonstrated that IgG4‐RD is associated with increased cancer risk.A search of articles,case reports,and reviews concerning malignancies in patients with IgG4‐RD was conducted on PubMed,Web of Science,and Google Scholar.The site of cancer development is not always affected by IgG4‐RD.The prevalence of solid cancers varies among populations.Moreover,B‐cell neoplasms constitute a proportion of the malignancies linked to this disease.The precise mechanism of oncogenesis in IgG4‐RD is ambiguous.Several mechanisms may be relevant to the increased cancer risk in patients with IgG4‐RD,including chronic inflammation,IgG4‐positive plasma cell infiltration,and the involvement of follicular helper T cells,macrophages,and plasmacytoid dendritic cells in tumor immunity.The risk factors include male sex,older age,smoking status,occupational exposure,disease recurrence,and involvement of specific organs.Malignancies in patients with IgG4‐RD are associated with a poor prognosis,underscoring the importance of cancer risk management and regular screening during follow‐up.The precise mechanisms linking IgG4‐RD to malignancy remain unclear and warrant further research.Regular cancer screening should be prioritized during follow‐up to facilitate early detection of malignancies.
基金Supported by "Kapodistrias" Research Program, Special Accounts Research Fund 70/4/6549, National and Kapodistrian University of Athens, Greece
文摘E2F family of transcription factors regulates various cellular functions related to cell cycle and apoptosis. Its individual members have traditionally been classified into activators and repressors, based on in vitro studies. However their contribution in human cancer is more complicated and difficult to predict. We review current knowledge on the expression of E2Fs in digestive system malignancies and its clinical implications for patient prognosis and treatment. E2F1, the most extensively studied member and the only one with prognostic value, exhibits a tumor-suppressing activity in esophageal, gastric and colorectal adenocarcinoma, and in hepatocellular carcinoma (HCC), whereas in pancreatic ductal adenocarcinoma and esophageal squamous cell carcinoma may function as a tumorpromoter. In the latter malignancies, E2F1 immunohistochemical expression has been correlated with higher tumor grade and worse patient survival, whereas in esophageal, gastric and colorectal adenocarcinomas is a marker of increased patient survival. E2F2 has only been studied in colorectal cancer, where its role is not considered significant. E2F4's role in colorectal, gastric and hepatic carcinogenesis is tumor-promoting. E2F8 is strongly upregulated in human HCC, thus possibly contributing to hepatocarcinogenesis. Adenoviral transfer of E2F as gene therapy to sensitize pancreatic cancer cells for chemotherapeutic agents has been used in experimental studies. Other therapeutic strategies are yet to be developed, but it appears that targeted approaches using E2F-agonists or antagonists should take into account the tissue-dependent function of each E2F member. Further understanding of E2Fs' contribution in cellular functions in vivo would help clarify their role in carcinogenesis.
文摘Hepatitis due to hepatitis B virus(HBV) reactivation can be severe and potentially fatal, but is preventable. HBV reactivation is most commonly reported in patients receiving cancer chemotherapy, especially rituximabcontaining therapy for hematological malignancies and those receiving stem cell transplantation. All patients with hematological malignancies receiving anticancer therapy should be screened for active or resolved HBV infection by blood tests for hepatitis B surface antigen(HBs Ag) and antibody to hepatitis B core antigen(antiHBc). Patients found to be positive for HBs Ag should be given prophylactic antiviral therapy to prevent HBV reactivation. For patients with resolved HBV infection, no standard strategy has yet been established to prevent HBV reactivation. There are usually two options. One is pre-emptive therapy guided by serial HBV DNA monitoring, whereby antiviral therapy is given as soon as HBV DNA becomes detectable. However, there is little evidence regarding the optimal interval and period of monitoring. An alternative approach is prophylactic antiviral therapy, especially for patients receiving highrisk therapy such as rituximab, newer generation of anti-CD20 monoclonal antibody, obinutuzumab or hematopoietic stem cell transplantation. This strategy may effectively prevent HBV reactivation and avoid the inconvenience of repeated HBV DNA monitoring. Entecavir or tenofovir are preferred over lamivudine as prophylactic therapy. Although there is no well-defined guideline on the optimal duration of prophylactic therapy, there is growing evidence to recommend continuing prophylactic antiviral therapy for at least 12 mo after cessation of chemotherapy, and even longer for those who receive rituximab or who had high serum HBV DNA levels before the start of immunosuppressive therapy. Many novel agents have recently become available for the treatment of hematological malignancies, and these agents may be associated with HBV reactivation. Although there is currently limited evidence to guide the optimal preventive measures, we recommend antiviral prophylaxis in HBs Ag-positive patients receiving novel treatments, especially the Bruton tyrosine kinase inhibitors and the phosphatidylinositol 3-kinase inhibitors, which are B-cell receptor signaling modulators and reduce proliferation of malignant B-cells. Further studies are needed to clarify the risk of HBV reactivation with these agents and the best prophylactic strategy in the era of targeted therapy for hematological malignancies.
文摘BACKGROUND Immunosuppression has undoubtedly raised the overall positive outcomes in the post-operative management of solid organ transplantation. However, long-term exposure to immunosuppression is associated with critical systemic morbidities. De novo malignancies following orthotopic liver transplants (OLTs) are a serious threat in pediatric and adult transplant individuals. Data from different experiences were reported and compared to assess the connection between immunosuppression and de novo malignancies in liver transplant patients. AIM To study the role of immunosuppression on the incidence of de novo malignancies in liver transplant recipients. METHODS A systematic literature examination about de novo malignancies and immunosuppression weaning in adult and pediatric OLT recipients was described in the present review. Worldwide data were collected from highly qualified institutions performing OLTs. Patient follow-up, immunosuppression discontinuation and incidence of de novo malignancies were reported. Likewise, the review assesses the differences in adult and pediatric recipients by describing the adopted immunosuppression regimens and the different type of diagnosed solid and blood malignancy.RESULTS Emerging evidence suggests that the liver is an immunologically privileged organ able to support immunosuppression discontinuation in carefully selected recipients. Malignancies are often detected in liver transplant patients undergoing daily immunosuppression regimens. Post-transplant lymphoproliferative diseases and skin tumors are the most detected de novo malignancies in the pediatric and adult OLT population, respectively. To date, immunosuppression withdrawal has been achieved in up to 40% and 60% of well-selected adult and pediatric recipients, respectively. In both populations, a clear benefit of immunosuppression weaning protocols on de novo malignancies is difficult to ascertain because data have not been specified in most of the clinical experiences. CONCLUSION The selected populations of tolerant pediatric and adult liver transplant recipients greatly benefit from immunosuppression weaning. There is still no strong clinical evidence on the usefulness of immunosuppression withdrawal in OLT recipients on malignancies. An interesting focus is represented by the complete reconstitution of the immunological pathways that could help in decreasing the incidence of de novo malignancies and may also help in treating liver transplant patients suffering from cancer.
文摘In this study,we used plasma factor V activity and parameters of the thrombin generation test to discuss their diagnostic and prognostic value for disseminated intravascular coagulation (DIC) in patients with hematological malignancies.A total of 164 patients who were diagnosed with hematological malignancies in the Department of Hematology,Union Hospital,between Apr 2014 and Dec.2014 were enrolled in this study.There were 131 patients in the study group and 33 patients in the control group in terms of the laboratory results for DIC.The patients in the study group were divided into a DIC subgroup (n=59) and a non-DIC subgroup (n=72) based on the International Society of Thrombosis and Hemostasis (ISTH) Integral System,and they were divided into four subgroups [score ≤3 (n=35),score=4 (n=37),score=5 (n=47),and score >6 (n=12)] according to ISTH scores.Using 28-day mortality as the endpoint,the patients in the study group were divided into a survival subgroup (n=111) and a non-survival subgroup (n=20).The results showed that the plasma factor V activity was significantly weaker,and lag time and time to peak were significantly shorter in the study group than in the control group (P<0.01).The factor V activity,peak and endogenous thrombin potential (ETP) were significantly decreased in the DIC subgroup as compared with those in the non-DIC subgroup (P<0.01).Among factor V activity,lag time,peak,ETP,and ttPeak,only the factor V activity was significantly decreased in the nonsurvival subgroup compared with the survival subgroup (P<0.01).With the increase in ISTH score,the ETP and peak decreased gradually.The binary logistic regression analysis revealed that PLT,D-dimer,factor V activity and ETP had linear relationship with DIC diagnosed by ISTH Integral System.Using DIC diagnosed by ISTH Integral System as the endpoint,the area under curve (AUC) of factor V activity was found to be similar to that of blood platelet count (PLT) and prothrombin time (PT).In conclusion,factor V activity,ETP and peak had diagnostic value for DIC in patients with hematological malignancies,and only factor V activity had limited prognostic value.
文摘AIM： To analyze the characteristics of multiple primary malignancies （MPMs） of digestive system; including incidence, types of tumor combinations, time intervals between development of multiple tumors, clinical course,and prognostic factors affecting survival and mortality.METHODS： Data from a total of 129 patients treated from January 1991 to December 2000 for pathologically proved MPMs, including at least one originating from the digestive system, were reviewed retrospectively.RESULTS： Among 129 patients, 120 （93.02%） had two primary cancers and 9 （6.98%） had three primary cancers. The major sites of MPMs of the digestive system were large intestine, stomach, and liver. Associated nondigestive cancers included 40 cases of gynecological cancers, of which 31 were carcinoma of cervix and 10 cases of genitourinary cancers, of which 5 were bladder cancers. Other cancers originated from the lung, breast,nasopharynx, larynx, thyroid, brain, muscle, and skin.Reproductive tract cancers, especially cervical, ovarian,bladder, and prostate cancers were the most commonlyassociated non-G! cancers, followed by cancer of the lung and breasts. Forty-three cases were synchronous, while the rest （86 cases） were metachronous cancers. Staging of MPMs and treatment regimes correlated with the prognosis between survival and non-survival groups.CONCLUSION： As advances in cancer therapy bring about a progressively larger percentage of long-term survivors, the proportion of patients with subsequent primary lesions will increase. Early diagnosis of these lesions, based on an awareness of the possibility of second and third cancers, and multidiscipiinary treatment strategies will substantially increase the survival of these patients.
基金supported by the National Science Foundation of China (No. 30800402)
文摘TMTP1, a 5-amino acid peptide NVVRQ, obtained by using the flagella peptide library screening in our previous studies, can be used for the labeling of malignant in situ and metastatic lesions, and even micro-metastases. In this study, TMTP1 was assessed for its ability to specifically target the malignant hematopoietic cells and metastatic lesions of hematological malignancies. FITC-TMTP1 was chemically synthesized. Immunofluorescence assay and competitive test were carried out to determine the specific binding capacity of TMTPl to hematological malignant cell lines, including HL60, k562, SHI-1, Jurkat, Raji, El-4 and umbilical cord blood mononuclear cells. Mononuclear cells were isolated from the bone marrow of healthy subjects and patients with chronic myeloid leukemia. Then the cells were co-clutured with TMTP1 or scrambled peptides and the binding and affinity of TMTP1 peptide to the primary cells of hematological malignancies were flow cytometrically analyzed. The binding speci-ficity of TMTP1 to target hematological malignancies was measured in vivo by intravenous injection of FITC-conjugated TMTP1 into El-4 lymphoma-bearing mice. The results showed that TMTP1 specifi-cally bound to the cells of a series of hematological malignancies, including HL60, k562, Jurkat, Raji , El-4 and chronic myeloid leukemia primary cells but not to bone marrow mononuclear cells from healthy subjects. By contrast, TMTP1 could bind to the metastatic foci of lymphoma originating from the EL-4 cell line while the scrambled peptide failed to do so. Moreover, the occult metastases could be identified, with high specificity, by detecting FITC-TMTP1. We are led to conclude that TMTP1, as a novel tumor-homing peptide, can serve as a marker for primary malignant and metastatic lesions for the early diagnosis of hematological malignances and a carrier of anticancer drugs for cancer treatment.
文摘Hepatectomy is still the major curative treatment for patients with liver malignancies.However,it is still a big challenge to remove the tumors in the central posterior area,especially if their location involves the retrohepatic inferior vena cava and hepatic veins.Ex vivo liver resection and auto-transplantation(ELRA),a hybrid technique of the traditional liver resection and transplantation,has brought new hope to these patients and therefore becomes a valid alternative to liver transplantation.Due to its technical difficulty,ELRA is still concentrated in a few hepatobiliary centers that have experienced surgeons in both liver resection and liver transplantation.The efficacy and safety of this technique has already been demonstrated in the treatment of benign liver diseases,especially in the advanced alveolar echinococcosis.Recently,the application of ELRA for liver malignances has gained more attention.However,standardization of clinical practice norms and international consensus are still lacking.The prognostic impact in these oncologic patients also needs further evaluation.In this review,we summarized the principles and recent progresses on ELRA.
