BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outc...BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outcome and identify the potential prognostic factors of esophageal cancer patients admitted into ICU.METHODS A multicenter cross-sectional study was performed from May 10,2021 to July 10,2021 at ICU departments of 37 cancer specialized hospitals in China.Patients aged≥14 years with ICU duration≥24 hours were included.Clinical records of patients with primary esophageal cancer diagnosis were reviewed.Patients were separated into groups according to the 90 days survival.Characteristics between groups were compared.Single and multi-variate regression tests were applied to analyze the correlated factors of ICU outcomes.Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.RESULTS Total 180 esophageal cancer patients were included.The 90 days mortality was 22.2%.Patients with mortality outcome showed differences from those survived mostly in disease severity and unplanned transfer from clinical ward.The current evaluation tools,including Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores had low accuracy in prediction of short-term death.ICU admitted esophageal cancer patients have poor prognosis,especially those with acute illness.CONCLUSION The prognostic tools for these patients need to be further optimized.展开更多
BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic...BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.展开更多
The present study assessed the efficacy and safety of thoracic radiotherapy(TRT)following first-line chemotherapy or chemoimmunotherapy in patients with extensive-stage small cell lung cancer(ES-SCLC),focusing on the ...The present study assessed the efficacy and safety of thoracic radiotherapy(TRT)following first-line chemotherapy or chemoimmunotherapy in patients with extensive-stage small cell lung cancer(ES-SCLC),focusing on the influence of different TRT timing strategies(consolidative vs.salvage)on survival rates.We retrospectively analyzed a total of 54 patients with ES-SCLC treated between January 2019 and July 2022.Patients receiving consolidative TRT(cTRT)within three months after completion of first-line treatment were compared with those receiving salvage TRT(sTRT)after disease progression.The primary endpoints were overall survival(OS),progression-free survival(PFS),locoregional-free survival(LRFS),and distant metastasis-free survival(DMFS);the secondary endpoint included safety.The cTRT group(n=41)showed significantly longer median OS(26.6 vs.14.8 months,P=0.048),PFS(12.9 vs.3.5 months,P<0.0001),and DMFS(10.7 vs.3.4 months,P=0.0044)than the sTRT group(n=13).Multivariate analysis revealed that cTRT was an independent,favorable prognostic factor.No significant differences in OS or LRFS were observed between high-dose(≥50 Gy)and low-dose(<50 Gy)TRT.Hematologic and respiratory toxicities were the most frequently reported adverse events,with acceptable tolerability.In conclusion,cTRT after chemoimmunotherapy significantly improves survival outcomes for ES-SCLC patients,and low-dose TRT may be a suitable option.展开更多
Gastric cancer(GC)is a prevalent and devastating disease with a poor prognosis.The lack of biomarkers for early detection and effective targeted therapeutics for GC patients represents two major challenges.Through iso...Gastric cancer(GC)is a prevalent and devastating disease with a poor prognosis.The lack of biomarkers for early detection and effective targeted therapeutics for GC patients represents two major challenges.Through isobaric tags for relative and absolute quantitation(iTRAQ)coupled with liquid chromatography-tandem mass spectrometry(LC-MS/MS)phosphoproteomic analysis of 14 GC and gastric epithelial cell lines,we discovered the discoidin domain receptor tyrosine kinase 1(DDR1)as a top potential drug target out of 40 tyrosine kinases detected along with over 1000 phosphoproteins profiled.The DDR1 protein and mRNA levels were upregulated in GC cells concurrent with DDR1 gene amplification.Immunohistochemistry staining of more than 200 clinical samples revealed that DDR1 was overexpressed in approximately 41%and 48%of the intestinal and diffuse types of GC cases,respectively,compared with only 3.5%in normal tissues.Higher DDR1 expression was associated with poor prognosis.In cellular models,DDR1 overexpression led to accelerated proliferation,invasion,and malignant transformation,putatively via inhibition of the Hippo pathway and consequent activation of YAP-TEAD target gene expression.Notably,DDR1-overexpressing GC cells exhibited high vulnerability to selective DDR1 inhibitors.The present study provides preclinical support for the application of DDR1-selective inhibitors in DDR1-overexpressing GC.展开更多
Small cell lung cancer(SCLC)constitutes approximately 15%of all lung cancer cases,characterized by rapid tumor growth,a high pro-liferation rate,and a propensity for early metastasis.1 Approximately one-third of SCLC ...Small cell lung cancer(SCLC)constitutes approximately 15%of all lung cancer cases,characterized by rapid tumor growth,a high pro-liferation rate,and a propensity for early metastasis.1 Approximately one-third of SCLC patients are diagnosed at the limited-stage.Histor-ically,the standard of care for these patients has been 4-6 cycles of concurrent chemoradiotherapy(cCRT),with the exception of a minor-ity of early-stage T1-2N0 patients who may undergo radical surgery.2 Despite an initial high sensitivity to treatment,over 50%of patients experience disease recurrence within two years,with a median overall survival(OS)ranging from 16 to 24 months.For the past three decades,while there have been novel explorations in radiotherapy dosing and fractionation,the treatment paradigm for limited-stage SCLC(LS-SCLC)has remained largely unchanged,with no significant improvement in patient survival outcomes.展开更多
Prostate cancer(PCa)is a prevalent malignancy in men,traditionally linked to androgen receptor signaling.Emerging evidence suggests thyroid hormones(THs,particularly T3/T4)play a complex role in PCa biology.THs regula...Prostate cancer(PCa)is a prevalent malignancy in men,traditionally linked to androgen receptor signaling.Emerging evidence suggests thyroid hormones(THs,particularly T3/T4)play a complex role in PCa biology.THs regulate gene transcription via nuclear receptors TRα/β,modulating proliferation,apoptosis,and AR signaling,while non-genomic pathways through integrin αvβ3 activate MAPK/PI3K-Akt signaling,driving metabolic reprogramming,migration,and angiogenesis.Local DIO enzymes fine-tune T3/T4 levels,with DIO2 enhancing proliferation and DIO3 creating a low-TH microenvironment to facilitate immune evasion.Epidemiological studies associate hyperthyroidism or low TSH with elevated PCa risk,whereas experimental models show inconsistent effects,reflecting regulation by hormone levels,receptor distribution,and tumor molecular features.Bibliometric analyses reveal a shift from epidemiological studies to molecular,immune,and metabolic mechanistic research,though clinical translation remains limited.This review synthesizes current knowledge on THs in PCa,highlighting mechanistic insights,evidence gaps,and future directions,aiming to inform early detection,stratification,and therapeutic strategies.展开更多
BACKGROUND Serum calcium ion(Ca2+)is an economical and readily available indicator as a routine screening test for hospitalized patients.There are no studies related to serum Ca2+level and digestive tract malignancy.A...BACKGROUND Serum calcium ion(Ca2+)is an economical and readily available indicator as a routine screening test for hospitalized patients.There are no studies related to serum Ca2+level and digestive tract malignancy.AIM To evaluate the effectiveness of serum Ca2+level in predicting the prognosis of patients with colorectal cancer(CRC).METHODS We retrospectively collected the data of 280 patients diagnosed with CRC who underwent radical surgery at the Affiliated Cancer Hospital of Xinjiang Medical University.By analyzing the clinicopathological features,differences between serum Ca2+concentrations on the first day after surgery were determined.We used the receiver operating characteristic curve to assess the predictive ability of serum Ca2+for survival.Survival analyses were performed using the Kaplan-Meier method,and multivariate Cox proportional risk regression was used to determine association between calibration serum Ca2+levels and CRC survival outcomes.RESULTS By receiver operating characteristic curve analysis,the ideal threshold value for Ca2+the first postoperative day and delta serum calcium(δCa2+)value were 1.975 and 0.245,respectively.Overall survival(OS)and progression-free survival(PFS)were better in both the high Ca2+group and highδCa2+group on the first postoperative day.The variables identified through univariate analysis were incorporated into multivariate analysis and showed that tumor differ-entiation(P=0.047),T stage(P=0.019),N stage(P<0.001),nerve vascular invasion(P=0.037),carcinoembryonic antigen(P=0.039),baseline serum Ca2+level(P=0.011),and serum Ca2+level on the first day(P=0.006)were independent predictors of prognosis for patients undergoing feasible radical CRC surgery.Using the findings from the multifactorial analysis,we developed a nomogram and the calibration showed a good predictive ability.CONCLUSION Low serum Ca2+level on the first postoperative day is an independent risk factor for OS and PFS in CRC.展开更多
BACKGROUND Colorectal cancer(CRC)is a common malignancy that has become a global burden.The prognostic prediction of CRC patients on the basis of inflammatory biomarkers and nutritional biomarkers has shown some poten...BACKGROUND Colorectal cancer(CRC)is a common malignancy that has become a global burden.The prognostic prediction of CRC patients on the basis of inflammatory biomarkers and nutritional biomarkers has shown some potential but has not been fully explored.AIM To develop and validate a prognostic model for CRC based on inflammation and nutrition-related biomarkers and to evaluate its predictive value for patient outcomes.METHODS Patients were randomized at a 3:2 ratio into a training cohort(n=282)or a validation cohort(n=188).To identify the optimal prognostic factors for constructing the risk score(RS),LASSO Cox regression analysis was conducted.The association between the RS and overall survival(OS)was evaluated using receiver operating characteristic(ROC)curves and Kaplan-Meier(K-M)survival analysis.Independent risk factors were screened by multivariate Cox regression analysis.Nomograms were constructed and validated on the basis of these factors.RESULTS In the training cohort,univariate analysis of all the inflammatory and nutritional biomarkers demonstrated some predictive value.A LASSO-Cox analysis included four biomarkers and constructed an RS.Through ROC analysis,the area under the prognostic curve was 0.795.K-M survival curve analyses revealed that the five-year OS was significantly greater in the Low-RS group than in the High-RS group(P<0.001).Multivariate analysis demonstrated that the degree of differentiation(P=0.001),degree of nerve invasion(P=0.022),and RS(P<0.001)were independent risk factors.We constructed a nomogram to predict the OS of CRC patients and validated it in a separate cohort.The calibration curve showed high accuracy.Additionally,decision curve analysis for 1-year,3-year,and 5-year survival probabilities indicated significant clinical utility in predicting survival outcomes.CONCLUSION This study developed a nomogram based on the RS to predict the OS of CRC patients.This nomogram can guide treatment decisions and enable the formulation of personalized follow-up strategies on the basis of predicted recurrence risk,aiming to improve long-term prognosis.展开更多
Objective:To understand the current status and changing trends in the lifetime risk of residents in Henan Province,China to develop and die from cancer.Methods:Lifetime risk was estimated using the Adjusted for Multip...Objective:To understand the current status and changing trends in the lifetime risk of residents in Henan Province,China to develop and die from cancer.Methods:Lifetime risk was estimated using the Adjusted for Multiple Primaries(AMP)method,incorporating cancer incidence,mortality,and all-cause mortality data from 55 cancer registries in Henan Province,China.Estimates were calculated overall and stratified by gender and area.The annual percent change(APC)in lifetime risk from 2010 to 2020,stratified by gender and cancer site,was estimated using a log-linear model.Results:In 2020,the lifetime risk of developing and dying from cancer was 30.19%(95%CI:29.63%-30.76%)and 23.62%(95%CI:23.28%-23.95%),respectively.These estimates were higher in men,with values of 31.22%(95%CI:30.59%-31.85%)for developing cancer and 26.73%(95%CI:26.29%-27.16%)for dying from cancer,compared with women,who had values of 29.02%(95%CI:28.12%-29.91%)and 20.08%(95%CI:19.51%-20.64%),respectively.There were also geographical differences,with higher estimates in urban areas compared with rural areas.Residents had the highest lifetime risk of developing lung cancer,with a rate of 6.94%,followed by breast cancer(4.14%),stomach cancer(3.95%),esophageal cancer(3.75%),and liver cancer(2.86%).Similarly,the highest lifetime risk of dying from cancer was observed for the following sites:lung(5.99%),stomach(3.60%),esophagus(3.39%),liver(2.78%),and colorectum(1.55%).Overall,the lifetime risk of developing cancer increased,with an APC of 0.75%(P<0.05).Varying trends were observed across different cancer sites.There were gradual decreases in nasopharynx,esophagus,stomach,and liver cancers.Conversely,increasing trends were noted for most other sites,with the highest APCs observed in thyroid,prostate,lymphoma,kidney,and gallbladder cancers.Conclusion:The lifetime risks of developing and dying from cancer were 30.19%and 23.62%,respectively.Variations in cancer risk across different regions,genders,specific cancer sites,and over calendar years provide important information for cancer prevention and policy making in the population.展开更多
BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in...BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in the prognostic evaluation of CRC.Laparoscopic radical resection is a common surgical approach for treating CRC.However,research on the link between preoperative imaging and short-term prognosis in this context is limited.We hypothesized that specific preope-rative imaging features can predict the short-term prognosis in patients under-going laparoscopic CRC resection.AIM To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.METHODS This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who under-went laparoscopic radical resection between January 2021 and February 2024.All patients underwent magnetic resonance imaging(MRI)and were diagnosed with CRC through pathological examination.MRI data and prognostic indicators were collected 30 days post-surgery.Logistic regression analysis identified imaging fea-tures linked to short-term prognosis,and a receiver operating characteristic(ROC)curve was used to evaluate the predictive value.RESULTS Among 122 patients,22 had irregular,low-intensity tumors with adjacent high signals.In 55,tumors were surrounded by alternating signals in the muscle layer.In 32,tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue.Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps.Logistic regression revealed differences in longitudinal tumor length,axial tumor length,volume transfer constant,plasma volume fraction,and apparent diffusion coefficient among patients with varying prognostic results.ROC analysis indicated that the areas under the curve for these parameters were 0.648,0.927,0.821,0.809,and 0.831,respectively.Sensitivity values were 0.643,0.893,0.607,0.714,and 0.714,and specificity 0.702,0.904,0.883,0.968,and 0.894(P<0.05).CONCLUSION The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection.These findings provide valuable insights for clinical decision-making.展开更多
BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses r...BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.展开更多
Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A t...Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A total of 27 patients with pancreatic cancer undergoing chemotherapy at two medical institutions were recruited between November 2023 and August 2024.Semi-structured interviews were conducted in person or over the phone.Data were analyzed using traditional content and thematic analyses.Results:Three themes were identified:symptom experience,self-coping patterns,and existing obstacles.During the early stages of chemotherapy,patients reported a higher frequency of unpleasant symptoms and recognized these symptoms earlier in the treatment course.Patients in the early stages primarily relied on external support to cope with symptoms,while those in the later stages adopted self-care strategies.Several challenges related to unpleasant symptoms were observed,which appeared to correlate with the self-coping patterns employed.Conclusion:Patients with pancreatic cancer undergoing chemotherapy experience a complex and diverse range of symptoms,with varying coping patterns at different stages of treatment.Symptom management during chemotherapy presents significant challenges.Healthcare providers should improve the ongoing monitoring of symptoms post-chemotherapy.By linking patients’symptom experiences and self-coping patterns at different stages of chemotherapy to their specific challenges,personalized symptom management strategies can be developed to enhance care quality.展开更多
BACKGROUND Colorectal cancer(CRC)is the third most diagnosed malignancy worldwide and a frequent comorbidity among these patients is type 2 diabetes mellitus(T2DM).The coexistence of these conditions poses significant...BACKGROUND Colorectal cancer(CRC)is the third most diagnosed malignancy worldwide and a frequent comorbidity among these patients is type 2 diabetes mellitus(T2DM).The coexistence of these conditions poses significant challenges to glycemic management,particularly during chemotherapy.AIM To assess the effects of individualized exercise training(IET)on glycemic control and nutritional status in patients with T2DM undergoing chemotherapy for CRC.METHODS In this retrospective study,clinical data from 245 patients with T2DM and on chemotherapy for CRC between November 2023 and December 2024 were analyzed.Patients were stratified into two groups according to their treatment regimens:The standard care(SC)group(n=111),which received conventional chemotherapy and diabetes management,and an IET group(n=134),which received additional personalized exercise interventions alongside SC.Parameters assessed included fasting plasma glucose,glycosylated hemoglobin,glycemic variability indices,nutritional biomarkers,markers of intestinal permeability,and adverse events.RESULTS Patients in the IET group demonstrated significant improvements in glycemic control,nutritional biomarkers,and glycemic variability(all P<0.05),compared with the SC group.The markers of intestinal permeability also improved significantly in the IET group(P<0.05).Meanwhile,no statistically significant difference in the incidence of adverse events was found between the two groups(P>0.05).These findings suggest that individualized exercise interventions can enhance metabolic,nutritional,and gastrointestinal outcomes without increasing treatment-related risks.CONCLUSION Personalized exercise training may offer clinically meaningful benefits in glycemic regulation and nutritional status for patients with T2DM and on chemotherapy for CRC.展开更多
BACKGROUND As a non-coding RNA molecule,circular RNAs(circRNAs)have significant specificity,and existing data suggest a close relationship between them and the prognosis of patients with gastric cancer(GC).However,thi...BACKGROUND As a non-coding RNA molecule,circular RNAs(circRNAs)have significant specificity,and existing data suggest a close relationship between them and the prognosis of patients with gastric cancer(GC).However,this mechanism has no evidence yet.This article explores the functions of hsa_circRNA_102415 in the malignant behavior and potential downstream signaling of GC cells.The chosen approach is loss of signal and functional gain.AIM To investigate and analyze the relationship between hsa_circRNA_102415 and GC and explore its specific role.Results provide reference for other researchers to develop targeted treatment plans.METHODS The gene expression omnibus(GEO)database can be used to obtain the microarray dataset GSE83521.Data were analyzed using the GEO2R tool to identify differences in circRNAs between normal and GC samples.Quantitative real-time polymerase chain reaction was used to detect differentially expressed genes in GC tissue samples and adjacent cancer tissue samples.GC cells were transfected with small interfering-hsa_circRNA_104415 and plasmid DNA(pcDNA)-hsa_ircRNA_102415.Multiple detection methods,such as Transwell and cell counting kit 8,were used to evaluate cellular physiological activities,including cell invasion and proliferation.The relationship between Wnt family members 2B,microRNA(miR)-4529-5p,etc.,including argonaute 2-RNA immunoprecipitation and luciferase reporter genes was analyzed.Rescue experiments were conducted to analyze and explore the relationship between the malignant behavior of GC cells and hsa_circRNA_102415.RESULTS GEO2R analysis confirmed that hsa_circRNA_102415 had significantly higher expression levels in disease tissues.hsa_circRNA_102415 and miR-4529-5p showed a negative correlation in disease cells,suggesting that hsa_circRNA_102415 upregulated WNT2B expression in GC cells as a competing endogenous RNA for miR-4529-5p.miR-4529-5p mimic or small interfering-WNT2B reversed the effects of pcDNA-hsa_circRNA_102415 or miR-4529-5p inhibitor on cell malignant functions.CONCLUSION miR-4529-5p was used to successfully activate the potential of WNT2B,clarify the role of hsa_circRNA_102415 in GC cells,and provide reference for other researchers to develop targeted treatment plans.展开更多
Background Given the relatively unfavorable prognosis and significant geographic differences in lung cancer burden,it is critical to update the global landscape of lung cancer to inform local strategies.Methods Based ...Background Given the relatively unfavorable prognosis and significant geographic differences in lung cancer burden,it is critical to update the global landscape of lung cancer to inform local strategies.Methods Based on the GLOBOCAN 2022,the age-standardized incidence rate(ASIR)and mortality rate(ASMR)were compared and linked to the Human Development Index(HDI)across different populations.The temporal trends in ASIR/ASMR were characterized as estimated annual percentage change(EAPC),and demographic projections were performed up to 2050.Results Globally,an estimated 2,480,675 cases and 1,817,469 deaths from lung cancer occurred in 2022.Both ASIR and ASMR of lung cancer varied widely by world region,with ASIR ranging from 2.06 to 39.38 per 100,000 and ASMR from 1.95 to 31.70 per 100,000.China alone accounted for>40%of cases and deaths worldwide.Both ASIR and ARMR of lung cancer increased with HDI(R2:0.54 and 0.47,all P values<0.001),regardless of gender.Based on available data,both ASIR during 2001–2010 and ASMR during 2001–2015 showed decreasing trends in males(EAPC:1.50%and−2.22%)but increasing trends in females(EAPC:1.08%and 0.07%).Similar trends in ASIR and ASMR were observed among the elder population(≥50 years);however,downward trends were observed in the younger population(<50 years).Alongside the aging and growth of the population,estimated cases and deaths from overall lung cancer would increase by 86.2%and 95.2%up to 2050 as compared with estimates in 2022,respectively.Notably,increased early-onset lung cancer was only observed in transitioning countries,while decreased early-onset lung cancer was observed in transitioned countries.Conclusion Lung cancer maintained as the leading cancer burden worldwide.Unless timely preventive interventions in tobacco mitigation,early screening,and precise treatment,the global lung cancer burden is expected to increase in the future,especially for transitioning countries.展开更多
BACKGROUND Immunotherapy is an approved treatment for metastatic rectal cancer in patients with defective mismatch repair(MMR).AIM To examine the clinical efficacy of neoadjuvant immunotherapy combined with radiothera...BACKGROUND Immunotherapy is an approved treatment for metastatic rectal cancer in patients with defective mismatch repair(MMR).AIM To examine the clinical efficacy of neoadjuvant immunotherapy combined with radiotherapy and chemotherapy for the treatment of locally advanced rectal cancer(LARC),with a focus on patients with proficient MMR(pMMR)and mic-rosatellite stability.METHODS Two researchers searched multiple databases for publications up to September 2024.All included publications examined neoadjuvant immunotherapy for LARC,and reported major pathological response(MPR),pathological complete response(pCR),clinical complete response(CCR),and rates of R0 resection and anus-pre-serving surgery.Meta-analysis,subgroup analysis,sensitivity analysis,and ana-lysis of publication bias were performed.RESULTS We included 15 publications(796 patients).The MPR,pCR,and CCR were sig-nificantly better in the group that received immunotherapy(all P<0.05),espe-cially for patients with pMMR.In addition,the rate of R0 resection and anus-preserving surgery were also significantly greater in the group that received neoadjuvant immunotherapy(both P<0.05).Hematological toxicity and abnormal liver function were the most common clinical adverse events above grade 3.Most patients successfully completed the immunotherapy treatment.The incidence of immune-related adverse reactions was 0%-13.5%,and the severities of these events were generally considered acceptable.CONCLUSION The addition of neoadjuvant immunotherapy improved the clinical remission rate of patients who had LARC with pMMR,and the treatment-related adverse reactions were generally acceptable.Neoadjuvant immunotherapy combined with radiotherapy and chemotherapy should be considered for patients with LARC.展开更多
BACKGROUND Esophageal cancer is a serious global health concern with poor prognosis in advanced stages.Immune checkpoint inhibitors(ICIs)have shown promise in enhancing survival,but they are associated with immune-rel...BACKGROUND Esophageal cancer is a serious global health concern with poor prognosis in advanced stages.Immune checkpoint inhibitors(ICIs)have shown promise in enhancing survival,but they are associated with immune-related adverse events,including potentially life-threatening myocarditis.Moreover,ICI-induced myocarditis can be asymptomatic,necessitating early diagnosis.Specific risk factors and biomarkers for esophageal cancer remain poorly characterized.AIM To investigate the determinants of ICI-associated asymptomatic myocarditis in patients with esophageal cancer and explore potential early biomarkers.METHODS A retrospective analysis was conducted on 202 cancer patients who received treatment at Shanxi Province Cancer Hospital from July 2019 to July 2024.RESULTS Older age,male gender,and elevated creatine kinase isoenzymes(CK-MB)and CK levels were found to be significant risk factors for asymptomatic myocarditis.The myocarditis occurrence group had higher CK-MB(3.05 ng/mL vs 5.02 ng/mL;P<0.001)and CK levels(187.29 U/L vs 212.25 U/L;P=0.005),and the predictive value of age,gender,CK,and CK-MB was low[are under the receiver operating characteristic curve(AUC)=0.579-0.608].However,their combination in a predictive model showed improved diagnostic capability,with an AUC of 0.808.CONCLUSION Age,gender,and cardiac biomarker levels considerably contribute to the risk of ICI-related myocarditis in patients with esophageal cancer.The integration of these factors into a predictive model enhances early diagnosis,facilitating personalized risk management.展开更多
Despite compelling preclinical and epidemiological evidence(e.g.,reduced lung cancer incidence in the CANTOS trial),IL-1βinhibition with canakinumab failed to achieve the expected therapeutic effect in the Phase III ...Despite compelling preclinical and epidemiological evidence(e.g.,reduced lung cancer incidence in the CANTOS trial),IL-1βinhibition with canakinumab failed to achieve the expected therapeutic effect in the Phase III clinical trials(CANOPY series)of non-small cell lung cancer(NSCLC).This perspective analyzes the disconnect between mechanistic promise and clinical outcomes.IL-1βdrives NSCLC progression by promoting immunosuppression,angiogenesis,and metastasis.However,CANOPY-2 showed no overall survival(OS)benefit,though a trend emerged in patients with an elevated baseline of high-sensitivity C-reactive protein(hs-CRP).Similarly,CANOPY-1 and adjuvant CANOPY-A missed primary endpoints for progression-free survival(PFS)and disease-free survival(DFS),respectively.These failures highlight limitations of IL-1 monotherapy in advanced,immunosuppressive microenvironments and underscore inadequate patient selection.We propose that IL-1 antagonism retains therapeutic potential but requires refined strategies:biomarker-driven enrichment(e.g.,inflammation signatures like hs-CRP),rational combinatorial regimens informed by successful multi-target agents(e.g.,cadonilimab),and early-stage intervention.Repositioning IL-1 blockers through precision approaches could unlock their value in immuno-oncology.展开更多
BACKGROUND The survival rate of pancreatic cancer is low,and there is a lack of effective treatment.AIM To explore the epidemiological characteristics of patients with pancreatic cancer in China and compare multiple c...BACKGROUND The survival rate of pancreatic cancer is low,and there is a lack of effective treatment.AIM To explore the epidemiological characteristics of patients with pancreatic cancer in China and compare multiple chemotherapy regimens at different stages.METHODS This was a retrospective study conducted from 2005 to 2014,involving six cancer hospitals and eight general hospitals across seven geographical regions of China(East,South,North,Central,Southwest,Northwest,and Northeast).Stratified sampling was used based on the population distribution of each region.Efficacy assessments were conducted by Cox proportional hazards regression models.When assessing the effectiveness of various chemotherapy regimens,traditional drugs such as gemcitabine used as monotherapy served as the reference.RESULTS A total of 3256 patients were included.The median follow-up time was 407 days,and the median overall survival was 183 days.At diagnosis,56%of patients were already in stage IV.Chemotherapy was administered to 39.73%of patients.In the adjuvant therapy phase,gemcitabine+fluorouracil was superior to gemcitabine monotherapy[hazard ratio(HR)=0.35,95%confidence interval(CI):0.14-0.89].In fluorouracil-based regimens,other combination regimens did not show effectiveness relative to monotherapy.For first-line treatment in patients with advanced disease,tegafur alone(HR=0.20,95%CI:0.06-0.66),gemcitabine plus cisplatin(HR=0.16,95%CI:0.04-0.70),and tegafur,gemcitabine plus platinum-based agents(HR=0.32,95%CI:0.11-0.91)were associated with a lower risk of death compared to gemcitabine alone.In second-line treatment,there were no significant differences in efficacy among various drugs,but FOLFIRINOX(irinotecan+oxaliplatin+leucovorin+5-fluorouracil)had an outstanding point estimate(HR=0.10,95%CI:0.01-1.27).CONCLUSION In China,pancreatic cancer is often diagnosed at advanced stages,emphasizing the need for early diagnosis and treatment.Combined therapies in adjuvant and first-line settings may reduce the risk of death compared with monotherapy,and FOLFIRINOX might offer more significant benefits in second-line treatment.展开更多
BACKGROUND Gastric cancer(GC)is an aggressive malignancy of the gastrointestinal tract characterized by high recurrence rates following radical gastrectomy.To enhance treatment efficacy,reduce recurrence,and improve p...BACKGROUND Gastric cancer(GC)is an aggressive malignancy of the gastrointestinal tract characterized by high recurrence rates following radical gastrectomy.To enhance treatment efficacy,reduce recurrence,and improve patient survival,adjuvant chemotherapy is commonly administered based on established postoperative guidelines.Despite advancements in chemotherapy delivery,the overall response rate remains below 50%,primarily due to the lack of targeted therapies tailored to specific patient populations.AIM To explore sensitive biomarkers to assess the efficacy of postoperative adjuvant chemotherapy in appropriate patient subgroups.METHODS This study retrospectively analyzed 1628 patients who underwent radical gastrectomy for GC at our hospital in 2017 and 2018,with a subsequent five-year follow-up.Patients were divided based on whether they received postoperative adjuvant chemotherapy.The study aimed to determine optimal cutoff values for various biomarkersneutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199,CA724,and CA242-using receiver operating characteristic(ROC)curves.Based on the optimal ROC cut-off,a novel combined metric,NLR-CEA,was developed to assess the efficacy of adjuvant chemotherapy following GC surgery.RESULTS Cox subgroup analysis demonstrated that postoperative adjuvant chemotherapy significantly improved overall survival in the NLR-CEA_Low group with a rate of 0.41(0.26-0.63).In the NLR-CEA_Middle group,the protective effect was observed at 0.69(0.54-0.87),while in the NLR-CEA_High group,it was 0.73(0.53-0.99).Notably,a 32%difference in the efficacy of chemotherapy was observed between the NLR-CEA_Low and NLR-CEA_High groups.CONCLUSION NLR-CEA is an effective biomarker for evaluating the efficacy of postoperative adjuvant chemotherapy in GC.Patients with NLR-CEA_Low exhibit significantly better responses to chemotherapy compared to those with NLRCEA_High.展开更多
文摘BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outcome and identify the potential prognostic factors of esophageal cancer patients admitted into ICU.METHODS A multicenter cross-sectional study was performed from May 10,2021 to July 10,2021 at ICU departments of 37 cancer specialized hospitals in China.Patients aged≥14 years with ICU duration≥24 hours were included.Clinical records of patients with primary esophageal cancer diagnosis were reviewed.Patients were separated into groups according to the 90 days survival.Characteristics between groups were compared.Single and multi-variate regression tests were applied to analyze the correlated factors of ICU outcomes.Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.RESULTS Total 180 esophageal cancer patients were included.The 90 days mortality was 22.2%.Patients with mortality outcome showed differences from those survived mostly in disease severity and unplanned transfer from clinical ward.The current evaluation tools,including Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores had low accuracy in prediction of short-term death.ICU admitted esophageal cancer patients have poor prognosis,especially those with acute illness.CONCLUSION The prognostic tools for these patients need to be further optimized.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.
基金supported by the Young Talents Program of Jiangsu Cancer Hospital(Grant No.QL201802)the Science and Technology Development Fund of Jiangsu Cancer Hospital(Grant No.ZL202105).
文摘The present study assessed the efficacy and safety of thoracic radiotherapy(TRT)following first-line chemotherapy or chemoimmunotherapy in patients with extensive-stage small cell lung cancer(ES-SCLC),focusing on the influence of different TRT timing strategies(consolidative vs.salvage)on survival rates.We retrospectively analyzed a total of 54 patients with ES-SCLC treated between January 2019 and July 2022.Patients receiving consolidative TRT(cTRT)within three months after completion of first-line treatment were compared with those receiving salvage TRT(sTRT)after disease progression.The primary endpoints were overall survival(OS),progression-free survival(PFS),locoregional-free survival(LRFS),and distant metastasis-free survival(DMFS);the secondary endpoint included safety.The cTRT group(n=41)showed significantly longer median OS(26.6 vs.14.8 months,P=0.048),PFS(12.9 vs.3.5 months,P<0.0001),and DMFS(10.7 vs.3.4 months,P=0.0044)than the sTRT group(n=13).Multivariate analysis revealed that cTRT was an independent,favorable prognostic factor.No significant differences in OS or LRFS were observed between high-dose(≥50 Gy)and low-dose(<50 Gy)TRT.Hematologic and respiratory toxicities were the most frequently reported adverse events,with acceptable tolerability.In conclusion,cTRT after chemoimmunotherapy significantly improves survival outcomes for ES-SCLC patients,and low-dose TRT may be a suitable option.
基金supported by the National Natural Science Foundation of China(Grant No.32170738)the National Medical Research Council of Singapore(Grant No.NMRC/CBRG/0013/2012).
文摘Gastric cancer(GC)is a prevalent and devastating disease with a poor prognosis.The lack of biomarkers for early detection and effective targeted therapeutics for GC patients represents two major challenges.Through isobaric tags for relative and absolute quantitation(iTRAQ)coupled with liquid chromatography-tandem mass spectrometry(LC-MS/MS)phosphoproteomic analysis of 14 GC and gastric epithelial cell lines,we discovered the discoidin domain receptor tyrosine kinase 1(DDR1)as a top potential drug target out of 40 tyrosine kinases detected along with over 1000 phosphoproteins profiled.The DDR1 protein and mRNA levels were upregulated in GC cells concurrent with DDR1 gene amplification.Immunohistochemistry staining of more than 200 clinical samples revealed that DDR1 was overexpressed in approximately 41%and 48%of the intestinal and diffuse types of GC cases,respectively,compared with only 3.5%in normal tissues.Higher DDR1 expression was associated with poor prognosis.In cellular models,DDR1 overexpression led to accelerated proliferation,invasion,and malignant transformation,putatively via inhibition of the Hippo pathway and consequent activation of YAP-TEAD target gene expression.Notably,DDR1-overexpressing GC cells exhibited high vulnerability to selective DDR1 inhibitors.The present study provides preclinical support for the application of DDR1-selective inhibitors in DDR1-overexpressing GC.
基金supported by the Young Talents Program of Jiangsu Cancer Hospital(grant number:QL201813).
文摘Small cell lung cancer(SCLC)constitutes approximately 15%of all lung cancer cases,characterized by rapid tumor growth,a high pro-liferation rate,and a propensity for early metastasis.1 Approximately one-third of SCLC patients are diagnosed at the limited-stage.Histor-ically,the standard of care for these patients has been 4-6 cycles of concurrent chemoradiotherapy(cCRT),with the exception of a minor-ity of early-stage T1-2N0 patients who may undergo radical surgery.2 Despite an initial high sensitivity to treatment,over 50%of patients experience disease recurrence within two years,with a median overall survival(OS)ranging from 16 to 24 months.For the past three decades,while there have been novel explorations in radiotherapy dosing and fractionation,the treatment paradigm for limited-stage SCLC(LS-SCLC)has remained largely unchanged,with no significant improvement in patient survival outcomes.
基金Guangzhou Medical and Health Science and Technology Project(Project No.:20231A011103)General projects of Guangzhou municipal Science and Technology Bureau(Project No.:2023A04J0598)Guangdong Basic and Applied Basic Research Foundation(Project No.:2022A1515111122)。
文摘Prostate cancer(PCa)is a prevalent malignancy in men,traditionally linked to androgen receptor signaling.Emerging evidence suggests thyroid hormones(THs,particularly T3/T4)play a complex role in PCa biology.THs regulate gene transcription via nuclear receptors TRα/β,modulating proliferation,apoptosis,and AR signaling,while non-genomic pathways through integrin αvβ3 activate MAPK/PI3K-Akt signaling,driving metabolic reprogramming,migration,and angiogenesis.Local DIO enzymes fine-tune T3/T4 levels,with DIO2 enhancing proliferation and DIO3 creating a low-TH microenvironment to facilitate immune evasion.Epidemiological studies associate hyperthyroidism or low TSH with elevated PCa risk,whereas experimental models show inconsistent effects,reflecting regulation by hormone levels,receptor distribution,and tumor molecular features.Bibliometric analyses reveal a shift from epidemiological studies to molecular,immune,and metabolic mechanistic research,though clinical translation remains limited.This review synthesizes current knowledge on THs in PCa,highlighting mechanistic insights,evidence gaps,and future directions,aiming to inform early detection,stratification,and therapeutic strategies.
文摘BACKGROUND Serum calcium ion(Ca2+)is an economical and readily available indicator as a routine screening test for hospitalized patients.There are no studies related to serum Ca2+level and digestive tract malignancy.AIM To evaluate the effectiveness of serum Ca2+level in predicting the prognosis of patients with colorectal cancer(CRC).METHODS We retrospectively collected the data of 280 patients diagnosed with CRC who underwent radical surgery at the Affiliated Cancer Hospital of Xinjiang Medical University.By analyzing the clinicopathological features,differences between serum Ca2+concentrations on the first day after surgery were determined.We used the receiver operating characteristic curve to assess the predictive ability of serum Ca2+for survival.Survival analyses were performed using the Kaplan-Meier method,and multivariate Cox proportional risk regression was used to determine association between calibration serum Ca2+levels and CRC survival outcomes.RESULTS By receiver operating characteristic curve analysis,the ideal threshold value for Ca2+the first postoperative day and delta serum calcium(δCa2+)value were 1.975 and 0.245,respectively.Overall survival(OS)and progression-free survival(PFS)were better in both the high Ca2+group and highδCa2+group on the first postoperative day.The variables identified through univariate analysis were incorporated into multivariate analysis and showed that tumor differ-entiation(P=0.047),T stage(P=0.019),N stage(P<0.001),nerve vascular invasion(P=0.037),carcinoembryonic antigen(P=0.039),baseline serum Ca2+level(P=0.011),and serum Ca2+level on the first day(P=0.006)were independent predictors of prognosis for patients undergoing feasible radical CRC surgery.Using the findings from the multifactorial analysis,we developed a nomogram and the calibration showed a good predictive ability.CONCLUSION Low serum Ca2+level on the first postoperative day is an independent risk factor for OS and PFS in CRC.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Colorectal cancer(CRC)is a common malignancy that has become a global burden.The prognostic prediction of CRC patients on the basis of inflammatory biomarkers and nutritional biomarkers has shown some potential but has not been fully explored.AIM To develop and validate a prognostic model for CRC based on inflammation and nutrition-related biomarkers and to evaluate its predictive value for patient outcomes.METHODS Patients were randomized at a 3:2 ratio into a training cohort(n=282)or a validation cohort(n=188).To identify the optimal prognostic factors for constructing the risk score(RS),LASSO Cox regression analysis was conducted.The association between the RS and overall survival(OS)was evaluated using receiver operating characteristic(ROC)curves and Kaplan-Meier(K-M)survival analysis.Independent risk factors were screened by multivariate Cox regression analysis.Nomograms were constructed and validated on the basis of these factors.RESULTS In the training cohort,univariate analysis of all the inflammatory and nutritional biomarkers demonstrated some predictive value.A LASSO-Cox analysis included four biomarkers and constructed an RS.Through ROC analysis,the area under the prognostic curve was 0.795.K-M survival curve analyses revealed that the five-year OS was significantly greater in the Low-RS group than in the High-RS group(P<0.001).Multivariate analysis demonstrated that the degree of differentiation(P=0.001),degree of nerve invasion(P=0.022),and RS(P<0.001)were independent risk factors.We constructed a nomogram to predict the OS of CRC patients and validated it in a separate cohort.The calibration curve showed high accuracy.Additionally,decision curve analysis for 1-year,3-year,and 5-year survival probabilities indicated significant clinical utility in predicting survival outcomes.CONCLUSION This study developed a nomogram based on the RS to predict the OS of CRC patients.This nomogram can guide treatment decisions and enable the formulation of personalized follow-up strategies on the basis of predicted recurrence risk,aiming to improve long-term prognosis.
基金supported by Henan Province Science and Technology Tackling Key Issues Project(grant number:232102310166).
文摘Objective:To understand the current status and changing trends in the lifetime risk of residents in Henan Province,China to develop and die from cancer.Methods:Lifetime risk was estimated using the Adjusted for Multiple Primaries(AMP)method,incorporating cancer incidence,mortality,and all-cause mortality data from 55 cancer registries in Henan Province,China.Estimates were calculated overall and stratified by gender and area.The annual percent change(APC)in lifetime risk from 2010 to 2020,stratified by gender and cancer site,was estimated using a log-linear model.Results:In 2020,the lifetime risk of developing and dying from cancer was 30.19%(95%CI:29.63%-30.76%)and 23.62%(95%CI:23.28%-23.95%),respectively.These estimates were higher in men,with values of 31.22%(95%CI:30.59%-31.85%)for developing cancer and 26.73%(95%CI:26.29%-27.16%)for dying from cancer,compared with women,who had values of 29.02%(95%CI:28.12%-29.91%)and 20.08%(95%CI:19.51%-20.64%),respectively.There were also geographical differences,with higher estimates in urban areas compared with rural areas.Residents had the highest lifetime risk of developing lung cancer,with a rate of 6.94%,followed by breast cancer(4.14%),stomach cancer(3.95%),esophageal cancer(3.75%),and liver cancer(2.86%).Similarly,the highest lifetime risk of dying from cancer was observed for the following sites:lung(5.99%),stomach(3.60%),esophagus(3.39%),liver(2.78%),and colorectum(1.55%).Overall,the lifetime risk of developing cancer increased,with an APC of 0.75%(P<0.05).Varying trends were observed across different cancer sites.There were gradual decreases in nasopharynx,esophagus,stomach,and liver cancers.Conversely,increasing trends were noted for most other sites,with the highest APCs observed in thyroid,prostate,lymphoma,kidney,and gallbladder cancers.Conclusion:The lifetime risks of developing and dying from cancer were 30.19%and 23.62%,respectively.Variations in cancer risk across different regions,genders,specific cancer sites,and over calendar years provide important information for cancer prevention and policy making in the population.
文摘BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in the prognostic evaluation of CRC.Laparoscopic radical resection is a common surgical approach for treating CRC.However,research on the link between preoperative imaging and short-term prognosis in this context is limited.We hypothesized that specific preope-rative imaging features can predict the short-term prognosis in patients under-going laparoscopic CRC resection.AIM To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.METHODS This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who under-went laparoscopic radical resection between January 2021 and February 2024.All patients underwent magnetic resonance imaging(MRI)and were diagnosed with CRC through pathological examination.MRI data and prognostic indicators were collected 30 days post-surgery.Logistic regression analysis identified imaging fea-tures linked to short-term prognosis,and a receiver operating characteristic(ROC)curve was used to evaluate the predictive value.RESULTS Among 122 patients,22 had irregular,low-intensity tumors with adjacent high signals.In 55,tumors were surrounded by alternating signals in the muscle layer.In 32,tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue.Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps.Logistic regression revealed differences in longitudinal tumor length,axial tumor length,volume transfer constant,plasma volume fraction,and apparent diffusion coefficient among patients with varying prognostic results.ROC analysis indicated that the areas under the curve for these parameters were 0.648,0.927,0.821,0.809,and 0.831,respectively.Sensitivity values were 0.643,0.893,0.607,0.714,and 0.714,and specificity 0.702,0.904,0.883,0.968,and 0.894(P<0.05).CONCLUSION The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection.These findings provide valuable insights for clinical decision-making.
文摘BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.
基金supported by the State Key Laboratory of Ultrasonic Medical Engineering/the Chongqing Science and Technology Bureau(Project No.2022KFKT7011)the Postdoctoral Fellowship Program of CPSF(GZC20233357)+1 种基金the Health Commission of Sichuan Province Medical Science and Technology Program(24QNMP007)the Medical Research Program of Health Commission of Chengdu(2023535).
文摘Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A total of 27 patients with pancreatic cancer undergoing chemotherapy at two medical institutions were recruited between November 2023 and August 2024.Semi-structured interviews were conducted in person or over the phone.Data were analyzed using traditional content and thematic analyses.Results:Three themes were identified:symptom experience,self-coping patterns,and existing obstacles.During the early stages of chemotherapy,patients reported a higher frequency of unpleasant symptoms and recognized these symptoms earlier in the treatment course.Patients in the early stages primarily relied on external support to cope with symptoms,while those in the later stages adopted self-care strategies.Several challenges related to unpleasant symptoms were observed,which appeared to correlate with the self-coping patterns employed.Conclusion:Patients with pancreatic cancer undergoing chemotherapy experience a complex and diverse range of symptoms,with varying coping patterns at different stages of treatment.Symptom management during chemotherapy presents significant challenges.Healthcare providers should improve the ongoing monitoring of symptoms post-chemotherapy.By linking patients’symptom experiences and self-coping patterns at different stages of chemotherapy to their specific challenges,personalized symptom management strategies can be developed to enhance care quality.
文摘BACKGROUND Colorectal cancer(CRC)is the third most diagnosed malignancy worldwide and a frequent comorbidity among these patients is type 2 diabetes mellitus(T2DM).The coexistence of these conditions poses significant challenges to glycemic management,particularly during chemotherapy.AIM To assess the effects of individualized exercise training(IET)on glycemic control and nutritional status in patients with T2DM undergoing chemotherapy for CRC.METHODS In this retrospective study,clinical data from 245 patients with T2DM and on chemotherapy for CRC between November 2023 and December 2024 were analyzed.Patients were stratified into two groups according to their treatment regimens:The standard care(SC)group(n=111),which received conventional chemotherapy and diabetes management,and an IET group(n=134),which received additional personalized exercise interventions alongside SC.Parameters assessed included fasting plasma glucose,glycosylated hemoglobin,glycemic variability indices,nutritional biomarkers,markers of intestinal permeability,and adverse events.RESULTS Patients in the IET group demonstrated significant improvements in glycemic control,nutritional biomarkers,and glycemic variability(all P<0.05),compared with the SC group.The markers of intestinal permeability also improved significantly in the IET group(P<0.05).Meanwhile,no statistically significant difference in the incidence of adverse events was found between the two groups(P>0.05).These findings suggest that individualized exercise interventions can enhance metabolic,nutritional,and gastrointestinal outcomes without increasing treatment-related risks.CONCLUSION Personalized exercise training may offer clinically meaningful benefits in glycemic regulation and nutritional status for patients with T2DM and on chemotherapy for CRC.
文摘BACKGROUND As a non-coding RNA molecule,circular RNAs(circRNAs)have significant specificity,and existing data suggest a close relationship between them and the prognosis of patients with gastric cancer(GC).However,this mechanism has no evidence yet.This article explores the functions of hsa_circRNA_102415 in the malignant behavior and potential downstream signaling of GC cells.The chosen approach is loss of signal and functional gain.AIM To investigate and analyze the relationship between hsa_circRNA_102415 and GC and explore its specific role.Results provide reference for other researchers to develop targeted treatment plans.METHODS The gene expression omnibus(GEO)database can be used to obtain the microarray dataset GSE83521.Data were analyzed using the GEO2R tool to identify differences in circRNAs between normal and GC samples.Quantitative real-time polymerase chain reaction was used to detect differentially expressed genes in GC tissue samples and adjacent cancer tissue samples.GC cells were transfected with small interfering-hsa_circRNA_104415 and plasmid DNA(pcDNA)-hsa_ircRNA_102415.Multiple detection methods,such as Transwell and cell counting kit 8,were used to evaluate cellular physiological activities,including cell invasion and proliferation.The relationship between Wnt family members 2B,microRNA(miR)-4529-5p,etc.,including argonaute 2-RNA immunoprecipitation and luciferase reporter genes was analyzed.Rescue experiments were conducted to analyze and explore the relationship between the malignant behavior of GC cells and hsa_circRNA_102415.RESULTS GEO2R analysis confirmed that hsa_circRNA_102415 had significantly higher expression levels in disease tissues.hsa_circRNA_102415 and miR-4529-5p showed a negative correlation in disease cells,suggesting that hsa_circRNA_102415 upregulated WNT2B expression in GC cells as a competing endogenous RNA for miR-4529-5p.miR-4529-5p mimic or small interfering-WNT2B reversed the effects of pcDNA-hsa_circRNA_102415 or miR-4529-5p inhibitor on cell malignant functions.CONCLUSION miR-4529-5p was used to successfully activate the potential of WNT2B,clarify the role of hsa_circRNA_102415 in GC cells,and provide reference for other researchers to develop targeted treatment plans.
基金supported by the National Key Research and Development Program of China(grant number:2021YFC2500400)Tianjin Health Committee Foundation(grant number:TJWJ2021MS008)+2 种基金Tianjin Key Medical Discipline(Specialty)Construction Project(grant number:TYXZDXK-009A)Science and Technology Program of the Joint Fund of Scientific Research for the Public Hospitals of Inner Mongolia Academy of Medical Sciences(grant number:2023GLLH0132)Scientific Research Fund for the Demonstration Project of Public Hospital Reform and Quality Development(Gastrointestinal Tumour)that is approved by Peking University Cancer Hospital(Inner Mongolia Campus)(grant number:2023SGGZ068)。
文摘Background Given the relatively unfavorable prognosis and significant geographic differences in lung cancer burden,it is critical to update the global landscape of lung cancer to inform local strategies.Methods Based on the GLOBOCAN 2022,the age-standardized incidence rate(ASIR)and mortality rate(ASMR)were compared and linked to the Human Development Index(HDI)across different populations.The temporal trends in ASIR/ASMR were characterized as estimated annual percentage change(EAPC),and demographic projections were performed up to 2050.Results Globally,an estimated 2,480,675 cases and 1,817,469 deaths from lung cancer occurred in 2022.Both ASIR and ASMR of lung cancer varied widely by world region,with ASIR ranging from 2.06 to 39.38 per 100,000 and ASMR from 1.95 to 31.70 per 100,000.China alone accounted for>40%of cases and deaths worldwide.Both ASIR and ARMR of lung cancer increased with HDI(R2:0.54 and 0.47,all P values<0.001),regardless of gender.Based on available data,both ASIR during 2001–2010 and ASMR during 2001–2015 showed decreasing trends in males(EAPC:1.50%and−2.22%)but increasing trends in females(EAPC:1.08%and 0.07%).Similar trends in ASIR and ASMR were observed among the elder population(≥50 years);however,downward trends were observed in the younger population(<50 years).Alongside the aging and growth of the population,estimated cases and deaths from overall lung cancer would increase by 86.2%and 95.2%up to 2050 as compared with estimates in 2022,respectively.Notably,increased early-onset lung cancer was only observed in transitioning countries,while decreased early-onset lung cancer was observed in transitioned countries.Conclusion Lung cancer maintained as the leading cancer burden worldwide.Unless timely preventive interventions in tobacco mitigation,early screening,and precise treatment,the global lung cancer burden is expected to increase in the future,especially for transitioning countries.
基金Supported by Start-up Fund for Doctor's Scientific Research in Shanxi Cancer Hospital,No.Dr202314and Natural Exploration Category of Shanxi Basic Research Plan,No.202203021221284.
文摘BACKGROUND Immunotherapy is an approved treatment for metastatic rectal cancer in patients with defective mismatch repair(MMR).AIM To examine the clinical efficacy of neoadjuvant immunotherapy combined with radiotherapy and chemotherapy for the treatment of locally advanced rectal cancer(LARC),with a focus on patients with proficient MMR(pMMR)and mic-rosatellite stability.METHODS Two researchers searched multiple databases for publications up to September 2024.All included publications examined neoadjuvant immunotherapy for LARC,and reported major pathological response(MPR),pathological complete response(pCR),clinical complete response(CCR),and rates of R0 resection and anus-pre-serving surgery.Meta-analysis,subgroup analysis,sensitivity analysis,and ana-lysis of publication bias were performed.RESULTS We included 15 publications(796 patients).The MPR,pCR,and CCR were sig-nificantly better in the group that received immunotherapy(all P<0.05),espe-cially for patients with pMMR.In addition,the rate of R0 resection and anus-preserving surgery were also significantly greater in the group that received neoadjuvant immunotherapy(both P<0.05).Hematological toxicity and abnormal liver function were the most common clinical adverse events above grade 3.Most patients successfully completed the immunotherapy treatment.The incidence of immune-related adverse reactions was 0%-13.5%,and the severities of these events were generally considered acceptable.CONCLUSION The addition of neoadjuvant immunotherapy improved the clinical remission rate of patients who had LARC with pMMR,and the treatment-related adverse reactions were generally acceptable.Neoadjuvant immunotherapy combined with radiotherapy and chemotherapy should be considered for patients with LARC.
文摘BACKGROUND Esophageal cancer is a serious global health concern with poor prognosis in advanced stages.Immune checkpoint inhibitors(ICIs)have shown promise in enhancing survival,but they are associated with immune-related adverse events,including potentially life-threatening myocarditis.Moreover,ICI-induced myocarditis can be asymptomatic,necessitating early diagnosis.Specific risk factors and biomarkers for esophageal cancer remain poorly characterized.AIM To investigate the determinants of ICI-associated asymptomatic myocarditis in patients with esophageal cancer and explore potential early biomarkers.METHODS A retrospective analysis was conducted on 202 cancer patients who received treatment at Shanxi Province Cancer Hospital from July 2019 to July 2024.RESULTS Older age,male gender,and elevated creatine kinase isoenzymes(CK-MB)and CK levels were found to be significant risk factors for asymptomatic myocarditis.The myocarditis occurrence group had higher CK-MB(3.05 ng/mL vs 5.02 ng/mL;P<0.001)and CK levels(187.29 U/L vs 212.25 U/L;P=0.005),and the predictive value of age,gender,CK,and CK-MB was low[are under the receiver operating characteristic curve(AUC)=0.579-0.608].However,their combination in a predictive model showed improved diagnostic capability,with an AUC of 0.808.CONCLUSION Age,gender,and cardiac biomarker levels considerably contribute to the risk of ICI-related myocarditis in patients with esophageal cancer.The integration of these factors into a predictive model enhances early diagnosis,facilitating personalized risk management.
文摘Despite compelling preclinical and epidemiological evidence(e.g.,reduced lung cancer incidence in the CANTOS trial),IL-1βinhibition with canakinumab failed to achieve the expected therapeutic effect in the Phase III clinical trials(CANOPY series)of non-small cell lung cancer(NSCLC).This perspective analyzes the disconnect between mechanistic promise and clinical outcomes.IL-1βdrives NSCLC progression by promoting immunosuppression,angiogenesis,and metastasis.However,CANOPY-2 showed no overall survival(OS)benefit,though a trend emerged in patients with an elevated baseline of high-sensitivity C-reactive protein(hs-CRP).Similarly,CANOPY-1 and adjuvant CANOPY-A missed primary endpoints for progression-free survival(PFS)and disease-free survival(DFS),respectively.These failures highlight limitations of IL-1 monotherapy in advanced,immunosuppressive microenvironments and underscore inadequate patient selection.We propose that IL-1 antagonism retains therapeutic potential but requires refined strategies:biomarker-driven enrichment(e.g.,inflammation signatures like hs-CRP),rational combinatorial regimens informed by successful multi-target agents(e.g.,cadonilimab),and early-stage intervention.Repositioning IL-1 blockers through precision approaches could unlock their value in immuno-oncology.
文摘BACKGROUND The survival rate of pancreatic cancer is low,and there is a lack of effective treatment.AIM To explore the epidemiological characteristics of patients with pancreatic cancer in China and compare multiple chemotherapy regimens at different stages.METHODS This was a retrospective study conducted from 2005 to 2014,involving six cancer hospitals and eight general hospitals across seven geographical regions of China(East,South,North,Central,Southwest,Northwest,and Northeast).Stratified sampling was used based on the population distribution of each region.Efficacy assessments were conducted by Cox proportional hazards regression models.When assessing the effectiveness of various chemotherapy regimens,traditional drugs such as gemcitabine used as monotherapy served as the reference.RESULTS A total of 3256 patients were included.The median follow-up time was 407 days,and the median overall survival was 183 days.At diagnosis,56%of patients were already in stage IV.Chemotherapy was administered to 39.73%of patients.In the adjuvant therapy phase,gemcitabine+fluorouracil was superior to gemcitabine monotherapy[hazard ratio(HR)=0.35,95%confidence interval(CI):0.14-0.89].In fluorouracil-based regimens,other combination regimens did not show effectiveness relative to monotherapy.For first-line treatment in patients with advanced disease,tegafur alone(HR=0.20,95%CI:0.06-0.66),gemcitabine plus cisplatin(HR=0.16,95%CI:0.04-0.70),and tegafur,gemcitabine plus platinum-based agents(HR=0.32,95%CI:0.11-0.91)were associated with a lower risk of death compared to gemcitabine alone.In second-line treatment,there were no significant differences in efficacy among various drugs,but FOLFIRINOX(irinotecan+oxaliplatin+leucovorin+5-fluorouracil)had an outstanding point estimate(HR=0.10,95%CI:0.01-1.27).CONCLUSION In China,pancreatic cancer is often diagnosed at advanced stages,emphasizing the need for early diagnosis and treatment.Combined therapies in adjuvant and first-line settings may reduce the risk of death compared with monotherapy,and FOLFIRINOX might offer more significant benefits in second-line treatment.
文摘BACKGROUND Gastric cancer(GC)is an aggressive malignancy of the gastrointestinal tract characterized by high recurrence rates following radical gastrectomy.To enhance treatment efficacy,reduce recurrence,and improve patient survival,adjuvant chemotherapy is commonly administered based on established postoperative guidelines.Despite advancements in chemotherapy delivery,the overall response rate remains below 50%,primarily due to the lack of targeted therapies tailored to specific patient populations.AIM To explore sensitive biomarkers to assess the efficacy of postoperative adjuvant chemotherapy in appropriate patient subgroups.METHODS This study retrospectively analyzed 1628 patients who underwent radical gastrectomy for GC at our hospital in 2017 and 2018,with a subsequent five-year follow-up.Patients were divided based on whether they received postoperative adjuvant chemotherapy.The study aimed to determine optimal cutoff values for various biomarkersneutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199,CA724,and CA242-using receiver operating characteristic(ROC)curves.Based on the optimal ROC cut-off,a novel combined metric,NLR-CEA,was developed to assess the efficacy of adjuvant chemotherapy following GC surgery.RESULTS Cox subgroup analysis demonstrated that postoperative adjuvant chemotherapy significantly improved overall survival in the NLR-CEA_Low group with a rate of 0.41(0.26-0.63).In the NLR-CEA_Middle group,the protective effect was observed at 0.69(0.54-0.87),while in the NLR-CEA_High group,it was 0.73(0.53-0.99).Notably,a 32%difference in the efficacy of chemotherapy was observed between the NLR-CEA_Low and NLR-CEA_High groups.CONCLUSION NLR-CEA is an effective biomarker for evaluating the efficacy of postoperative adjuvant chemotherapy in GC.Patients with NLR-CEA_Low exhibit significantly better responses to chemotherapy compared to those with NLRCEA_High.
