Objectives:Decades of clinical and fundamental research advancements in oncology have led to significant breakthroughs such as early screening,targeted therapies,and immunotherapy,contributing to reduced mortality rat...Objectives:Decades of clinical and fundamental research advancements in oncology have led to significant breakthroughs such as early screening,targeted therapies,and immunotherapy,contributing to reduced mortality rates in cancer patients.Despite these achievements,cancer continues to be a major public health challenge.This study employs bibliometric techniques to visually analyze the English literature on cancer prevention,screening,diagnosis,treatment,and rehabilitation.Methods:We systematically reviewed publications from 01 March 2014,to 01 March 2024,indexed in the Web of Science core collection.Tools such as VOSviewer Version 1.6.20 is characterized by its core idea of co-occurrence clustering.CiteSpace 6.3.R3 is distinguished by its powerful capabilities in bibliometric analysis,including co-citation analysis,co-occurrence analysis of keywords,author collaboration network analysis,and journal co-citation analysis,providing effective insights into research hotspots and detecting emerging trends.Bibliometrix version 3.0.3 offers rich visualization features,including collaboration network diagrams,citation distribution graphs,and keyword clouds.facilitated the analysis of the literature,helping to map out the current research landscape,identify pressing issues,and discern emerging trends,thus offering insights for future research directions.Results:The analysis revealed that major research hotspots include lung and breast cancer.Attention is predominantly concentrated on cancer treatment,subdivided into targeted therapy,immunotherapy,traditional Chinese medicine,and the development of new anticancer drugs.Significant terms identified in the study include immune checkpoint inhibitors,tumor microenvironment,and cancer stem cells.Conclusion:This bibliometric analysis highlights the evolving directions in oncology research,pinpointing nanotherapy,resistance to targeted therapies,and the integration of artificial intelligence as pivotal future research avenues in the prevention,screening,diagnosis,treatment,and rehabilitation of cancer.展开更多
BACKGROUND The combination of anti-epidermal growth factor receptor(EGFR)therapy and chemotherapy is currently a preferred first-line treatment for patients with unre-sectable,RAS and BRAF wild-type,left-sided metasta...BACKGROUND The combination of anti-epidermal growth factor receptor(EGFR)therapy and chemotherapy is currently a preferred first-line treatment for patients with unre-sectable,RAS and BRAF wild-type,left-sided metastatic colorectal cancer(mCRC).Several studies have also demonstrated the benefit of anti-EGFR therapy in sub-sequent line settings for this patient population.However,direct evidence com-paring the effectiveness of frontline vs subsequent anti-EGFR therapy remains limited,leaving a crucial gap in guiding optimal treatment strategies.AIM To compare overall survival(OS)between frontline and subsequent anti-EGFR treatment in patients with unresectable,RAS and BRAF wild-type,left-sided mCRC.METHODS We retrospectively reviewed the medical records of mCRC patients treated at The King Chulalongkorn Memorial Hospital and Songklanagarind Hospital,Thailand,between January 2013 and April 2023.Patients were classified into two groups based on the sequence of their anti-EGFR treatment.The primary endpoint was OS.RESULTS Among 222 patients with a median follow-up of 29 months,no significant difference in OS was observed between the frontline and subsequent-line groups(HR 1.03,95%CI:0.73-1.46,P=0.878).The median OS was 35.53 months(95%CI:26.59-44.47)for the frontline group and 31.60 months(95%CI:27.83-35.37)for the subsequent-line group.In the subsequent-line group,71 patients(32.4%)who ultimately never received anti-EGFR therapy had a significantly worse median OS of 19.70 months(95%CI:12.87-26.53).CONCLUSION Frontline and subsequent-line anti-EGFR treatments provide comparable OS in unresectable,RAS/BRAF wild-type,left-sided mCRC patients,but early exposure is vital for those unlikely to receive subsequent therapy.展开更多
Background While China’s socioeconomic transformation has driven divergent trends in gastrointestinal cancers,comprehensive data on esophageal,gastric,and liver cancer burden remain limited.This study examines the gl...Background While China’s socioeconomic transformation has driven divergent trends in gastrointestinal cancers,comprehensive data on esophageal,gastric,and liver cancer burden remain limited.This study examines the global burden of esophageal,gastric,and liver cancers in 2022 and analyzes the trends of age-standardized incidence and mortality rate(ASRs)in China from 2000 to 2018,thereby providing evidence for the formulation of cancer control strategies.Methods The global burden of esophageal,gastric and liver cancers including the estimated number of cases and deaths and the ASRs for incidence and mortality were from GLOBALCAN 2022 dataset.Data from 22 cancer registries in China were employed for the trend analysis of the ASRs for incidence and mortality of these three cancers.The Joinpoint model was used to compute the average annual percentage change(AAPC)of the incidence and mortality of the three cancers from 2000 to 2018.Results Globally,esophageal,gastric and liver cancers accounted for 11.8%of incident cancer cases and 19.1%of cancer deaths.China bore a disproportionately high burden,representing 43.8%,37.0%,and 42.4%of global esophageal,gastric,and liver cancer cases respectively,and 42.1%,39.4%,and 41.7%of corresponding deaths.However,the ASRs for incidence and mortality for all three cancers declined significantly in China(2000–2018),with absolute case numbers decreasing for gastric and esophageal cancers during 2010–2022.Age-specific analysis revealed most pronounced declines in incidence and mortality in populations under 40 years old,with AAPCs of less than–6.0%for esophageal cancer,around–4.0%for gastric cancer,and approximately–2.0%for liver cancer.Conclusions China has achieved remarkable progress in controlling esophageal,gastric and liver cancers,yet these malignancies remain major public health challenges.Future efforts should intensify existing prevention measures while expanding screening programs,particularly for aging populations.These findings offer valuable insights for regions undergoing similar epidemiological transitions.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
In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strat...In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strategies:human papillomavirus(HPV)vaccination,cervical cancer screening,and treatment of precancerous lesions and cancer.Subsequently,the WHO and its partners developed a global strategy to accelerate the reduction of cervical cancer incidence,with an ultimate goal of achieving elimination within the next century.This Global Strategy represents a formal international commitment and is anchored in the 90-70-90 targets to be achieved by 2030.In parallel,several countries have also set national commitments,such as Sweden's pledge to achieve elimination by 2027 and Australia's target of achieving elimination by 2035.展开更多
Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the as...Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey(NHANES).Methods:Data from female participants in NHANES 2003—2018 were analyzed.Using R software,datasets(DEMO,BMX,etc.)were merged,and complete cases were retained by intersecting row names,yielding a total of 2999 participants.After applying strict exclusion criteria,2802 participants were included:83 with gynecologic cancer(cancer group)and 2719 without(control group).Demographic,reproductive health,and urinary cadmium and arsenic data were collected.Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk.Results:High urinary cadmium and arsenic levels were risk factors for gynecologic cancers,with odds ratios(ORs)of 1.623(95%CI 1.217 to 2.166)and 1.003(95%CI 1.001 to 1.005),respectively.After propensity score matching(PSM),the trend remained;cadmium was still a statistically significant risk factor with an OR of 2.182(95%CI 1.343 to 3.545),while arsenic’s association,though not statistically significant,still trended toward risk(OR=1.004,95%CI 0.999 to 1.009).Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer(OR=1.745,95%CI 1.178 to 2.586 and OR=1.005,95%CI 1.002 to 1.008,respectively);these associations persisted after PSM.Additionally,cadmium increased the risk of endometrial cancer(OR=1.617,95%CI 1.109 to 2.356).Conclusion:Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers.These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.展开更多
Gastric cancer(GC)remains a major global health challenge,because of its poor prognosis and limited treatment options in advanced stages1,2.Recent advancements in immunotherapy,highlighted by the findings of the CHECK...Gastric cancer(GC)remains a major global health challenge,because of its poor prognosis and limited treatment options in advanced stages1,2.Recent advancements in immunotherapy,highlighted by the findings of the CHECKMATE-649,ORIENT-16,and KEYNOTE-859 trials,have markedly transformed the treatment paradigm for advanced gastric cancer(AGC)3-5.展开更多
The“Global Cancer Statistics Report 2022”estimates that there were approximately 20 million new cancer cases worldwide,including 9.7 million in females,of which 2.31 million were breast cancer cases1.Breast cancer i...The“Global Cancer Statistics Report 2022”estimates that there were approximately 20 million new cancer cases worldwide,including 9.7 million in females,of which 2.31 million were breast cancer cases1.Breast cancer is the most common malignant tumor in women and one of the leading causes of cancer-related deaths.展开更多
Colorectal cancer(CRC)is the third most common cancer worldwide and the second leading cause of cancer-related mortality.While early-stage CRC patients generally exhibit favorable overall survival(OS)rates,the prognos...Colorectal cancer(CRC)is the third most common cancer worldwide and the second leading cause of cancer-related mortality.While early-stage CRC patients generally exhibit favorable overall survival(OS)rates,the prognosis for metastatic CRC(mCRC)remains poor,with a survival rate<15%.Targeted combination therapy remains the main treatment strategy for mCRC,with a median OS(mOS)of only 25-30 months.展开更多
Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and ...Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and requires further understanding to improve health policy.For instance,a single hospital-based prospective cohort study found that esophageal cancer survival outcomes were associated with different healthcare payment patterns and situations.Comparing the extracted literature-data between urban employee basic medical insurance and urban and rural resident basic medical insurance,the proportions of tumor-node-metastasis(TNM)stage I-II were 27.1%and 34.6%,while those of TNM stage IV were 35.0%and 26.1%,respectively.Additionally,high out-of-pocket rate(>60%)of hospitalization was associated with a higher proportion of TNM stage I-II(40.3%vs 26.9%)and a lower proportion of TNM stage IV(22.7%vs 32.8%).In addition,healthcare payment simultaneously influenced or was influenced by the proportions of early and advanced esophageal cancers.The critical difficulty in improving survival of esophageal cancer in populations should be a low proportion of early disease.A more comprehensive and robust public healthcare insurance system is desired to support cancer prevention and control in particular,in order to increase the proportion of early cancers and consequently improve patient survival.Additionally,commercial medical insurance and social charities hope to be fully introduced and encouraged to achieve these goals as active supplement.展开更多
It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mo...It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mouse models(GEMM)induce car-cinogenesis too rapidly to study these influences.Standard strains,such as C57BL/6,commonly used in GEMMs,further limit the exploration of aging and metabolic health effects.A similar challenge arises in modeling periodontitis,a disease influenced by aging,diabesity,and genetic architecture.We propose using diverse mouse popula-tions with hybrid vigor,such as the Collaborative Cross(CC)×Apc ^(Min) hybrid,to slow disease progression and better model human colorectal cancer(CRC)and comorbidi-ties.This perspective highlights the advantages of this model,where delayed car-cinogenesis reveals interactions with aging and adiposity.Unlike Apc ^(Min) mice,which develop cancer rapidly,CC×Apc ^(Min) hybrids recapitulate human-like progression.This facilitates the identification of modifier loci affecting inflammation,diet susceptibility,organ size,and polyposis distribution.The CC×Apc ^(Min) model offers a transformative platform for studying CRC as a disease of adulthood,reflecting its complex inter-play with aging and comorbidities.The insights gained from this approach will en-hance early detection,management,and treatment strategies for CRC and related conditions.展开更多
The development of colorectal cancer(CRC)can be influenced by genetic factors in both familial cases and sporadic cases.Familial CRC has been associated with genetic changes in high-,moderate-and low-penetrance suscep...The development of colorectal cancer(CRC)can be influenced by genetic factors in both familial cases and sporadic cases.Familial CRC has been associated with genetic changes in high-,moderate-and low-penetrance susceptibility genes.However,despite the availability of current gene-identification techniques,the genetic causes of a considerable proportion of hereditary cases remain unknown.Genome-wide association studies of CRC have identified a number of common lowpenetrance alleles associated with a slightly increased or decreased risk of CRC.The accumulation of low-risk variants may partly explain the familial risk of CRC,and some of these variants may modify the risk of cancer in patients with mutations in high-penetrance genes.Understanding the predisposition to develop CRC will require investigators to address the following challenges:the identification of genes that cause uncharacterized hereditary cases of CRC such as familial CRC type X and serrated polyposis;the classification of variants of unknown significance in known CRC-predisposing genes;and the identification of additional cancer risk modifiers that can be used to perform risk assessments for individual mutation carriers.We performed a comprehensive review of the genetically characterized and uncharacterized hereditary CRC syndromes and of lowand moderate-penetrance loci and variants identified through genome-wide association studies and candidate-gene approaches.Current challenges and future perspectives in the field of CRC predisposition are also discussed.展开更多
Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and ...Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.展开更多
Introduction Small cell lung cancer(SCLC)is a highly aggressive malignancy with limited treatment options.Despite advances in immunotherapy,response rates remain low,and the efficacy of current molecular subtyping1,2 ...Introduction Small cell lung cancer(SCLC)is a highly aggressive malignancy with limited treatment options.Despite advances in immunotherapy,response rates remain low,and the efficacy of current molecular subtyping1,2 is insufficient to predict therapeutic outcomes3,4.A recently identified vulnerability in SCLC involves the dysregulation of nuclear-cytoplasmic transport,particularly through exportin 1(XPO1)5-7.展开更多
BACKGROUND Pancreatic cancer(PC),ranking among the most aggressive solid malignancies,currently lacks validated prognostic biomarkers to guide survival stratification.With a 5-year survival rate under 10%,this maligna...BACKGROUND Pancreatic cancer(PC),ranking among the most aggressive solid malignancies,currently lacks validated prognostic biomarkers to guide survival stratification.With a 5-year survival rate under 10%,this malignancy urgently requires precision tools for outcome prediction to optimize therapeutic decision-making.AIM To analyze whether the advanced lung cancer inflammation index(ALI)is a prognostic indicator for PC.METHODS Patients who were diagnosed with PC and underwent radical resection were included from January 2007 to January 2023 in a clinical center from National Cancer Center of China.The patients were divided into low and high ALI groups according to an ALI cut-off of 34.0 calculated with software X-tile.Overall survival(OS)and surgical outcomes were calculated between the two groups.Follow-up was conducted through telephone interview.Kaplan-Meier analysis was performed to estimate OS,while the log-rank test was utilized to compare OS among different tumor stages.Cox regression was used to identify independent risk factors for OS.RESULTS This study included 611 patients who underwent radical PC surgery.Using an ALI cutoff of 34.0,the patients were categorized into a high ALI group(n=378)and a low ALI group(n=233).The low ALI group had significantly lower body mass index,serum albumin,lymphocyte count,and ALI(P<0.01),but higher neutrophil count,a higher proportion of head and neck PC,and longer operation time(P<0.01).As for prognosis,the low ALI group had worse OS in stage I patients(P<0.01),and low ALI(P=0.018,hazard ratio=0.784,95%confidence interval:0.641-0.960)independently conferred an increased risk for mortality.CONCLUSION Lower ALI is associated with worse OS for PC patients who underwent radical surgery.Patients demonstrating low ALI preoperatively require special attention from surgeons.展开更多
Drug resistance continues to be the principal limiting factor in achieving a cure for patients with cancer,significantly hindering the long-term efficacy of novel cancer drugs.Accumulating evidence has shown that meta...Drug resistance continues to be the principal limiting factor in achieving a cure for patients with cancer,significantly hindering the long-term efficacy of novel cancer drugs.Accumulating evidence has shown that metabolites derived from tumor cells regulate immune cell metabolism via tumor microenvironment crosstalk.However,as immunometabolic research has deepened,the leading role played by the intrinsic metabolic regulation of immune cells in the drug resistance of tumor cells has been discovered.Immune metabolites have been shown to cause immune resistance,target therapy resistance,and chemotherapy resistance,and drugs that target immune metabolism have great potential.To date,researchers have not fully explored the impact of immune-derived metabolites on tumor cells and their influence on the responsiveness to cancer drugs.In this review,we focus on the lactate,fatty acid,glucose,and nucleotide metabolic alterations that take place in T cells and macrophages and how these changes can impair anti-tumor immunity,ultimately promoting tumor cell survival and decreasing responsiveness to the corresponding therapeutic approaches.We present the current developments in drugs targeting immunometabolic pathways and propose constructive suggestions,such as precise delivery to immune cell targets to enhance efficacy and safety,offering novel perspectives for cancer drug development.展开更多
Pancreatic cancer is a highly aggressive malignancy with a poor prognosis and limited therapeutic options.The tumor microenvironment(TME),including cancer-associated fibroblasts(CAFs),plays a pivotal role in tumor pro...Pancreatic cancer is a highly aggressive malignancy with a poor prognosis and limited therapeutic options.The tumor microenvironment(TME),including cancer-associated fibroblasts(CAFs),plays a pivotal role in tumor progression and therapy resistance.Senescent CAFs,which exhibit a senescence-associated secretory phenotype(SASP),further exacerbate cancer growth through inflammatory cytokine secretion.This editorial highlights a study by Jiang et al,which investigates the potential of resveratrol,a natural polyphenolic compound,in targeting senescent CAFs to inhibit pancreatic cancer progression.The study demonstrates that resveratrol reduces senescent CAFs and downregulates SASP factors,thereby disrupting the pro-tumorigenic activities of these cells.Resveratrol’s ability to modulate the TME,induce apoptosis in pancreatic cancer cells,and inhibit metastasis underscores its potential as an adjunctive therapy.This research offers promising insights into novel strategies for improving therapeutic outcomes in pancreatic cancer by targeting the TME and senescent CAFs.展开更多
Background The Global Cancer Observatory(GLOBOCAN)2022 and the Global Burden of Disease(GBD)2021 are two primary databases for assessing the global cancer burden.This study aimed to compare the incidence and mortality...Background The Global Cancer Observatory(GLOBOCAN)2022 and the Global Burden of Disease(GBD)2021 are two primary databases for assessing the global cancer burden.This study aimed to compare the incidence and mortality rates of tracheal,bronchus,and lung(TBL)cancer reported in these databases and to analyze the observed discrepancies.Methods Age-standardized rates(ASRs),including age-standardized incidence rates and age-standardized mortality rates for TBL cancer,were obtained from GLOBOCAN 2022 and GBD 2021 for the most recent available year.Differences in ASRs at the national level between the two databases were quantified using pairwise differences,calculated as the absolute difference in ASRs divided by the mean of the ASRs from both sources.Correlations between macroeconomic factors and pairwise differences in ASRs were evaluated,and country features correlated with high pairwise differences were assessed.The data sources and methods used in the two databases were also compared.Results Strong correlations were identified between ASRs reported by GLOBOCAN 2022 and GBD 2021;however,significant differences were observed between estimates from the two data sources.African countries commonly exhibited larger pairwise differences in ASRs,whereas European countries demonstrated smaller pairwise differences in ASRs.Additionally,some populous developing countries,including China,South Africa,Brazil and India,showed smaller differences in ASRs.Countries lacking vital registration systems or high-quality population-based cancer registries displayed larger differences in ASRs.Furthermore,differences in ASRs were negatively correlated with macroeconomic factors.The data sources and estimation methods used by the two databases were inconsistent.Conclusions Discrepancies in TBL cancer incidence and mortality were observed between GLOBOCAN 2022 and GBD 2021.While differences in sources and methods partially explain these discrepancies,a country's cancer surveillance maturity and economic status also correlate with the accuracy of the estimates.Estimating the cancer burden in less wealthy countries remains a substantial challenge,necessitating long-term assistance and investment.展开更多
The resistance to cancer treatment is a major clinical obstacle,being strongly influenced by the tumor microen-vironment(TME).Cancer-associated fibroblasts(CAFs)are critical elements of the TME.CAFs are heterogeneous ...The resistance to cancer treatment is a major clinical obstacle,being strongly influenced by the tumor microen-vironment(TME).Cancer-associated fibroblasts(CAFs)are critical elements of the TME.CAFs are heterogeneous and are activated through diverse pathways.These CAFs engage in reciprocal interactions with tumor cells,driv-ing tumor progression and therapeutic resistance.In this review,we discuss the role of CAFs in the development of tumor resistance to chemotherapy,radiotherapy,targeted therapy,and immunotherapy.Besides,we sum-marize recent clinical trials in CAF-targeted therapies.The development of resistance involves physical barrier formation,metabolic reprogramming,exosome release,DNA repair,bypass pathway activation,multidrug resis-tance protein upregulation,and immune checkpoint inhibition.Challenges remain in addressing drug resistance despite the therapeutic potential of targeting CAFs:the cellular origins of CAFs need to be clarified,and their limited clinical applications need to be increased.Future studies should focus on elucidating the reasons for CAF heterogeneity,developing precise targeting strategies,and validating the clinical safety and efficacy of CAF-based therapies to overcome treatment resistance and improve patient outcomes.展开更多
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
基金supported by the grants from the Scientific and Technological Innovation Project of Information Traditional Chinese Medicine,China Academy of Chinese Medical Sciences(No.CI2021 B002).
文摘Objectives:Decades of clinical and fundamental research advancements in oncology have led to significant breakthroughs such as early screening,targeted therapies,and immunotherapy,contributing to reduced mortality rates in cancer patients.Despite these achievements,cancer continues to be a major public health challenge.This study employs bibliometric techniques to visually analyze the English literature on cancer prevention,screening,diagnosis,treatment,and rehabilitation.Methods:We systematically reviewed publications from 01 March 2014,to 01 March 2024,indexed in the Web of Science core collection.Tools such as VOSviewer Version 1.6.20 is characterized by its core idea of co-occurrence clustering.CiteSpace 6.3.R3 is distinguished by its powerful capabilities in bibliometric analysis,including co-citation analysis,co-occurrence analysis of keywords,author collaboration network analysis,and journal co-citation analysis,providing effective insights into research hotspots and detecting emerging trends.Bibliometrix version 3.0.3 offers rich visualization features,including collaboration network diagrams,citation distribution graphs,and keyword clouds.facilitated the analysis of the literature,helping to map out the current research landscape,identify pressing issues,and discern emerging trends,thus offering insights for future research directions.Results:The analysis revealed that major research hotspots include lung and breast cancer.Attention is predominantly concentrated on cancer treatment,subdivided into targeted therapy,immunotherapy,traditional Chinese medicine,and the development of new anticancer drugs.Significant terms identified in the study include immune checkpoint inhibitors,tumor microenvironment,and cancer stem cells.Conclusion:This bibliometric analysis highlights the evolving directions in oncology research,pinpointing nanotherapy,resistance to targeted therapies,and the integration of artificial intelligence as pivotal future research avenues in the prevention,screening,diagnosis,treatment,and rehabilitation of cancer.
文摘BACKGROUND The combination of anti-epidermal growth factor receptor(EGFR)therapy and chemotherapy is currently a preferred first-line treatment for patients with unre-sectable,RAS and BRAF wild-type,left-sided metastatic colorectal cancer(mCRC).Several studies have also demonstrated the benefit of anti-EGFR therapy in sub-sequent line settings for this patient population.However,direct evidence com-paring the effectiveness of frontline vs subsequent anti-EGFR therapy remains limited,leaving a crucial gap in guiding optimal treatment strategies.AIM To compare overall survival(OS)between frontline and subsequent anti-EGFR treatment in patients with unresectable,RAS and BRAF wild-type,left-sided mCRC.METHODS We retrospectively reviewed the medical records of mCRC patients treated at The King Chulalongkorn Memorial Hospital and Songklanagarind Hospital,Thailand,between January 2013 and April 2023.Patients were classified into two groups based on the sequence of their anti-EGFR treatment.The primary endpoint was OS.RESULTS Among 222 patients with a median follow-up of 29 months,no significant difference in OS was observed between the frontline and subsequent-line groups(HR 1.03,95%CI:0.73-1.46,P=0.878).The median OS was 35.53 months(95%CI:26.59-44.47)for the frontline group and 31.60 months(95%CI:27.83-35.37)for the subsequent-line group.In the subsequent-line group,71 patients(32.4%)who ultimately never received anti-EGFR therapy had a significantly worse median OS of 19.70 months(95%CI:12.87-26.53).CONCLUSION Frontline and subsequent-line anti-EGFR treatments provide comparable OS in unresectable,RAS/BRAF wild-type,left-sided mCRC patients,but early exposure is vital for those unlikely to receive subsequent therapy.
基金supported by the National Natural Science Foundation of China(grant numbers:82273721,82304220)Cooperation Fund of CHCAMS and SZCH(grant number:CFA202201003).
文摘Background While China’s socioeconomic transformation has driven divergent trends in gastrointestinal cancers,comprehensive data on esophageal,gastric,and liver cancer burden remain limited.This study examines the global burden of esophageal,gastric,and liver cancers in 2022 and analyzes the trends of age-standardized incidence and mortality rate(ASRs)in China from 2000 to 2018,thereby providing evidence for the formulation of cancer control strategies.Methods The global burden of esophageal,gastric and liver cancers including the estimated number of cases and deaths and the ASRs for incidence and mortality were from GLOBALCAN 2022 dataset.Data from 22 cancer registries in China were employed for the trend analysis of the ASRs for incidence and mortality of these three cancers.The Joinpoint model was used to compute the average annual percentage change(AAPC)of the incidence and mortality of the three cancers from 2000 to 2018.Results Globally,esophageal,gastric and liver cancers accounted for 11.8%of incident cancer cases and 19.1%of cancer deaths.China bore a disproportionately high burden,representing 43.8%,37.0%,and 42.4%of global esophageal,gastric,and liver cancer cases respectively,and 42.1%,39.4%,and 41.7%of corresponding deaths.However,the ASRs for incidence and mortality for all three cancers declined significantly in China(2000–2018),with absolute case numbers decreasing for gastric and esophageal cancers during 2010–2022.Age-specific analysis revealed most pronounced declines in incidence and mortality in populations under 40 years old,with AAPCs of less than–6.0%for esophageal cancer,around–4.0%for gastric cancer,and approximately–2.0%for liver cancer.Conclusions China has achieved remarkable progress in controlling esophageal,gastric and liver cancers,yet these malignancies remain major public health challenges.Future efforts should intensify existing prevention measures while expanding screening programs,particularly for aging populations.These findings offer valuable insights for regions undergoing similar epidemiological transitions.
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supported by the CAMS Innovation Fund for Medical Sciences(No.2023-I2M-3-019)National Natural Science Foundation of China(No.82404366)。
文摘In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strategies:human papillomavirus(HPV)vaccination,cervical cancer screening,and treatment of precancerous lesions and cancer.Subsequently,the WHO and its partners developed a global strategy to accelerate the reduction of cervical cancer incidence,with an ultimate goal of achieving elimination within the next century.This Global Strategy represents a formal international commitment and is anchored in the 90-70-90 targets to be achieved by 2030.In parallel,several countries have also set national commitments,such as Sweden's pledge to achieve elimination by 2027 and Australia's target of achieving elimination by 2035.
基金supported by the Science and Technology Innovation Program of Hunan Province,China(2020SK2073).
文摘Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey(NHANES).Methods:Data from female participants in NHANES 2003—2018 were analyzed.Using R software,datasets(DEMO,BMX,etc.)were merged,and complete cases were retained by intersecting row names,yielding a total of 2999 participants.After applying strict exclusion criteria,2802 participants were included:83 with gynecologic cancer(cancer group)and 2719 without(control group).Demographic,reproductive health,and urinary cadmium and arsenic data were collected.Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk.Results:High urinary cadmium and arsenic levels were risk factors for gynecologic cancers,with odds ratios(ORs)of 1.623(95%CI 1.217 to 2.166)and 1.003(95%CI 1.001 to 1.005),respectively.After propensity score matching(PSM),the trend remained;cadmium was still a statistically significant risk factor with an OR of 2.182(95%CI 1.343 to 3.545),while arsenic’s association,though not statistically significant,still trended toward risk(OR=1.004,95%CI 0.999 to 1.009).Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer(OR=1.745,95%CI 1.178 to 2.586 and OR=1.005,95%CI 1.002 to 1.008,respectively);these associations persisted after PSM.Additionally,cadmium increased the risk of endometrial cancer(OR=1.617,95%CI 1.109 to 2.356).Conclusion:Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers.These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.
基金supported by The National Key Research and Development Program of China(Grant no.2021YFA0910100)Healthy Zhejiang One Million People Cohort(Grant no.K-20230085)+5 种基金Post-doctoral Innovative Talent Support Program(Grant no.BX2023375)Lingyan Project of Zhejiang Provincial Department of Science and Technology(Grant no.2025C02059)the National Natural Science Foundation of China(Grant nos.82304946,82473489,and 82403546)Natural Science Foundation of Zhejiang Province(Grant nos.LR21H280001,LGF22H160056,ZCLQN25H1602,and LMS25H160006)Medicine and Health Science Fund of Zhejiang Province Health Commission(Grant nos.2025KY047 and 2022KY658)Traditional Chinese Medicine Science and Technology Project of Zhejiang Provincial Health Commission(Grant no.2022ZA023).
文摘Gastric cancer(GC)remains a major global health challenge,because of its poor prognosis and limited treatment options in advanced stages1,2.Recent advancements in immunotherapy,highlighted by the findings of the CHECKMATE-649,ORIENT-16,and KEYNOTE-859 trials,have markedly transformed the treatment paradigm for advanced gastric cancer(AGC)3-5.
基金supported by grants from the National Natural Science Foundation of China(Grant No.81672638)。
文摘The“Global Cancer Statistics Report 2022”estimates that there were approximately 20 million new cancer cases worldwide,including 9.7 million in females,of which 2.31 million were breast cancer cases1.Breast cancer is the most common malignant tumor in women and one of the leading causes of cancer-related deaths.
基金supported by grants from the National Natural Science Foundation of China(Nos.U22A20330 and 82373372)the Key Project of Research and Development Plan in Heilongjiang Province(Nos.2022ZX06C01 and JD2023SJ40)+1 种基金the Natural Science Funding of Heilongjiang(No.YQ2022H017)the Haiyan Foundation of Harbin Medical University Cancer Hospital(No.JJJQ 2024-02).
文摘Colorectal cancer(CRC)is the third most common cancer worldwide and the second leading cause of cancer-related mortality.While early-stage CRC patients generally exhibit favorable overall survival(OS)rates,the prognosis for metastatic CRC(mCRC)remains poor,with a survival rate<15%.Targeted combination therapy remains the main treatment strategy for mCRC,with a median OS(mOS)of only 25-30 months.
基金Supported by the Foundation of Science and Technology Department of Sichuan Province,China,No.23ZDYF0839Ya'an Science and Technology Plan of Economic and Social Development(Health Field),Ya’an,China,No.2024-1the Ya’an Philosophic and Social Science Research Plan,Ya’an,China,No.YAA20240035.
文摘Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and requires further understanding to improve health policy.For instance,a single hospital-based prospective cohort study found that esophageal cancer survival outcomes were associated with different healthcare payment patterns and situations.Comparing the extracted literature-data between urban employee basic medical insurance and urban and rural resident basic medical insurance,the proportions of tumor-node-metastasis(TNM)stage I-II were 27.1%and 34.6%,while those of TNM stage IV were 35.0%and 26.1%,respectively.Additionally,high out-of-pocket rate(>60%)of hospitalization was associated with a higher proportion of TNM stage I-II(40.3%vs 26.9%)and a lower proportion of TNM stage IV(22.7%vs 32.8%).In addition,healthcare payment simultaneously influenced or was influenced by the proportions of early and advanced esophageal cancers.The critical difficulty in improving survival of esophageal cancer in populations should be a low proportion of early disease.A more comprehensive and robust public healthcare insurance system is desired to support cancer prevention and control in particular,in order to increase the proportion of early cancers and consequently improve patient survival.Additionally,commercial medical insurance and social charities hope to be fully introduced and encouraged to achieve these goals as active supplement.
基金Israel Cancer Research FoundationSamuel Waxman Cancer Research FoundationCore funding from Tel Aviv University。
文摘It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mouse models(GEMM)induce car-cinogenesis too rapidly to study these influences.Standard strains,such as C57BL/6,commonly used in GEMMs,further limit the exploration of aging and metabolic health effects.A similar challenge arises in modeling periodontitis,a disease influenced by aging,diabesity,and genetic architecture.We propose using diverse mouse popula-tions with hybrid vigor,such as the Collaborative Cross(CC)×Apc ^(Min) hybrid,to slow disease progression and better model human colorectal cancer(CRC)and comorbidi-ties.This perspective highlights the advantages of this model,where delayed car-cinogenesis reveals interactions with aging and adiposity.Unlike Apc ^(Min) mice,which develop cancer rapidly,CC×Apc ^(Min) hybrids recapitulate human-like progression.This facilitates the identification of modifier loci affecting inflammation,diet susceptibility,organ size,and polyposis distribution.The CC×Apc ^(Min) model offers a transformative platform for studying CRC as a disease of adulthood,reflecting its complex inter-play with aging and comorbidities.The insights gained from this approach will en-hance early detection,management,and treatment strategies for CRC and related conditions.
基金The Spanish Ministry of the Economy(State Secretariat for Research,Development and Innovation),grant SAF2012-38885Ramon y Cajal contract+1 种基金L’Oreal-UNESCO"For Women in Science"and the Scientific Foundation Asociacion Espanola Contra el Cancer
文摘The development of colorectal cancer(CRC)can be influenced by genetic factors in both familial cases and sporadic cases.Familial CRC has been associated with genetic changes in high-,moderate-and low-penetrance susceptibility genes.However,despite the availability of current gene-identification techniques,the genetic causes of a considerable proportion of hereditary cases remain unknown.Genome-wide association studies of CRC have identified a number of common lowpenetrance alleles associated with a slightly increased or decreased risk of CRC.The accumulation of low-risk variants may partly explain the familial risk of CRC,and some of these variants may modify the risk of cancer in patients with mutations in high-penetrance genes.Understanding the predisposition to develop CRC will require investigators to address the following challenges:the identification of genes that cause uncharacterized hereditary cases of CRC such as familial CRC type X and serrated polyposis;the classification of variants of unknown significance in known CRC-predisposing genes;and the identification of additional cancer risk modifiers that can be used to perform risk assessments for individual mutation carriers.We performed a comprehensive review of the genetically characterized and uncharacterized hereditary CRC syndromes and of lowand moderate-penetrance loci and variants identified through genome-wide association studies and candidate-gene approaches.Current challenges and future perspectives in the field of CRC predisposition are also discussed.
基金supported(in part)by the National Key Research and Development Program(2022YFC3600700)the Fundamental Research Funds for the Central Universities(2042024YXA008)the Young Top-Notch Talent Cultivation Program of Hubei Province(for Prof.Xian-Tao Zeng).
文摘Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82172635,82272686,and 82203628)Natural Science Foundation of Tianjin(Grant No.23JCZDJC00200)Tianjin Key Medical Discipline(Specialty)Construction Project(Grant No.TJYXZDXK-010A).
文摘Introduction Small cell lung cancer(SCLC)is a highly aggressive malignancy with limited treatment options.Despite advances in immunotherapy,response rates remain low,and the efficacy of current molecular subtyping1,2 is insufficient to predict therapeutic outcomes3,4.A recently identified vulnerability in SCLC involves the dysregulation of nuclear-cytoplasmic transport,particularly through exportin 1(XPO1)5-7.
基金Supported by Special Research Fund for Central Universities,Peking Union Medical College,No.3332023024Beijing Hope Run Special Fund of Cancer Foundation of China,No.LC2021B20.
文摘BACKGROUND Pancreatic cancer(PC),ranking among the most aggressive solid malignancies,currently lacks validated prognostic biomarkers to guide survival stratification.With a 5-year survival rate under 10%,this malignancy urgently requires precision tools for outcome prediction to optimize therapeutic decision-making.AIM To analyze whether the advanced lung cancer inflammation index(ALI)is a prognostic indicator for PC.METHODS Patients who were diagnosed with PC and underwent radical resection were included from January 2007 to January 2023 in a clinical center from National Cancer Center of China.The patients were divided into low and high ALI groups according to an ALI cut-off of 34.0 calculated with software X-tile.Overall survival(OS)and surgical outcomes were calculated between the two groups.Follow-up was conducted through telephone interview.Kaplan-Meier analysis was performed to estimate OS,while the log-rank test was utilized to compare OS among different tumor stages.Cox regression was used to identify independent risk factors for OS.RESULTS This study included 611 patients who underwent radical PC surgery.Using an ALI cutoff of 34.0,the patients were categorized into a high ALI group(n=378)and a low ALI group(n=233).The low ALI group had significantly lower body mass index,serum albumin,lymphocyte count,and ALI(P<0.01),but higher neutrophil count,a higher proportion of head and neck PC,and longer operation time(P<0.01).As for prognosis,the low ALI group had worse OS in stage I patients(P<0.01),and low ALI(P=0.018,hazard ratio=0.784,95%confidence interval:0.641-0.960)independently conferred an increased risk for mortality.CONCLUSION Lower ALI is associated with worse OS for PC patients who underwent radical surgery.Patients demonstrating low ALI preoperatively require special attention from surgeons.
基金supported by the National Key Research and Development Program of China(No.2023YFC2508500)National Natural Science Foundation of China(No.82272951)National Natural Science Foundation of China(No.82272953)。
文摘Drug resistance continues to be the principal limiting factor in achieving a cure for patients with cancer,significantly hindering the long-term efficacy of novel cancer drugs.Accumulating evidence has shown that metabolites derived from tumor cells regulate immune cell metabolism via tumor microenvironment crosstalk.However,as immunometabolic research has deepened,the leading role played by the intrinsic metabolic regulation of immune cells in the drug resistance of tumor cells has been discovered.Immune metabolites have been shown to cause immune resistance,target therapy resistance,and chemotherapy resistance,and drugs that target immune metabolism have great potential.To date,researchers have not fully explored the impact of immune-derived metabolites on tumor cells and their influence on the responsiveness to cancer drugs.In this review,we focus on the lactate,fatty acid,glucose,and nucleotide metabolic alterations that take place in T cells and macrophages and how these changes can impair anti-tumor immunity,ultimately promoting tumor cell survival and decreasing responsiveness to the corresponding therapeutic approaches.We present the current developments in drugs targeting immunometabolic pathways and propose constructive suggestions,such as precise delivery to immune cell targets to enhance efficacy and safety,offering novel perspectives for cancer drug development.
基金Supported by National Natural Science Foundation of China,No.82304151.
文摘Pancreatic cancer is a highly aggressive malignancy with a poor prognosis and limited therapeutic options.The tumor microenvironment(TME),including cancer-associated fibroblasts(CAFs),plays a pivotal role in tumor progression and therapy resistance.Senescent CAFs,which exhibit a senescence-associated secretory phenotype(SASP),further exacerbate cancer growth through inflammatory cytokine secretion.This editorial highlights a study by Jiang et al,which investigates the potential of resveratrol,a natural polyphenolic compound,in targeting senescent CAFs to inhibit pancreatic cancer progression.The study demonstrates that resveratrol reduces senescent CAFs and downregulates SASP factors,thereby disrupting the pro-tumorigenic activities of these cells.Resveratrol’s ability to modulate the TME,induce apoptosis in pancreatic cancer cells,and inhibit metastasis underscores its potential as an adjunctive therapy.This research offers promising insights into novel strategies for improving therapeutic outcomes in pancreatic cancer by targeting the TME and senescent CAFs.
基金supported by the Major Program of Scientific and Technical Innovation 2030(grant number:2020AAA0109504)the Science and Technology Planning Project of Beijing City(grant number:Z191100006619116).
文摘Background The Global Cancer Observatory(GLOBOCAN)2022 and the Global Burden of Disease(GBD)2021 are two primary databases for assessing the global cancer burden.This study aimed to compare the incidence and mortality rates of tracheal,bronchus,and lung(TBL)cancer reported in these databases and to analyze the observed discrepancies.Methods Age-standardized rates(ASRs),including age-standardized incidence rates and age-standardized mortality rates for TBL cancer,were obtained from GLOBOCAN 2022 and GBD 2021 for the most recent available year.Differences in ASRs at the national level between the two databases were quantified using pairwise differences,calculated as the absolute difference in ASRs divided by the mean of the ASRs from both sources.Correlations between macroeconomic factors and pairwise differences in ASRs were evaluated,and country features correlated with high pairwise differences were assessed.The data sources and methods used in the two databases were also compared.Results Strong correlations were identified between ASRs reported by GLOBOCAN 2022 and GBD 2021;however,significant differences were observed between estimates from the two data sources.African countries commonly exhibited larger pairwise differences in ASRs,whereas European countries demonstrated smaller pairwise differences in ASRs.Additionally,some populous developing countries,including China,South Africa,Brazil and India,showed smaller differences in ASRs.Countries lacking vital registration systems or high-quality population-based cancer registries displayed larger differences in ASRs.Furthermore,differences in ASRs were negatively correlated with macroeconomic factors.The data sources and estimation methods used by the two databases were inconsistent.Conclusions Discrepancies in TBL cancer incidence and mortality were observed between GLOBOCAN 2022 and GBD 2021.While differences in sources and methods partially explain these discrepancies,a country's cancer surveillance maturity and economic status also correlate with the accuracy of the estimates.Estimating the cancer burden in less wealthy countries remains a substantial challenge,necessitating long-term assistance and investment.
文摘The resistance to cancer treatment is a major clinical obstacle,being strongly influenced by the tumor microen-vironment(TME).Cancer-associated fibroblasts(CAFs)are critical elements of the TME.CAFs are heterogeneous and are activated through diverse pathways.These CAFs engage in reciprocal interactions with tumor cells,driv-ing tumor progression and therapeutic resistance.In this review,we discuss the role of CAFs in the development of tumor resistance to chemotherapy,radiotherapy,targeted therapy,and immunotherapy.Besides,we sum-marize recent clinical trials in CAF-targeted therapies.The development of resistance involves physical barrier formation,metabolic reprogramming,exosome release,DNA repair,bypass pathway activation,multidrug resis-tance protein upregulation,and immune checkpoint inhibition.Challenges remain in addressing drug resistance despite the therapeutic potential of targeting CAFs:the cellular origins of CAFs need to be clarified,and their limited clinical applications need to be increased.Future studies should focus on elucidating the reasons for CAF heterogeneity,developing precise targeting strategies,and validating the clinical safety and efficacy of CAF-based therapies to overcome treatment resistance and improve patient outcomes.
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.
