Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based supp...Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based support and establish levels of evidence for clinical application.Method:A comprehensive search was conducted to identify systematic reviews on acupuncture and mox-ibustion for the prevention and management of cancer-related conditions,covering databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Biomedical Databases,China Science and Technology Journal Database,and Wanfang Data,from their in-ception to August 1,2024.The methodological quality of the included systematic reviews was assessed by using AMSTAR 2,and bubble plots were employed to visualize the evidence.Results:Overall,137 systematic reviews were included,with China being the most prolific country,with 117 reviews.These reviews addressed 21 cancer-related conditions,with the three most frequently stud-ied being cancer-related fatigue(25 reviews),nausea and vomiting(20 reviews),and cancer pain(19 re-views).The three most commonly used acupuncture modalities were manual acupuncture(81 reviews),electroacupuncture(55 reviews),and moxibustion(39 reviews).Quality assessment revealed that one systematic review was rated as“high quality,”eight as“low quality,”and 128 as“critically low quality,”primarily due to the absence of protocol registration and lists of excluded studies.Conclusion:Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related con-ditions and treatment-related adverse effects,and their clinical use has been widely reported.However,the overall methodological quality of the included systematic reviews was low,limiting the reliability and the strength of the evidence.Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.展开更多
Preprint:https://doi.org/10.1101/2022.11.22.22282622.Randomized trials,cohort and modeling studies have consistently demonstrated a major impact of screening endoscopies on reducing colorectal cancer(CRC)inci-dence an...Preprint:https://doi.org/10.1101/2022.11.22.22282622.Randomized trials,cohort and modeling studies have consistently demonstrated a major impact of screening endoscopies on reducing colorectal cancer(CRC)inci-dence and mortality[1].Over time,CRC mortality starts to be lower in those who underwent screening compared to those who did not due to earlier detection of prevalent.展开更多
Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical ca...Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.展开更多
Cancer poses a serious threat to human health worldwide and is a leading cause of death1.The analysis of radiological imaging is crucial in early detection,accurate diagnosis,effective treatment planning,and ongoing m...Cancer poses a serious threat to human health worldwide and is a leading cause of death1.The analysis of radiological imaging is crucial in early detection,accurate diagnosis,effective treatment planning,and ongoing monitoring of patients with cancer.However,several challenges impede the effectiveness of cancer imaging analysis in clinical practice.One difficulty is that healthcare professionals’immense clinical workloads can result in time constraints and increase pressure,thereby hindering their ability to maintain high accuracy and thoroughness in image analysis.Additionally,subjective variability among radiologists can lead to inconsistent interpretations and diagnoses.Because this variability is often influenced by personal biases,standardized assessments are often difficult to achieve.Moreover,the inherent complexity of cancer imaging necessitates extensive clinical experience;this aspect can also be a limiting factor,particularly if expertise or resources are limited.The application of artificial intelligence(AI)can alleviate these problems by enhancing the accuracy,objectivity,and efficiency of cancer imaging analysis while assisting physicians.Therefore,the advancement of AI research is crucial for achieving progress in radiology.展开更多
Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were ...Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were sourced from GLOBOCAN 2022,including estimated new cases and deaths from BC across 21 United Nation(UN)regions and 185 countries,the age-standardized incidence rate(ASIR)and mortality rate(ASMR),the estimated annual percentage changes(EAPC),and demographic projections through 2050.The region-specific and country-specific BC burden for women of all ages and for young women(<40 years old)was reorganized and re-plotted to highlight subgroup differences.Linear regression was used to explore the link between ASIR/ASMR and the human development index(HDI).Transitioning countries referred to those with low or medium HDI,while transitioned countries were those with high or very high HDI.Results In 2022,an estimated 2.3 million new BC cases and 666,000 BC-related deaths occurred globally,accounting for 23.8%and 15.4%of all cancer cases and deaths in women,respectively.Regionally,Eastern Asia reported the highest number of cases(480,019,ASIR:37.54/100,000),while South-Central Asia had the highest number of deaths(135,348,ASMR:13.41/100,000).At the country level,China had the highest number of cases due to its large population,whereas India reported the highest number of deaths.ASIR for both overall and early-onset BC increased with HDI,while ASMR for early-onset BC decreased with HDI(P<0.05).Overall BC showed an increasing trend in ASIR during 2003–2015(EAPC:0.92%)and a decreasing trend in ASMR during 2006–2016(EAPC:-1.06%).Early-onset BC showed a more significant rise in ASIR(EAPCs:1.4%)and a slight increase in ASMR(EAPCs:0.16%).If national rates remain stable,BC cases and deaths will increase by 54.7%and 70.9%,respectively,by 2050.Notably,increased early-onset BC cases are only observed in transitioning countries,while decreased cases are seen in transitioned countries.Conclusions Breast cancer remains the leading cancer burden in women,particularly in transitioning countries.Addressing this growing burden requires urgent integration of primary prevention,early detection and high-quality treatment through multi-sectoral collaboration.展开更多
Objectives Primary prevention targeting modifiable risk factors would reduce the global burden of colorectal cancer,but the quantitative results are uncertain.We aimed to assess the global burden of colorectal cancer ...Objectives Primary prevention targeting modifiable risk factors would reduce the global burden of colorectal cancer,but the quantitative results are uncertain.We aimed to assess the global burden of colorectal cancer attributed to modifiable lifestyle factors and quantify the potential increase in life expectancy resulting from the elimination of these risk factors.Methods Based on the Global Burden of Disease Study 2021,we examined colorectal cancer deaths and disability-adjusted life years attributed to modifiable risk factors(including smoking,diet low in whole grains,diet low in milk,diet high in red meat,diet low in calcium,diet high in processed meat,and diet low in fiber)at the global,regional,and national levels from 1990 to 2021.The abridged period life table method was utilized to quantify the potential gain in life expectancy from eliminating these risk factors.Results Globally in 2021,57.1%of colorectal cancer deaths and 56.4%of disability-adjusted life years were preventable,with rates of 7.55(4.94–9.64)and 174.67(114.54–222.24)per 100,000 population,respectively.The modifiable burden has diminished in the high,high-middle,and low socio-demographic index quintiles and remained steady in the middle one.However,there is a concerning increase in the low-middle one.In 2021,the elimination of global colorectal cancer attributed to modifiable factors would increase the life expectancy for males and females by 0.107 and 0.109 years,respectively.Conclusion Our results quantitatively demonstrate the substantial burden reduction in colorectal cancer and the significant gain in life expectancy that can be achieved by eliminating modifiable lifestyle factors.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
Objectives:This study aimed to classify young breast cancer patients into distinct ambivalence over emotional expression and to explore the factors influencingthe level of ambivalence over emotional expression.Methods...Objectives:This study aimed to classify young breast cancer patients into distinct ambivalence over emotional expression and to explore the factors influencingthe level of ambivalence over emotional expression.Methods:A total of 217 young breast cancer patients were enrolled from a tertiary Grade A oncology hospital in Tianjin,China,using the convenience sampling method.All participants completed the general questionnaire,Ambivalence over Emotion Expression Questionnaire(AEQ),and Family Adapt-Ability and Cohesion Evaluation Scales-Chinese Version(FACES-CV).We employed exploratory latent profileanalysis for ambivalence over emotional expression profilingand logistic regression analysis to identify the influentialfactors Results:The results of the latent profileanalysis supported the models of four latent profiles,which were definedas“low conflict-lowexpression reflection”(19.2%),“high conflict-high inhibition expression”(43.9%),“moderate conflict-highregret expression”(18.1%),and“moderate conflict-desire understand”(18.8%).Logistic regression revealed that family cohesion,marital status,residence,per capita monthly income,and cancer stage were the influencingfactors of ambivalence over emotional expression in young breast cancer patients(P<0.05)Conclusions:Levels of ambivalence over emotional expression ameast cancer patients with breast cancer were highly heterogeneous.Medical staff should provide psychological counseling and health education tailored to the unique characteristics of emotional expression ambivalence in different patient groups to promote healthy emotional expression among patients.展开更多
Objective:The role of intraoperative radiation therapy(IORT)in the management of resectable pancreatic cancer(RPC)remains unclear.To date,the application of IORT using a low-energy X-ray source has not been extensivel...Objective:The role of intraoperative radiation therapy(IORT)in the management of resectable pancreatic cancer(RPC)remains unclear.To date,the application of IORT using a low-energy X-ray source has not been extensively investigated.Therefore,this study was conducted to evaluate the safety and efficacy of IORT using a 50 kV X-ray source in treating RPC.Methods:Patients with RPC who underwent radical pancreatectomy and IORT were enrolled.The primary endpoint was time to treatment failure(TTF)survival,whereas the secondary endpoints were safety and overall survival(OS).Results:By November 2023,35 patients with RPC were treated according to the study protocol.The median TTF was 11.67 months,whereas the median OS for the cohort was 22.2 months.The local recurrence rate was 20%.The most common postoperative complication was pancreatic fistula.The incidence of delayed gastric emptying was 20%.Within 30 days after surgery,one patient experienced abdominal pain,another experienced vomiting,and one died because of abdominal infection and a grade C pancreatic fistula.Carcinoembryonic antigen(CEA)and D-dimer levels significantly correlated with TTF and OS in multivariate analyses.The carbohydrate antigen 19-9(CA19-9)level was another prognostic factor significantly associated with OS.Patients with low D-dimer and normal CA19-9 levels showed prolonged OS with an IORT dose≤15 Gy.Conclusions:This study supports use of IORT with a 50 kV X-ray source in treating RPC.IORT using a low-energy X-ray source was well-tolerated and feasible.Additionally,D-dimer,CEA,and CA19-9 levels may help identify patient profiles potentially benefitting from IORT.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
Colorectal cancer(CRC)is the most frequently diagnosed malignancy of the digestive system and the second leading cause of cancer-related deaths worldwide(1).In China,CRC ranks as the second most common cancer with inc...Colorectal cancer(CRC)is the most frequently diagnosed malignancy of the digestive system and the second leading cause of cancer-related deaths worldwide(1).In China,CRC ranks as the second most common cancer with incidence and mortality rates continuing to rise(2).The Chinese Society of Clinical Oncology(CSCO)first introduced its guidelines in 2017,and since then,they have been updated annually to incorporate the latest clinical research findings,drug availability,and expert consensus(3-8).This article presents the key updates in the 2025 edition compared to the 2024 version.展开更多
Background:The nuclear receptor coactivator(NCOA)family,including NCOA1,NCOA2,and NCOA3,is critical in regulating gene expression through interactions with nuclear receptors and other transcription factors.These coact...Background:The nuclear receptor coactivator(NCOA)family,including NCOA1,NCOA2,and NCOA3,is critical in regulating gene expression through interactions with nuclear receptors and other transcription factors.These coactivators are implicated in various cancers,but their comprehensive roles across different cancer types remain poorly understood.Methods:We performed a pan-cancer bioinformatics analysis using data from The Cancer Genome Atlas and the Genotype-Tissue Expression project.We assessed the differential expression,copy number variations,mutations,methylation status,tumor mutation burden,microsatellite instability,and immune cell infiltration associated with NCOA family members across various cancers.Differential expression analysis was conducted using the DESeq2 package.Methylation data were analyzed using the ChAMP package,and immune cell infiltration was estimated using the CIBERSORT algorithm.Results:NCOA1 and NCOA2 were predominantly downregulated in multiple cancers,suggesting potential tumor suppressor roles,whereas NCOA3 was largely upregulated,indicating a consistent oncogenic function.These expression patterns significantly correlated with patient prognosis.Frequent copy number variations,particularly gains,and high mutation rates were observed in NCOA2.NCOA3 demonstrated consistent hypomethylation in tumors,which was associated with increased gene expression.Significant correlations were found between NCOA expression and tumor mutation burden,microsatellite instability,and immune cell infiltration,indicating their involvement in genomic instability and immune modulation.Conclusion:This comprehensive analysis reveals significant alterations in the expression,genomic,and epigenetic profiles of NCOA family members across various cancers.The findings highlight the multifaceted roles of NCOA1,NCOA2,and NCOA3 in tumorigenesis and their potential as biomarkers and therapeutic targets.Future research should focus on elucidating the mechanisms underlying the associations between NCOA expression,genomic alterations,and immune modulation to develop targeted cancer therapies.展开更多
Immunomodulatory cancer therapy is witnessing the rise of viral immunotherapy.The oncolytic influenza A virus,although promising in preclinical investigations,remains to be implemented in clinical practice.Recent prog...Immunomodulatory cancer therapy is witnessing the rise of viral immunotherapy.The oncolytic influenza A virus,although promising in preclinical investigations,remains to be implemented in clinical practice.Recent progress in genetic engineering,coupled with experiential insights,offers opportunities to enhance the therapeutic efficacy of the influenza A virus.This review explores the use of the influenza virus,its attenuated forms,and associated vaccines in cancer immunotherapy,highlighting their respective advantages and challenges.We further elucidate methods for engineering influenza viruses and innovative approaches to augment them with cytokines or immune checkpoint inhibitors,aiming to maximize their clinical impact.Our goal is to provide insights essential for refining influenza A virus-based viral tumor immunotherapies.展开更多
BACKGROUND Gastric cancer(GC)is a major global health challenge,and the treatment of proximal GC in particular presents unique clinical and surgical complexities.Currently,there is no consensus on whether proximal gas...BACKGROUND Gastric cancer(GC)is a major global health challenge,and the treatment of proximal GC in particular presents unique clinical and surgical complexities.Currently,there is no consensus on whether proximal gastrectomy(PG)or total gastrectomy(TG)should be used for advanced proximal GC,and the choice of postoperative gastrointestinal reconstruction method remains controversial.AIM To compare the short-term efficacy,long-term survival,and postoperative reflux outcomes of PG with tubular stomach reconstruction vs TG with Roux-en-Y re-construction in patients with proximal GC following neoadjuvant chemotherapy(NACT)in an effort to provide valuable insights for clinical decision-making regarding the optimal surgical approach.METHODS A multicenter retrospective cohort study was conducted at two Chinese medical centers between December,2012 and December,2022.Patients with histologically confirmed proximal GC who received NACT followed by either PG with tubular stomach reconstruction or TG with Roux-en-Y reconstruction were included.Propensity score matching(PSM)was performed to balance baseline characteristics,and the primary endpoint was 5-year overall survival(OS).Se-condary endpoints included recurrence-free survival(RFS),postoperative complications,and reflux severity.RESULTS After PSM,244 patients(122 PG,122 TG)were finally included and all baseline characteristics were comparable between groups.The PG group had a significantly shorter operation time compared to the TG group(189.50 vs 215.00 minutes,P<0.001),with no differences in intraoperative blood loss or postoperative complications(19.68%vs 14.75%,P=0.792).The 5-year OS rates were 52.7%vs 45.5%(P=0.330),and 5-year RFS rates were 54.3%vs 47.6%(P=0.356)for the PG and TG groups,respectively.Reflux symptoms(18.0%vs 31.1%,P=0.017)and clinically significant reflux based on gastroesophageal reflux disease questionnaire scores≥8(7.4%vs 21.3%,P<0.001)were significantly less frequent in the PG group.Multivariate analysis identified histological differentiation(HR=2.98,95%CI:2.03-4.36,P<0.001)and tumor size(HR=0.26,95%CI:0.17-0.41 for tumors≤4 cm,P<0.001)as independent prognostic factors.CONCLUSION PG with tubular stomach reconstruction is comparable to TG in terms of surgical safety and long-term oncological outcomes for proximal GC patients following NACT.Additionally,PG has the advantages of shorter operation time and lower rates of postoperative reflux,suggesting potential benefits for patient quality of life.Notably,the analysis of postoperative prognostic factors,including histological differentiation and tumor size,further informs clinical decision-making and highlights the importance of individualized treatment strategies.展开更多
Treatment of locally advanced unresectable pancreatic cancer remains a major clinical challenge due to pronounced heterogeneity and resistance to standard regimens.Increasing evidence highlights the critical role of t...Treatment of locally advanced unresectable pancreatic cancer remains a major clinical challenge due to pronounced heterogeneity and resistance to standard regimens.Increasing evidence highlights the critical role of the tumor microenvironment(TME)in shaping therapeutic response and driving drug resistance.In this minireview,we summarize recent advances in TME phenotyping and its potential to guide precision therapy.A four-dimensional framework integrating stromal,immune,genomic,and metabolic features has been proposed to better characterize TME heterogeneity.Preclinical and clinical studies indicate that strategies targeting the stroma,modulating immunity,or exploiting genomic vulnerabilities such as homologous recombination deficiency may enhance the efficacy of chemotherapy,immunotherapy,and targeted agents.Dynamic biomarkers,including circulating tumor DNA and carbohydrate antigen 19-9,also show promise for real-time therapy adaptation,although their clinical application remains limited.By synthesizing current evidence,we emphasize the importance of individualized treatment strategies that account for TME complexity.While encouraging,the translation of multiomics phenotyping and biomarker monitoring into routine clinical practice requires standardization,prospective validation,and integration of novel technologies.Future research should focus on establishing reproducible TME-guided models to enable dynamic and personalized therapy for patients with unresectable pancreatic cancer.展开更多
Background The potential of exercise as a concurrent therapy for actively treated primary tumors has been suggested by emerging preclinical and observational studies.However,clinical trials regarding this question are...Background The potential of exercise as a concurrent therapy for actively treated primary tumors has been suggested by emerging preclinical and observational studies.However,clinical trials regarding this question are scarce.Therefore,we conducted a randomized controlled trial investigating the effects of aerobic or resistance exercise concomitant to neoadjuvant chemotherapy(NACT)on tumor size.Methods In the BENEFIT study(German title:Bewegung bei neoadjuvanter chemotherapie zur verbesserung der fitness),patients with breast cancer scheduled for NACT were randomly assigned to supervised resistance training(RT,n=60)or aerobic training(AT,n=60)twice weekly during NACT or to a waitlist control group(WCG,n=60).The primary outcome,“change in tumor size”,as well as the secondary clinical outcomes pathologic complete response(pCR),type of surgery(breast conserving/mastectomy),axillary lymph node dissection(ALND,yes/no),premature discontinuation of chemotherapy(yes/no),and relative dose intensity(RDI)were derived from clinical records.Due to the highly skewed distribution,the primary outcome was categorized.Multiple(ordinal)logistic regression analyses were performed.Results Overall,there was no significant difference in post-intervention tumor size between RT or AT and WCG.However,there was a significant effect modification by hormone receptor(HR)status(P_(interaction)=0.030).Among patients with HR+tumors,results suggest a beneficial effect of AT on tumor shrinkage(odds ratio(OR)=2.37,95%confidence interval(95%CI):0.97‒5.78),on pCR(OR=3.21,95%CI:0.97‒10.61);and on ALND(OR=3.76,95%CI:0.78‒18.06)compared to WCG.The effects of RT were slightly less pronounced.For HR−subtypes,beneficial effects on RDI were found for AT(OR=3.71,95%CI:1.20‒11.50)and similarly for RT(OR=2.58,95%CI:0.88‒7.59).Both AT and RT had favorable effects on premature discontinuation of chemotherapy(OR(no vs.yes)=2.34,95%CI:1.10‒5.06),irrespective of tumor receptor status.Conclusion While there was no significant effect on the primary outcome in the overall group,aerobic and resistance exercise concomitant to NACT seem to beneficially affect tumor shrinkage and pCR,reduce the need for ALND among patients with HR+breast cancers,and prevent low RDI among patients with HR–breast cancers.These results warrant confirmation in further trials.展开更多
Objective:The key molecular events signifying the Helicobacter pylori-induced gastric carcinogenesis process are largely unknown.Methods:Bulk tissue-proteomics profiling were leveraged across multi-stage gastric lesio...Objective:The key molecular events signifying the Helicobacter pylori-induced gastric carcinogenesis process are largely unknown.Methods:Bulk tissue-proteomics profiling were leveraged across multi-stage gastric lesions from Linqu(n=166)and Beijing sets(n=99)and single-cell transcriptomic profiling(n=18)to decipher key molecular signatures of H.pylori-related gastric lesion progression and gastric cancer(GC)development.The association of key proteins association with gastric lesion progression and GC development were prospectively studied building on follow-up of the Linqu set and UK Biobank(n=48,529).Results:Concordant proteomics signatures associated with H.pylori infection and gastric carcinogenesis(ρ=0.784,correlation P=1.80×10^(−36))were identified.RNA expression of genes encoding 13 up-and 15 down-regulated key proteins displayed trending alterations in the transition from normal gastric epithelium to intestinal metaplasia,then to malignant cells.A 15-tissue protein panel integrating these signatures demonstrated potential for targeting individuals at high risk for progressing to gastric neoplasia(OR=7.22,95%CI:1.31-39.72 for the high-score group).A 4-circulating protein panel may be used as non-invasive markers predicting the risk of GC development(hazard ratio=3.73,95%confidence interval:1.63-8.54,high-risk vs.low-risk populations,area under the curve=0.75).Conclusions:Concordant proteomics signatures associated with H.pylori infection and gastric carcinogenesis were unveiled with potential as biomarkers for targeted prevention strategies.展开更多
BACKGROUND Studies on the application of recombinant human endostatin(RH-endostatin)intraperitoneal perfusion in gastric cancer(GC)with malignant ascites are limited.AIM To explore the effectiveness,prognosis,and safe...BACKGROUND Studies on the application of recombinant human endostatin(RH-endostatin)intraperitoneal perfusion in gastric cancer(GC)with malignant ascites are limited.AIM To explore the effectiveness,prognosis,and safety of intraperitoneal RH-endostatin perfusion in treating patients with GC and malignant ascites.METHODS Patients with GC and malignant ascites were divided into the cisplatin intraperi-toneal perfusion(control group)group and the cisplatin combined with RH-endostatin intraperitoneal perfusion group(RH-endostatin group).Efficient ascites control,overall survival(OS),quality of life,and adverse events were observed,and possible influencing factors on prognosis outcomes analyzed.RESULTS We identified no significant differences in baseline characteristics between the control and RH-endostatin groups.The latter group had higher ascites control rates than the control group.Treatment methods were identified as an independent OS factor.Clinically,RH-endostatin-treated patients had significantly improved OS rates when compared with control patients,particularly in those with small and moderate ascites volumes.Quality of life improvements in control patients were significantly lower when compared with RH-endostatin patients.Adverse events were balanced between the groups.CONCLUSION Overall,intraperitoneal RH-endostatin improved treatment efficacy and prolonged prognosis in patients with GC and malignant ascites.This approach may benefit further clinical applications for treating GC.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
Objective:Current clinical staging of pancreatic ductal adenocarcinoma(PDAC)relies predominantly on anatomical resectability,thus limiting its prognostic utility.We developed and validated a pretreatment prognostic gr...Objective:Current clinical staging of pancreatic ductal adenocarcinoma(PDAC)relies predominantly on anatomical resectability,thus limiting its prognostic utility.We developed and validated a pretreatment prognostic grading system incorporating multidimensional parameters.Methods:Patients with histologically confirmed PDAC undergoing curative-intent pancreatectomy were retrospectively enrolled.Independent prognostic determinants of overall survival(OS)and disease-free survival(DFS),identified through multivariable Cox proportional hazards regression,provided the basis for deriving the Tianjin Prognostic Score and its corresponding risk stratification scheme.Results:Resectability status,lymph node metastasis indicated by imaging,pretreatment serum CA19-9 levels,and the prognostic nutritional score(PNS)independently predicted both OS and DFS.These parameters were integrated into the Tianjin Prognostic Score for PDAC prognosis stratification.The Tianjin-Grade system,subsequently established according to this score,segregated patients into 4 discrete prognostic cohorts with significantly divergent survival outcomes.This system exhibited significantly greater discriminatory ability for prognosis than conventional serum CA19-9 and resectability criteria.Notably,patients classified as having high risk or extremely high risk derived substantial survival benefits from neoadjuvant chemotherapy(NAC),whereas those with low or intermediate risk demonstrated comparable survival outcomes regardless of NAC administration.Conclusion:The Tianjin-Grade system provides accurate pretreatment prognosis prediction in patients with PDAC through integration of anatomical and biological parameters,thus serving as a reliable tool for prognostic assessment.This system facilitates the development of personalized preoperative therapeutic strategies.展开更多
基金Supported by WFAS 2023 International Standard Project of Acupuncture-Moxibustion:WFASRP2023-SC05Tianjin Nankai District Pilot Demonstration Project for Integrated Inheritance and Innovation of Traditional Chinese Medicine:20250102001Beijing Natural Science:7252224。
文摘Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based support and establish levels of evidence for clinical application.Method:A comprehensive search was conducted to identify systematic reviews on acupuncture and mox-ibustion for the prevention and management of cancer-related conditions,covering databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Biomedical Databases,China Science and Technology Journal Database,and Wanfang Data,from their in-ception to August 1,2024.The methodological quality of the included systematic reviews was assessed by using AMSTAR 2,and bubble plots were employed to visualize the evidence.Results:Overall,137 systematic reviews were included,with China being the most prolific country,with 117 reviews.These reviews addressed 21 cancer-related conditions,with the three most frequently stud-ied being cancer-related fatigue(25 reviews),nausea and vomiting(20 reviews),and cancer pain(19 re-views).The three most commonly used acupuncture modalities were manual acupuncture(81 reviews),electroacupuncture(55 reviews),and moxibustion(39 reviews).Quality assessment revealed that one systematic review was rated as“high quality,”eight as“low quality,”and 128 as“critically low quality,”primarily due to the absence of protocol registration and lists of excluded studies.Conclusion:Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related con-ditions and treatment-related adverse effects,and their clinical use has been widely reported.However,the overall methodological quality of the included systematic reviews was low,limiting the reliability and the strength of the evidence.Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.
基金support for this study was provided in part by grants from the German Federal Ministry of Education and Research(grant numbers 01GL1712 and 01KD2104A)the German Cancer Aid(grant number 70114735).
文摘Preprint:https://doi.org/10.1101/2022.11.22.22282622.Randomized trials,cohort and modeling studies have consistently demonstrated a major impact of screening endoscopies on reducing colorectal cancer(CRC)inci-dence and mortality[1].Over time,CRC mortality starts to be lower in those who underwent screening compared to those who did not due to earlier detection of prevalent.
基金supported by the National Key R&D Program of China(grant number:2021YFC2500400)National Natural Science Foundation of China(grant numbers:82172894,82073028,82204121)China Postdoctoral Science Foundation(grant number:2023M742617).
文摘Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.
基金funded by grants from the National Natural Science Foundation of China(Grant Nos.82171932 and 82302180)the Ministry of Science and Technology of China(Grant No.2024ZD0520002)+3 种基金the Chinese National Key Research and Development Project(Grant Nos.2021YFC2500402 and 2021YFC2500400)the National Health Commission Capacity Building and Continuing Education Center(Grant No.YXFSC2022JJSJ011)the Tianjin Key Medical Discipline(Specialty)Construction Project(Grant No.TJYXZDXK-010A)the Scientific Developing Foundation of Tianjin Education Commission(Grant No.2024KJ182).
文摘Cancer poses a serious threat to human health worldwide and is a leading cause of death1.The analysis of radiological imaging is crucial in early detection,accurate diagnosis,effective treatment planning,and ongoing monitoring of patients with cancer.However,several challenges impede the effectiveness of cancer imaging analysis in clinical practice.One difficulty is that healthcare professionals’immense clinical workloads can result in time constraints and increase pressure,thereby hindering their ability to maintain high accuracy and thoroughness in image analysis.Additionally,subjective variability among radiologists can lead to inconsistent interpretations and diagnoses.Because this variability is often influenced by personal biases,standardized assessments are often difficult to achieve.Moreover,the inherent complexity of cancer imaging necessitates extensive clinical experience;this aspect can also be a limiting factor,particularly if expertise or resources are limited.The application of artificial intelligence(AI)can alleviate these problems by enhancing the accuracy,objectivity,and efficiency of cancer imaging analysis while assisting physicians.Therefore,the advancement of AI research is crucial for achieving progress in radiology.
基金supported by the National Key R&D Program of China(grant number:2021YFC2500400)Tianjin Health Committee Foundation(grant number:TJWJ2021MS008).
文摘Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were sourced from GLOBOCAN 2022,including estimated new cases and deaths from BC across 21 United Nation(UN)regions and 185 countries,the age-standardized incidence rate(ASIR)and mortality rate(ASMR),the estimated annual percentage changes(EAPC),and demographic projections through 2050.The region-specific and country-specific BC burden for women of all ages and for young women(<40 years old)was reorganized and re-plotted to highlight subgroup differences.Linear regression was used to explore the link between ASIR/ASMR and the human development index(HDI).Transitioning countries referred to those with low or medium HDI,while transitioned countries were those with high or very high HDI.Results In 2022,an estimated 2.3 million new BC cases and 666,000 BC-related deaths occurred globally,accounting for 23.8%and 15.4%of all cancer cases and deaths in women,respectively.Regionally,Eastern Asia reported the highest number of cases(480,019,ASIR:37.54/100,000),while South-Central Asia had the highest number of deaths(135,348,ASMR:13.41/100,000).At the country level,China had the highest number of cases due to its large population,whereas India reported the highest number of deaths.ASIR for both overall and early-onset BC increased with HDI,while ASMR for early-onset BC decreased with HDI(P<0.05).Overall BC showed an increasing trend in ASIR during 2003–2015(EAPC:0.92%)and a decreasing trend in ASMR during 2006–2016(EAPC:-1.06%).Early-onset BC showed a more significant rise in ASIR(EAPCs:1.4%)and a slight increase in ASMR(EAPCs:0.16%).If national rates remain stable,BC cases and deaths will increase by 54.7%and 70.9%,respectively,by 2050.Notably,increased early-onset BC cases are only observed in transitioning countries,while decreased cases are seen in transitioned countries.Conclusions Breast cancer remains the leading cancer burden in women,particularly in transitioning countries.Addressing this growing burden requires urgent integration of primary prevention,early detection and high-quality treatment through multi-sectoral collaboration.
基金supported by the National Natural Science Foundation of China(grant number:82404340)the CAMS Innovation Fund for Medical Science(grant number:2021-I2M-1–067)+1 种基金the Zhejiang Provincial Natural Science Foundation of China(grant number:LTGY23H260004)the Beijing Natural Science Foundation(grant number:Z240004).
文摘Objectives Primary prevention targeting modifiable risk factors would reduce the global burden of colorectal cancer,but the quantitative results are uncertain.We aimed to assess the global burden of colorectal cancer attributed to modifiable lifestyle factors and quantify the potential increase in life expectancy resulting from the elimination of these risk factors.Methods Based on the Global Burden of Disease Study 2021,we examined colorectal cancer deaths and disability-adjusted life years attributed to modifiable risk factors(including smoking,diet low in whole grains,diet low in milk,diet high in red meat,diet low in calcium,diet high in processed meat,and diet low in fiber)at the global,regional,and national levels from 1990 to 2021.The abridged period life table method was utilized to quantify the potential gain in life expectancy from eliminating these risk factors.Results Globally in 2021,57.1%of colorectal cancer deaths and 56.4%of disability-adjusted life years were preventable,with rates of 7.55(4.94–9.64)and 174.67(114.54–222.24)per 100,000 population,respectively.The modifiable burden has diminished in the high,high-middle,and low socio-demographic index quintiles and remained steady in the middle one.However,there is a concerning increase in the low-middle one.In 2021,the elimination of global colorectal cancer attributed to modifiable factors would increase the life expectancy for males and females by 0.107 and 0.109 years,respectively.Conclusion Our results quantitatively demonstrate the substantial burden reduction in colorectal cancer and the significant gain in life expectancy that can be achieved by eliminating modifiable lifestyle factors.
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.
基金funded by Tianjin Key Medical Discipline(Specialty)Construction Project,China(Grant No.TJYXZDXK-011A)Tianjin Medical University Cancer Institute&Hospital Nursing Special Fund Project(H2304)。
文摘Objectives:This study aimed to classify young breast cancer patients into distinct ambivalence over emotional expression and to explore the factors influencingthe level of ambivalence over emotional expression.Methods:A total of 217 young breast cancer patients were enrolled from a tertiary Grade A oncology hospital in Tianjin,China,using the convenience sampling method.All participants completed the general questionnaire,Ambivalence over Emotion Expression Questionnaire(AEQ),and Family Adapt-Ability and Cohesion Evaluation Scales-Chinese Version(FACES-CV).We employed exploratory latent profileanalysis for ambivalence over emotional expression profilingand logistic regression analysis to identify the influentialfactors Results:The results of the latent profileanalysis supported the models of four latent profiles,which were definedas“low conflict-lowexpression reflection”(19.2%),“high conflict-high inhibition expression”(43.9%),“moderate conflict-highregret expression”(18.1%),and“moderate conflict-desire understand”(18.8%).Logistic regression revealed that family cohesion,marital status,residence,per capita monthly income,and cancer stage were the influencingfactors of ambivalence over emotional expression in young breast cancer patients(P<0.05)Conclusions:Levels of ambivalence over emotional expression ameast cancer patients with breast cancer were highly heterogeneous.Medical staff should provide psychological counseling and health education tailored to the unique characteristics of emotional expression ambivalence in different patient groups to promote healthy emotional expression among patients.
基金supported by the Tianjin Science and Technology Commission key project(Grant No.21JCZDJC00980)Tianjin Science and Technology Commission project(Grant No.22ZXJBSY00030)Tianjin Health Research project(Grant No.TJWJ2022MS007)。
文摘Objective:The role of intraoperative radiation therapy(IORT)in the management of resectable pancreatic cancer(RPC)remains unclear.To date,the application of IORT using a low-energy X-ray source has not been extensively investigated.Therefore,this study was conducted to evaluate the safety and efficacy of IORT using a 50 kV X-ray source in treating RPC.Methods:Patients with RPC who underwent radical pancreatectomy and IORT were enrolled.The primary endpoint was time to treatment failure(TTF)survival,whereas the secondary endpoints were safety and overall survival(OS).Results:By November 2023,35 patients with RPC were treated according to the study protocol.The median TTF was 11.67 months,whereas the median OS for the cohort was 22.2 months.The local recurrence rate was 20%.The most common postoperative complication was pancreatic fistula.The incidence of delayed gastric emptying was 20%.Within 30 days after surgery,one patient experienced abdominal pain,another experienced vomiting,and one died because of abdominal infection and a grade C pancreatic fistula.Carcinoembryonic antigen(CEA)and D-dimer levels significantly correlated with TTF and OS in multivariate analyses.The carbohydrate antigen 19-9(CA19-9)level was another prognostic factor significantly associated with OS.Patients with low D-dimer and normal CA19-9 levels showed prolonged OS with an IORT dose≤15 Gy.Conclusions:This study supports use of IORT with a 50 kV X-ray source in treating RPC.IORT using a low-energy X-ray source was well-tolerated and feasible.Additionally,D-dimer,CEA,and CA19-9 levels may help identify patient profiles potentially benefitting from IORT.
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 the National Natural Science Foundation of China(No.82373415)Beijing Xisike Clinical Oncology Research Foundation(No.Ytongshu2021/ms-0003)。
文摘Colorectal cancer(CRC)is the most frequently diagnosed malignancy of the digestive system and the second leading cause of cancer-related deaths worldwide(1).In China,CRC ranks as the second most common cancer with incidence and mortality rates continuing to rise(2).The Chinese Society of Clinical Oncology(CSCO)first introduced its guidelines in 2017,and since then,they have been updated annually to incorporate the latest clinical research findings,drug availability,and expert consensus(3-8).This article presents the key updates in the 2025 edition compared to the 2024 version.
基金supported by grants from the Tianjin Health Technology Project(Grant No.2022QN106).
文摘Background:The nuclear receptor coactivator(NCOA)family,including NCOA1,NCOA2,and NCOA3,is critical in regulating gene expression through interactions with nuclear receptors and other transcription factors.These coactivators are implicated in various cancers,but their comprehensive roles across different cancer types remain poorly understood.Methods:We performed a pan-cancer bioinformatics analysis using data from The Cancer Genome Atlas and the Genotype-Tissue Expression project.We assessed the differential expression,copy number variations,mutations,methylation status,tumor mutation burden,microsatellite instability,and immune cell infiltration associated with NCOA family members across various cancers.Differential expression analysis was conducted using the DESeq2 package.Methylation data were analyzed using the ChAMP package,and immune cell infiltration was estimated using the CIBERSORT algorithm.Results:NCOA1 and NCOA2 were predominantly downregulated in multiple cancers,suggesting potential tumor suppressor roles,whereas NCOA3 was largely upregulated,indicating a consistent oncogenic function.These expression patterns significantly correlated with patient prognosis.Frequent copy number variations,particularly gains,and high mutation rates were observed in NCOA2.NCOA3 demonstrated consistent hypomethylation in tumors,which was associated with increased gene expression.Significant correlations were found between NCOA expression and tumor mutation burden,microsatellite instability,and immune cell infiltration,indicating their involvement in genomic instability and immune modulation.Conclusion:This comprehensive analysis reveals significant alterations in the expression,genomic,and epigenetic profiles of NCOA family members across various cancers.The findings highlight the multifaceted roles of NCOA1,NCOA2,and NCOA3 in tumorigenesis and their potential as biomarkers and therapeutic targets.Future research should focus on elucidating the mechanisms underlying the associations between NCOA expression,genomic alterations,and immune modulation to develop targeted cancer therapies.
基金supported by the Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang(No.2022R01002)the National Natural Science Foundation of China(Nos.82272300 and 82102893)the Fundamental Research Funds for the Central Universities(No.226-2024-00062),China.
文摘Immunomodulatory cancer therapy is witnessing the rise of viral immunotherapy.The oncolytic influenza A virus,although promising in preclinical investigations,remains to be implemented in clinical practice.Recent progress in genetic engineering,coupled with experiential insights,offers opportunities to enhance the therapeutic efficacy of the influenza A virus.This review explores the use of the influenza virus,its attenuated forms,and associated vaccines in cancer immunotherapy,highlighting their respective advantages and challenges.We further elucidate methods for engineering influenza viruses and innovative approaches to augment them with cytokines or immune checkpoint inhibitors,aiming to maximize their clinical impact.Our goal is to provide insights essential for refining influenza A virus-based viral tumor immunotherapies.
基金Supported by Special Fund for the Beijing Hope Marathon of the China Cancer Foundation,No.LC2019 L05and the Capital Health Development Research Special Fund Project,No.2024-2-4026.
文摘BACKGROUND Gastric cancer(GC)is a major global health challenge,and the treatment of proximal GC in particular presents unique clinical and surgical complexities.Currently,there is no consensus on whether proximal gastrectomy(PG)or total gastrectomy(TG)should be used for advanced proximal GC,and the choice of postoperative gastrointestinal reconstruction method remains controversial.AIM To compare the short-term efficacy,long-term survival,and postoperative reflux outcomes of PG with tubular stomach reconstruction vs TG with Roux-en-Y re-construction in patients with proximal GC following neoadjuvant chemotherapy(NACT)in an effort to provide valuable insights for clinical decision-making regarding the optimal surgical approach.METHODS A multicenter retrospective cohort study was conducted at two Chinese medical centers between December,2012 and December,2022.Patients with histologically confirmed proximal GC who received NACT followed by either PG with tubular stomach reconstruction or TG with Roux-en-Y reconstruction were included.Propensity score matching(PSM)was performed to balance baseline characteristics,and the primary endpoint was 5-year overall survival(OS).Se-condary endpoints included recurrence-free survival(RFS),postoperative complications,and reflux severity.RESULTS After PSM,244 patients(122 PG,122 TG)were finally included and all baseline characteristics were comparable between groups.The PG group had a significantly shorter operation time compared to the TG group(189.50 vs 215.00 minutes,P<0.001),with no differences in intraoperative blood loss or postoperative complications(19.68%vs 14.75%,P=0.792).The 5-year OS rates were 52.7%vs 45.5%(P=0.330),and 5-year RFS rates were 54.3%vs 47.6%(P=0.356)for the PG and TG groups,respectively.Reflux symptoms(18.0%vs 31.1%,P=0.017)and clinically significant reflux based on gastroesophageal reflux disease questionnaire scores≥8(7.4%vs 21.3%,P<0.001)were significantly less frequent in the PG group.Multivariate analysis identified histological differentiation(HR=2.98,95%CI:2.03-4.36,P<0.001)and tumor size(HR=0.26,95%CI:0.17-0.41 for tumors≤4 cm,P<0.001)as independent prognostic factors.CONCLUSION PG with tubular stomach reconstruction is comparable to TG in terms of surgical safety and long-term oncological outcomes for proximal GC patients following NACT.Additionally,PG has the advantages of shorter operation time and lower rates of postoperative reflux,suggesting potential benefits for patient quality of life.Notably,the analysis of postoperative prognostic factors,including histological differentiation and tumor size,further informs clinical decision-making and highlights the importance of individualized treatment strategies.
文摘Treatment of locally advanced unresectable pancreatic cancer remains a major clinical challenge due to pronounced heterogeneity and resistance to standard regimens.Increasing evidence highlights the critical role of the tumor microenvironment(TME)in shaping therapeutic response and driving drug resistance.In this minireview,we summarize recent advances in TME phenotyping and its potential to guide precision therapy.A four-dimensional framework integrating stromal,immune,genomic,and metabolic features has been proposed to better characterize TME heterogeneity.Preclinical and clinical studies indicate that strategies targeting the stroma,modulating immunity,or exploiting genomic vulnerabilities such as homologous recombination deficiency may enhance the efficacy of chemotherapy,immunotherapy,and targeted agents.Dynamic biomarkers,including circulating tumor DNA and carbohydrate antigen 19-9,also show promise for real-time therapy adaptation,although their clinical application remains limited.By synthesizing current evidence,we emphasize the importance of individualized treatment strategies that account for TME complexity.While encouraging,the translation of multiomics phenotyping and biomarker monitoring into routine clinical practice requires standardization,prospective validation,and integration of novel technologies.Future research should focus on establishing reproducible TME-guided models to enable dynamic and personalized therapy for patients with unresectable pancreatic cancer.
基金supported by an intramural proof of concept grant of the NCT Heidelberg.
文摘Background The potential of exercise as a concurrent therapy for actively treated primary tumors has been suggested by emerging preclinical and observational studies.However,clinical trials regarding this question are scarce.Therefore,we conducted a randomized controlled trial investigating the effects of aerobic or resistance exercise concomitant to neoadjuvant chemotherapy(NACT)on tumor size.Methods In the BENEFIT study(German title:Bewegung bei neoadjuvanter chemotherapie zur verbesserung der fitness),patients with breast cancer scheduled for NACT were randomly assigned to supervised resistance training(RT,n=60)or aerobic training(AT,n=60)twice weekly during NACT or to a waitlist control group(WCG,n=60).The primary outcome,“change in tumor size”,as well as the secondary clinical outcomes pathologic complete response(pCR),type of surgery(breast conserving/mastectomy),axillary lymph node dissection(ALND,yes/no),premature discontinuation of chemotherapy(yes/no),and relative dose intensity(RDI)were derived from clinical records.Due to the highly skewed distribution,the primary outcome was categorized.Multiple(ordinal)logistic regression analyses were performed.Results Overall,there was no significant difference in post-intervention tumor size between RT or AT and WCG.However,there was a significant effect modification by hormone receptor(HR)status(P_(interaction)=0.030).Among patients with HR+tumors,results suggest a beneficial effect of AT on tumor shrinkage(odds ratio(OR)=2.37,95%confidence interval(95%CI):0.97‒5.78),on pCR(OR=3.21,95%CI:0.97‒10.61);and on ALND(OR=3.76,95%CI:0.78‒18.06)compared to WCG.The effects of RT were slightly less pronounced.For HR−subtypes,beneficial effects on RDI were found for AT(OR=3.71,95%CI:1.20‒11.50)and similarly for RT(OR=2.58,95%CI:0.88‒7.59).Both AT and RT had favorable effects on premature discontinuation of chemotherapy(OR(no vs.yes)=2.34,95%CI:1.10‒5.06),irrespective of tumor receptor status.Conclusion While there was no significant effect on the primary outcome in the overall group,aerobic and resistance exercise concomitant to NACT seem to beneficially affect tumor shrinkage and pCR,reduce the need for ALND among patients with HR+breast cancers,and prevent low RDI among patients with HR–breast cancers.These results warrant confirmation in further trials.
基金funded by the National Natural Science Foundation of China(Grant No.82273704)Noncommunicable Chronic Diseases-National Science and Technology Major Project(Grant Nos.2023ZD0501400-2023ZD0501402)+3 种基金Beijing Hospitals Authority’s Ascent Plan(Grant No.DFL20241102)Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(Grant No.ZLRK202325)Peking University Medicine Fund for World’s Leading Discipline or Discipline Cluster Development(Grant No.BMU2022XKQ004)the Science Foundation of Peking University Cancer Hospital(Grant Nos.BJCH2024BJ02,XKFZ2410,and 2022-27).
文摘Objective:The key molecular events signifying the Helicobacter pylori-induced gastric carcinogenesis process are largely unknown.Methods:Bulk tissue-proteomics profiling were leveraged across multi-stage gastric lesions from Linqu(n=166)and Beijing sets(n=99)and single-cell transcriptomic profiling(n=18)to decipher key molecular signatures of H.pylori-related gastric lesion progression and gastric cancer(GC)development.The association of key proteins association with gastric lesion progression and GC development were prospectively studied building on follow-up of the Linqu set and UK Biobank(n=48,529).Results:Concordant proteomics signatures associated with H.pylori infection and gastric carcinogenesis(ρ=0.784,correlation P=1.80×10^(−36))were identified.RNA expression of genes encoding 13 up-and 15 down-regulated key proteins displayed trending alterations in the transition from normal gastric epithelium to intestinal metaplasia,then to malignant cells.A 15-tissue protein panel integrating these signatures demonstrated potential for targeting individuals at high risk for progressing to gastric neoplasia(OR=7.22,95%CI:1.31-39.72 for the high-score group).A 4-circulating protein panel may be used as non-invasive markers predicting the risk of GC development(hazard ratio=3.73,95%confidence interval:1.63-8.54,high-risk vs.low-risk populations,area under the curve=0.75).Conclusions:Concordant proteomics signatures associated with H.pylori infection and gastric carcinogenesis were unveiled with potential as biomarkers for targeted prevention strategies.
基金Supported by Scientific Research Project of Tianjin Municipal Education Commission,No.2018KJ015.
文摘BACKGROUND Studies on the application of recombinant human endostatin(RH-endostatin)intraperitoneal perfusion in gastric cancer(GC)with malignant ascites are limited.AIM To explore the effectiveness,prognosis,and safety of intraperitoneal RH-endostatin perfusion in treating patients with GC and malignant ascites.METHODS Patients with GC and malignant ascites were divided into the cisplatin intraperi-toneal perfusion(control group)group and the cisplatin combined with RH-endostatin intraperitoneal perfusion group(RH-endostatin group).Efficient ascites control,overall survival(OS),quality of life,and adverse events were observed,and possible influencing factors on prognosis outcomes analyzed.RESULTS We identified no significant differences in baseline characteristics between the control and RH-endostatin groups.The latter group had higher ascites control rates than the control group.Treatment methods were identified as an independent OS factor.Clinically,RH-endostatin-treated patients had significantly improved OS rates when compared with control patients,particularly in those with small and moderate ascites volumes.Quality of life improvements in control patients were significantly lower when compared with RH-endostatin patients.Adverse events were balanced between the groups.CONCLUSION Overall,intraperitoneal RH-endostatin improved treatment efficacy and prolonged prognosis in patients with GC and malignant ascites.This approach may benefit further clinical applications for treating GC.
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 the Tianjin Natural Science Foundation(Grant No.24JCYBJC00580).
文摘Objective:Current clinical staging of pancreatic ductal adenocarcinoma(PDAC)relies predominantly on anatomical resectability,thus limiting its prognostic utility.We developed and validated a pretreatment prognostic grading system incorporating multidimensional parameters.Methods:Patients with histologically confirmed PDAC undergoing curative-intent pancreatectomy were retrospectively enrolled.Independent prognostic determinants of overall survival(OS)and disease-free survival(DFS),identified through multivariable Cox proportional hazards regression,provided the basis for deriving the Tianjin Prognostic Score and its corresponding risk stratification scheme.Results:Resectability status,lymph node metastasis indicated by imaging,pretreatment serum CA19-9 levels,and the prognostic nutritional score(PNS)independently predicted both OS and DFS.These parameters were integrated into the Tianjin Prognostic Score for PDAC prognosis stratification.The Tianjin-Grade system,subsequently established according to this score,segregated patients into 4 discrete prognostic cohorts with significantly divergent survival outcomes.This system exhibited significantly greater discriminatory ability for prognosis than conventional serum CA19-9 and resectability criteria.Notably,patients classified as having high risk or extremely high risk derived substantial survival benefits from neoadjuvant chemotherapy(NAC),whereas those with low or intermediate risk demonstrated comparable survival outcomes regardless of NAC administration.Conclusion:The Tianjin-Grade system provides accurate pretreatment prognosis prediction in patients with PDAC through integration of anatomical and biological parameters,thus serving as a reliable tool for prognostic assessment.This system facilitates the development of personalized preoperative therapeutic strategies.
