Colorectal cancer(CRC)is one of the most popular malignancies globally,with 930000 deaths in 2020.The evaluation of CRC-related pathogenesis and the discovery of po-tential therapeutic targets will be meaningful and h...Colorectal cancer(CRC)is one of the most popular malignancies globally,with 930000 deaths in 2020.The evaluation of CRC-related pathogenesis and the discovery of po-tential therapeutic targets will be meaningful and helpful for improving CRC treat-ment.With huge efforts made in past decades,the systematic treatment regimens have been applied to improve the prognosis of CRC patients.However,the sensitivity of CRC to chemotherapy and targeted therapy is different from person to person,which is an important cause of treatment failure.The emergence of patient-derived xenograft(PDX)models shows great potential to alleviate the straits.PDX models possess similar genetic and pathological characteristics as the features of primary tu-mors.Moreover,PDX has the ability to mimic the tumor microenvironment of the original tumor.Thus,the PDX model is an important tool to screen precise drugs for individualized treatment,seek predictive biomarkers for prognosis supervision,and evaluate the unknown mechanism in basic research.This paper reviews the recent advances in constructed methods and applications of the CRC PDX model,aiming to provide new knowledge for CRC basic research and therapeutics.展开更多
Objective: The objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a p...Objective: The objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a populationbased cancer registry.Methods: Data on the incidence of cancer from 2000 to 2016 were obtained from the Beijing Cancer Registry.We examined trends in the sex-specific, age-standardized incidence of lung cancer by histological type using a Joinpoint regression model.Results: A total of 117,409 cases of lung cancer were diagnosed from 2000 to 2016. Overall, 73,062(62.23%)patients were males. The most common histological type among both sexes was adenocarcinoma; however, the proportion of adenocarcinoma differed significantly between males and females(45.36% vs. 77.14%, respectively,P<0.0001). The age-standardized incidence of total lung cancer increased from 2000 to 2010 with an annual percent change(APC) of 2.2% [95% confidence interval(95% CI), 1.5% to 2.9%] and stabilized thereafter. Among males, the incidence of total lung cancer peaked in 2008 and then decreased slightly, with an APC of-1.1%(95%CI,-2.1% to-0.1%). Among females, the incidence increased continuously during the study period, with an APC of 1.4%(95% CI, 0.9% to 1.9%). The incidence of squamous cell carcinoma decreased significantly in recent years among both sexes, with APCs of-2.6%(95% CI,-4.5% to-0.6%) from 2007 to 2016 for males and-5.4%(95%CI,-7.2% to-3.6%) from 2004 to 2016 for females. In contrast, the incidence of adenocarcinoma increased continuously throughout the study period, by APCs of 4.0%(95% CI, 2.6% to 5.4%) for males and 6.2%(95% CI,4.8% to 7.6%) for females. The incidence of small cell carcinoma peaked in 2007 and stabilized thereafter among males, whereas it peaked in 2012 and then decreased with an APC of-14.7%(95% CI,-25.3% to-2.6%) among females. The incidence of large cell carcinoma and other specified malignant neoplasm did not change much,whereas the incidence of unspecified type decreased among both sexes during the study period.Conclusions: Although the incidence of squamous cell carcinoma decreased significantly among both sexes in recent years in Beijing, China, adenocarcinoma increased continuously throughout the study period among both sexes. Knowledge of differences in trends is useful for surveillance and control of lung cancer. However, the reason for the increase in adenocarcinoma remains unclear and warrants investigation.展开更多
Objective: To evaluate the effects of health insurance status on long-term cancer-specific survival of non-small cell lung cancer(NSCLC) in Beijing, China, using a population-based cancer registry data.Methods: Inform...Objective: To evaluate the effects of health insurance status on long-term cancer-specific survival of non-small cell lung cancer(NSCLC) in Beijing, China, using a population-based cancer registry data.Methods: Information on NSCLC patients diagnosed in 2008 was derived from the Beijing Cancer Registry.The medical records of 1,134 cases were sampled and re-surveyed to obtain information on potential risk factors.Poorly-insured status was defined as Uninsured and New Rural Cooperative Medical Insurance Scheme(NRCMS),while well-insured included Urban Employees Basic Medical Insurance(UEBMI) and Free Medical Care(FMC).To estimate survival outcomes, individuals were followed-up until December 31, 2018. Cancer-specific survival probabilities at 5 and 10 years after diagnosis were estimated using the Kaplan-Meier method. Log-rank test was used to compare long-term survival with different characteristics. Multivariable Cox proportional hazard regression model was used to examine the relative effect of insurance status on cancer-specific mortality.Results: Well-insured NSCLC patients have longer cancer-specific survival than poorly-insured individuals[hazard ratio(HR)=0.81;95% confidence interval(95% CI): 0.67-0.97), even after adjusting for age, gender, cancer stage, smoking status, family history and residential area. Older age and rural residence were associated with a higher risk of cancer-specific mortality(HR=1.03;95% CI: 1.02-1.03 and HR=1.25;95% CI: 1.07-1.46,respectively). Smoking individuals had a 41% higher long-term cancer-specific mortality risk than non-smoking ones(HR=1.41;95% CI: 1.20-1.66).Conclusions: NSCLC patients with good insurance status had better survival rates than those with poor insurance. An association was significant even after 10 years. Large population-based studies are needed to validate that high reimbursement insurance status can lead to the improvement of long-term cancer prognosis in China.展开更多
Objective： To analyze cancer incidence data in Beijing in 2014 and temporal trends for selected common cancers during 2005 and 2014.Methods： A total of 144 secondary and tertiary hospitals reported newly diagnosed c...Objective： To analyze cancer incidence data in Beijing in 2014 and temporal trends for selected common cancers during 2005 and 2014.Methods： A total of 144 secondary and tertiary hospitals reported newly diagnosed cancer cases to Beijing Cancer Registry, which covers 13 million residents in Beijing. The cancer incidence rate was calculated in strata by cancer type, sex, age group and area. The population composition of China in 1982 and Segi＇s population structure were used to calculate age-standardized rates. Extensive procedures were used to assure the quality of the data.Results： The overall data quality indicators of the percentage of morphology verification（MV）（%）, the percentage of death certificate-only（DCO）（%） and the mortality to incidence ratio（M/I） were 72.15%, 0.94% and0.54 respectively. A total of 45,300 new cancer cases were diagnosed in Beijing in 2014. The incidence rate was341.92/100,000（343.50/100,000 in males, 340.33/100,000 in females）, and the age-standardized incidence rates by Chinese standard population（ASIRC） and by world standard population（ASIRW） were 143.48/100,000 and182.99/100,000, respectively. The cumulative incidence rate for cancer before 75 years was 20.61%. Cancers of lung, colorectum, liver, stomach and prostate were the top five common cancer types for males, while cancers of breast, lung, thyroid, colorectum and uterus were the top five common cancer types for females. The different patterns were also observed between rural and urban areas. Regarding temporal trends, the incidence of thyroid cancer has the fastest growth between 2005 and 2014. The incidence of liver cancer decreased, and stomach and esophageal cancer also decreased significantly for males in the last decade. Incidence rate for lung cancer was relatively stable during that period of time.Conclusions： With more than 45,000 new cases in Beijing in 2014, cancer remains an important public health problem. Actions should be taken to diminish total cancer incidence in Beijing.展开更多
BACKGROUND Accurate target volume delineation is the premise for the implementation of precise radiotherapy.Inadequate target volume delineation may diminish tumor control or increase toxicity.Although several clinica...BACKGROUND Accurate target volume delineation is the premise for the implementation of precise radiotherapy.Inadequate target volume delineation may diminish tumor control or increase toxicity.Although several clinical target volume(CTV)delineation guidelines for rectal cancer have been published in recent years,significant interobserver variation(IOV)in CTV delineation still exists among radiation oncologists.However,proper education may serve as a bridge that connects complex guidelines with clinical practice.AIM To examine whether an education program could improve the accuracy and consistency of preoperative radiotherapy CTV delineation for rectal cancer.METHODS The study consisted of a baseline target volume delineation,a 150-min education intervention,and a follow-up evaluation.A 42-year-old man diagnosed with stage IIIC(T3N2bM0)rectal adenocarcinoma was selected for target volume delineation.CTVs obtained before and after the program were compared.Dice similarity coefficient(DSC),inclusiveness index(IncI),conformal index(CI),and relative volume difference[ΔV(%)]were analyzed to quantitatively evaluate the disparities between the participants’delineation and the standard CTV.Maximum volume ratio(MVR)and coefficient of variation(CV)were calculated to assess the IOV.Qualitative analysis included four common controversies in CTV delineation concerning the upper boundary of the target volume,external iliac area,groin area,and ischiorectal fossa.RESULTS Of the 18 radiation oncologists from 10 provinces in China,13 completed two sets of CTVs.In quantitative analysis,the average CTV volume decreased from 809.82 cm3 to 705.21 cm3(P=0.001)after the education program.Regarding the indices for geometric comparison,the mean DSC,IncI,and CI increased significantly,whileΔV(%)decreased remarkably,indicating improved agreement between participants’delineation and the standard CTV.Moreover,an 11.80%reduction in MVR and 18.19%reduction in CV were noted,demonstrating a smaller IOV in delineation after the education program.Regarding qualitative analysis,the greatest variations in baseline were observed at the external iliac area and ischiorectal fossa;61.54%(8/13)and 53.85%(7/13)of the participants unnecessarily delineated the external iliac area and the ischiorectal fossa,respectively.However,the education program reduced these variations.CONCLUSION Wide variations in CTV delineation for rectal cancer are present among radiation oncologists in China's Mainland.A well-structured education program could improve delineation accuracy and reduce IOVs.展开更多
In recent years,exosomes have garnered extensive attention as therapeutic agents and early diagnostic markers in neurodegenerative disease research.Exosomes are small and can effectively cross the blood-brain barrier,...In recent years,exosomes have garnered extensive attention as therapeutic agents and early diagnostic markers in neurodegenerative disease research.Exosomes are small and can effectively cross the blood-brain barrier,allowing them to target deep brain lesions.Recent studies have demonstrated that exosomes derived from different cell types may exert therapeutic effects by regulating the expression of various inflammatory cytokines,mRNAs,and disease-related proteins,thereby halting the progression of neurodegenerative diseases and exhibiting beneficial effects.However,exosomes are composed of lipid bilayer membranes and lack the ability to recognize specific target cells.This limitation can lead to side effects and toxicity when they interact with non-specific cells.Growing evidence suggests that surface-modified exosomes have enhanced targeting capabilities and can be used as targeted drug-delivery vehicles that show promising results in the treatment of neurodegenerative diseases.In this review,we provide an up-to-date overview of existing research aimed at devising approaches to modify exosomes and elucidating their therapeutic potential in neurodegenerative diseases.Our findings indicate that exosomes can efficiently cross the blood-brain barrier to facilitate drug delivery and can also serve as early diagnostic markers for neurodegenerative diseases.We introduce the strategies being used to enhance exosome targeting,including genetic engineering,chemical modifications(both covalent,such as click chemistry and metabolic engineering,and non-covalent,such as polyvalent electrostatic and hydrophobic interactions,ligand-receptor binding,aptamer-based modifications,and the incorporation of CP05-anchored peptides),and nanomaterial modifications.Research into these strategies has confirmed that exosomes have significant therapeutic potential for neurodegenerative diseases.However,several challenges remain in the clinical application of exosomes.Improvements are needed in preparation,characterization,and optimization methods,as well as in reducing the adverse reactions associated with their use.Additionally,the range of applications and the safety of exosomes require further research and evaluation.展开更多
Since the first laparoscopic radical surgery for early gastric cancer 30 years ago, there has been a gradual shift from“open” to “minimally invasive” surgery for gastric cancer. This transition is due to advanceme...Since the first laparoscopic radical surgery for early gastric cancer 30 years ago, there has been a gradual shift from“open” to “minimally invasive” surgery for gastric cancer. This transition is due to advancements in refined anatomy, enlarged field of view, faster recovery, and comparable oncological outcomes. Several high-quality clinical studies have demonstrated the safety and effectiveness of laparoscopy in the treatment of both early and locally advanced gastric cancer. The role of perioperative chemotherapy in managing locally advanced gastric cancer has been widely recognized, and there have been continuous breakthroughs in the exploration of targeted therapy and immunotherapy for perioperative treatment. Additionally, the application of indocyanine green near-infrared imaging technology, 3D laparoscopic technology, and robotic surgery systems has further improved the accuracy and minimally invasive nature of gastric cancer surgeries. Looking ahead, the field of minimally invasive surgery for gastric cancer is expected to become more standardized, resulting in a significant enhancement in the quality of life for gastric cancer patients.展开更多
Gastric cancer(GC)remains a leading cause of cancerrelated morbidity and mortality worldwide(1).Despite advancements in early detection,surgical techniques,and drug therapies,the prognosis for patients with advanced G...Gastric cancer(GC)remains a leading cause of cancerrelated morbidity and mortality worldwide(1).Despite advancements in early detection,surgical techniques,and drug therapies,the prognosis for patients with advanced GC remains poor.展开更多
As one of the most promising tools for deep analyses of tumor characteristics, single-cell RNA sequencing(sc RNAseq) is well welcomed for the great advantages of analyzing tumor features at single cell levels(1). Howe...As one of the most promising tools for deep analyses of tumor characteristics, single-cell RNA sequencing(sc RNAseq) is well welcomed for the great advantages of analyzing tumor features at single cell levels(1). However, the substantial gap between clinical practice and basis research on sc RNA-seq still could not be ignored.展开更多
Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely int...Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely integrated into routine clinical diagnostics of gastric cancer to guide personalized treatment.Human epidermal growth factor receptor 2(HER2)was the first molecular biomarker to be used in gastric cancer with trastuzumab being the first approved targeted therapy for HER2-positive gastric cancer.Programmed death-ligand 1 positivity and microsatellite instability can guide the use of immunotherapies,such as pembrolizumab and nivolumab.More recently,zolbetuximab has been approved for patients with claudin 18.2-positive diseases in some countries.More targeted therapies,including savolitinib for MET-positive patients,are currently under clinical investigation.However,the clinical application of these diagnostic approaches could be hampered by many existing challenges,including invasive and costly sampling methods,variability in immunohistochemistry interpretation,high costs and long turnaround times for next-generation sequencing,the absence of standardized and clinically validated diagnostic cut-off values for some biomarkers,and tumor heterogeneity.Novel testing and analysis techniques,such as artificial intelligence-assisted image analysis and multiplex immunohistochemistry,and emerging therapeutic strategies,including combination therapies that integrate immune checkpoint inhibitors with targeted therapies,offer potential solutions to some of these challenges.This article reviews recent progress in gastric cancer testing,outlines current challenges,and explores future directions for biomarker testing and targeted therapy for gastric cancer.展开更多
Objective:Based on multistage metabolomic profiling and Mendelian randomization analyses,the current study identified plasma metabolites that predicted the risk of developing gastric cancer(GC)and determined whether k...Objective:Based on multistage metabolomic profiling and Mendelian randomization analyses,the current study identified plasma metabolites that predicted the risk of developing gastric cancer(GC)and determined whether key metabolite levels modified the GC primary prevention effects.Methods:Plasma metabolites associated with GC risk were identified through a case-control study.Bi-directional two-sample Mendelian randomization analyses were performed to determine potential causal relationships utilizing the Shandong Intervention Trial(SIT),a nested case-control study of the Mass Intervention Trial in Linqu,Shandong province(MITS),China,the UK Biobank,and the Finn Gen project.Results:A higher genetic risk score for plasma L-aspartic acid was significantly associated with an increased GC risk in the northern Chinese population(SIT:HR=1.26 per 1 SD change,95%CI:1.07±1.49;MITS:HR=1.07,95%CI:1.00±1.14)and an increased gastric adenocarcinoma risk in Finn Gen(OR=1.68,95%CI:1.16±2.45).Genetically predicted plasma L-aspartic acid levels also modified the GC primary prevention effects with the beneficial effect of Helicobacter pylori eradication notably observed among individuals within the top quartile of L-aspartic acid level(P-interaction=0.098)and the beneficial effect of garlic supplementation only for those within the lowest quartile of L-aspartic acid level(P-interaction=0.02).Conclusions:Elevated plasma L-aspartic acid levels significantly increased the risk of developing GC and modified the effects of GC primary prevention.Further studies from other populations are warranted to validate the modification effect of plasma L-aspartic acid levels on GC prevention and to elucidate the underlying mechanisms.展开更多
Urothelial carcinoma(UC)is the 9th most common and the 13th most deadly cancer worldwide1.Despite the availability of platinum-based chemotherapy and immune checkpoint inhib-itors(ICIs),the 5-year survival rate of pat...Urothelial carcinoma(UC)is the 9th most common and the 13th most deadly cancer worldwide1.Despite the availability of platinum-based chemotherapy and immune checkpoint inhib-itors(ICIs),the 5-year survival rate of patients with metastatic UC(mUC)remains poor(10-15%)2.展开更多
Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the ...Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the scarcity of these NENs has hindered extensive clinical investigations,thereby leading to a dearth of robust evidence for guiding clinical practice and impeding the establishment of standardized approaches for diagnosis and treatment.However,with the increasing awareness of population screening,as well as the increasing popularity of colonoscopy screening programs,the incidence of colorectal NENs has gradually increased.Moreover,some high-grade NENs are highly malignant and invasive,thereby leading to poor treatment outcomes and prognoses.These challenges have elicited increased attention from clinical physicians,thus prompting researchers to explore relevant studies using limited specimens and clinical data.This scenario has resulted in preliminary findings that provide evidence for addressing diagnostic and therapeutic challenges associated with NENs of the colon and rectum.In this article,we review recent literature reports and summarize the advances regarding the diagnosis and treatment of colorectal NENs.展开更多
BACKGROUND Malignant transformation of an ectopic pancreas is exceptionally rare,posing significant diagnostic challenges.As such,there are currently no established management guidelines.We present a rare case of gast...BACKGROUND Malignant transformation of an ectopic pancreas is exceptionally rare,posing significant diagnostic challenges.As such,there are currently no established management guidelines.We present a rare case of gastric adenocarcinoma arising from ectopic pancreatic tissue and provide a systematic review of previous case reports of adenocarcinomas derived from ectopic pancreas in the stomach,duodenum,and jejunum in the past 20 years.We provide an overview of the clinicopathological characteristics and discuss critical diagnostic and therapeutic considerations.CASE SUMMARY A 58-year-old female was admitted to our hospital in August 2024 due to elevated carbohydrate antigen 19-9.Relevant examinations found a huge abdominal tumor that was radiologically adherent to both the pancreatic head and the greater curvature of the gastric antrum.A preoperative endoscopic biopsy-confirmed adenocarcinoma,prompting a pancreaticoduodenectomy.Histopathological examination subsequently identified the tumor as an adenocarcinoma originating from a gastric ectopic pancreas.Adjuvant chemotherapy(gemcitabine+cap ecitabine)commenced on November 13,2024.After five cycles,surveillance imaging(April 3,2025)revealed metastatic progression,prompting a transition to second-line therapy(nab-paclitaxel+gemcitabine).The patient is currently undergoing regular chemotherapy and has been followed up regularly,and the condition has not changed significantly compared with before.CONCLUSION We hope that our findings will facilitate the clinical recognition of this entity and help to increase knowledge regarding its management.展开更多
BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related co...BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.展开更多
BACKGROUND Retroperitoneal fibrosis is a rare fibro-inflammatory condition which can be classified into idiopathic(accounting for over 75%)and secondary types(due to malignancies,infections,medications,radiotherapy or...BACKGROUND Retroperitoneal fibrosis is a rare fibro-inflammatory condition which can be classified into idiopathic(accounting for over 75%)and secondary types(due to malignancies,infections,medications,radiotherapy or other conditions).Idiopathic retroperitoneal fibrosis(IRPF)typically affects the abdominal aorta and iliac arteries along with the surrounding retroperitoneal area.This case review aims to summarize the imaging characteristics of IRPF arising from the peritoneal space.CASE SUMMARY An abdominal mass was discovered in a 52-year-old man during a routine physical examination,he had not complained of abdominal pain,distension,nausea,vomiting,diarrhea,fever,and had no significant past medical or family history.Abdominal magnetic resonance imaging revealed a soft tissue mass with poorly defined margins surrounding the duodenum,exhibiting slight to moderate high signal intensity on both T1-weighted and T2-weighted images.Diffusionweighted imaging with aβvalue of 800 mm²/second demonstrated slightly to moderate high signal intensity.Dynamic contrast enhanced images showed uneven enhancement on the arterial phase,with significant enhancement observed on the delayed phase.The mass infiltrated adjacent structures,including the head of the pancreas,the hepatic flexure of the colon,and part of the intestine,raising suspicion for malignant tumors such as sarcoma or lymphoma.However,surgery confirmed the diagnosis of IRPF.The patient underwent routine followup for one year,with no recurrence.CONCLUSION IRPF is a rare condition that presents considerable diagnostic challenges when lesions arise from the peritoneal space.In cases where imaging findings are atypical,a further puncture biopsy may be necessary to confirm the diagnosis.展开更多
Neutrophil extracellular traps (NETs) are web-like structures of DNA and proteins that are released by activated neutrophils. While originally identified as antimicrobial defense mechanisms, NETs are now recognized as...Neutrophil extracellular traps (NETs) are web-like structures of DNA and proteins that are released by activated neutrophils. While originally identified as antimicrobial defense mechanisms, NETs are now recognized as key modulators of tumor progression. NETs interact with the tumor microenvironment and metabolic pathways in renal cell carcinoma (RCC), which promotes immune evasion and metastasis. This review explores the interplay between NET formation and metabolic reprogramming in RCC, highlighting the implications for immunotherapy resistance and therapeutic targeting. NET-associated signaling, immunometabolism disruption, and current strategies to inhibit NETs in preclinical and clinical settings are discussed. Targeting NETs may represent a promising adjunct in RCC therapy, particularly when integrated with immune checkpoint blockade.展开更多
Objective:This study aimed to evaluate the clinical utility of[^(68)Ga]Ga-RM2 positron emission tomography/computed tomography(PET/CT),in comparison with^(18)F-fluorodeoxyglucose([^(18)F]FDG)PET/CT,for staging and pro...Objective:This study aimed to evaluate the clinical utility of[^(68)Ga]Ga-RM2 positron emission tomography/computed tomography(PET/CT),in comparison with^(18)F-fluorodeoxyglucose([^(18)F]FDG)PET/CT,for staging and prognosis in patients with estrogen receptor-positive(ER+)breast cancer.Methods:This prospective study enrolled nine female patients with breast cancer(mean age 45.5±11.5 years).Eight patients were confirmed to have ER+disease.All participant underwent both[^(68)Ga]Ga-RM2 PET/CT and[^(18)F]FDG PET/CT scans within a one-week interval.The maximum standardized uptake values(SUV_(max))was measured for primary tumors,lymph nodes,and metastatic lesions.The physiological distribution of[^(68)Ga]GaRM2 was also evaluated.Results:No adverse events were observed.Metastatic were identified in lymph nodes(n=29 lesions),bone(n=19),liver(n=7),brain(n=3),and multiple other sites.[^(68)Ga]Ga-RM2 demonstrated a significantly higher median SUV_(max)than[^(18)F]FDG across all lesions[7.5(interquartile range,IQR,3.4-14.0)vs.4.0(IQR,2.3-6.1);P<0.001].Similarly,the tumor-to-background ratio(TBR)was significantly superior with[^(68)Ga]Ga-RM2 for all type of lesions:primary tumors[12.3(IQR,10.4-18.3)vs.7.0(IQR,6.0-10.0);P<0.001],lymph node metastases[17.8(IQR,4.4-39.0)vs.4.7(IQR,2.7-10.2);P<0.001],hepatic metastases[5.4(IQR,3.7-8.3)vs.1.0(IQR,0.9-1.5);P<0.001],and osseous metastases[13.9(IQR,7.3-18.0)vs.4.3(IQR,1.6-5.9);P<0.001].Physiological uptake of[^(68)Ga]Ga-RM2 was the highest in the pancreas(SUV_(max),77.82±22.64),with moderate uptake in the kidneys(2.82±0.62),heart(1.83±0.29),and liver(1.33±0.41).Conclusions:[^(68)Ga]Ga-RM2 PET/CT demonstrates superior uptake metrics for the detection of metastatic lesions,particularly in the brain and breast,suggesting its potential as a valuable complementary imaging modality to[^(18)F]FDG PET/CT.These promising foundings warrant further validation in larger cohorts to confirm their clinical impact and to standardize imaging protocols.展开更多
BACKGROUND KRAS mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases(CLMs).Emerging evidence suggests a potential interaction between these two variables that...BACKGROUND KRAS mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases(CLMs).Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.AIM To investigate the association of KRAS mutations with recurrence in patients with CLM who underwent radiofrequency ablation(RFA)according to the primary tumor location.METHODS This retrospective study analyzed 164 patients with KRAS-determined CLM treated with percutaneous RFA between January 2012 and December 2018.The clinicopathological characteristics,recurrence patterns,and survival outcomes were systematically evaluated.RESULTS A total of 164 patients(mean age:58.0±9.8 years,range:34-83 years)who underwent percutaneous RFA of 325 CLMs(mean size:2.2±1.0 cm,range:0.7-5.0 cm)were included in the study.Eighty-nine(54.3%)patients had wild-type KRAS,and 75(45.7%)patients had mutated KRAS.Compared with wild-type patients,patients with KRAS mutations presented significantly higher local tumor progression rates(30.7%vs 14.6%,P=0.013).Among 126 patients(76.8%)who experienced post-RFA recurrence,61.6%developed intrahepatic metastases,and 53.7%developed extrahepatic metastases.Primary tumor location significantly modified KRASrelated outcomes:Compared with wild-type patients,left-sided colorectal cancer(CRC)patients with KRAS mutations presented higher intrahepatic recurrence rates(77.2%vs 52.5%,P=0.003)and shorter median intrahepatic recurrence-free survival(15 vs 25 months,P=0.007).No significant differences in KRAS expression were detected in right-sided tumors.CONCLUSION KRAS mutation status predicts differential recurrence patterns after CLM ablation,with significant prognostic implications,specifically in left-sided CRCs.These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.展开更多
Objective:To evaluate the efficacy and safety of QL1206(a denosumab biosimilar to Xgeva■)in breast cancer patients with bone metastasis(BM)through subgroup analysis of a randomized,double-blind phaseⅢtrial(No.NCT045...Objective:To evaluate the efficacy and safety of QL1206(a denosumab biosimilar to Xgeva■)in breast cancer patients with bone metastasis(BM)through subgroup analysis of a randomized,double-blind phaseⅢtrial(No.NCT04550949).Methods:This subgroup analysis included patients with BM from breast cancer enrolled in a phaseⅢtrial.Patients were randomized(1:1)to receive either three cycles of QL1206 or denosumab(120 mg subcutaneously every 4 weeks).Subsequently,they received 10 cycles of QL1206(120 mg)over 40 weeks,followed by a 20-week safety follow-up.The primary endpoint was the percentage changes from baseline to week 13 in urinary Ntelopeptide corrected for creatinine(u NTx/Cr).Results:The breast cancer cohort consisted of 311 patients.Vertebral involvement(66.4%)was the most prevalent BM site at enrollment,while 27.7%of patients presented with≥3 metastatic bone lesions.At week 13,QL1206 demonstrated a median u NTx/Cr reduction of-69.9%(range:-98.1%-568.0%)vs.-74.3%(range:-97.7%-386.3%)for denosumab.The analysis of covariance revealed comparable least-square means for log-transformed changes:-1.416[95%confidence interval(95%CI):-1.736 to-1.096]vs.-1.501(95%CI:-1.824 to-1.178),yielding an between-group difference of 0.085(90%CI:-0.062-0.232;P=0.343).After a 53-week treatment period,83.6%achieved bone density improvement/disease stabilization.Safety profiles were comparable between groups.Conclusions:QL1206 demonstrated similar efficacy and safety to the reference denosumab in patients with BM from breast cancer,supporting QL1206 as a new option for management of BM from breast cancer.展开更多
基金National Natural Science Foundation of China Grant(81802305 and 31971192).
文摘Colorectal cancer(CRC)is one of the most popular malignancies globally,with 930000 deaths in 2020.The evaluation of CRC-related pathogenesis and the discovery of po-tential therapeutic targets will be meaningful and helpful for improving CRC treat-ment.With huge efforts made in past decades,the systematic treatment regimens have been applied to improve the prognosis of CRC patients.However,the sensitivity of CRC to chemotherapy and targeted therapy is different from person to person,which is an important cause of treatment failure.The emergence of patient-derived xenograft(PDX)models shows great potential to alleviate the straits.PDX models possess similar genetic and pathological characteristics as the features of primary tu-mors.Moreover,PDX has the ability to mimic the tumor microenvironment of the original tumor.Thus,the PDX model is an important tool to screen precise drugs for individualized treatment,seek predictive biomarkers for prognosis supervision,and evaluate the unknown mechanism in basic research.This paper reviews the recent advances in constructed methods and applications of the CRC PDX model,aiming to provide new knowledge for CRC basic research and therapeutics.
基金supported by the Beijing Young Talent Program (No. 20160000 21469G189)
文摘Objective: The objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a populationbased cancer registry.Methods: Data on the incidence of cancer from 2000 to 2016 were obtained from the Beijing Cancer Registry.We examined trends in the sex-specific, age-standardized incidence of lung cancer by histological type using a Joinpoint regression model.Results: A total of 117,409 cases of lung cancer were diagnosed from 2000 to 2016. Overall, 73,062(62.23%)patients were males. The most common histological type among both sexes was adenocarcinoma; however, the proportion of adenocarcinoma differed significantly between males and females(45.36% vs. 77.14%, respectively,P<0.0001). The age-standardized incidence of total lung cancer increased from 2000 to 2010 with an annual percent change(APC) of 2.2% [95% confidence interval(95% CI), 1.5% to 2.9%] and stabilized thereafter. Among males, the incidence of total lung cancer peaked in 2008 and then decreased slightly, with an APC of-1.1%(95%CI,-2.1% to-0.1%). Among females, the incidence increased continuously during the study period, with an APC of 1.4%(95% CI, 0.9% to 1.9%). The incidence of squamous cell carcinoma decreased significantly in recent years among both sexes, with APCs of-2.6%(95% CI,-4.5% to-0.6%) from 2007 to 2016 for males and-5.4%(95%CI,-7.2% to-3.6%) from 2004 to 2016 for females. In contrast, the incidence of adenocarcinoma increased continuously throughout the study period, by APCs of 4.0%(95% CI, 2.6% to 5.4%) for males and 6.2%(95% CI,4.8% to 7.6%) for females. The incidence of small cell carcinoma peaked in 2007 and stabilized thereafter among males, whereas it peaked in 2012 and then decreased with an APC of-14.7%(95% CI,-25.3% to-2.6%) among females. The incidence of large cell carcinoma and other specified malignant neoplasm did not change much,whereas the incidence of unspecified type decreased among both sexes during the study period.Conclusions: Although the incidence of squamous cell carcinoma decreased significantly among both sexes in recent years in Beijing, China, adenocarcinoma increased continuously throughout the study period among both sexes. Knowledge of differences in trends is useful for surveillance and control of lung cancer. However, the reason for the increase in adenocarcinoma remains unclear and warrants investigation.
基金supported by grants from the National Natural Science Foundation of China (No.81600070)Science Foundation of Peking University Cancer Hospital (No.2020-10)。
文摘Objective: To evaluate the effects of health insurance status on long-term cancer-specific survival of non-small cell lung cancer(NSCLC) in Beijing, China, using a population-based cancer registry data.Methods: Information on NSCLC patients diagnosed in 2008 was derived from the Beijing Cancer Registry.The medical records of 1,134 cases were sampled and re-surveyed to obtain information on potential risk factors.Poorly-insured status was defined as Uninsured and New Rural Cooperative Medical Insurance Scheme(NRCMS),while well-insured included Urban Employees Basic Medical Insurance(UEBMI) and Free Medical Care(FMC).To estimate survival outcomes, individuals were followed-up until December 31, 2018. Cancer-specific survival probabilities at 5 and 10 years after diagnosis were estimated using the Kaplan-Meier method. Log-rank test was used to compare long-term survival with different characteristics. Multivariable Cox proportional hazard regression model was used to examine the relative effect of insurance status on cancer-specific mortality.Results: Well-insured NSCLC patients have longer cancer-specific survival than poorly-insured individuals[hazard ratio(HR)=0.81;95% confidence interval(95% CI): 0.67-0.97), even after adjusting for age, gender, cancer stage, smoking status, family history and residential area. Older age and rural residence were associated with a higher risk of cancer-specific mortality(HR=1.03;95% CI: 1.02-1.03 and HR=1.25;95% CI: 1.07-1.46,respectively). Smoking individuals had a 41% higher long-term cancer-specific mortality risk than non-smoking ones(HR=1.41;95% CI: 1.20-1.66).Conclusions: NSCLC patients with good insurance status had better survival rates than those with poor insurance. An association was significant even after 10 years. Large population-based studies are needed to validate that high reimbursement insurance status can lead to the improvement of long-term cancer prognosis in China.
基金support by the Beijing Young Talent Program (No. 20160000214 69G189)
文摘Objective： To analyze cancer incidence data in Beijing in 2014 and temporal trends for selected common cancers during 2005 and 2014.Methods： A total of 144 secondary and tertiary hospitals reported newly diagnosed cancer cases to Beijing Cancer Registry, which covers 13 million residents in Beijing. The cancer incidence rate was calculated in strata by cancer type, sex, age group and area. The population composition of China in 1982 and Segi＇s population structure were used to calculate age-standardized rates. Extensive procedures were used to assure the quality of the data.Results： The overall data quality indicators of the percentage of morphology verification（MV）（%）, the percentage of death certificate-only（DCO）（%） and the mortality to incidence ratio（M/I） were 72.15%, 0.94% and0.54 respectively. A total of 45,300 new cancer cases were diagnosed in Beijing in 2014. The incidence rate was341.92/100,000（343.50/100,000 in males, 340.33/100,000 in females）, and the age-standardized incidence rates by Chinese standard population（ASIRC） and by world standard population（ASIRW） were 143.48/100,000 and182.99/100,000, respectively. The cumulative incidence rate for cancer before 75 years was 20.61%. Cancers of lung, colorectum, liver, stomach and prostate were the top five common cancer types for males, while cancers of breast, lung, thyroid, colorectum and uterus were the top five common cancer types for females. The different patterns were also observed between rural and urban areas. Regarding temporal trends, the incidence of thyroid cancer has the fastest growth between 2005 and 2014. The incidence of liver cancer decreased, and stomach and esophageal cancer also decreased significantly for males in the last decade. Incidence rate for lung cancer was relatively stable during that period of time.Conclusions： With more than 45,000 new cases in Beijing in 2014, cancer remains an important public health problem. Actions should be taken to diminish total cancer incidence in Beijing.
基金Supported by the Beijing Municipal Science&Technology Commission,No.Z181100001718192the Capital’s Funds for Health Improvement and Research,No.2020-2-1027 and No.2020-1-4021+1 种基金the National Natural Science Foundation,No.82073333the Beijing Natural Science Foundation,No.1212011.
文摘BACKGROUND Accurate target volume delineation is the premise for the implementation of precise radiotherapy.Inadequate target volume delineation may diminish tumor control or increase toxicity.Although several clinical target volume(CTV)delineation guidelines for rectal cancer have been published in recent years,significant interobserver variation(IOV)in CTV delineation still exists among radiation oncologists.However,proper education may serve as a bridge that connects complex guidelines with clinical practice.AIM To examine whether an education program could improve the accuracy and consistency of preoperative radiotherapy CTV delineation for rectal cancer.METHODS The study consisted of a baseline target volume delineation,a 150-min education intervention,and a follow-up evaluation.A 42-year-old man diagnosed with stage IIIC(T3N2bM0)rectal adenocarcinoma was selected for target volume delineation.CTVs obtained before and after the program were compared.Dice similarity coefficient(DSC),inclusiveness index(IncI),conformal index(CI),and relative volume difference[ΔV(%)]were analyzed to quantitatively evaluate the disparities between the participants’delineation and the standard CTV.Maximum volume ratio(MVR)and coefficient of variation(CV)were calculated to assess the IOV.Qualitative analysis included four common controversies in CTV delineation concerning the upper boundary of the target volume,external iliac area,groin area,and ischiorectal fossa.RESULTS Of the 18 radiation oncologists from 10 provinces in China,13 completed two sets of CTVs.In quantitative analysis,the average CTV volume decreased from 809.82 cm3 to 705.21 cm3(P=0.001)after the education program.Regarding the indices for geometric comparison,the mean DSC,IncI,and CI increased significantly,whileΔV(%)decreased remarkably,indicating improved agreement between participants’delineation and the standard CTV.Moreover,an 11.80%reduction in MVR and 18.19%reduction in CV were noted,demonstrating a smaller IOV in delineation after the education program.Regarding qualitative analysis,the greatest variations in baseline were observed at the external iliac area and ischiorectal fossa;61.54%(8/13)and 53.85%(7/13)of the participants unnecessarily delineated the external iliac area and the ischiorectal fossa,respectively.However,the education program reduced these variations.CONCLUSION Wide variations in CTV delineation for rectal cancer are present among radiation oncologists in China's Mainland.A well-structured education program could improve delineation accuracy and reduce IOVs.
基金supported by the National Natural Science Foundation of China,No.22103055(to JG)the Natural Science Foundation of Hebei Province,No.F2024110001(to HC)Open Project of Tianjin Key Laboratory of Optoelectronic Detection Technology and System,Nos.2024LODTS215(to NL),2024LODTS216(to XS).
文摘In recent years,exosomes have garnered extensive attention as therapeutic agents and early diagnostic markers in neurodegenerative disease research.Exosomes are small and can effectively cross the blood-brain barrier,allowing them to target deep brain lesions.Recent studies have demonstrated that exosomes derived from different cell types may exert therapeutic effects by regulating the expression of various inflammatory cytokines,mRNAs,and disease-related proteins,thereby halting the progression of neurodegenerative diseases and exhibiting beneficial effects.However,exosomes are composed of lipid bilayer membranes and lack the ability to recognize specific target cells.This limitation can lead to side effects and toxicity when they interact with non-specific cells.Growing evidence suggests that surface-modified exosomes have enhanced targeting capabilities and can be used as targeted drug-delivery vehicles that show promising results in the treatment of neurodegenerative diseases.In this review,we provide an up-to-date overview of existing research aimed at devising approaches to modify exosomes and elucidating their therapeutic potential in neurodegenerative diseases.Our findings indicate that exosomes can efficiently cross the blood-brain barrier to facilitate drug delivery and can also serve as early diagnostic markers for neurodegenerative diseases.We introduce the strategies being used to enhance exosome targeting,including genetic engineering,chemical modifications(both covalent,such as click chemistry and metabolic engineering,and non-covalent,such as polyvalent electrostatic and hydrophobic interactions,ligand-receptor binding,aptamer-based modifications,and the incorporation of CP05-anchored peptides),and nanomaterial modifications.Research into these strategies has confirmed that exosomes have significant therapeutic potential for neurodegenerative diseases.However,several challenges remain in the clinical application of exosomes.Improvements are needed in preparation,characterization,and optimization methods,as well as in reducing the adverse reactions associated with their use.Additionally,the range of applications and the safety of exosomes require further research and evaluation.
基金funded by the Scientific Research Foundation of Peking University Cancer Hospital (No: 2022-9)。
文摘Since the first laparoscopic radical surgery for early gastric cancer 30 years ago, there has been a gradual shift from“open” to “minimally invasive” surgery for gastric cancer. This transition is due to advancements in refined anatomy, enlarged field of view, faster recovery, and comparable oncological outcomes. Several high-quality clinical studies have demonstrated the safety and effectiveness of laparoscopy in the treatment of both early and locally advanced gastric cancer. The role of perioperative chemotherapy in managing locally advanced gastric cancer has been widely recognized, and there have been continuous breakthroughs in the exploration of targeted therapy and immunotherapy for perioperative treatment. Additionally, the application of indocyanine green near-infrared imaging technology, 3D laparoscopic technology, and robotic surgery systems has further improved the accuracy and minimally invasive nature of gastric cancer surgeries. Looking ahead, the field of minimally invasive surgery for gastric cancer is expected to become more standardized, resulting in a significant enhancement in the quality of life for gastric cancer patients.
文摘Gastric cancer(GC)remains a leading cause of cancerrelated morbidity and mortality worldwide(1).Despite advancements in early detection,surgical techniques,and drug therapies,the prognosis for patients with advanced GC remains poor.
文摘As one of the most promising tools for deep analyses of tumor characteristics, single-cell RNA sequencing(sc RNAseq) is well welcomed for the great advantages of analyzing tumor features at single cell levels(1). However, the substantial gap between clinical practice and basis research on sc RNA-seq still could not be ignored.
基金support by grants from Capital’s Funds for Health Improvement and Research(Grant No.2024-2-1024)Beijing Natural Science Foundation(Grant No.7232018).
文摘Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely integrated into routine clinical diagnostics of gastric cancer to guide personalized treatment.Human epidermal growth factor receptor 2(HER2)was the first molecular biomarker to be used in gastric cancer with trastuzumab being the first approved targeted therapy for HER2-positive gastric cancer.Programmed death-ligand 1 positivity and microsatellite instability can guide the use of immunotherapies,such as pembrolizumab and nivolumab.More recently,zolbetuximab has been approved for patients with claudin 18.2-positive diseases in some countries.More targeted therapies,including savolitinib for MET-positive patients,are currently under clinical investigation.However,the clinical application of these diagnostic approaches could be hampered by many existing challenges,including invasive and costly sampling methods,variability in immunohistochemistry interpretation,high costs and long turnaround times for next-generation sequencing,the absence of standardized and clinically validated diagnostic cut-off values for some biomarkers,and tumor heterogeneity.Novel testing and analysis techniques,such as artificial intelligence-assisted image analysis and multiplex immunohistochemistry,and emerging therapeutic strategies,including combination therapies that integrate immune checkpoint inhibitors with targeted therapies,offer potential solutions to some of these challenges.This article reviews recent progress in gastric cancer testing,outlines current challenges,and explores future directions for biomarker testing and targeted therapy for gastric cancer.
基金funded by the National Natural Science Foundation of China(No.82273704)Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0501400-2023ZD0501402)+4 种基金Beijing Hospitals Authority’s Ascent Plan(DFL20241102)Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(No.ZLRK202325)China Postdoctoral Science Foundation(2024M760152)Peking University Medicine Fund for World’s Leading Discipline or Discipline Cluster Development(No.BMU2022XKQ004)Science Foundation of Peking University Cancer Hospital(Nos.BJCH2024BJ02,XKFZ2410,BJCH2025CZ04,and 2022-27)。
文摘Objective:Based on multistage metabolomic profiling and Mendelian randomization analyses,the current study identified plasma metabolites that predicted the risk of developing gastric cancer(GC)and determined whether key metabolite levels modified the GC primary prevention effects.Methods:Plasma metabolites associated with GC risk were identified through a case-control study.Bi-directional two-sample Mendelian randomization analyses were performed to determine potential causal relationships utilizing the Shandong Intervention Trial(SIT),a nested case-control study of the Mass Intervention Trial in Linqu,Shandong province(MITS),China,the UK Biobank,and the Finn Gen project.Results:A higher genetic risk score for plasma L-aspartic acid was significantly associated with an increased GC risk in the northern Chinese population(SIT:HR=1.26 per 1 SD change,95%CI:1.07±1.49;MITS:HR=1.07,95%CI:1.00±1.14)and an increased gastric adenocarcinoma risk in Finn Gen(OR=1.68,95%CI:1.16±2.45).Genetically predicted plasma L-aspartic acid levels also modified the GC primary prevention effects with the beneficial effect of Helicobacter pylori eradication notably observed among individuals within the top quartile of L-aspartic acid level(P-interaction=0.098)and the beneficial effect of garlic supplementation only for those within the lowest quartile of L-aspartic acid level(P-interaction=0.02).Conclusions:Elevated plasma L-aspartic acid levels significantly increased the risk of developing GC and modified the effects of GC primary prevention.Further studies from other populations are warranted to validate the modification effect of plasma L-aspartic acid levels on GC prevention and to elucidate the underlying mechanisms.
基金supported by the Beijing Natural Science Foundation(Grant No.L244024)National Natural Science Foundation of China(Grant Nos.82172604 and 82473199)CSCO Clinical Oncology Research Foundation(Grant No.Y-2022HER2AZMS-0258).
文摘Urothelial carcinoma(UC)is the 9th most common and the 13th most deadly cancer worldwide1.Despite the availability of platinum-based chemotherapy and immune checkpoint inhib-itors(ICIs),the 5-year survival rate of patients with metastatic UC(mUC)remains poor(10-15%)2.
文摘Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the scarcity of these NENs has hindered extensive clinical investigations,thereby leading to a dearth of robust evidence for guiding clinical practice and impeding the establishment of standardized approaches for diagnosis and treatment.However,with the increasing awareness of population screening,as well as the increasing popularity of colonoscopy screening programs,the incidence of colorectal NENs has gradually increased.Moreover,some high-grade NENs are highly malignant and invasive,thereby leading to poor treatment outcomes and prognoses.These challenges have elicited increased attention from clinical physicians,thus prompting researchers to explore relevant studies using limited specimens and clinical data.This scenario has resulted in preliminary findings that provide evidence for addressing diagnostic and therapeutic challenges associated with NENs of the colon and rectum.In this article,we review recent literature reports and summarize the advances regarding the diagnosis and treatment of colorectal NENs.
基金Supported by Hygiene and Health Development Scientific Research Fostering Plan of Haidian District Beijing,No.HP2024-19-503002National Key R&D Program of China,No.2023YFC2413802Beijing Municipal Administration of Hospitals Incubating Program,No.PX2024041.
文摘BACKGROUND Malignant transformation of an ectopic pancreas is exceptionally rare,posing significant diagnostic challenges.As such,there are currently no established management guidelines.We present a rare case of gastric adenocarcinoma arising from ectopic pancreatic tissue and provide a systematic review of previous case reports of adenocarcinomas derived from ectopic pancreas in the stomach,duodenum,and jejunum in the past 20 years.We provide an overview of the clinicopathological characteristics and discuss critical diagnostic and therapeutic considerations.CASE SUMMARY A 58-year-old female was admitted to our hospital in August 2024 due to elevated carbohydrate antigen 19-9.Relevant examinations found a huge abdominal tumor that was radiologically adherent to both the pancreatic head and the greater curvature of the gastric antrum.A preoperative endoscopic biopsy-confirmed adenocarcinoma,prompting a pancreaticoduodenectomy.Histopathological examination subsequently identified the tumor as an adenocarcinoma originating from a gastric ectopic pancreas.Adjuvant chemotherapy(gemcitabine+cap ecitabine)commenced on November 13,2024.After five cycles,surveillance imaging(April 3,2025)revealed metastatic progression,prompting a transition to second-line therapy(nab-paclitaxel+gemcitabine).The patient is currently undergoing regular chemotherapy and has been followed up regularly,and the condition has not changed significantly compared with before.CONCLUSION We hope that our findings will facilitate the clinical recognition of this entity and help to increase knowledge regarding its management.
基金Beijing Municipal Administration of Hospitals Incubating Program,No.PZ20200272018 Beijing Talent Incubating Funding,No.2018-4+3 种基金National Natural Science Foundation of China,No.81773214Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZYLX202116the National Key R&D Program of China,No.2021YFF1201104Science Foundation of Peking University Cancer Hospital-2023,No.JC202310.
文摘BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.
文摘BACKGROUND Retroperitoneal fibrosis is a rare fibro-inflammatory condition which can be classified into idiopathic(accounting for over 75%)and secondary types(due to malignancies,infections,medications,radiotherapy or other conditions).Idiopathic retroperitoneal fibrosis(IRPF)typically affects the abdominal aorta and iliac arteries along with the surrounding retroperitoneal area.This case review aims to summarize the imaging characteristics of IRPF arising from the peritoneal space.CASE SUMMARY An abdominal mass was discovered in a 52-year-old man during a routine physical examination,he had not complained of abdominal pain,distension,nausea,vomiting,diarrhea,fever,and had no significant past medical or family history.Abdominal magnetic resonance imaging revealed a soft tissue mass with poorly defined margins surrounding the duodenum,exhibiting slight to moderate high signal intensity on both T1-weighted and T2-weighted images.Diffusionweighted imaging with aβvalue of 800 mm²/second demonstrated slightly to moderate high signal intensity.Dynamic contrast enhanced images showed uneven enhancement on the arterial phase,with significant enhancement observed on the delayed phase.The mass infiltrated adjacent structures,including the head of the pancreas,the hepatic flexure of the colon,and part of the intestine,raising suspicion for malignant tumors such as sarcoma or lymphoma.However,surgery confirmed the diagnosis of IRPF.The patient underwent routine followup for one year,with no recurrence.CONCLUSION IRPF is a rare condition that presents considerable diagnostic challenges when lesions arise from the peritoneal space.In cases where imaging findings are atypical,a further puncture biopsy may be necessary to confirm the diagnosis.
基金supported by the National Natural Science Foundation of China(Grant nos.82473157,82460510,82203565,82103388,31960145 and 82560591)the Natural Science Foundation of Beijing(Grant no.L248059)+1 种基金Yunnan Province applied research funds(Grant nos.202201AY070001-011,202201AY070001-043,and 202301AS070018)the Science and Technology Innovation Team of tumor metabolism research at Kunming Medical University(Grant no.CXTD202102).
文摘Neutrophil extracellular traps (NETs) are web-like structures of DNA and proteins that are released by activated neutrophils. While originally identified as antimicrobial defense mechanisms, NETs are now recognized as key modulators of tumor progression. NETs interact with the tumor microenvironment and metabolic pathways in renal cell carcinoma (RCC), which promotes immune evasion and metastasis. This review explores the interplay between NET formation and metabolic reprogramming in RCC, highlighting the implications for immunotherapy resistance and therapeutic targeting. NET-associated signaling, immunometabolism disruption, and current strategies to inhibit NETs in preclinical and clinical settings are discussed. Targeting NETs may represent a promising adjunct in RCC therapy, particularly when integrated with immune checkpoint blockade.
基金supported by the National Natural Science Foundation of China(No.82372001,82171973,82171980)the Youth Talent Support Program(No.A002863)Scientific Research Foundation of Peking University Cancer Hospital(No.BJCH2024CZ02)。
文摘Objective:This study aimed to evaluate the clinical utility of[^(68)Ga]Ga-RM2 positron emission tomography/computed tomography(PET/CT),in comparison with^(18)F-fluorodeoxyglucose([^(18)F]FDG)PET/CT,for staging and prognosis in patients with estrogen receptor-positive(ER+)breast cancer.Methods:This prospective study enrolled nine female patients with breast cancer(mean age 45.5±11.5 years).Eight patients were confirmed to have ER+disease.All participant underwent both[^(68)Ga]Ga-RM2 PET/CT and[^(18)F]FDG PET/CT scans within a one-week interval.The maximum standardized uptake values(SUV_(max))was measured for primary tumors,lymph nodes,and metastatic lesions.The physiological distribution of[^(68)Ga]GaRM2 was also evaluated.Results:No adverse events were observed.Metastatic were identified in lymph nodes(n=29 lesions),bone(n=19),liver(n=7),brain(n=3),and multiple other sites.[^(68)Ga]Ga-RM2 demonstrated a significantly higher median SUV_(max)than[^(18)F]FDG across all lesions[7.5(interquartile range,IQR,3.4-14.0)vs.4.0(IQR,2.3-6.1);P<0.001].Similarly,the tumor-to-background ratio(TBR)was significantly superior with[^(68)Ga]Ga-RM2 for all type of lesions:primary tumors[12.3(IQR,10.4-18.3)vs.7.0(IQR,6.0-10.0);P<0.001],lymph node metastases[17.8(IQR,4.4-39.0)vs.4.7(IQR,2.7-10.2);P<0.001],hepatic metastases[5.4(IQR,3.7-8.3)vs.1.0(IQR,0.9-1.5);P<0.001],and osseous metastases[13.9(IQR,7.3-18.0)vs.4.3(IQR,1.6-5.9);P<0.001].Physiological uptake of[^(68)Ga]Ga-RM2 was the highest in the pancreas(SUV_(max),77.82±22.64),with moderate uptake in the kidneys(2.82±0.62),heart(1.83±0.29),and liver(1.33±0.41).Conclusions:[^(68)Ga]Ga-RM2 PET/CT demonstrates superior uptake metrics for the detection of metastatic lesions,particularly in the brain and breast,suggesting its potential as a valuable complementary imaging modality to[^(18)F]FDG PET/CT.These promising foundings warrant further validation in larger cohorts to confirm their clinical impact and to standardize imaging protocols.
基金Supported by Capital Health Development Research Project,No.2020-2-2152National Natural Science Foundation of China,No.82472002.
文摘BACKGROUND KRAS mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases(CLMs).Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.AIM To investigate the association of KRAS mutations with recurrence in patients with CLM who underwent radiofrequency ablation(RFA)according to the primary tumor location.METHODS This retrospective study analyzed 164 patients with KRAS-determined CLM treated with percutaneous RFA between January 2012 and December 2018.The clinicopathological characteristics,recurrence patterns,and survival outcomes were systematically evaluated.RESULTS A total of 164 patients(mean age:58.0±9.8 years,range:34-83 years)who underwent percutaneous RFA of 325 CLMs(mean size:2.2±1.0 cm,range:0.7-5.0 cm)were included in the study.Eighty-nine(54.3%)patients had wild-type KRAS,and 75(45.7%)patients had mutated KRAS.Compared with wild-type patients,patients with KRAS mutations presented significantly higher local tumor progression rates(30.7%vs 14.6%,P=0.013).Among 126 patients(76.8%)who experienced post-RFA recurrence,61.6%developed intrahepatic metastases,and 53.7%developed extrahepatic metastases.Primary tumor location significantly modified KRASrelated outcomes:Compared with wild-type patients,left-sided colorectal cancer(CRC)patients with KRAS mutations presented higher intrahepatic recurrence rates(77.2%vs 52.5%,P=0.003)and shorter median intrahepatic recurrence-free survival(15 vs 25 months,P=0.007).No significant differences in KRAS expression were detected in right-sided tumors.CONCLUSION KRAS mutation status predicts differential recurrence patterns after CLM ablation,with significant prognostic implications,specifically in left-sided CRCs.These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.
文摘Objective:To evaluate the efficacy and safety of QL1206(a denosumab biosimilar to Xgeva■)in breast cancer patients with bone metastasis(BM)through subgroup analysis of a randomized,double-blind phaseⅢtrial(No.NCT04550949).Methods:This subgroup analysis included patients with BM from breast cancer enrolled in a phaseⅢtrial.Patients were randomized(1:1)to receive either three cycles of QL1206 or denosumab(120 mg subcutaneously every 4 weeks).Subsequently,they received 10 cycles of QL1206(120 mg)over 40 weeks,followed by a 20-week safety follow-up.The primary endpoint was the percentage changes from baseline to week 13 in urinary Ntelopeptide corrected for creatinine(u NTx/Cr).Results:The breast cancer cohort consisted of 311 patients.Vertebral involvement(66.4%)was the most prevalent BM site at enrollment,while 27.7%of patients presented with≥3 metastatic bone lesions.At week 13,QL1206 demonstrated a median u NTx/Cr reduction of-69.9%(range:-98.1%-568.0%)vs.-74.3%(range:-97.7%-386.3%)for denosumab.The analysis of covariance revealed comparable least-square means for log-transformed changes:-1.416[95%confidence interval(95%CI):-1.736 to-1.096]vs.-1.501(95%CI:-1.824 to-1.178),yielding an between-group difference of 0.085(90%CI:-0.062-0.232;P=0.343).After a 53-week treatment period,83.6%achieved bone density improvement/disease stabilization.Safety profiles were comparable between groups.Conclusions:QL1206 demonstrated similar efficacy and safety to the reference denosumab in patients with BM from breast cancer,supporting QL1206 as a new option for management of BM from breast cancer.
