Objective:Drawbacks of human papillomavirus(HPV)primary screening,including high referral rates and low specificity,highlight the necessity for triage strategies to balance the screening benefits with potential harms....Objective:Drawbacks of human papillomavirus(HPV)primary screening,including high referral rates and low specificity,highlight the necessity for triage strategies to balance the screening benefits with potential harms.Methods:A cross-sectional,population-based diagnostic study was conducted in rural Xinjiang,China involving 8,638 women≥25 years of age who participated in organized cervical cancer screening between 2023 and 2024.The study evaluated the accuracy and efficiency of multiple HPV-based"screen-triage"strategies.Histologically confirmed cervical intraepithelial neoplasia grade 2 or worse(CIN2+and CIN3+)served as disease outcomes.Results:Among single-step triage strategies,only extended genotyping for the seven most carcinogenic HPV types(HPV16/18/31/33/45/52/58)maintained sensitivity for CIN2+comparable to HPV screening without triage(90.0%vs.92.5%,P=0.50)but significantly improved specificity(94.7%vs.90.8%,P<0.001).This approach led to a 38%reduction in colposcopy referrals(relative rate,0.62;95%CI:0.59±0.65).Two-step triage algorithms(HPV16/18 with reflex ASC-US+or methylation)showed slightly lower but non-significant sensitivity(87.5%,P=0.13/89.6%,P=0.50)than HPV primary screening without triage,yet achieved significantly increased specificity(>95%,P<0.001)and reduced colposcopy referral by~50%(relative rate,0.5;P<0.001).If negative for cytology or methylation,women positive for 12 high-risk HPV types(excluding HPV16/18)had a<2%risk of CIN2+(CIN3+risk<1%),indicating delayed follow-up.Conclusions:Focusing on the seven high-risk HPV types within a one-step"screen-triage"framework effectively balances minimal sensitivity loss with significant gains in specificity,reducing unnecessary referrals and treatments,especially valuable in resourcelimited settings.Integrating HPV genotyping with methylation results improves the accurate identification of women requiring immediate referral,which is advisable when resources allow.展开更多
三阴性乳腺癌(triple-negative breast cancer,TNBC)明显的肿瘤异质性和多样的肿瘤微环境(tumor microenvironment,TME)特征加大了其研究和治疗的难度。化疗是TNBC治疗的重要手段之一,治疗后疗效预测及化疗耐药仍是临床亟待解决的难题,...三阴性乳腺癌(triple-negative breast cancer,TNBC)明显的肿瘤异质性和多样的肿瘤微环境(tumor microenvironment,TME)特征加大了其研究和治疗的难度。化疗是TNBC治疗的重要手段之一,治疗后疗效预测及化疗耐药仍是临床亟待解决的难题,其中TME的变化是一个主要的原因。了解肿瘤微环境在其中起到的促进作用对这一困境的突破至关重要。本文综合多组学研究的结论,探讨了TNBC临床疗效及化疗耐药与肿瘤微环境相关性的研究进展,为该问题的解决提供可能的方向。展开更多
Esophageal cancer(EC)is one of the most lethal cancers in the world[1].Esophageal squamous cell carcinoma(ESCC)is the dominant subtype of EC in China,with a poor prognosis and low survival rate[1].Currently,surgical r...Esophageal cancer(EC)is one of the most lethal cancers in the world[1].Esophageal squamous cell carcinoma(ESCC)is the dominant subtype of EC in China,with a poor prognosis and low survival rate[1].Currently,surgical resection,radiotherapy,and chemotherapy are the primary clinical treatments for EC[2,3].展开更多
Background:Breast cancer is one of the most common cancer in women and a proportion of patients experiences brain metastases with poor prognosis.The study aimed to construct a novel predictive clinical model to evalua...Background:Breast cancer is one of the most common cancer in women and a proportion of patients experiences brain metastases with poor prognosis.The study aimed to construct a novel predictive clinical model to evaluate the overall survival(OS)of patients with postoperative brain metastasis of breast cancer(BCBM)and validate its effectiveness.Methods:From 2010 to 2020,a total of 310 female patients with BCBM were diagnosed in The Affiliated Cancer Hospital of Xinjiang Medical University,and they were randomly assigned to the training cohort and the validation cohort.Data of another 173 BCBM patients were collected from the Surveillance,Epidemiology,and End Results Program(SEER)database as an external validation cohort.In the training cohort,the least absolute shrinkage and selection operator(LASSO)Cox regression model was used to determine the fundamental clinical predictive indicators and the nomogram was constructed to predict OS.The model capability was assessed using receiver operating characteristic,C-index,and calibration curves.Kaplan-Meier survival analysis was performed to evaluate clinical effectiveness of the risk stratification system in the model.The accuracy and prediction capability of the model were verified using the validation and SEER cohorts.Results:LASSO Cox regression analysis revealed that lymph node metastasis,molecular subtype,tumor size,chemotherapy,radiotherapy,and lung metastasis were statistically significantly correlated with BCBM.The C-indexes of the survival nomogram in the training,validation,and SEER cohorts were 0.714,0.710,and 0.670,respectively,which showed good prediction capability.The calibration curves demonstrated that the nomogram had great forecast precision,and a dynamic diagram was drawn to increase the maneuverability of the results.The Risk Stratification System showed that the OS of lowrisk patients was considerably better than that of high-risk patients(P<0.001).Conclusion:The nomogram prediction model constructed in this study has a good predictive value,which can effectively evaluate the survival rate of patients with postoperative BCBM.展开更多
Objective:To estimate the incidence and mortality of cervical cancer in China based on the cancer registration data in 2015,collected by the National Central Cancer Registry(NCCR).Methods:There were 501 cancer registr...Objective:To estimate the incidence and mortality of cervical cancer in China based on the cancer registration data in 2015,collected by the National Central Cancer Registry(NCCR).Methods:There were 501 cancer registries that submitted data to the NCCR,whose data were the basis for estimating the incidence and mortality of cervical cancer in China in 2015.After evaluating the data quality,368 registries’data were accepted for the analysis and stratified by area(urban/rural)and age group.Combined with data on the national population in 2015,the nationwide incidence and mortality of cervical cancer were estimated.Cervical Cancer cases of 22 cancer registries were applied for temporal trends from 2000 to 2015.The Chinese population census in 2000 and Segi’s population were used to calculate age-standardized incidence and mortality rates.Results:An estimated 111,000 new cases were attributed to cervical cancer in China in 2015,accounting for 6.24%of all female new cancer cases in that year in China.The crude rate(CR)of incidence and age-standardized incidence rates by the China standard population(ASIRC)and by Segi’s world standard population(ASIRW)of cervical cancer were 16.56/100,000,11.78/100,000,and 10.86/100,000,respectively.The cumulative incidence rate from birth to 74 years old was 1.15%,whereas the calculation of incidence rates over the truncated age range of 35-64 years by Segi’s world standard population(T-ASIRW)was 27.66/100,000.The estimates of cervical cancer deaths were about 33,800 and 3.94%of all female cancer-related deaths in China in 2015,with a crude mortality rate of 5.04/100,000.The age-standardized mortality rates adjusted by the Chinese standard population(ASMRC)and by world Segi’s population(ASMRW)were 3.29/100,000 and 3.15/100,000,respectively,with a cumulative mortality rate(0-74 years old)of 0.35%.Both the incidence and mortality were higher in rural than in urban areas.The age-specific cervical cancer incidence significantly increased with age,particularly after age 25 years,and peaked at 50-54 years old,whereas age-specific mortality increased rapidly after 35 years old,peaking at 80-84 years old.The age-standardized incidence rates increased by about 8.6(95%CI:6.9,10.3)per year during the period of 2000−2015.The age at diagnosis of patients with cervical cancer tended to be younger.In rural areas,the mean age at diagnosis decreased about 3.22 years from 2000 to 2015(𝛽=-0.33,P<0.001).Conclusions:China has a high burden of cervical cancer and important disparities among different regions.Es-pecially in the middle and western areas and rural areas,cervical cancer is a serious issue in women’s health,and prevention strategies need to be enhanced.Prevention and control strategies need to be enhanced and imple-mented with reference to local status,such as human papillomavirus(HPV)vaccination and screening programs.展开更多
Cancer informatics has significantly progressed in the big data era.We summarize the application of informatics approaches to the cancer domain from both the informatics perspective(e.g.,data management and data scien...Cancer informatics has significantly progressed in the big data era.We summarize the application of informatics approaches to the cancer domain from both the informatics perspective(e.g.,data management and data science)and the clinical perspective(e.g.,cancer screening,risk assessment,diagnosis,treatment,and prognosis).We discuss various informatics methods and tools that are widely applied in cancer research and practices,such as cancer databases,data standards,terminologies,high‐throughput omics data mining,machine‐learning algorithms,artificial intelligence imaging,and intelligent radiation.We also address the informatics challenges within the cancer field that pursue better treatment decisions and patient outcomes,and focus on how informatics can provide opportunities for cancer research and practices.Finally,we conclude that the interdisciplinary nature of cancer informatics and collaborations are major drivers for future research and applications in clinical practices.It is hoped that this review is instrumental for cancer researchers and clinicians with its informatics‐specific insights.展开更多
基金supported by grants from The Key Research and Development Program of Xinjiang Uygur Autonomous Region of China(Grant No.2022B03019-2)the National Natural Science Foundation of China(Grant Nos.82260660 and 72264038)the CAMS Innovation Fund for Medical Sciences(Grant No.CAMS 2021-I2M-1-004)。
文摘Objective:Drawbacks of human papillomavirus(HPV)primary screening,including high referral rates and low specificity,highlight the necessity for triage strategies to balance the screening benefits with potential harms.Methods:A cross-sectional,population-based diagnostic study was conducted in rural Xinjiang,China involving 8,638 women≥25 years of age who participated in organized cervical cancer screening between 2023 and 2024.The study evaluated the accuracy and efficiency of multiple HPV-based"screen-triage"strategies.Histologically confirmed cervical intraepithelial neoplasia grade 2 or worse(CIN2+and CIN3+)served as disease outcomes.Results:Among single-step triage strategies,only extended genotyping for the seven most carcinogenic HPV types(HPV16/18/31/33/45/52/58)maintained sensitivity for CIN2+comparable to HPV screening without triage(90.0%vs.92.5%,P=0.50)but significantly improved specificity(94.7%vs.90.8%,P<0.001).This approach led to a 38%reduction in colposcopy referrals(relative rate,0.62;95%CI:0.59±0.65).Two-step triage algorithms(HPV16/18 with reflex ASC-US+or methylation)showed slightly lower but non-significant sensitivity(87.5%,P=0.13/89.6%,P=0.50)than HPV primary screening without triage,yet achieved significantly increased specificity(>95%,P<0.001)and reduced colposcopy referral by~50%(relative rate,0.5;P<0.001).If negative for cytology or methylation,women positive for 12 high-risk HPV types(excluding HPV16/18)had a<2%risk of CIN2+(CIN3+risk<1%),indicating delayed follow-up.Conclusions:Focusing on the seven high-risk HPV types within a one-step"screen-triage"framework effectively balances minimal sensitivity loss with significant gains in specificity,reducing unnecessary referrals and treatments,especially valuable in resourcelimited settings.Integrating HPV genotyping with methylation results improves the accurate identification of women requiring immediate referral,which is advisable when resources allow.
文摘三阴性乳腺癌(triple-negative breast cancer,TNBC)明显的肿瘤异质性和多样的肿瘤微环境(tumor microenvironment,TME)特征加大了其研究和治疗的难度。化疗是TNBC治疗的重要手段之一,治疗后疗效预测及化疗耐药仍是临床亟待解决的难题,其中TME的变化是一个主要的原因。了解肿瘤微环境在其中起到的促进作用对这一困境的突破至关重要。本文综合多组学研究的结论,探讨了TNBC临床疗效及化疗耐药与肿瘤微环境相关性的研究进展,为该问题的解决提供可能的方向。
基金supported by the National Key R&D Program of China(2022YFA1303200 and 2022YFA1303201)National Natural Science Foundation of China(32330062,31972933,82272166,32471498,and 81925012)+10 种基金Program of Shanghai Academic/Technology Research Leader(22XD1420100)Major Project of Special Development Funds of Zhangjiang National Independent Innovation Demonstration Zone(ZJ2019-ZD004)Shanghai Municipal Science and Technology Major Project(2023SHZDZX02)the Fudan Original Research Personalized Support Project,the New Cornerstone Science Foundation(NCI202242 and the Xplorer Prize)the Young Scientists Fund of the National Natural Science Foundation of China(32201212 and 32301236)Shanghai Sailing Program(23YF1402800)the Guiding Funds of Central Government for Supporting the Development of the Local Science and Technology(2022)the Science and Technology Commission of Shanghai Municipality(22ZR1426400)the Shanghai Municipal Science and Technology Major Projectthe Human Phenome Data Center of Fudan universityShanghai Phenomic precision measurement professional technical service platform(23DZ2290800)。
文摘Esophageal cancer(EC)is one of the most lethal cancers in the world[1].Esophageal squamous cell carcinoma(ESCC)is the dominant subtype of EC in China,with a poor prognosis and low survival rate[1].Currently,surgical resection,radiotherapy,and chemotherapy are the primary clinical treatments for EC[2,3].
基金supported by National Natural Science Foundation of China(No.82060520)Tianshan Cedar Talent Training Project of Science and Technology Department of Xinjiang Uygur Autonomous Region(No.2020XS14).
文摘Background:Breast cancer is one of the most common cancer in women and a proportion of patients experiences brain metastases with poor prognosis.The study aimed to construct a novel predictive clinical model to evaluate the overall survival(OS)of patients with postoperative brain metastasis of breast cancer(BCBM)and validate its effectiveness.Methods:From 2010 to 2020,a total of 310 female patients with BCBM were diagnosed in The Affiliated Cancer Hospital of Xinjiang Medical University,and they were randomly assigned to the training cohort and the validation cohort.Data of another 173 BCBM patients were collected from the Surveillance,Epidemiology,and End Results Program(SEER)database as an external validation cohort.In the training cohort,the least absolute shrinkage and selection operator(LASSO)Cox regression model was used to determine the fundamental clinical predictive indicators and the nomogram was constructed to predict OS.The model capability was assessed using receiver operating characteristic,C-index,and calibration curves.Kaplan-Meier survival analysis was performed to evaluate clinical effectiveness of the risk stratification system in the model.The accuracy and prediction capability of the model were verified using the validation and SEER cohorts.Results:LASSO Cox regression analysis revealed that lymph node metastasis,molecular subtype,tumor size,chemotherapy,radiotherapy,and lung metastasis were statistically significantly correlated with BCBM.The C-indexes of the survival nomogram in the training,validation,and SEER cohorts were 0.714,0.710,and 0.670,respectively,which showed good prediction capability.The calibration curves demonstrated that the nomogram had great forecast precision,and a dynamic diagram was drawn to increase the maneuverability of the results.The Risk Stratification System showed that the OS of lowrisk patients was considerably better than that of high-risk patients(P<0.001).Conclusion:The nomogram prediction model constructed in this study has a good predictive value,which can effectively evaluate the survival rate of patients with postoperative BCBM.
文摘Objective:To estimate the incidence and mortality of cervical cancer in China based on the cancer registration data in 2015,collected by the National Central Cancer Registry(NCCR).Methods:There were 501 cancer registries that submitted data to the NCCR,whose data were the basis for estimating the incidence and mortality of cervical cancer in China in 2015.After evaluating the data quality,368 registries’data were accepted for the analysis and stratified by area(urban/rural)and age group.Combined with data on the national population in 2015,the nationwide incidence and mortality of cervical cancer were estimated.Cervical Cancer cases of 22 cancer registries were applied for temporal trends from 2000 to 2015.The Chinese population census in 2000 and Segi’s population were used to calculate age-standardized incidence and mortality rates.Results:An estimated 111,000 new cases were attributed to cervical cancer in China in 2015,accounting for 6.24%of all female new cancer cases in that year in China.The crude rate(CR)of incidence and age-standardized incidence rates by the China standard population(ASIRC)and by Segi’s world standard population(ASIRW)of cervical cancer were 16.56/100,000,11.78/100,000,and 10.86/100,000,respectively.The cumulative incidence rate from birth to 74 years old was 1.15%,whereas the calculation of incidence rates over the truncated age range of 35-64 years by Segi’s world standard population(T-ASIRW)was 27.66/100,000.The estimates of cervical cancer deaths were about 33,800 and 3.94%of all female cancer-related deaths in China in 2015,with a crude mortality rate of 5.04/100,000.The age-standardized mortality rates adjusted by the Chinese standard population(ASMRC)and by world Segi’s population(ASMRW)were 3.29/100,000 and 3.15/100,000,respectively,with a cumulative mortality rate(0-74 years old)of 0.35%.Both the incidence and mortality were higher in rural than in urban areas.The age-specific cervical cancer incidence significantly increased with age,particularly after age 25 years,and peaked at 50-54 years old,whereas age-specific mortality increased rapidly after 35 years old,peaking at 80-84 years old.The age-standardized incidence rates increased by about 8.6(95%CI:6.9,10.3)per year during the period of 2000−2015.The age at diagnosis of patients with cervical cancer tended to be younger.In rural areas,the mean age at diagnosis decreased about 3.22 years from 2000 to 2015(𝛽=-0.33,P<0.001).Conclusions:China has a high burden of cervical cancer and important disparities among different regions.Es-pecially in the middle and western areas and rural areas,cervical cancer is a serious issue in women’s health,and prevention strategies need to be enhanced.Prevention and control strategies need to be enhanced and imple-mented with reference to local status,such as human papillomavirus(HPV)vaccination and screening programs.
基金National Key Research&Development Program of China。
文摘Cancer informatics has significantly progressed in the big data era.We summarize the application of informatics approaches to the cancer domain from both the informatics perspective(e.g.,data management and data science)and the clinical perspective(e.g.,cancer screening,risk assessment,diagnosis,treatment,and prognosis).We discuss various informatics methods and tools that are widely applied in cancer research and practices,such as cancer databases,data standards,terminologies,high‐throughput omics data mining,machine‐learning algorithms,artificial intelligence imaging,and intelligent radiation.We also address the informatics challenges within the cancer field that pursue better treatment decisions and patient outcomes,and focus on how informatics can provide opportunities for cancer research and practices.Finally,we conclude that the interdisciplinary nature of cancer informatics and collaborations are major drivers for future research and applications in clinical practices.It is hoped that this review is instrumental for cancer researchers and clinicians with its informatics‐specific insights.
