Relationship between Helicobacter pylori infection and programmed death-ligand 1 in gastric cancer: A meta-analysis

BACKGROUND

Gastric cancer (GC) is one of the most common malignancies worldwide, and Helicobacter pylori (HP) infection is a well-established risk factor for its development. Programmed death-ligand 1 (PD-L1) expression is a crucial biomarker for predicting the efficacy of immune checkpoint inhibitors in cancer treatment. While HP infection and PD-L1 expression in GC may be linked, the relationship between them remains unclear, in part because there have been conflicting results reported from various studies.

AIM

To perform a meta-analysis to assess the relationship between HP and PD-L1 expression in patients with GC.

METHODS

A systematic literature review was conducted using PubMed, Embase, Cochrane Library, and Web of Science databases. Observational studies that examined the association between HP infection and PD-L1 expression in patients with GC were included. Odds ratios and 95% confidence intervals were calculated to estimate the association. Heterogeneity was assessed using Cochrane’s Q test and I² statistic. A random-effects model was used due to significant heterogeneity across studies.

RESULTS

Fourteen studies involving a total of 3069 patients with GC were included. The pooled analysis showed a significant association between HP infection and increased PD-L1 expression in GC tissues (odd ratio = 1.69, 95% confidence interval: 1.24-2.29, P < 0.001, I² = 59%). Sensitivity analyses confirmed the robustness of these findings. Subgroup analyses did not show significant variation based on geographic region, sample size, or method of PD-L1 assessment. Publication bias was minimal, as shown by funnel plots and Egger’s regression test.

CONCLUSION

HP infection is associated with increased PD-L1 expression in GC, suggesting that HP status may influence the response to programmed cell death protein 1/PD-L1 blockade therapy.

Is the use of a transanal drainage tube effective in treating anastomotic leakage for mid-low rectal cancer

BACKGROUND

Anastomotic leakage (AL) is a severe surgical complication for mid-low rectal cancers. The efficacy of transanal drainage tube (TDT) has rarely been reported.

AIM

To evaluate the efficacy of TDT after AL.

METHODS

A retrospective analysis was conducted on 68 patients with mid-low rectal cancer who underwent laparoscopic low anterior resection (LAR) and developed ALs. Leakage were identified using imaging studies and digital rectal examinations when local abscesses or systemic infections were present. In each patient, the leakage site was determined using the index finger and a drainage tube was inserted transanally to drain the abscesses and exudates outside the anus. The clinical outcomes of the patients following transanal drainage were analyzed.

RESULTS

A total of 43 patients received TDT treatment, while 25 patients did not receive TDT treatment. Among the patients in the TDT group, 9 required reoperation compared to 12 in the non-TDT group. In the TDT group, 76.74% of the patients were able to restore intestinal continuity, whereas only 40% of the patients in the non-TDT group achieved restored intestinal continuity. In the TDT group, 48.48% of patients developed LAR syndrome (LARS), whereas in the non-TDT group, 90% of patients developed LARS. The median drainage time was 7 days, the median postoperative hospital stay was 21 days, the median fasting time was 6.5 days, and the median hospitalization cost was 109205.93 RMB.

CONCLUSION

TDT use lowered reoperation rate but did not increase hospitalization expenses. After ≥ 1 year of follow-up, its use improved intestinal patency rate and reduced the incidence of LARS.

Splenic artery aneurysm with double-rupture phenomenon and circulatory collapse following anesthesia induction: A case report

BACKGROUND

Splenic artery aneurysm (SAA) rupture is a rare, life-threatening condition characterized by acute intra-abdominal hemorrhage and hemodynamic instability. Ruptured SAAs may exhibit a biphasic and relatively slow clinical progression, commonly referred to as the “double-rupture phenomenon”. The reported incidence of the double-rupture phenomenon ranges 12%-21% in patients with ruptured SAAs, potentially due to variations in intra-abdominal pressure. Following anesthesia induction, muscle relaxation can decrease intra-abdominal pressure, potentially triggering the double-rupture phenomenon and leading to circulatory collapse.

CASE SUMMARY

A 61-year-old female presented to the Department of Emergency with upper abdominal pain, abdominal distension, dizziness, and vomiting. Her vital signs were initially stable. Physical examination revealed abdominal tenderness and positive-shifting dullness. Abdominal contrast-enhanced computed tomography revealed cirrhosis, severe portal hypertension, and splenomegaly. Acute rupture was suggested by a hematoma on the upper left side outside the SAA. Surgeons deemed intravascular intervention challenging and open splenectomy inevitable. Circulatory collapse occurred after anesthesia induction, likely due to a double rupture of the SAA. This double-rupture phenomenon may have resulted from an initial rupture of the SAA into the omental bursa, forming a hematoma that exerted a tamponade effect. A second rupture into the peritoneal cavity may have been triggered by decreased intra-abdominal pressure following anesthesia induction. The patient’s life was saved through early, coordinated, multidisciplinary team collaboration. Following cardiopulmonary resuscitation and emergency splenectomy, she recovered without significant postoperative bleeding or hypoxic encephalopathy.

CONCLUSION

Anesthesia-induced pressure reduction may trigger a second SAA rupture, causing collapse. Early diagnosis and multidisciplinary teamwork improve outcomes. This is a rare and life-threatening case of SAA rupture, which is of great significance to the medical community for understanding and handling such emergencies.

Construction and validation of a novel prognostic nomogram for patients with poorly differentiated gastric neuroendocrine neoplasms

BACKGROUND

The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms (PDGNENs) is dismal and related research is limited.

AIM

To investigate the prognostic factors, and validate a novel prognostic nomogram for PDGNEN patients.

METHODS

We conducted a retrospective study using clinical and pathological data from PDGNEN patients treated at the First Medical Center of the Chinese PLA General Hospital from January 2000 to June 2023. Overall survival (OS) differences were assessed with the Log-rank test and Kaplan-Meier survival curves. Cox regression analysis identified independent risk factors for prognosis. Model performance was evaluated using Harrell’s concordance index, receiver operating characteristic analysis, area under the curve, calibration curves, and decision curve analysis (UDC), including the area under the UDC.

RESULTS

The study included 336 patients (227 with neuroendocrine carcinoma and 109 with mixed adenoneuroendocrine carcinoma). The average age was 62.7 years. The cohort comprised 80 (24.7%) patients in stage I, 146 (42.9%) in stage II, 62 (18.1%) in stage III, and 48 (14.3%) in stage IV. Significant differences in OS were observed across tumor-node-metastasis stages (P < 0.001). Multivariate analysis showed age, Ki-67 index, invasion depth, lymph node metastasis, distant metastasis, and platelet-to-lymphocyte ratio as independent risk factors. We developed a nomogram with a concordance index of 0.779 (95% confidence interval: 0.743-0.858). Receiver operating characteristic analysis showed area under the curves for 1-year, 3-year, and 5-year OS predictions of 0.865, 0.850, and 0.890, respectively. The calibration curve demonstrated good agreement with actual outcomes. The area under the UDC for the nomogram vs the 8^th American Joint Committee on Cancer tumor-node-metastasis staging system were 0.047 vs 0.027, 0.291 vs 0.179, and 0.376 vs 0.216 for 1-year, 3-year, and 5-year OS, respectively.

CONCLUSION

PDGNENs are predominantly found in older men, often in advanced stages at diagnosis, resulting in poor prognosis. The established nomogram demonstrates strong predictive capability and clinical utility.

Prognostic value of the preoperative systemic immune-inflammation nutritional index in patients with gastric cancer

BACKGROUND

Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer-related deaths in China. Many patients with GC frequently experience symptoms related to the disease, including anorexia, nausea, vomiting, and other discomforts, and often suffer from malnutrition, which in turn negatively affects perioperative safety, prognosis, and the effectiveness of adjuvant therapeutic measures. Consequently, some nutritional indicators such as nutritional risk index (NRI), prognostic nutritional index (PNI), and systemic immune-inflammatory-nutritional index (SIINI) can be used as predictors of the prognosis of GC patients.

AIM

To examine the prognostic significance of PNI, NRI, and SIINI in postoperative patients with GC.

METHODS

A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018. The area under the receiver operating characteristic (ROC) curve was assessed using ROC curve analysis, and the optimal cutoff values for NRI, PNI, and SIINI were identified using the You-Review-HTMLden index. Survival analysis was performed using the Kaplan-Meier method. In addition, univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.

RESULTS

This study included a total of 803 patients. ROC curves were used to evaluate the prognostic ability of NRI, PNI, and SIINI. The results revealed that SIINI had superior predictive accuracy. Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group (P < 0.05). Univariate analysis identified NRI [hazard ratio (HR) = 0.68, 95% confidence interval (CI): 0.52-0.89, P = 0.05], PNI (HR = 0.60, 95%CI: 0.46-0.79, P < 0.001), and SIINI (HR = 2.10, 95%CI: 1.64-2.69, P < 0.001) as prognostic risk factors for patients with GC. However, multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC (HR = 1.65, 95%CI: 1.26-2.16, P < 0.001).

CONCLUSION

Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC. Compared with NRI and PNI, SIINI may offer greater application for prognostic assessment.

Pretreatment radiomic imaging features combined with immunological indicators to predict targeted combination immunotherapy response in advanced hepatocellular carcinoma

BACKGROUND

Early symptoms of hepatocellular carcinoma (HCC) are not obvious, and more than 70% of which does not receive radical hepatectomy, when first diagnosed. In recent years, molecular-targeted drugs combined with immunotherapy and other therapeutic methods have provided new treatment options for middle and advanced HCC (aHCC). Predicting the effect of targeted combined immunotherapy has become a hot topic in current research.

AIM

To explore the relationship between nodule enhancement in hepatobiliary phase and the efficacy of combined targeted immunotherapy for aHCC.

METHODS

Data from 56 patients with aHCC for magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid were retrospectively collected. Signal intensity of intrahepatic nodules was measured, and the hepatobiliary relative enhancement ratio (RER) was calculated. Progression-free survival (PFS) of patients with high and low reinforcement of HCC nodules was compared. The model was validated using receiver operating characteristic curves. Univariate and multivariate logistic regression and Kaplan-Meier analysis were performed to explore factors influencing the efficacy of targeted immunization and PFS.

RESULTS

Univariate and multivariate analyses revealed that the RER, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index were significantly associated with the efficacy of tyrosine kinase inhibitors combined with immunotherapy (P < 0.05). The area under the curve of the RER for predicting the efficacy of tyrosine kinase inhibitors combined with anti-programmed death 1 antibody in patients with aHCC was 0.876 (95% confidence interval: 0.781-0.971, P < 0.05), the optimal cutoff value was 0.904, diagnostic sensitivity was 87.5%, and specificity was 79.2%. Kaplan-Meier analysis showed that neutrophil-to-lymphocyte ratio < 5, platelet-to-lymphocyte ratio < 300, prognostic nutritional index < 45, and RER < 0.9 significantly improved PFS.

CONCLUSION

AHCC nodules enhancement in the hepatobiliary stage was significantly correlated with PFS. Imaging information and immunological indicators had high predictive efficacy for targeted combined immunotherapy and were associated with PFS.

Impact of family history of breast disease on knowledge, attitudes, and breast cancer preventive practices among reproductive-age females

BACKGROUND

Breast cancer is one of the most prevalent causes of morbidity and mortality worldwide, presenting an increasing public health challenge, particularly in low-income and middle-income countries. However, data on the knowledge, attitudes, and preventive practices regarding breast cancer and the associated factors among females in Wollo, Ethiopia, remain limited.

AIM

To assess the impact of family history (FH) of breast disease on knowledge, attitudes, and breast cancer preventive practices among reproductive-age females.

METHODS

A community-based cross-sectional study was conducted in May and June 2022 in Northeast Ethiopia and involved 143 reproductive-age females with FH of breast diseases and 209 without such a history. We selected participants using the systematic random sampling technique. We analyzed the data using Statistical Package for Social Science version 25 software, and logistic regression analysis was employed to determine odds ratios for variable associations, with statistical significance set at P < 0.05.

RESULTS

Among participants with FH of breast diseases, the levels of knowledge, attitudes, and preventive practices were found to be 83.9% [95% confidence interval (CI): 77.9-89.9], 49.0% (95%CI: 40.8-57.1), and 74.1% (95%CI: 66.9-81.3), respectively. In contrast, among those without FH of breast diseases, these levels were significantly decreased to 10.5% (95%CI: 6.4-14.7), 32.1% (95%CI: 25.7-38.4), and 16.7% (95%CI: 11.7-21.8), respectively. This study also indicated that knowledge, attitudes, and preventive practices related to breast cancer are significantly higher among participants with FH of breast diseases compared to those without HF breast diseases.

CONCLUSION

Educational status, monthly income, and community health insurance were identified as significant factors associated with the levels of knowledge, attitudes, and preventive practices regarding breast cancer among reproductive-age females.

Review of the mechanisms of the biliary-enteric axis in the development of cholangiocarcinoma

Cholangiocarcinoma (CCA) is a particularly aggressive and challenging type of cancer, known for its poor prognosis, which is worsened by the complex interplay of various biological and environmental factors that contribute to its development. Recently, researchers have increasingly focused on the significant role of the biliary-enteric communication of liver-gut axis in the pathogenesis of CCA, highlighting a complex relationship that has not been thoroughly explored before. This review aims to summarize the key concepts related to the biliary-enteric communication of liver-gut axis and investigate its potential mechanisms that may lead to the onset and progression of CCA, a disease that presents substantial treatment challenges. Important areas of focus will include the microbiome's profound influence, which interacts with host physiology in ways that may worsen cancer development; changes in bile acid metabolism that can create toxic environments favorable for tumor growth; the regulation of inflammatory processes that may either promote or inhibit tumor progression; the immune system's involvement, which is crucial in the body's response to cancer; and the complex interactions within metabolic pathways that can affect cellular behavior and tumor dynamics. By integrating recent research findings from various studies, we aim to explore the multifaceted roles of the biliary-enteric communication of liver-gut axis in CCA, providing new insights and perspectives for future research while identifying promising therapeutic targets that could lead to innovative treatment strategies aimed at improving patient outcomes in this challenging disease.

Diagnosis and treatment of pulmonary lymphoepithelioma-like carcinoma: A case report

BACKGROUND

Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare primary epithelial lung cancer associated with the Epstein-Barr virus. Standard treatment guideline for PLELC is yet not to be established, surgery remains the primary treatment for early-stage PLELC, and platinum chemotherapy is the most common first-line treatment for advanced PLELC. While targeted therapy and immunotherapy has emerged as effective way to treat various malignant tumors, including lung cancer, reports on PLELC are relatively scarce.

CASE SUMMARY

A 38-year-old man was diagnosed with right PLELC. Chest computed tomography (CT) revealed a mass in the medial segment of the middle lobe of the right lung, with lymph node metastasis in the mediastinum and right hilum of the lung. CT-guided lung tumor biopsy was performed and the postoperative pathological examination combined with immune phenotype analysis and in situ hybridization confirmed PLELC. Standard molecular testing for patients with non-small cell lung cancer was negative and programmed cell death ligand-1 expression was about 2%. The patient declined radiotherapy and chemotherapy. Consequently, immunotherapy was administered, which included toripalimab 240 mg on day 1 and anlotinib 10 mg on days 1-14 for 10 cycles, followed by a maintenance dose of anlotinib 10 mg daily every 3 weeks. As a result, his progression-free survival reached 48 months.

CONCLUSION

A combination of toripalimab and anlotinib may benefit patients with advanced diseases who have not received systematic antitumor therapy.

Long non-coding RNA in the regulation of cell death in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer, accounting for 90% of all cases. Currently, early diagnosis of HCC can be achieved through serum alpha-fetoprotein detection, B-ultrasound, and computed tomography scanning; however, their specificity and sensitivity are suboptimal. Despite significant advancements in HCC biomarker detection, the prognosis for patients with HCC remains unfavorable due to tumor heterogeneity and limited understanding of its pathogenesis. Therefore, it is crucial to explore more sensitive HCC biomarkers for improved diagnosis, monitoring, and management of the disease. Long non-coding RNA (lncRNA) serves as an auxiliary carrier of genetic information and also plays diverse intricate regulatory roles that greatly contribute to genome complexity. Moreover, investigating gene expression regulation networks from the perspective of lncRNA may provide insights into the diagnosis and prognosis of HCC. We searched the PubMed database for literature, comprehensively classified regulated cell death mechanisms and systematically reviewed research progress on lncRNA-mediated cell death pathways in HCC cells. Furthermore, we prospectively summarize its potential implications in diagnosing and treating HCC.

New research progress of sarcopenia in surgically resectable malignant tumor diseases

With the aging global population, the decline in muscle mass and function among the elderly has emerged as a significant concern. This systemic progressive generalized loss of muscle function and mass is referred to as sarcopenia (SP). In recent years, a growing number of studies have investigated SP, revealing that many tumor diseases, especially in the digestive system, promote its occurrence due to the influence of the disease itself, diet, and other factors. Moreover, SP patients tend to have poorer postoperative recovery. At present, many diagnostic methods have been developed for SP, but no unified standard has been established. Furthermore, the cutoff values of many diagnostic methods for different populations are still in the exploratory stage, and additional clinical studies are required to explore these issues. This article comprehensively and systematically summarizes the diagnostic methods and criteria mentioned in previous research, focusing on the impact of SP on post-surgical patients with various malignant tumors.

Combination of anlotinib and albumin-bound paclitaxel in 2nd line and above treatment of advanced gastric cancer: A retrospective study

BACKGROUND

Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer (AGC); however, the regimen needs optimization.

AIM

To evaluate the efficacy of albumin-bound paclitaxel (nab-ptx) combined with the small molecule vascular endothelial growth factor inhibitor anlotinib in second-line and beyond treatment of AGC.

METHODS

We collected data from AGC patients at our hospital who experienced disease progression after first-line chemotherapy and received anlotinib combined with nab-ptx. The primary endpoints included overall survival (OS) and progression-free survival (PFS), while the secondary endpoints were objective response rate (ORR), disease control rate (DCR), and adverse events (AEs).

RESULTS

Preliminary results indicated that anlotinib combined with nab-ptx can provide significant efficacy in second-line or above treatment for AGC (median PFS = 6.0 months, median OS = 12.0 months), with an ORR of 42% and a DCR of 78%. Further analysis revealed that patients who experienced hypertension, proteinuria, and hand-foot syndrome during treatment had better efficacy compared to those who did not experience these AEs. Mechanistic studies suggest that this regimen likely exerts synergistic anti-tumor effects by activating the immune response through the reduction of regulatory T-cell proportions. Common adverse reactions included bone marrow suppression, peripheral neuropathy, hypertension, proteinuria, and hand-foot syndrome, which were manageable and resolved with appropriate interventions, indicating the promising application of this regimen in second-line or above treatment for AGC.

CONCLUSION

The combination of anlotinib and nab-ptx shows promising efficacy with fewer toxicities in AGC treatment. The regimen holds promise as a second-line treatment of AGC; however, its specific clinical value requires further research.

Application of comprehensive geriatric assessment in oncology nursing: A literature review on optimizing treatment decisions and patient outcomes

With the global population aging, the care of elderly cancer patients has become increasingly complex and significant. Comprehensive geriatric assessment (CGA), a multidimensional evaluation tool, has been widely implemented in oncology nursing to enhance the precision of treatment decisions and improve patient outcomes. This review examines the application of CGA in oncology nursing, drawing on literature published between 2010 and 2024 in major databases using keywords such as “Comprehensive Geriatric Assessment” and “Oncology Nursing”. It highlights how CGA contributes to optimizing treatment selection, monitoring the treatment process, and improving patients’ quality of life and long-term outcomes. CGA provides a comprehensive evaluation of elderly cancer patients, including physical, psychological, and social aspects, enabling the identification of high-risk patients and reducing treatment-related side effects and complications. It also offers a critical foundation for developing personalized care plans. The article discusses various practical examples of CGA implementation across different countries and regions, including multidisciplinary collaborative models in France, the United States, and Australia, demonstrating CGA’s flexible application in diverse healthcare settings. Although significant progress has been made in applying CGA in oncology nursing, numerous challenges remain in its implementation, such as resource limitations and insufficient personnel training. Future research will focus on integrating CGA with emerging technologies, such as artificial intelligence and precision medicine, to further improve the quality of care and treatment outcomes for elderly cancer patients. By summarizing the current status and challenges of CGA in oncology nursing, this review provides guidance for future research and clinical practice, emphasizing the importance of advancing CGA application to meet the growing demands of elderly oncology care.

Current status and recent progress of nanomaterials in transcatheter arterial chemoembolization therapy for hepatocellular carcinoma

Hepatocellular carcinoma (HCC) remains one of the most common cancers worldwide. Transcatheter arterial chemoembolization has become a common treatment modality for some patients with unresectable advanced HCC. Since the introduction of nanomaterials in 1974, their use in various fields has evolved rapidly. In medical applications, nanomaterials can serve as carriers for the delivery of chemotherapeutic drugs to tumour tissues. Additionally, nanomaterials have potential for in vivo tumour imaging. This article covers the properties and uses of several kinds of nanomaterials, focusing on their use in transcatheter arterial chemoembolization for HCC treatment. This paper also discusses the limitations currently associated with the use of nanomaterials.

Multiple primary tumors patient developed microsatellite stable gastric cancer after cadonilimab treatment for liver cancer: A case report

BACKGROUND

Multiple primary malignant tumors refer to the occurrence of two or more primary malignant tumors in the same organ or multiple organs or tissues at the same time or successively in the same patient, and can occur anywhere in the body. The treatment guidelines for patients with multiple primary malignant tumors are currently controversial.

CASE SUMMARY

A 51-year-old male patient with liver cancer and portal hypertension received 42 months of co-treatment with atezolizumab and bevacizumab. After that, the disease was rated stable disease. The patient was then diagnosed with gastric cancer. Since the patient was not sensitive to anti-programmed death ligand 1 immunosuppressive agents, a co-treatment with oxaliplatin, tegafur, apatinib, and cadonilimab was selected after multidisciplinary consultation and the patient’s agreement. After four cycles of treatment, partial response and stable disease were observed in gastric and liver cancers, respectively. Surgical treatment was performed considering the high-risk factors of gastrointestinal bleeding in patients with gastroesophageal varices. Postoperative pathology showed that the Tumor Regression Grade was 1. Moreover, the genetic testing of postoperative tumor specimens indicated negative programmed death ligand 1 and microsatellite stability. In addition, the latest follow-up indicated an 8 and 40-month progression-free survival in gastric and liver cancer patients, respectively. Currently, the patient is receiving postoperative immunotherapy with cadonilimab.

CONCLUSION

Cadonilimab not only treats microsatellite stability gastric cancer patients but can also be used for liver cancer treatment.

Construction of a nomogram-based risk prediction model for depressive symptoms in middle-aged and young breast cancer patients

BACKGROUND

Breast cancer (BC) is the second most common malignancy globally. Young and middle-aged patients face more pressures from diagnosis, treatment, costs, and psychological issues like self-image concerns, social barriers, and professional challenges. Compared to other age groups, they have higher recurrence rates, lower survival rates, and increased risk of depression. Research is lacking on factors influencing depressive symptoms and predictive models for this age group.

AIM

To analyze factors influencing depressive symptoms in young/middle-aged BC patients and construct a depression risk predictive model.

METHODS

A total of 360 patients undergoing BC treatment at two tertiary hospitals in Jiangsu Province, China from November 2023 to April 2024 were included in the study. Participants were surveyed using a general information questionnaire, the patient health questionnaire depression scale, the visual analog scale for pain, the revised family support scale, and the long form of the international physical activity questionnaire. Univariate and multivariate analyses were conducted to identify the factors affecting depression in middle-aged and young BC patients, and a predictive model for depression risk was developed based on these findings.

RESULTS

Among the 360 middle-aged and young BC patients, the incidence rate of depressive symptoms was 38.61% (139/360). Multivariate analysis revealed that tumor grade, patient’s monthly income, pain score, family support score, and physical activity score were factors influencing depression in this patient group (P < 0.05). The risk prediction model constructed based on these factors yielded an area under the receiver operating characteristic curve of 0.852, with a maximum Youden index of 0.973, sensitivity of 86.80%, specificity of 89.50%, and a diagnostic odds ratio of 0.552. The Hosmer-Lemeshow test for goodness of fit indicated an adequate model fit (χ² = 0.360, P = 0.981).

CONCLUSION

The constructed predictive model demonstrates good predictive performance and can serve as a reference for medical professionals to early identify high-risk patients and implement corresponding preventive measures to decrease the incidence of depressive symptoms in this population.

Multidisciplinary tumor board is associated with improved survival in patients with hepatocellular carcinoma after liver transplantation

BACKGROUND

Hepatocellular carcinoma (HCC) ranks as the sixth most common cancer and the third- leading cause of cancer-related deaths worldwide. The multidisciplinary tumor board (MDTB) has been recognized for improving outcomes in cancer management, but its role in patients with HCC undergoing liver transplantation (LT) remains underexplored.

AIM

To evaluate the impact of an MDTB on survival outcomes in patients with HCC undergoing LT.

METHODS

We retrospectively analyzed 393 patients with HCC who underwent LT at our institution from October 2015 to October 2021. Patients were categorized into the MDTB and non-MDTB groups. We compared preoperative and postoperative characteristics, overall survival (OS), and disease-free survival (DFS) between the two groups.

RESULTS

Within the University of California, San Francisco (UCSF) criteria, no significant differences in OS and DFS were noted between the MDTB and non-MDTB groups. However, for patients who exceeded the UCSF criteria, the MDTB group exhibited a substantial improvement in both OS and DFS. The 1-year, 3-year, and 5-year OS rates for the MDTB group in this subgroup were 88.68%, 75.29%, and 61.78%, respectively, compared to 83.02%, 64.07%, and 38.25%, respectively in the non-MDTB group. Similarly, DFS rates were 89.47%, 71.35%, and 63.52%, respectively, vs 82.18%, 53.78%, and 34.04%, respectively.

CONCLUSION

The MDTB approach was particularly beneficial for patients with HCC exceeding the UCSF criteria, significantly improving OS and DFS. These findings advocate for integrating MDTB into clinical practice for optimizing the management of high-risk patients with HCC undergoing LT.

Oxaliplatin-induced diffuse alveolar hemorrhage: A case report

BACKGROUND

Drug-induced lung injury is a common adverse effect of chemotherapeutic agents. Diffuse alveolar hemorrhage (DAH) is a fatal complication associated with drug-induced lung injury. Early diagnosis and treatment of DAH is critical, as delayed management can lead to respiratory failure and poor outcomes. However, the diagnosis of DAH is difficult because of the nonspecific clinical manifestations; as such, bronchoscopy is necessary to establish a diagnosis.

CASE SUMMARY

The patient presented with fever and dry cough. He had been receiving fluoropyrimidine and oxaliplatin therapy for esophageal squamous cell carcinoma. Chest imaging revealed diffuse ground-glass opacities. Bronchoscopy with bronchoalveolar lavage was performed, which confirmed the diagnosis of DAH. Although the patient’s respiratory status rapidly worsened, high-dose corticosteroid therapy with respiratory support gradually improved the patient’s condition and he was successfully extubated.

CONCLUSION

Prompt DAH diagnosis and bronchoscopy in patients receiving oxaliplatin-containing chemotherapy presenting with acute respiratory failure are critical for improving outcomes.

Downregulation of huntingtin-associated protein 1 predicts poor prognosis in gastric cancer

BACKGROUND

Highly expressed in the gastrointestinal mucosa, huntingtin-associated protein 1 (HAP1) is closely associated with tumor development and prognosis.

AIM

To investigate the clinical utility of HAP1 expression in gastric cancer (GC).

METHODS

We randomly selected 124 GC patients had not undergone preoperative radiotherapy or chemotherapy, they were diagnosed at the Central Hospital of Wuhan between May 2013 and October 2018. Immunohistochemistry was used to detect HAP1 expression in paraffin-embedded GC tissues, as well as metastatic lymph nodes. Their clinical data were collected and all participants were follow up for 5 years. Western blotting and quantitative polymerase chain reaction were used to detect HAP1 levels in 20 matched pairs of fresh GC tissues.

RESULTS

HAP1 protein and mRNA levels were lower in fresh GC tissues than in normal mucosal tissues (P < 0.001, respectively). Immunohistochemistry also revealed lower HAP1 expression in GC tissues and metastatic lymph nodes than in normal mucosal tissues (P < 0.05). HAP1 expression in GC was closely associated with differentiation, lymph node metastasis, lymph node ratio, remote metastasis, clinical stage, tumor location, and survival time (P < 0.05). Furthermore, HAP1 expression independently predicted GC (P < 0.05) and was more accurate in advanced GC than in early GC (P < 0.05).

CONCLUSION

HAP1 is an important prognostic biomarker for GC, with low HAP1 expression positively correlating with poor overall survival, especially in advanced clinical stages.

Combining anti-PD-1 antibodies with surufatinib for gastrointestinal neuroendocrine carcinoma: Two cases report and review of literature

BACKGROUND

Gastrointestinal neuroendocrine carcinoma (GI NEC) has a low incidence rate and poor prognosis. Most patients already have metastatic disease when they are diagnosed. Platinum chemotherapy is the main means of treating metastatic GI NECs. There is a lack of effective treatment methods after chemotherapy failure. Therefore, Therefore, selecting appropriate posterior-line treatment programs to improve the prognosis of patients is urgently needed.

CASE SUMMARY

A 64-year-old female was diagnosed with stage IV NEC of the rectum due to abdominal pain and rectal bleeding. After multiline chemotherapy, the condition progressed, and the patient was treated with a combination of camrelizumab and surufatinib. The efficacy evaluation revealed partial remission (PR) and stable conditions, with the expression of the tumor marker neuron-specific enolase (NSE) returning to normal. The adverse reactions were controllable, and the overall condition was good, with weight gain achieved in the past four years. Another 51-year-old female experienced recurrence and metastasis of a duodenal NEC after surgery. After multiline chemotherapy, she received sintilimab combined with surufatinib. The curative effect fluctuated between PR and stability. During treatment, she recovered from immune-related diabetes and later died due to deterioration of her condition. During the treatment, the patient’s NSE level returned to normal.

CONCLUSION

The combination of antiangiogenic targeted drugs and immunotherapy provides a new therapeutic approach for the treatment of metastatic GI-NECs.

Overview of serrated polyposis syndrome from pathophysiology, diagnosis, and management

This editorial discusses Thompson et al's original article, which is published in the most recent edition of the World Journal of Clinical Oncology and sheds critical light on the intertwined issues of health anxiety and work loss in individuals diagnosed with serrated polyposis syndrome (SPS). SPS is rare, characterized by the development of multiple serrated colorectal polyps. This editorial provides an overview of SPS, including its pathophysiology, clinical presentation, diagnostic criteria, management strategies, and the psychosocial impact. SPS is linked to molecular alterations, which drive carcinogenesis. Colonoscopy and histological analysis are used for diagnosis. Genetic testing is also considered where there is a family history. Quality of life can be greatly impacted by the psychosocial effects of SPS, especially health anxiety. Further understanding of the molecular mechanisms and creating individualized surveillance are required.

Emerging salivary biomarkers for early detection of oral squamous cell carcinoma

Oral cancer, particularly oral squamous cell carcinoma (OSCC), remains a leading cause of cancer-related morbidity and mortality, with delayed diagnosis being a major contributing factor. Although salivary biomarkers have been explored for over three decades, the need for reliable, non-invasive diagnostic methods that enable early detection and continuous monitoring of OSCC remains unmet. This review aims to provide an updated overview of the latest advancements in salivary biomarker research, focusing on emerging biomarkers such as interleukin-6, interleukin-8, microRNAs and DNA methylation patterns, as well as metabolites and microbiota, all of which show significant promise for early OSCC detection. In addition to discussing well-established biomarkers, we explore recent technological developments that increase the sensitivity and specificity of these biomarkers, such as mass spectrometry, multiplex assays, and nanobiosensors. These developments are complemented by the integration of artificial intelligence for data analysis, which enables more accurate, point-of-care diagnostics that could revolutionize oral cancer screening. This review not only consolidates current knowledge but also addresses the challenges that hinder the widespread clinical adoption of salivary diagnostics, such as saliva variability and assay standardization. By overcoming these barriers, salivary biomarker-based diagnostics have the potential to transform OSCC detection, offering a non-invasive, cost-effective solution that can improve early diagnosis and patient outcomes.

Cytochrome P450 3A gene family in gastric cancer: Unveiling diagnostic biomarkers and therapeutic targets for personalized treatment

The cytochrome P450 3A (CYP3A) gene family’s role in early progression of gastric cancer was comprehensively investigated. Its potential as a therapeutic target was evaluated. Upon literature review, aberrant expression of the CYP3A gene family has a strong correlation with gastric cancer onset, although the precise underlying mechanisms remain unclear. To assess its potential as a biomarker for early diagnosis and a therapeutic target, we have provided a comprehensive review of the regulatory mechanisms governing CYP3A gene family expression in gastric cancer, as well as its relation with early tumor progression and the tumor microenvironment. The CYP3A gene family is crucial in the proliferation, migration, and invasion of gastric cancer cells and promotes cancer progression by modulating inflammatory responses and oxidative stress within the tumor microenvironment. Furthermore, genetic polymorphisms in CYP3Aenzymes highlight its potential value in personalized medicine. Based on these findings, this paper explores the feasibility of developing inhibitors and activators targeting CYP3A enzymes and discusses potential applications in gene therapy. This research provides crucial theoretical support for the CYP3A gene family as an early diagnostic marker and therapeutic target for gastric cancer. In the future, multi-omics studies and large-scale clinical trials will be essential to advance clinical translation of these findings.

Candida albicans and colorectal cancer: A paradoxical role revealed through metabolite profiling and prognostic modeling

BACKGROUND

Emerging evidence implicates Candida albicans (C. albicans) in human oncogenesis. Notably, studies have supported its involvement in regulating outcomes in colorectal cancer (CRC). This study investigated the paradoxical role of C. albicans in CRC, aiming to determine whether it promotes or suppresses tumor development, with a focus on the mechanistic basis linked to its metabolic profile.

AIM

To investigate the dual role of C. albicans in the development and progression of CRC through metabolite profiling and to establish a prognostic model that integrates the microbial and metabolic interactions in CRC, providing insights into potential therapeutic strategies and clinical outcomes.

METHODS

A prognostic model integrating C. albicans with CRC was developed, incorporating enrichment analysis, immune infiltration profiling, survival analysis, Mendelian randomization, single-cell sequencing, and spatial transcriptomics. The effects of the C. albicans metabolite mixture on CRC cells were subsequently validated in vitro. The primary metabolite composition was characterized using liquid chromatography-mass spectrometry.

RESULTS

A prognostic model based on five specific mRNA markers, EHD4, LIME1, GADD45B, TIMP1, and FDFT1, was established. The C. albicans metabolite mixture significantly reduced CRC cell viability. Post-treatment analysis revealed a significant decrease in gene expression in HT29 cells, while the expression levels of TIMP1, EHD4, and GADD45B were significantly elevated in HCT116 cells. Conversely, LIME1 expression and that of other CRC cell lines showed reductions. In normal colonic epithelial cells (NCM460), GADD45B, TIMP1, and FDFT1 expression levels were significantly increased, while LIME1 and EHD4 levels were markedly reduced. Following metabolite treatment, the invasive and migratory capabilities of NCM460, HT29, and HCT116 cells were reduced. Quantitative analysis of extracellular ATP post-treatment showed a significant elevation (P < 0.01). The C. albicans metabolite mixture had no effect on reactive oxygen species accumulation in CRC cells but led to a reduction in mitochondrial membrane potential, increased intracellular lipid peroxidation, and induced apoptosis. Metabolomic profiling revealed significant alterations, with 516 metabolites upregulated and 531 downregulated.

CONCLUSION

This study introduced a novel prognostic model for CRC risk assessment. The findings suggested that the C. albicans metabolite mixture exerted an inhibitory effect on CRC initiation.

Checkpoint kinase 1 as a promising target in colorectal cancer management

This editorial provides insights into the pivotal role of checkpoint kinase 1 (CHEK1) as both a biomarker and therapeutic target in colorectal cancer (CRC), based on findings from a recent study by Pang et al. Using single-cell RNA sequencing and immunohistochemistry, the study demonstrates significant CHEK1 overexpression in CRC tissues and identifies nitidine chloride as a potent CHEK1 inhibitor that disrupts DNA damage repair pathways. These findings underscore the therapeutic potential of CHEK1 inhibition and highlight the need for further research to address gaps in CRC treatment.