Cancer statistics in China and United States, 2022: profiles, trends, and determinants

Knowledge, attitude, and practice (KAP) towards pulmonary nodules among Chinese adults: a mediation analysis

The management of pulmonary nodules involves self-management. This study, conducted in China between September and October 2022, explored the knowledge, attitude, and practice (KAP) towards pulmonary nodules among Chinese adults. The participants were enrolled through convenience sampling when they visited the hospital. The KAP questionnaire was developed by the investigators. Participants who received scores of ≥ 75% of the total score for each dimension were defined as good or positive, 50-75% as moderate, and ≤ 50% as poor or negative. A total of 1209 participants, with an average age of 38.7 years, completed a self-administered online questionnaire. The knowledge, attitude, and practice scores were 5.95 ± 3.54/12, 29.05 ± 4.04/40, and 23.72 ± 6.08/45, respectively, indicating poor knowledge, moderate attitude, and moderate practice regarding pulmonary nodules. The multivariable analyses showed significant associations among knowledge, attitudes, and practice. The mediation analysis indicated that knowledge, education, income, smoking habits, and awareness of pulmonary nodules influenced participants' practices. In conclusion, a significant population of adults in China had inadequate knowledge, attitude, and practice towards pulmonary nodules. Sufficient knowledge was associated with appropriate practices toward pulmonary nodules. Therefore, health education programs aimed at improving knowledge about pulmonary nodules may be helpful for encouraging appropriate attitudes and maintaining healthy practices.

Family Sense of Coherence, Dyadic Coping, and Quality of Life in Young and Middle-Aged Patients With Advanced Lung Cancer and Spousal Caregivers: An Actor-Partner Interdependence Mediation Model

BACKGROUND

Cancer is now recognized as a dyadic stress that seriously impacts the mental and physical well-being of both patients and their spousal caregivers (SCs). Analyzing from a dyadic perspective whether and how dyadic coping and family sense of coherence (FSOC) affect the quality of life (QOL) of couples is crucial.

OBJECTIVE

To investigate the dyadic association between FSOC, dyadic coping, and QOL in young and middle-aged couples facing advanced lung cancer and to evaluate the mediating role of dyadic coping from a dyadic perspective.

METHODS

From October 2023 to April 2024, 202 dyads were recruited from 2 tertiary care hospitals in Tianjin, China. The participants' measurement indicators were evaluated using corresponding questionnaires. The procedure for dyadic analysis was based on the Actor-Partner Interdependence Mediation Model.

RESULTS

The actor effect of FSOC on the QOL was mediated by the dyadic coping of patients (β = .100; 95% confidence interval [CI], 0.053-0.155; P = .001) and SCs (β = .124; 95% CI, 0.059-0.193; P = .002). The partner effect suggested that patients' QOL may be indirectly impacted by SCs' FSOC through patients' dyadic coping (β = .078; 95% CI, 0.038-0.127; P = .004).

CONCLUSIONS

The QOL, dyadic coping, and FSOC of young and middle-aged couples facing advanced lung cancer were dyadically interdependent. To enhance couples' QOL, strategies for intervention must be developed.

IMPLICATIONS FOR PRACTICE

This study offered a novel viewpoint on the relationship between QOL, dyadic coping, and FSOC and provided a theoretical foundation for the creation of dyadic intervention strategies meant to enhance cancer couples' QOL.

A nomogram for predicting overall survival in patients with gastric cancer based on tumor suppressor RCAN1.4 expression and clinical risk factors

Gastric cancer (GC) is one of the most prevalent malignant tumors in the world and has an extremely poor prognosis. Regulator of calcineurin 1 (RCAN1), a known tumor suppressor in various cancers, has an undefined role in the proliferation and metastasis of GC. Primary tumor and paired normal gastric tissues were collected from 77 patients with GC for evaluating the mRNA levels of 3 RCAN1 transcripts. Kaplan-Meier survival curves and Cox regression analysis were used to assess the prognostic value of 3 RCAN1 transcripts, and to select variables for nomogram. The mRNA levels of RCAN1 isoform 1 (RCAN1.1, P = .0312) and isoform 2 (RCAN1.2, P = .007) were significantly diminished in GC tissues compared with normal tissues, whereas isoform 4 (RCAN1.4) expression level showed no significant differences. GC patients with lower RCAN1.4 mRNA levels had shorter overall survival time than patients whose tumors had high RCAN1.4 levels (P = .04). Downregulated expression of RCAN1.4 was found to be an independent prognostic factor of overall survival in GC patients, with a hazard ratio of 2.485 and a significant P-value of .023 in multivariate Cox analysis. The concordance index of nomogram to predict overall survival was 0.788, based on RCAN1.4 level, tumor stage and lymph node metastasis status. In conclusion, our findings suggest that RCAN1.4 is a novel prognostic marker for gastric cancer, targeting RCAN1.4 may provide a promising therapeutic strategy in GC management.

Inhibitory effects of circR-127aa on gastric cancer progression and tumor growth

This study investigates the function of a newly identified 127-amino acid peptide, circR-127aa, encoded by hsa_circ_0075402 (circRACK1), in gastric cancer (GC), a condition with significant prevalence in China. Utilizing a comprehensive analysis of circular RNA (circRNA) ribosome profiling data alongside experimental validations through mass spectrometry, Western blot, and immunofluorescence, we demonstrate that circR-127aa Inhibits Malignant Phenotypes and suppresses tumor growth in nude mice models. Significantly, the interaction of circR-127aa with Vimentin, a crucial element in actin-actin-cytoskeletal remodeling, indicates that circR-127aa functions as a tumor suppressor by facilitating the ubiquitination of Vimentin. These findings advance our comprehension of gastric cancer (GC) progression and propose circR-127aa as a promising therapeutic target and biomarker in the management of GC.

PDK1 promotes epithelial ovarian cancer progression by upregulating BGN

Pyruvate dehydrogenase kinase 1 (PDK1) is a new therapeutic target that is dysregulated in multiple tumors. This study aims to explore the potential role and regulatory mechanism of PDK1 in epithelial ovarian cancer (EOC). We detect PDK1 expression in EOC tissues and cells using qRT-PCR and western blot analysis, and the effects of PDK1 on EOC cell malignant behaviors are explored. RNA sequencing analyses are performed to explore the differentially expressed genes in PDK1-silenced EOC cells. Furthermore, tumor-bearing mouse models are established to assess the impacts of PDK1 and BGN on EOC tumor growth and metastasis in vivo. The results show that PDK1 is upregulated in EOC tissues and cell lines. Biglycan (BGN) is downregulated in PDK1-silenced EOC cells, and its expression is positively correlated with PDK1 levels in EOC tissues. PDK1 depletion inhibits EOC cell proliferation, migration and invasion. Mechanistically, PDK1 and BGN are colocalized in the cytoplasm of EOC cells and interact with each other. PDK1 positively regulates BGN expression by enhancing BGN mRNA stability. BGN overexpression partially reverses the anti-tumor effects of PDK1 depletion on EOC cell malignant behaviors. PDK1 has also been revealed to upregulate BGN to activate the NF-κB oncogenic pathway in EOC cells. Additionally, PDK1 accelerates tumor growth and metastasis by modulating BGN expression. In conclusion, PDK1 functions as an oncogene, facilitating EOC progression by upregulating BGN and activating the NF-κB pathway. These findings may provide valuable biomarkers for the diagnosis and treatment of EOC.

Holliday junction recognition protein (HJURP) could reflect the clinical outcomes of lung adenocarcinoma patients, and impact the choice of precision therapy

Background

Lung adenocarcinoma (LUAD) is the most prevalent subtype of non-small cell lung cancer (NSCLC), characterized by poor prognosis and a high mortality rate. Identifying reliable prognostic biomarkers and potential therapeutic targets is crucial for improving patient outcomes.

Methods

We conducted a comprehensive analysis of HJURP expression in LUAD using data from four cohorts: TCGA-LUAD (n = 453), GSE31210 (n = 226), GSE68465 (n = 442), and GSE72094 (n = 386). Univariate Cox regression analysis was employed to identify prognostic genes, with Kaplan-Meier survival analysis used to assess the predictive power of HJURP. Functional enrichment analyses were performed using MetaScape and FGSEA, and spatial transcriptomics and single-cell sequencing data were analyzed to explore HJURP's distribution and potential functions. Additionally, correlations between HJURP expression and genetic alterations, immune cell infiltration, and potential therapeutic responses were evaluated.

Results

HJURP was identified as a significant prognostic biomarker in all four cohorts, with high expression associated with increased risk of overall survival (OS) death (TCGA-LUAD: HR = 1.93, 95% CI: 1.321-2.815, P < 0.001; GSE31210: HR = 2.75, 95% CI: 1.319-5.735, P = 0.007; GSE68465: HR = 1.57, 95% CI: 1.215-2.038, P < 0.001; GSE72094: HR = 2.2, 95% CI: 1.485-3.27, P < 0.001). Functional analyses indicated that HJURP is involved in DNA metabolic processes, cell cycle regulation, and mitotic processes, with significant activation of pathways related to MYC targets, G2M checkpoint, and DNA repair. High HJURP expression was associated with higher mutation frequencies in TP53, CSMD3, TTN, and MUC16, and positively correlated with pro-inflammatory immune cell infiltration and several immune checkpoints, including PD-L1 and PD-L2. Chemotherapeutic agents such as gefitinib and sorafenib were predicted to be effective against high HJURP-expressing tumors.

Conclusion

HJURP is a pivotal biomarker for LUAD, consistently associated with poor prognosis and advanced disease stages. Its high expression correlates with specific genetic alterations and immune profiles, highlighting its potential as a therapeutic target. Future studies should validate these findings in larger cohorts.

Association of low-carbohydrate diet score and carbohydrate quality index with colorectal cancer risk: a large-scale case-control study

PURPOSE

Carbohydrate intake has been linked to colorectal cancer (CRC) risk, with variations depending on the quantity and quality of carbohydrates consumed. This study aimed to investigate the association between carbohydrate quantity and quality, using the low-carbohydrate diet score (LCD) and carbohydrate quality index (CQI), and the risk of CRC in the Chinese population.

METHODS

We conducted a case-control study in Guangzhou, China, with 2,799 CRC cases and an equal number of sex- and age-matched controls. Dietary data were collected using a validated food frequency questionnaire to derive the LCD and CQI, assessing the quantity and quality of carbohydrate intake separately. Odds ratios (OR) and 95% confidence interval (CI) for CRC risk were estimated using unconditional logistic regression models, and restricted cubic splines were used to explore potential non-linear relationships.

RESULTS

The results demonstrated that higher adherence to the overall LCD score, plant-based LCD score, and CQI was associated with a lower risk of CRC. The adjusted ORs (95%CIs) for the highest quintile of intake in comparison with the lowest quintile were 0.76 (0.63, 0.91) for the overall LCD score, 0.61 (0.50, 0.74) for the plant-based LCD score, and 0.70 (0.58,0.84) for the CQI, respectively. However, the animal-based LCD did not show a significant association with CRC risk, with the adjusted OR (95%CI) for the highest quintile compared to the lowest being 0.98 (0.81, 1.18). Restricted cubic splines analysis showed non-linear associations of the overall LCD score, animal-based LCD score, and plant-based LCD score with CRC risk. In contrast, a linear relationship was observed between CQI and CRC risk (Pnonlinear = 0.594).

CONCLUSIONS

Our findings indicate that the overall LCD score, the plant-based LCD score, and the CQI were inversely associated with the risk of CRC.

Investigating the Role of C-Reactive Protein/Albumin Ratio in the Preliminary Diagnosis of Patients With Unexplained Neck Lymphadenopathy

Purpose: Lymphadenopathies in the neck are associated with several etiological factors, such as inflammation, infection, and tumors. We diagnose some of these lymphadenopathies using serologic tests, while others are diagnosed using biopsies. The C-reactive protein/albumin ratio (CAR) has recently emerged as a crucial inflammatory marker in cardiovascular diseases and various types of cancer. Our aim in this study was to investigate the role of the CAR in the preliminary diagnosis of patients with unexplained neck lymphadenopathy. Methods: Between 2013 and 2020, 223 patients presented to our clinic with neck lymphadenopathy. Among these patients, whose cause of lymphadenopathy was not identified, 74 patients (8 children, 66 adults) who underwent neck lymphadenopathy excision were included in the study. Patients were divided into 4 groups according to pathology results: (1) patients with reactive lymphoid hyperplasia; (2) patients with granulomatous disease; (3) patients with lymphoma; and (4) patients with metastatic disease. C-reactive protein (CRP), albumin, and CAR values were compared. Results: When the CAR of the patients were compared, a significant difference was found between reactive lymphoid hyperplasia and lymphomas (P = .006). CRP values were significantly higher in lymphomas than in lymphoid hyperplasia (P = .007). When the albumin values of the patients were compared, it was found that the albumin value was significantly lower in patients with metastatic disease than in those with reactive lymphoid hyperplasia (P = .032). Patients with carcinoma metastases were more common in male patients than in other groups. Conclusion: The CAR is a parameter that can be used in the preliminary diagnosis of unexplained neck lymphadenopathy. The elevation should be evaluated in favor of malignancy. It can be used as an auxiliary parameter, particularly in the diagnosis between the preliminary diagnosis of reactive lymphoid hyperplasia and lymphoma.

A comprehensive nomogram for assessing the prognosis of non-small cell lung cancer patients receiving immunotherapy: a prospective cohort study in China

Objective

In China, lung cancer ranks first in both incidence and mortality among all malignant tumors. Non-small cell lung cancer (NSCLC) constitutes the vast majority of cases, accounting for 80% to 85% of cases. Immune checkpoint inhibitors (ICIs), either as monotherapies or combined with other treatments, have become the standard first-line therapy for NSCLC patients. This study aimed to establish a nomogram model for NSCLC patients receiving immunotherapy incorporating demographic information, clinical characteristics, and laboratory indicators.

Methods

From January 1, 2019, to December 31, 2022, a prospective longitudinal cohort study involving 1321 patients with NSCLC undergoing immunotherapy was conducted at Chongqing University Cancer Hospital. Clinical and pathological characteristics, as well as follow-up data, were collected and analyzed. To explore prognostic factors affecting overall survival (OS), a Cox regression model was used to test the significance of various variables. Independent prognostic indicators were identified through multivariate analysis and then used to construct a nomogram prediction model. To validate the accuracy and practicality of this model, the concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) were used to assess the predictive performance of the nomogram.

Result

In the final model, 11 variables from the training cohort were identified as independent risk factors for patients with NSCLC: age, KPS score, BMI, diabetes, targeted therapy, Hb, WBC, LDH, CRP, PLR, and LMR. The C-index for OS in the training cohort was 0.717 (95% CI, 0.689-0.745) and 0.704 (95% CI, 0.660-0.750) in the validation cohort. Calibration curves for survival probability showed good concordance between the nomogram predictions and actual observations. The AUCs for 1-year, 2-year, and 3-year OS in the training cohort were 0.724, 0.764, and 0.79, respectively, and 0.725, 0.736, and 0.818 in the validation cohort. DCA demonstrated that the nomogram model had a greater overall net benefit.

Conclusion

A prognostic model for OS in NSCLC patients receiving immunotherapy was established, providing a simple and reliable tool for predicting patient survival (https://icisnsclc.shinyapps.io/DynNomapp/). This model offers valuable guidance for clinicians in making treatment decisions and recommendations.

Correlation between benefit finding and caregiving abilities among family caregivers of patients with lung cancer: a network analysis

Objective

This study aimed to construct a network analysis model for benefit finding (BF) and caregiving abilities to clarify the interrelationships and mutual influences among different dimensions and propose nursing strategies.

Methods

Convenience sampling was used to select 272 family caregivers of patients with lung cancer admitted to a tertiary hospital in Guangzhou City, China, from April 2023 to November 2023. Socio-demographic and disease characteristics questionnaire, the revised BF Scale, and the Family Caregiver Task Inventory (FCTI) were used for data collection. The R software was used to construct networks for BF and caregiving abilities, and network analysis methods were employed to identify network characteristics, core nodes, and bridge nodes.

Results

In the overall network, the social relationship dimension (rs = 3.04) exhibited the highest strength centrality index, followed by the family relationship dimension (rs = 2.94). In addition, the social relationship dimension (rbs = 0.30) had the highest bridge strength centrality index, followed by the dimension of addressing personal emotional needs (rbs = 0.26).

Conclusion

This study provides a new perspective on exploring the underlying mechanisms of interaction among different dimensions of BF and caregiving abilities in family caregivers of patients with lung cancer using network analysis. The findings suggest that healthcare professionals can improve family caregivers' social relationships, family relationships and address emotion regulation to enhance BF and caregiving abilities. Specific nursing strategies are proposed, offering new intervention targets for enhancing BF and caregiving abilities among family caregivers of patients with lung cancer.

Differences in the epidemiology and survival of patients with colorectal cancer between China and the United States: a large cross-sectional study

Studying the epidemiological and management characteristics of colorectal cancer (CRC) between China and the US has important implications. The present cross-sectional study included patients from SEER and Southwest China Colorectal (SCC) databases. Incidence, treatment and survival information were compared between two countries. 86859 patients in the SEER database and 5838 patients in the SCC database were included. The estimated incidence of CRC in the US was greater than that in China from 2006 to 2019. The most common tumor sites of CRC patients in China were the RSC (66.5%), RCC (20.2%) and LCC (13.3%), while those in the US were the RCC (44.4%), RSC (29.8%) and LCC (25.8%). Chinese CRC patients were more likely to be male (58.9% vs 52.4%, p < 0.001), have a greater stage II CRC rate (49.8% vs 27.8%, p < 0.001), younger age at diagnosis (median 64 vs 66 years, p < 0.001). Radical surgery rates were lower in Chinese RCC (92.3% vs 93.9%, p < 0.001) and LCC (88.9% vs 92.0%, p < 0.001) patients. The adjuvant therapy rates were lower in Chinese CRC patients. The 5-year overall survival rates were 71.8% and 78.2% for Chinese and US CRC patients, respectively (p < 0.001). China is undergoing an increasing incidence of CRC. The treatment and mortality of CRC differ in China and US populations. China had a lower adjuvant therapy rate and a lower 5-year OS rate compared with the US.

Efficacy and safety of RET-TKI in advanced RET-rearranged non-small cell lung cancer in China: a real-world retrospective chart review

BACKGROUND

Selective RET inhibitors have been approved by the Chinese government for the treatment of RET-rearranged non-small cell lung cancer. This study aimed to illustrate the efficacy and safety of selective RET inhibitors in a real-world clinical context in China.

METHODS

Patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring RET rearrangement and receiving RET tyrosine kinase inhibitors (RET-TKI) in the real world were enrolled in this retrospective study. Clinical data, including baseline clinicopathological information, efficacy parameters such as objective response rate (ORR) and progression-free survival (PFS), and adverse events (AEs), were collected from the electronic medical record system. The pattern of treatment failure of first-line RET-TKI was also described.

RESULTS

Fifty-one patients were enrolled in this study. RET-TKI induced an ORR of 73.1% and a median PFS (mPFS) of 22.7 months (95%CI, 11.7-33.7) in the first-line setting. The ORR and mPFS were 58.3% and 17.7 months (95%CI, 9.1-26.2), 55.6% and 14.7 months (95%CI, 12.6-16.8) in the second-line and later-line settings, respectively. No significant difference was observed among different application lines with respect to the ORR (P = 0.534) or PFS (P = 0.795). In the first-line setting, RET-TKI significantly prolonged PFS compared to other regimens including chemotherapy-based regimens, multikinase inhibitors and other systemic regimens without chemotherapy (P < 0.05). Poor ECOG performance status was related to shorter PFS (P = 0.018). The most common AEs of grade 3 or worse were a decreased neutrophil count (11.4%) and anemia (11.4%). No new AEs or grade 5 AEs were observed. Brain metastasis was one of the most common patterns of treatment failure. In patients with baseline brain metastasis, the intracranial ORR was 50%, and the DCR was 100%.

CONCLUSIONS

RET-TKI had favorable efficacy and safety in real-world contexts in China and should be considered the preferred choice for first-line treatment in RET-rearranged NSCLC patients.

Effects of a couple-based self-efficacy intervention on health outcomes among colorectal cancer patients and spousal caregivers: A randomized controlled trial

PURPOSE

This study aimed to assess the feasibility and acceptability of a couple-based self-efficacy (SE) intervention, and to examine the effects of the intervention on health outcomes for CRC couples.

METHODS

An assessor-blinded, two-armed, randomized controlled design was used. The study randomly assigned 144 patients hospitalized for colorectal cancer to receive either the SE intervention or the usual care. SE was the primary outcome. The secondary outcomes included quality of life and mental health (positive emotions and negative emotions). Repeated measures analysis of variance was used to examine the data.

RESULTS

The recruitment and retention rates were 80% and 87.5%, respectively. First, we found that patients scored significantly higher on anxiety (p = 0.001), depression (p = 0.001) and benefit findings (p = 0.009) than did spousal caregivers, whereas spousal caregivers scored significantly higher than patients on the quality of life (p < 0.001 for both physical scores and mental scores) in the SE group. Second, immediately after the intervention, the SE group showed statistically significant improvements were found in SE (p < 0.001 for both couples), quality of life (mental scores) (p = 0.002 for spousal caregivers), negative emotion (anxiety, p < 0.05 for both couples; depression, p = 0.03 for patients), and positive emotion (benefit findings) (p < 0.001 for both couple) when compared to the control group.

CONCLUSION

A couple-based SE intervention significantly improved SE, quality of life (mental scores), and psychological well-being, suggesting a short-term intervention effect.

Risk factors of the low anterior resection syndrome (LARS) after ileostomy reversal in rectal cancer patient

This study is aimed at identifying risk factors of Low Anterior Resection Syndrome following ileostomy reversal in rectal cancer patients who had undergone preventive ileostomy. This retrospective analysis was conducted on a cohort of 605 patients treated at the Fourth Hospital of Hebei Medical University between January 2018 and December 2021. These patients were grouped based on LARS score, and Clinical and follow-up data were collected to conduct univariate analyses of potential factors influencing LARS occurrence based on variable type. Variables with statistical significance were included in a logistic regression model to analyze potential influences on the occurrence of LARS. Univariate and Multivariate logistic regression analysis showed that N2 stage (OR = 2.290 95%CI: 1.076-4.873, P = 0.031), chemoradiotherapy (OR = 2.271, 95%CI: 1.246-4.138, P = 0.007), and anastomosis height (OR = 0.836, 95%CI: 0.717-0.975, P = 0.022) were independent influences on the occurrence of LARS. In model 3 (adjusting for all covariates), the relationship between anastomotic height and patient LARS status showed a negative correlation. In subgroup analyses, there were significant differences in the effect of anastomotic height on LARS in subgroups with different hemoglobin concentrations. A high occurrence rate of LARS is observed in rectal cancer patients with preventive ileostomy reversal. N2 stage, history of chemoradiotherapy, and anastomotic height are independent influence factors for the occurrence of major LARS after ileostomy reversal.

Influence of impaired glucose tolerance and type 2 diabetes on the multimorbidity cluster of cardiovascular disease and cancer: a post hoc analysis of the Da Qing Diabetes Prevention Outcome Study

BACKGROUND

This study explored the influence of type 2 diabetes and impaired glucose tolerance (IGT) on the risk of the multimorbidity cluster of cardiovascular disease (CVD) and cancer.

METHODS

A total of 1629 participants in the Da Qing Diabetes Prevention Outcome Study were recruited in the present analysis, including normal glucose tolerance (NGT, N = 492), IGT (N = 540), and newly diagnosed type 2 diabetes (N = 597) groups. Cox proportional hazards analyses were performed to assess the relationship between NGT, IGT, and newly diagnosed type 2 diabetes and the risk of the multimorbidity cluster of CVD and cancer.

RESULTS

The incidence rates for multimorbidity cluster CVD and cancer were 1.25, 3.17, and 3.23 per 1000 person-years in people with NGT, IGT, and the newly diagnosed type 2 diabetes groups, respectively, over 34-year follow-up. Cox analysis revealed that diabetes status (as time-dependent variable) was significantly associated with the subsequent increased risk of multimorbidity cluster of CVD and cancer compared with non-diabetes (hazard ratios [HR] = 2.55, 95% confidence interval [CI] 1.51-4.31) after adjustment of potential confounders. Similar analysis showed that this risk was significantly higher in the IGT and newly diagnosed type 2 diabetes groups compared with NGT, with HR of 3.28 (95% CI 1.83-5.87) and HR of 3.90 (95% CI 2.14-7.09), respectively. Whereas compared diabetes with IGT group, this risk was not significantly different.

CONCLUSIONS

Similar to newly diagnosed type 2 diabetes, IGT is significantly associated with an increased risk of the multimorbidity cluster of CVD and cancer compared with NGT. This finding highlights the urgent need for an active detection of IGT and effective prevention and management of diabetes.

Hesperidin：a citrus plant component, plays a role in the central nervous system

Hesperidin is a kind of flavonoids, which has the biological activities of antioxidation, anti-inflammation, antibacterial, anti-virus, anti-allergy, anti-cancer, heart protection and neuroprotection. More and more studies have begun to pay attention to the therapeutic prospect of hesperidin in central nervous system (CNS) diseases. This paper describes its current role in the treatment of central nervous system diseases, especially stroke, and discusses its bioavailability, so as to provide a theoretical basis for the clinical application of hesperidin.

Stress responses, social support and death care experience among spouse caregivers of young and middle-aged patients with terminal cancer: a mixed-methods analysis

Background

Faced with cancer patients in the near-death stage, spousal caregivers may experience a series of stress reactions and have a high risk of suffering from physical and psychological problems. Good social support can help alleviate stressful reactions.

Objectives

To investigate stress responses and social support among spouse caregivers of young and middle-aged patients with terminal cancer in the near-death stage, and to explore the death care experience of spouse caregivers.

Methods

A prospective mixed-methods study was conducted. Questionnaires of stress response questionnaire and social support rating scale were used to investigate stress responses and social support of spouse caregivers. And semi-structured interviews were conducted to explore the death care experience of spouse caregivers in at a university-affiliated hospital in China.

Results

Spouse caregivers with higher social support scores were significantly more likely to have poor stress response. Meanwhile, whether the spouses had alternative care for other dependents, the number of venous pathways and instruments in/on the patient's body significantly affected the spousal stress response. Among them, spousal social support was the best influencing factor to predict spousal stress response. Four qualitative themes of the death care experience were identified. Theme 1: Psychological feelings of spouses caregivers when they care for the patients' physical function. Theme 2: Psychological feelings of spouse caregivers when they communicated with the patients. Theme 3: Psychological feelings of spouses caregivers when they will being widowed soon. Theme 4: The focus of life shift, and life concept change.

Conclusion

Overall, spousal stress response was statistically affected by alternative caregivers for spouses, spousal social support, and the number of venous pathways and instruments in/on the patient's body. Among that, social support was the best influencing factor to predict the stress response. Meanwhile, spousal caregivers was distressed and felt deeply fear, wronged and helpless deep and when facing the patients' dying symptoms and communicating with patient, and reflected on the essence of life, and changing the concept of life.

Implications for practice

Medical staff should pay special attention to spousal caregivers' physical discomfort and improve spousal social support, and provide targeted information and assistance to decrease spousal stress response in the near-death stage of cancer patients.

Effects of Baduanjin exercise on cancer-related fatigue in patients with prostate cancer treated with androgen deprivation therapy in Shanghai, China: a study protocol for a randomised controlled trial

INTRODUCTION

Cancer-related fatigue (CRF) is one of the most common and painful symptoms in patients with prostate cancer (PCa). Moreover, PCa patients who receive the androgen deprivation therapy (ADT) are more likely to develop CRF. Baduanjin exercise has been shown to improve CRF in some cancers. However, such effects have not been verified in patients with PCa treated with the ADT. So, this study was designed as a randomised controlled trial (RCT) to explore the effects of Baduanjin exercise on CRF in PCa patients treated with the ADT.

METHODS AND ANALYSIS

This study will be a single-centre, assessor and statistician blinded, RCT consisting of a 12 week intervention and 12 week follow-up. Patients with PCa who meet the inclusion criteria will be recruited from Shanghai Hudong Hospital. Participants will be randomly assigned to Baduanjin exercise group (n=42) and the control group (n=42), performing 12 weeks of Baduanjin exercise or reeiving the standard care. The primary outcome will be the clinical effect of Baduanjin exercise on CRF in PCa patients, which will be measured using the Piper Fatigue Self-Assessment (PFS) scale, a multidimensional measure of CRF using three different dimensions: somatic, emotional and cognitive. The secondary outcome will be the clinical effect of the Baduanjin exercise on the patient's level of fatigue, sleep, depression and life quality at the time, which will be assessed by the Brief Fatigue Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory (BDI) and the Functional Assessment of Cancer Therapy-Prostate (FACT-P).

ETHICS AND DISSEMINATION

This study has been approved by Shanghai Hudong Hospital Ethics Committee, Shanghai province (2022 SHHDKY08). The trial results will be submitted to conferences and peer-reviewed journals.

TRAIL REGISTRATION NUMBER

ChiCTR2300074293.

Tumor-Derived Extracellular Vesicles Enable Tumor Tropism Chemo-Genetherapy for Local Immune Activation in Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is highly heterogeneous, lacks accessible therapeutic targets, and features an immunosuppressive tumor microenvironment (TME). Anthracycline-based chemotherapy remains the primary treatment method for TNBC, while the current popular immune checkpoint inhibitors persistently encounter therapeutic resistance. Therefore, there is an urgent need to explore combined therapeutic strategies to remodel the TME and improve the treatment response. Considering the highly specific homing ability of tumor cell-derived vesicles and the key role of the signal transduction and activation of the transcription factor 3 (STAT3) pathway in TNBC, we propose a synergistic therapeutic strategy that integrates gene therapy, chemotherapy, and immunotherapy based on STAT3 short interfering RNA (siSTAT3) and doxorubicin (DOX)-functionalized tumor-derived extracellular vesicles (TEVs) (siSTAT3-DOX@TEV). The in vitro and in vivo results demonstrate that siSTAT3-DOX@TEV target tumor tissues precisely, downregulate STAT3 expression, and synergistically and efficiently induce immunogenic death, thereby reversing the immunosuppressive TME. Moreover, mass cytometry and immunohistochemistry reveal the local immune activation effect of siSTAT3-DOX@TEV, with a significant increase in M1 macrophages, CD4+ T cells, and CD8+ T cells in tumor tissues. These results provide strong hints for the development of TEV-based chemo-gene therapeutic agents for TNBC treatment at the clinical level.

Netupitant Inhibits the Proliferation of Breast Cancer Cells by Targeting AGK

Background: Currently, there is a significant lack of effective pharmacological agents for the treatment of breast cancer. Acylglycerol Kinase (AGK), a lipid kinase, has been found to be aberrantly expressed in breast cancer and is closely associated with tumor proliferation, migration, and invasion. However, no clinical anti-tumor drugs specifically targeting this kinase have been developed. Methods: siRNA was utilized to knock down the AGK gene; CCK8 and colony formation assays were employed to evaluate the in vitro proliferative capacity of tumor cells. Molecular dynamics simulations and BIL assays were conducted to analyze drug binding affinity. Annexin V/PI staining was used to assess apoptotic phenomena; subcutaneous xenograft tumor experiments in nude mice were performed to confirm the in vivo anti-tumor efficacy of the drug. Results: Netupitant exhibited stable binding affinity for AGK and interacted with amino acids within the ATP-binding region of the enzyme. The IC50 values for the SK-BR-3 and MDA-MB-231 cell lines were determined as 16.15 ± 4.25 µmol/L and 24.02 ± 4.19 µmol/L, respectively; at a concentration of 2.5 µmol/L, Netupitant effectively inhibited clonogenic capacity in breast cancer cells; furthermore, treatment with 10 µmol/L significantly induced apoptosis in these cells. Doses of 50 mg/kg and 100 mg/kg Netupitant markedly suppressed growth rates of subcutaneous xenograft tumors in nude mice while also promoting apoptotic processes. Both in vivo and in vitro studies indicated that Netupitant could inhibit the activation of the PI3K/AKT/mTOR signaling pathway. Conclusions: By targeting AGK, Netupitant inhibits its kinase activity, which leads to reduced phosphorylation levels of PTEN, thereby suppressing the activation of the PI3K/AKT/mTOR signaling pathway and ultimately resulting in apoptosis in breast cancer cells.

Understanding the patient-spouse communication experience during chemotherapy for gastric cancer: A qualitative study

PURPOSE

This study examines how patients with gastric cancer and their spouses communicate about the illness, assessing the impact of positive or negative communication on their psychological adaptation and the intimacy of their relationship as a couple.

METHOD

Employing The Relationship Intimacy Model of Couple Adaptation to Cancer, this study used purposive sampling with the principle of maximum variation to select participants. Sixteen pairs of patients with gastric cancer and their spouse caregivers, hospitalized in the oncology department of a tertiary hospital in Jingjiang City, Jiangsu Province, from March to July 2023, were chosen for semi-structured face-to-face interviews. The recorded data were transcribed within 24 h following each interview and supplemented with field notes. Directed content analysis was employed for the qualitative content analysis.

RESULTS

The interview data revealed three themes and six subthemes. Theme 1: The impact of negative patient-spouse communication, with the subthemes being (i) a decline in couples' relationship intimacy and (ii) reduced psychological adaptation. Theme 2: The impact of positive patient-spouse communication, with the subthemes being (i) enhanced couples' relationship intimacy and (ii) increased psychological adaptation. Theme 3: The impact of protective concealment, with the subthemes being (i) declined couples' relationship intimacy and psychological adaptation, and (ii) increased couples' relationship intimacy and psychological adaptation. Throughout the chemotherapy period, patients with gastric cancer and their spouses experienced both positive and negative forms of patient-spouse communication. This underscores the significance of acknowledging protective concealment within couples. Moreover, the study highlights how the dynamics of couples' relationship intimacy and psychological adaptation are influenced by both positive and negative communication patterns surrounding the illness.

CONCLUSIONS

For patients with gastric cancer and their spouses, it is crucial for nurses to emphasize the importance of spousal disease communication during chemotherapy. Efforts should be made to mitigate one-sided, conflictual communication and avoidance behaviors, and to adopt appropriate communication strategies in terms of content and timing to deeply promote couple communication. Additionally, there is a need to focus on the physical and psychological stress of protective concealment in couples.

Progestin-based pharmacotherapy in fertility preservation in early endometrial cancer

Endometrial cancer is a common tumor of the female reproductive system. In recent years, as the age of onset of the disease has gradually become younger, this has caused distress to some young patients with reproductive needs, and the active search for methods of preserving reproductive function has gradually attracted attention. In this paper, we will systematize the current status of progestin-based pharmacotherapy in combination with other drug therapies in the conservative management of early-stage endometrial cancer. With the expectation of providing a reference for the treatment of early stage endometrial cancer patients in China and for the in-depth development of related research in this field.

Cell components of tumor microenvironment in lung adenocarcinoma: Promising targets for small-molecule compounds

ABSTRACT

Lung cancer is one of the most lethal tumors in the world with a 5-year overall survival rate of less than 20%, mainly including lung adenocarcinoma (LUAD). Tumor microenvironment (TME) has become a new research focus in the treatment of lung cancer. The TME is heterogeneous in composition and consists of cellular components, growth factors, proteases, and extracellular matrix. The various cellular components exert a different role in apoptosis, metastasis, or proliferation of lung cancer cells through different pathways, thus contributing to the treatment of adenocarcinoma and potentially facilitating novel therapeutic methods. This review summarizes the research progress on different cellular components with cell-cell interactions in the TME of LUAD, along with their corresponding drug candidates, suggesting that targeting cellular components in the TME of LUAD holds great promise for future theraputic development.

Amino acid deletions at positions 893 and 894 of cytotoxin-associated gene A protein affect Helicobacter pylori gastric epithelial cell interactions

BACKGROUND

Helicobacter pylori (H. pylori) persistently colonizes the human gastric mucosa in more than 50% of the global population, leading to various gastroduodenal diseases ranging from chronic gastritis to gastric carcinoma. Cytotoxin-associated gene A (CagA) protein, an important oncoprotein, has highly polymorphic Glu-Pro-Ile-Tyr-Ala segments at the carboxyl terminus, which play crucial roles in pathogenesis. Our previous study revealed a significant association between amino acid deletions at positions 893 and 894 and gastric cancer.

AIM

To investigate the impact of amino acid deletions at positions 893 and 894 on CagA function.

METHODS

We selected a representative HZT strain from a gastric cancer patient with amino acid deletions at positions 893 and 894. The cagA gene was amplified and mutated into cagA-NT and cagA-NE (sequence characteristics of strains from nongastric cancer patients), cloned and inserted into pAdtrack-CMV, and then transfected into AGS cells. The expression of cagA and its mutants was examined using real-time polymerase chain reaction and Western blotting, cell elongation via cell counting, F-actin cytoskeleton visualization using fluorescence staining, and interleukin-8 (IL-8) secretion via enzyme-linked immunosorbent assay.

RESULTS

The results revealed that pAdtrack/cagA induced a more pronounced hummingbird phenotype than pAdtrack/cagA-NT and pAdtrack/cagA-NE (40.88 ± 3.10 vs 32.50 ± 3.17, P < 0.001 and 40.88 ± 3.10 vs 32.17 ± 3.00, P < 0.001) at 12 hours after transfection. At 24 hours, pAdtrack/cagA-NE induced significantly fewer hummingbird phenotypes than pAdtrack/cagA and pAdtrack/cagA-NT (46.02 ± 2.12 vs 53.90 ± 2.10, P < 0.001 and 46.02 ± 2.12 vs 51.15 ± 3.74, P < 0.001). The total amount of F-actin caused by pAdtrack/cagA was significantly lower than that caused by pAdtrack/cagA-NT and pAdtrack/cagA-NE (27.54 ± 17.37 vs 41.51 ± 11.90, P < 0.001 and 27.54 ± 17.37 vs 41.39 ± 14.22, P < 0.001) at 12 hours after transfection. Additionally, pAdtrack/cagA induced higher IL-8 secretion than pAdtrack/cagA-NT and pAdtrack/cagA-NE at different times after transfection.

CONCLUSION

Amino acid deletions at positions 893 and 894 enhance CagA pathogenicity, which is crucial for revealing the pathogenic mechanism of CagA and identifying biomarkers of highly pathogenic H. pylori.

Succession of the multi-site microbiome along pancreatic ductal adenocarcinoma tumorigenesis

Background

To investigate microbial characteristics across multibody sites from chronic pancreatitis (CP), through pancreatic benign tumors, to pancreatic ductal adenocarcinoma (PDAC) at different stages.

Methods

16S ribosomal RNA (rRNA) amplicon sequencing was conducted on saliva, duodenal fluid, and pancreatic tissue obtained via endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of patients with CP, pancreatic benign tumors, PDAC in stage I/II, III, and IV. The neutral community model (NCM) assessed the microbial assembly contribution and MaAslin2 identified the differential microbes.

Results

From CP to stage IV PDAC patients, there was a marked surge in influence of salivary and duodenal microbiota on constitution of pancreatic microbial communities. Our observations revealed a successive alteration in microbial species across various bodily sites during PDAC tumorigenesis. Notably, Porphyromonas gingivalis, Treponema denticola, Peptoanaerobacter stomatis, Propionibacterium acidifaciens, Porphyromonas endodontalis, Filifactor alocis, etc., sequentially increased along PDAC progression in pancreatic tissue, whereas bacteria commonly used as probiotics Bifidobacterium breve, Lactiplantibacillus plantarum, etc., declined. Furthermore, the sequentially escalating trends of Peptoanaerobacter stomatis and Propionibacterium acidifaciens during PDAC tumorigenesis were mirrored in duodenal fluid and saliva. Porphyromonas gingivalis, Porphyromonas endodontalis, and Filifactor alocis, which intensified from CP to stage IV PDAC in pancreatic tissue, were also found to be enriched in saliva of patients with short-term survival (STS) compared with those with long-term survival (LTS).

Conclusions

Salivary and duodenal microorganisms were prominent factors in shaping pancreatic microbial landscape in PDAC context. Further exploration of these microbial entities is imperative to unravel their specific roles in PDAC pathogenesis, potentially yielding insights for future therapeutic strategies.

Upregulation of ENAH by a PI3K/AKT/β-catenin cascade promotes oral cancer cell migration and growth via an ITGB5/Src axis

BACKGROUND

Oral cancer accounts for 2% of cancer-related deaths globally, with over 90% of cases being oral cavity squamous cell carcinomas (OSCCs). Approximately 50% of patients with OSCC succumb to the disease within 5 years, primarily due to the advanced stage at which it is typically diagnosed. This underscores an urgent need to identify proteins related to OSCC progression to develop effective diagnostic and therapeutic strategies.

METHODS

To identify OSCC progression-related proteins, we conducted integrated proteome and transcriptome analyses on cancer tissues from patients and patient-derived xenograft (PDX) model mice. We investigated the role of protein-enabled homolog (ENAH), identified as an OSCC progression-associated protein, through proliferation, transwell migration, and invasion assays in OSCC cells. The mechanisms underlying ENAH-mediated functions were elucidated using gene knockdown and ectopic expression techniques in OSCC cells.

RESULTS

ENAH was identified as a candidate associated with OSCC progression based on integrated analyses, which showed increased ENAH levels in primary OSCC tissues compared with adjacent noncancerous counterparts, and sustained overexpression in the cancer tissues of PDX models. We confirmed that level of ENAH is increased in OSCC tissues and that its elevated expression correlates with poorer survival rates in patients with OSCC. Furthermore, the upregulation of ENAH in OSCC cells results from the activation of the GSK3β/β-catenin axis by the EGFR/PI3K/AKT cascade. ENAH expression enhances cell proliferation and mobility by upregulating integrin β5 in oral cancer cells.

CONCLUSIONS

The upregulation of ENAH through a PI3K/AKT/β-catenin signaling cascade enhances oral cancer cell migration and growth via the ITGB5/Src axis. These findings offer a new interpretation of the ENAH function in the OSCC progression and provide crucial information for developing new OSCC treatment strategies.

Mechanistic study of NUPR1 in bladder cancer development through transcriptional regulation of CCR2

Nuclear protein-1 (NUPR1) (also known as p8) is one of the genes associated with transcription factors that participate in various aspects of cancer initiation and development. However, the molecular mechanisms of NUPR1 in bladder cancer (BLCA) remain unclear. We conducted an analysis of the correlation between NUPR1 expression and related genes using the Gene Expression Omnibus (GEO) online database. We employed lentivirus-mediated small interfering RNA (siRNA) to knockdown the expression of NUPR1 in two human BLCA cell lines. In vitro experiments were conducted to validate the impact of NUPR1 interference on BLCA and the influence of NUPR1 on the transcription of chemokine receptor-2 (CCR2). Furthermore, transcription factors for CCR2 were predicted using the PROMO database. Co-immunoprecipitation (Co-IP) and immunofluorescence double staining were used to detect the binding between NUPR1 and CCAAT/enhancer binding protein γ (CEBPG). In vivo and in vitro experiments were conducted to validate that NUPR1 regulates CCR2 transcription through CEBPG. In vitro experiments indicate that the suppression of NUPR1 inhibited BLCA growth. Analysis of the GEO database revealed a positive correlation between the expression of NUPR1 and CCR2. Luciferase experiments confirmed that NUPR1 influences the transcription of CCR2. Online data indicates that CEBPG is a transcription factor for CCR2. Co-IP and immunofluorescence double staining confirmed binding between NUPR1 and CEBPG. Luciferase assays and chromatin immunoprecipitation (ChIP) demonstrate that CEBPG regulates the transcription of CCR2. Additionally, rescue experiments at the cellular level and animal experiments validated the aforementioned mechanism. NUPR1 promotes a promotional role in BLCA, and interference with NUPR1 can inhibit the proliferation and invasive abilities of BLCA. There was a correlation between the expressions of NUPR1 and CCR2, and NUPR1 binds with CEBPG in the cell nucleus. Transcriptional regulation of CCR2 by NUPR1 may be achieved through the involvement of CEBPG.

A new chemotherapy strategy for advanced hepatocellular carcinoma with exrahepatic metastasis: predictors of long-term survival

The prognosis of hepatocellular carcinoma (HCC) with extrahepatic metastasis (EHM) is extremely poor. This study aimed to identify prognostic factors for systemic chemotherapy of HCC with EHM. Eighty-five patients who received systemic chemotherapy for HCC with EHM between May 2014 and October 2021 were retrospectively evaluated. Patient demographic data and characteristics of hepatic tumors and EHM were assessed to identify factors that were significantly associated with prognosis. Of the 85 patients, 68 (80.0%) had pulmonary metastasis, 11 (12.9%) had abdominal lymph node metastasis, 7 (8.2%) had abdominal metastasis, and 4 (4.7%) had bone metastasis. The median overall survival (OS) was 17.0 months, and the median progression-free survival (PFS) was 5.1 months. Univariate analysis of OS showed that synchronous EHM-HCC, serum albumin level<35 g/l and number of hepatic tumors>1 were significantly associated with poorer OS. The results of the multivariate analysis indicated that the serum albumin level and number of hepatic tumors were independent prognostic factors. Subgroup analysis of patients with 0, 1, or 2 of these independent prognostic factors showed that the median OS was 24.0 months, 16.2 months and 7.7 months and that the ORR was 38.3%, 22.6% and 0, respectively. Systemic chemotherapy is beneficial for well-selected HCC patients with EHM. The number of hepatic tumors and serum albumin level were independent risk factors for prognosis, and the number of risk factors significantly influenced OS. Therefore, these factors need to be considered before administering systemic chemotherapy for HCC patients with EHM.

OLR-Net: Object Label Retrieval Network for principal diagnosis extraction

BACKGROUND

Extracting principal diagnosis from patient discharge summaries is an essential task for the meaningful use of medical data. The extraction process, usually by medical staff, is laborious and time-consuming. Although automatic models have been proposed to retrieve principal diagnoses from medical records, many rare diagnoses and a small amount of training data per rare diagnosis provide significant statistical and computational challenges.

OBJECTIVE

In this study, we aimed to extract principal diagnoses with limited available data.

METHODS

We proposed the OLR-Net, Object Label Retrieval Network, to extract principal diagnoses for discharge summaries. Our approach included semantic extraction, label localization, label retrieval, and recommendation. The semantic information of discharge summaries was mapped into the diagnoses set. Then, one-dimensional convolutional neural networks slid into the bottom-up region for diagnosis localization to enrich rare diagnoses. Finally, OLR-Net detected the principal diagnosis in the localized region. The evaluation metrics focus on the hit ratio, mean reciprocal rank, and the area under the receiver operating characteristic curve (AUROC).

RESULTS

12,788 desensitized discharge summary records were collected from the oncology department at Hainan Hospital of Chinese People's Liberation Army General Hospital. We designed five distinct settings based on the number of training data per diagnosis: the full dataset, the top-50 dataset, the few-shot dataset, the one-shot dataset, and the zero-shot dataset. The performance of our model had the highest HR@5 of 0.8778 and macro-AUROC of 0.9851. In the limited available (few-shot and one-shot) dataset, the macro-AUROC were 0.9833 and 0.9485, respectively.

CONCLUSIONS

OLR-Net has great potential for extracting principal diagnosis with limited available data through label localization and retrieval.

PARD6A promotes lung adenocarcinoma cell proliferation and invasion through Serpina3

Par6α encoded by PARD6A is a member of the PAR6 family and is reported to promote cancer initiation and progression. PARD6A is frequently upregulated in different types of cancers, but its regulatory role in lung cancer progression is yet to be established. In this study, we analyzed the PARD6A expression in biopsies from lung adenocarcinoma (LUAD) patients, and the survival probability using LUAD tissue microarray (TMA) and online datasets from TCGA and GEO. We conducted in vitro and in vivo assays to assess the role of PARD6A in regulating lung cancer progression, including proliferation, wound healing, transwell, RNA-seq, and subcutaneous tumor mice models. Our findings revealed that PARD6A is highly expressed in cancer tissues from LUAD patients and is associated with poor prognosis in LUAD patients. In vitro assays showed that PARD6A promoted cell proliferation, migration, and invasion. The transcriptome sequencing identified Serpina3 as one of the key downstream molecules of PARD6A. Ectopic expression of Serpina3 rescued impaired proliferation, migration, and invasion in PARD6A-knocking down H1299 cells, whereas silencing Serpina3 impeded enhanced proliferation, migration, and invasion in PARD6A-overexpressing H1975 cells. Our findings suggest that PARD6A promotes lung cancer progression by inducing Serpina3, which may be a promising therapeutic target.

Latent profile analysis of resilience and its influencing factors in patients with lung cancer undergoing chemotherapy

Objective

This study aims to analyze the classification characteristics of resilience in patients with lung cancer undergoing chemotherapy using latent profile analysis and explore the influencing factors and their relationship with medical coping strategies.

Methods

A questionnaire survey was conducted on 265 patients with lung cancer undergoing chemotherapy at a tertiary Grade-A hospital in Guangzhou from November 2023 to March 2024, using the General Information Questionnaire, Resilience Scale Specific to Cancer (RS-SC), Lung Cancer Chemotherapy Symptom Cluster Assessment Questionnaire, and Medical Coping Modes Questionnaire (MCMQ). Latent profile analysis was performed using Mplus 8.3 to identify resilience classifications, estimate influencing factors, and evaluate their impact on medical coping strategy selection.

Results

A total of 259 valid questionnaires were collected, with an effective response rate of 97.74%. Patients were categorized into three groups based on resilience levels: low-resilience group (20.46%), mid-resilience group (40.52%), and high-resilience group (38.97%). Multinomial logistic regression analysis revealed that education level, family per capita monthly income, and gastrointestinal and emotional symptom cluster scores were significant influencing factors for different resilience classifications (P < 0.05). Statistically significant differences were found in the scores for the confrontation and resignation dimensions of medical coping strategies across different latent profiles (P < 0.01).

Conclusions

Resilience in patients with lung cancer undergoing chemotherapy is heterogeneous, presenting in three distinct categories. Medical staff should provide tailored interventions based on the characteristics and influencing factors of each patient profile to enhance resilience and coping strategies.

Prognostic value of the systemic immune-inflammation index in lung cancer patients receiving immune checkpoint inhibitors: A meta-analysis

PURPOSE

To explore the association between the systemic immune-inflammation index (SII) score and prognosis in immune checkpoint inhibitor (ICI)-treated patients with lung cancer.

METHODS

PubMed, EMBASE, Web of Science, and CNKI databases were searched up to August 1, 2024. Progression-free survival (PFS) and overall survival (OS) were the primary outcomes queried. Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined, and subgroup analysis was based on pathological type [non-small cell lung cancer (NSCLC) vs. small-cell lung cancer (SCLC)], lines of ICIs (first-line vs. second- or further-line), and combinations of other therapies (yes vs. no).

RESULTS

Twenty retrospective studies with 2424 participants were included. The pooled results demonstrated that an elevated SII was associated with poorer PFS (HR = 1.82, 95% CI: 1.49-2.21; P < 0.001) and OS (HR = 2.31, 95% CI: 1.73-3.09; P < 0.001) in lung cancer patients receiving ICIs. Subgroup analysis stratified by pathological type, lines of ICIs and combinations of other therapies for PFS and OS further revealed the predictive role of the SII in ICI-treated lung cancer patients.

CONCLUSION

Based on current evidence the SII is significantly related to prognosis and could serve as a reliable prognostic indicator in lung cancer patients receiving ICIs.

Oxaliplatin lipidated prodrug synergistically enhances the anti-colorectal cancer effect of IL12 mRNA

Colorectal cancer (CRC) is the fourth most common cancer in the world, with the second highest incidence rate after lung cancer. Oxaliplatin (OXA) is a broad-spectrum anti-tumor agent with significant therapeutic efficacy in colorectal cancer, and as a divalent platinum analog, it is not selective in its distribution in the body and has systemic toxicity with continued use. Interleukin-12 (IL12) is an immunostimulatory cytokine with cytokine monotherapy that has made advances in the fight against cancer, limiting the clinical use of cytokines due to severe toxicity. Here, we introduced a long alkyl chain and N-methyl-2,2-diaminodiethylamine to the ligand of OXA to obtain OXA-LIP, which effectively reduces its toxicity and improves the uptake of the drug by tumor cells. We successfully constructed IL12 mRNA and used LNPs to deliver IL12 mRNA, and in vivo pharmacodynamic studies demonstrated that OXA-LIP combined with IL12 mRNA had better tumor inhibition and higher biosafety. In addition, it was investigated by pharmacokinetic experiments that the OXA-LIP drug could accumulate in nude mice at the tumor site, which prolonged the half-life and enhanced the anti-tumor efficiency of OXA. It is hoped that these results will provide an important reference for the subsequent research and development of OXA-LIP with IL12 mRNA, as well as provide new therapeutic approaches for the treatment of colon cancer.

Preoperative plasma fibrinogen level is a risk factor for the long-term survival of postmenopausal women after surgery for breast cancer

BACKGROUND

Studies have indicated an association between fibrinogen levels and the prognosis of breast cancer patients. However, fibrinogen levels are notably susceptible to fluctuations due to the menstrual cycle. This study explored the relationship between preoperative plasma fibrinogen levels and the prognosis of postmenopausal breast cancer women after surgery.

METHOD

855 patients with postmenopausal breast cancer were monitored for 10 years. Cox proportional hazards regression models were used to perform univariate and multivariate analyses to identify factors that are of substantial prognostic value.

RESULTS

The median follow-up was 77 months (51-105 months), and the maximum 142 months. Over the follow-up period, 65 deaths (7.6 %) were recorded. Multivariate Cox regression results show that preoperative plasma fibrinogen level (hazard ratio [HR] =1.615, 95 % confidence interval [CI]: 1.233-2.115) and age (HR = 1.626, 95%CI: 1.250-2.116) were independent risk factors for 10-year overall survival after surgery in postmenopausal breast cancer patients, while endocrine therapy (HR = 0.414, 95%CI: 0.202-0.846) was an independent protective factor. Multivariate Cox regression results also show preoperative plasma fibrinogen level was an independent risk factor for 10-year disease-free survival (HR = 1.398, 95 % CI: 1.137-1.719) and 10-year distant metastasis-free survival (HR = 1.436, 95%CI: 1.153-1.787).

CONCLUSION

Elevated pretreatment plasma fibrinogen levels are associated with a poorer long-term prognosis in postmenopausal breast cancer patients following surgical treatment.

Mechanism of LMNB1 activating GPR84 through JAK-STAT pathway to mediate M2 macrophage polarization in lung cancer

BACKGROUND

It is reported that G protein-coupled receptor 84 (GPR84) can participate in inflammation and immune regulation to repress anti-tumor responses. However, the function of GPR84 in lung cancer (LC) and its potential molecular mechanisms are still largely unknown.

METHODS

Bioinformatics and molecular experiments were employed to assess the expression of GPR84 in LC. The pathways enriched by GPR84 were analyzed by the Kyoto Encyclopedia of Genes and Genomes. Bioinformatics prediction identified the potential upstream regulatory factors of GPR84, which were verified through dual luciferase and chromatin immunoprecipitation experiments. Cell viability was measured by methyl thiazolyl tetrazolium assay. The expression levels of key proteins related to the janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway such as JAK2, p-JAK2, p-STAT3, and STAT3 were detected by western blot. Macrophages were co-cultured with LC cells. Flow cytometry was employed to examine the proportion of mannose receptor-positive cells. The expression levels of M2 polarization marker genes chitinase-like protein 3, arginase-1, and found in inflammatory zone 1 were measured by quantitative reverse transcription polymerase chain reaction. We applied an enzyme-linked immunosorbent assay to determine levels of cytokines (interleukin-10 and transforming growth factor beta) to evaluate the M2 macrophage polarization.

RESULTS

GPR84 was highly expressed in LC and substantially enriched in the JAK-STAT pathway. GPR84 facilitated the M2 polarization of macrophages in LC. Adding the JAK-STAT pathway inhibitor weakened the promoting effect of GPR84 overexpression on M2 macrophage polarization. Furthermore, GPR84 also had an upstream regulatory factor lamin B1 (LMNB1). Knocking down LMNB1 blocked the JAK-STAT signaling pathway to repress M2 macrophage polarization in LC, while overexpression of GPR84 reversed the impact of LMNB1 knockdown on macrophage polarization.

CONCLUSION

The project suggested that the LMNB1/GPR84 axis can facilitate M2 polarization of macrophages in LC by triggering the JAK-STAT pathway. Targeting LMNB1/GPR84 or blocking the JAK-STAT pathway may be a novel approach for LC diagnosis and treatment.

USP22 promotes gefitinib resistance and inhibits ferroptosis in non-small cell lung cancer by deubiquitination of MDM2

BACKGROUND

The emergence of chemoresistance markedly compromised the treatment efficiency of human cancer, including non-small cell lung cancer (NSCLC). In the present study, we aimed to explore the effects of ubiquitin-specific peptidase 22 (USP22) and murine double minute 2 (MDM2) in gefitinib resistance in NSCLC.

METHODS

Immunohistochemistry (IHC) assay, quantitative real-time polymerase chain reaction (qRT-PCR) assay and western blot assay were carried out to determine the expression of USP22 and MDM2. Transwell assay and flow cytometry analysis were performed to evaluate cell migration and apoptosis. Cell Counting Kit-8 (CCK-8) assay was employed to assess gefitinib resistance. The phenomenon of ferroptosis was estimated by related commercial kits. The oxidized C11-BODIPY fluorescence intensity by C11-BODIPY staining. The relation between USP22 and MDM2 was analyzed by ubiquitination assay and co-immunoprecipitation (Co-IP) assay.

RESULTS

USP22 was abnormally upregulated in NSCLC tissues and cells, and USP22 silencing markedly repressed NSCLC cell migration and facilitated apoptosis and ferroptosis. Moreover, our results indicated that ferroptosis could enhance the suppressive effect of gefitinib on NSCLC cells. Besides, USP22 overexpression enhanced gefitinib resistance and ferroptosis protection in NSCLC cells. Mechanically, USP22 stabilized MDM2 and regulated MDM2 expression through deubiquitination of MDM2. MDM2 deficiency partially restored the effects of USP22 on gefitinib resistance and ferroptosis in NSCLC cells. Of note, we validated the promotional effect of USP22 on gefitinib resistance in NSCLC in vivo through establishing the murine xenograft model.

CONCLUSION

USP22/MDM2 promoted gefitinib resistance and inhibited ferroptosis in NSCLC, which might offer a novel strategy for overcoming gefitinib resistance in NSCLC.

Protein nutritional support: The prevention and regulation of colorectal cancer and its mechanism research

Colorectal cancer (CRC) is a common malignant tumor of the digestive tract in China; its incidence rates and mortality rates have been on the rise in recent years, ranking third in terms of incidence and second in mortality. Rational dietary intervention plays an important role in human health, and prevention and adjuvant treatment of CRC through dietary supplementation is the most ideal and safest way to treat the disease at present. More importantly, dietary protein is the basis of our diet and the key nutrient to maintain the normal function of the human body. Therefore, this narrative review delivered an overview of the common causes and therapeutic treatments for CRC. It emphasized the importance of dietary interventions, with a particular focus on elucidating the distinct regulatory impacts of plant proteins, animal proteins, and their mixed proteins.

SOX4 inhibits ferroptosis and promotes proliferation of endometrial cancer cells via the p53/SLC7A11 signaling

AIM

Sex-determining region Y-related high-mobility group box 4 (SOX4) has been reported to play a carcinogenic role in endometrial cancer (EC). However, the biological function and regulatory mechanisms of SOX4 in ferroptosis during the progression of EC are still unknown.

METHODS

The mRNA and protein levels were scrutinized by quantitative reverse-transcription polymerase chain reaction and western blot, respectively. The cell viability and proliferative capability were determined by cell counting kit-8 assay and 5-ethynyl-2'-deoxyuridine (EdU) assay. Transcriptional regulation of gene expression was investigated by dual-luciferase reporter assay and chromatin immunoprecipitation. Ferroptosis was evaluated by detection of reactive oxygen species, malondialdehyde, Fe2+, and ferroptosis-related proteins. The mice test was implemented to confirm the influence of SOX4 on EC tumor growth and ferroptosis in vivo.

RESULTS

We here discovered the elevation of SOX4 in EC tissues and cells. Functionally, SOX4 knockdown hampered proliferation and promoted ferroptosis of EC cells. Mechanistically, SOX4 bound to p53 promoter and inhibited its transcriptional activity in EC cells. In addition, p53 transcriptionally suppressed SLC7A11 expression in EC cells. Downregulation of p53 reverses the effect of SOX4 knockdown on proliferation and ferroptosis of EC cells. Finally, in vivo experiments demonstrated that SOX4 depletion hindered tumor growth and triggered ferroptosis in EC.

CONCLUSIONS

These findings collectively suggested that SOX4 inhibited ferroptosis and promoted proliferation of EC cells via the p53/SLC7A11 signaling. Our research unveiled a novel regulatory mechanism of ferroptosis in EC, offering promising perspectives for the development of EC therapies.

AUP1 transcriptionally activated by KDM5B reprograms lipid metabolism to promote the malignant progression of cervical cancer

Cervical cancer is one of the reproductive malignancies threatening women's lives worldwide. In the present study, it was aimed to explore the role and mechanism of ancient ubiquitous protein 1 (AUP1) in cervical cancer. Through bioinformatics analysis, AUP1 expression in cervical cancer tissues and the correlation between AUP1 and the prognosis of patients were analyzed. AUP1 expression in several cervical cancer cell lines was detected. Following the co‑transfection of short hairpin RNA specific to AUP1 with or without lysine demethylase 5B (KDM5B) overexpression plasmids in SiHa cells, the proliferation and apoptosis of SiHa cells were detected. Additionally, wound healing and Transwell assays were used to detect SiHa cell migration and invasion. Cellular lipid droplets level was detected using the Oil red O staining. Meantime, the levels of triglyceride, cholesterol, oxygen consumption rates and expression of lipid metabolism‑related proteins were detected to assess the lipid metabolism in SiHa cells. Then, the luciferase reporter assay and ChIP assay were used to verify the binding between KDM5B and AUP1. Finally, the effects of AUP1 and KDM5B on the growth and lipid metabolism in SiHa tumor‑bearing mice were measured. AUP1 was significantly upregulated in cervical cancer tissues and cells. AUP1 interference inhibited the malignant biological behaviors and lipid metabolism reprogramming of SiHa cells, which was blocked by KDM5B overexpression. Moreover, KDM5B could transcriptionally activate AUP1 and upregulate AUP1 expression. Furthermore, AUP1 knockdown transcriptionally regulated by KDM5B limited the tumor growth and suppressed the lipid metabolism reprogramming in vivo. Collectively, AUP1 could be transcriptionally activated by KDM5B to reprogram lipid metabolism, thereby promoting the progression of cervical cancer. These findings reveal possible therapeutic strategies in targeting metabolic pathways.

Exploring the anti-gastric cancer mechanism of action of Bidentis Bipinnatae Herba based on network pharmacology, molecular docking, and cellular experimental validation

The purpose of this study is to explore the potential molecular mechanism of Bidentis Bipinnatae Herba against gastric cancer by using network pharmacology methods, molecular docking, and cellular experimental validation. Medicinal plants related to gastric cancer were queried through TCMSP, SymMap, and Herb databases. The TCSMP database (drug-likeness ≥ 0.18) was used to retrieve the bioactive constituents. TCSMP, SwissTargetPrediction, and Herb databases were used to retrieve the target genes, and Cytoscape software was used to construct the "active ingredient-target" network. After protein interaction analysis using String 11.0 platform, the hub genes were screened using CytoHubba. The obtained hub genes were uploaded to the cBioPortal for pathway enrichment. The genes involved in gastric cancer-related RTK-RAS pathway were molecularly docked and experimentally validated. Bidentis Bipinnatae Herba was common to TCMSP, SymMap, and Herb databases. A total of nine active ingredients were obtained in Bidentis Bipinnatae Herba, acting on 192 targets. Seven hub genes were obtained from these target genes and enriched in the RTK-RAS pathway in gastric cancer. MAPK1 and EGFR had good molecular docking results with their corresponding chemicals. Cellular experiments showed that the treatment of luteolin, quercetin, and Okanin reduced the expression of EGFR in AGS cells; the treatment of luteolin and quercetin could reduce the expression of MAPK1. Bidentis Bipinnatae Herba contained active components, which may be anti-gastric cancer in a multi-target (MAPK1 and EGFR) manner.

New avenues for cancer immunotherapy: Cell-mediated drug delivery systems

Cancer research has become increasingly complex over the past few decades as knowledge of the heterogeneity of cancer cells, their proliferative ability, and their tumor microenvironments has become available. Although conventional therapies remain the most compelling option for cancer treatment to date, immunotherapy is a promising way to harness natural immune defenses to target and kill cancer cells. Cell-mediated drug delivery systems (CDDSs) have been an active line of research for enhancing the therapeutic efficacy and specificity of cancer immunotherapy. These systems can be tailored to different types of immune cells, allowing immune evasion and accumulation in the tumor microenvironment. By enabling the targeted delivery of therapeutic agents such as immune stimulants, cytokines, antibodies, and antigens, CDDSs have improved the survival of some patients with cancer. This review summarizes the research status of CDDSs, with a focus on their underlying mechanisms of action, biology, and clinical applications. We also discuss opportunities and challenges for implementation of CDDSs into mainstream cancer immunotherapy.

Molecular mechanisms and targeted therapy for the metastasis of prostate cancer to the bones (Review)

The incidence of prostate cancer (PCa) is increasing, making it one of the prevalent malignancies among men. Metastasis of PCa to the bones poses the greatest danger to patients, potentially resulting in treatment ineffectiveness and mortality. At present, the management of patients with bone metastasis focuses primarily on providing palliative care. Research has indicated that the spread of PCa to the bones occurs through the participation of numerous molecules and their respective pathways. Gaining knowledge regarding the molecular processes involved in bone metastasis may result in the development of innovative and well‑tolerated therapies, ultimately enhancing the quality of life and prognosis of patients. The present article provides the latest overview of the molecular mechanisms involved in the formation of bone metastatic tumors from PCa. Additionally, the clinical outcomes of targeted drug therapies for bone metastasis are thoroughly analyzed. Finally, the benefits and difficulties of targeted therapy for bone metastasis of PCa are discussed, aiming to offer fresh perspectives for treatment.

Regorafenib monotherapy as the later-line treatment for elderly patients with metastatic colorectal cancer: a multicenter real-world study

Background

Colorectal cancer is one of the tumors with the highest morbidity and mortality rates in China and the world. Regorafenib is a targeted drug for standard third-line treatment of metastatic colorectal cancer (mCRC). Regorafenib monotherapy has shown certain efficacy in the elderly population, but more robust evidence is needed. The aim of this study was to evaluate the dosing characteristics, prognosis, and safety of regorafenib monotherapy in elderly Chinese patients with mCRC.

Methods

This retrospective study comprised elderly patients (aged ≥60 years) with mCRC who received regorafenib monotherapy as a third-line or above treatment in 10 hospitals from August 2017 to June 2020. We analyzed the association between different dosing regimens and prognosis. The primary endpoint was overall survival (OS), and other endpoints included progression-free survival (PFS) and adverse events (AEs).

Results

In total, 203 patients were included in the analysis. The median PFS was 3.88 months [95% confidence interval (CI): 3.48-5.65], and the median OS was 10.1 months (95% CI: 8.94-12.1). There was no significant difference in the survival curves between the different dosage groups. The multivariate Cox analysis showed a significant benefit in OS in the high final daily dose group (120-160 mg/day) [hazard ratio (HR): 0.45, 95% CI: 0.25-0.84, P=0.01], which was further confirmed by the propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis. No significant association was found between the initial daily dose and prognosis. Nor was any significant association found between PFS and drug dosage. Subsequently, an age subgroup analysis was conducted using 70 years as the cut-off value. In those aged <70 years, the application of higher final doses (120-160 mg/day) was significantly associated with the prolongation of OS compared to a final dose of 80 mg/day [HR (95% CI): 0.38 (0.16-0.91), P=0.03], and the prolongation of OS was predominantly observed in the 120 mg/day dose group [HR (95% CI): 0.24 (0.09-0.67), P=0.006]. Besides, we observed a statistically insignificant increase in the incidence of AEs in the higher dose group compared to the lower dose group.

Conclusions

Regorafenib monotherapy was shown to be efficacious in the elderly population, but further evidence is needed for guidance. Based on our multicenter real-world investigation, the final daily dose was significantly associated with OS. For those aged <70 years, maintaining the final dose at 120 mg/day may have prognostic advantages. The suggested medication protocol requires validation through comprehensive clinical trials.

Machine learning-based analysis identifies a 13-gene prognostic signature to improve the clinical outcomes of colorectal cancer

Background

Colorectal cancer (CRC) is a common intestinal malignancy worldwide, posing a serious threat to public health. Due to its high heterogeneity, prognosis and drug response of different CRC patients vary widely, limiting the effectiveness of traditional treatment. Therefore, this study aims to construct a novel CRC prognostic signature using machine learning algorithms to assist in making informed clinical decisions and improving treatment outcomes.

Methods

Gene expression matrix and clinical information of CRC patients were obtained from the The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Then, genes with prognostic value were identified through univariate Cox regression analysis. Next, nine machine learning algorithms, including least absolute shrinkage and selection operator (LASSO), gradient boosting machine (GBM), CoxBoost, plsRcox, Ridge, Enet, StepCox, SuperPC and survivalSVM were integrated to form 97 combinations, which was employed to screen the best strategy for building a prognostic model based on the average C-index in the three CRC cohorts. Kaplan Meier survival analysis, receiver operating curve (ROC) analysis and multivariate regression analysis were conducted to assess the predictive performance of the constructed signature. Furthermore, the CIBERSORT and ESTIMATE algorithms were utilized to quantify the infiltration level of immune cells. Besides, a nomogram were developed to predict 1-, 2-, and 3-year overall survival (OS) probabilities for individual patient.

Results

A prognostic signature consisting of 13 genes was developed utilizing LASSO Cox regression and GBM methods. Across both the training and validation datasets, the performance evaluation consistently indicated the signature's capacity to accurately predict the prognosis of CRC patients. Especially, compared with 30 published signatures, the 13-gene model exhibited dramatically superior predictive power. Even within clinical subgroups, it could still precisely stratify the prognosis. Functional analysis revealed a robust association between the signature and the immune status as well as chemotherapy response in CRC patients. Furthermore, a nomogram was created based on the signature-derived risk score, which demonstrated a strong predictive ability for OS in CRC patients.

Conclusions

The 13-gene prognostic signature is expected to be a valuable tool for risk stratification, survival prediction, and treatment evaluation of patients with CRC.

Assessing the effectiveness of Renzhu Jianwei Granula in managing precancerous lesions of gastric cancer: A meta-analysis of randomized clinical trials

Background

Renzhu Jianwei Granula (RJG) is a traditional Chinese medicine compound initially formulated to address precancerous lesions for gastric cancer. The aim of this study was to assess RJG's efficacy in treating precancerous lesions of gastric cancer through a comprehensive meta-analysis of randomized clinical trials.

Methods

Two authors separately conducted an exhaustive search across three databases (PubMed, CNKI and Wanfang) without imposing any restrictions on publication year or language. Eligible studies, spanning from the inception of databases to July 18th, 2024, were included. Valid data were summarized and those with a group size of 3 or more were preserved. R software and Cochrane collaboration tools were employed for sensitivity analysis and assessing the quality of the included studies. The data from selected studies were transformed into risk ratios (RRs) and subjected to meta-analysis. This study was prospectively registered in PROSPERO.

Results

Data from 9 studies encompassing 912 participants revealed that the RJG group exhibited superior clinical efficacy compared to the control group, with an RR of 0.36 (95 % confidence interval (CI): 0.25 to 0.52). RJG demonstrated enhanced efficacy over the control group in both comprehensive efficacy (RR: 0.42, 95 % CI: 0.31 to 0.55) and gastroscopy efficacy (RR: 0.56, 95 % CI: 0.46 to 0.69). Moreover, significant improvements in pathological features such as atrophy (RR: 0.58, 95 % CI: 0.45 to 0.73), dysplasia (RR: 0.41, 95 % CI: 0.27 to 0.61), and intestinal metaplasia (RR: 0.54, 95 % CI: 0.43 to 0.69) in precancerous lesions of gastric cancer were observed following RJG administration.

Conclusion

This study's synthesized data provide compelling evidence of RJG's substantial therapeutic impact in ameliorating symptoms associated with precancerous lesions of gastric cancer.

Trial registration number

The study protocol was registered at PROSPERO (CRD42024572606).

Epidemiology of biliary tract cancer in China: A narrative review

Biliary tract cancer (BTC) is a group of rare malignancies that affect the gallbladder and bile ducts. Although rare, BTC is becoming a significant public health burden in China, particularly among males and older individuals. The increasing trends in BTC incidence and mortality in China are influenced by various demographic, environmental, and lifestyle factors. In this review, we examine available epidemiological data on the incidence, mortality, prognosis, and trends of different BTC subtypes in China. We also discuss the challenges and opportunities for improving the prevention, diagnosis, and management of BTC in China, and identify areas for further research and intervention. The article aims to provide a better understanding of the epidemiological features of BTC in China and to inform public health strategies and clinical practice.

SLIT3 deficiency promotes non-small cell lung cancer progression by modulating UBE2C/WNT signaling

In our prior research, it was noted that slit guidance ligand 3 (SLIT3), a member of the SLIT-secreted protein family, may play a potential role in tumorigenesis. In addition, our prior work has found that the SLIT3 gene is highly methylated, especially in advanced-stage lung cancer tissues. Herein, we propose the hypothesis that abnormal SLIT3 expression may be linked to lung cancer development. In this study, decreased SLIT3 at the transcriptome and proteome levels was observed in lung cancer tissues. Furthermore, the downregulation of SLIT3 was related to a higher tumor stage and poorer prognosis. Silencing SLIT3 expression enhanced cell proliferation and migration, indicating potential characteristics of a tumor suppressor gene of SLIT3 in non-small-cell lung cancer (NSCLC). Furthermore, SLIT3 deficiency stimulates UBE2C upregulation and regulates NSCLC progression through Wnt3A/β-catenin signaling. The activation of the WNT signaling pathway was highly correlated with chemoresistance development in lung cancer. In conclusion, SLIT3 deficiency promotes lung cancer onset and progression by modulating UBE2C/WNT signaling. SLIT3/UBE2C/WNT may serve as novel biomarkers and therapeutic targets in NSCLC.